Lexical semantic memory and confrontation naming in aphasic patients

Abstract

The present study examined (1) the relation between semantic processing and confrontation naming abilities in aphasic patients, and (2) the possibility of the existence of separate semantic organizations for different stimulus modes. Semantic processing ability of the patients was investigated using similarity judgements of body parts represented by line drawings and kanji. One hundred line drawings were used for assessing confrontation naming ability. Both semantic processing and confrontation naming were studied on a single subject basis. The results showed that semantic processing and naming abilities were dissociated, indicating that these processes can be independently impaired. The underlying mechanism for the dissociation was discussed. Some patients showed better semantic judgment in the line drawings than in kanji but the reverse pattern was not observed. We interpreted this differential performance not as evidence supporting the existence of separate semantic organizations for line drawing and kanji but as an indication of the relative complexity of kanji processing.     

Poor self-awareness of levodopa-induced dyskinesias in Parkinson's disease: Clinical features and mechanisms

ObjectivesTo study the factors and possible mechanisms associated with decreased self-awareness of levodopa-induced dyskinesias (LIDs) in patients with Parkinson's disease (PD).MethodsWe enrolled 30 PD patients with LIDs. Patients were video-recorded in an “on” phase while experiencing LIDs. LIDs were objectively rated by means of the Unified Dyskinesias Rating Scale (UDyRS) by two movement disorders specialists while examining the patients. Patients were asked to rate the body site and the severity of their LIDs according to the 5-point UDyRS. Patients then rated their own LIDs while watching the video recording of themselves. Lastly, the patients rated the LIDs of other reference PD patients on a video recording. The same reference video recordings were shown to 15 healthy individuals matched for age, gender and education.ResultsSeven of the 30 PD patients investigated were subjectively unaware of the presence of their LIDs. The majority of patients, however, recognized their LIDs when watching video recording of themselves. Patients displayed a specific poor self-awareness of trunk LIDs, in both the subjective evaluation and in the video recording-based subjective evaluation. By contrast PD patients correctly recognized LIDs in video recordings of reference PD patients. Poor self-awareness correlated with predominance of motor symptoms on the left body side.ConclusionsPoor self-awareness of LIDs is present in a proportion of PD patients as a form of anosognosia. The poor self-awareness of LIDs in the trunk is likely to be due to a complex interplay involving both anosognosic mechanisms and deficits in proprioceptive axial kinesthesia.     

Body Image Changes in Adolescents II Comparison among Patients with Eating Disorders and Controls with Thin, Normal and Obese Body Shapes

Abstract: The Self-Rating Body Image (SRBI) test was used to determine whether the patients with eating disorders such as anorexia nervosa or bulimia showed their body image disturbance or not. The SRBI was completed by 120 subjects who consisted of 30 low weight (LW) controls, 30 normal weight (NW) controls, 30 high weight (HW) controls, 18 anorexic patients (AN) and 12 bulimic patients (BN). The AN group had a significantly greater dissatisfaction with the scales of the body shape, visceral organ and face image of the SRBI than the weight-matched LW group. The BN group had a significantly greater dissatisfaction with the visceral organ image than the weight-matched NW group. However, no significant difference in the body shape and face images between the BN and NW groups was found. Our results suggest that the anorexic patients may disturb more parts of the body image than the bulimic patients though both the anorexic and bulimic patients showed the disturbance of body image.     

Assessment of the distorted video image of the body by schizophrenic patients

A method is described using a modified video-image with a continuous image distortion of +/- 45%. By turning a potentiometer-dial the self-estimation of one's own body image can be adjusted. A sample of 108 schizophrenic patients assessed their own body-image as 12% too thin when compared with a matched control group of healthy volunteers (5.8%). This effect of estimating one's body proportions as too thin was shown to be exclusively caused by the female patients. In addition, the schizophrenic patients assessed their faces as significantly thinner than did the controls. The self-estimations made by different diagnostic subgroups of patients according to DSM III and those made on the second and tenth days after admission did not differ significantly. This remarkable tendency to estimate one's own image too thin in female schizophrenics is interpreted as an illusory approximation to an ideal image.     

Neural drive increases following resistance training in patients with multiple sclerosis

The present study tested the hypothesis that lower body progressive resistance training (PRT) increases the neural drive expressed as surface electromyographical (EMG) activity in patients with multiple sclerosis (MS). The study was a randomised controlled trial (RCT) including a 12-week follow up period. Thirty-eight MS patients were randomized to an exercise group (n = 19) or a control group (n = 19). During the intervention period, the exercise group performed a 12-week supervised lower body PRT program, whereas the control group maintained their usual daily activity level. After the 12 week intervention period, the exercise group were encouraged to continue training on their own for a 12-week follow up period, while the control group completed the 12-week supervised PRT program. Surface EMG was recorded from vastus lateralis, rectus femoris and semitendinosus during maximal isometric knee extension and knee flexion, before and after the intervention and at follow up. From the recordings, the area under the rectified, low-pass filtered EMG signal (integrated EMG, iEMG) was calculated. Muscle strength was expressed as the angular impulse (AI) and was measured during the same period as the iEMG. After PRT significant improvements for iEMG of vastus lateralis and rectus femoris during maximal knee extension and for semitendinosus during maximal knee flexion and for AI during both maximal knee extension and flexion were found in the exercise group, when compared to the control group. When compared to the post values, all effects, except for AI during knee flexion, were maintained at follow up in the exercise group. When the control group was exposed to PRT, a similar pattern of improvements were found, albeit not all improvements were significant. In conclusion twelve weeks of intense PRT of the lower extremities improved the neural drive expressed as maximal surface EMG activity in patients with MS, with effects persisting 12 weeks after the intervention. The study was registered at clinicalTrials.gov, Protocol no. NCT00381576.     

Topiramate as an adjuvant treatment with atypical antipsychotics in schizophrenic patients experiencing weight gain

Schizophrenic patients commonly suffer weight gain, which is often associated with widely prescribed antipsychotic medicines. It is distressing to most patients who experience it and may affect their response to treatment of schizophrenia. Weight gain is also associated with treatment noncompliance and several medical conditions. This study explored the efficacy and tolerability of topiramate as an adjuvant treatment of patients with schizophrenia who were carrying excess weight. In this 12-week, randomized, placebo-controlled prospective study, 66 hospitalized patients with schizophrenia who were carrying excess weight were given topiramate at doses of 100 mg/day or 200 mg/day, or a placebo. The primary measures made were body weight, body mass index, waist measurement, hip measurement, and waist-to-hip ratio. Safety measures included physical examinations and the monitoring of adverse effects, clinical laboratory data, and vital signs. The Clinical Global Impression-Severity of Illness scale (CGI-S) and the Brief Psychiatric Rating Scale (BPRS) were used to quantify changes in schizophrenic symptoms and signs. In the 200-mg/day topiramate group, body weight, body mass index, waist measurement, and hip measurement decreased significantly compared with the 100-mg/day topiramate and placebo groups over 12 weeks. However, the waist-to-hip ratio did not change in any group. Scores on the CGI-S and BPRS decreased significantly over the 12-week period in both topiramate groups, but the decrease was not clinically meaningful. These results suggest that a higher dose of topiramate is efficacious as an adjuvant treatment of patients with schizophrenia experiencing excess weight gain. Further clinical research is required to establish guidelines for the use of topiramate as an antiobesity agent in schizophrenic patients.     

Quantitative study of spontaneous eye blinks and eye tics in Gilles de la Tourette's syndrome

Spontaneous eye blink rate and frequency of eye tics were studied in nine Tourette patients during periods of rest, conversation, and video watching. In comparison with controls, the Tourette patients showed a significantly higher blink rate during rest and video watching. Conversation induced a significant increase in blink rate in the control group, but not in the Tourette patients, whereas video watching significantly increased blink rate in both groups. The frequency of eye tics showed a significant decrease during conversation and increased significantly during video watching in Tourette patients. In five patients, a significant positive correlation between blink rate and eye tic frequency was found, whereas one patient showed a significant negative correlation. Our results show that, even though some of our patients were on neuroleptic treatment, blink rate was about twofold to threefold increased versus healthy controls, suggesting increased central dopaminergic activity. Furthermore, these first quantitative data illustrate task specific effects on eye tic frequency and the complexity of their relation with eye blinks.     

The Relationship Between Type of Naming Error and Semantic-Lexical Discrimination in aphasic Patients

When submitted to confrontation naming tasks, aphasic patients show different types of naming errors: phonetic, phonemic and verbal-semantic paraphasias, neologisms and anomia, but it is generally difficult to decide whether these errors are mainly due to a breakdown of the semantic systems or to post-lexical phonological disorders. In order to clarify this issue, 118 aphasic patients were given 3 tests of confrontation naming and 3 tests of semantic-lexical discrimination. Naming errors on confrontation were used to classify aphasic patients in various subgroups (according to the prevalence of a given type of naming error), whereas performances obtained on tests of semantic-lexical discrimination were taken as an index of disorganization of the semantic systems. The performances on semantic discrimination tests of patients showing a prevalence of phonetic, phonemic and verbalsemantic paraphasias, neologisms and anomia on confrontation naming tasks were compared. a very small number of semantic discrimination errors was obtained by patients showing a prevalence of phonetic or phonemic transformations on confrontation, whereas a much larger number of semantic discrimination errors was obtained by patients showing a prevalence of verbal-semantic paraphasias, neologisms and anomia.     

Treatment of infantile spasms with methysergide and alpha-methylparatyrosine

Twenty-four newly diagnosed and previously untreated infantile spasm patients were treated for 3 weeks with either methysergide (12 patients) or alpha-methylparatyrosine (12 patients). Response to therapy was determined objectively with 24-h polygraphic/video monitoring techniques and was defined as cessation of spasms and disappearance of the hypsarrhythmic EEG pattern. Two (17%) of the patients treated with alpha-methylparatyrosine responded to therapy, and one (8%) of the methysergide-treated group showed a response.     

Degree of life-threat and differential use of coping modes

This investigation sought to determine whether medical patients facing life-threatening illnesses (i.e. cancer, myocardial infarction) differed in their coping responses from medical patients facing nonlife-threatening illnesses (e.g. arthritis, dermatitis). Subjects' coping responses were measured by a Medical Coping Modes Questionnaire which was developed to measure three forms of coping: confrontation, avoidance, and acceptance-resignation. The scales were based on a 32-item questionnaire and were derived by a combination of rational and factor analytic procedures. Construct validity data gathered from patients, physicians, and significant others verified the nature of the scales. Results indicated that life-threatened patients used confrontation significantly more than did nonlife-threatened patients in dealing with their illness. Acceptance-resignation was used least of all by each of the groups. Findings appear to support those theorists who conceptualize coping behavior in dealing with life-threat as being shaped more by situational context than by personal style.     

Effect of olanzapine on body composition and energy expenditure in adults with first-episode psychosis

OBJECTIVE: Weight gain is a commonly observed adverse effect of atypical antipsychotic medications, but associated changes in energy balance and body composition are not well defined. The authors report here the effect of olanzapine on body weight, body composition, resting energy expenditure, and substrate oxidation as well as leptin, insulin, glucose, and lipid levels in a group of outpatient volunteers with first-episode psychosis. METHOD: Nine adults (six men and three women) experiencing their first psychotic episode who had no previous history of antipsychotic drug therapy began a regimen of olanzapine and were studied within 7 weeks and approximately 12 weeks after olanzapine initiation. RESULTS: After approximately 12 weeks of olanzapine therapy, the median increase in body weight was 4.7 kg, a significant increase of 7.3% from first observation. Body fat, measured by dual-energy x-ray absorptiometry, increased significantly, with a propensity for central fat deposition. Lean body mass and bone mineral content did not change. Resting energy expenditure, measured by indirect calorimetry, did not change. Respiratory quotient significantly increased 0.12 with olanzapine and was greatest in those who gained >5% of their initial weight. Fasting insulin, C-peptide, and triglyceride levels significantly increased, but there were no changes in glucose levels; total, high density lipoprotein, or low density lipoprotein cholesterol levels; or leptin levels. CONCLUSIONS: Olanzapine appears to have induced an increase in central body fat deposition, insulin, and triglyceride levels, suggesting the possible development of insulin resistance. The decrease in fat oxidation may be secondary or predispose patients to olanzapine-induced weight gain.     

The impact of an implicit manipulation of self-esteem on body dissatisfaction

Background and objectivesGiven the theoretically postulated causal pathway from low self-esteem on body dissatisfaction, the aim of the present study was to experimentally test this linkage before and after a mirror exposure in body dissatisfied females.MethodThirty-six women with high body dissatisfaction (HBD) and 39 women with low body dissatisfaction (LBD) received either a positive or a negative implicit manipulation of self-esteem and participants’ actual body dissatisfaction and negative emotions were assessed (T1). Following that, they underwent a one minute mirror exposure and actual body dissatisfaction and emotions were assessed once more (T2).ResultsIn the HBD group no effects of the self-esteem manipulation were found prior to the mirror exposure. However, the negative manipulation of self-esteem led to a significant increase of body dissatisfaction over the course of the mirror exposure. The positive manipulation of self-esteem did not decrease body dissatisfaction over the course of the mirror exposure. No effects of self-esteem on body dissatisfaction were found in the LBD group.LimitationsFormal eating disorder diagnosis in study participants was not established. Therefore, the extension of the results to an eating disordered population is recommended.ConclusionsThe results yield evidence of a close linkage between negative self-esteem and body dissatisfaction in individuals high on body dissatisfaction. Consistent with cognitive theories, this link is only apparent when shape and weight schemas are activated, e.g. by the confrontation with one’s own body.     

Metformin addition attenuates olanzapine-induced weight gain in drug-naive first-episode schizophrenia patients: a double-blind, placebo-controlled study

OBJECTIVE: The purpose of this study was to assess the efficacy of metformin in preventing olanzapine-induced weight gain. METHOD: Forty patients with schizophrenia were randomly assigned to treatment for 12 weeks with olanzapine, 15 mg/day, plus metformin, 750 mg/day (N=20), or olanzapine, 15 mg/day, plus placebo (N=20). This investigation was conducted in a double-blind fashion. Planned assessments included body weight, body mass index, proportion of patients who gained more than 7% of their baseline weight at the end of the 12-week treatment, waist circumference, waist-to-hip ratio, fasting glucose and insulin, insulin resistance index, and scores on the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). RESULTS: Of the 40 patients who were randomly assigned, 37 (92.5%) completed treatments. The weight, body mass index, waist circumference, and waist-to-hip ratio levels increased less in the olanzapine plus metformin group relative to the olanzapine plus placebo group during the 12-week follow-up period. The insulin and insulin resistance index values of the olanzapine plus placebo group increased significantly at weeks 8 and 12. In contrast, the insulin and insulin resistance index levels of the olanzapine plus metformin group remained unchanged. Significantly fewer patients in the olanzapine plus metformin group relative to patients in the olanzapine plus placebo group increased their baseline weight by more than 7%, which was the cutoff for clinically meaningful weight gain. There was a significant decrease in SAPS and SANS scores within each group from baseline to week 12, with no between-group differences. Metformin was tolerated well by all patients. CONCLUSIONS: Metformin was effective and safe in attenuating olanzapine-induced weight gain and insulin resistance in drug-naive first-episode schizophrenia patients. Patients displayed good adherence to this type of preventive intervention.     

Impact of confrontations by therapists on impairment and utilization of the therapeutic alliance

Objective: Striking the balance between creating challenge through confrontation (drawing attention to discrepancies) to encourage change and offering support through the therapeutic relationship to ensure safety for patients represents a central issue for psychotherapists. The aim of the present study was to assess immediate effects of confrontations by therapists on the therapeutic alliance. Method: We rated video recordings of 77 therapies to measure incidences of alliance ruptures/resolution attempts as well as confrontations by therapists. Change in the therapeutic alliance and therapy outcome were measured through questionnaires filled out by patients. Results: Confrontations were significantly associated with ruptures/resolution attempts on the micro level. Changes in the therapeutic alliance moderated the association between confrontations and alliance ruptures on the macro level: The bigger the fraction of a session containing confrontations, the larger the fraction containing ruptures, given a prior positive change in the therapeutic alliance. Therapists’ use of confrontation during a resolution attempt was associated with significantly better therapy outcomes than no use of confrontation during or no resolution attempt. Conclusions: Confrontations by therapists may temporarily impair the therapeutic alliance, but might also lead to better therapy outcomes when used to make an alliance rupture explicit as part of a resolution attempt.

Clinical or methodological significance: This study provides quantitative explorations of therapists’ fears and hopes regarding the use of confrontations (defined as focus on a discrepancy by the therapist). Results point to associations between confrontations and alliance ruptures, especially in the context of a secure alliance. Furthermore, resolution attempts might profit from initial confrontations regarding the relevant alliance rupture.     

Consistency, context and confidence in judgements of affective communication in adults with profound intellectual and multiple disabilities

Twenty‐four service providers rated 12 video samples of four service users with whom they were familiar for affective behaviour (i.e. ‘like’/‘dislike’) and confidence (i.e. ‘certain’/’uncertain’) in their judgement. Each video sample had been recorded as part of a stimulus preference assessment during which a wide range of specific stimuli were presented to each service user. Each video sample was presented twice in a counterbalanced design either with contextual information, i.e. what the presented stimulus was (C) or without such information, i.e. context free (CF). The observers showed considerable individual variation in their judgements, largely uninfluenced by the availability or otherwise of contextual information. However, as a group, observers significantly distinguished between video samples with regard to affective communication (determined through multiple analyses of variance) and the pattern of judgements, i.e. the relative judgement of positive or negative affect, from one sample to another. This showed a good level of consistency between observers (determined through principal components analysis). The impact of contextual information was not apparent for all video samples. However, contextual information significantly influenced judgements in four samples, typically making them more extreme; for example, a response indicative of positive affect in the CF situation became more positive when contextual information was provided, indicating that the stimulus was one that the participant was thought to like.     

Word-finding in the conversational discourse of children with closed head injury

Abstract

Despite the fact that dysnomia or word-finding difficulty is consistently documented as a characteristic feature of the language sequelae of childhood closed head injury (CHI), few studies have examined the effects of such wordfinding problems on language performance outside the constraints of a standard confrontation naming test. The present study examined evidence for word-finding difficulties in both confrontation naming and conversation in a group of 11 children (aged 9–17) who had experienced a severe CHI. Performance of the children with CHI was compared to that of a control group individually matched for age, gender and handedness. The children with CHI demonstrated inferior performance on the test of confrontation naming. In addition, the children with CHI were found to have a conversational error profile that was different from the control group. These findings are discussed with respect to the relationship between standard test performance and communicative competence in the conversational discourse setting.     

Corps, psychose et travail

The article studies the question of psychotic patients bodies invested in occupational work. This article shows how the work exigencies that change the body into tool are articulated with the difficulty of psychical structuring of their corporal schema for psychotic subjects. The effects of this confrontation can be salutary and/or pathogenic. These effects are illustrated by three clinical cases studied with a qualitative method (analysis of three clinical interviews).     

Effects of videorecorded interactions and counseling for teachers on their responses to preschoolers with intellectual impairments

Effects of an intervention and video interaction counseling with teachers of 78 children from school and centers were investigated. The study involved a quasi-experimental pretest-intervention-posttest control group design. In Condition 1 teachers received the counseling for 12 weeks, followed by withdrawal of this intervention for weeks. In Condition 2 the intervention was in reversed order. The students' competent behavior was assessed by rating their response to social support during engagement in a standardized task, their performance of standardized tasks of cognitive skills, and ratings of their social skills. Results revealed differences in favor of the participants in the two video interaction counseling research conditions on measures of social support and cognitive competence.     

Effectiveness of personalised reminiscence photo videos for individuals with dementia

Reminiscence intervention is effective for increasing self-esteem and decreasing behavioural disturbances in individuals with dementia. This paper introduces the concept of a “personalised reminiscence photo video” as a convenient method for reminiscence intervention. The video utilises a slideshow video of personal photos with narration, background music, and pan/zoom visual effects. A group of 15 individuals with dementia watched personalised reminiscence photo videos as well as two types of TV shows: a variety show and a news show. Eighty percent of the subjects (12 out of 15) showed more attention to their personalised reminiscence photo video than to the other two types of TV shows, thus suggesting the effectiveness of personalised reminiscence photo videos for reminiscence intervention.