Biological Conceptualizations of Mental Disorders Among Affected Individuals: A Review of Correlates and Consequences

Psychopathology is increasingly conceptualized as a biological phenomenon. The consequences of this conceptual shift for the general public's beliefs and attitudes regarding mental illness have been the subject of considerable study, but effects among individuals who suffer from mental disorders have received less attention. This review considers recent observational and experimental studies of the beliefs, attitudes, and behaviors associated with biological conceptions of psychopathology among affected individuals. Included in the review is research that has examined the implications of such conceptualizations for prognostic beliefs, internalization of stigmatizing attitudes, treatment usage and other behaviors and intentions, and perspectives on the use of biomedical technologies in mental health. Potential conclusions, limitations of the existing literature, and considerations for future studies are discussed.     

Neurocognitive impairment in middle-aged and older adults with bipolar disorder: comparison to schizophrenia and normal comparison subjects

BACKGROUND: The frequency, pattern, and correlates of neurocognitive impairment in older patients with bipolar disorder have received little study. We examined neurocognitive abilities in middle-aged and older adults with bipolar disorder to groups with schizophrenia or normal subjects, as well as the relation of neurocognition to clinical characteristics. METHOD: We administered a battery of neurocognitive and clinical measures to older (45-85 years) outpatients with bipolar disorder (n=67), schizophrenia (n=150), and normal comparison subjects (n=85). Within the bipolar group, we assessed the association between neurocognitive performance and psychiatric symptoms, quality of life, and medication status. RESULTS: The group with bipolar disorder differed on nearly all neuropsychological tests compared to normal subjects, with medium effect sizes. Bipolar patients as impaired as those with schizophrenia on half of the tests administered, and performed better on the remaining tests, with small effect sizes. Neurocognitive deficits in bipolar disorder group related to lower quality of life, but not to psychiatric symptom severity or duration of illness. LIMITATIONS: Samples were outpatients with mild-moderate symptoms, and findings may not generalize to acutely ill populations. We lacked data on illness history to examine the cumulative impact of psychopathology. CONCLUSIONS: Among clinically stable middle-aged and older outpatients, bipolar disorder was associated with substantial neurocognitive impairment, with a pattern that was somewhat distinct from that found in schizophrenia. Deficits in the bipolar group were not related to severity or duration of psychiatric symptoms, but were related to quality of life. Bipolar disorder often involve disabling and enduring cognitive impairments in older outpatients.     

Native associations of early hematopoietic stem cells and stromal cells isolated in bone marrow cell aggregates

In suspensions of murine bone marrow, many stromal cells are tightly entwined with hematopoietic cells. These cellular aggregations appear to exist normally within the marrow. Previous studies showed that lymphocytes and stem cells adhered to stromal cells via vascular cell adhesion molecule 1 (VCAM1). Injection of anti-VCAM1 antibody into mice disrupts the aggregates, showing the importance of VCAM1 in the adhesion between stromal cells and hematopoietic cells in vivo. Early hematopoietic stem cells were shown to be enriched in aggregates by using a limiting-dilution culture assay. Myeloid progenitors responsive to WEHI-3CM in combination with stem cell factor (c-kit ligand) and B220- B-cell progenitors responsive to insulin-like growth factor-1 in combination with interleukin-7 are not enriched. We propose a scheme of stromal cell-hematopoietic cell interactions based on the cell types selectively retained within the aggregates. The existence of these aggregates as native elements of bone marrow organization presents a novel means to study in vivo stem cell-stromal cell interaction.     

Bereavement: Course,Consequences, and Care

This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.     

Coercive and disruptive behaviors in pediatric obsessive–compulsive disorder

Background: This study explored the nature of disruptive and coercive behaviors in pediatric obsessive–compulsive disorder (OCD). Method: Thirty children with OCD and a disruptive behavior disorder (DBD) were compared to 30 children with DBD alone using the Child Behavior Checklist and a novel 18‐item questionnaire focused on distinctive coercive and disruptive behaviors seen in pediatric OCD (CD‐POC). Results: Although youth with DBD alone had higher ratings of Externalizing Behaviors on the CBCL compared to the youth with OCD + DBD, their ratings on the CB‐POC scale were lower. For example, 83% of OCD + DBD parents reported that their child “Imposes rules or behaviors on others due to tactile or other sensitivity and reacts to disobedience with rage or violence (e.g. forbids certain sounds, demands specific temperature settings)” compared to 23% of the parents of youth with DBD alone. Other highly discriminating behaviors included: “Demands special ‘cuddling’ or ritualized contact without regard for the will of others” and “Forbids the use of objects in his/her vicinity because of feelings of fear or disgust (e.g. knives, scissors, creams).” Total scores on the CD‐POC were also correlated with OCD severity (P<.01). Conclusion: The results suggest that the nature of DBD in pediatric OCD may be distinctive and worthy of further study. Depression and Anxiety, 2011.© 2011 Wiley‐Liss, Inc.