The Germinal Cell of Freud’s Psychoanalytic Psychology and Therapy

Objective: The effects of televised trauma on the emotional well-being of television viewers has received some scientific attention in recent years, suggesting that the general public is placed at risk of developing distress and possibly posttraumatic psychopathology as a result of secondary exposure via mass media. At the break of a recent war in Gaza, we assessed the psychological effects of the extensive news broadcasting. Method: An omnibus survey was performed two weeks into Operation Protective Edge with a sample of 500 participants representing the adult (> 18) Jewish population of Israel. Results: The results suggest that a vast majority (87.2%) of the population tuned in to the newscasts and the majority (76.7%) of viewers increased their news consumption compared to normal. Increased frequency of viewing newscasts was associated with reported anxiety reflected in uncontrolled fear, physiological hyperarousal, sleeping difficulties, and fearful thoughts. A regression model revealed that viewers watching the constant newscasts more than usual are 1.6 times more likely to report at least one anxiety symptom compared to those watching at the same frequency or less, standardized to gender and age. Conclusions: Increased viewing patterns of televised traumatic content, as well as negative perception of such broadcasts, are associated with the report of anxiety symptoms or psychopathology. The public health implications of the findings are discussed.     

The Social Dynamics of the Physician’s Status†

The delusional belief that a close relative has been replaced by a look-alike impostor was named the Capgras delusion in honor of Joseph Capgras, who described the first case. Capgras's original patient, Mme M., had a complex mental illness with various symptoms in addition to the delusion of substitution. The focus in the literature has always been on her eponymous delusion, ignoring the rest of her condition. However, studying the substitution delusion in isolation from the rest of her illness has led to inadequate conclusions. It is necessary to understand the delusion within the broad context of her illness. Toward that goal, her mental illness is described here in detail. A particular pattern of delusions and illness is identified. This same pattern is noted in other cases of Capgras in the literature. Three new cases are reported here, each with the same overall pattern of illness that Mme M. had. This pattern is labeled the Syndrome of Capgras. A hypothesis is offered to explain the Capgras delusion within the context of this illness.     

The Recovery Process Utilizing Erikson’s Stages of Human Development

Of current interest to the field are clinical frameworks that foster recovery. The authors offer a psycho-developmental model that parallels Erik Erikson’s theory of human development, and theorize that the process of psychiatric recovery involves a psychic reworking of these fundamental steps. Understanding recovery in this context allows the client and the practitioner of psychiatric rehabilitation to design and implement a coherent treatment strategy.     

A Systematic Review of Research into the Impact of Loose Parts Play on Children’s Cognitive,Social and Emotional Development

Loose parts play (LPP) interventions introduce moveable materials and equipment to children’s play spaces to facilitate unstructured, child-led play. Meta-analysis of previous school-based research has shown significant benefits of LPP for physical activity. In the current paper, we review the scope and quality of the quantitative evidence relating to cognitive, social and emotional outcomes. We conducted a systematic search of the literature on LPP interventions for primary school-aged children which used quantitative outcome indicators for cognitive, social and/or emotional development. Studies were screened for inclusion by two independent researchers and reviewed for content, relevant outcomes and quality indicators. Five studies met the review inclusion criteria. Two studies used a randomised controlled trial design, two studies used quasi-experimental design, and one used an observational design. Outcomes measured focused mainly on social development. With the exception of enjoyment, school satisfaction and self-esteem, emotional outcomes were almost entirely absent. No measures of cognitive or academic outcomes were found. For the studies using control groups, few differences between groups were reported, although one study found increased happiness at school and increased odds of reporting being pushed/shoved at playtime associated with intervention. Null results were found for peer acceptance, relational bullying, social competence, social skills, peer group size and psychosocial quality of life. In the non-controlled study, there were observed increases in co-operative play. There is insufficient high-quality, quantitative, empirical evidence available to determine whether or not LPP interventions have an impact on children’s cognitive, social and emotional development. We conclude our review with some recommendations which we hope will assist future research in this promising field.     

Direct and Indirect Effects of Maltreatment and Social Support on Children’s Social Competence Across Reporters

Children’s social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children’s social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n?=?783 caregiver-child dyads. CPS report history (age 0–8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity.     

The influence of cognitive reserve on cognition in Parkinson’s disease

There are considerable differences in cognition between individuals with Parkinson’s Disease (PD) which might be explained by the theory of cognitive reserve. This theory states that premorbid factors, such as high intellectual capacities, provide a buffer against cognitive impairments. This study determines whether cognitive reserve influences cognition in PD. Forty-eight PD patients were included. All were assessed with two proxies of cognitive reserve, tests of cognition and both measures of disease characteristic and symptoms of depression. After accounting for age, gender, disease characteristics and depression, cognitive reserve was an independent predictor of cognitive performance. In conclusion, cognitive reserve influences cognition in PD, i.e. PD patients with a high premorbid intellectual ability show fewer cognitive impairments than patients with a low premorbid ability. This indicates that cognitive reserve needs to be taken into account when monitoring the evolution of cognition in PD, however, verification of results on a larger patient sample would be desirable.     

The spectrum of Susac’s syndrome

We report a series of four patients with Susac’s syndrome, which is characterized by the triad of visual loss due to branch retinal artery occlusions, sensorineural hearing loss due to cochlear involvement, and encephalopathy due to cerebral microangiopathy. However, as we describe in this series, the clinical triad may not be apparent for years, resulting in delays in diagnosis. We also report the variable cerebrospinal fluid and brain magnetic resonance imaging findings, and treatment using a combination of steroids and intravenous immunoglobulin, followed by mycophenolate mofetil.     

The genetics of Alzheimer’s disease

Alzheimer’s disease (AD) is a genetically complex disorder. Mutations in the amyloid precursor protein and presenilin 1 (PS1) genes are fully penetrant and cause early-onset AD. Mutations in presenilin 2, a PS1 homologue, cause partially penetrant autosomal dominant AD with onset age beginning at 40 years and extending past 75 years. A fourth gene, apolipoprotein E (ApoE) is a riskfactor for late-onset AD. Over 40 genes have been tested as AD candidate genes, yet none has been clearly established as an AD risk factor. Linkage studies have implicated a number of chromosome regions as possible sites for late-onset AD loci with the strongest evidence being for chromosome 12. Candidate genes in this regioninclude α2-macroglobulin (A2M) and low-density lipoprotein receptor-related gene (LRP), although neither has been clearly established as an AD gene. Identification of additional late-onset genes will require larger samples, more sophisticated analysis methods, and large-scale positional cloning efforts.     

The effect of maternal migraine headache on their children’s quality of life

Migraine is an episodic disease characterized by a throbbing and generally unilateral headache, often accompanied by nausea, vomiting and light and sound sensitivity. Migraine is known to affect one’s quality of life; not only the person with migraine but also his/her family and social environment are affected by this condition. Our study aimed to evaluate the effects of maternal migraine on children’s quality of life. The patient group comprised 70 mothers with migraine diagnoses and their 111 healthy children, while 50 healthy mothers and their 86 children were included in this study as the control group. The Visual Analog Scale (VAS), Migraine Disability Assessment Scale, Beck Depression Index (BDI) and Beck Anxiety Index (BAI) were used for evaluation of mothers; 3 to 7-year old KINDL and 7- to 17-year-old KINDL-R Quality of Life Scales were used to evaluate the quality of life of children. The SPSS 21.0 program was used for statistical analysis and p < 0.05 was assumed to be statistically significant. The mean age of the migraine group was 37.09 ± 6.94 years, and the mean age of the control group was 38.2 ± 4.5. Symptoms of depression and anxiety were more frequently found in subjects with migraine (p < 0.05). In comparison with the control group: 3 to 7-year old KINDL total scores, self-esteem and school subscales, 7- to 17-year-old KINDL total scores, self-esteem and the social relationships subscale scores were lower in migraine group. It was found to be significant that VAS, BDI and BAI scores of the mothers were negatively correlated with the children’s quality of life. Our study concluded that the presence of migraine-type headache in mothers worsen the relations in school, self-esteem and quality of life in younger children and social relations, relations in school and quality of life in older children. The maternal age, disease severity, and anxiety and depression symptoms were shown to predict the quality of life in children. Performing preventive interventions by individually assessing bio-psycho-social elements for the treatment of mothers with migraine will preserve other family member’s and especially children’s quality of life.     

The effect of Parkinson’s disease subgroups on verbal and nonverbal fluency

Background. Parkinson’s disease (PD) leads to deficits in executive function, including verbal and nonverbal fluency, as a result of compromised frontostriatal circuits. It is unknown whether deficits in verbal and nonverbal fluency in PD are driven by certain subgroups of patients, or how strategy use may facilitate performance. Participants. Sixty-five nondemented individuals with PD, including 36 with right-body onset (RPD; 20 with tremor as their initial symptom, 16 nontremor) and 29 with left-body onset (LPD; 14 with tremor as their initial symptom, 15 nontremor), and 52 normal control participants (NC) took part in the study. Measurements. Verbal fluency was assessed using the FAS and Animals tests. Nonverbal fluency was assessed using the Ruff Figural Fluency Test. Results. Both RPD and LPD were impaired in generating words and in using clustering and switching strategies on phonemic verbal fluency, whereas different patterns of impairment were found on nonverbal fluency depending on the interaction of side of onset and initial motor symptom (tremor vs. nontremor). Strategy use correlated with number of correct responses on verbal fluency in LPD, RPD, and NC. By contrast, on nonverbal fluency, strategy use correlated with correct responses for RPD and LPD, but not for NC. Conclusion. Our findings demonstrate the importance of considering subgroups in PD and analyzing subcomponents of verbal and nonverbal fluency (correct responses, errors, and strategies), which may depend differently on the integrity of dorsolateral prefrontal cortex, inferior frontal cortex, and anterior cingulate cortex.     

The surgeon general’s national action agenda on children’s mental health

The Surgeon General’s National Action Agenda highlighted key issues that challenge the public health system in appropriately meeting the mental health needs of children and their families. Among these issues included the need for screening and early identification, improving access to appropriate mental health care, strengthening the infrastructure, and expanding training for providers. Two key gate-keeping systems identified as critical in this reform of mental health care for children and their families are education and primary care. This paper focuses on these two systems to illustrate problems related to these issues. Central to the Surgeon General’s call for reform is also the pressing public health responsibility to improve and use the science base by strengthening the connection between what we know from the scientific evidence base and what we do in practice. The implications of this reform for specialty mental health are discussed.     

Development of Parkinson’s disease in patients with Narcolepsy

Although amphetamine drugs can damage dopaminergic axons, it is unknown whether chronic treatment with amphetamine increases the risk of developing Parkinson's disease (PD). Of 1,152 consecutive PD patients, 3 had a prior diagnosis of narcolepsy. This rate is five times higher than expected (p = 0.02). These patients had typical onset of narcolepsy and underwent treatment with amphetamine. Although preliminary, this observation raises the possibility that some factors intrinsic to narcolepsy or its treatment may be a risk factor for PD.     

The impact of deep brain stimulation on the nonmotor symptoms of Parkinson’s disease

Deep brain stimulation (DBS) is a well-established therapy for patients with advanced Parkinson’s disease (PD) with clear benefits on many of the motor symptoms. The effects of DBS on the nonmotor symptoms are less well examined. Emergence of tools to measure the nonmotor burden in PD is now allowing a more objective assessment of impact of DBS on such symptoms. Here we review the pertinent evidence and conclude that, as a therapy, DBS has a major potential to contribute towards the holistic care of PD patients.     

The cerebellar component of Friedreich’s ataxia

Lack of frataxin in Friedreich’s ataxia (FRDA) causes a complex neurological and pathological phenotype. Progressive atrophy of the dentate nucleus (DN) is a major intrinsic central nervous system lesion. Antibodies to neuron-specific enolase (NSE), calbindin, glutamic acid decarboxylase (GAD), and vesicular glutamate transporters 1 and 2 (VGluT1, VGluT2) allowed insight into the disturbed synaptic circuitry of the DN. The available case material included autopsy specimens of 24 patients with genetically defined FRDA and 14 normal controls. In FRDA, the cerebellar cortex revealed intact Purkinje cell somata and dendrites as assessed by calbindin immunoreactivity. The DN, however, displayed severe loss of large NSE-reactive neurons. Small neurons remained intact. Labeling of Purkinje cells, basket fibers, Golgi neurons, and Golgi axonal plexuses with antibodies to GAD indicated normal intrinsic circuitry of the cerebellar cortex involving γ-aminobutyric acid (GABA). In contrast, the DN displayed severe loss of GABA-ergic terminals and formation of GAD- and calbindin-reactive grumose degeneration. The surviving small GAD-positive DN neurons provided normal GABA-ergic terminals to intact inferior olivary nuclei. The olives also received normal glutamatergic terminals as shown by VGluT2-reactivity. VGluT1-immunocytochemistry of the cerebellar cortex confirmed normal glutamatergic input to the molecular layer by parallel fibers and the granular layer by mossy fibers. VGluT2-immunoreactivity visualized normal climbing fibers and mossy fiber terminals. The DN, however, showed depletion of VGluT1- and VGluT2-reactive terminals arising from climbing and mossy fiber collaterals. The main functional deficit underlying cerebellar ataxia in FRDA is defective processing of inhibitory and excitatory impulses that converge on the large neurons of the DN. The reason for the selective vulnerability of these nerve cells remains elusive.