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[Computer Game Playing: Clinical characteristics of dependence and abuse among adolescents.]

Wien Klin Wochenschr. 2009;121(15-16):502-9

Authors: Batthyány D, Müller KW, Benker F, Wölfling K

OBJECTIVE AND METHODS: The aim of the study was to investigate the prevalence of excessive computer game playing behaviour among adolescents with psychopathological tendencies that resemble the classic symptoms of addiction. To address this question, criteria for excessive computer game playing behaviour were developed on the basis of diagnostic criteria for substance-related disorders according to ICD-10. RESULTS: Excessive computer playing corresponding to addictive behaviour were found in 12.3% of the adolescents (n = 1068; 9.6% showed abusive and 2.7% dependent behaviour). Adolescents with excessive computer and video game playing behaviour also show substantial correlations with other psychosocial and psychopathological abnormalities, such as alterations in the intensity of social conflict, concentration deficits, maladaptive coping behaviour, stress and psychosomatic challenge, and school phobia. CONCLUSIONS: The study provides the first empirical data about excessive computer game playing among adolescents in Austria. It shows that pathological computer game playing can be well described by criteria developed in accordance to substance dependence, and that abusive or dependent computer game playing shows specific connections with psycho-social, psychopathological and motivational factors. Overall, the results demonstrate a clear need for deeper research on this subject and the need for a design of prevention measures.

PMID: 19787320 [PubMed - in process]

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The dynamic mechanisms of placebo induced analgesia: Evidence of sustained and transient regional involvement.

Pain. 2008 Oct 31;139(3):660-9

Authors: Craggs JG, Price DD, Perlstein WM, Verne GN, Robinson ME

Previously, we demonstrated that placebo analgesia (PA) accompanies reductions in neural activity during painful stimulation. This study investigated areas of the brain where the neural activity was increased during PA. The literature has associated PA with two potential mechanisms of action; one sustained (e.g., engaged for the duration of PA), the other, transitory (e.g., a feedback mechanism). We propose that PA results from the engagement of two complementary pain-modulation mechanisms that are identified with fMRI data as a main effect for condition or a time *condition interaction. The mechanism with sustained activity should activate the emotional regulation circuitry needed for memory formation of the event. The mechanism with transient activity should process cognitive and evaluative information of the stimuli in the context of the placebo suggestion to confirm the expectations set by it. To identify regions involved with these mechanisms, we re-analyzed fMRI data from two conditions: baseline (B) and PA. Results support the presence of both mechanisms, identified as two neural-networks with different temporal characteristics. Regions with sustained activity primarily involved the temporal and parahippocampal cortices. Conversely, brain regions with transient activity included linguistic centers in the left hemisphere and frontal regions of the right hemisphere generally associated with executive functioning. Together, these mechanisms likely engage analgesic processes and then simply monitor the system for unexpected stimuli, effectively liberating resources for other processes. Identifying brain regions associated with pain-modulation with different temporal profiles is consistent with the multidimensionality of PA and highlights the need for continued investigation of this construct.

PMID: 18804916 [PubMed - indexed for MEDLINE]

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Attention deficit hyperactivity disorder (ADHD): gender- and age-related differences in neurocognition.

Psychol Med. 2009 Aug;39(8):1337-45

Authors: Bálint S, Czobor P, Komlósi S, Mészáros A, Simon V, Bitter I

BACKGROUND: Despite the growing recognition that the clinical symptom characteristics associated with attention deficit hyperactivity disorder (ADHD) persist into adulthood in a high proportion of subjects, little is known about the persistence of neurocognitive deficits in ADHD. The objective was twofold: (1) to conduct a meta-analysis of neuropsychological studies to characterize attentional performance in subjects with adult ADHD by examining differences in ADHD versus normal control subjects; and (2) to investigate whether these differences vary as a function of age and gender. METHOD: Twenty-five neuropsychological studies comparing subjects with adult ADHD and healthy controls were evaluated. Statistical effect size was determined to characterize the difference between ADHD and control subjects. Meta-regression analysis was applied to investigate whether the difference between ADHD and control subjects varied as a function of age and gender across studies. RESULTS: Tests measuring focused and sustained attention yielded an effect size with medium to large magnitude whereas tests of simple attention resulted in a small to medium effect size in terms of poorer attention functioning of ADHD subjects versus controls. On some of the measures (e.g. Stroop interference), a lower level of attention functioning in the ADHD group versus the controls was associated with male gender. CONCLUSIONS: Adult ADHD subjects display significantly poorer functioning versus healthy controls on complex but not on simple tasks of attention, and the degree of impairment varies with gender, with males displaying a higher level of impairment.

PMID: 18713489 [PubMed - indexed for MEDLINE]

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Psychosocial interventions for adolescent cancer patients: a systematic review of the literature.

Psychooncology. 2009 Jul;18(7):683-90

Authors: Seitz DC, Besier T, Goldbeck L

OBJECTIVE: Both cancer diagnosis and the consequent treatment are particularly challenging for adolescent patients. Adjuvant psychological interventions to reduce cancer-related distress are therefore a fundamental part of a multidisciplinary treatment. Assuming that psycho-oncology has to consider developmentally specific aspects, this review summarizes empirical studies of the efficacy and effectiveness of psychosocial interventions for adolescent cancer patients. METHODS: Electronic searches were conducted in four databases. Studies were included only if they were exclusively designed for adolescent cancer patients and incorporated a defined outcome measure to evaluate the effects of the implemented intervention. RESULTS: Only four studies fulfilled the inclusion criteria. One of those studies reported a significant improvement compared with a waitlist control group. The relevant gains were found in the overall level of distress, as well as in additional outcome variables such as knowledge of sexual issues, body image and anxiety about psychosexual issues. The remaining studies revealed no significant changes related to psychological distress and psychosocial functioning. CONCLUSION: Taken together, the findings point out that there is a lack of intervention research in psycho-oncology with adolescents. So far, there is only limited evidence for the effectiveness of psychosocial interventions to improve coping with cancer-associated problems in adolescent patients. Future research needs to be done in this population. In order to establish more conclusive results, larger samples and interventions particularly designed for adolescent patients ought to be studied.

PMID: 19021149 [PubMed - indexed for MEDLINE]

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Affective temperaments, as measured by TEMPS-A, among nonviolent suicide attempters.

J Affect Disord. 2009 Jul;116(1-2):18-22

Authors: Rihmer A, Rozsa S, Rihmer Z, Gonda X, Akiskal KK, Akiskal HS

BACKGROUND: The aim of this study was to investigate the role of affective temperaments in suicidal behavior. METHOD: Using the standardized Hungarian version of the full-scale 110-item version of the TEMPS-A autoquestionnaire we compared the affective temperament-profiles of 150 consecutively investigated nonviolent suicide attempters (106 females and 44 males) and 302 age, sex and education matched normal controls (216 females and 86 males). RESULTS: Compared to controls, both female and male suicide attempters scored significantly higher in the four of the five affective temperaments, containing more or less depressive component (depressive, cyclothymic, irritable and anxious). On the other hand, however, no significant difference between the suicide attempters and controls was found for the hyperthymic temperament. Significantly higher rate of suicide attempters (90.0%) than controls (21.5%) have had some kind of dominant (mean score+2SD or above) affective temperament. Compared to controls, depressive, cyclothymic, irritable and anxious temperaments were significantly more frequent and hyperthymic temperament was nonsignificantly less common among suicide attempters. CONCLUSIONS: The findings support the strong relationship between depression and suicidal behavior even on temperamental level, and suggest that hyperthymic temperament does not have predisposing role for suicidal behavior at least in the case of nonviolent suicide attempters. LIMITATION: As only nonviolent suicide attempters were studied, our findings should pertain only for this patient-population.

PMID: 19036456 [PubMed - indexed for MEDLINE]

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Evaluation of a psycho-educational group intervention for children treated for cancer: a descriptive pilot study.

Psychooncology. 2009 Jul;18(7):762-6

Authors: Maurice-Stam H, Silberbusch LM, Last BF, Grootenhuis MA

OBJECTIVE: The present paper reports about the content and evaluation of a psycho-educational group intervention for children growing up with a history of cancer, Op Koers Oncologie (OK Onco). OK Onco is aimed at empowerment of survivors of childhood cancer by teaching disease-related skills. The purpose of this pilot study is to evaluate whether OK Onco was appropriate for use among paediatric survivors of childhood cancer. METHODS: Eleven participating children and their parents completed questionnaires about the disease-related skills that were taught in the intervention, before the intervention and 0-4 weeks after the intervention. In addition, parents were interviewed in focus groups. RESULTS: Positive outcomes were found on most items concerning disease-related skills. Remarkable improvements were found with respect to the intervention goals ’social competence’ and ‘positive thinking’. The parents reported that sharing emotions and experiences with other survivors of childhood cancer was an important element of the OK Onco program, which underscores the benefit of a disease-specific program for cancer survivors. CONCLUSIONS: In conclusion, the results of the pilot study indicate that OK Onco is appropriate for paediatric survivors of childhood cancer. Implementation of the intervention is the next challenge.

PMID: 19061197 [PubMed - indexed for MEDLINE]

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Sexual dysfunction and spousal communication in couples coping with prostate cancer.

Psychooncology. 2009 Jul;18(7):735-46

Authors: Badr H, Taylor CL

OBJECTIVE: To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns. METHODS: In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires. RESULTS: Patients and partners reported high rates of sexual dysfunction. Within couples, patients’ and their partners’ sexual function was moderately to highly correlated (r=0.30-0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners’ marital distress (Sobel’s Z=12.47, p=0.001). Patients and partners who reported high levels (+1SD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (-1SD) of mutual constructive communication (p<0.05). CONCLUSION: Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients’ and their partners’ marital adjustment.

PMID: 19061199 [PubMed - indexed for MEDLINE]

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Aggression is related to frontal serotonin-1A receptor distribution as revealed by PET in healthy subjects.

Hum Brain Mapp. 2009 Aug;30(8):2558-70

Authors: Witte AV, Flöel A, Stein P, Savli M, Mien LK, Wadsak W, Spindelegger C, Moser U, Fink M, Hahn A, Mitterhauser M, Kletter K, Kasper S, Lanzenberger R

OBJECTIVES: Various studies indicate that serotonin regulates impulsivity and the inhibitory control of aggression. Aggression is also known to be modified by sex hormones, which exert influence on serotonergic neurotransmission. The present study aimed to elucidate potential interactions between human aggression, the inhibitory serotonergic 5-HT(1A) receptor, and sex hormones. EXPERIMENTAL DESIGN: Thirty-three healthy volunteers (16 women, aged 26.24 +/- 5.5 yr) completed a validated questionnaire incorporating five dimensions of aggression. Subsequently, all subjects underwent positron emission tomography with the radioligand [carbonyl-(11)C]WAY-100635 to quantify 5-HT(1A) binding potentials (BP(ND)s) in the prefrontal cortex, limbic areas, and midbrain. Also, plasma levels of testosterone, 17beta-estradiol and sex hormone-binding globulin (SHBG) were measured. Relations between aggression scores, regional 5-HT(1A) BP(ND)s, and hormone levels were analyzed using correlations, multivariate analyses of variance, and linear regressions. PRINCIPAL OBSERVATIONS: Statistical analyses revealed higher 5-HT(1A) receptor BP(ND)s in subjects exhibiting higher aggression scores in prefrontal (all P < 0.041) and anterior cingulate cortices (P = 0.016). More aggressive subjects were also characterized by lower SHBG levels (P = 0.015). Moreover, higher SHBG levels were associated with lower 5-HT(1A) BP(ND)s in frontal (P = 0.048) and cingulate cortices (all P < 0.013) and in the amygdala (P = 0.03). CONCLUSIONS: The present study provides first-time evidence for a specific interrelation between the 5-HT(1A) receptor distribution, sex hormones, and aggression in humans. Our findings point to a reduced down-stream control due to higher amounts or activities of frontal 5-HT(1A) receptors in more aggressive subjects, which is presumably modulated by sex hormones.

PMID: 19086022 [PubMed - indexed for MEDLINE]

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Relationship among latitude, climate, season and self-reported mood in bipolar disorder.

J Affect Disord. 2009 Jul;116(1-2):152-7

Authors: Bauer M, Glenn T, Grof P, Rasgon NL, Marsh W, Sagduyu K, Alda M, Murray G, Quiroz D, Malliaris Y, Sasse J, Pilhatsch M, Whybrow PC

OBJECTIVE: Many researchers have analyzed seasonal variation in hospital admissions for bipolar disorder with inconsistent results. We investigated if a seasonal pattern was present in daily self-reported daily mood ratings from patients living in five climate zones in the northern and southern hemispheres. We also investigated the influence of latitude and seasonal climate variables on mood. METHOD: 360 patients who were receiving treatment as usual recorded mood daily (59,422 total days of data). Both the percentage of days depressed and hypomanic/manic, and the episodes of depression and mania were determined. The observations were provided by patients from different geographic locations in North and South America, Europe and Australia. These data were analyzed for seasonality by climate zone using both a sinusoidal regression and the Gini index. Additionally, the influence of latitude and climate variables on mood was estimated using generalized linear models for each season and month. RESULTS: No seasonality was found in any climate zone by either method. In spite of vastly different weather, neither latitude nor climate variables were associated with mood by season or month. CONCLUSION: Daily self-reported mood ratings of most patients with bipolar disorder did not show a seasonal pattern. Neither climate nor latitude has a primary influence on the daily mood changes of most patients receiving medication for bipolar disorder.

PMID: 19091424 [PubMed - indexed for MEDLINE]

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Chronic fatigue in Gulf War veterans: should it be treated as chronic fatigue syndrome?

Psychol Med. 2009 Aug;39(8):1401-2

Authors: Knoop H, van der Meer JW, Bleijenberg G

PMID: 19386143 [PubMed - indexed for MEDLINE]

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