Cognitive inhibition and interference in dissociative identity disorder: the effects of anxiety on specific executive functions

Using an experimentally based, computer-presented task, this study assessed cognitive inhibition and interference in individuals from the dissociative identity disorder (DID; n=12), generalized anxiety disorder (GAD; n=12) and non-clinical (n=12) populations. Participants were assessed in a neutral and emotionally negative (anxiety provoking) context, manipulated by experimental instructions and word stimuli. The DID sample displayed effective cognitive inhibition in the neutral but not the anxious context. The GAD sample displayed the opposite findings. However, the interaction between group and context failed to reach significance. There was no indication of an attentional bias to non-schema specific negative words in any sample. Results are discussed in terms of the potential benefit of weakened cognitive inhibition during anxious arousal in dissociative individuals.     

Increased brain serotonin turnover in panic disorder patients in the absence of a panic attack: reduction by a selective serotonin reuptake inhibitor

Since the brain neurotransmitter changes characterising panic disorder remain uncertain, we quantified brain noradrenaline and serotonin turnover in patients with panic disorder, in the absence of a panic attack. Thirty-four untreated patients with panic disorder and 24 matched healthy volunteers were studied. A novel method utilising internal jugular venous sampling, with thermodilution measurement of jugular blood flow, was used to directly quantify brain monoamine turnover, by measuring the overflow of noradrenaline and serotonin metabolites from the brain. Radiographic depiction of brain venous sinuses allowed differential venous sampling from cortical and subcortical regions. The relation of brain serotonin turnover to serotonin transporter genotype and panic disorder severity were evaluated, and the influence of an SSRI drug, citalopram, on serotonin turnover investigated. Brain noradrenaline turnover in panic disorder patients was similar to that in healthy subjects. In contrast, brain serotonin turnover, estimated from jugular venous overflow of the metabolite, 5-hydroxyindole acetic acid, was increased approximately 4-fold in subcortical brain regions and in the cerebral cortex (P < 0.01). Serotonin turnover was highest in patients with the most severe disease, was unrelated to serotonin transporter genotype, and was reduced by citalopram (P < 0.01). Normal brain noradrenaline turnover in panic disorder patients argues against primary importance of the locus coeruleus in this condition. The marked increase in serotonin turnover, in the absence of a panic attack, possibly represents an important underlying neurotransmitter substrate for the disorder, although this point remains uncertain. Support for this interpretation comes from the direct relationship which existed between serotonin turnover and illness severity, and the finding that SSRI administration reduced serotonin turnover. Serotonin transporter genotyping suggested that increased whole brain serotonin turnover most likely derived not from impaired serotonin reuptake, but from increased firing in serotonergic midbrain raphe neurons projecting to both subcortical brain regions and the cerebral cortex.     

The Role of Positive Emotions in Reducing Depressive Symptoms Among Army Wives

The homecoming period following combat deployment can be as stressful to military spouses as the deployment itself. This study used the broaden-and-build theory of positive emotions to examine whether personal resources (adaptive coping, maladaptive coping, and resilience) mediate the relationship between positive emotions and depressive symptoms in Army wives (N = 252) following the homecoming of a deployed active-duty service member. Using path analysis, after controlling for demographic variables and marital satisfaction, positive emotions were related to all 3 personal resources (positively to adaptive coping and resilience, negatively to maladaptive coping). In turn, adaptive coping and resilience were related to fewer depressive symptoms and maladaptive coping to greater depressive symptoms. The direct path between positive emotions and depressive symptoms was nonsignificant, suggesting complete mediation. The final model accounted for 54% of the total variance in depressive symptoms. Results support the important role that positive emotions play in decreasing depressive symptoms in this high-risk population.     

The relationship between post-trauma problem reporting and carer quality of life after severe head injury

Abstract

Head injury is a significant cause of death and disability. This study examined the quality of life of carers of individuals following severe head injury from the acute neurosurgical care period to one year post discharge from hospital. The contribution of patterns of problem reporting by patients and their carers to quality of life was examined. Carer psychosocial adjustment and individual quality of life evaluations were significantly poorer than general population levels and did not change over a one year period. However, significant increases in the number of problems reported were noted over time. No significant differences were found between patients and carers in the numbers of problems identified at each of three assessments, although the level of agreement about problems identified was quite low. Female patients reported significantly more problems than male patients. Carer problem reporting was found to significantly predict carer quality of life and psychosocial functioning to a greater extent than patient problem reporting, a pattern which emerged after the patient had been discharged from hospital. The study demonstrates increasing problem profiles and differing perceptions of patients and carers over time. Combined with a lack of improvement in carer quality of life over a one year recovery period, this highlights the need for longer-term professional support and advice services aimed at both patients and carers.     

Book Reviews

The Cambridge Companion to Marx Edited by Terrell Carver Cambridge University Press, 1991. Pp. xiii + 357. ISBN 0–521–36625–9 £40.00 hbk.

Paul Ricoeur By Stephen H. Clark Routledge, 1990. Pp. 216. ISBN 0–415–02309–2. £30.00 hbk. £9.99 pbk.

The Analysis of Political Structure By David Easton Routledge, 1990. Pp. xv + 336 ISBN 0–415–90310–6. £35.00 hbk.

Varieties of Moral Personality: Ethics and Psychological Realism By Owen Flanagan Harvard University Press, 1991. Pp. 393. ISBN 0–674–93218–8. £27.95.

God and Greek Philosophy By L. P. Gerson Routledge, 1990. Pp. xi + 340. ISBN 0–415–02219–3. £35.00.

Scepticism By Christopher Hookway Routledge, 1990. Pp. xii + 251. ISBN 0–415–03396–9. £35.00 hbk.

Russell, Idealism and the Emergence of Analytic Philosophy By Peter Hylton Clarendon Press, 1990. Pp. 420. ISBN 0–19–824626–9. £50 hbk. £15.95 pbk

The Poetics of Imagining: from Husserl to Lyotard By Richard Kearney Harper Collins, 1991. Pp. xiii + 234. ISBN 04–445–4503. £30.00.

The Language of Art History Edited by Salim Kemal and Ivan Gaskell Cambridge University Press, 1991. Pp. 255. ISBN 0–521–35384‐X. £32.50.

Newman After a Hundred Years Edited by Ian Ker and Alan G. Hill Clarendon Press, 1990. Pp. xvi + 470. ISBN 0–19–812–8916 £45.00

Inference to the Best Explanation By Peter Lipton Routledge, 1991. Pp. x + 194. ISBN 0–415–05886–4. £35.00 hbk.

Dretske and His Critics Edited by Brian McLaughlin Blackwell, 1991. Pp. xvii + 231. ISBN 1–55786–198–6. £40.00.

A History and Interpretation of the Logic of Hegel By Giacomo Rinaldi The Edwin Mellen Press, 1992. Pp. 525. $99.95 hbk.

The Secret Connexion: Causation, Realism, and David Hume By Galen Strawson Clarendon Press, 1989 (1992 issued in paperback with corrections). Pp. xiv + 291. ISBN 0–19–824038–4. £14.95 pbk.

Analysis and Metaphysics By P. F. Strawson Oxford University Press, 1992. Pp. 152. ISBN 0–19–875517–6. £22.50 hbk; £7.95 pbk.

Physics and Metaphysics: Theories of Space and Time By Jennifer Trusted Routledge, 1991. Pp. xii + 210. ISBN 0–415–05948–8. £30.00.

Political Theory and Postmodernism By Stephen K. White Cambridge University Press, 1991. Pp. 153. ISBN 0–521–40122–4. £25.00 hbk. ISBN 0–521–40948–9. £9.95 pbk.

Nietzsche's Philosophy of Art By Julian Young Cambridge University Press, 1992. Pp. xiii + 170. ISBN 0–521–51124–6. £27.95.     

Sex-role orientation as related to psychological and physiological responses during achievement and orthostatic stress

The Bem sex-role inventory was used to select, from an Irish student population, females and males who differed with regard to feminine and masculine personality characteristics. Four groups were established for each sex: (1) subjects with low scores in both femininity and masculinity, i.e., undifferentiated subjects; (2) subjects with high scores in both femininity and masculinity, i.e., androgynous subjects; (3) subjects with high scores in femininity and low scores in masculinity; (4) subjects with high scores in masculinity and low scores in femininity. The Cattell 16 PF scale showed that the undifferentiated groups were more reserved and detached and more cautious and taciturn than the androgynous groups. Each subject was exposed to mental stress in one session and orthostatic stress in another session. Mental stress was induced by five different intellectual performance tests. Males and females differed significantly only on a test of perceptual speed, with females performing better than males, as expected. The group of androgynous females was superior to all other groups on four of the five performance tasks. The group of androgynous males was not superior in terms of objective performance but reported feeling more confident andThis collaboration was made possible by a twinning grant to Dr. John Cullen and Professor Marianne Frankenhaeuser from the European Training Programme in Brain and Behaviour Research, European Science Foundation. Financial support was also obtained by grants from the Swedish Medical Research Council (Project No. 997) and the Swedish Council for Research in the Humanities and Social Sciences. satisfied with their performance than most other groups, particularly the undifferentiated males. Blood pressure and heart rate were significantly elevated in all groups during both stress conditions. Heart rate was significantly higher in the high-femininity and androgynous females than in the other female groups.     

Sex role patterns in an Irish student sample as measured by the bem sex role inventory (comparisons with an American sample)

Sex roles in 171 male and 180 female university students in Ireland were examined by the Bem Sex Role Inventory (BSRI). The distribution of scores for masculinity and femininity showed the same general pattern as in American samples. However, the Irish males rated themselves significantly lower in masculinity and significantly higher in femininity than the American males, indicating a more androgynous profile. Irish females rated themselves significantly lower than American females in both masculinity and femininity, and were less androgynous relative to Irish males. The distribution of subjects on sex role types showed a larger percentage of androgynous males and undifferentiated females in the Irish sample than in American samples. Both the male and the female Irish students scored lower than American students on the Social Desirability Scale. Separate scores were calculated for the positive and the negative items of the Social Desirability Scale, and it was found that positive items were assigned considerably higher ratings than the negative (reversed) items in both sexes. When controlled for social desirability, the masculinity and femininity scores were found to be uncorrelated. Factor analysis of the BSRI revealed six factors, which correspond to previous findings. In general, the present results support the view that masculinity and femininity, as measured by the BSRI, can be treated as separate dimensions, but that a more complex model than the two-factor structure is required.This is a joint report from the Psychosomatic Unit of the Irish Foundation for Human Development, Dublin; the Department of Psychiatry and Psychology, Karolinska Institutet, Stockholm; and the Department of Psychology, University of Stockholm. This collaboration was made possible by a twinning grant to Dr. John Cullen and Professor Marianne Frankenhaeuser from the European Training Programme in Brain and Behavior Research, European Science Foundation. Financial support was also obtained as grants from the Swedish Medical Research Council (Project No. 979) and the Swedish Council for Research in the Humanities and Social Sciences. The authors are indebted to Professor Desmond Swan, University College, Dublin, for his generous support, particularly during the initial stages of our work, and to Professor Liam Ryan, Maynooth College, who also gave valuable assistance.     

Measuring the impact on relatives of caring for people with Alzheimer's disease: Quality of life,burden and well-being

Abstract

This study compared key correlates of caregiver stress in 50 Alzheimer's disease patients and their primary caregivers. in relation to three outcome measures - perceived burden, psychological well-being, and quality of life (QoL). These were evaluated using the Zarit Burden Interview. General Health Questionnaire (GHQ-30), and Schedule for the Evaluation of Individual QoL (SEIQoL-DW) respectively. Informal social support was evaluated on Vaux's Social Support Appraisal Scale. Patients' cognitive. functional, and behavioural status were rated on Mini-Mental State Examination, Blessed-Roth Dementia Scale. and Baumgarten Dementia Behaviour Disturbance Scale respectively. Standardised multiple regression analysis was used to compare the outcome measures. In this model burden was highly related to behaviour disturbance. and also to social support (adjusted R² = 0.45). Well-being was significantly related to behaviour disturbance, and also to functional status (adjusted R² = 0.40). With regard to QoL the model performed poorly as most of the variance in QoL was not accounted for by the model (adjusted R² = 0.14). These findings highlight differences in factors determining caregiver QoL. burden and well-being.