情感性障碍患者脑诱发电位变异与自杀行为的相关性研究

目的探讨情感性障碍患者脑诱发电位(BEP)变异与自杀行为的关系。方法应用国产脑诱发电位仪,记录了41例抑郁症、24例躁狂发作患者和33名正常对照者的3种脑诱发电位。结果与正常对照组相比,抑郁症和躁狂发作组均出现脑诱发电位主成分波幅降低,抑郁症VEP/P2潜伏期延迟[正常对照组(194±19)m s,抑郁症自杀史阳性组(212±22)m s,抑郁症自杀史阴性组(209±17)m s,P<0.01]。两组患者的BEP改变主要与患者有无自杀行为史有关。结论脑诱发电位临床价值得到了初步证实,与自杀行为相关的生物学指标研究中需进一步追踪随访。     

Racism,Trauma and Positive Aspects of Exposure to Race-Related Experiences

ABSTRACT

Ex po sure to race-re lated ex pe ri ences, such as race-hate as sault and dis crim i nation, are not rou tinely and sys tern at i cally ad dressed in as sess ment and treat ment in ter ventions or in so cial work prac tice formulations. A psychodynamic, ethnocultural, and strengths-ori ented conceptual framework is presented to describe exposure to stressful, traumatic, and positive race-re lated experiences. Criteria are identified for con ducting an in quiry about race-re lated ex pe ri ences to help as sess pos-si ble en vi ron men tal stress ors re lated to pre senting symp toms of Adjustment, Acute Stress or Post-Trau matic Stress Dis or ders. Also, there is an identification of obstacles and factors to consider when in ter viewing about ex po sure to race-re lated ex pe ri ences, and aspe cific in ter view format to guide sys tern atic in quiry about such ex po sure. Finally, sa lient im pli cations for as sess ment, treat ment and re search are de scribed.     

The Relationship between Social Defiance,Vindictiveness, Anger,and Brain Morphology in Eight‐year‐old Boys and Girls

The goal of this study is twofold: (1) to assess brain anatomical differences between children meeting diagnostic criteria for oppositional defiant disorder (ODD) and healthy controls, and (2) to investigate whether morphological brain characteristics associated with ODD differ in boys and girls. Eight‐year‐old participants (N = 38) were scanned using magnetic resonance imaging. ODD symptoms were assessed using the Dominic‐R interactive. In ODD participants, we observed a significant reduction of gray matter density in the left orbitofrontal cortex—a prefrontal region that plays a pivotal role in emotional self‐regulation and impulse control—and, conversely, an increase in the left temporal area—an area that has been associated with aggressive, impulsive, and antisocial personality. Furthermore, ODD boys showed a reduction of both gray matter density in the left orbitofrontal cortex and of white matter density in the left superior frontal area. The structural abnormalities found in the present study, in particular, the correlation between ODD symptoms and reduction of gray matter density in the left orbitofrontal cortex, may present some evidence for the existence of neuropathology associated with ODD symptoms during childhood. Furthermore, our findings indicate morphometric differences between boys and girls with ODD, which may be associated with gender differences in social behavior in children showing ODD symptoms.     

Mapping the boundaries of courtship disorder

The courtship disorder hypothesis maintains that voyeurism, exhibitionism, toucheurism‐frotteurism, and the preferential rape pattern are expressions of the same disorder (courtship disorder). Earlier studies had shown that with the exception of the preferential rape pattern these paraphilias co‐occur to a reasonably high degree. The present study (1) demonstrated that the preferential rape pattern co‐occurs with the above reasonably well established expressions of courtship disorder to a higher degree than other main paraphilic activity patterns do and (2) supported the conjecture that in addition to an erotic preference for unfamiliarity of target person‐or‐object (noted by earlier authors), three other paraphilic target‐person or object preferences may be connected with courtship disorder, though they are not at all virtually obligatory as is erotic unfamiliarity. These are choosing children and adults alike as target persons of the paraphilic activities, non‐gender dysphoric transvestism, and fetishism.     

Pemoline in Adult Attention Deficit Hyperactivity Disorder: Predictors of Nonresponse

Abstract

The psychostimulants are the most widely used treatment modality for attention deficit/hyperactivity disorder (ADHD). Although positive responses to psychostimulants have been demonstrated, 46% of adults with ADHD, on average, are nonresponsive or cannot tolerate the medications because of adverse effects. We reviewed the charts of 43 students treated with pemoline and studied parameters of nonresponse. Sixteen (37%) met the study definition of nonresponse. Of these, 5 (12%) were symptom nonresponders and 11 (25%) were nonresponders because of adverse effects. We found a significant relationship between age and nonresponse resulting from adverse effects, yet no other factors predicted nonresponse to pemoline. Clinicians should consider using smaller starting doses of pemoline in adults to minimize adverse effects.     

Adaptation and validation of the Gambling Motives Questionnaire-Financial (GMQ-F) in a sample of French-speaking gamblers

Previous research has identified specific gambling motives and linked them with both healthy and disordered gambling. The Gambling Motives Questionnaire (GMQ) is currently the most widely used measure for these motives. The present study aimed to offer a French validation of the latest version of this scale, the GMQ-Financial (GMQ-F), which measures four distinct motives (enhancement, social, coping, financial). The French GMQ-F was completed by 278 gamblers from the community and 22 treatment-seeking pathological gamblers, along with scales assessing gambling cognitions, impulsivity, disordered gambling symptoms and psychopathological symptoms. Confirmatory factor analysis supported the expected four-factor model. The GMQ-F subscales have good internal reliability. Validity of the GMQ-F is supported by specific correlations with the other constructs measured. Pathological gamblers differed from gamblers from the community on all but one (social) of the GMQ-F subscales. The French GMQ-F presents good psychometric properties and constitutes a reliable instrument for measuring gambling motives in research and clinical practice.     

A qualitative investigation into military veterans’ experiences in a problem-solving court: Factors that impact graduation rates

Veterans treatment courts (VTCs) are designed to offer a rehabilitative approach to criminal justice, focusing on treatment for mental health and substance use disorders. This qualitative study develops an in-depth understanding of a Midwestern VTC by asking participants (n = 15) their views on the most helpful aspects of the program and how the program could be more helpful. Three themes emerged from the data. 1) Military veterans felt that they were treated in a compassionate and caring manner, while also being held accountable for their behaviors. 2) Military veterans felt that they were not labeled by their mental health diagnoses, but that their identities as people and military veterans were more fully recognized. 3) Military veterans were dissatisfied with some of the services they received from the local VA. These findings are discussed in the context of problem-solving courts and military veterans’ experiences of services.     

Dictating the boundaries of ab/normality: a critical discourse analysis of the diagnostic criteria for attention deficit hyperactivity disorder and hyperkinetic disorder

In this article we report the findings of a critical discourse analysis of the diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and hyperkinetic disorder (HD) in two clinical manuals – Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. We examine the actions (behaviors) that are said to indicate the presence of ADHD/HD and analyze what the inclusion of these actions reveals about the relationship between ADHD/HD, cultural knowledge, and values. Our analysis reveals that both manuals use subjective, value-laden language to construct a mentally ill individual in opposition to an unseen, supposedly ‘normal’ person. We argue that the current criteria draw into question whether ADHD/HD meets the manuals’ own definitions of a disorder, and further that the discourse of the manuals is intertwined with the everyday practices of schools and serve to legitimize status quo educational practices.     

Improving research about us,with us: a draft framework for inclusive autism research

It is both epistemologically as well as ethically problematic if the autistic voice is not heard in relation to social scientific research seeking to further develop knowledge of autism. Ever since autism first emerged, it has remained medicalised and almost exclusively the preserve of non-autistic researchers. More recently, autistic individuals have begun to contribute to autism research. However, the vast majority of research in autism is still undertaken on autistic people, rather than with them, and is often not concerned with improving the day-to-day lives of people with autism. We discuss the concepts of participatory research and emancipatory research before presenting a draft framework for what we regard as truly inclusive research in autism. Our proposals are firmly based on ideas developed by the members of a university-based group of autistic adults (the Asperger’s Consultation Group) as well as the knowledge and experience of the other contributors.