Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

Rate of Torque Development and Feedforward Control of the Hip and Knee Extensors: Gender Differences

The purpose of this study was to determine whether women demonstrate decreased rate of torque development (RTD) of the hip and knee extensors and altered onset timing of the vastus lateralis and gluteus maximus during a drop-jump task when compared with men. On average, women demonstrated significantly lower normalized RTD of the hip extensors (women: 11.6 ± 1.3 MVT.s^?1, men: 13.1 ± 0.9 MVT.s^?1; p ≤ .01); however, there was no significant difference in knee extensor RTD. Women also demonstrated significantly earlier activation of their vastus lateralis (women: 206.0 ± 130.6 ms, men: 80.9 ± 69.6 ms; p ≤ .01) and gluteus maximus (women: 85.7 ± 58.6 ms, men: 54.5 ± 35.4 ms; p = .02). In both men and women, there was a significant negative correlation between the hip extensor RTD and the vastus lateralis electromyographic onset time (men: r = –.386, p = .046; women: r = –.531, p = .008). The study findings suggest that women may utilize a feedforward control strategy in which they activate their knee extensors earlier than men to compensate for deficits in hip extensor RTD. The impaired capacity to rapidly stabilize the hip and knee joints during dynamic maneuvers may contribute to the increased risk of anterior cruciate ligament injury observed in women.     

The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.     

Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability

The aim of this study was to evaluate stride-to-stride variability of the lower extremity during walking in individuals with and without chronic ankle instability (CAI) using a nonlinear analysis. Twenty-five participants with self-reported CAI and 27 healthy control participants volunteered for this study. Participants walked on a motor-driven treadmill for 3 min at their selected speed. Lower extremity kinematics in the sagittal and frontal planes were recorded using a passive retroreflective marker motion capture system. The temporal structure of walking variability was analyzed with sample entropy (SampEn). The CAI group produced lower SampEn values in frontal-plane ankle kinematics compared to the control group (P = .04). No significant group differences were observed for SampEn values of other kinematics (P > .05). Participants with CAI demonstrated less stride-to-stride variability of the frontal plane ankle kinematics compared to healthy controls. Decreased variability of walking patterns demonstrated by participants with CAI indicates that the presence of CAI may be associated with a less adaptable sensorimotor system to environmental changes. The altered sensorimotor function associated with CAI may be targets for clinical interventions, and it is critical to explore how interventions protocols affect sensorimotor system function.     

要注意中药对肝的损伤作用

含有生物碱类、皂苷类、萜类、毒蛋白类、重金属类成分的中药易致急性肝损伤.中药对肝脏损伤的原因及机制较为复杂,可能与药物对肝脏的直接毒性或特异性体质有关.此外,中药炮制方法、给药途径、剂型、剂量、疗程及配伍不当也会引起药物性肝损伤.中药所致的药物性肝损伤的诊断主要依据用药史、发病的时间、过程和临床表现并排除其他因素.治疗可选用还原型谷胱甘肽、S-腺苷蛋氨酸、多烯磷脂酰胆碱、熊去氧胆酸、水飞蓟素等药物,重症可选择人工肝脏支持治疗.     

How do Motor Systems Deal with the Problems of Controlling Three-Dimensional Rotations?

Rotations are fundamental to motor control, not only for orienting to stimuli but also in the joint articulations that underlie translational movements. Studying three-dimensional (3-D) rotations of the simplest joint system, the eye, has provided general insights into the neural control of movement. First, in selecting one 3-D eye orientation for each two-dimensional (2-D) gaze direction, the oculomotor system generates a behavior called Listing's law that constrains eye position to a 2-D plane, Listing's plane. This selection is made internally by an inverse kinematic transformation called the Listing's law operator. Second, the oculomotor system incorporates the inherent multiplicative relationship between rotational velocity and position to generate the 3-D movement and position commands required by Listing's law. Finally, the coordinate systems for these commands appear to align with Listing's plane rather than with anatomic structures. Recent investigations have revealed similar behavioral constraints in the orientations of the head and arm, suggesting that the neural mechanisms for Listing's law may have analogues in many motor systems.     

Limb Segment Load Inhibits the Recovery of Soleus H-Reflex After Segmental Vibration in Humans

We investigated the effects of vertical vibration and compressive load on soleus H-reflex amplitude and postactivation depression. We hypothesized that, in the presence of a compressive load, limb vibration induces a longer suppression of soleus H-reflex. Eleven healthy adults received vibratory stimulation at a fixed frequency (30 Hz) over two loading conditions (0% and 50% of individual's body weight). H-reflex amplitude was depressed ～88% in both conditions during vibration. Cyclic application of compression after cessation of the vibration caused a persistent reduction in H-reflex excitability and postactivation depression for > 2.5 min. A combination of limb segment vibration and compression may offer a nonpharmacologic method to modulate spinal reflex excitability in people after CNS injury.     

Regional brain activity change predicts responsiveness to treatment for stuttering in adults

Developmental stuttering is known to be associated with aberrant brain activity, but there is no evidence that this knowledge has benefited stuttering treatment. This study investigated whether brain activity could predict progress during stuttering treatment for 21 dextral adults who stutter (AWS). They received one of two treatment programs that included periodic H₂¹⁵O PET scanning (during oral reading, monologue, and eyes-closed rest conditions). All participants successfully completed an initial treatment phase and then entered a phase designed to transfer treatment gains; 9/21 failed to complete this latter phase. The 12 pass and 9 fail participants were similar on speech and neural system variables before treatment, and similar in speech performance after the initial phase of their treatment. At the end of the initial treatment phase, however, decreased activation within a single region, L. putamen, in all 3 scanning conditions was highly predictive of successful treatment progress.     

Social comparison,coping and depression in people with spinal cord injury

The present study among 70 people with spinal cord injury examined the prevalence and correlates of identification (seeing others as a potential future) and contrast (seeing others in competitive terms) in social comparison as related to coping and depression. The most prevalent social comparison strategy was downward contrast (a positive response to seeing others who were worse-off), followed by upward identification (a positive response to perceiving better-off others as a potential future), downward identification (a negative response to perceiving worse-off others as a potential future), and upward contrast (a negative response to seeing others who were better-off). Those with less severe lesions reported the highest levels of upward contrast, coping through blaming others, and depression. Downward contrast was particularly related to constructive coping, and upward identification to wishful thinking. The less adaptive social comparison strategies, i.e., upward contrast and downward identification, were quite strongly related to wishful thinking and blaming others. Particularly upward contrast, i.e., feeling bad as response to seeing that others are better-off, was related to depression.     

A survey of smoking status and cancer risk perceptions among participants attending a hospital-based head and neck screening program

Abstract

Screening for head and neck cancer is underutilized. Given that lack of knowledge of the risk factors may partially account for screening underutilization. we surveyed subjective risk and knowledge of risk factors for head and neck cancer among 124 individuals who attended a free. hospital-based head and neck cancer screening. Few participants were current smokers. Most attendees perceived their risk as similar to others of their age and sex. Personal health habits comprised almost all of the risk-decreasing factors, yet less than half of the risk-increasing factors. generated. Personal habits were less frequently endorsed than factors such as pollution and heredity. Those who mentioned a risk behavior, or a family cancer history, reported higher subjective risk. Those who mentioned a personal health habit reported lower subjective risk. Results highlight needed efforts to increase screening among high-risk individuals through targeted education messages.