Body, Mind & Spirit Articles and Latest News

Drawing on psychoanalytic pedagogy: the influence of August Aichhorn on the psychotherapy of adolescents.

Psychoanal Q. 2009 Oct;78(4):1091-108

Authors: Houssier F, Marty F

The authors locate August Aichhorn’s pioneering ideas about the psychodynamics and psychotherapy of adolescents in the context of psychoanalytic pedagogy in Europe in the 1920s and ’30s. Strongly influenced by Freud’s discoveries and theory, Aichhorn was himself a major influence on the work of Anna Freud and of many other child and adolescent psychoanalytic theoreticians, including Spitz, Mahler, Eissler, Erikson, and Blos. His technique drew heavily on the element of surprise and on the adolescent patient’s identification with the analyst, as well as on the use of humor and empathy in treatment. The authors utilize brief vignettes from Aichhorn’s descriptions of his practice to illustrate his unique clinical style.

PMID: 19928439 [PubMed - in process]

[Read more →]

Using signal detection theory to test the impact of negative emotion on sub-clinical paranoia.

J Behav Ther Exp Psychiatry. 2009 Nov 3;

Authors: Westermann S, Lincoln TM

A novel experimental paradigm for measuring state paranoia by means of signal detection theory was evaluated. A liberal response bias, indicating the tendency to recognize facial expressions as threatening, was expected to reflect paranoia. Against theoretical expectations, heightened paranoia questionnaire scores were associated with a non-liberal bias, which was not affected by negative emotion per se. However, subsequent analyses revealed that, if anxious, participants with heightened paranoia adopted a comparatively more liberal response bias. These findings corroborate the eminent role of anxiety in paranoia and demonstrate that state paranoia can be captured with the presented paradigm.

PMID: 19931042 [PubMed - as supplied by publisher]

[Read more →]

To eat or not to eat: availability of food modulates the electrocortical response to food pictures in restrainED eaters.

Appetite. 2009 Nov 18;

Authors: Blechert J, Feige B, Hajcak G, Tuschen-Caffier B

Restrained eating is a pattern of chronic dietary restriction interspersed with episodes of disinhibited overeating. The present study investigated whether this eating pattern is related to altered electrocortical processing of appetitive food stimuli in two different motivational contexts. Restrained (n=19) and unrestrained eaters (n=21) passively viewed high caloric food pictures, along with normative emotional pictures in a first block. In a second block, food availability was manipulated: participants were told that half of the food items should later be eaten (available food items), whereas the other half of food items was said to be unavailable. While no group differences were obtained during the first block, restrained eaters’ event related potentials (ERPs) were significantly modulated by the availability manipulation: ERPs for available food cues were significantly less positive than ERPs to unavailable food cues. Restrained eaters might down-regulate their reactivity to available food cues to maintain their dietary rules.

PMID: 19931582 [PubMed - as supplied by publisher]

[Read more →]

Metabolic Alterations in the Amygdala in Borderline Personality Disorder: A Proton Magnetic Resonance Spectroscopy Study.

Biol Psychiatry. 2009 Nov 20;

Authors: Hoerst M, Weber-Fahr W, Tunc-Skarka N, Ruf M, Bohus M, Schmahl C, Ende G

BACKGROUND: Emotional dysfunction in a frontolimbic network has been implicated in the pathophysiology of borderline personality disorder (BPD). The amygdala is a key region of the limbic system and plays an important role in impulsivity, affect regulation, and emotional information processing and thus is likely related to BPD symptoms. Alterations of the metabolism in the amygdala might be of interest for understanding the pathophysiology of BPD. However, the amygdala is a difficult region from which to acquire magnetic resonance spectra. We implemented a method for proton magnetic resonance spectroscopy ((1)H MRS) at 3.0 T in which we acquire data within only the small amygdala. The purpose of this study was to determine alterations of the metabolism in the amygdala in BPD patients. METHODS: Twenty-one unmedicated BPD patients and 20 age-matched healthy control participants underwent (1)H MRS to determine neurometabolite concentrations in the left amygdala. All participants underwent psychometric assessments. RESULTS: Significantly reduced total N-acetylaspartate (tNAA) and total creatine (tCr) concentrations in the left amygdala of patients with BPD were found. BPD patients with comorbid posttraumatic stress disorder (PTSD) showed lower levels of tCr compared with BPD patients without PTSD and healthy control subjects. No significant correlations between neurochemical concentrations and psychometric measures were found. CONCLUSIONS: Decreased tNAA and tCr might indicate disturbed affect regulation and emotional information processing in the amygdala of BPD patients. These findings are consistent with many functional and structural neuroimaging studies and may help to explain the greater emotional reactivity of BPD patients.

PMID: 19931853 [PubMed - as supplied by publisher]

[Read more →]

The influence of temperament on symptoms and functional outcome in people with psychosis in the Northern Finland 1966 Birth Cohort.

Eur Psychiatry. 2009 Nov 20;

Authors: Poustka L, Murray GK, Jääskeläinen E, Veijola J, Jones P, Isohanni M, Miettunen J

OBJECTIVE: To describe symptom expression and functional outcome in psychotic disorders in relation with temperament traits assessed with the Temperament and Character Inventory (TCI) in a population-based sample. METHOD: As part of the 31-year follow-up survey of the Northern Finland 1966 Birth Cohort, TCI temperament items were filled in by 4349 members of the cohort. In individuals with psychotic disorders, also positive and negative symptoms and outcome variables were assessed in a 35-year follow-up. Information of TCI and outcomes were available for altogether 41 individuals with psychosis. RESULT: Reward dependence (RD) (rho=-0.45) and Persistence (P) (rho=-0.52) were significantly correlated with Positive and Negative Syndrome Scale (PANSS) negative symptoms. Higher P scores predicted higher social and occupational functioning (as measured by Social and Occupational Functioning Assessment Scale [SOFAS]), and higher Harm avoidance (HA) predicted a higher likelihood of being on a disability pension. CONCLUSION: Results indicate that understanding of personality dimensions support better understanding of outcome and symptom expressions in psychotic disorders.

PMID: 19932601 [PubMed - as supplied by publisher]

[Read more →]

Prediction of institutionalization in the elderly. A systematic review.

Age Ageing. 2009 Nov 23;

Authors: Luppa M, Luck T, Weyerer S, König HH, Brähler E, Riedel-Heller SG

OBJECTIVE: in the past decades, many studies have examined predictors of nursing home placement (NHP) in the elderly. This study provides a systematic review of predictors of NHP in the general population of developed countries. DESIGN: relevant articles were identified by searching the databases MEDLINE, Web of Science, Cochrane Library and PSYNDEXplus. Studies based on population-based samples with prospective study design and identification of predictors by multivariate analyses were included. Quality of studies and evidence of predictors were determined. RESULTS: thirty-six studies were identified; one-third of the studies were of high quality. Predictors with strong evidence were increased age, low self-rated health status, functional and cognitive impairment, dementia, prior NHP and a high number of prescriptions. Predictors with inconsistent results were male gender, low education status, low income, stroke, hypertension, incontinence, depression and prior hospital use. CONCLUSIONS: findings suggested that predictors of NHP are mainly based on underlying cognitive and/or functional impairment, and associated lack of support and assistance in daily living. However, the methodical quality of studies needs improvement. More theoretical embedding of risk models of NHP would help to establish more clarity in complex relationships in using nursing homes.

PMID: 19934075 [PubMed - as supplied by publisher]

[Read more →]

Trait anxiety in children and adolescents with anorexia nervosa.

Eat Weight Disord. 2009 Jun-Sep;14(2-3):e163-8

Authors: Schulze UM, Calame S, Keller F, Mehler-Wex C

In this study of trait anxiety in children and adolescents with anorexia nervosa, a consecutive series of 23 newly admitted children and adolescents with anorexia nervosa was studied by use of the State-Trait-Anxiety-Inventory, the Eating Disorders Inventory (EDI), the Social Phobia and Anxiety Inventory for Children (SPAI-C), and a structured psychiatric interview (DIPS: Diagnostisches Interview bei psychischen Störungen). In addition, clinical diagnoses were taken from the files. Trait anxiety was significantly increased at the time of admission and social phobia was present in a large proportion of the patients. Specific eating disorder psychopathology as measured by the EDI was significantly associated with trait anxiety. There were no clinical diagnoses (according to the International Classification of Diseases - Tenth Revision) of anxiety disorders. Features of anxiety are very common in young patients with anorexia nervosa and closely linked to specific psychopathology. Anxiety disorders need careful evaluation in these patients.

PMID: 19934633 [PubMed - in process]

[Read more →]

Inside and outside: autumn reflections.

J Psychiatr Pract. 2009 Nov;15(6):467-9

Authors: Clemens NA

The concepts of “inner” and “outer” interact with each other in myriad ways, both in the way we view mental life and in the practice of psychotherapy, within a therapeutic frame and in relation to the larger environment. This dichotomy pervades the relationship between the therapist and the patient, and the boundary between the therapy and the outside world. Through personal impressions, the author reflects on the dynamically shifting emotional and mental life of the therapist in his or her own life cycle and in today’s world. (Journal of Psychiatric Practice 2009;15:467-469).

PMID: 19934722 [PubMed - in process]

[Read more →]

Olanzapine for the treatment of acquired neurogenic stuttering.

J Psychiatr Pract. 2009 Nov;15(6):484-8

Authors: Catalano G, Robben DL, Catalano MC, Kahn DA

Stuttering is a vocal phenomenon, which manifests itself as disturbances in speech fluency. While stuttering is most commonly treated with speech therapy and psychotherapy, a number of antipsychotic agents have been investigated as possible treatments. We present the case of a 37-year-old man who developed a post-concussive syndrome with psychosis and associated stuttering after his second exposure to a blast from an improvised explosive device (IED). After treatment with olanzapine, both his psychosis and his stuttering showed significant improvement. We also discuss stuttering and review previous studies that have investigated antipsychotic use in stuttering. (Journal of Psychiatric Practice 2009;15:484-488).

PMID: 19934725 [PubMed - in process]

[Read more →]

Social Anxiety Disorder: Epidemiology, Biology and Treatment.

Psychiatr Danub. 2009 Dec;21(4):533-542

Authors: Fink M, Akimova E, Spindelegger C, Hahn A, Lanzenberger R, Kasper S

Social anxiety disorder (SAD) is considered to be one of the most common anxiety disorders. Despite its high prevalence, the disorder is still considerably underdiagnosed and undertreated. SAD shows a typically early onset in childhood or early adolescence and generally becomes chronic. The disease places a massive burden on patients lives, affecting not only their social interactions but also their educational and professional activities, thereby constituting a severe disability. Although substantial progress in the study of the etiology of SAD has been made, no commonly accepted model has emerged yet. Data from genetic and neuroimaging studies point towards a contribution of several neurotransmitter systems (i.e. norepinephrine, dopamine and serotonin) to the pathophysiology of this disorder. Functional magnetic resonance imaging studies have repeatedly emphasized the central role of the amygdalae and insula in the neural circuitry of the disorder. Selective serotonin reuptake inhibitors (SSRI) are commonly accepted as first line therapy, however other substance classes like serotonin norepineprine reuptake inhibitors (SNRI), monoamine oxidase inhibitors (MAOI), benzodiazepines and several other agents have also proved effective. There is still a substantial lack of data on therapeutic options in cases of non-responsive SAD as well as on add-on therapy. A combined treatment-approach including psychotherapy (e.g. cognitive behavioural therapy) may prove useful.

PMID: 19935490 [PubMed - as supplied by publisher]

[Read more →]