Range Of Clinical Disorders Research Articles

The Saudi Population's Knowledge and Attitude Towards Human Papillomavirus (HPV) Infection and Its Vaccination.

Human papillomavirus (HPV) infection is a major worldwide public health concern that can result in a range of clinical disorders, including cervical cancer. Saudi Arabia, similar to numerous other nations, has difficulties in facing HPV and its impact on society. The high incidence of cervical cancer in Saudi Arabia continues to be a cause for worry, highlighting the need for the adoption of efficient immunization programs. Nevertheless, public hesitation and inadequate knowledge can hinder the acceptance of vaccines. Evaluating public knowledge and attitudes concerning HPV and its vaccination is essential in order to create focused programs that enhance awareness and increase vaccine acceptance. This study was cross-sectional in nature, using data from a sample of 516 Saudi participants 18 years and above. The participants completed online questionnaires that were distributed using Google Forms across social media platforms and ensured anonymity. A total of 516 participants made up the sample for this study, which had a predominance of females (83.5%, n=431); the majority aged 18-25 years (78.3%, n=404) and most of them (28.3%, n=146) were from the central region. The study results revealed that 43.7% (n=225) of the participants had a good knowledge level while 56.3% (n=291) of them had a poor level of knowledge about the HPV vaccine. A substantial proportion (35.9%, n=185) of the participants had good knowledge that HPV can be transmitted sexually from one person to another with only 30.2% (n=156) of them being aware that HPV is a common infection that causes cervical cancer (41.5%, n=214) and most of them (76.2%, n=393) knew that cervical cancer can be cured particularly when detected in early stages. The results established statistically significant associations between gender, education level, and occupation with p-values <0.005 (0.023, 0.003 and 0.001 respectively) and level of knowledge about the HPV vaccine. The study emphasizes the necessity of implementing focused health education and vaccination initiatives in Saudi Arabia to enhance understanding and attitudes regarding HPV infection and its vaccine. The results can provide guidance to healthcare professionals, legislators, and public health authorities in creating programs that increase knowledge and acceptance of the HPV vaccine, ultimately decreasing the prevalence of HPV-related diseases in the nation.

The effect of using group-averaged or individualized brain parcellations when investigating connectome dysfunction in psychosis.

Functional magnetic resonance imaging (fMRI) is widely used to investigate functional coupling (FC) disturbances in a range of clinical disorders. Most analyses performed to date have used group-based parcellations for defining regions of interest (ROIs), in which a single parcellation is applied to each brain. This approach neglects individual differences in brain functional organization and may inaccurately delineate the true borders of functional regions. These inaccuracies could inflate or underestimate group differences in case-control analyses. We investigated how individual differences in brain organization influence group comparisons of FC using psychosis as a case study, drawing on fMRI data in 121 early psychosis patients and 57 controls. We defined FC networks using either a group-based parcellation or an individually tailored variant of the same parcellation. Individualized parcellations yielded more functionally homogeneous ROIs than did group-based parcellations. At the level of individual connections, case-control FC differences were widespread, but the group-based parcellation identified approximately 7.7% more connections as dysfunctional than the individualized parcellation. When considering differences at the level of functional networks, the results from both parcellations converged. Our results suggest that a substantial fraction of dysconnectivity previously observed in psychosis may be driven by the parcellation method, rather than by a pathophysiological process related to psychosis.

Membrane Trafficking Mechanisms and Their Biological Relevance.

Most chemicals expressed in mammalian cells have complex delivery and transport mechanisms to get to the right intracellular sites. One of these mechanisms transports most transmembrane proteins, as well as almost all secreted proteins, from the endoplasmic reticulum, where they are formed, to their final location. Nearly all eukaryotic cells have a membrane trafficking mechanism that is both a prominent and critical component. This system, which consists of dynamically coupled compartments, supports the export and uptake of extracellular material, remodeling and signaling at the cellular interface, intracellular alignment, and maintenance of internal compartmentalization (organelles). In animal cells, this system enables both regular cellular activities and specialized tasks, such as neuronal transmission and hormone control. Human diseases, including neurodegenerative diseases, such as Alzheimer's disease, heart disease, and cancer, are associated with the dysfunction or dysregulation of the membrane trafficking system. Treatment and cure of human diseases depends on understanding the cellular and molecular principles underlying membrane trafficking pathways. A single gene mutation or mutations that result in impaired membrane trafficking cause a range of clinical disorders that are the result of changes in cellular homeostasis. Other eukaryotic organisms with significant economic and agricultural value, such as plants and fungi, also depend on the membrane trafficking system for their survival. In this review, we focused on the major human diseases associated with the process of membrane trafficking, providing a broad overview of membrane trafficking.

Membrane Trafficking Mechanisms and Their Biological Relevance

Most chemicals expressed in mammalian cells have complex delivery and transport mechanisms to get to the right intracellular sites. One of these mechanisms transports most transmembrane proteins, as well as almost all secreted proteins, from the endoplasmic reticulum, where they are formed, to their final location. Nearly all eukaryotic cells have a membrane trafficking mechanism that is both a prominent and critical component. This system, which consists of dynamically coupled compartments, supports the export and uptake of extracellular material, remodeling and signaling at the cellular interface, intracellular alignment, and maintenance of internal compartmentalization (organelles). In animal cells, this system enables both regular cellular activities and specialized tasks, such as neuronal transmission and hormone control. Human diseases, including neurodegenerative diseases, such as Alzheimer's disease, heart disease, and cancer, are associated with the dysfunction or dysregulation of the membrane trafficking system. Treatment and cure of human diseases depends on understanding the cellular and molecular principles underlying membrane trafficking pathways. A single gene mutation or mutations that result in impaired membrane trafficking cause a range of clinical disorders that are the result of changes in cellular homeostasis. Other eukaryotic organisms with significant economic and agricultural value, such as plants and fungi, also depend on the membrane trafficking system for their survival. In this review, we focused on the major human diseases associated with the process of membrane trafficking, providing a broad overview of membrane trafficking.

Sleep and Mental Health Issues in Current and Former Athletes: A Mini Review.

Sleep and mental health are important aspects of human health that work concurrently. However, sleep and mental health disorders are often overlooked and undiagnosed in sport due to the negative stigma associated with them. Evidence suggests that athletes are disproportionately affected by mental health issues and sleep problems. Internal and external pressures contribute to psychological distress. Variable competition times, travel and stress are detrimental to sleep quality. Retirement from sport can deteriorate sleep and psychological wellbeing, particularly for those who retired involuntarily and identify strongly with their athletic role. When untreated, these issues can manifest into a range of clinical disorders. This is concerning, not only for compromised athletic performance, but for general health and wellbeing beyond sport. Previous research has focussed on sleep and health independently among currently competing, or former, athletes. To date, no research has comprehensively assessed and compared sleep complaints and mental health issues between these two cohorts. Moreover, research has failed to obtain data across a variety of different competition levels, sports, and genders, leaving the current scope of the literature narrow. Comorbid conditions (e.g., concussion history, obesity), ex-college athletes, and mental health has been the focus of existing literature post-retirement. Future research would benefit from employing both quantitative and qualitative methodologies to comprehensively assess the prevalence and severity of sleep and mental health disorders across current and retired athletes. Research outcomes would inform education strategies, safeguarding athletes from these issues by reducing negative stigmas associated with help-seeking in sport and ultimately increase self-guided treatment.

GENETIC AND ENVIRONMENTAL CONTRIBUTIONS TO POSITIVE AFFECT: INSIGHTS FROM ADOLESCENT TWINS.

Disturbances in positive affect and reductions in social reward/interpersonal pleasure are common across a range of clinical disorders and are often related. We examined the relationship between the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS-A), and other measures of positive affect in adolescents in a genetically informative research design. The sample consisted of 177 MZ and 136 same sex DZ twins drawn from a study of adolescent twins (M = 16.4 ± .97 years) who were part of the Wisconsin Twin Project. The self-report questionnaires included the Behavioral Activation Scale (BAS), Psychological Well-Being Scale, revised Early Adolescent Temperament Questionnaire (EATQR) and the adolescent version of the ACIPS (ACIPS-A). Structural equation modeling estimated the relative contribution of genetic and environmental factors to the phenotypic variance in each of the measures. Follow-up bivariate analyses parsed the genetic and environmental contributions to the phenotypic covariances between the ACIPS-A and each of the other measures of positive affect. We found evidence of moderate heritability for the ACIPS-A scale scores. Overall, models specifying additive genetic and unique environmental effects (AE models) were the most parsimonious models for each of the measures. Several of the measures showed moderate positive phenotypic intercorrelations, and all but one of these intercorrelations showed significant partial genetic underpinnings. Moreover, the bivariate biometric analyses indicated that the ACIPS-A also captures unique heritable variation. Thus, the ACIPS-A captures unique heritable contributions to social/interpersonal pleasure, as well as shared genetic variance with other measures of positive affectivity.

Constructing the social world: Impaired capacity for social simulation in dementia

Scene construction refers to the capacity to imagine richly detailed scenes in one's mind's eye and has been demonstrated to be compromised across a range of clinical disorders in which episodic memory processes are also affected. It remains unclear however, how task demands modulate the content of the to-be-simulated scenes. Here, we sought to investigate the capacity for social forms of scene construction in the behavioural-variant of frontotemporal dementia (bvFTD), a progressive neurodegenerative disorder characterised by pronounced social cognitive and executive dysfunction, alongside episodic memory impairments. Twenty bvFTD patients, 14 Alzheimer's disease (AD) patients, and 20 healthy controls completed a scene construction task involving imagining social (e.g., busy restaurant, crowded train), and non-social (e.g., forest, abandoned warehouse) scenes, as well as a comprehensive neuropsychological battery. Relative to Controls, patient groups provided significantly fewer contextual details during scene construction, irrespective of condition, with no difference between the patient groups. A significant group by condition interaction reflected the fact that bvFTD patients were disproportionately impaired on social relative to non-social scenes, whereas performance was comparable across conditions within Control and AD groups. Social construction impairments correlated with response inhibition and verbal episodic memory in bvFTD, with no such associations emerging in the AD group. A multiple regression confirmed that response inhibition and verbal episodic memory were significant predictors of social construction capacity, accounting for ~54% of the overall variance on the task. Our findings suggest that the capacity to simulate social scenes represents a special class of mental construction that relies upon a number of interacting cognitive processes, including aspects of executive function and episodic memory. How the process of social construction relates to acts of prosocial behaviour or empathy will be important for future studies to address.

Bayesian regression-based developmental norms for the Benton Facial Recognition Test in males and females.

Face identity recognition is important for social interaction and is impaired in a range of clinical disorders, including several neurodevelopmental disorders. The Benton Facial Recognition Test (BFRT; Benton & Van Allen, 1968), a widely used assessment of identity recognition, is the only standardized test of face identity perception, as opposed to face memory, that has been normed on children and adolescents. However, the existing norms for the BFRT are suboptimal, with several ages not represented and no established time limit (which can lead to inflated scores by allowing individuals with prosopagnosia to use feature matching). Here we address these issues with a large normative dataset of children and adolescents (ages 5-17, N = 398) and adults (ages 18-55; N = 120) who completed a time-limited version of the BFRT. Using Bayesian regression, we demonstrate that face identity perception increases asymptotically from childhood through adulthood, and provide continuous norms based on age and sex that can be used to calculate standard scores. We show that our time limit of 16 seconds per item yields scores comparable to the existing norms without time limits from the non-prosopagnostic samples. We also find that females (N = 156) score significantly higher than males (N = 362), supporting the existence of a female superiority effect for face identification. Overall, these results provide more robust norms for the BFRT and promote future research on face identity perception in developmental populations.

Human Craniofacial Spliceosomopathies

Germline mutation of core components of the spliceosomes have been associated with a range of clinical disorders from isolated retinitis pigmentosa (RP) to developmental syndromes, while somatic mutations of spliceosome components are linked to cell cycle dysregulation and cancer. Recently a group of craniofacial and skeletal disorders caused by dominant mutations in spliceosomal genes has emerged. The first of these to be identified is mandibulofacial dysostosis type Guion‐Almeida (MFDGA), caused by haploinsufficiency of the U5 snRNP component EFTUD2. We recently identified haploinsufficiency of SF3B4 as the cause of Nager syndrome, an acrofacial dysostosis (AFD), although only in 60% of cases suggesting genetic heterogeneity. Mutation of SF3B4 was subsequently reported in AFD Rodriquez type. SF3B4 is part of the U2 snRNP of the major spliceosome. We also identified heterozygous mutations in a highly conserved regulatory exon of SNRPBas the cause of cerebro‐costo‐mandibular syndrome (CCMS). Our experimental data show that these mutations disturb highly conserved exonic splicing silencer sequences crucial to the regulation of the gene's expression. SNRPB encodes a component of the Sm complex of the spliceosome. Additional craniofacial spliceosomopathies result from mutations in splicing factors TXNL4A, RBM8A and CWC27. The frequent involvement of craniofacial structures invite questions on the sensitivity of craniofacial and in particular pharyngeal arch development to spliceosomal defects, and on the role of the spliceosome in the regulation of development. The report of a young patient with Nager syndrome with bilateral synchronous breast cancer raises the possibility of a link between germline mutation of splicing factors and cancer predisposition. We also have a patient with a pathogenic SNRPB mutation who is non‐penetrant for CCMS syndrome but was diagnosed with early onset breast cancer, further linking heritable splicing mutations with cancer predisposition.Many of the craniofacial spliceosomopathies share overlapping features with Treacher‐Collins syndrome (TCS), a ribosomopathy. We are currently validating mutations in a ribosomal gene in two patients with typical Nager syndrome. This finding may provide unique insight into the overlapping roles of transcription and translation in craniofacial development. A combination of human genetics and model systems research will be required to further unravel the role of the spliceosome and the ribosome in craniofacial and skeletal development.Support or Funding InformationGenome Canada, Alberta Children's Hospital Research Institute, Genome AlbertaThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Progressive and self-limiting neurodegenerative disorders in Africa: a new prominent field of research led by South Africa but without strong health policy.

IntroductionNeurodegenerative disorders are involved in mortality and morbidity of every country. A high prevalence is estimated in Africa. Neurodegenerative disorders are defined by a progressive or self-limiting alteration of neurons implied in specific functional and anatomical functions. It encompasses a various range of clinical disorders from self-limiting to progressive. Focus on public health policies and scientific research is needed to understand the mechanisms to reduce this high prevalence. We use bibliometrics and mapping tools to explore the area studies and countries involved in scientific research on neurodegenerative disorders in Africa.MethodsWe used two databases: Web of Science and Pubmed. We analyzed the journals, most cited articles, authors, publication years, organizations, funding agencies, countries and keywords in Web of Science Core collection database and publication years and Medical Subject Headings in Pubmed database. We mapped the data using VOSviewer.ResultsWe accessed 44 articles published between 1975 and 2014 in Web of Science Core collection Database and 669 from Pubmed database. The majority of which were after 2006. The main countries involved in research on neurodegenerative disorders in Africa the USA, the United Kingdom, France and South Africa representing the main network collaboration. Clinical neurology and Genetics hereditary are the main Web of Science categories whereas Neurosciences and Biochemistry and Molecular Biology are the main Web of Science categories for the general search “neurodegenerative disorders” not restrained to Africa. This is confirmed by Medical Subject Headings analysis from Pubmed with one more area study: Treatment.ConclusionNeurodegenerative disorders research is leaded by South Africa with a network involving the USA, the UK, as well as African countries such Zambia. The chief field that emerged was on patient and hereditary as well as treatment. Public health policies were lacking fields in research whereas prevalence is estimated to be important in every country. New 17 sustainable development goals of the United Nations could help in this way.

Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.

Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.

An imagery-based road map to tackle maladaptive motivation in clinical disorders.

There is now a widespread recognition of the importance of mental imagery in a range of clinical disorders (1). This provides the potential for a transdiagnostic route to integrate some aspects of these disorders and their treatment within a common framework. This opinion piece argues that we need to understand why imagery is such a central and recurring feature, if we are to progress theories of the origin and maintenance of disorders. This will aid us in identifying therapeutic techniques that are not simply targeting imagery as a symptom, but as a manifestation of an underlying problem. As papers in this issue highlight, imagery is a central feature across many clinical disorders, but has been ascribed varying roles. For example, the involuntary occurrence of traumatic memories is a diagnostic criterion for PTSD (2), and it has been suggested that multisensory imagery of traumatic events normally serves a functional role in allowing the individual to reappraise the situation (3), but that this re-appraisal is disabled by extreme affective responses. In contrast to the disabling flashbacks associated with PTSD, depressed adults who experience suicidal ideation often report “flash forward” imagery related to suicidal acts (4), motivating them to self-harm. Socially anxious individuals who engage in visual imagery about giving a talk in public become more anxious and make more negative predictions about future performance than others who engage in more abstract, semantic processing of the past event (5). People with Obsessive Compulsive Disorder (OCD) frequently report imagery of past adverse events, and imagery seems to be associated with severity (6). The content of intrusive imagery has been related to psychotic symptoms (7), including visual images of the catastrophic fears associated with paranoia and persecution. Imagery has been argued (8) to play a role in the maintenance of psychosis through negative appraisals of imagined voices, misattribution of sensations to external sources, by the induction of negative mood states that trigger voices, and through maintenance of negative schemas. In addiction and substance dependence, Elaborated Intrusion (EI) Theory (9, 10) emphasizes the causal role that imagery plays in substance use, through its role in motivating an individual to pursue goals directed toward achieving the pleasurable outcomes associated with substance use. In this opinion piece, we would like to put forward the proposition that the motivating role that imagery plays in behavior may be a key reason for its presence in this wide range of psychopathologies, and that understanding its motivating role can help us identify common features in disorders and their treatments. It has already been recognized that the link between imagery and affect gives imagery a causative role in affective disorders (11), with the emotional amplifier hypothesis suggesting that in bipolar and anxiety disorders, state-congruent imagery leads to further affective responses, in a vicious cycle. Within EI Theory, the affective consequences of imagery are also used to explain why a cycle of elaboration follows an initial intrusive thought. The intrusive thoughts themselves are seen as the product of associative processes relating to both environmental cues and cognitions. Previous work on EI Theory focused initially on desires, and then on motivation in general. Our suggestion here moves a step further, highlighting its potential relevance to dysfunctional motivational imagery in multiple disorders.

A novel rat model of vitamin D deficiency: safe and rapid induction of vitamin D and calcitriol deficiency without hyperparathyroidism.

Vitamin D deficiency is associated with a range of clinical disorders. To study the mechanisms involved and improve treatments, animal models are tremendously useful. Current vitamin D deficient rat models have important practical limitations, including time requirements when using, exclusively, a vitamin D deficient diet. More importantly, induction of hypovitaminosis D causes significant fluctuations in parathyroid hormone (PTH) and mineral levels, complicating the interpretation of study results. To overcome these shortcomings, we report the successful induction of vitamin D deficiency within three weeks, with stable serum PTH and minerals levels, in Wistar rats. We incorporated two additional manoeuvres compared to a conventional diet. Firstly, the vitamin D depleted diet is calcium (Ca) enriched, to attenuate the development of secondary hyperparathyroidism. Secondly, six intraperitoneal injections of paricalcitol during the first two weeks are given to induce the rapid degradation of circulating vitamin D metabolites. After three weeks, serum 25-hydroxyvitamin D3 (25D) and 1,25-dihydroxyvitamin D3 (1,25D) levels had dropped below detection limits, with unchanged serum PTH, Ca, and phosphate (P) levels. Therefore, this model provides a useful tool to examine the sole effect of hypovitaminosis D, in a wide range of research settings, without confounding changes in PTH, Ca, and P.

Involuntary memories of emotional scenes: the effects of cue discriminability and emotion over time.

Involuntary episodic memories come to mind spontaneously--that is, with no preceding retrieval attempts. Such memories are frequent in daily life, in which they are predominantly positive and often triggered by situational features matching distinctive parts of the memory. However, individuals suffering from psychological disorders, such as posttraumatic stress disorder, have stressful, repetitive, and unwanted involuntary memories about negative events in their past. These unwanted recollections are disturbing and debilitating. Although such intrusive involuntary memories are observed across a range of clinical disorders, there is no broadly agreed upon explanation of their underlying mechanisms and no successful experimental simulations of their retrieval. In a series of experiments, we experimentally manipulated the activation of involuntary episodic memories for emotional and neutral scenes and predicted their activation on the basis of manipulations carried out at encoding and retrieval. Our findings suggest that the interplay between cue discriminability at the time of retrieval and emotional arousal at the time of encoding are crucial for explaining intrusive memories following negative events. While cue distinctiveness is important directly following encoding of the scenes, emotional intensity influences retrieval after delays of 24 hr and 1 week. Voluntary remembering follows the same pattern as involuntary remembering. Our results suggest an explanatory model of intrusive involuntary memory for emotional events in clinical disorders.

Why am I remembering this now? Predicting the occurrence of involuntary (spontaneous) episodic memories.

Involuntary episodic memories are memories of events that come to mind spontaneously, that is, with no preceding retrieval attempts. They are common in daily life and observed in a range of clinical disorders in the form of negative, intrusive recollections or flashbacks. However, little is known about their underlying mechanisms. Here we report a series of experiments in which-for the first time-the activation of involuntary memories is controlled and predicted on the basis of manipulations done at encoding. During encoding, participants were presented with pictures of scenes paired with sounds. Both scene and sound could be either unique (derived from a category that was presented only once) or repeated (derived from a category that was presented several times). During retrieval, the participants conducted an attention-demanding sound location task employing sounds from the encoding phase. In addition to the sound location task, they were asked to record all memories that might spontaneously arise during this task. Unique sounds generated most involuntary memories, consistent with the notion of cue overload. Repeated sounds rarely generated involuntary memories, but often yielded memories of repeated scenes in a voluntary (strategic) recall condition. Retrieval times were lower for involuntary than for comparable samples of strategically retrieved memories, suggesting less executive control involved in involuntary recall. Our findings show that it is possible to control the activation of involuntary episodic memories of daily scenes on the basis of well-known mechanisms of associative memory.

Validity and Reliability of the Persian Language Version of the Neuropsychiatry Unit Cognitive Assessment Tool

Background/Aims: Only a limited number of cognitive screening tools are available for the Persian-speaking population, and we sought to translate and validate the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), a multidimensional cognitive screening tool. Methods: We used multiple language specialists to translate and then back-translate the NUCOG, and administered the Persian language NUCOG and Mini-Mental State Examination (MMSE) to 184 individuals: 60 controls and 124 patients, 33 of whom had dementia, 30 non-dementing neurological disorders and 61 a psychiatric illness. Results: The NUCOG outperformed the MMSE in differentiating the patient groups and controls. The ‘profile’ across the 5 NUCOG domains differentiated dementia subgroups such as senile dementia of the Alzheimer type (SDAT), frontotemporal dementia and mild cognitive impairment (MCI). Psychiatric patients with psychosis and posttraumatic stress disorder were more impaired than patients with affective disorders. The NUCOG reliably differentiated controls from patients with MCI (at 86.5/100, sensitivity of 83.3% and specificity of 87.5%) and SDAT (at 75/100, sensitivity and specificity of 100%) patients from controls. Conclusions: The Persian language NUCOG appears to perform strongly in an unselected population, reliably differentiating patients with dementia from controls, and detecting cognitive impairment in a range of clinical disorders.

The self or the voice? Relative contributions of self-esteem and voice appraisal in persistent auditory hallucinations

Background Persistent auditory hallucinations are common, disabling and difficult to treat. Cognitive behavioural therapy is recommended in their treatment though there is limited empirical evidence of the role of cognitive factors in the formation and persistence of voices. Low self-esteem is thought to play a causal and maintaining role in a range of clinical disorders, particularly depression, which is prevalent and disabling in schizophrenia. It was hypothesized that low self-esteem is prominent in, and contributes to, depression in voice hearers. Methods Beliefs about persistent auditory hallucinations were investigated in 82 patients using the Beliefs About Voices Questionnaire — revised in a cross-sectional design. Self-esteem and depression were assessed using standardized measures. Results Depression and low self-esteem were prominent as were beliefs about the omnipotence and malevolence of auditory hallucinations. Beliefs about the uncontrollability and dominance of auditory hallucinations and low self-esteem were significantly correlated with depression. Low self-esteem did not mediate the effect of beliefs about auditory hallucinations- both acted independently to contribute to depression in this sample of patients with schizophrenia and persistent auditory hallucinations. Conclusions Low self-esteem is of fundamental importance to the understanding of affective disturbance in voice hearers. Therapeutic interventions need to address both the appraisal of self and hallucinations in schizophrenia. Measures which ameliorate low self-esteem can be expected to improve depressed mood in this patient group. Further elucidation of the mechanisms involved can strengthen existing models of positive psychotic symptoms and provide targets for more effective treatments.

Bioefficacy of Mauritian Endemic Medicinal Plants: Assessment of Their Phenolic Contents and Antioxidant Potential

The role of free radicals in the etiology and development of a wide range of clinical disorders has continued to fuel the suggestion that phenolic antioxidants can offer a realistic promise to reduce the incidence of a number of pathologies involving oxidative stress. In this study, the total phenol, flavonoid, and proanthocyanidin contents of the Mauritian medicinal plants Crinum mauritianum. Lodd. (Asteraceae), Gaertnera psychotroides. DC (Rubiaceae), Psidia terebinthina. A.J. Scott (Asteraceae), and Tylophora coriacea. Marais. (Monimiaceae) were assessed and contrasted with their antioxidant potential. The antioxidant propensity was evaluated by the ability of the extracts to scavenge hypochlorous acid and hydroxyl radical and the ABTS⋅ + radical including their abilities to inhibit microsomal lipid peroxidation. The endemic plants Badula multiflora. A. DC. (Myrsinaceae), Croton vaughanii. L. (Euphorbiaceae), Erythroxylum macrocarpum. Lam. (Erythroxylaceae), Ochna mauritiana. Lam. (Ochnaceae), Tambourissa cordifolia. Lorence. (Monimiaceae), and Turraea rigida. Vent. (Meliaceae) were similarly investigated. Badula multiflora. and Erythoxylum macrocarpum. showed highest antioxidant activity in the TEAC and FRAP assay. Badula multiflora., Ochna mauritiana., and Gaertnera psychotroides. were very potent scavengers of hypochlorous acid and inhibited microsomal lipid peroxidation induced by 2,2′-azobis.(2-amidinopropane) hydrochloride (AAPH), suggesting that the inhibition was intrinsically linked to peroxyl radical scavenging. The antioxidant activity of Gaertnera psychotroides., Tylophora coriacea., Psidia terebinthina., and Crinum mauritianum. may account for the therapeutic effects of these extracts, in particular, in conditions characterized by inflammation and oxidative mechanisms. While these polyphenolic-rich endemics are good sources of natural prophylactic antioxidants, there is an urgent need for sustainable conservation programs for their protection.

Haematological characteristics of morbid members of the Macropodidae

Haematological data from clinically ill animals coming from six species of macropodids were retrospectively analysed. A haematological indication of inflammation was the most commonly observed abnormality, present in 19/29 animals. Of these, 18/19 exhibited changes in neutrophil concentration. The magnitude of neutrophilia was typically ‘mild’ with only two animals having a neutrophil concentration greater than 10×109/l. Morphological atypia of neutrophils was less commonly present (10/19). Hyperfibrinogenaemia was the least reliable indicator of inflammation (6/19). Mild anaemia was evident in three animals with no indication of increased erythropoietic response. This study indicates that the haematological response by macropodids, to a range of clinical disorders, is likely to result in only mild changes in haematological values. Consequently, when such mild changes are encountered, a thorough investigation of the animal’s health should ensue.

The current status and future direction of clinical behavior analysis: Introduction to the special section.

During the 1960s and early 1970s, when Skinnerian behaviorism had reached its apogee, many behavior therapists in clinical practice employed operant principles in their work with the range of clinical disorders. Behavior therapists prided themselves in the utilization of principles that were derived from well-controlled laboratory experiments. Their empirically based approach commanded a far greater scientific respectability than the rather vaguely defined interventions of psychodynamic and humanistic therapists. However, starting in the early 1970s, cognitive psychology began to develop momentum and many behavior therapists gradually began to shift from a behavioral to a cognitive stance. This movement eventually resulted in a split between two types of behaviorally oriented practitioners. On the one hand, there were the applied behavior analysts who faithfully carried on the operant tradition. They worked mainly with developmentally disabled children and adults or employed behavior modification principles in relatively closed systems such as educational, correctional, and organizational settings. On the other hand, there were the behavior therapists who worked with the range of problems presented by adult outpatients. In their majority, these therapists began to embrace the new cognitive-behavioral perspective, whereas psychotherapists employing Skinnerian principles in the treatment of adult outpatients all but disappeared. This situation changed when in the late 1980s two approaches to adult outpatient psychotherapy were introduced which were both based on Skinner's radical behaviorism: Acceptance and Commitment Therapy (ACT; Hayes, 1987) and Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1987). With the advent of these therapies, a novel form of operant based behavior therapy was born, which during the early 1990s eventually established itself as 'clinical behavior analysis' (CBA). CBA has its philosophical roots in a modernized version of radical behaviorism termed 'functional contextualism' (Biglan & Hayes, 1996) and is geared toward the amelioration of emotional problems that more typically have been the purview of traditional adult psychotherapy. A number of writers have shown how CBA based approaches can be extended to the treatment of a wide spectrum of psychological disorders, including problems as complex as personality, mood, sexual, or substance use disorders (Dougher, 1999; Hayes, Jacobson, Follette, & Dougher, 1994). The beauty of CBA is that it deals effectively with the fundamental theoretical problem of how talking within the therapy session helps ameliorate clients' problems that occur in their everyday lives. By carefully examining the verbal interactions between therapists and clients within a conceptual framework that brings to bear the principles of verbal behavior (Skinner, 1957), rule-governed behavior (Skinner, 1969), and stimulus equivalence (Sidman, 1994), clinical behavior analysts have developed a theoretical basis for adult psychotherapy that is consistent with contemporary radical behaviorism. Thus, for the first time in a long time there is evidence of a renewed rapprochement between basic behavioral science and its application. Over the past several decades, behavior therapy has gradually separated itself from its theoretical and philosophical foundation in behaviorism, which during its beginnings had been its greatest strength. With the advent of CBA, the gap between the basic and the applied branch of the behavioral approach is closing. Thus, CBA holds the clear promise of reestablishing the conceptual integrity of the behavioral approach to psychotherapy. …