Generalized Social Phobia and social judgments: the salience of self- and partner-information

Individuals with Generalized Social Phobia (GSP, N = 25) and community controls (N = 26) participated in a social interaction task. They then rated how well they had performed in the situation and assigned weights and valences to the different types of information they used to arrive at this judgment. The GSP group weighed anxiety-related self-information more heavily than did the Control group. In contrast, their conversational partners weighed verbal behavior more heavily. These findings are generally supportive of cognitive models of social phobia and point to the negative interpersonal implications of relying on different social information than others.     

Dementia Deficits Scale. Rating self-awareness of deficits

Impaired deficit awareness is important to detect because of its clinical implications; for example, patients with impaired awareness are more likely to engage in potentially dangerous activities, such as operating the stove. This study evaluated the reliability and validity of the Dementia Deficits Scale (DDS), a new multidimensional instrument for the assessment of self-awareness of cognitive, emotional, and functional deficits associated with dementia. Three parallel forms of the DDS were independently completed by the patient, clinician, and informant. The DDS yields two measures of deficit awareness: the discrepancy between clinician and patient assessments of the patient's deficits, and the discrepancy between informant and patient assessments. The DDS demonstrated adequate reliability and good divergent and convergent validity. Clinician and informant reports each added unique information, highlighting the importance of including both perspectives in the awareness assessment process. The DDS is recommended as a reliable and valid tool for the clinical and empirical assessment of deficit awareness in patients with dementia.     

Expression of a catalytically inactive transmembrane protein tyrosine phosphatase epsilon (tm-PTP epsilon) delays optic nerve myelination

Reversible tyrosine phosphorylation is integral to the process of oligodendrocyte differentiation. To interfere with the subset of the phosphorylation cycle overseen by protein tyrosine phosphatase epsilon (PTP epsilon) in oligodendrocytes, we applied a substrate-trapping approach in the development of transgenic mice overexpressing a catalytically inactive, transmembrane PTP epsilon-hemaglutinin (tm-PTP epsilon-HA) from the dual promoter element of the gene encoding the myelin protein 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP). Transgene expression peaked during the active myelinating period, at 2-3 weeks postnatal. Two tyrosine phosphoproteins, alpha-enolase and beta-actin, were phosphorylated to a greater degree in transgenic mice. Despite a high degree of tm-PTP epsilon-HA expression, myelin was grossly normal in nearly all axonal tracts. Phenotypic abnormalities were limited to optic nerve, where a decrease in the degree of myelination was reflected by reduced levels of myelin proteins on postnatal day 21 (PND21), as well as a decrease in the density of differentiated oligodendrocytes. The optic chiasm was reduced in thickness in transgenic mice; optic nerves similarly exhibited a reduction in transverse width. Further analyses of the optic pathway demonstrated that transgenic protein was unexpectedly present in retinal ganglion cells, whose axons are the targets of myelination by optic nerve oligodendrocytes. On PND28, transgenic protein declined dramatically in both oligodendrocytes and retinal ganglion cells contributing to the recovery of optic nerve myelination. Thus, delayed myelination arises only when tm-PTP epsilon-HA is simultaneously expressed in myelin-forming glia and their neuronal targets. While tm-PTP epsilon related signaling pathways may figure in axon-glial interactions, interfering with tm-PTP epsilon activity does not perceptibly affect the development or myelinating capacity of most oligodendrocytes.     

Reaching out to see: arm position can attenuate human visual loss

Electrophysiological recordings in monkeys have now revealed several brain regions that contain bimodal visuotactile neurons capable of responding to either tactile or visual stimuli placed on or near the hands, arms, and face. These cells have now been found in frontal, parietal, and subcortical areas of the monkey brain, suggesting a cortical network of neurons that preferentially represent near peripersonal space. The degree to which the visual responses of such cells rely on input from the primary visual cortex and the extent to which they may contribute to visual perception is not completely understood. Nonetheless, recent neuropsychological studies suggest that a similar representation of near space may be bimodally coded in humans as well. Given the accumulating evidence for specialized processing of visual stimuli placed near the hands and arms, we hypothesized that arm position may be capable of modulating human visual ability. Here we report the case of WM, who lost his ability to see in his left visual hemifield after sustaining damage to his right primary visual cortex. Interestingly, the placement of WM's left arm into his "blind" field resulted in significantly better detection of left visual field stimuli compared to when his hand was placed in his lap at midline. Moreover, we found this attenuation to be confined to stimuli presented within reaching distance (unless a tool that extended WM's reach was held while he performed the test). These findings are highly consistent with the characteristics of the bimodal visuo-tactile neurons that have been described in monkeys. Thus, it seems that arm position can modulate human visual ability, even after damage to the primary visual cortex. This study provides an exciting bridge between monkey neurophysiology and human visual capacity while also offering a novel approach for improving visual defects acquired via cortical injury.     

Religion and spirituality in child and adolescent psychiatry: a new frontier

This article introduces the interface between child and adolescent psychiatry and religion and spirituality. Developmental psychopathology has become increasingly diverse in its study of risk and protective factors for child and adolescent psychopathology. The effect of religion and spirituality on clinical conditions is among those factors. This review addresses (1) historical aspects of the relationship between psychiatry and religion/spirituality, (2) definitional issues, and (3) unique factors in child and adolescent work. Considering these factors and some general principles of intervention, it prepares the reader for other articles in this issue. The article concludes with some observations on the "secular family".     

Religious professionals and institutions: untapped resources for clinical care

In the vast majority of situations, religious professionals and institutions are competent, caring, and respectful of child and adolescent psychiatrists and mental health workers and welcome the opportunity to collaborate to meet the religious/spiritual, medical, physical, and emotional needs of children, adolescents, and families. Clinicians are well advised to familiarize themselves with the religious professionals, institutions, and resources in the geographic areas in which they practice.     

Use of psychotropic medications by youths with psychiatric diagnoses in the U.S. mental health system

This study estimated the overall rate of use of psychotropic medications among youths (less than 18 years of age) in the U.S. mental health service system and compared rates of use for youths with a single diagnosis and those with co-occurring diagnoses. Results were based on nationally representative client data from the 1997 Client/Patient Sample Survey. On any given day, about one-third (32.5 percent) of the 559,769 youths in the service system received psychotropic medication. Youths with co-occurring diagnoses were significantly more likely to receive medication than youths with a single diagnosis. Future research on best practices may be most effective if the role of medication in the treatment of single and co-occurring disorders among youths is evaluated.     

Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors

OBJECTIVE: To examine the relation between baseline measurements of thyroid function and response to selective serotonin reuptake inhibitors (SSRIs) and to consider the effect of these antidepressants on thyroid hormone levels. METHODS: Nineteen subjects with major depression, but without a history of thyroid treatment or lithium treatment, were treated openly with either sertraline or fluoxetine in a university- affiliated tertiary care hospital. Hamilton Depression Rating Scale (Ham-D) scores were measured before and after treatment. Clinical Global Impressions (CGI) scores were measured at study end. Thyroid data, consisting of values for thyroid-stimulating hormone (TSH), triiodothyronine (T(3), measured by radioimmunoassay [RIA]), thyroxine (T(4), measured by RIA) and free T(4), were collected before and after treatment. Complete thyroid data were available for 17 subjects. Data were collected during 1997-1999. RESULTS: Baseline TSH correlated strongly with response to treatment as measured by change in Ham-D scores (r = 0.64, p = 0.003). Low TSH values correlated with greater improvement in depressive symptoms. Thyroid hormone levels decreased with treatment, but these decreases did not correlate with clinical improvement. CONCLUSION: Baseline thyroid function, as measured by serum TSH, may predict a patient's response to antidepressant treatment with SSRIs. Optimal thyroid function, beyond simply being within the normal laboratory values, may be necessary for an optimal response to antidepressants.     

Pause before you respond: handedness influences response style on the Tower of Hanoi task

Comparative laterality research has indicated that marmoset monkeys with a righthand preference take less time to respond to novel objects within a novel environment (Cameron & Rogers, 1999). This suggests that right hemisphere dominance may be associated with a more cautious cognitive style in novel situations. The present study tested this hypothesis using right- and left-handed human participants to complete a three-disk Tower of Hanoi (TOH) task. It was hypothesised that left-handers would be slower to initiate responding. A total of 84 participants (42 left-handers, 42 right-handers) took part and the time taken to make the first move, completion time, and the number of moves taken to complete the task were recorded. Analysis of Variance revealed a significant main effect of handedness, with left-handers taking longer to move the first disk and significantly fewer moves to complete the task. However, left-handers were not significantly faster at completing the TOH, although males completed the task more quickly than females. These initial findings support the hypothesis that left-hand dominance is associated with a more cautious cognitive style in novel problem-solving situations.     

The Canadian Dermatology Workforce Survey: Implications for the Future of Canadian Dermatology—Who will be <Emphasis Type="Italic">your</Emphasis> skin expert?

Objective To survey Canadian dermatologists for specialty-specific physician resource information including demographics, workload and future career plans.Background and Methods In 2001, the Canadian Dermatology Association (CDA) surveyed 555 dermatologists in Canada to gain specialty-specific physician resource information. Three hundred and seventy-one dermatologists (69%) provided information about themselves, their workloads and their future career goals.Results The average Canadian dermatologist is 52 years old and 35% of practicing dermatologists are over the age of 55. Eighty-nine percent of dermatologists practice in an urban setting, 19% include practice in a rural setting while less than 0.5% practice in remote areas. Canadian dermatologists spend 61% of their clinical time providing services in Medical Dermatology. Within 5 years, 50% of dermatologists reported that they plan to reduce their practices or retire.Conclusion The Canadian Dermatology Workforce Survey provides a snapshot of the current practice of dermatology in Canada. It also serves to highlight the critical shortage of dermatologists, which will continue to worsen without immediate, innovative planning for the future.

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SommaireObjectif Mener une enquête auprès des dermatologues canadiens en vue de recueillir des données sur les spécialtiés, y compris les données démographiques, la charge de travail et le plan de carrière.Antécédents et methodes En 2001, lAssociation canadienne de dermatologie (ACD) a mené une enquête auprès de 555 dermatologues au Canada en vue dobtenir des données propres aux spécialités. Parmi les dermatologues sondés, 371 (69%) ont fourni de linformation sur eux-mêmes, leur charge de travail et leurs objectifs de carrière.Résultats Le dermatologue canadien moyen est âgé de 52 ans, et 35% des dermatologues actifs ont plus de 55 ans. Parmi les dermatologues actifs, 89% travaillent dans des villes, 19% exercent dans des régions rurales alors que 0.5% se trouvent dans des régions éloignées. Au Canada, les dermatologues passent 61% de leur temps en clinique à offrir des services en dermatologie médicale. Au cours des 5 prochaines années, 50% des répondants comptent réduire leur temps de travail ou aller en retraite.Conclusion Lenquête sur les ressources dermatologiques trace le profil actuel de la profession au Canada. Également, lenquête souligne le manque de dermatologues qui saggrave sans quil ny ait en place une stratégic immédiate et novatrice pour lavenir.