Social reasoning in Tourette syndrome

Introduction. Tourette syndrome (TS) is thought to be associated with striatal dysfunction. Changes within frontostriatal pathways in TS could lead to changes in abilities reliant on the frontal cortex. Such abilities include executive functions and aspects of social reasoning.

Methods. This study aimed to investigate executive functioning and Theory of Mind (ToM; the ability to reason about mental states, e.g., beliefs and emotions), in 18 patients with TS and 20 controls. A range of tasks involving ToM were used. These required participants to make judgements about mental states based on pictures of whole faces or the eyes alone, reason about humour in cartoons that featured sarcasm, irony or “slapstick” style humour, and make economic decisions. The executive measures assessed inhibition and verbal fluency.

Results. Patients with TS exhibited significantly poorer performance than controls on all four tasks involving ToM, even when patients with comorbid obsessive-compulsive disorder were excluded. These difficulties were despite no inhibitory deficits. Patients with TS exhibited impairment on the verbal fluency task but their performance on executive and ToM tasks was not related.

Conclusions. We propose that TS is associated with changes in ToM. The observed deficits could reflect dysfunction in frontostriatal pathways involving ventromedial prefrontal cortex.     

Subversion et humour dans le traitement analytique d'un patient schizophrène

The psychoanalytical therapy of schizophrenic patients is traditionally based on the development of a positive transference and on an interpreting, holding analytic work. In this paper, we present the case-study of a patient for whom all “making-sense” work became persecuting. We will name this very ambivalent person an “alterno-valent” patient. Within this conflicting transference, only a humoristic approach allowed us to develop a trustful relationship with the patient. We describe the subversive nature of this relationship-humour, which is to take a completely opposite position to the analytical position, but to remain nevertheless attentive and empathic. We show further how this humoristic play serves us to interpret the transference. The humour-concept is assimilated to the Freud's “Witz”. We refer further to the literature in order to describe the psychotic transference as an oscillating movement between “transference-erotomania” and the “let-down-position”, both also deleterious. We propose the idea that the therapist's effort to make sense could induce in psychotic patient a psychic disorder who acts first as a defence (against the confusing pointing of the Big Other), second as a guarantee for the permanency of the relationship (the subject's disorder engage the Big Other in an organizing work). We also use “the concept of “projective identification””-concept, which is considered not only as the projection against bad objects, and also as a mechanism that allows the projection of the working-out abilities.     

L'ironie morbide

Irony is a system and humour is the outcome. Intrinsic, ironic is not pathological, but can become pathological if two bases are both disturbed: mild excitation and sufficient intelligence. Morbid irony can be found in some mental conditions.     

Is evaluation of humorous stimuli associated with frontal cortex morphology? A pilot study using facial micro-movement analysis and MRI

Humour involves the ability to detect incongruous ideas violating social rules and norms. Accordingly, humour requires a complex array of cognitive skills for which intact frontal lobe functioning is critical. Here, we sought to examine the association of facial expression during an emotion inducing experiment with frontal cortex morphology in healthy subjects.Thirty-one healthy male subjects (mean age: 30.8 ± 8.9 years; all right-handers) watching a humorous movie (“Mr. Bean”) were investigated. Markers fixed at certain points of the face emitting high-frequency ultrasonic signals allowed direct measurement of facial movements with high spatial–temporal resolution. Magnetic resonance images of the frontal cortex were obtained with a 1.5-T Magnetom using a coronar T2- and protondensity-weighted Dual-Echo-Sequence and a 3D-magnetization-prepared rapid gradient echo (MPRAGE) sequence. Volumetric analysis was performed using BRAINS.Frontal cortex volume was partly associated with slower speed of “laughing” movements of the eyes (“genuine” or Duchenne smile). Specifically, grey matter volume was associated with longer emotional reaction time ipsilaterally, even when controlled for age and daily alcohol intake.These results lend support to the hypothesis that superior cognitive evaluation of humorous stimuli – mediated by larger prefrontal grey and white matter volume – leads to a measurable reduction of speed of emotional expressivity in normal adults.     

Just jokes! Icebreakers,innuendo, teasing and talking: The role of humour in HIV/AIDS peer education among university students

Peer conversation provides an important platform for people to explore and disseminate sexual health knowledge. Humour forms part of conversations held between peers including those where sexual health and sexual decisions are discussed. The central argument of this article links conversation, humour and peer education. Drawing on interviews and diaries kept by 12 student peer educators over a two-month period in a South African university, the article explores the forms and functions of humour in instigating and encouraging informal peer education between young people in a university setting. The evidence shows that humour can foster intimacy, familiarity and camaraderie in peer interactions; keeps conversation moving; and acts as a gateway to discussion of taboo, personal and private subjects that lie at the core of effective peer education. Components of humour (joking, teasing, innuendo, provocation) and the transformation of the serious (and boring) into the enjoyable (and accessible) are found in these peer interactions. However, humour can also limit communication by keeping conversations light and superficial or, in the case of inappropriate humour, close conversation altogether. Acknowledging the nuances of humour within conversation and peer education allows for a clearer understanding of the ways in which humour contributes to effective health promotion efforts and how it can be used within peer educator practice. The effect of the personality traits of peer educators on effective use of humour in conversation is an area that could benefit from further insight and research.     

幽默的医学功能

1　幽默医学的兴起与现状本世纪以来 ,随着工业社会和科学技术的迅猛发展。人类的生存环境日趋复杂、紧张、健康也越来越多地受到社会因素尤其心理因素的困扰和危害。因此 ,打破旧的传统医学模式、开辟新的医学思维、满足人们高层次的健康需求便成为世界医学发展的一大趋势。顺应这一趋势 ,早在 2 0年代 ,美国便率先成立了身心医学学会 ,注重人的社会心理因素在健康与疾病中的作用 ,在医学领域中开辟了新的途径。到了5 0、6 0年代 ,以“笑疗”为萌芽的“幽默医学”便作为其中的一朵奇芭 ,迅速地发展 ,并逐渐地渗透到人们的生活和治疗实践中…     

Humour : quels regards portés par les professionnels et étudiants manipulateurs en électroradiologie médicale ?

Objectives

Although many scientific studies have focused on humour in the care relationship, we thought it would be a good idea to interview radiographers, whose role illustrates the dichotomy between humanity and sophisticated healthcare techniques. We intended to highlight the need to introduce humour – an essential part of communication with the patient – in the technical environment of this profession. We collected data on how practitioners perceive humour in their day-to-day practice, and then compared the results with the abstract opinions the radiographer students have on using humour in their future practice. This study thus reports on the comparison between the students’ expectations and the reality of radiographers in the field, dealing with the extent to which it is relevant to introduce a more personal approach in healthcare through humour and laugher.

��Tails�� �C A fairy tale on furry tails: A 15-year theatre experience for hospitalized children created by health professionals

OVERVIEW

The present article describes an innovative theatre production that has been running in The Hospital for Sick Children in Toronto, Ontario, for the past 15 years. It is directed at, and created for, hospitalized children and their families. The effects of hospitalization on children and their families are reviewed, and the benefits of humour and support during the stressful time the children have to spend in the hospital is highlighted. The play and its message, as well as possible health benefits, are also described.

PRACTICAL IMPLICATIONS

Theatre productions may help ease the anxiety felt by children and their families concerning illness, hospitalization and the associated medical procedures. Theatre may also assist in increasing patients’ compliance with medical procedures and follow-up.

ORIGINALITY

The play described is the first regular children’s theatre created by medical staff for hospitalized children. It is valuable because it may result in other hospitals following this example, and because it may generate research on the effects of theatre on patients and their families.