Basic Self‐Awareness

Basic self‐awareness is the kind of self‐awareness reflected in our standard use of the first‐person. Patients suffering from severe forms of depersonalization often feel reluctant to use the first‐person and can even, in delusional cases, avoid it altogether, systematically referring to themselves in the third‐person. Even though it has been neglected since then, depersonalization has been extensively studied, more than a century ago, and used as probe for understanding the nature and the causal mechanisms of basic self‐awareness. In this paper, I argue that depersonalized patients indeed have an impaired basic self‐awareness, and that their study allows us both to favor one specific theory of basic self‐awareness and to understand what is wrong with its rivals. According to the favored theory, which I call Cartesian, we are basically self‐aware in virtue of being acquainted with ourselves through introspection.     

Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness

Background and Objectives: partners’ caregiving efforts are not always beneficial to both recipient and provider. Bowlby’s conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one’s compulsive caregiving would associate positively, and one’s sensitive caregiving would associate negatively, with one’s and one’s partner’s anxiety across contexts (cardiac and non-cardiac) and gender. Design: A comparative design of 131 couples with a diagnosis of husbands’ acute cardiac syndrome and 68 matched couples in the community was applied. Methods: The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. Results: Structural equation modeling revealed that one’s compulsive caregiving was positively associated with one’s anxiety, across most contexts. Multi-group analyses revealed that the associations between one’s compulsive caregiving and one’s partner’s anxiety levels differed depending on gender and context. Conclusions: The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one’s and one’s partner’s developmental history.     

Relationship quality of persons with obstructive sleep apnoea syndrome

In the field of sleep disorders, the quality of couple relationship is arousing increasing attention, given its implications for quality of life and treatment adherence. The aim of the present study was to evaluate relationship quality in a sample of treated or untreated patients with Obstructive Sleep Apnoea Syndrome. Eighty-seven patients were recruited in a hospital-based Centre for Sleep Medicine. Subjects were administered the Dyadic Adjustment Scale (DAS) to evaluate relationship quality, and the Epworth Sleepiness Scale (ESS). Apnoea-hypopnoea indexes (AHI) were collected through nocturnal polysomnography or home testing with a portable monitoring device. Although the DAS average scores were similar to local normative values, relationship quality was significantly lower in the untreated patients when compared with the ones treated. The ESS scores showed a negative correlation with many DAS scores, whereas no significant correlation emerged for AHI. Such data suggest a significant impact of perceived sleep apnoea symptoms on marital satisfaction, even though in the absence of striking differences between the whole sample and the general population.     

Evaluating the role of contingency in differentially reinforced tic suppression

The current study evaluated the effects of tokens delivered on differential reinforcement of zero-rate behavior (DRO) schedules or noncontingently on tic suppression in 4 children with tics. Tic frequency was lower in 3 of 4 children when tokens were delivered contingent on the absence of tics than when tokens were delivered noncontingently.     

Synchrnoic consciousness from a neurological point of view: the philosophical foundations for neuroethics

Daniel Kolak’s theory of synchronic consciousness according to which the entire range of dissociative phenomena, from pathologies such as MPD and schizophrenia to normal dream states, are best explained in terms of consciousness becoming simultaneously identified as many selves, has revolutionary therapeutic implications for neurology and psychiatry. All these selves, according to Kolak—even the purely imaginary ones that exist as such only in our dreams—are not just conscious but also self-conscious, with beliefs, intentions, living lives informed by memories (confabulatory, in the case of the fictional ones) and personal histories. Kolak’s derivation of psychiatrically relevant aspects of his theory—a neurological rendition of a Kantian transcendental argument—can be given a straightforward neurological, and therefore open to scientific scrutiny, interpretation that would then more easily lend itself to the clinical setting in which these perplexing phenomena, along with their purveyors, must live and cope. This will be the main focus of this paper.     

Changes in lower limb co-contraction and stiffness by toddlers with Down syndrome and toddlers with typical development during the acquisition of independent gait

During gait acquisition, children learn to use their changing resources to meet the requirements of the task. Compared to typically developing toddlers (TD), toddlers with Down syndrome (DS) have functionally different musculoskeletal characteristics, such as hypotonia, and joint and ligament laxity, that could produce a reduced passive stiffness. The interplay between this inherently lower passive stiffness and the demands of walking may result in different strategies during gait acquisition. This study compared normalized global stiffness and lower limb's co-contraction indices (CCI) used by toddlers with TD (n=12) and with DS (n=12), during the early stages of gait acquisition. Stiffness and CCI were normalized by gravitational torque (mLg) in both phases of gait (stance, swing). Five longitudinal evaluations were conducted from the onset of locomotion until three months post-acquisition. All children were video taped and had electromyographic (EMG) recordings from muscle pairs of one leg, which were used to calculate CCI of hip, knee, ankle, and total leg CCI. Body and lower limb stiffness were calculated according to a hybrid pendulum resonance equation. Results from ANOVAs revealed no group differences on stiffness or on CCI's during stance but children with DS showed greater CCI during swing. Despite the structural musculoskeletal differences between toddlers with TD and with DS, the similarities observed in their processes of gait development suggest functional equivalences.     

Memory abilities in Williams syndrome: Dissociation or developmental delay hypothesis?

Williams syndrome (WS) is a neurodevelopmental genetic disorder often described as being characterized by a dissociative cognitive architecture, in which profound impairments of visuo-spatial cognition contrast with relative preservation of linguistic, face recognition and auditory short-memory abilities. This asymmetric and dissociative cognition has been also proposed to characterize WS memory ability, with sparing of auditory short-term memory and impairment of spatial and long-term memory abilities. In this study, we explored the possibility of a double memory dissociation in WS (short- versus long-term memory; verbal versus visual memory). Thus, verbal memory abilities were assessed using California Verbal Learning Test and Digit Span and Rey-Osterrieth Complex Figure and Corsi Blocks was used to assess visual-spatial memory abilities. Overall, WS subjects were found to present a generalized significant impairment in verbal and visuo-spatial components either in short- or long-term memory. In sum, data from this study brings support for a developmental delay hypothesis, rather than a double dissociation within memory systems in WS.     

Fragile X syndrome: Neural network models of sequencing and memory

A comparative framework of memory processes in males with fragile X syndrome (FXS) and typically developing (TYP) mental age-match children is presented. Results indicate a divergence in sequencing skills, such that males with FXS recall sequences similarly to TYP children around five and a half years of age, but the males with FXS recall significantly worse when compared to TYP children around seven and a half years of age. Performance on one working memory measure, an n-back Card Task, is modeled with a neural network. To date, no network models explicate the sequencing and memory processes in those with FXS. Noise was added to various levels (weight matrices) in the FXS model and outputs approximated human FXS performance. Three models were compared: (1) FXS; (2) younger mental age-TYP matches; (3) older reading level-TYP matches. Modeling can help to reify conceptualizations of deficits and to guide in the creation of more valid, science-based remediations. The FXS model suggested that the levels of phonological representation and sequencing in memory were candidates for targeted therapies in males with FXS.     

代谢综合征在临床应用中的去留

代谢综合征的概念由来已久,迄今已有数千个围绕代谢综合征的相关研究,探讨其病理生理机制、诊断标准、流行病学、与心血管疾病的相关性及治疗等。然而近年来,代谢综合征的临床适用性及对心血管病和糖尿病的防治意义被质疑,引发了诸多争议。对于“代谢综合征之去留”问题,目前仍不是盖棺定论之时。     

代谢综合征发病机制研究进展

随着经济的发展和人们生活水平的提高以及生活方式的改变,代谢综合征（metabolic syndrome,MS）的患病率逐年上升。代谢综合征是一种涉及多种代谢异常、与心血管病紧密联系的疾病状态。肥胖或超重、糖调节异常或糖尿病、高血压和高血脂是MS的重要组成元素。代谢综合征一直是人们关注的热点,但截止目前确切机制仍不明确。主要围绕肥胖与胰岛素抵抗展开研究,特别是在脂毒性和脂肪分泌因子的调控以及各种炎性因子的影响方面取得了一些进展。