Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.     

The Premonitory Urge to Tic: Measurement,Characteristics, and Correlates in Older Adolescents and Adults

In addition to motor and/or vocal tics, many individuals with Tourette syndrome (TS) or chronic tic disorder (CTD) report frequent, uncomfortable sensory phenomena that immediately precede the tics. To date, examination of these premonitory sensations or urges has been limited by inconsistent assessment tools. In this paper, we examine the psychometric properties of a nine-item self-report measure, the Premonitory Urge to Tic Scale (PUTS) and examine the characteristics and correlates of the premonitory urge to tic in a clinical sample of 122 older adolescents and adults with TS or CTD. The PUTS demonstrated adequate internal consistency, temporal stability, and concurrent validity. Premonitory urges were endorsed by the majority of individuals. Most individuals reported some relief from the urges after completing a tic and being able to stop their tics even if only temporarily. Degree of premonitory urges was not significantly correlated with age, and we did not observe any gender differences. Degree of premonitory urges was significantly correlated with estimated IQ and tic severity, but not severity of comorbid obsessive–compulsive disorder or attention-deficit hyperactivity disorder. Also, it was not related to concomitant medication status. These findings represent another step forward in our understanding of the premonitory sensations associated with TS and CTD.     

First symbols in a girl with Down syndrome: A longitudinal study from 12 to 18 months

Symbolic uses of objects originate in communicative and triadic contexts (adult–child-object). In this longitudinal study we explore the emergence and development of the first symbolic uses in triadic interaction contexts in a girl with Down syndrome between 12 and 18-months of age. We conducted five sessions of video recording, at 12, 13½, 15, 16½, and 18 months chronological age. At each session we videotaped the girl and her mother interacting with different objects. Data were coded in semiotic categories used in previous studies (Rodríguez & Moro, 1999) and a microgenetic analysis was conducted for each session. The first symbolic uses by the girl appeared at 13½ months. Symbols were of different types and levels of complexity, and the adult had an important role in facilitating the production of these symbols.     

严重脓毒症与免疫功能障碍

脓毒症多呈现典型的促炎效应和抗炎反应,并与获得性免疫功能障碍同时出现,且免疫细胞中超过80％的基因表达发生改变。由于单核／巨噬细胞细胞因子谱的改变、主要组织相容性复合体Ⅱ类抗原（MHCⅡ）及共刺激分子表达下降以及树突状细胞的凋亡,诱发细胞免疫功能下降;中性粒细胞活性降低和补体系统的激活,又增加感染易感性。T淋巴细胞表现...     

Prevalence and correlates of metabolic syndrome in Hong Kong Chinese adults—a random community sample study

The study investigates the prevalence and correlates of metabolic syndrome (MS) among Hong Kong Chinese adults. Random cluster sampling design and International Diabetes Federation (IDF) MS criteria were adopted. Totally 737 adults participated in questionnaire survey and received waist circumference (WC) measurement. Among them 335 showed central obesity (WC > 80 and 85 cm for women and men respectively). Subsequently 229 accepted blood test. Totally 71 participants met MS criteria, suggesting an overall prevalence of 14.1%. Both central obesity and MS increase sharply with age. Chi-square/ANOVA analyses revealed significant positive associations between central obesity with: being male, marital status being married/cohabit, lower education level, occupation as managers or housewives, and alcohol consumption. For MS, the significant positive correlates were: lower education level, occupation as service workers or housewives, lower income level, and alcohol consumption. After controlling for age, binary logistic regression analyses suggested the significant risk factors for central obesity were being male (OR = 1.4), married/cohabit (OR = 1.8), longer working hours (OR = 1.5), eating less vegetables (OR = 1.5), and alcohol consumption (OR = 1.8). For MS, only alcohol consumption appeared to be a significant risk factor (OR = 2.3). Multivariate binary logistic regressions also supported that age group and alcohol consumption were significant predictors of MS. To conclude, adopting randomized cluster sampling and IDF criteria, the study revealed a prevalence rate of MS at 14.1%. Alcohol consumption appears to be the strongest risk factor of MS, which however needs further investigation.     

Attention network test: Assessment of cognitive function in chronic fatigue syndrome

Information processing difficulties are common in patients with chronic fatigue syndrome (CFS). It has been shown that the time it takes to process a complex cognitive task, rather than error rate, may be the critical variable underlying CFS patients' cognitive complaints. The Attention Network Task (ANT) developed by Fan and colleagues may be of clinical utility to assess cognitive function in CFS, because it allows for simultaneous assessment of mental response speed, also called information processing speed, and error rate under three conditions challenging the attention system. Comparison of data from two groups of CFS patients (those with and without comorbid major depressive disorder; n = 19 and 22, respectively) to controls (n = 29) consistently showed that error rates did not differ among groups across conditions, but speed of information processing did. Processing time was prolonged in both CFS groups and most significantly affected in response to the most complex task conditions. For simpler tasks, processing time was only prolonged in CFS participants with depression. The data suggest that the ANT may be a task that could be used clinically to assess information processing deficits in individuals with CFS.     

Gray’s revised Reinforcement Sensitivity Theory in relation to Attention-Deficit/Hyperactivity and Tourette-like behaviors in the general population

Attention-Deficit/Hyperactivity Disorder (ADHD) and Tourette syndrome (TS) present as distinct conditions clinically; however, they show comorbidity and inhibitory control deficits have been proposed to underlie both. The role of reinforcement sensitivity in ADHD has been studied previously, but no study has addressed this in relation to TS-like behaviors in the general population. The present study examined these associations within the remit of the revised Reinforcement Sensitivity Theory (rRST). One hundred and thirty-eight participants completed psychometric measures of the rRST, and self-report checklists for ADHD- and TS-like behaviors. The results show that whilst ADHD-inattention was only linked to increased anxiety (BIS), ADHD-hyperactivity/impulsivity was linked to increased impulsivity (BAS-fun seeking), anxiety (BIS) and punishment sensitivity (FFFS), and to reduced reward sensitivity (BAS-reward responsiveness), independently of ‘comorbid’ TS-like behaviors. TS-related phonic tics were associated with increased BIS and FFFS, and TS-related obsessive–compulsive behaviors (OCBs) with increased goal-orientation (BAS-drive) and reduced impulsivity (BAS-fun seeking). However, these associations were driven by ADHD-like behaviors or OCB co-occurrence, respectively, suggesting little role of the rRST in pure TS-like behaviors. The results are discussed in light of mixed findings in the literature and the importance of distinguishing between multiple processing models of the rRST in distinct disorder phenotypes.