Pituitary volumes are changed in patients with conversion disorder.

PubMed

Atmaca, Murad; Baykara, Sema; Mermi, Osman; Yildirim, Hanefi; Akaslan, Unsal

2016-03-01

Our study group previously measured pituitary volumes and found a relationship between somatoform disoders and pituitary volumes. Therefore, in conversion disorder, another somatoform disorder, we hypothesized that pituitary gland volumes would be reduced. Twenty female patients and healthy controls were recruited to the present investigation. The volumes of the pituitary gland were determined by using a 1.5 Tesla magnetic resonance scanner. We found that the pituitary gland volumes of the patients with conversion disorder were significantly smaller than those of healthy control subjects. In the patients with conversion disorder but not in the healthy control group, a significant negative correlation between the duration of illness and pituitary gland volume was determined. In summary, in the present study, we suggest that the patients with conversion disorder have smaller pituitary volumes compared to those of healthy control subjects. Further studies should confirm our data and ascertain whether volumetric alterations determined in the patients with conversion disorder can be changed with treatment or if they change over time.

Progress in understanding conversion disorder

PubMed Central

Allin, Matthew; Streeruwitz, Anna; Curtis, Vivienne

2005-01-01

Conversion disorder has a history that may reach back into antiquity, and it continues to present a clinical challenge to both psychiatrists and neurologists. This article reviews the current state of knowledge surrounding the prevalence, etiology, and neurobiology of conversion disorder. There have been improvements in the accuracy of diagnosis that are possibly related to improved technologies such as neuroimaging. Once the diagnosis is made, it is important to develop a therapeutic alliance between the patient and the medical team, and where comorbid psychiatric diagnoses have been made, these need to be adequately treated. While there have been no formal trials of medication or psychoanalytic treatments in this disorder, case reports suggest that a combination of antidepressants, psychotherapy, and a multidisciplinary approach to rehabilitation may be beneficial. PMID:18568070

Childhood Trauma and Alexithymia in Patients with Conversion Disorder.

PubMed

Farooq, Anum; Yousaf, Aasma

2016-07-01

To determine the relationship between childhood trauma (physical, sexual, emotional abuse and neglect) and alexithymia in patients with conversion disorder, and to identify it as a predictor of alexithymia in conversion disorder. An analytical study. Multiple public sector hospitals in Lahore, from September 2012 to July 2013. Eighty women with conversion disorder were recruited on the basis of DSM IV-TR diagnostic criteria checklist to screen conversion disorder. Childhood abuse interview to measure childhood trauma and Bermond Vorst Alexithymia Questionnaire, DSM-IV TR Dianostic Criteria Checklist, and Childhood Abuse Interview to assess alexithymia were used, respectively. The mean age of the sample was 18 ±2.2 years. Thirty-six cases had a history of childhood trauma, physical abuse was the most reported trauma (f = 19, 23.8%) in their childhood. Patients with conversion disorder has a significant association with alexithymia (p < 0.05). Multiple regression analysis showed that childhood sexual abuse could predict alexithymia (F= 7.05, p < 0.05). Among the alexithymia domain, childhood physical abuse significantly predicted the difficulty in verbalizing emotions among the abused patients (F= 6.40, p < 0.05). The study highlighted childhood abuse and emotional pent up as an etiological factor of conversion disorder. Strategies should be devised to reduce this disorder among women in Pakistani society.

[Conversion Disorder in Children and Adolescents].

PubMed

Duque, Paula Andrea; Vásquez, Rafael; Cote, Miguel

2015-01-01

Conversion disorder is diagnosed late, by exclusion and with a high risk of complications. There is a wide experience in adults that is not extrapolated to paediatric patients. According to the literature, the prognosis is better in children, but this changes when other variables such are included, such as comorbidities, late diagnosis and a very convincing social image of the neurological disease. To review the medical literature on the clinical features, diagnosis, comorbidities and treatment of this disorder. A literature research was performed on Medline and Pubmed, the terms used were "conversion disorder", pseudoseizures, treatment, clinic, children ("conversion disorder" OR hysteria OR hysterical) (child OR children OR childhood OR pediatric OR paediatric). The most relevant material found is included in this review. Conversion disorder is often an imprecise diagnosis in high complexity paediatric services. No consensus was found in the literature search on how to treat patients after the initial diagnosis. The evidence that it becomes chronic is not strong enough, just as the evidence is not convincing enough to argue that comorbidity factors are those maintained over time. Clearly, there is no medical experience of the natural history of this disorder in children and adolescents. It is only known is that it is a complex condition, on which there is experience only in the diagnosis and treatment of the acute state, but not so in the long-term care. It is proposed that each patient is studied in detail in order to define the psychiatric diagnosis and its treatment. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Conversion disorder: a problematic diagnosis.

PubMed

Nicholson, Timothy R J; Stone, Jon; Kanaan, Richard A A

2011-11-01

The diagnosis of conversion disorder is problematic. Since doctors have conceptually and practically differentiated the symptoms from neurological ('organic') disease it has been presumed to be a psychological disorder, but the psychological mechanism, and how this differs from feigning (conscious simulation), has remained elusive. Although misdiagnosis of neurological disease as conversion disorder is uncommon, it remains a concern for clinicians, particularly for psychiatrists who may be unaware of the positive ways in which neurologists can exclude organic disease. The diagnosis is anomalous in psychiatry in that current diagnostic systems require that feigning is excluded and that the symptoms can be explained psychologically. In practice, feigning is very difficult to either disprove or prove, and a psychological explanation cannot always be found. Studies of childhood and adult psychological precipitants have tended to support the relevance of stressful life events prior to symptom onset at the group level but they are not found in a substantial proportion of cases. These problems highlight serious theoretical and practical issues not just for the current diagnostic systems but for the concept of the disorder itself. Psychology, physiology and functional imaging techniques have been used in attempts to elucidate the neurobiology of conversion disorder and to differentiate it from feigning, but while intriguing results are emerging they can only be considered preliminary. Such work looks to a future that could refine our understanding of the disorder. However, until that time, the formal diagnostic requirement for associated psychological stressors and the exclusion of feigning are of limited clinical value. Simplified criteria are suggested which will also encourage cooperation between neurology and psychiatry in the management of these patients.

Psychometric properties of Conversion Disorder Scale- Revised (CDS) for children.

PubMed

Ijaz, Tazvin; Nasir, Attikah; Sarfraz, Naema; Ijaz, Shirmeen

2017-05-01

To revise conversion disorder scale and to establish the psychometric properties of the revised scale. This case-control study was conducted from February to June, 2014, at the Government College University, Lahore, Pakistan, and comprised schoolchildren and children with conversion disorder. In order to generate items for revised version of conversion disorder scale, seven practising mental health professionals were consulted. A list of 42 items was finalised for expert ratings. After empirical validation, a scale of 40 items was administered on the participants and factor analysis was conducted. Of the240 participants, 120(50%) were schoolchildren (controls group) and 120(50%)were children with conversion disorder (clinical group).The results of factor analysis revealed five factors (swallowing and speech symptoms, motor symptoms, sensory symptoms, weakness and fatigue, and mixed symptoms) and retention of all 40 items of revised version of conversion disorder scale. Concurrent validity of the revised scale was found to be 0.81 which was significantly high. Similarly, discriminant validity of the scale was also high as both clinical and control groups had significant difference (p<0.001) in scores. Cronbach's alpha of scale was a=0.91 while item total correlation ranged from 0.50 to 0.80. The sensitivity and specificity analysis indicated that the revised conversion disorder scale was 76% sensitive to predicting conversion disorder while specificity showed that the scale was 73% accurate in specifying participants of the control group. The revised version of conversion disorder scale was a reliable and valid tool to be used for screening of children with conversion disorder.

Neuroanatomy of conversion disorder: towards a network approach.

PubMed

Conejero, Ismael; Thouvenot, Eric; Abbar, Mocrane; Mouchabac, Stéphane; Courtet, Philippe; Olié, Emilie

2018-06-27

The pathophysiology of conversion disorder is not well understood, although studies using functional brain imaging in patients with motor and sensory symptoms are progressively increasing. We conducted a systematic review of the literature with the aim of summarising the available data on the neuroanatomical features of this disorder. We also propose a general model of the neurobiological disturbance in motor conversion disorder. We systematically searched articles in Medline using the Medical Subject Headings terms '(conversion disorder or hysterical motor disorder) and (neuropsychology or cognition) or (functional magnetic resonance imaging or positron emission tomography or neuroimaging) or (genetics or polymorphisms or epigenetics) or (biomarkers or biology)', following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two authors independently reviewed the retrieved records and abstracts, assessed the exhaustiveness of data abstraction, and confirmed the quality rating. Analysis of the available literature data shows that multiple specialised brain networks (self-agency, action monitoring, salience system, and memory suppression) influence action selection and modulate supplementary motor area activation. Some findings suggest that conceptualisation of movement and motor intention is preserved in patients with limb weakness. More studies are needed to fully understand the brain alterations in conversion disorders and pave the way for the development of effective therapeutic strategies.

MULTIPLE PERSONALITY DISORDER FOLLOWING CONVERSION AND DISSOCIATIVE DISORDER NOS : A CASE REPORT

PubMed Central

Jhingan, Harsh Prem; Aggarwal, Neeruj; Saxena, Shekhar; Gupta, Dhanesh K.

2000-01-01

A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed. PMID:21407917

Motor and somatosensory conversion disorder: a functional unawareness syndrome?

PubMed

Perez, David L; Barsky, Arthur J; Daffner, Kirk; Silbersweig, David A

2012-01-01

Although conversion disorder is closely connected to the origins of neurology and psychiatry, it remains poorly understood. In this article, the authors discuss neural and clinical parallels between lesional unawareness disorders and unilateral motor and somatosensory conversion disorder, emphasizing functional neuroimaging/disease correlates. Authors suggest that a functional-unawareness neurobiological framework, mediated by right hemisphere-lateralized, large-scale brain network dysfunction, may play a significant role in the neurobiology of conversion disorder. The perigenual anterior cingulate and the posterior parietal cortices are detailed as important in disease pathophysiology. Further investigations will refine the functional-unawareness concept, clarify the role of affective circuits, and delineate the process through which functional neurologic symptoms emerge.

Conversion disorder and mass psychogenic illness in child neurology.

PubMed

Mink, Jonathan W

2013-11-01

A common problem faced by neurologists is the existence of disorders that present with neurological symptoms but do not have identifiable neurological bases. Conversion disorder is the most common of these disorders. In some situations, members of a cohesive social group will develop the same or similar symptoms. This review discusses conversion disorder in children, with an emphasis on function movement disorders. It also reviews a recent occurrence of mass psychogenic illness in New York State with discussion of the key features of mass psychogenic illness. © 2013 New York Academy of Sciences.

Conversion disorder: towards a neurobiological understanding

PubMed Central

Harvey, Samuel B; Stanton, Biba R; David, Anthony S

2006-01-01

Conversion disorders are a common cause of neurological disability, but the diagnosis remains controversial and the mechanism by which psychological stress can result in physical symptoms “unconsciously” is poorly understood. This review summarises research examining conversion disorder from a neurobiological perspective. Early observations suggesting a role for hemispheric specialization have not been replicated consistently. Patients with sensory conversion symptoms have normal evoked responses in primary and secondary somatosensory cortex but a reduction in the P300 potential, which is thought to reflect a lack of conscious processing of sensory stimuli. The emergence of functional imaging has provided the greatest opportunity for understanding the neural basis of conversion symptoms. Studies have been limited by small patient numbers and failure to control for confounding variables. The evidence available would suggest a broad hypothesis that frontal cortical and limbic activation associated with emotional stress may act via inhibitory basal ganglia–thalamocortical circuits to produce a deficit of conscious sensory or motor processing. The conceptual difficulties that have limited progress in this area are discussed. A better neuropsychiatric understanding of the mechanisms of conversion symptoms may improve our understanding of normal attention and volition and reduce the controversy surrounding this diagnosis. PMID:19412442

Conversion disorders: psychiatric and psychotherapeutic aspects.

PubMed

Cottencin, O

2014-10-01

Hysteria is still stigmatized and frequently associated with lying or malingering. However, conversion disorder is not malingering, nor factitious disorder. The first step for the clinician faced with suspected conversion disorder is to make a positive diagnosis, which is in fact an integral part of treatment. In the emergency situation, it is important to look for an underlying somatic disorder. Although no specific treatment exists, there is a consensus in favor of a positive role of psychotherapy. First of all, the main problem is to explain to patients that their physical complaint has a psychological cause. In order to deliver the diagnosis in the most appropriate and useful manner, physicians have to first convince themselves before trying to convince patients. Combined consultation (medicine and psychiatry) is a useful tool to help patients. With or without combined consultation, this approach requires patience and open-mindedness to motivate patients to recognize the value of psychotherapy. Coordination between specialists and general practitioners is an important part of this treatment, which frequently requires long-term intervention. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Conversion disorder: current problems and potential solutions for DSM-5.

PubMed

Stone, Jon; LaFrance, W Curt; Brown, Richard; Spiegel, David; Levenson, James L; Sharpe, Michael

2011-12-01

Conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes neurological symptoms, including weakness, numbness and events resembling epilepsy or syncope, which can be positively identified as not being due to recognised neurological disease. This review combines perspectives from psychiatry, psychology and neurology to identify and discuss key problems with the current diagnostic DSM-IV criteria for conversion disorder and to make the following proposals for DSM-5: (a) abandoning the label "conversion disorder" and replacing it with an alternative term that is both theoretically neutral and potentially more acceptable to patients and practitioners; (b) relegating the requirements for "association of psychological factors" and the "exclusion of feigning" to the accompanying text; (c) adding a criterion requiring clinical findings of internal inconsistency or incongruity with recognised neurological or medical disease and altering the current 'disease exclusion' criteria to one in which the symptom must not be 'better explained' by a disease if present, (d) adding a 'cognitive symptoms' subtype. We also discuss whether conversion symptoms are better classified with other somatic symptom disorders or with dissociative disorders and how we might address the potential heterogeneity of conversion symptoms in classification. 2011 Elsevier Inc. All rights reserved.

Conversion, Factitious Disorder and Malingering: A Distinct Pattern or a Continuum?

PubMed

Galli, Silvio; Tatu, Laurent; Bogousslavsky, Julien; Aybek, Selma

2018-01-01

This chapter is aimed at highlighting the recent findings concerning physiopathology, diagnosis, and management of conversion, factitious disorder, and malingering. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist's consultation. The first challenge is to detect them, and recent studies have confirmed the importance of "positive" clinical bedside signs based on incoherence and discordance, such as the Hoover's sign for the diagnosis of conversion disorder. Functional neuroimaging has allowed a better understanding of the pathophysiology, and highlighted abnormal cerebral activation patterns in conversion disorder in relation to motor, emotional, and limbic networks, different from feigners. This supports the theory evoked by Charcot of a "psychodynamic lesion," which is also reflected by the new term introduced in the DSM-5: functional neurological disorder. Multidisciplinary therapy is recommended with behavioral cognitive therapy, antidepressant to treat frequent comorbid anxiety or depression, and physiotherapy. Factitious disorder and malingering should be clearly delineated from conversion disorder. Factitious disorder should be considered as a mental illness and more research on its physiopathology and treatment is needed, when malingering is a non-medical condition encountered in medico-legal cases. © 2018 S. Karger AG, Basel.

Postoperative Conversion Disorder in Elderly Oral Cancer Patient.

PubMed

Yakushiji, Takashi; Hayashi, Kamichika; Morikawa, Takamichi; Migita, Masashi; Ogane, Satoru; Muramatsu, Kyotaro; Kamio, Takashi; Shibahara, Takahiko; Takano, Nobuo

2016-01-01

Conversion disorder is a condition in which psychological stress in response to difficult situations manifests as physical symptoms. Here, we report a case of postoperative coma due to conversion disorder in an elderly oral cancer patient. An 82-year-old woman was referred to Tokyo Dental College Chiba Hospital with a mass lesion on the tongue. A biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment was performed for the tongue carcinoma and tracheotomy for management of the airway. On postoperative day 5, the patient exhibited loss of consciousness (Glasgow Coma Scale: E1, VT, M1; Japan Coma Scale: III-300). The patient's vital signs were all normal, as were the results of a full blood count, brain-CT, MRI, and MRA. Only the arm dropping test was positive. Therefore, the cause of the coma was diagnosed as conversion disorder. Seven hours later, the patient showed a complete recovery.

Childhood trauma and dissociation in women with pseudoseizure-type conversion disorder.

PubMed

Ozcetin, Adnan; Belli, Hasan; Ertem, Umit; Bahcebasi, Talat; Ataoglu, Ahmet; Canan, Fatih

2009-11-01

Conversion disorder is thought to be associated with psychological factors because of the presence of conflict and other stressors prior to the condition. The aim of this study is to compare adult patients with pseudoseizure-type conversion disorder with healthy control group in terms of childhood trauma, dissociative disorder and family history of psychiatric disorders. 56 female patients were admitted to the general psychiatry hospital outpatient clinic between January and July 2005. All patients had a negative experience about their families just before having the conversion. Diagnosis was made according to the DSM-IV criteria. A control group consisting of similar patient demographics of the disease group has been selected. Socio-demographic information forms, the Childhood Trauma Questionnaire (CTQ) and Dissociation Questionnaire (DIS-Q), were completed on the patients. CTQ total (t=12.12, P<0.001) and subscales, emotional abuse and emotional neglect (EA-EN) (t=12.74, P<0.001), physical abuse (PA) (t=10.05, P<0.001), and sexual abuse (SA) (t=7.69, P<0.001) were significantly high in the conversion group. DIS-Q mean points were statistically higher in the conversion group (t=11.05, P<0.001). The findings suggest that pseudoseizures (conversion disorder) should be included within dissociative disorders in DSM system as in ICD. It is usually uncommon for the patient to tell about childhood trauma without being specially questioned about this issue. Thus, it would be helpful to uncover these experiences by using related scales in conversion disorder patients.

Prosopagnosia as a Type of Conversion Disorder.

PubMed

Power, Clodagh; Hannigan, Oisin; Coen, Robert; Bruce, Irene; Gibb, Matthew; McCarthy, Marie; Robinson, David; Lawlor, Brian A

2018-01-01

Conversion disorder is a common and debilitating condition that remains poorly understood. We present a previously undescribed form of conversion disorder to highlight the complexity of the condition and consider the interplay of factors that produce conversion symptoms. A 50-year-old male presented with acquired prosopagnosia and language impairment. Neuropsychological testing indicated right temporal lobe dysfunction. Extensive work-up outruled an organic aetiology. Reactivation of childhood trauma coincided with the onset of his symptoms. Childhood trauma is known to have adverse effects on the developing brain which may affect an individual's emotional behaviour and coping style. Functional neuroimaging techniques suggest that conversion symptoms may be linked to the disruption of higher order neural circuitry involved in the integration of emotional processing and cortical functioning. We propose that our patient's adverse childhood experiences led to the development of a particular personality and coping style that "primed" him for a later abnormal emotional and behavioural response when confronted with reminders of his traumatic background. Further interdisciplinary studies are required to further elucidate the neurobiological basis for this condition.

Case Study: Camptocormia, a Rare Conversion Disorder.

ERIC Educational Resources Information Center

Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

2004-01-01

Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

The relationship between temperament and character in conversion disorder and comorbid depression.

PubMed

Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

2013-05-01

The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (P<.001), more impulsivity (P<.01) and more sentimentality (P<.01) than the healthy controls, but were less persistent (P<.05). In terms of character qualities, conversion disorder patients had high self-transcendence (P<.05), but were inadequate in terms of self-directedness (P<.001) and took on less responsibility (P<.05) than the healthy controls. Conversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.

Stiff person case misdiagnosed as conversion disorder: A case report.

PubMed

Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

2017-01-01

Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.

Symptom-specific amygdala hyperactivity modulates motor control network in conversion disorder.

PubMed

Hassa, Thomas; Sebastian, Alexandra; Liepert, Joachim; Weiller, Cornelius; Schmidt, Roger; Tüscher, Oliver

2017-01-01

Initial historical accounts as well as recent data suggest that emotion processing is dysfunctional in conversion disorder patients and that this alteration may be the pathomechanistic neurocognitive basis for symptoms in conversion disorder. However, to date evidence of direct interaction of altered negative emotion processing with motor control networks in conversion disorder is still lacking. To specifically study the neural correlates of emotion processing interacting with motor networks we used a task combining emotional and sensorimotor stimuli both separately as well as simultaneously during functional magnetic resonance imaging in a well characterized group of 13 conversion disorder patients with functional hemiparesis and 19 demographically matched healthy controls. We performed voxelwise statistical parametrical mapping for a priori regions of interest within emotion processing and motor control networks. Psychophysiological interaction (PPI) was used to test altered functional connectivity of emotion and motor control networks. Only during simultaneous emotional stimulation and passive movement of the affected hand patients displayed left amygdala hyperactivity. PPI revealed increased functional connectivity in patients between the left amygdala and the (pre-)supplemental motor area and the subthalamic nucleus, key regions within the motor control network. These findings suggest a novel mechanistic direct link between dysregulated emotion processing and motor control circuitry in conversion disorder.

The role of psychiatrists in diagnosing conversion disorder: a mixed-methods analysis

PubMed Central

Kanaan, Richard A; Armstrong, David; Wessely, Simon

2016-01-01

Objective Since DSM-5 removed the requirement for a psychosocial formulation, neurologists have been able to make the diagnosis of conversion disorder without psychiatric input. We sought to examine whether neurologists and specialist psychiatrists concurred with this approach. Design We used mixed methods, first surveying all the neurologists in the UK and then interviewing the neuropsychiatrists in a large UK region on the role of psychiatrists in diagnosing conversion disorder. Results Of the surveyed neurologists, 76% did not think that psychiatrists were essential for the diagnosis and 71% thought that psychiatrists did not even consider conversion disorder when referred a case. The neuropsychiatrists who were interviewed held complex models of conversion disorder. They believed all cases could be explained psychosocially in theory, but the nature of the diagnostic encounter often prevented it in practice; all felt that psychosocial formulation could be very helpful and some felt that it was essential to diagnosis. Conclusion Although neurologists do not think psychiatrists are required for diagnosing conversion disorder, specialist psychiatrists disagree, at least in some cases. PMID:27274253

The role of psychiatrists in diagnosing conversion disorder: a mixed-methods analysis.

PubMed

Kanaan, Richard A; Armstrong, David; Wessely, Simon

2016-01-01

Since DSM-5 removed the requirement for a psychosocial formulation, neurologists have been able to make the diagnosis of conversion disorder without psychiatric input. We sought to examine whether neurologists and specialist psychiatrists concurred with this approach. We used mixed methods, first surveying all the neurologists in the UK and then interviewing the neuropsychiatrists in a large UK region on the role of psychiatrists in diagnosing conversion disorder. Of the surveyed neurologists, 76% did not think that psychiatrists were essential for the diagnosis and 71% thought that psychiatrists did not even consider conversion disorder when referred a case. The neuropsychiatrists who were interviewed held complex models of conversion disorder. They believed all cases could be explained psychosocially in theory, but the nature of the diagnostic encounter often prevented it in practice; all felt that psychosocial formulation could be very helpful and some felt that it was essential to diagnosis. Although neurologists do not think psychiatrists are required for diagnosing conversion disorder, specialist psychiatrists disagree, at least in some cases.

Stiff person case misdiagnosed as conversion disorder: A case report

PubMed Central

Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

2017-01-01

Background: Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. Case presentation: We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0–34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. Conclusion: It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered. PMID:29201327

Emotional Stimuli and Motor Conversion Disorder

ERIC Educational Resources Information Center

Voon, Valerie; Brezing, Christina; Gallea, Cecile; Ameli, Rezvan; Roelofs, Karin; LaFrance, W. Curt, Jr.; Hallett, Mark

2010-01-01

Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to…

Conversive disorders among children and adolescents: towards new "complementarist" paradigms?

PubMed

Ouss, L; Tordjman, E

2014-10-01

This paper aims to describe current questions concerning conversive disorders among children and adolescents. We first describe prevalence and clinical characteristics of these. Many unresolved questions remain. Why do patients show excess, or loss of function? Attachment theory offers a relevant framework to answer this question. Does neurobiology of conversion disorders shed light on conversive processes? Current neurobiological research paradigms focus on the symptom, trying to infer processes, instead of proposing paradigms that test theoretical hypotheses. The most convincing theoretical framework that has already proposed a coherent theory of conversion is a psychodynamic one, which has not yet been tested with neurobiological paradigms. The interest of studying child and adolescent conversive disorders is to provide a means to more deeply investigate the two challenges we face: theoretical, and clinical ones. It provides the opportunity to access a pathopsychological process at its roots, not yet hidden by many defensive, rationalizing attitudes, and to better explore environmental features. We propose a "complementarist" model, which allows the combination of different approaches (neural, cognitive, environmental, attachment, intra-psychic) and permits proposal of different levels of therapeutic targets and means. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Conversion Disorder Comorbidity and Childhood Trauma.

PubMed

Akyüz, Fatma; Gökalp, Peykan G; Erdiman, Sezgin; Oflaz, Serap; Karşidağ, Çağatay

2017-03-01

The aim of this study is to examine the socio-demographic and clinical characteristics, the presence of comorbidity, and the link with childhood traumatic experiences in patients with conversion disorder (CD) in a psychiatric outpatient clinic. A total of 60 literate, female patients between 18 and 65 years of age who were referred to the general psychiatry outpatient clinic and who were diagnosed with conversion disorder according to the DSM-IV diagnostic criteria were included in the study. A questionnaire on sociodemographic and clinical characteristics, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Events Scale (DES) were used to assess the cases. The mean age of the participants was 36.27±11.18 years. 72% of the patients were married and 63% were primary school graduates. The most common symptoms were asthenia (100%), aphasia (96.7%), and crying-convulsions (93%). The most common co-morbidities were depression (50%) and dissociative disorders (48.3%). Among the patients, 53.3% reported a history of exposure to physical violence and 25% reported a history of sexual assault in childhood. Assessment of the Childhood Traumatic Questionnaire revealed a significant positive relation between emotional, physical, and sexual abuse scores and DES score. CD has not yet been fully analyzed in detail in health institutions; co-existence of another mental disorder and the presence of traumatic experiences in the past further complicate the issue. Consideration of these factors during treatment will have a positive impact on the course and prognosis of the disorder.

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder).

PubMed

Voon, Valerie; Cavanna, Andrea E; Coburn, Kerry; Sampson, Shirlene; Reeve, Alya; LaFrance, W Curt

2016-01-01

Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes.

Conversion Disorder; an Unusual Etiology of Unilateral Foot Drop.

PubMed

Ayaz, Saeed Bin; Matee, Sumeera; Malik, Riffat; Ahmad, Khalil

2015-06-01

Foot drop is generally a consequence of common peroneal or sciatic nerve injury or L5 radiculopathy but rarely, it can be a manifestation of conversion disorder. A 24-year-old male presented with a foot drop on left side that developed overnight. He had difficulty walking with a trunk tilt towards right side and numbness in left leg up to mid-thigh. The initial diagnosis by the general practitioner was common peroneal nerve injury, which was not supported by the subsequent detailed examination in the physiatry department. Routine laboratory investigations, computed tomographic scan of brain and electrophysiological evaluation were normal. In a multidisciplinary team evaluation involving a psychiatrist, he was diagnosed to be suffering from conversion disorder and was advised gait retraining, cognitive and behavioral therapy and tablet venlafaxine. By sixth day of treatment, the patient was able to walk independently with a normal gait pattern and reported complete recovery of his symptoms. In the absence of an identifiable organic cause of foot drop in a patient, conversion disorder may be considered necessitating early intervention by a psychiatrist.

Functional neuroimaging of conversion disorder: the role of ancillary activation.

PubMed

Burke, Matthew J; Ghaffar, Omar; Staines, W Richard; Downar, Jonathan; Feinstein, Anthony

2014-01-01

Previous functional neuroimaging studies investigating the neuroanatomy of conversion disorder have yielded inconsistent results that may be attributed to small sample sizes and disparate methodologies. The objective of this study was to better define the functional neuroanatomical correlates of conversion disorder. Ten subjects meeting clinical criteria for unilateral sensory conversion disorder underwent fMRI during which a vibrotactile stimulus was applied to anesthetic and sensate areas. A block design was used with 4 s of stimulation followed by 26 s of rest, the pattern repeated 10 times. Event-related group averages of the BOLD response were compared between conditions. All subjects were right-handed females, with a mean age of 41. Group analyses revealed 10 areas that had significantly greater activation (p < .05) when stimulation was applied to the anesthetic body part compared to the contralateral sensate mirror region. They included right paralimbic cortices (anterior cingulate cortex and insula), right temporoparietal junction (angular gyrus and inferior parietal lobule), bilateral dorsolateral prefrontal cortex (middle frontal gyri), right orbital frontal cortex (superior frontal gyrus), right caudate, right ventral-anterior thalamus and left angular gyrus. There was a trend for activation of the somatosensory cortex contralateral to the anesthetic region to be decreased relative to the sensate side. Sensory conversion symptoms are associated with a pattern of abnormal cerebral activation comprising neural networks implicated in emotional processing and sensory integration. Further study of the roles and potential interplay of these networks may provide a basis for an underlying psychobiological mechanism of conversion disorder.

Participant characteristics and observed support in conversations involving people with communication disorders.

PubMed

Eriksson, Karin; Hartelius, Lena; Saldert, Charlotta

2016-10-01

Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored. Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson's disease along with 10 significant others and two enrolled nurses. Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses. Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.

[Conversion disorder in an internal medicine department: A series of 37 cases].

PubMed

Régny, P; Cathébras, P

2016-04-01

To describe the clinical characteristics of a series of patients presenting conversion disorder in a general internal medicine ward and outpatient clinic, the arguments retained by the physicians in favour of the diagnosis, the somatic and psychiatric co-morbidities, the management and the outcome of the disorder. We report the study of 37 patients diagnosed with conversion disorder in an internal medicine department of a French university hospital over a period of 14 years. We retrospectively reviewed the charts of the patients and contacted their primary care physicians to obtain follow-up data. No structured instrument was used for the diagnosis of conversion disorder or for the assessment of psychiatric comorbidities. As expected, patients were mostly young females, although a great variety of age, gender, and socio-cultural background was observed. Motor symptoms predominated (62%). A relevant psychogenic factor was explicitly mentioned in only 43% of the cases. In many cases, organic disease was also present, and an organic cause for the symptom initially considered as conversion was suspected in 3 cases. Depressive and anxious disorders were present respectively in 38% and 35% of cases. A pain complaint was associated in half of the cases. Among patients for whom follow-up data is available, conversion symptoms persisted or recurred in 70% of cases and were associated with a poor quality of life. This case series confirms that the DSM-IV-TR criterion of "psychogenicity" (later abandoned in DSM-5) is highly problematic in clinical practice. It suggests a close relationship between conversion disorder and unexplained chronic pain. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder.

PubMed

Boeckle, Markus; Liegl, Gregor; Jank, Robert; Pieh, Christoph

2016-06-10

Conversion Disorders (CD) are prevalent functional disorders. Although the pathogenesis is still not completely understood, an interaction of genetic, neurobiological, and psychosocial factors is quite likely. The aim of this study is to provide a systematic overview on imaging studies on CDs and investigate neuronal areas involved in Motor Conversion Disorders (MCD). A systematic literature search was conducted on CD. Subsequently a meta-analysis of functional neuroimaging studies on MCD was implemented using an Activation Likelihood Estimation (ALE). We calculated differences between patients and healthy controls as well as between affected versus unaffected sides in addition to an overall analysis in order to identify neuronal areas related to MCD. Patients with MCD differ from healthy controls in the amygdala, superior temporal lobe, retrosplenial area, primary motor cortex, insula, red nucleus, thalamus, anterior as well as dorsolateral prefrontal and frontal cortex. When comparing affected versus unaffected sides, temporal cortex, dorsal anterior cingulate cortex, supramarginal gyrus, dorsal temporal lobe, anterior insula, primary somatosensory cortex, superior frontal gyrus and anterior prefrontal as well as frontal cortex show significant differences. Neuronal areas seem to be involved in the pathogenesis, maintenance or as a result of MCD. Areas that are important for motor-planning, motor-selection or autonomic response seem to be especially relevant. Our results support the emotional unawareness theory but also underline the need of more support by conduction imaging studies on both CD and MCD.

Temperament and character traits in patients with conversion disorder and their relations with dissociation.

PubMed

Sarisoy, Gökhan; Kaçar, Ö Mer Faruk; Öztürk, Arif; Yilman, Tuba; Mor, Sema; Özturan, Deniz Deniz; Yazici, Neslihan; Gümüş, Kübra

2015-12-01

The purpose of this study was to investigate temperament and character traits in patients with conversion disorder and the relation of these traits with dissociative symptoms. Sixty patients (60) diagnosed with conversion disorder according to DSM-IV-TR and 60 healthy volunteers were included in the study. All participants' temperament and character traits were determined using Cloninger's Temperament and Character Inventory (TCI). Patients with conversion disorder were divided into two subgroups using the Dissociative Experiences Scale (DES), dissociative (n=30, 50%) and non-dissociative (n=30, 50%). The two conversion disorder subgroups were compared with the control group in terms of temperament and character traits. Correlation analysis was also performed between TCI and DES scores in the entire conversion group. Novelty seeking (NS) scores were lower in both the dissociative and non-dissociative groups compared to the control group. Harm avoidance (HA) scores were higher in the dissociative group than in the control group. Reward dependence (RD) scores were lower in the dissociative group than in the non-dissociative and control group. Self-directedness (SD) scores were lower in the dissociative group than in the control group. Self-transcendence (ST) scores were higher in the dissociative group than in the non-dissociative group. DES scores were negatively correlated with RD and SD scores in the entire conversion group and positively correlated with ST scores. Low NS temperament traits may be associated with conversion disorder. High HA and low RD temperament traits and low SD and high ST character traits may be associated with pathological dissociation in patients with conversion disorder.

An atypical presentation of visual conversion disorder.

PubMed

Foutch, Brian K

2015-01-01

Nonorganic vision loss accounts for up to 5% of patients and presents in two forms, malingering and visual conversion disorder (VCD). It is described a case of VCD in a new mother struggling both with her husband being deployed overseas and the recent death of her father. In addition, she had been evaluated for a concussion secondary to a motor vehicle accident three months prior. An inexpensive series of clinical tests were performed to rule out organic disease and obtained equivocal results. Some tests revealed intact vision in the affected eye while others supported a neurological cause for the vision loss. However, the patient quickly recovered normal visual acuity when encouraged to discuss situations that have been causing emotional stress. This almost immediate recovery of vision confirmed the diagnosis of VCD. This report should make primary eye care professionals more aware of visual conversion disorder and its clinical evaluation. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Conversion disorder: A systematic review of current terminology.

PubMed

Ding, Juen Mei; Kanaan, Richard Antony Alexander

It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from conversion disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these. Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted. Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "non-epileptic/organic" was relatively popular with both groups. "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms - however the views of neither psychiatrists nor actual patients with the disorder were considered. Copyright © 2016 Elsevier Inc. All rights reserved.

Psychiatric comorbidity in patients with conversion disorder and prevalence of dissociative symptoms.

PubMed

Yayla, Sinan; Bakım, Bahadır; Tankaya, Onur; Ozer, Omer Akil; Karamustafalioglu, Oguz; Ertekin, Hulya; Tekin, Atilla

2015-01-01

The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis.

PubMed

Starzer, Marie Stefanie Kejser; Nordentoft, Merete; Hjorthøj, Carsten

2018-04-01

The authors investigated the rates of conversion to schizophrenia and bipolar disorder after a substance-induced psychosis, as well as risk factors for conversion. All patient information was extracted from the Danish Civil Registration System and the Psychiatric Central Research Register. The study population included all persons who received a diagnosis of substance-induced psychosis between 1994 and 2014 (N=6,788); patients were followed until first occurrence of schizophrenia or bipolar disorder or until death, emigration, or August 2014. The Kaplan-Meier method was used to obtain cumulative probabilities for the conversion from a substance-induced psychosis to schizophrenia or bipolar disorder. Cox proportional hazards regression models were used to calculate hazard ratios for all covariates. Overall, 32.2% (95% CI=29.7-34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI=42.7-52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm after a substance-induced psychosis was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder. Half the cases of conversion to schizophrenia occurred within 3.1 years after a substance-induced psychosis, and half the cases of conversion to bipolar disorder occurred within 4.4 years. Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases.

Functional networks of motor inhibition in conversion disorder patients and feigning subjects.

PubMed

Hassa, Thomas; de Jel, Esther; Tuescher, Oliver; Schmidt, Roger; Schoenfeld, Mircea Ariel

2016-01-01

The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG), with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

Rate and predictors of conversion from unipolar to bipolar disorder: A systematic review and meta-analysis.

PubMed

Kessing, Lars Vedel; Willer, Inge; Andersen, Per Kragh; Bukh, Jens Drachman

2017-08-01

For the first time to present a systematic review and meta-analysis of the conversion rate and predictors of conversion from unipolar disorder to bipolar disorder. A systematic literature search up to October 2016 was performed. For the meta-analysis, we only included studies that used survival analysis to estimate the conversion rate. A total of 31 studies were identified, among which 11 used survival analyses, including two register-based studies. The yearly rate of conversion to bipolar disorder decreased with time from 3.9% in the first year after study entry with a diagnosis of unipolar disorder to 3.1% in years 1-2, 1.0% in years 2-5 and 0.8% in years 5-10. A total of eight risk factors were evaluated comprising gender, age at onset of unipolar disorder, number of depressive episodes, treatment resistance to antidepressants, family history of bipolar disorder, the prevalence of psychotic depression, the prevalence of chronic depression, and severity of depression. It was not possible to identify risk factors that were consistently or mainly confirmed to predict conversion across studies. The conversion rate from unipolar to bipolar disorder decreases with time. It was not possible to identify predictors of conversion that were consistently or mainly confirmed across studies, which may be due to variations in methodology across studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.

PubMed

Yegya-Raman, Nikhil; Aziz, Rehan; Schneider, Daniel; Tobia, Anthony; Leitch, Megan; Nwobi, Onyi

2017-01-01

Background . Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. Methods . PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder". Case . The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder and unspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease. Discussion . This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations.

[Dissociation (conversion) - malingering - antisocial personality disorder: differential diagnostic reflection on the basis of a case study].

PubMed

Rothuber, Helfried; Mitterauer, Bernhard

2011-01-01

In this case report we refer to the big challenge of making a diagnosis in a deliberate malingering in the field of mental disorders. We specifically describe the difficulty regarding the differentiation between a conversion disorder and malingering of a serial delinquent. For such a person avoiding criminal persecution is one of the most frequent reason to deceitfully simulate a mental illness. In this field, symptoms of conversion disorders exceed the average; furthermore, a great number of organic-neurological illnesses may appear to be very similar to a conversion disorder or in many cases a neurological disorder can actually be detected in the course of a somatic examination. A further obstacle for the differential diagnosis can be seen in the difficulty to discern it from factitious disorders. However, it is quite possible to discern the deliberate malingering of a mental disorder from a conversion disorder by means of the diligent diagnosis of a competent and experienced doctor/assessor who specialises.

Brief Report: A Scale for Rating Conversational Impairment in Autism Spectrum Disorder

ERIC Educational Resources Information Center

de Villiers, Jessica; Fine, Jonathan; Ginsberg, Gary; Vaccarella, Liezanne; Szatmari, Peter

2007-01-01

There are few well-standardized measures of conversational breakdown in Autism Spectrum Disorders (ASD). The study's objective was to develop a scale for measuring pragmatic impairments in conversations of individuals with ASD. We analyzed 46 semi-structured conversations of children and adolescents with high-functioning ASD using a functional…

Personality Disorder Symptom Severity Predicts Onset of Mood Episodes and Conversion to Bipolar I Disorder in Individuals with Bipolar Spectrum Disorder

PubMed Central

Ng, Tommy H.; Burke, Taylor A.; Stange, Jonathan P.; Walshaw, Patricia D.; Weiss, Rachel B.; Urosevic, Snezana; Abramson, Lyn Y.; Alloy, Lauren B.

2017-01-01

Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every four months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR]= 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR= 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. PMID:28368159

Cathecol-O-methyl transferase Val158Met genotype is not a risk factor for conversion disorder.

PubMed

Armagan, E; Almacıoglu, M L; Yakut, T; Köse, A; Karkucak, M; Köksal, O; Görükmez, O

2013-03-19

Alterations in catechol-O-methyltransferase (COMT) activity are involved in various types of neurological disorders. We examined a possible association between the COMT Val158Met polymorphism and conversion disorder in a study of 48 patients with conversion disorder and 48 control patients. In the conversion disorder group, 31 patients were Val/Met heterozygotes, 15 patients were Val/Val homozygotes and 2 patients were Met/Met homozygotes. In the control group, 32 patients were Val/Met heterozygotes and 16 patients were Val/Val homozygotes. There was no significant difference between the groups. We conclude that the COMT Val158Met genotype is quite common in Turkey and that it is not a risk factor for conversion disorder in the Turkish population.

Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.

PubMed

Ng, Tommy H; Burke, Taylor A; Stange, Jonathan P; Walshaw, Patricia D; Weiss, Rachel B; Urosevic, Snezana; Abramson, Lyn Y; Alloy, Lauren B

2017-04-01

Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

PubMed

Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

2015-03-15

The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Neurophysiology of conversion disorders: a historical perspective.

PubMed

Crommelinck, M

2014-10-01

The aim of this paper is to present a short historical perspective on the neurophysiological approach to hysteria and conversion disorders. The body of this paper will be constituted of three main parts. In the first part, we will present the significant progress due to some pioneers of neurology/psychiatry during the XIXth century. As we shall see, this period was particularly rich in personalities whose work gradually laid the foundations to a true medical approach to hysteria. In the first half of the XXth century, different factors have led to a long eclipse of the neurological approach to hysteria. In the second part, we will show how, by the 1960's-1970's, the conceptual and methodological advances in neurophysiology, as well as the turning point of cognitive sciences (and cognitive psychology in particular) allowed a gradual reinstatement of hysteria within the fields of neurology and clinical neurophysiology. Finally, and this is the third part of this paper, we will show how over the past three decades, an entirely new neurophysiological approach to hysteria and conversion disorders has emerged. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

When symptoms don't fit: a case series of conversion disorder in the pediatric otolaryngology practice.

PubMed

Caulley, Lisa; Kohlert, Scott; Gandy, Hazen; Olds, Janet; Bromwich, Matthew

2018-05-29

Conversion disorder refers to functional bodily impairments that can be precipitated by high stress situations including trauma and surgery. Symptoms of conversion disorder may mimic or complicate otolaryngology diseases in the pediatric population. In this report, the authors describe 3 cases of conversion disorder that presented to a pediatric otolaryngology-head and neck surgery practice. This report highlights a unique population of patients who have not previously been investigated. The clinical presentation and management of these cases are discussed in detail. Non-organic otolaryngology symptoms of conversion disorder in the pediatric population are reviewed. In addition, we discuss the challenges faced by clinicians in appropriately identifying and treating these patients and present an approach to management of their care. In this report, the authors highlight the importance of considering psychogenic illnesses in patients with atypical clinical presentations of otolaryngology disorders.

Chronic subjective dizziness versus conversion disorder: discussion of clinical findings and rehabilitation.

PubMed

Honaker, Julie A; Gilbert, Jane M; Staab, Jeffrey P

2010-06-01

Audiologists frequently encounter patients who complain of chronic dizziness or imbalance, in the absence of active vestibular or neurological deficits. Knowledge about conditions that cause this clinical presentation will allow audiologists to make important contributions to accurate diagnosis and effective management of these patients. This article reviews 2 such conditions, chronic subjective dizziness (CSD) and conversion disorder. A case of CSD and another of conversion disorder are presented, with a literature review of their clinical presentations, key diagnostic features, and treatment strategies. The role of the audiologist in assessing patients with these conditions and facilitating appropriate treatment referrals is discussed. The audiologist is in a key position to identify individuals with CSD and conversion disorder, 2 conditions that can be effectively managed if properly recognized. The authors demonstrate an effective team approach program that includes the audiologist's contribution to differential diagnosis, education of patients and other clinicians about these conditions, and development of recommendations for neurological, psychiatric, otologic, and physical therapy referrals.

Spin-charge conversion in disordered two-dimensional electron gases lacking inversion symmetry

NASA Astrophysics Data System (ADS)

Huang, Chunli; Milletarı, Mirco; Cazalilla, Miguel A.

2017-11-01

We study the spin-charge conversion mechanisms in a two-dimensional gas of electrons moving in a smooth disorder potential by accounting for both Rashba-type and Mott's skew scattering contributions. We find that the quantum interference effects between spin-flip and skew scattering give rise to anisotropic spin precession scattering (ASP), a direct spin-charge conversion mechanism that was discovered in an earlier study of graphene decorated with adatoms [Huang et al., Phys. Rev. B 94, 085414 (2016), 10.1103/PhysRevB.94.085414]. Our findings suggest that, together with other spin-charge conversion mechanisms such as the inverse galvanic effect, ASP is a fairly universal phenomenon that should be present in disordered two-dimensional systems lacking inversion symmetry.

Is physiotherapy effective in the management of child and adolescent conversion disorder? A systematic review.

PubMed

FitzGerald, Tara L; Southby, Alesha K; Haines, Terrence P; Hough, Janet P; Skinner, Elizabeth H

2015-02-01

Child and adolescent conversion disorder has the potential to impart significant burden on health-care services and affect quality of life. Clinically, physiotherapists are involved in conversion disorder management; however, no systematic reviews have examined physiotherapy effectiveness in its management. The aim of this review is to identify the efficacy of physiotherapy management of child and adolescent conversion disorder. A search of multiple databases (Medline, CINAHL, Embase, PsychINFO, PEDro and the Cochrane Library) was completed along with manual searching of relevant reference lists to identify articles including children 0-18 years with a diagnosis of conversion disorder who received physical management. Two independent reviewers screened titles and abstracts using criteria. Data were extracted regarding study characteristics, functional outcome measures, length of stay, physiotherapy service duration and resolution of conversion symptoms. Methodological quality was assessed using a tool designed for observational studies. Twelve observational studies were included. No functional outcome measures were used to assess the effectiveness of the treatment protocols in the case studies. Resolution of symptoms occurred in all but two cases, with conversion symptoms still present at 11 months and at 2 years. Length of stay varied from 3 days to 16 weeks, with similar variation evident in length of physiotherapy service provision (2.5 weeks to 16 weeks). There was limited and poor quality evidence to establish the efficacy of physiotherapy management of child and adolescent conversion disorders. More rigorous study designs with consistent use of reliable, valid and sensitive functional outcome measures are needed in this area. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion.

PubMed

Martinez, Molly S; Fristad, Mary A

2013-06-01

Bipolar disorder-not otherwise specified (BD-NOS) is an imprecise, heterogeneous diagnosis that is unstable in youth. This study reports rates of conversion from BD-NOS to BD-I or II in children aged 8-12, and investigates the impact of family history of bipolar disorder and depression on conversion. As part of the Multi-Family Psychoeducational Psychotherapy (MF-PEP) study, 27 children (6-12 years of age) diagnosed with BD-NOS at baseline were reassessed every 6 months over an 18-month period. Family history of bipolar disorder and depression was assessed at baseline. One-third of the sample converted from BD-NOS to BD-I or II over 18-months. Having a first-degree relative with symptoms of bipolar disorder and having a loaded pedigree for diagnosis of depression each were associated with conversion from BD-NOS to BD-I or II (odds ratio range: 1.09-3.14; relative risk range: 1.06-2.34). This study had very low power (range: 10-45) given the small sample size, precluding statistical significance of non-parametric Fisher's Exact test findings. This study replicates the previous finding of a high rate of conversion from BD-NOS to BD-I or II among youth, and suggests conversion is related to symptoms of bipolar disorder or depression diagnoses in the family history. Additional research is warranted in a larger sample with a longer follow-up period. Copyright © 2012 Elsevier B.V. All rights reserved.

"Hunger Hurts, but Starving Works". The Moral Conversion to Eating Disorders.

PubMed

Orsini, Gisella

2017-03-01

This article aims to shed light on the self-perceptions of people with eating disorders in Malta and Italy through a deep understanding of their narratives. In contrast to the biomedical perception of the phenomenon and in opposition with the prevalent feminist theories on the subject, I consider eating disorders as the result of self-transformative processes. I suggest that anorexics, bulimics and binge eaters are actively and deliberately engaged in a project of moral self-transformation that is culturally defined. The moral transformations of women with eating disorders in Malta and Italy, the two considered contexts of this research, reflect the social expectations of women in these societies. The drastic changes in personal attitudes towards both food and the body that characterise eating disorders are the result of a complete dedication to the moral values embodied in thinness, namely the control of bodily needs and pleasure. The self-transformative process of people with eating disorders can be understood as a form of moral conversion along a continuum of increasing control over hunger: the higher the control, the higher the level of satisfaction and the degree of moral conversion achieved. Considering the general low recovery rates of people with eating disorders, this approach helps in the understanding of why people who are diagnosed with an eating disorder accept medical definitions and treatments to different extents.

Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder

PubMed Central

Voon, V; Brezing, C; Gallea, C; Hallett, M

2014-01-01

Background Conversion disorder is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self-monitoring, limbic processing or top-down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that conversion disorder with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amgydala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Methods Subjects performed either an internally or externally generated two-button action selection task in a functional MRI study. Results Eleven conversion disorder patients without major depression and 11 age- and gender-matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. Conclusion We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system which is both hypoactive and functionally disconnected from prefrontal top-down regulation. PMID:21935985

Clinical Considerations Regarding Regression in Psychotherapy with Patients with Conversion Disorder.

PubMed

Kaplan, Marcia

Regression is a ubiquitous phenomenon in psychodynamic psychotherapy and psychoanalysis, typically part of a reorganization that leads to progression, at least with respect to recruiting elements in the unconscious to consciousness. Regression in patients with conversion disorder (i.e., pseudo-neurological symptoms without an organic basis) is often itself somatic/physical rather than psychic in nature. Psychotherapists working with these patients must be prepared for confusing or frightening forms of regression that should be expected as part of the therapeutic process. In conversion disorder patients with adequate character structure, this regression, when handled effectively by the psychotherapist, ultimately leads to verbalized thoughts and feelings and a gradually strengthening alternative to physically experienced psychic conflict.

Parent Conversations about Healthful Eating and Weight: Associations with Adolescent Disordered Eating Behaviors

PubMed Central

Berge, Jerica M.; MacLehose, Rich; Loth, Katie A.; Eisenberg, Marla; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne

2013-01-01

Objective The prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental. This study aimed to examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors. Design Cross-sectional analysis using data from two linked multi-level population-based studies. Setting Anthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009–2010. Participants Socio-economically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from EAT (Eating and Activity in Teens) 2010 (n = 2,793, mean age=14.4) and parents from F-EAT (Families and Eating and Activity in Teens) (n = 3,709, mean age = 42.3). Main Exposure Parent conversations about healthful eating and weight/size. Outcome Measures Adolescent dieting, unhealthy weight control behaviors, and binge eating. Results Mothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight control behaviors, and engage in binge eating. Overweight/obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight control behaviors. Additionally, sub-analyses with adolescents with data from two parents showed that when both parents engaged in healthful eating conversations, their overweight/obese adolescent children were less likely to diet and use unhealthy weight control behaviors. Conclusion Parent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors. PMID:23797808

[Neurology of hysteria (conversion disorder)].

PubMed

Sonoo, Masahiro

2014-07-01

Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

The role of emotion dysregulation in Conversion Disorder.

PubMed

Del Río-Casanova, Lucía; González-Vázquez, Ana Isabel; Justo, Ania; Andrade, Vanessa; Páramo, Mario; Brenlla, Julio; Blanco-Hortas, Andrés

2018-05-01

The role that emotion regulation plays in Conversion Disorders (CD) is not well known. This research deepens in this subject and describes the main differences between a group of conversion patients and a control group on different measures of emotion regulation and other clinical variables. A case-control study was conducted including 43 patients suffering from CD and 42 healthy controls. Both groups went thought two psychiatric interviews and fulfilled 6 questionnaires assessing depression, anxiety, alexithymia, emotion dysregulation, affect intensity, psychoform and somatoform dissociation. Patients suffering from CD scored significantly higher on all the six questionnaires (p<0.001). Negative reactivity and negative intensity were also higher in patients (p<0.01), while cases and controls did not show any significant differences on positive affectivity and serenity. Anxiety, alexithymia and emotional dysregulation were the most relevant factors (OR=5.85/3.50/3.23 respectively). Anxiety and difficulties in emotion regulation were the most explicative variables for conversion in the regression analysis performed. Within the five factors assessing difficulties in emotion regulation, lack of emotional control and interference in goal directed behaviors were the most relevant. Positive and negative conversion where correlated to different emotional impairments. People suffering from CD show several emotional impairments when compared to healthy controls. Emotion dysregulation can be considered a relevant aspect in CD. The existence of specific emotional patterns for different conversion manifestations is suspected.

Etiology, pathogenesis, and therapy according to Pierre Janet concerning conversion disorders and dissociative disorders.

PubMed

Bühler, Karl-Ernst; Heim, Gerhard

2011-01-01

Pierre Janet's works on conversion disorders or dissociative disorders has mainly fallen to the wayside in favour of Freud's works. In the first part of this paper, Janet's conception of hysteria is discussed and his place in French psychiatry described. Different aspects of Janet's diathesis-stress approach are presented (particularly the pathogenic concept of fixed ideas), which refer not only to a conception of hysteria but also to traumatic (stress) disorders and other psychological disturbances. The second part of the paper details the varieties of Janetian therapeutic treatments of these disorders: the "liquidation" of fixed ideas by hypnosis and suggestion, confrontation techniques, which resemble contemporary cognitive behavioural approaches, and special cognitive ("logagogic") interventions. Finally, we discuss the various treatment strategies based on psychoeconomic considerations such as physical or psycho-phyical therapies, psychoeducation, treatment through rest, and simplification of life for dealing with basic disturbances of psychic disorders.

Conversational fluency and executive function in adolescents with conduct disorder

PubMed Central

Turkstra, Lyn S.; Fuller, Tracy; Youngstrom, Eric; Green, Kristen; Kuegeler, Elizabeth

2017-01-01

SUMMARY Background EF impairments are known to occur among adolescents with conduct disorder (CD) but their influence on communication ability is not well-understood. The purpose of this study was to relate scores on a clinical EF questionnaire to performance on a communication task. Extemporaneous conversation was chosen as the target task, because it places a high demand on EFs and it is a critical medium for adolescent social development. Material and Methods The participants were 18 incarcerated adolescents with conduct disorder (I-CD), 12 incarcerated adolescents without CD (I-NCD), and 26 typically developing (TD) non-incarcerated adolescents. Participants completed the Self-Report form of the Behavior Rating Inventory of Executive Function (BRIEF) and extemporaneous conversations. Results The I-CD and I-NCD groups produced four times more dysfluencies in conversation than the TD group. There was also a significant group effect on BRIEF subscores for executive memory (TD vs. I-CD), but not for planning and organization. Fluency data correlated significantly with BRIEF scores for executive memory, and the combination of fluency and BRIEF data accounted for 65% of the variance in group membership between TD adolescents and their incarcerated peers, regardless of CD diagnosis. Conclusions BRIEF scores seem to be related to performance on communication tasks relevant for adolescents in daily living. Our results also revealed very high dysfluency rates among incarcerated juveniles. The EF and conversation measures differentiated incarcerated vs. non-incarcerated juveniles, but were less sensitive to CD. PMID:29213294

Toward Meaningful Outcomes in Teaching Conversation and Greeting Skills with Individuals with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hood, Stephanie A.; Luczynski, Kevin C.; Mitteer, Daniel R.

2017-01-01

We identified greeting and conversation deficits based on a parent interview and semistructured direct assessment for one child and two adolescents with autism spectrum disorder. We taught the greeting and conversation skills using behavioral skills training and within-session corrective feedback. A multiple baseline across conversation and…

[When a patient falls (asleep) and can't get up: conversion disorder - paraplegia following general anesthesia].

PubMed

Mason, Chawla LaToya

This case report describes the rare occurrence of paraplegia caused by conversion disorder in a woman who received general anesthesia for breast surgery. A 46-year-old healthy woman received general anesthesia for excision of a left breast fibroepithelial lesion. In the post-anesthesia care unit, she reported bilateral loss of both sensation and motor function below the knees. Physical signs and symptoms did not correlate with any anatomical or neurological patterns; imaging revealed no abnormalities. Psychiatric consultation was performed wherein familial stressor circumstances were identified, leading to diagnosis and management of conversion disorder. Conversion disorder is characterized by alteration of physical function due to expression of an underlying psychological ailment. Its diagnosis requires thorough evaluation including appropriate workup to exclude organic causes. The meshing together of anesthesiology and psychiatry - as demonstrated by this case report - offers an opportunity to highlight important information pertaining to the definition, diagnosis, and management of conversion disorder as it may be encountered in the postanesthesia recovery period. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland.

PubMed

Ani, Cornelius; Reading, Richard; Lynn, Richard; Forlee, Simone; Garralda, Elena

2013-06-01

Little is known about conversion disorder in childhood. To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the U.K. and Ireland. Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System. In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a non-medical explanation of the symptoms either fully or partially. Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

[Conversion disorder: from DSM IV to DSM 5 or from a psychiatric to a neurological diagnosis].

PubMed

Vermeulen, M; Willems, M H A

2015-01-01

According to one of the diagnostic criteria of the dsm iv for conversion disorder there has to be a temporal relationship between psychological factors and the onset, or the worsening, of the symptoms. This criterion has been omitted in the dsm-5. Another criterion, namely that the symptoms are not produced intentionally, has also been abandoned. A new recommendation is that therapists should look for neurological symptoms that support the diagnosis. To investigate whether studies support the changes in the criteria. We searched literature using PubMed. When the symptoms first appear, trauma or stress in 37% of patients is of a physical rather than a psychological nature. Different forms of stress were found in equal proportions (20%) in patients with or without conversion disorder. There are no specific stressors, except possibly in patients with dysphonia. The percentages of childhood abuse vary widely, namely from 0 to 85%. The characteristic phenomenon of 'la belle indifference' occurs in only 3% of patients with conversion disorder versus only 2% of controls. Most of the 'positive' clinical tests for partial paralysis and sensory and gait disorders are highly specific. There are no reliable tests for distinguishing conversion disorder from simulation. The changes of the criteria are supported by recent studies.

Action-effect binding is decreased in motor conversion disorder: implications for sense of agency.

PubMed

Kranick, Sarah M; Moore, James W; Yusuf, Nadia; Martinez, Valeria T; LaFaver, Kathrin; Edwards, Mark J; Mehta, Arpan R; Collins, Phoebe; Harrison, Neil A; Haggard, Patrick; Hallett, Mark; Voon, Valerie

2013-07-01

The abnormal movements seen in motor conversion disorder are affected by distraction and entrainment, similar to voluntary movement. Unlike voluntary movement, however, patients lack a sense of control for the abnormal movements, a failure of "self-agency." The action-effect binding paradigm has been used to quantify the sense of self-agency, because subjective contraction of time between an action and its effect only occurs if the patient feels that they are the agent responsible for the action. We used this paradigm, coupled with emotional stimuli, to investigate the sense of agency with voluntary movements in patients with motor conversion disorder. Twenty patients with motor conversion disorder and 20 age-matched and sex-matched healthy volunteers used a rotating clock to judge the time of their own voluntary key presses (action) and a subsequent auditory tone (effect) after they completed conditioning blocks in which high, medium, and low tones were coupled to images of happy, fearful, and neutral faces. The results replicated those produced previously: it was reported that an effect after a voluntary action occurred earlier, and the preceding action occurred later, compared with trials that used only key presses or tones. Patients had reduced overall binding scores relative to healthy volunteers, suggesting a reduced sense of agency. There was no effect of the emotional stimuli (faces) or other interaction effects. Healthy volunteers with subclinical depressive symptoms had higher overall binding scores. We demonstrate that patients with motor conversion disorder have decreased action-effect binding for normal voluntary movements compared with healthy volunteers, consistent with the greater experience of lack of control. Copyright © 2013 Movement Disorder Society.

Conversion Disorder in an Appalachian Community.

PubMed

Slocum, Sarah; Holroyd, Suzanne

2016-08-01

Conversion disorder (CD) is believed to be the manifestation of physical and/or neurological symptoms for primary gain without an identifiable organic cause. Although it is believed to be more common in rural areas, the literature examining this claim is sparse. To our knowledge, no study has been published evaluating the prevalence of CD in a rural Appalachian population. The aim of this study was to characterize and determine the prevalence of CD per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria in a rural Appalachian psychiatric consultation service and to compare this population with control patients from the same service. We performed a retrospective chart review of all patients diagnosed as having CD per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria on a psychiatric consultation service at a rural Appalachian academic medical center during a 13-month time period. For each case, two consecutive control patients were selected from the same service and time span. There were 21 cases and 42 controls in this study, with a CD prevalence rate of 6.0% (N = 21/351). Sociodemographic, comorbidity, and recent symptomatology data were obtained. Compared with controls, cases were significantly younger and were more likely to have a history of sexual abuse, seizure disorder, antiepileptic use, neurologic referral, electroencephalogram, magnetic resonance imaging of the brain, and history of CD. We found it interesting that fewer cases reported alcohol and drug use. The observed prevalence of 6.0% does not support the historical theory that CD is more prevalent in rural or lower socioeconomic populations. Our data add to the characterization of the Appalachian CD population.

Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia): A case study.

PubMed

Nasiri, Hamid; Ebrahimi, Amrollah; Zahed, Arash; Arab, Mostafa; Samouei, Rahele

2015-05-01

Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia) was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

Using a Behavioral Skills Training Package to Teach Conversation Skills to Young Adults with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Nuernberger, Jodi E.; Ringdahl, Joel E.; Vargo, Kristina K.; Crumpecker, Anna C.; Gunnarsson, Karl F.

2013-01-01

A behavioral skills training package was used to teach vocal and non-vocal conversation skills to young adults with autism spectrum disorders. A task analysis was created and verified that included both vocal conversation skills such as making comments related to the conversation topic, and non-vocal conversation skills such as maintaining…

Conversational behaviour of children with Asperger syndrome and conduct disorder.

PubMed

Adams, Catherine; Green, Jonathan; Gilchrist, Anne; Cox, Anthony

2002-07-01

Social communication problems in individuals who have Asperger syndrome constitute one of the most significant problems in the syndrome. This study makes a systematic analysis of the difficulties demonstrated with the use of language (pragmatics) in adolescents who have Asperger syndrome. Recent advances in discourse analysis were applied to conversational samples from a group of children with Asperger syndrome and a matched control group of children with severe conduct disorder. Two types of conversation were sampled from each group, differing in emotional content. The results showed that in these contexts children with Asperger syndrome were no more verbose as a group than controls, though they showed a tendency to talk more in more emotion-based conversations. Children with Asperger syndrome, as a group, performed similarly to control subjects in ability to respond to questions and comments. However, they were more likely to show responses which were problematic in both types of conversation. In addition, individuals with Asperger syndrome showed more problems in general conversation than during more emotionally and socially loaded topics. The group with Asperger syndrome was found to contain a small number of individuals with extreme verbosity but this was not a reliable characteristic of the group as a whole.

Children with Autism Spectrum Disorder: Teaching Conversation Involving Feelings about Events

ERIC Educational Resources Information Center

Conallen, K.; Reed, P.

2017-01-01

Background: Two procedures were developed to teach individuals with Autism Spectrum Disorders labels (tacts) for various private events (emotions): Study 1 attempted to distinguish them from pure tacts and mands (requests); and Study 2 attempted to train initiating a conversation with grammatically correct subject-verb-comment construction.…

Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders.

PubMed

Jones, Danielle; Drew, Paul; Elsey, Christopher; Blackburn, Daniel; Wakefield, Sarah; Harkness, Kirsty; Reuber, Markus

2016-01-01

In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on 'timely diagnosis' aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints. This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group. Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences. The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

[Before you diagnose a patient with a conversion disorder, perform a thorough general medical and neurological examination. Case study].

PubMed

Pawełczyk, Tomasz; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta

2012-01-01

Dissociative and conversion disorders are classified together according to ICD-10 as states that are not confirmed by the presence of somatic diseases, which they suggest. According to the DSM-IV, both disorders are classified separately. Conversion disorders are a group of psychiatric disorders whose symptoms mimic the presence of malfunction or loss of motor or sensory function, whereas the nature and dynamics of the observed symptoms is not fully explained by the results of objective assessments and consultations, nor is the direct effect of a psychoactive substance. Impaired mental integration of different functions which normally interact simultaneously in the perception of reality and inner experience of the individual is found in dissociative disorders. The article describes the case of 25-year old man, in whom after initial suspicion of myasthenia gravis and its exclusion, a diagnosis of conversion disorder was made on the basis of the clinical picture and treatment with an SSRI antidepressant and individual psychotherapy were recommended. No improvement in mental and neurological status after six month therapy resulted in an in-depth diagnostics in a clinical setting and diagnosis of brain stem tumor (aastrocytoma fibrillare). (a) Neuroimaging is a source of important clinical data and in many cases should constitute an inherent element of a psychiatric diagnosis. (b) Diagnosis of conversion (dissociative) disorders requires a precise differential diagnosis, excluding the somatic causes of observed neurological ailments. (c) A late diagnosis of neurological or somatic causes of symptoms which arouse a suspicion of conversion (dissociative) disorders may make a radical treatment impossible or may considerably aggravate the remote prognosis and quality of the patients' life.

The classification of conversion disorder (functional neurologic symptom disorder) in ICD and DSM.

PubMed

Levenson, J L; Sharpe, M

2016-01-01

The name given to functional neurologic symptoms has evolved over time in the different editions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), reflecting a gradual move away from an etiologic conception rooted in hysterical conversion to an empiric phenomenologic one, emphasizing the central role of the neurologic examination and testing in demonstrating that the symptoms are incompatible with recognized neurologic disease pathophysiology, or are internally inconsistent. © 2016 Elsevier B.V. All rights reserved.

Specific biases for identifying facial expression of emotion in children and adolescents with conversion disorders.

PubMed

Kozlowska, Kasia; Brown, Kerri J; Palmer, Donna M; Williams, Lea M

2013-04-01

This study aimed to assess how children and adolescents with conversion disorders identify universal facial expressions of emotion and to determine whether identification of emotion in faces relates to subjective emotional distress. Fifty-seven participants (41 girls and 16 boys) aged 8.5 to 18 years with conversion disorders and 57 age- and sex-matched healthy controls completed a computerized task in which their accuracy and reaction times for identifying facial expressions were recorded. To isolate the effect of individual emotional expressions, participants' reaction times for each emotion (fear, anger, sadness, disgust, and happiness) were subtracted from their reaction times for the neutral control face. Participants also completed self-report measures of subjective emotional distress. Children/Adolescents with conversion disorders showed faster reaction times for identifying expressions of sadness (t(112) = -2.2, p = .03; 444 [609] versus 713 [695], p = .03) and slower reactions times for happy expressions (t(99.3) = 2.28, p ≤ .024; -33 [35] versus 174 [51], p = .024), compared with controls (F(33.75, 419.81) = 3.76, p < .001). There were no significant correlations (at the corrected p value of .01) between reaction times and subjective reports of perceived distress (r values ranged from 092 to 0.221; p > .018). There were also no differences in identification accuracy for any emotion (p > .82). The observation of faster reaction times to sad faces in children and adolescents with conversion disorders suggests increased vigilance and motor readiness to emotional signals that are potential threats to self or to close others. These effects may occur before conscious processing.

Functional neuroimaging of recovery from motor conversion disorder: A case report.

PubMed

Dogonowski, Anne-Marie; Andersen, Kasper W; Sellebjerg, Finn; Schreiber, Karen; Madsen, Kristoffer H; Siebner, Hartwig R

2018-03-27

A patient with motor conversion disorder presented with a functional paresis of the left hand. After exclusion of structural brain damage, she was repeatedly examined with whole-brain functional magnetic resonance imaging, while she performed visually paced finger-tapping tasks. The dorsal premotor cortex showed a bilateral deactivation in the acute-subacute phase. Recovery from unilateral hand paresis was associated with a gradual increase in task-based activation of the dorsal premotor cortex bilaterally. The right medial prefrontal cortex displayed the opposite pattern, showing initial task-based activation that gradually diminished with recovery. The inverse dynamics of premotor and medial prefrontal activity over time were found during unimanual finger-tapping with the affected and non-affected hand as well as during bimanual finger-tapping. These observations suggest that reduced premotor and increased medial prefrontal activity reflect an effector-independent cortical dysfunction in conversion paresis which gradually disappears in parallel with clinical remission of paresis. The results link the medial prefrontal and dorsal premotor areas to the generation of intentional actions. We hypothesise that an excessive 'veto' signal generated in medial prefrontal cortex along with decreased premotor activity might constitute the functional substrate of conversion disorder. This notion warrants further examination in a larger group of affected patients. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder.

PubMed

Voon, Valerie; Brezing, Christina; Gallea, Cecile; Hallett, Mark

2011-11-01

Conversion disorder (CD) is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self-monitoring, limbic processing or top-down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that CD with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amygdala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Subjects performed either an internally or externally generated 2-button action selection task in a functional MRI study. Eleven CD patients without major depression and 11 age- and gender-matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula, and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system, which is both hypoactive and functionally disconnected from prefrontal top-down regulation. Copyright © 2011 Movement Disorder Society.

Recurrence of conversion disorder symptoms in a successfully treated 16-year-old female.

PubMed

Shapiro, Michael; Mehta, Anuja; Avila, Jorge; Nguyen, Mathew

2015-01-01

We present a case of a 16-year-old Caucasian female with a history of major depressive disorder and post-traumatic stress disorder who was admitted to an inpatient adolescent psychiatric unit with symptoms of conversion disorder, including non-epileptic seizures, an inability to speak or walk, and not eating on her own. She has a history of multiple previous medical and psychiatric hospitalizations without any significant resolution of symptoms, and extensive medical workups have all been negative. Treatment ultimately involved reassuring the patient and family that there was no underlying medical condition and emphasizing the conversion disorder diagnosis. The patient participated daily in physical therapy to improve mobility, deconditioning, and functioning. Hospital staff was instructed on the nature of the non-epileptic seizures, which continued to occur during the hospitalization. After one month, the patient was discharged home fully functional: walking, speaking, and eating on her own. One week after discharge, the patient presented with the same symptoms and was readmitted to the psychiatric facility. She subsequently never regained her previous level of functioning, and she was ultimately transferred to a residential treatment facility. We will discuss factors that led to the initial improvement and the factors that led to recurrence and persistence of symptoms. © The Author(s) 2015.

Caloric Vestibular Stimulation as a Treatment for Conversion Disorder: A Case Report and Medical Hypothesis

PubMed Central

Noll-Hussong, Michael; Holzapfel, Sabrina; Pokorny, Dan; Herberger, Simone

2014-01-01

Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal–parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure. PMID:24917828

Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder.

PubMed

Yılmaz, Savaş; Bilgiç, Ayhan; Akça, Ömer Faruk; Türkoğlu, Serhat; Hergüner, Sabri

2016-01-01

This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Fifty outpatients, aged 8-18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.

Postoperative Conversion Disorder Presenting as Inspiratory Stridor and Hemiparesis in a Pediatric Patient.

PubMed

Nelson, Erik J; Wu, Jennifer Y

2017-01-17

BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal. CONCLUSIONS After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder.

Behavioral Treatment of Conversion Disorder in Adolescence: A Case Example of Globus Hystericus.

ERIC Educational Resources Information Center

Donohue, Brad; Thevenin, Deborah M.; Runyon, Melissa K.

1997-01-01

Using a case study, evaluates the efficacy of a cognitive-behavioral intervention for the treatment of a patient diagnosed with a conversion disorder characterized by a perceived lump in the throat and subsequent weight loss. Results indicate that the behavioral therapy procedures contributed to increased weight and improved eating behavior. (RJM)

Conversion from depression to bipolar disorder in a cohort of young people in England, 1999-2011: A national record linkage study.

PubMed

James, Anthony; Wotton, Clare J; Duffy, Anne; Hoang, Uy; Goldacre, Michael

2015-10-01

To estimate the conversion rate from unipolar depression (ICD10 codes F32-F33) to bipolar disorder (BP) (ICD10 codes F31) in an English national cohort. It was hypothesised that early-onset BP (age <18 years) is a more severe form of the disorder, with a more rapid, and higher rate of conversion from depression to BP. This record linkage study used English national Hospital Episode Statistics (HES) covering all NHS inpatient and day case admissions between 1999 and 2011. The overall rate of conversion from depression to BP for all ages was 5.65% (95% CI: 5.48-5.83) over a minimum 4-year follow-up period. The conversion rate from depression to BP increased in a linear manner with age from 10-14 years - 2.21% (95% C: 1.16-4.22) to 30-34 years - 7.06% (95% CI: 6.44-7.55) (F1,23=77.6, p=0.001, R(2)=0.77). The time to conversion was constant across the age range. The rate of conversion was higher in females (6.77%; 95% CI: 6.53-7.02) compared to males, (4.17%; 95% CI: 3.95-4.40) (χ(2)=194, p<0.0001), and in those with psychotic depression 8.12% (95% CI: 7.65-8.62) compared to non-psychotic depression 5.65% (95% CI: 5.48-5.83) (χ(2)=97.0, p<0.0001). The study was limited to hospital discharges and diagnoses were not standardised. Increasing conversion rate from depression to bipolar disorder with age, and constant time for conversion across the age range does not support the notion that early-onset BP is a more severe form of the disorder. Copyright © 2015 Elsevier B.V. All rights reserved.

P-wave and QT dispersion in patients with conversion disorder.

PubMed

Izci, Filiz; Hocagil, Hilal; Izci, Servet; Izci, Vedat; Koc, Merve Iris; Acar, Rezzan Deniz

2015-01-01

The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD). A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist. There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001) and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01) were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, P<0.001, and 47±4.8 vs 20±6.1, P<0.001, respectively). A similar relation to that in literature between QTd and anxiety and somatoform disorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients.

Conversion Disorder— Mind versus Body: A Review

PubMed Central

Jabeen, Shagufta; Pate, Rebecca J.; Shahid, Marwah; Chinala, Sandhya; Nathani, Milankumar; Shah, Rida

2015-01-01

In this article, the authors accentuate the signs and symptoms of conversion disorder and the significance of clinical judgment and expertise in order to reach the right diagnosis. The authors review the literature and provide information on the etiology, prevalence, diagnostic criteria, and the treatment methods currently employed in the management of conversion disorder. Of note, the advancements of neuropsychology and brain imaging have led to emergence of a relatively sophisticated picture of the neuroscientific psychopathology of complex mental illnesses, including conversion disorder. The available evidence suggests new methods with which to test hypotheses about the neural circuits underlying conversion symptoms. In context of this, the authors also explore the neurobiological understanding of conversion disorder. PMID:26155375

Effectiveness of therapeutic conversation intervention among caregivers of people with eating disorders: quasi-experimental design.

PubMed

Gisladottir, Margret; Treasure, Janet; Svavarsdottir, Erla Kolbrun

2017-03-01

The aim of this study was to evaluate the effectiveness of therapeutic conversation intervention in group and caregiver sessions on the supporting role of caregivers. Caregivers of people with eating disorders are known to suffer major difficulties and are in great need of support. Unhelpful parental support strategies can delay the recovery of an individual with an eating disorder. Skill training interventions can equip parents with skills, guidance and techniques by helping them to be a support person and making them one of the most important links in the treatment process. The therapeutic conversation intervention consisted of five group and caregiver sessions and three booster sessions. The Calgary Family Assessment and Calgary Family Intervention Models, the Illness Beliefs Model and the New Maudsley Method were used as theoretical frameworks. The content of the intervention consisted of work on difficult behaviours, feelings and helpful strategies. The participants (n = 58) included primary and secondary caregivers of 12- to 24-year-old patients with eating disorders. Eight caregivers dropped out of treatment. This study had a quasi-experimental design with one pre- and two post-test measures. Between 90-96% of caregivers rated the therapeutic conversation intervention as supportive. Furthermore, the study revealed significant differences in caregiver emotional and cognitive support, illness beliefs, disruptive behaviour and quality of life, negative aspects of care giving demands and caregiver and patient behavioural difficulties after the intervention and/or at follow-up. Therapeutic conversation intervention with caregivers in group and private sessions proved to be beneficial. This outcome provides information for healthcare professionals on how they can help primary caregivers in their supporting role, which can, in turn, improve services in healthcare centres and psychiatric hospitals. © 2016 John Wiley & Sons Ltd.

Brain dysfunction behind functional symptoms: neuroimaging and somatoform, conversive, and dissociative disorders.

PubMed

García-Campayo, Javier; Fayed, Nicolas; Serrano-Blanco, Antoni; Roca, Miquel

2009-03-01

Neuroimaging research in psychiatry has been increasing exponentially in recent years, yet many psychiatrists are relatively unfamiliar with this field. This article summarizes the findings of the most relevant research articles on the neuroimaging of somatoform, conversive, and dissociative disorders published from January 2007 through June 2008. Neuroimaging findings summarized here include alterations of stress regulation and coping in somatoform pain disorders, the importance of catastrophizing in somatization disorder, and the relevance of a history of physical/sexual abuse in irritable bowel syndrome. Regarding fibromyalgia, three of the most significant advances have been the impossibility of differentiating primary and concomitant fibromyalgia in the presence of quiescent underlying disease, the role of hippocampal dysfunction, and the possibility that fibromyalgia may be characterized as an aging process. In dissociative disorders, the high levels of elaborative memory encoding and the reduced size of the parietal lobe are highlighted. The most promising clinical consequence of these studies, in addition to improving knowledge about the etiology of these illnesses, is the possibility of using neuroimaging findings to identify subgroups of patients, which could allow treatments to be tailored.

Monetary conversion factors for economic evaluations of substance use disorders.

PubMed

McCollister, Kathryn; Yang, Xuan; Sayed, Bisma; French, Michael T; Leff, Jared A; Schackman, Bruce R

2017-10-01

Estimating the economic consequences of substance use disorders (SUDs) is important for evaluating existing programs and new interventions. Policy makers in particular must weigh program effectiveness with scalability and sustainability considerations in deciding which programs to fund with limited resources. This study provides a comprehensive list of monetary conversion factors for a broad range of consequences, services, and outcomes, which can be used in economic evaluations of SUD interventions (primarily in the United States), including common co-occurring conditions such as HCV and HIV. Economic measures were selected from standardized clinical assessment instruments that are used in randomized clinical trials and other research studies (e.g., quasi-experimental community-based projects) to evaluate the impact of SUD interventions. National datasets were also reviewed for additional SUD-related consequences, services, and outcomes. Monetary conversion factors were identified through a comprehensive literature review of published articles as well as targeted searches of other sources such as government reports. Eight service/consequence/outcome domains were identified containing more than sixty monetizable measures of medical and behavioral health services, laboratory services, SUD treatment, social services, productivity outcomes, disability outcomes, criminal activity and criminal justice services, and infectious diseases consequences. Unit-specific monetary conversion factors are reported, along with upper and lower bound estimates, whenever possible. Having an updated and standardized source of monetary conversion factors will facilitate and improve future economic evaluations of interventions targeting SUDs and other risky behaviors. This exercise should be repeated periodically as new sources of data become available to maintain the timeliness, comprehensiveness, and quality of these estimates. Copyright © 2017 The Authors. Published by Elsevier Inc

Toward meaningful outcomes in teaching conversation and greeting skills with individuals with autism spectrum disorder.

PubMed

Hood, Stephanie A; Luczynski, Kevin C; Mitteer, Daniel R

2017-07-01

We identified greeting and conversation deficits based on a parent interview and semistructured direct assessment for one child and two adolescents with autism spectrum disorder. We taught the greeting and conversation skills using behavioral skills training and within-session corrective feedback. A multiple baseline across conversation and greeting skills demonstrated experimental control over the effects of the teaching on acquisition and generalization to novel adults. We also conducted embedded reversals to assess maintenance of the acquired skills. Teaching produced robust acquisition, generalization, maintenance, and treatment extension for 15 of the 16 targeted skills across participants. Participant and parent reports indicated high levels of social validity for the intervention and outcomes. The results support individualized assessment and intervention for improving greeting and conversation skills during unscripted interactions, which are requisite for more extended and complex social interactions. © 2017 Society for the Experimental Analysis of Behavior.

Using Self-Management to Improve the Reciprocal Social Conversation of Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Koegel, Lynn Kern; Park, Mi N.; Koegel, Robert L.

2014-01-01

Individuals with autism spectrum disorders often exhibit difficulties with reciprocal social conversation, engaging in limited verbal exchanges, even when language structures are intact. This study employed a multiple baseline design to examine the effectiveness of a self-management intervention targeting (1) on-topic responsiveness to a…

Risk factors for conversion from unipolar psychotic depression to bipolar disorder.

PubMed

Østergaard, Søren Dinesen; Straszek, Sune; Petrides, Georgios; Skadhede, Søren; Jensen, Signe Olrik Wallenstein; Munk-Jørgensen, Povl; Nielsen, Jimmi

2014-03-01

Patients with unipolar psychotic depression (PD) are at high risk of developing bipolar disorder (BD). This conversion has important implications for the choice of treatment. This study, therefore, aimed to identify risk factors associated with diagnostic conversion from PD to BD. We conducted a population-based, historical prospective cohort study by merging data from Danish registers. Patients assigned an ICD-10 diagnosis of PD between 1 January 1995 and 31 December 2007 were identified in the Danish Central Psychiatric Research Register and were followed until the development of BD, death, loss to follow-up, or 31 December 2007. Potential risk factors for conversion to BD, also defined through various Danish registers, were tested in multiple logistic regression analyses with risk expressed as adjusted odds ratios (AOR). We identified 8,588 patients with PD, of whom 609 (7.1%) developed BD during follow-up. The following characteristics were significantly associated with diagnostic conversion from PD to BD: early onset of PD [AOR = 0.99 (per year of increasing age), p = 0.044], recurrent depression [AOR = 1.02 (per episode), p = 0.036], living alone (AOR = 1.29, p = 0.007), receiving a disability pension (AOR = 1.55, p < 0.001), and the highest educational level being a technical education (AOR = 1.55, p < 0.001), short-cycle higher education (AOR = 2.65, p < 0.001), or medium-cycle higher education (AOR = 1.75, p < 0.001). Diagnostic conversion to BD was prevalent among patients with PD. The following characteristics were significantly associated with this conversion: early onset of PD, recurrent depression, living alone, receiving a disability pension, and the highest educational level being a technical education, short-cycle higher education, or medium-cycle higher education. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

What's on Your Mind? Conversation Topics Chosen by People With Degenerative Cognitive-Linguistic Disorders for Communication Boards

PubMed Central

Daniels, Darlene; Ettinger, Olivia; Mooney, Aimee; Noethe, Glory; Rowland, Charity

2015-01-01

Purpose Conversational topics chosen by a group of adults with degenerative cognitive-linguistic disorders for personalized communication board development were examined. The patient-generated themes commonly selected are presented to guide treatment planning and communication board development. Method Communication boards were created for 109 adults as part of a larger research project. One autobiographical topic that each participant would enjoy discussing multiple times was represented on each communication board with 16 pictures and word labels. For this review, topics were collapsed into general themes through a consensus process and examined by gender and age. Results Sixty unique conversational topics were identified from 109 participants and collapsed into 9 general themes: Hobbies, Family, Travel, Work, Home/Places I've Lived, Sports/Fitness, Religion, Animals, and World War II. Age and gender produced variations in themes chosen, though no significance in rank orders was found across groups. Conclusions Topics selected by adults with degenerative cognitive-linguistic disorders for communication boards resemble common conversational adult themes and do not center around basic needs or medical issues. Differences in gender and age for topic selection tend to be based on traditional roles. These general themes should be used when creating personalized communication boards for those who benefit from conversational aids. PMID:25835511

Using Reframing to Reduce Negative Statements in Social Conversation for Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Koegel, Lynn Kern; Navab, Anahita; Ashbaugh, Kristen; Koegel, Robert L.

2016-01-01

This study examined the effects of teaching the reframing of negative statements through self-management and video-feedback on social conversation in adults with autism spectrum disorder (ASD). A multiple baseline design across five participants showed that, following intervention, all were able to increase their positive and neutral statements…

Clinical predictors of conversion to bipolar disorder in a prospective longitudinal familial high-risk sample: focus on depressive features.

PubMed

Frankland, Andrew; Roberts, Gloria; Holmes-Preston, Ellen; Perich, Tania; Levy, Florence; Lenroot, Rhoshel; Hadzi-Pavlovic, Dusan; Breakspear, Michael; Mitchell, Philip B

2017-11-07

Identifying clinical features that predict conversion to bipolar disorder (BD) in those at high familial risk (HR) would assist in identifying a more focused population for early intervention. In total 287 participants aged 12-30 (163 HR with a first-degree relative with BD and 124 controls (CONs)) were followed annually for a median of 5 years. We used the baseline presence of DSM-IV depressive, anxiety, behavioural and substance use disorders, as well as a constellation of specific depressive symptoms (as identified by the Probabilistic Approach to Bipolar Depression) to predict the subsequent development of hypo/manic episodes. At baseline, HR participants were significantly more likely to report ⩾4 Probabilistic features (40.4%) when depressed than CONs (6.7%; p < .05). Nineteen HR subjects later developed either threshold (n = 8; 4.9%) or subthreshold (n = 11; 6.7%) hypo/mania. The presence of ⩾4 Probabilistic features was associated with a seven-fold increase in the risk of 'conversion' to threshold BD (hazard ratio = 6.9, p < .05) above and beyond the fourteen-fold increase in risk related to major depressive episodes (MDEs) per se (hazard ratio = 13.9, p < .05). Individual depressive features predicting conversion were psychomotor retardation and ⩾5 MDEs. Behavioural disorders only predicted conversion to subthreshold BD (hazard ratio = 5.23, p < .01), while anxiety and substance disorders did not predict either threshold or subthreshold hypo/mania. This study suggests that specific depressive characteristics substantially increase the risk of young people at familial risk of BD going on to develop future hypo/manic episodes and may identify a more targeted HR population for the development of early intervention programs.

The value of 'positive' clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review.

PubMed

Daum, Corinna; Hubschmid, Monica; Aybek, Selma

2014-02-01

Experts in the field of conversion disorder have suggested for the upcoming DSM-V edition to put less weight on the associated psychological factors and to emphasise the role of clinical findings. Indeed, a critical step in reaching a diagnosis of conversion disorder is careful bedside neurological examination, aimed at excluding organic signs and identifying 'positive' signs suggestive of a functional disorder. These positive signs are well known to all trained neurologists but their validity is still not established. The aim of this study is to provide current evidence regarding their sensitivity and specificity. We conducted a systematic search on motor, sensory and gait functional signs in Embase, Medline, PsycINfo from 1965 to June 2012. Studies in English, German or French reporting objective data on more than 10 participants in a controlled design were included in a systematic review. Other relevant signs are discussed in a narrative review. Eleven controlled studies (out of 147 eligible articles) describing 14 signs (7 motor, 5 sensory, 2 gait) reported low sensitivity of 8-100% but high specificity of 92-100%. Studies were evidence class III, only two had a blinded design and none reported on inter-rater reliability of the signs. Clinical signs for functional neurological symptoms are numerous but only 14 have been validated; overall they have low sensitivity but high specificity and their use should thus be recommended, especially with the introduction of the new DSM-V criteria.

Neuropsychological function and memory suppression in conversion disorder.

PubMed

Brown, Laura B; Nicholson, Timothy R; Aybek, Selma; Kanaan, Richard A; David, Anthony S

2014-09-01

Conversion disorder (CD) is a condition where neurological symptoms, such as weakness or sensory disturbance, are unexplained by neurological disease and are presumed to be of psychological origin. Contemporary theories of the disorder generally propose dysfunctional frontal control of the motor or sensory systems. Classical (Freudian) psychodynamic theory holds that the memory of stressful life events is repressed. Little is known about the frontal (executive) function of these patients, or indeed their general neuropsychological profile, and psychodynamic theories have been largely untested. This study aimed to investigate neuropsychological functioning in patients with CD, focusing on executive and memory function. A directed forgetting task (DFT) using words with variable emotional valence was also used to investigate memory suppression. 21 patients and 36 healthy controls completed a battery of neuropsychological tests and patients had deficits in executive function and auditory-verbal (but not autobiographical) memory. The executive deficits were largely driven by differences in IQ, anxiety and mood between the groups. A subgroup of 11 patients and 28 controls completed the DFT and whilst patients recalled fewer words overall than controls, there were no significant effects of directed forgetting or valence. This study provides some limited support for deficits in executive, and to a lesser degree, memory function in patients with CD, but did not find evidence of altered memory suppression to support the psychodynamic theory of repression. © 2013 The British Psychological Society.

Systemic Lupus Erythematosus and Sjögren's Syndrome Complicated by Conversion Disorder: a Case Report.

PubMed

Nakamura, Misa; Tanaka, Seiji; Inoue, Tadashi; Maeda, Yasuto; Okumiya, Kiyohito; Esaki, Takuya; Shimomura, G O; Masunaga, Kenji; Nagamitsu, Shinichiro; Yamashita, Yushiro

2018-05-21

Conversion disorder (CD) is sometimes accompanied by motor and sensory impairments, such as muscle weakness, paralysis, sensory hypersensitivity, and sensory loss. Sjögren's syndrome (SS) complicates 5-10% of cases of systemic lupus erythematosus (SLE). Patients with SS or SLE present with various neurological symptoms and psychiatric manifestations. When neurological symptoms are present, it is important to distinguish whether the symptoms are caused by a neurological or a mental disorder because the former requires early intensive intervention, such as methylprednisolone pulse therapy (MPT), whereas psychotherapy or antidepressant drugs are recommended for mental disorders. We noticed SS- and SLE-like symptoms just after a diagnosis of idiopathic thrombocytopenic purpura in a 14-year-old girl. At approximately the same time, paralysis started in her lower limbs and subsequently spread to her upper limbs. An examination for neurological symptoms revealed no abnormalities. Because of the conversion reaction between her neurological symptoms and her disease state, CD was suspected as the etiology of her physical symptoms. Nevertheless, because of the progressive nature of the neurological symptoms, MPT was initiated with concurrent administration of intravenous immunoglobulin, but it failed to achieve a good outcome. The patient's symptoms eventually improved after she underwent psychotherapy treatment for a few months. Because early diagnosis of the cause of neurological symptoms accompanying SS and SLE is difficult, it may be necessary to combine the two lines of treatment in the early stages. However, when a mental disorder is suspected, psychotherapy should be started early to minimize the use of unnecessary neurological treatment.

Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication.

PubMed

Soto, Gloria; Clarke, Michael T

2017-07-12

This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. https://doi.org/10.23641/asha.5150113.

[Postoperative visual loss due to conversion disorder after spine surgery: a case report].

PubMed

Bezerra, Dailson Mamede; Bezerra, Eglantine Mamede; Silva Junior, Antonio Jorge; Amorim, Marco Aurélio Soares; Miranda, Denismar Borges de

Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. A male patient, 39 years old, 71kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target-controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conversion disorders may have different signs and symptoms of non-organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Diagnostic conversion to bipolar disorder in unipolar depressed patients participating in trials on antidepressants.

PubMed

Holmskov, J; Licht, R W; Andersen, K; Bjerregaard Stage, T; Mørkeberg Nilsson, F; Bjerregaard Stage, K; Valentin, J B; Bech, P; Ernst Nielsen, R

2017-02-01

In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder. A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.8 years (SD=11.9) participating in three randomized trials on antidepressants conducted in the period 1985-1994. The independent effects of explanatory variables were examined by applying Cox regression analyses. The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10-1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM-D subscales included was found. The patients were followed-up through the Danish Psychiatric Central Research Register, which resulted in inherent limitations such as possible misclassification of outcome. In a sample of middle-aged hospitalized unipolar depressed patients participating in trials on antidepressants, the risk of conversion was associated with the number of previous depressive episodes. Therefore, this study emphasizes that unipolar depressed patients experiencing a relatively high number of recurrences should be followed more closely, or at least be informed about the possible increased risk of conversion. Copyright © 2016. Published by Elsevier Masson SAS.

Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication

PubMed Central

Clarke, Michael T.

2017-01-01

Purpose This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. Supplemental Materials https://doi.org/10.23641/asha.5150113 PMID:28672283

The modified gait abnormality rating scale in patients with a conversion disorder: a reliability and responsiveness study.

PubMed

Vandenberg, Justin M; George, Deanna R; O'Leary, Andrea J; Olson, Lindsay C; Strassburg, Kaitlyn R; Hollman, John H

2015-01-01

Individuals with conversion disorder have neurologic symptoms that are not identified by an underlying organic cause. Often the symptoms manifest as gait disturbances. The modified gait abnormality rating scale (GARS-M) may be useful for quantifying gait abnormalities in these individuals. The purpose of this study was to examine the reliability, responsiveness and concurrent validity of GARS-M scores in individuals with conversion disorder. Data from 27 individuals who completed a rehabilitation program were included in this study. Pre- and post-intervention videos were obtained and walking speed was measured. Five examiners independently evaluated gait performance according to the GARS-M criteria. Inter- and intrarater reliability of GARS-M scores were estimated with intraclass correlation coefficients (ICCs). Responsiveness was estimated with the minimum detectable change (MDC). Pre- to post-treatment changes in GARS-M scores were analyzed with a dependent t-test. The correlation between GARS-M scores and walking speed was analyzed to assess concurrent validity. GARS-M scores were quantified with good-to-excellent inter- (ICC = 0.878) and intrarater reliability (ICC = 0.989). The MDC was 2 points. Mean GARS-M scores decreased from 7 ± 5 at baseline to 1 ± 2 at discharge (t26 = 7.411, p < 0.001) and 85% of patients improved beyond the MDC. Furthermore, GARS-M scores and walking speed measurements were moderately correlated (r = -0.582, p = 0.004), indicating that the GARS-M has acceptable concurrent validity. Our findings provide evidence that the GARS-M scores are reliable, valid and responsive for quantifying gait abnormalities in patients with conversion disorder. GARS-M scores provide objective measures upon which treatment effects can be assessed. Copyright © 2014 Elsevier B.V. All rights reserved.

Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study.

PubMed

Bukh, J D; Andersen, P K; Kessing, L V

2016-04-01

In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first lifetime episode of depression. A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011 to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8.6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family history of affective disorder and co-morbid alcohol or drug abuse. The identified clinical characteristics of the first lifetime episode of depression should guide patients and clinicians for long-term individualized tailored treatment.

Elevated left mid-frontal cortical activity prospectively predicts conversion to bipolar I disorder

PubMed Central

Nusslock, Robin; Harmon-Jones, Eddie; Alloy, Lauren B.; Urosevic, Snezana; Goldstein, Kim; Abramson, Lyn Y.

2013-01-01

Bipolar disorder is characterized by a hypersensitivity to reward-relevant cues and a propensity to experience an excessive increase in approach-related affect, which may be reflected in hypo/manic symptoms. The present study examined the relationship between relative left-frontal electroencephalographic (EEG) activity, a proposed neurophysiological index of approach-system sensitivity and approach/reward-related affect, and bipolar course and state-related variables. Fifty-eight individuals with cyclothymia or bipolar II disorder and 59 healthy control participants with no affective psychopathology completed resting EEG recordings. Alpha power was obtained and asymmetry indices computed for homologous electrodes. Bipolar spectrum participants were classified as being in a major/minor depressive episode, a hypomanic episode, or a euthymic/remitted state at EEG recording. Participants were then followed prospectively for an average 4.7 year follow-up period with diagnostic interview assessments every four-months. Sixteen bipolar spectrum participants converted to bipolar I disorder during follow-up. Consistent with hypotheses, elevated relative left-frontal EEG activity at baseline 1) prospectively predicted a greater likelihood of converting from cyclothymia or bipolar II disorder to bipolar I disorder over the 4.7 year follow-up period, 2) was associated with an earlier age-of-onset of first bipolar spectrum episode, and 3) was significantly elevated in bipolar spectrum individuals in a hypomanic episode at EEG recording. This is the first study to identify a neurophysiological marker that prospectively predicts conversion to bipolar I disorder. The fact that unipolar depression is characterized by decreased relative left-frontal EEG activity suggests that unipolar depression and vulnerability to hypo/mania may be characterized by different profiles of frontal EEG asymmetry. PMID:22775582

Proinsulin maturation disorder is a contributor to the defect of subsequent conversion to insulin in {beta}-cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jie, E-mail: jie.wang2@osumc.edu; Osei, Kwame

2011-07-22

Highlights: {yields} Primary proinsulin maturation disorder is inherent in Ins2{sup +/Akita} islets/{beta}-cells. {yields} A consequence is the inefficient conversion of proinsulin to insulin. {yields} Post-translational defects occur as well in the involved PC1/3 and PC2 convertases. {yields} Proinsulin maturation chaos results in defects in the following conversion process. {yields} A link of the proinsulin maturation disorder and hyperproinsulinemia is suggested. -- Abstract: Disproportionate hyperproinsulinemia is an indicator of {beta}-cell dysfunction in diabetes and the basis underlying this abnormality remains obscure. Recently, we have found proinsulin is an aggregation-prone molecule inherent with a low relative folding rate and maintains a homeostaticmore » balance of natively and plentiful non-natively folded states (i.e., proinsulin homeostasis, PIHO) in normal {beta}-cells as a result of the integration of maturation and disposal processes. PIHO is susceptible to environmental and genetic influences. Perturbation of PIHO produces a number of toxic consequences with known association to {beta}-cell failure in diabetes. To explore whether the perturbation of PIHO has a link to disproportionate hyperproinsulinemia, we investigated proinsulin conversion and the involved prohormone convertase 1/3 (PC1/3) and 2 (PC2) in mouse Ins2{sup +/Akita} islets/{beta}-cells that preserve a primary PIHO disorder due to a mutation (C96Y) in the insulin 2 (Ins2) gene. Our metabolic-labeling studies found an increased ratio of proinsulin to insulin in the cellular or released proteins of Ins2{sup +/Akita} islets. Histological, metabolic-labeling, and RT-PCR analyses revealed decreases of the PC1/3 and PC2 immunoreactivities in the {beta}-cells of Ins2{sup +/Akita} islets in spite of no declines of these two convertases at the transcriptional and translational levels. Immunoblot analyses in cloned Ins2{sup +/Akita} {beta}-cells further confirmed the increased ratio of

Patterns and predictors of conversion to bipolar disorder in 91 587 individuals diagnosed with unipolar depression.

PubMed

Musliner, K L; Østergaard, S D

2018-05-01

Conversion from unipolar depression (UD) to bipolar disorder (BD) is a clinically important event that should lead to treatment modifications. Unfortunately, recognition of this transition is often delayed. Therefore, the objective of this study was to identify predictors of diagnostic conversion from UD to BD. Historical prospective cohort study based on 91 587 individuals diagnosed with UD in Danish hospital psychiatry between 1995 and 2016. The association between a series of potential predictors and the conversion from UD to BD during follow-up (702 710 person-years) was estimated by means of Cox regression with death as competing risk. During follow-up, 3910 individuals with UD developed BD. The cumulative incidence of conversion was slightly higher in females (8.7%, 95% CI: 8.2-9.3) compared to males (7.7%, 95% CI: 7.0-8.4). The strongest predictor of conversion from UD to BD was parental history of BD (adjusted hazard ratio (aHR) = 2.60, 95% CI: 2.20-3.07)). Other predictors included psychotic depression at the index UD episode (aHR = 1.73, 95% CI: 1.48-2.02), a prior/concomitant non-affective psychosis (aHR = 1.73, 95% CI: 1.51-1.99), and in-patient treatment at the index episode (aHR = 1.76, 95% CI: 1.63-1.91). Diagnostic conversion from UD to BD is predicted by severe depression requiring in-patient treatment, psychotic symptomatology, and parental history of BD. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Conversion disorder as psychogenic nonepileptic seizures in suspected cancer: a case report.

PubMed

Jimenez, Xavier F; Sharma, Jennifer S; Dar, Syma A

2014-01-01

Psychogenic nonepileptic seizures (PNES), a form of conversion disorder, are paroxysmal episodes resembling epilepsy while lacking electrographic correlation. The phenomenon has rarely been reported in elderly patients and has not been associated with a new-onset medical diagnosis. We present the case of an 81-year-old female with no past psychiatric or traumatic history who developed PNES within the context of a new, suspected cancer. To our knowledge, this is the first such reported case of a suspected cancer (or otherwise medical) diagnosis contributing directly and temporally to the development of PNES. Discussion of involved psychosocial variables follows the vignette, and a brief review of relevant literature is offered. Copyright © 2014 Elsevier Inc. All rights reserved.

Are psychogenic non-epileptic seizures just another symptom of conversion disorder?

PubMed

Kanaan, Richard A A; Duncan, Roderick; Goldstein, Laura H; Jankovic, Joseph; Cavanna, Andrea E

2017-05-01

Psychogenic non-epileptic seizures (PNES) are classified with other functional neurological symptoms as 'Conversion Disorder', but there are reasons to wonder whether this symptomatology constitutes a distinct entity. We reviewed the literature comparing PNES with other functional neurological symptoms. We find eight studies that directly examined this question. Though all but one found significant differences-notably in presenting age, trauma history, and dissociation-they were divided on whether these differences represented an important distinction. We argue that the aetiological and mechanistic distinctions they support, particularly when bolstered by additional data, give reason to sustain a separation between these conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder.

PubMed

Kaplan, Marcia J; Dwivedi, Alok K; Privitera, Michael D; Isaacs, Kelly; Hughes, Cynthia; Bowman, Michelle

2013-08-01

It has been theorized that conversion disorder is the result of emotion that cannot be experienced consciously as feeling states or put into words (i.e., alexithymia), but there is little confirming empirical evidence. We sought to characterize subjects with conversion disorder compared to subjects with a distinct medical illness, using the model of psychogenic non-epileptic seizures (PNES) vs. epilepsy (ES), on measures of childhood traumatic experience, alexithymia and maturity of psychological defensive strategies. All subjects admitted to the Epilepsy Monitoring Unit of the University of Cincinnati Medical Center were offered self-report questionnaires (Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20 and Response Evaluation Measure-71) at the outset of evaluation. Diagnosis of each subject was confirmed by video-EEG and we compared subjects with PNES to those with ES on these measures. 82 subjects had ES AND 96 had PNES. Those with PNES were significantly more likely to have experienced childhood trauma in all domains (p=.005 to p=.05), and were significantly more likely to have alexithymia (p=.0267). There was a significant difference in the capacity to identify feelings, and a trend towards significance in capacity to describe feelings. There were no differences in defensive styles between the two groups. PNES diagnosis was associated with female sex, higher alexithymia scores and higher rates of childhood trauma, but not with differences in defensive styles compared to ES. These findings add empirical evidence for theories regarding the cause of conversion disorder and may aid in the design of prospective treatment trials in patients with conversion disorder. Copyright © 2013 Elsevier Inc. All rights reserved.

Teaching a Student with Autism Spectrum Disorder On-Topic Conversational Responses with an iPad: A Pilot Study

ERIC Educational Resources Information Center

Sng, Cheong Ying; Carter, Mark; Stephenson, Jennifer

2017-01-01

Scripts in written or auditory form have been used to teach conversational skills to individuals with autism spectrum disorder (ASD), but with the proliferation of handheld tablet devices the scope to combine these 2 formats has broadened. The aim of this pilot study was to investigate if a script-based intervention, presented on an iPad…

Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study.

PubMed

Bolger, Ashlee; Collins, Andrew; Michels, Michelle; Pruitt, David

2018-03-14

Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known. To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms. Retrospective study. Inpatient rehabilitation unit within a large children's hospital. All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period. Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of <.05 was statistically significant. Average length of stay, Functional Independence Measure for Children (WeeFIM) scores, WeeFIM change, WeeFIM efficiency, recommended therapies, number of repeat admissions to the same hospital for conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics. 30 admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P <.001). WeeFIM efficiency was 4.8 ± 4.1 points/d. For patients with documented WeeFIM scores at 3 months, all were improved or maintained. More than three-fourths (80%) had no documented readmission to the same hospital for CD symptoms for one year after discharge from inpatient rehabilitation. Close to half (47%) returned to school within one week of discharge from inpatient rehabilitation (when school was in session). This study suggests that a multidisciplinary inpatient rehabilitation approach is a potentially effective and efficient treatment for

Emotion-motion interactions in conversion disorder: an FMRI study.

PubMed

Aybek, Selma; Nicholson, Timothy R; O'Daly, Owen; Zelaya, Fernando; Kanaan, Richard A; David, Anthony S

2015-01-01

To evaluate the neural correlates of implicit processing of negative emotions in motor conversion disorder (CD) patients. An event related fMRI task was completed by 12 motor CD patients and 14 matched healthy controls using standardised stimuli of faces with fearful and sad emotional expressions in comparison to faces with neutral expressions. Temporal changes in the sensitivity to stimuli were also modelled and tested in the two groups. We found increased amygdala activation to negative emotions in CD compared to healthy controls in region of interest analyses, which persisted over time consistent with previous findings using emotional paradigms. Furthermore during whole brain analyses we found significantly increased activation in CD patients in areas involved in the 'freeze response' to fear (periaqueductal grey matter), and areas involved in self-awareness and motor control (cingulate gyrus and supplementary motor area). In contrast to healthy controls, CD patients exhibited increased response amplitude to fearful stimuli over time, suggesting abnormal emotional regulation (failure of habituation / sensitization). Patients with CD also activated midbrain and frontal structures that could reflect an abnormal behavioral-motor response to negative including threatening stimuli. This suggests a mechanism linking emotions to motor dysfunction in CD.

Conversion disorder in children and adolescents: a disorder of cognitive control.

PubMed

Kozlowska, Kasia; Palmer, Donna M; Brown, Kerri J; Scher, Stephen; Chudleigh, Catherine; Davies, Fiona; Williams, Leanne M

2015-03-01

To assess cognitive function in children and adolescents presenting with acute conversion symptoms. Fifty-seven participants aged 8.5-18 years (41 girls and 16 boys) with conversion symptoms and 57 age- and gender-matched healthy controls completed the IntegNeuro neurocognitive battery, an estimate of intelligence, and self-report measures of subjective emotional distress. Participants with conversion symptoms showed poorer performance within attention, executive function, and memory domains. Poorer performance was reflected in more errors on specific tests: Switching of Attention (t(79) = 2.17, p = .03); Verbal Interference (t(72) = 2.64, p = .01); Go/No-Go (t(73) = 2.20, p = .03); Memory Recall and Verbal Learning (interference errors for memory recall; t(61) = 3.13, p < .01); and short-delay recall (t(75) = 2.05, p < .01) and long-delay recall (t(62) = 2.24, p = .03). Poorer performance was also reflected in a reduced span of working memory on the Digit Span Test for both forward recall span (t(103) = -3.64, p < .001) and backward recall span (t(100) = -3.22, p < .01). There was no difference between participants and controls on IQ estimate (t(94) = -589, p = .56), and there was no correlation between cognitive function and perceived distress. Children and adolescents with acute conversion symptoms have a reduced capacity to manipulate and retain information, to block interfering information, and to inhibit responses, all of which are required for effective attention, executive function, and memory. © 2014 The British Psychological Society.

Hospital revisit rate after a diagnosis of conversion disorder.

PubMed

Merkler, Alexander E; Parikh, Neal S; Chaudhry, Simriti; Chait, Alanna; Allen, Nicole C; Navi, Babak B; Kamel, Hooman

2016-04-01

To estimate the hospital revisit rate of patients diagnosed with conversion disorder (CD). Using administrative data, we identified all patients discharged from California, Florida and New York emergency departments (EDs) and acute care hospitals between 2005 and 2011 with a primary discharge diagnosis of CD. Patients discharged with a primary diagnosis of seizure or transient global amnesia (TGA) served as control groups. Our primary outcome was the rate of repeat ED visits and hospital admissions after initial presentation. Poisson regression was used to compare rates between diagnosis groups while adjusting for demographic characteristics. We identified 7946 patients discharged with a primary diagnosis of CD. During a mean follow-up of 3.0 (±1.6) years, patients with CD had a median of three (IQR, 1-9) ED or inpatient revisits, compared with 0 (IQR, 0-2) in patients with TGA and 3 (IQR, 1-7) in those with seizures. Revisit rates were 18.25 (95% CI, 18.10 to 18.40) visits per 100 patients per month in those with CD, 3.90 (95% CI, 3.84 to 3.95) in those with TGA and 17.78 (95% CI, 17.75 to 17.81) in those with seizures. As compared to CD, the incidence rate ratio for repeat ED visits or hospitalisations was 0.89 (95% CI, 0.86 to 0.93) for seizure disorder and 0.32 (95% CI 0.31 to 0.34) for TGA. CD is associated with a substantial hospital revisit rate. Our findings suggest that CD is not an acute, time-limited response to stress, but rather that CD is a manifestation of a broader pattern of chronic neuropsychiatric disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Disordered speech disrupts conversational entrainment: a study of acoustic-prosodic entrainment and communicative success in populations with communication challenges

PubMed Central

Borrie, Stephanie A.; Lubold, Nichola; Pon-Barry, Heather

2015-01-01

Conversational entrainment, a pervasive communication phenomenon in which dialogue partners adapt their behaviors to align more closely with one another, is considered essential for successful spoken interaction. While well-established in other disciplines, this phenomenon has received limited attention in the field of speech pathology and the study of communication breakdowns in clinical populations. The current study examined acoustic-prosodic entrainment, as well as a measure of communicative success, in three distinctly different dialogue groups: (i) healthy native vs. healthy native speakers (Control), (ii) healthy native vs. foreign-accented speakers (Accented), and (iii) healthy native vs. dysarthric speakers (Disordered). Dialogue group comparisons revealed significant differences in how the groups entrain on particular acoustic–prosodic features, including pitch, intensity, and jitter. Most notably, the Disordered dialogues were characterized by significantly less acoustic-prosodic entrainment than the Control dialogues. Further, a positive relationship between entrainment indices and communicative success was identified. These results suggest that the study of conversational entrainment in speech pathology will have essential implications for both scientific theory and clinical application in this domain. PMID:26321996

Evidence of embodied social competence during conversation in high functioning children with autism spectrum disorder

PubMed Central

Fitzpatrick, Paula; Roulier, Stephanie; Duncan, Amie; Richardson, Michael J.; Schmidt, R. C.

2018-01-01

Even high functioning children with Autism Spectrum Disorder (ASD) exhibit impairments that affect their ability to carry out and maintain effective social interactions in multiple contexts. One aspect of subtle nonverbal communication that might play a role in this impairment is the whole-body motor coordination that naturally arises between people during conversation. The current study aimed to measure the time-dependent, coordinated whole-body movements between children with ASD and a clinician during a conversational exchange using tools of nonlinear dynamics. Given the influence that subtle interpersonal coordination has on social interaction feelings, we expected there to be important associations between the dynamic motor movement measures introduced in the current study and the measures used traditionally to categorize ASD impairment (ADOS-2, joint attention and theory of mind). The study found that children with ASD coordinated their bodily movements with a clinician, that these movements were complex and that the complexity of the children’s movements matched that of the clinician’s movements. Importantly, the degree of this bodily coordination was related to higher social cognitive ability. This suggests children with ASD are embodying some degree of social competence during conversations. This study demonstrates the importance of further investigating the subtle but important bodily movement coordination that occurs during social interaction in children with ASD. PMID:29505608

Life events and escape in conversion disorder.

PubMed

Nicholson, T R; Aybek, S; Craig, T; Harris, T; Wojcik, W; David, A S; Kanaan, R A

2016-09-01

Psychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged. Forty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel 'escape' rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of 'secondary gain'. CD patients had significantly more severe life events and 'escape' events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients - significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56-13.70] and healthy controls (OR 5.81, 95% CI 1.86-18.2). In the same time period 53% of CD patients had at least one 'high escape' event - again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05-23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events. Evidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.

Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder.

PubMed

Blakemore, Rebekah L; Sinanaj, Indrit; Galli, Silvio; Aybek, Selma; Vuilleumier, Patrik

2016-12-01

Conversion disorder or functional neurological symptom disorder (FND) can affect the voluntary motor system, without an organic cause. Functional symptoms are thought to be generated unconsciously, arising from underlying psychological stressors. However, attempts to demonstrate a direct relationship between the limbic system and disrupted motor function in FND are lacking. We tested whether negative affect would exacerbate alterations of motor control and corresponding brain activations in individuals with FND. Ten patients and ten healthy controls produced an isometric precision-grip contraction at 10% of maximum force while either viewing visual feedback of their force output, or unpleasant or pleasant emotional images (without feedback). Force magnitude was continuously recorded together with change in brain activity using fMRI. For controls, force output decayed from the target level while viewing pleasant and unpleasant images. Patients however, maintained force at the target level without decay while viewing unpleasant images, indicating a pronounced effect of negative affect on force output in FND. This emotional modulation of force control was associated with different brain activation patterns between groups. Contrasting the unpleasant with the pleasant condition, controls showed increased activity in the inferior frontal cortex and pre-supplementary motor area, whereas patients had greater activity in the cerebellum (vermis), posterior cingulate cortex, and hippocampus. Engagement of a cerebellar-limbic network in patients is consistent with heightened processing of emotional salience, and supports the role of the cerebellum in freezing responses in the presence of aversive events. These data highlight a possible neural circuit through which psychological stressors elicit defensive behaviour and modulate motor function in FND. Copyright © 2016 Elsevier Ltd. All rights reserved.

A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners.

PubMed

Kagan, Aura; Winckel, Joanne; Black, Sandra; Duchan, Judith Felson; Simmons-Mackie, Nina; Square, Paula

2004-01-01

Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner's skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications.

Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

ERIC Educational Resources Information Center

Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

2011-01-01

Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

Abnormal Parietal Function in Conversion Paresis

PubMed Central

van Beilen, Marije; de Jong, Bauke M.; Gieteling, Esther W.; Renken, Remco; Leenders, Klaus L.

2011-01-01

The etiology of medically unexplained symptoms such as conversion disorder is poorly understood. This is partly because the interpretation of neuroimaging results in conversion paresis has been complicated by the use of different control groups, tasks and statistical comparisons. The present study includes these different aspects in a single data set. In our study we included both normal controls and feigners to control for conversion paresis. We studied both movement execution and imagery, and we contrasted both within-group and between-group activation. Moreover, to reveal hemisphere-specific effects that have not been reported before, we performed these analyses using both flipped and unflipped data. This approach resulted in the identification of abnormal parietal activation which was specific for conversion paresis patients. Patients also showed reduced activity in the prefrontal cortex, supramarginal gyrus and precuneus, including hemisphere-specific activation that is lateralized in the same hemisphere, regardless of right- or left-sided paresis. We propose that these regions are candidates for an interface between psychological mechanisms and disturbed higher-order motor control. Our study presents an integrative neurophysiological view of the mechanisms that contribute to the etiology of this puzzling psychological disorder, which can be further investigated with other types of conversion symptoms. PMID:22039428

Effects of propranolol on conversational reciprocity in autism spectrum disorder: a pilot, double-blind, single-dose psychopharmacological challenge study.

PubMed

Zamzow, Rachel M; Ferguson, Bradley J; Stichter, Janine P; Porges, Eric C; Ragsdale, Alexandra S; Lewis, Morgan L; Beversdorf, David Q

2016-04-01

Pharmacological intervention for autism spectrum disorder (ASD) is an important addition to treatment, yet currently available agents target co-morbid psychiatric concerns, such as aggression and irritability. Propranolol, a beta-adrenergic antagonist with anxiolytic effects, has been shown to improve verbal fluency and working memory in adults and adolescents with ASD in single-dose challenges. The present pilot study explores the acute effects of propranolol on a measure of conversational reciprocity in this population. We also examined whether autonomic activity and anxiety moderate or mediate response to the drug, given relationships between these variables and ASD, as well as the drug's effects. In a within-subject crossover design, 20 individuals with ASD received a single dose of propranolol or placebo during two sessions in a double-blinded, counterbalanced manner. After drug administration, participants performed a conversational reciprocity task by engaging in a short conversation with the researcher. Measurements of autonomic activity and anxiety were obtained before and after drug administration. Propranolol significantly improved performance on the conversational reciprocity task total [d = 0.40] and nonverbal communication domain scores when compared to the placebo condition. However, neither autonomic activity nor anxiety was significantly associated with drug response. Acute propranolol administration improved conversational reciprocity in ASD. Further exploration of these preliminary findings, as well as other potential treatment response predictors, with serial doses is warranted.

Uncovering the etiology of conversion disorder: insights from functional neuroimaging

PubMed Central

Ejareh dar, Maryam; Kanaan, Richard AA

2016-01-01

Conversion disorder (CD) is a syndrome of neurological symptoms arising without organic cause, arguably in response to emotional stress, but the exact neural substrates of these symptoms and the underlying mechanisms remain poorly understood with the hunt for a biological basis afoot for centuries. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from CDs in both motor and nonmotor domains. This review summarizes recent functional neuroimaging studies including functional magnetic resonance imaging (fMRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET) to see whether they bring us closer to understanding the etiology of CD. Convergent functional neuroimaging findings suggest alterations in brain circuits that could point to different mechanisms for manifesting functional neurological symptoms, in contrast with feigning or healthy controls. Abnormalities in emotion processing and in emotion-motor processing suggest a diathesis, while differential reactions to certain stressors implicate a specific response to trauma. No comprehensive theory emerges from these clues, and all results remain preliminary, but functional neuroimaging has at least given grounds for hope that a model for CD may soon be found. PMID:26834476

Differences in psychopathology and behavioral characteristics of patients affected by conversion motor disorder and organic dystonia.

PubMed

Pastore, Adriana; Pierri, Grazia; Fabio, Giada; Ferramosca, Silvia; Gigante, Angelo; Superbo, Maria; Pellicciari, Roberta; Margari, Francesco

2018-01-01

Typically, the diagnosis of conversion motor disorder (CMD) is achieved by the exclusion of a wide range of organic illnesses rather than by applying positive criteria. New diagnostic criteria are highly needed in this scenario. The main aim of this study was to explore the use of behavioral features as an inclusion criterion for CMD, taking into account the relationship of the patients with physicians, and comparing the results with those from patients affected by organic dystonia (OD). Patients from the outpatient Movement Disorder Service were assigned to either the CMD or the OD group based on Fahn and Williams criteria. Differences in sociodemographics, disease history, psychopathology, and degree of satisfaction about care received were assessed. Patient-neurologist agreement about the etiological nature of the disorder was also assessed using the k -statistic. A logistic regression analysis estimated the discordance status as a predictor to case/control status. In this study, 31 CMD and 31 OD patients were included. CMD patients showed a longer illness life span, involvement of more body regions, higher comorbidity with anxiety, depression, and borderline personality disorder, as well as higher negative opinions about physicians' delivering of proper care. Contrary to our expectations, CMD disagreement with neurologists about the etiological nature of the disorder was not statistically significant. Additional analysis showed that having at least one personality disorder was statistically associated with the discordance status. This study suggests that CMD patients show higher conflicting behavior toward physicians. Contrary to our expectations, they show awareness of their psychological needs, suggesting a possible lack of recognition of psychological distress in the neurological setting.

Differences in psychopathology and behavioral characteristics of patients affected by conversion motor disorder and organic dystonia

PubMed Central

Pastore, Adriana; Pierri, Grazia; Fabio, Giada; Ferramosca, Silvia; Gigante, Angelo; Superbo, Maria; Pellicciari, Roberta; Margari, Francesco

2018-01-01

Purpose Typically, the diagnosis of conversion motor disorder (CMD) is achieved by the exclusion of a wide range of organic illnesses rather than by applying positive criteria. New diagnostic criteria are highly needed in this scenario. The main aim of this study was to explore the use of behavioral features as an inclusion criterion for CMD, taking into account the relationship of the patients with physicians, and comparing the results with those from patients affected by organic dystonia (OD). Patients and methods Patients from the outpatient Movement Disorder Service were assigned to either the CMD or the OD group based on Fahn and Williams criteria. Differences in sociodemographics, disease history, psychopathology, and degree of satisfaction about care received were assessed. Patient–neurologist agreement about the etiological nature of the disorder was also assessed using the k-statistic. A logistic regression analysis estimated the discordance status as a predictor to case/control status. Results In this study, 31 CMD and 31 OD patients were included. CMD patients showed a longer illness life span, involvement of more body regions, higher comorbidity with anxiety, depression, and borderline personality disorder, as well as higher negative opinions about physicians’ delivering of proper care. Contrary to our expectations, CMD disagreement with neurologists about the etiological nature of the disorder was not statistically significant. Additional analysis showed that having at least one personality disorder was statistically associated with the discordance status. Conclusion This study suggests that CMD patients show higher conflicting behavior toward physicians. Contrary to our expectations, they show awareness of their psychological needs, suggesting a possible lack of recognition of psychological distress in the neurological setting. PMID:29849460

[Cognitive-behavioral therapy of conversion aphonia].

PubMed

Kuljić, Blagoje

2004-01-01

Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

Teaching Children with Autism to Respond to Conversation Partners' Interest

ERIC Educational Resources Information Center

Peters, Lindsay C.; Thompson, Rachel H.

2015-01-01

Successful conversation requires that the speaker's behavior is sensitive to nonvocal listener responses. We observed children with autism spectrum disorder during conversation probes in which a listener periodically displayed nonvocal cues that she was uninterested in the conversation. We used behavioral skills training to teach conversation…

Inpatient rehabilitation approach for a young woman with conversion hemiparesis and sensory deficits.

PubMed

Kanarek, Samantha L; Stevenson, Jennifer E; Wakefield, Holly; Reite, Elizabeth; Zumsteg, Jennifer M; Brockway, Jo Ann

2013-01-01

In the treatment of conversion disorder, the inpatient rehabilitation setting supports interdisciplinary functional goals and a structured approach consistent with encouraging psychological well-being. This case presentation illustrates 1 approach to the rehabilitation of hemiparesis secondary to conversion disorder that includes a behavioral management plan, as well as protocols for "learning to walk" and "learning to use your arm." We provide a practical starting point for advancing function in patients with conversion disorder when functional loss is present in both upper and lower extremities. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Do Children with Social Communication Disorder Have Explicit Knowledge of Pragmatic Rules They Break? A Comparison of Conversational Pragmatic Ability and Metapragmatic Awareness

ERIC Educational Resources Information Center

Lockton, Elaine; Adams, Catherine; Collins, Anna

2016-01-01

Background: Children who have social communication disorder (CwSCD) demonstrate persistent difficulties with language pragmatics in conversations and other verbal interactions. Speech-language interventions for these children often include promotion of metapragmatic awareness (MPA); that is, the ability to identify explicitly and reflect upon…

Effects of a Conversation-Based Intervention on the Linguistic Skills of Children with Motor Speech Disorders Who Use Augmentative and Alternative Communication

ERIC Educational Resources Information Center

Soto, Gloria; Clarke, Michael T.

2017-01-01

Purpose: This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method: Eight children aged from 8 to 13 years participated in the study.…

Differences in MMPI-2 FBS and RBS scores in brain injury, probable malingering, and conversion disorder groups: a preliminary study.

PubMed

Peck, C P; Schroeder, R W; Heinrichs, R J; Vondran, E J; Brockman, C J; Webster, B K; Baade, L E

2013-01-01

This study examined differences in raw scores on the Symptom Validity Scale and Response Bias Scale (RBS) from the Minnesota Multiphasic Personality Inventory-2 in three criterion groups: (i) valid traumatic brain injured, (ii) invalid traumatic brain injured, and (iii) psychogenic non-epileptic seizure disorders. Results indicate that a >30 raw score cutoff for the Symptom Validity Scale accurately identified 50% of the invalid traumatic brain injured group, while misclassifying none of the valid traumatic brain injured group and 6% of the psychogenic non-epileptic seizure disorder group. Using a >15 RBS raw cutoff score accurately classified 50% of the invalid traumatic brain injured group and misclassified fewer than 10% of the valid traumatic brain injured and psychogenic non-epileptic seizure disorder groups. These cutoff scores used conjunctively did not misclassify any members of the psychogenic non-epileptic seizure disorder or valid traumatic brain injured groups, while accurately classifying 44% of the invalid traumatic brain injured individuals. Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders.

Dissociative disorders in DSM-5.

PubMed

Spiegel, David; Lewis-Fernández, Roberto; Lanius, Ruth; Vermetten, Eric; Simeon, Daphne; Friedman, Matthew

2013-01-01

The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. Dissociative identity disorder will include reference to possession as well as identity fragmentation, to make the disorder more applicable to culturally diverse situations. Dissociative amnesia will include dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia but does not always include confused wandering or loss of personality identity. Depersonalization disorder will include derealization as well, since the two often co-occur. A dissociative subtype of posttraumatic stress disorder (PTSD), defined by the presence of depersonalization or derealization in addition to other PTSD symptoms, is being recommended, based upon new epidemiological and neuroimaging evidence linking it to an early life history of adversity and a combination of frontal activation and limbic inhibition. Conversion disorder (functional neurological symptom disorder) will likely remain with the somatic symptom disorders, despite considerable dissociative comorbidity.

Parents' Strategies to Elicit Autobiographical Memories in Autism Spectrum Disorders, Developmental Language Disorders and Typically Developing Children

ERIC Educational Resources Information Center

Goldman, Sylvie; DeNigris, Danielle

2015-01-01

Conversations about the past support the development of autobiographical memory. Parents' strategies to elicit child's participation and recall during past event conversations were compared across three school-age diagnostic groups: autism spectrum disorder (ASD, n = 11), developmental language disorders (n = 11) and typically developing (TD,…

La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder.

PubMed

van Meerkerk-Aanen, Petra J; de Vroege, Lars; Khasho, David; Foruz, Aziza; van Asseldonk, J Thies; van der Feltz-Cornelis, Christina M

2017-01-01

Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD). However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson's syndrome (PSPS) misdiagnosed as a case of CD. A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient's physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS. La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological reexamination and reinterpretation of la belle indifférence should be considered.

Downwards Vertical Attention Bias in Conversion Disorder vs Controls: A Pilot Study.

PubMed

Gazit, Sivan; Elkana, Odelia; Dawidowicz, Liraz; Yeshayahu, Liel; Biran, Iftah

Conversion disorder (CD) is a largely enigmatic disorder, one that requires a thorough ruling-out process. Prior research suggests that metaphors and conceptualization are rooted in physical experience, and that we interpret our affective world through metaphors. Spatial metaphors (interaction of affect and vertical space) are a prominent example of the grounding of metaphors. This is a relatively unpaved direction of research of CD. The present pilot study sought to explore this view by investigating the "healthy is up, sick is down" spatial metaphors (e.g., "fell ill" and "top shape") in patients with CD, examining the correlation between the processing of bodily-related words, CD, and vertical space. We hypothesized that patients with CD, who experience their bodies as ill, will demonstrate a downwards bias when processing bodily-related words; corresponding to the "healthy is up, sick is down" spatial metaphor. A total of 8 female patients (ages M-38.13 SD-10.44) and 42 female controls (ages M-36.4 SD-14.57) performed a visual attention task. Participants were asked to identify a spatial probe at the top or the bottom of a screen, following either a bodily related (e.g., arm) or non-bodily related (e.g., clock) prime word. As predicted, when processing bodily-related words, patients with CD demonstrated a downwards attention bias. Moreover, the higher the patient's level of somatization, the faster the patient detected lower (vs upper) spatial targets. This study suggests that the changed health paradigm of patients with CD is grounded in sensorimotor perception. Further research could propose new diagnostic and treatment options for CD. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The use of effective treatments: the case of an adolescent girl with anorexia nervosa in the context of a conversion disorder.

PubMed

Goldstein, Mandy; Madden, Sloane; Peters, Lorna

2013-04-01

The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.

Parents' strategies to elicit autobiographical memories in autism spectrum disorders, developmental language disorders and typically developing children.

PubMed

Goldman, Sylvie; DeNigris, Danielle

2015-05-01

Conversations about the past support the development of autobiographical memory. Parents' strategies to elicit child's participation and recall during past event conversations were compared across three school-age diagnostic groups: autism spectrum disorder (ASD, n = 11), developmental language disorders (n = 11) and typically developing (TD, n = 11). We focused on the prevalence of directives versus enrichment of events. Groups did not differ in number of events, length, and total turns. However, parents of children with ASD produced more direct questions, corrections, and unrelated turns than parents of TD children. Results highlight how parents adjusted their conversational style to their child's communication difficulties to maximize interactions and how these strategies may affect the development of personal conversations.

Order and Disorder in Conversation: Encounters with Dementia of the Alzheimer's Type

ERIC Educational Resources Information Center

Muller, Nicole; Guendouzi, Jacqueline A.

2005-01-01

After a brief introduction to Dementia of the Alzheimer's Type (DAT), its behavioral diagnostic symptom complex and a summary of communicative implications, we present data from two conversations involving participants with and without DAT. We discuss the concept of "order" in conversation, and the central importance of interactional monitoring.…

A prospective study of diagnostic conversion of major depressive disorder to bipolar disorder in pregnancy and postpartum.

PubMed

Sharma, Verinder; Xie, Bin; Campbell, M Karen; Penava, Debbie; Hampson, Elizabeth; Mazmanian, Dwight; Pope, Carley J

2014-02-01

The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM-IV at study intake and repeated using the Mini-International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. A total of 146 participants completed the intake interview and at least one follow-up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11- to 18-fold higher than the rates of switching in similar studies conducted in both men and women. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antidepressant treatment outcomes of psychogenic movement disorder.

PubMed

Voon, Valerie; Lang, Anthony E

2005-12-01

Psychogenic movement disorder (PMD) is a subtype of conversion disorder. We describe the outcomes of a series of PMD patients following antidepressant treatment. Twenty-three outpatients with chronic PMD, diagnosed using Fahn and Williams' criteria, underwent psychiatric assessment. The patients were referred for assessment and management from January 2003 to July 2004. Fifteen agreed to be treated with antidepressants. Patients received citalopram or paroxetine; those who did not respond after 4 weeks of taking an optimal dose were switched to venlafaxine. Concurrently, 3 had supportive psychotherapy, and 1 had family intervention. Assessments included the DSM-IV-based Mini-International Neuropsychiatric Interview and scales measuring depression, anxiety, and motor and global severity. Eighteen patients (78%) had at least 1 Axis I diagnosis in addition to the somatoform diagnosis, and 3 (13%) had somatization disorder. Five (22%) had previous psychiatric contact. Nine (39%) had previously been treated with antidepressants, but only 4 (17%) had adequate trials. No significant differences existed in patient characteristics between treated and untreated groups. Among treated patients, Montgomery-Asberg Depression Rating Scale scores improved from baseline (p < .01). Two treated subgroups were identified: 10 patients (67%) had primary conversion disorder, of whom 8 had marked motor and global improvements with 7 complete remissions, and 5 (33%) had primary hypochondriasis, somatization disorder, or probable factitious disorder/malingering, of whom none improved. All of the patients with primary conversion disorder had a current or previous depressive or anxiety disorder compared with 40% (N = 2) of the patients with additional somatoform diagnoses. Our preliminary findings suggest that chronic PMD with primary conversion symptoms and with recent or current depression or anxiety may respond to antidepressants. Further well-designed studies, now under way, are required

Communication disorders and executive function impairment after severe traumatic brain injury: an exploratory study using the GALI (a grid for linguistic analysis of free conversational interchange).

PubMed

Sainson, C; Barat, M; Aguert, M

2014-12-01

Following severe traumatic brain injury (TBI), failure to adjust language to communication abilities has been described and attributed by many authors to executive function impairment. Interactional dysfunctions may damage family-based, social and vocational equilibrium, and they are of key importance in prognosis of rehabilitation outcome. In conversation, frequently occurring inappropriate formulations connote difficulties in discursive organization and are likely to include numerous digressions, if not confabulations. The main objective of this study was to improve assessment of the non-verbal as well as the verbal aspects of the communication disorders observed in TBI subjects. We have developed and are proposing the grid for linguistic analysis (GALI) of free conversational interchange that constitutes an original French-language tool. We wish to demonstrate its validity as a means of measuring interactive skills in a given population. We assessed 17 severely brain injured patients presenting executive dysfunction, who were compared with 34 matched and healthy individuals. Fifty-one 10-minute sequences of free conversation between study participants and therapists were filmed and analyzed by applying the GALI. Three independent raters coded the conversations. Inter-rater reproducibility was considered statistically satisfactory. The results successfully distinguished TBI patients from healthy subjects and thereby underscored the discriminatory value of the tool. A significant correlation was found between the patients' performances in executive tests and in the GALI. In severe TBI a social handicap results from several associated cognitive disorders. Interactive discourse analysis combining non-verbal with verbal aspects confirms the existence of difficulties in communication that are usually underestimated in classic formal language testing methods. The GALI is likely to meet speech therapists' need for reliable assessment of their patients' interactional

Huntington's Disease in a Patient Misdiagnosed as Conversion Disorder.

PubMed

Nogueira, João Machado; Franco, Ana Margarida; Mendes, Susana; Valadas, Anabela; Semedo, Cristina; Jesus, Gustavo

2018-01-01

Huntington's disease (HD) is an inherited, progressive, and neurodegenerative neuropsychiatric disorder caused by the expansion of cytosine-adenine-guanine (CAG) trinucleotide in Interested Transcript (IT) 15 gene on chromosome 4. This pathology typically presents in individuals aged between 30 and 50 years and the age of onset is inversely correlated with the length of the CAG repeat expansion. It is characterized by chorea, cognitive deficits, and psychiatric symptoms. Usually the psychiatric disorders precede motor and cognitive impairment, Major Depressive Disorder and anxiety disorders being the most common presentations. We present a clinical case of a 65-year-old woman admitted to our Psychiatric Acute Unit. During the 6 years preceding the admission, the patient had clinical assessments made several times by different specialties that focused only on isolated symptoms, disregarding the syndrome as a whole. In the course of her last admission, the patient was referred to our Neuropsychiatric Team, which made the provisional diagnosis of late-onset Huntington's disease, later confirmed by genetic testing. This clinical vignette highlights the importance of a multidisciplinary approach to atypical clinical presentations and raises awareness for the relevance of investigating carefully motor symptoms in psychiatric patients.

Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study.

PubMed

McCormack, Ruaidhri; Moriarty, John; Mellers, John D; Shotbolt, Paul; Pastena, Rosa; Landes, Nadine; Goldstein, Laura; Fleminger, Simon; David, Anthony S

2014-08-01

Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases. To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit. All patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted. Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment. Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Treatment of borderline personality disorder and co-occurring anxiety disorders

PubMed Central

Valenstein, Helen R.

2013-01-01

Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

Evidence for somatic gene conversion and deletion in bipolar disorder, Crohn's disease, coronary artery disease, hypertension, rheumatoid arthritis, type-1 diabetes, and type-2 diabetes.

PubMed

Ross, Kenneth Andrew

2011-02-03

During gene conversion, genetic information is transferred unidirectionally between highly homologous but non-allelic regions of DNA. While germ-line gene conversion has been implicated in the pathogenesis of some diseases, somatic gene conversion has remained technically difficult to investigate on a large scale. A novel analysis technique is proposed for detecting the signature of somatic gene conversion from SNP microarray data. The Wellcome Trust Case Control Consortium has gathered SNP microarray data for two control populations and cohorts for bipolar disorder (BD), cardiovascular disease (CAD), Crohn's disease (CD), hypertension (HT), rheumatoid arthritis (RA), type-1 diabetes (T1D) and type-2 diabetes (T2D). Using the new analysis technique, the seven disease cohorts are analyzed to identify cohort-specific SNPs at which conversion is predicted. The quality of the predictions is assessed by identifying known disease associations for genes in the homologous duplicons, and comparing the frequency of such associations with background rates. Of 28 disease/locus pairs meeting stringent conditions, 22 show various degrees of disease association, compared with only 8 of 70 in a mock study designed to measure the background association rate (P < 10-9). Additional candidate genes are identified using less stringent filtering conditions. In some cases, somatic deletions appear likely. RA has a distinctive pattern of events relative to other diseases. Similarities in patterns are apparent between BD and HT. The associations derived represent the first evidence that somatic gene conversion could be a significant causative factor in each of the seven diseases. The specific genes provide potential insights about disease mechanisms, and are strong candidates for further study.

Everyday social and conversation applications of theory-of-mind understanding by children with autism-spectrum disorders or typical development.

PubMed

Peterson, Candida C; Garnett, Michelle; Kelly, Adrian; Attwood, Tony

2009-02-01

Children with autism-spectrum disorders (ASD) often fail laboratory false-belief tests of theory of mind (ToM). Yet how this impacts on their everyday social behavior is less clear, partly owing to uncertainty over which specific everyday conversational and social skills require ToM understanding. A new caregiver-report scale of these everyday applications of ToM was developed and validated in two studies. Study 1 obtained parent ratings of 339 children (85 with autism; 230 with Asperger's; 24 typically-developing) on the new scale and results revealed (a) that the scale had good psychometric properties and (b) that children with ASD had significantly more everyday mindreading difficulties than typical developers. In Study 2, we directly tested links between laboratory ToM and everyday mindreading using teacher ratings on the new scale. The sample of 25 children included 15 with autism and 10 typical developers aged 5-12 years. Children in both groups who passed laboratory ToM tests had fewer everyday mindreading difficulties than those of the same diagnosis who failed. Yet, intriguingly, autistic ToM-passers still had more problems with everyday mindreading than younger typically-developing ToM-failers. The possible roles of family conversation and peer interaction, along with ToM, in everyday social functioning were considered.

Can motor imagery and hypnotic susceptibility explain Conversion Disorder with motor symptoms?

PubMed

Srzich, Alexander J; Byblow, Winston D; Stinear, James W; Cirillo, John; Anson, J Greg

2016-08-01

Marked distortions in sense of agency can be induced by hypnosis in susceptible individuals, including alterations in subjective awareness of movement initiation and control. These distortions, with associated disability, are similar to those experienced with Conversion Disorder (CD), an observation that has led to the hypothesis that hypnosis and CD share causal mechanisms. The purpose of this review is to explore the relationships among motor imagery (MI), hypnotic susceptibility, and CD, then to propose how MI ability may contribute to hypnotic responding and CD. Studies employing subjective assessments of mental imagery have found little association between imagery abilities and hypnotic susceptibility. A positive association between imagery abilities and hypnotic susceptibility becomes apparent when objective measures of imagery ability are employed. A candidate mechanism to explain motor responses during hypnosis is kinaesthetic MI, which engages a strategy that involves proprioception or the "feel" of movement when no movement occurs. Motor suppression imagery (MSI), a strategy involving inhibition of movement, may provide an alternate objective measurable phenomenon that underlies both hypnotic susceptibility and CD. Evidence to date supports the idea that there may be a positive association between kinaesthetic MI ability and hypnotic susceptibility. Additional evidence supports a positive association between hypnotic susceptibility and CD. Disturbances in kinaesthetic MI performance in CD patients indicate that MI mechanisms may also underlie CD symptoms. Further investigation of the above relationships is warranted to explain these phenomena, and establish theoretical explanations underlying sense of agency. Copyright © 2016. Published by Elsevier Ltd.

Multifaceted Communication Problems in Everyday Conversations Involving People with Parkinson’s Disease

PubMed Central

Saldert, Charlotta; Bauer, Malin

2017-01-01

It is known that Parkinson’s disease is often accompanied by a motor speech disorder, which results in impaired communication. However, people with Parkinson’s disease may also have impaired word retrieval (anomia) and other communicative problems, which have a negative impact on their ability to participate in conversations with family as well as healthcare staff. The aim of the present study was to explore effects of impaired speech and language on communication and how this is managed by people with Parkinson’s disease and their spouses. Using a qualitative method based on Conversation Analysis, in-depth analyses were performed on natural conversational interaction in five dyads including elderly men who were at different stages of Parkinson’s disease. The findings showed that the motor speech disorder in combination with word retrieval difficulties and adaptations, such as using communication strategies, may result in atypical utterances that are difficult for communication partners to understand. The coexistence of several communication problems compounds the difficulties faced in conversations and individuals with Parkinson’s disease are often dependent on cooperation with their communication partner to make themselves understood. PMID:28946714

Diffusion and transport in locally disordered driven lattices

NASA Astrophysics Data System (ADS)

Wulf, Thomas; Okupnik, Alexander; Schmelcher, Peter

2016-09-01

We study the effect of disorder on the particle density evolution in a classical Hamiltonian driven lattice setup. If the disorder is localized within a finite sub-domain of the lattice, the emergence of strong tails in the density distribution which even increases towards larger positions is shown, thus yielding a highly non-Gaussian particle density evolution. As the key underlying mechanism, we identify the conversion between different components of the unperturbed systems mixed phase space which is induced by the disorder. Based on the introduction of individual conversion rates between chaotic and regular components, a theoretical model is developed which correctly predicts the scaling of the particle density. The effect of disorder on the transport properties is studied where a significant enhancement of the transport for cases of localized disorder is shown, thereby contrasting strongly the merely weak modification of the transport for global disorder.

Self-reference, emotion inhibition and somatosensory disturbance: preliminary investigation of network perturbations in conversion disorder.

PubMed

Monsa, R; Peer, M; Arzy, S

2018-06-01

Conversion disorder (CD), or functional neurological disorder, is manifested as a neurological disturbance that is not macroscopically visible on clinical structural neuroimaging and is instead ascribed to underlying psychological stress. Known for many years in neuropsychiatry, a comprehensive explanation of the way in which psychological stress leads to a neurological deficit of a structural-like origin is still lacking. We applied whole-brain network-based data-driven analyses on resting-state functional magnetic resonance imaging, recorded in seven patients with acute-onset, stroke-like CD with unilateral paresis and hypoesthesia as compared with 15 age-matched healthy controls. We used a clustering analysis to measure functional connectivity (FC) strength within 10 different brain networks, as well as between these networks. Finally, we tested FC of specific brain regions that are known to be involved in CD. We found a significant increase in FC strength only within the default-mode network (DMN), which manages self-referential processing. Examination of inter-connectivity between networks showed a structure of disturbed connectivity, which included decreased connectivity between the DMN and limbic/salience network, increased connectivity between the limbic/salience network and body-related temporo-parieto-occipital junction network, decreased connectivity between the temporo-parieto-occipital junction and memory-related medial temporal lobe, and decreased connectivity between the medial temporal lobe and sensorimotor network. Region-specific FC analysis showed increased connectivity between the hippocampus and DMN. These preliminary results of disturbances in brain networks related to memory, emotions and self-referential processing, and networks involved in motor planning and execution, suggest a role of these cognitive functions in the psychopathology of CD. © 2018 EAN.

Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies.

PubMed

Ludwig, Lea; Pasman, Joëlle A; Nicholson, Timothy; Aybek, Selma; David, Anthony S; Tuck, Sharon; Kanaan, Richard A; Roelofs, Karin; Carson, Alan; Stone, Jon

2018-04-01

Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder. We did a meta-analysis, with assessments of methodology, sources of bias, and sensitivity analyses. 34 case-control studies, with 1405 patients, were eligible. Studies were of moderate-to-low quality. The frequency of childhood and adulthood stressors was increased in cases compared with controls. Odds ratios (OR) were higher for emotional neglect in childhood (49% for cases vs 20% for controls; OR 5·6, 95% CI 2·4-13·1) compared with sexual abuse (24% vs 10%; 3·3, 2·2-4·8) or physical abuse (30% vs 12%; 3·9, 2·2-7·2). An association with stressful life events preceding onset (OR 2·8, 95% CI 1·4-6·0) was stronger in studies with better methods (interviews; 4·3, 1·4-13·2). Heterogeneity was significant between studies (I 2 21·1-90·7%). 13 studies that specifically ascertained that the participants had not had either severe life events or any subtype of maltreatment all found a proportion of patients with functional neurological disorder reporting no stressor. Stressful life events and maltreatment are substantially more common in people with functional neurological disorder than in healthy controls and patient controls. Emotional neglect had a higher risk than traditionally emphasised sexual and physical abuse, but many cases report no stressors. This outcome supports changes to diagnostic criteria in DSM-5; stressors, although relevant to the cause in many patients, are not a core diagnostic feature. This

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks.

PubMed

Hubschmid, M; Aybek, S; Maccaferri, G E; Chocron, O; Gholamrezaee, M M; Rossetti, A O; Vingerhoets, F; Berney, A

2015-01-01

The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective. Copyright © 2015 Elsevier Inc. All rights reserved.

Generation of diverse neural cell types through direct conversion

PubMed Central

Petersen, Gayle F; Strappe, Padraig M

2016-01-01

A characteristic of neurological disorders is the loss of critical populations of cells that the body is unable to replace, thus there has been much interest in identifying methods of generating clinically relevant numbers of cells to replace those that have been damaged or lost. The process of neural direct conversion, in which cells of one lineage are converted into cells of a neural lineage without first inducing pluripotency, shows great potential, with evidence of the generation of a range of functional neural cell types both in vitro and in vivo, through viral and non-viral delivery of exogenous factors, as well as chemical induction methods. Induced neural cells have been proposed as an attractive alternative to neural cells derived from embryonic or induced pluripotent stem cells, with prospective roles in the investigation of neurological disorders, including neurodegenerative disease modelling, drug screening, and cellular replacement for regenerative medicine applications, however further investigations into improving the efficacy and safety of these methods need to be performed before neural direct conversion becomes a clinically viable option. In this review, we describe the generation of diverse neural cell types via direct conversion of somatic cells, with comparison against stem cell-based approaches, as well as discussion of their potential research and clinical applications. PMID:26981169

Enhancing the thermoelectric performance of gamma-graphyne nanoribbons by introducing edge disorder.

PubMed

Cui, Xiao; Ouyang, Tao; Li, Jin; He, Chaoyu; Tang, Chao; Zhong, Jianxin

2018-03-07

Structure disorder especially edge disorder is unavoidable during the fabrication of nanomaterials. In this paper, using the non-equilibrium Green's function method, we investigate the influence of edge disorder on the thermoelectric performance of gamma(γ)-graphyne nanoribbons (GYNRs). Our results show that the high Seebeck coefficient in pristine γ-GYNR could still be preserved although edge disorder is introduced into the structure. Meanwhile, in these edge-disordered nanoribbons the suppression of thermal conductance including electronic and phononic contributions outweighs the reduction of electronic conductance. These two positive effects combine together, and finally boost the thermoelectric conversion efficiency of γ-GYNRs. The thermoelectric figure of merit ZT in the edge-disordered γ-GYNRs (the length and width are about 55.68 and 1.41 nm) could approach 2.5 at room temperature, and can even reach as high as 4.0 at 700 K, which is comparable to the efficiency of conventional energy conversion methods. The findings in this paper indicate that the edge-disordered γ-GYNRs are a promising candidate for efficient thermoelectric energy conversion and thermal management of nanodevices.

Evidence for somatic gene conversion and deletion in bipolar disorder, Crohn's disease, coronary artery disease, hypertension, rheumatoid arthritis, type-1 diabetes, and type-2 diabetes

PubMed Central

2011-01-01

Background During gene conversion, genetic information is transferred unidirectionally between highly homologous but non-allelic regions of DNA. While germ-line gene conversion has been implicated in the pathogenesis of some diseases, somatic gene conversion has remained technically difficult to investigate on a large scale. Methods A novel analysis technique is proposed for detecting the signature of somatic gene conversion from SNP microarray data. The Wellcome Trust Case Control Consortium has gathered SNP microarray data for two control populations and cohorts for bipolar disorder (BD), cardiovascular disease (CAD), Crohn's disease (CD), hypertension (HT), rheumatoid arthritis (RA), type-1 diabetes (T1D) and type-2 diabetes (T2D). Using the new analysis technique, the seven disease cohorts are analyzed to identify cohort-specific SNPs at which conversion is predicted. The quality of the predictions is assessed by identifying known disease associations for genes in the homologous duplicons, and comparing the frequency of such associations with background rates. Results Of 28 disease/locus pairs meeting stringent conditions, 22 show various degrees of disease association, compared with only 8 of 70 in a mock study designed to measure the background association rate (P < 10-9). Additional candidate genes are identified using less stringent filtering conditions. In some cases, somatic deletions appear likely. RA has a distinctive pattern of events relative to other diseases. Similarities in patterns are apparent between BD and HT. Conclusions The associations derived represent the first evidence that somatic gene conversion could be a significant causative factor in each of the seven diseases. The specific genes provide potential insights about disease mechanisms, and are strong candidates for further study. Please see Commentary: http://www.biomedcentral.com/1741-7015/9/13/abstract. PMID:21291537

The relationship between borderline personality disorder and bipolar disorder

PubMed Central

Zimmerman, Mark; Morgan, Theresa A.

2013-01-01

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum. PMID:24174890

Conversational Profiles of Children with ADHD, SLI and Typical Development

ERIC Educational Resources Information Center

Redmond, Sean M.

2004-01-01

Conversational indices of language impairment were used to investigate similarities and differences among children with Attention-Deficit/Hyperactivity Disorder (ADHD), children with Specific Language Impairment (SLI) and children with typical development (TD). Utterance formulation measures (per cent words mazed and average number of words per…

Virtual Conversation Partner for Adults with Autism

PubMed Central

Trepagnier, Cheryl Y.; Olsen, Dale E.; Bell, Corinne A.

2011-01-01

Abstract Autistic Spectrum Disorder (ASD) is notable for severely impaired reciprocal social interaction skills relative to language and intellectual abilities, presenting a major barrier to social integration and vocational success. Evidence-based interventions to address these needs are lacking. We report on the development of a small, prototype conversation simulation to teach conversational skills to adolescents and adults with ASD and average to superior intellectual abilities. We also report on a test of the feasibility and acceptability of the simulation approach with a sample of the target population. The simulation engages the user in a virtual conversation with an on-screen partner whose reactions provide naturalistic feedback geared to the appropriateness of the learner's response choices. The prototype simulation, which provides for up to 12 potentially unique multi-turn conversations, was used over a period of 2 weeks by 16 adolescents and adults who then rated statements about the system on a linear scale of 1 (disagreement) to 5 (high agreement). The participants highly endorsed the majority of positive statements about the quality and credibility of the interaction and the virtual conversation partner. In contrast, agreement with positive statements about instructional features external to the conversation was moderate. Unexpectedly, most participants strongly agreed that using the simulation had been helpful to them. Further development and testing in the context of a controlled study with randomized assignment to control and experimental groups are needed to determine whether this approach is effective in improving real-world pragmatic language behavior of high-functioning adults with ASD. PMID:21329439

Prospective, population-based study of the transition from major depressive disorder to bipolar disorder

PubMed Central

Gilman, Stephen E.; Dupuy, Jamie M.; Perlis, Roy H.

2013-01-01

Objective It is currently not possible to determine which individuals with unipolar depression are at highest risk for a manic episode. This study investigates clinical and psychosocial risk factors for mania among individuals with major depressive disorder (MDD), indicating diagnostic conversion from MDD to bipolar I disorder. Methods We fitted logistic regression models to predict the first onset of a manic episode among 6,214 cases of lifetime MDD according to DSM-IV criteria in the National Epidemiologic Survey on Alcohol and Related Conditions. Results Approximately 1 in 20 individuals with MDD transitioned to bipolar disorder during the study's 3-year follow-up period. Demographic risk factors for the transition from MDD to bipolar disorder included younger age, Black race/ethnicity, and less than high school education. Clinical characteristics of depression (e.g., age at first onset, presence of atypical features) were not associated with diagnostic conversion. However, prior psychopathology was associated with the transition to bipolar disorder: history of social phobia (Odds Ratio=2.20; 95% Confidence Interval=1.47, 3.30) and generalized anxiety disorder (OR=1.58; CI=1.06, 2.35). Lastly, we identified environmental stressors over the life course that predicted the transition to bipolar disorder: these include a history of child abuse (OR=1.26; CI=1.12, 1.42) and past-year problems with one's social support group (OR=1.79; CI=1.19, 2.68). The overall predictive power of these risk factors based on a receiver operating curve analysis is modest. Conclusions A wide range of demographic, clinical, and environmental risk factors were identified that indicate a heightened risk for the transition to bipolar disorder. Additional work is needed to further enhance the prediction of bipolar disorder among cases of MDD, and to determine whether interventions targeting these factors could reduce the risk of bipolar disorder. PMID:22394428

Functional neurological symptom disorder (conversion disorder): A role for microglial-based plasticity mechanisms?

PubMed

Stephenson, Chris P; Baguley, Ian J

2018-02-01

Functional Neurological Symptom Disorder (FND) is a relatively common neurological condition, accounting for approximately 3-6% of neurologist referrals. FND is considered a transient disorder of neuronal function, sometimes linked to physical trauma and psychological stress. Despite this, chronic disability is common, for example, around 40% of adults with motor FND have permanent disability. Building on current theoretical models, this paper proposes that microglial dysfunction could perpetuate functional changes within acute motor FND, thus providing a pathophysiological mechanism underlying the chronic stage of the motor FND phenotypes seen clinically. Core to our argument is microglia's dual role in modulating neuroimmunity and their control of synaptic plasticity, which places them at a pathophysiological nexus wherein coincident physical trauma and psychological stress could cause long-term change in neuronal networks without producing macroscopic structural abnormality. This model proposes a range of hypotheses that are testable with current technologies. Copyright © 2017. Published by Elsevier Ltd.

Comorbidity between central disorders of hypersomnolence and immune-based disorders.

PubMed

Barateau, Lucie; Lopez, Régis; Arnulf, Isabelle; Lecendreux, Michel; Franco, Patricia; Drouot, Xavier; Leu-Semenescu, Smaranda; Jaussent, Isabelle; Dauvilliers, Yves

2017-01-03

To assess and compare the frequencies of personal and family history of autoimmune diseases (AID), autoinflammatory disorders (ID), and allergies in a population of patients, adults and children, with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), 3 central hypersomnia disorders, and healthy controls. Personal and family history of AID, ID, and allergies were assessed by questionnaire and medical interview in a large cohort of 450 consecutive adult patients (206 NT1, 106 NT2, 138 IH) and 95 pediatric patients (80 NT1) diagnosed according to the third International Classification of Sleep Disorders criteria in national reference centers for narcolepsy in France and 751 controls (700 adults, 51 children) from the general population. Ten adults with NT1 (4.9%) had a comorbid AID vs 3.4% of adult controls, without between-group differences in adjusted models. AID frequency did not differ between children with NT1 and controls. Conversely, compared with controls, AID frequency was higher in adults with NT2 (p = 0.002), whereas ID (p = 0.0002) and allergy (p = 0.003) frequencies were higher in adults with IH. A positive family history of AID was found in the NT1 group and of ID in the IH group. NT1 is not associated with increased risk of comorbid immune disorders, in favor of a potentially unique pathophysiology. Conversely, compared with controls, the frequency of autoimmune diseases was higher in adults with NT2, whereas allergies and autoinflammatory disorders were more common in adults with IH, suggesting an immune dysregulation mechanism in these conditions. © 2016 American Academy of Neurology.

Topological energy conversion through the bulk or the boundary of driven systems

NASA Astrophysics Data System (ADS)

Peng, Yang; Refael, Gil

2018-04-01

Combining physical and synthetic dimensions allows a controllable realization and manipulation of high-dimensional topological states. In our work, we introduce two quasiperiodically driven one-dimensional systems which enable tunable topological energy conversion between different driving sources. Using three drives, we realize a four-dimensional quantum Hall state which allows energy conversion between two of the drives within the bulk of the one-dimensional system. With only two drives, we achieve energy conversion between the two at the edge of the chain. Both effects are a manifestation of the effective axion electrodynamics in a three-dimensional time-reversal-invariant topological insulator. Furthermore, we explore the effects of disorder and commensurability of the driving frequencies, and show the phenomena are robust. We propose two experimental platforms, based on semiconductor heterostructures and ultracold atoms in optical lattices, in order to observe the topological energy conversion.

Do (epi)genetics impact the brain in functional neurologic disorders?

PubMed

Frodl, T

2016-01-01

Advances in neuropsychiatric research are supposed to lead to significant improvements in understanding functional neurologic disorders and their diagnosis. However, epigenetic and genetic research on conversion disorders and somatoform disorders is only at its start. This review demonstrates the current state within this field and tries to bridge a gap from what is known on gene-stress interactions in other psychiatric disorders like depression. The etiology of conversion disorders is hypothesized to be multifactorial. These considerations also suggest that potential etiologic factors lead to alterations in brain function, either episodically or chronically, eventually leading to structural brain changes. In particular, the knowledge of how the environment influences brain structure and function, e.g., via epigenetic regulation, may be interesting for future research in functional neurologic disorders. Reviewing the literature results in evidence that childhood adversities play a role in the development of functional neurologic disorders, whereby at present no reports exist about the interactive effect between childhood adversity and genetic factors or about the impact of epigenetics. © 2016 Elsevier B.V. All rights reserved.

Structural Conversion of Aβ17–42 Peptides from Disordered Oligomers to U-Shape Protofilaments via Multiple Kinetic Pathways

PubMed Central

Cheon, Mookyung; Hall, Carol K.; Chang, Iksoo

2015-01-01

Discovering the mechanisms by which proteins aggregate into fibrils is an essential first step in understanding the molecular level processes underlying neurodegenerative diseases such as Alzheimer’s and Parkinson's. The goal of this work is to provide insights into the structural changes that characterize the kinetic pathways by which amyloid-β peptides convert from monomers to oligomers to fibrils. By applying discontinuous molecular dynamics simulations to PRIME20, a force field designed to capture the chemical and physical aspects of protein aggregation, we have been able to trace out the entire aggregation process for a system containing 8 Aβ17–42 peptides. We uncovered two fibrillization mechanisms that govern the structural conversion of Aβ17–42 peptides from disordered oligomers into protofilaments. The first mechanism is monomeric conversion templated by a U-shape oligomeric nucleus into U-shape protofilament. The second mechanism involves a long-lived and on-pathway metastable oligomer with S-shape chains, having a C-terminal turn, en route to the final U-shape protofilament. Oligomers with this C-terminal turn have been regarded in recent experiments as a major contributing element to cell toxicity in Alzheimer’s disease. The internal structures of the U-shape protofilaments from our PRIME20/DMD simulation agree well with those from solid state NMR experiments. The approach presented here offers a simple molecular-level framework to describe protein aggregation in general and to visualize the kinetic evolution of a putative toxic element in Alzheimer’s disease in particular. PMID:25955249

An epidemic of collective conversion and dissociation disorder in an indigenous group of Colombia: its relation to cultural change.

PubMed

Piñeros, M; Rosselli, D; Calderon, C

1998-06-01

We describe a collective episode of psychogenic illness in an indigenous group (Embera) of Colombia, geographically isolated from its native homeland and surrounded by non-indigenous settlers. The condition, which affected three young adult men and six adolescent women, was attributed by them to a spell (maleficio). It was designated as ataques de locura (madness attacks) according to their traditional medical system; and as a conversive disorder with dissociative features by psychiatrists. Different therapeutic approaches, including antipsychotic medication, religious healers and traditional herbal remedies were unsuccessful. Contact with shamans of the same ethnic origin, on the other hand, proved to be an effective way of dealing with the symptoms. We interpret the situation as an expression of psychosocial stress secondary to cultural change. This medical problem bears close resemblance to other specific culture-bound syndromes such as ataques de nervios or possession syndromes and gives clues to ways of dealing with psychogenic expressions of cultural stress.

Electrophysiological correlates of motor conversion disorder.

PubMed

Liepert, Joachim; Hassa, Thomas; Tüscher, Oliver; Schmidt, Roger

2008-11-15

In patients with a functional (psychogenic) paresis, motor conduction tests are, by definition, normal. We investigated whether these patients exhibit an abnormal motor excitability. Four female patients with a functional paresis of the left upper extremity were studied using transcranial magnetic stimulation (TMS). We investigated motor thresholds, intracortical inhibition and intracortical facilitation at rest. Corticospinal excitability was evaluated by single pulse TMS during rest and during imagination of tonic index finger adductions. Data obtained from the affected first dorsal interosseous muscle were compared with the unaffected hand and with a healthy age-matched control group. Three patients demonstrated a flaccid paresis, one patient had a psychogenic dystonia. Motor thresholds, short interval intracortical inhibition and intracortical facilitation recorded from the affected side were normal. In healthy subjects, movement imagination produced an increase of corticospinal excitability. In the patients, motor imagery with the affected index finger resulted in a decrease of corticospinal excitability compared to rest, being significantly different from the unaffected side and from the control group. We suggest that suppression of corticospinal excitability during movement imagination is an electrophysiological correlate of the patients' inability to move voluntarily and provides some insight into the pathophysiology of this disorder.

Dissociative disorders in medical settings.

PubMed

MacPhee, Edward

2013-10-01

Despite the challenges of conducting research on dissociation and the dissociative disorders, our understanding has grown greatly over the past three decades, including our knowledge of the often overlooked sensorimotor manifestations of dissociation, more commonly referred to as somatoform dissociation. This article will first review the definitions and presentations of dissociation in general along with recent research on the concept of somatoform dissociation. Then, each of the dissociative disorders and conversion disorder will be discussed in further detail as well as how they might present in a medical setting. Current recommendations for diagnosis and treatment will also be provided.

Communication in conversation in stroke patients.

PubMed

Rousseaux, Marc; Daveluy, Walter; Kozlowski, Odile

2010-07-01

In stroke patients, it has been suggested that communication disorders could result from lexical and syntactic disorders in left hemisphere lesions and from pragmatics problems in right lesions. However, we have little information on patient behaviour in dyadic communication, especially in conversation. Here, we analyzed the various processes participating in communication difficulties at the rehabilitation phase (1-6 months) post-stroke, in order to define the main mechanisms of verbal and non-verbal communication (VC, NVC) disorders and their relationship with aphasic disorders. Sixty-three patients were recruited, who belonged to six groups, with left or right cortico-sub-cortical (L-CSC, R-CSC) or sub-cortical (L-SC, R-SC), frontal (Fro) or posterior fossa (PF) lesions. They were compared with an equivalent control group (gender, age, education level). We used the Lille Communication Test, which comprises three parts: participation to communication (greeting, attention, engagement), verbal communication (verbal comprehension, speech outflow, intelligibility, word production, syntax, verbal pragmatics and verbal feedback) and non-verbal communication (understanding gestures, affective expressivity, producing gestures, pragmatics and feedback). We also used the Functional Communication Profile and the Boston Diagnostic Aphasia Examination (BDAE). Decrease in participation was found in L-CSC, R-CSC and Fro patients. Verbal communication was essentially disrupted in L-SCS and L-SC groups, including by verbal pragmatic disorders, and to a lesser degree in frontal patients. Nonverbal communication was mainly affected in R-CSC patients, especially by pragmatic difficulties. L-CSC patients showed an increase in gesture production, compensating for aphasia. In conclusion, communication disorders were relatively complex and could not be summarised by syntactical and lexical difficulties in left stroke and pragmatic problems in right stroke. The former also showed severe

Case series of diagnostic shift from bipolar disorder to schizoaffective disorder.

PubMed

Argolo, Lucas; Batista, Fabrício; Bezerra-Filho, Severino; Kapczinski, Flávio; Miranda-Scippa, Ângela

2018-04-01

To describe three cases of diagnostic shift from bipolar I disorder (BD) to schizoaffective disorder (SAD). BD patients were clinically assessed and followed up in a mood disorder program. A questionnaire was applied to assess clinical and socio-demographic characteristics, and a Structured Clinical Interview (SCID-I) was conducted. We identified three patients with diagnosis conversion to SAD from 2005 to 2016. The mean time between BD diagnosis and the diagnostic shift to SAD was 9 years. Psychotic symptoms may become persistent, chronic and unrelated to the presence of mood episodes many years after the beginning of BD. Psychiatrists should be aware of this and reassess the diagnosis during the longitudinal course of BD, especially in those patients who present psychotic symptoms.

Conversational pursuit of medication compliance in a Therapeutic Community for persons diagnosed with mental disorders*

PubMed Central

Mortari, Luigina

2014-01-01

Purpose In this article, we contribute to the debate on medication compliance by exploring the conversational “technologies” entailed in the process of promoting clients’ adherence to psychopharmacological prescriptions. Using a case study approach, we explore how medication-related problems are dealt with in conversational interaction between the staff members and the clients of a mental health Therapeutic Community (TC) in Italy. Method Four meetings between two staff members (Barbara and Massimo) and the clients of the TC were audio-recorded. The data were transcribed and analyzed using the method of Conversation Analysis. Results Barbara and Massimo recur to practices of topic articulation to promote talk that references the clients’ failure to take the medications. Through these practices they deal with the practical problem of mobilizing the clients’ cooperation in courses of action that fit into the institutional agenda of fostering medication adherence. Conclusions Barbara and Massimo’s conversational practices appear to reflect the assumption that medication-related problems can be reduced to compliance problems. This assumption works to make the clients accountable for their failure to take the medications while shaping a conversational environment that is unreceptive to their complaints about side effects. Implications for the understanding of mental health rehabilitation practice in TCs are discussed. Implications of RehabilitationTherapeutic community staff members should be aware of the challenges and blocks in communicating with their clients.Therapeutic communities can promote staff members’ awareness of communication challenges through reflective workshops in which they can jointly view and comment on interaction with their clients.Reflective workshops can be used to raise awareness of the presuppositions underlying therapeutic community staff members’ communication practices. PMID:24053481

Conversational Behaviors in Youth with High-Functioning ASD and Asperger Syndrome

ERIC Educational Resources Information Center

Paul, Rhea; Orlovski, Stephanie Miles; Marcinko, Hillary Chuba; Volkmar, Fred

2009-01-01

Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. "Psychol Med" 22:245-254, 1992). The ASD group…

Life as the Middle Child: A Conversation With Mary Margaret Kerr

ERIC Educational Resources Information Center

Teagarden, James M.; Zabel, Robert H.; Kaff, Marilyn S.

2015-01-01

As part of an ongoing oral history project, a conversation was held with Dr. Mary Margaret Kerr on the past, present, and possible future of the field of providing services to children with emotional-behavioral disorders. Dr. Wood stresses the increasing importance of providing an interdisciplinary approach to meet the needs for children or, as…

Conversing Cooperatively: Using "Mini-Conversations" to Develop Conversational Knowledge and Skill

ERIC Educational Resources Information Center

Jones, Elizabeth B.

2017-01-01

Courses: Interpersonal communication, relational communication, language and social interaction, professional communication, interviewing practices. Objectives: This single class activity enables students to understand the theoretical foundations of conversation and to develop their conversational skills by talking in dyads with classmates. Upon…

Echolalia or functional repetition in conversation--a case study of an individual with Huntington's disease.

PubMed

Saldert, Charlotta; Hartelius, Lena

2011-01-01

In this case study, we investigated the use of repetition in an individual with a neurogenic communication disorder. We present an analysis of interaction in natural conversations between a woman with advanced Huntington's disease (HD), whose speech had been described as sometimes characterised by echolalia, and her personal assistant. The conversational interaction is analysed on a sequential level, and recurrent patterns are explored. Although the ability of the person with HD to interact is affected by chorea, word retrieval problems and reduced comprehension, she takes an active part in conversation. The conversational partner's contributions are often adapted to her communicative ability as they are formulated as questions or suggestions that can be elaborated on or responded to with a simple 'yes' or 'no'. The person with HD often repeats the words of her conversational partner in a way that extends her contributions and shows listenership, and this use of repetition is also frequent in ordinary conversations between non-brain-damaged individuals. The results show that the conversation partners in this case cooperate in making the conversation proceed and evolve, and that verbal repetition is used in a way that works as a strategy for compensating for the impairment.

Clinical profile of depressive disorder in children.

PubMed

Krishnakumar, P; Geeta, M G

2006-06-01

The aim of this retrospective study was to evaluate the risk factors, clinical features and co-morbid disorders of depressive disorder in children below the age of 12 years. Children who attended the child guidance clinic between January 2000 and December 2003 formed the subjects for the study. The diagnosis of depressive disorder was based on DSMIV diagnostic criteria for Major Depressive Disorder, Single episode. There were 26 boys and 19 girls. Stress at school and in the family was significantly associated with depressive disorder. Children with depressive disorder had significantly more family members affected with mental illnesses. The clinical features included diminished interest in play and activities, excessive tiredness, low self- esteem, problems with concentration, multiple somatic complaints, behavior symptoms like anger and aggression, recent deterioration in school performance and suicidal behavior. Majority of children had other associated psychiatric disorders which included dysthymic disorder, anxiety disorders, conduct disorder and conversion disorder.

Efficacy of treatment for somatoform disorders: a review of randomized controlled trials.

PubMed

Kroenke, Kurt

2007-12-01

To review the evidence from randomized clinical trials (RCTs) that have focused on the treatment of patients with Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition (DSM-IV) somatoform disorders. Although somatoform disorders are among the most common mental disorders presenting in the general medical setting, the strength of evidence for specific treatments has not been well synthesized. MEDLINE search of articles published in English from 1966 to 2006, using the following search terms: randomized clinical trial, somatoform disorders, somatization disorder, undifferentiated somatoform disorder, hypochrondriasis, conversion disorder, pain disorder, and body dysmorphic disorder. A total of 34 RCTs involving 3922 patients were included. Two thirds of the studies involved somatization disorder (n = 4 studies) and lower threshold variants, such as abridged somatization disorder (n = 9) and medically unexplained symptoms (n = 10). Cognitive behavioral therapy (CBT) was effective in most studies (11 of 13), as were antidepressants in a small number (4 of 5) of studies. RCTs examining a variety of other treatments showed benefit in half (8 of 16) of the studies, the most consistent evidence existing for a consultation letter to the primary care physician. Effective treatments have been established for all somatoform disorders except conversion disorder (1 of 3 studies showing benefit) and pain disorder (no studies reported). CBT is the best established treatment for a variety of somatoform disorders, with some benefit also demonstrated for a consultation letter to the primary care physician. Preliminary but not yet conclusive evidence exists for antidepressants.

Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

PubMed

Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

2016-05-01

Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

Sexy gene conversions: locating gene conversions on the X-chromosome.

PubMed

Lawson, Mark J; Zhang, Liqing

2009-08-01

Gene conversion can have a profound impact on both the short- and long-term evolution of genes and genomes. Here, we examined the gene families that are located on the X-chromosomes of human (Homo sapiens), chimpanzee (Pan troglodytes), mouse (Mus musculus) and rat (Rattus norvegicus) for evidence of gene conversion. We identified seven gene families (WD repeat protein family, Ferritin Heavy Chain family, RAS-related Protein RAB-40 family, Diphosphoinositol polyphosphate phosphohydrolase family, Transcription Elongation Factor A family, LDOC1-related family, Zinc Finger Protein ZIC, and GLI family) that show evidence of gene conversion. Through phylogenetic analyses and synteny evidence, we show that gene conversion has played an important role in the evolution of these gene families and that gene conversion has occurred independently in both primates and rodents. Comparing the results with those of two gene conversion prediction programs (GENECONV and Partimatrix), we found that both GENECONV and Partimatrix have very high false negative rates (i.e. failed to predict gene conversions), which leads to many undetected gene conversions. The combination of phylogenetic analyses with physical synteny evidence exhibits high resolution in the detection of gene conversions.

An Open Conversation on Using Eye-Gaze Methods in Studies of Neurodevelopmental Disorders

ERIC Educational Resources Information Center

Venker, Courtney E.; Kover, Sara T.

2015-01-01

Purpose: Eye-gaze methods have the potential to advance the study of neurodevelopmental disorders. Despite their increasing use, challenges arise in using these methods with individuals with neurodevelopmental disorders and in reporting sufficient methodological detail such that the resulting research is replicable and interpretable. Method: This…

Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms?

PubMed

Rajkumar, Ravi Philip

2014-01-01

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.

Gender Identity Disorder and Schizophrenia: Neurodevelopmental Disorders with Common Causal Mechanisms?

PubMed Central

Rajkumar, Ravi Philip

2014-01-01

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed. PMID:25548672

Weight conversations in romantic relationships: What do they sound like and how do partners respond?

PubMed

Berge, Jerica M; Pratt, Keeley; Miller, Laura

2016-09-01

The limited research examining weight conversations (i.e., conversations about weight, body shape, or size) in adult romantic relationships has shown associations between engaging in these conversations and disordered eating behaviors, overweight/obesity, and psychosocial problems in adults. Given the potential harmful consequences of these conversations, it is important to gather more rich qualitative data to understand how weight talk is experienced in romantic relationships and how romantic partners respond to these conversations. Adults (n = 118; mean age 35 years) from a cross-sectional study were interviewed in their homes. The majority of adults (90% female; mean age = 35 years) were from minority (64% African American) and low-income (<$25,000/year) households. Qualitative data were analyzed using inductive content analysis. Sixty-five percent of participants reported that weight conversations were occurring in their romantic relationships. Qualitative themes included the following: (a) Weight conversations were direct and focused on physical characteristics; (b) weight conversations included joking or sarcastic remarks; (c) weight conversations focused on "we" and being healthy; (d) weight conversations occurred after watching TV or movies, as a result of insecurities in oneself, as length of the relationship increased, or as partners aged; and (e) partners responded to weight conversations by feeling insecure or by engaging in reciprocal weight conversations with their romantic partner. Weight conversations were prevalent in romantic relationships, with some conversations experienced as negative and some positive. Qualitative themes from the current study should be confirmed in quantitative studies to inform future intervention research targeting weight conversations in romantic relationships. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

People with "MECP2" Mutation-Positive Rett Disorder Who Converse

ERIC Educational Resources Information Center

Kerr, A. M.; Archer, H. L.; Evans, J. C.; Prescott, R. J.; Gibbon, F.

2006-01-01

Background: People with useful speech after regression constitute a distinct group of those with mutation-positive Rett disorder, 6% (20/331) reported among mutation-positive people in the British Survey. We aimed to determine the physical, mental and genetic characteristics of this group and to gain insight into their experience of Rett syndrome.…

The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder.

PubMed

Melca, Isabela A; Yücel, Murat; Mendlowicz, Mauro V; de Oliveira-Souza, Ricardo; Fontenelle, Leonardo F

2015-06-01

We assessed correlates of obsessive-compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive-compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of "low-order" behaviors (i.e., touching), lower low-planning impulsivity and greater "behavioral" compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater "cognitive" compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hypersomnia in children: interface with psychiatric disorders.

PubMed

Kotagal, Suresh

2009-10-01

Patients being evaluated in child psychiatry clinics for behavior and mood disturbances frequently exhibit daytime sleepiness. Conversely, patients being evaluated for hypersomnia by sleep specialists may have depressed mood or hyperactive and aggressive behavior. The etiology of daytime sleepiness in children and adolescents is diverse and includes inadequate sleep hygiene, obstructive sleep apnea, delayed sleep phase syndrome, idiopathic hypersomnia, periodic hypersomnia, narcolepsy, and mood disorders per se. Treatment of a sleep disorder can have a favorable impact on alertness and quality of life. A high index of suspicion for sleep problems should be maintained in children and adolescents with psychiatric disorders.

The Relationship between Psychopathology and Speech and Language Disorders in Neurologic Patients.

ERIC Educational Resources Information Center

Sapir, Shimon; Aronson, Arnold E.

1990-01-01

This paper reviews findings that suggest a causal relationship between depression, anxiety, or conversion reaction and voice, speech, and language disorders in neurologic patients. The paper emphasizes the need to consider the psychosocial and psychopathological aspects of neurologic communicative disorders, the link between emotional and…

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

PubMed

Yamada, Shunsuke; Ueki, Kenji; Tokumoto, Masanori; Suehiro, Takaichi; Kimura, Hiroshi; Taniguchi, Masatomo; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

2016-02-01

Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Childhood and Current Autistic Features in Adolescents with Schizotypal Personality Disorder

PubMed Central

Esterberg, Michelle L.; Trotman, Hanan D.; Brasfield, Joy L.; Compton, Michael T.; Walker, Elaine F.

2008-01-01

The diagnostic boundaries between autistic- and schizophrenia-spectrum disorders have varied over the years, and some overlap in diagnostic criteria persists. The present study examined childhood and current signs of autistic disorder (AD) in adolescents with schizotypal personality disorder (SPD) or other personality disorders, as well as healthy controls. A structured interview was administered to rate participants’ current symptoms. Participants’ guardians were interviewed with the Autism Diagnostic Inventory-Revised (ADI-R), a clinical assessment of childhood and current autistic signs. Compared to both the other personality-disordered and healthy groups, adolescents with SPD were rated as having significantly more impairment on childhood and current social functioning, and having more unusual interests and behaviors. For the entire sample, impaired childhood social functioning and unusual interests and behaviors were associated with higher negative symptom scores. Current impairments in social functioning, unusual interests and behaviors, and communication were also linked with greater negative symptoms. However, neither childhood nor current autistic features significantly predicted later conversion to an Axis I psychotic disorder over the course of three years of follow-up. The findings indicate that past and current autistic signs are more common in adolescents with SPD, but neither current nor childhood autistic features are linked with conversion to psychosis. PMID:18554872

High resolution A/D conversion based on piecewise conversion at lower resolution

DOEpatents

Terwilliger, Steve [Albuquerque, NM

2012-06-05

Piecewise conversion of an analog input signal is performed utilizing a plurality of relatively lower bit resolution A/D conversions. The results of this piecewise conversion are interpreted to achieve a relatively higher bit resolution A/D conversion without sampling frequency penalty.

Embodied Conversational Agents in Clinical Psychology: A Scoping Review

PubMed Central

Lau, Ho Ming; Ruwaard, Jeroen; Riper, Heleen

2017-01-01

Background Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors. Objective We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research. Methods Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study’s background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study’s aims and outcomes. Results This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into

Embodied Conversational Agents in Clinical Psychology: A Scoping Review.

PubMed

Provoost, Simon; Lau, Ho Ming; Ruwaard, Jeroen; Riper, Heleen

2017-05-09

Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors. We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research. Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes. This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a

Toward the definition of a bipolar prodrome: Dimensional predictors of bipolar spectrum disorder in at-risk youth

PubMed Central

Hafeman, Danella M.; Merranko, John; Axelson, David; Goldstein, Benjamin I.; Goldstein, Tina; Monk, Kelly; Hickey, Mary Beth; Sakolsky, Dara; Diler, Rasim; Iyengar, Satish; Brent, David; Kupfer, David; Birmaher, Boris

2016-01-01

Objective We aimed to assess dimensional symptomatic predictors of new-onset bipolar spectrum disorder in youth at familial risk of bipolar disorder (“at-risk” youth). Method Offspring aged 6–18 of parents with bipolar-I/II disorder (n=391) and offspring of community controls (n=248) were recruited without regard to non-bipolar psychopathology. At baseline, 8.4% (33/391) of offspring of bipolar parents had bipolar spectrum; 14.7% (44/299) of offspring with follow-up developed new-onset bipolar spectrum (15 with bipolar-I/II) over eight years. Scales collected at baseline and follow-up were reduced using factor analyses; factors (both at baseline and visit proximal to conversion or last contact) were then assessed as predictors of new-onset bipolar spectrum. Results Relative to community control offspring, at-risk and bipolar offspring had higher baseline levels of anxiety/depression, inattention/disinhibition, externalizing, subsydromal manic, and affective lability symptoms (p<.05). The strongest predictors of new-onset bipolar spectrum were: baseline anxiety/depression, baseline and proximal affective lability, and proximal subsyndromal manic symptoms (p<.05). While affective lability and anxiety/depression were elevated throughout follow-up in those who later developed bipolar spectrum, manic symptoms increased up to the point of conversion. A path analysis supported the hypothesized model that affective lability at baseline predicted new-onset bipolar spectrum, in part, through increased manic symptoms at the visit prior to conversion; earlier parental age of mood disorder onset also significantly increased risk of conversion (p<.001). While youth without anxiety/depression, affective lability, and mania (and with a parent with older age of mood disorder onset) had a 2% predicted chance of conversion to bipolar spectrum, those with all risk factors had a 49% predicted chance of conversion. Conclusions Dimensional measures of anxiety/depression, affective

Metric Conversion

Atmospheric Science Data Center

2013-03-12

Metric Weights and Measures The metric system is based on 10s.  For example, 10 millimeters = 1 centimeter, 10 ... Special Publications: NIST Guide to SI Units: Conversion Factors NIST Guide to SI Units: Conversion Factors listed ...

Learning through Conversation.

ERIC Educational Resources Information Center

Kelly, Patricia R.; Klein, Adria F.; Pinnell, Gay Su

1996-01-01

Through teacher-child conversation, experts use oral language to help novices take on more complex tasks; and Reading Recovery children, who are obviously having difficulty with school-based learning, are especially in need of significant conversations with adults. Reading and writing processes are supported through conversation with Reading…

Prospective progression from high-prevalence disorders to bipolar disorder: Exploring characteristics of pre-illness stages.

PubMed

Ratheesh, Aswin; Cotton, Susan M; Betts, Jennifer K; Chanen, Andrew; Nelson, Barnaby; Davey, Christopher G; McGorry, Patrick D; Berk, Michael; Bechdolf, Andreas

2015-09-01

Identification of risk factors within precursor syndromes, such as depression, anxiety or substance use disorders (SUD), might help to pinpoint high-risk stages where preventive interventions for Bipolar Disorder (BD) could be evaluated. We examined baseline demographic, clinical, quality of life, and temperament measures along with risk clusters among 52 young people seeking help for depression, anxiety or SUDs without psychosis or BD. The risk clusters included Bipolar At-Risk (BAR) and the Bipolarity Index as measures of bipolarity and the Ultra-High Risk assessment for psychosis. The participants were followed up for 12 months to identify conversion to BD. Those who converted and did not convert to BD were compared using Chi-Square and Mann Whitney U tests. The sample was predominantly female (85%) and a majority had prior treatment (64%). Four participants converted to BD over the 1-year follow up period. Having an alcohol use disorder at baseline (75% vs 8%, χ(2)=14.1, p<0.001) or a family history of SUD (67% vs 12.5%, χ(2)=6.0, p=0.01) were associated with development of BD. The sub-threshold mania subgroup of BAR criteria was also associated with 12-month BD outcomes. The severity of depressive symptoms and cannabis use had high effects sizes of association with BD outcomes, without statistical significance. The small number of conversions limited the power of the study to identify associations with risk factors that have previously been reported to predict BD. However, subthreshold affective symptoms and SUDs might predict the onset of BD among help-seeking young people with high-prevalence disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Validation of the MDS research criteria for prodromal Parkinson's disease: Longitudinal assessment in a REM sleep behavior disorder (RBD) cohort.

PubMed

Fereshtehnejad, Seyed-Mohammad; Montplaisir, Jacques Y; Pelletier, Amelie; Gagnon, Jean-François; Berg, Daniela; Postuma, Ronald B

2017-06-01

Recently, the International Parkinson and Movement Disorder Society introduced the prodromal criteria for PD. Objectives Our study aimed to examine diagnostic accuracy of the criteria as well as the independence of prodromal markers to predict conversion to PD or dementia with Lewy bodies. This prospective cohort study was performed on 121 individuals with rapid eye movement sleep behavior disorder who were followed annually for 1 to 12 years. Using data from a comprehensive panel of prodromal markers, likelihood ratio and post-test probability of the criteria were calculated at baseline and during each follow-up visit. Forty-eight (39.7%) individuals with rapid eye movement sleep behavior disorder converted to PD/dementia with Lewy bodies. The prodromal criteria had 81.3% sensitivity and 67.9% specificity for conversion to PD/dementia with Lewy bodies at 4-year follow-up. One year before conversion, sensitivity was 100%. The criteria predicted dementia with Lewy bodies with even higher accuracy than PD without dementia at onset. Those who met the threshold of prodromal criteria at baseline had significantly more rapid conversion into a neurodegenerative state (4.8 vs. 9.1 years; P < 0.001). Pair-wise combinations of different prodromal markers showed that markers were independent of one another. The prodromal criteria are a promising tool for predicting incidence of PD/dementia with Lewy bodies and conversion time in a rapid eye movement sleep behavior disorder cohort, with high sensitivity and high specificity with long follow-up. Prodromal markers influence the overall likelihood ratio independently, allowing them to be reliably multiplied. Defining additional markers with high likelihood ratio, further studies with longitudinal assessment and testing thresholds in different target populations will improve the criteria. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Somatoform and psychoform dissociation among women with orgasmic and sexual pain disorders.

PubMed

Farina, Benedetto; Mazzotti, Eva; Pasquini, Paolo; Mantione, Maria Giuseppina

2011-01-01

Since the 20th century, psychogenic female sexual dysfunctions (FSD), like some somatoform and conversion disorders, have been considered an expression of somatoform dissociation. Several studies have reported dissociative symptoms in different somatoform and conversion disorders, but limited data are available on dissociation among patients with FSD. The aim of this study was to assess somatoform and psychoform dissociation among patients with women's orgasmic disorder, dyspareunia, and vaginismus. A battery of self-administered questionnaires (Somatoform Dissociation Questionnaire, Dissociative Experiences Scale, Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised) was given to 200 gynecological outpatients to assess psychoform and somatoform dissociation and their association with FSD. A strong association between somatoform dissociation and FSD was observed (adjusted odds ratio [OR] = 5.39, 95% confidence interval [CI] = 1.15-25.32), the association between somatoform and psychoform dissociation being estimated by an adjusted OR of 4.83 (95% CI = 1.17-19.91). Our results are compatible with the idea that some forms of FSD could be regarded as somatoform dissociative disorders.

The effects of enactment on communicative competence in aphasic casual conversation: a functional linguistic perspective.

PubMed

Groenewold, Rimke; Armstrong, Elizabeth

2018-05-14

Previous research has shown that speakers with aphasia rely on enactment more often than non-brain-damaged language users. Several studies have been conducted to explain this observed increase, demonstrating that spoken language containing enactment is easier to produce and is more engaging to the conversation partner. This paper describes the effects of the occurrence of enactment in casual conversation involving individuals with aphasia on its level of conversational assertiveness. To evaluate whether and to what extent the occurrence of enactment in speech of individuals with aphasia contributes to its conversational assertiveness. Conversations between a speaker with aphasia and his wife (drawn from AphasiaBank) were analysed in several steps. First, the transcripts were divided into moves, and all moves were coded according to the systemic functional linguistics (SFL) framework. Next, all moves were labelled in terms of their level of conversational assertiveness, as defined in the previous literature. Finally, all enactments were identified and their level of conversational assertiveness was compared with that of non-enactments. Throughout their conversations, the non-brain-damaged speaker was more assertive than the speaker with aphasia. However, the speaker with aphasia produced more enactments than the non-brain-damaged speaker. The moves of the speaker with aphasia containing enactment were more assertive than those without enactment. The use of enactment in the conversations under study positively affected the level of conversational assertiveness of the speaker with aphasia, a competence that is important for speakers with aphasia because it contributes to their floor time, chances to be heard seriously and degree of control over the conversation topic. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Somatoform and dissociative disorders in children and adolescents: A comparative study

PubMed Central

Malhotra, Savita; Singh, Gagandeep; Mohan, Ashwin

2005-01-01

Background: Somatoform and dissociative (conversion) disorders in adults have been reported to have a close relationship because of a diagnostic overlap and comparable aetiological models. The literature on these disorders in children and adolescents is scarce. Aim: The present study attempted to compare these two disorders in children and adolescents since antecedents of these disorders are said to be laid in childhood. Methods: Case files of 118 patients (69 of somatoform disorders and 49 of dissociative disorders) were reviewed and the two groups were compared with respect to sociodemographic profile, clinical profile, neurotic traits, behavioural problems, temperament, intelligence and family dysfunction. Results: Age at presentation and intelligence were significantly higher in those with somatoform disorders than in those with dissociative disorders. Patients with dissociative disorders had a significantly higher number of co-morbid somatoform symptoms. Conclusion: Somatoform and dissociative disorders are closely linked.

Conversion of broadband IR radiation and structural disorder in lithium niobate single crystals with low photorefractive effect

NASA Astrophysics Data System (ADS)

Litvinova, Man Nen; Syuy, Alexander V.; Krishtop, Victor V.; Pogodina, Veronika A.; Ponomarchuk, Yulia V.; Sidorov, Nikolay V.; Gabain, Aleksei A.; Palatnikov, Mikhail N.; Litvinov, Vladimir A.

2016-11-01

The conversion of broadband IR radiation when the noncritical phase matching condition is fulfilled in lithium niobate (LiNbO3) single crystals with stoichiometric (R = Li/Nb = 1) and congruent (R = 0.946) compositions, as well as in congruent single crystals doped with zinc has been investigated. It is shown that the spectrum parameters of converted radiation, such as the conversion efficiency, spectral width and position of maximum, depend on the ordering degree of structural units of the cation sublattice along the polar axis of crystal.

The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders

PubMed Central

Zulauf, Courtney A.; Sprich, Susan E.; Safren, Steven A.

2015-01-01

Adolescents and young adults with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) are increasingly presenting in clinical practice. The overlap and role of treatment for these co-occurring disorders remains unclear. A review of the literature was conducted to highlight and update recent evidence on the overlap of ADHD and SUD, the role of ADHD medication on later SUD, and the treatment of ADHD and SUD in adolescents and young adults. Recent work continues to highlight the high risk for comorbid ADHD in patients with SUD; and conversely, the high risk for SUD developing in ADHD across the lifespan, particularly in the context of comorbid conduct disorder. Although the data remains discordant, it appears that ADHD pharmacotherapy does not increase the risk for SUD. Medication treatment alone does not appear to be particularly effective in treating SUD in currently active substance abusing individuals with ADHD. Structured therapies may be effective in treating adolescents and young adults with ADHD and SUD. Further controlled trials evaluating the sequence and effect of structured psychotherapies and/or ADHD pharmacotherapy on SUD relapse in these groups are warranted. PMID:24526271

Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment

PubMed Central

Belli, Hasan

2014-01-01

Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial. PMID:25133142

Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment.

PubMed

Belli, Hasan

2014-08-16

Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.

[Emotional and impulsive dimensions in bipolar disorder and borderline personality disorder].

PubMed

Leblanc, A; Jarroir, M; Vorspan, F; Bellivier, F; Leveillee, S; Romo, L

2017-05-01

Studies have shown that patients with borderline personality disorder are often misdiagnosed to have bipolar disorder and conversely. Indeed, a number of characteristics common to both disorders could explain this problem: emotional instability as well as impulsivity represent confounding factors and contribute to the risk of misdiagnosis. However, it appears that these characteristics manifest themselves in different ways according to the pathology. The aim of the study is to show differences between affective lability, emotional intensity and impulsivity dimensions. The clinical aim is to refine bipolar disorder and borderline personality disorder diagnosis, to improve psychological care for these patients in the long-term. We compared the emotional and impulsive dimensions in two groups of patients: a group of 21 patients with bipolar disorder and a group of 19 patients with borderline personality disorder. Tools: ALS, a self-report questionnaire to evaluate affective lability, AIM, a self-report questionnaire to see affective intensity, and UPPS, a self-report questionnaire to measure impulsivity according to several dimensions. The results indicate that borderline patients scored significantly higher than bipolar patients at the ALS and AIM scales. Regarding the UPPS, borderline patients scored significantly higher than bipolar patients for the dimensions "lack of premeditation" and "lack of perseverance"; however, bipolar patients had significantly higher scores than borderline patients for the dimension "negative emergency". This study shows that bipolar disorder and borderline personality can be differentiated thanks to emotional dimensions as well as different dimensions of impulsivity: borderline patients appear to have an affective lability and intensity more important than bipolar patients; it also appears that impulsivity manifests itself differently according to the disorder. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All

Conversion disorder

MedlinePlus

... Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

The association between social skills deficits and family history of mood disorder in bipolar I disorder.

PubMed

Fernandes, Francy B F; Rocca, Cristiana C; Gigante, Alexandre D; Dottori-Silva, Paola R; Gerchmann, Luciana; Rossini, Danielle; Sato, Rodrigo; Lafer, Beny; Nery, Fabiano G

2018-03-26

To compare social skills and related executive functions among bipolar disorder (BD) patients with a family history of mood disorders (FHMD), BD patients with no FHMD and healthy control (HCs). We evaluated 20 euthymic patients with FHMD, 17 euthymic patients without FHMD, and 31 HCs using the Social Skills Inventory (SSI) and a neuropsychological battery evaluating executive function, inhibitory control, verbal fluency and estimated intelligence. Both BD groups had lower SSI scores than controls. Scores for one subfactor of the social skills questionnaire, conversational skills and social performance, were significantly lower among patients with FHMD than among patients without FHMD (p = 0.019). Both groups of BD patients exhibited significant deficits in initiation/inhibition, but only BD patients with FHMD had deficits in verbal fluency, both compared to HC. There were no associations between social skills questionnaire scores and measures of cognitive function. Euthymic BD patients have lower social skills and executive function performance than HC. The presence of FHMD among BD patients is specifically associated with deficits in conversational and social performance skills, in addition to deficits in verbal fluency. Both characteristics might be associated with a common genetically determined pathophysiological substrate.

Neuropsychiatric manifestations in late-onset urea cycle disorder patients.

PubMed

Serrano, Mercedes; Martins, Cecilia; Pérez-Dueñas, Belén; Gómez-López, Lilian; Murgui, Empar; Fons, Carmen; García-Cazorla, Angels; Artuch, Rafael; Jara, Fernando; Arranz, José A; Häberle, Johannes; Briones, Paz; Campistol, Jaume; Pineda, Mercedes; Vilaseca, Maria A

2010-03-01

Inherited urea cycle disorders represent one of the most common groups of inborn errors of metabolism. Late-onset urea cycle disorders caused by partial enzyme deficiencies may present with unexpected clinical phenotypes. We report 9 patients followed up in our hospital presenting late-onset urea cycle disorders who initially manifested neuropsychiatric/neurodevelopmental symptoms (the most prevalent neuropsychiatric/neurodevelopmental diagnoses were mental retardation, attention-deficit hyperactivity disorder [ADHD], language disorder, and delirium). Generally, these clinical pictures did not benefit from pharmacological treatment. Conversely, dietary treatment improved the symptoms. Regarding biochemical data, 2 patients showed normal ammonium but high glutamine levels. This study highlights the fact that neuropsychiatric/neurodevelopmental findings are common among the initial symptomatology of late-onset urea cycle disorders. The authors recommend that unexplained or nonresponsive neuropsychiatric/neurodevelopmental symptoms appearing during childhood or adolescence be followed by a study of ammonia and amino acid plasmatic levels to rule out a urea cycle disorder.

Brief report: treating stuttering in an adult with autism spectrum disorder.

PubMed

Brundage, Shelley B; Whelan, Cory J; Burgess, Cathleen M

2013-02-01

Stuttering and autism can co-occur and when they do it presents a significant communication challenge. This study examined the effectiveness of a modified version of the fluency rules program (FRP; Runyan and Runyan, Stuttering and related disorders of fluency, in 2007) to reduce stuttering frequency in a man with autism spectrum disorder (ASD). The participant's percentage of stuttered words (%SW) was calculated during conversational interactions with multiple conversation partners both within and outside of the clinic treatment sessions. Visual inspection methods revealed a reduction in %SW from an average of 14.5 %SW during baseline to 2.07 %SW during the withdrawal phase. The mean baseline reduction in %SW from baseline to the second treatment phase was 91.8 %. The FRP holds promise for reducing %SW in persons with ASD who stutter.

The role of alexithymia in the development of functional motor symptoms (conversion disorder)

PubMed Central

Demartini, Benedetta; Petrochilos, Panayiota; Ricciardi, Lucia; Price, Gary; Edwards, Mark J; Joyce, Eileen

2014-01-01

Background The mechanisms leading to the development of functional motor symptoms (FMS) are of pathophysiological and clinical relevance, yet are poorly understood. Aim The aim of the present study was to evaluate whether impaired emotional processing at the cognitive level (alexithymia) is present in patients affected by FMS. We conducted a cross-sectional study in a population of patients with FMS and in two control groups (patients with organic movement disorders (OMD) and healthy volunteers). Methods 55 patients with FMS, 33 patients affected by OMD and 34 healthy volunteers were recruited. The assessment included the 20-item Toronto Alexithymia Scale (TAS-20), the Montgomery-Asberg Depression Rating Scale, the Reading the Mind in the Eyes’ Test and the Structured Clinical Interview for Personality Disorders. Results Alexithymia was present in 34.5% of patients with FMS, 9.1% with OMD and 5.9% of the healthy volunteers, which was significantly higher in the FMS group (χ2 (2)=14.129, p<0.001), even after controlling for the severity of symptoms of depression. Group differences in mean scores were observed on both the difficulty identifying feelings and difficulty describing feelings dimensions of the TAS-20, whereas the externally orientated thinking subscale score was similar across the three groups. Regarding personality disorder, χ2 analysis showed a significantly higher prominence of obsessive-compulsive personality disorder (OCPD) in the FMS group (χ2 (2)=16.217, p<0.001) and 71.4% of those with OCPD also reached threshold criteria for alexithymia. Conclusions Because alexithymia is a mental state denoting the inability to identify emotions at a cognitive level, one hypothesis is that some patients misattribute autonomic symptoms of anxiety, for example, tremor, paraesthesiae, paralysis, to that of a physical illness. Further work is required to understand the contribution of OCPD to the development of FMS. PMID:24610939

Prevalence and Correlates of Bullying Involvement among Adolescents with an Autism Spectrum Disorder

PubMed Central

Sterzing, Paul R.; Shattuck, Paul T.; Narendorf, Sarah C.; Wagner, Mary; Cooper, Benjamin P.

2012-01-01

Objectives Produce nationally representative estimates for rates of bullying involvement among adolescents with an autism spectrum disorder, compare population estimates to adolescents with other developmental disabilities, and identify social ecological correlates of bullying involvement Design Nationally representative surveys from 2001 Setting United States Participants Parents of adolescents with an autism spectrum disorder, principals of the schools they attended, and staff members most familiar with their school programs Main Exposure Autism spectrum disorders Outcomes Measures: Bullying involvement (parent report of victimization, perpetration, and victimization/perpetration within the last school year) Results The prevalence rates of bullying involvement for adolescents with an autism spectrum disorder were 46.3% (victimization), 14.8% (perpetration), and 8.9% (victimization/perpetration). Victimization was related to having a non-Hispanic ethnic identity, attention-deficit/hyperactivity disorder, lower social skills, some form of conversational ability, and more classes in general education. Correlates of perpetration included being White, having attention-deficit/hyperactivity disorder, and getting together with friends at least once a week. Victimization/perpetration was associated with being White, non-Hispanic ethnicity, attention-deficit/hyperactivity disorder, and getting together with friends at least once a week Conclusions School-based bullying interventions need to target the core deficits of autism (conversational ability, social skills) and comorbid conditions (attention-deficit/hyperactivity disorder). Future bullying interventions also need to address the higher rates of victimization that occur in general education settings by increasing social integration into protective peer groups and increasing the empathy and social skills of typically developing students toward their peers with an autism spectrum disorder. PMID:22945284

Cross-national prevalence and cultural correlates of bipolar I disorder.

PubMed

Johnson, Kaja R; Johnson, Sheri L

2014-07-01

Bipolar disorder has been consistently related to heightened sensitivity to reward. Greater reward sensitivity predicts the onset of disorder, a more severe course, and conversion from milder to severe forms. No studies consider whether cultural factors related to reward sensitivity influence the course of bipolar disorder. This study examines the relationship of reward-relevant cultural values to global prevalence rates of bipolar I disorder. Lifetime prevalence of bipolar I disorder for 17 countries was drawn from epidemiological studies that used structured diagnostic interviews of large community samples. Bivariate correlations were used to assess the relationship of bipolar disorder prevalence with national scores on four reward-relevant cultural dimensions (Power Distance, Individualism, Long-Term Orientation, and Performance Orientation). The prevalence of bipolar I disorder was correlated in the predicted manner with Power Distance and Individualism, and with Long-Term Orientation and Performance Orientation after outliers were removed. Findings provide evidence for a cultural model of reward sensitivity in bipolar disorder.

Conversing with Computers

NASA Technical Reports Server (NTRS)

2004-01-01

I/NET, Inc., is making the dream of natural human-computer conversation a practical reality. Through a combination of advanced artificial intelligence research and practical software design, I/NET has taken the complexity out of developing advanced, natural language interfaces. Conversational capabilities like pronoun resolution, anaphora and ellipsis processing, and dialog management that were once available only in the laboratory can now be brought to any application with any speech recognition system using I/NET s conversational engine middleware.

Sleep Disorders and their Association with Laboratory Pain Sensitivity in Temporomandibular Joint Disorder

PubMed Central

Smith, Michael T.; Wickwire, Emerson M.; Grace, Edward G.; Edwards, Robert R.; Buenaver, Luis F.; Peterson, Stephen; Klick, Brendan; Haythornthwaite, Jennifer A.

2009-01-01

Study Objectives: We characterized sleep disorder rates in temporomandibular joint disorder (TMD) and evaluated possible associations between sleep disorders and laboratory measures of pain sensitivity. Design: Research diagnostic examinations were conducted, followed by two consecutive overnight polysomnographic studies with morning and evening assessments of pain threshold. Setting: Orofacial pain clinic and inpatient sleep research facility Participants: Fifty-three patients meeting research diagnostic criteria for myofascial TMD. Interventions: N/A Measurements and Results: We determined sleep disorder diagnostic rates and conducted algometric measures of pressure pain threshold on the masseter and forearm. Heat pain threshold was measured on the forearm; 75% met self-report criteria for sleep bruxism, but only 17% met PSG criteria for active sleep bruxism. Two or more sleep disorders were diagnosed in 43% of patients. Insomnia disorder (36%) and sleep apnea (28.4%) demonstrated the highest frequencies. Primary insomnia (PI) (26%) comprised the largest subcategory of insomnia. Even after controlling for multiple potential confounds, PI was associated with reduced mechanical and thermal pain thresholds at all sites (P < 0.05). Conversely, the respiratory disturbance index was associated with increased mechanical pain thresholds on the forearm (P < 0.05). Conclusions: High rates of PI and sleep apnea highlight the need to refer TMD patients complaining of sleep disturbance for polysomnographic evaluation. The association of PI and hyperalgesia at a non-orofacial site suggests that PI may be linked with central sensitivity and could play an etiologic role in idiopathic pain disorders. The association between sleep disordered breathing and hypoalgesia requires further study and may provide novel insight into the complex interactions between sleep and pain-regulatory processes. Citation: Smith MT; Wickwire EM; Grace EG; Edwards RR; Buenaver LF; Peterson S; Klick B

Solar thermal conversion

NASA Technical Reports Server (NTRS)

Selcuk, M. K.

1978-01-01

A brief review of the fundamentals of the conversion of solar energy into mechanical work (or electricity via generators) is given. Both past and present work on several conversion concepts are discussed. Solar collectors, storage systems, energy transport, and various types of engines are examined. Ongoing work on novel concepts of collectors, energy storage and thermal energy conversion are outlined and projections for the future are described. Energy costs for various options are predicted and margins and limitations are discussed.

Immigration-related factors and mental disorders among Asian Americans.

PubMed

Takeuchi, David T; Zane, Nolan; Hong, Seunghye; Chae, David H; Gong, Fang; Gee, Gilbert C; Walton, Emily; Sue, Stanley; Alegría, Margarita

2007-01-01

We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. Data were derived from the National Latino and Asian American Study, the first national epidemiological survey of Asian Americans in the United States. The relationships between immigration-related factors and mental disorders were different for men and women. Among women, nativity was strongly associated with lifetime disorders, with immigrant women having lower rates of most disorders compared with US-born women. Conversely, English proficiency was associated with mental disorders for Asian men. Asian men who spoke English proficiently generally had lower rates of lifetime and 12-month disorders compared with nonproficient speakers. For Asian Americans, immigration-related factors were associated with mental disorders, but in different ways for men and women. Future studies will need to examine gender as an important factor in specifying the association between immigration and mental health.

Immigration-Related Factors and Mental Disorders Among Asian Americans

PubMed Central

Takeuchi, David T.; Zane, Nolan; Hong, Seunghye; Chae, David H.; Gong, Fang; Gee, Gilbert C.; Walton, Emily; Sue, Stanley; Alegría, Margarita

2007-01-01

Objectives. We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. Methods. Data were derived from the National Latino and Asian American Study, the first national epidemiological survey of Asian Americans in the United States. Results. The relationships between immigration-related factors and mental disorders were different for men and women. Among women, nativity was strongly associated with lifetime disorders, with immigrant women having lower rates of most disorders compared with US-born women. Conversely, English proficiency was associated with mental disorders for Asian men. Asian men who spoke English proficiently generally had lower rates of lifetime and 12-month disorders compared with nonproficient speakers. Conclusions. For Asian Americans, immigration-related factors were associated with mental disorders, but in different ways for men and women. Future studies will need to examine gender as an important factor in specifying the association between immigration and mental health. PMID:17138908

Conversational Behaviors in Youth with High-functioning ASD and Asperger Syndrome

PubMed Central

Orlovski, Stephanie Miles; Marcinko, Hillary Chuba; Volkmar, Fred

2010-01-01

Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. Psychol Med 22:245–254, 1992). The ASD group was divided into AS and HFA/PDD-NOS subgroups. Significant differences were found among groups on approximately one-third of the PRS items. These items involved primarily the management of topics and information, reciprocity, intonation, and gaze management. The only differences to reach significance between the AS and HFA/PDD-NOS group were a greater tendency for overly formal speech on the part of the AS group, and more difficulty with gaze management on the part of the group with HFA/PDD-NOS. The implications of these findings for understanding and treating conversational deficits in ASD are discussed. PMID:18607708

Uranium Conversion & Enrichment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karpius, Peter Joseph

2017-02-06

The isotopes of uranium that are found in nature, and hence in ‘fresh’ Yellowcake’, are not in relative proportions that are suitable for power or weapons applications. The goal of conversion then is to transform the U 3O 8 yellowcake into UF 6. Conversion and enrichment of uranium is usually required to obtain material with enough 235U to be usable as fuel in a reactor or weapon. The cost, size, and complexity of practical conversion and enrichment facilities aid in nonproliferation by design.

Everyday conversation in dementia: a review of the literature to inform research and practice.

PubMed

Kindell, Jacqueline; Keady, John; Sage, Karen; Wilkinson, Ray

2017-07-01

discussed. The review indicates that interventions targeting conversation in dementia are often advocated in the literature but currently such approaches remain to be systematically evaluated. In addition, many of the important insights arising from these studies have yet to inform multidisciplinary dementia care practice. © 2016 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Direct Conversion of Energy.

ERIC Educational Resources Information Center

Corliss, William R.

This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

The role of alexithymia in the development of functional motor symptoms (conversion disorder).

PubMed

Demartini, Benedetta; Petrochilos, Panayiota; Ricciardi, Lucia; Price, Gary; Edwards, Mark J; Joyce, Eileen

2014-10-01

The mechanisms leading to the development of functional motor symptoms (FMS) are of pathophysiological and clinical relevance, yet are poorly understood. The aim of the present study was to evaluate whether impaired emotional processing at the cognitive level (alexithymia) is present in patients affected by FMS. We conducted a cross-sectional study in a population of patients with FMS and in two control groups (patients with organic movement disorders (OMD) and healthy volunteers). 55 patients with FMS, 33 patients affected by OMD and 34 healthy volunteers were recruited. The assessment included the 20-item Toronto Alexithymia Scale (TAS-20), the Montgomery-Asberg Depression Rating Scale, the Reading the Mind in the Eyes' Test and the Structured Clinical Interview for Personality Disorders. Alexithymia was present in 34.5% of patients with FMS, 9.1% with OMD and 5.9% of the healthy volunteers, which was significantly higher in the FMS group (χ(2) (2)=14.129, p<0.001), even after controlling for the severity of symptoms of depression. Group differences in mean scores were observed on both the difficulty identifying feelings and difficulty describing feelings dimensions of the TAS-20, whereas the externally orientated thinking subscale score was similar across the three groups. Regarding personality disorder, χ(2) analysis showed a significantly higher prominence of obsessive-compulsive personality disorder (OCPD) in the FMS group (χ(2) (2)=16.217, p<0.001) and 71.4% of those with OCPD also reached threshold criteria for alexithymia. Because alexithymia is a mental state denoting the inability to identify emotions at a cognitive level, one hypothesis is that some patients misattribute autonomic symptoms of anxiety, for example, tremor, paraesthesiae, paralysis, to that of a physical illness. Further work is required to understand the contribution of OCPD to the development of FMS. Published by the BMJ Publishing Group Limited. For permission to use (where not

Laser energy conversion

NASA Technical Reports Server (NTRS)

Jalufka, N. W.

1989-01-01

The conversion of laser energy to other, more useful, forms is an important element of any space power transmission system employing lasers. In general the user, at the receiving sight, will require the energy in a form other than laser radiation. In particular, conversion to rocket power and electricity are considered to be two major areas where one must consider various conversion techniques. Three systems (photovoltaic cells, MHD generators, and gas turbines) have been identified as the laser-to-electricity conversion systems that appear to meet most of the criteria for a space-based system. The laser thruster also shows considerable promise as a space propulsion system. At this time one cannot predict which of the three laser-to-electric converters will be best suited to particular mission needs. All three systems have some particular advantages, as well as disadvantages. It would be prudent to continue research on all three systems, as well as the laser rocket thruster. Research on novel energy conversion systems, such as the optical rectenna and the reverse free-electron laser, should continue due to their potential for high payoff.

Isomolybdate conversion coatings

NASA Technical Reports Server (NTRS)

Minevski, Zoran (Inventor); Maxey, Jason (Inventor); Nelson, Carl (Inventor); Eylem, Cahit (Inventor)

2002-01-01

A conversion coating solution and process forms a stable and corrosion-resistant layer on metal substrates or layers or, more preferably, on a boehmite layer or other base conversion coating. The conversion coating process involves contacting the substrate, layer or coating with an aqueous alkali metal isomolybdate solution in order to convert the surface of the substrate, layer or coating to a stable conversion coating. The aqueous alkali metal molybdates are selected from sodium molybdate (Na.sub.2 MoO.sub.4), lithium molybdate (Li.sub.2 MoO.sub.4), potassium molybdate (K.sub.2 MoO.sub.4), or combinations thereof, with the most preferred alkali metal molybdate being sodium molybdate. The concentration of alkali metal molybdates in the solution is preferably less than 5% by weight. In addition to the alkali metal molybdates, the conversion coating solution may include alkaline metal passivators selected from lithium nitrate (LiNO.sub.3), sodium nitrate (NaNO.sub.3), ammonia nitrate (NH.sub.4 NO.sub.3), and combinations thereof; lithium chloride, potassium hexafluorozirconate (K.sub.2 ZrF.sub.6) or potassium hexafluorotitanate (K.sub.2 TiF.sub.6).

Conversation Compass© Communication Screener: A Conversation Screener for Teachers

ERIC Educational Resources Information Center

Gardner, Shari L.; Curenton, Stephanie M.

2017-01-01

The purpose of this study was to report preliminary reliability and validity data from the Conversation Compass© Communication Screener (CCCS), a teacher-reported language screener intended to capture children's skills related to classroom conversations with peers and teachers. Three preschool teachers completed the CCCS and the Child Observation…

Conversion of PCDP Dialogs.

ERIC Educational Resources Information Center

Bork, Alfred M.

An introduction to the problems involved in conversion of computer dialogues from one computer language to another is presented. Conversion of individual dialogues by complete rewriting is straightforward, if tedious. To make a general conversion of a large group of heterogeneous dialogue material from one language to another at one step is more…

[Conversation analysis for improving nursing communication].

PubMed

Yi, Myungsun

2007-08-01

Nursing communication has become more important than ever before because quality of nursing services largely depends on the quality of communication in a very competitive health care environment. This article was to introduce ways to improve nursing communication using conversation analysis. This was a review study on conversation analysis, critically examining previous studies in nursing communication and interpersonal relationships. This study provided theoretical backgrounds and basic assumptions of conversation analysis which was influenced by ethnomethodology, phenomenology, and sociolinguistic. In addition, the characteristics and analysis methods of conversation analysis were illustrated in detail. Lastly, how conversation analysis could help improve communication was shown, by examining researches using conversation analysis not only for ordinary conversations but also for extraordinary or difficult conversations such as conversations between patients with dementia and their professional nurses. Conversation analysis can help in improving nursing communication by providing various structures and patterns as well as prototypes of conversation, and by suggesting specific problems and problem-solving strategies in communication.

24 CFR 884.123 - Conversions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversions. 884.123 Section 884... RENTAL HOUSING PROJECTS Applicability, Scope and Basic Policies § 884.123 Conversions. (a) Conversion of... and an appropriate PHA to agree, if they are willing, to a conversion of any such project to a Private...

24 CFR 884.123 - Conversions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversions. 884.123 Section 884... RENTAL HOUSING PROJECTS Applicability, Scope and Basic Policies § 884.123 Conversions. (a) Conversion of... and an appropriate PHA to agree, if they are willing, to a conversion of any such project to a Private...

Parents' Perceptions of Their Children's Social Behavior: The Social Validity of Social Stories[TM] and Comic Strip Conversations

ERIC Educational Resources Information Center

Hutchins, Tiffany L.; Prelock, Patricia A.

2013-01-01

This article describes a family-centered collaborative approach to the development and socially valid assessment of Social Stories[TM] and comic strip conversations (CSCs) for supporting the social behaviors in children with autism spectrum disorder (ASD). Seventeen children with ASD (ages 4-12 years) participated in either an immediate or a…

Rhythm as a Coordinating Device: Entrainment With Disordered Speech

PubMed Central

Borrie, Stephanie A.; Liss, Julie M.

2014-01-01

Purpose The rhythmic entrainment (coordination) of behavior during human interaction is a powerful phenomenon, considered essential for successful communication, supporting social and emotional connection, and facilitating sense-making and information exchange. Disruption in entrainment likely occurs in conversations involving those with speech and language impairment, but its contribution to communication disorders has not been defined. As a first step to exploring this phenomenon in clinical populations, the present investigation examined the influence of disordered speech on the speech production properties of healthy interactants. Method Twenty-nine neurologically healthy interactants participated in a quasi-conversational paradigm, in which they read sentences (response) in response to hearing prerecorded sentences (exposure) from speakers with dysarthria (n = 4) and healthy controls (n = 4). Recordings of read sentences prior to the task were also collected (habitual). Results Findings revealed that interactants modified their speaking rate and pitch variation to align more closely with the disordered speech. Production shifts in these rhythmic properties, however, remained significantly different from corresponding properties in dysarthric speech. Conclusion Entrainment offers a new avenue for exploring speech and language impairment, addressing a communication process not currently explained by existing frameworks. This article offers direction for advancing this line of inquiry. PMID:24686410

Early Intervention in Bipolar Disorder.

PubMed

Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

2018-05-01

Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

12 CFR 563b.365 - May other voting members purchase conversion shares in the conversion?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false May other voting members purchase conversion shares in the conversion? 563b.365 Section 563b.365 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY CONVERSIONS FROM MUTUAL TO STOCK FORM Standard Conversions Offers and Sales of...

12 CFR 563b.365 - May other voting members purchase conversion shares in the conversion?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false May other voting members purchase conversion shares in the conversion? 563b.365 Section 563b.365 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY CONVERSIONS FROM MUTUAL TO STOCK FORM Standard Conversions Offers and Sales of...

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.

PubMed

Prasko, Jan; Grambal, Ales; Kasalova, Petra; Kamardova, Dana; Ociskova, Marie; Holubova, Michaela; Vrbova, Kristyna; Sigmundova, Zuzana; Latalova, Klara; Slepecky, Milos; Zatkova, Marta

2016-01-01

The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety-depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program - Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale. A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients' mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher

Common conversion factors.

PubMed

2001-05-01

This appendix presents tables of some of the more common conversion factors for units of measure used throughout Current Protocols manuals, as well as prefixes indicating powers of ten for SI units. Another table gives conversions between temperatures on the Celsius (Centigrade) and Fahrenheit scales.

Metric Conversion: Remedy or Rip-Off?

ERIC Educational Resources Information Center

Schenck, John P.

1975-01-01

Opinions on metric conversion from seven large industrial organizations reflect inadequate evidence predicating conversion, no compelling need for conversion, opposition to hard conversion, lack of information about the financial and social costs of conversion, and feelings that metrics as the sole language of measurement will be regressive.…

Anticipatory other-completion of augmentative and alternative communication talk: a conversation analysis study.

PubMed

Bloch, Steven

2011-01-01

The study described here investigates the practice of anticipatory completion of augmentative and alternative communication (AAC) utterances in progress. The aims were to identify and analyse features of this practice as they occur in natural conversation between a person using an AAC system and a family member. The methods and principles of Conversation Analysis (CA) were used to video record conversations between people with progressive neurological diseases and a progressive speech disorder (dysarthria) and their family members. Key features of interaction were identified and extracts transcribed. Four extracts of talk between a man with motor neurone disease/amyotrophic lateral sclerosis and his mother are presented here. Anticipatory completion of AAC utterances is intimately related to the sequential context in which such utterances occur. Difficulties can arise from topic shifts, understanding the intended action of an AAC word in progress and in recognising the possible end point an utterance. The analysis highlights the importance of understanding how AAC talk works in everyday interaction. The role of co-participants is particularly important here. These results may have implications for both AAC software design and clinical intervention.

Conversational Flow Promotes Solidarity

PubMed Central

Koudenburg, Namkje; Postmes, Tom; Gordijn, Ernestine H.

2013-01-01

Social interaction is fundamental to the development of various aspects of “we-ness”. Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here). The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay). Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition) increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed. PMID:24265683

Conversational flow promotes solidarity.

PubMed

Koudenburg, Namkje; Postmes, Tom; Gordijn, Ernestine H

2013-01-01

Social interaction is fundamental to the development of various aspects of "we-ness". Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here). The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay). Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition) increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed.

A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations.

PubMed

Priebe, Åsa; Wiklund Gustin, Lena; Fredriksson, Lennart

2018-04-01

The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise. © 2017 Australian College of Mental Health Nurses Inc.

A Review of MR Spectroscopy Studies of Pediatric Bipolar Disorder

PubMed Central

Kondo, D.G.; Hellem, T.L.; Shi, X.-F.; Sung, Y.H.; Prescot, A.P.; Kim, T.S.; Huber, R.S.; Forrest, L.N.; Renshaw, P.F.

2015-01-01

Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be linked because 85% of glucose in the brain is consumed by glutamatergic neurotransmission and the conversion of glutamate to glutamine. The purpose of this article is to review the MR spectroscopic imaging literature in pediatric bipolar disorder, at-risk samples, and severe mood dysregulation, with a focus on the published findings that are relevant to glutamatergic and mitochondrial functioning. Potential directions for future MR spectroscopy studies of the glutamate system and mitochondrial dysfunction in pediatric bipolar disorder are discussed. PMID:24557702

DUF6 Conversion Facility EISs

Science.gov Websites

Conversion EIS Documents News FAQs Internet Resources Glossary Home » Conversion Facility EISs EIS Logo Guide | DU Uses | DUF6 Management | DUF6 Conversion Facility EISs | Documents News | FAQs | Internet

FANCJ helicase controls the balance between short- and long-tract gene conversions between sister chromatids

PubMed Central

Nath, Sarmi; Somyajit, Kumar; Mishra, Anup; Scully, Ralph

2017-01-01

Abstract The FANCJ DNA helicase is linked to hereditary breast and ovarian cancers as well as bone marrow failure disorder Fanconi anemia (FA). Although FANCJ has been implicated in the repair of DNA double-strand breaks (DSBs) by homologous recombination (HR), the molecular mechanism underlying the tumor suppressor functions of FANCJ remains obscure. Here, we demonstrate that FANCJ deficient human and hamster cells exhibit reduction in the overall gene conversions in response to a site-specific chromosomal DSB induced by I-SceI endonuclease. Strikingly, the gene conversion events were biased in favour of long-tract gene conversions in FANCJ depleted cells. The fine regulation of short- (STGC) and long-tract gene conversions (LTGC) by FANCJ was dependent on its interaction with BRCA1 tumor suppressor. Notably, helicase activity of FANCJ was essential for controlling the overall HR and in terminating the extended repair synthesis during sister chromatid recombination (SCR). Moreover, cells expressing FANCJ pathological mutants exhibited defective SCR with an increased frequency of LTGC. These data unravel the novel function of FANCJ helicase in regulating SCR and SCR associated gene amplification/duplications and imply that these functions of FANCJ are crucial for the genome maintenance and tumor suppression. PMID:28911102

The Classification of Hysteria and Related Disorders: Historical and Phenomenological Considerations

PubMed Central

North, Carol S.

2015-01-01

This article examines the history of the conceptualization of dissociative, conversion, and somatoform syndromes in relation to one another, chronicles efforts to classify these and other phenomenologically-related psychopathology in the American diagnostic system for mental disorders, and traces the subsequent divergence in opinions of dissenting sectors on classification of these disorders. This article then considers the extensive phenomenological overlap across these disorders in empirical research, and from this foundation presents a new model for the conceptualization of these disorders. The classification of disorders formerly known as hysteria and phenomenologically-related syndromes has long been contentious and unsettled. Examination of the long history of the conceptual difficulties, which remain inherent in existing classification schemes for these disorders, can help to address the continuing controversy. This review clarifies the need for a major conceptual revision of the current classification of these disorders. A new phenomenologically-based classification scheme for these disorders is proposed that is more compatible with the agnostic and atheoretical approach to diagnosis of mental disorders used by the current classification system. PMID:26561836

Conversation after Right Hemisphere Brain Damage: Motivations for Applying Conversation Analysis

ERIC Educational Resources Information Center

Barnes, Scott; Armstrong, Elizabeth

2010-01-01

Despite the well documented pragmatic deficits that can arise subsequent to Right Hemisphere Brain Damage (RHBD), few researchers have directly studied everyday conversations involving people with RHBD. In recent years, researchers have begun applying Conversation Analysis (CA) to the everyday talk of people with aphasia. This research programme…

Weak- versus strong-disorder superfluid—Bose glass transition in one dimension

NASA Astrophysics Data System (ADS)

Doggen, Elmer V. H.; Lemarié, Gabriel; Capponi, Sylvain; Laflorencie, Nicolas

2017-11-01

Using large-scale simulations based on matrix product state and quantum Monte Carlo techniques, we study the superfluid to Bose glass transition for one-dimensional attractive hard-core bosons at zero temperature, across the full regime from weak to strong disorder. As a function of interaction and disorder strength, we identify a Berezinskii-Kosterlitz-Thouless critical line with two different regimes. At small attraction where critical disorder is weak compared to the bandwidth, the critical Luttinger parameter Kc takes its universal Giamarchi-Schulz value Kc=3 /2 . Conversely, a nonuniversal Kc>3 /2 emerges for stronger attraction where weak-link physics is relevant. In this strong-disorder regime, the transition is characterized by self-similar power-law-distributed weak links with a continuously varying characteristic exponent α .

24 CFR 972.218 - Conversion assessment components.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversion assessment components... URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Conversion Assessments § 972.218 Conversion assessment components. The conversion...

24 CFR 972.218 - Conversion assessment components.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversion assessment components... URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Conversion Assessments § 972.218 Conversion assessment components. The conversion...

Educational Design as Conversation: A Conversation Analytical Perspective on Teacher Dialogue

ERIC Educational Resources Information Center

van Kruiningen, Jacqueline F.

2013-01-01

The aim of this methodological paper is to expound on and demonstrate the value of conversation-analytical research in the area of (informal) teacher learning. The author discusses some methodological issues in current research on interaction in teacher learning and holds a plea for conversation-analytical research on interactional processes in…

Changing Our Conversations

ERIC Educational Resources Information Center

Porto, Mark

2007-01-01

In this article, a principal is inspired to change the conversations with students and staff members from discipline and deficit to hope and planning for future achievement. He wants conversations to be more about academic goals and decision making and less about discipline and random acceptance of postsecondary plans. He has asked all staff…

The Conversation Class

ERIC Educational Resources Information Center

Jackson, Acy L.

2012-01-01

The conversation class occupies a unique place in the process of learning English as a second or foreign language. From the author's own experience in conducting special conversation classes with Persian-speaking adults, he has drawn up a number of simple but important guidelines, some of which he hopes may provide helpful suggestions for the…

Direct conversion technology

NASA Technical Reports Server (NTRS)

Massier, Paul F.; Bankston, C. P.; Williams, R.; Underwood, M.; Jeffries-Nakamura, B.; Fabris, G.

1989-01-01

The overall objective of the Direct Conversion Technology task is to develop an experimentally verified technology base for promising direct conversion systems that have potential application for energy conservation in the end-use sectors. This report contains progress of research on the Alkali Metal Thermal-to-Electric Converter (AMTEC), and on the Two-Phase Liquid-Metal Magnetohydrodynamic Electrical Generator (LMMHD) for the period January 1, 1989 through December 31, 1989. Research on these concepts was initiated during October 1987. Reports prepared on previous occasions contain discussions on the following other direct conversion concepts: thermoelectric, pyroelectric, thermionic, thermophotovoltaic, thermoacoustic, thermomagnetic, thermoelastic (nitinol heat engines); and also, more complete discussions of AMTEC and LMMHD systems.

Using social stories and comic strip conversations to promote socially valid outcomes for children with autism.

PubMed

Hutchins, Tiffany L; Prelock, Patricia A

2006-02-01

Very little is documented regarding the efficacy of social stories and comic strip conversations for promoting an understanding of social situations and the appropriate social behaviors of individuals with autism spectrum disorder (ASD). In addition, few studies on the efficacy of social stories have examined whether outcomes are socially valid. The purpose of this article is to respond to some of the gaps in the literature on the efficacy of a frequently used intervention for children with ASD and to describe a family-centered collaborative approach to developing social stories and comic strip conversations. The results of intervention employing an A-B design are reported for two case vignettes. Clinical implications, limitations of the available data, and potential factors contributing to outcome variability are discussed.

Two-photon Anderson localization in a disordered quadratic waveguide array

NASA Astrophysics Data System (ADS)

Bai, Y. F.; Xu, P.; Lu, L. L.; Zhong, M. L.; Zhu, S. N.

2016-05-01

We theoretically investigate two-photon Anderson localization in a χ (2) waveguide array with off-diagonal disorder. The nonlinear parametric down-conversion process would enhance both the single-photon and the two-photon Anderson localization. In the strong disorder regime, the two-photon position correlation exhibits a bunching distribution around the pumped waveguides, which is independent of pumping conditions and geometrical structures of waveguide arrays. Quadratic nonlinearity can be supplied as a new ingredient for Anderson localization. Also, our results pave the way for engineering quantum states through nonlinear quantum walks.

24 CFR 972.230 - Conversion plan components.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversion plan components. 972.230... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Conversion Plans § 972.230 Conversion plan components. A conversion plan must: (a) Describe the...

24 CFR 972.230 - Conversion plan components.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversion plan components. 972.230... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Conversion Plans § 972.230 Conversion plan components. A conversion plan must: (a) Describe the...

A STUDY OF SOMATIZATION DISORDER IN AN INDUSTRIAL HOSPITAL

PubMed Central

Hariharan, G.; Ramakrishnan, A.N.; Mathrubootham, N.

1993-01-01

SUMMARY A group of psychiatric outpatients who satisfied the DSM-IIIR criteria for Somatization Disorder (n=33) were compared with a group of other Somatisers (n=32). The results show that somatization disorder was found predominantly in females. Their mean age was 31 and they had a lower income and poor educational level, with more life events and stress in the family. The main symptoms were gastrointestinal, cardiopulmonary, pain and conversion followed by menstrual and sexual symptoms. They were more extroverted, neurotic and anxious depressed with significant basic neurotic traits. These results are discussed. PMID:21743644

5 CFR 317.301 - Conversion coverage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion coverage. 317.301 Section 317... THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.301 Conversion coverage. (a) When applicable. These conversion provisions apply in the following circumstances. (1) The...

5 CFR 317.301 - Conversion coverage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion coverage. 317.301 Section 317... THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.301 Conversion coverage. (a) When applicable. These conversion provisions apply in the following circumstances. (1) The...

16 CFR 1012.7 - Telephone conversations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are not...

Conversational Agents in E-Learning

NASA Astrophysics Data System (ADS)

Kerry, Alice; Ellis, Richard; Bull, Susan

This paper discusses the use of natural language or 'conversational' agents in e-learning environments. We describe and contrast the various applications of conversational agent technology represented in the e-learning literature, including tutors, learning companions, language practice and systems to encourage reflection. We offer two more detailed examples of conversational agents, one which provides learning support, and the other support for self-assessment. Issues and challenges for developers of conversational agent systems for e-learning are identified and discussed.

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

PubMed Central

Prasko, Jan; Grambal, Ales; Kasalova, Petra; Kamardova, Dana; Ociskova, Marie; Holubova, Michaela; Vrbova, Kristyna; Sigmundova, Zuzana; Latalova, Klara; Slepecky, Milos; Zatkova, Marta

2016-01-01

Objective The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. Methods The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale. Results A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients’ mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without

43 CFR 3140.4 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Conversion. 3140.4 Section 3140.4 Public... OF THE INTERIOR MINERALS MANAGEMENT (3000) LEASING IN SPECIAL TAR SAND AREAS Conversion of Existing Oil and Gas Leases and Valid Claims Based on Mineral Locations § 3140.4 Conversion. ...

31 CFR 800.205 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Conversion. 800.205 Section 800.205 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF INVESTMENT... FOREIGN PERSONS Definitions § 800.205 Conversion. The term conversion means the exercise of a right...

5 CFR 536.303 - Geographic conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Geographic conversion. 536.303 Section... PAY RETENTION Pay Retention § 536.303 Geographic conversion. (a) Geographic conversion at time of... basic pay resulting from this geographic conversion is not a basis for entitlement to pay retention. The...

5 CFR 536.303 - Geographic conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Geographic conversion. 536.303 Section... PAY RETENTION Pay Retention § 536.303 Geographic conversion. (a) Geographic conversion at time of... basic pay resulting from this geographic conversion is not a basis for entitlement to pay retention. The...

NUCLEAR CONVERSION APPARATUS

DOEpatents

Seaborg, G.T.

1960-09-13

A nuclear conversion apparatus is described which comprises a body of neutron moderator, tubes extending therethrough, uranium in the tubes, a fluid- circulating system associated with the tubes, a thorium-containing fluid coolant in the system and tubes, and means for withdrawing the fluid from the system and replacing it in the system whereby thorium conversion products may be recovered.

Frequency conversion system

NASA Technical Reports Server (NTRS)

Sanders, Steven (Inventor); Waarts, Robert G. (Inventor)

2001-01-01

A frequency conversion system comprises first and second gain sources providing first and second frequency radiation outputs where the second gain source receives as input the output of the first gain source and, further, the second gain source comprises a Raman or Brillouin gain fiber for wave shifting a portion of the radiation of the first frequency output into second frequency radiation output to provided a combined output of first and second frequencies. Powers are gain enhanced by the addition of a rare earth amplifier or oscillator, or a Raman/Brillouin amplifier or oscillator between the high power source and the NFM device. Further, polarization conversion using Raman or Brillouin wavelength shifting is provided to optimize frequency conversion efficiency in the NFM device.

Alternative Fuels Data Center: Vehicle Conversions

Science.gov Websites

: Vehicle Conversions to someone by E-mail Share Alternative Fuels Data Center: Vehicle Conversions on Facebook Tweet about Alternative Fuels Data Center: Vehicle Conversions on Twitter Bookmark Alternative Fuels Data Center: Vehicle Conversions on Google Bookmark Alternative Fuels Data Center: Vehicle

5 CFR 317.302 - Conversion procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion procedures. 317.302 Section... IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.302 Conversion... pursuant to § 317.305(b)(4) or § 317.306(b)(4); If the employee is offered conversion, the notice shall...

5 CFR 317.302 - Conversion procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion procedures. 317.302 Section... IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.302 Conversion... pursuant to § 317.305(b)(4) or § 317.306(b)(4); If the employee is offered conversion, the notice shall...

Conversion of adult endothelium to immunocompetent haematopoietic stem cells.

PubMed

Lis, Raphael; Karrasch, Charles C; Poulos, Michael G; Kunar, Balvir; Redmond, David; Duran, Jose G Barcia; Badwe, Chaitanya R; Schachterle, William; Ginsberg, Michael; Xiang, Jenny; Tabrizi, Arash Rafii; Shido, Koji; Rosenwaks, Zev; Elemento, Olivier; Speck, Nancy A; Butler, Jason M; Scandura, Joseph M; Rafii, Shahin

2017-05-25

Developmental pathways that orchestrate the fleeting transition of endothelial cells into haematopoietic stem cells remain undefined. Here we demonstrate a tractable approach for fully reprogramming adult mouse endothelial cells to haematopoietic stem cells (rEC-HSCs) through transient expression of the transcription-factor-encoding genes Fosb, Gfi1, Runx1, and Spi1 (collectively denoted hereafter as FGRS) and vascular-niche-derived angiocrine factors. The induction phase (days 0-8) of conversion is initiated by expression of FGRS in mature endothelial cells, which results in endogenous Runx1 expression. During the specification phase (days 8-20), RUNX1 + FGRS-transduced endothelial cells commit to a haematopoietic fate, yielding rEC-HSCs that no longer require FGRS expression. The vascular niche drives a robust self-renewal and expansion phase of rEC-HSCs (days 20-28). rEC-HSCs have a transcriptome and long-term self-renewal capacity similar to those of adult haematopoietic stem cells, and can be used for clonal engraftment and serial primary and secondary multi-lineage reconstitution, including antigen-dependent adaptive immune function. Inhibition of TGFβ and CXCR7 or activation of BMP and CXCR4 signalling enhanced generation of rEC-HSCs. Pluripotency-independent conversion of endothelial cells into autologous authentic engraftable haematopoietic stem cells could aid treatment of haematological disorders.

Audiovisual Speech Integration in Pervasive Developmental Disorder: Evidence from Event-Related Potentials

ERIC Educational Resources Information Center

Magnee, Maurice J. C. M.; de Gelder, Beatrice; van Engeland, Herman; Kemner, Chantal

2008-01-01

Background: Integration of information from multiple sensory sources is an important prerequisite for successful social behavior, especially during face-to-face conversation. It has been suggested that communicative impairments among individuals with pervasive developmental disorders (PDD) might be caused by an inability to integrate synchronously…

Changing the conversation: the influence of emotions on conversational valence and alcohol consumption.

PubMed

Hendriks, Hanneke; van den Putte, Bas; de Bruijn, Gert-Jan

2014-10-01

Health campaign effects may be improved by taking interpersonal communication processes into account. The current study, which employed an experimental, pretest-posttest, randomized exposure design (N = 208), investigated whether the emotions induced by anti-alcohol messages influence conversational valence about alcohol and subsequent persuasion outcomes. The study produced three main findings. First, an increase in the emotion fear induced a negative conversational valence about alcohol. Second, fear was most strongly induced by a disgusting message, whereas a humorous appeal induced the least fear. Third, a negative conversational valence elicited healthier binge drinking attitudes, subjective norms, perceived behavioral control, intentions, and behaviors. Thus, health campaign planners and health researchers should pay special attention to the emotional characteristics of health messages and should focus on inducing a healthy conversational valence.

Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia.

PubMed

Phillips, Katharine A; Stout, Robert L

2006-06-01

Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression--that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications.

Roadmap on optical energy conversion

NASA Astrophysics Data System (ADS)

Boriskina, Svetlana V.; Green, Martin A.; Catchpole, Kylie; Yablonovitch, Eli; Beard, Matthew C.; Okada, Yoshitaka; Lany, Stephan; Gershon, Talia; Zakutayev, Andriy; Tahersima, Mohammad H.; Sorger, Volker J.; Naughton, Michael J.; Kempa, Krzysztof; Dagenais, Mario; Yao, Yuan; Xu, Lu; Sheng, Xing; Bronstein, Noah D.; Rogers, John A.; Alivisatos, A. Paul; Nuzzo, Ralph G.; Gordon, Jeffrey M.; Wu, Di M.; Wisser, Michael D.; Salleo, Alberto; Dionne, Jennifer; Bermel, Peter; Greffet, Jean-Jacques; Celanovic, Ivan; Soljacic, Marin; Manor, Assaf; Rotschild, Carmel; Raman, Aaswath; Zhu, Linxiao; Fan, Shanhui; Chen, Gang

2016-07-01

For decades, progress in the field of optical (including solar) energy conversion was dominated by advances in the conventional concentrating optics and materials design. In recent years, however, conceptual and technological breakthroughs in the fields of nanophotonics and plasmonics combined with a better understanding of the thermodynamics of the photon energy-conversion processes reshaped the landscape of energy-conversion schemes and devices. Nanostructured devices and materials that make use of size quantization effects to manipulate photon density of states offer a way to overcome the conventional light absorption limits. Novel optical spectrum splitting and photon-recycling schemes reduce the entropy production in the optical energy-conversion platforms and boost their efficiencies. Optical design concepts are rapidly expanding into the infrared energy band, offering new approaches to harvest waste heat, to reduce the thermal emission losses, and to achieve noncontact radiative cooling of solar cells as well as of optical and electronic circuitries. Light-matter interaction enabled by nanophotonics and plasmonics underlie the performance of the third- and fourth-generation energy-conversion devices, including up- and down-conversion of photon energy, near-field radiative energy transfer, and hot electron generation and harvesting. Finally, the increased market penetration of alternative solar energy-conversion technologies amplifies the role of cost-driven and environmental considerations. This roadmap on optical energy conversion provides a snapshot of the state of the art in optical energy conversion, remaining challenges, and most promising approaches to address these challenges. Leading experts authored 19 focused short sections of the roadmap where they share their vision on a specific aspect of this burgeoning research field. The roadmap opens up with a tutorial section, which introduces major concepts and terminology. It is our hope that the roadmap

24 CFR 972.109 - Conversion of developments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversion of developments. 972.109... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Required Conversion Process § 972.109 Conversion of developments. (a)(1) The PHA may proceed to...

24 CFR 972.130 - Conversion plan components.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversion plan components. 972.130... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Conversion Plans § 972.130 Conversion plan components. (a) With respect to any development that is...

24 CFR 972.109 - Conversion of developments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversion of developments. 972.109... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Required Conversion Process § 972.109 Conversion of developments. (a)(1) The PHA may proceed to...

24 CFR 972.130 - Conversion plan components.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversion plan components. 972.130... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Conversion Plans § 972.130 Conversion plan components. (a) With respect to any development that is...

Increasing conversion efficiency of two-step photon up-conversion solar cell with a voltage booster hetero-interface.

PubMed

Asahi, Shigeo; Kusaki, Kazuki; Harada, Yukihiro; Kita, Takashi

2018-01-17

Development of high-efficiency solar cells is one of the attractive challenges in renewable energy technologies. Photon up-conversion can reduce the transmission loss and is one of the promising concepts which improve conversion efficiency. Here we present an analysis of the conversion efficiency, which can be increased by up-conversion in a single-junction solar cell with a hetero-interface that boosts the output voltage. We confirm that an increase in the quasi-Fermi gap and substantial photocurrent generation result in a high conversion efficiency.

Ownership conversions and nursing home performance.

PubMed

Grabowski, David C; Stevenson, David G

2008-08-01

To examine the effects of ownership conversions on nursing home performance. Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004. Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods. The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement. Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.

12 CFR 5.24 - Conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Conversion. 5.24 Section 5.24 Banks and Banking... ACTIVITIES Initial Activities § 5.24 Conversion. (a) Authority. 12 U.S.C. 35, 93a, 214a, 214b, 214c, and 2903... savings association. (d) Conversion of a state bank or Federal savings association to a national bank—(1...

12 CFR 5.24 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Conversion. 5.24 Section 5.24 Banks and Banking... ACTIVITIES Initial Activities § 5.24 Conversion. (a) Authority. 12 U.S.C. 35, 93a, 214a, 214b, 214c, and 2903... savings association. (d) Conversion of a state bank or Federal savings association to a national bank—(1...

Global warming and neurodegenerative disorders: speculations on their linkage.

PubMed

Habibi, Laleh; Perry, George; Mahmoudi, Morteza

2014-01-01

Climate change is having considerable impact on biological systems. Eras of ice ages and warming shaped the contemporary earth and origin of creatures including humans. Warming forces stress conditions on cells. Therefore, cells evolved elaborate defense mechanisms, such as creation of heat shock proteins, to combat heat stress. Global warming is becoming a crisis and this process would yield an undefined increasing rate of neurodegenerative disorders in future decades. Since heat stress is known to have a degenerative effects on neurons and, conversely, cold conditions have protective effect on these cells, we hypothesize that persistent heat stress forced by global warming might play a crucial role in increasing neurodegenerative disorders.

Improving question asking in high-functioning adolescents with autism spectrum disorders: effectiveness of small-group training.

PubMed

Palmen, Annemiek; Didden, Robert; Arts, Marieke

2008-01-01

Small-group training consisting of feedback and self-management was effective in improving question-asking skills during tutorial conversations in nine high-functioning adolescents with autism spectrum disorder. Training was implemented in a therapy room and lasted 6 weeks. Sessions were conducted once a week and lasted about an hour. Experimenters collected data during tutorial conversations in a natural setting. Training of question-asking skills consisted of verbal feedback and role-play during short simulated conversations and a table game. A self-management strategy and common stimuli (e.g., flowchart) were included to promote generalization. Mean percentage of correct questions during tutorial conversations improved significantly after training. Response efficiency also increased. Participants and personal coaches evaluated the training as effective and acceptable.

Social dysfunction in bipolar disorder: pilot study.

PubMed

de Almeida Rocca, Cristiana Castanho; de Macedo-Soares, Marcia Britto; Gorenstein, Clarice; Tamada, Renata Sayuri; Issler, Cilly Kluger; Dias, Rodrigo Silva; Schwartzmann, Angela Maria; Lafer, Beny

2008-08-01

The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder. A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-report questionnaire, the Brazilian Inventario de Habilidades Sociais (IHS, Social Skills Inventory). Two Wechsler Adult Intelligence Scale subtests (Picture Arrangement and Comprehension) were also used in order to assess subject ability to analyse social situations and to make judgements, respectively. Patients with bipolar disorder had lower IHS scores for the domains that assessed conversational skills/social self-confidence and social openness to new people/situations. Patients with anxiety disorders had high scores for the domain that assessed self-confidence in the expression of positive emotions. No differences were found between patients and controls in performance on the Wechsler Adult Intelligence Scale Picture Arrangement and Comprehension subtests. Euthymic patients with bipolar disorder present inhibited and overattentive behaviour in relation to other people and their environment. This behaviour might have a negative impact on their level of social functioning and quality of life.

Roadmap on optical energy conversion

DOE PAGES

Boriskina, Svetlana V.; Green, Martin A.; Catchpole, Kylie; ...

2016-06-24

For decades, progress in the field of optical (including solar) energy conversion was dominated by advances in the conventional concentrating optics and materials design. In recent years, however, conceptual and technological breakthroughs in the fields of nanophotonics and plasmonics combined with a better understanding of the thermodynamics of the photon energy-conversion processes reshaped the landscape of energy-conversion schemes and devices. Nanostructured devices and materials that make use of size quantization effects to manipulate photon density of states offer a way to overcome the conventional light absorption limits. Novel optical spectrum splitting and photon-recycling schemes reduce the entropy production in themore » optical energy-conversion platforms and boost their efficiencies. Optical design concepts are rapidly expanding into the infrared energy band, offering new approaches to harvest waste heat, to reduce the thermal emission losses, and to achieve noncontact radiative cooling of solar cells as well as of optical and electronic circuitries. Light-matter interaction enabled by nanophotonics and plasmonics underlie the performance of the third- and fourth-generation energy-conversion devices, including up- and down-conversion of photon energy, near-field radiative energy transfer, and hot electron generation and harvesting. Finally, the increased market penetration of alternative solar energy-conversion technologies amplifies the role of cost-driven and environmental considerations. This roadmap on optical energy conversion provides a snapshot of the state of the art in optical energy conversion, remaining challenges, and most promising approaches to address these challenges. Leading experts authored 19 focused short sections of the roadmap where they share their vision on a specific aspect of this burgeoning research field. The roadmap opens up with a tutorial section, which introduces major concepts and terminology. As a result, it is our

Optical analysis of down-conversion OLEDs

NASA Astrophysics Data System (ADS)

Krummacher, Benjamin; Klein, Markus; von Malm, Norwin; Winnacker, Albrecht

2008-02-01

Phosphor down-conversion of blue organic light-emitting diodes (OLEDs) is one approach to generate white light, which offers the possibility of easy color tuning, a simple device architecture and color stability over lifetime. In this article previous work on down-conversion devices in the field of organic solid state lighting is briefly reviewed. Further, bottom emitting down-conversion OLEDs are studied from an optical point of view. Therefore the physical processes occurring in the down-conversion layer are translated into a model which is implemented in a ray tracing simulation. By comparing its predictions to experimental results the model is confirmed. For the experiments a blue-emitting polymer OLED (PLED) panel optically coupled to a series of down-conversion layers is used. Based on results obtained from ray tracing simulation some of the implications of the model for the performance of down-conversion OLEDs are discussed. In particular it is analysed how the effective reflectance of the underlying blue OLED and the particle size distribution of the phosphor powder embedded in the matrix of the down-conversion layer influence extraction efficiency.

Using Comic Strip Conversations to Increase Social Satisfaction and Decrease Loneliness in Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Pierson, Melinda R.; Glaeser, Barbara C.

2007-01-01

Comic Strip Conversations have been used to improve the social skills of students on the autism spectrum. Research on the effectiveness of this strategy was extended to three lower elementary-aged male students diagnosed as exhibiting high-functioning autism. One elementary special education teacher and her 2 paraprofessionals used Comic Strip…

The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

PubMed

Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

2017-03-01

Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

Associations in the Longitudinal Course of Body Dysmorphic Disorder with Major Depression, Obsessive Compulsive Disorder, and Social Phobia

PubMed Central

Phillips, Katharine A.; Stout, Robert L.

2009-01-01

Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD’s relationship to putative “near-neighbor” disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1 to 3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression – that is, change in the status of BDD and major depression were closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD – i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD’s relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications. PMID:16309706

Speech Rate Entrainment in Children and Adults With and Without Autism Spectrum Disorder.

PubMed

Wynn, Camille J; Borrie, Stephanie A; Sellers, Tyra P

2018-05-03

Conversational entrainment, a phenomenon whereby people modify their behaviors to match their communication partner, has been evidenced as critical to successful conversation. It is plausible that deficits in entrainment contribute to the conversational breakdowns and social difficulties exhibited by people with autism spectrum disorder (ASD). This study examined speech rate entrainment in children and adult populations with and without ASD. Sixty participants including typically developing children, children with ASD, typically developed adults, and adults with ASD participated in a quasi-conversational paradigm with a pseudoconfederate. The confederate's speech rate was digitally manipulated to create slow and fast speech rate conditions. Typically developed adults entrained their speech rate in the quasi-conversational paradigm, using a faster rate during the fast speech rate conditions and a slower rate during the slow speech rate conditions. This entrainment pattern was not evident in adults with ASD or in children populations. Findings suggest that speech rate entrainment is a developmentally acquired skill and offers preliminary evidence of speech rate entrainment deficits in adults with ASD. Impairments in this area may contribute to the conversational breakdowns and social difficulties experienced by this population. Future work is needed to advance this area of inquiry.

Predictability of Conversation Partners

NASA Astrophysics Data System (ADS)

Takaguchi, Taro; Nakamura, Mitsuhiro; Sato, Nobuo; Yano, Kazuo; Masuda, Naoki

2011-08-01

Recent developments in sensing technologies have enabled us to examine the nature of human social behavior in greater detail. By applying an information-theoretic method to the spatiotemporal data of cell-phone locations, [C. Song , ScienceSCIEAS0036-8075 327, 1018 (2010)] found that human mobility patterns are remarkably predictable. Inspired by their work, we address a similar predictability question in a different kind of human social activity: conversation events. The predictability in the sequence of one’s conversation partners is defined as the degree to which one’s next conversation partner can be predicted given the current partner. We quantify this predictability by using the mutual information. We examine the predictability of conversation events for each individual using the longitudinal data of face-to-face interactions collected from two company offices in Japan. Each subject wears a name tag equipped with an infrared sensor node, and conversation events are marked when signals are exchanged between sensor nodes in close proximity. We find that the conversation events are predictable to a certain extent; knowing the current partner decreases the uncertainty about the next partner by 28.4% on average. Much of the predictability is explained by long-tailed distributions of interevent intervals. However, a predictability also exists in the data, apart from the contribution of their long-tailed nature. In addition, an individual’s predictability is correlated with the position of the individual in the static social network derived from the data. Individuals confined in a community—in the sense of an abundance of surrounding triangles—tend to have low predictability, and those bridging different communities tend to have high predictability.

Personality Disorder Symptoms Are Differentially Related to Divorce Frequency

PubMed Central

Disney, Krystle L.; Weinstein, Yana; Oltmanns, Thomas F.

2013-01-01

Divorce is associated with a multitude of outcomes related to health and well-being. Data from a representative community sample (N = 1,241) of St. Louis residents (ages 55–64) were used to examine associations between personality pathology and divorce in late midlife. Symptoms of the 10 DSM–IV personality disorders were assessed with the Structured Interview for DSM–IV Personality and the Multisource Assessment of Personality Pathology (both self and informant versions). Multiple regression analyses showed Paranoid and Histrionic personality disorder symptoms to be consistently and positively associated with number of divorces across all three sources of personality assessment. Conversely, Avoidant personality disorder symptoms were negatively associated with number of divorces. The present paper provides new information about the relationship between divorce and personality pathology at a developmental stage that is understudied in both domains. PMID:23244459

Statistical thermodynamics foundation for photovoltaic and photothermal conversion. II. Application to photovoltaic conversion

NASA Astrophysics Data System (ADS)

Badescu, Viorel; Landsberg, Peter T.

1995-08-01

The general theory developed in part I was applied to build up two models of photovoltaic conversion. To this end two different systems were analyzed. The first system consists of the whole absorber (converter), for which the balance equations for energy and entropy are written and then used to derive an upper bound for solar energy conversion. The second system covers a part of the absorber (converter), namely the valence and conduction electronic bands. The balance of energy is used in this case to derive, under additional assumptions, another upper limit for the conversion efficiency. This second system deals with the real location where the power is generated. Both models take into consideration the radiation polarization and reflection, and the effects of concentration. The second model yields a more accurate upper bound for the conversion efficiency. A generalized solar cell equation is derived. It is proved that other previous theories are particular cases of the present more general formalism.

Frequency conversion of structured light.

PubMed

Steinlechner, Fabian; Hermosa, Nathaniel; Pruneri, Valerio; Torres, Juan P

2016-02-15

Coherent frequency conversion of structured light, i.e. the ability to manipulate the carrier frequency of a wave front without distorting its spatial phase and intensity profile, provides the opportunity for numerous novel applications in photonic technology and fundamental science. In particular, frequency conversion of spatial modes carrying orbital angular momentum can be exploited in sub-wavelength resolution nano-optics and coherent imaging at a wavelength different from that used to illuminate an object. Moreover, coherent frequency conversion will be crucial for interfacing information stored in the high-dimensional spatial structure of single and entangled photons with various constituents of quantum networks. In this work, we demonstrate frequency conversion of structured light from the near infrared (803 nm) to the visible (527 nm). The conversion scheme is based on sum-frequency generation in a periodically poled lithium niobate crystal pumped with a 1540-nm Gaussian beam. We observe frequency-converted fields that exhibit a high degree of similarity with the input field and verify the coherence of the frequency-conversion process via mode projection measurements with a phase mask and a single-mode fiber. Our results demonstrate the suitability of exploiting the technique for applications in quantum information processing and coherent imaging.

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale.

PubMed

Lyssenko, Lisa; Schmahl, Christian; Bockhacker, Laura; Vonderlin, Ruben; Bohus, Martin; Kleindienst, Nikolaus

2018-01-01

Dissociation is a complex, ubiquitous construct in psychopathology. Symptoms of dissociation are present in a variety of mental disorders and have been connected to higher burden of illness and poorer treatment response, and not only in disorders with high levels of dissociation. This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences Scale, within different categories of mental disorders, and it updates an earlier meta-analysis. More than 1,900 original publications were screened, and 216 were included in the meta-analysis, comprising 15,219 individuals in 19 diagnostic categories. The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating disorders, schizophrenia, anxiety disorder, OCD, and most affective disorders also showed mean dissociation scores >15. Bipolar disorders yielded the lowest dissociation scores (mean score, 14.8). The findings underline the importance of careful psychopathological assessment of dissociative symptoms in the entire range of mental disorders.

Retrospective Conversion of Three Library Collections.

ERIC Educational Resources Information Center

Johnson, Carolyn A.

1982-01-01

Reports on the retrospective conversion via OCLC of cataloging for three library collections at the University of South Carolina--the main, rare book, and historical collections. Backgrounds of the collections, conversion procedures, determinants of conversion rates, and cost factors are discussed. (Author/JL)

Description and Preliminary Evaluation of a Curriculum for Teaching Conversational Skills to Children with High-Functioning Autism and Other Social Cognition Challenges

ERIC Educational Resources Information Center

Müller, Eve; Cannon, Lynn R.; Kornblum, Courtney; Clark, Jonna; Powers, Michal

2016-01-01

Purpose: The purpose of this clinical focus article is to provide (a) a detailed description of a school-based intervention designed to teach children with high-functioning autism spectrum disorders (HF-ASDs) and other social cognition challenges both the "how" and the "why" of conversation and (b) a preliminary evaluation of…

Calculation Methods and Conversions for Pesticide Application.

ERIC Educational Resources Information Center

Cole, Herbert, Jr.

This agriculture extension service publication from Pennsylvania State University consists of conversion tables and formulas for determining concentration and rate of application of pesticides. Contents include: (1) Area and volume conversions; (2) Important conversion formulae; (3) Conversions for rates of application; (4) Quantities of pesticide…

Conversing as Metaphor of Human Thinking: Is Mind like a Conversation?

PubMed

Sorsana, Christine; Trognon, Alain

2018-06-01

How can researchers shape their ideas so that they understand the mind better? This theoretical paper discusses the merits of the conversation metaphor as a means of analyzing the human mind. We will develop arguments concerning conversation as i) a situated and distributed activity, ii) a "product" in perpetual construction, and iii) the amount of credence and belief we afford it. Finally, we will advocate for metaphorical tools that promote a more dynamic conceptualization of human thinking.

Alternative Fuels Data Center: Propane Vehicle Conversions

Science.gov Websites

Conversions to someone by E-mail Share Alternative Fuels Data Center: Propane Vehicle Conversions on Facebook Tweet about Alternative Fuels Data Center: Propane Vehicle Conversions on Twitter Bookmark Alternative Fuels Data Center: Propane Vehicle Conversions on Google Bookmark Alternative Fuels

Using Conversation MOPs in Natural Language Interfaces.

ERIC Educational Resources Information Center

Turner, Elise H.; Cullingford, Richard E.

1989-01-01

Explores a method of combining convention and intention by representing conversation structure with conversation MOPs (schematic structures that store conversation rules as generalized episodes associated with goals the episodes achieved). Discusses how conversation MOPs process the opening portion of a dialogue in an interactive advice-giving…

Conversion of adult endothelium to immunocompetent haematopoietic stem cells

PubMed Central

Lis, Raphael; Karrasch, Charles C.; Poulos, Michael G.; Kunar, Balvir; Redmond, David; Barcia Duran, Jose G.; Badwe, Chaitanya R.; Schachterle, Will; Ginsberg, Michael; Xiang, Jenny; Tabrizi, Arash Rafii; Shido, Koji; Rosenwaks, Zev; Elemento, Olivier; Speck, Nancy; Butler, Jason M.; Scandura, Joseph M.; Rafii, Shahin

2018-01-01

Developmental pathways that orchestrate the fleeting transition of endothelial cells into haematopoietic stem cells remain undefined. Here we demonstrate a tractable approach for fully converting adult mouse endothelial cells to haematopoietic stem cells (rEC-HSCs) through transient expression of genes encoding the transcription factors Fosb, Gfi1, Runx1, and Spi1 (also known as Fgrs) and vascular-niche-derived angiocrine factors. The induction phase (day 0–8) of conversion is initiated by expression of Fgrs in mature endothelial cells, which results in endogenous Runx1 expression. During the specification phase (day 8–20), Runx1+ Fgrs-transduced endothelial cells commit to a haematopoietic fate yielding rEC-HSCs that no longer require Fgrs expression. The vascular niche drives a robust self-renewal and expansion phase of rEC-HSCs (at day 20–28). rEC-HSCs have a transcriptome and long-term self-renewal capacity similar to those of adult haematopoietic stem cells, are competent for clonal engraftment and serial primary and secondary multi-lineage reconstituting potential, including antigen-dependent adaptive immune function. Inhibition of TGF-β and CXCR7 or activation of BMP and CXCR4 signalling enhanced generation of rEC-HSCs. Conversion of endothelial cells into autologous authentic engraftable haematopoietic stem cells could aid treatment of haematological disorders. PMID:28514438

Phenomenology of neutron-antineutron conversion

NASA Astrophysics Data System (ADS)

Gardner, Susan; Yan, Xinshuai

2018-03-01

We consider the possibility of neutron-antineutron (n -n ¯ ) conversion, in which the change of a neutron into an antineutron is mediated by an external source, as can occur in a scattering process. We develop the connections between n -n ¯ conversion and n -n ¯ oscillation, in which a neutron spontaneously transforms into an antineutron, noting that if n -n ¯ oscillation occurs in a theory with baryon number minus lepton number (B-L) violation, then n -n ¯ conversion can occur also. We show how an experimental limit on n -n ¯ conversion could connect concretely to a limit on n -n ¯ oscillation, and vice versa, using effective field theory techniques and baryon matrix elements computed in the MIT bag model.

Conversational evidence in therapeutic dialogue.

PubMed

Strong, Tom; Busch, Robbie; Couture, Shari

2008-07-01

Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

Effective communication during difficult conversations.

PubMed

Polito, Jacquelyn M

2013-06-01

A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

24 CFR 965.404 - Order of conversion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Order of conversion. 965.404...-Owned Projects § 965.404 Order of conversion. Conversions to individually metered utility service shall... be analyzed both for the installation of checkmeters and for conversion to retail service. (d) Low...

24 CFR 965.404 - Order of conversion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Order of conversion. 965.404...-Owned Projects § 965.404 Order of conversion. Conversions to individually metered utility service shall... be analyzed both for the installation of checkmeters and for conversion to retail service. (d) Low...

Sacred changes: Spiritual conversion and transformation.

PubMed

Mahoney, Annette; Pargament, Kenneth I

2004-05-01

We use Pargament's (1997) definition of religion-"the search for significance in ways related to the sacred"-as a framework to understand spiritual conversion. Like other life-changing transformations, spiritual conversion alters the destinations that clients perceive to be of greatest importance in life (significance) and the pathways by which clients discover what is most significant in life (search). Unlike other transformative experiences, however, spiritual conversion incorporates the third element of religion, "the sacred," into the content of change. To illustrate these points, we discuss two theological models of spiritual conversion rooted in Christianity: a traditional model based on classic western theology and an alternative model based on feminist theology. We then compare processes of spiritual conversion to nonreligious models of transformation. We also highlight the importance for clinical work of the fit between the context of a client's life and the type of spiritual conversion experienced. Copyright 2004 Wiley Periodicals, Inc.

Direct conversion technology

NASA Technical Reports Server (NTRS)

Massier, P. F.; Bankston, C. P.; Fabris, G.; Kirol, L. D.

1988-01-01

The overall objective of the Direct Conversion Technology task is to develop an experimentally verified technology base for promising direct thermal-to-electric energy conversion systems that have potential application for energy conservation in the end-use sectors. This report contains progress of research on the Alkali Metal Thermal-to-Electric Converter (AMTEC), and on the Two-Phase Liquid-Metal MHD Electrical Generator (LMMHD) for the period January 1988 through December 1988. Research on these concepts was initiated during October 1987. In addition, status reviews and assessments are presented for thermomagnetic converter concepts and for thermoelastic converters (Nitinol heat engines). Reports prepared on previous occasions contain discussions on the following other direct conversion concepts: thermoelectric, pyroelectric, thermionic thermophotovoltaic and thermoacoustic; and also, more complete discussions of AMTEC and LMMHD systems. A tabulated summary of the various systems which have been reviewed thus far has been prepared. Some of the important technical research needs are listed and a schematic of each system is shown.

Digital optical conversion module

DOEpatents

Kotter, Dale K.; Rankin, Richard A.

1991-02-26

A digital optical conversion module used to convert an analog signal to a computer compatible digital signal including a voltage-to-frequency converter, frequency offset response circuitry, and an electrical-to-optical converter. Also used in conjunction with the digital optical conversion module is an optical link and an interface at the computer for converting the optical signal back to an electrical signal. Suitable for use in hostile environments having high levels of electromagnetic interference, the conversion module retains high resolution of the analog signal while eliminating the potential for errors due to noise and interference. The module can be used to link analog output scientific equipment such as an electrometer used with a mass spectrometer to a computer.

12 CFR 543.10 - Organization after conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Organization after conversion. 543.10 Section... SAVINGS ASSOCIATIONS-INCORPORATION, ORGANIZATION, AND CONVERSION Conversion § 543.10 Organization after conversion. Except as provided in § 543.11, after a Federal charter is issued under § 543.9 the association's...

12 CFR 543.10 - Organization after conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Organization after conversion. 543.10 Section... SAVINGS ASSOCIATIONS-INCORPORATION, ORGANIZATION, AND CONVERSION Conversion § 543.10 Organization after conversion. Except as provided in § 543.11, after a Federal charter is issued under § 543.9 the association's...

Passenger and cell phone conversations in simulated driving.

PubMed

Drews, Frank A; Pasupathi, Monisha; Strayer, David L

2008-12-01

This study examines how conversing with passengers in a vehicle differs from conversing on a cell phone while driving. We compared how well drivers were able to deal with the demands of driving when conversing on a cell phone, conversing with a passenger, and when driving without any distraction. In the conversation conditions, participants were instructed to converse with a friend about past experiences in which their life was threatened. The results show that the number of driving errors was highest in the cell phone condition; in passenger conversations more references were made to traffic, and the production rate of the driver and the complexity of speech of both interlocutors dropped in response to an increase in the demand of the traffic. The results indicate that passenger conversations differ from cell phone conversations because the surrounding traffic not only becomes a topic of the conversation, helping driver and passenger to share situation awareness, but the driving condition also has a direct influence on the complexity of the conversation, thereby mitigating the potential negative effects of a conversation on driving. PsycINFO Database Record (c) 2008 APA, all rights reserved.

Energy conversion alternatives study

NASA Technical Reports Server (NTRS)

Shure, L. T.

1979-01-01

Comparison of coal based energy systems is given. Study identifies and compares various advanced energy conversion systems using coal or coal derived fuels for baselaoad electric power generation. Energy Conversion Alternatives Study (ECAS) reports provede government, industry, and general public with technically consistent basis for comparison of system's options of interest for fossilfired electric-utility application.

Hand stereotypies distinguish Rett syndrome from autism disorder.

PubMed

Goldman, Sylvie; Temudo, Teresa

2012-07-01

Rett syndrome (RTT) and autism disorder (AD) are 2 neurodevelopmental disorders of early life that share phenotypic features, one being hand stereotypies. Distinguishing RTT from AD often represents a challenge, and given their distinct long-term prognoses, this issue may have far-reaching implications. With the advances in genetic testing, the contribution of clinical manifestations in distinguishing RTT from AD has been overlooked. A comparison of hand stereotypies in 20 children with RTT and 20 with AD was performed using detailed analyses of videotaped standardized observations. Striking differences are observed between RTT and AD children. In RTT, hand stereotypies are predominantly complex, continuous, localized to the body midline, and involving mouthing. Conversely, in AD children, hand stereotypies are simple, bilateral, intermittent, and often involving objects. These results provide important clinical signs useful to the differential diagnosis of RTT versus AD, especially when genetic testing for RTT is not an option. Copyright © 2012 Movement Disorder Society.

36 CFR 72.72 - Conversion requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Conversion requirements. 72... Conversion requirements. (a) Background and legal requirements. The UPARR program has made funds available... converted to other than public recreation uses. A conversion will only be approved if it is found to be in...

41 CFR 101-30.402 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Conversion. 101-30.402... Federal Catalog System § 101-30.402 Conversion. Following completion of cataloging action, GSA will establish a time period in which conversion to the Federal Catalog System shall be accomplished by all civil...

36 CFR 59.3 - Conversion requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Conversion requirements. 59.3... RESPONSIBILITIES § 59.3 Conversion requirements. (a) Background and legal requirements. Section 6(f)(3) of the L... of at least equal fair market value. (b) Prerequisites for conversion approval. Requests from the...

41 CFR 101-30.402 - Conversion.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Conversion. 101-30.402... Federal Catalog System § 101-30.402 Conversion. Following completion of cataloging action, GSA will establish a time period in which conversion to the Federal Catalog System shall be accomplished by all civil...

5 CFR 534.506 - Conversion provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion provisions. (a) This section covers initial conversion to the pay system under 5 U.S.C. 5376 as of the...

36 CFR 72.72 - Conversion requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Conversion requirements. 72... Conversion requirements. (a) Background and legal requirements. The UPARR program has made funds available... converted to other than public recreation uses. A conversion will only be approved if it is found to be in...

5 CFR 534.506 - Conversion provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion provisions. (a) This section covers initial conversion to the pay system under 5 U.S.C. 5376 as of the...

5 CFR 317.301 - Conversion coverage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Conversion coverage. 317.301 Section 317... THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.301 Conversion coverage... statutory action extending coverage under 5 U.S.C. 3132(a)(1) to that agency. Except as otherwise provided...

[Hydroxylamine conversion by anammox enrichment].

PubMed

Hu, Anhui; Zheng, Ping; Lu, Huifeng; Ding, Shuang; Wang, Caihua

2010-04-01

Hydroxylamine is an important intermediate product of anammox. This study was focused on the characteristics of hydroxylamine and nitrite conversions by anammox enrichment. The changes of nitrogenous substrates and related products with time were measured using batch tests with anammox enrichment as inoculum. Since hydroxylamine didn't react with nitrite in uninoculated control culture, these two compounds were chemically stable. Both of them decreased with time in anammox enrichment inoculated cultures, in which ammonia as intermediate product would be produced and converted with the maximum concentration being 0.338 mg/L. The total nitrogen concentration decreased from 4.694 mmol/L to 0.812 mmol/L with conversion rate 82.7% in the end. When hydroxylamine and nitrite concentrations were about 2.5 mmol/L respectively, the maximum specific sludge conversion rates of hydroxylamine was 0.535 mmol/(gVSS.h), which was 1.81 times bigger than that of ammonia in ammonia reaction system; the maximum specific sludge rate of total nitrogen was slightly higher than that in ammonia reaction system. When hydroxylamine concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 26.7% and 120.7% respectively; and the maximum ammonia accumulated was 1.810 mmol/L. When nitrite concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 6.9% and 9.0% respectively; and the maximum ammonia accumulated was 0.795 mmol/L. Anammox enrichment was capable of converting hydroxylamine and nitrite simultaneously and had the higher conversion rate of hydroxylamine than ammonia conversion rate. Hydroxylamine and nitrite conversion rates were less affected by increase in nitrite concentration, but more significantly influenced by increase in hydroxylamine. The maximum ammonia concentration accumulated would rise as the result of increasing both hydroxylamine and nitrite. The result of experiment was consistent with pathway

Pragmatic Impairments in Adults with Childhood Diagnoses of Autism or Developmental Receptive Language Disorder.

ERIC Educational Resources Information Center

Eales, Martin J.

1993-01-01

Analysis of conversations of 15 adults with autism and 17 with developmental receptive language disorders in childhood indicated that the autistic adults showed greater pragmatic impairment because of their greater difficulty in forming context-relevant communicative intentions. Pragmatic impairments arising from failures in translating intentions…

Microbial Energy Conversion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buckley, Merry; Wall, Judy D.

2006-10-01

The American Academy of Microbiology convened a colloquium March 10-12, 2006, in San Francisco, California, to discuss the production of energy fuels by microbial conversions. The status of research into various microbial energy technologies, the advantages and disadvantages of each of these approaches, research needs in the field, and education and training issues were examined, with the goal of identifying routes for producing biofuels that would both decrease the need for fossil fuels and reduce greenhouse gas emissions. Currently, the choices for providing energy are limited. Policy makers and the research community must begin to pursue a broader array ofmore » potential energy technologies. A diverse energy portfolio that includes an assortment of microbial energy choices will allow communities and consumers to select the best energy solution for their own particular needs. Funding agencies and governments alike need to prepare for future energy needs by investing both in the microbial energy technologies that work today and in the untested technologies that will serve the world’s needs tomorrow. More mature bioprocesses, such as ethanol production from starchy materials and methane from waste digestors, will find applications in the short term. However, innovative techniques for liquid fuel or biohydrogen production are among the longer term possibilities that should also be vigorously explored, starting now. Microorganisms can help meet human energy needs in any of a number of ways. In their most obvious role in energy conversion, microorganisms can generate fuels, including ethanol, hydrogen, methane, lipids, and butanol, which can be burned to produce energy. Alternatively, bacteria can be put to use in microbial fuel cells, where they carry out the direct conversion of biomass into electricity. Microorganisms may also be used some day to make oil and natural gas technologies more efficient by sequestering carbon or by assisting in the recovery of oil

24 CFR 972.212 - Timing of voluntary conversion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Timing of voluntary conversion. 972... URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Voluntary Conversion Procedure § 972.212 Timing of voluntary conversion. (a) A PHA...

24 CFR 972.212 - Timing of voluntary conversion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Timing of voluntary conversion. 972... URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Voluntary Conversion Procedure § 972.212 Timing of voluntary conversion. (a) A PHA...

47 CFR 73.1206 - Broadcast of telephone conversations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Broadcast of telephone conversations. 73.1206... conversations. Before recording a telephone conversation for broadcast, or broadcasting such a conversation... broadcast the conversation, except where such party is aware, or may be presumed to be aware from the...

47 CFR 73.1206 - Broadcast of telephone conversations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Broadcast of telephone conversations. 73.1206... conversations. Before recording a telephone conversation for broadcast, or broadcasting such a conversation... broadcast the conversation, except where such party is aware, or may be presumed to be aware from the...

The Growing Regulation of Conversion Therapy

PubMed Central

Drescher, Jack; Schwartz, Alan; Casoy, Flávio; McIntosh, Christopher A.; Hurley, Brian; Ashley, Kenneth; Barber, Mary; Goldenberg, David; Herbert, Sarah E.; Lothwell, Lorraine E.; Mattson, Marlin R.; McAfee, Scot G.; Pula, Jack; Rosario, Vernon; Tompkins, D. Andrew

2016-01-01

Conversion therapies are any treatments, including individual talk therapy, behavioral (e.g. aversive stimuli), group therapy or milieu (e.g. “retreats or inpatient treatments” relying on all of the above methods) treatments, which attempt to change an individual’s sexual orientation from homosexual to heterosexual. However these practices have been repudiated by major mental health organizations because of increasing evidence that they are ineffective and may cause harm to patients and their families who fail to change. At present, California, New Jersey, Oregon, Illinois, Washington, DC, and the Canadian Province of Ontario have passed legislation banning conversion therapy for minors and an increasing number of US States are considering similar bans. In April 2015, the Obama administration also called for a ban on conversion therapies for minors. The growing trend toward banning conversion therapies creates challenges for licensing boards and ethics committees, most of which are unfamiliar with the issues raised by complaints against conversion therapists. This paper reviews the history of conversion therapy practices as well as clinical, ethical and research issues they raise. With this information, state licensing boards, ethics committees and other regulatory bodies will be better able to adjudicate complaints from members of the public who have been exposed to conversion therapies. PMID:27754500

The urea cycle disorders.

PubMed

Helman, Guy; Pacheco-Colón, Ileana; Gropman, Andrea L

2014-07-01

The urea cycle is the primary nitrogen-disposal pathway in humans. It requires the coordinated function of six enzymes and two mitochondrial transporters to catalyze the conversion of a molecule of ammonia, the α-nitrogen of aspartate, and bicarbonate into urea. Whereas ammonia is toxic, urea is relatively inert, soluble in water, and readily excreted by the kidney in the urine. Accumulation of ammonia and other toxic intermediates of the cycle lead to predominantly neurologic sequelae. The disorders may present at any age from the neonatal period to adulthood, with the more severely affected patients presenting earlier in life. Patients are at risk for metabolic decompensation throughout life, often triggered by illness, fasting, surgery and postoperative states, peripartum, stress, and increased exogenous protein load. Here the authors address neurologic presentations of ornithine transcarbamylase deficiency in detail, the most common of the urea cycle disorders, neuropathology, neurophysiology, and our studies in neuroimaging. Special attention to late-onset presentations is given. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

38 CFR 9.9 - Conversion privilege.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Conversion privilege. 9.9... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.9 Conversion privilege. (a) With respect to a... competent authority there shall be no right of conversion unless the insurance is continued in force under...

38 CFR 9.9 - Conversion privilege.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Conversion privilege. 9.9... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.9 Conversion privilege. (a) With respect to a... competent authority there shall be no right of conversion unless the insurance is continued in force under...

47 CFR 80.761 - Conversion graphs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Conversion graphs. 80.761 Section 80.761... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.761 Conversion graphs. The following graphs must be employed where conversion from one to the other of the indicated types of units is...

47 CFR 80.761 - Conversion graphs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Conversion graphs. 80.761 Section 80.761... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.761 Conversion graphs. The following graphs must be employed where conversion from one to the other of the indicated types of units is...

[Psychiatric Disorders in Pediatric Patients With Systemic Lupus Erythematosus in a Reference Hospital].

PubMed

Zuñiga Zambrano, Yenny Carolina; Vásquez, Rafael

2014-01-01

To describe the psychiatric manifestations in pediatric patients with systemic erythematous lupus seen in the Fundación Hospital de la Misericordia. Observational descriptive study. Medical charts and test results of inpatients and outpatients between 2007 and2013 were reviewed; 39 patients were selected. SPSS 19 was used for statistical analysis. Statistical significance was considered with P=.05. Mean age was 13.7 (2.33), with 78.9% female. The most frequent psychiatric manifestation was anxiety (52.6%), followed by adjustment disorder and depression (36.8% each one), psychosis (10%), conversion disorder (7.9%), and obsessive compulsive disorder (5.3%). The mean SLICC score was 2.76 (2.8), and the mean SLEDAI score was 20.81 (20.82). Antinuclear antibodies were positive in 81.25%. Neuropsychiatric lupus was diagnosed in 65.8% of patients; seizures were observed in 23.7%, headache in 36.8%, stroke in 13.2%, vasculitis, chorea 5.3%, and meningitis 5.3% of patients. The mean time from lupus diagnosis was 20.47 (22.2) months, with the shortest period for adjustment disorder and the longest period in patients with conversion disorder (pseudo-seizures) being 15 months and 31 months, respectively. The highest SLEDAI score was in patients with psychosis (35.5 [16.21] vs 19.08 [13.72]; P=.032), and also the highest disease damage (SLICC, 4.25 [4.03] vs 2.58 [2.67]; P=.27) in comparison with the other manifestations. The most frequent psychiatric manifestations were anxiety, depression, and adjustment disorder, with a higher frequency than other studies, and with lupus activity principally in patients with psychosis. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Personality disorder symptoms are differentially related to divorce frequency.

PubMed

Disney, Krystle L; Weinstein, Yana; Oltmanns, Thomas F

2012-12-01

Divorce is associated with a multitude of outcomes related to health and well-being. Data from a representative community sample (N = 1,241) of St. Louis residents (ages 55-64) were used to examine associations between personality pathology and divorce in late midlife. Symptoms of the 10 DSM-IV personality disorders were assessed with the Structured Interview for DSM-IV Personality and the Multisource Assessment of Personality Pathology (both self and informant versions). Multiple regression analyses showed Paranoid and Histrionic personality disorder symptoms to be consistently and positively associated with number of divorces across all three sources of personality assessment. Conversely, Avoidant personality disorder symptoms were negatively associated with number of divorces. The present paper provides new information about the relationship between divorce and personality pathology at a developmental stage that is understudied in both domains. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study.

PubMed

Chen, Mu-Hong; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

2015-05-01

Previous studies have found that attention-deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with an increased risk of major depression and bipolar disorder in later life. However, the effect of ADHD comorbidity on the diagnostic conversion to bipolar disorder among patients with major depression is still uncertain. Using the Taiwan National Health Insurance Research Database, 58,023 subjects < 30 years of age who had major depression with (n = 1,193) or without (n = 56,830) ADHD comorbidity between the years 2000 and 2008 were enrolled in our study. Subjects who developed bipolar disorder during the follow-up to the end of 2011 were identified. Adolescents and young adults who had major depression with ADHD comorbidity had an increased incidence of subsequent bipolar disorder (18.9% versus 11.2%, p < 0.001) compared to those without ADHD. Cox regression analysis showed that ADHD comorbidity was an independent risk factor (hazard ratio = 1.50, 95% confidence interval 1.30-1.72) predicting subsequent bipolar disorder among those with major depression, adjusting for demographic data and psychiatric comorbidities. Patients with comorbid diagnoses of major depression and ADHD had an increased risk of diagnostic conversion to bipolar disorder compared to those who had major depression alone. Further studies would be required to validate this finding and to investigate the possible underlying mechanisms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

NSF presentation. [summary on energy conversion research program

NASA Technical Reports Server (NTRS)

Morse, F. H.

1973-01-01

Wind energy conversion research is considered in the framework of the national energy problem. Research and development efforts for the practical application of solar energy -- including wind energy -- as alternative energy supplies are assessed in: (1) Heating and cooling of buildings; (2) photovoltaic energy conversion; (3) solar thermal energy conversion; (4) wind energy conversion; (5) ocean thermal energy conversion; (6) photosynthetic production of organic matter; and (7) conversion of organic matter into fuels.

Digital optical conversion module

DOEpatents

Kotter, D.K.; Rankin, R.A.

1988-07-19

A digital optical conversion module used to convert an analog signal to a computer compatible digital signal including a voltage-to-frequency converter, frequency offset response circuitry, and an electrical-to-optical converter. Also used in conjunction with the digital optical conversion module is an optical link and an interface at the computer for converting the optical signal back to an electrical signal. Suitable for use in hostile environments having high levels of electromagnetic interference, the conversion module retains high resolution of the analog signal while eliminating the potential for errors due to noise and interference. The module can be used to link analog output scientific equipment such as an electrometer used with a mass spectrometer to a computer. 2 figs.

Conversational sensemaking

NASA Astrophysics Data System (ADS)

Preece, Alun; Webberley, Will; Braines, Dave

2015-05-01

Recent advances in natural language question-answering systems and context-aware mobile apps create opportunities for improved sensemaking in a tactical setting. Users equipped with mobile devices act as both sensors (able to acquire information) and effectors (able to act in situ), operating alone or in collectives. The currently- dominant technical approaches follow either a pull model (e.g. Apple's Siri or IBM's Watson which respond to users' natural language queries) or a push model (e.g. Google's Now which sends notifications to a user based on their context). There is growing recognition that users need more flexible styles of conversational interaction, where they are able to freely ask or tell, be asked or told, seek explanations and clarifications. Ideally such conversations should involve a mix of human and machine agents, able to collaborate in collective sensemaking activities with as few barriers as possible. Desirable capabilities include adding new knowledge, collaboratively building models, invoking specific services, and drawing inferences. As a step towards this goal, we collect evidence from a number of recent pilot studies including natural experiments (e.g. situation awareness in the context of organised protests) and synthetic experiments (e.g. human and machine agents collaborating in information seeking and spot reporting). We identify some principles and areas of future research for "conversational sensemaking".

Serious Illness Conversations in ESRD

PubMed Central

Bernacki, Rachelle E.; Block, Susan D.

2017-01-01

Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less. This high intensity of care is often inconsistent with the wishes of patients on dialysis but persists due to failure to explore or discuss patient goals, values, and preferences in the context of their serious illness. Fewer than 10% of patients on dialysis report having had a conversation about goals, values, and preferences with their nephrologist, although nearly 90% report wanting this conversation. Many nephrologists shy away from these conversations, because they do not wish to upset their patients, feel that there is too much uncertainty in their ability to predict prognosis, are insecure in their skills at broaching the topic, or have difficulty incorporating the conversations into their clinical workflow. In multiple studies, timely discussions about serious illness care goals, however, have been associated with enhanced goal-consistent care, improved quality of life, and positive family outcomes without an increase in patient distress or anxiety. In this special feature article, we will (1) identify the barriers to serious illness conversations in the dialysis population, (2) review best practices in and specific approaches to conducting serious illness conversations, and (3) offer solutions to overcome barriers as well as practical advice, including specific language and tools, to implement serious illness conversations in the dialysis population. PMID:28031417

Phonon bottleneck identification in disordered nanoporous materials

NASA Astrophysics Data System (ADS)

Romano, Giuseppe; Grossman, Jeffrey C.

2017-09-01

Nanoporous materials are a promising platform for thermoelectrics in that they offer high thermal conductivity tunability while preserving good electrical properties, a crucial requirement for high-efficiency thermal energy conversion. Understanding the impact of the pore arrangement on thermal transport is pivotal to engineering realistic materials, where pore disorder is unavoidable. Although there has been considerable progress in modeling thermal size effects in nanostructures, it has remained a challenge to screen such materials over a large phase space due to the slow simulation time required for accurate results. We use density functional theory in connection with the Boltzmann transport equation to perform calculations of thermal conductivity in disordered porous materials. By leveraging graph theory and regressive analysis, we identify the set of pores representing the phonon bottleneck and obtain a descriptor for thermal transport, based on the sum of the pore-pore distances between such pores. This approach provide a simple tool to estimate phonon suppression in realistic porous materials for thermoelectric applications and enhance our understanding of heat transport in disordered materials.

Considerations in pharmaceutical conversion: focus on antihistamines.

PubMed

Garbus, S B; Moulton, B W; Meltzer, E O; Reich, P R; Weinreb, L F; Friedman, J A; Orland, B I

1997-04-01

The practice of pharmaceutical conversion, which encompasses three types of drug interchange (generic, brand, and therapeutic substitution), is increasing in managed care settings. Pharmaceutical conversion has numerous implications for managed care organizations, their healthcare providers, and their customers. Although drug cost may be a driving consideration in pharmaceutical conversion, a number of other considerations are of equal or greater importance in the decision-making process may affect the overall cost of patient care. Among these considerations are clinical, psychosocial, and safety issues; patient adherence; patient satisfaction; and legal implications of pharmaceutical conversion. Patient-centered care must always remain central to decisions about pharmaceutical conversion. This article discusses the issues related to, and implications of, pharmaceutical conversion utilizing the antihistamines class of drugs as the case situation.

Energy conversion at dipolarization fronts

NASA Astrophysics Data System (ADS)

Khotyaintsev, Yu. V.; Divin, A.; Vaivads, A.; André, M.; Markidis, S.

2017-02-01

We use multispacecraft observations by Cluster in the Earth's magnetotail and 3-D particle-in-cell simulations to investigate conversion of electromagnetic energy at the front of a fast plasma jet. We find that the major energy conversion is happening in the Earth (laboratory) frame, where the electromagnetic energy is being transferred from the electromagnetic field to particles. This process operates in a region with size of the order several ion inertial lengths across the jet front, and the primary contribution to E·j is coming from the motional electric field and the ion current. In the frame of the front we find fluctuating energy conversion with localized loads and generators at sub-ion scales which are primarily related to the lower hybrid drift instability excited at the front; however, these provide relatively small net energy conversion.

[Pierre Janet's views on the etiology, pathogenesis and therapy of dissociative and conversion disorders ("hysterias")].

PubMed

Bühler, Karl-Ernst; Heim, Gerhard

2010-01-01

Pierre Janet (1859-1947) is one of those more or less forgotten authors whose approach differed significantly from Freud's psychoanalysis. In the first part of this paper, Janet's conception of hysteria is discussed and his place in French psychiatry described. Different aspects of Janet's diathesis-stress-approach are presented (particularly his important pathogenic concept of fixed ideas) which refer not only to a conception of hysteria, but also to traumatic (stress) disorders and other psychological disturbances. The second part of the paper details the varieties of Janetian therapeutic treatments for these disorders: the 'liquidation' of fixed ideas by hypnosis and suggestion, confrontation techniques which resemble contemporary cognitive behavioural approaches, and special cognitive ("logagogic") interventions. Finally, we also discuss the various treatment strategies Janet proposes for dealing with symptoms, such as asthenic or depressive states, from his psycho-economic perspective.

Passenger and Cell Phone Conversations in Simulated Driving

ERIC Educational Resources Information Center

Drews, Frank A.; Pasupathi, Monisha; Strayer, David L.

2008-01-01

This study examines how conversing with passengers in a vehicle differs from conversing on a cell phone while driving. We compared how well drivers were able to deal with the demands of driving when conversing on a cell phone, conversing with a passenger, and when driving without any distraction. In the conversation conditions, participants were…

Planetary image conversion task

NASA Technical Reports Server (NTRS)

Martin, M. D.; Stanley, C. L.; Laughlin, G.

1985-01-01

The Planetary Image Conversion Task group processed 12,500 magnetic tapes containing raw imaging data from JPL planetary missions and produced an image data base in consistent format on 1200 fully packed 6250-bpi tapes. The output tapes will remain at JPL. A copy of the entire tape set was delivered to US Geological Survey, Flagstaff, Ariz. A secondary task converted computer datalogs, which had been stored in project specific MARK IV File Management System data types and structures, to flat-file, text format that is processable on any modern computer system. The conversion processing took place at JPL's Image Processing Laboratory on an IBM 370-158 with existing software modified slightly to meet the needs of the conversion task. More than 99% of the original digital image data was successfully recovered by the conversion task. However, processing data tapes recorded before 1975 was destructive. This discovery is of critical importance to facilities responsible for maintaining digital archives since normal periodic random sampling techniques would be unlikely to detect this phenomenon, and entire data sets could be wiped out in the act of generating seemingly positive sampling results. Reccomended follow-on activities are also included.

Tables and conversions for microclimatology.

Treesearch

James M. Brown

1973-01-01

A series of tables, charts, and conversion factors have been prepared for use in microclimatic and ecological studies. Included are: the solution to various equations of radiant energy exchange; solar radiation diagrams; psychometric and precipitation data; and unit conversion factors.

Structured luminescence conversion layer

DOEpatents

Berben, Dirk; Antoniadis, Homer; Jermann, Frank; Krummacher, Benjamin Claus; Von Malm, Norwin; Zachau, Martin

2012-12-11

An apparatus device such as a light source is disclosed which has an OLED device and a structured luminescence conversion layer deposited on the substrate or transparent electrode of said OLED device and on the exterior of said OLED device. The structured luminescence conversion layer contains regions such as color-changing and non-color-changing regions with particular shapes arranged in a particular pattern.

Teaching autistic children conversational speech using video modeling.

PubMed Central

Charlop, M H; Milstein, J P

1989-01-01

We assessed the effects of video modeling on acquisition and generalization of conversational skills among autistic children. Three autistic boys observed videotaped conversations consisting of two people discussing specific toys. When criterion for learning was met, generalization of conversational skills was assessed with untrained topics of conversation; new stimuli (toys); unfamiliar persons, siblings, and autistic peers; and other settings. The results indicated that the children learned through video modeling, generalized their conversational skills, and maintained conversational speech over a 15-month period. Video modeling shows much promise as a rapid and effective procedure for teaching complex verbal skills such as conversational speech. PMID:2793634

Biomass conversion processes for energy and fuels

NASA Astrophysics Data System (ADS)

Sofer, S. S.; Zaborsky, O. R.

The book treats biomass sources, promising processes for the conversion of biomass into energy and fuels, and the technical and economic considerations in biomass conversion. Sources of biomass examined include crop residues and municipal, animal and industrial wastes, agricultural and forestry residues, aquatic biomass, marine biomass and silvicultural energy farms. Processes for biomass energy and fuel conversion by direct combustion (the Andco-Torrax system), thermochemical conversion (flash pyrolysis, carboxylolysis, pyrolysis, Purox process, gasification and syngas recycling) and biochemical conversion (anaerobic digestion, methanogenesis and ethanol fermentation) are discussed, and mass and energy balances are presented for each system.

Improving Empathic Communication Skills in Adults with Autism Spectrum Disorder.

PubMed

Kern Koegel, Lynn; Ashbaugh, Kristen; Navab, Anahita; Koegel, Robert L

2016-03-01

The literature suggests that many individuals diagnosed with Autism Spectrum Disorder (ASD) experience challenges with recognizing and describing emotions in others, which may result in difficulties with the verbal expression of empathy during communication. Thus, there is a need for intervention techniques targeting this area. Using a multiple baseline across participants design, this study examined the effectiveness of a video-feedback intervention with a visual framework component to improve verbal empathetic statements and questions during conversation for adults with ASD. Following intervention, all participants improved in verbal expression of empathetic statements and empathetic questions during conversation with generalization and maintenance of gains. Furthermore, supplemental assessments indicated that each participant improved in their general level of empathy and confidence in communication skills.

Improving Verbal Empathetic Communication for Adults with Autism Spectrum Disorder

PubMed Central

Koegel, Lynn; Ashbaugh, Kristen; Navab, Anahita; Koegel, Robert

2015-01-01

The literature suggests that many individuals diagnosed with Autism Spectrum Disorder (ASD) experience challenges with recognizing and describing emotions in others, which may result in difficulties with the verbal expression of empathy during communication. Thus, there is a need for intervention techniques targeting this area. Using a multiple baseline across participants design, this study examined the effectiveness of a video-feedback intervention with a visual framework component to improve verbal empathetic statements and questions during conversation for adults with ASD. Following intervention, all participants improved in verbal expression of empathetic statements and empathetic questions during conversation with generalization and maintenance of gains. Furthermore, supplemental assessments indicated that each participant improved in their general level of empathy and confidence in communication skills. PMID:26520148

Faculty Meetings: Hidden Conversational Dynamics

ERIC Educational Resources Information Center

Bowman, Richard F.

2015-01-01

In the everydayness of faculty meetings, collegial conversations mirror distinctive dynamics and practices, which either enhance or undercut organizational effectiveness. A cluster of conversational practices affect how colleagues connect, engage, interact, and influence others during faculty meetings in diverse educational settings. The…

Management of ejaculatory disorders in infertile men

PubMed Central

Barazani, Yagil; Stahl, Peter J; Nagler, Harris M; Stember, Doron S

2012-01-01

Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation (PE), through retarded or delayed ejaculation (DE), to complete anejaculation (AE). Retrograde ejaculation (RE) represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed. PMID:22580636

Solar energy, its conversion and utilization

NASA Technical Reports Server (NTRS)

Farber, E. A.

1972-01-01

The work being carried out at the University of Florida Solar Energy and Energy Conversion Laboratory in converting solar energy, our only income, into other needed and useful forms of energy is described. A treatment such as this demonstrates, in proper perspective, how solar energy can benefit mankind with its many problems of shortages and pollution. Descriptions were given of the conversion processes, equipment, and performance. The testing of materials, solar water heating, space heating, cooking and baking, solar distillation, refrigeration and air-conditioning, work with the solar furnace, conversion to mechanical power, hot air engines, solar-heated sewage digestion, conversion to electricity, and other devices will be discussed.

Caffeine, mental health, and psychiatric disorders.

PubMed

Lara, Diogo R

2010-01-01

Caffeine intake is so common that its pharmacological effects on the mind are undervalued. Since it is so readily available, individuals can adjust their own dose, time of administration and dose intervals of caffeine, according to the perceived benefits and side effects of each dose. This review focuses on human studies of caffeine in subjects with and without psychiatric disorders. Besides the possibility of mild drug dependence, caffeine may bring benefits that contribute to its widespread use. These benefits seem to be related to adaptation of mental energy to the context by increasing alertness, attention, and cognitive function (more evident in longer or more difficult tasks or situations of low arousal) and by elevating mood. Accordingly, moderate caffeine intake (< 6 cups/day) has been associated with less depressive symptoms, fewer cognitive failures, and lower risk of suicide. However, its putative therapeutic effects on depression and ADHD have been insufficiently studied. Conversely, in rare cases high doses of caffeine can induce psychotic and manic symptoms, and more commonly, anxiety. Patients with panic disorder and performance social anxiety disorder seem to be particularly sensitive to the anxiogenic effects of caffeine, whereas preliminary data suggests that it may be effective for some patients with obsessive compulsive disorder (OCD). The threshold for the anxiogenic effect of caffeine is influenced by a polymorphism of the A2A receptor. In summary, caffeine can be regarded as a pharmacological tool to increase energy and effortful behavior in daily activities. More populational (cross-sectional and prospective) and experimental studies are necessary to establish the role of caffeine intake in psychiatric disorders, especially its putative efficacy on depressive mood and cognitive/attentional disorders.

How do I look? Self-focused attention during a video chat of women with social anxiety (disorder).

PubMed

Vriends, Noortje; Meral, Yasemin; Bargas-Avila, Javier A; Stadler, Christina; Bögels, Susan M

2017-05-01

We investigated the role of self-focused attention (SFA) in social anxiety (disorder) in an ecologically valid way. In Experiment 1 high (n = 26) versus low (n = 25) socially anxious single women between 18 and 30 years had a video ("Skype") conversation with an attractive male confederate, while seeing themselves and the confederate on-screen. The conversation was divided in four phases: (I) warm-up, (II) positive (confederate was friendly to the participant), (III) critical (confederate was critical to the participant), and (IV) active (participant was instructed to ask questions to the confederate). Participant's SFA was measured by eye-tracked gaze duration at their own image relative to the confederates' video image and other places at the computer screen. Results show that high socially anxious participants were more self-focused in the critical phase, but less self-focused in the active phase than low socially anxious participants. In Experiment 2 women diagnosed with SAD (n = 32) and controls (n = 30) between 18 and 30 years conducted the same experiment. Compared to controls participants with SAD showed increased SFA across all four phases of the conversation, and SFA predicted increased self-rated anxiety during the conversation. In conclusion, in subclinical social anxiety SFA is high only when the interaction partner is critical, whereas instructions to ask questions to the confederate reduces subclinical socially anxious' SFA, while clinical SAD is characterized by heightened self-focused attention throughout the interaction. Results support theories that social anxiety disorder is maintained by SFA, and imply that interventions that lower SFA may help prevent and treat social anxiety disorder, but that SFA can also be adaptive in certain types of interaction, such as when receiving compliments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neuropsychological Outcomes in Fatty Acid Oxidation Disorders: 85 Cases Detected by Newborn Screening

ERIC Educational Resources Information Center

Waisbren, Susan E.; Landau, Yuval; Wilson, Jenna; Vockley, Jerry

2013-01-01

Mitochondrial fatty acid oxidation disorders include conditions in which the transport of activated acyl-Coenzyme A (CoA) into the mitochondria or utilization of these substrates is disrupted or blocked. This results in a deficit in the conversion of fat into energy. Most patients with fatty acid oxidation defects are now identified through…

Hospital staff corridor conversations: work in passing.

PubMed

González-Martínez, Esther; Bangerter, Adrian; Lê Van, Kim; Navarro, Cécile

2016-03-01

First, to document the prevalence of corridor occupations and conversations among the staff of a hospital clinic, and their main features. Second, to examine the activities accomplished through corridor conversations and their interactional organization. Despite extensive research on mobility in hospital work, we still know fairly little about the prevalence and features of hospital staff corridor conversations and how they are organized. We conducted a study combining descriptive statistical analysis and multimodal conversation analysis of video recordings of staff corridor practices in a hospital outpatient clinic in Switzerland. In 2012, we collected 59 hours of video recordings in a corridor of a hospital clinic. We coded and statistically analysed the footage that showed the clinic staff exclusively. We also performed qualitative multimodal conversation analysis on a selection of the recorded staff conversations. Corridor occupations by the clinic staff are frequent and brief and rarely involve stops. Talk events (which include self-talk, face-to-face conversations and telephone conversations) during occupations are also brief and mobile, overwhelmingly focus on professional topics and are particularly frequent when two or more staff members occupy the corridor. The conversations present several interactional configurations and comprise an array of activities consequential to the provision of care and work organization. These practices are related to the fluid work organization of a spatially distributed team in a fast-paced, multitasking environment and should be taken into consideration in any undertaking aimed at improving hospital units' functioning. © 2015 John Wiley & Sons Ltd.

NASA Radioisotope Power Conversion Technology NRA Overview

NASA Technical Reports Server (NTRS)

Anderson, David J.

2005-01-01

The focus of the National Aeronautics and Space Administration's (NASA) Radioisotope Power Systems (RPS) Development program is aimed at developing nuclear power and technologies that would improve the effectiveness of space science missions. The Radioisotope Power Conversion Technology (RPCT) NASA Research Announcement (NRA) is an important mechanism through which research and technology activities are supported in the Advanced Power Conversion Research and Technology project of the Advanced Radioisotope Power Systems Development program. The purpose of the RPCT NRA is to advance the development of radioisotope power conversion technologies to provide higher efficiencies and specific powers than existing systems. These advances would enable a factor of two to four decrease in the amount of fuel and a reduction of waste heat required to generate electrical power, and thus could result in more cost effective science missions for NASA. The RPCT NRA selected advanced RPS power conversion technology research and development proposals in the following three areas: innovative RPS power conversion research, RPS power conversion technology development in a nominal 100 W(sub e) scale; and, milliwatt/multi-watt RPS (mWRPS) power conversion research. Ten RPCT NRA contracts were awarded in 2003 in the areas of Brayton, Stirling, thermoelectric (TE), and thermophotovoltaic (TPV) power conversion technologies. This paper will provide an overview of the RPCT NRA, a summary of the power conversion technologies approaches being pursued, and a brief digest of first year accomplishments.

NASA Radioisotope Power Conversion Technology NRA Overview

NASA Technical Reports Server (NTRS)

Anderson, David J.

2005-01-01

The focus of the National Aeronautics and Space Administration s (NASA) Radioisotope Power Systems (RPS) Development program is aimed at developing nuclear power and technologies that would improve the effectiveness of space science missions. The Radioisotope Power Conversion Technology (RPCT) NASA Research Announcement (NRA) is an important mechanism through which research and technology activities are supported in the Advanced Power Conversion Research and Technology project of the Advanced Radioisotope Power Systems Development program. The purpose of the RPCT NRA is to advance the development of radioisotope power conversion technologies to provide higher efficiencies and specific powers than existing systems. These advances would enable a factor of 2 to 4 decrease in the amount of fuel and a reduction of waste heat required to generate electrical power, and thus could result in more cost effective science missions for NASA. The RPCT NRA selected advanced RPS power conversion technology research and development proposals in the following three areas: innovative RPS power conversion research, RPS power conversion technology development in a nominal 100We scale; and, milliwatt/multi-watt RPS (mWRPS) power conversion research. Ten RPCT NRA contracts were awarded in 2003 in the areas of Brayton, Stirling, thermoelectric (TE), and thermophotovoltaic (TPV) power conversion technologies. This paper will provide an overview of the RPCT NRA, a summary of the power conversion technologies approaches being pursued, and a brief digest of first year accomplishments.

Conversational sensing

NASA Astrophysics Data System (ADS)

Preece, Alun; Gwilliams, Chris; Parizas, Christos; Pizzocaro, Diego; Bakdash, Jonathan Z.; Braines, Dave

2014-05-01

Recent developments in sensing technologies, mobile devices and context-aware user interfaces have made it pos- sible to represent information fusion and situational awareness for Intelligence, Surveillance and Reconnaissance (ISR) activities as a conversational process among actors at or near the tactical edges of a network. Motivated by use cases in the domain of Company Intelligence Support Team (CoIST) tasks, this paper presents an approach to information collection, fusion and sense-making based on the use of natural language (NL) and controlled nat- ural language (CNL) to support richer forms of human-machine interaction. The approach uses a conversational protocol to facilitate a ow of collaborative messages from NL to CNL and back again in support of interactions such as: turning eyewitness reports from human observers into actionable information (from both soldier and civilian sources); fusing information from humans and physical sensors (with associated quality metadata); and assisting human analysts to make the best use of available sensing assets in an area of interest (governed by man- agement and security policies). CNL is used as a common formal knowledge representation for both machine and human agents to support reasoning, semantic information fusion and generation of rationale for inferences, in ways that remain transparent to human users. Examples are provided of various alternative styles for user feedback, including NL, CNL and graphical feedback. A pilot experiment with human subjects shows that a prototype conversational agent is able to gather usable CNL information from untrained human subjects.

The processive kinetics of gene conversion in bacteria

PubMed Central

Paulsson, Johan; El Karoui, Meriem; Lindell, Monica

2017-01-01

Summary Gene conversion, non‐reciprocal transfer from one homologous sequence to another, is a major force in evolutionary dynamics, promoting co‐evolution in gene families and maintaining similarities between repeated genes. However, the properties of the transfer – where it initiates, how far it proceeds and how the resulting conversion tracts are affected by mismatch repair – are not well understood. Here, we use the duplicate tuf genes in Salmonella as a quantitatively tractable model system for gene conversion. We selected for conversion in multiple different positions of tuf, and examined the resulting distributions of conversion tracts in mismatch repair‐deficient and mismatch repair‐proficient strains. A simple stochastic model accounting for the essential steps of conversion showed excellent agreement with the data for all selection points using the same value of the conversion processivity, which is the only kinetic parameter of the model. The analysis suggests that gene conversion effectively initiates uniformly at any position within a tuf gene, and proceeds with an effectively uniform conversion processivity in either direction limited by the bounds of the gene. PMID:28256783

Conversion of phenolic constituents in aqueous Hamamelis virginiana leaf extracts during fermentation.

PubMed

Duckstein, Sarina M; Lorenz, Peter; Stintzing, Florian C

2012-01-01

Hamamelis virginiana, known for its high level of tannins and other phenolics is widely used for treatment of dermatological disorders. Although reports on hydroalcoholic and aqueous extracts from Hamamelis leaf and bark exist, knowledge on fermented leaf preparations and the underlying conversion processes are still scant. Aqueous Hamamelis leaf extracts were monitored during fermentation and maturation in order to obtain an insight into the bioconversion of tannins and other phenolics. Aliquots taken during the production period were investigated by HPLC-DAD-MS/MS as well as GC-MS after derivatisation into the corresponding trimethylsilyl compounds. In Hamamelis leaf extracts, the main constituents exhibited changes during the observational period of 6 months. By successive depside bond cleavage, the gallotannins were completely transformed into gallic acid after 1 month. Although not completely, kaempferol and quercetin glycosides were also converted during 6 months to yield their corresponding aglycones. Following C-ring fission, phloroglucinol was formed from the A-ring of both flavonols. The B-ring afforded 3-hydroxybenzoic acid from quercetin and 3,4-dihydroxybenzoic acid as well as 2-(4-hydroxyphenyl)-ethanol from kaempferol. Interestingly, hydroxycinnamic acids remained almost stable in the same time range. The present study broadens the knowledge on conversion processes in aqueous fermented extracts containing tannins, flavonol glycosides and hydroxycinnamic acids. In particular, the analogy between the microbial metabolism of phenolics from fermented Hamamelis extracts, fermented sourdough by heterofermentative lactic acid bacteria or conversion of phenolics by the human microbial flora is indicated. Copyright © 2012 John Wiley & Sons, Ltd.

Leadership is a conversation.

PubMed

Groysberg, Boris; Slind, Michael

2012-06-01

Globalization and new technologies have sharply reduced the efficacy of command-and-control management and its accompanying forms of corporate communication. In the course of a recent research project, the authors concluded that by talking with employees, rather than simply issuing orders, leaders can promote operational flexibility, employee engagement, and tight strategic alignment. Groysberg and Slind have identified four elements of organizational conversation that reflect the essential attributes of interpersonal conversation: intimacy, interactivity, inclusion, and intentionality. Intimacy shifts the focus from a top-down distribution of information to a bottom-up exchange of ideas. Organizational conversation is less corporate in tone and more casual. And it's less about issuing and taking orders than about asking and answering questions. Interactivity entails shunning the simplicity of monologue and embracing the unpredictable vitality of dialogue. Traditional one-way media-print and broadcast, in particular-give way to social media buttressed by social thinking. Inclusion turns employees into full-fledged conversation partners, entitling them to provide their own ideas, often on company channels. They can create content and act as brand ambassadors, thought leaders, and storytellers. Intentionality enables leaders and employees to derive strategically relevant action from the push and pull of discussion and debate.

Direct digital conversion detector technology

NASA Astrophysics Data System (ADS)

Mandl, William J.; Fedors, Richard

1995-06-01

Future imaging sensors for the aerospace and commercial video markets will depend on low cost, high speed analog-to-digital (A/D) conversion to efficiently process optical detector signals. Current A/D methods place a heavy burden on system resources, increase noise, and limit the throughput. This paper describes a unique method for incorporating A/D conversion right on the focal plane array. This concept is based on Sigma-Delta sampling, and makes optimum use of the active detector real estate. Combined with modern digital signal processors, such devices will significantly increase data rates off the focal plane. Early conversion to digital format will also decrease the signal susceptibility to noise, lowering the communications bit error rate. Computer modeling of this concept is described, along with results from several simulation runs. A potential application for direct digital conversion is also reviewed. Future uses for this technology could range from scientific instruments to remote sensors, telecommunications gear, medical diagnostic tools, and consumer products.

Conversation Analysis.

ERIC Educational Resources Information Center

Schiffrin, Deborah

1990-01-01

Summarizes the current state of research in conversation analysis, referring primarily to six different perspectives that have developed from the philosophy, sociology, anthropology, and linguistics disciplines. These include pragmatics; speech act theory; interactional sociolinguistics; ethnomethodology; ethnography of communication; and…

Thermal Management Considerations in Energy Conversion Devices

DTIC Science & Technology

2001-05-01

1000 W). Thermal Conversion Devices: Thermoelectrics (TE) Thermophotovoltaics (TPV) Alkali Metal Thermal to Electric Conversion (AMTEC) Free...300 - 400C Heat Input 700 - 850C Na vapor Electrodes Alkali Metal Thermal - to - Electric Conversion: Sodium is vaporized and condensed in a thermally

Persuasive Conversational Agent with Persuasion Tactics

NASA Astrophysics Data System (ADS)

Narita, Tatsuya; Kitamura, Yasuhiko

Persuasive conversational agents persuade people to change their attitudes or behaviors through conversation, and are expected to be applied as virtual sales clerks in e-shopping sites. As an approach to create such an agent, we have developed a learning agent with the Wizard of Oz method in which a person called Wizard talks to the user pretending to be the agent. The agent observes the conversations between the Wizard and the user, and learns how to persuade people. In this method, the Wizard has to reply to most of the user's inputs at the beginning, but the burden gradually falls because the agent learns how to reply as the conversation model grows.

Alternative Fuels Data Center: Flexible Fuel Vehicle Conversions

Science.gov Websites

Conversions to someone by E-mail Share Alternative Fuels Data Center: Flexible Fuel Vehicle Conversions on Facebook Tweet about Alternative Fuels Data Center: Flexible Fuel Vehicle Conversions on Twitter Bookmark Alternative Fuels Data Center: Flexible Fuel Vehicle Conversions on Google Bookmark

7 CFR 1450.101 - Qualified biomass conversion facility.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Qualified biomass conversion facility. 1450.101... (BCAP) Matching Payments § 1450.101 Qualified biomass conversion facility. (a) To be considered a qualified biomass conversion facility, a biomass conversion facility must enter into an agreement with CCC...

Outlining the psychopathology behind a case of conversion syndrome: Is a holistic approach beneficial?

PubMed

Aquilina, Francesca Falzon; Fondacaro, Daniel Vella

2016-03-01

Conversion disorder refers to a set of symptoms where no relevant organic cause is found. These include sensory/motor disturbances, and other neurological symptoms, such as pseudoseizures. Patients with this condition may, by having it, achieve a primary or secondary gain. The condition should be diagnosed when all the relevant investigations are inconclusive. In this case, we use the bio-psycho-social model for the interpretation and guidance of treatment. We also demonstrate how a holistic approach is beneficial when it comes to a multi-dimensional interpretation of such a case. This review outlines a case of a patient with several neurological and orthopedic problems who failed to improve with several treatment plans and surgical interventions. After several years of medical and surgical consultations, a thorough analysis by psychiatrists was made, resulting in a diagnosis of conversion syndrome. The patient gradually improved on psychiatric treatment, including psychotherapy, and with the necessary psychiatric follow-ups. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Having "The Talk": Youth-Parent Climate Conversations

NASA Astrophysics Data System (ADS)

Anderson, R. K.; Flora, J. A.; Lertzman, R.; Saphir, M.

2017-12-01

Youth are concerned about climate change. Recent research conducted by the Alliance for Climate Education, in partnership with the Skoll Global Threats Fund, demonstrates that youth have agency within their families regarding climate relevant behaviors, particularly resulting from conversations that rely on listening. In this pilot project, we examined whether youth involved in a year-long climate action program will carry out climate related conversations with their parents, and whether youth who have engaged online with a climate education group, will carry out similar conversations with their parents when asked to do so via SMS. In study one, we used mixed methods to determine if youth participating in a training would carry out a climate conversation with their parents, adhere to guidelines such as reflective listening, and have positive experiences. Further, we investigated to what extent parents would experience the conversation as a positive and impactful event. Parents overall reported a positive experience, and were proud of their child's work. In study two, in a randomized controlled trial conducted entirely via SMS, we investigated whether youth would watch a brief instructional animated video, and have a conversation with a parent. Results showed the majority of youth reported gained confidence in conducting a climate conversation and intended to speak to relatives. Preliminary results indicate when youth can express their climate engagement to a parent using these techniques, they have positive experiences, gain confidence in future engagements and can influence family. The studies highlight the positive impact of climate conversations as well as the potential to scale climate conversations to reach more youth and families.

Reflection during Portfolio-Based Conversations

ERIC Educational Resources Information Center

Oosterbaan, Anne E.; van der Schaaf, Marieke F.; Baartman, Liesbeth K. J.; Stokking, Karel M.

2010-01-01

This study aims to explore the relationship between the occurrence of reflection (and non-reflection) and thinking activities (e.g., orientating, selecting, analysing) during portfolio-based conversations. Analysis of 21 transcripts of portfolio-based conversations revealed that 20% of the segments were made up of reflection (content reflection…

Psychologic theories in functional neurologic disorders.

PubMed

Carson, A; Ludwig, L; Welch, K

2016-01-01

In this chapter we review key psychologic theories that have been mooted as possible explanations for the etiology of functional neurologic symptoms, conversion disorder, and hysteria. We cover Freudian psychoanalysis and later object relations and attachment theories, social theories, illness behavior, classic and operant conditioning, social learning theory, self-regulation theory, cognitive-behavioral theories, and mindfulness. Dissociation and modern cognitive neuroscience theories are covered in other chapters in this series and, although of central importance, are omitted from this chapter. Our aim is an overview with the emphasis on breadth of coverage rather than depth. © 2016 Elsevier B.V. All rights reserved.

14 CFR 1274.206 - Metric Conversion Act.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Metric Conversion Act. 1274.206 Section 1274.206 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION COOPERATIVE AGREEMENTS WITH COMMERCIAL FIRMS Pre-Award Requirements § 1274.206 Metric Conversion Act. The Metric Conversion...

5 CFR 870.907 - Termination and conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Termination and conversion. 870.907....907 Termination and conversion. (a) Assigned insurance terminates under the conditions stated in... time the conversion policy is issued. (5) The employing office must notify each assignee of the...

5 CFR 870.907 - Termination and conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Termination and conversion. 870.907....907 Termination and conversion. (a) Assigned insurance terminates under the conditions stated in... time the conversion policy is issued. (5) The employing office must notify each assignee of the...

Environmental Pressure May Change the Composition Protein Disorder in Prokaryotes

PubMed Central

Vicedo, Esmeralda; Schlessinger, Avner; Rost, Burkhard

2015-01-01

Many prokaryotic organisms have adapted to incredibly extreme habitats. The genomes of such extremophiles differ from their non-extremophile relatives. For example, some proteins in thermophiles sustain high temperatures by being more compact than homologs in non-extremophiles. Conversely, some proteins have increased volumes to compensate for freezing effects in psychrophiles that survive in the cold. Here, we revealed that some differences in organisms surviving in extreme habitats correlate with a simple single feature, namely the fraction of proteins predicted to have long disordered regions. We predicted disorder with different methods for 46 completely sequenced organisms from diverse habitats and found a correlation between protein disorder and the extremity of the environment. More specifically, the overall percentage of proteins with long disordered regions tended to be more similar between organisms of similar habitats than between organisms of similar taxonomy. For example, predictions tended to detect substantially more proteins with long disordered regions in prokaryotic halophiles (survive high salt) than in their taxonomic neighbors. Another peculiar environment is that of high radiation survived, e.g. by Deinococcus radiodurans. The relatively high fraction of disorder predicted in this extremophile might provide a shield against mutations. Although our analysis fails to establish causation, the observed correlation between such a simplistic, coarse-grained, microscopic molecular feature (disorder content) and a macroscopic variable (habitat) remains stunning. PMID:26252577

Alternative Fuels Data Center: Natural Gas Vehicle Conversions

Science.gov Websites

Conversions to someone by E-mail Share Alternative Fuels Data Center: Natural Gas Vehicle Conversions on Facebook Tweet about Alternative Fuels Data Center: Natural Gas Vehicle Conversions on Twitter Bookmark Alternative Fuels Data Center: Natural Gas Vehicle Conversions on Google Bookmark Alternative

5 CFR 534.605 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion. 534.605 Section 534.605 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.605 Conversion. On the first day of the first pay period beginning...

5 CFR 534.605 - Conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion. 534.605 Section 534.605 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.605 Conversion. On the first day of the first pay period beginning...

Conversational Competence in Academic Settings

ERIC Educational Resources Information Center

Bowman, Richard F.

2014-01-01

Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

Thermochemical Conversion Techno-Economic Analysis | Bioenergy | NREL

Science.gov Websites

Conversion Techno-Economic Analysis Thermochemical Conversion Techno-Economic Analysis NREL's Thermochemical Conversion Analysis team focuses on the conceptual process design and techno-economic analysis , detailed process models, and TEA developed under this project provide insights into the potential economic

14 CFR 1274.206 - Metric Conversion Act.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Metric Conversion Act. 1274.206 Section 1274.206 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION COOPERATIVE AGREEMENTS WITH COMMERCIAL FIRMS Pre-Award Requirements § 1274.206 Metric Conversion Act. The Metric Conversion Act, as...

5 CFR 317.305 - Conversion of excepted appointees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion of excepted appointees. 317... EMPLOYMENT IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.305 Conversion of...), the employee may request conversion to a career appointment. Such request must be made on or before...

5 CFR 317.305 - Conversion of excepted appointees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion of excepted appointees. 317... EMPLOYMENT IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.305 Conversion of...), the employee may request conversion to a career appointment. Such request must be made on or before...

Energy Conversion and Storage Program

NASA Astrophysics Data System (ADS)

Cairns, E. J.

1993-06-01

This report is the 1992 annual progress report for the Energy Conversion and Storage Program, a part of the Energy and Environment Division of the Lawrence Berkeley Laboratory. Work described falls into three broad areas: electrochemistry; chemical applications; and materials applications. The Energy Conversion and Storage Program applies principles of chemistry and materials science to solve problems in several areas: (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes and chemical species, and (5) study and application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Chemical applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing product and waste streams from synfuel plants, coal gasifiers, and biomass conversion processes. Materials applications research includes evaluation of the properties of advanced materials, as well as development of novel preparation techniques. For example, techniques such as sputtering, laser ablation, and poised laser deposition are being used to produce high-temperature superconducting films.

12 CFR 708b.203 - Conversion of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Conversion of insurance. 708b.203 Section 708b... OF FEDERALLY-INSURED CREDIT UNIONS; VOLUNTARY TERMINATION OR CONVERSION OF INSURED STATUS Voluntary Termination or Conversion of Insured Status § 708b.203 Conversion of insurance. (a) A federally-insured state...

12 CFR 708b.203 - Conversion of insurance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Conversion of insurance. 708b.203 Section 708b... OF FEDERALLY-INSURED CREDIT UNIONS; VOLUNTARY TERMINATION OR CONVERSION OF INSURED STATUS Voluntary Termination or Conversion of Insured Status § 708b.203 Conversion of insurance. (a) A federally-insured state...

41 CFR 101-30.101-8 - Conversion.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Conversion. 101-30.101-8 Section 101-30.101-8 Public Contracts and Property Management Federal Property Management Regulations...-General § 101-30.101-8 Conversion. Conversion means the changeover from using existing supply...

41 CFR 101-30.101-8 - Conversion.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Conversion. 101-30.101-8 Section 101-30.101-8 Public Contracts and Property Management Federal Property Management Regulations...-General § 101-30.101-8 Conversion. Conversion means the changeover from using existing supply...

Relationship between anhedonia and impulsivity in schizophrenia, major depression and schizoaffective disorder.

PubMed

Amr, Mostafa; Volpe, Fernando Madalena

2013-12-01

Anhedonia and impulsivity are prominent symptoms of many psychiatric disorders and may indicate worse prognosis, notably in schizophrenia and major depression. Despite the convergence of negative outcomes from both dimensions, the relationship between anhedonia and impulsivity in psychiatric disorders has been seldom directly assessed. The objective of the present study is to examine the correlations between anhedonia and impulsivity in three diagnostic groups: major depression, schizophrenia and schizoaffective disorder. 121 outpatients (Mansoura University Hospital, Egypt) with major depressive disorder (N=29), schizophrenia (N=59), and schizoaffective disorder (N=33), were assessed and responded to the Beck Depression Inventory, Barrat's Impulsivity Scale-11, and Chapman's Social and Physical Anhedonia Scales. Physical and social anhedonia scores were negatively correlated to impulsivity scores in major depression patients. Conversely, higher scores in physical and social anhedonia predicted higher impulsivity scores in schizophrenia. No correlations between impulsivity and anhedonia were evidenced among schizoaffectives. The relationship between self-reported physical and social anhedonia and impulsivity is diagnosis-specific. Copyright © 2013 Elsevier B.V. All rights reserved.

14 CFR 1274.206 - Metric Conversion Act.

Code of Federal Regulations, 2012 CFR

2012-01-01

... metric measurement system is stated in NPD 8010.2, Use of the Metric System of Measurement in NASA... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Metric Conversion Act. 1274.206 Section... WITH COMMERCIAL FIRMS Pre-Award Requirements § 1274.206 Metric Conversion Act. The Metric Conversion...

14 CFR 1274.206 - Metric Conversion Act.

Code of Federal Regulations, 2013 CFR

2013-01-01

... metric measurement system is stated in NPD 8010.2, Use of the Metric System of Measurement in NASA... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Metric Conversion Act. 1274.206 Section... WITH COMMERCIAL FIRMS Pre-Award Requirements § 1274.206 Metric Conversion Act. The Metric Conversion...

5 CFR 870.1007 - Termination and conversion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Termination and conversion. 870.1007... Iraq and Kuwait and United States Hostages Captured in Lebanon § 870.1007 Termination and conversion... the 31-day extension of coverage and conversion as set forth in subpart F of this part, unless the...

5 CFR 870.1007 - Termination and conversion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Termination and conversion. 870.1007... Iraq and Kuwait and United States Hostages Captured in Lebanon § 870.1007 Termination and conversion... the 31-day extension of coverage and conversion as set forth in subpart F of this part, unless the...

16 CFR 801.32 - Conversion and acquisition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Conversion and acquisition. 801.32 Section... INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.32 Conversion and acquisition. A conversion is an acquisition within the meaning of the act. Example: Assume that...

16 CFR 801.32 - Conversion and acquisition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Conversion and acquisition. 801.32 Section... INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.32 Conversion and acquisition. A conversion is an acquisition within the meaning of the act. Example: Assume that...

Adaptive Feedback Improving Learningful Conversations at Workplace

ERIC Educational Resources Information Center

Gaeta, Matteo; Mangione, Giuseppina Rita; Miranda, Sergio; Orciuoli, Francesco

2013-01-01

This work proposes the definition of an Adaptive Conversation-based Learning System (ACLS) able to foster computer-mediated tutorial dialogues at the workplace in order to increase the probability to generate meaningful learning during conversations. ACLS provides a virtual assistant selecting the best partner to involve in the conversation and…

Thin-thick quadrature frequency conversion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eimerl, D.

1985-02-07

The quadrature conversion scheme is a method of generating the second harmonic. The scheme, which uses two crystals in series, has several advantages over single-crystal or other two crystal schemes. The most important is that it is capable of high conversion efficiency over a large dynamic range of drive intensity and detuning angle.

Comprehension in NS-NNS Conversation.

ERIC Educational Resources Information Center

Nikko, Tuija

A study of interlanguage comprehension, part of a larger project by the Gothenburg research group, investigated the telephone conversations between advanced learners and native speakers of Swedish. In four of the eight conversations, the non-native speakers called the public library to get information on how to borrow books; in the other four the…

DUF6 Conversion Facility EIS Schedule

Science.gov Websites

and Uses DUF6 Conversion EIS Documents News FAQs Internet Resources Glossary Home » Conversion News | FAQs | Internet Resources | Glossary Help | Mailing Services | Contact Us | About Us | Security

42 CFR 417.432 - Conversion of enrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Conversion of enrollment. 417.432 Section 417.432... PREPAYMENT PLANS Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.432 Conversion of... Medicare Parts A and B or Part B only. (b) Effective date of conversion. Unless the individual chooses to...

7 CFR 46.33 - Conversion of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Conversion of funds. 46.33 Section 46.33 Agriculture... THAN RULES OF PRACTICE) UNDER THE PERISHABLE AGRICULTURAL COMMODITIES ACT, 1930 Conversion of Funds § 46.33 Conversion of funds. Any licensee who collects or receives funds for or on behalf of another...

42 CFR 417.432 - Conversion of enrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Conversion of enrollment. 417.432 Section 417.432... PREPAYMENT PLANS Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.432 Conversion of... Medicare Parts A and B or Part B only. (b) Effective date of conversion. Unless the individual chooses to...

43 CFR 3140.3-1 - Conversion applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Conversion applications. 3140.3-1 Section 3140.3-1 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... Conversion of Existing Oil and Gas Leases and Valid Claims Based on Mineral Locations § 3140.3-1 Conversion...

7 CFR 46.33 - Conversion of funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Conversion of funds. 46.33 Section 46.33 Agriculture... THAN RULES OF PRACTICE) UNDER THE PERISHABLE AGRICULTURAL COMMODITIES ACT, 1930 Conversion of Funds § 46.33 Conversion of funds. Any licensee who collects or receives funds for or on behalf of another...

Alpha and conversion electron spectroscopy of 238,239Pu and 241Am and alpha-conversion electron coincidence measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dion, Michael P.; Miller, Brian W.; Warren, Glen A.

2016-09-01

A technique to determine the isotopics of a mixed actinide sample has been proposed by measuring the coincidence of the alpha particle during radioactive decay with the conversion electron (or Auger) emitted during the relaxation of the daughter isotope. This presents a unique signature to allow the deconvolution of isotopes that possess overlapping alpha particle energy. The work presented here are results of conversion electron spectroscopy of 241Am, 238Pu and 239Pu using a dual-stage peltier-cooled 25 mm2 silicon drift detector. A passivated ion implanted planar silicon detector provided measurements of alpha spectroscopy. The conversion electron spectra were evaluated from 20–55more » keV based on fits to the dominant conversion electron emissions, which allowed the relative conversion electron emission intensities to be determined. These measurements provide crucial singles spectral information to aid in the coincident measurement approach.« less

Tree value conversion standards revisited

Treesearch

Paul S. DeBald; Martin E. Dale; Martin E. Dale