This study explored facets of personality between pathological gamblers (n = 69) and nonpathological gamblers (n = 55) in a convenience sample in Los Angeles, California. Pathological gamblers were more prone to mood disturbance, impulsivity, feelings of frustration, interpersonal sensitivity, vulnerability to distress, and distrust of others as measured by the NEO Personality Inventory–Revised. Pathological gamblers also reported diminished competence
Rory C. Reid; Desiree S. Li; Jean Lopez; Michael Collard; Iman Parhami; Reef Karim; Timothy Fong
SUMMARY The present study explored facets of personality in a sample of pathological gamblers with ADHD (n = 52) and without ADHD (n = 43). Participants were assessed for psychopathology and gambling disorders using the Mini International Neuropsychiatric Interview, the National Opinion Research Center DSM Screen for Gambling Problems, and the Adult ADHD Self-Report Scale. Facets of personality were assessed using the NEO Personality Inventory–Revised. Group differences emerged across several facets of personality when analyzed using multivariate statistics. Although both groups experienced difficulties in several areas compared with norming data (e.g., greater depression, higher impulsivity, lower self-esteem and lower self-discipline), these facets of personality were more pronounced in pathological gamblers with ADHD. Most notable among these differences are tendencies for gamblers with ADHD to experience greater levels of emotional instability, interpersonal sensitivity and stress proneness. Pathological gamblers with ADHD also appear to experience lower self-esteem, greater difficulty being assertive and lower levels of self-discipline. Surprisingly, both groups were comparable on facets of impulsivity. These findings suggest that pathological gamblers diagnosed with adult ADHD may experience additional challenges compared with pathological gamblers without ADHD.
Davtian, Margarit; Reid, Rory C; Fong, Timothy W
This review summarizes studies of pathological gambling and personality. Meta-analyses were conducted on 44 studies that reported personality traits of pathological gamblers (N = 2134) and nonpathological gambling control groups (N = 5321). Effect size estimates were calculated for 128 comparisons and organized according to the factors associated with two integrative accounts of personality. Four of the meta-analyses examined traits that have previously been found to load on the Urgency, Premeditation, Perseverance, and Sensation Seeking aspects of impulsivity (Whiteside & Lynam 2001). Substantial effects were found for traits associated with Negative Urgency (Cohen's d =.99) and Low Premeditation (d =.84), but not for Low Perseverance or Sensation Seeking. A second set of meta-analyses examined broad domains of personality that have previously been found to load on Negative Affect, Positive Affect, Disagreeable Disinhibition, and Unconscientious Disinhibition (Markon, Krueger, & Watson, 2005). Substantial effects were found for Unconscientious Disinhibition (d =.79), Negative Affect (d =.50), and Disagreeable Disinhibition (d =.50), but not Positive Affect. It was concluded that these individual personality characteristics may be important in the etiology of pathological gambling. The personality profile implicated in the etiology of pathological gambling is similar to that found in a recent meta-analysis of substance use disorders (Kotov, Gamez, Schmidt, & Watson, 2010). These results suggest that pathological gambling may be part of a broad cluster of externalizing psychopathology, and also call into question the current classification of pathological gambling as an Impulse Control Disorder in the DSM-IV. PMID:21802620
Maclaren, Vance V; Fugelsang, Johnathan A; Harrigan, Kevin A; Dixon, Michael J
This study extends the work completed with pathological gamblers and substance abusers, looking at associations between a history of trauma and comorbid substance dependence, impulsivity, measures of problem severity, and personality variables. We studied 111 patients admitted to the gambling treatment program at the Brecksville VA Medical Center and found that 64% of gamblers reported a history of emotional trauma; 40.5%, physical trauma; and 24.3%, sexual trauma. Most of this trauma occurred in childhood. A history of trauma was associated with a greater relative frequency of suicide attempts and drug and alcohol dependence, more severe scores in measures of psychiatric distress, and limited effects on personality functioning. PMID:16449091
Kausch, Otto; Rugle, Loreen; Rowland, Douglas Y
High rates of psychiatric symptoms have been reported in pathological gamblers. This study of psychiatric comorbidity in pathological gamblers is the first to use structured psychiatric interviews assessing DSM-III-R Axis I and II disorders. The Structured Clinical Interview for DSM III-R (SCID-P, SCID-II) was administered to 40 (25 male, 15 male) pathological gamblers seeking outpatient treatment in Minnesota for gambling,
Sheila M. Specker; Gregory A. Carlson; Karen M. Edmonson; Paula E. Johnson; Michael Marcotte
This paper argues that there area priori reasons to extract measures of ego strength and achievement motivation from the psychometric data base routinely collected from inpatient pathological gambers in order to clarify the meaning of these constructs and to evaluate their roles in personality organization. A sample of 57 subjects engaged in an inpatient treatment program for pathological gamblers was
Julian I. Taber; Angel M. Russo; Bonnie J. Adkins; Richard A. McCormick
The available evidence suggests that pathological gambling significantly disrupts family relationships and has a substantial impact on family members. However, these conclusions are based almost exclusively on male pathological gamblers and their female spouses or partners. The current study, which was a secondary study derived from a treatment…
Dowling, Nicki; Smith, David; Thomas, Trang
The present study demonstrated the relative impact of gambling and nongambling contexts on the degree of delay discounting by pathological gamblers. We used a delay-discounting task with 20 pathological gamblers in and out of the natural context in which they regularly gambled. For 16 of the 20 participants, it appeared that the difference of…
Dixon, Mark R.; Jacobs, Eric A.; Sanders, Scott
Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients meeting the criteria for IGD were compared to 167 control subjects displaying either regular or intense use of online games. Additionally, 115 patients meeting diagnostic criteria for pathological gambling were included. IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion. The comparisons to pathological gamblers indicate that low conscientiousness and low extraversion in particular are characteristic of IGD. An integration of personality variables into an etiopathological model describing presumable mechanisms fostering and maintaining addictive online gaming is proposed. This model could be helpful for the theoretical understanding of addictive gaming, public health campaigns and psychoeducation within therapeutic settings. © 2013 S. Karger AG, Basel. PMID:24247280
Müller, K W; Beutel, M E; Egloff, B; Wölfling, K
In this first study on gambling in Brazil, pathological and non-pathological gamblers were surveyed at three bingo clubs, one video poker club, and one horse-racing club in São Paulo. The South Oaks Gambling Screen and a questionnaire were administered to 171 subjects. When compared to nonpathological gamblers, a significantly higher proportion of pathological gamblers played cards, horse races, video poker, and dice in their lifetime. The two groups were similar with respect to socially acceptable games such as lotteries, bingo, sports, and the stock market. No significant differences were observed in drug consumption except for a higher lifetime consumption of tobacco among pathological gamblers. Only 4.9% of the gamblers sought help for gambling-related problems, suggesting that gambling is not generally perceived as a mental health problem by these subjects. PMID:10993389
Oliveira, M P; Silva, M T
The present study examined the neurological correlates of slot machine gambling by pathological and nonpathological gamblers while undergoing an fMRI scanning procedure. Twenty-two total participants were exposed to a series of losses, small wins, and large wins on a computerized simulated slot machine. Results indicate that the two types of gamblers responded differently to the various game options, and that an apparent "dose effect" exists when small and big wins are compared for pathological gamblers. Specifically more neural activation occurred in the dopaminergic pathway under conditions of large wins. These data suggest that a non-drug substance such as gambling may mimic typical drug-dose effects shown in previous literature. Implications for the treatment of pathological gamblers are discussed. PMID:24607394
Dixon, Mark R; Wilson, Alyssa; Habib, Reza
A sample of 23 veterans entering the Pathological Gambling Treatment Program at the Veterans Administration Medical Center in Miami, Florida, were administered a battery of tests including the following: Wechsler Adult Intelligence Scale (WAIS), Minnesota Multiphasic Personality Inventory (MMPI), Edwards Personal Preference Schedule (EPPS), and the Personal Orientation Inventory (POI). Findings on the intelligence testing indicated that on the average the pathological gamblers were of bright normal intelligence with a mean WAIS Full Scale IQ of 116.78, mean Verbal IQ of 119.30, and a mean Performance IQ of 111.30. Group profile results on the MMPI showed significant mean clinical scale elevations on two of the nine clinical scales: Scale 2, Depression; and Scale 4, Psychopathic Deviate. Group profile results on the EPPS indicated relatively high scores on the variables of achievement, exhibition, autonomy, dominance, and heterosexuality; and relatively low scores on the variables of deference, order, and endurance. Group profile results on the POI were essentially within normal limits with a tendency toward time incompetency noted, suggesting difficulty living fully in the present here and now. PMID:6642793
Moravec, J D; Munley, P H
This study explores correlates of psychological distress and relationship satisfaction among concerned significant others (CSOs) of pathological gamblers. CSOs often seek help in dealing with the gambling problem and are influential in recovery, but little is known about the sources of their distress. A sample of 186 CSOs responded to media announcements offering telephone and bibliotherapy support. In multivariate models, CSOs who were spouses and who were younger reported more personal distress, and higher distress was associated with a greater number of CSO emotional and behavioral consequences. Lower relationship satisfaction was associated with more CSO emotional consequences, fewer gambler consequences, and greater severity of gambling problem. Implications for treatment are discussed. PMID:17220742
Hodgins, David C; Shead, N Will; Makarchuk, Karyn
The transtheoretical model has been applied to many addictive disorders. In this study, psychometrics properties of the University of Rhode Island Change Assessment (URICA) scale were evaluated in 234 pathological gamblers initiating treatment. Four components were identified--reflective of precontemplation, contemplation, action, and maintenance…
Petry, Nancy M.
Neurocognitive disturbances suggesting a frontal lobe dysfunction have been observed in pathological gamblers and alcohol dependents. Given that a high homocysteine level has been suggested to be a mediating factor in alcohol-related cognitive decline, we have determined homocysteine and cobalamine in cerebrospinal fluid (CSF) obtained from 11…
Nordin, Conny; Sjodin, Ingemar
The present study explored the delay discounting of future and past monetary rewards by pathological gamblers. Using a multiple baseline design, following repeated exposure to choices between smaller immediate and larger delayed consequences, participants completed a relational responding task that attempted to alter the psychological functions of…
Dixon, Mark R.; Holton, Bethany
An illusion of control is said to occur when a person believes that he or she controls an outcome that is uncontrollable. Pathological gambling has often been related to an illusion of control, but the assessment of the illusion has generally used introspective methods in domain-specific (i.e., gambling) situations. The illusion of control of pathological gamblers, however, could be a more general problem, affecting other aspects of their daily life. Thus, we tested them using a standard associative learning task which is known to produce illusions of control in most people under certain conditions. The results showed that the illusion was significantly stronger in pathological gamblers than in a control undiagnosed sample. This suggests (1) that the experimental tasks used in basic associative learning research could be used to detect illusions of control in gamblers in a more indirect way, as compared to introspective and domain-specific questionnaires; and (2), that in addition to gambling-specific problems, pathological gamblers may have a higher-than-normal illusion of control in their daily life.
Orgaz, Cristina; Estevez, Ana; Matute, Helena
Research findings on comorbidity and pathological gambling are non–existent in Chinese communities. The objectives of this study were to: (a) determine the prevalence of comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong; (b) compare demographic profiles and clinical features in pathological gamblers with and without comorbid mood and adjustment disorders; and (c) explore the association
D. T. L. Shek; E. M. L. Chan; R. H. Y. Wong
This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent
Alesia N. Burge; Robert H. Pietrzak; Nancy M. Petry
Adult alcoholics as well as pathological gamblers reported that, as children, they had higher than control levels of attention deficit disorder-related behaviors. On the other hand, alcoholics and only a subset of gamblers showed deficits in a test of behavioral restraint.Copyright © 1992 S. Karger AG, Basel
Peter L. Carlton; Paul Manowitz
Pathological gambling (PG) has been associated to both impulsiveness and attention deficit\\/hyperactivity disorder (ADHD) in different studies. Our objective was to compare different impulsivity and sustained attention variables, using both behavioural tasks and self-administered questionnaires, in a group of pathological gamblers with a history of childhood ADHD (PG-ADHD; n = 16), a group of pathological gamblers without this history (PG-non-ADHD; n = 39), and
R. Rodriguez-Jimenez; C. Avila; M. A. Jimenez-Arriero; G. Ponce; R. Monasor; M. Jimenez; M. Aragües; J. Hoenicka; G. Rubio; T. Palomo
The project is an investigation into the nature of compulsive gamblers and compulsive gambling. First, it studies who these compulsive gamblers are: what regularities of personality or self-concept they exhibit, how they go about their business, how they ...
Although effective therapies for pathological gambling exist, their uptake is limited to 10% of the target population. To lower the barriers for help seeking, the authors tested an online alternative in a randomized trial (N = 66). The participants were pathological gamblers not presenting with severe comorbid depression. A wait-list control was…
Carlbring, Per; Smit, Filip
This article describes the socio-demographic characteristics and gambling behavior of 39 pathological gamblers who participated in our treatment study in 2009. The inclusion criteria of the study were: score of five or more on both the South Oaks Gambling Screen (SOGS) and a pathological gambling screen based on the Diagnostic and Statistical…
Lahti, Tuuli; Halme, Jukka; Pankakoski, Maiju; Sinclair, David; Alho, Hannu
The aim of this study was to examine the structural relationship among gambling motivation, gambling passion, and behavioral intentions to gamble between recreational and pathological gamblers. Specifically, this study aimed to shed light on the different ways in which gambling motivation and affective attitude are associated with recreational and pathological gamblers. Using a purposive sampling method, 400 subjects were selected for and participated in this study during their visits to a casino. Study results echoed the notion of distinctive and separate gambling motivations and passions between recreational and pathological gamblers. Also, results identified specific areas to which casino operators or policy makers should pay special attention in developing effective marketing strategies to promote responsible gambling. PMID:20680417
Back, Ki-Joon; Lee, Choong-Ki; Stinchfield, Randy
To investigate the hypothesized causal relationship between pathological gambling and gambling-related illegal behaviors, 77 patients seeking behavioral treatment for excessive gambling and 32 members of Gamblers Anonymous were administered a structured interview schedule. Data on the incidence, nature and extent of both gambling and non-gambling related illegal behaviors was obtained and DSM-III (A.P.A., 1980) criteria for Antisocial personality were used
Alex Blaszczynski; Neil McConaghy; Anna Frankova
Comorbid DSM-IV Axis II personality disorders appear to be common in pathological gambling (PG) and may contribute to the chronic problems often associated with the disorder. This study sought to examine the relationship between PG, personality disorders, and impulsivity in a sample of pathological gamblers. Personality assessments included the SCID-II, Eysenck Impulsiveness Questionnaire, Tridimensional Personality Questionnaire, and Barratt Impulsiveness Scale. A total of 77 individuals with DSM-IV PG were included in this study, of which 35 (45.5%) met criteria for at least one personality disorder. Specific aspects of impulsivity were associated with certain personality disorders in PG when grouped by cluster, yet the presence of a personality disorder was not positively correlated with gambling severity. It remains unclear how the presence of a personality disorder and aspects of impulsivity may affect treatment outcome. Further exploration of these disorders and dimensions of personality may encourage a more inclusively global treatment approach. PMID:22494174
Odlaug, Brian L; Schreiber, Liana R N; Grant, Jon E
Comorbid DSM-IV Axis II personality disorders appear to be common in pathological gambling (PG) and may contribute to the chronic problems often associated with the disorder. This study sought to examine the relationship between PG, personality disorders, and impulsivity in a sample of pathological gamblers. Personality assessments included the SCID-II, Eysenck Impulsiveness Questionnaire, Tridimensional Personality Questionnaire, and Barratt Impulsiveness Scale. A total of 77 individuals with DSM-IV PG were included in this study, of which 35 (45.5%) met criteria for at least one personality disorder. Specific aspects of impulsivity were associated with certain personality disorders in PG when grouped by cluster, yet the presence of a personality disorder was not positively correlated with gambling severity. It remains unclear how the presence of a personality disorder and aspects of impulsivity may affect treatment outcome. Further exploration of these disorders and dimensions of personality may encourage a more inclusively global treatment approach. PMID:22686226
Odlaug, Brian L; Schreiber, Liana R N; Grant, Jon E
Background: The links between attention deficit hyperactivity disorder (ADHD) and substance use disorders have been the subject of numerous papers. Few studies, however, have focused specifically on the relationship between ADHD and behavioural addictions. The aim of this study was to (i) examine the frequency of pathological and at-risk gamblers having a previous history of ADHD; (ii) give details of
Marie Grall-Bronnec; Laura Wainstein; Jennyfer Augy; Gaëlle Bouju; Fanny Feuillet; Jean-Luc Vénisse; Véronique Sébille-Rivain
The purpose of this translational study was twofold: (1) to contrast behavioral and brain activity between pathological and nonpathological gamblers, and (2) to examine differences as a function of the outcome of the spin of a slot machine, focusing predominately on the “Near-Miss”—when two reels stop on the same symbol, and that symbol is just above or below the payoff line on the third reel. Twenty-two participants (11 nonpathological; 11 pathological) completed the study by rating the closeness of various outcomes of slot machine displays (wins, losses, and near-misses) to a win. No behavioral differences were observed between groups of participants, however, differences in brain activity were found in the left midbrain, near the substantia nigra and ventral tegmental area (SN / VTA). Near-miss outcomes uniquely activated brain regions associated with wins for the pathological gamblers and regions associated with losses for the nonpathological gamblers. Thus, near-miss outcomes on slot machines may contain both functional and neurological properties of wins for pathological gamblers. Such a translational approach to the study of gambling behavior may be considered an example that gives life to B. F. Skinner's conceptualization of the physiologist of the future.
Habib, Reza; Dixon, Mark R
The purpose of this translational study was twofold: (1) to contrast behavioral and brain activity between pathological and nonpathological gamblers, and (2) to examine differences as a function of the outcome of the spin of a slot machine, focusing predominately on the "Near-Miss"--when two reels stop on the same symbol, and that symbol is just…
Habib, Reza; Dixon, Mark R.
Although the literature concerning the association between irrational thinking and gambling continues to grow, a number of methodological problems raise questions about the validity of such findings. The present research examined the cognitions and beliefs of a small convenience sample of pathological (n = 5) and social (n = 5) fruit machine gamblers using a within- and between-subjects design, employing
Background Pathological gambling (PG) is a form of behavioural addiction that has been associated with elevated impulsivity and also cognitive distortions in the processing of chance, probability and skill. We sought to assess the relationship between the level of cognitive distortions and state and trait measures of impulsivity in treatment-seeking pathological gamblers. Method Thirty pathological gamblers attending the National Problem Gambling Clinic, the first National Health Service clinic for gambling problems in the UK, were compared with 30 healthy controls in a case-control design. Cognitive distortions were assessed using the Gambling-Related Cognitions Scale (GRCS). Trait impulsivity was assessed using the UPPS-P, which includes scales of urgency, the tendency to be impulsive in positive or negative mood states. Delay discounting rates were taken as a state measure of impulsive choice. Results Pathological gamblers had elevated impulsivity on several UPPS-P subscales but effect sizes were largest (Cohen's d>1.4) for positive and negative urgency. The pathological gamblers also displayed higher levels of gambling distortions, and elevated preference for immediate rewards, compared to controls. Within the pathological gamblers, there was a strong relationship between the preference for immediate rewards and the level of cognitive distortions (R2=0.41). Conclusions Impulsive choice in the gamblers was correlated with the level of gambling distortions, and we hypothesize that an impulsive decision-making style may increase the acceptance of erroneous beliefs during gambling play.
Michalczuk, R.; Bowden-Jones, H.; Verdejo-Garcia, A.; Clark, L.
Very few studies have investigated motivational differences between pathological gamblers (PG) and non-problem gamblers (NPG), or between men and women. Motives for starting gambling have not been distinguished from motives for continuing gambling. From a community survey questionnaire listing reasons generated from the population studied, the motives of 103 current PG met the DSM-IV-TR criteria of five or more symptoms
DAVE CLARKE; SAMSON TSE; MAX W. ABBOTT; SONIA TOWNSEND; PEFI KINGI; WIREMU MANAIA
Research on predictors of treatment outcome among pathological gamblers (PGs) is inconclusive and dominated by studies from Western countries. Using a prospective longitudinal design, the current study examined demographic, clinical, behavioural and treatment programme predictors of gambling frequency at 3, 6 and 12-months, among PGs treated at an addiction clinic in Singapore. Measures included the Hospital anxiety and depression scale, gambling symptom assessment scale (GSAS), personal well-being index (PWI), treatment perception questionnaire and gambling readiness to change scale. Treatment response in relation to changes in symptom severity, personal wellbeing and abstinence were also assessed. Abstinence rates were 38.6, 46.0 and 44.4 % at 3, 6 and 12-months respectively. Significant reductions in gambling frequency, GSAS, and improvement in PWI were reported between baseline and subsequent outcome assessments, with the greatest change occurring in the initial three months. No demographic, clinical, behavioural or treatment programme variable consistently predicted outcome at all three assessments, though treatment satisfaction was the most frequent significant predictor. However, being unemployed, having larger than average debts, poor treatment satisfaction and attending fewer sessions at the later stages of treatment were associated with significantly poorer outcomes, up to 1-year after initiating treatment. These findings show promise for the effectiveness of a CBT-based treatment approach for the treatment of predominantly Chinese PGs. Clinical implications and suggestions for future research are discussed. Taken together, the findings suggest early treatment satisfaction is paramount in improving short-term outcomes, with baseline gambling behaviour and treatment intensity playing a more significant role in the longer term. PMID:22945784
Guo, Song; Manning, Victoria; Thane, Kyaw Kyaw Wai; Ng, Andrew; Abdin, Edimansyah; Wong, Kim Eng
This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers.…
Tang, Catherine So-kum; Wu, Anise M. S.
Stress plays a major role at the onset and relapse of pathological gambling (PG), but at the same time it can also be the aftermath of gambling behavior, thus revealing a reciprocal relationship. Although the role of stress has been well-documented, there is a paucity of studies investigating the effect of an adjunctive stress management program on PG. In this 8-week parallel randomized waitlist controlled trial pathological gamblers, already in the gamblers anonymous (GA) group, were assigned randomly in two groups, with the intervention group (n = 22) receiving an additional stress management program (consisting of education on diet and exercise, stress coping methods, relaxation breathing -RB- and progressive muscle relaxation -PMR). Self-reported measures were used in order to evaluate stress, depression, anxiety, sleep quality/disturbances, life-satisfaction and daily routine. The statistical analyses for the between group differences concerning the main psychosocial study outcomes revealed a statistically significant amelioration of stress, depression, anxiety symptoms and an increase of life-satisfaction and a better daily routine in participants of the intervention group. We hope that these will encourage researchers and clinicians to adopt stress management in their future work. PMID:24912736
Linardatou, C; Parios, A; Varvogli, L; Chrousos, G; Darviri, C
It has been demonstrated that craving for gambling is associated with anxiety and depression in pathological gamblers. Exercise has been shown to reduce anxiety and depression, as well as positively influence abstinence rates in individuals with substance use disorders. In this study, we examined the impact of a physical activity program in 33 pathological gamblers. We also analyzed the association between craving and plasmatic levels of stress hormones (adrenocorticotropic hormone, cortisol, and prolactin). The program involved eight 50-min sessions. Craving was assessed 24 h before, immediately before, and immediately after each session, as well as on a weekly basis. Before and after the program, we evaluated gambling behavior, depressive symptoms, anxiety, and plasma levels of stress hormones. We identified a significant reduction in craving following each session and at the end of the program. There was improvement in anxiety, depressive symptoms, and gambling behavior. The post-session reduction in craving was accompanied by post-program reductions in craving and anxiety but not by a post-program reduction in depressive symptoms. The craving reduction was associated with a variation in prolactin levels but not with variations in levels of cortisol or adrenocorticotropic hormone. PMID:22661334
Angelo, Daniela Lopes; Tavares, Hermano; Zilberman, Monica Levit
Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys. This article is a report of some of the data from the gamblers' survey. This survey focused on two time periods of the compulsive gambler's life—during
Valerie C. Lorenz; Robert A. Yaffee
This paper reports the underlying structure of the demographic and clinical characteristics of level 3 (i.e., pathological) Korean casino gamblers. The participants reported their gambling behavior and clinical characteristics known to be associated with gambling problems (e.g., alcohol use problems, eating disorders, depression, anxiety, and…
Lee, Tae Kyung; LaBrie, Richard A.; Grant, Jon E.; Kim, Suck Won; Shaffer, Howard J.
This study examined the effects of modafinil (200 mg) on slot machine betting profiles from a previous sample of low and high impulsivity (LI/HI) pathological gamblers (10/Group; Zack and Poulos, 2009). Hierarchical regression assessed the prospective relationship between Payoff and Bet Size on consecutive trials, along with moderating effects of Group, Cumulative Winnings (low/high) and Phase of game (early/late) under drug and placebo. Y intercepts for the simple regressions of Bet Size on Payoff indexed overall motivation to bet. Under placebo, both groups gauged their bets less closely to the preceding Payoff as trials continued when Winnings were low but not high. Under modafinil, both groups gauged their bets more closely to the preceding Payoff when Winnings were low but gauged their bets less closely to the previous Payoff when Winnings were high. The tendency to gauge bets closely to the previous Payoff coincided with a bias toward low overall Bet Size, and modafinil accentuated this relationship, in LI but not HI subjects. Results suggest that modafinil increases the salience of environmental rewards, leading to more tightly calibrated responses to individual rewards when resources are low, but progressively loosens reward-response calibration when resources are high. Increased relative impact of phasic vs. tonic dopamine signals may account for patterns seen at low vs. high Winnings, respectively, under the drug. Clinically, modafinil may deter pathological gamblers from chasing losses but also encourage them to continue betting rather than quit while they are ahead. Whether low-dose modafinil confers more uniform benefits deserves investigation. PMID:23711549
Smart, Kelly; Desmond, Renée C; Poulos, Constantine X; Zack, Martin
This paper reports the underlying structure of the demographic and clinical characteristics of level 3 (i.e., pathological)\\u000a Korean casino gamblers. The participants reported their gambling behavior and clinical characteristics known to be associated\\u000a with gambling problems (e.g., alcohol use problems, eating disorders, depression, anxiety, and impulsivity). Factor analysis\\u000a identified three domains underlying level 3 gambling: emotional instability, reward sensitivity\\/drive, and
Tae Kyung Lee; Richard A. LaBrie; Jon E. Grant; Suck Won Kim; Howard J. Shaffer
Aims To apply social network analysis (SNA) to investigate whether frequency and severity of gambling problems were associated with different network characteristics among friends, family, and co-workers. is an innovative way to look at relationships among individuals; the current study was the first to our knowledge to apply SNA to gambling behaviors. Design Egocentric social network analysis was used to formally characterize the relationships between social network characteristics and gambling pathology. Setting Laboratory-based questionnaire and interview administration. Participants Forty frequent gamblers (22 non-pathological gamblers, 18 pathological gamblers) were recruited from the community. Findings The SNA revealed significant social network compositional differences between the two groups: pathological gamblers (PGs) had more gamblers, smokers, and drinkers in their social networks than did nonpathological gamblers (NPGs). PGs had more individuals in their network with whom they personally gambled, smoked, and drank with than those with who were NPG. Network ties were closer to individuals in their networks who gambled, smoked, and drank more frequently. Associations between gambling severity and structural network characteristics were not significant. Conclusions Pathological gambling is associated with compositional but not structural differences in social networks. Pathological gamblers differ from non-pathological gamblers in the number of gamblers, smokers, and drinkers in their social networks. Homophily within the networks also indicates that gamblers tend to be closer with other gamblers. This homophily may serve to reinforce addictive behaviors, and may suggest avenues for future study or intervention.
Meisel, Matthew K.; Clifton, Allan D.; MacKillop, James; Miller, Joshua D.; Campbell, W. Keith; Goodie, Adam S.
Limited research exists regarding methods for reducing problem gambling. Problem gamblers (N = 180) were randomly assigned to assessment only control, 10 min of brief advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy. Gambling was assessed at baseline, at 6 weeks, and…
Petry, Nancy M.; Weinstock, Jeremiah; Ledgerwood, David M.; Morasco, Benjamin
Pathological gamblers (PGs) may have high levels of impulsivity, and a correlation between substance use disorders (SUD) and impulsivity is well established. However, only a handful of studies have attempted to assess impulsivity and other impulse-spectrum traits (e.g., sensation seeking) using a variety of behavioral and self-report measures in PGs and few examined the independent impact of SUDs. We compared 30 PGs without SUD histories, 31 PGs with SUD histories and 40 control participants on self-reported impulsivity, delayed discounting, attention/memory, response inhibition, risk taking, sensation seeking and distress tolerance measures. PGs, regardless of SUD history, discounted delayed rewards at greater rates than controls. PGs also reported acting on the spur of the moment, experienced trouble planning and thinking carefully, and noted greater attention difficulties than controls. PGs with SUD took greater risks on a risk-taking task than did PGs without SUD histories, but the two groups did not differ on any other measures of impulsivity. We conclude that PGs are more impulsive than non-problem gamblers in fairly specific ways, but PGs with and without SUD histories differ on few measures. More research should focus on specific ways in which PGs exhibit impulsivity to better address impulsive behaviors in treatment.
Ledgerwood, David M.; Alessi, Sheila M.; Phoenix, Natalie; Petry, Nancy M.
Drawing on extant work on shame and emotion regulation, this article proposes that three broad forms of maladaptive shame regulation strategies are fundamental in much of personality pathology: Prevention (e.g., dependence, fantasy), used preemptively, lessens potential for shame; Escape (e.g., social withdrawal, misdirection) reduces current or imminent shame; Aggression, used after shame begins, refocuses shame into anger directed at the self (e.g., physical self-harm) or others (e.g., verbal aggression). This article focuses on the contributions of shame regulation to the development and maintenance of personality pathology, highlighting how various maladaptive shame regulation strategies may lead to personality pathology symptoms, associated features, and dimensions. Consideration is also given to the possible shame-related constructs necessitating emotion regulation (e.g., shame aversion and proneness) and the points in the emotion process when regulation can occur. PMID:21895346
Schoenleber, Michelle; Berenbaum, Howard
Pathological gambling is a behavioral addiction characterized by a chronic failure to resist the urge to gamble. It shares many similarities with drug addiction. Glucocorticoid hormones including cortisol are thought to play a key role in the vulnerability to addictive behaviors, by acting on the mesolimbic reward pathway. Based on our previous report of an imbalanced sensitivity to monetary versus non-monetary incentives in the ventral striatum of pathological gamblers (PGs), we investigated whether this imbalance was mediated by individual differences in endogenous cortisol levels. We used functional magnetic resonance imaging (fMRI) and examined the relationship between cortisol levels and the neural responses to monetary versus non-monetary cues, while PGs and healthy controls were engaged in an incentive delay task manipulating both monetary and erotic rewards. We found a positive correlation between cortisol levels and ventral striatal responses to monetary versus erotic cues in PGs, but not in healthy controls. This indicates that the ventral striatum is a key region where cortisol modulates incentive motivation for gambling versus non-gambling related stimuli in PGs. Our results extend the proposed role of glucocorticoid hormones in drug addiction to behavioral addiction, and help understand the impact of cortisol on reward incentive processing in PGs.
Li, Yansong; Sescousse, Guillaume; Dreher, Jean-Claude
Personality traits have proven to be consistent and important factors in a variety of externalizing behaviors including addiction, aggression, and antisocial behavior. Given the comorbidity of these behaviors with pathological gambling (PG), it is important to test the degree to which PG shares these trait correlates. In a large community sample of regular gamblers (N=354; 111 with diagnoses of pathological gambling), the relations between measures of two major models of personality – Big Three and Big Five – were examined in relation to PG symptoms derived from a semi-structured diagnostic interview. Across measures, traits related to the experience of strong negative emotions were the most consistent correlates of PG, regardless of whether they were analyzed using bivariate or multivariate analyses. In several instances, however, the relations between personality and PG were moderated by demographic variable such as gender, race, and age. It will be important for future empirical work of this nature to pay closer attention to potentially important moderators of these relations.
Miller, Joshua D.; MacKillop, James; Fortune, Erica E.; Maples, Jessica; Lance, Charles E.; Campbell, W. Keith; Goodie, Adam S.
Despite high rates of comorbidity among pathological gambling, substance use disorders, and other psychiatric conditions, health professionals rarely screen their clients for gambling problems. We report on the performance of the NODS-CLiP, an existing brief, three-item screen for problem and pathological gambling, and an alternative four-item screen that demonstrates improved sensitivity, good positive and negative predictive power and invariance across key demographic groups. Given high rates of comorbidity, routine and accurate identification of gambling-related problems among individuals seeking help for substance abuse and related disorders is important. The original and the alternative brief screens are likely to be useful in a range of clinical settings.
Volberg, Rachel A.; Munck, Ingrid M.; Petry, Nancy M.
The current study examined the differences in arousal (physiologically and subjectively) between gamblers and non-gamblers. Thirty students from a mid-sized university took part in the study for a chance to win money in a gambling task. Nearly half of the participants identified themselves as non-gamblers and slightly more than half of the participants considered themselves gamblers. Findings indicated that gamblers experienced a significantly higher increase in physiological arousal (heart rate) compared to non-gamblers during the gambling experience. The results suggests the possibility that physiological arousal may play a role in the appeal of gambling to certain types of people. Furthermore, when gamblers suffered a loss at the end of the game, they reported feeling worse as compared to the non-gamblers and relative to their state before playing. Moreover, this affective change explained 28.6% of the variance in gambling behavior according to self-reports. Findings suggest that gamblers in our study may have been more personally invested in the gambling tasks, such that losing was more disappointing to the habitual gamblers than the non-gamblers. PMID:22057368
Pascual-Leone, Antonio; Campeau, Jennifer L; Harrington, Shawn J
Sex differences in incidence and severity of some stress-related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic-pituitary-adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or post traumatic stress disorder (PTSD). Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor-vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress-related experiences, will be the subject of future investigation.
Paris, Jason J.; Franco, Christine; Sodano, Ruthlyn; Freidenberg, Brian; Gordis, Elana; Anderson, Drew A.; Forsyth, John P.; Wulfert, Edelgard; Frye, Cheryl A.
The present study aimed to replicate the previous relationship between the Zuckerman personality model and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) and to evaluate the contribution of the facets and factors from Zuckerman's new instrument Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) versus the old Zuckerman-Kuhlman Personality Questionnaire to the four clusters of the DAPP-BQ. The sample consisted of 443 subjects from the general population of both sexes. The ZKA-PQ dimensions predicted between 35 % and 61% of the DAPP-BQ cluster variance and facets between 54% and 63%. Local regression graphical analysis (LOESS) showed that neuroticism and aggressiveness are the dimensions most related with emotional dysregulation. Sensation seeking and aggressiveness were associated with dissocial behaviour. Neuroticism and extraversion (negative) were associated with social avoidance and activity and sensation seeking (negative) with compulsiveness. The new ZKA-PQ improves the psychometric properties of the old Zuckerman-Kuhlman Personality Questionnaire. Both dimensional personality measures can play a role in the prediction of the future DSM-V personality disorder dimensional system. PMID:24343978
Aluja, Anton; Blanch, Angel; Balada, Ferran
Although sleep has been extensively studied in substance related disorders, it has yet to be examined as thoroughly in gambling-related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Mean ESS scores for recreational, problem, and pathological gamblers were 4.13, 5.81, and 8.69, respectively, with a significant difference between pathological gamblers and both problem (P = .007) and recreational gamblers (P < .001). Mean PSQI scores for recreational, problem, and pathological gamblers were 3.35, 5.30, and 5.44, respectively, with a significant difference in sleep quality between recreational and problem gamblers (P = .018), as well as recreational and pathological gamblers (P = .008). As the first study to use objective sleep measures, these findings will not only increase awareness of this relationship, but also provide a foundation on which others can investigate the benefits of screening and adjunct treatment for sleep disorders in the gambling population.
Parhami, Iman; Siani, Aaron; Rosenthal, Richard J.; Lin, Stephanie; Collard, Michael; Fong, Timothy W.
The Iowa Gambling Task (IGT) involves exploratory learning via rewards and penalties, where most advantageous task performance requires subjects to forego potential large immediate rewards for small longer-term rewards to avoid larger punishments. Pathological gambling (PG) subjects perform worse on the IGT compared to controls, relating to their persistence at high risk decisions involving the continued choice of potential large immediate rewards despite experiencing larger punishments. We wished to determine if neural processing of risk and reward within striatal and frontal cortex is associated with this behaviour observed in PG. Functional magnetic resonance imaging (fMRI) was used to assess brain activity in response to a computerized version of the IGT. Thirteen male PG subjects with no active comorbidities were compared to 13 demographically matched control subjects. In agreement with previous behavioural studies, PG subjects performed worse on the IGT and made more high-risk choices compared to controls, particularly after experiencing wins and losses. During high-risk gambling decisions, fMRI demonstrated that PG subjects exhibited relatively increased frontal lobe and basal ganglia activation, particularly involving the orbitofrontal cortex (OFC), caudate and amygdala. Increased activation of regions encompassing the extended reward pathway in PG subjects during high risk choices suggests that the persistence of PG may be due to the increased salience of immediate and greater potential monetary rewards relative to lower monetary rewards or potential future losses. Whether this over activation of the reward pathway is associated with the development of PG warrants further investigation. PMID:22037936
Power, Yuri; Goodyear, Bradley; Crockford, David
We examine two issues linking personality pathology and judgment of traits within the Five-Factor Model of personality. We hypothesize that pathology moderates self-other agreement--"target" participants with pathology should be less judgable than participants without pathology. In addition, we hypothesize that pathology could partially produce agreement across a variety of traits, particularly those traits fundamental to the pathology. In an adolescent sample including a group with Conduct Disorder (CD) and a Control group, we examine agreement between adolescents' self-reports and their mothers' informant reports. Using trait-centered and person-centered perspectives, we find support for both hypotheses. Results have implications for understanding the processes affecting personality judgment, for increasing integration of traditional personality research and personality pathology, and for personality assessment. PMID:17489894
Furr, R Michael; Dougherty, Donald M; Marsh, Dawn M; Mathias, Charles W
Previous findings suggest that self-perception of health relates to many physical health outcomes, including mortality. Many factors appear to shape health perceptions, like personality. Little research, however, has focused on whether personality pathology may affect perceived health. This preliminary study examined the unique effects of personality pathology on health perceptions beyond those of objective health and normal personality factors. We studied an epidemiologically-based, representative sample (N=697) of Saint Louis residents (ages 55–64). The Diagnostic Interview Schedule and the Health Status Inventory were used to collect reports of health perceptions, chronic illnesses, and physical functioning. Personality traits were measured with the revised NEO Personality Inventory and personality disorders were assessed using the Structured Interview for DSM-IV Personality. Number of physical illnesses, physical functioning, normal personality, and personality disorders all predicted self-perception of health separately. Personality disorders also predicted health perception above and beyond objective health and personality variables. These findings elucidate the importance of personality pathology in understanding perceived health and suggest that certain patterns of pathology may be particularly detrimental to subjective health.
Powers, Abigail D.; Oltmanns, Thomas F.
The goal of this study was to investigate gambling-related behavior, onset and progression in a sample of at-risk gamblers from the community. A national household survey was conducted in Brazil, covering individuals 14 years old or older. Subjects were screened for at-risk gambling, those testing positive answered a questionnaire about gambling progression, preferred games and DSM-IV pathological gambling criteria. Out of 3007 respondents, 118 were considered at-risk gamblers according to the Lie/Bet Questionnaire. According to the DSM-IV, 32.7% and 24.9% of those were considered problem and pathological gamblers, respectively. Early at-risk gamblers (onset prior to 20 years of age), were more likely to be male, to prefer non-commercially structured games, and to chase losses while gambling. Young pathological gamblers (under 35 years of age) progressed faster from regular to problem gambling (roughly 2 years) than mature pathological gamblers (12 years). Such findings had not been described before because previous reports focused mostly on clinical samples that lack young, male, early-onset gamblers. Gambling programs have not satisfactorily covered this segment of gamblers. Outreach strategies and early interventions should be provided to prevent these individuals from rapidly evolving into pathological gambling. PMID:24656520
Carneiro, Elizabeth; Tavares, Hermano; Sanches, Marcos; Pinsky, Ilana; Caetano, Raul; Zaleski, Marcos; Laranjeira, Ronaldo
Background This study examines the structure of the Personality Belief Questionnaire (PBQ), a self-report instrument designed to assess dysfunctional beliefs associated with personality pathology, as proposed by the cognitive theory of personality dysfunction. Methods The PBQ was examined using exploratory factor analysis with responses from 438 depressed outpatients, and confirmatory factor analysis with responses from 683 treatment-seeking psychiatric outpatients. All participants were assessed for personality disorder using a standard clinical interview. The validity of the resulting factor structure was assessed in the combined sample (N=1121) by examining PBQ scores for patients with and without personality disorder diagnoses. Results Exploratory and confirmatory analyses converged to indicate that the PBQ is best described by 7 empirically identified factors: 6 assess dysfunctional beliefs associated with forms of personality pathology recognized in DSM-IV. Validity analyses revealed that those diagnosed with a personality disorder evidenced a higher average score on all factors, relative to those without these disorders. Subsets of patients diagnosed with specific DSM-IV personality disorders scored higher, on average, on the factor associated with their respective diagnosis, relative to all other factors. Conclusions The pattern of results has implications for the conceptualization of personality pathology. To our knowledge, no formal diagnostic or assessment system has yet systematically incorporated the role of dysfunctional beliefs into its description of personality pathology. The identification of dysfunctional beliefs may not only aid in case conceptualization, but may provide unique targets for psychological treatment. Recommendations for future personality pathology assessment systems are provided.
Fournier, Jay C.; DeRubeis, Robert J.; Beck, Aaron T.
This applet allows you to experience the fate of a gambler by simulating the whole gambling session in a matter of seconds. The applet plots the successive rises and falls of the capital during the whole duration of the game. It also displays the maximum and minimum values attained by the capital during the session and allows you to get precise information (by clicking at a point of the histogram) of the amount of capital after that particular bet.
Garsia, A. M.
A prospective design was used to explore the precipitants of relapse in a naturalistic sample of pathological gamblers (N = 101) who had recently quit gambling. Relapse rates were high; only 8% were entirely free of gambling during the 12-month follow-up. Relapses were highly variable but occurred most frequently in the evening, when the person…
Hodgins, David C.; el-Guebaly, Nady
Addiction can involve substances (heroin, cannabis, cocaine) or be characterised by behaviour (pathological gambling, addiction to sport, etc.). The question is to establish whether or not there is a specific personality profile (character, temperament) and emotional functioning (anxiety, depression, alexithymia) in subjects presenting addictive behaviour with and without substance use. To find some answers, a team from Sainte-Marguerite General Hospital in Marseille carried out a study comparing a group of cannabis addicts and a group of pathological gamblers. PMID:24741830
Parolaa, Nathalie; Boyer, Laurent; Simon, Nicolas; Aghababian, Valérie; Lançon, Christophe
The present study assessed the divergent validity of several self-report and objective behavioral measures for assessing pathological gambling using three samples divided by South Oaks Gambling Scale score [Lesieur, & Blume (1987). American Journal of Psychiatry, 144, 1184–1188]: pathological gamblers, potential pathological gamblers, and non-pathological gamblers. Self-report measures included the Gamblers’ Beliefs Questionnaire [GBQ; Steenbergh, Meyers, May, & Whelan (2002).
James MacKillop; Emily J. Anderson; Bryan A. Castelda; Richard E. Mattson; Peter J. Donovick
The aim of this study was to explore the association between pathological gambling (PG) and anger by assessing whether psychopathology and personality are related to PG and to evaluate gender differences. The sample comprised 71 PGs and 37 healthy controls. Anger, psychopathology and personality were assessed with the STAXI-2, SCL-90-R and TCI-R respectively. Gender did not affect anger expression after stratifying by diagnostic condition (p > .05). Among PG patients, anger, psychopathology and personality measures were correlated with good effect-size (r > .30). Scores in the Anger Temperament (B = 0.21, p = .038) and Anger External-Expression (B = 0.27, p = .029) scales were positively associated with PG severity scores. Anger expression in PG should be considered in future treatment programs. PMID:25011386
Aymamí, Neus; Granero, Roser; Penelo, Eva; Fernández-Aranda, Fernando; Krug, Isabel; Gunnard, Katarina; Santamaría, Juan José; Bueno, Blanca; Jaurrieta, Nuria; Gómez-Peña, Mónica; Alvarez-Moya, Eva; Claes, Laurence; Fagundo, Ana Beatriz; Menchón, José Manuel; Jiménez-Murcia, Susana
A multidimensional trait system has been proposed for representing personality disorder (PD) features in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to address problematic classification issues such as comorbidity. In this model, which may also assist in providing scaffolding for the underlying structure of major forms of psychopathology more generally, 25 primary traits are organized by 5 higher order dimensions: Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism. We examined (a) the generalizability of the structure proposed for DSM-5 PD traits, and (b) the potential for an integrative hierarchy based upon DSM-5 PD traits to represent the dimensions scaffolding psychopathology more generally. A large sample of student participants (N = 2,461) completed the Personality Inventory for DSM-5, which operationalizes the DSM-5 traits. Exploratory factor analysis replicated the initially reported 5-factor structure, as indicated by high factor congruencies. The 2-, 3-, and 4-factor solutions estimated in the hierarchy of the DSM-5 traits bear close resemblance to existing models of common mental disorders, temperament, and personality pathology. Thus, beyond the description of individual differences in personality disorder, the trait dimensions might provide a framework for the metastructure of psychopathology in the DSM-5 and the integration of a number of ostensibly competing models of personality trait covariation. PMID:22448740
Wright, Aidan G C; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Pincus, Aaron L; Krueger, Robert F
A multidimensional trait system has been proposed for representing personality disorder (PD) features in DSM-5 to address problematic classification issues such as comorbidity. In this model, which may also assist in providing scaffolding for the underlying structure of major forms of psychopathology more generally, 25 primary traits are organized by 5 higher order dimensions: Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism. We examined a) the generalizability of the structure proposed for DSM-5 PD traits and b) the potential for an integrative hierarchy based upon DSM-5 PD traits to represent the dimensions scaffolding psychopathology more generally. A large sample of student participants (N=2,461) completed the Personality Inventory for DSM-5, which operationalizes the DSM-5 traits. Exploratory factor analysis replicated the initially reported five-factor structure as indicated by high factor congruencies. The two-, three-, and four- factor solutions estimated in the hierarchy of the DSM-5 traits bear close resemblance to existing models of common mental disorders, temperament, and personality pathology. Thus, beyond the description of individual differences in personality disorder, the trait dimensions might provide a framework for the metastructure of psychopathology in the DSM-5 and the integration of a number of ostensibly competing models of personality trait covariation.
Wright, Aidan G.C.; Thomas, Katherine M.; Hopwood, Christopher J.; Markon, Kristian E.; Pincus, Aaron L.; Krueger, Robert F.
Dispositional trait frameworks offer great potential to elucidate the nature and development of psychopathology, including the construct of relational aggression. The present study sought to explore the dispositional context of relational aggression across three dispositional frameworks: temperament, personality, and personality pathology. Participants comprised a large community sample of youth, aged 6 to 18 years (N = 1,188; 51.2% female). Ratings of children's relational aggression, temperament, personality, and personality pathology traits were obtained through parent report (86.3% mothers). Results showed convergence and divergence across these three dispositional frameworks. Like other antisocial behavior subtypes, relational aggression generally showed connections with traits reflecting negative emotionality and poor self-regulation. Relational aggression showed stronger connections with temperament traits than with personality traits, suggesting that temperament frameworks may capture more relationally aggressive content. Findings at the lower order trait level help differentiate relational aggression from other externalizing problems by providing a more nuanced perspective (e.g., both sociability and shyness positively predicted relational aggression). In addition, there was little evidence of moderation of these associations by gender, age, or age2, and findings remained robust even after controlling for physical aggression. Results are discussed in the broader context of conceptualizing relational aggression in an overarching personality-psychopathology framework. PMID:25047304
Tackett, Jennifer L; Kushner, Shauna C; Herzhoff, Kathrin; Smack, Avante J; Reardon, Kathleen W
This study seeks to integrate two research traditions that lie at the base of the understanding of personality pathology in adolescents. The first research tradition refers to normal personality according to the Five Factor Model (FFM). The second tradition specifies the key feature of personality disorder as the capacity to mentalize, which can be reflected in Social Information Processing (SIP). In a clinical sample of 96 adolescents, the authors investigated response generation, coping strategy, and memories of past frustrating experiences as part of SIP, as mediator in the relationship between personality and personality pathology, and a possible moderating role of personality on the relationship between SIP and personality pathology. The hypothesized mediation, by which the effects of personality dimensions on personality pathology was expected to be mediated by SIP variables, was found only for the effect of Neuroticism, most specifically on BPD, which appeared to be mediated by memories the patients had about past frustrating conflict situations with peers. Some moderating effects of personality on the relationship between SIP variables and personality pathology were found, suggesting that high Agreeableness and sometimes low Neuroticism can buffer this relationship. These results suggest that personality dimensions and social cognitions both independently and together play a role in adolescents' personality pathology. PMID:24344893
Hessels, Christel; van den Hanenberg, Danique; de Castro, Bram Orobio; van Aken, Marcel A G
Relapse rates among pathological gamblers are high with as many as 75% of gamblers returning to gambling shortly after a serious\\u000a attempt to quit. The present study focused on providing a low cost, easy to access relapse prevention program to such individuals.\\u000a Based on information collected in our ongoing study of the process of relapse, a series of relapse prevention
David C. Hodgins; Shawn R. Currie; Nady el-Guebaly; Katherine M. Diskin
This study sought to extend extant research on the association between borderline personality (BP) pathology and at-risk parenting by examining the dynamic nature of parenting in response to infant distress in mothers with and without clinically relevant levels of BP pathology. Findings revealed that mothers with clinically relevant levels of BP pathology were less likely than those without BP pathology
Elizabeth J. Kiel; Kim L. Gratz; Sarah Anne Moore; Robert D. Latzman; Matthew T. Tull
This study aims to analyze psychometric properties and validity of the Compulsive Internet Use Scale (CIUS) and the Internet Addiction Test (IAT) and, second, to determine a threshold for the CIUS which matches the IAT cut-off for detecting problematic Internet use. A total of 292 subjects with problematic or pathological gambling (237 men, 55 women) aged 14-63 years and with private Internet use for at least 1 h per working or weekend day were recruited via different recruitment channels. Results include that both scales were internally consistent (Cronbach's ?=0.9) and had satisfactory convergent validity (r=0.75; 95% CI 0.70-0.80). The correlation with duration of private Internet use per week was significantly higher for the CIUS (r=0.54) compared to the IAT (r=0.40). Among all participants, 25.3% were classified as problematic Internet users based on the IAT with a cut-off?40. The highest proportion of congruent classified cases results from a CIUS cut-off ?18 (sensitivity 79.7%, specificity 79.4%). However, a higher cut-off (?21) seems to be more appropriate for prevalence estimation of problematic Internet use. PMID:24080838
Guertler, Diana; Rumpf, Hans-Juergen; Bischof, Anja; Kastirke, Nadin; Petersen, Kay Uwe; John, Ulrich; Meyer, Christian
The present study examines 817 adolescent High School students' gambling behavior. Participants completed the DSM-IV-J, a gambling screen examining severity of gambling problems along with the High School Personality Questionnaire (HSPQ), the Reynolds Adolescent Depression Scale (RADS) and a questionnaire devised by the authors inquiring about gambling behavior, substance abuse, alcohol consumption, and cigarette smoking. The study seeks to test the Jacobs' (1986) General Theory of Addictions, using problem and pathological adolescent gamblers as the prototype to test the model. The results obtained through path analysis and logistic regression suggest that Jacobs' theory is a plausible and likely explanation for the development of a gambling addiction amongst adolescents. The clinical implications are addressed. PMID:12766433
Gupta, Rina; Derevensky, Jeffrey L.
Objective It has been theorized that there may be subtypes of pathological gambling, particularly in relation to the main type of gambling activities undertaken. Whether or not putative pathological gambling subtypes differ in terms of their clinical and cognitive profiles has received little attention. Method Subjects meeting DSM-IV criteria for pathological gambling were grouped into two categories of preferred forms of gambling – strategic (e.g., cards, dice, sports betting, stock market) and non-strategic (e.g., slots, video poker, pull tabs). Groups were compared on clinical characteristics (gambling severity, and time and money spent gambling), psychiatric comorbidity, and neurocognitive tests assessing motor impulsivity and cognitive flexibility. Results Seventy-seven subjects were included in this sample (45.5% females; mean age: 42.7±14.9) which consisted of the following groups: strategic (n=22; 28.6%) and non-strategic (n=55; 71.4%). Non-strategic gamblers were significantly more likely to be older, female, and divorced. Money spent gambling did not differ significantly between groups although one measure of gambling severity reflected more severe problems for strategic gamblers. Strategic and non-strategic gamblers did not differ in terms of cognitive function; both groups showed impairments in cognitive flexibility and inhibitory control relative to matched healthy volunteers. Conclusion These preliminary results suggest that preferred form of gambling may be associated with specific clinical characteristics but are not associated dissociable in terms of cognitive inflexibility and motor impulsivity.
Grant, Jon E.; Odlaug, Brian L.; Chamberlain, Samuel R.; Schreiber, Liana R.N.
Some clinical reports suggest that adult children of alcoholics display personality pathology etiologically related in part to developmental object relational deficits. In this study, adult children of alcoholics (ACA) showed more personality pathology than controls and relatively lower levels of object relational development on a multivariate Rorschach measure. Findings from this exploratory correlational study are consistent with the clinically inferred
Gambling is characterized by cognitive distortions in the processing of chance and skill that are exacerbated in pathological gambling. Opioid and dopamine dysregulation is implicated in pathological gambling, but it is unclear whether these neurotransmitters modulate gambling distortions. The objective of the current study was to assess the effects of the opioid receptor antagonist naltrexone and the dopamine D2 receptor antagonist haloperidol on gambling behavior. Male recreational gamblers (n = 62) were assigned to receive single oral doses of naltrexone 50 mg, haloperidol 2 mg or placebo, in a parallel-groups design. At 2.5 h post-dosing, participants completed a slot machine task to elicit monetary wins, “near-misses,” and a manipulation of personal choice, and a roulette game to elicit two biases in sequential processing, the gambler's fallacy and the hot hand belief. Psychophysiological responses (electrodermal activity and heart rate) were taken during the slot machine task, and plasma prolactin increase was assessed. The tasks successfully induced the gambling effects of interest. Some of these effects differed across treatment groups, although the direction of effect was not in line with our predictions. Differences were driven by the naltrexone group, which displayed a greater physiological response to wins, and marginally higher confidence ratings on winning streaks. Prolactin levels increased in the naltrexone group, but did not differ between haloperidol and placebo, implying that naltrexone but not haloperidol may have been functionally active at these doses. Our results support opioid modulation of cognition during gambling-like tasks, but did not support the more specific hypothesis that naltrexone may act to ameliorate cognitive distortions.
Porchet, Roseline I.; Boekhoudt, Linde; Studer, Bettina; Gandamaneni, Praveen K.; Rani, Nisha; Binnamangala, Somashekar; Muller, Ulrich; Clark, Luke
Researchers have proposed replacing the current system for diagnosing personality disorders with a dimensional trait model. Proposed trait models have been derived primarily from data provided by untrained lay informants (often via self-report questionnaires) using item sets derived from lay conceptions of personality. An alternative is to derive personality trait dimensions from data provided by clinically expert informants using an instrument that includes personality features salient to clinicians who treat personality dysfunction. The authors report the factor structure of the latest edition of the Shedler-Westen Assessment Procedure (SWAP-II) using a normative clinical sample of 1,201 North American patients assessed by experienced psychologists and psychiatrists. Factor analysis identified 14 clinically and empirically coherent factors. The findings highlight dimensions of personality and personality pathology that have not emerged in personality item sets designed for lay personality description. PMID:22984863
Westen, Drew; Waller, Niels G; Shedler, Jonathan; Blagov, Pavel S
Personality disorders were examined in 157 incarcerated women, using the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1996) to assess 10 Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R; American Psychiatric Association, 1987) diagnostic categories and dimensions and 15 domains of trait/temperament relevant to disordered personality. Similar to both community samples and incarcerated men, older women had lower rates of personality disorders than younger women, and the difference was mostly accounted for by differences in the Cluster B disorders. In an exploratory analysis of trait and temperament scales, the older women also scored lower in Aggression, Disinhibition, Entitlement, Exhibitionism, Impulsivity, and Manipulativeness while younger women scored lower in Workaholism and Propriety. These findings suggest that remission of antisocial behavior in women may be associated with changes in lower order personality traits or temperament. PMID:11920697
Hurt, Susan; Oltmanns, Thomas F
In this study, we examined how patients diagnosed with borderline pathology (BP) would respond on the Personality Assessment Inventory (Morey, 1991) Borderline (BOR) scales in relation to patients without BP pathology. In addition, we examined whether the PAI BOR scales would be related to variables on the Social Cognition and Object Relations Scale (SCORS; Hilsenroth, Stein, & Pinsker, 2004; Westen,
Michelle B. Stein; Janet H. Pinsker-aspen; Mark J. Hilsenroth
Psychiatrists independently evaluated 82 aviators referred to an aeromedical consultation service who had been administered the Millon Clinical Multiaxial Inventory (MCMI). The MCMI personality scales of those aviators psychiatrically deemed to be free from personality pathology were compared to the scales of those aviators psychiatrically assessed to have maladaptive personalities. The MCMI personality scales reached statistical significance (p < 0.005) for identifying Diagnostic and Statistical Manual of Mental Disorders (2) Cluster C (dependent or avoidant or both) maladaptive personality traits, but did not reach statistical significance for Cluster B (histrionic or narcissistic or both) traits. Military aviators are a highly selected group who have mastered numerous obstacles and who continually prove their adaptability. The prevalence of personality pathology is likely not as great in this population as would be suggested by the MCMI. An elevation of a Cluster C scale, however, warrants a high index of suspicion. PMID:8185552
King, R E
Dopaminergic agents are commonly used and effective treatments for restless legs syndrome (RLS), a disabling sensorimotor disorder. Less known are some of the potentially disabling side effects of these treatments, particularly iatrogenic gambling addiction, as is described here. Here the authors present a 62-year-old man, with a 20–year history of RLS, who developed gambling addiction while on dopaminergic treatment. He was not forewarned of this side effect, nor was he ever screened for gambling behaviours prior to or during treatment. Eight months after discontinuation of dopaminergic treatment and after 10 sessions of cognitive–behavioural therapy for gambling addiction, his gambling behaviours have partially resolved. To our knowledge, this is the first ever first person account of this condition. To prevent the devastating consequences of gambling addiction or to minimise its impact by early intervention, the authors call for clinicians involved in treatment of RLS to follow these simple measures: screen patients for gambling behaviours prior to the onset and during dopaminergic treatment; forewarn patients of this potential side effect; and if patients screen positive, refer them to specialist gambling treatment services, in addition to making necessary changes to their medication regime.
Jones, Henrietta Bowden; George, Sanju
Dopaminergic agents are commonly used and effective treatments for restless legs syndrome (RLS), a disabling sensorimotor disorder. Less known are some of the potentially disabling side effects of these treatments, particularly iatrogenic gambling addiction, as is described here. Here the authors present a 62-year-old man, with a 20-year history of RLS, who developed gambling addiction while on dopaminergic treatment. He was not forewarned of this side effect, nor was he ever screened for gambling behaviours prior to or during treatment. Eight months after discontinuation of dopaminergic treatment and after 10 sessions of cognitive-behavioural therapy for gambling addiction, his gambling behaviours have partially resolved. To our knowledge, this is the first ever first person account of this condition. To prevent the devastating consequences of gambling addiction or to minimise its impact by early intervention, the authors call for clinicians involved in treatment of RLS to follow these simple measures: screen patients for gambling behaviours prior to the onset and during dopaminergic treatment; forewarn patients of this potential side effect; and if patients screen positive, refer them to specialist gambling treatment services, in addition to making necessary changes to their medication regime. PMID:22678941
Jones, Henrietta Bowden; George, Sanju
There are insufficient data investigating the relative associations between different kinds of childhood maltreatment and the severity of adult personality pathology. Personality pathology and childhood maltreatment (sexual, physical, and emotional abuse and neglect) were assessed in 156 nonpsychotic psychiatric patients. Measures included the Personality Diagnostic Questionnaire for DSM-IV (PDQ-4+), the Childhood Trauma Questionnaire (CTQ), the Multidimensional Neglectful Behavior Scale (MNBS), and the Conflict Tactics Scales Parent-Child version (CTSPC-CA). Bivariate logistic regression analyses revealed each maltreatment type to significantly correlate with adult personality pathology. However, in multivariate logistic analyses controlling for education, neglect and emotional abuse were the only significant predictors of adult personality pathology (adjusted odds ratio [AOR] for MNBS neglect, 3.60; AOR for CTQ emotional abuse, 3.81). Analysis of the CTSPC-CA yielded a strong effect on maternal (AOR, 3.71) but not paternal neglect. These data suggest that clinicians should routinely evaluate for histories of neglect and emotional abuse, particularly in patients with marked personality pathology. PMID:23417013
Cohen, Lisa J; Foster, Michelle; Nesci, Cristina; Tanis, Thachell; Halmi, Winter; Galynker, Igor
Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitraitmultimethod models, the authors examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD. PMID:23586934
Scott, Lori N; Kim, Yookyung; Nolf, Kimberly A; Hallquist, Michael N; Wright, Aidan G C; Stepp, Stephanie D; Morse, Jennifer Q; Pilkonis, Paul A
The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self-functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality) and personality traits, first independently, then jointly. The disability/functioning measures yielded the 3 dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the 5-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were cofactored, a hierarchical structure again emerged which, at the 5-factor level, included (a) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction); (b) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness); (c) disinhibition; (d) poor basic functioning; and (e) rigid goal engagement. Results are discussed in terms of developing an integrated PD diagnostic model. PMID:24588062
Clark, Lee Anna; Ro, Eunyoe
The Authors report their experience on the management of gastrointestinal stromal tumors (GISTs). In addition to recent cases immediately diagnosed as GISTs, a pathological review of stored material from non-epithelial tumors of the gastrointestinal tract operated on over the past 20 years was performed. Twenty-three out of a total of 31 cases were shown to be positive for the immunophenotypic characteristics (CD117/CD34) of GISTs. Most cases (approximately 60%) were symptomatic, with hemorrhage being the most common presenting sign, followed by occlusion, pain and perforation. Asymptomatic cases were detected incidentally during procedures for other conditions. Diagnostic techniques (ultrasound, endoscopy, endoscopic ultrasound, X-ray, CT, MRI) allowed only the detection of wall (extraluminal) involvement. Apart from differentiating between benign and malignant, preoperative biopsy was seldom valuable. All cases were treated surgically, with intervention tailored to location and anatomical/surgical and anatomical/pathological features. Long-term follow-up was conducted in all patients and for most is still ongoing: five patients died from recurrent disease at varying intervals after surgery (from 17 to 102 months). Relationships between observed aggressiveness and risk were studied. Parameters that may prove useful for the early detection and appropriate management of these lesions are discussed. PMID:16241088
Mattioli, Francescopaolo; Puglisi, Maria; Ceppa, Paola; Peresi, Monica; Borgonovo, Giacomo; Ansaldo, Gianluca; Varaldo, Emanuela; Milone, Luca; Assalino, Michela; Torre, Gian Carlo
A substantial portion of gamblers in treatment may have co-occurring mental health disorders including substance use disorders, especially alcohol dependency, personality disorders, affective disorders, anxiety disorders and impulse control disorders. Co-occurring mental health disorders affect treatment seeking, the treatment process and its outcome, quality of life and functioning in many mental health disorders. Participants in this study were 78 adults
James R. Westphal; Lera Joyce Johnson
Two studies sought to determine whether perceived control has different effects on confidence assessment and betting decisions\\u000a among pathological and problem gamblers than among non-problem gamblers. In Study 1, 200 college students who were frequent\\u000a gamblers (80 female and 120 male, median age 20) completed the South Oaks Gambling Screen (SOGS) and then engaged in a task\\u000a in which they
Adam S. Goodie
Objective: To examine the joint hierarchical structure of two measures of adolescent personality pathology within a community sample of Canadian adolescents. Method: Self-reported data on demographic information and pathological personality traits were obtained from 144 youth (Mage = 16.08 years, SD = 1.30). Personality pathology was measured using the youth-version of the Schedule for Nonadaptive and Adaptive Personality (SNAP-Y; Linde, Stringer, Simms, & Clark, in press) and the Dimensional Personality Symptom Item Pool (DIPSI; De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006). Lower-order scales were subjected to structural hierarchical analyses. Results: Scales from the two measures were complementary in defining higher-order traits. Traits at the 4-factor level of the hierarchy (Need for Approval, Disagreeableness, Detachment, and Compulsivity) showed similarities and differences with previous results in adults. Conclusions: The current investigation integrated top-down and bottom-up measures for a comprehensive account of the higher-order hierarchy of adolescent personality pathology. Results are discussed in the context of convergence across approaches and in comparison with previous findings in adult samples.
Kushner, Shauna C.; Tackett, Jennifer L.; De Clercq, Barbara
Personality disorders (PDs) are associated with a host of interpersonal problems, including unstable and dysfunctional romantic relationships. In previous research, PD symptoms have been linked to one's own and spouse's self-reported level of marital satisfaction and marital conflict. The current study extends on this work by examining whether Diagnostic and Statistical Manual of Mental Disorders (DSM) PD criteria would predict aspects of daily marital functioning. A total of 99 newlywed couples (N = 198) recruited from the community were assessed for PD symptoms using a self-report measure and subsequently completed a 6-day diary protocol. Multilevel modeling was used to examine the association of PD symptoms with three major aspects of daily functioning: overall relationship sentiment, serious conflicts with one's spouse, and quality of interactions. Results indicated that PD symptoms significantly predicted aspects of all three measures of daily functioning. The individual PDs generally showed the greatest associations with aspects of conflict. Paranoid, schizoid, avoidant, and obsessive-compulsive PD scores were significantly negatively related to overall relationship sentiment whereas Cluster A and Cluster C PD scores negatively predicted various daily interaction behaviors. Findings provide insight into the mechanisms that might explain the associations between PD symptoms and overall measures of relationship functioning. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24364502
South, Susan C
The traditional task of the pathologist is to assist physicians in making the correct diagnosis of diseases at the earliest possible stage to effectuate the optimal treatment strategy for each individual patient. In this respect surgical pathology (the traditional tissue diagnosis) is but a tool. It is not, of itself, the purpose of pathology practice; and change is in the air. This January 2014 issue of Applied Immunohistochemistry and Molecular Morphology (AIMM) embraces that change by the incorporation of the agenda and content of the journal Diagnostic Molecular Morphology (DMP). Over a decade ago AIMM introduced and promoted the concept of "molecular morphology," and has sought to publish molecular studies that correlate with the morphologic features that continue to define cancer and many diseases. That intent is now reinforced and extended by the merger with DMP, as a logical and timely response to the growing impact of a wide range of genetic and molecular technologies that are beginning to reshape the way in which pathology is practiced. The use of molecular and genomic techniques already demonstrates clear value in the diagnosis of disease, with treatment tailored specifically to individual patients. Personalized medicine is the future, and personalized medicine demands personalized pathology. The need for integration of the flood of new molecular data, with surgical pathology, digital pathology, and the full range of pathology data in the electronic medical record has never been greater. This review describes the possible impact of these pressures upon the discipline of pathology, and examines possible outcomes. There is a sense of excitement and adventure. Active adaption and innovation are required. The new AIMM, incorporating DMP, seeks to position itself for a central role in this process. PMID:24326463
Gu, Jiang; Taylor, Clive R
Dissatisfaction with the DSM-IV model of personality disorders has led to the development of alternative conceptualizations, including pathological trait models and models linked to particular theoretical approaches, such as Beck and Freeman’s (1990) cognitive framework. An important issue involves the potential to interweave such models into a single, parsimonious system that combines their distinct advantages. In this study, pathological trait and dysfunctional belief data from 616 individuals in a non-clinical sample were evaluated for commensurability using structural equation modeling. These models can be integrated via five higher-order factors, and that specific dimensions of dysfunctional beliefs can be differentiated based on features of the DSM-5 trait model. Overall, these results suggest that traits provide scaffolding for individual differences in pathological personality, within which dysfunctional beliefs offer specific vectors for clinical intervention in a cognitive framework. Implications of the empirical commensurability of trait and cognitive models are discussed.
Hopwood, Christopher J.; Schade, Nick; Krueger, Robert F.; Wright, Aidan G.C.; Markon, Kristian E.
The Schedule for Nonadaptive and Adaptive Personality-Youth Version (SNAP-Y) is a new, reliable self-report questionnaire that assesses 15 personality traits relevant to both normal-range personality and the alternative DSM-5 model for personality disorder. Community adolescents, 12 to 18 years old (N = 364), completed the SNAP-Y; 347 also completed the Big Five Inventory-Adolescent, 144 provided 2-week retest data, and 128 others completed the Minnesota Multiphasic Personality Inventory-Adolescent. Outpatient adolescents (N = 103) completed the SNAP-Y, and 97 also completed the Minnesota Multiphasic Personality Inventory-Adolescent. The SNAP-Y demonstrated strong psychometric properties, and structural, convergent, discriminant, and external validities. Consistent with the continuity of personality, results paralleled those in adult and college samples using the adult Schedule for Nonadaptive and Adaptive Personality-Second Edition (SNAP-2), from which the SNAP-Y derives and which has established validity in personality-trait assessment across the normal-abnormal continuum. The SNAP-Y thus provides a new, clinically useful instrument to assess personality traits and personality pathology in adolescents. PMID:23794180
Linde, Jennifer A; Stringer, Deborah; Simms, Leonard J; Clark, Lee Anna
Little is known about the effectiveness of treatment programmes for personality disordered adolescents. This study investigates the treatment outcome of Inpatient Psychotherapy for Adolescents (IPA), i.e. an intensive programme for treatment refractory adolescents with personality pathology. In addition, this study examines predictors of treatment outcome. One hundred and nine adolescents admitted for treatment of their personality problems were followed up during their stay in IPA. Axis I and Axis II disorders were measured using semi-structured interviews, and the adolescents completed several questionnaires to measure symptom severity (global indices of distress), personality styles and functioning, and quality of life at both start and 12 months after start of treatment. Patients showed improvement in level of symptom severity, personality functioning and quality of life (d ranging from 0.49 to 0.97). As for level of symptom severity, 29% of the adolescents moved into a normative range of symptom severity. Higher levels of self-criticism significantly predicted poorer outcome in terms of symptom severity. Type of personality disorder did not predict treatment outcome. IPA is a potentially effective treatment programme for (a subgroup of) treatment refractory adolescents with personality pathology. PMID:24700734
Feenstra, Dine J; Laurenssen, Elisabeth M P; Hutsebaut, Joost; Verheul, Roel; Busschbach, Jan J V
A Swedish mutual support group for young problem gamblers is described and discussed. During the study period, 116 weekly meetings occurred, usually involving six to ten participants; in total, 69 problem gamblers (66 male and three female), aged 17-25, and 23 partners and friends attended the meetings. Half the gamblers had problems with Internet…
While all patients become more concrete in their psychological functioning in areas of conflict, especially in the setting of transference regression, in the treatment of patients with severe personality pathology this process poses a particular clinical challenge. In the psychoanalytic psychotherapy of patients with severe personality pathology in general, and borderline personality disorder in particular, the interpretive process serves multiple functions. This process comprises a series of steps or phases that can be viewed as moving the patient further away from a single, poorly elaborated, and concrete experience in the transference, which dominates and floods subjectivity, and toward more fully elaborated, complex, stable, and integrated representations of the analyst and of what he or she evokes in the patient's internal world. PMID:19516053
Caligor, Eve; Diamond, Diana; Yeomans, Frank E; Kernberg, Otto F
Differences in pathological personality traits and disturbances in brain metabolites between non consumers, abstinent and non abstinent consumers were assessed. Participants (n=113) aged between 18-45 years with personality disorder (PD) were diagnosed with clinical interview and scales for depression, anxiety, impulsivity and dimensions of personality pathology. Brain metabolites were analyzed with magnetic resonance spectroscopy. Data were analyzed with ANOVA and multiple comparisons. Abstinent and non-abstinent differentiated from non-consumers in emotional deregulation, inhibition, and restricted expression; abstinent and non-abstinent differentiated from each other in self-aggression, dissocial behaviour, conduct disorder, stimulus seeking and intimacy problems. N-Acetyl Aspartate and creatine values were lower between non-abstinent in prefrontal, anterior cingulate cortex, cerebellar vermis and superior corona radiata. For abstinent, choline levels were greater in cerebellar vermis and n-acetyl aspartate were lower in dorso-lateral prefrontal and anterior cingulated cortex and insula. Regarding personality traits, insecure attachment, narcissism, lability, self-aggression and anxiety characterize consumers and abstinent, while suspiciousness, rejection and character hardness are found in consumers (non-abstinent and abstinent). Compulsive traits, unplanned body impulsiveness and lack of control in emotional regulation predominated in non-abstinent and participants with co-morbidities. Detachment and inhibition predominate in alcohol abuse disorder and narcissistic traits in substance abuse. PMID:23880833
Serrani Azcurra, Daniel
Prevalence rates of gambling are influenced by gender. Among normative populations, hypothalamic-pituitary-adrenal (HPA) axis response to stress is affected by gender. However, pathological, compared to recreational, gamblers demonstrate perturbations in HPA activation in response to gambling stimuli. We examined whether there were gender differences in HPA response to gambling in a naturalistic setting among horse-race bettors and scratch-off lottery bettors. Salivary cortisol was collected from horse-race gamblers (n=32) and scratch-off lottery ticket players (n=39) before and after (0, 10, or 20 minutes) betting on a horse race at an off-track betting establishment. Salivary cortisol levels were significantly higher among men than among women, both prior to and following, betting on a horse race. Among women, but not men, there was a decline in salivary cortisol across time in scratch-off bettors, whereas women horse-race bettors maintained consistent low concentrations of salivary cortisol at every time point sampled. Together these data suggest that engaging in gambling may have different effects on stress responses of men, compared to women. Whether these gender differences in HPA activation contribute to gender-related differences in gambling behavior is the subject of ongoing investigation.
Franco, C.; Paris, J. J.; Wulfert, E.; Frye, A. C.
This article describes the use of neural networks (a type of artificial intelligence) and an empirical data sample of, inter\\u000a alia, the amounts of bets laid and the winnings\\/losses made in successive games by a number of cyber-gamblers to longitudinally\\u000a model gamblers’ behavior and decisions as to such bet amounts and the temporal trajectory of winnings\\/losses. The data was\\u000a collected
Victor K. Y. Chan
One focus of concern is 'pathological' gambling the inability to resist the impulse to gamble. Identified as a psychiatric disorder, pathological gambling can have a number of harmful consequences for the compulsive gambler and his or her family. The just...
The paper argues that despite maintaining the image of a twelve-step organization, the central theme of the history of Gamblers Anonymous (GA) in the United States is the increasing secularization of the program of the recovery. The paper documents the increasing secularization and pragmatism of Gamblers Anonymous, as reflected in key documents, despite the spiritual vision of its founding member. The author speculates on why Gamblers Anonymous took a secularized development path. Further research is called for. PMID:24234922
Browne, B R
While considerable data support the relationship between childhood trauma and adult personality pathology in general, there is little research investigating the specific relationships between different types of childhood maltreatment and adult personality disorders. The present study tested a model incorporating five a priori hypotheses regarding the association between distinct forms of childhood maltreatment and personality pathology in 231 psychiatric patients using multiple self-report measures (Personality Diagnostic Questionnaire-4th Edition, Child Trauma Questionnaire, Conflict in Tactics Scale Parent-Child Child-Adult, and Multidimensional Neglectful Behavior Scale). Step-wise linear regressions supported three out of five hypotheses, suggesting independent relationships between: physical abuse and antisocial personality disorder traits; emotional abuse and Cluster C personality disorder traits; and maternal neglect and Cluster A personality disorder traits after controlling for co-occurring maltreatment types and personality disorder traits. Results did not support an independent relationship between sexual abuse and borderline personality traits nor between emotional abuse and narcissistic personality disorder traits. Additionally, there were three unexpected findings: physical abuse was independently and positively associated with narcissistic and paranoid traits and negatively associated with Cluster C traits. These findings can help refine our understanding of adult personality pathology and support the future development of clinical tools for survivors of childhood maltreatment. PMID:24268580
Cohen, Lisa Janet; Tanis, Thachell; Bhattacharjee, Reetuparna; Nesci, Christina; Halmi, Winter; Galynker, Igor
This review documents two themes of emphasis found in phenotypic descriptions of pathological narcissism across clinical theory, social/personality psychology, and psychiatric diagnosis. Clinical theories of narcissism spanning 35 years consistently describe variations in the expression of pathological narcissism that emphasize either grandiosity or vulnerable affects and self-states. Recent research in social/personality psychology examining the structure of narcissistic personality traits consistently finds two broad factors representing Grandiosity-Exhibitionism and Vulnerability-Sensitivity-Depletion respectively. However, the majority of psychiatric criteria for narcissistic personality disorder (NPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) emphasize expressions of grandiosity. By placing most of the diagnostic emphasis on overt grandiosity, DSM NPD has been limited by poor discriminant validity, modest levels of temporal stability, and the lowest prevalence rate on Axis II. Despite converging support for two phenotypic themes associated with pathological narcissism, psychiatric diagnosis and social/personality psychology research often focus only on grandiosity in the assessment of narcissism. In contrast, clinical theory struggles with a proliferation of labels describing these broad phenotypic variations. We conclude that the construct of pathological narcissism is at a crossroads and provide recommendations for diagnostic assessment, clinical conceptualization, and future research that could lead to a more integrated understanding of narcissistic personality and narcissistic personality pathology. PMID:18029072
Cain, Nicole M; Pincus, Aaron L; Ansell, Emily B
Self-report college student surveys on childhood maltreatment, and borderline and narcissistic personality features are examined to determine their influence on stalking victimization vulnerability. Stalking victimization was measured using Spitzberg and Cupach's (2008) Obsessive Relational Intrusion scale. Ordinary least squares (OLS) regression models were run separately for men (N = 677) and women (N = 1,017). Results indicated childhood sexual maltreatment and borderline traits were associated with stalking victimization among both men and women. These were the only significant relationships for men (R2 = .10). For women, stalking victimization was also associated with narcissistic grandiosity and vulnerability and with a child sexual abuse by borderline features interaction (R2 = .13), demonstrating women reporting prior sexual abuse and borderline personality pathology are especially vulnerable. Methodological and policy implications are discussed. PMID:24834749
Ménard, Kim S; Pincus, Aaron L
There is a movement towards a dimensional classification of personality disorders (PD). However, data linking dimensional systems and the categorical system for classifying PD are lacking. In the present study, N = 165 normal subjects and N = 222 nonpsychotic in-patients (including N = 81 patients with a PD diagnosis) completed the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) measuring 18 PD traits. DSM-IV PD symptoms were assessed by SCID-II interviews. Group differences were analyzed by ANCOVA, and the relation between the dimensional and categorical approach was investigated by regression, ROC, and MDS analyses. Patients with PD exhibited elevated scores on all DAPP traits compared with controls. Patients without PD scored in between. Each DSM-IV PD could be described by a distinct profile of DAPP traits. Results support the assumption that the DAPP trait system can represent mean differences between clinically defined subgroups. The categorical system can be mapped onto the dimensional DAPP system with sufficient clinical specificity. PMID:20001176
Pukrop, Ralf; Steinbring, Iris; Gentil, Iris; Schulte, Caspar; Larstone, Roseann; Livesley, John W
Borderline personality disorder (BPD) is associated with many negative physical health outcomes, including increased risk for serious chronic diseases such as diabetes, heart disease, and arthritis. BPD is also linked with obesity, a condition that is strongly related to many of the same physical health problems. Although research has shown that BPD is related to these physical conditions, there is limited evidence of whether body mass mediates the relation between BPD and serious physical health problems. The present study examined the associations among BPD features, body mass index (BMI), and six major physical health problems in an epidemiologically-based sample (N=1051) of Saint Louis residents, ages 55–64. Using interviewer-, self-, and informant-report of personality pathology, we found that BPD features were significantly related to reported presence of heart disease, arthritis, and obesity. BMI was also significantly related to heart disease and arthritis. Sobel mediation models showed that BMI fully mediated the relation between BPD features and arthritis. These results suggest that borderline pathology is an important risk factor for serious health problems in later adulthood. Obesity appears to be one pathway that leads to more health problems among individuals with BPD symptoms and may be a useful starting point when thinking about future intervention strategies.
Powers, Abigail D.; Oltmanns, Thomas F.
The aim of the present study was to analyze comorbid Axis I-disorders in a sample of individuals with at-risk, problem, and pathological gambling. A number of 164 adult gamblers derived from a random sample of 15,023 individuals were compared with a general population sample. The lifetime prevalence of any psychiatric disorder was 93.6% among pathological (five-10 criteria), 83.5% among problem (three or four criteria), and 81.0% among at-risk gamblers (one or two criteria). Substance use disorders were the most common comorbid disorders in gamblers. Logistic regression analyses revealed elevated odds ratios for having a comorbid disorder in at-risk (Conditional Odds Ratio (COR) 3.5, Confidence Interval (CI) 2.6-4.6), problem (COR 4.9, CI 3.3-7.3), and pathological gamblers (COR 4.6, CI 3.0-6.9) compared to the general population. No significant differences were found between at-risk and problem gamblers or problem and pathological gamblers. Compared to at-risk gamblers, pathological gamblers showed elevated rates of comorbid substance use disorders. The data suggest a linear association between gambling disorder severity and comorbid Axis I-disorders. In conclusion, comorbid disorders are very prevalent in individuals with gambling problems. Even at-risk gamblers with one or two DSM-IV criteria show high rates of Axis I-disorders. Therefore, this group should be included in further studies on problematic gambling. PMID:23962739
Bischof, Anja; Meyer, Christian; Bischof, Gallus; Kastirke, Nadin; John, Ulrich; Rumpf, Hans-Juergen
The present study examined the association between personality pathology (PP) and alcohol dependence (AD; both lifetime and in the past 12 months) among middle-aged to older adults incorporating three sources of assessment, specifically, diagnostic interviews as well as self- and informant reports. We collected data from a representative sample of community participants (N = 1,630; ages 54 – 65 years) and their informants (N = 1,462). Measures employed were the substance use disorder sections of the Mini-International Neuropsychiatric Interview Schedule for Mental Disorders, the Structured Interview for DSM-IV Personality (American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev.; DSM–IV–TR SIDP) and the NEO-Personality Inventory–Revised (Costa, P. T., & McCrae, R. R., Revised NEO-Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual, 1992, Odessa, FL, Psychological Assessment Resources; self-report and informant versions). To complement the diagnostic interview for personality disorders (PDs), we utilized a PD-count technique derived from the five-factor model (FFM), which provided an index of PP liability. Factors representing lifetime and past-12 month AD were regressed on each of the 10 PP factors constructed from the SIDP interview, as well as self-report and informant FFM-count scores. Lifetime diagnosis of AD was positively associated with higher scores on several PP measures, including paranoid, schizotypal, antisocial, borderline, histrionic, and narcissistic PP. There was an inverse relation between lifetime AD and the factor score for obsessive– compulsive PP. With regard to AD in the past 12 months, antisocial, borderline, histrionic, and narcissistic PP factors were significantly associated with increased risk for AD, whereas the obsessive– compulsive and schizoid PP factors were associated with decreased risk for AD. The present data indicate that features of antisocial and borderline PP continue to exhibit a relatively strong association with risk for AD in later middle age.
Agrawal, Arpana; Narayanan, Gitanjali; Oltmanns, Thomas F.
Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18-45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and exhibitionism for NASUD) were higher among individuals with current relative to past diagnoses, perhaps indicating concurrent effects of substance abuse on personality. The positive temperament characteristics detachment and entitlement distinguished AUDs and NASUDs, respectively, perhaps clarifying why this higher order trait tends to show limited relations to SUD generally. These findings suggest the importance of systematically integrating pathological and normative traits in reference to substance-related diagnosis. PMID:21782347
Hopwood, Christopher J; Morey, Leslie C; Skodol, Andrew E; Sanislow, Charles A; Grilo, Carlos M; Ansell, Emily B; McGlashan, Thomas H; Markowitz, John C; Pinto, Anthony; Yen, Shirley; Shea, M Tracie; Gunderson, John G; Zanarini, Mary C; Stout, Robert L
This study extended previous theory and research on interpersonal heterogeneity in depression by identifying groups of depressed young adults who differ in their type and degree of interpersonal problems, and by examining patterns of pathological personality traits and alcohol abuse among these groups. We examined the interpersonal problems, personality traits, and alcohol-related problems of 172 college students with at least moderate levels of self-reported depression on the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999). Scores from the Inventory of Interpersonal Problems – Short Circumplex (Soldz, Budman, Demby, & Merry, 1995) were subjected to latent profile analysis, which classified individuals into five distinct groups defined by the types of interpersonal problems they experience (dominant, warm, submissive, cold, and undifferentiated). As hypothesized, groups did not differ in depression severity, but did show predicted patterns of differences on normative and maladaptive personality traits, as well as alcohol-related problems. The presence of clinically meaningful interpersonal heterogeneity in depression may have important implications for designing more individualized treatments and prevention efforts for depression that target diverse associated interpersonal problems.
Dawood, Sindes; Thomas, Katherine M.; Wright, Aidan G.C.; Hopwood, Christopher J.
Aims College students experience high rates of problem and pathological gambling, yet little research has investigated methods for reducing gambling in this population. This study sought to examine the efficacy of brief intervention strategies. Design Randomized trial. Setting College campuses. Participants 117 college student problem and pathological gamblers. Interventions Students were randomly assigned to: an assessment-only control, 10 minutes of Brief Advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy (CBT). The three interventions were designed to reduce gambling. Measurements Gambling was assessed at baseline, week 6, and month 9 using the Addiction Severity Index-Gambling (ASI-G) module, which also assesses days and dollars wagered. Findings Compared to the assessment-only condition, those receiving any intervention had significant decreases in ASI-G scores and days and dollars wagered over time. The MET condition significantly decreased ASI-G scores and dollars wagered over time, and it increased the odds of a clinically significant reduction in gambling at the 9-month follow-up relative to the assessment-only condition, even after controlling for baseline indices that could impact outcomes. The Brief Advice and MET+CBT conditions had benefits on some, but not all, indices of gambling. None of the interventions differed significantly from one another. Conclusions These results suggest the efficacy of brief interventions for reducing gambling problems in college students.
Petry, Nancy M.; Weinstock, Jeremiah; Morasco, Benjamin J.; Ledgerwood, David M.
This paper critically reviews prevalence estimates of problem and pathological gambling in Canada. Populations studied are adults, adolescents and primary school children. The proportions of pathological gamblers found in Canadian studies (ranging from 1.2% to 1.9% for adults) are similar to prevalence rates reported in the United States. Given the apparent link between gambling availability and increases in the prevalence
This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants' clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality. PMID:23710108
Barbot, Baptiste; Hunter, Scott R; Grigorenko, Elena L; Luthar, Suniya S
This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants’ clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality.
Barbot, Baptiste; Hunter, Scott R.; Grigorenko, Elena L.; Luthar, Suniya S.
Kleptomania and pathological gambling (PG) are currently classified in the DSM IV as impulse control disorders. Impulse control disorders are characterized by an overwhelming temptation to perform an act that is harmful to the person or others. The patient usually feels a sense of tension before committing the act and then experiences pleasure or relief while in the process of performing the act. Kleptomania and PG are often associated with other comorbid psychiatric diagnoses. Forty-four pathological gamblers and 19 kleptomanics were included in this study. All enrolled patients underwent a complete diagnostic psychiatric evaluation and were examined for symptoms of depression and anxiety using the Hamilton depression rating scale and the Hamilton anxiety rating scale, respectively. In addition, the patients completed self-report questionnaires about their demographic status and addictive behavior. The comorbid lifetime diagnoses found at a high prevalence among our kleptomanic patients included 47% with affective disorders (9/19) and 37% with anxiety disorders (7/19). The comorbid lifetime diagnoses found at a high prevalence in our sample of pathological gamblers included 27% with affective disorders (12/44), 21% with alcohol abuse (9/44), and 7% with a history of substance abuse (3/44). A larger study is needed to confirm these preliminary results. PMID:15276663
Dannon, Pinhas N; Lowengrub, Katherine; Sasson, Marina; Shalgi, Bosmat; Tuson, Lali; Saphir, Yafa; Kotler, Moshe
Impulsivity is considered a core feature of problem gambling; however, self-reported impulsivity and inhibitory control may reflect disparate constructs. We examined self-reported impulsivity and inhibitory control in 39 treatment-seeking problem gamblers and 41 matched controls using a range of self-report questionnaires and laboratory inhibitory control tasks. We also investigated differences between treatment-seeking problem gamblers who prefer strategic (e.g., sports betting) and nonstrategic (e.g., electronic gaming machines) gambling activities. Treatment-seeking problem gamblers demonstrated elevated self-reported impulsivity, more go errors on the Stop Signal Task, and a lower gap score on the Random Number Generation task than matched controls. However, overall we did not find strong evidence that treatment-seeking problem gamblers are more impulsive on laboratory inhibitory control measures. Furthermore, strategic and nonstrategic problem gamblers did not differ from their respective controls on either self-reported impulsivity questionnaires or laboratory inhibitory control measures. Contrary to expectations, our results suggest that inhibitory dyscontrol may not be a key component for some treatment-seeking problem gamblers. PMID:24479640
Lorains, Felicity K; Stout, Julie C; Bradshaw, John L; Dowling, Nicki A; Enticott, Peter G
The Personality Inventory for DSM-5 (PID-5) assesses traits relevant for diagnosing personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). We examined the PID-5 in relation to the Big-Three and Big-Five personality traits in outpatient and community adult samples. Domain-level analyses revealed that PID-5 Negative Affectivity correlated strongly with Neuroticism, and PID-5 Antagonism and Disinhibition correlated strongly negatively with Agreeableness and Conscientiousness, respectively; Antagonism and Disinhibition also were both linked strongly to Big-Three trait Disinhibition. PID-5 Detachment related strongly to personality, including Extraversion/Positive Temperament, but did not show its expected specificity to this factor. Finally, PID-5 Psychoticism correlated only modestly with Openness. Facet-level analyses indicated that some PID-5 scales demonstrated replicable deviations from their DSM-5 model placements. We discuss implications of these data for the DSM-5 model of personality disorder, and for integrating it with well-established structures of normal personality. PMID:23596272
Watson, David; Stasik, Sara M; Ro, Eunyoe; Clark, Lee Anna
The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…
Guercio, John M.; Johnson, Taylor; Dixon, Mark R.
Objective: Analysis of the patient-therapist relationship (relationship work) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances these interventions are beneficial. This study investigates long-term effects of relationship work in the context of patients' level of personality pathology and therapists' self-reported parental feelings. Method: One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to weekly dynamic psychotherapy, either with or without relationship work, for 1 year. Personality pathology was evaluated before treatment as the sum of fulfilled personality disorder criteria items on the Structured Clinical Interview for DSM-III-R Personality Disorders. Therapist feelings were assessed using the Feeling Word Checklist-58. The outcome variables were the Psychodynamic Functioning Scales and Inventory of Interpersonal Problems, measured at pretreatment, midtreatment, posttreatment, 1 year, and 3 years after treatment termination. Results: A significant interaction of treatment group (relationship work vs. no relationship work) by personality pathology by parental therapist feelings was present, indicating that parental feelings were differentially associated with long-term effects of relationship work, depending on the level of personality pathology. In the context of low parental feelings, relationship work was positive for all patients. However, when parental feelings were stronger, the specific effects of such interventions were even more positive for patients with high levels of personality pathology, but negative for patients with low levels of personality pathology. Conclusion: The interaction of parental therapist feelings and patients' personality pathology was strongly associated with the long-term specific effects of analysis of the patient-therapist relationship. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24660675
Dahl, Hanne-Sofie J; Røssberg, Jan Ivar; Crits-Christoph, Paul; Gabbard, Glen O; Hersoug, Anne Grete; Perry, John Christopher; Ulberg, Randi; Høglend, Per A
Comments on the original article by Widiger (see record 2013-45025-016). As Widiger notes, it is important to compare competing systems for the measurement of personality disorders (PD) using empirical data. The current author comments that classification systems are not right or wrong; they are simply more or less useful. What kind of evidence is needed for these comparisons? Clearly the relevant data will cover a wide range of topics, from basic descriptive information to behavior genetics and treatment outcome data. The current author makes three recommendations regarding studies of this sort. First, evidence regarding the presence of personality pathology should come from all sources, not simply self-report instruments. Second, investigators should study community samples as well as samples composed exclusively of patients who are receiving treatment. The third point is that investigators who compare diagnostic models should consider longitudinal evidence collected across all phases of the life span. PMID:24378174
Oltmanns, Thomas F
The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week one-on-one client–patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed.
Guercio, John M; Johnson, Taylor; Dixon, Mark R
Research investigating the relationship between gambling and sensation seeking has yet to establish conclusively whether pathological\\u000a gamblers (PGs) are more or less sensation seeking than nonpathological gamblers (NPGs). Sensation seeking is usually measured\\u000a with the Zuckerman et al. (J Consult Clin Psychol 46:139–149, 1978) SS Scale form V (SSS-V). Whereas previous studies relied\\u000a on the SSS-V total score, the current
Erica E. Fortune; Adam S. Goodie
This paper reports the findings of a study of explicit and implicit learning and gambling with non-problem (n = 107), sub-clinical problem gamblers (n = 13), and probable pathological gamblers (n = 46). Two probability learning tasks modeled after gambling games and an artificial grammar task were used to explore how people learn patterns. In each of the two probability learning tasks, the outcome of the
Nigel Turner; Keith D. Horton; Barry Fritz
Purpose: To discuss constructs and methods related to assessing the magnitude and the meaning of clinical outcomes, with a focus on applications in speech-language pathology. Method: Professionals in medicine, allied health, psychology, education, and many other fields have long been concerned with issues referred to variously as practical…
Bothe, Anne K.; Richardson, Jessica D.
Due to continuous technical developments and new insights into the high complexity of many diseases, molecular pathology is a rapidly growing field gaining center stage in the clinical management of tumors as well as in the pharmaceutical development of new anti-cancer drugs. The application of novel compounds in clinical trials has revealed promising results; however, the current diagnostic procedures available
Manfred Dietel; Christine Sers
Gamblers Anonymous (GA) has long been described in the scientific literature as more secular in orientation than similar 12-step fellowships such as Alcoholics Anonymous. Through interviews and meeting observations during the course of two studies (beginning in 2003), we found this reputation well earned, with GA putting considerably less emphasis on the “12 steps” themselves. The latter is a spiritual
Peter Ferentzy; Wayne Skinner; Paul Antze
Although sleep has been extensively studied in substance related disorders, sleep has yet to be examined as thoroughly in gambling related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).
Iman Parhami; Aaron Siani; Richard J. Rosenthal; Stephanie Lin; Michael Collard; Timothy W. Fong
The multivariate socio-demographic risk factors for problem gambling have been well documented. While this body of research is valuable in determining risk factors aggregated across various populations, the majority of studies tend not to specifically identify particular subgroups of problem gamblers based on the interaction between variables. The…
Markham, Francis; Young, Martin; Doran, Bruce
The present study examined Internet gambling behavior in a sample of online gamblers. Participants (N = 563; 382 male; ages 18-over 65) were recruited from a banner placed in an online newsletter. Questionnaires were completed online and assessed demographic information, game-play patterns (e.g., frequency, duration, wagering), preferred type of…
McBride, Jessica; Derevensky, Jeffrey
This paper briefly examines 'telehealth', online therapy (and the various types currently available), the relative advantages and disadvantages of online therapy, and the implications for the treatment of problem gamblers. The authors approach this discussion acknowledging that online therapy has to be incorporated within the overall framework of…
Griffiths, Mark; Cooper, Gerry
Melanocytic proliferations are notoriously difficult lesions to evaluate histologically, even among experts, as there is a lack of objective, highly reproducible criteria, which can be broadly applied to the wide range of melanocytic lesions encountered in daily practice. These difficult diagnoses are undeniably further compounded by the substantial medicolegal risks of an "erroneous" diagnosis. Molecular information and classification of melanocytic lesions is already vast and constantly expanding. The application of molecular techniques for the diagnosis of benignity or malignancy is, at times, confusing and limits its utility if not used properly. In addition, current and future therapies will necessitate molecular classification of melanoma into one of several distinct subtypes for appropriate patient-specific therapy. An understanding of what different molecular markers can and cannot predict is of the utmost importance. We discuss both mutational analysis and chromosomal gains/losses to help clarify this continually developing and confusing facet of pathology. PMID:24856851
Bradish, Joshua R; Cheng, Liang
The careers and contributions of some of those who have played a major role in the development of knowledge concerning gynaecological pathology are summarised. The emphasis is on workers of prior times beginning with those of the German-speaking school: Carl Ruge, Felix Marchand, Hermann Pfannenstiel, Oskar Frankl, Walter Schiller, and Robert Meyer. The two great Scandinavian investigators Lars Santesson and Gunnar Teilum are then considered, followed by those of the British school: John H. Teacher, Elizabeth Hurdon, Magnus Haines, Claud Taylor, Fred Langley, and Harold Fox. North American workers reviewed are: Thomas S. Cullen, Emil Novak, John Albertson Sampson, Arthur Hertig, and Robert E. Scully. The essay concludes with Australasian contributors, those considered in detail being: Hans Frederick Bettinger, Rupert A. Willis, Hazel (Mansell) Gore, Robert Barter, Harold Attwood, Andrew Ostör (the last two also noted historians), Denys Fortune, Alan Ng, and Peter Russell. PMID:17365820
Young, Robert H
Recent contributions to the body of knowledge on traumatic brain injury (TBI) favor the view that multimodal neuroimaging using structural and functional magnetic resonance imaging (MRI and fMRI, respectively) as well as diffusion tensor imaging (DTI) has excellent potential to identify novel biomarkers and predictors of TBI outcome. This is particularly the case when such methods are appropriately combined with volumetric/morphometric analysis of brain structures and with the exploration of TBI-related changes in brain network properties at the level of the connectome. In this context, our present review summarizes recent developments on the roles of these two techniques in the search for novel structural neuroimaging biomarkers that have TBI outcome prognostication value. The themes being explored cover notable trends in this area of research, including (1) the role of advanced MRI processing methods in the analysis of structural pathology, (2) the use of brain connectomics and network analysis to identify outcome biomarkers, and (3) the application of multivariate statistics to predict outcome using neuroimaging metrics. The goal of the review is to draw the community's attention to these recent advances on TBI outcome prediction methods and to encourage the development of new methodologies whereby structural neuroimaging can be used to identify biomarkers of TBI outcome.
Irimia, Andrei; Wang, Bo; Aylward, Stephen R.; Prastawa, Marcel W.; Pace, Danielle F.; Gerig, Guido; Hovda, David A.; Kikinis, Ron; Vespa, Paul M.; Van Horn, John D.
In the study of addiction, attentional bias refers to the observation that substance-related cues tend to capture the attention of experienced substance users. Attentional bias is a cognitive intermediate in the conditioned association between drug-related cues, craving, and relapse. Numerous studies have documented the existence of attentional bias for cues associated with substances. By contrast, few studies have investigated attentional bias in individuals with pathological gambling (PG) or problematic gambling. In this study, we sought to assess attentional bias at the level of maintenance of attention in a sample of pathological gamblers. Twenty-three pathological gamblers and 21 healthy volunteers performed the Visual Probe Task to compare attentional bias with gambling-related cues between individuals with PG and healthy volunteers. The measured of attentional bias was based on their reaction times (RTs) to probes replacing neutral and gambling-related cues (images). Second, we examined the correlation between PG severity and degree of attentional bias among individuals with PG. Results show that pathological gamblers, but not healthy volunteers, had attentional bias for gambling-related cues with exposure times that assess maintenance of attention. There was no correlation between PG severity and degree of attentional bias. Theoretical and clinical implications of these results are discussed. PMID:23713570
Vizcaino, Ernesto Jose Verdura; Fernandez-Navarro, Pablo; Blanco, Carlos; Ponce, Guillermo; Navio, Mercedes; Moratti, Stephan; Rubio, Gabriel
The present study examined Internet gambling behavior in a sample of online gamblers. Participants (N?=?563; 382 male; ages 18–over 65) were recruited from a banner placed in an online newsletter. Questionnaires were completed\\u000a online and assessed demographic information, game-play patterns (e.g., frequency, duration, wagering), preferred type of play,\\u000a and problem gambling (using the DSM-IV). In addition, participation in gambling-type games
Jessica McBride; Jeffrey Derevensky
Aims Neurocognitive functions in pathological gambling have relevance for the aetiology and treatment of this disorder, yet are poorly understood. This study therefore investigated neurocognitive impairments of executive functions in a group of carefully screened Diagnostic and Statistical Manual version IV (DSM-IV-TR) pathological gamblers. Performance was compared to a group of normal control participants. To study the specificity of these
Anna E. Goudriaan; Jaap Oosterlaan; Beurs de P; Wim van den Brink
Objective: The present study utilized a prospective, longitudinal design to examine the role of temperament and maltreatment in predicting the emergence of borderline (BPD) and antisocial (ASPD) personality disorder symptoms during adolescence. Method: Two hundred and forty-five children aged between 11 and 13 years were recruited from primary schools in Melbourne, Australia. Participants completed temperament, maltreatment, BPD and ASPD symptom measures, and approximately two years later, 206 participants were again assessed for BPD and ASPD symptoms. Results: The findings indicate that childhood neglect is a significant predictor of an increase in BPD symptoms, while childhood abuse is a significant predictor of an increase in ASPD symptoms. Moreover, abuse and neglect acted as moderators of the relationship between temperament dimensions and increase in BPD and ASPD symptoms, respectively. Abuse was associated with an increase in BPD symptoms for children with low Affiliation, while neglect was associated with an increase in ASPD symptoms for children with low Effortful Control. Conclusions: The current study contributes much needed prospective, longitudinal information on the early development of symptoms of BPD and ASPD, and supports importance of both temperamental and environmental factors in predicting the emergence of these mental health problems early in life.
Jovev, Martina; McKenzie, Trudi; Whittle, Sarah; Simmons, Julian G.; Allen, Nicholas B.; Chanen, Andrew M.
In the present study Brazilian gamblers from different settings were compared on socio-demographic characteristics, gambling behavior, and use of drugs. The SOGS was administered to 171 subjects at bingo (BG), video poker (VP), and horse-racing clubs (HR) of São Paulo. BG concentrated most women, VP the youngest and single gamblers, and HR the lowest income subjects. More VP than HR
Maria Paula M. T. Oliveira; Maria Teresa Araujo Silva
The “gambler's fallacy” is the belief that the probability of an event is decreased when the event has occurred recently, even though the probability is objectively known to be independent across trials. Clotfelter and Cook (1991, 1993) find evidence of the gambler's fallacy in analysis of data from the Maryland lottery's“Pick 3” numbers game. In the Maryland lottery, the payout
Problem gambling can significantly affect the lives of concerned significant others (CSOs) of problem gamblers, especially family members, but little is known about their help-seeking activities and experiences. This paper explores help-seeking by CSOs of problem gamblers and their related motivators and barriers. A telephone interview was…
Hing, Nerilee; Tiyce, Margaret; Holdsworth, Louise; Nuske, Elaine
Slot machine gambling is a popular leisure activity worldwide yet there has been very little research into different types of slot machine gamblers. Earlier typologies of slot machine gamblers have only concentrated on adolescents in arcade environments. This study presents a new typology of slot machine players based on over 1000 h of participant…
Griffiths, Mark D.
This paper is largely based on a year long observation study of Gamblers Anonymous and Alcoholics Anonymous meetings in northern California. The paper argues, contrary to popular assumption, that Gamblers Anonymous is significantly different from Alcoholics Anonymous. Differences, in members' consciousness for example, are discussed. The paper contends that although there is some12 step consciousness in G.A., the dominant consciousness
Basil R. Browne
Pathological gambling has many similarities to pharmacological addiction. Notably, both pathological gambling and drug addiction are characterized by aberrations in hypothalamic-pituitary-adrenal (HPA) axis responding. As well, there are indications that gender differences may play a role in these processes. Whether gender and/or HPA response are associated with pathological gambling was of interest. Recreational and pathological gamblers (15 men and 6 women per group) had the HPA factor, cortisol, assessed in saliva collected before and after watching a video of their preferred mode of gambling (slot machines, horse race betting, scratch-off tickets, blackjack, video poker, craps, sports betting, online casino games, or lottery tickets), and a video of neutral stimuli (a rollercoaster ride). Basal levels of salivary cortisol did not significantly differ among recreational and pathological gamblers. However, recreational gamblers demonstrated significantly increased salivary cortisol levels after the gambling and rollercoaster videos, whereas pathological gamblers demonstrated no salivary cortisol increase in response to either video stimulus. There was also a non-significant trend for women to have a greater cortisol response to video stimuli compared to men. These data suggest that pathological gambling is associated with hypoactive HPA response to gambling stimuli, similar to chronic drug exposure, and gender may contribute to this effect.
Paris, J.J.; Franco, C.; Sodano, R.; Frye, C.A.; Wulfert, E.
People suffering from the hot-hand fallacy unreasonably expect winning streaks to continue whereas those suffering from the gamblers' fallacy unreasonably expect losing streaks to reverse. We took 565,915 sports bets made by 776 online gamblers in 2010 and analyzed all winning and losing streaks up to a maximum length of six. People who won were more likely to win again (apparently because they chose safer odds than before) whereas those who lost were more likely to lose again (apparently because they chose riskier odds than before). However, selection of safer odds after winning and riskier ones after losing indicates that online sports gamblers expected their luck to reverse: they suffered from the gamblers' fallacy. By believing in the gamblers' fallacy, they created their own hot hands. PMID:24549140
Xu, Juemin; Harvey, Nigel
Summary Background Severe problem gambling is most often related to income producing offences such as larceny and embezzlement. In addition, the high rate of relapse to gambling problems and the link between gambling debts and crime have clinical, forensic and penitentiary implications. Considering the data from the literature presented here I decided to form and empirically verify a hypothesis that incarcerated men with a diagnosis of pathological gambling are characterized by psychopathic personality disorders, alcohol problems and criminality. Material/Methods The groups of participants encompassed 90 men 26–52 years of age, serving a criminal sentence. All participants had to fulfil the following clinical criteria: a) be interviewed by a psychiatrist and diagnosed with pathological gambling and/or antisocial personality disorders b) obtain a result in the PCL-R test; c) estimate the relationship between gambling problems and crime. Taking into consideration the abovementioned criteria three patient test groups were formed: Group 1, which included those for whom gambling had led to crime; Group 2, where gambling was a part of a criminal lifestyle, and Group 3, in which the mutual relationship between gambling and crime was unclear. Results The participants were diagnosed as pathological gamblers (DSM-IV-TR, ICD-10) and psychopaths (PCL-R). Those tested differed with regard to the intensification of the personality disturbance tested, the co-occurrence of other disturbances, particularly psychoactive addictions, the motivations for taking up gambling, and the type of criminal activity. Conclusions The hypothesis was confirmed that incarcerated men with a diagnosis of pathological gambling are characterized by psychopathic personality disorders, alcohol problems and criminality.
Pathological gambling is classified in the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) and in the ICD-10 (International Classification of Disease) as an impulse control disorder. The association between impulsivity and pathological gambling remains a matter of debate: some researchers find high levels of impulsivity within pathological gamblers, others report no difference compared to controls, and yet others even suggest that it is lower. In this review we examine the relationship between pathological gambling and impulsivity assessed by various neurocognitive tests. These tests--the Stroop task, the Stop Signal Task, the Matching Familiar Figures Task, the Iowa Gambling Task, the Wisconsin Card Sorting Test, the Tower of London test, and the Continuous Performance Test--demonstrated less impulsivity in gambling behavior. The differences in performance between pathological gamblers and healthy controls on the neurocognitive tasks could be due to addictive behavior features rather than impulsive behavior. PMID:20803888
Dannon, Pinhas N; Shoenfeld, Netta; Rosenberg, Oded; Kertzman, Semion; Kotler, Moshe
OBJECTIVES: To investigate how gamblers interact with, and respond to, downstream social marketing campaigns that focus on the risks and harms of problem gambling and/or encourage help seeking. METHODS: Qualitative study of 100 gamblers with a range of gambling behaviours (from non-problem to problem gambling). We used a Social Constructivist approach. Our constant comparative method of data interpretation focused on how participants' experiences and interactions with gambling influenced their opinions towards, and interactions with social marketing campaigns. RESULTS: Three key themes emerged from the narratives. (i) Participants felt that campaigns were heavily skewed towards encouraging individuals to take personal responsibility for their gambling behaviours or were targeted towards those with severe gambling problems. (ii) Participants described the difficulty for campaigns to achieve 'cut through' because of the overwhelming volume of positive messages about the benefits of gambling that were given by the gambling industry. (iii) Some participants described that dominant discourses about personal responsibility prevented them from seeking help and reinforced perceptions of stigma. CONCLUSIONS AND IMPLICATIONS: Social marketing campaigns have an important role to play in the prevention of gambling risk behaviours and the promotion of help seeking. Social marketers should explore how to more effectively target campaigns to different audience segments, understand the role of environmental factors in undermining the uptake of social marketing strategies and anticipate the potential unforeseen consequences of social marketing strategies. PMID:23134256
Thomas, Samantha L; Lewis, Sophie; Westberg, Kate
Pathological gambling is an emerging psychiatric disorder that has medical, psychiatric, and social consequences. Recently, research has been focusing on identifying which portions of the population are most vulnerable to developing problems related to ongoing gambling. Specific populations of interest have included adolescents, elderly, minorities, those with comorbid psychiatric or substance use disorders, and gender differences. Each group possesses unique biological, psychological, and/or social characteristics that confer a vulnerability to develop pathological gambling behaviors. Being able to recognize those who are at risk to become pathological gamblers is the first step toward developing effective prevention and early intervention programs. This is Part Two of a three-part series on pathological gambling. Part One appeared in the March issue of Psychiatry 2005.
Disinhibition over drug use, enhanced salience of drug use and decreased salience of natural reinforcers are thought to play an important role substance dependence. Whether this is also true for pathological gambling is unclear. To understand the effects of affective stimuli on response inhibition in problem gamblers (PRGs), we designed an affective Go/Nogo to examine the interaction between response inhibition and salience attribution in 16 PRGs and 15 healthy controls (HCs). Four affective blocks were presented with Go trials containing neutral, gamble, positive or negative affective pictures. The No-Go trials in these blocks contained neutral pictures. Outcomes of interest included percentage of impulsive errors and mean reaction times in the different blocks. Brain activity related to No-Go trials was assessed to measure response inhibition in the various affective conditions and brain activity related to Go trials was assessed to measure salience attribution. PRGs made fewer errors during gamble and positive trials than HCs, but were slower during all trials types. Compared to HCs, PRGs activated the dorsolateral prefrontal cortex, anterior cingulate and ventral striatum to a greater extent while viewing gamble pictures. The dorsal lateral and inferior frontal cortex were more activated in PRGs than in HCs while viewing positive and negative pictures. During neutral inhibition, PRGs were slower but similar in accuracy to HCs, and showed more dorsolateral prefrontal and anterior cingulate cortex activity. In contrast, during gamble and positive pictures PRGs performed better than HCs, and showed lower activation of the dorsolateral and anterior cingulate cortex. This study shows that gambling-related stimuli are more salient for PRGs than for HCs. PRGs seem to rely on compensatory brain activity to achieve similar performance during neutral response inhibition. A gambling-related or positive context appears to facilitate response inhibition as indicated by lower brain activity and fewer behavioural errors in PRGs.
van Holst, Ruth J.; van Holstein, Mieke; van den Brink, Wim; Veltman, Dick J.; Goudriaan, Anna E.
A naturalistic sample of pathological gamblers (N = 101) who recently quit gambling was followed prospectively for a year (follow-up rate 80%). Lifetime mood disorders were identified in 61% of participants and 73% and 48% had lifetime alcohol use and drug use disorders, respectively. Current prevalence rates, however, were much lower. Current mood disorders were found for 20% and 7% had a
David C. Hodgins; Nicole Peden; Erin Cassidy
Using actual gambling behavior provides the opportunity to develop behavioral markers that operators can use to predict the development of gambling-related problems among their subscribers. Participants were 4,056 Internet gamblers who subscribed to the Internet betting service provider bwin.party. Half of this sample included multiple platform gamblers who were identified by bwin.party's Responsible Gambling (RG) program; the other half were controls randomly selected from those who had the same first deposit date. Using the daily aggregated Internet betting transactions for gamblers' first 31 calendar days of online betting activities at bwin.party, we employed a 2-step analytic strategy: (a) applying an exploratory chi-squared automatic interaction detection (CHAID) decision tree method to identify characteristics that distinguished a subgroup of high-risk Internet gamblers from the rest of the sample, and (b) conducting a confirmatory analysis of those characteristics among an independent validation sample. This analysis identified two high-risk groups (i.e., groups in which 90% of the members were identified by bwin.party's RG program): Group 1 engaged in three or more gambling activities and evidenced high wager variability on casino-type games; Group 2 engaged in two different gambling activities and evidenced high variability for live action wagers. This analysis advances an ongoing research program to identify potentially problematic Internet gamblers during the earliest stages of their Internet gambling. Gambling providers and public policymakers can use these results to inform early intervention programs that target high-risk Internet gamblers. PMID:24059836
Braverman, Julia; LaPlante, Debi A; Nelson, Sarah E; Shaffer, Howard J
This study explores gender differences in lifetime and recent substance use/internalizing behavior, childhood externalizing behavior and gambling preferences among African-American youth gamblers. Data are from a prospective study of a community sample of 452 urban African-American youth that began at entry into first grade and was followed for ten years. Gambling was associated with high teacher ratings of childhood externalizing behaviors among males, and with high parent ratings of childhood impulsivity and hyperactivity among both genders. Internalizing behavior was associated with female gambling. No male-female differences in substance use/lifetime conduct disorder among gamblers were noted. Gambling preferences/frequency differed across genders.
Martins, Silvia S.; Storr, Carla L.; Ialongo, Nicholas S.; Chilcoat, Howard D.
Temporal or delay discounting refers to the phenomenon that the value of a reward is discounted as a function of time to delivery. A range of models have been proposed that approximate the shape of the discount curve describing the relationship between subjective value and time. Recent evidence suggests that more than one free parameter may be required to accurately model human temporal discounting data. Nonetheless, many temporal discounting studies in psychiatry, psychology and neuroeconomics still apply single-parameter models, despite their oftentimes poor fit to single-subject data. Previous comparisons of temporal discounting models have either not taken model complexity into account, or have overlooked particular models. Here we apply model comparison techniques in a large sample of temporal discounting datasets using several discounting models employed in the past. Among the models examined, an exponential-power model from behavioural economics (CS model, Ebert & Prelec 2007) provided the best fit to human laboratory discounting data. Inter-parameter correlations for the winning model were moderate, whereas they were substantial for other dual-parameter models examined. Analyses of previous group and context effects on temporal discounting with the winning model provided additional theoretical insights. The CS model may be a useful tool in future psychiatry, psychology and neuroscience work on inter-temporal choice.
Peters, Jan; Miedl, Stephan Franz; Buchel, Christian
Legalized gambling in Canada is governed by Provincial legislation. In Ontario, the Ontario Lottery and Gaming Corporation is responsible for all aspects of gambling in the Province. There have been a number of recent lawsuits against this Crown agency of the Government of Ontario by gamblers, most of which have been settled or otherwise resolved. A recent class-action lawsuit on behalf of thousands of Ontario gamblers against this agency raises a number of interesting questions regarding the issue of responsibility and liability. The questions surround the issue of self-exclusionary practices of gamblers who deem themselves in need of external intervention in order interesting questions regarding the issue of responsibility and liability. The questions surround the issue to abstain from further gambling. A contract is voluntarily signed by the self-excluding gamblers whereby their further attendance at gaming venues is prevented and could be punishable by law. Where the gaming venues have failed to enforce the terms of this contract, gamblers have continued to gamble at these establishments. The class-action lawsuit stems from the grievances of these self-excluded gamblers who were not turned away. Relevant psychological theories and recent findings pertaining to gambling are reviewed and questions relevant to these grievances are discussed in favor of government responsibility and liability toward gamblers. PMID:19212809
Faregh, Neda; Leth-Steensen, Craig
The current study was constructed to examine the similarities and differences in the quality of life of patients with kleptomania and pathological gambling (PG). Thirty patients with kleptomania, 43 with PG, and 30 normal control subjects were assessed with the Quality of Life Inventory that assesses self-reported satisfaction with life. Both patients with kleptomania and PG had significantly lower quality of life scores than normal control subjects ( t = 7.32; df = 58; P < .001; t = 7.32; df = 71; P < .001, respectively). These results suggest that patients with kleptomania and pathological gamblers have notably poor quality of life. PMID:15714192
Grant, Jon E; Kim, Suck Won
Purpose of review This article reviews recently identified genomic mutations in prostate cancer. Recent findings Advanced sequencing technologies have made it possible to obtain large amounts of data on genomes and transcriptomes of cancers. Such technologies have been used to sequence prostate cancer of different stages, from treatment-naive cancers, to advanced, castration-resistant cancers to the aggressive small cell neuroendocrine carcinomas. For each category of prostate cancer, distinct and overlapping DNA sequence alterations were discovered, including point mutations, small insertions or deletions, copy number changes and chromosomal rearrangements. There appears to be a stepwise increase in genomic alterations from low risk to high risk to advanced cancers. Summary These novel findings have significantly increased our knowledge of the genetic basis of human prostate cancer and the molecular mechanisms responsible for disease progression and treatment resistance. Some of the lesions are potential therapeutic targets. Studies along this direction will eventually make it possible to design personalized management plans for individual patients.
Huang, Jiaoti; Wang, Jason K.; Sun, Yin
Tackles a tricky problem of probability based on the well-known carnival game Chuck-a-Luck which, at first glance, appears to favor the bettor. Presents an activity in which students correct a common fallacy in probabilistic reasoning and extend play to a gambler's ruin analysis. (Author/ASK)
Previous research suggests that gambling can induce effects that closely resemble a psychostimulant drug effect. Modest doses of addictive drugs can prime motivation for drugs with similar properties. Together, these findings imply that a dose of a psychostimulant drug could prime motivation to gamble in problem gamblers. This study assessed priming effects of oral D-amphetamine (AMPH) (30 mg) in a
Martin Zack; Constantine X Poulos
Background: The goal of this study is to identify betting patterns displayed during the first month of actual Internet gambling on a betting site that can serve as behavioural markers to predict the development of gambling-related problems. Methods: Using longitudinal data, k-means clustering analysis identified a small subgroup of high-risk gamblers. Results: Seventy-three percent of the members of this subgroup eventually closed their account due to gambling-related problems. The characteristics of this high-risk subgroup were as follows: (i) frequent and (ii) intensive betting combined with (iii) high variability across wager amount and (iv) an increasing wager size during the first month of betting. Conclusion: This analysis provides important information that can help to identify potentially problematic gamblers during the early stages of gambling-related problems. Public health workers can use these results to develop early interventions that target high-risk Internet gamblers for prevention efforts. However, one study limitation is that the results distinguish only a small proportion of the total sample; therefore, additional research will be necessary to identify markers that can classify larger segments of high-risk gamblers.
Shaffer, Howard J.
An innovative pilot treatment program was developed for problem gamblers living in rural areas of Australia using cognitive behaviour therapy (CBT) modified from an established specialist therapy service. The standard 12 weekly group program was delivered on site by adapting it to two 1 week blocks with daily group sessions and 1 week of patient…
Oakes, Jane; Gardiner, Paula; McLaughlin, Kristin; Battersby, Malcolm
Exploratory data from both structured and unstructured interviews with members of Alcoholics Anonymous and Gamblers Anonymous, as well as additional data from previous observations, suggest that the recovery rate of A.A. is higher than that of G.A.. Since the programs are virtually the same an examination of the social context of the labeling process reveals that the more readily available
Frederick W. Preston; Ronald W. Smith
Both neuroticism and borderline personality disorder (BPD) are associated with increased frequency of stressful life events in young adults. It is not clear, however, whether this effect extends to later life because BPD is apparently diminished in frequency and severity when people reach middle adulthood. This issue was examined in a representative, community sample of men and women between the ages of 55 and 64 (N = 1,234). Ten DSM-IV PDs and neuroticism were assessed at baseline using a semistructured interview (SIDP-IV) and questionnaire (NEO-PI-R). Life events were measured 6 months later with a self-report questionnaire (LTE-Q) followed by a telephone interview. BPD features and neuroticism predicted increased frequency of life events, based on both self and interviewer-adjusted reports of negative life events. Avoidant and paranoid PD features predicted decreased frequency of negative life events. Approximately 42% of events reported on the LTE-Q were discounted following the telephone interview; higher scores on BPD symptoms were associated with more adjustments to self-report of threatening experiences. These findings indicate that symptoms of BPD and neuroticism continue to have a harmful impact on the lives of older adults. PMID:22022953
Gleason, Marci E J; Powers, Abigail D; Oltmanns, Thomas F
This is the first study from Central America to analyze genetic mutations and histopathological features associated with gastrointestinal stromal tumors (GIST). Mutations found in the tyrosine kinase membrane receptors c-kit and pdgfra are associated with clinical and pathological characteristics of GIST. New drugs that inhibit the expression of these oncogenes at the molecular level substantially improve the quality of life for patients with this tumor. It is therefore essential for patient care in Panama that genetic analysis of GIST tumors continues to develop from the pilot study presented herein into routine clinical use. This study evaluated 39 cases of GIST in Panama, using samples archived at the Instituto Oncológico Nacional from 1994 to 2004. DNA from paraffin?embedded tumor tissues was isolated and amplified for the exons of c-kit and pdgfra associated with a high frequency of mutations. Direct PCR sequencing of specific exons was performed, and those with different alleles were cloned and re-sequenced. Amino acid sequences were inferred from DNA and aligned to Genbank reference sequences to determine the position and type of mutation. The highest frequency of mutations was found in exon 11 of the c-kit gene (70%). Mutations found in this exon were heterogeneous, while only one type of mutation (p.A502_Y503dup) was observed in c-kit exon 9. Mutations in the pdgfra gene constituted several substitutions, with the deletion p.D842V being observed most frequently. The observed GIST-associated mutations were previously described. Four patients with mutations associated with familial GIST were also found. The majority (66%) of patients with mutations in exon 11 (residues 550-591) were considered to be at high risk and 75% of patients with mutations specifically within residues 556-560 (exon 11) were considered to have high-risk GIST. This is the first molecular study of GIST in Central America. It was performed to gain a better understanding of the cancer-associated mutations of KIT and platelet?derived growth factor receptor ? (PDGFRA) receptors. This may aid in the prediction of clinical evolution and guide the use of specific drug treatments in patients with GIST in Panama. PMID:22866155
Mendoza, Yaxelis; Singh, Carlos; Castillo Mewa, Juan; Fonseca, Evelise; Smith, Rebecca; Pascale, Juan M
It is mandatory that programs, particularly social programs, generate evidence of efficacy, safety, and cost-effectiveness of the treatment of illness. Thus a study was conducted to determine the cost-effectiveness of treatment of pathological gamblers at the Johns Hopkins Center for Pathological Gambling. This Center provides two types of treatment programs: an intensive residential program, and an out-patient program. Although abstinence
Robert M. Politzer; James S. Morrow; Sandra B. Leavey
A prospective study of the role of comorbid substance abuse and dependence and mood disorders in the outcome from pathological\\u000a gambling. A naturalistic sample of pathological gamblers who had recently quit gambling (N = 101) was followed and data were available for 83% of participants at 3 months, 80% at 12 months, and 52% at 5 years. Those\\u000a participants with a drug diagnosis during their
David C. Hodgins; Nady el-Guebaly
Given the rates of pathological gambling and its impact on affected individuals and their relatives, effective treatments are needed. There are, however, no approved pharmacological treatments for pathological gambling. This paper describes the development of pharmacological treatments for pathological gambling and is based on a review of the literature published in the past 10 years. Important studies were carried-out on antidepressants, mood stabilizers, and antipsychotic agents. In the absence of comorbid psychiatric disorder, these studies did not conclude to the efficacy of these psychotropic drugs. A possible efficacy of opiate antagonist treatment for pathological gambling has been replicated in a number of placebo-controlled studies. Preliminary results on N-acetyl cysteine, Memantine and Topiramate produced significant improvement for pathological gamblers and may open new avenues for treatment. PMID:21524264
Achab, Sophia; Khazaal, Yasser
The search for neuronal and psychological underpinnings of pathological gambling in humans would benefit from investigating related phenomena also outside of our species. In this paper, we present a survey of studies in three widely different populations of agents, namely rodents, non-human primates, and robots. Each of these populations offers valuable and complementary insights on the topic, as the literature demonstrates. In addition, we highlight the deep and complex connections between relevant results across these different areas of research (i.e., cognitive and computational neuroscience, neuroethology, cognitive primatology, neuropsychiatry, evolutionary robotics), to make the case for a greater degree of methodological integration in future studies on pathological gambling.
Paglieri, Fabio; Addessi, Elsa; De Petrillo, Francesca; Laviola, Giovanni; Mirolli, Marco; Parisi, Domenico; Petrosino, Giancarlo; Ventricelli, Marialba; Zoratto, Francesca; Adriani, Walter
Problem gamblers account for almost one-third of the industry’s total revenue with the adverse effects of problem gambling\\u000a including significant financial loss, legal and occupational difficulties, family problems, psychological distress and suicide.\\u000a As such, it is important to understand the influential factors in gambling abstinence and relapse, which will assist in the\\u000a development of relapse prevention methods in therapeutic treatment
Tian P. S. Oei; Leon M. Gordon
Background Research has demonstrated that optimism and “positive illusions” can be used a coping mechanism among those facing adversity.\\u000a Gamblers are a little studied group who also experience adversity and uncertainty. They often feel considerable levels of\\u000a frustration, guilt, anger and a sense of feeling cheated after making significant losses. In order to deal with such feelings\\u000a it is hypothesized that
Jonathan Parke; Mark D. Griffiths; Adrian Parke
Superstitious beliefs, defined as a strong conviction based on the erroneous perception of a cause-effect association between two independent events, are considered to play an instrumental role in the maintenance of gambling behaviour. In this preliminary study, responses to eight items assessing superstitious beliefs were compared among 56 electronic gaming machine (EGM) problem gamblers, 22 non-problem EGM and 23 non-EGM
Jackie Joukhador; Alex Blaszczynski; Fiona Maccallum
A 30-year-old woman with severe pathological gambling and cyclothymia presented to our program with no previous history of pharmacologic or psychotherapeutic treatment. Pathological gambling is an impulse -control disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) in which comorbidity is common, particularly with substance abuse, obsessive-compulsive disorder and mood disorders. As described in this case, pathological gamblers with bipolar comorbidity may be effectively treated with mood stabilizers such as lithium. After receiving 10 weeks of lithium treatment, the patient showed improvement in both gambling behavior and affective instability. The identification of specific subtypes among patients with pathological gambling may be relevant to the choice of pharmacologic treatment. PMID:16041292
Dell'Osso, Bernardo; Hollander, Eric
Studies attempting to identify the specific 'addictive' features of electronic gaming machines (EGMs) have yielded largely inconclusive results, suggesting that it is the interaction between a gambler's cognitions and the machine, rather than the machine itself, which fuels excessive play. Research has reported that machine players with gambling problems adopt a number of erroneous cognitive perceptions regarding the probability of winning and the nature of randomness. What is unknown, however, is whether motivations for gambling and attitudes toward pre-session monetary limit-setting vary across levels of gambling severity, and whether proposed precommitment strategies would be useful in minimizing excessive gambling expenditures. The current study explored these concepts in a sample of 127 adults, ages 18 to 81, attending one of four gambling venues in Queensland, Australia. The study found that problem gamblers were more likely than other gamblers to play machines to earn income or escape their problems rather than for fun and enjoyment. Similarly, they were less likely to endorse any type of monetary limit-setting prior to play. They were also reticent to adopt the use of a 'smart card' or other strategy to limit access to money during a session, though they indicated they lost track of money while gambling and were rarely aware of whether they were winning or losing during play. Implications for precommitment policies and further research are discussed. PMID:20084433
Nower, Lia; Blaszczynski, Alex
The paper reports one of the first ever studies to evaluate the effectiveness of an online help and guidance service for problem gamblers. The evaluation utilised a mixed methods design in order to examine both primary and secondary data relating to the client experience. In addition, the researchers posed as problem gamblers in order to obtain…
Wood, Richard T. A.; Griffiths, Mark D.
Disordered Internet gambling is a psychological disorder that represents an important public health issue due to the increase in highly available and conveniently accessible Internet gambling sites. Chasing losses is one of the few observable markers of at-risk and problem gambling that may be used to detect early signs of disordered Internet gambling. This study examined loss chasing behaviour in a sample of Internet casino and poker players and the socio-demographic variables, irrational beliefs, and gambling behaviours associated with chasing losses. An online survey was completed by 10,838 Internet gamblers (58% male) from 96 countries. The results showed that Internet casino players had a greater tendency to report chasing losses than poker players and gamblers who reported chasing losses were more likely to hold irrational beliefs about gambling and spend more time and money gambling than those who reported that they were unaffected by previous losses. Gamblers who played for excitement and to win money were more likely to report chasing losses. This study is one of the largest ever studies of Internet gamblers and the results are highly significant as they provide insight into the characteristics and behaviours of gamblers using this mode of access. PMID:24746392
Gainsbury, Sally M; Suhonen, Niko; Saastamoinen, Jani
Problem gambling has become a widespread problem following the rapid expansion of electronic gaming machines into hotels and clubs over the last 10 years. Recent literature indicates that certain factors can influence problem gambling severity, such as psychiatric co-morbidity and personality traits, gambling related cognitions, substance use and…
Hounslow, Vanessa; Smith, David; Battersby, Malcolm; Morefield, Kate
Colorectal carcinoma is one of the most common cancers and one of the leading causes of cancer-related death in the United States. Pathologic examination of biopsy, polypectomy and resection specimens is crucial to appropriate patient managemnt, prognosis assessment and family counseling. Molecular testing plays an increasingly important role in the era of personalized medicine. This review article focuses on the histopathology and molecular pathology of colorectal carcinoma and its precursor lesions, with an emphasis on their clinical relevance.
Fleming, Matthew; Ravula, Sreelakshmi; Tatishchev, Sergei F.
According to a report of National Gambling Impact Study Commission (National Gambling Impact Study Commission (1999). Final report. Washington, DC: Government Printing Office.), 97% of problem gamblers in the United States do not seek treatment. Within the small proportion of problem gamblers who enter into treatment, a high percentage drops out. Despite the fact that some researchers argue against abstinence as the only acceptable treatment goal and that regaining control over gambling behaviour appears to be possible for some pathological gamblers (PG), abstinence has been the only gambling intervention treatment goal. The primary goal of this study was to verify whether controlled gambling is a viable goal for pathological gamblers. The second goal was to identify the characteristics that predicted a successful outcome for treatment with a controlled gambling goal. Eighty-nine PGs were enrolled in cognitive-behavioural treatment aimed at controlled gambling. Six and twelve month follow-ups were conducted in order to evaluate the maintenance of therapeutic gains and to identify significant predictors of successful controlled gambling. Results showed that using the intent-to-treat procedure, 63% had a score of 4 or less on the DSM-IV at the end of treatment. That proportion was 56% and 51% at the 6- and 12-month follow-ups. If we retain only those who completed the treatment, these proportions increased to 92%, 80% and 71% at post-treatment, 6- and 12-month follow-ups, respectively. On the majority of the measures, significant improvements were found at post-treatment and the therapeutic gains were maintained at the 6- and 12-month follow-ups. However, few variables were identified to predict who would benefit from control rather than abstinence. The clinical and philosophical implications of these results are discussed in this paper. PMID:19118818
Ladouceur, Robert; Lachance, Stella; Fournier, Patricia-Maude
The obsessive-compulsive spectrum disorder (OCSD) theory postulates that a wide range of disorders is closely related to OCD. Current cognitive models ascertain that certain beliefs leading to misinterpretation of the significance of intrusions are important in the etiology and maintenance of OCD. This study examined whether pathological gambling, a disorder belonging to the OC spectrum, is characterized by similar dysfunctional cognitions as OCD. Dysfunctional beliefs of OCD patients were compared to those of patients with pathological gambling, panic disorder and normal controls. These beliefs were measured by the Obsessive-compulsive Beliefs Questionnaire-87 (OBQ-87), which was developed by a group of leading OCD researchers [Behav. Res. Ther. 35 (1997) 667]. It was hypothesized that according to the OCSD theory, pathological gamblers would exhibit similar cognitions to OCD patients, as well as increased levels of OCD symptoms. Analysis showed that OCD patients exhibited higher OBQ-87 scores than both panic patients and normal controls, but equal to pathological gambling patients. Pathological gamblers exhibited, however, no increase in OCD symptoms. These mixed results do not seem to support the OC spectrum theory for pathological gambling, moreover being contradictory to contemporary cognitive OCD models. PMID:15033499
Anholt, Gideon E; Emmelkamp, Paul M G; Cath, Danielle C; van Oppen, Patricia; Nelissen, Henri; Smit, Johannes H
This article is a critical literature review of pathological gambling focused in the family factors, particularly in the couple dynamics. Its main goal is to develop an explicative integrative systemic model of pathological gambling, based in these couple dynamics. To achieve that aim, a bibliography search was made, using on-line data bases (e.g., EBSCO Host) and recognized books in pathological gambling subject, as well as in the systemic approach in general. This process privileged the recent works (about 70 % of the reviewed literature was published in the last decade), however, also considered some classic works (the oldest one dates back to 1970). The guiding focus of this literature search evolves according to the following steps: (1) search of general comprehension of pathological gambling (19 references), (2) search specification to the subject "pathological gambling and family" (24 references), (3) search specification to the subject "pathological gambling and couple"(11 references), (4) search of systemic information which integrates the evidence resulted in the previous steps (4 references). The developed model is constituted by different levels of systemic complexity (social context, family of origin, couple and individual) and explains the problem as a signal of perturbation in the marital subsystem vital functions (e.g., power and control) though the regularities of marital dynamics of pathological gamblers. Furthermore, it gives theoretical evidence of the systemic familiar intervention in the pathological gambling. PMID:23423730
Cunha, Diana; Relvas, Ana Paula
Impulsivity is a core process underlying addictive behaviors, including nonpharmacological addictive behaviors such as problem gambling. Although considerable attention has been given to the investigation of delay discounting within the context of addiction-related behaviors, relatively little research has examined the relationship between discounting and individual variables, such as race/ethnicity. The purpose of this study was to compare discounting rates in the three most prevalent racial/ethnic groups in the United States: Whites, African Americans, and Hispanics. The study was conducted with 315 problem gamblers. Participants completed a delay-discounting questionnaire involving choices between a smaller amount of money delivered immediately and a larger amount delivered later. A hyperbolic discounting function estimated delay-discounting rates based on participants' indifference points obtained via the questionnaires. Results showed significant effects of race/ethnicity on delay discounting. White gamblers discounted delayed money at lower rates than African Americans and Hispanics, even after controlling for confounding variables. These data suggest that among individuals who develop problem gambling, Whites are less impulsive than African Americans and Hispanics, at least in terms of choosing between delayed and immediate reinforcers. These results have implications for evaluating the onset and treatment of addictive disorders from a health-disparities perspective. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24955678
Andrade, Leonardo F; Petry, Nancy M
The impacts of two types of social desirability bias, self-deceptive enhancement (SDE) and impression management (IM), were examined on self-reports of gambling problems, measured by the South Oaks Gambling Screen (SOGS), and recent gambling behavior, as measured by the Timeline Followback (TLFB) method, in a sample of college students (N = 191), and a sample of treatment-seeking problem gamblers (N = 49). Consistent with our expectations, IM was negatively associated with SOGS scores in both samples. IM was most highly correlated with SOGS scores among treatment-seeking participants (r = -.44, p < .01). Substantial numbers of participants in both samples had high enough IM scores as to call into question the validity of their self-report gambling data, according to published interpretive guidelines. With respect to SDE, we had predicted that it would be positively related to gambling behaviors and gambling-related problems, but found that SDE was inversely related to SOGS scores in both samples. Very little evidence was found for social desirability effects on TLFB scores. Thus, preliminary evidence was obtained that self-report data on gambling problems, but not on gambling behavior (frequency of gambling and amount of time and money spent), may be susceptible to the effects of impression management in both college students and treatment-seeking gamblers. PMID:18369710
Kuentzel, Jeffrey G; Henderson, Melinda J; Melville, Cam L
Physiological arousal is purportedly a key determinant in the development and maintenance of gambling behaviors, with problem gambling conceptualized in terms of abnormal autonomic responses. Theoretical conceptualizations of problem gambling are discordant regarding the nature of deficit in this disorder; some accounts posit that problem gamblers are hypersensitive to reward, and others that they are hyposensitive to reward and/or punishment. Previous research examining phasic electrodermal responses in gamblers has been limited to laboratory settings, and reactions to real gaming situations need to be examined. Skin conductance responses (SCRs) to losses, wins, and losses disguised as wins (LDWs) were recorded from 15 problem gamblers (PGs) and 15 nonproblem gamblers (NPGs) while they wagered their own money during electronic gaming machine play. PGs demonstrated significantly reduced SCRs to reward. SCRs to losses and LDWs did not differ for either PGs or NPGs. This hyposensitivity to wins may reflect abnormalities in incentive processing, and may represent a potential biological marker for problem gambling. PMID:24588340
Lole, Lisa; Gonsalvez, Craig J; Barry, Robert J; Blaszczynski, Alex
This article explores the potential of a bio-psycho-social-sociological model as it pertains to C. Wright Mills's articulation of a sociological imagination and, especially, how these formulations may be used to help problem gamblers and their families. This tool might be seen as a “clinical sociological” one that complements, rather than replaces, existing psychologically oriented approaches. A number of speculations about
Bo J. Bernhard
Human decision-making involving independent events is often biased and affected by prior outcomes. Using a controlled task that allows us to manipulate prior outcomes, the present study examined the effect of prior outcomes on subsequent decisions in a group of young adults. We found that participants were more risk-seeking after losing a gamble (Riskloss) than after winning a gamble (Riskwin), a pattern resembling the gambler’s fallacy. Functional MRI data revealed that decisions after Riskloss were associated with increased activation in the frontoparietal network, but decreased activation in the caudate and ventral striatum. The increased risk-seeking behavior after a loss showed a trend of positive correlation with activation in the frontoparietal network and the left lateral orbitofrontal cortex but a trend of negative correlation with activation in the amgydala and caudate. In addition, there was a trend of positive correlation between feedback-related activation in the left lateral frontal cortex and subsequent increased risk-seeking behavior. These results suggest that a strong cognitive control mechanism but a weak affective decision-making and reinforcement learning mechanism that usually contribute to flexible, goal-directed decisions can lead to decision biases involving random events. This has significant implications for our understanding of the gambler’s fallacy and human decision making under risk.
Xue, Gui; Lu, Zhonglin; Levin, Irwin P.; Bechara, Antoine
We evaluated the association between mini-mental status examination (MMSE) scores proximal to death and the values of 43 different clinical and pathological parameters. Studies were performed using data from 334 elderly, longitudinally evaluated research subjects who had undergone autopsy and satisfied inclusion criteria from an initial study group of 501. Interindividual variance in MMSE scores was used as a surrogate for the severity of cognitive impairment linked to aging (CILA). A statistical linear regression-based model provided a framework for assessing the parameters with significant, direct impact on CILA severity. Strong association between CILA and Alzheimer’s disease (AD) pathology, especially isocortical neurofibrillary tangles, was evident. The pattern of association between AD lesion densities with cognitive impairment severity was biologically informative, with neuritic plaques having more impact in relatively high-functioning individuals. Abundant isocortical Lewy bodies tended to be an additive pathology correlating with final MMSE scores approximately 10 points lower. In a subset of cases we found evidence for association between TDP-43-related pathology and CILA severity, independent of AD or hippocampal sclerosis. There was no support for independent association between CILA severity and most evaluated indices including diffuse plaques, argyrophilic grains, heart disease, education level, apolipoprotein E alleles or diabetes.
Nelson, Peter T.; Abner, Erin L.; Schmitt, Frederick A.; Kryscio, Richard J.; Jicha, Gregory A.; Smith, Charles D.; Davis, Daron G.; Poduska, John W.; Patel, Ela; Mendiondo, Marta S.; Markesbery, William R.
Increased neurological soft signs (NSSs) have been found in a number of neuropsychiatric syndromes, including chemical addiction. The present study examined NSSs related to perceptual-motor and visuospatial processing in a behavioral addiction viz., pathological gambling (PG). As compared to mentally healthy individuals, pathological gamblers displayed significantly poorer ability to copy two- and three-dimensional figures, to recognize objects against a background noise, and to orient in space on a road-map test. Results indicated that PG is associated with subtle cerebral cortical abnormalities. Further prospective clinical research is needed to address the NSSs' origin and chronology (e.g., predate or follow the development of PG) as well as their response to therapeutic interventions and/or their ability to predict such a response.
Elman, Igor; Gurvits, Tamara V.; Tschibelu, Evelyne; Spring, Justin D.; Lasko, Natasha B.; Pitman, Roger K.
In this article, findings of a panel study among former EGM gamblers are discussed. The data were collected in two waves during\\u000a 2007, and 1293 people, 18 years or older, participated. The background for the study was the Norwegian ban on EGMs from 1\\u000a July 2007, and the aim was to investigate how this ban affected gambling involvement and problem levels
Family environments of married male members of Gamblers Anonymous (GA) and married female members of GamAnon were measured with the Family Environment Scale (FES), a measure of 10 characteristics of family life. The total sample of 86 included 50 male GA and 36 female GamAnon members. GA and GamAnon groups did not differ from each other. However, the short-term GA
Joseph W. Ciarrocchi; Duane F. Reinert
This study aims to investigate the characterization of male gamblers in popular Hong Kong movies in the past 50 years. A total\\u000a of nine Hong Kong films with gambling themes were selected for analysis. The criteria for selection of the films were as follows:\\u000a the movies in which the protagonists are portrayed by well known Hong Kong actors that attracted a
Chi Chuen Chan; Keis Ohtsuka
This overview of orbital pathology deals with different kinds of tumors, inflammatory, vascular, and traumatic diseases, which may involve the orbit. Depending on the respective orbital compartment of the globe, the intrakonal, extrakonal and optic nerve the most important and most frequent lesions are presented with their specific clinical symptoms. Their specific presentation on CT- and MR-imaging is discussed in
W Müller-Forell; S Pitz
The present study explores gender-related differences in the demographic and gambling-related characteristics of 2670 problem gamblers participating in a state-administered (Missouri) casino self-exclusion program between 2001 and 2003. Female (n=1298, 48.4%) and male (n=1372, 51.1%) participants ranged in age from 21 to 84 years. Gender-related differences were noted among demographic variables, patterns of gambling behavior, reasons for self-exclusion, and involvement in self-help, counseling, and bankruptcy services. Female self-excluders were more likely than males to be older at time of application, African American, and either retired, unemployed or otherwise outside the traditional workforce. In addition, female self-excluders were more likely to report a later age of gambling onset, a shorter period between onset and self-exclusion, a preference for non-strategic forms of gambling and prior bankruptcy. The main predictors for female participation in self-exclusion included a desire to gain control and prevent suicide and referral by a counselor. The desire to save the marriage was a motivating factor for all participants. Findings suggest that the most efficacious treatment strategies with this group will include family systemic therapy and financial management in addition to pharmaco-treatment and culturally-sensitive individual therapy. PMID:16374658
Nower, Lia; Blaszczynski, Alex
\\u000a Forensic pathology is a branch of medicine that deals with the determination of the cause and manner of death in cases in\\u000a which death occurred under suspicious or unknown circumstances. Identification of the decedent and interpretation of postmortem\\u000a changes are duties of the forensic pathologist. Sudden death from natural disease frequently involves vascular disease, obstructive\\u000a or reactive lung disease, diabetes
Frank P. Miller; Jeffrey J. Barnard
This study examined whether comorbid personality disorder pathology in the eating disorders clusters into broader patterns, and whether those clusters have clinical validity in terms of levels of eating pathology and axis 1 comorbidity. The sample consisted of 214 eating-disordered women who completed measures of personality disorder cognitions, eating pathology and axis 1 pathology at assessment. Three clusters of eating disorder patients emerged-low levels of personality pathology overall, high levels of cognitions underpinning anxiety-based personality pathology, and high levels of all of the dimensions of personality pathology. These groups were validated by differences in levels of eating cognitions and axis 1 pathology. Personality disorder cognitions are clinically relevant to the eating disorders, but they might best be understood as broader sets of cognitions ('anxiety-centred' and 'general'), rather than in terms of individual personality disorder comorbidity or existing DSM personality disorder clusters. PMID:23080210
Waller, Glenn; Ormonde, Lisa; Kuteyi, Yemi
This paper describes the characteristics of subjective time (in contrast to objective time), with particular reference to a specific form of pathological experience and relation to the passage of time in patients with narcissistic personality undergoing psychoanalytic treatment. The clinical manifestations and technical approach to this pathology of time experience are outlined in the context of illustrative clinical vignettes. PMID:18405285
Kernberg, Otto F
Huntington’s disease (HD) is a genetic, neurodegenerative disorder, which specifically affects striatal neurons of the indirect pathway, resulting in a progressive decline in muscle coordination and loss of emotional and cognitive control. Interestingly, predisposition to pathological gambling and other addictions involves disturbances in the same cortico-striatal circuits that are affected in HD, and display similar disinhibition-related symptoms, including changed sensitivity to punishments and rewards, impulsivity, and inability to consider long-term advantages over short-term rewards. Both HD patients and pathological gamblers also show similar performance deficits on risky decision-making tasks, such as the Iowa Gambling Task (IGT). These similarities suggest that HD patients are a likely risk group for gambling problems. However, such problems have only incidentally been observed in HD patients. In this review, we aim to characterize the risk of pathological gambling in HD, as well as the underlying neurobiological mechanisms. Especially with the current rise of easily accessible Internet gambling opportunities, it is important to understand these risks and provide appropriate patient support accordingly. Based on neuropathological and behavioral findings, we propose that HD patients may not have an increased tendency to seek risks and start gambling, but that they do have an increased chance of developing an addiction once they engage in gambling activities. Therefore, current and future developments of Internet gambling possibilities and related addictions should be regarded with care, especially for vulnerable groups like HD patients.
Kalkhoven, Carla; Sennef, Cor; Peeters, Ard; van den Bos, Ruud
Abnormal cue reactivity is a central characteristic of addiction, associated with increased activity in motivation, attention and memory related brain circuits. In this neuroimaging study, cue reactivity in problem gamblers (PRG) was compared with cue reactivity in heavy smokers (HSM) and healthy controls (HC). A functional magnetic resonance imaging event-related cue reactivity paradigm, consisting of gambling, smoking-related and neutral pictures,
A. E. Goudriaan; Ruiter de M. B; Brink van den W; J. Oosterlaan; D. J. Veltman
Although a number of previous studies have speculated about the relationship between adolescent and adult gambling, there is very little prospective longitudinal data available to examine whether under-aged gambling makes a person more likely to gamble as an adult. To investigate this issue, the gambling habits of 578 young people were tracked for four years from mid-adolescence (age 15 years)
Paul H. Delfabbro; Anthony H. Winefield; Sarah Anderson
Research investigating the relationship between gambling and sensation seeking has yet to establish conclusively whether pathological gamblers (PGs) are more or less sensation seeking than nonpathological gamblers (NPGs). Sensation seeking is usually measured with the Zuckerman et al. (J Consult Clin Psychol 46:139–149, 1978) SS Scale form V (SSS-V). Whereas previous studies relied on the SSS-V total score, the current study uses two samples to demonstrate the importance of the SSS-V subscales, which include Thrill and Adventure Seeking (TA), Experience Seeking (ES), Disinhibition (DS), and Boredom Susceptibility (BS). In two samples, strong intrascale correlations between DS and BS, and between TA and ES, suggest that certain subscales reflect similar underlying characteristics. In both samples PGs displayed higher scores than NPGs on the DS and BS subscales, with mean differences in Sample 2 reaching significant levels for both DS and BS. Results support the notion that the SSS-V can be divided into concepts reflecting actual behavior, based on the DS and BS subscales, and hypothetical behavior, based on the TA and ES subscales. Furthermore, PGs appear to have a preference for the more behavioral subscales while NPGs show a preference for the more hypothetical subscales. Reasons for the subscale divisions and preferences are discussed.
Fortune, Erica E.
Objectives: Pathological gambling (PG) is a highly prevalent and disabling impulse control disorder. A range of psychopharmacological options are available for the treatment of PG, including selective serotonin reuptake inhibitors, opioid receptor antagonists, anti-addiction drugs, and mood stabilizers. In our preliminary study, we examined the efficacy of two anti-addiction drugs, baclofen and acamprosate, in the treatment of PG. Materials and Methods: Seventeen male gamblers were randomly divided into two groups. Each group received one of the two drugs without being blind to treatment. All patients underwent a comprehensive psychiatric diagnostic evaluation and completed a series of semi-structured interviews. During the 6-months of study, monthly evaluations were carried out to assess improvement and relapses. Relapse was defined as recurrent gambling behavior. Results: None of the 17 patients reached the 6-months abstinence. One patient receiving baclofen sustained abstinence for 4?months. Fourteen patients succeeded in sustaining abstinence for 1-3?months. Two patients stopped attending monthly evaluations. Conclusion: Baclofen and acamprosate did not prove efficient in treating pathological gamblers. PMID:21713109
Dannon, Pinhas N; Rosenberg, Oded; Schoenfeld, Netta; Kotler, Moshe
Objectives: Pathological gambling (PG) is a highly prevalent and disabling impulse control disorder. A range of psychopharmacological options are available for the treatment of PG, including selective serotonin reuptake inhibitors, opioid receptor antagonists, anti-addiction drugs, and mood stabilizers. In our preliminary study, we examined the efficacy of two anti-addiction drugs, baclofen and acamprosate, in the treatment of PG. Materials and Methods: Seventeen male gamblers were randomly divided into two groups. Each group received one of the two drugs without being blind to treatment. All patients underwent a comprehensive psychiatric diagnostic evaluation and completed a series of semi-structured interviews. During the 6-months of study, monthly evaluations were carried out to assess improvement and relapses. Relapse was defined as recurrent gambling behavior. Results: None of the 17 patients reached the 6-months abstinence. One patient receiving baclofen sustained abstinence for 4?months. Fourteen patients succeeded in sustaining abstinence for 1–3?months. Two patients stopped attending monthly evaluations. Conclusion: Baclofen and acamprosate did not prove efficient in treating pathological gamblers.
Dannon, Pinhas N.; Rosenberg, Oded; Schoenfeld, Netta; Kotler, Moshe
An examination of 150 patients suffering from pathological gambling (PG) has shown that a PG predisposition includes 3 components: personal, morphofunctional and gender. The personal component is a combination of lability and hyperthymia, higher extraversion, easy communication, riskiness, low empathic ability, inclination to emotional satiation. The morphofunctional component embraces structural (a pathology of cortical and subcortical areas, localized mainly in the frontal region and limbic structure of brain) and functional (abnormalities of regulatory processes, signs of cerebral immaturity) peculiarities of the central nervous system. The gender component is reflected in the notable predominance of males, weak and medium-weak sexual constitution, psychosexual development peculiarities manifested as a reduced romantic stage. This complex predisposition, though non-fatal, raises the risk of the disorder. PMID:19008847
Bukhanovski?, A O; Soldatkin, V A; Baranova, I V
Cognitive-behavioral therapy for pathological gambling has a long-term success rate of more than 50%. This study evaluated the effect of self-hypnosis in cognitive-behavioral treatment of pathological gamblers. Forty-nine participants were assigned to 2 groups. Both groups received a cognitive-behavioral protocol, and Group 1, the no-hypnosis group, received an 11-session intervention and Group 2, the hypnosis group, received 7 sessions that included self-hypnosis. Both groups were equal in gambling chronicity, frequency, intensity, change motivation, and problems derived from gambling. All participants reported significant improvement in gambling behavior and consequences at both treatment end and 6-month follow-up. Data show no differences between the interventions in abstinence, therapeutic compliance, fulfillment, and satisfaction. Results suggest that self-hypnosis reinforces treatment and can be a supportive technique for future brief interventions. PMID:24256479
Lloret, Daniel; Montesinos, Rosa; Capafons, Antonio
Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology and dysfunction in marriage--a relationship that most people find central to their lives. In a cross-sectional study of a community sample of married couples (N = 82), the authors…
South, Susan C.; Turkheimer, Eric; Oltmanns, Thomas F.
Evidence indicates that tobacco use and gambling often co-occur. Despite this association, little is known about how tobacco use affects the propensity to gamble. Nicotine, the putative addictive component of tobacco, has been reported to potentiate the hedonic value of other nonsmoking stimuli. Environmental cues have been identified as an important contributor to relapse in addictive behavior; however, the extent to which nicotine can affect the strength of gambling cues remains unknown. This study examined whether nicotine influences subjective ratings for gambling following gambling cues. In a mixed within/between-subjects design, 30 (20 men) video lottery terminal (VLT) gamblers ('moderate-risk' or 'problem' gamblers) who smoke daily were assigned to nicotine (4 mg deliverable) or placebo lozenge conditions. Subjective and behavioral responses were assessed at baseline, following lozenge, following neutral cues, and following presentation of gambling cues. Nicotine lozenge was found to significantly reduce tobacco-related cravings (P<0.05) but did not affect gambling-related cravings, the choice to play a VLT, or other subjective responses. These results suggest that a low dose of acutely administered nicotine does not increase cue-induced craving for gambling in at-risk VLT gamblers who smoke. PMID:23412113
McGrath, Daniel S; Dorbeck, Anders; Barrett, Sean P
Use of technology in individual health monitoring is predicted to be widespread in near future healthcare systems and in smart home environments. The term Personalized Health Monitoring (PHM) is proposed for these applications. A framework describing aspects of personalization and personality that are relevant to personalized health monitoring is presented. The framework addresses personal data, adaptability, feedback, and personality. Influence
Prevalence and structure of comorbidity a somatic pathology in military men with neurotic disorders was studied. It was established that 40,4% of surveyed noted concomitant somatic pathology, the structure of which was dominated by gastro-intestinal tract (26,8%), and pathology of the cardiovascular system (21,6%). It is shown that concomitant somatic pathology provided aggravating effect on clinic neurotic disorders in serviceman, making it difficult to diagnose mental disorders. The greatest risk concomitant a somatic pathology was marked in patients with depressive and somatoform disorders. Indicates the need for specialized standards of care for persons with comorbid mental and somatic disorders. PMID:22712246
Kurasov, E S; Marchenko, A A; Krasnov, A A; Golovach, I G; Kozlova, S N
It was hypothesized that a pathological liar might be characterized by a construct system atypically loose over a wide range of conventional, socially relevant constructs. Evidence consistent with this hypothesis was obtained from the Thought Disorder Grid (TDG) and by a marked response bias on the Eysenck Personality Inventory (EPI). (Author)
Stones, M. J.
CCR Home About CCR CCR Intranet Laboratory of Pathology LP Home Clinical Services Basic Sciences Training LP Staff Accessibility of Web Site DLM Website Autopsy Pathology Autopsy Pathology Procedure Manual Autopsy Pathology Staff About
This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS,\\u000a N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general\\u000a population (non-help-seekers, NHS,\\u000a N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers\\u000a to
Justin Pulford; Maria Bellringer; Max Abbott; Dave Clarke; David Hodgins; Jeremy Williams
The Surgical Pathology Section provides expertise and diagnostic services in the field of Anatomic Pathology for Clinical Center patients and collaborates with the research staff in those investigations, which involve the use and study of human pathological material. Approximately 6,000 surgical specimens and biopsies (more than 60,000 slides which include routine and a variety of special stains) are accessioned each year. These include more than 2,000 fresh human tissues.
This book contains 11 selections. Some of the titles are: Applications of in situ DNA hybridization technology to diagnostic surgical pathology; Neoplasms associated with immune deficiencies; Chronic gastritis: The pathologists's role; Necrosis in lymph nodes; Pathologic changes of osteochondrodysplasia in infancy: A review; and Immunoglobulin light chain nephropathies.
Fechner, R.E.; Rosen, P.P.
Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys, with 215 having completed the questionnaire for the spouse. This article is a report of some of the data from the spouse's survey. This survey focused
Valerie C. Lorenz; Robert A. Yaffee
Histological structures of a pathological tissue sample convey information relevant to the diagnosis of the disease that might have afficted the person. To reveal the morphology of these structures clearly, pathological tissues are stained. In this paper, a digital staining methodology for pathological tissue samples is introduced. Digital staining implies the application of digital processing techniques to transform the image
Pinky A. Bautista; Tokiya Abe; Masahiro Yamaguchi; Yukako Yagi; Nagaaki Ohyama
This is a pulmonary pathology case study presented by the University of Pittsburgh Department of Pathology in which a 55 year old female has spontaneously occurring hemoptysis. Visitors are given both the microscopic and gross descriptions, radiology, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in pulmonary pathology.
Holst, Valerie; Yousem, Sam
The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in the medical/health science field. In this case, a 79 year old male with headaches and sinus problems is evaluated. The patient previously had "an inverted papilloma resected." Using the gross description, microscopic description, and images provided, students are encouraged to test their knowledge of pathology and diagnose the patient's medical problem. This is an excellent resource for providing students experience with patient history, lab results and diagnostics.
Nine, Jeff S.
Until nowadays there is no conclusive information about causality relationship between some disorders and pathological gambling, but what is evident is the association of pathological gambling with some disorders that affect perso- nal, family, social and working aspects. Concerning personal aspects, the most im- portant disorders that have an effect on patholo- gical gamblers are: Affective disorders (deep de- pression),
José Luis García Martínez; Carmen Díaz Navarro; Jose A. Aranda Romero
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.
Disney, Krystle L.; Weinstein, Yana; Oltmanns, Thomas F.
Advises child psychiatrists to use personality disorder diagnoses sparingly; to be aware of the constraints on adaptability of normal variations of temperament; and to positively diagnose those rare pathological impairments of personality brought about by minimal cerebral dysfunction, schizoid traits, and traits of excessive shyness. (RH)
Significant changes are proposed in the personality disorders section of the 5th. edition of the DSM. The article summarizes the historical background of the personality disorder classification, including personality-types theory, trait-theory, and clinical concepts based upon psychiatric and psychoanalytical traditions. After briefly summarizing concerns on current approach to diagnosing personality disorders in DSM-IV, we summarise the most important features of the newly developed personality disorders classification, including concepts have been modified during long years of investigation. The new system will have modified less than was originally intended, and will be a hybrid model of dimensional categorical approach to diagnosing personality disorders. The ten personality disorder types are reduced to six, and they will have new criteria based on maladaptive trait dimensions. The trait structure model was derived from existing personality and personality disorder trait models, and includes five broad higher-order trait domains, which are negative affectivity, detachment, antagonism, disinhibition, and psychoticism. A new set of general criteria are developed for defining personality disorder. Self and interpersonal functioning represent the core impairment in personality functioning central to personality disorder, and the presence of maladaptive personality traits is also required. Severity continuum of personality pathology can be rated on the Levels of Personality Functioning Scale. PMID:23180732
Kuritárné Szabó, Ildikó
After nothing the rarity of papers describing the pathology of delayed radiation necrosis of the spinal cord, the clinical and pathological findings from four cases are presented. The main pathological features are asymmetric demyelination of the lateral columns and to a lesser degree the posterior and anterior columns of white matter, with coagulative necrosis at the level of irradiation which affected the grey matter to a lesser degree. There is ascending and descending secondary tract degeneration, and poor glial response in the lesions themselves. Vascular changes, mainly hyalilne thickening of arteriolar walls, are present, but not in degree sufficient to explain the primary lesion. The discussion of the pathogenesis of the myelopathy weighs the merits of a primary vascular lesion against those of a primary effect of the radiation on neural tissue. The latter is favoured. Images
Burns, R. J.; Jones, A. N.; Robertson, J. S.
Mastocytosis encompasses a group of clinically and pathologically heterogeneous disorders most commonly involving the skin, which typically takes the form of urticaria pigmentosa. Mastocytosis may also involve other organs, most often bone marrow, followed by gastrointestinal tract, liver, spleen, and lymph nodes. The presence of extracutaneous involvement by mastocytosis is a major diagnostic criterion for systemic disease. However, mast cell infiltrates are often subtle in skin and extracutaneous organs, and the histologic features of mastocytosis at different anatomic sites may be variable. This article reviews the pathologic features and clinical correlates of mastocytosis involving skin and other extramedullary sites. PMID:24745677
Doyle, Leona A; Hornick, Jason L
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 6-hour-old baby was found to have petechiae. Visitors are given the case description and the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and transfusion medicine.
Lopez-Plaza, Iliana; Nester, Theresa; Qu, Lirong
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 24-day-old baby is failing to thrive and experiencing seizures. Visitors are given the microscopic description, with images, the results of the postmortem examination, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pediatric pathology.
Dickman, Paul S.; Lyons, Valerie
Obesity is, in part, a result of positive energy balance or energy intake exceeding physiological needs. Excess energy intake is determined by a series of food choices over time. These choices involve both motivational and executive function processes. Problems arise when there is excessive motivation to eat and low impulse control, a situation we have termed reinforcement pathology. Motivational and executive function processes have also been implicated in the development of drug dependence and addiction. In this review we discuss the application of reinforcement pathology to obesity, and implications of this approach for obesity treatment. PMID:21999693
Carr, Katelyn A; Daniel, Tinuke Oluyomi; Lin, Henry; Epstein, Leonard H
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 70-year-old man has peritonitis. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology.
Nine, Jeff S.
Obesity is, in part, a result of positive energy balance or energy intake exceeding physiological needs. Excess energy intake is determined by a series of food choices over time. These choices involve both motivational and executive function processes. Problems arise when there is excessive motivation to eat and low impulse control, a situation we have termed reinforcement pathology. Motivational and executive function processes have also been implicated in the development of drug dependence and addiction. In this review we discuss the application of reinforcement pathology to obesity, and implications of this approach for obesity treatment.
Carr, Katelyn A.; Daniel, Tinuke Oluyomi; Lin, Henry; Epstein, Leonard H.
From the American Phytopathological Society (APS), this Careers & Placement website is open to both members and non-members. The site allows job seekers and employers to view available job openings and candidates; post a resume or vita for free; and post a job opening (fee required). Job seekers can also sign up for free, bi-monthly email notifications regarding recent job openings. In addition, the APS Careers website connects to a list of hyperlinked plant pathology programs at universities across the country, and to a downloadable brochure about careers in plant pathology.
This article features a mathematical game called "Mystery Person." The author describes how the Mystery Person game was tried with first-graders [age 6]. The Mystery games involve the generation of key questions, the coordination of information--often very complex information--and the formulation of consequences based on this coordination.…
Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated.
De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.
There is mounting evidence that vascular pathology plays a role in the initiation and\\/or progression of the major disease of joints: osteoarthritis (OA). Potential mechanisms are: episodically reduced blood flow through the small vessels in the subchondral bone at the ends of long bones, and related to this, reduced interstitial fluid flow in subchondral bone. Blood flow may be reduced
D. M. Findlay
Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
Mandelker, Diana; Lee, Roy E.; Platt, Mia Y.; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K. F.; Klepeis, Veronica E.; Mahowald, Michael; Lane, William J.; Beckwith, Bruce A.; Baron, Jason M.; McClintock, David S.; Kuo, Frank C.; Lebo, Matthew S.; Gilbertson, John R.
Describes the six basic elements of personalized instruction: The dual teacher role (coach and advisor), diagnosing student learning characteristics, a culture of collegiality, interactive learning environments, flexible scheduling and pacing, and authentic assessment. (Contains 23 references.) (PKP)
Keefe, James W.; Jenkins, John M.
This is a case study presented by the University of Pittsburgh Department of Pathology where a 74 year old man with a history of diabetes mellitus, coronary artery disease, inferior wall myocardial infarction, peripheral vascular disease, hypertension, and hypercholesterolemia. He was admitted for a left femoral-popliteal bypass graft. The case study provides both gross and microscopic descriptions along with pertinent laboratory studies in order to allow the user the opportunity to diagnose the patient. Clicking on the final diagnosis link will provide users with a discussion of the actual diagnosis along with important learning points as well as a list of references. This is an excellent resource for students in health sciences to familiarize themselves with using patient history and laboratory results to develop a diagnosis. It is also a helpful site for educators to use to introduce or test student learning in pathology and clinical microbiology.
Callahan, Debra L.
The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors. In this particular study an otherwise healthy 9 month old infant is presented with hydrocephalus. The case study provides test results and images along with microscopic photos and description. Clicking on the final diagnosis provides a thorough explanation of the diagnosis and treatment.
Pathologic lesions of the orbit continue to be a great challenge to the diagnostic radiologist. The complex anatomy of the\\u000a orbit on the one hand and the multitude of disease entities that may affect the orbit on the other hand demand a simple, well-structured\\u000a approach to diagnostic imaging. Subdividing the orbit into four (or five) distinct spaces, i.e., the eyeball,
Ullrich G. Mueller-Lisse; JuerGen Lutz
Cell-cell and cell-matrix interactions are important regulators of normal cell growth and differentiation and play essential roles in pathological conditions such as tumor metastasis and infection by pathogens. We are defining functions of adhesion molecules, their cell surface and matrix receptors, and the signal transduction pathways that regulate their activities in specific diseases. These studies will identify new molecular targets and could provide a basis for designing novel therapeutic agents.
This pilot study evaluated Seeking Safety (SS) therapy for seven outpatients with current comorbid pathological gambling (PG) and posttraumatic stress disorder (PTSD). This represents the first treatment outcome study of this population, and included both genders and 29% minorities. We found significant improvements in: PTSD/trauma (the PTSD Checklist criterion B symptoms; the Trauma Symptom Inventory overall mean and subscales anxiety, dissociation, sexual abuse trauma index, sex problems; and the World Assumptions Scale benevolence subscale); gambling (the Gamblers Beliefs Questionnaire overall mean and subscales illusion of control); functioning (the Basis-32 overall mean and depression/anxiety subscale); psychopathology (the Brief Symptom Inventory overall mean and subscales anxiety and depression; and the Addiction Severity Index, ASI, psychiatric composite score); self-compassion (the Self-Compassion Scale overall mean and subscales isolation, overidentified, and self-judgment); and helping alliance (the Helping Alliance Questionnaire overall mean). One variable indicated worsening (employment composite subscale on the ASI), possibly reflecting measurement issues. SS attendance was excellent. PTSD onset occurred prior to PG onset for most of the sample, and most believed the two disorders were related. Overall, we found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability. Limitations are discussed. PMID:23662327
Najavits, Lisa M; Smylie, Diane; Johnson, Kay; Lung, John; Gallop, Robert J; Classen, Catherine C
Aims This paper describes the role of endothelial nicotinic acetylcholine receptors (nAChR) in diseases where pathological angiogenesis plays a role. Main methods An extensive review of the literature was performed, focusing on studies that investigated the effect of nicotine upon angiogenesis. Key findings Nicotine induces pathological angiogenesis at clinically relevant concentrations (i.e. at tissue and plasma concentrations similar to those of a light to moderate smoker). Nicotine promotes endothelial cell migration, proliferation, survival, tube formation and nitric oxide (NO) production in vitro, mimicking the effect of other angiogenic growth factors. These in vitro findings indicate that there may be an angiogenic component to the pathophysiology of major tobacco related diseases such as carcinoma, atherosclerosis, and age-related macular degeneration. Indeed, nicotine stimulates pathological angiogenesis in pre-clinical models of these disorders. Subsequently, it has been demonstrated that nicotine stimulates nAChRs on the endothelium to induce angiogenic processes; that these nAChRs are largely of the ?7 homomeric type; and that there are synergistic interactions between the nAChRs and angiogenic growth factor receptors at the phosphoproteomic and genomic levels. Significance These findings are of potential clinical relevance, and provide mechanistic insights into tobacco-related disease. Furthermore, these findings may lead to novel therapies for diseases characterized by insufficient or inappropriate angiogenesis.
Lee, Jieun; Cooke, John P.
OBJECTIVE To review the differences between physiologic and pathologic phimosis, review proper foreskin care, and discuss when it is appropriate to seek consultation regarding a phimotic foreskin. SOURCES OF INFORMATION This paper is based on selected findings from a MEDLINE search for literature on phimosis and circumcision referrals and on our experience at the Children’s Hospital of Eastern Ontario Urology Clinic. MeSH headings used in our MEDLINE search included “phimosis,” “referral and consultation,” and “circumcision.” Most of the available articles about phimosis and foreskin referrals were retrospective reviews and cohort studies (levels II and III evidence). MAIN MESSAGE Phimosis is defined as the inability to retract the foreskin. Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention. Great anxiety exists among patients and parentsregarding non-retractile foreskins. Most phimosis referrals seen in pediatric urology clinics are normal physiologically phimotic foreskins. Referrals of patients with physiologic phimosis to urology clinics can create anxiety about the need for surgery among patients and parents, while unnecessarily expanding the waiting list for specialty assessment. Uncircumcised penises require no special care. With normal washing, using soap and water, and gentle retraction during urination and bathing, most foreskins will become retractile over time. CONCLUSION Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management.
McGregor, Thomas B.; Pike, John G.; Leonard, Michael P.
The second quarter of 2009 saw steady advances in bone marrow biopsy (BMB) pathology. The following publications are a personal selection of the highlights. Quality issues in diagnostic immunohistochemistry for BMB have largely been ignored in external quality assurance programmes, and this issue is highlighted. In other areas, publications reflecting advances in flow cytometry and aspirate morphology are discussed where translation to the BMB is possible. Classifications undergo constant change, and several publications address the redefinition of the cut off points between malignancy, benign, and normal. Lastly, current scientific research is presented where it is relevant to the understanding of BMB pathobiology. PMID:20309423
van der Walt, Jon
This paper reports on the results of a psychological study conducted in Ontario, Canada, that attempted to answer the question of why some people develop gambling problems while others do not. A group of social gamblers (n = 38), sub-clinical problem gamblers (n = 33) and pathological gamblers (n = 34) completed a battery of questionnaires. Compared to non-problem gamblers, pathological gamblers were more likely to
Nigel E. Turner; Masood Zangeneh; Nina Littman-Sharp
Evidence of high population density's serious inhibiting effects on the reproductive, aggressive, withdrawal and sexual behavior of various animals, motivated a study of human pathology in overcrowded areas. Ecological relationships in Chicago and their impact on human behavior were assessed. The number of persons per acre, Standardized Mortality…
Galle, Omer R.; And Others
The article describes a tool to increase professional effectiveness in supervisory conferencing in speech-language pathology based on the dual areas of role expectations for clinicians and personal needs as derived from Maslow's hierarchy of needs. The conferencing questionnaire aids in recognizing the needs of the supervisee, stating problems,…
Houle, Gail Ruppert
The problem of pathological fractures of the lower jaw with particular reference to their aetiology is examined in the light of personal experience. Odontogenic and hematogenic osteomyelitis, primary and metastatic tumours, degenerative lesions, traumas, inclusions of the teeth and the whole apparatus are discussed individually. PMID:3488524
Marchetti, C; Ercolani, G; Gibelli, R; Donati, D; Catani, F
The cognitive-affective processing system (CAPS) has been proposed as a useful metaframework for integrating contextual differences in situations with individual differences in personality pathology. In this article, we evaluated the potential of combining the CAPS metaframework and contemporary interpersonal theory to investigate how individual differences in pathological narcissism influenced interpersonal functioning in daily life. University students (N = 184) completed event-contingent reports about interpersonal interactions across a 7-day diary study. Using multilevel regression models, we found that combinations of narcissistic expression (grandiosity, vulnerability) were associated with different interpersonal behavior patterns reflective of interpersonal dysfunction. These results are among the first to empirically demonstrate the usefulness of the CAPS model to conceptualize personality pathology through the patterning of if-then interpersonal processes. PMID:23205698
Roche, Michael J; Pincus, Aaron L; Conroy, David E; Hyde, Amanda L; Ram, Nilam
Ophthalmology has been an early adopter of personalized medicine. Drawing on genomic advances to improve molecular diagnosis, such as next-generation sequencing, and basic and translational research to develop novel therapies, application of genetic technologies in ophthalmology now heralds development of gene replacement therapies for some inherited monogenic eye diseases. It also promises to alter prediction, diagnosis and management of the complex disease age-related macular degeneration. Personalized ophthalmology is underpinned by an understanding of the molecular basis of eye disease. Two important areas of focus are required for adoption of personalized approaches: disease stratification and individualization. Disease stratification relies on phenotypic and genetic assessment leading to molecular diagnosis; individualization encompasses all aspects of patient management from optimized genetic counseling and conventional therapies to trials of novel DNA-based therapies. This review discusses the clinical implications of these twin strategies. Advantages and implications of genetic testing for patients with inherited eye diseases, choice of molecular diagnostic modality, drivers for adoption of personalized ophthalmology, service planning implications, ethical considerations and future challenges are considered. Indeed, whilst many difficulties remain, personalized ophthalmology truly has the potential to revolutionize the specialty. PMID:24665880
Porter, L F; Black, G C M
The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors. The patient in this particular case is a 64-year-old male with difficulty swallowing anything other than liquids. Patient history and both the gross and microscopic descriptions, which include images, are included in this case study. The contributing doctors provide a detailed discussion of the patientÃ¢ÂÂs condition in the Ã¢ÂÂFinal DiagnosisÃ¢ÂÂ section. Students will find this resource especially helpful, as it provides experience with patient history, lab results, and diagnostics.
Barnes, Leon, 1941-; Fusco, Gregory P.; Perez, Mia C.
Toxic effects of formaldehyde in humans are discussed in relation to occupational exposure and tolerance to this agent. Carcinogenic and mutagenic properties of formaldehyde have been reported in animals and this has led to concern about a possible role in human cancer. The current state of affairs is reviewed in the light of a lack of direct evidence linking formaldehyde with cancer in man and in relation to recommended exposure levels. It is important to employ effective means of containment and practical methods for reducing exposure to formaldehyde in pathology departments and post-mortem rooms are described. Images
Clark, R P
Activity: You are going to develop a scripture chain that teaches us how we can receive Personal Revelation. Remember, when we talk to Heavenly Father we call it prayer. When Heavenly Father responds to us by the Holy Ghost we call it Personal Revelation. Teaching Emphasis (Core) I cannot use any language that describes to you what a revelation is. Somebody said, How can I tell if I have a revelation? I have had a feeling that such and such is true. How can I be sure? ...Revelation is something you experience, and the way that ...
Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment outcome. This study examined the effects of borderline personality characteristics (BPC) on 131 female
Stephanie B. Clarke; Shireen L. Rizvi; Patricia A. Resick
This study revised the theory of planned behavior (TPB) by incorporating the new concepts of gambling passion and responsible gambling strategy (RGS) to predict gamblers' intention to gamble in online sports betting. The data were collected at the end of March in 2012 through an online gambling website. The findings indicated that the inclusion of two types of gambling passion and two types of RGS explains online gambling intention well. Specifically, out of the original antecedent predictors of TPB, attitude toward online gambling was positively related to harmonious passion. Subjective norm had a positive relationship with both harmonious and obsessive passion. The results also showed that perceived behavioral control does not have a significant effect on the two gambling passions but has a direct and significant influence on behavioral intention. Additionally, the compulsory RGS had a negative effect on obsessive passion, whereas supplementary RGS had concurrent positive impacts on harmonious and obsessive passion. Lastly, the two gambling passions were notable predictors of behavioral intention toward online sports betting. PMID:23334577
Lee, Jaeseok; Chen, Chih-Chien; Song, Hak-Jun; Lee, Choong-Ki
This article reviews the essential primary and secondary injuries attributable to traumatic brain injury (TBI) which causes one third of all injury deaths in the United States. Motor vehicle crashes, falls, assaults, guns, sports, and recreational activities are the major causes of TBI. Secondary peak incidences of TBI occur in infants and children and the elderly. Conditions that increase risk for accidents include alcoholism, prior head injury, prior meningitis, seizure disorders, mental retardation, and psychiatric disorders. However, gunshot wounds to the head are steadily increasing and since 1990 have caused more deaths each year than motor vehicle accidents. The incidence, severity, etiology, and specific types of injuries have been assessed in clinicopathologic studies of head injuries. The pathologic features of both the primary and secondary lesions attributed to TBI should be understood by anyone caring for head-injured patients. The computed tomography (CT) and magnetic resonance (MR) images mirror the pathologic abnormalities found in head trauma. Radiologists must accurately interpret the CT and MR images of injured patients. Forensic pathologists have long appreciated the characteristic focal lesions, such as coup and contracoup contusions, that occur in falls or vehicle accidents, but the understanding of diffuse injuries has been more elusive. Understanding the nature of the focal and diffuse injuries is critical to understanding the morbidity and mortality of brain injury. PMID:12391630
Hardman, John M; Manoukian, Anthony
The acquired immunodeficiency syndrome (AIDS) is a devastating new disease caused by the human immunodeficiency virus (HIV). This retrovirus causes profound immunoincompetence in its infected hosts, who are thereafter susceptible to develop myriad severe and relapsing protozoal, fungal, bacterial, viral, and arthropodal opportunistic infections, as well as unusual malignancies. The more than 50,000 patients who have developed AIDS in the United States have produced a sudden unexpected deluge of diagnostic dilemmas that are stressing laboratories of pathology everywhere. This paper describes the gross and microscopic pathology of the numerous complications in patients infected by HIV: (a) the prodromal AIDS-related complex with persistent generalized lymphadenopathy, (b) lymphoid infiltration of salivary gland and lung, including the complex of lymphoid interstitial pneumonitis-pulmonary lymphoid hyperplasia, (c) extranodal non-Hodgkin's lymphomas, (d) multifocal mucocutaneous and visceral Kaposi's sarcoma, (e) small cell undifferentiated (oat cell) carcinomas, (f) protozoal infections caused by Pneumocystis carinii, Toxoplasma gondii, Acanthamoeba, Cryptosporidium species (sp.), and Isospora belli, (g) the causes of chronic enteritis, (h) mycotic infections caused by Candida sp., Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, and Sporothrix schenckii, (i) bacterial infections caused by Mycobacterium avium-intracellulare, M. tuberculosis, M. kansasii, Nocardia sp., Listeria monocytogenes, Legionella sp., Treponema pallidum, and others, (j) viral infections caused by cytomegalovirus, herpes simplex and zoster, polyomavirus (progressive multifocal leukoencephalopathy), hepatitis B, molluscum contagiosum, and papillomavirus, (k) oral hairy leukoplakia, (l) subacute encephalopathy, and (m) Norwegian scabies.
Macher, A M
Nanotechnology involves technology, science, and engineering in dimensions less than 100 nm. A virtually infinite number of potential nanoscale products can be produced from many different molecules and their combinations. The exponentially increasing number of nanoscale products will solve critical needs in engineering, science, and medicine. However, the virtually infinite number of potential nanotechnology products is a challenge for toxicologic pathologists. Because of their size, nanoparticulates can have therapeutic and toxic effects distinct from micron-sized particulates of the same composition. In the nanoscale, distinct intercellular and intracellular translocation pathways may provide a different distribution than that obtained by micron-sized particulates. Nanoparticulates interact with subcellular structures including microtubules, actin filaments, centrosomes, and chromatin; interactions that may be facilitated in the nanoscale. Features that distinguish nanoparticulates from fine particulates include increased surface area per unit mass and quantum effects. In addition, some nanotechnology products, including the fullerenes, have a novel and reactive surface. Augmented microscopic procedures including enhanced dark-field imaging, immunofluorescence, field-emission scanning electron microscopy, transmission electron microscopy, and confocal microscopy are useful when evaluating nanoparticulate toxicologic pathology. Thus, the pathology assessment is facilitated by understanding the unique features at the nanoscale and the tools that can assist in evaluating nanotoxicology studies. PMID:23389777
Hubbs, Ann F; Sargent, Linda M; Porter, Dale W; Sager, Tina M; Chen, Bean T; Frazer, David G; Castranova, Vincent; Sriram, Krishnan; Nurkiewicz, Timothy R; Reynolds, Steven H; Battelli, Lori A; Schwegler-Berry, Diane; McKinney, Walter; Fluharty, Kara L; Mercer, Robert R
The past century has seen tremendous changes in the scope and practice of pathology laboratories in tandem with the development of the medical services in Malaysia. Major progress was made in the areas of training and specialization of pathologists and laboratory technical staff. Today the pathology laboratory services have entered the International arena, and are propelled along the wave of globalization. Many new challenges have emerged as have new players in the field. Landmark developments over the past decade include the establishment of national quality assurance programmes, the mushrooming of private pathology laboratories, the establishment of a National Accreditation Standard for medical testing laboratories based on ISO 15189, and the passing of the Pathology Laboratory Act in Parliament in mid-2007. The Pathology Laboratory Act 2007 seeks to ensure that the pathology laboratory is accountable to the public, meets required standards of practice, participates in Quality Assurance programmes, is run by qualified staff, complies with safety requirements and is subject to continuous audit. The Act is applicable to all private laboratories (stand alone or hospital) and laboratories in statutory bodies (Universities, foundations). It is not applicable to public laboratories (established and operated by the government) and side-room laboratories established in clinics of registered medical or dental practitioners for their own patients (tests as in the First and Second Schedules respectively). Tests of the Third Schedule (home test blood glucose, urine glucose, urine pregnancy test) are also exempted. The Act has 13 Parts and provides for control of the pathology laboratory through approval (to establish and maintain) and licensing (to operate or provide). The approval or license may only be issued to a sole proprietor, partnership or body corporate, and then only if the entity includes a registered medical practitioner. Details of personnel qualifications and laboratory practices are left to be specified by the Director-General of Health, providing for a formal recognition process and room for revision as pathology practices evolve. Encompassed in the responsibilities of the licensee is the requirement that samples are received and results issued through, and management vested in, a registered medical or dental practitioner. This effectively prohibits "walk-ins" to the laboratory and indiscriminate public screening. The requirement for a person-in-charge in accordance with class and speciality of laboratory ensures that the laboratory is under the charge of the pathology profession. Examined carefully, the requirements of the Act are similar to laboratory accreditation, but are backed by legislation. Many of these details will be spelt out in the Regulations, and these in turn are likely to fall back on National professional guidelines, as accreditation does. Although not at first obvious, enforcement of the Act is based on self-regulation by pathology laboratory professionals. Sincere professional input is thus required to embrace its philosophy, ensure rational and transparent enforcement of legislation, and develop National guidelines for good pathology practices upon which enforcement may be based. PMID:19108405
This study examined whether personality differences might ac- count for meaningful heterogeneity within and across DSM-IV diagnostic categories for disruptive adolescent boys. In a broader study of personality pathology in adolescence, a national sample of 293 clinicians completed the Shedler-Westen Assessment Procedure 200-A on randomly selected outpa- tients aged 14 to 18 in their care. Of 138 boys in the
John J. DiLallo; Meredith Jones; Drew Westen
The age of a patient is a strong moderator of both the course and the evolution of disorders/diseases. However, the effects of current age in pathological gambling (PG) have rarely been examined. The aim of this study is to explore the moderating effects of the patients' current age in relation to personality traits and clinical outcomes of PG. A total sample of 2,309 treatment-seeking patients for PG, diagnosed according to DSM-IV criteria, participated in this study and were assessed with the Diagnostic Questionnaire for Pathological Gambling according to DSM-IV criteria, the South Oaks Gambling Screen, the Symptom Checklist, the Temperament and Character Inventory-R, and other clinical and psychopathological measures. Orthogonal polynomial contrasts showed linear trends in the relationship between age and PG: the older the patient, the more comorbid health problems were visible. The presence of additional quadratic trends also suggests that age plays a significant role in moderating the possibility of existing PG problems and general psychopathology. No interaction term was found between age and sex, but it was present for age and some personality traits: self-transcendence and reward dependence (these two traits were only relevant to the level of impairment due to PG at specific ages). This study suggests that the patients' age influences psychopathological and clinical aspects associated to PG. Intervention in the earliest manifestations of this complex problem is essential in order to better address the need of successful treatment planning. PMID:23494243
Granero, Roser; Penelo, Eva; Stinchfield, Randy; Fernandez-Aranda, Fernando; Savvidou, Lamprini G; Fröberg, Frida; Aymamí, Neus; Gómez-Peña, Mónica; Pérez-Serrano, Miriam; del Pino-Gutiérrez, Amparo; Menchón, José M; Jiménez-Murcia, Susana
Developed as part of the Marine Corps Institute (MCI) correspondence training program, this course on personal finance is designed to provide all Marines with the ability to manage their financial affairs successfully. Introductory materials include specific information for MCI students, a course introduction, and a study guide (guidelines to…
Marine Corps Inst., Washington, DC.
Kris (1956) described the concept of the personal myth as an autobiographical story built around a family romance fantasy seen specifically in obsessive characters and serving a defensive function. In this paper the concept of the personal myth was expanded to include similar defensive constellations originating from within the grandiose self, built around omnipotent and omniscient fantasies and occurring in character formations with pregenital, narcissistic pathology. The case of a known author and poet, Nikos Kazantzakis, was used to illustrate the thesis of the paper. The available biographical material and the work of the author offer evidence to support the claim that the author's personal myth was a protective shield against anxiety originating in early narcissistic traumata. PMID:3749397
Lester, E P
Background: In 2007, our healthcare system established a clinical fellowship program in Pathology Informatics. In 2010 a core didactic course was implemented to supplement the fellowship research and operational rotations. In 2011, the course was enhanced by a formal, structured core curriculum and reading list. We present and discuss our rationale and development process for the Core Curriculum and the role it plays in our Pathology Informatics Fellowship Training Program. Materials and Methods: The Core Curriculum for Pathology Informatics was developed, and is maintained, through the combined efforts of our Pathology Informatics Fellows and Faculty. The curriculum was created with a three-tiered structure, consisting of divisions, topics, and subtopics. Primary (required) and suggested readings were selected for each subtopic in the curriculum and incorporated into a curated reading list, which is reviewed and maintained on a regular basis. Results: Our Core Curriculum is composed of four major divisions, 22 topics, and 92 subtopics that cover the wide breadth of Pathology Informatics. The four major divisions include: (1) Information Fundamentals, (2) Information Systems, (3) Workflow and Process, and (4) Governance and Management. A detailed, comprehensive reading list for the curriculum is presented in the Appendix to the manuscript and contains 570 total readings (current as of March 2012). Discussion: The adoption of a formal, core curriculum in a Pathology Informatics fellowship has significant impacts on both fellowship training and the general field of Pathology Informatics itself. For a fellowship, a core curriculum defines a basic, common scope of knowledge that the fellowship expects all of its graduates will know, while at the same time enhancing and broadening the traditional fellowship experience of research and operational rotations. For the field of Pathology Informatics itself, a core curriculum defines to the outside world, including departments, companies, and health systems considering hiring a pathology informatician, the core knowledge set expected of a person trained in the field and, more fundamentally, it helps to define the scope of the field within Pathology and healthcare in general.
McClintock, David S.; Levy, Bruce P.; Lane, William J.; Lee, Roy E.; Baron, Jason M.; Klepeis, Veronica E.; Onozato, Maristela L.; Kim, JiYeon; Dighe, Anand S.; Beckwith, Bruce A.; Kuo, Frank; Black-Schaffer, Stephen; Gilbertson, John R.
Functional neuroimaging studies of pathological gambling (PG) demonstrate alterations in frontal and subcortical regions of the mesolimbic reward system. However, most investigations were performed using tasks involving reward processing or executive functions. Little is known about brain network abnormalities during task-free resting state in PG. In the present study, graph-theoretical methods were used to investigate network properties of resting state functional magnetic resonance imaging data in PG. We compared 19 patients with PG to 19 healthy controls (HCs) using the Graph Analysis Toolbox (GAT). None of the examined global metrics differed between groups. At the nodal level, pathological gambler showed a reduced clustering coefficient in the left paracingulate cortex and the left juxtapositional lobe (supplementary motor area, SMA), reduced local efficiency in the left SMA, as well as an increased node betweenness for the left and right paracingulate cortex and the left SMA. At an uncorrected threshold level, the node betweenness in the left inferior frontal gyrus was decreased and increased in the caudate. Additionally, increased functional connectivity between fronto-striatal regions and within frontal regions has also been found for the gambling patients. These findings suggest that regions associated with the reward system demonstrate reduced segregation but enhanced integration while regions associated with executive functions demonstrate reduced integration. The present study makes evident that PG is also associated with abnormalities in the topological network structure of the brain during rest. Since alterations in PG cannot be explained by direct effects of abused substances on the brain, these findings will be of relevance for understanding functional connectivity in other addictive disorders.
Tschernegg, Melanie; Crone, Julia S.; Eigenberger, Tina; Schwartenbeck, Philipp; Fauth-Buhler, Mira; Lemenager, Tagrid; Mann, Karl; Thon, Natasha; Wurst, Friedrich M.; Kronbichler, Martin
The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors in the health sciences field. In this case, a 68-year-old male patient experiencing fevers, chills, an associated non-productive cough, and weight loss was admitted to the hospital for examination. The Ã¢ÂÂGross Description,Ã¢ÂÂ Ã¢ÂÂMicroscopic Description,Ã¢ÂÂ and Ã¢ÂÂ MicrobiologyÃ¢ÂÂ sections provide key information and images that contributed to the patientÃ¢ÂÂs diagnosis. Clicking on the Ã¢ÂÂFinal DiagnosisÃ¢ÂÂ provides a thorough explanation of the diagnosis and treatment from the contributing doctors.
Kulich, Scott; Pasculle, A. W.
Cholangiocarcinoma (CC) arises from the biliary epithelium and in most cases represents adenocarcinoma. Pathomorphological evaluation is of decisive impact for the prognosis and management of CC. Morphological subtyping (histotype; hilar vs peripheral type), TNM classification, lymphatic spread, and resection margin status are of prognostic relevance. Distinction from hepatic metastases may be aided by immunohistology and clinico-pathological correlation. There is convincing evidence of the development of CC via premalignant lesions, especially biliary intraepithelial neoplasia, although further knowledge about the biology and diagnostic definition of these lesions has to be accumulated. Currently, there are no established molecular markers of prognosis or therapeutic target structures to be evaluated at the tissue level. Future progress is needed and expected in novel differential diagnostic and predictive markers, in uniform definition of resection margin status and further understanding of molecular and morphological changes in the development of CC.
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes "a 72-year-old white male who presented to an outside facility with chest pain of 24 hours duration." Visitors are given patient history, admission data, peripheral blood and bone marrow findings, including images. They are also given flow cytometry and cytogenic data as well as molecular genetics, with images, and are also given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.
Contis, Lydia C.; Nambiar, Ashok; Pindzola, Ander
The MicroPLB (personal locator beacon) is a search and rescue satellite-aided tracking (SARSAT) transmitter. When activated it emits a distress signal to a constellation of internationally operated satellites. The endangered person's identity and location anywhere on Earth is automatically forwarded to central monitoring stations around the world. It is accurate to within just a few meters. The user uses the device to download navigation data from a global positioning satellite receiver. After the download is complete, the MicroPLB functions as a self-locating beacon. Also, it is the only PLB to use a safe battery. In the past, other PLB devices have used batteries that have enough volatility to explode with extreme force. It was developed by Microwave Monolithic, Inc. through SBIR funding from Glenn Research Center and Goddard Space Flight Center.
IMPORTANCE The effect of ?-amyloid (A?) accumulation on regional structural brain changes in early stages of Alzheimer disease (AD) is not well understood. OBJECTIVE To test the hypothesis that the development of A? pathology is related to increased regional atrophy in the brains of cognitively normal (CN) persons. DESIGN, SETTING, AND PARTICIPANTS Longitudinal clinicobiomarker cohort study involving 47 CN control subjects and 15 patients with AD dementia. All participants underwent repeated cerebrospinal fluid A?42 and structural magnetic resonance imaging measurements for up to 4 years. Cognitively normal controls were classified using the longitudinal cerebrospinal fluid A?42 data and included 13 stable A? negative (normal baseline A?42 levels, with less than the median reduction over time), 13 declining A? negative (normal baseline A?42 levels, with greater than the median reduction over time), and 21 A? positive (pathologic baseline A?42 levels). All 15 patients with AD dementia were A? positive. MAIN OUTCOMES AND MEASURES Group effects on regional gray matter volumes at baseline and over time, tested by linear mixed-effects models. RESULTS Baseline gray matter volumes were similar among the CN A? groups, but atrophy rates were increased in frontoparietal regions in the declining A?-negative and A?-positive groups and in amygdala and temporal regions in the A?-positive group. A?-positive patients with AD dementia had further increased atrophy rates in hippocampus and temporal and cingulate regions. CONCLUSIONS AND RELEVANCE Emerging A? pathology is coupled to increased frontoparietal (but not temporal) atrophy rates. Atrophy rates peak early in frontoparietal regions but accelerate in hippocampus, temporal, and cingulate regions as the disease progresses to dementia. Early-stage A? pathology may have mild effects on local frontoparietal cortical integrity while effects in temporal regions appear later and accelerate, leading to the atrophy pattern typically seen in AD. PMID:24781145
Mattsson, Niklas; Insel, Philip S; Nosheny, Rachel; Tosun, Duygu; Trojanowski, John Q; Shaw, Leslie M; Jack, Clifford R; Donohue, Michael C; Weiner, Michael W
With the disclosure of the human genome a new era for bio-medicine has arisen, characterized by the challenge to investigate pathogenic mechanisms, studying simultaneously metabolites, DNA, RNA, and proteins. As a result, the "omics" revolution boomed, giving birth to a new medicine named "omics-based medicine". Among the other "omics", proteomics has been widely used in medicine, since it can produce a more "holistic" overview of a disease and provide a "constellation" of possible specific markers, a molecular fingerprinting that defines the clinical condition of an individual. Endpoint of this comprehensive and detailed analysis is the "diagnostic-omics", i.e. the achievement of personalized diagnoses with obvious benefits for prevention and therapy and this goal can be reached only with a perfect integration between clinicians and proteomists. To impact on the possible key factors involved in the pathological processes, oligonucleotide-based knock-down strategies can be helpful. They exploit omics-derived molecular tools (antisense, siRNA, ribozymes, decoys, and aptamers) that can be used to inhibit, at transcriptional or post-transcriptional levels, the events leading to protein synthesis, thus decreasing its expression. The identification of the pivotal mechanisms involved in diseases using global, "scenic" approaches such as the "omics" ones, and the subsequent validation and detailed description of the processes by specific molecular tools, can result in a more preventive, predictive and personalized medicine. PMID:23748691
Rocchiccioli, Silvia; Tedeschi, Lorena; Citti, Lorenzo; Cecchettini, Antonella
The diagnosis of a personality disorder is defined by the fact that personality traits are formed by early childhood, but German clinicians very rarely diagnose children and adolescents with personality disorders. Opponents of diagnosing personality disorders in childhood want to avoid labeling and refer to the developmental aspect of the personality. Supporters argue that children and adolescents already possess a describable personality and the developmental process continues into adulthood. By recognizing the pathological personality tendencies early enough allows an early therapy which can prevent an acute progression. The aim of the present study was to ascertain whether the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) is applicable for use with adolescents. This empirical study indicated that one-third of the adolescents investigated were still diagnosed with a personality disorder 1 year after the primary assessment. However, the present categorizing diagnosis system proved to be insensible for childhood and adolescence. This supports the notion that dimensional systems are needed to diagnose personality traits in childhood in adolescence. PMID:19768448
Jucksch, V; Salbach-Andrae, H; Lehmkuhl, U
Native Hawaiian forests are characterised by a high degree of endemism, including pathogens as well as their hosts. With the exceptions of koa (Acacia koa Gray), possibly maile (Alyxia oliviformis Gaud.), and, in the past, sandalwood (Santalum spp.), forest species are of little commercial value. On the other hand, these forests are immensely important from a cultural, ecological, and evolutionary standpoint. Forest disease research was lacking during the mid-twentieth century, but increased markedly with the recognition of ohia (Metrosideros polymorpha Gaud.) decline in the 1970s. Because many pathogens are themselves endemic, or are assumed to be, having evolved with their hosts, research emphasis in natural areas is on understanding host-parasite interactions and evolutionary influences, rather than disease control. Aside from management of native forests, attempts at establishing a commercial forest industry have included importation of several species of pine, Araucaria, and Eucalyptus as timber crops, and of numerous ornamentals. Diseases of these species have been introduced with their hosts. The attacking of native species by introduced pathogens is problematic - for example, Armillaria mellea (Vahl ex Fr.) Que??l. on koa and mamane (Sophora chrysophylla (Salisb.) Seem.). Much work remains to be done in both native and commercial aspects of Hawaiian forest pathology.
Gardner, D. E.
Criteria to differentiate personality disorder from extremes of normal personality variations are important given growing interest in dimensional classification because an extreme level of a personality dimension does not necessarily indicate disorder. The DSM-5 proposed classification of personality disorder offers a definition of general personality disorder based on chronic interpersonal and self/identity pathology. The ability of this approach to differentiate personality disorder from other mental disorders was evaluated using a self-report questionnaire, the General Assessment of Personality Disorder (GAPD). This measure was administered to a sample of psychiatric patients (N?=?149) from different clinical sub-sites. Patients were divided into personality disordered and non-personality disordered groups on the basis of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The results showed a hit rate of 82% correct identified patients and a good accuracy of the predicted model. There was a substantial agreement between SCID-II interview and GAPD personality disorder diagnoses. The GAPD appears to predict personality disorder in general, which provides support of the DSM-5 general diagnostic criteria of personality disorder. PMID:24343939
Hentschel, Annett G; John Livesley, W
To make a dimensional assessment of personality in individuals with pathological anxiety, the Tridimensional Personality Questionnaire (TPQ) was administered to 32 patients with panic disorder (PD) and 49 patients with generalized anxiety disorder (GAD). The most striking findings were a substantially increased score on the harm avoidance dimension in both groups of patients, and a lack of significant differences between
Vladan Starcevic; E. H. Uhlenhuth; Stephanie Fallon; Dorothy Pathak
Personality influences several characteristics of normal and pathologic behaviors and it is associated with neurotransmitter systems that are under genetic control. The dopaminergic system has been proposed to play a role in the modulation of personality traits. In the present study, variants of the tyrosine hydroxylase (TH) and DOPA decarboxylase (DDC) genes (for TH: rs3842727, rs6356; for DDC: rs1451371, rs1470750,
Ina Giegling; Daniel Moreno-De-Luca; Raffaella Calati; Annette M. Hartmann; Hans-Jürgen Möller; Diana De Ronchi; Dan Rujescu; Alessandro Serretti
Exploring the interface of neurobehaviorally linked personality dimensions and personality organization in borderline personality disorder: the Multidimensional Personality Questionnaire and Inventory of Personality Organization.
Advances in our understanding of complex psychopathology will likely benefit from approaches to mind, brain, and behavior that seek to (a) specify those general neurobehavioral processes underpinning pathology and (b) bridge to other process-based models of psychopathology at different levels of analysis. Well-defined neurobehavioral processes (e.g., positive emotionality, negative emotionality, nonaffective constraint, fear, affiliation) and their phenotypic indicators are firmly rooted in neural substrates (Depue & Lenzenweger, 2005). Furthermore, long-studied psychodynamic psychological processes, such as identity diffusion, primitive psychological defensive functioning, and reality-testing dimensions, are important to understanding personality pathology (Kernberg & Caligor, 2005). Both theoretical perspectives view the cardinal processes involved in the determination of personality disorders (PDs) as relevant across existing PD diagnostic entities. The authors examined relationships between psychometric indicators of these two sets of processes, the neurobehavioral and the psychodynamic, in a well-characterized sample of individuals with borderline personality disorder (BPD; N = 92). In bridging these two levels of analysis, the authors found that the alienation, aggression, and absorption constructs represent important linkages to the psychodynamic processes, especially primitive psychological defenses and reality-testing impairments. These results are discussed in terms of their potential for joining these two domains of analysis--a neurobehaviorally informed view of personality and the psychodynamic--in efforts to (a) foster a process-oriented approach, (b) resolve heterogeneity, and (c) facilitate identification of endophenotypes in BPD. The heuristic value of this approach for understanding other forms of psychopathology is also discussed. PMID:23281675
Lenzenweger, Mark F; McClough, Joel F; Clarkin, John F; Kernberg, Otto F
Decades of technological developments have populated the field of neuroprosthetics with myriad replacement strategies, neuromodulation therapies, and rehabilitation procedures to improve the quality of life for individuals with neuromotor disorders. Despite the few but impressive clinical successes, and multiple breakthroughs in animal models, neuroprosthetic technologies remain mainly confined to sophisticated laboratory environments. We summarize the core principles and latest achievements in neuroprosthetics, but also address the challenges that lie along the path toward clinical fruition. We propose a pragmatic framework to personalize neurotechnologies and rehabilitation for patient-specific impairments to achieve the timely dissemination of neuroprosthetic medicine. PMID:24197737
Borton, David; Micera, Silvestro; Millán, José del R; Courtine, Grégoire
The diverse embryological origins of the contents of the scrotum create an environment that fosters a wide variety of unusual pathologies. Most scrotal pathologies are discovered by the patient and are initially evaluated by a thorough physical examination and scrotal ultrasonography. Scrotal lesions can be broadly grouped by the anatomical location in which they develop; the clinician must consider a
Henry M. Rosevear; Alek Mishail; Yefim Sheynkin; Moshe Wald
Summary Patients exhibiting pathological grief reactions are those in the middle portion of a spectrum between those on one end with “normal” grief and those on the other end who suffer from full-blown neurosis, psychosomatic symptoms, etc., which are directly related to aknown loss. After examining 23 cases, the author suggests that patients who suffer from pathological grief share a
Most of the extant literature on borderline personality disorder has focused on the course, consequences, and correlates of this disorder among adults. However, little is known about childhood borderline personality (BP) features, or the factors associated with the emergence of BP pathology in childhood. A greater understanding of childhood BP features and associated risk factors has important implications for the
Elizabeth K. Reynolds; C. W. Lejuez
The treatment of patients with intrinsic brain tumors is radically changing. This change is currently not (yet) signified by the use of targeted therapy in clinical practice but more by the definition of molecular markers as predictors for response to therapy which have been used for a long time. While in the past the choice of treatment has been based solely on the tumor entity and its degree of malignancy derived from histological analyses, large randomized trials have now provided a solid basis for personalized molecular-guided treatment decisions. For instance, in the German NOA-08 trial a benefit of chemotherapy with temozolomide alone was only demonstrated in a subgroup of elderly patients with malignant gliomas displaying promoter hypermethylation of the DNA repair enzyme MGMT. This is only one of several examples where molecular analysis of tumor tissue becomes clinically relevant as these analyses can and should be taken into account for treatment decisions and not, as previously, just as an additional parameter for estimating prognosis. This article illustrates the current developments in the area of personalized neurooncology and critically reviews the impact on clinical decision-making in daily practice. PMID:23775285
Platten, M; Steinbach, J P; Wick, W
BACKGROUND Pathological gambling (PG), a disabling disorder experienced by approximately 1% of adults, has few empirically validated treatments. A recent study demonstrated that 6 sessions of imaginal desensitization plus motivational interviewing (IDMI) was effective in achieving abstinence for a majority of individuals with PG. This study sought to examine whether those benefits were maintained 6 months post-treatment. METHODS Sixty-eight individuals who met DSM-IV criteria for PG were randomly assigned to 6 sessions of IDMI or Gamblers Anonymous (GA) referral over an 8-week period. Participants who failed to respond to GA were offered IDMI after the 8-week acute treatment period. All individuals who responded to IDMI were contacted after 6 months and assessed with measures of gambling severity and psychosocial functioning. RESULTS Forty-four participants completed 6 sessions of IDMI (25 initially assigned to IDMI and 19 to GA). Thirty-five of the 44 (79.5%) responded during acute treatment, and all 35 were available for a 6-month evaluation. All gambling severity scales maintained statistically significant gains from baseline, although some measures showed significant worsening compared with post-IDMI treatment. CONCLUSIONS Six sessions of IDMI resulted in statistically significant reductions in PG urges and behavior, which were largely maintained for 6 months.
Grant, Jon E.; Donahue, Christopher B.; Odlaug, Brian L.; Kim, Suck Won
The American Phytopathological Society (APS) is a professional society dedicated to "high-quality, innovative plant pathology research." Founded in 1908, the APS continues to provide educational resources for those seeking to learn more about the science of plant pathology. One way they work to accomplish this goal is through this particular section of their website. The materials on this site include "Plant Disease Management Simulations", "Laboratory Exercises", and "Topics in Plant Pathology". The "Topics in Plant Pathology" area includes topical articles that deal with various aspects of plant pathology, including the use of reverse genetic tools for investigating gene function and the population genetics of plant pathogens. Moving on, the "Laboratory Exercises" area contains two activities that can be used by college students studying plant pathology. The "Plant Disease Management" area contains a handful of simulations that will help students learn about the spread and management of some common plant diseases. Finally, the site is rounded out by an illustrated glossary of plant pathology.
The Accreditation Council for Graduate Medical Education accredits LP for its residency program in Anatomic Pathology and fellowship programs in Cytopathology and Hematopathology. Additional information and application process may be reviewed at the NIH Office of Graduate Medical Education.
This is a pediatric pathology case study presented by the University of Pittsburgh Department of Pathology in which a 19-month-old boy has a renal mass. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in pediatric pathology.
Christakos, Peter; Dickman, Paul S.
The authors take part in the discussion concerning the formulation (structure) of pathological diagnosis in pediatric practice, particularly in perinatology. A scheme of formulation of pathological diagnosis which must reflect sections of the "Certificate on Perinatal Death" with due consideration for the new IX revision of International Classification of Diseases is proposed. The authors discuss the justification of the diagnosis of asphyxia and formulation of pathological diagnosis in cases of death of newborn babies due to noninfectious pneumopathies. The rules of formulation of the clinico-anatomical epicrisis is also discussed. PMID:6847406
Maksimovich, N A; Chistiakova, M B
The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics. PMID:24679180
Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G
Before Schleiden and Schwann, Darwin and Mendel there passed briefly a towering giant, Johann Friedrich Meckel the Younger (1781-1833), now glimpsed only fleetingly and obscurely through the mist of time and former controversies, who can nowadays easily and clearly be identified as the father of a "pre-modern" developmental biology. At his beginning this prodigiously gifted physician-scholar had, as one would say nowadays, an unfair advantage, his cradle having been rocked, as it were, by the preparators in his father's and grandfather's huge collection of normal and abnormal anatomical "specimens" in the home in which he was born and raised including his father's own skeleton (with two anatomical anomalies!). Initially reluctant to follow in the steps of his illustrious anatomist/physician grandfather and father, he nevertheless early demonstrated extraordinary gifts in anatomy and zootomy. Napoleon's conquest of his homeland notwithstanding, Meckel spent at least 2 extremely fruitful years in Paris, under the tutelage of Cuvier, but also in close contact with Geoffroy St. Hilaire (Etienne), Lamarck, and von Humboldt. He not only translated Cuvier's Leçons d'anatomie comparée into German but also greatly enriched this pivotal treatise with observations of embryonic and malformed fetuses and animals only of passing interest to his mentor. In his numerous publications, Meckel was the first to relate abnormal to normal development, define anomalies of incomplete differentiation (vestigia), but, most importantly, to relate those malformations known in humans to those that are normal adult developmental states in "lower" animals (atavisms). Thus, Meckel's three-fold parallelism of the scala naturae, normal ontogeny, and the malformations in humans and animals makes him a recapitulationist par excellence, however, without ever venturing into a fully articulated and explicit theory of descent. Today Meckel is remembered solely as the discoverer of the syndrome and cartilage named after him, and as having interpreted, correctly, the developmental nature of the "Meckel" diverticulum. It is virtually unknown that Meckel also first enuntiated the concept and distinction between primary and secondary malformations/anomalies, introduced the notion of heredity into the causal analysis of congenital anomalies, was the father of syndromology (the Meckel syndrome), had a clear understanding of pleiotropy and heterogeneity, and can unequivocally be regarded as the father of developmental pathology. In hindsight, and inspite of much professional success, Meckel emerges as a tragic figure in the history of biology, his life cut short at 52 without an ability to incorporate cell theory and the embryological insights of his younger contemporaries into his intellectual edifice which might have made it possible for him to finally and clearly see "analogy" (now homology), of which he was the greatest expert in his era, as incontrovertible evidence for descent. In that case, Darwin and Haeckel might have even had the courtesy of a tip-of-the-hat in Meckel's direction. PMID:16353245
Opitz, John M; Schultka, Rüdiger; Göbbel, Luminita
Arias-Stella, J., Krüger, H., and Recavarren, S. (1973).Thorax, 28, 701-708. Pathology of chronic mountain sickness. Pathological data on chronic mountain sickness are scarce due to the fact that the disease is ameliorated or cured by descent to a low altitude. In this report we describe a case of chronic mountain sickness occurring in a woman of 48 years at Cerro de Pasco (4,300 m above sea level). The necropsy findings are compared with the limited pathological observations reported by others. It is apparent from our findings that in fatal cases the main changes are located within the pulmonary circulation. So far histological studies have been reported only in cases of the secondary form of chronic mountain sickness. The basic pathology of the primary form (Monge's disease) remains to be defined. Images
Arias-Stella, Javier; Kruger, Hever; Recavarren, Sixto
With the increasing use of individualized medical care (personalized medicine) in treating and managing patients with cancer, the utilization of biomarkers in selecting and tailoring such medical approaches also is increasing and becoming more important. Specifically, many therapies are effective against only a subgroup of a specific type of tumors and exposing patients with different non-responsive subgroups of the same tumor to ineffective therapies, not only exposes these patients needlessly to acute and chronic side effects of the therapy, but also adds to the costs of medical care. For example, the Oncotype Dx test for estrogen receptor positive tumors that are node negative has been used to identify low risk tumors for which surgery alone is an adequate therapy. Biomarkers may be used to aid in multiple aspects of medical care related to cancer, including early detection, diagnosis, risk assessment, as well as in predicting the aggressiveness of cancers (i.e., prognosis) and predicting the therapeutic efficacy of treatments (i.e., prediction). Biomarkers may be also used as surrogate endpoints to aid in evaluating therapies and preventive approaches. Types of biomarkers vary greatly and include histopathologic appearance, stage of the lesion, quantitative morphologic features, size of the lesion, metastatic pattern and extent of metastasis, as well as imaging and molecular features. The types of measurements of biomarkers also vary; for example, molecular features can be measured at the DNA, mRNA or protein levels as well as at regulatory levels (e.g., microRNA). The usefulness of each biomarker is limited by its sensitivity and specificity in fulfilling its role (e.g., in early detection) and the requirements of sensitivity and specificity to accomplish specific tasks are affected by multiple variables. For example, both very high specificity and sensitivity of a test are required to screen a population with a low prevalence of a specific tumor. The goal of this manuscript is to introduce the reader to how biomarkers may be used and the limitations on the uses of biomarkers in translational research.
Grizzle, William E.; Srivastava, Sudhir; Manne, Upender
In this study we evaluated aspects of criterion validity and clinical utility of the grandiosity and vulnerability components of the Pathological Narcissism Inventory (PNI) using two undergraduate samples (Ns = 299, 500). Criterion validity was assessed by evaluating the correlations of narcissistic grandiosity and narcissistic vulnerability with established indices of normal personality traits, psychopathology and clinical concerns, and pathological personality traits. Overall, the pattern of correlations supported the convergent and discriminate validity of grandiose and vulnerable conceptualizations of pathological narcissism as measured by the PNI. Clinical utility was assessed by evaluating the extent to which clinicians without specific training in pathological narcissism as well as clinicians with expertise in pathological narcissism could accurately predict the correlates of PNI grandiosity and vulnerability with normal and pathological personality traits and psychopathology. The rcontrast-cv coefficient (Westen & Rosenthal, 2003) provided a global index of accuracy in clinicians’ predictions that was more fully elaborated by examining systematic discrepancies across groups. Overall, novice and expert clinicians were generally able to predict criterion correlations, with some exceptions (e.g., counter to predictions, pathological narcissism was negatively associated with treatment resistance). These results provide further evidence regarding the validity and utility of the narcissistic grandiosity and narcissistic vulnerability constructs as measured by the PNI.
Thomas, Katherine M.; Wright, Aidan G.C.; Lukowitsky, Mark R.; Donnellan, M. Brent; Hopwood, Christopher J.
Pediatric forensic pathology is an emerging medical subspecialty that spans the area between pediatric and forensic pathology.\\u000a Advances in both of these fields have increased the sophistication of diagnoses, with overlap of disorders that might present\\u000a to either the pediatric or forensic pathologist, adding further layers of complexity. Not surprisingly, therefore, there are\\u000a important ethical and medical controversies in pediatric
Henry F. Krous; Roger W. Byard
...2013-10-01 2013-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health...Combination of These Tests Â§ 493.853 Condition: Pathology. The specialty of pathology includes, for purposes of proficiency...
The present study demonstrates that (1) computer personalities can be easily created using a minimal set of cues, and (2) that people will respond to these personalities in the same way they would respond to similar human personalities. The present study focuses on the “simikirityattraction hypothesis,” which predicts that people will prefer to interact with others who are similar in
Clifford Nass; Youngme Moon; B. J. Fogg; Byron Reeves; Chris Dryer
Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets. PMID:23620353
Strickland, Casey M; Drislane, Laura E; Lucy, Megan; Krueger, Robert F; Patrick, Christopher J
Pain without accompanying tissue pathology poses a classic puzzle, presented in extreme form by phantom pain in a non-existent amputated limb. A clue to the origin of such pain is given by the recent discovery of a region of cortex active in response to incongruence between motor intention, awareness of movement, and visual feedback. Phantom-limb sensation, and repetitive strain injuries or focal hand dystonias in writers, musicians, or keyboard operators, are accompanied by plastic changes in sensorimotor cortex and by pathological pain. Disorganised or inappropriate cortical representation of proprioception may falsely signal incongruence between motor intention and movement, which results in pathological pain in the same way that incongruence between vestibular and visual sensation results in motion sickness. PMID:10543687
Harris, A J
The relationship between forgiveness and borderline personality symptomatology has been rarely studied. Using a consecutive cross-sectional sample of 307 internal medicine outpatients and a survey methodology, we examined correlations between the Forgiveness Scale and borderline personality symptomatology as measured by the borderline personality disorder scale of the Personality Diagnostic Questionnaire-4 and the Self-Harm Inventory. Numerous forgiveness subscales as well as the composite Forgiveness Scale score demonstrated statistically significant relationships with both measures for borderline personality symptomatology, such that individuals with this personality pathology demonstrated lower scores on these forgiveness subscales. Findings indicate that among individuals with borderline personality symptomatology, there are numerous aspects of forgiveness that are significantly lower than in individuals without this symptomatology. PMID:23543112
Sansone, Randy A; Kelley, Amy R; Forbis, Jeremy S
This is a case study presented by the University of Pittsburgh Department of Pathology in which a man reported a history of chronic sinusitis that was not responding to nasal and antibiotic treatments. Visitors can view both microscopic and gross descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of head and neck pathology.
Becich, Michael J.; Fowler, Jason C.
The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in learning. A 59-year-old patient with a history of smoking was admitted for a biopsy of his recently transplanted liver. Laboratory results, X-ray images, microscopic descriptions and images are provided to aid in the understanding of the final diagnosis. The doctor's official conclusions and references are included in the "Final Diagnosis" section. Students entering health sciences fields will find this resource very helpful, as it provides experience with patient history, lab results and diagnostics.
Bastacky, Sheldon; Holst, Valerie
This is a case study presented by the University of Pittsburgh Department of Pathology in which a young woman experienced vomiting, dizziness, headaches, and change of mental status due to conjunctival petechiae. Visitors are given the transfusion reaction investigation, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in transfusion pathology.
Johnson, Douglas R.; Triulzi, Darrell
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old woman with systemic rheumatoid arthritis has developed renal insufficiency. Visitors are given the gross and microscopic descriptions, electron microscopy exam results, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in renal pathology.
Bastacky, Sheldon; Wang, Jianzhou
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 18-year-old male with "painless enlargement of the right testes over a period of several months, initially attributed to a sports injury." Visitors are given admission data along with gross and microscopic description, including images and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in genitourinary pathology.
Fowler, Jason C.; Halpern, Melissa B.; Rao, Uma N.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 69-year-old man has a pigmented lesion on his right ear. Visitors are given the patient history and microscopic description, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in dermatologic pathology.
This is a case study presented by the University of Pittsburgh Department of Pathology in which an older woman developed a renal mass without evidence of angiomyolipoma. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in endocrine pathology.
Hardy, Hunter T.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a man complained of diaphoresis nausea and substernal chest pain through his left arm. Subsequent tests revealed a mediastinal mass with both fatty and solid components. Visitors can view both microscopic and gross descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of soft tissue pathology.
Fowler, Jason C.; Rao, Uma N.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a man presented with a large range of symptoms from chills and fever to underdeveloped calf muscles. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in cardiovascular pathology.
Defrances, Marie C.; Lee, Robert E.
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 62-year-old woman who presented with two months of back pain. Visitors are given patient history, laboratory findings, along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pulmonary pathology.
Lu, Zhengbin; Schoedel, Karen
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 43-year-old male with Hepatitis C has had a laparoscopic cholecystectomy performed. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in transplant pathology.
Richert, Charles A.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 60-year-old man has a recently enlarging coccygeal mass. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in skeletal and soft tissue pathology.
Horn, Kevin D.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 38-year-old woman with a history of morbid obesity and gastric bypass surgery complains of fatigue, sore throat, and rash. Visitors are given the physical examination results and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in dermatologic pathology.
Flynn, Kevin J.; Malone, Mark
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 34-year-old is experiencing complications following a liver transplant. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in transplant pathology.
Richert, Charles A.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 20-year-old man has a history of pulmonary hypertension. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in cardiovascular pathology.
Horn, Kevin D.
This is a case study presented by the University of Utah Department of Pathology in which a woman developed jaundice while on vacation. Subsequent testing revealed a pancreatic mass. Visitors can view both microscopic and gross descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of autopsy pathology.
Klatt, Edward C., 1951-
A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) has obtained only inconsistent support. The current study administered multiple measures of 1) conscientiousness-related personality traits, 2) DSM-IV OCPD, and 3) specific components of OCPD (e.g., compulsivity and perfectionism) to a sample of 536 undergraduates who were oversampled for elevated OCPD scores. Six existing measures of conscientiousness-related personality traits converged strongly with each other supporting their assessment of a common trait. These measures of conscientiousness correlated highly with scales assessing specific components of OCPD, but obtained variable relationships with measures of DSM-IV OCPD. More specifically, there were differences within the conscientiousness instruments such that those designed to assess general personality functioning had small to medium relationships with OCPD, but those assessing more maladaptive variants obtained large effect sizes. These findings support the view that OCPD does represent a maladaptive variant of normal-range conscientiousness. PMID:22448765
Samuel, Douglas B; Widiger, Thomas A
Throughout the course of history, gambling has been a popular activity across most cultures. In the United States, gambling has transitioned from early acceptance to prohibition to widespread proliferation. For most, gambling is a relaxing and recreational activity; however, for some individuals gambling becomes more than harmless fun. The most severe form of gambling, pathological gambling, is recognized as a
Larry L. Ashley; Karmen K. Boehlke
In a study of 57 actual or impending pathologic fractures of the humerus in 52 patients with inoperable cancer treated between 1972 and 1982, we retrospectively reviewed the charts for analysis and comparison of the functional result and pain relief afforded by the various treatments used. Function of the extremity and relief of pain were each graded as excellent, good, fair, or poor using a modification of Perez's rating system. Seven pathologic fractures were treated nonoperatively. These patients generally had only fair pain relief and a poor functional result. Forty-six pathologic fractures were treated with intramedullary fixation using a Rush rod (n = 16), a Küntscher rod (n = 29), or an Ender rod (n = 1); the Neer endoprosthesis was used in four patients. Thirty-one patients received radiation to the humerus. There were seven operative complications, the most common (n = 3) being prominence of an intramedullary rod at the insertion site which required a second minor procedure for advancement of the rod. From this series, we conclude that any patient who has a pathologic fracture or impending fracture of the humerus and a predicted survival of six weeks or more is likely to benefit from rigid internal fixation with an appropriately selected device, adjunctive use of methylmethacrylate, and postoperative local irradiation therapy as needed. PMID:3336802
Lancaster, J M; Koman, L A; Gristina, A G; Rovere, G D; Poehling, G G; Nicastro, J F; Adair, D M
A large variety of gastrointestinal and abdominal pathologic processes can be diagnosed or suspected by their direct effects on the chest. The chest radiograph, as often the first admission film, can aid the radiologist in recommending the appropriate follow-up examinations. PMID:6382420
Gedgaudas-McClees, R K; Torres, W E; Colvin, R S; McClees, E C; Baron, M G
This text details recent advances in methods for detecting, diagnosing, and managing genitourinary diseases. Included are chapters on imaging techniques (including magnetic resonance imaging, computed tomography, and ultrasound; tumor markers (such as alphafetoprotein, human chorionic gonadotropin, prostatic specific antigen, and T-antigens); immunocytochemistry; pediatric urologic pathology; and other key topics.
Javadpour, N.; Barsky, S.H.
DATA FROM RECENT COMPREHENSIVE STUDIES OF THE PATHOLOGY OF MENTAL RETARDATION ARE ASSEMBLED, INCLUDING MATERIAL ON ETIOLOGY, MORPHOLOGY, BIOCHEMISTRY, AND LABORATORY DIAGNOSIS. AREAS COVERED ARE (1) GENETIC CAUSES OF MENTAL RETARDATION, (2) DISORDERS OF GESTATION, (3) BIRTH INJURY, (4) GENERAL CONSIDERATIONS OF POSTNATAL CAUSES OF MENTAL…
CROME, L.; STERN, J.
Chronic pain is a major challenge to clinical practice and basic science. The peripheral and central neural networks that mediate nociception show extensive plasticity in pathological disease states. Disease-induced plasticity can occur at both structural and functional levels and is manifest as changes in individual molecules, synapses, cellular function and network activity. Recent work has yielded a better understanding of
A radical reworking of Axis II has been proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders whereby personality disorder categories will be replaced by a trait dimensional model of personality pathology. Perfectionism is specified as a lower order facet of Compulsivity within this proposed model. This marginalization of the perfectionism construct is inconsistent with the empirical literature that suggests that perfectionism is an important dimension of maladaptive personality in its own right, complete with its own set of more specific lower order facets. Further, perfectionism in the current proposed system is relevant only to the characterization of the obsessive-compulsive personality disorder type, despite compelling empirical research that demonstrates that various dimensions of perfectionism are differentially associated with personality pathology of all kinds. The present article reviews existing research on the role of various dimensions of perfectionism in personality disorder, highlights these seemingly ignored areas of the perfectionism literature, and discusses the problems and consequences that will arise if perfectionism continues to be defined narrowly and is largely excluded from dimensional models of personality pathology. PMID:22452778
Ayearst, Lindsay E; Flett, Gordon L; Hewitt, Paul L
This paper provides a brief review of genetically informative studies of personality disorders. Findings from twin and adoption studies suggest that personality disorders are moderately to strongly heritable (heritability estimates between 30% and 80%) and that environmental factors that increase the risk of personality disorder are individual specific (non-shared environment estimates between 25% and 70%). Molecular genetic studies of personality
Nathalie Fontaine; Essi Viding
Working from normalization theory, uses a graphical metaphor to illustrate the liberation of the "hidden self." Explains the layers of the metaphor, the "false person," the "intelligent, rational person," and the "hidden person," and offers several ways educators can work to uncover the layers surrounding the hidden person. (EV)
Zener, Rita; Ezcurdia, Laura Noriega
Objectives: To determine whether patients with psychogenic non-epileptic seizures (PNES) have evidence of maladaptive personality, and whether they have a single or several different typical pathological personality profiles. Methods: Patients were recruited from the department of epileptology, Bonn, Germany. In all, 85 patients with PNES and 63 with epilepsy completed a postal questionnaire including the dimensional assessment of personality pathology – basic questionnaire (DAPP-BQ). The DAPP-BQ was also completed by 100 healthy volunteers. The groups were compared and the PNES group was subjected to cluster analysis. Results: Patients with PNES had a greater degree of personality abnormality than clinical and non-clinical controls. There were several clusters of personality pathology. The profile of the largest cluster (n = 43) resembled that found in borderline personality disorder, that of the second largest (n = 37) was characterised by an overly controlled personality, that of the third (n = 4) was similar to the profile in avoidant personality disorder. Outcome differed between clusters. Conclusions: Maladaptive personality is common in patients with PNES. PNES are associated with several distinct profiles of pathological personality. This is relevant because outcome differed between profiles.
Reuber, M; Pukrop, R; Bauer, J; Derfuss, R; Elger, C
Background The purpose of this study was to compare the socio-demographic characteristics of non-problem gamblers, problem gamblers and pathological gamblers, to investigate the association between gambling related factors and perceived health and well-being among the three subgroups of gamblers, and to analyse simultaneously socio-demographic characteristics, gambling related factors and perceived health and well-being and the severity of disordered gambling (problem gamblers and pathological gamblers). Methods The data were collected through a nationwide telephone survey in 2011. Participants were selected through a random population sample of 15-74-year-old Finns. From that sample, persons with any past-year gambling involvement (N?=?3451) were selected for a subsample for the descriptive and inferential analysis in the present paper. Gambling was assessed using the South Oaks Gambling Screen. Statistical significance was determined by chi-squared tests. The odds ratio and effect size were computed by using multivariate-adjusted multinomial logistic regression analysis. Results The most significant socio-demographic characteristics (male gender, young age, education ?12 years), gambling related factors (slot machine gambling, internet gambling) and perceived health and well-being (feeling lonely, smoking daily, risky alcohol consumption, mental health problems) explained 22.9 per cent of the variation in the severity of disordered gambling. Conclusion Male gender and loneliness were found to be associated with problem gambling in particular, along with smoking and risky alcohol consumption. Mental health problems and risky alcohol consumption were associated with pathological gambling. These identified associations between disordered gambling, mental health problems and risky alcohol consumption should be taken into consideration when implementing screenings of disordered gambling.
In this postscript the authors applaud Hahn and Warren's effort in their reply to remove the ambiguity in distinguishing events such as occurrence, occurrence at least once, and nonoccurrence in Hahn and Warren (2009). Still, it appears that differences between us exist regarding the nature of waiting time and its connections to the probability of…
Sun, Yanlong; Tweney, Ryan D.; Wang, Hongbin
A set of characteristic symptoms allow for the relatively straightforward diagnosis of eating disorders. Simultaneously and paradoxically, underlying the eating disorders are a wide variety of personality organizations/disorders, stretching from the neurotic to the borderline and narcissistic, and even to conditions approaching psychosis. This paper will argue that the inherent commonalities can be ascribed to pathological organizations of a similar nature and quality, operational across the spectrum of eating disorders and functioning in a particular, sadomasochistic way. The typical forms that eating disorders take are based on the specific ways that food and the body are used, that is, symptom manifestation. These distinctive symptom manifestations appear to be related to Steiner's (1982, 1993) notion of a psychic retreat. Pathological organizations and psychic retreats are latent until called upon either sporadically or continuously. When activated, these defensive structures operate like a complex psychic skeleton around which the unique psychodynamics of each patient become rearranged and thereby transformed. PMID:22489814
Kadish, Yael Adira
This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD) and explored stability of cluster membership over a six-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Study of Personality Disorders (CLPS). The CLPS project tracked a large sample of individuals who met criteria for one of four target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded three clusters: “internalizing,” “externalizing,” and “low pathology.” Using K-means cluster analysis, the results did not replicate prior work. Using Ward’s method, the hypothesized 3-cluster structure was confirmed at baseline, but did not demonstrate temporal stability at 6 months.
McDevitt-Murphy, Meghan E.; Shea, M. Tracie; Yen, Shirley; Grilo, Carlos M.; Sanislow, Charles A.; Markowitz, John C.; Skodol, Andrew E.
Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher\\u000a order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity\\u000a between personality pathology and other clinical constructs in adolescents. In this study, personality pattern scales from\\u000a the Millon Adolescent Clinical Inventory in a sample of 492 adolescent inpatients were
Christopher J. HopwoodCarlos; Carlos M. Grilo
Glycation, the nonenzymatic glycosylation of biomolecules, is commonly observed in diabetes and ageing. Reactive dicarbonyl species such as methylglyoxal and glyoxal are thought to be major physiological precursors of glycation. Because these dicarbonyls tend to be formed intracellularly, the levels of advanced glycation end products on cellular proteins are higher than on extracellular ones. The formation of glycation adducts within cells can have severe functional consequences such as inhibition of protein activity and promotion of DNA mutations. Although several lines of evidence suggest that there are specific mitochondrial targets of glycation, and mitochondrial dysfunction itself has been implicated in disease and ageing, it is unclear if glycation of biomolecules specifically within mitochondria induces dysfunction and contributes to disease pathology. We discuss here the possibility that mitochondrial glycation contributes to disease, focussing on diabetes, ageing, cancer, and neurodegeneration, and highlight the current limitations in our understanding of the pathological significance of mitochondrial glycation.
Pun, Pamela Boon Li; Murphy, Michael P.
Neonatal jaundice is the occurrence of elevated bilirubin levels in the blood. It may be physiological or pathological. If the concentration of non-conjugated bilirubin in the blood is too high, it breaches the blood brain barrier and bilirubin encephalopathy occurs with serious consequences for the child. The aim of the research was to examine the incidence frequency of unconjugated pathologic jaundice in newborns and connect it to some epidemiological variations (medical, social, demographic) as well as to prove the increased frequency of jaundice in children born by stimulation and labour induction. The study included 800 infants: 198 (24.8%) of them did, and 602 (75.2%) did not suffer from jaundice. Statistical analysis confirmed the association between the onset of jaundice in newborns and the following parameters: gestational age, birth weight, maternal infections and other illnesses during pregnancy and premature rupture of membranes as complications during labor and the mode of delivery. PMID:24851614
Mesi?, Ivana; Milas, Vesna; Medimurec, Maja; Rimar, Zeljka
The molecular pathology of prostate cancer is complex; not only are multiple genes involved in its pathogenesis, but additional environmental factors such as diet and inflammation are also involved. The exhaustive research into prostate cancer to date has demonstrated a complex interaction of multiple genes and environmental factors, some of which may be more important in individual prostate cancer cases. This is an exciting era, with the emergence of new investigative tools such as DNA microarray technology and the application of the field of proteomics to the study of human cancers. Knowledge of genetic changes underlying the initiation, development, and progression of prostate cancer is accumulating rapidly. With increasing knowledge, it may be possible to distinguish indolent from aggressive prostate tumours by molecular fingerprinting. This review discusses the most consistently reported molecular pathological findings in hereditary and sporadic prostate cancer, together with new concepts and technologies.
Hughes, C; Murphy, A; Martin, C; Sheils, O; O'Leary, J
This pediatric pathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent resource for students and instructors in the health science fields. The learning objectives located at the top of the page are a great way for students to evaluate their learning progress. This case involves a 12-year-old girl presenting with recurrent lung nodules. Images from chest x-rays and a lung biopsy provide conclusive information that contributes to the patientÃ¢ÂÂs diagnosis. A description of these images is also provided. The official final diagnosis is accompanied by a discussion of the contributing doctorÃ¢ÂÂs findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientÃ¢ÂÂs conditions.
Arnold, Sonya; Hasegawa, Susan
This gynecologic pathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent resource for students and instructors in the health science fields. This case involves 57-year-old female with postmenopausal bleeding. The patientÃ¢ÂÂs history, and results from a pelvic ultrasound are included in the case study to aid in the understanding of the final diagnosis. The official final diagnosis is accompanied by a discussion of the contributing doctorÃ¢ÂÂs findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientÃ¢ÂÂs conditions.
Chen, Lei; Kanbour, Anisa; Kessinger, Rovena L.
This is a case study presented by the University of Pittsburgh Department of Pathology which presents a 29 year old Hispanic woman who delivered a stillborn fetus with a estimated gestation of 29 weeks. Visitors are provided with patient history along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in perinatal pathology.
Klatt, Edward C., 1951-; Mccune, Ryan
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes "a 46-year-old gentleman with a persistent right lower lobe pulmonary mass after a successfully treated cavitary pneumonia 5 months ago." Visitors are given patient history along with radiology findings and images. They are also given gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pulmonary pathology.
Gregorio, Remigio; Johnson, Douglas R.; Nodit, Laurentia; Yousem, Sam
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 60-year-old woman who presented with a history of marked abdominal distention lasted for several months with associated progressive fatigue, progressive weight loss and fever. Visitors are given patient history along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in soft tissue pathology.
Rao, Uma N.; Sepulveda, Antonia; Yu, Hongbo
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 16-year-old female who presented with a seven-month history of headaches and difficulty with gait. Visitors are given examination findings, imaging studies, and pathological findings, including images, and are given the opportunity to diagnose the patient. A "Diagnosis and Discussion" section provides the findings, discussion of the disease, along with references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Cummings, Thomas J.; Ebert, Robert H.; McLendon, Roger E., 1957-; Provenzale, James M.
The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in the medical/health science field. This particular case involves a 41 year-old woman experiencing the following symptoms for a period of 18 months: fatigue, weakness, lethargy, and decreased concentration. The patientÃ¢ÂÂs history, description of CT scans, and images from histological examinations, which contributed to the conclusive diagnosis, are all provided here for your review. The contributing doctors provide a detailed discussion of the patientÃ¢ÂÂs condition in the Ã¢ÂÂFinal DiagnosisÃ¢ÂÂ section. Students will find this resource especially helpful, as it provides experience with patient history, lab results, and diagnostics.
Dacic, Sanja; Rajan, Prabha B.
The aim of this study was to identify personality factors predicting psychotherapy utilization on the basis of personality pathology, affect regulation and interpersonal functioning. The authors assessed affectivity (using the Affect Experience and Affect Regulation Q-Sort), interpersonal context (using the Quality of Object Relations Scale), and character pathology (using the Shedler–Westen Assessment Procedure-200). Combination of instruments showed one stable factor
Henriette Löffler-Stastka; Victor Blueml; Christa Boes
The choroid plexus is an epithelial–endothelial vascular convolute within the ventricular system of the vertebrate brain.\\u000a It consists of epithelial cells, fenestrated blood vessels, and the stroma, dependent on various physiological or pathological\\u000a conditions, which may contain fibroblasts, mast cells, macrophages, granulocytes or other infiltrates, and a rich extracellular\\u000a matrix. The choroid plexus is mainly involved in the production of
Hartwig Wolburg; Werner Paulus
We report the pathological findings in cases of acrylic implants obtained by direct intratumoral injection of poly-methyl-methacrylate (PMMA) and N-butyl-cyano-acrylate (NBCA). Direct intratumoral injection of acrylic implants was performed for a variety of primary and secondary bone lesions. These types of treatments have been used at our institution in the last 4 years for 40 vertebroplasty (PMMA) procedures and for
D San Millán Ruíz; K Burkhardt; B Jean; M Muster; J. B Martin; J Bouvier; J. H. D Fasel; D. A Rüfenacht; A. M Kurt
This is a neuropathology case study presented by the University of Pittsburgh Department of Pathology in which a 49 year old woman has visual disturbances. Visitors are given the microscopic description, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Bilbao, Juan M., 1938-; Horvath, Eva, Ph.D.; Kovacs, Kalman; Syro, Luis; Uribe, Humberto; Vidal, Sergio
AIMS: To study the postmortem pathology associated with ring substituted amphetamine (amphetamine derivatives) misuse. METHODS: The postmortem findings in deaths associated with the ring substituted amphetamines 3,4-methylenedioxymethyl-amphetamine (MDMA, ecstasy) and 3,4-methylenedioxyethylamphetamine (MDEA, eve) were studied in seven young white men aged between 20 and 25 years. RESULTS: Striking changes were identified in the liver, which varied from foci of individual
C M Milroy; J C Clark; A R Forrest
Narcissistic personality disorder (NPD) is a trait-based disorder that can be understood as a pathological amplification of narcissistic traits. While temperamental vulnerability and psychological adversity are risk factors for NPD, sociocultural factors are also important. This review hypothesizes that increases in narcissistic traits and cultural narcissism could be associated with changes in the prevalence of NPD. These shifts seem to be a relatively recent phenomenon, driven by social changes associated with modernity. While the main treatment for NPD remains psychotherapy, that form of treatment is itself a product of modernity and individualism. The hypothesis is presented that psychological treatment, unless modified to address the specific problems associated with NPD, could run the risk of supporting narcissism. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:22800179
Summary The pathology of human influenza has been studied most intensively during the three pandemics of the last century, the last of which occurred in 1968. It is important to revisit this subject because of the recent emergence of avian H5N1 influenza in humans as well as the threat of a new pandemic. Uncomplicated human influenza virus infection causes transient tracheo-bronchitis, corresponding with predominant virus attachment to tracheal and bronchial epithelial cells. The main complication is extension of viral infection to the alveoli, often with secondary bacterial infection, resulting in severe pneumonia. Complications in extra-respiratory tissues such as encephalopathy, myocarditis, and myopathy occur occasionally. Sensitive molecular and immunological techniques allow us to investigate whether these complications are a direct result of virus infection or an indirect result of severe pneumonia. Human disease from avian influenza virus infections is most severe for subtype H5N1, but also has been reported for H7 and H9 subtypes. In contrast to human influenza viruses, avian H5N1 virus attaches predominantly to alveolar and bronchiolar epithelium, corresponding with diffuse alveolar damage as the primary lesion. Viremia and extra-respiratory complications appear to be more common for infections with avian H5N1 virus than with human influenza viruses. Further understanding and comparison of the pathology of human and avian influenza virus infections only can be achieved by directed and careful pathological analysis of additional influenza cases.
Kuiken, Thijs; Taubenberger, Jeffery
Objectives: We aimed to review how personality characteristics contribute to the onset, maintenance or modulation of fibromyalgia. Method: The databases Medline and PsychINFO were examined from 1967 to 2012 to identify studies that investigated associations between fibromyalgia and personality. Search terms included fibromyalgia and personality, trait psychology, characteristics and individual differences. Results: Numerous studies indicate that patients with fibromyalgia experience psychological distress. Various instruments have been used to evaluate distress and related psychological domains, such as anxiety or depression, in fibromyalgia. In many cases, these same instruments have been used to study personality characteristics in fibromyalgia with a subsequent blurring of cause and effect between personality and psychological distress. In addition, the symptoms of fibromyalgia may change pre-illness personality characteristics themselves. These issues make it difficult to identify specific personality characteristics that might influence the fibromyalgia process. Despite this inherent problem with the methodologies used in the studies that make up this literature review, or perhaps because of it, we found no defined personality profile specific to fibromyalgia. However, many patients with fibromyalgia do show personality characteristics that facilitate psychological responses to stressful situations, such as catastrophising or poor coping techniques, and these in turn associate with mechanisms contributing to fibromyalgia. Conclusion: No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism.
Malin, Katrina; Littlejohn, Geoffrey O
The concept of multiple personality ia critically examined in the light of its historical development. Various conceptions of multiple personality are considered: aa a diagnostic fashion; aa a product of shaping in therapy; as a product of hypnotic suggestion; as simulation; and aa an extension of characteristica found in “normal” personslitiea. These considerations lead to the conclusion that the significant
J. P. Sutcliffe; Jean Jones
MicroRNAs are small endogenous noncoding RNAs that are critical regulators of several physiologic and pathologic processes including cancers. Variations in the level of microRNA expression have been linked with the development, progression, and spread of cancer to distant organs. These tiny molecules may play a role in accurate and early diagnosis, and also as prognostic determinants. Modulating their activity provides opportunities for developing and designing novel cancer therapeutics. Recent studies indicate their detection in a wide variety of human biologic specimens including blood, serum, fine-needle aspirates, and tissues, making them clinically useful biomarkers of disease for early detection, prognosis, and for designing personalized therapies. PMID:24267185
Sethi, Seema; Ali, Shadan; Kong, Dejuan; Philip, Philip A; Sarkar, Fazlul H
Objective This study examined evidence for personality variability in adolescents with eating disorder features based in light of previous evidence that personality variability in adult women with eating pathology carries important clinical implications. Method Millon Adolescent Clinical Inventory personality data from adolescent girls with disturbed eating who were psychiatrically hospitalized were cluster analyzed and resulting groups were compared in terms of eating and comorbid pathology. Results Three sub-groups were identified among the 153 patients with eating disorder features: high-functioning, internalizing, and externalizing. The internalizing group was marked by eating-related and mood dysfunction, the externalizing group by elevated eating and mood pathology as well as impulsivity, aggression, and substance use, and the high-functioning group by lower levels of psychopathology and relatively high self-esteem. Conclusions These findings converge with previous research using different personality models in adult samples and highlight the clinical utility of considering personality heterogeneity among adolescent and adult women with disturbed eating.
Hopwood, Christopher J.; Ansell, Emily B.; Fehon, Dwain C.; Grilo, Carlos M.
Summary The salivary proteome is a complex protein mixture resulting from the activity of salivary glands with the contribution of other components that form the oral environment such as oral tissues and micro-organisms. For diagnosis purposes, saliva collection has the great advantage of being an easy and non-invasive technique. Human saliva proteomics have proven to be a novel approach in the search for protein biomarkers for detection of different local and systemic diseases. Currently, more than 1400 salivary proteins have been identified. In the last few years, our research group has extensively studied the salivary proteomics in order to analyse the salivary composition, investigating the major families of proteins present in human and mammalian saliva, the post-translational modifications, the different contributions of glands, the physiological and pathological modifications of saliva. The aim of this report is to present our personal experience in salivary proteomics. In conclusion, salivary proteome analysis represents an important field both for diagnosis and monitoring of various diseases and could be considered a novel approach to prevention of various pathological conditions.
Scarano, E; Fiorita, A; Picciotti, PM; Passali, GC; Calo, L; Cabras, T; Inzitari, R; Fanali, C; Messana, I; Castagnola, M; Paludetti, G
In the past 10 years there has been increasing concern about recruitment of junior doctors into pathology, particularly histopathology, in the UK. In this study, we report on career choices for pathology, derived from postal questionnaire surveys of all qualifiers from all UK medical schools in nine qualification years since 1974. 74% (24,623/33,417) and 73% (20,709/28,468) of doctors responded at 1 and 3 years after qualification. The percentage of doctors choosing pathology 1 year after qualification has fallen sharply in recent years: between 1974 and 1983 it was 4.5% (95% confidence interval 4.1-4.9%) and between 1993 and 2002 it was 2.3% (CI 2.0-2.5%). 57% of doctors who chose pathology 1 year after qualification were still working in pathology at year 10. Hours and conditions of work, the doctor's personal assessment of their aptitudes, and their experience of the subject as a student influenced long-term career choices for pathology. Recruitment of UK graduates into the pathology specialties must increase to meet demand in the new and expanding subspecialties. This depends on developing innovative ways of raising the profile of pathology to medical students and junior hospital doctors. PMID:16278816
Lambert, Trevor W; Goldacre, Michael J; Turner, Gill; Domizio, Paola; du Boulay, Clair
This report presents the results and conclusions of a 1972 study performed by the Task Force on Speech Pathology and Audiology. Thirteen educational institutions offering degrees in speech pathology and audiology in Louisiana were surveyed, and completed ...
J. L. Peterson
Seven papers report on speech language pathology and audiology studies performed by graduate students. The first paper reports on intelligibility of two popular synthetic speech systems used in communication aids for the speech impaired, the Votrax Personal Speech System and the Echo II synthesizer. The second paper reports facilitation of tense…
City Univ. of New York, Flushing. Queens Coll. Dept. of Communication Arts and Sciences.
Therapeutic doses of X-rays to the thyroid region of children have been followed after some years by the development of thyroid neoplasms. Whereas the percent of cases of malignant neoplasms is small, the proportion of persons irradiated who develop nodul...
This volume establishes clinical, pathological, and radiological criteria for identifying aortitis of various etiologies. A historical review of major advances in the diagnosis of aortitis is followed by descriptions of the pathology of the aorta and major arteries. The pathological features of Takayasu's arteritis and secondary changes of the aorta are detailed, and state-of-the-art methods of pathological and radiological diagnosis of aortitis are presented.
Lande, A.; Berkman, Y.M.; McAllister, H.A.
This paper examines authoritariansim and prejudice from the perspective of contemporary personality theory and literature. Historical theories are reviewed, concluding with current views on right-wing authoritariansim. Factor- based models of personality ...
J. L. Johnson
... results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. J Personal Disord . 2006 Oct;20( ... McCormick B, Allen J, Arndt S, Black DW. Systems Training for Emotional Predictability and Problem Solving (STEPPS) for ...
The Personal Software Process (PSP) provides engineers with a disciplined personal framework for doing software work. The PSP process consists of a set of methods, forms. and scripts that show software engineers how to plan, measure, and manage their work...
W. S. Humphrey
In this essay I consider the future of personality development in light of the past effects of Personality and Assessment on the field of personality in general and personality development in particular. The essay is organized around 1) the effect of Mischel's book on the foundational theories informing personality development; 2) definitions of personality traits; 3) an alternative model of personality traits, described as the sociogenomic model of personality traits, that can bridge the divide that still characterizes the field of personality development; 4) the application of the sociogenomic model of personality traits to issues of personality trait development, and 5) a “Newtonian” vision for the future of personality psychology.
Roberts, Brent W.
The current description of personalized medicine by the National Institutes of Health is “the science of individualized prevention and therapy.” Although physicians are just beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a true revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers an individual’s physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act upon personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. As these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care.
Cornetta, Kenneth; Brown, Candy Gunther
Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study,…
Hopwood, Christopher J.; Grilo, Carlos M.
This article presents a theoretical framework for analyzing psychological systems that contribute to the variability, consistency, and cross-situational coherence of personality functioning. In the proposed knowledge-and-appraisal personality architecture (KAPA), personality structures and processes are delineated by combining 2 principles:…
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 59-year-old woman with a three-year history of headache and fatigue is determined to have an intrasellar non contrast-enhancing lesion. Visitors are given the clinical history and microscopic description, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Deckert, Martina; Hans, Volkmar H.; Kristof, Rudolf A.; Urbach, Horst
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 78-year-old male who presented with a 6 month history of cervical adenopathy. Visitors are given patient history, microscopic description, differential diagnosis, and immunohistochemistry, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.
Craig, Fiona; Krishnamurti, Uma
Recent advances in molecular biology have allowed us to develop an almost complete picture of the molecular pathology of the thalassemia syndromes. The different classes of mutations that are responsible for the thalassemia syndromes will be discussed along with the special insights they have provided into the controls of eukaryotic gene expression. While management of these disorders has not kept pace with our understanding of their cause, there have been notable advances in treatment. Perhaps even more exciting is what the future holds, as the continued march of molecular biology is melded with novel approaches to the definitive treatment of thalassemias. PMID:3057912
Steinberg, M H
The Lagrangian and Hamiltonian formalisms are discussed about pathological dynamical systems in which constraints exist and the canonical Hamiltonians are singular on the constraint submanifold. It is attempted to define the generalized total Hamiltonian by requiring the consistent correspondence of the Lagrangian formalism with the Hamiltonian one extensively. While one has a system where the Hamiltonian is determined uniquely except for arbitrary gauge functions by adding only the intrinsic constraints, there exists a peculiar case where one must resort to an artificial technique in order to obtain the solution in the phase space consistent with one in the velocity phase space.
Sugano, R.; Kimura, T.
This is a case study presented by the University of Pittsburgh Department of Pathology in which an older man suffering from chronic bronchitis and macrocytic anemia also developed persistent flu symptoms. Visitors view the microscopic and gross descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.
Bahler, David; Kulich, Scott; Shekhter-Levin, Sofia
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 62-year-old woman with a 20-year history of gait disorders and dizziness. Visitors are given patient history, laboratory findings, along with microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 4-year-old girl has a three-month history of headache, nausea, and vomiting. Visitors are given both the microscopic description and radiographs, including the images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Christakos, Peter; Hamilton, Ronald
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 81-year-old woman has a five centimeter axillary mass. Visitors are given the microscopic description and immunohistochemical findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.
Horn, Kevin D.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old man is complaining of abdominal pain. Visitors are given the radiology, gross and microscopic descriptions, flow cytometry, and molecular diagnostics, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.
Latulippe, Steven; Ohori, N. P.
Radiographic correlation is an essential adjunct for the accurate diagnosis of orthopedic lesions, yet it is a skill neglected by pathologists. The purpose of this review is to demonstrate why performing this correlation is an essential part of the diagnostic process and not merely an interesting adjunct to the surgical pathology of orthopedic lesions. The relationships between x-rays and tissues are explored with an emphasis on bone and soft tissue composition and structure. In addition, the rudiments of complementary imaging studies and how to incorporate their data into diagnoses are examined. PMID:16096379
Klein, Michael J
Currently, there are several different types of psychotherapeutic approaches that can be used with problem gamblers. Those most commonly used are cognitive-behavioral therapy (CBT), psychodynamic therapy, motivational interviewing, and supportive psychotherapy. Research into the effectiveness of each of these therapies is just now beginning. Demand for treatment services, however, is rising quickly in every developed country. Coupled with the fact
Timothy W. Fong
This chapter includes discussion of the molecular pathology of tissue, blood, urine, and expressed prostatic secretions. Because we are unable to reliably image the disease in vivo, a 12 core method that oversamples the peripheral zone is widely used. This generates large numbers of cores that need to be carefully processed and sampled. In spite of the large number of tissue cores, the amount of tumor available for study is often quite limited. This is a particular challenge for research, as new biomarker assays will need to preserve tissue architecture intact for histopathology. Methods of processing and reporting pathology are discussed. With the exception of ductal variants, recognized subtypes of prostate cancer are largely confined to research applications, and most prostate cancers are acinar. Biomarker discovery in urine and expressed prostatic secretions would be useful since these are readily obtained and are proximate fluids. The well-known challenges of biomarker discovery in blood and urine are referenced and discussed. Mediators of carcinogenesis can serve as biomarkers as exemplified by mutations in PTEN and TMPRSS2:ERG fusion. The use of proteomics in biomarker discovery with an emphasis on imaging mass spectroscopy of tissues is discussed. Small RNAs are of great interest, however, their usefulness as biomarkers in clinical decision making remains the subject of ongoing research. The chapter concludes with an overview of blood biomarkers such as circulating nucleic acids and tumor cells and bound/free isoforms of prostate specific antigen (PSA). PMID:22112489
Cazares, L H; Drake, R R; Esquela-Kirscher, A; Lance, R S; Semmes, O J; Troyer, D A
The dopamine agonists ropinirole and pramipexole exhibit highly specific affinity for the cerebral dopamine D3 receptor. Use of these medications in Parkinson's disease has been complicated by the emergence of pathologic behavioral patterns such as hypersexuality, pathologic gambling, excessive hobbying, and other circumscribed obsessive-compulsive disorders of impulse control in people having no history of such disorders. These behavioral changes typically remit following discontinuation of the medication, further demonstrating a causal relationship. Expression of the D3 receptor is particularly rich within the limbic system, where it plays an important role in modulating the physiologic and emotional experience of novelty, reward, and risk assessment. Converging neuroanatomical, physiological, and behavioral science data suggest the high D3 affinity of these medications as the basis for these behavioral changes. These observations suggest the D3 receptor as a therapeutic target for obsessive-compulsive disorder and substance abuse, and improved understanding of D3 receptor function may aid drug design of future atypical antipsychotics.
Kelley, Brendan J.; Duker, Andrew P.; Chiu, Peter
In 1817, James Parkinson described the symptoms of the shaking palsy, a disease that was subsequently defined in greater detail, and named after Parkinson, by Jean-Martin Charcot. Parkinson expected that the publication of his monograph would lead to a rapid elucidation of the anatomical substrate of the shaking palsy; in the event, this process took almost a century. In 1912, Fritz Heinrich Lewy identified the protein aggregates that define Parkinson disease (PD) in some brain regions outside the substantia nigra. In 1919, Konstantin Nikolaevich Tretiakoff found similar aggregates in the substantia nigra and named them after Lewy. In the 1990s, ?-synuclein was identified as the main constituent of the Lewy pathology, and its aggregation was shown to be central to PD, dementia with Lewy bodies, and multiple system atrophy. In 2003, a staging scheme for idiopathic PD was introduced, according to which ?-synuclein pathology originates in the dorsal motor nucleus of the vagal nerve and progresses from there to other brain regions, including the substantia nigra. In this article, we review the relevance of Lewy's discovery 100 years ago for the current understanding of PD and related disorders. PMID:23183883
Goedert, Michel; Spillantini, Maria Grazia; Del Tredici, Kelly; Braak, Heiko
This paper refers to a machine-mediated person-to-person multilingual communication system. Stress is put on robustness, that is the ability of the system to preserve communication even in presence of the variability and errors typical of spoken language systems. The statistical approach is adopted not only at the acoustic level, but also for the linguistic processing. Therefore, while an overview of
B. Angelini; M. Cettolo; A. Corazza; D. Falavigna; G. Lazzari
This article describes the headlines of the Educational Program on Personality Disorders produced by the WPA Section on Personality Disorders and the International Society on the Study of Personality Disorders. Lifelong personality traits serve as a substrate and a context for understanding more florid and distinct forms of psychopathology. Personality disorders affect at least 10% of the population, and the direct and indirect social costs associated with crime, substance abuse, increased need for medical care, family disruption, delayed recovery from clinical syndromes and medical diseases is substantial. Numerous theories, models and methods have been proposed to describe and to understand personality and its disorders: descriptive, statistical, psychoanalytic, evolutionary, neurobiologic. Classification has either taken a prototypical or a polythetic approach, but in recent years dimensional formats for classifying personalities have gained more interest. Personality pathology has a complex and variable character of interwoven developmental bio-psycho-social influences. A number of reliable instruments for assessment of personality and its disorders have emerged during the last three decades and a wide range of tailored psychotherapeutic techniques are now available. Personality disorders are treatable and remission is more likely than treatment resistance. Education is needed for all health professionals in psychiatric services. The full WPA program is available to be downloaded for free from WPA’s website www.wpanet.org
SIMONSEN, ERIK; RONNINGSTAM, ELSA; MILLON, THEODORE
The DSM-IV-TR currently conceptualizes personality disorders (PDs) as categorical syndromes that are distinct from normal personality. However, an alternative dimensional viewpoint is that PDs are maladaptive expressions of general personality traits. The dimensional perspective postulates that personality pathology exists at a more extreme level of the latent trait than does general personality. This hypothesis was examined using item response theory analyses comparing scales from two personality pathology instruments – the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; Livesley & Jackson, in press) and the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993; Clark, Simms, Wu, & Casillas, in press) – with scales from an instrument designed to assess normal range personality, the NEO Personality Inventory – Revised (NEO PI-R; Costa & McCrae, 1992). The results indicate that respective scales from these instruments assess shared latent constructs, with the NEO PI-R providing more information at the lower (normal) range and the DAPP-BQ and SNAP providing more information at the higher (abnormal) range. Nevertheless, the results also demonstrated substantial overlap in coverage. Implications of the findings are discussed with respect to the study and development of items that would provide specific discriminations along underlying trait continua.
Samuel, Douglas B.; Simms, Leonard J.; Clark, Lee Anna; Livesley, W. John; Widiger, Thomas A.
Background: Stress coping is defined as a behavioral or cognitive response of an individual to uncomfortable or difficult situations. It has been suggested that coping, like personality, is related to the pathology and course of mental disorders. Accordingly, we here used a clinical sample to investigate the relationships between coping strategies and personality traits. Methods: Subjects were 60 outpatients who
Toru Uehara; Kaoru Sakado; Miwako Sakado; Tetsuya Sato; Toshiyuki Someya
Introduction A personality pathology framework may be useful in the diagnosis and treatment of children with chronic psychopathology and impairment in many domains of functioning. This paper presents the utility of such an approach through a description of research investigating borderline pathology of childhood (BPC). Methods Literature regarding the phenomenology, risk factors, and outcomes of BPC and similar disorders is reviewed. Results Research conducted at the SMBD-Jewish General Hospital in Montreal has shown that children with BPC can be reliably identified via chart review, and that they exhibit a pattern of risk factors similar to that of adults with borderline personality disorder, such as psychological trauma and deficits in executive function. Preliminary results of a follow-up study in adolescence suggests that these children remain more functionally impaired than a comparison group. Our current research investigates neuropsychological deficits and their relationship to trauma in children with BPC. We are also exploring whether a similar pattern can be observed in their parents. Conclusion We conclude that BPC symptom patterns may diagnostically define a group of high risk children and may eventually guide our approach to early intervention.
Zelkowitz, Phyllis; Guzder, Jaswant; Paris, Joel; Feldman, Ron; Roy, Carmella; Schiavetto, Alessandra
Two types of sexual trauma, sexual abuse in childhood and rape in adulthood, were investigated in terms of possible effects on personality. Four groups of participants were studied: women who had experienced sexual abuse in childhood, women who had experienced rape as adults, women who had experienced both of these sexual traumas, and a control group of women who had experienced no sexual trauma. Personality functioning was assessed using the Dimensional Assessment of Personality Pathology. Groups who had experienced childhood sexual abuse displayed the highest degree of personality disturbance; however, the additive effects of repeated sexual trauma were limited. These findings may reflect the outcome of specific adversity in childhood on the psychobiological constructs underlying personality. PMID:11778391
Wonderlich, S A; Crosby, R D; Mitchell, J E; Thompson, K; Smyth, J M; Redlin, J; Jones-Paxton, M
Although Passive Aggressive personality disorder (PAPD) plays an important role in many theories of personality pathology, it was consigned to the appendix of the fourth edition of the DSM. The scientific basis of this decision has been questioned, but several controversies persist regarding PAPD, including its structure, content validity, overlap with other PDs, and relations to validating variables such as personality traits, childhood experiences, and clinically relevant correlates. This study examined these facets of PAPD’s construct validity in a large clinical sample. Results suggest that the construct is unidimensional, internally consistent, and reasonably stable. Furthermore, PAPD appears systematically related to borderline and narcissistic personality disorders, sets of personality traits, and childhood experiences consistent with several theoretical formulations, dysfunction, substance abuse disorders, and history of hospitalizations. Overall, results support the construct validity of PAPD.
Hopwood, Christopher J.; Morey, Leslie C.; Markowitz, John C.; Pinto, Anthony; Skodol, Andrew E.; Gunderson, John G.; Zanarini, Mary C.; Shea, M. Tracie; Yen, Shirley; McGlashan, Thomas H.; Ansell, Emily B.; Grilo, Carlos M.; Sanislow, Charles A.
Advances in nanotechnology and chemical engineering have led to the development of many different drug delivery systems. These 1-100(0) nm-sized carrier materials aim to increase drug concentrations at the pathological site, while avoiding their accumulation in healthy non-target tissues, thereby improving the balance between the efficacy and the toxicity of systemic (chemo-) therapeutic interventions. An important advantage of such nanocarrier materials is the ease of incorporating both diagnostic and therapeutic entities within a single formulation, enabling them to be used for theranostic purposes. We here describe the basic principles of using nanomaterials for targeting therapeutic and diagnostic agents to pathological sites, and we discuss how nanotheranostics and image-guided drug delivery can be used to personalize nanomedicine treatments.
Theek, Benjamin; Rizzo, Larissa Y.; Ehling, Josef; Kiessling, Fabian; Lammers, Twan
... and Gowns FDA's Role in Regulating PPE About Personal Protective Equipment (PPE) On this page: What is personal protective ... protective equipment with other users? Q. What is personal protective equipment? A. Personal protective equipment is any type of ...
This hematopathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent resource for students and instructors in the health science fields. This case involves a 40-year-old woman presenting with a nodule in the skin on the left jaw line. Images from a biopsy of the nodule provide conclusive information that contributes to the patientÃ¢ÂÂs diagnosis. A description of these images, and the patientÃ¢ÂÂs immunohistochemistry and molecular studies are also provided. The official final diagnosis is accompanied by a discussion of the contributing doctorÃ¢ÂÂs findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientÃ¢ÂÂs conditions.
The National Institute of Diabetes and Digestive and Kidney Diseases-supported Kidney Research National Dialogue asked the scientific community to formulate and prioritize research objectives aimed at improved understanding of kidney function and disease progression. Over the past 2 years, 1600 participants posted almost 300 ideas covering all areas of kidney disease. An overriding theme that evolved through these discussions is the need to move beyond pathology to take advantage of basic science and clinical research opportunities to improve diagnostic classification and therapeutic options for people with primary glomerular disease. High-priority research areas included focus on therapeutic targets in glomerular endothelium and podocytes, regenerating podocytes through developmental pathways, use of longitudinal phenotypically defined disease cohorts to improve classification schemes, identifying biomarkers, disease-specific therapeutics, autoantibody triggers, and changing the clinical research culture to promote participation in clinical trials. Together, these objectives provide a path forward for improving clinical outcomes of glomerular disease. PMID:24700796
Wiggins, Roger C; Alpers, Charles E; Holzman, Lawrence B; He, John C; Salant, David J; Chugh, Sumant S; Natarajan, Rama; Trachtman, Howard; Brasile, Lauren; Star, Robert A; Rys-Sikora, Krystyna E; Moxey-Mims, Marva M; Flessner, Michael F
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 54 year-old woman presented with a Ã¢ÂÂleft breast nodule.Ã¢ÂÂ Visitors are given the patientÃ¢ÂÂs history, mammogram image, and the results from a fine needle aspiration (including images), and are given the opportunity to diagnose the patient. Students can check their conclusions by clicking on the Ã¢ÂÂFinal DiagnosisÃ¢ÂÂ section, which provides a thorough explanation of the diagnosis and treatment. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease.
Deal, Karen; Kanbour, Anisa; Nath, Manju E.
We report the diagnostic surgical pathology of two children who underwent multivisceral abdominal transplantation and survived for 1 month and 6 months. There is little relevant literature, and diagnostic criteria for the various clinical possibilities are not established; this is made more complicated by the simultaneous occurrence of more than one process. We based our interpretations on conventional histology, augmented with immunohistology, including HLA staining that distinguished graft from host cells in situ. In some instances functional analysis of T cells propagated from the same biopsies was available and was Used to corroborate morphological interpretations. A wide spectrum of changes was encountered. Graft-versus-host disease, a prime concern before surgery, was not seen. Rejection was severe in 1 patient, not present in the other, and both had evidence of lymphoproliferative disease, which was related to Epstein-Barr virus. Bacterial translocation through the gut wall was also feature in both children. This paper documents and illustrates the various diagonstic possibilities.
Jaffe, Ronald; Trager, Jonathan D. K.; Zeevi, Adriana; Sonmez-Alpan, Eni; Duquesnoy, Rene; Todo, Satoru; Rowe, Marc; Starzl, Thomas E.
This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 56-year-old male with a past medical history significant for lymphoma (in remission). The patient is a health care worker who presented to the emergency room because of a dog bite. Visitors are given a patient history and culture findings, including images. They are also given an opportunity to diagnose the patient before clicking on the "Final Diagnosis" section, which provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in clinical microbiology.
Iscoll, Eileen; Lourduraj, Leena T.; Pasculle, A. W.
This is a case study presented by the University of Pittsburgh Department of Pathology where a boy aged 2 years presented with a swelling beneath the skin of the lower back, incontinence, bilateral leg weakness and a history of bilateral hip dislocation at birth. The case study provides imaging studies and histopathology in order to allow the user the opportunity to diagnose the patient. Clicking on the final diagnosis link will provide users with a discussion of the actual diagnosis along with important learning points as well as a list of references. This is an excellent resource for students in health sciences to familiarize themselves with using patient history and laboratory results to develop a diagnosis. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Ellison, David W.; Ibrahim, A. E.; Lang, D. A.; Myles, L.
Professional-quality photography of nail pathologies can easily be a routine in a dermatologist's office with the use of modern equipment for a camera system. The camera body component should be a single-lens reflex. The optics should be a true "macro" lens focusing to half life-size for multiple nails and, with an accessory tube, to life-size (X 1 or 1:1) for individual nails. If a choice of focal length macro lenses is available, the longer-length lens is preferable, somewhere between 90 and 120 mm, depending on the manufacturer. A portable electronic flash unit with both thyristor circuitry plus macro focusing sensor calibration is recommended. A flash bracket enabling off-camera flash positioning will provide shadow-producing "pointlight" illumination for delineating pictorial texture and anatomic architecture. One film should be standardized: a daylight-rated color film producing slides not prints, preferably Kodachrome 64 or Ektachrome 64 or 100, manufactured by Eastman Kodak Co. The ASA rating of the film should be matched with the power of the flash unit so that exposure should be a minimum of f.11 or f.16 to provide adequate depth of field at the close-up and ultra close-up magnifications required for nail pathologies. Patient and camera should be positioned so that the major axis of the anatomic site parallels that of camera back (plane of film). The image should fill up as much of the film frame as possible by moving the camera system into close-ups while retaining anatomic landmarks and some portion of uninvolved nail or skin in the immediate area. Film inventories should be stored in either a refrigerator or freezer to avoid heat- and humidity-induced degradation of imaging. When exposed, the film should always be developed by the same processing laboratory, preferably one of Eastman Kodak's regional laboratories throughout the United States. PMID:3830513
Weiss, C H
Pathological gambling (PG) is a relatively common and often disabling psychiatric condition characterized by intrusive urges to engage in deleterious gambling behaviour. Although common and financially devastating to individuals and families, there currently exist no formally approved pharmacotherapeutic interventions for this disorder. This review seeks to examine the history of medication treatments for PG. A systematic review of the 18 double-blind, placebo-controlled pharmacotherapy studies conducted for the treatment of pathological gambling was conducted. Study outcome and the mean dose of medication administered was documented in an effort to determine a preferred medication choice in this population. A variety of medication classes have been examined in the treatment of PG with varying results. Antidepressants, atypical antipsychotics and mood stabilizers have demonstrated mixed results in controlled clinical trials. Although limited information is available, opioid antagonists and glutamatergic agents have demonstrated efficacious outcomes, especially for individuals with PG suffering from intense urges to engage in the behaviour. Given that several studies have demonstrated their efficacy in treating the symptoms associated with PG, opioid antagonists should be considered the first line treatment for PG at this time. Most published studies, however, have employed relatively small sample sizes, are of limited duration and involve possibly non-representative clinical groups (e.g. those without co-occurring psychiatric disorders). Response measures have varied across studies. Heterogeneity of PG treatment samples may also complicate identification of effective treatments. Identification of factors related to treatment response will help inform future studies and advance treatment strategies for PG. PMID:22979951
Grant, Jon E; Odlaug, Brian L; Schreiber, Liana R N
In recent years there has been increased interest in whether vascular disease contributes to Alzheimer's disease (AD). This review considers how modifiable risk factors such as hypertension, atherosclerosis, diabetes, dyslipidaemia and adiposity may impact on vascular structure and function to promote neurodegenerative processes and instigate AD. The presence of vascular pathology involving arterial stiffness, arteriolosclerosis, endothelial degeneration and blood-brain barrier dysfunction leads to chronic cerebral hypoperfusion. Pathological changes in human brain and animal studies suggest cerebral hypoperfusion which in turn induces several features of AD pathology including selective brain atrophy, white matter changes and accumulation of abnormal proteins such as amyloid ?. Cerebral pathological changes may be further modified by genetic factors such as the apoliopoprotein E ?4 allele. Although tau hyperphosphorylation and tangle formation still needs robust explanation further support for the notion that vascular pathology influences AD changes is provided by the evidence that interventions which improve vascular function attenuate AD pathology. PMID:22884479
Kalaria, Raj N; Akinyemi, Rufus; Ihara, Masafumi
The author reviews some clinical experiences of the treatment of personality disordered patients suffering from internal domination of ego functioning by a defensive pathological organization. In particular, the function and purpose of perverse, sadistic attacks by the organization on the ego are considered and questions pertaining to technique are raised. It is suggested that different forms of sadistic, subjugating activity by pathological organizations may denote differences in intent borne of the type and severity of the psychopathology of the individual. Patients with severe narcissistic psychopathology for whom object contact has become associated with the arousal of intense psychotic anxieties seem more likely to be subjected to an invasive, annihilatory imperative by the pathological organization, the purpose of which appears to be to obliterate the experience of contact with any differentiated object, to avoid emotion and to use coercion to enforce a primitive identification by the ego with the psychotic organization in the mind. Certain patients with less severe narcissistic psychopathology, yet for whom object contact can also be associated with the arousal of psychotic anxieties due to intense or persistent conflict with the object, sometimes expressed as organized sadomasochistic clinging to a punishing and punished object (for example, in certain borderline or depressed patients) exhibit sadistic attacks that serve less to annihilate object contact and more to intrusively control and punish the object. Observations of these phenomena have been made by a number of psychoanalysts in recent decades and these contributions are discussed. This paper is addressed primarily to the implications for technique with such patients, particularly a need for triangulation of their experiences of oppression in order to loosen the controls over the ego by the pathological organization. PMID:24620792
\\u000a Although historical archaeologists have generally neglected to apprehend the potent meanings of personal possessions, the\\u000a field is stirring. All too often, personal artifacts have been subsumed into broader categories of artifacts, their meanings\\u000a blurred or diminished. Personal artifacts have been assessed as subgroups classified by material, resulting in a muting of\\u000a the individual significance of particular artifacts and a preference
Carolyn L. White; Mary C. Beaudry
This article presents a theoretical framework for analyzing psychological systems that contribute to the variability, consistency, and cross-situational coherence of personality functioning. In the proposed knowledge-and-appraisal personality architecture (KAPA), personality structures and processes are delineated by combining 2 principles: distinctions (a) between knowledge structures and appraisal processes and (b) among intentional cognitions with varying directions of fit, with the latter
\\u000a Personality is the study of individual differences and thus holds promise for a better understanding of how our gendered society\\u000a shapes and reinforces differences in women’s and men’s attitudes, emotions, and behaviors. Two strengths of present-day personality\\u000a research are particularly relevant for the study of gender. First, personality researchers gather data from large samples\\u000a of normally functioning individuals and emphasize
Jayne E. Stake; Heather Eisele
Objective To compare the 10-year retest stability of normal traits, pathological traits, and personality disorder dimensions in a clinical sample. Method Ten-year rank order stability estimates for the Revised NEO Personality Inventory, Schedule for Nonadaptive and Adaptive Personality, and Diagnostic Interview for DSM-IV Personality Disorders were evaluated before and after correcting for test-retest dependability and internal consistency in a clinical sample (N = 266). Results Dependability corrected stability estimates were generally in the range of .60–.90 for traits and .25–.65 for personality disorders. Conclusions The relatively lower stability of personality disorder symptoms may indicate important differences between pathological behaviors and relatively more stable self-attributed traits and imply that a full understanding of personality and personality pathology needs to take both traits and symptoms into account. The Five-Factor Theory distinction between basic tendencies and characteristic adaptations provides a theoretical framework for the separation of traits and disorders in terms of stability in which traits reflect basic tendencies that are stable and pervasive across situations, whereas personality disorder symptoms reflect characteristic maladaptations that are a function of both basic tendencies and environmental dynamics.
Hopwood, Christopher J.; Morey, Leslie C.; Donnellan, M. Brent; Samuel, Douglas B.; Grilo, Carlos M.; McGlashan, Thomas H.; Shea, M. Tracie; Zanarini, Mary C.; Gunderson, John G.; Skodol, Andrew E.
The majority of prevention and intervention research in problem gambling (PG) has focused on identifying negative risk factors. However, not all at-risk individuals go on to develop anticipated disorders and many thrive in spite of them. In healthcare settings, PG and other disorders are typically conceptualized from the biomedical perspective that frame disorders as something negative residing within the individual and reduction in negativity is seen as success. Indeed, this problem-focused conceptualization may be adequate in many cases as reducing PG behaviour is undoubtedly an important outcome, but the focus on negativity alone is too narrow to capture the complexity of human behaviour. Hence, this study attempts to bridge the gap in literature by providing an evaluation of the predictive ability of the positive dispositions on problem gambling severity, gambling-related cognitions, and gambling urges. The positive psychological dispositions examined were curiosity, gratitude, hope, personal growth initiative, and mindfulness. Participants consisted of 801 Taiwanese Chinese students and community individuals (Mean age?=?25.36 years). Higher levels of gratitude and hope have been found to predict lower PG, gambling-related cognitions, or gambling urges. Meanwhile, higher mindfulness predicted lower PG, but only among Chinese males. However, lower personal growth initiative predicted lower PG, gambling-related cognitions, and gambling urges. These analyses have small to medium effect sizes with significant predictions. Findings of this study have essential implications in understanding and treating Chinese problem gamblers. These positive dispositions should be addressed by mental health professionals in preventative and treatment programs among Chinese individuals. Further implications and suggestions for future research are discussed.
Loo, Jasmine M. Y.; Tsai, Jung-Shun; Raylu, Namrata; Oei, Tian P. S.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 60-year-old man was admitted to the Emergency Department with severe back pain. The patientÃ¢ÂÂs medical history and detailed description of her symptoms after admittance to the hospital are included in the Ã¢ÂÂPatient HistoryÃ¢ÂÂ section. Results from laboratory tests are also provided in a table. After looking at the Ã¢ÂÂPatient HistoryÃ¢ÂÂ and Ã¢ÂÂLaboratory InvestigationsÃ¢ÂÂ sections, students should proceed on to the Ã¢ÂÂQuestionsÃ¢ÂÂ section, where they can test their knowledge of diagnostics. Then test your answers with the official findings in the Ã¢ÂÂDiagnosisÃ¢ÂÂ section. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student knowledge of transfusion medicine.
Lopez-Plaza, Iliana; Nambiar, Ashok
Old mice will have a subset of lesions as part of the progressive decline in organ function that defines aging. External and palpable lesions will be noted by the research, husbandry, or veterinary staff during testing, cage changing, or physical exams. While these readily observable lesions may cause alarm, not all cause undue distress or are life-threatening. In aging research, mice are maintained until near end of life that, depending on strain and genetic manipulation, can be upwards of 33 months. Aging research has unique welfare issues related to age-related decline, debilitation, fragility, and associated pain of chronic diseases. An effective aging research program includes the collaboration and education of the research, husbandry, and veterinary staff, and of the members of the institution animal care and use committee. This collaborative effort is critical to humanely maintaining older mice and preventing excessive censorship due to non-lethal diseases. Part of the educational process is becoming familiar with how old mice appear clinically, at necropsy and histopathologically. This baseline knowledge is important in making the determination of humane end points, defining health span, contributing causes of death and effects of interventions. The goal of this paper is to introduce investigators to age-associated diseases and lesion patterns in mice from clinical presentation to pathologic assessment. To do so, we present and illustrate the common clinical appearances, necropsy and histopathological lesions seen in subsets of the aging colonies maintained at the University of Washington.
Pettan-Brewer, Christina; Treuting, Piper M.
This article provides a historical perspective on how both American and European psychiatrists have conceptualized and categorized sexual deviance throughout the past 150 years. During this time, quite a number of sexual preferences, desires, and behaviors have been pathologized and depathologized at will, thus revealing psychiatry's constant struggle to distinguish mental disorder--in other words, the "perversions," "sexual deviations," or "paraphilias"--from immoral, unethical, or illegal behavior. This struggle is apparent in the works of 19th- and early-20th-century psychiatrists and sexologists, but it is also present in the more recent psychiatric textbooks and diagnostic manuals, such as the consecutive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). While much of the historical literature revolves around the controversy over homosexuality, this article also reviews the recent medicohistorical and sociohistorical work on other forms of sexual deviance, including the diagnostic categories listed in the latest edition, the DSM-IV-TR: exhibitionism, voyeurism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, and transvestic fetishism. PMID:23480073
De Block, Andreas; Adriaens, Pieter R
Pathological gambling (PG) affects about 0.2–2% of adults and the impact extends to family members, employers and society as a whole. Recent research has identified similarities in the pathophysiologies of PG and substance use disorders (SUDs). As such, findings regarding SUDs provide a framework for investigating PG. The aims of the manuscript are two-fold. First, we will briefly revivew neural systems implicated in PG. Cortico-limbic circuitry involving the ventral striatum, ventromedial prefrontal cortex, anterior cingulate cortex, and dorsolateral prefrontal cortex are discussed as are the neurotransmitters norepinephrine, serotonin, dopamine, opioids, glutamate, and gamma-aminobutyric acid (GABA). This background will provide a framework for reviewing the psychopharmacological treatments that have been tested for efficacy and safety in treating PG. Of medications, the strongest data suggest the efficacy and tolerability of opioid antagonists in the treatment of PG, and other agents have varying degree of empirical support. As behavioral therapies have also shown efficacy, they will be briefly considered as well. Future research is needed to understand how treatments work in PG and for whom specific treatments might work best.
Bullock, Scott A.; Potenza, Marc N.
There is a belief that persons diagnosed with antisocial personality disorder (APD) do not respond well to treatment, but the existing research has not supported this hypothesis. This study examined the relationship of APD to therapeutic community (TC) treatment outcomes. A total of 275 men and women were randomly assigned to two TCs. It was hypothesized that clients diagnosed with APD via the Millon Clinical Multiaxial Inventory (MCMI-II) would have poorer treatment outcomes than those with no APD. The MCMI-II was used to diagnose APD because of its focus in underlying pathological personality traits, as opposed to strict behavioral criteria as used in the Diagnostic and Statistical Manual of Mental Disorders classifications for APD; this hypothesis was not supported. Logistic regression analyses indicated that an MCMI-II diagnosis of APD was unrelated to treatment outcomes. Treatment completion was the most important factor in reducing recent drug use and post-discharge arrests. The results indicate that persons diagnosed with APD, with histories of substantial drug abuse and criminality, can benefit from TC treatment with aftercare in the community or at the very least, do as well as those with no APD. In light of the high prevalence rates of APD in substance-abusing populations, future research should continue to explore the many issues surrounding the diagnosis of APD, as well as its relationship to treatment outcomes. PMID:12014812
Messina, Nena P; Wish, Eric D; Hoffman, Jeffrey A; Nemes, Susanna
The "dual-hormone" hypothesis predicts that testosterone and cortisol will jointly regulate aggressive and socially dominant behavior in children and adults (e.g., Mehta & Josephs, 2010). The present study extends research on the dual-hormone hypothesis by testing the interaction between testosterone, cortisol, and personality disorder (PD) traits in predicting externalizing problems in a community sample of adolescent males and females. Participants were 106 youth from the community, ranging in age from 13-18 (Mage = 16.01 years, SDage = 1.29), and their parents. Parents and youth provided ratings on an omnibus measure of personality pathology and externalizing problems. Youth provided saliva samples via passive drool from which testosterone and cortisol levels were obtained. Robust moderation of the joint effects of testosterone and cortisol on parent-reported externalizing problems was found for both higher-order PD traits associated with externalizing psychopathology (Disagreeableness and Emotional Instability). Higher testosterone was associated with externalizing outcomes, but only when cortisol was low, and only among youth with high levels of Disagreeableness and Emotional Instability. These findings provide the first evidence for the dual-hormone hypothesis in a mixed-sex sample of community adolescents, but importantly offer novel evidence for the importance of personality traits. Examination of the joint regulation of externalizing problems by testosterone and cortisol in the context of adolescent personality may help to clarify inconsistent main effects of testosterone and cortisol on clinical externalizing phenotypes. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24932763
Tackett, Jennifer L; Herzhoff, Kathrin; Harden, K Paige; Page-Gould, Elizabeth; Josephs, Robert A
The primary purpose of this chapter is to elucidate the role of therapy homework in the context of an empirically supported treatment for borderline personality disorder— Dialectical Behavior Therapy (DBT; Linehan, 1993a). Borderline personality disorder (BPD) is a disorder of emotion dysregulation, and patients who meet criteria for BPD often present with myriad life difficulties and comorbid disorders. According to
Noam Lindenboim; Alex L. Chapman; Marsha M. Linehan
The history of the US Federal Communications Commission (FCC) examination of proposals to allocate radio frequency spectrum to a new and innovative range of services it calls personal communications services (PCS) is outlined. Personal communication networks (PCN), which will supply mobile two-way, mass-market communications services, the most advanced offering of the PCS area, and spectrum allocation for PCS are discussed.
G. T. Hardy
The goal of this paper is to argue the need to approach the personalization issues in Web applications from the very beginning in the application's development cycle. Since personalization is a critical aspect in many popular domains such as e-commerce, it important enough that it should be dealt with through a design view, rather than only an implementation view (which
Gustavo Rossi; Daniel Schwabe; Robson Guimarães
In the daily life, people often repeat regular routes in certain periods. Predicting personal future routes using this information helps to achieve many goals, including improving the quality of intelligent transportation systems (ITSs) and location-based services (LBSs) for individuals. In this paper, a novel system is developed to predict the personal future routes based on the continuous route patterns extracted
Qian Ye; Ling Chen; Gencai Chen
A logically constructed format for the recording of the patient's personality profile is proposed. The term "personality" is used in a broad sense and refers to data that should be part of the patient's clinical record in any clinical situation and that describe the patient's general vulnerability. (Author/MLW)
Benbassat, Jochanan; And Others
Literacy is inextricably linked to the social context in which literacy is taught, and in which the language is used. Cultural expectations require the use of specific literacies. Who a person is, in terms of a literacy user and a literacy worker are dictated by the culture in which a person chooses to operate. Literacy is not neutral, but an…
Knotts, Lester William
Personal communication systems (PCS) represent a rapidly growing and increasingly important segment of the telecommunication industry. The goal of PCS is to provide truly personal, cost-efficient communication services to users through portable handsets. In this paper, we present a survey on the research and development in PCS, emphasizing several important aspects such as the PCS concept, service requirements, system architecture,
V. O. K. Li; Xiaoxin Qiu
An experiment with 766 homeowners compared 3 strategies for delivering radon test results to homeowners. Small improvements in consumer satisfaction were found for personalized messages (a telephone call or personal letter) over a form letter. No detectable improvement was found in recall of advice or compliance for any strategy. (SLD)
Weinstein, Neil D.; And Others
In many testing situations, differential item functioning (DIF) is a potentially serious problem. It occurs when a test item appears to be easier for one group of examinees than another even after controlling for overall skill level. Differential person functioning (DPF) can occur when "items" can be considered raters and the persons are the…
Johanson, George; Alsmadi, Abdalla
Summary-The Eysenck Personality Profiler (EPP) was given to 109 male and 133 female physicists and comparisons made with male and female population norms. Results confirm previous research with male scientists, showing them to be introverted and cautious (particularly careful, controlled, inhibited and unsociable). They were not, however, especially stable relative to same-sex controls. The personality profile of the female physicists
Glenn D. Wilson; Chris Jackson
In this paper, it is argued, based on evidence from psychological literature, that there are three major approaches to the study of personality, namely (1) situationism, (2) interactionism, and (3) constructivism. It is also noticed that these approaches have resulted in the emergence of three major types of personality theories: (i) type…
Al Shalabi, M. Fadi; Salmani Nodoushan, Mohammad Ali
The interconnection between personal computers and other personal, mini, or mainframe computer systems is discussed. The following topics relevant to college personnel are addressed: hardware techniques for tying computers together, advantages and disadvantages of available software, the prospects for sophisticated micro/mainframe links with major…
Although the field is young, studies pertinent to genetic hypotheses have accumulated for several personality disorders. Genetic links to personality disorders from the domains of normal personality and Axis I disorders are reviewed. Evidence of a link to schizophrenia is clearest for schizotypal and less conclusive for paranoid and schizoid personality disorders. A genetic association between borderline personality disorder and
Joel T. Nigg; H. Hill Goldsmith
This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands.
This paper reports a simple nonlinear approach to online acoustic speech pathology detection for automatic screening purposes. Straightforward linear preprocessing followed by two nonlinear measures, based parsimoniously upon the biophysics of speech production, combined with subsequent linear classification, achieves an overall normal\\/pathological detection performance of 91.4%, and over 99% with rejection of 15% ambiguous cases. This compares favourably with more
Max Little; P. McSharry; I. Moroz; S. Roberts
A pathology of science is defined as a two-level breakdown in processes of critical inquiry: first, a hypothesis is accepted without serious attempts being made to test it; and, second, this first-level failure is ignored. Implications of this concept of pathology of science for the Kuhnian concept of normal science are explored. It is then shown that the hypothesis upon
Pathological detonation waves with velocities greater than Chapman-Jouguet (C-J) have been proposed theoretically but never observed experimentally in gaseous, liquid or solid explosives. Two types of pathological chemical reaction zones have been identified within the Zeldovich - von Neumann - Doring (ZND) model: an exothermic chemical decomposition with a mole decrease from the von Neumann spike state to the C-J
Craig M. Tarver
Despite a wide phenomenological interest in body image pathology in schizophrenia, there has been little systematic empirical research. This study aimed at establishing the specificity of body image pathology in patients with schizophrenia, its changes during acute treatment, and its association with other symptom factors. Cognitive (thoughts\\/beliefs regarding the body — body concept), affective (body satisfaction — body cathexis) and
Stefan Priebe; Frank Röhricht
Tissues from 23 Australian water rats (Hydromys chrysogaster) collected from five localities in central and northern Queens- land, Australia, between February 1992 and May 1993, were examined for protozoan para- sites and additional pathological changes. We found Kiossiella hydromyos in the kidneys, Toxoplasma gondii in the brain and skeletal miuuiscles and Sarcocystis sp. in the somatic mus- culatimre. Other pathological
Mount Pleasant Labo; Kings Meadows
Evaluates the prevalence of pathological gambling and related problems among 3,426 students in junior and senior high schools in Quebec City. Results indicate that 77% have gambled in the last twelve months and 13% gamble at least once a week. Results also reveal that pathological gambling is associated with drug and alcohol use, poor grades, and…
Ladouceur, Robert; Boudreault, Normand; Jacques, Christian; Vitaro, Frank
An inexpensive feature card retrieval system has been combined with the Systematised Nomenclature of Pathology (SNOP) to provide simple but efficient means of indexing and filing 2 in. x 2 in. transparencies within a department of pathology. Using this system 2400 transparencies and the associated index cards can be conveniently stored in one drawer of a standard filing cabinet. Images
Brown, R A; Fawkes, R S; Beck, J S
Plant Pathology: Past to Present is an illustrated storybook describing the origin, relevance, and science of plant pathology. The story unfolds as if told by Anton deBary, father of plant pathology, and is suitable for elementary and secondary students to adults.
Frank Tainte (American Phytopathological Society;); Kate Salley Palmer (American Phytopathological Society;)
Starting with the paradigm change of health systems towards personalized health services, the paper introduces the technical paradigms to be met for enabling ubiquitous pHealth including ePathology. The system-theoretical, architecture-centric approach to mobile, pervasive and autonomous solutions has to be based on an open component system framework such as the Generic Component Model. The crucial challenge to be met for comprehensive interoperability is multi-disciplinary knowledge representation, which must be integrated into the aforementioned framework. The approach is demonstrated for security and privacy services fundamental for any eHealth or ePathology environment. PMID:21489199
Starting with the paradigm change of health systems towards personalized health services, the paper introduces the technical paradigms to be met for enabling ubiquitous pHealth including ePathology. The system-theoretical, architecture-centric approach to mobile, pervasive and autonomous solutions has to be based on an open component system framework such as the Generic Component Model. The crucial challenge to be met for comprehensive interoperability is multi-disciplinary knowledge representation, which must be integrated into the aforementioned framework. The approach is demonstrated for security and privacy services fundamental for any eHealth or ePathology environment.
The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008 ) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2009 ) personality disorder scales and clinical syndrome scales in a Flemish/Dutch sample of psychiatric inpatients and outpatients, substance abuse patients, correctional inmates, and forensic psychiatric patients (N = 968). Structural validity of psychopathology and personality disorders as conceptualized by both instruments was investigated by means of principal component analysis. Results reveal a higher order structure with 4 dimensions (internalizing disorders, externalizing disorders, paranoid ideation/thought disturbance, and pathological introversion) that parallels earlier research on pathological personality dimensions as well as research linking pathological personality traits with mental disorders. Theoretical and clinical implications are considered. PMID:22338624
van der Heijden, Paul T; Egger, Jos I M; Rossi, Gina M P; Derksen, Jan J L
Problems with impulse control and pathological gambling are known as possible side effects of dopaminergic therapy in patients with Parkinson's disease. We report 2 cases of pathological gambling induced by dopamine agonists in patients without Parkinson's disease. The first patient, a 46-year-old man, was treated with ropinirole for restless legs syndrome and had lost huge amounts of money in the context of internet-based poker game. Another 46-year-old male patient developed pathological gambling under treatment with cabergoline administered for prolactinoma. The two cases implicate pathological gambling as a possible consequence of dopaminergic treatment and support the increasing evidence regarding pathological gambling as an adverse drug reaction of dopaminergic treatment, also in patients who do not suffer from Parkinson's disease. PMID:21809260
Gahr, M; Connemann, B J; Schönfeldt-Lecuona, C J
Diagnostic histological and cytological specimens are routinely stored in pathology department archives. These biobanks are a valuable research resource for many diseases, particularly if they can be linked to high quality population-based health registries, allowing large retrospective epidemiological studies to be carried out. Such studies are of significant importance, for example in the search for novel prognostic and predictive biomarkers in the era of personalized medicine. Denmark has a wealth of highly-regarded population-based registries that are ideally suited to conduct this type of epidemiological research. We describe two recent additions to these databases: the Danish National Pathology Registry (DNPR) and its underlying national online registration database, the Danish Pathology Data Bank (DPDB). The DNPR and the DPDB contain detailed nationwide records of all pathology specimens analyzed in Denmark since 1997, and an incomplete but nonetheless valuable record of specimens from some pathology departments dating back to the 1970s. The data are of high quality and completeness and are sufficient to allow precise and efficient localization of the specimens. We describe the relatively uncomplicated procedures required to use these pathology databases in clinical research and to gain access to the archived specimens.
Erichsen, Rune; Lash, Timothy L; Hamilton-Dutoit, Stephen J; Bjerregaard, Beth; Vyberg, Mogens; Pedersen, Lars
Abstract Significance: Reactive oxygen species (ROS) play a critical role in vascular disease. While there are many possible sources of ROS, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases play a central role. They are a source of “kindling radicals,” which affect other enzymes, such as nitric oxide synthase endothelial nitric oxide synthase or xanthine oxidase. This is important, as risk factors for atherosclerosis (hypertension, diabetes, hypercholesterolemia, and smoking) regulate the expression and activity of NADPH oxidases in the vessel wall. Recent Advances: There are seven isoforms in mammals: Nox1, Nox2, Nox3, Nox4, Nox5, Duox1 and Duox2. Nox1, Nox2, Nox4, and Nox5 are expressed in endothelium, vascular smooth muscle cells, fibroblasts, or perivascular adipocytes. Other homologues have not been found or are expressed at very low levels; their roles have not been established. Nox1/Nox2 promote the development of endothelial dysfunction, hypertension, and inflammation. Nox4 may have a role in protecting the vasculature during stress; however, when its activity is increased, it may be detrimental. Calcium-dependent Nox5 has been implicated in oxidative damage in human atherosclerosis. Critical Issues: NADPH oxidase-derived ROS play a role in vascular pathology as well as in the maintenance of normal physiological vascular function. We also discuss recently elucidated mechanisms such as the role of NADPH oxidases in vascular protection, vascular inflammation, pulmonary hypertension, tumor angiogenesis, and central nervous system regulation of vascular function and hypertension. Future Directions: Understanding the role of individual oxidases and interactions between homologues in vascular disease is critical for efficient pharmacological regulation of vascular NADPH oxidases in both the laboratory and clinical practice. Antioxid. Redox Signal. 20, 2794–2814.
Konior, Anna; Schramm, Agata; Czesnikiewicz-Guzik, Marta
Abstract Significance: Reactive oxygen species (ROS) play a critical role in vascular disease. While there are many possible sources of ROS, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases play a central role. They are a source of "kindling radicals," which affect other enzymes, such as nitric oxide synthase endothelial nitric oxide synthase or xanthine oxidase. This is important, as risk factors for atherosclerosis (hypertension, diabetes, hypercholesterolemia, and smoking) regulate the expression and activity of NADPH oxidases in the vessel wall. Recent Advances: There are seven isoforms in mammals: Nox1, Nox2, Nox3, Nox4, Nox5, Duox1 and Duox2. Nox1, Nox2, Nox4, and Nox5 are expressed in endothelium, vascular smooth muscle cells, fibroblasts, or perivascular adipocytes. Other homologues have not been found or are expressed at very low levels; their roles have not been established. Nox1/Nox2 promote the development of endothelial dysfunction, hypertension, and inflammation. Nox4 may have a role in protecting the vasculature during stress; however, when its activity is increased, it may be detrimental. Calcium-dependent Nox5 has been implicated in oxidative damage in human atherosclerosis. Critical Issues: NADPH oxidase-derived ROS play a role in vascular pathology as well as in the maintenance of normal physiological vascular function. We also discuss recently elucidated mechanisms such as the role of NADPH oxidases in vascular protection, vascular inflammation, pulmonary hypertension, tumor angiogenesis, and central nervous system regulation of vascular function and hypertension. Future Directions: Understanding the role of individual oxidases and interactions between homologues in vascular disease is critical for efficient pharmacological regulation of vascular NADPH oxidases in both the laboratory and clinical practice. Antioxid. Redox Signal. 20, 2794-2814. PMID:24180474
Konior, Anna; Schramm, Agata; Czesnikiewicz-Guzik, Marta; Guzik, Tomasz J
Periodontal disease and diabetes, two diseases that have achieved epidemic status, share a bidirectional relationship driven by micro-inflammatory processes. The present review frames the current understanding of the pathological processes that appear to link these diseases and advances the hypothesis that reversal of the epidemic is possible through application of interdisciplinary intervention and advancement of oral-systemic personalized medicine. An overview of how Marshfield Clinic's unique clinical, informatics and bio-repository resources and infrastructures are being aligned to advance oral-systemic personalized medicine is presented as an interventional model with the potential to reverse the epidemic trends seen for these two chronic diseases over the past several decades. The overall vision is to engineer a transformational shift in paradigm from 'personalized medicine' to 'personalized health'. PMID:22458294
Glurich, I; Acharya, A; Shukla, S K; Nycz, G R; Brilliant, M H
Narcissism is a multifaceted term which encompasses traits of normal personality as well as a specific personality disorder. While much research has been concerned with narcissism as a trait there are only few empirical studies available on narcissistic personality disorder (NPS). The current diagnostic of NPS according to DSM-IV-TR focuses on grandiose type narcissism whereas vulnerable narcissism, which has been described by clinicians and researchers has not yet been recognised. Psychotherapy of narcissistic patients through different psychotherapeutic schools focuses mainly on processes in the therapeutic relationship, the analysis and change of grandiose and vulnerable schemas, emotion regulation techniques and correction of narcissistic behavior in favor of prosocial interactions. PMID:23636574
Lammers, C-H; Vater, A; Roepke, S
A method for creating a personalized musical file is presented, the method comprising receiving a birth date, determining angular distribution of planets on a birth sky based, at least in part, on the birth date, selecting a plurality of Names from Shem ha-Meforash based, at least in part, on the angular distribution of planets, associating vowels with at least some of the Names, generating a recorded musical portion for at least some of the Names, assembling at least some of the recorded musical portions in a musical file and recording the musical file. A method for creating a personalized mandala and a personalized mantra is also presented herein.
Ecologies shape cultures; cultures influence the development of personalities. There are both universal and culture-specific aspects of variation in personality. Some culture-specific aspects correspond to cultural syndromes such as complexity, tightness, individualism, and collectivism. A large body of literature suggests that the Big Five personality factors emerge in various cultures. However, caution is required in arguing for such universality, because most studies have not included emic (culture-specific) traits and have not studied samples that are extremely different in culture from Western samples. PMID:11752482
Triandis, Harry C; Suh, Eunkook M
The current Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic system for Axis II disorders continues to be characterized by considerable heterogeneity and poor discriminant validity. Such problems impede accurate personality disorder (PD) diagnosis. As a result, alternative assessment tools are often used in conjunction with the DSM. One popular framework is the object relational model developed by Kernberg and his colleagues (J. F. Clarkin, M. F. Lenzenweger, F. Yeomans, K. N. Levy, & O. F. Kernberg, 2007, An object relations model of borderline pathology, Journal of Personality Disorders, Vol. 21, pp. 474-499; O. F. Kernberg, 1984, Severe Personality Disorders, New Haven, CT: Yale University Press; O. F. Kernberg & E. Caligor, 2005, A psychoanalytic theory of personality disorders, in M. F. Lenzenweger & J. F. Clarkin, Eds., Major Theories of Personality Disorder, New York, NY: Guilford Press). Drawing on this model and empirical studies thereof, the current study attempted to clarify Kernberg's (1984) PD taxonomy and identify subtypes within a sample with varying levels of personality pathology using finite mixture modeling. Subjects (N = 141) were recruited to represent a wide range of pathology. The finite mixture modeling results indicated that 3 components were harbored within the variables analyzed. Group 1 was characterized by low levels of antisocial, paranoid, and aggressive features, and Group 2 was characterized by elevated paranoid features. Group 3 revealed the highest levels across the 3 variables. The validity of the obtained solution was then evaluated by reference to a variety of external measures that supported the validity of the identified grouping structure. Findings generally appear congruent with previous research, which argued that a PD taxonomy based on paranoid, aggressive, and antisocial features is a viable supplement to current diagnostic systems. Our study suggests that Kernberg's object relational model offers a plausible substantive aid in refining PD classification. PMID:23046042
Yun, Rebecca J; Stern, Barry L; Lenzenweger, Mark F