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Sample records for conversion disorder

  1. Conversion Disorder

    MedlinePlus

    ... the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, ... In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; ...

  2. Postoperative conversion disorder.

    PubMed

    Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

    2016-05-01

    Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. [Neuropsychological assessment in conversion disorder].

    PubMed

    Demır, Süleyman; Çelıkel, Feryal Çam; Taycan, Serap Erdoğan; Etıkan, İlker

    2013-01-01

    Conversion disorder is characterized by functional impairment in motor, sensory, or neurovegetative systems that cannot be explained by a general medical condition. Diagnostic systems emphasize the absence of an organic basis for the dysfunction observed in conversion disorder. Nevertheless, there is a growing body of data on the specific functional brain correlates of conversion symptoms, particularly those obtained via neuroimaging and neurophysiological assessment. The present study aimed to determine if there are differences in measures of cognitive functioning between patients with conversion disorder and healthy controls. The hypothesis of the study was that the patients with conversion disorder would have poorer neurocognitive performance than the controls. The patient group included 43 patients diagnosed as conversion disorder and other psychiatric comorbidities according to DSM-IV-TR. Control group 1 included 44 patients diagnosed with similar psychiatric comorbidities, but not conversion diosorder, and control group 2 included 43 healthy individuals. All participants completed a sociodemographic questionnaire and were administered the SCID-I and a neuropsychological test battery of 6 tests, including the Serial Digit Learning Test (SDLT), Auditory Verbal Learning Test (AVLT), Wechsler Memory Scale, Stroop Color Word Interference Test, Benton Judgment of Line Orientation Test (BJLOT), and Cancellation Test. The patient group had significantly poorer performance on the SDLT, AVLT, Stroop Color Word Interference Test, and BJLOT than both control groups. The present findings highlight the differences between the groups in learning and memory, executive and visuospatial functions, and attention, which seemed to be specific to conversion disorder.

  4. Progress in understanding conversion disorder

    PubMed Central

    Allin, Matthew; Streeruwitz, Anna; Curtis, Vivienne

    2005-01-01

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

  5. Conversion disorder: a problematic diagnosis.

    PubMed

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

    2011-11-01

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

  6. Interrogative suggestibility in patients with conversion disorders.

    PubMed

    Foong, J; Lucas, P A; Ron, M A

    1997-09-01

    We tested the hypothesis that increased interrogative suggestibility may contribute to the shaping and maintaining of conversions symptoms. Interrogative suggestibility was measured in 12 patients with conversion disorder and 10 control patients with confirmed neurological disease matched for age, premorbid intelligence, and as closely as possible in terms of their neurological symptoms to the patients with conversion disorder. Our observations do not support the contention that individual differences in interrogative suggestibility are of importance in the etiology of conversion disorders.

  7. [Conversion disorder : functional neuroimaging and neurobiological mechanisms].

    PubMed

    Lejeune, J; Piette, C; Salmon, E; Scantamburlo, G

    2017-04-01

    Conversion disorder is a psychiatric disorder often encountered in neurology services. This condition without organic lesions was and still is sometimes referred as an imaginary illness or feigning. However, the absence of organic lesions does not exclude the possibility of cerebral dysfunction. The etiologic mechanisms underlying this disorder remain uncertain even today.The advent of cognitive and functional imaging opens up a field of exploration for psychiatry in understanding the neurobiological mechanisms underlying mental disorders and especially the conversion disorder. This article reports several neuroimaging studies of conversion disorder and attempts to generate hypotheses about neurobiological mechanisms.

  8. Neural correlates of motor conversion disorder.

    PubMed

    Scott, Rebekah L; Anson, J Gregory

    2009-04-01

    Conversion Disorder affects voluntary motor and sensory function and involves unexplained neurological symptoms without an organic cause. Many researchers have attempted to explain how these symptoms arise but the neural correlates associated with Conversion Disorder remain largely unknown to clinicians and neuroscientists alike. This review focuses on investigations of Conversion Disorder (with motor symptoms) when deficits in voluntary movement occur. No single consistent hypothesis has emerged regarding the underlying cortical mechanisms associated with motor Conversion Disorder. However, findings from electrophysiology, neuroimaging, and behavioral research implicate the involvement of prefrontal networks. With further research using measurement techniques precise in spatial as well as temporal resolution, the conflict associated with two views of the neural correlates of motor Conversion Disorder may be resolved. This will provide a better understanding of the impairment associated with the preparation, generation, and execution of intentional movement in Conversion Disorder.

  9. [Neurology of hysteria (conversion disorder)].

    PubMed

    Sonoo, Masahiro

    2014-07-01

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

  10. Conversion Disorder in Australian Pediatric Practice

    ERIC Educational Resources Information Center

    Kozlowska, Kasia; Nunn, Kenneth P.; Rose, Donna; Morris, Anne; Ouvrier, Robert A.; Varghese, John

    2007-01-01

    Objectives: To describe the incidence and clinical features of children presenting to Australian child health specialists with conversion disorder. Method: Active, national surveillance of conversion disorder in children younger than 16 years of age during 2002 and 2003. Results: A total of 194 children were reported on. The average age was 11.8…

  11. Conversion Disorder in Australian Pediatric Practice

    ERIC Educational Resources Information Center

    Kozlowska, Kasia; Nunn, Kenneth P.; Rose, Donna; Morris, Anne; Ouvrier, Robert A.; Varghese, John

    2007-01-01

    Objectives: To describe the incidence and clinical features of children presenting to Australian child health specialists with conversion disorder. Method: Active, national surveillance of conversion disorder in children younger than 16 years of age during 2002 and 2003. Results: A total of 194 children were reported on. The average age was 11.8…

  12. [Management of patients with conversion disorder].

    PubMed

    Vermeulen, Marinus; Hoekstra, Jan; Kuipers-van Kooten, Mariëtte J; van der Linden, Els A M

    2014-01-01

    The symptoms of conversion disorder are not due to conscious simulation. There should be no doubt that the symptoms of conversion disorder are genuine, even if scans do not reveal any abnormalities. The management of patients with conversion disorder starts with an explanation of the diagnosis. The essence of this explanation is that patients first hear about what the diagnosis actually means and only after this about what they do not have. When explaining the diagnosis it is a good idea to use metaphors. The treatment of patients with conversion disorder is carried out together with a physical therapist. The collaboration of healthcare professionals who are involved in the treatment of a patient with conversion disorder should preferably be coordinated by the patient's general practitioner.

  13. Neurologists' understanding and management of conversion disorder.

    PubMed

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

    2011-09-01

    Conversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients. A postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists. 349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past. Neurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients.

  14. Neurologists' understanding and management of conversion disorder

    PubMed Central

    Armstrong, David; Wessely, Simon Charles

    2011-01-01

    Background Conversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients. Methods A postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists. Results 349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past. Discussion Neurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients. PMID:21325661

  15. Conversion Disorder- Mind versus Body: A Review.

    PubMed

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

    2015-01-01

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

  16. Conversion disorder in a pediatric transgender patient.

    PubMed

    Orfanelli, Laura; Borkowski, Winslow J

    2006-04-01

    Somatoform disorders are difficult to diagnosis and often present as a neurological illness in pediatric populations. Conversion disorder is the somatoform disorder most commonly seen in children, particularly adolescents, who have anxiety related to sexual behaviors and orientation. In a transgender patient, the risk of conversion disorder is even higher. The patient described in this article presented with multiple neurological symptoms that disappeared after she began presenting herself as a male. There is a significant need for research into somatoform disorders as well as research into the transgender population.

  17. [Chronic conversion somatic disorder: a case report].

    PubMed

    Macrì, Francesco; Minichino, Amedeo; Campi, Sandra; Marino, Marzia; Pannese, Rossella; De Michele, Francesco; Capra, Enrico; Trabucchi, Guido; Bersani, Francesco Saverio

    2013-02-01

    Conversion disorder is characterized by several neurological and internistical symptoms that cannot be explained by an organic cause, exacerbating after stress events. The course of this disorder is typically short: it usually lasts about two weeks, and only 20-25% of patients relapse in the following year. This paper aims to show the clinical history of a patient complaining conversion symptoms from 7 consecutive years.

  18. Case Study: Camptocormia, a Rare Conversion Disorder.

    ERIC Educational Resources Information Center

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

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

  19. Case Study: Camptocormia, a Rare Conversion Disorder.

    ERIC Educational Resources Information Center

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

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

  20. Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.

    PubMed

    Debadatta, Mohapatra; Mishra, Ajay K

    2013-07-01

    Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent.

  1. Conversion disorder following termination of pregnancy.

    PubMed

    Tollefson, G D; Garvey, M J

    1983-01-01

    A variety of psychologic disorders may present as physical complaints without organic basis. As characterized by Sydenham over 300 years ago, such disorders "mimic all the physical disease to which man is heir." The case here presents the evolution of a conversion disorder (urinary retention) in response to a decision to terminate pregnancy. The predominant disturbance in a conversion disorder is an involuntary loss or alteration in somatic function that is temporally related with an environmental stressor. Conversion, as a defense mechanism, provides primary gain by keeping the conflict from the patient's awareness and secondary gains by generating environmental support and avoidance of undesired activities. Awareness of a patient's current life events, past responses to stress, and support systems is essential in order to recognize and manage this array of physical complaints of functional origin.

  2. Alexithymia in patients with conversion disorder.

    PubMed

    Gulpek, Demet; Kelemence Kaplan, Figen; Kesebir, Sermin; Bora, Ozlem

    2014-07-01

    In the recent years, it has been observed that alexithymia is not specified for the psychosomatic disorders. It is known that alexithymia is observed frequently in various psychiatric disorders especially in the somatoform disorders. The aim of this study is to evaluate alexithymia in the patients with the conversion disorder. The study was performed in the Psychiatry Outpatients Clinics of the Izmir Atatürk Training and Research Hospital and Erenköy Psychiatry Education and Research Hospital. A total of 93 cases-47 outpatients who were diagnosed with conversion disorder according to the DSM-IV criteria and 46 age, gender and educational level matched healthy controls-were included in the study. All the cases were assessed by a Structured Clinical Interview for DSM-IV and were evaluated with a questionnaire (which included demographics and clinical data), the Toronto Alexithymia Scale and the Somatosensory Amplification Scale. When the two groups were compared, the Toronto Alexithymia Scale scores (except "externally oriented thinking" subscale) and the Somatosensory Amplification Scale score of the conversion disorder group were statistically significantly higher than the control group. The number of the alexithymic cases of the patient group was significantly higher than the control group's. The level of alexithymia in conversion disorder patients, without any other psychiatric disorder, is higher than that of the healthy controls. During the evaluation of the psychological state of patients with conversion disorder, it could be useful to keep in mind the probability of them having alexithymia to determine the type of suitable therapy.

  3. Response inhibition in motor conversion disorder.

    PubMed

    Voon, Valerie; Ekanayake, Vindhya; Wiggs, Edythe; Kranick, Sarah; Ameli, Rezvan; Harrison, Neil A; Hallett, Mark

    2013-05-01

    Conversion disorders (CDs) are unexplained neurological symptoms presumed to be related to a psychological issue. Studies focusing on conversion paralysis have suggested potential impairments in motor initiation or execution. Here we studied CD patients with aberrant or excessive motor movements and focused on motor response inhibition. We also assessed cognitive measures in multiple domains. We compared 30 CD patients and 30 age-, sex-, and education-matched healthy volunteers on a motor response inhibition task (go/no go), along with verbal motor response inhibition (color-word interference) and measures of attention, sustained attention, processing speed, language, memory, visuospatial processing, and executive function including planning and verbal fluency. CD patients had greater impairments in commission errors on the go/no go task (P < .001) compared with healthy volunteers, which remained significant after Bonferroni correction for multiple comparisons and after controlling for attention, sustained attention, depression, and anxiety. There were no significant differences in other cognitive measures. We highlight a specific deficit in motor response inhibition that may play a role in impaired inhibition of unwanted movement such as the excessive and aberrant movements seen in motor conversion. Patients with nonepileptic seizures, a different form of conversion disorder, are commonly reported to have lower IQ and multiple cognitive deficits. Our results point toward potential differences between conversion disorder subgroups. © 2013 Movement Disorder Society. Copyright © 2013 Movement Disorder Society.

  4. Emotional stimuli and motor conversion disorder.

    PubMed

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

    2010-05-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to positive stimuli. We investigated the relationship between conversion disorder and affect by assessing amygdala activity to affective stimuli. We conducted a functional magnetic resonance imaging study using a block design incidental affective task with fearful, happy and neutral face stimuli and compared valence contrasts between 16 patients with conversion disorder and 16 age- and gender-matched healthy volunteers. The patients with conversion disorder had positive movements such as tremor, dystonia or gait abnormalities. We also assessed functional connectivity between the amygdala and regions associated with motor preparation. A group by affect valence interaction was observed. Post hoc analyses revealed that whereas healthy volunteers had greater right amygdala activity to fearful versus neutral compared with happy versus neutral as expected, there were no valence differences in patients with conversion disorder. There were no group differences observed. The time course analysis also revealed greater right amygdala activity in patients with conversion disorder for happy stimuli (t = 2.96, P = 0.006) (with a trend for fearful stimuli, t = 1.81, P = 0.08) compared with healthy volunteers, with a pattern suggestive of impaired amygdala habituation even when controlling for depressive and anxiety symptoms. Using psychophysiological interaction analysis, patients with conversion disorder had greater functional connectivity between the right amygdala and the right supplementary motor area during both fearful versus neutral, and happy versus neutral 'stimuli' compared with healthy volunteers. These results were confirmed with

  5. Emotional stimuli and motor conversion disorder

    PubMed Central

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

    2010-01-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to positive stimuli. We investigated the relationship between conversion disorder and affect by assessing amygdala activity to affective stimuli. We conducted a functional magnetic resonance imaging study using a block design incidental affective task with fearful, happy and neutral face stimuli and compared valence contrasts between 16 patients with conversion disorder and 16 age- and gender-matched healthy volunteers. The patients with conversion disorder had positive movements such as tremor, dystonia or gait abnormalities. We also assessed functional connectivity between the amygdala and regions associated with motor preparation. A group by affect valence interaction was observed. Post hoc analyses revealed that whereas healthy volunteers had greater right amygdala activity to fearful versus neutral compared with happy versus neutral as expected, there were no valence differences in patients with conversion disorder. There were no group differences observed. The time course analysis also revealed greater right amygdala activity in patients with conversion disorder for happy stimuli (t = 2.96, P = 0.006) (with a trend for fearful stimuli, t = 1.81, P = 0.08) compared with healthy volunteers, with a pattern suggestive of impaired amygdala habituation even when controlling for depressive and anxiety symptoms. Using psychophysiological interaction analysis, patients with conversion disorder had greater functional connectivity between the right amygdala and the right supplementary motor area during both fearful versus neutral, and happy versus neutral ‘stimuli’ compared with healthy volunteers. These results were confirmed with

  6. The developmental origins of conversion disorders.

    PubMed

    Kozlowska, Kasia

    2007-10-01

    Attachment theory offers a novel developmental framework for understanding conversion reactions as having phylogenetic roots in two different innate animal defense behaviours: The 'freeze response' and 'appeasement defense behaviours'. From this perspective, conversion symptoms reflect two distinct, threat-elicited emotional responses, which are primed in context-dependent developmental experiences (pathways) and underpinned by different neurobiological mechanisms. The first of these two developmental pathways to conversion disorder involves the organization of self-protective strategies that incorporate components of the freeze response and involve inhibition of negative affective states in the context of punishment by caregivers. The second of these pathways involves the organization of self-protective strategies that incorporate innate appeasement defense behaviours in the context of unpredictable parental behaviours that threaten children's physical safety or emotional health. Seen from this developmental perspective, children with conversion disorders are not a homogenous group but fall into two distinct functional groups requiring different types of treatment.

  7. Postoperative conversion disorder in a pediatric patient.

    PubMed

    Judge, Amy; Spielman, Fred

    2010-11-01

    According to the Diagnostic and Statistical Manual IV (DSM IV), conversion disorder is classified as a somatoform illness and defined as an alteration or loss of physical function because of the expression of an underlying psychological ailment. This condition, previously known as hysteria, hysterical neurosis, or conversion hysteria occurs rarely, with an incidence of 11-300 cases per 100,000 people (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edn. Washington, DC: American Psychiatric Association, 1994). Presentation after an anesthetic is exceptional. After thorough review of the literature, fewer than 20 cases have been documented, with only two instances in patients younger than 18 years of age after general anesthesia; both were mild in nature. We present a severe case of postoperative conversion disorder that developed upon emergence from anesthesia in a previously healthy 16-year-old girl following direct laryngoscopy with vocal fold injection.

  8. Response Inhibition in Motor Conversion Disorder

    PubMed Central

    Voon, Valerie; Ekanayake, Vindhya; Wiggs, Edythe; Kranick, Sarah; Ameli, Rezvan; Harrison, Neil A.; Hallett, Mark

    2014-01-01

    Conversion disorders (CDs) are unexplained neurological symptoms presumed to be related to a psychological issue. Studies focusing on conversion paralysis have suggested potential impairments in motor initiation or execution. Here we studied CD patients with aberrant or excessive motor movements and focused on motor response inhibition. We also assessed cognitive measures in multiple domains. We compared 30 CD patients and 30 age-, sex-, and education-matched healthy volunteers on a motor response inhibition task (go/no go), along with verbal motor response inhibition (color-word interference) and measures of attention, sustained attention, processing speed, language, memory, visuospatial processing, and executive function including planning and verbal fluency. CD patients had greater impairments in commission errors on the go/no go task (P <.001) compared with healthy volunteers, which remained significant after Bonferroni correction for multiple comparisons and after controlling for attention, sustained attention, depression, and anxiety. There were no significant differences in other cognitive measures. We highlight a specific deficit in motor response inhibition that may play a role in impaired inhibition of unwanted movement such as the excessive and aberrant movements seen in motor conversion. Patients with nonepileptic seizures, a different form of conversion disorder, are commonly reported to have lower IQ and multiple cognitive deficits. Our results point toward potential differences between conversion disorder subgroups. PMID:23554084

  9. Emotional Stimuli and Motor Conversion Disorder

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. Emotional Stimuli and Motor Conversion Disorder

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  11. Psychiatric symptoms and dissociation in conversion, somatization and dissociative disorders.

    PubMed

    Espirito-Santo, Helena; Pio-Abreu, Jose Luis

    2009-03-01

    Conversion, dissociation and somatization are historically related in the long established concept of hysteria. Somewhere along the way they were separated due to the Cartesian dualistic view. The aim of the present study was to compare these pathologies and investigate whether symptoms of these pathologies overlap in their clinical appearance in a Portuguese sample. Twenty-six patients with conversion disorder, 38 with dissociative disorders, 40 with somatization disorder, and a comparison group of 46 patients having other psychiatric disorders answered questions about dissociation (Dissociative Experiences Scale), somatoform dissociation (Somatoform Dissociation Questionnaire), and psychopathological symptoms (Brief Symptom Inventory). Dissociative and somatoform symptoms were significantly more frequent in dissociative and conversion disorder than in somatization disorder and controls. There were no significant differences between dissociative and conversion patients. Conversion disorder is closely related to dissociative disorders. These results support the ICD-10 categorization of conversion disorder among dissociative disorders and the hypothesis of analogous psychopathological processes in conversion and dissociative disorders versus somatization disorder.

  12. [Conversion Disorder in Children and Adolescents].

    PubMed

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

    2015-01-01

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

  13. Conversion disorder revisited: severe parasomnia discovered.

    PubMed

    Bokey, K

    1993-12-01

    In light of recently described and reviewed disorders of movement and behaviour during sleep, the long standing diagnosis of conversion disorder in a forty-nine year old Vietnam veteran was reappraised. Polysomnographic studies showed that the nocturnal component of his "pseudoseizures" was due to physical disorder, a severe mixed parasomnia comprising the recently described REM behaviour disorder and a non-REM parasomnia. His sleep architecture was also deranged, featuring reduced REM latency and increased REM density. An association between these abnormalities and psychological trauma is recognised in the literature. Treatment with clonazepam has abolished the nocturnal behavioural disturbance. His daytime pseudoseizures occur less frequently and his general well being is improved. The case is a reminder that physical disorder may underlie and act as prototype to the psychologically-driven symptom. Before attributing behavioural disturbance at night to psychological causes alone, polysomnographic studies should be done to exclude a treatable parasomnia.

  14. Conversion disorder: towards a neurobiological understanding

    PubMed Central

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

    2006-01-01

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

  15. Conversion disorder: towards a neurobiological understanding.

    PubMed

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

    2006-03-01

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

  16. Psychosocial Factors in Children and Adolescents with Conversion Disorder

    ERIC Educational Resources Information Center

    Sharma, I.; Giri, D.; Dutta, Anna; Mazumder, P.

    2005-01-01

    Introduction: In view of the limited studies on the psychosocial environment of children presenting with conversion disorders, the present study was carried out to study the psychosocial factors in children with conversion disorders. Method: 40 patients of Conversion Disorder, who presented with "pseudo seizures" and were diagnosed…

  17. Conversion disorders: psychiatric and psychotherapeutic aspects.

    PubMed

    Cottencin, O

    2014-10-01

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

  18. Conversion Disorder Comorbidity and Childhood Trauma.

    PubMed

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

    2017-03-01

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

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

    PubMed

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

    2016-01-01

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

  20. An atypical presentation of visual conversion disorder.

    PubMed

    Foutch, Brian K

    2015-01-01

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

  1. Proinflammatory cytokine levels in patients with conversion disorder.

    PubMed

    Tiyekli, Utkan; Calıyurt, Okan; Tiyekli, Nimet Dilek

    2013-06-01

    It was aimed to evaluate the relationship between proinflammatory cytokine levels and conversion disorder both commonly known as stress regulated. Baseline proinflammatory cytokine levels-[Tumour necrosis factor alpha (TNF-α), Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6)]-were evaluated with enzyme-linked immunosorbent assay in 35 conversion disorder patients and 30 healthy controls. Possible changes in proinflammatory cytokine levels were evaluated again, after their acute phase in conversion disorder patients. Statistically significant decreased serum TNF-α levels were obtained in acute phase of conversion disorder. Those levels increased after acute conversion phase. There were no statistically significant difference observed between groups in serum IL-1β and (IL-6) levels. Stress associated with conversion disorder may suppress immune function in acute conversion phase and may have diagnostic and therapeutic value.

  2. Conversion Disorder in an Appalachian Community.

    PubMed

    Slocum, Sarah; Holroyd, Suzanne

    2016-08-01

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

  3. Hysteria to conversion disorders: Babinski's contributions.

    PubMed

    Gomes, Marleide da Mota; Engelhardt, Eliasz

    2014-04-01

    The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.

  4. Culture and conversion disorder: implications for DSM-5.

    PubMed

    Brown, Richard J; Lewis-Fernández, Roberto

    2011-01-01

    The diagnostic criteria and related features of conversion disorder are under revision for DSM-5, including the requirement that psychological factors accompany the symptoms or deficits in question (Criterion B) and whether conversion disorder should be re-labeled as a dissociative, rather than a somatoform, condition. We examined the cross-cultural evidence on the prevalence, characteristics, and associated features of pseudoneurological symptoms more generally, and conversion disorder in particular, in order to inform the ongoing re-evaluation of the conversion disorder category. We also examined the relationship between these constructs and dissociative symptoms and disorders across cultural groups. Searches were conducted of the mental health literature, particularly since 1994, regarding culture, race, or ethnicity factors related to conversion disorder. Many proposed DSM-5 revisions were supported, such as the elimination of Criterion B. We also found cross-cultural variability in predominant symptoms, disorder prevalence, and relationship with cultural syndromes. Additional information that may contribute to DSM-5 includes the elevated rates across cultures of traumatic exposure and psychiatric comorbidity in conversion disorder. Cross-culturally, conversion disorder is associated strongly with both dissociative and somatoform presentations, revealing no clear basis on which to locate the disorder in DSM-5. Careful consideration should be given to the possible alternatives.

  5. Multiple personality disorder following conversion and dissociative disorder nos : a case report.

    PubMed

    Jhingan, H P; Aggarwal, N; Saxena, S; Gupta, D K

    2000-01-01

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

  6. Life events and escape in conversion disorder.

    PubMed

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

    2016-09-01

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

  7. Conversion disorder and mass psychogenic illness in child neurology.

    PubMed

    Mink, Jonathan W

    2013-11-01

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

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

    PubMed

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

    2017-05-01

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

  9. Case study: negative reinforcement and behavioral management of conversion disorder.

    PubMed

    Campo, J V; Negrini, B J

    2000-06-01

    Behavioral interventions have been advocated for conversion disorder, but controlled trials are lacking. The authors report the case of a 12-year-old boy with conversion disorder after 3 months of persistent right arm pain and immobility whose symptoms rapidly resolved after an outpatient behavioral intervention using negative reinforcement. The importance of careful assessment, frank discussion of the diagnosis, patient and family psychoeducation, and a rehabilitative mindset are emphasized. Negative reinforcement may be a powerful tool in the management of pediatric conversion disorder, with the potential to reduce parental anxiety and prevent unnecessary physical assessments and interventions.

  10. Childhood Trauma and Alexithymia in Patients with Conversion Disorder.

    PubMed

    Farooq, Anum; Yousaf, Aasma

    2016-07-01

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

  11. Treatment of conversion disorder. A clinical and holistic approach.

    PubMed

    Tocchio, Sandra L

    2009-08-01

    Conversion disorder is rare, but when it affects a young woman on the verge of adulthood, it can be devastating. The intent of this article is to encourage others by describing the success that psychiatry and alternative medicine can offer to patients with conversion disorder and to emphasize the value of nursing as a part of that team. This article will explore the attitude change in both staff and patient that was needed to achieve the ultimate goal of wellness.

  12. Abreaction for conversion disorder: systematic review with meta-analysis.

    PubMed

    Poole, Norman A; Wuerz, Axel; Agrawal, Niruj

    2010-08-01

    The value of drug interviews in the treatment of conversion disorder is at present unknown. To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.

  13. Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment.

    PubMed

    Tsui, Patricia; Deptula, Andrew; Yuan, Derek Y

    2017-06-01

    This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

  14. Pituitary volumes are changed in patients with conversion disorder.

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2011-12-01

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

  16. Dissociative and conversion disorders: defining boundaries.

    PubMed

    Isaac, Mohan; Chand, Prabhat K

    2006-01-01

    Although dissociative disorders have been described and diagnosed for some time, their aetiology, pathogenesis, phenomenology and management continues to arouse debate. It is only in recent times that researchers have made some progress by integrating trauma related theories with more contemporary cognitive theories and neurobiology. Dissociation as a phenomenon is reported to occur in a variety of disorders. This widespread occurrence has contributed to a better understanding of dissociation. An expansion of this concept may have contributed to the loss of its original significance. Recent studies in the field of dissociation that pertain to its aetiology, pathophysiology, neurobiology and management are critically reviewed. Dissociative disorder is conceptually a difficult disorder to study. Apart from exposure to trauma, certain primary personality attributes may contribute to the propensity to develop dissociative disorder. Recent advances in functional neuroimaging facilitated by enhanced knowledge in the neural representation of body state have helped to improve our understanding of dissociation. There is confusion over the use of various terms such as sexual abuse and physical abuse in explaining causality. Current classificatory systems have not been found suitable when applied across cultures. In spite of all of these limitations, there has been recent progress toward a better understanding of dissociative disorders.

  17. Motor and somatosensory conversion disorder: a functional unawareness syndrome?

    PubMed

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

    2012-01-01

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

  18. Caesarean delivery complicated by unintentional subdural block and conversion disorder.

    PubMed

    Elsharkawy, Hesham; Khanna, Ashish K; Barsoum, Sabri

    2013-01-01

    Combined spinal epidural (CSE) can provide excellent labor analgesia. Subdural block is also a potential but rare complication of attempted epidural placement during a CSE procedure, which may present as a block that is usually patchy in nature, with a component of sensory and/or motor deficit and a variable duration of action. In addition, a conversion disorder or a functional neurological disorder has been described with epidural and spinal anesthesia in obstetric patients. In this clinical report, we describe a 33-year-old G4P3 at 40 weeks gestation that received an unintentional subdural block as part of her labor analgesia and after an uneventful caesarean delivery presented with a conversion disorder. The rarity of the association between a subdural block and a conversion disorder complicated by the fact that the neurological deficit produced by the subdural block and that produced by a conversion disorder are similar in distribution made the clinical presentation and diagnosis a challenge for the obstetric anesthesia team. A functional neurological disorder of this nature complicating a subdural block in an obstetric anesthesia clinical practice has not been described so far.

  19. [A case of conversion disorder (hysteria) after spinal anesthesia].

    PubMed

    Sugimoto, Yumi; Makino, Shiho; Doi, Yumiko; Nishimura, Mitsuo; Baba, Miwa; Mizukawa, Shunichi; Kobayashi, Yoji

    2009-02-01

    We report a case of conversion disorder after spinal anesthesia. A 16-year-old healthy woman underwent arthroscopic surgery under spinal anesthesia. She showed tremor all over and it did not stop. We sedated her with propofol during the operation. After the operation, her involuntary tremble continued. We consulted with a pediatrician who diagnosed her as conversion disorder. Magnetic resonance imaging and computed tomography were performed to rule out some pathological changes and abnormality in her head. As a result, Rathke cleft cyst was suspected but it could not explain this episode. We consider that her stress for the operation under spinal anesthesia caused this episode. In a case of a younger patient, it is necessary to consider mental support. And we need to suspect conversion disorder when we see tremor during operation under regional anesthesia.

  20. Postoperative Conversion Disorder in Elderly Oral Cancer Patient.

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2014-01-01

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

  2. Frustration and fulfillment of needs in dissociative and conversion disorders.

    PubMed

    Ishikura, Reiji; Tashiro, Nobutada

    2002-08-01

    We reviewed all patients with dissociative disorders (nine patients with dissociative amnesia or dissociative fugue) and conversion disorders (10 patients) who were admitted and treated during the past 15 years. Needs frustrated at the appearance of the symptoms and those fulfilled at discharge were studied in both groups using Maslow's hierarchy of needs. The patients of both groups who encountered troubles in their life events were found to have frustrated needs. These symptoms tended to be accompanied more often by frustrations regarding a 'need for love' in the dissociative disorders group and by frustration in the need for 'self-esteem and self-actualization' in the conversion disorders group. In addition, needs of lower orders were already threatened at onset in many patients. The symptoms disappeared in patients in whom the situation completely improved (needs were fulfilled), but the symptoms were alleviated or unchanged in those in whom the problems remained unresolved.

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

    PubMed

    Ouss, L; Tordjman, E

    2014-10-01

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

  4. Embedded Narratives: Metabolic Disorders and Pentecostal Conversion in Samoa.

    PubMed

    Hardin, Jessica

    2017-03-10

    Drawing from interviews and participant observation, this article explores the intersection of diagnosis of metabolic disorders and religious conversion among Pentecostal Christians in Samoa by analyzing what I call embedded narratives--conversion narratives embedded in illness narratives. Drawing from ethnographic data, I examine how using conversion narrative conventions enabled those living with metabolic disorders to narrate behavior change in a culturally and socially valorized way. By embedding their narratives, I suggest those living with metabolic disorders shifted the object of care from a disease process toward the creation of a religious life and in turn transformed the risks associated with metabolic disorders, including diet, exercise, and pharmaceutical use into moral risks associated with everyday religious life. In these cases, Pentecostal conversion created possible scripts for changing health practices, managing stress, and shifting resource use in the name of religious commitment, providing insights into how self-care can be an expression of religious practice. This article is protected by copyright. All rights reserved.

  5. In the psychiatrist's chair: how neurologists understand conversion disorder.

    PubMed

    Kanaan, Richard; Armstrong, David; Barnes, Philip; Wessely, Simon

    2009-10-01

    Conversion disorder ('hysteria') was largely considered to be a neurological problem in the 19th century, but without a neuropathological explanation it was commonly assimilated with malingering. The theories of Janet and Freud transformed hysteria into a psychiatric condition, but as such models decline in popularity and a neurobiology of conversion has yet to be found, today's neurologists once again face a disorder without an accepted model. This article explores how today's neurologists understand conversion through in-depth interviews with 22 neurology consultants. The neurologists endorsed psychological models but did not understand their patients in such terms. Rather, they distinguished conversion from other unexplained conditions clinically by its severity and inconsistency. While many did not see this as clearly distinct from feigning, they did not feel that this was their problem to resolve. They saw themselves as 'agnostic' regarding non-neuropathological explanations. However, since neurologists are in some ways more expert in conversion than psychiatrists, their continuing support for the deception model is important, and begs an explanation. One reason for the model's persistence may be that it is employed as a diagnostic device, used to differentiate between those unexplained symptoms that could, in principle, have a medical explanation and those that could not.

  6. In the psychiatrist's chair: how neurologists understand conversion disorder

    PubMed Central

    Armstrong, David; Barnes, Philip; Wessely, Simon

    2009-01-01

    Conversion disorder (‘hysteria’) was largely considered to be a neurological problem in the 19th century, but without a neuropathological explanation it was commonly assimilated with malingering. The theories of Janet and Freud transformed hysteria into a psychiatric condition, but as such models decline in popularity and a neurobiology of conversion has yet to be found, today's neurologists once again face a disorder without an accepted model. This article explores how today's neurologists understand conversion through in-depth interviews with 22 neurology consultants. The neurologists endorsed psychological models but did not understand their patients in such terms. Rather, they distinguished conversion from other unexplained conditions clinically by its severity and inconsistency. While many did not see this as clearly distinct from feigning, they did not feel that this was their problem to resolve. They saw themselves as ‘agnostic’ regarding non-neuropathological explanations. However, since neurologists are in some ways more expert in conversion than psychiatrists, their continuing support for the deception model is important, and begs an explanation. One reason for the model's persistence may be that it is employed as a diagnostic device, used to differentiate between those unexplained symptoms that could, in principle, have a medical explanation and those that could not. PMID:19321463

  7. Functional neuroimaging of conversion disorder: The role of ancillary activation

    PubMed Central

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

    2014-01-01

    Background Previous functional neuroimaging studies investigating the neuroanatomy of conversion disorder have yielded inconsistent results that may be attributed to small sample sizes and disparate methodologies. The objective of this study was to better define the functional neuroanatomical correlates of conversion disorder. Methods Ten subjects meeting clinical criteria for unilateral sensory conversion disorder underwent fMRI during which a vibrotactile stimulus was applied to anesthetic and sensate areas. A block design was used with 4 s of stimulation followed by 26 s of rest, the pattern repeated 10 times. Event-related group averages of the BOLD response were compared between conditions. Results All subjects were right-handed females, with a mean age of 41. Group analyses revealed 10 areas that had significantly greater activation (p < .05) when stimulation was applied to the anesthetic body part compared to the contralateral sensate mirror region. They included right paralimbic cortices (anterior cingulate cortex and insula), right temporoparietal junction (angular gyrus and inferior parietal lobule), bilateral dorsolateral prefrontal cortex (middle frontal gyri), right orbital frontal cortex (superior frontal gyrus), right caudate, right ventral-anterior thalamus and left angular gyrus. There was a trend for activation of the somatosensory cortex contralateral to the anesthetic region to be decreased relative to the sensate side. Conclusions Sensory conversion symptoms are associated with a pattern of abnormal cerebral activation comprising neural networks implicated in emotional processing and sensory integration. Further study of the roles and potential interplay of these networks may provide a basis for an underlying psychobiological mechanism of conversion disorder. PMID:25379447

  8. Conversion disorder in women with the FMR1 premutation.

    PubMed

    Seritan, Andreea L; Schneider, Andrea; Olichney, John M; Leehey, Maureen A; Akins, R Scott; Hagerman, Randi J

    2009-11-01

    Women with fragile X mental retardation (FMR1) gene premutations (55-200 CGG repeats) were until recently believed to be unaffected. It is now known that up to 8% of older female FMR1 premutation carriers develop fragile X-associated tremor/ataxia syndrome (FXTAS). Female carriers may also develop primary ovarian insufficiency, thyroid disease, hypertension, seizures, peripheral neuropathy, and fibromyalgia. We present a 60-year-old woman with FMR1 premutation who had depression, anxiety, and conversion disorder with seizures. The FMR1 premutation with its associated mRNA toxicity is postulated as an underlying neurobiological mechanism of conversion symptoms, through functional and structural neural dysconnectivity.

  9. Trauma and dissociation in conversion disorder and chronic pelvic pain.

    PubMed

    Spinhoven, Philip; Roelofs, Karin; Moene, Franny; Kuyk, Jarl; Nijenhuis, Ellert; Hoogduin, Kees; Van Dyck, Richard

    2004-01-01

    The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology. This report examines data from four separate samples. Fifty-two patients with chronic pelvic pain, 61 patients with non-epileptic seizures, and two samples of patients (102 and 54) with predominantly motor or sensory types of conversion disorder were studied. Using point-biserial correlations no compelling evidence for a consistent and positive association of sexual and/or physical abuse with dissociation was found. After statistically controlling for level of psychopathology using multiple regression analyses, in most of the cases the association of abuse with dissociation was no longer statistically significant. Only physical abuse predicted level of somatoform dissociation over and above level of psychopathology. In future clinical studies of dissociation in patients with conversion disorder and chronic pelvic pain more complex models may be needed with less exclusive reliance on historical antecedents such as childhood abuse and more emphasis on recent potentially traumatizing experiences or co-morbid psychiatric disorders.

  10. Aphonia induced by conversion disorder during a Cesarean section.

    PubMed

    Ng, Kwok-On; Lee, Jia-Fu; Mui, Wui-Chiu

    2012-09-01

    Aphonia induced by conversion disorder during surgery is a rare event. We report a woman 28 years of age who was undergoing a Cesarean section under epidural anesthesia. The patient sustained aphonia without detected neurologic deficits. Emergency consultations of a psychiatrist and neurologist were carried out in the operating room postoperatively. After a thorough medical and neurologic work-up, the consultative psychiatrist and the neurologist unanimously made the diagnosis of conversion disorder. Thirty-six hours after the operation, the patient's voice started to return. We venture on sharing the findings of this case with our fellow anesthesiologists in order to highlight discussion and illuminate the differential diagnosis. We have reviewed the literature and excluded an organic lesion as the culprit of the event.

  11. Conversion (dissociative) symptoms as a presenting feature in early onset bipolar disorder: a case series

    PubMed Central

    Ghosal, Malay Kumar; Guha, Prathama; Sinha, Mausumi; Majumdar, Debabrata; Sengupta, Payel

    2009-01-01

    We present three cases of early onset bipolar disorder where dissociative (conversion) symptoms preceded the onset of mania. This case series underscores the significance of dissociative/conversion symptoms as an early atypical presentation in juvenile bipolar disorder. PMID:21687018

  12. The neural circuitry of conversion disorder and its recovery.

    PubMed

    Bryant, Richard A; Das, Pritha

    2012-02-01

    Little is understood about neural networks associated with conversion disorders. This case study reports the first investigation of the neural circuitry associated with the recovery of chronic conversion disorder. A patient with a four year history of hysterical mutism was assessed with functional MRI (fMRI) during a vocalization task, and then provided psychotherapy that attempted to reduce motivational factors that maintained mutism. The patient resumed full speech, and was readministered the fMRI vocalization task. Vocalization during mutism and following recovery of speech resulted in increases in speech-related networks, including the inferior frontal gyrus (IFG), middle frontal, and supplementary motor area of the frontal cortex, temporal and parietal cortices, and also in the primary and sensory motor regions. Following speech recovery but not during mutism, the IFG was correlated positively with the anterior cingulate cortex and negatively with the amygdala. This pattern suggests that during the conversion disorder there was impaired connectivity between speech networks and networks that regulate anxiety.

  13. Conversion Disorder; an Unusual Etiology of Unilateral Foot Drop.

    PubMed

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

    2015-06-01

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

  14. Conversion disorder: A systematic review of current terminology.

    PubMed

    Ding, Juen Mei; Kanaan, Richard Antony Alexander

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

  15. ['Histrionic personality disorder with regression and conversion': a meningioma].

    PubMed

    Oude Elberink, A M L; Oudijn, M S; Kwa, V I H; Van, H L

    2011-01-01

    A 47-year-old woman, who was believed to be suffering from histrionic personality disorder with regression and conversion, was finally diagnosed with a frontal meningioma. Patients with meningiomas can present with a variety of psychiatric symptoms, sometimes even before neurological symptoms occur. The diagnosis is often delayed because the symptoms are misleading and it is difficult to modify a psychiatric diagnosis once this has been made. Discussion focuses on the characteristic signs of a meningioma, the reasons for delays in diagnosis and the indications for brain-imaging on psychiatric patients.

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

    PubMed

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

    2016-06-10

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

  17. Treatment outcome for children and adolescents with conversion disorder.

    PubMed

    Turgay, A

    1990-10-01

    This paper describes the clinical impressions of conversion disorders developed after long term in-depth clinical work with 137 children and adolescents and their families. Almost half of the 89 patients who were directly treated and followed by the author through an integrative child and family therapy approach recovered less than two weeks after the initiation of the treatment. Only three out of 89 patients required longer than four weeks for recovery. The rest responded well to the therapy and recovered with two to four weeks of treatment. Factors associated with positive treatment outcome are: younger age of patient, healthy personality characteristics, lack of psychopathology, insight and treatment compliance, healthy family functioning, acceptance by the family of the psychological nature of the illness, positive feelings towards the child and the family by the staff, lack of internal conflict and inflexible neurotic defences, and early therapeutic interventions. It was found that child and adolescent patients with conversion disorders responded quite well to an integrative, condensed treatment approach.

  18. Monetary conversion factors for economic evaluations of substance use disorders.

    PubMed

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

    2017-10-01

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

  19. Behavioural treatment of a food refusal conversion disorder in a mentally retarded adult.

    PubMed

    Weinman, B; Haydon, S; Sapan, J

    1990-12-01

    A 31-year-old woman with mental retardation who demonstrated total food refusal as the symptom of a conversion disorder was successfully treated with behavioural management techniques. The treatment utilized a shaping paradigm combined with relaxation procedures. The results supported the hypothesis that conversion disorder symptoms are maintained through their consequences, and the efficacy of behavioural treatments for those disorders.

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

    PubMed

    Bühler, Karl-Ernst; Heim, Gerhard

    2011-01-01

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

  1. Neuropsychological function and memory suppression in conversion disorder.

    PubMed

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

    2014-09-01

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

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

    PubMed

    Rothuber, Helfried; Mitterauer, Bernhard

    2011-01-01

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

  3. [Pseudo-dementia conversion and post-traumatic stress disorder].

    PubMed

    Montefiore, D; Mallet, L; Lévy, R; Allilaire, J-F; Pélissolo, A

    2007-01-01

    Post-traumatic stress disorder (PTSD) is often associated with other psychiatric syndromes. However, studies exploring conversion and PTSD comorbidity are scarce. This paper reports the case of a 45 year-old patient without medical or psychiatric history. In 2003, he suddenly started suffering from amnesia and symptoms of delirium: he was at his office with a cup of coffee but he did not remember why. Aphasia, trembling, behavioural disorders appeared over the next hours and days. Numerous neurological examinations and laboratory tests (including cerebral imagery) were performed without evidence of any physical disease. Three psychiatric examinations were also negative, even if a possible psychogenic origin was hypothesized. Neurological or psychiatric diagnoses were discussed but without definitive conclusion. One year later, the symptoms were unchanged until the patient watched a movie ("Mystic River") that described the story of a man with sexual abuse in childhood. He suddenly remembered that he lived the same experience when he was 8 years old. At the end of the movie, his wife surprisingly noticed that he was walking and speaking normally. All the neurological symptoms disappeared. Unfortunately, symptoms of a severe PTSD appeared, as well as a major depressive disorder. The patient and his parents remembered that he had been more irritable, depressed and anxious at school and during the night, between 8 and 13 years of age, with a possible PTSD during this period. He always refused to talk with his parents about the traumatic event. When he was 13, the family moved house, the patient seemed to forget everything and the symptoms disappeared. About thirty years later, the symptoms were similar with the reexperien of the traumatic event through unwanted recollections, distressing images, nightmares, or flashbacks. He had also symptoms of hyperarousal with physiological manifestations, such as irritability, insomnia, impaired concentration, hypervigilance, and

  4. Subtypes of dissociative (conversion) disorder in two tertiary hospitals in Bangladesh.

    PubMed

    Ahsan, M S; Mullick, S I; Sobhan, M A; Khanam, M; Nahar, J S; Salam, M A; Ali, R; Islam, M; Kabir, M S

    2010-01-01

    Dissociative (conversion) disorders are common among the patients attending in and out patients of Psychiatry Department of tertiary hospitals in Bangladesh. This study was done to see the subtypes of dissociative (conversion) disorder according to International Classification of Diseases, Tenth Revision (ICD-10). This is a descriptive, cross sectional study done on 100 consecutive patients from the Departments of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH). Study period was July 2005 to June 2006. Among the patients of dissociative (conversion) disorder, mixed dissociative (conversion) disorder was found highest 34%, followed by dissociative convulsion 33%, dissociative motor disorders 19%, dissociative anaesthesia and sensory loss 5%, dissociative amnesia 4%, dissociative fugue 3%. However, the researcher did not find any multiple personality disorder which is relatively common in North America. This finding reflected that there are differences in prevalence of sub types of dissociative disorders in Bangladesh and Western countries.

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  6. Hysteria, conversion and functional disorders: a neurological contribution to classification issues.

    PubMed

    Reynolds, Edward H

    2012-10-01

    Proposals by psychiatrists to reclassify conversion disorder in DSM-5 and ICD-11 are proving difficult and controversial. Patients with conversion disorder usually present initially to neurologists, who often use different concepts and terminology. History and clinical practice suggest that the way forward is to seek agreed principles and a common understanding between the two disciplines, preferably in a single universal classification.

  7. Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder.

    PubMed

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

    2016-12-01

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

  8. Hospital revisit rate after a diagnosis of conversion disorder.

    PubMed

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

    2016-04-01

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

  9. Uncovering the etiology of conversion disorder: insights from functional neuroimaging

    PubMed Central

    Ejareh dar, Maryam; Kanaan, Richard AA

    2016-01-01

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

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

    PubMed

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

    2015-01-01

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

  11. Uncovering the etiology of conversion disorder: insights from functional neuroimaging.

    PubMed

    Ejareh Dar, Maryam; Kanaan, Richard Aa

    2016-01-01

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

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

    PubMed Central

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

    2013-01-01

    Individuals with autism spectrum disorders (ASD) often exhibit difficulties with reciprocal social conversation, engaging in limited verbal exchanges, even when language structures are intact. This study employed a multiple baseline design to examine the effectiveness of a self-management intervention targeting (1) on-topic responsiveness to a conversational partner; (2) expansion of the conversational topic; and (3) on-topic question asking. Results demonstrated improved reciprocal social conversation through elaborated responses and on-topic question asking, which generalized and maintained. Social validity measures by naïve observers indicated that the intervention led to meaningful improvements during conversation, including interest, naturalness, and desirability as a conversational partner. PMID:24127164

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

    PubMed

    Levenson, J L; Sharpe, M

    2016-01-01

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

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

    PubMed

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

    2013-05-01

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

  15. Conversion disorder presenting as hemiplegia and hemianesthesia with loss of neurologic reflexes: a case report.

    PubMed

    Hill, Eric; Haydel, Micelle

    2006-04-01

    Conversion disorders can present with a variety of sensorimotor signs and symptoms. We present the case of a young woman who presented with sudden onset hemiplegia and hemianesthesia including unilateral loss of deep tendon reflexes, Babinski reflex, and loss of rectal tone with bladder incontinence. The loss of rectal tone, loss of deep tendon reflexes, and a flaccid Babinski reflex are unusual signs in conversion disorders. A thorough medical workup including x-rays, CT scans, and magnetic resonance imaging revealed no organic causes for the neurologic deficits. Before the onset of symptoms, the patient was emotionally upset during an argument, which may have provided the psychologic stressor necessary for a conversion disorder. The young woman gradually regained full neurologic function over the next 14 hours. Conversion disorders should be considered when the neurologic findings do not correspond to known anatomic or physiologic pathways, although a thorough medical investigation must be performed to search for organic causes.

  16. Sex distribution and psychiatric features of child and adolescent conversion disorder across 2 decades.

    PubMed

    Huang, Kai-Lin; Su, Tung-Ping; Lee, Ying-Chiao; Bai, Ya-Mei; Hsu, Ju-Wei; Yang, Cheng-Hung; Chen, Ying-Shue

    2009-09-01

    Earlier research suggested female predominance in adult conversion disorder, and the strong association between conversion disorder and experiences of being abused is well known. However, the data for child and adolescent populations are limited. In Taiwan, the dramatic increase in child abuse may have some impact on the features of child and adolescent conversion disorder. This study aimed to compare the demographic characteristics, psychiatric comorbidity, and experiences of being abused in Taiwanese children and adolescents diagnosed with conversion disorder in psychiatric consultations across 2 decades. Retrospective and consecutive chart reviews were conducted for child and adolescent patients (< 20 years old) who were newly diagnosed with conversion disorder in psychiatric consultations at Taipei Veterans General Hospital from 1987 to 2006. The first group included patients who were diagnosed between 1987 and 1996 (the first decade), and the second group included patients who were diagnosed between 1997 and 2006 (the second decade). A total of 42 patients diagnosed with conversion disorder were included in this study. Nineteen of the 42 subjects were diagnosed in the first decade (from 1987 to 1996), and 23 in the second decade (from 1997 to 2006). There existed among patients a tendency toward an increasing number of male subjects (p < 0.05), suffering more abuse (p < 0.05), and higher prevalence rates of depression and dysthymia comorbidity (p < 0.05) in the second decade compared to the first. The sex distribution in conversion disorder might have significantly changed over the past 2 decades. There is an increasing need for screening and interventions for psychiatric comorbidity and experiences of being abused in children and adolescents with conversion disorder. Because of the small sample size of our study, further studies that include multiple study sites and a larger number of patients are needed before a firm conclusion can be drawn.

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

    PubMed

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

    2015-02-01

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

  18. Enhancing the conversation skills of a boy with Asperger's Disorder through Social Stories and video modeling.

    PubMed

    Scattone, Dorothy

    2008-02-01

    This study combined Social Stories with video modeling in an effort to enhance the conversation skills of a boy with Asperger's Disorder. Treatment consisted of two components: (a) observation of video taped Social Stories that included two adults modeling targeted conversational skills and (b) 5-min social interactions. A multiple baseline design across behaviors was used to evaluate the intervention and an increase in 2 out of 3 targeted conversation skills occurred. In addition, generalized behavior changes were observed. These findings provide support for including Social Stories as part of a video treatment package in teaching complex social interaction behaviors to young children with Asperger's Disorder.

  19. [Evoked potentials and regional cerebral blood flow changes in conversion disorder: a case report and review].

    PubMed

    Gürses, Nadide; Temuçin, Cağri Mesut; Lay Ergün, Eser; Ertuğrul, Aygün; Ozer, Suzan; Demir, Başaran

    2008-01-01

    Conversion disorder is defined as the presence of functional impairment in motor, sensory or neurovegetative systems which cannot be explained by a general medical condition. Although the diagnostic systems emphasize the absence of an organic basis for the dysfunction in conversion disorder, there has been a growing interest in the specific functional brain correlates of conversion symptoms in recent years, particularly by examining neuroimaging and neurophysiological measures. In this case report, regional cerebral blood flow changes and evoked potentials of a patient with conversion symptoms are presented. Somatosensory evoked potentials (SEP) of this patient with conversion disorder who had signs of movement disorder revealed that the latency to N20, P 25 waves were in normal limits while the amplitudes of the P25 and N33 components were extremely high (giant SEP). Regional cerebral blood flow assessment revealed hypoperfusion in the left parietal and temporal lobes of the brain. Three months after the first assessment, the control scans showed that the left parietal hypoperfusion disappeared while the left temporal hypoperfusion was still present. The following SEP evaluations which were repeated twice in three months intervals after the initial recordings, showed the persistence of the abnormalities in somatosensorial measures. The neurophysiological and neuroimaging findings in conversion disorder were reviewed and the results of the evaluations of this case were discussed in this article.

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

    PubMed

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

    2015-12-01

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

  1. Increased activation in cingulate cortex in conversion disorder: what does it mean?

    PubMed

    van Beilen, M; Vogt, B A; Leenders, K L

    2010-02-15

    Conversion disorder is one of the terms used to describe various psychosomatic neurological symptoms that are thought to originate from a psychological conflict. Psychological stressors can usually be identified but appear to be almost similar to the severity of psychological stress in non-psychosomatic neurological disorders. Recent neuroimaging research provides one rather robust finding of increased activation in the anterior cingulate gyrus. This activation has been explained as a reflection of 'active inhibition' or 'self-monitoring' but its meaning in conversion disorder still remains mysterious. In this paper, current theories are re-examined from a neuroanatomical point of view.

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

    PubMed

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

    2009-11-01

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

  3. [Assessment and treatment of conversion disorder: the most fascinating borderline of psychiatry and neurology].

    PubMed

    Vataja, Risto; Leppävuori, Antero

    2012-01-01

    Conversion disorder or functional neurological disorder is a neurological symptom complex originating from psychological factors, which manifests in voluntary motor and sensory functions or as unexplained epilepsy-like seizures. Until the 1980's the disorder was called hysterical neurosis. Later on, various general terms, such as unexplained somatic symptoms, pseudoneurological, somatoformic, psychogenic, or psychosomatic symptoms, have been applied. The latest phrase, functional neurological symptoms, emphasizes the change in the functioning of the nervous system rather than in its structure.

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-03-15

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2010-06-01

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

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

    PubMed

    Régny, P; Cathébras, P

    2016-04-01

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

  13. Clinical characteristics of patients with motor disability due to conversion disorder: a prospective control group study

    PubMed Central

    Binzer, M.; Andersen, P.; Kullgren, G.

    1997-01-01

    OBJECTIVES—Previous studies have suggested associations between conversion and many different clinical characteristics. This study investigates these findings in a prospective design including a control group.
METHODS—Thirty consecutive patients with a recent onset of motor disability due to a conversion disorder were compared with a control group of patients with corresponding motor symptoms due to a definite organic lesion. Both groups had a similar duration of symptoms and a comparable age and sex profile and were assessed on a prospective basis. Background information about previous somatic and psychiatric disease was collected and all patients were assessed by means of a structured clinical interview linked to the diagnostic system DSM III-R, the Hamilton rating depression scale, and a special life events inventory.
RESULTS—The conversion group had a higher degree of psychopathology with 33% of the patients fulfilling the criteria for psychiatric syndromes according to DSM-III-R axis I, whereas 50% had axis II personality disorders compared with 10% and 17% respectively in the control group. Conversion patients also had significantly higher scores according to the Hamilton rating depression scale. Although patients with known neurological disease were not included in the conversion group, a concomitant somatic disorder was found in 33% of the patients and 50% complained of benign pain. The educational background in conversion patients was poor with only 13% having dropped out of high school compared with 67% in the control group. Self reported global assessment of functioning according to the axis V on DSM IV was significantly lower in conversion patients, who also registered significantly more negative life events before the onset of symptoms than controls. Logistic regression analysis showed that low education, presence of a personality disorder, and high Hamilton depression score were significantly associated with conversion disorder

  14. Brief report: a scale for rating conversational impairment in autism spectrum disorder.

    PubMed

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

    2007-08-01

    There are few well-standardized measures of conversational breakdown in Autism Spectrum Disorders (ASD). The study's objective was to develop a scale for measuring pragmatic impairments in conversations of individuals with ASD. We analyzed 46 semi-structured conversations of children and adolescents with high-functioning ASD using a functional linguistic paradigm. Five constructs were developed that assessed difficulties related to the pragmatics of conversation: atypical intonation; semantic drift; terseness; pedantic speech; perseveration. The scale shows good inter-rater reliability and variation in the scales is not simply a reflection of IQ or language competence. This tool represents a way of characterizing language use in ASD and is an initial step towards developing a tool to evaluate change in degree of social impairments in conversation.

  15. A 14-year-old girl with an unusual combination of incontinentia pigmenti and conversion disorder.

    PubMed

    Wang, Yan; Chen, Yihui; Wang, Qiaoshu; Wang, Guodong; Guo, Chunni; Wang, Feng; Deng, Xiaolei; Wang, Weizhen

    2013-01-01

    Incontinentia pigmenti is a rare X-linked neurological-skin genetic disease. Some studies have shown that about 30~40% of patients with IP have varying symptoms of eye/central nervous system which are the major causes of disability. Conversion disorder is one of the most common mental diseases in children and may exhibit the single or multiple neurological symptoms. In this paper, we will report a child with new and rare incontinentia pigmenti accompanied by conversion disorder and explore the relationship of this rare combination.

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

    PubMed

    Vermeulen, M; Willems, M H A

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    1997-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  1. Pseudolabor: A New Conversion Disorder Subtype? A Case Presentation and Literature Review

    PubMed Central

    Lyman, David

    2004-01-01

    Pseudolabor is not a recognized conversion disorder subtype. The diagnosis of conversion disorder is suspected when a patient presents with symptoms under voluntary control that mimic a neurologic or medical condition. The term pseudolabor was first used in 1994 to describe a patient who presented at 27 weeks' gestation with monitored contraction activity and no palpable uterine contractions. A second case is presented herein. Both patients were initially managed as though they had preterm labor or uterine irritability with minimal cervical changes. The diagnosis was suspected only after each patient failed to respond to aggressive tocolysis. On external tocodynamometry, contractions were abrupt in onset and abrupt in descent. Only after palpating abdominal contractions and not uterine contractions did the attending physicians make the correct diagnosis. The development of pseudolabor in a patient with previously diagnosed pseudoseizures suggests that the condition was conversion disorder. The prevalence of pseudolabor is unknown and may be underestimated: electronic fetal monitoring has minimized the need to palpate uterine contractions in the laboring patient. The diagnosis of pseudolabor as a subtype of conversion disorder should be considered in any patient who presents with recurrent preterm uterine contractions, no (or minimal) cervical changes, and an atypical contraction pattern. PMID:15254598

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Conallen, K.; Reed, P.

    2017-01-01

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

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

    ERIC Educational Resources Information Center

    Conallen, K.; Reed, P.

    2017-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  7. Parent conversations about healthful eating and weight: associations with adolescent disordered eating behaviors.

    PubMed

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

    2013-08-01

    The prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental. To examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors. Cross-sectional analysis using data from 2 linked multilevel population-based studies. Anthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009-2010. Socioeconomically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from Eating and Activity in Teens 2010 (EAT 2010) (n = 2793; mean age, 14.4 years) and parents from Project Families and Eating and Activity in Teens (Project F-EAT) (n = 3709; mean age, 42.3 years). EXPOSURE Parent conversations about healthful eating and weight/size. Adolescent dieting, unhealthy weight-control behaviors, and binge eating. Mothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight-control behaviors, and engage in binge eating. Overweight or obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight-control behaviors. Additionally, subanalyses with adolescents with data from 2 parents showed that when both parents engaged in healthful eating conversations, their overweight or obese adolescent children were less likely to diet and use unhealthy weight-control behaviors. Parent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2017-07-01

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

  10. Teaching conversational speech to children with autism spectrum disorder using text-message prompting.

    PubMed

    Grosberg, Denise; Charlop, Marjorie H

    2017-09-04

    The present study was designed to teach conversational speech using text-message prompts to children with autism spectrum disorder (ASD) in home play settings with siblings and peers. A multiple baseline design across children was used. Children learned conversational speech through the text-message prompts, and the behavior generalized across peers and settings. Maintenance of treatment gains was seen at 1-month follow-up probes. Social validity measures indicated that parents of typically developing children viewed the participants' conversational speech as much improved after the intervention. Results are discussed in terms of the efficacy of text-message prompts as a promising way to improve conversational speech for children with ASD. © 2017 Society for the Experimental Analysis of Behavior.

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

    PubMed

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

    2016-01-01

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

  12. Role of sexual abuse in development of conversion disorder: case report.

    PubMed

    Sobot, V; Ivanovic-Kovacevic, S; Markovic, J; Misic-Pavkov, G; Novovic, Z

    2012-02-01

    Described case report speaks in favour of the relation between childhood sexual abuse with the development of conversion disorder. Following Salmonella poisoning, adolescent, at the age of 16, develops series of severe somatic symptoms. Results of diagnostic procedures excluded organic foundation of the symptoms; diagnosis of conversion disorder is established. Soon, patient's problems stop abruptly and spontaneously, and the aetiology of the mental disorder remains unexplained. Six years later, adolescent reveals for the first time data about the childhood sexual abuse during the forensic evaluation (within the court process related to the request for compensation for the complications which occurred following the Salmonella infection). During the forensic evaluation, we had insight into the previous medical history, while an interview, psychological and psychiatric exploration was conducted with the examinee. Data about the sexual abuse retrospectively explain the dynamics of the development of conversion disorder. The described case indicates that sexual abuse of children and adolescents frequently remains unrecognized, which has sequels for treatment and prevention of subsequent consequences for mental health. It is important to emphasize the significance of examining history of abuse during the diagnostic of certain mental disorders. Forensic implications of the case have not been discussed in details for the needs of this report.

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

    PubMed

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

    2017-01-01

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

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

    PubMed

    Orsini, Gisella

    2017-03-01

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

  15. Brain circuits implicated in psychogenic paralysis in conversion disorders and hypnosis.

    PubMed

    Vuilleumier, P

    2014-10-01

    Conversion disorders are defined as neurological symptoms arising without organic damage to the nervous system, presumably in relation to various emotional stress factors, but the exact neural substrates of these symptoms and the mechanisms responsible for their production remain poorly understood. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from conversion disorders in both motor and non-motor (e.g. somatosensory, visual) domains. Several studies have also compared brain activation patterns in conversion to those observed during hypnosis, where similar functional losses can be evoked by suggestion. The current review summarizes these recent results and the main neurobiological hypotheses proposed to account for conversion symptoms, in particular motor deficits. An emerging model points to an important role of ventromedial prefrontal cortex (VMPFC), precuneus, and perhaps other limbic structures (including amygdala), all frequently found to be hyperactivated in conversion disorders in parallel to impaired recruitment of primary motor and/or sensory pathways at the cortical or subcortical (basal ganglia) level. These findings are only partly shared with hypnosis, where increases in precuneus predominate, together with activation of attentional control systems, but without any activation of VMPFC. Both VMPFC and precuneus are key regions for access to internal representations about the self, integrating information from memory and imagery with affective relevance (in VMPFC) and sensory or agency representations (in precuneus). It is therefore postulated that conversion deficits might result from an alteration of conscious sensorimotor functions and self-awareness under the influence of affective and sensory representations generated in these regions, which might promote certain patterns of behaviors in response to self-relevant emotional states.

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

    PubMed

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

    2013-07-01

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

  17. Conversion disorder

    MedlinePlus

    ... debilitating symptom that begins suddenly History of a psychological problem that gets better after the symptom appears Lack of concern that usually occurs with a severe symptom Exams and Tests The provider will do a physical exam and ...

  18. Group Dialectical-Behavior Therapy Skills Training for Conversion Disorder With Seizures.

    PubMed

    Bullock, Kim D; Mirza, Nida; Forte, Craig; Trockel, Mickey

    2015-01-01

    Neuroimaging evidence suggests deficits in affective regulation in conversion disorder (CD). Dialectical-behavior therapy skills training (DBT-ST) was developed to target emotion dysregulation. This study was aimed to test the feasibility of stand-alone DBT-ST for CD using Linehan's manual for borderline personality disorder. In a prospective naturalistic design, 19 adult outpatients diagnosed with video EEG-confirmed seizure type CD were recruited and received weekly group DBT. Seventeen out of 19 subjects finished an average of 20.5 weeks of treatment. The mean seizure rate decreased by 66%. Cessation of seizures occurred in 35% of the sample. Completion rates reached 90%.

  19. [Antiphospolipid syndrome related chorea gravidarum case with psychotic symptoms misdiagnosed as conversion disorder: case report].

    PubMed

    Kuz Tekşut, Tuba; Özcan, Halil; Işık, Mein; Karslı, Fatih

    2013-01-01

    Chorea gravidarum (CG) is a rare movement disorder characterized by rapid, irregular randomly distributed involuntary movements during pregnancy. Similar to Sydenham chorea, psychiatric symptoms may be observed in cases of CG. CG may be idiopathic or secondary to an underlying cause. One of the most common causes of CG is antiphospholipid syndrome. Herein we present a case of recurrent CG that was considered to be due to antiphospholipid syndrome. The patient had a history of 3 pregnancy losses and her fourth pregnancy was treated appropriately, resulting in the birth of healthy full-term baby. During the patient's first pregnancy CG was accompanied by psychotic symptoms and was misdiagnosed as conversion disorder.

  20. Children with autism spectrum disorder: teaching conversation involving feelings about events.

    PubMed

    Conallen, K; Reed, P

    2017-03-01

    Two procedures were developed to teach individuals with Autism Spectrum Disorders labels (tacts) for various private events (emotions): Study 1 attempted to distinguish them from pure tacts and mands (requests); and Study 2 attempted to train initiating a conversation with grammatically correct subject-verb-comment construction. A multiple treatment reversal design was used in both studies, followed by a probe to see if the tacts were used across novel settings. The children were prompted to initiate a series of language exchanges, which resulted in an increased ability to participate in conversations about private events. Together, the results of both studies suggest that, by providing an effective and reinforcing means of teaching both the function and the form of these tacts, conversations can be successfully initiated by children with ASD. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

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

    PubMed

    Kaplan, Marcia

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

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

    PubMed

    Nelson, Erik J; Wu, Jennifer Y

    2017-01-17

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

  3. A study of clinical correlates and socio-demographic profile in conversion disorder.

    PubMed

    Deka, Kamala; Chaudhury, Pranit K; Bora, Kavery; Kalita, Pranab

    2007-07-01

    To study the clinical presentations and relationship of socio-demographic variables with conversion disorder. Forty patients admitted to the department of psychiatry, Assam Medical College and Hospital, Dibrugarh, during November 2004 to August 2005 who fulfilled the inclusion criteria of the study were evaluated for socio-demographic variables and clinical presentations on a semi-structured pro forma. Conversion disorder is more common in young adults (57.5%), females (92.5%) and among students belonging to nuclear family of lower socioeconomic status. A majority of the patients had an obvious precipitating factor, of which family-related (40%) and school-related (30%) problems accounted for the major types. Motor symptoms were the predominant presentation (87.5%) with pseudo seizure being the commonest.

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

    PubMed

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

    2017-08-01

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

  5. Stroke mimicking conversion disorder: two young women who put our feet back on the ground.

    PubMed

    Booij, H A; Hamburger, H L; Jöbsis, G J; Beuerle, E Y; Kruyt, N D

    2012-06-01

    We describe two young female patients with symptoms and signs initially of conversion disorder. It became apparent, however, that both patients had a posterior circulation stroke. These cases remind us of just how broad the clinical presentation of neurological diseases is and illustrate how careful we must be in our own attributions, actions and diagnoses particularly when assessing patients with bizarre behaviour and with apparent inconsistencies on neurological examination.

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

    PubMed Central

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

    2013-01-01

    BACKGROUND The abnormal movements seen in motor conversion disorder are affected by distraction and entrainment, similar to voluntary movement. Unlike voluntary movement, however, patients lack a sense of control for the abnormal movements, a failure of “self-agency.” The action-effect binding paradigm has been used to quantify the sense of self-agency, because subjective contraction of time between an action and its effect only occurs if the subject feels that they are the agent responsible for the action. We used this paradigm, coupled with emotional stimuli, to investigate the sense of agency with voluntary movements in patients with motor conversion disorder. METHODS Twenty patients with motor conversion disorder and 20 age- and gender-matched healthy volunteers used a rotating clock to judge the time of their own voluntary keypresses (action) and a subsequent auditory tone (effect), after completing conditioning blocks in which high, medium and low tones were coupled to images of happy, fearful and neutral faces. RESULTS The results replicate those shown previously: an effect following a voluntary action was reported as occurring earlier, and the preceding action later, compared to trials of only keypresses or tones. Patients had reduced overall binding scores relative to healthy volunteers, suggesting a reduced sense of agency. There was no effect of the emotional stimuli (faces) or other interaction effects. Healthy volunteers with subclinical depressive symptoms had higher overall binding scores. CONCLUSIONS We show that motor conversion disorder patients have decreased action-effect binding for normal voluntary movements compared to healthy volunteers, consistent with the greater experience of lack of control. PMID:23494975

  7. Conversion disorder: a case report of treatment with the Main Puteri, a Malay shamanastic healing ceremony.

    PubMed

    Razali, S M

    1999-12-01

    We report on the case of a 38-year-old Malay housewife diagnosed with conversion disorder. It was believed that 'evil spirits' caused her symptoms. The patient was eventually treated by the Main Puteri, a Malay shamanistic healing ceremony, after previous treatments failed. The patient improved on the third day of the performance, which was attributed to the departure of the spirits from her body. This case documents the potential benefits of indigenous psychotherapy.

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

    PubMed

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

    2011-11-01

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

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

    PubMed

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

    2013-03-19

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

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

    PubMed Central

    Nelson, Erik J.; Wu, Jennifer Y.

    2017-01-01

    Patient: Female, 13 Final Diagnosis: Postoperative conversion disorder Symptoms: Right-sided weakness and right-sided sensory loss • difficulty speaking Medication: — Clinical Procedure: EUS/EGD Specialty: Anesthesiology Objective: Rare co-existance of disease or pathology Background: Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. Case Report: We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal. Conclusions: After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder. PMID:28093564

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

    PubMed

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

    2017-02-01

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

  12. Spontaneous peer conversation in preschoolers with high-functioning autism spectrum disorder versus typical development.

    PubMed

    Bauminger-Zviely, Nirit; Karin, Eynat; Kimhi, Yael; Agam-Ben-Artzi, Galit

    2014-04-01

    In typical development, early peer talk is crucial for pragmatic development. The pragmatic deficit, reflected in remarkably deficient conversational capabilities, is considered the hallmark of the language deficit in autism spectrum disorder (ASD); yet, spontaneous peer talk in preschoolers with ASD was rarely explored. We conducted comparative assessment of spontaneous peer talk during 10-min free-play scenarios in preschoolers with high-functioning ASD (HFASD; n = 27) versus those with typical development (n = 30). Groups were matched on SES, verbal/nonverbal MA, IQ, and CA. Correlations with CA, IQ, VMA, and NVMA were examined. We compared the two groups' interactions with a friend-partner versus a nonfriend partner; in addition, in the HFASD group, we examined interactions with a typical partner (mixed dyads) versus a partner with HFASD (nonmixed dyads). Children's conversations were videotaped and coded to tap pragmatic capabilities and conversational quality. Findings revealed group differences in pragmatic abilities and conversational quality, with the typical group showing more intact capacities than the HFASD group. However, in the HFASD group, interactions with friends surpassed interactions with nonfriends on several key pragmatic capabilities and on all conversational quality measures (meshing, assertiveness, and responsiveness), thus suggesting that friendship may enable children to converse in a more socially complex and coregulated way. Also, children with higher cognitive capabilities, especially in the HFASD group, demonstrated more intact pragmatic capacities. Despite the robust pragmatic deficit in HFASD, reflected in conversational capabilities, involvement in friendship relationships and high cognitive capabilities were linked to more intact pragmatic capacities. Theoretical and therapeutic implications are discussed. © 2013 The Authors. Journal of Child Psychology and Psychiatry. © 2013 Association for Child and Adolescent Mental Health.

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

    PubMed

    Daum, Corinna; Hubschmid, Monica; Aybek, Selma

    2014-02-01

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

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

    PubMed

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

    2015-01-01

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

  15. Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis.

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2017-03-01

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

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

    PubMed

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

    2017-04-01

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

  20. Enhancing the Conversation Skills of a Boy with Asperger's Disorder through Social Stories[TM] and Video Modeling

    ERIC Educational Resources Information Center

    Scattone, Dorothy

    2008-01-01

    This study combined Social Stories with video modeling in an effort to enhance the conversation skills of a boy with Asperger's Disorder. Treatment consisted of two components: (a) observation of video taped Social Stories that included two adults modeling targeted conversational skills and (b) 5-min social interactions. A multiple baseline design…

  1. The impact of early trauma and recent life-events on symptom severity in patients with conversion disorder.

    PubMed

    Roelofs, Karin; Spinhoven, Philip; Sandijck, Pieter; Moene, Franny C; Hoogduin, Kees A L

    2005-08-01

    Although the presence of psychological stress factors in the evolution of conversion symptoms forms an important criterion for the DSM-IV diagnosis of conversion disorder, little is known about the nature and timing of these stress factors. Fifty-four patients with conversion disorder and 50 control patients with an affective disorder were screened for life events experienced in the year before the symptom onset. Conversion patients did not differ from control patients in the number or severity of life events, but showed a significant relation between the recent life events and the severity of conversion symptoms. Especially life events with respect to work and relationships contributed to this effect. These results remained when controlling for the previously found effects of childhood traumatization on the severity of conversion symptoms. The findings imply that conversion symptoms may be elicited by a complex of early and later negative life events and that traditional unifactorial trauma-theories of conversion disorder should be replaced by multifactorial stress models.

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

    PubMed

    Martinez, Molly S; Fristad, Mary A

    2013-06-01

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

  3. Evaluation of oxidant, antioxidant, and S100B levels in patients with conversion disorder.

    PubMed

    Büyükaslan, Hasan; Kandemir, Sultan Basmacı; Asoğlu, Mehmet; Kaya, Halil; Gökdemir, Mehmet Tahir; Karababa, İbrahim Fatih; Güngörmez, Fatih; Kılıçaslan, Fethiye; Şavik, Emin

    2016-01-01

    Various psychodynamic, neurobiological, genetic, and sociocultural factors are believed to be involved in the etiology of conversion disorder (CD). Oxidative metabolism has been shown to deteriorate in association with many health problems and psychiatric disorders. We evaluated oxidative metabolism and S100B levels in the context of this multifactorial disease. Thirty-seven patients with CD (25 females and 12 males) and 42 healthy volunteers (21 females and 21 males), all matched for age and sex, were included in this study. The total oxidant status, total antioxidant status, oxidative stress index, and S100B levels were compared between the two groups. The total oxidant status, oxidative stress index, and S100B levels were significantly higher in patients with CD than in the control group, whereas the total antioxidant status was significantly lower. CD is associated with deterioration of oxidative metabolism and increased neuronal damage.

  4. MicroRNA association with synucleinopathy conversion in rapid eye movement behavior disorder.

    PubMed

    Fernández-Santiago, Rubén; Iranzo, Alex; Gaig, Carles; Serradell, Mónica; Fernández, Manel; Tolosa, Eduardo; Santamaría, Joan; Ezquerra, Mario

    2015-05-01

    Recently, we reported downregulated circulating levels of the microRNAs miR-19b, miR-29a, and miR-29c in Parkinson disease. Here we investigated the expression of these microRNAs in serum samples from 56 patients with idiopathic rapid eye movement sleep behavior disorder, before and after their conversion into a synucleinopathy. Compared to controls, we found that the expression level of miR-19b is downregulated in patients with idiopathic rapid eye movement sleep behavior disorder and antedates the diagnosis of Parkinson disease and dementia with Lewy bodies after 4.67 ± 2.61 years of follow-up. Our findings indicate that dysregulation of the microRNA miR-19b occurs in the prodromal stage of synucleinopathies. © 2015 American Neurological Association.

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

    PubMed

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

    2009-03-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2016-01-21

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

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

    PubMed

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

    2014-03-01

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

  9. Multidisciplinary assessment and diagnosis of conversion disorder in a patient with foreign accent syndrome.

    PubMed

    Jones, Harrison N; Story, Tyler J; Collins, Timothy A; Dejoy, Daniel; Edwards, Christopher L

    2011-01-01

    Multiple reports have described patients with disordered articulation and prosody, often following acute aphasia, dysarthria, or apraxia of speech, which results in the perception by listeners of a foreign-like accent. These features led to the term foreign accent syndrome (FAS), a speech disorder with perceptual features that suggest an indistinct, non-native speaking accent. Also correctly known as psuedoforeign accent, the speech does not typically match a specific foreign accent, but is rather a constellation of speech features that result in the perception of a foreign accent by listeners. The primary etiologies of FAS are cerebrovascular accidents or traumatic brain injuries which affect cortical and subcortical regions critical to expressive speech and language production. Far fewer cases of FAS associated with psychiatric conditions have been reported. We will present the clinical history, neurological examination, neuropsychological assessment, cognitive-behavioral and biofeedback assessments, and motor speech examination of a patient with FAS without a known vascular, traumatic, or infectious precipitant. Repeated multidisciplinary examinations of this patient provided convergent evidence in support of FAS secondary to conversion disorder. We discuss these findings and their implications for evaluation and treatment of rare neurological and psychiatric conditions.

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2017-05-01

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

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

    PubMed

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

    2014-01-01

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

  13. Clinical correlates of dissociative tendencies in male soldiers with conversion disorder.

    PubMed

    Evren, Cuneyt; Can, Suat

    2007-01-01

    The aim of this study is to examine the relationship of dissociative tendencies (DT) with conversion subtype, alexithymia, severity of anxiety and depression symptoms in male soldiers with conversion disorder (CD). Fifty-five male soldiers, patients who met DSM-IV criteria for CD, were included in the study. Subjects were given Structured Clinical Interview for DSM-IV (SCID-I), Dissociative Experiences Scale (DES), Hamilton Depression Rating Scale (Ham-D), Hamilton Anxiety Rating Scale (Ham-A), State-Trait Anxiety Inventory (STAI) and Toronto Alexithymia Scale (TAS-20). Those who had motor symptoms or deficits had lower mean DES scores than those who had no motor symptoms or deficits, whereas those who had seizures or convulsions had higher mean DES scores than those who had no seizures or convulsions. DES scores were correlated with psychic subscale of Ham-A, Ham-D, TAS-20 and both state anxiety and trait anxiety scores of STAI. Trait anxiety score and duration of military service were predictors for DT and they explained 34% of variance. The data suggest that although DT correlated with alexithymia and depression, they are fundamentally different constructs and only trait anxiety and duration of military service predicts DT in soldiers with CD.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    Objective The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD). Patients and methods A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist. Results There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001) and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01) were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, P<0.001, and 47±4.8 vs 20±6.1, P<0.001, respectively). Conclusion A similar relation to that in literature between QTd and anxiety and somatoform disorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients. PMID:25848293

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

    PubMed

    Mason, Chawla LaToya

    2016-09-19

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

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

    PubMed

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

    2013-06-01

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

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

    ERIC Educational Resources Information Center

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

    2017-01-01

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

  19. Development of the Conversation Participation Rating Scale: Intervention Planning Implications for Two School-Age Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Timler, Geralyn R.; Boone, William J.; Bergmann, Amelia A.

    2014-01-01

    Purpose: School-age children with autism spectrum disorders (ASDs) have pervasive challenges in social interactions with peers. This study examined the feasibility of eliciting children's perceptions of their conversation participation with peers for the purposes of assessment and intervention planning. Methods: Two school-age children with ASD…

  20. Development of the Conversation Participation Rating Scale: Intervention Planning Implications for Two School-Age Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Timler, Geralyn R.; Boone, William J.; Bergmann, Amelia A.

    2014-01-01

    Purpose: School-age children with autism spectrum disorders (ASDs) have pervasive challenges in social interactions with peers. This study examined the feasibility of eliciting children's perceptions of their conversation participation with peers for the purposes of assessment and intervention planning. Methods: Two school-age children with ASD…

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

    PubMed

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

    2017-07-15

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2014-08-01

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

  4. Knowledge of conversion disorder in children by pediatricians in a developing country.

    PubMed

    Ndukuba, A C; Ibekwe, R C; Odinka, P C; Muomah, R C; Nwoha, S O; Eze, C

    2015-01-01

    Conversion disorder (CD) in children presents the clinician with a diagnostic and treatment dilemma. Mistaking a physical condition for CD carries serious consequences for the child while continued investigation in line with physical disease in a child with CD also may expose the child to serious harm. One hundred and seventy-four consenting doctors who attended a national conference of pediatricians were administered a 10 item questionnaire developed by the researchers. Only 5 (2.9%) of participants had good knowledge (scored above the mean plus one standard deviation of the score obtained by the psychiatry residents. Gender, rank, years of experience, availability of psychiatric service in center and duration of the psychiatry posting as the medical student could not differentiate those with good/fair knowledge from those without. However, those who have referred children for psychiatric assessment (P=0.015), those who believe that children can have CD (P=0.000) and those who are fairly confident that they could diagnose CD in children (P=0.000) had better knowledge of CD. Pediatricians have poor knowledge of CDs in children. Those that know that children could have the condition have confidence that they can identify children with the condition and have referred with mental health problems to psychiatrists have better knowledge than those who did not.

  5. Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms.

    PubMed

    Barnum, Richard

    2014-01-01

    Conversion Disorder (CD) is a diagnosis offered to explain signs and symptoms that do not correspond to recognized medical conditions. Pediatric patients with variable, vague, and multisystem complaints are at increased risk for being diagnosed with CD. Little is known about the impact of such a diagnosis. In making such diagnoses, it is likely that pediatric providers hope to encourage patients to access mental health care, but no basis exists to show that these diagnoses result in such access in any useful way. This article presents the case of a child with Ehlers-Danlos Syndrome, who had been previously (incorrectly) diagnosed with CD and referred for mental health care. It offers commentary based on interviews with other pediatric patients with similar experiences - conducted in collaboration with the Ehlers-Danlos National Foundation. These cases indicate that CD diagnoses can seriously undermine patients' trust in doctors, and can create such defensiveness that it may interfere with (especially) patients' abilities to engage with mental health services. Such interference is an important problem, if the diagnosis is accurate. But, in the (more likely) event that it is not accurate, this defensiveness can interfere with both important mental health care and further ongoing necessary medical care.

  6. Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms

    PubMed Central

    Barnum, Richard

    2014-01-01

    Conversion Disorder (CD) is a diagnosis offered to explain signs and symptoms that do not correspond to recognized medical conditions. Pediatric patients with variable, vague, and multisystem complaints are at increased risk for being diagnosed with CD. Little is known about the impact of such a diagnosis. In making such diagnoses, it is likely that pediatric providers hope to encourage patients to access mental health care, but no basis exists to show that these diagnoses result in such access in any useful way. This article presents the case of a child with Ehlers-Danlos Syndrome, who had been previously (incorrectly) diagnosed with CD and referred for mental health care. It offers commentary based on interviews with other pediatric patients with similar experiences – conducted in collaboration with the Ehlers-Danlos National Foundation. These cases indicate that CD diagnoses can seriously undermine patients’ trust in doctors, and can create such defensiveness that it may interfere with (especially) patients’ abilities to engage with mental health services. Such interference is an important problem, if the diagnosis is accurate. But, in the (more likely) event that it is not accurate, this defensiveness can interfere with both important mental health care and further ongoing necessary medical care. PMID:24808723

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

    PubMed

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

    2016-08-01

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

  8. Emotion-Motion Interactions in Conversion Disorder: An fMRI Study

    PubMed Central

    O’Daly, Owen; Zelaya, Fernando; Kanaan, Richard A.; David, Anthony S.

    2015-01-01

    Objectives To evaluate the neural correlates of implicit processing of negative emotions in motor conversion disorder (CD) patients. Methods An event related fMRI task was completed by 12 motor CD patients and 14 matched healthy controls using standardised stimuli of faces with fearful and sad emotional expressions in comparison to faces with neutral expressions. Temporal changes in the sensitivity to stimuli were also modelled and tested in the two groups. Results We found increased amygdala activation to negative emotions in CD compared to healthy controls in region of interest analyses, which persisted over time consistent with previous findings using emotional paradigms. Furthermore during whole brain analyses we found significantly increased activation in CD patients in areas involved in the ‘freeze response’ to fear (periaqueductal grey matter), and areas involved in self-awareness and motor control (cingulate gyrus and supplementary motor area). Conclusions In contrast to healthy controls, CD patients exhibited increased response amplitude to fearful stimuli over time, suggesting abnormal emotional regulation (failure of habituation / sensitization). Patients with CD also activated midbrain and frontal structures that could reflect an abnormal behavioral-motor response to negative including threatening stimuli. This suggests a mechanism linking emotions to motor dysfunction in CD. PMID:25859660

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

    PubMed

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

    2014-02-01

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

  10. Treatment of a severe conversion disorder in a 10-year-old boy: a case study and overview.

    PubMed

    Ozsungur, Berna; Foto-Özdemir, Dilşad; Ozusta, Seniz; Topçu, Meral; Topaloğlu, Haluk

    2012-01-01

    Conversion disorder (CD) in children remains a major challenge both in pediatric and mental health clinics and is still a prevalent psychiatric disorder in developing countries. The authors describe a 10-year-old boy with the complaints of inability to walk, speak or eat, excessive drooling, urinary and fecal incontinence, disturbance from light and sound, and expression of needs only by eye movements. The patient diagnosed with CD was followed by the Department of Child and Adolescent Psychiatry with play therapy, individual psychotherapy and family therapy. At the end of three months, the patient was discharged. This is one of the most challenging cases of CD in children. The most important aim of the treatment is to understand the need for conversion symptoms and to constitute a healthy psychological environment for the child rather than to remove the physical symptoms.

  11. Long-lasting conversion disorder and hospitalization in a young girl: importance of early recognition and intervention.

    PubMed

    Coşkun, Murat; Zoroğlu, Salih

    2009-01-01

    Psychosomatic symptoms are frequently observed in children in response to psychosocial stressors and may be a reason for referral. However, it may be difficult to identify psychosomatic symptoms in a non-psychiatric clinical setting, and it is not unusual in pediatric practice for patients to be admitted and/or investigated for psychosomatic symptoms. Here, we present a case of a 10-year-old girl who was admitted and investigated for a suddenly developing motor loss in her legs for more than three months. However, no medical causes were detected to explain her clinical picture and she was eventually diagnosed with conversion disorder. We discuss herein the importance of early recognition and intervention and clues to the diagnosis of conversion disorder in children in a non-psychiatric clinical setting.

  12. Personality disorders and accentuations in at-risk persons with and without conversion to first-episode psychosis.

    PubMed

    Schultze-Lutter, Frauke; Klosterkötter, Joachim; Michel, Chantal; Winkler, Karen; Ruhrmann, Stephan

    2012-11-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Cluster A personality disorders (PDs), particularly schizotypal PD, are considered a part of the schizophrenia spectrum and a risk factor of psychosis. The role of PDs and personality accentuations (PAs) in predicting conversion to psychosis was studied in patients symptomatically considered at risk, assuming a major role of the schizotypal subtype. PDs and PAs, assessed at baseline with a self-report questionnaire, were compared between risk-, gender- and age-matched at-risk patients with (n = 50) and without conversion to psychosis (n = 50). Overall, Cluster A-PDs were the least frequent cluster (14%), and schizotypal PD was rare (7%). Yet, PDs in general were frequent (46%), especially Cluster B- (31%) and C-PDs (23%). Groups did not differ in frequencies of PDs, yet converters tended to have a higher expression of schizoid (P = 0.057) and Cluster A-PAs (P = 0.027). In regression analyses, schizoid PA was selected as sole but weak predictor of conversion (OR = 1.685; 95% CIs: 1.134/2.504). Unexpectedly, schizotypal PD was infrequent and did not predict conversion. Conversion was best predicted by schizoid PA, indicating more severe, persistent social deficits already at baseline in later converters. This corresponds to premorbid social deficits reported for genetic high-risk children and low social functioning in at-risk patients later converting to psychosis. Further, PDs occurred frequently in at-risk patients irrespective of conversion. As psychopathology and personality relate closely to one another, this result highlights that, beyond the current narrow focus on schizotypal PD, personality-related factors should be considered more widely in the prevention of psychosis. © 2012 Wiley Publishing Asia Pty Ltd.

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

    PubMed

    Fried-Oken, Melanie; Daniels, Darlene; Ettinger, Olivia; Mooney, Aimee; Noethe, Glory; Rowland, Charity

    2015-05-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Treatment of post-transplantation lymphoproliferative disorders after kidney transplant with rituximab and conversion to m-TOR inhibitor.

    PubMed Central

    Nieto-Rios, John Fredy; Gómez de los Ríos, Sandra Milena; Ocampo-Kohn, Catalina; Aristizabal-Alzate, Arbey; Gálvez-Cárdenas, Kenny Mauricio; Zuluaga-Valencia, Gustavo Adolfo

    2016-01-01

    Abstract Background: Post-transplantation lymphoproliferative disorders are serious complications of organ transplantation which treatment is not yet standardized. Objective: To describe the clinical response, overall and graft survival of patients in our center with this complication after kidney transplantation, which received rituximab as part of their treatment as well as conversion to m-TOR. Methods: Retrospective study, which included patients, diagnosed with post-transplant lymphoproliferative disorders after kidney transplantation from January 2011 to July 2014. Results: Eight cases were found with a wide spectrum of clinical presentations. Most had monomorphic histology, 85% were associated with Epstein-Barr virus, 25% of patients had tumor involvement of the renal graft, and 12.5% ​​had primary central nervous system lymphoma. All patients were managed with reduction of immunosuppression, conversion to m-TOR (except one who lost the graft at diagnosis) and rituximab-based therapy. The overall response rate was 87.5% (62.5% complete response, 25% partial response). Survival was 87.5% with a median follow-up of 34 months. An additional patient lost the graft, with chronic nephropathy already known. All the remaining patients had stable renal function. Conclusions: There are no standardized treatment regimens for lymphoproliferative disorders after kidney transplantation, but these patients can be managed successfully with reduction of immunosuppression, conversion to m-TOR and rituximab-based schemes. PMID:28293043

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

    ERIC Educational Resources Information Center

    Muller, Nicole; Guendouzi, Jacqueline A.

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Muller, Nicole; Guendouzi, Jacqueline A.

    2005-01-01

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

  18. A Case of Neurological Symptoms and Severe Urinary Retention on a Pediatric Ward: Is this Conversion Disorder?

    PubMed

    Parmar, Varinderjit; Roberts, Nasreen

    2013-02-01

    a) To illustrate the etiological role of sexual and physical abuse in the development of childhood conversion disorder b) to highlight the importance of collaborative care in cases of conversion disorder c) to identify particular areas or needs for future research in the topic. We discuss the case of a fifteen-year old girl who was admitted to pediatrics with medically unexplained neurological complaints, chiefly urinary retention. Psychiatry was consulted after all organic work up was completed. Patient was transferred to the psychiatry ward and we present the unfolding of this case. Pediatrics and psychiatry generated a collaborative management plan. The patient presented, initially, with tremors, severe urinary retention and constipation. After her second admission to pediatrics, for severe urinary retention, the girl disclosed chronic sexual and physical abuse and neglect. Conversion symptoms often occur in cases of severe psychosocial stresses including sexual and physical abuse. This case highlights the importance of interdisciplinary professional collaboration in the management of complex presentations with unexplained symptoms and psychosocial stressors.

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

    PubMed

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Venker, Courtney E.; Kover, Sara T.

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Venker, Courtney E.; Kover, Sara T.

    2015-01-01

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

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

    PubMed Central

    Mortari, Luigina

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    SciTech Connect

    Wang, Jie; Osei, Kwame

    2011-07-22

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  8. [Acute hemiplegia and hemianesthesia together with decreased tendon reflexes mimicking acute stroke representing a conversion disorder].

    PubMed

    Schif, Aharon; Ravid, Sarit; Hafner, Hava; Shahar, Eli

    2010-01-01

    Acute hemiplegia and hemianesthesia is commonly caused by obstruction of major cortical arteries. Such a presentation secondary to a conversion reaction is very rare, especially in the pediatric age group. The authors report an adolescent presenting with acute complete left-sided hemiplegia and sensory loss together with decreased tendon reflexes mimicking an acute arterial stroke. Examination revealed Hoover's sign was present and the patient was oblivious to his stern neurological state. Movement of his paralytic limbs was observed during sleep. Cortical and spinal CT, cortical MRI, motor and somatosensory evoked potentials and a PET study were all normal. As such, the diagnosis of psychogenic hemiplegia was established, apparently within a period that the patient had experienced severe emotional stress while questioning his gender identity. After three days, the adolescent began to move the paralytic limbs along gradual resolution of sensory deficit, leading to complete clinical recovering within two months. Although extremely rare, a conversion reaction should be taken into account in children presenting with acute hemiplegia and anaesthesia, even accompanied with decreased tendon reflexes, when the patient is oblivious to his alleged grave state, and when clinical observations such as Hoover's sign remain intact, substantiated by normal extensive radiological and neurophysiological investigation. Intact motor evoked potentials serve as a key for the diagnosis of psychogenic hemiplegia and, should therefore be performed in suspected cases.

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2017-01-01

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

  11. [What would you do when faced with a Muslim patient with a conversational disorder?

    PubMed

    Martínez Gandolfi, A; Rodríguez Mir, J

    2017-09-07

    The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Differences in sleep disturbances among offspring of parents with and without bipolar disorder: Association with conversion to bipolar disorder

    PubMed Central

    Levenson, Jessica C.; Axelson, David A.; Merranko, John; Angulo, Melina; Goldstein, Tina R.; Goldstein, Ben I.; Brent, David A.; Diler, Rasim; Hickey, Mary Beth; Monk, Kelly; Sakolsky, Dara; Kupfer, David J.; Birmaher, Boris

    2016-01-01

    Objectives Disruptions in sleep and dysregulation in circadian functioning may represent core abnormalities in the pathophysiology of bipolar disorder (BP). However, it is not clear whether these dysfunctions are “state” or “trait” markers of BP. This report compared sleep and circadian phenotypes among three groups: offspring of bipolar parents diagnosed with (BP/OB; n=47) and without (non-BP/OB; n=386) BP at intake and offspring of matched control parents who did not have BP (controls; n=301). We also examined the association of baseline sleep parameters with subsequent development of BP among the non-BP/OB group. Methods Pittsburgh Bipolar Offspring Study youth (ages 6-18) and their parents completed assessments every two years pertaining to child's sleep and circadian phenotypes and current psychopathology. Mixed-effects models examined differences on baseline sleep and circadian variables among the three groups. Results BP/OB offspring who were in a mood episode differed significantly on sleep parameters from the non-BP/OB and the offspring of controls, such as having inadequate sleep. Mixed logistic regression procedures showed that baseline sleep and circadian variables, such as frequent waking during the night, significantly predicted the development of BP among non-BP/OB over longitudinal follow-up. Conclusions While lifetime diagnostic status accounted for differences among the groups on sleep and circadian disturbances, psychopathology explained the differences even further. Additionally, sleep disturbance may be a prognostic indicator of the development of BP in high-risk youth. Future studies are required to further disentangle whether sleep and circadian disruption are state or trait features of BP. PMID:26547512

  13. Embodied conversational agents for multimodal automated social skills training in people with autism spectrum disorders

    PubMed Central

    Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

    2017-01-01

    Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social communication skills through interaction with a computer avatar. Even though previous work that simulated social skills training only considered acoustic and linguistic information, human social skills trainers take into account visual and other non-verbal features. In this paper, we create and evaluate a social skills training system that closes this gap by considering the audiovisual features of the smiling ratio and the head pose (yaw and pitch). In addition, the previous system was only tested with graduate students; in this paper, we applied our system to children or young adults with autism spectrum disorders. For our experimental evaluation, we recruited 18 members from the general population and 10 people with autism spectrum disorders and gave them our proposed multimodal system to use. An experienced human social skills trainer rated the social skills of the users. We evaluated the system’s effectiveness by comparing pre- and post-training scores and identified significant improvement in their social skills using our proposed multimodal system. Computer-based social skills training is useful for people who experience social difficulties. Such a system can be used by teachers, therapists, and social skills trainers for rehabilitation and the supplemental use of human-based training anywhere and anytime. PMID:28796781

  14. Embodied conversational agents for multimodal automated social skills training in people with autism spectrum disorders.

    PubMed

    Tanaka, Hiroki; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

    2017-01-01

    Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social communication skills through interaction with a computer avatar. Even though previous work that simulated social skills training only considered acoustic and linguistic information, human social skills trainers take into account visual and other non-verbal features. In this paper, we create and evaluate a social skills training system that closes this gap by considering the audiovisual features of the smiling ratio and the head pose (yaw and pitch). In addition, the previous system was only tested with graduate students; in this paper, we applied our system to children or young adults with autism spectrum disorders. For our experimental evaluation, we recruited 18 members from the general population and 10 people with autism spectrum disorders and gave them our proposed multimodal system to use. An experienced human social skills trainer rated the social skills of the users. We evaluated the system's effectiveness by comparing pre- and post-training scores and identified significant improvement in their social skills using our proposed multimodal system. Computer-based social skills training is useful for people who experience social difficulties. Such a system can be used by teachers, therapists, and social skills trainers for rehabilitation and the supplemental use of human-based training anywhere and anytime.

  15. Mood episodes and mood disorders: patterns of incidence and conversion in the first three decades of life

    PubMed Central

    Beesdo, Katja; Höfler, Michael; Leibenluft, Ellen; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea

    2009-01-01

    Objectives Significant questions remain regarding both the incidence patterns of mood episodes in adolescents and young adults from the community and the conversion rate from unipolar to bipolar disorders. We addressed these issues by examining data from a prospective longitudinal community study to (i) determine the cumulative incidence of mood episodes and disorders in the first three decades of life; (ii) determine the risk for first onset of depression among individuals with a previous history of hypomanic/manic episodes and vice versa; and (iii) determine the clinical and treatment characteristics of these subjects. Methods Using the Munich-Composite International Diagnostic Interview, clinically trained interviewers assessed mood episodes and mental disorders in 3,021 community subjects (aged 14–24 at baseline and 21–34 at third follow-up). Results The estimated cumulative incidence at age 33 was 2.9% for manic, 4.0% for hypomanic, 29.4% for major depressive, and 19.0% for minor depressive episodes; overall, 26.0% had unipolar major depression, 4.0% bipolar depression, 1.5% unipolar mania, and 3.6% unipolar hypomania (no major depression). Overall, 0.6% and 1.8% had unipolar mania or hypomania, respectively, without indication for even minor depression. A total of 3.6% of the initial unipolar major depression cases subsequently developed (hypo)mania, with particularly high rates in adolescent onset depression (< 17 years: 9%). A total of 49.6% of the initial unipolar mania cases subsequently developed major depression and 75.6% major or minor depression. While bipolar cases had more adverse clinical and course depression characteristics and higher treatment rates than unipolar depressed cases, bipolar cases did not significantly differ in mania characteristics from unipolar mania cases. Conclusions Unipolar and bipolar mood disorders are more frequent than previously thought in adolescence and young adulthood, a time period when both the recognition and

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

    ERIC Educational Resources Information Center

    Lockton, Elaine; Adams, Catherine; Collins, Anna

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Lockton, Elaine; Adams, Catherine; Collins, Anna

    2016-01-01

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

  18. Interaction and Use of Speech-Generating Devices in the Homes of Children with Autism Spectrum Disorders--An Analysis of Conversational Topics

    ERIC Educational Resources Information Center

    Thunberg, Gunilla; Ahlsen, Elisabeth; Sandberg, Annika Dahlgren

    2009-01-01

    This project investigated the communication of four children with autism spectrum disorders, who used a speech-generating device (SGD) in one or two selected activities in their home environment. The children were between five and seven years of age. The conversational topics introduced by the children and their parents were analyzed. The…

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

    PubMed

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

    2016-04-01

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

  20. The use of conversation analysis to study social accessibility of an online support group on eating disorders.

    PubMed

    Stommel, Wyke; Meijman, Frans J

    2011-06-01

    We conducted a conversation analysis of 21 threads initiated by newcomers of an online support group (OSG) on eating disorders, to examine the discursive process of entering such a group. The analysis revealed three important issues. First, many newcomers articulate that the step to join the group is extremely difficult. Second, a presentation of the self in terms of a diagnosis works as a legitimization for joining the forum. The data suggest that participants who do not fulfil the conditions for such a legitimization do not join the forum. Third, the option of acquiring a serious symptom as a solution to the legitimization problem is offered by one of the regular members. Hence, the newcomers' discourse reveals issues relevant to the accessibility for undiagnosed sufferers. We discuss these findings theoretically as a phenomenon of self-presentation in relation to community norms. The analysis generates the hypothesis that newcomers are confronted with implicit norms regarding membership legitimacy that they should obey in their self-presentation, although they may not be ready yet to actually do so. OSGs should find strategies to facilitate various possibilities for newcomers to present themselves to the group while becoming a member.

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

    PubMed

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

    2013-08-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

    Ross, Kenneth Andrew

    2011-02-03

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

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

    PubMed Central

    2011-01-01

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

  5. Do children with social communication disorder have explicit knowledge of pragmatic rules they break? A comparison of conversational pragmatic ability and metapragmatic awareness.

    PubMed

    Lockton, Elaine; Adams, Catherine; Collins, Anna

    2016-09-01

    Children who have social communication disorder (CwSCD) demonstrate persistent difficulties with language pragmatics in conversations and other verbal interactions. Speech-language interventions for these children often include promotion of metapragmatic awareness (MPA); that is, the ability to identify explicitly and reflect upon pragmatic rules (MP explicitation). Improved MPA is assumed to support increased self-monitoring and generalization of pragmatic knowledge. Evidence to support this as a mechanism of intervention depends upon the identification of a systematic relationship between MPA and use of pragmatic rules in conversational behaviour. To explore whether there is a relationship between MPA and conversational pragmatic ability in CwSCD. Further, it is asked whether CwSCD can demonstrate MPA for the pragmatic rules they themselves violate in conversation. Thirty-nine CwSCD (aged 6;1-10;7 years), recruited from NHS speech and language therapy caseloads across the North West of England and South East Scotland, completed (1) a novel task, the Assessment of Metapragmatics (AMP), in which they identified and described a series of pragmatic errors depicted in scripted films; responses on this task were categorized into levels of MP explicitation; and (2) the Targeted Observation of Pragmatics in Children's Conversations (TOPICC), a semi-structured conversation-elicitation task from which 12 aspects of pragmatics were coded for presence of impairment. Regression analysis was used to explore the interaction between scores on the two tasks. Expressive language score was a significant predictor of TOPICC score. However, AMP score, when added into the regression model, did not explain a significant amount of unique variance in TOPICC score. Over half of CwSCD demonstrated moderate or marked impairment in one or two pragmatic behaviours on TOPICC. For just over half of the occasions where a child showed moderate/marked impairment of a pragmatic rule on TOPICC did

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

    PubMed

    Goldstein, Mandy; Madden, Sloane; Peters, Lorna

    2013-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-11-01

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

  8. Using conversation analysis to explore the recurrence of a topic in the talk of a boy with an autism spectrum disorder.

    PubMed

    Stribling, Penny; Rae, John; Dickerson, Paul

    2009-08-01

    Some higher functioning individuals with autism spectrum disorders (ASDs) are reported to produce perseverative talk, especially around 'special interests'. Topic perseveration is a form of pragmatic impairment captured in Prizant and Rydell's (1993) continuum of unconventional verbal behaviour in autism. Although widely reported, there is little systematic empirical research into this phenomenon. This paper considers the utility of Conversation Analysis in developing knowledge in this area, drawing upon data involving a boy with an ASD interacting with a researcher and a mobile robot platform. Although a frequency analysis of the boy's talk on a single topic may suggest that it is perseverative in nature, in a sequential analysis of both talk and non-spoken activities this study aims to show how these may be interactionally-embedded. It is suggested that, in considering the interactional salience of apparently perseverative talk, it can be useful to explore the participation framework in which the topic is revisited.

  9. A conversion disorder or a stroke? A proximal basilar artery thrombosis induced 'locked-in' syndrome in a young Caucasian woman.

    PubMed

    Li, Wang; Brandon, Ohman; Smith, Debbie Villarreal; Petersen, Eric

    2013-03-14

    The incidence of the basilar artery occlusion is relatively low among all strokes. Clinical presentation varies depending on the location of the occlusion. The symptoms include mild dysarthria to coma or sudden death. The initial subtle clinical presentation could lead to misdiagnosis. Psychogenic diagnosis in the differential could make the timely diagnosis more difficult. This case involves a 34-year-old woman presenting with a gradual onset of slurred speech. The initial CT scan of head did not indicate any intracranial pathology, and she was initially treated for an anxiety/conversion disorder. With progression of the pathology, the patient quickly developed a 'locked-in' syndrome, with preserved high cognitive function and vertical eye movement, but otherwise total loss of motor function. The diagnosis was confirmed with MRI/MR angiography studies, which indicated thrombosis of the proximal basilar artery. Serological studies did not disclose any relevant risk factors.

  10. Conversational Dominance.

    ERIC Educational Resources Information Center

    Esau, Helmut; Poth, Annette

    Details of conversational behavior can often not be interpreted until the social interaction, including the rights and obligations of the participants, their intent, the topic, etc., has been defined. This paper presents a model of conversation in which the conversational image a person presents in a given conversational situation is a function of…

  11. A university psychotherapy training program in a psychiatric hospital: 25 years of the conversational model in the treatment of patients with borderline personality disorder.

    PubMed

    Haliburn, Joan; Stevenson, Janine; Gerull, Friederike

    2009-02-01

    The aim of this paper is to describe the development, delivery and experience of a university psychotherapy training program for psychiatry trainees in a public psychiatric hospital, demonstrating that patients with severe borderline personality disorder can be treated successfully with psychodynamic psychotherapy and stressing the need for structured psychodynamic psychotherapy training in psychiatry. Two of the authors (JH and JS) were part of the first group of eight trainees supervised by Professor Russell Meares and several other experienced psychiatrists. Ninety trainees have successfully completed the course. Two hundred and forty patients have been treated by trainees in this program to date; 49 patients have dropped out. The training program provided a sound psychodynamic base and an improved capacity to relate with our patients, not only in the program but also in our routine work as psychiatrists. An important public health issue and community need was addressed, which also proved to make sound economic sense as the number of patients who were treated might not have otherwise received long-term psychotherapy. An integrated process model of psychoanalytic psychotherapy--the conversational model--has evolved and continues to be offered as a 3-year part-time clinically oriented course leading to a Masters in Medicine, Psychotherapy at the University of Sydney. Several outcome studies and papers have been published and workshops have been presented both in Australia and overseas. The patients improved considerably--their self harming behaviour stopped within 6 months and they were no longer clinically depressed at the end of 1 year.

  12. Contentious Conversations

    ERIC Educational Resources Information Center

    Zuidema, Leah A.

    2011-01-01

    The idea of joining a conversation through reading and writing is not new; in his 1941 book "The Philosophy of Literary Form: Studies in Symbolic Action," Kenneth Burke suggests that the acts of reading and writing are like entering a parlor where others are already conversing. The author explores the place of professional debate within NCTE and…

  13. Contentious Conversations

    ERIC Educational Resources Information Center

    Zuidema, Leah A.

    2011-01-01

    The idea of joining a conversation through reading and writing is not new; in his 1941 book "The Philosophy of Literary Form: Studies in Symbolic Action," Kenneth Burke suggests that the acts of reading and writing are like entering a parlor where others are already conversing. The author explores the place of professional debate within NCTE and…

  14. Metric Conversion

    Atmospheric Science Data Center

    2013-03-12

    ... 1,000,000 1,000,000 micrometers nano- 1,000,000,000 1,000,000,000 nanometers ... conversions, see the National Institute of Standards and Technology (NIST) Special Publications: NIST Guide to SI Units: ...

  15. Conversation Analysis.

    ERIC Educational Resources Information Center

    Schiffrin, Deborah

    1990-01-01

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

  16. Conversational Telugu.

    ERIC Educational Resources Information Center

    Beinstein, Judith; And Others

    The purpose of this text is to develop elementary conversational skills in Telugu. The language materials consist of four types of language learning activities. The first, and most predominant, is the unit microwave cycle. These cycles divide the learning process into two basic phases, the first of which involves mimicry, memorization, and…

  17. Conversational Tamil.

    ERIC Educational Resources Information Center

    Beinstein, Judith; And Others

    The purpose of this text is to develop conversational skills in Tamil. It is to be used as a review of what has been learned in class and not as a teaching device. The language materials consist of four types of language learning activities. The unit microwave cycle divides the learning process into two basic phases. The first phase involves…

  18. Conversion Disorder— Mind versus Body: A Review

    PubMed Central

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

    2015-01-01

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

  19. Conversational sensing

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  20. Conversational sensemaking

    NASA Astrophysics Data System (ADS)

    Preece, Alun; Webberley, Will; Braines, Dave

    2015-05-01

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

  1. Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

    PubMed Central

    Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

    2011-01-01

    Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts. PMID:21668080

  2. Using Conversation Analysis to Explore the Recurrence of a Topic in the Talk of a Boy with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Stribling, Penny; Rae, John; Dickerson, Paul

    2009-01-01

    Some higher functioning individuals with autism spectrum disorders (ASDs) are reported to produce perseverative talk, especially around "special interests". Topic perseveration is a form of pragmatic impairment captured in Prizant and Rydell's (1993) continuum of unconventional verbal behaviour in autism. Although widely reported, there…

  3. Dissociative disorders.

    PubMed

    Kihlstrom, John F

    2005-01-01

    The dissociative disorders, including "psychogenic" or "functional" amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an "epidemic" of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next "epidemic" of dissociation.

  4. Childhood emotional abuse and dissociation in patients with conversion symptoms.

    PubMed

    Sar, Vedat; Islam, Serkan; Oztürk, Erdinç

    2009-10-01

    The aim of the present study was to evaluate the relationship between reported childhood trauma and dissociation in patients who have a conversion symptom. Thirty-two outpatients with a conversion symptom were evaluated using Dissociative Experiences Scale, Somatoform Dissociation Questionnaire, Childhood Trauma Questionnaire, Spielberger Trait Anxiety Inventory, Clinician-Administered Dissociative State Scale, and Dissociative Disorders Interview Schedule. A DSM-IV dissociative disorder was diagnosed in 46.9% of the patients. Conversion patients with a dissociative disorder had borderline personality disorder more frequently than those without a dissociative disorder. Among childhood trauma types, emotional abuse was the only significant predictor of dissociation in regression analysis. None of the childhood trauma types predicted borderline personality disorder criteria. Borderline personality disorder, dissociation and reports of childhood emotional abuse refer to a subgroup among patients with conversion symptom. Dissociation seems to be a mediator between childhood trauma and borderline phenomena among these patients.

  5. Teaching Children with Autism to Respond to Conversation Partners' Interest

    ERIC Educational Resources Information Center

    Peters, Lindsay C.; Thompson, Rachel H.

    2015-01-01

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

  6. Teaching Children with Autism to Respond to Conversation Partners' Interest

    ERIC Educational Resources Information Center

    Peters, Lindsay C.; Thompson, Rachel H.

    2015-01-01

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

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

    PubMed

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

    2004-01-01

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

  8. Pashto Conversation Manual and Pashto Conversation Tapescript.

    ERIC Educational Resources Information Center

    Tegey, Habibullah; Robson, Barbara

    This conversation manual and tapescript are part of a set of materials that have been developed to teach oral and written Afghan Pashto to English speakers. In addition to the conversation manual and tapescript, the set consists of a beginning textbook, an intermediate textbook, a reader, and a set of taped lessons that correlate with the…

  9. Roles of Peroxisome Proliferator-Activated Receptor α in Bitter Melon Seed Oil-Corrected Lipid Disorders and Conversion of α-Eleostearic Acid into Rumenic Acid in C57BL/6J Mice

    PubMed Central

    Chang, Ya-Yuan; Su, Hui-Min; Chen, Szu-Han; Hsieh, Wen-Tsong; Chyuan, Jong-Ho; Chao, Pei-Min

    2016-01-01

    We previously reported that bitter melon seed oil (BMSO) was an effective anti-steatosis and antiobesity agent. Since the major fatty acid α-eleostearic acid (α-ESA) in BMSO is a peroxisome proliferator-activated receptor α (PPARα) activator, the objective was to investigate the role of PPARα in BMSO-modulated lipid disorders and α-ESA metabolism. C57BL/6J wild (WD) and PPARα knockout (KO) mice were fed a high-fat diet containing BMSO (15% soybean oil + 15% BMSO, HB) or not (30% soybean oil, HS) for 5 weeks. The HB diet significantly reduced hepatic triglyceride concentrations and increased acyl-CoA oxidase activity in WD, but not in KO mice. However, regardless of genotype, body fat percentage was lowered along with upregulated protein levels of uncoupling protein 1 (UCP1) and tyrosine hydroxylase, as well as signaling pathway of cAMP-dependent protein kinase and AMP-activated protein kinase in the white adipose tissue of HB-treated groups compared to HS cohorts. In WD-HB and KO-HB groups, white adipose tissue had autophagy, apoptosis, inflammation, and browning characteristics. Without PPARα, in vivo reduction of α-ESA into rumenic acid was slightly but significantly lowered, along with remarkable reduction of hepatic retinol saturase (RetSat) expression. We concluded that BMSO-mediated anti-steatosis depended on PPARα, whereas the anti-adiposity effect was PPARα-independent. In addition, PPARα-dependent enzymes may participate in α-ESA conversion, but only have a minor role. PMID:27973445

  10. Direct Conversion of Energy.

    ERIC Educational Resources Information Center

    Corliss, William R.

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

  11. Learning through Conversation.

    ERIC Educational Resources Information Center

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

    1996-01-01

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

  12. Iterated multidimensional wave conversion

    SciTech Connect

    Brizard, A. J.; Tracy, E. R.; Johnston, D.; Kaufman, A. N.; Richardson, A. S.; Zobin, N.

    2011-12-23

    Mode conversion can occur repeatedly in a two-dimensional cavity (e.g., the poloidal cross section of an axisymmetric tokamak). We report on two novel concepts that allow for a complete and global visualization of the ray evolution under iterated conversions. First, iterated conversion is discussed in terms of ray-induced maps from the two-dimensional conversion surface to itself (which can be visualized in terms of three-dimensional rooms). Second, the two-dimensional conversion surface is shown to possess a symplectic structure derived from Dirac constraints associated with the two dispersion surfaces of the interacting waves.

  13. NGL data conversion system

    NASA Astrophysics Data System (ADS)

    Shoji, Masahiro; Horiuchi, Nobuyasu

    2005-06-01

    We are developing a NGL data conversion system for EPL, for LEEPL, and for EBDW, which is based on our established photomask data conversion system, PATACON PC-cluster. For EPL data conversion, it has SF division, Complementary division, Stitching, Proximity effect correction, Alignment mark insertion, EB stepper control data creation, and Mask inspection data creation. For LEEPL data conversion, it has Pattern checking, Complementary division, Stitching, Stress distortion correction, Alignment mark insertion, and Mask inspection data creation. For EB direct-writing data conversion, it has Proximity effect correction and Extraction of aperture pattern for cell projection exposure.

  14. Conversing with Computers

    NASA Technical Reports Server (NTRS)

    2004-01-01

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

  15. Functional neurological disorders: imaging.

    PubMed

    Voon, V

    2014-10-01

    Functional neurological disorders, also known as conversion disorder, are unexplained neurological symptoms. These symptoms are common and can be associated with significant consequences. This review covers the neuroimaging literature focusing on functional motor symptoms including motor functioning and upstream influences including self-monitoring and internal representations, voluntariness and arousal and trauma. Copyright © 2014. Published by Elsevier SAS.

  16. Conversational Responsiveness and Assertiveness in Language-Impaired Children.

    ERIC Educational Resources Information Center

    Rosinski-McClendon, Mary Kay; Newhoff, Marilyn

    1987-01-01

    The conversational responsiveness and assertiveness of 10 language-disordered children (4:1 to 5:9 years old) was compared to that of 10 non-impaired younger children matched for language ability. Results indicated that the handicapped children responded to questions less often but were as assertive in conversation as normal children. (DB)

  17. Conversation et Television (Conversation and Television)

    ERIC Educational Resources Information Center

    Vadde, Jean-Pierre

    1977-01-01

    Czechosovakian television has just presented a series of French Conversation Classes using audiovisual techniques and starring Czech actors and actresses. The setting of each dialog is in Czechoslovakia, and the situations are those in which a Czech would use French in his or her native land. (Text is in French.) (AMH)

  18. Conversations in Child Care

    ERIC Educational Resources Information Center

    Bardige, Betty; Segal, Marilyn

    2004-01-01

    In this article, Bardige and Segal discuss how teachers can help a toddler's language and literacy development through conversation. They suggest an array of tactics, from asking young children open-ended, intellectually challenging questions to going beyond the here and now when carrying on a conversation. Research has shown that the practice of…

  19. Energy conversion alternatives study

    NASA Technical Reports Server (NTRS)

    Shure, L. T.

    1979-01-01

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

  20. The Art of Conversation.

    ERIC Educational Resources Information Center

    Ervin-Tripp, Susan

    1984-01-01

    Criticizes Dorval and Eckerman (included in this issue) for their findings' lack of generality due to the artificial nature of the conversational groups studied. Also both age changes in the ability to plan large conversational units and the functions of particular kinds of turns within these larger units are left unexplored. (CB)

  1. Recording Conversations in Schools.

    ERIC Educational Resources Information Center

    Gluckman, Ivan B.; Koerner, Thomas J., Jr.

    1988-01-01

    In general, because of varying federal and state legislation and a paucity of court decisions, the law governing the recording of conversations is in considerable flux. School personnel desiring to record conversations in school without the consent or knowledge of all parties involved must proceed with considerable caution. (Author)

  2. Content for Conversation Partners.

    ERIC Educational Resources Information Center

    Olson, Kathleen

    2002-01-01

    Suggests that a good strategy for helping English language learners to develop communicative competence in English is by pairing them with native English speakers. In such conversation programs, conversation partners should be provided with topics and activities that incorporate the goals, interests, and experiences of the learners. Recommends…

  3. The Conversation Class

    ERIC Educational Resources Information Center

    Jackson, Acy L.

    2012-01-01

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

  4. NUCLEAR CONVERSION APPARATUS

    DOEpatents

    Seaborg, G.T.

    1960-09-13

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

  5. Abnormal Parietal Function in Conversion Paresis

    PubMed Central

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

    2011-01-01

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

  6. Headaches and sleep disorders.

    PubMed

    Freedom, Thomas

    2015-06-01

    Headaches and sleep disorders are associated in a complex manner. Both the disorders are common in the general population, but the relationship between the two is more than coincidental. Sleep disorders can exacerbate headache sand the converse is also true. Treatment of sleep disorders can have a positive impact on the treatment of headaches. Screening for sleep disorders should be considered in all patients with headaches. This can be accomplished with brief screening tools. Those who screen positively can be further evaluated or referred to asleep specialist.

  7. Mental Disorders

    MedlinePlus

    ... disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and phobias Bipolar disorder Depression Mood ...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  10. Solar Thermal Conversion

    SciTech Connect

    Kreith, F.; Meyer, R. T.

    1982-11-01

    The thermal conversion process of solar energy is based on well-known phenomena of heat transfer (Kreith 1976). In all thermal conversion processes, solar radiation is absorbed at the surface of a receiver, which contains or is in contact with flow passages through which a working fluid passes. As the receiver heats up, heat is transferred to the working fluid which may be air, water, oil, or a molten salt. The upper temperature that can be achieved in solar thermal conversion depends on the insolation, the degree to which the sunlight is concentrated, and the measures taken to reduce heat losses from the working fluid.

  11. Responsive Teaching through Conversation

    ERIC Educational Resources Information Center

    Dozier, Cheryl; Garnett, Susan; Tabatabai, Simeen

    2011-01-01

    Conversations are the heart of responsive teaching. By talking with struggling learners, teachers can find out about their interests in order to design effective, personalized instruction; build relationships; work through complexities in teaching and learning; and celebrate successes.

  12. Photochemical Energy Conversion.

    ERIC Educational Resources Information Center

    Batschelet, William H.; George, Arnold

    1986-01-01

    Describes procedures for two demonstrations: (1) photochemical energy conversion using ferric oxalate actinometry and (2) liquification of gases using Freon 114. Safety precautions are given for both demonstrations, as are procedures and material specifications. (JM)

  13. Responsive Teaching through Conversation

    ERIC Educational Resources Information Center

    Dozier, Cheryl; Garnett, Susan; Tabatabai, Simeen

    2011-01-01

    Conversations are the heart of responsive teaching. By talking with struggling learners, teachers can find out about their interests in order to design effective, personalized instruction; build relationships; work through complexities in teaching and learning; and celebrate successes.

  14. Structured luminescence conversion layer

    DOEpatents

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

    2012-12-11

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

  15. Conversational flow promotes solidarity.

    PubMed

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

    2013-01-01

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

  16. [Cognitive-behavioral therapy of conversion aphonia].

    PubMed

    Kuljić, Blagoje

    2004-01-01

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

  17. Clients as conversational agents.

    PubMed

    Massfeller, Helen F; Strong, Tom

    2012-08-01

    Conversational agency is our invented term that orients us to ways in which clients participate in therapeutic dialogues. In this study we examined how clients' conversational correctives and initiatives influenced collaborative therapeutic consultations. Thirty-five single-session lifestyle consultations were videotaped in which adult clients volunteered to discuss concerns of non-clinical severity with a counselor. We discursively microanalyzed excerpts where clients initiated topic shifts or corrected counselor misunderstandings and how counselors responded to them. Clients were actively involved in co-managing conversational developments during the consultations. They influenced the content and course of the conversations with the counselors by correcting, interrupting, or speaking from positions contrary or unrelated to those of the counselors. Clients observably influenced the conversational agenda through their correctives and initiatives if counselors were responsive during face-to-face consultations. Clinicians should demonstrate increased sensitivity and relational responsivity by intentionally engaging with clients' agentive contributions to consultative dialogues. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Isomolybdate conversion coatings

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  19. Laser energy conversion

    NASA Technical Reports Server (NTRS)

    Jalufka, N. W.

    1989-01-01

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

  20. Laser energy conversion

    NASA Astrophysics Data System (ADS)

    Jalufka, N. W.

    1989-07-01

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

  1. Immunodeficiency disorders.

    PubMed

    Cooper, Max D; Lanier, Lewis L; Conley, Mary Ellen; Puck, Jennifer M

    2003-01-01

    Hematological complications occur frequently in patients with both primary and secondary immunodeficiency disorders. Anemia, thrombocytopenia or leukopenias may bring these individuals to the attention of hematologists. Conversely, evidence suggesting a lymphoproliferative disorder may be the cause for referral. This session will provide an update on the diagnosis and treatment of immunodeficiency diseases ranging from isolated defects in antibody production to the severe combined immunodeficiencies (SCID). Immunodeficiency diseases have traditionally been defined as defects in the development and function of T and B cells, the primary effector cells of specific cellular and humoral immunity. However, it has become increasingly evident that innate immune mechanisms contribute greatly to host defense, either through acting alone or by enhancing specific T and B cell responses. In Section I, Dr. Lewis Lanier reviews the burgeoning information on the extensive families of activating and inhibitory immunoreceptors that are expressed on NK cells, dendritic cells, T and B cells, and phagocytic cells. He provides an overview on the biological functions of these receptors in host defense. In Section II, Dr. Mary Ellen Conley defines the spectrum of antibody deficiency disorders, the most frequently occurring types of primary immunodeficiencies. She covers the different defects in B-cell development and function that lead to antibody deficiencies, and includes diagnosis and therapy of these disorders. In Section III, Dr. Jennifer Puck discusses the diagnosis and treatment of the different types of SCID. She describes the genetic basis for SCID, and the benefits, pitfalls, and complications of gene therapy and bone marrow transplantation in SCID patients.

  2. Direct conversion technology

    SciTech Connect

    Massier, P.F.; Back, L.H.; Ryan, M.A.; Fabris, G.

    1992-01-07

    The overall objective of the Direct Conversion Technology task is to develop an experimentally verified technology base for promising direct conversion systems that have potential application for energy conservation in the end-use sectors. This report contains progress of research on the Alkali Metal Thermal-to-Electric Converter (AMTEC) and on the Two-Phase Liquid-Metal MHD Electrical Generator (LMMHD) for the period January 1, 1991 through December 31, 1991. Research on AMTEC and on LMMHD was initiated during October 1987. Reports prepared on previous occasions (Refs. 1--5) contain descriptive and performance discussions of the following direct conversion concepts: thermoelectric, pyroelectric, thermionic, thermophotovoltaic, thermoacoustic, thermomagnetic, thermoelastic (Nitionol heat engine); and also, more complete descriptive discussions of AMTEC and LMMHD systems.

  3. Frequency conversion system

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

  4. Overview of coal conversion

    SciTech Connect

    Clark, B.R.

    1981-03-27

    The structure of coal and the processes of coal gasification and coal liquefaction are reviewed. While coal conversion technology is not likely to provide a significant amount of synthetic fuel within the next several years, there is a clear interest both in government and private sectors in the development of this technology to hedge against ever-diminishing petroleum supplies, especially from foreign sources. It is evident from this rather cursory survey that there is some old technology that is highly reliable; new technology is being developed but is not ready for commercialization at the present state of development. The area of coal conversion is ripe for exploration both on the applied and basic research levels. A great deal more must be understood about the reactions of coal, the reactions of coal products, and the physics and chemistry involved in the various stages of coal conversion processes in order to make this technology economically viable.

  5. Direct conversion technology

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

  6. Digital optical conversion module

    DOEpatents

    Kotter, Dale K.; Rankin, Richard A.

    1991-02-26

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

  7. Digital optical conversion module

    DOEpatents

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

    1988-07-19

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

  8. Excitatory and inhibitory conversive experiences: neurobiological features involving positive and negative conversion symptoms.

    PubMed

    Río-Casanova, Lucía Del; González, Anabel; Páramo, Mario; Brenlla, Julio

    2016-01-01

    Previous reviews have focused on neurobiological and physiological mechanisms underlying conversion disorder, but they do not usually distinguish between negative and positive conversion symptoms. Some authors have proposed that different phenomena should underlie both situations and that diverse emotion regulation strategies (under- vs. overregulation of affect) should be related to different internal experiences (excitatory experiences with hyperarousal manifestations vs. inhibitory experiences coexisting with hypoarousal states, respectively). After a careful review of the literature, we conclude that there is not a unique theory comprising all findings. Nevertheless, we have also collected some replicated findings that should be salient. Patients manifesting positive conversion symptoms tended to present with limbic hyperfunction, not sufficiently counteracted by prefrontal control. This leads to underregulation of affect mechanisms, increased emotional reactivity and autonomic hyperarousal. The opposite pattern (with a prefrontal overfunction working as a cognitive brake over the limbic system) has been described during negative conversion manifestations. We also highlight the influence of fronto-limbic circuits over cortico-striato-thalamo-cortical circuits' regulation, whose horizontal and vertical synchronization has been at the spotlight of the genesis of conversion and dissociative disorders.

  9. Predictability of Conversation Partners

    NASA Astrophysics Data System (ADS)

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

    2011-08-01

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

  10. ADEPT: Efficient Power Conversion

    SciTech Connect

    2011-01-01

    ADEPT Project: In today’s increasingly electrified world, power conversion—the process of converting electricity between different currents, voltage levels, and frequencies—forms a vital link between the electronic devices we use every day and the sources of power required to run them. The 14 projects that make up ARPA-E’s ADEPT Project, short for “Agile Delivery of Electrical Power Technology,” are paving the way for more energy efficient power conversion and advancing the basic building blocks of power conversion: circuits, transistors, inductors, transformers, and capacitors.

  11. Power conversion technologies

    SciTech Connect

    Haigh, R E

    1998-01-01

    The Power Conservation Technologies thrust area supports initiatives that enhance the core competencies of the Lawrence Livermore National Laboratory (LLNL) Engineering Directorate in the area of solid-state power electronics. Through partnerships with LLNL programs, projects focus on the development of enabling technologies for existing and emerging programs that have unique power conversion requirements. This year, a multi-disciplinary effort was supported which demonstrated solid-state, high voltage generation by using a dense, monolithic photovoltaic array. This effort builds upon Engineering's strengths in the core technology areas of power conversion, photonics, and microtechnologies.

  12. Direct Conversion Technology

    SciTech Connect

    Back, L.H.; Fabris, G.; Ryan, M.A.

    1992-07-01

    The overall objective of the Direct Conversion Technology task is to develop an experimentally verified technology base for promising direct conversion systems that have potential application for energy conservation in the end-use sectors. Initially, two systems were selected for exploratory research and advanced development. These are Alkali Metal Thermal-to-Electric Converter (AMTEC) and Two-Phase Liquid Metal MD Generator (LMMHD). This report describes progress that has been made during the first six months of 1992 on research activities associated with these two systems. (GHH)

  13. Planetary image conversion task

    NASA Technical Reports Server (NTRS)

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

    1985-01-01

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

  14. Clinical Linguistics: Conversational Reflections

    ERIC Educational Resources Information Center

    Crystal, David

    2013-01-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference…

  15. Stories in Conversation.

    ERIC Educational Resources Information Center

    Hofer, Roberta Senner

    Although conversational stories within one individual's corpus share the same structure, they have features that set them apart from one another. Based on the stories' general characteristics and the way they function in ongoing talk, they can be identified as: (1) durable personal experience narratives (PENs), which are often repeated during the…

  16. Evaluating Energy Conversion Efficiency

    NASA Technical Reports Server (NTRS)

    Byvik, C. E.; Smith, B. T.; Buoncristiani, A. M.

    1983-01-01

    Devices that convert solar radiation directly into storable chemical or electrical energy, have characteristic energy absorption spectrum; specifically, each of these devices has energy threshold. The conversion efficiency of generalized system that emcompasses all threshold devices is analyzed, resulting in family of curves for devices of various threshold energies operating at different temperatures.

  17. A Conversation about Observation

    NASA Technical Reports Server (NTRS)

    Mather, John C.; Mao, Minnie Yuan

    2012-01-01

    In the spirit of the Lindau Meeting, we present a dialogue between a Nobel laureate and a young researcher. This interchange started online, where it continues to unfold. Here is a digest of this conversation, which has developed across time and space.

  18. Conversations and Collaborations

    ERIC Educational Resources Information Center

    Korpan, Cynthia

    2010-01-01

    This paper looks at how a series of conversations contributed to the development of a newly formed role at the University of Victoria--Teaching Assistant Consultants (TACs). TACs act as departmental mentors for teaching assistants (TAs) in their respective departments, charged with providing support in the form of discipline-specific workshops…

  19. Clinical Linguistics: Conversational Reflections

    ERIC Educational Resources Information Center

    Crystal, David

    2013-01-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference…

  20. Ocean thermal energy conversion

    SciTech Connect

    Avery, W.H.

    1983-03-17

    A brief explanation of the Ocean Thermal Energy Conversion (OTEC) concept and an estimate of the amount of energy that can be produced from the ocean resource without introducing environmental concerns are presented. Use of the OTEC system to generate electric power and products which can replace fossil fuels is shown. The OTEC program status and its prospects for the future are discussed.

  1. Electromechanical Energy Conversion.

    ERIC Educational Resources Information Center

    LePage, Wilbur R.

    This programed text on electromechanical energy conversion (motors and generators) was developed under contract with the U.S. Office of Education as Number 12 in a series of materials for use in an electrical engineering sequence. It is intended to be used in conjunction with other materials and with other short texts in the series. (DH)

  2. Evaluating Energy Conversion Efficiency

    NASA Technical Reports Server (NTRS)

    Byvik, C. E.; Smith, B. T.; Buoncristiani, A. M.

    1983-01-01

    Devices that convert solar radiation directly into storable chemical or electrical energy, have characteristic energy absorption spectrum; specifically, each of these devices has energy threshold. The conversion efficiency of generalized system that emcompasses all threshold devices is analyzed, resulting in family of curves for devices of various threshold energies operating at different temperatures.

  3. Conversational English Program, 2.

    ERIC Educational Resources Information Center

    Instituto de Idiomas Yazigi, Sao Paulo (Brazil). Centro de Linguistica Aplicada.

    This second book of a conversational English program for adults contains an introductory section in Portuguese and exercises in English. The text centers around an English-speaking family from the United States that goes to live in Brazil. It contains color photographs with captions followed by exercises. The exercises are in English and involve…

  4. Mechanochemical Energy Conversion

    ERIC Educational Resources Information Center

    Pines, E.; And Others

    1973-01-01

    Summarizes the thermodynamics of macromolecular systems, including theories and experiments of cyclic energy conversion with rubber and collagen as working substances. Indicates that an early introduction into the concept of chemical potential and solution thermodynamics is made possible through the study of the cyclic processes. (CC)

  5. Conversational English Program, 1.

    ERIC Educational Resources Information Center

    Instituto de Idiomas Yazigi, Sao Paulo (Brazil). Centro de Linguistica Aplicada.

    This first book of a conversational English program for adults contains an introductory section in Portuguese and exercises in English. The text centers around an English-speaking family from the United States that goes to live in Brazil. It contains color photographs with captions followed by exercises. The exercises are in English and involve…

  6. Mechanochemical Energy Conversion

    ERIC Educational Resources Information Center

    Pines, E.; And Others

    1973-01-01

    Summarizes the thermodynamics of macromolecular systems, including theories and experiments of cyclic energy conversion with rubber and collagen as working substances. Indicates that an early introduction into the concept of chemical potential and solution thermodynamics is made possible through the study of the cyclic processes. (CC)

  7. Leadership is a conversation.

    PubMed

    Groysberg, Boris; Slind, Michael

    2012-06-01

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

  8. Conversations on ecology IV

    USGS Publications Warehouse

    Leopold, Luna Bergere

    1963-01-01

    The conversations on ecology have mentioned the pesticide problem, and in such discussion it is easy to lose sight of the basic philosophic view which is an undercurrent in Miss Carson's book. I should like to expand on that philosophic premise and examine some of its implications for planning vegetation management measures as well as other measures for resource development.

  9. Conversion or New Building?

    ERIC Educational Resources Information Center

    Berkeley, Phil

    1970-01-01

    Examined first is "the overall problem of housing a TV studio complex to see what particular sorts of buildings are required and how they must be related," and then considered are "the relative merits and particular problems of new studio building or a conversion." (LS)

  10. Solar energy conversion.

    SciTech Connect

    Crabtree, G. W.; Lewis, N. S.

    2008-03-01

    If solar energy is to become a practical alternative to fossil fuels, we must have efficient ways to convert photons into electricity, fuel, and heat. The need for better conversion technologies is a driving force behind many recent developments in biology, materials, and especially nanoscience. The Sun has the enormous untapped potential to supply our growing energy needs. The barrier to greater use of the solar resource is its high cost relative to the cost of fossil fuels, although the disparity will decrease with the rising prices of fossil fuels and the rising costs of mitigating their impact on the environment and climate. The cost of solar energy is directly related to the low conversion efficiency, the modest energy density of solar radiation, and the costly materials currently required. The development of materials and methods to improve solar energy conversion is primarily a scientific challenge: Breakthroughs in fundamental understanding ought to enable marked progress. There is plenty of room for improvement, since photovoltaic conversion efficiencies for inexpensive organic and dye-sensitized solar cells are currently about 10% or less, the conversion efficiency of photosynthesis is less than 1%, and the best solar thermal efficiency is 30%. The theoretical limits suggest that we can do much better. Solar conversion is a young science. Its major growth began in the 1970s, spurred by the oil crisis that highlighted the pervasive importance of energy to our personal, social, economic, and political lives. In contrast, fossil-fuel science has developed over more than 250 years, stimulated by the Industrial Revolution and the promise of abundant fossil fuels. The science of thermodynamics, for example, is intimately intertwined with the development of the steam engine. The Carnot cycle, the mechanical equivalent of heat, and entropy all played starring roles in the development of thermodynamics and the technology of heat engines. Solar-energy science faces

  11. Virtual Conversation Partner for Adults with Autism

    PubMed Central

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

    2011-01-01

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

  12. Wind energy conversion system

    DOEpatents

    Longrigg, Paul

    1987-01-01

    The wind energy conversion system includes a wind machine having a propeller connected to a generator of electric power, the propeller rotating the generator in response to force of an incident wind. The generator converts the power of the wind to electric power for use by an electric load. Circuitry for varying the duty factor of the generator output power is connected between the generator and the load to thereby alter a loading of the generator and the propeller by the electric load. Wind speed is sensed electro-optically to provide data of wind speed upwind of the propeller, to thereby permit tip speed ratio circuitry to operate the power control circuitry and thereby optimize the tip speed ratio by varying the loading of the propeller. Accordingly, the efficiency of the wind energy conversion system is maximized.

  13. Frequency conversion system

    NASA Technical Reports Server (NTRS)

    Sanders, Steven (Inventor); Lang, Robert J. (Inventor)

    2001-01-01

    Laser diode pumped mid-IR wavelength sources include at least one high power, near-IR wavelength, injection and/or sources wherein one or both of such sources may be tunable providing a pump wave output beam to a quasi-phase matched (QPM) nonlinear frequency mixing (NFM) device. The NFM device may be a difference frequency mixing (DFM) device or an optical parametric oscillation (OPO) device. Wavelength tuning of at least one of the sources advantageously provides the ability for optimizing pump or injection wavelengths to match the QPM properties of the NFM device enabling a broad range of mid-IR wavelength selectivity. Also, pump powers are gain enhanced by the addition of a rare earth amplifier or oscillator, or a Raman/Brillouin amplifier or oscillator between the high power source and the NFM device. Further, polarization conversion using Raman or Brillouin wavelength shifting is provided to optimize frequency conversion efficiency in the NFM device.

  14. Clinical linguistics: conversational reflections.

    PubMed

    Crystal, David

    2013-04-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference participants during that time.

  15. Advanced Thermal Conversion Systems

    DTIC Science & Technology

    2015-03-18

    BAA09-31 3  Figure 1. (a) Energy diagram of the PETE process. Photo -excitation leads to enhanced...photovoltaic cells at 3000x concentration (~38%). As shown in Fig. 2(b), the highest conversion efficiencies are obtained by using photo -cathodes...p-type 4H-SiC (left) and polycrystalline n-type 3C-SiC (right). The fabrication process for p-type devices used bulk p- doped 4H-SiC wafers from

  16. Session: Energy Conversion

    SciTech Connect

    Robertson, David; LaSala, Raymond J.; Kukacka, Lawrence E.; Bliem, Carl J.; Premuzic, Eugene T.; Weare, John H.

    1992-01-01

    This session at the Geothermal Energy Program Review X: Geothermal Energy and the Utility Market consisted of five presentations: ''Hydrothermal Energy Conversion Technology'' by David Robertson and Raymond J. LaSala; ''Materials for Geothermal Production'' by Lawrence E. Kukacka; ''Supersaturated Turbine Expansions for Binary Geothermal Power Plants'' by Carl J. Bliem; ''Geothermal Waster Treatment Biotechnology: Progress and Advantages to the Utilities'' by Eugen T. Premuzic; and ''Geothermal Brine Chemistry Modeling Program'' by John H. Weare.

  17. Persuasion Detection in Conversation

    DTIC Science & Technology

    2010-03-01

    is the first step in developing machine learning systems that can automatically detect persuasion in conversations. This corpus was developed from...requires some form of persuasion. Based on this research, it may be possible to construct a machine learning system that can automatically detect...specific markers, can these markers be learned and identified by annotators? Our research attempted to answer all of these questions by annotating a

  18. Direct conversion technology

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

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

  19. Natural gas conversion process

    SciTech Connect

    Not Available

    1992-01-01

    The experimental apparatus was dismantled and transferred to a laboratory space provided by Lawrence Berkeley Laboratory (LBL) which is already equipped with a high-ventilation fume hood. This will enable us to make tests at higher gas flow rates in a safe environment. Three papers presented at the ACS meeting in San Francisco (Symposium on Natural Gas Upgrading II) April 5--10, 1992 show that the goal of direct catalytic conversion of Methane into heavier Hydrocarbons in a reducing atmosphere is actively pursued in three other different laboratories. There are similarities in their general concept with our own approach, but the temperature range of the experiments reported in these recent papers is much lower and this leads to uneconomic conversion rates. This illustrates the advantages of Methane activation by a Hydrogen plasma to reach commercial conversion rates. A preliminary process flow diagram was established for the Integrated Process, which was outlined in the previous Quarterly Report. The flow diagram also includes all the required auxiliary facilities for product separation and recycle of the unconverted feed as well as for the preparation and compression of the Syngas by-product.

  20. Direct conversion technology

    NASA Astrophysics Data System (ADS)

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

    1988-12-01

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

  1. Dissociative Motor Disorder

    PubMed Central

    Jith, Arya; Narayanan, Dinesh

    2017-01-01

    Conversion disorders are more prevalent in childhood and adolescence, especially in females. They are usually associated with stressors and symptoms usually reflect a means to avoid the stressor, or also with a primary and secondary gain. This case report involves a similar situation where a young girl was treated successfully with diazepam, therapeutic nerve conduction study, and behavioral psychotherapy. PMID:28250569

  2. Conversion of Questionnaire Data

    SciTech Connect

    Powell, Danny H; Elwood Jr, Robert H

    2011-01-01

    During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC&A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC&A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relative risk values for all of the basic MC&A tasks performed in the facility. If a specific material protection, control, and accountability (MPC&A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC&A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC&A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A.D. Swain and H.E. Guttmann

  3. Tables and conversions for microclimatology.

    Treesearch

    James M. Brown

    1973-01-01

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

  4. Microbial Energy Conversion

    SciTech Connect

    Buckley, Merry; Wall, Judy D.

    2006-10-01

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

  5. Crucial Conversations about America's Schools

    ERIC Educational Resources Information Center

    Draper, John C.; Protheroe, Nancy

    2010-01-01

    It's up to school leaders to shift the momentum away from conversations based on misperceptions and toward those that study critical issues about school improvement. "Crucial Conversations About America's Schools" talks about how to do this and provides examples of how to reframe conversations on the hot-button but important topics of…

  6. The Personal Enjoyment of Conversation.

    ERIC Educational Resources Information Center

    Keller, Paul W.

    Conversation reminds us that we are not alone, that shared language is the opportunity to try on our many masks to see how many of them we can do without. The variety of pleasures accrued from conversation--"layers of pleasure"--deepen only as they move away from the individual orbits into the circle of mutual experience. When conversation is…

  7. Crucial Conversations about America's Schools

    ERIC Educational Resources Information Center

    Draper, John C.; Protheroe, Nancy

    2010-01-01

    It's up to school leaders to shift the momentum away from conversations based on misperceptions and toward those that study critical issues about school improvement. "Crucial Conversations About America's Schools" talks about how to do this and provides examples of how to reframe conversations on the hot-button but important topics of…

  8. Special Features in Children's Conversations.

    ERIC Educational Resources Information Center

    Karjalainen, Merja

    In a study of features that seem to be typical of children's conversations, 10 Finnish preschool children's conversations were videotaped and audiotaped over a period of 10 hours. The children were taped in conversation, play, fairy tale, and eating situations. Among the findings are that all children enjoy playing with language, but some initiate…

  9. Zinc phosphate conversion coatings

    DOEpatents

    Sugama, T.

    1997-02-18

    Zinc phosphate conversion coatings for producing metals which exhibit enhanced corrosion prevention characteristics are prepared by the addition of a transition-metal-compound promoter comprising a manganese, iron, cobalt, nickel, or copper compound and an electrolyte such as polyacrylic acid, polymethacrylic acid, polyitaconic acid and poly-L-glutamic acid to a phosphating solution. These coatings are further improved by the incorporation of Fe ions. Thermal treatment of zinc phosphate coatings to generate {alpha}-phase anhydrous zinc phosphate improves the corrosion prevention qualities of the resulting coated metal. 33 figs.

  10. Zinc phosphate conversion coatings

    DOEpatents

    Sugama, Toshifumi

    1997-01-01

    Zinc phosphate conversion coatings for producing metals which exhibit enhanced corrosion prevention characteristics are prepared by the addition of a transition-metal-compound promoter comprising a manganese, iron, cobalt, nickel, or copper compound and an electrolyte such as polyacrylic acid, polymethacrylic acid, polyitaconic acid and poly-L-glutamic acid to a phosphating solution. These coatings are further improved by the incorporation of Fe ions. Thermal treatment of zinc phosphate coatings to generate .alpha.-phase anhydrous zinc phosphate improves the corrosion prevention qualities of the resulting coated metal.

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

    ERIC Educational Resources Information Center

    Jones, Elizabeth B.

    2017-01-01

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

  12. Communication in conversation in stroke patients.

    PubMed

    Rousseaux, Marc; Daveluy, Walter; Kozlowski, Odile

    2010-07-01

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

  13. Direct somatic lineage conversion

    PubMed Central

    Tanabe, Koji; Haag, Daniel; Wernig, Marius

    2015-01-01

    The predominant view of embryonic development and cell differentiation has been that rigid and even irreversible epigenetic marks are laid down along the path of cell specialization ensuring the proper silencing of unrelated lineage programmes. This model made the prediction that specialized cell types are stable and cannot be redirected into other lineages. Accordingly, early attempts to change the identity of somatic cells had little success and was limited to conversions between closely related cell types. Nuclear transplantation experiments demonstrated, however, that specialized cells even from adult mammals can be reprogrammed into a totipotent state. The discovery that a small combination of transcription factors can reprogramme cells to pluripotency without the need of oocytes further supported the view that these epigenetic barriers can be overcome much easier than assumed, but the extent of this flexibility was still unclear. When we showed that a differentiated mesodermal cell can be directly converted to a differentiated ectodermal cell without a pluripotent intermediate, it was suggested that in principle any cell type could be converted into any other cell type. Indeed, the work of several groups in recent years has provided many more examples of direct somatic lineage conversions. Today, the question is not anymore whether a specific cell type can be generated by direct reprogramming but how it can be induced. PMID:26416679

  14. Conversion program in Sweden

    SciTech Connect

    Jonsson, E.B.

    1997-08-01

    The conversion of the Swedish 50 MW R2 reactor from HEU to LEU fuel has been successfully accomplished over a 16 cycles long process. The conversion started in January 1991 with the introduction of 6 LEU assemblies in the 8*8 core. The first all LEU core was loaded in March 1993 and physics measurements were performed for the final licensing reports. A total of 142 LEU fuel assemblies have been irradiated up until September 1994 without any fuel incident. The operating licence for the R2 reactor was renewed in mid 1994 taking into account new fuel type. The Swedish Nuclear Inspectorate (SKI) pointed out one crucial problem with the LEU operation, that the back end of the LEU fuel cycle has not yet been solved. For the HEU fuel Sweden had the reprocessing alternative. The country is now relying heavily on the success of the USDOEs Off Site Fuels Policy to take back the spent fuel from the research reactors. They have in the meantime increased their intermediate storage facilities. There is, however, a limit both in time and space for storage of MTR-type of assemblies in water. The penalty of the lower thermal neutron flux in LEU cores has been reduced by improvements of the new irradiation rigs and by fine tuning the core calculations. The Studsvik code package, CASMO-SIMULATE, widely used for ICFM in LWRs has been modified to suit the compact MTR type of core.

  15. Energy conversion system

    SciTech Connect

    Murphy, Lawrence M.

    1987-01-01

    The energy conversion system includes a photo-voltaic array for receiving solar radiation and converting such radiation to electrical energy. The photo-voltaic array is mounted on a stretched membrane that is held by a frame. Tracking means for orienting the photo-voltaic array in predetermined positions that provide optimal exposure to solar radiation cooperate with the frame. An enclosure formed of a radiation transmissible material includes an inside containment space that accommodates the photo-voltaic array on the stretched membrane, the frame and the tracking means, and forms a protective shield for all such components. The enclosure is preferably formed of a flexible inflatable material and maintains its preferred form, such as a dome, under the influence of a low air pressure furnished to the dome. Under this arrangement the energy conversion system is streamlined for minimizing wind resistance, sufficiently weatherproof for providing protection against weather hazards such as hail, capable of using diffused light, lightweight for low-cost construction, and operational with a minimal power draw.

  16. Natural gas conversion process

    SciTech Connect

    Not Available

    1991-01-01

    The main objective is to design and operate a laboratory apparatus for the catalytic reforming of natural gas in order to provide data for a large-scale process. To accelerate the assembly and calibration of this equipment, a request has been made to the Lawrence Berkeley Laboratory for assistance, under the DOE's Industrial Visitor Exchange Program. Pr. Heinz Heinemann (Catalysis), Dr. John Apps (Geochemistry) and Dr. Robert Fulton (Mechanical Engineering) have expressed interest in supporting our request. Pr. Heinemann's recent results on the conversion of Petroleum Coke residues into CO2 and H2 mixtures using highly basic metal oxides catalysts, similar to ours, are very encouraging regarding the possibility of converting the Coke residue on our catalyst into Syngas in the Regenerator/riser, as proposed. To minimize Coke formation in the vapor phase, by the Plasmapyrolytic Methane Conversion reactions, the experimental data of H. Drost et al. (Ref. 12) have been reviewed. Work is underway to design equipment for the safe and non-polluting disposal of the two gaseous product streams of the flow loop. 2 refs.

  17. Mode conversion in ITER

    NASA Astrophysics Data System (ADS)

    Jaeger, E. F.; Berry, L. A.; Myra, J. R.

    2006-10-01

    Fast magnetosonic waves in the ion cyclotron range of frequencies (ICRF) can convert to much shorter wavelength modes such as ion Bernstein waves (IBW) and ion cyclotron waves (ICW) [1]. These modes are potentially useful for plasma control through the generation of localized currents and sheared flows. As part of the SciDAC Center for Simulation of Wave-Plasma Interactions project, the AORSA global-wave solver [2] has been ported to the new, dual-core Cray XT-3 (Jaguar) at ORNL where it demonstrates excellent scaling with the number of processors. Preliminary calculations using 4096 processors have allowed the first full-wave simulations of mode conversion in ITER. Mode conversion from the fast wave to the ICW is observed in mixtures of deuterium, tritium and helium3 at 53 MHz. The resulting flow velocity and electric field shear will be calculated. [1] F.W. Perkins, Nucl. Fusion 17, 1197 (1977). [2] E.F. Jaeger, L.A. Berry, J.R. Myra, et al., Phys. Rev. Lett. 90, 195001-1 (2003).

  18. Energy conversion system

    DOEpatents

    Murphy, L.M.

    1985-09-16

    The energy conversion system includes a photo-voltaic array for receiving solar radiation and converting such radiation to electrical energy. The photo-voltaic array is mounted on a stretched membrane that is held by a frame. Tracking means for orienting the photo-voltaic array in predetermined positions that provide optimal exposure to solar radiation cooperate with the frame. An enclosure formed of a radiation transmissible material includes an inside containment space that accommodates the photo-voltaic array on the stretched membrane, the frame and the tracking means, and forms a protective shield for all such components. The enclosure is preferably formed of a flexible inflatable material and maintains its preferred form, such as a dome, under the influence of a low air pressure furnished to the dome. Under this arrangement the energy conversion system is streamlined for minimizing wind resistance, sufficiently weathproof for providing protection against weather hazards such as hail, capable of using diffused light, lightweight for low-cost construction and operational with a minimal power draw.

  19. Spatial language and converseness.

    PubMed

    Burigo, Michele; Coventry, Kenny R; Cangelosi, Angelo; Lynott, Dermot

    2016-12-01

    Typical spatial language sentences consist of describing the location of an object (the located object) in relation to another object (the reference object) as in "The book is above the vase". While it has been suggested that the properties of the located object (the book) are not translated into language because they are irrelevant when exchanging location information, it has been shown that the orientation of the located object affects the production and comprehension of spatial descriptions. In line with the claim that spatial language apprehension involves inferences about relations that hold between objects it has been suggested that during spatial language apprehension people use the orientation of the located object to evaluate whether the logical property of converseness (e.g., if "the book is above the vase" is true, then also "the vase is below the book" must be true) holds across the objects' spatial relation. In three experiments using sentence acceptability rating tasks we tested this hypothesis and demonstrated that when converseness is violated people's acceptability ratings of a scene's description are reduced indicating that people do take into account geometric properties of the located object and use it to infer logical spatial relations.

  20. Light alkane conversion

    SciTech Connect

    Harandi, M.N.; Owen, H.

    1991-07-09

    This patent describes a process for the aromatization of an aliphatic feedstream. It comprises fluidizing finely divided solid particles in a combustion zone; charging oxygen-containing combustion gas and fuel to the combustion zone under combustion conditions; withdrawing a stream of finely divided particles from the combustion zone; flowing the withdrawn stream of finely divided particles above to a cracking/dehydrogenation zone; fluidizing the finely divided particles above in an aliphatic feedstream under conditions within the cracking/dehydrogenation zone controlled to at least partially crack and at least partially dehydrogenate the aliphatic feedstream to form an intermediate product stream containing a quantity of C{sub 4}-olefins such that the exothermic catalytic conversion of the C{sub 4}-olefins is sufficient to supply a portion of the endothermic heat of reaction for the endothermic catalytic conversion of paraffins contained in the intermediate feedstream to aromatics; contacting the intermediate product stream with an aromatization catalyst under aromatization conditions sufficient to evolve an aromatics-rich products stream.

  1. Conversational Characteristics of Children with Fragile X Syndrome: Repetitive Speech.

    ERIC Educational Resources Information Center

    Belser, Richard C.; Sudhalter, Vicki

    2001-01-01

    Comparison of the production of repetitive speech during conversations in 30 people with either fragile X syndrome, autistic disorder, or mental retardation not caused by fragile X found repetitive speech more prevalent among those with fragile X. Results support the hypothesis that such speech dysfluency reflects the effects of physiological…

  2. Dissociative disorders in DSM-5.

    PubMed

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

    2013-01-01

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

  3. [Prevention of bipolar disorders].

    PubMed

    Leopold, K; Pfennig, A; Severus, E; Bauer, M

    2013-11-01

    In the past, preventive measures for psychoses have focused mainly on schizophrenic disorders. Bipolar disorders are often diagnosed and treated with a significant delay. The expansion of preventive measures for bipolar disorders aims at minimizing the substantial negative consequences associated with the disease. Some of the shared aspects of prevention in psychoses and bipolar disorders are that the first symptoms commonly appear during adolescence and early adulthood and that there is a symptomatic overlap between the disorders. To improve efforts to seek early help, public information about mental illness, low threshold services as well as cooperation between adult, child and adolescent psychiatry are needed for this target group. One differences is that psychotic symptoms play a minor role in bipolar disorders. Specific biological markers, such as disturbances of sleep and circadian rhythm and clinical characteristics, such as substance use and behavioral problems in childhood and youth supplement (subsyndromal) clinical symptoms in a multifactorial risk model. Besides severity and frequency of symptoms, specific periodic course patterns are crucial. Strategies of early intervention require a careful consideration of risks and benefits. Two aims should be distinguished: the improvement of current symptomatology and the prevention of conversion to bipolar disorder. Currently, studies evaluating risks and benefits of such interventions are first conducted. Expertise and resources for early recognition of psychoses and bipolar disorders should be pooled. Common standards are the basis for advancement and implementation of preventive strategies for bipolar disorders.

  4. Cooperative down-conversion of UV light in disordered scheelitelike Yb-doped NaGd(MoO4)2 and NaLa(MoO4)2 crystals

    NASA Astrophysics Data System (ADS)

    Subbotin, K. A.; Osipova, Yu. N.; Lis, D. A.; Smirnov, V. A.; Zharikov, E. V.; Shcherbakov, I. A.

    2017-07-01

    Concentration series of disordered scheelitelike Yb:NaGd(MoO4)2 and Yb:NaLa(MoO4)2 single crystals are grown by the Czochralski method. The actual concentrations of Yb3+ ions in the crystals are determined by optical-absorption spectroscopy. The luminescence of Yb3+ ions in these crystals in the region of 1 μm is studied under UV and IR excitation. In the case of UV excitation, this luminescence appears as a result of nonradiative excited state energy transfer from donor centers of unknown nature to ytterbium. The character of the concentration dependence of Yb3+ luminescence indicates that the energy transfer at high Yb concentrations occurs with active participation of a cooperative mechanism, according to which the excitation energy of one donor center is transferred simultaneously to two Yb3+ ions. In other words, the quantum yield of this transfer exceeds unity, which can be used to increase the efficiency of crystalline silicon (c-Si) solar cells.

  5. Power conversion technologies

    SciTech Connect

    Newton, M. A.

    1997-02-01

    The Power Conversion Technologies thrust area identifies and sponsors development activities that enhance the capabilities of engineering at Lawrence Livermore National Laboratory (LLNL) in the area of solid- state power electronics. Our primary objective is to be a resource to existing and emerging LLNL programs that require advanced solid-state power electronic technologies.. Our focus is on developing and integrating technologies that will significantly impact the capability, size, cost, and reliability of future power electronic systems. During FY-96, we concentrated our research efforts on the areas of (1) Micropower Impulse Radar (MIR); (2) novel solid-state opening switches; (3) advanced modulator technology for accelerators; (4) compact accelerators; and (5) compact pulse generators.

  6. Advanced thermionic energy conversion

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Developments towards space and terrestrial applications of thermionic energy conversion are presented. Significant accomplishments for the three month period include: (1) devised a blade-type distributed lead design with many advantages compared to the stud-type distributed lead; (2) completed design of Marchuk tube test apparatus; (3) concluded, based on current understanding, that residual hydrogen should not contribute to a negative space charge barrier at the collector; (4) modified THX design program to include series-coupled designs as well as inductively-coupled designs; (5) initiated work on the heat transfer technology, THX test module, output power transfer system, heat transfer system, and conceptual plant design tasks; and (6) reached 2200 hours of operation in JPL-5 cylindrical converter envelope test.

  7. Automated FORTRAN conversion

    NASA Technical Reports Server (NTRS)

    Aharonian, Gregory

    1986-01-01

    The most pratical solution to the conversion of FORTRAN to other programming languages which STO and a few others have adopted, uses an intermediate language that is easy to translate FORTRAN into, and allows for source codes in other languages to be generated automatically. The intermediate language is the union of all other programming languages (and the trick is to create a useful union) with some extensions that reflect the nature of the algorithms. The benefits of this approach are many. First the original FORTRAN program has to be rewritten only once, and then only parts of the program: most FORTRAN code passes through without and change (i.e., assignment and simple IF statements). Software tools are provided to ease this initial translation. Once in the intermediate language, the algorithm can then be obtained in any other language automatically. An example of a subroutine from the Rispack library in ten different languages is given.

  8. Laser plasmadynamic energy conversion

    NASA Technical Reports Server (NTRS)

    Shimada, K.

    1976-01-01

    The generation of electrons ions by interacting an intense laser beam with cesium vapor is considered. Theoretical calculation shows that the conversion efficiency is as high as 40 percent if the entire photon energy is utilized in ionizing the cesium vapor that is generated initially by the incoming laser beam. An output voltage is expected to be generated across two electrodes, one of which is the liquid cesium, by keeping the other electrode at a different work function. Evaluation of the laser plasmadynamic (LPD) converter was performed using pulsed ruby and Nd-glass lasers. Although the results obtained to date indicate an efficiency smaller than that of theoretical predictions, an unoptimized LPD converter did demonstrate the capability of converting laser energy at large power levels. The limitations in the performance may by due to converter geometry, the types of lasers used, and other limitations inherent to the cesium plasma.

  9. Thermal Energy Conversion Branch

    NASA Technical Reports Server (NTRS)

    Bielozer, Matthew C.; Schreiber, Jeffrey, G.; Wilson, Scott D.

    2004-01-01

    The Thermal Energy Conversion Branch (5490) leads the way in designing, conducting, and implementing research for the newest thermal systems used in space applications at the NASA Glenn Research Center. Specifically some of the most advanced technologies developed in this branch can be broken down into four main areas: Dynamic Power Systems, Primary Solar Concentrators, Secondary Solar Concentrators, and Thermal Management. Work was performed in the Dynamic Power Systems area, specifically the Stirling Engine subdivision. Today, the main focus of the 5490 branch is free-piston Stirling cycle converters, Brayton cycle nuclear reactors, and heat rejection systems for long duration mission spacecraft. All space exploring devices need electricity to operate. In most space applications, heat energy from radioisotopes is converted to electrical power. The Radioisotope Thermoelectric Generator (RTG) already supplies electricity for missions such as the Cassini Spacecraft. The focus of today's Stirling research at GRC is aimed at creating an engine that can replace the RTG. The primary appeal of the Stirling engine is its high system efficiency. Because it is so efficient, the Stirling engine will significantly reduce the plutonium fuel mission requirements compared to the RTG. Stirling is also being considered for missions such as the lunar/Mars bases and rovers. This project has focused largely on Stirling Engines of all types, particularly the fluidyne liquid piston engine. The fluidyne was developed by Colin D. West. This engine uses the same concepts found in any type of Stirling engine, with the exception of missing mechanical components. All the working components are fluid. One goal was to develop and demonstrate a working Stirling Fluidyne Engine at the 2nd Annual International Energy Conversion Engineering Conference in Providence, Rhode Island.

  10. The Role of Conversation Policy in Carrying Out Agent Conversations

    SciTech Connect

    Link, Hamilton E.; Phillips, Laurence R.

    1999-05-20

    Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word "policy" connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification.

  11. Teaching children with autism to respond to conversation partners' interest.

    PubMed

    Peters, Lindsay C; Thompson, Rachel H

    2015-09-01

    Successful conversation requires that the speaker's behavior is sensitive to nonvocal listener responses. We observed children with autism spectrum disorder during conversation probes in which a listener periodically displayed nonvocal cues that she was uninterested in the conversation. We used behavioral skills training to teach conversation skills. First, we taught participants to tact nonvocal listener behavior (interested or uninterested), but this was insufficient to improve responding aimed at regaining listener interest. Participants were then taught to ask a question (Experiments 1 and 2) or change the topic (Experiment 2) when the listener was uninterested. Responding persisted over time and with changes in the stimulus conditions. The behavior change was also deemed socially valid by blind observers. In Experiment 3, participants learned to shift to the other trained response when exposed to extinction. This study illustrates a set of procedures for bringing speaker behavior under control of nonvocal listener cues.

  12. Respiratory markers of conversational interaction.

    PubMed

    McFarland, D H

    2001-02-01

    Respiratory movements were recorded from 10 dyads (20 subjects) during quiet breathing, reading aloud, spontaneous monologue, scripted dialog, and spontaneous conversation. Timing measures of inspiratory, expiratory, and total cycle duration were used to compare respiratory function during quiet breathing, listening, and speech. Cross-correlation analyses of the respiratory movements of conversational partners provided an index of conversational synchrony. Inspiratory duration was found to be the most consistent and sensitive measure for discriminating quiet breathing from speech breathing. In the scripted dialog and spontaneous conversation conditions, respiratory kinematics changed during listening to more closely resemble speech, and systematic changes were observed in anticipation of turn-taking speech onset. For the breathing cycles immediately surrounding turn changes and simultaneously produced vocal events, the kinematic signals of conversational partners were strongly correlated. Results are discussed in the context of similar findings concerning conversational interactions and motor preparation for speech.

  13. Clinical profile of depressive disorder in children.

    PubMed

    Krishnakumar, P; Geeta, M G

    2006-06-01

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

  14. Solar energy conversion apparatus

    SciTech Connect

    Nash, S.G.

    1983-10-18

    Solar energy conversion apparatus is disclosed including a housing portion, an energy absorbing portion, a fluid directing portion and a cover portion; the housing portion including a molded plastic pan member including a base section with upwardly extending spaced spacer sections, the pan member including outwardly inclined sidewall sections having spaced inner and outer wall sections with a top section including an outwardly extending flange section and an inwardly extending slotted frame section; the energy absorbing portion including a conductive metal liner member positioned within the housing portion and resting on the upper surfaces of the spacer sections, a conductive metal separator section extending between the liner sidewall sections adjacent the upper ends thereof and enclosing the liner member; the fluid directing portion including a plurality of parallel spaced longitudinal baffle members arranged in a staggered relationship to provide a tortuous fluid path through the apparatus, an inlet opening and an outlet opening to the tortuous path, the baffle members extending upwardly from the liner bottom to the separator section; the cover portion including transparent impact resistant flat and dome members, the edges of the flat member being secured to the top section, the dome member being disposed over the flat member with its edges engaged with the flange section slots, the dome member including flat sections extending upwardly at an angle of 20/sup 0/ to 30/sup 0/ and a convex central section joining the flat sections.

  15. Reactor for methane conversion

    SciTech Connect

    Bader, R.A.; Axelrod, M.G.

    1989-08-08

    This patent describes a reactor adapted for the conversion of methane to higher molecular weight hydrocarbons. It comprises a central support column and an outer shell which together define an annular reaction zone, inlet means for introducing a mixture of methane containing gas and fluidized solid catalyst particles into the reaction zone, and outlet means for withdrawing a mixture of gas and fluidized solid catalyst particles from the zone, and a plurality of vertically spaced ceramic baffle assemblies comprised of wedged-shaped segments positioned in the reaction zone each perpendicular to the central support column and the outer shell. The baffle assemblies filling the annular cross-section between the support column and the outer shell and being supported at the outer wall of the central support column and at the inner wall of the outer shell, adjacent baffle assembly segments also being supported by radial ceramic support beams. The baffle assemblies each having a plurality of openings 0.25 to 3 inches in diameter adapted to permit passage of the mixture of gas and fluidized solid catalyst particles through the baffle assemblies only toward the outlet means, the area of the openings being 10-70% of the baffle area of each baffle assembly.

  16. Geothermal energy conversion facility

    SciTech Connect

    Kutscher, C.F.

    1997-12-31

    With the termination of favorable electricity generation pricing policies, the geothermal industry is exploring ways to improve the efficiency of existing plants and make them more cost-competitive with natural gas. The Geothermal Energy Conversion Facility (GECF) at NREL will allow researchers to study various means for increasing the thermodynamic efficiency of binary cycle geothermal plants. This work has received considerable support from the US geothermal industry and will be done in collaboration with industry members and utilities. The GECF is being constructed on NREL property at the top of South Table Mountain in Golden, Colorado. As shown in Figure 1, it consists of an electrically heated hot water loop that provides heating to a heater/vaporizer in which the working fluid vaporizes at supercritical or subcritical pressures as high as 700 psia. Both an air-cooled and water-cooled condenser will be available for condensing the working fluid. In order to minimize construction costs, available equipment from the similar INEL Heat Cycle Research Facility is being utilized.

  17. Microbial conversion of coal

    SciTech Connect

    Bean, R.M. )

    1989-10-01

    The objectives of this project were to describe in detail the degradation of coals by fungi and microbes, to expand the range of applicability of the process to include new microbes and other coal types, to identify the means by which biosolubilization of coal is accomplished, and to explore means to enhance the rates and extent of coal bioconversion. The project was initiated in a response to the discovery by Dr. Martin Cohen at the University of Hartford, of a fungal strain of Coriolus versicolor that would render a solid coal substance, leonardite, into a liquid product. The project has identified the principal agent of leonardite solubilization as a powerful metal chelator, most likely a fungal-produced siderophore. Another nonlaccase enzyme has also been identified as a unique biosolubilizing agent produced by C. versicolor. Assays were developed for the quantitative determination of biological coal conversion, and for the determination of potency of biosolubilizing agent. Screening studies uncovered several microbial organisms capable of coal biodegradation, and led to the discovery that prolonged heating in air at the moderate temperature of 150{degree}C allowed the biodegradation of Illinois {number sign}6 coal to material soluble in dilute base. Chemical studies showed that leonardite biosolubilization was accompanied by relatively small change in composition, while solubilization of Illinois {number sign}6 coal involves considerable oxidation of the coal. 24 refs., 32 figs., 27 tabs.

  18. Energy conversion apparatus

    SciTech Connect

    Porter, D.R.

    1988-10-18

    This patent describes an energy conversion apparatus comprising: an engine, the engine comprising a cylinder and a piston reciprocally mounted therein, the cylinder defining a combustion chamber on one side of the piston for receiving a fuel mixture and a fluid drive chamber on the other side of the piston for receiving hydraulic fluid, a turbine, the turbine comprising a housing and a vaned turbine wheel rotatably mounted on a drive shaft journalled in the housing, hydraulic means for coupling fluid in the fluid drive chamber of the cylinder with the housing for rotatably driving the turbine wheel and the drive shaft upon a given movement of the piston, means for providing the combustion chamber of the engine with a fuel mixture comprising hydrogen and oxygen, an ignition means for selectively igniting the mixture in the combustion chamber, and purging means for selectively rotating the turbine prior to ignition of the fuel mixture in the engine to remove air therefrom, the purging means comprising a pump means for moving fluid from the reservoir into the fluid drive chambers, the conduit means and the turbine housing, whereby the piston driven by the ignited fuel mixture forces fluid in the fluid drive chamber against the vanes of the turbine wheel to rotate the drive shaft.

  19. GPU color space conversion

    NASA Astrophysics Data System (ADS)

    Chase, Patrick; Vondran, Gary

    2011-01-01

    Tetrahedral interpolation is commonly used to implement continuous color space conversions from sparse 3D and 4D lookup tables. We investigate the implementation and optimization of tetrahedral interpolation algorithms for GPUs, and compare to the best known CPU implementations as well as to a well known GPU-based trilinear implementation. We show that a 500 NVIDIA GTX-580 GPU is 3x faster than a 1000 Intel Core i7 980X CPU for 3D interpolation, and 9x faster for 4D interpolation. Performance-relevant GPU attributes are explored including thread scheduling, local memory characteristics, global memory hierarchy, and cache behaviors. We consider existing tetrahedral interpolation algorithms and tune based on the structure and branching capabilities of current GPUs. Global memory performance is improved by reordering and expanding the lookup table to ensure optimal access behaviors. Per multiprocessor local memory is exploited to implement optimally coalesced global memory accesses, and local memory addressing is optimized to minimize bank conflicts. We explore the impacts of lookup table density upon computation and memory access costs. Also presented are CPU-based 3D and 4D interpolators, using SSE vector operations that are faster than any previously published solution.

  20. Dissociative Disorders

    MedlinePlus

    ... last minutes, hours, or rarely, months or years. Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder ... each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have ...

  1. Anxiety Disorders

    MedlinePlus

    ... here. generalized anxiety disorder social phobia panic disorder Generalized Anxiety Disorder (GAD) Click for more information All of us ... health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many ...

  2. Eating Disorders

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Eating Disorders KidsHealth > For Teens > Eating Disorders A A A ... average weight or can be overweight. continue Binge Eating Disorder This eating disorder is similar to anorexia and ...

  3. Record Conversion at Oregon State.

    ERIC Educational Resources Information Center

    Watkins, Deane

    1985-01-01

    Describes the conversion of card catalog records at William Jasper Kerr Library, Oregon State University, to an online system. Discussion covers the use of OCLC and student assistants, procedures and specifications, and problems associated with massive retrospective conversion needs and uncertain budget allocations. Eight sources are recommended.…

  4. Conversational Competence in Academic Settings

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2014-01-01

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

  5. In Conversation with Jim Blair

    ERIC Educational Resources Information Center

    Holman, Andrew

    2012-01-01

    Jim Blair is the only consultant nurse working with people with learning disabilities in the country. His job helps make people better and saves money. This article shares a conversation with Jim Blair. In the conversation, Blair says he is unhappy Valuing People programme did not do as much as it could have done. Jim is worried all the changes,…

  6. Older Siblings as Conversational Partners.

    ERIC Educational Resources Information Center

    Hoff-Ginsberg, Erika; Krueger, Wendy M.

    1991-01-01

    Discusses a study of conversational dyadic interaction between children aged 1.5 to 3 years; their 4-, 5-, 7-, or 8-year-old siblings; and their mothers. Mothers were more supportive conversational partners and adapted their level of speech more than siblings. (GH)

  7. Language Teacher Educators Collaborative Conversations.

    ERIC Educational Resources Information Center

    Bailey, Francis; Hawkins, Maggie; Irujo, Suzanne; Larsen-Freeman, Diane; Rintell, Ellen; Willett, Jerri

    1998-01-01

    Conveys the power and value of collaborative conversation among a small group of language teacher educators who meet regularly to discuss practice. Excerpts from a discussion are presented to show a sample of real issues the teachers face and illustrate how the conversations allow ongoing feedback about real dilemmas from a supportive community of…

  8. Tree value conversion standards revisited

    Treesearch

    Paul S. DeBald; Martin E. Dale; Martin E. Dale

    1991-01-01

    Updated tree value conversion standards (TVCS) are presented for 12 important hardwood species of the oak-hickory forest. These updated standards-developed for each species by butt-log grade, merchantable height, and diameter at breast height-reflect the changes in lumber prices and in conversion costs which have occurred since 1976 when the original TVCS were...

  9. Selecting a Retrospective Conversion Vendor.

    ERIC Educational Resources Information Center

    Lisowski, Andrew; Sessions, Judith

    1984-01-01

    Discussion of using vendors for retrospective conversion of library catalogs rather than in-house projects highlights reasons to consider vendors, four conversion methodologies, and vendor selection criteria (database, non-matches, local data, accuracy, charging, schedule, product delivery time, local system compatibility, MARC format, impact on…

  10. Faculty Meetings: Hidden Conversational Dynamics

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2015-01-01

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

  11. Record Conversion at Oregon State.

    ERIC Educational Resources Information Center

    Watkins, Deane

    1985-01-01

    Describes the conversion of card catalog records at William Jasper Kerr Library, Oregon State University, to an online system. Discussion covers the use of OCLC and student assistants, procedures and specifications, and problems associated with massive retrospective conversion needs and uncertain budget allocations. Eight sources are recommended.…

  12. Selecting a Retrospective Conversion Vendor.

    ERIC Educational Resources Information Center

    Lisowski, Andrew; Sessions, Judith

    1984-01-01

    Discussion of using vendors for retrospective conversion of library catalogs rather than in-house projects highlights reasons to consider vendors, four conversion methodologies, and vendor selection criteria (database, non-matches, local data, accuracy, charging, schedule, product delivery time, local system compatibility, MARC format, impact on…

  13. Conversational Competence in Academic Settings

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2014-01-01

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

  14. Conversational Expansion in Young Children.

    ERIC Educational Resources Information Center

    Boynton, Kathleen Reardon; Henke, Lucy L.

    1978-01-01

    The importance of contextual influences to conversational competence development is emphasized. Included are one or more significant adults whose systematic patterns of feedback teach children rules of conversation while providing guided practice in the use of these rules. The role of expansion is examined as one of the common patterns of feedback…

  15. Faculty Meetings: Hidden Conversational Dynamics

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2015-01-01

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

  16. In Conversation with Jim Blair

    ERIC Educational Resources Information Center

    Holman, Andrew

    2012-01-01

    Jim Blair is the only consultant nurse working with people with learning disabilities in the country. His job helps make people better and saves money. This article shares a conversation with Jim Blair. In the conversation, Blair says he is unhappy Valuing People programme did not do as much as it could have done. Jim is worried all the changes,…

  17. Bipolar Disorder.

    PubMed

    Miller, Thomas H

    2016-06-01

    Bipolar disorder is a chronic mental health disorder that is frequently encountered in primary care. Many patients with depression may actually have bipolar disorder. The management of bipolar disorder requires proper diagnosis and awareness or referral for appropriate pharmacologic therapy. Patients with bipolar disorder require primary care management for comorbidities such as cardiovascular and metabolic disorders.

  18. Medicinal relationships: caring conversation.

    PubMed

    Mikesell, Lisa

    2013-05-01

    Good social relationships are crucial to well-being and to health in particular. The perception of having supportive social relationships has effects on reducing morbidity and mortality comparable with those of a good diet, regular exercise and cessation of moderate smoking. This suggests that supportive, trusting relationships with doctors could have a substantial direct biomedical effect on patients' health. A critical review of the patient-doctor relationship (PDR) literature is presented, along with a review of relevant interactional studies that examine doctor-patient interactions from the perspective of conversation analysis (CA). This literature shows how patients respond to doctors' verbal and non-verbal behaviours in systematic ways that affect how they disclose and how they relate to doctors. Findings from the CA literature suggest that clinicians might consider several important interactional features to improve the PDR and perhaps also patient health outcomes: (i) the use of open-ended questions (e.g. 'What brought you in today?') and positive polarity items (e.g. 'Is there something else you wanted to talk about today?') elicits patient concerns and addresses unmet concerns more effectively than the use of closed questions and negative polarity items, respectively; (ii) eye gaze suggests availability and an attending recipient, and patients indicate that doctor attentiveness at crucial parts of their problem presentation is important, and (iii) verbal dysfluencies are one practice speakers employ to gain the attention of a non-attending recipient. Doctors may want to pay attention to patients' dysfluencies to better understand when their attention is valued. Constructing supportive relationships with patients often does not require a great investment of time, but it does require commitment to 'being there for patients'. This review suggests that when doctors attune to language and social practices during medical consultations, the relationships they

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

    ERIC Educational Resources Information Center

    Goldman, Sylvie; DeNigris, Danielle

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Goldman, Sylvie; DeNigris, Danielle

    2015-01-01

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

  1. Psychogenic speech disorder--a case report.

    PubMed

    Koźmin-Burzyńska, Agnieszka; Bratek, Agnieszka; Zawada, Karolina; Krysta, Krzysztof; Krupka-Matuszczyk, Irena

    2015-09-01

    Conversion (dissociative) disorder is a psychiatric disorder in which somatic symptoms or deficits are present in the absence of a definable organic cause. The etiology of this disorder is not yet fully understood. The most characteristic presentations are: pseudosensory syndromes, pseudoseizures, psychogenic movement disorders and pseudoparalysis. Psychogenic speech disorder is a rare form of conversion (dissociative) disorder. The aim of present case study is to complete the knowledge on this subject. The article presents a case of a fifty year old woman who developed psychogenic disorder of speech after being degraded to a lower position at work. After excluding organic background of observed symptoms, the diagnosis of conversion (dissociative) disorder was stated and adequate therapy was implemented, within the capabilities of the Ward. Partial remission of presented symptoms was achieved as a result of psychopharmacotherapy and psychotherapy. Before stating the diagnosis of conversion (dissociative) disorder, possible somatic causes of the observed symptoms should be excluded. Special attention should be drawn to the importance of studying the psychological and family context of this case and the patient's difficulty to understand and accept that produced symptoms might be triggered by a psychogenic factor.

  2. Petite fabrique de conversation francaise (Little Factory of French Conversation).

    ERIC Educational Resources Information Center

    Dubroca, Danielle

    1987-01-01

    A technique using dialogues and realistic prose passages from the works of Georges Simenon and Simone de Beauvoir to teach French conversational skills at the college level is explained and illustrated. (MSE)

  3. Petite fabrique de conversation francaise (Little Factory of French Conversation).

    ERIC Educational Resources Information Center

    Dubroca, Danielle

    1987-01-01

    A technique using dialogues and realistic prose passages from the works of Georges Simenon and Simone de Beauvoir to teach French conversational skills at the college level is explained and illustrated. (MSE)

  4. Roadmap on optical energy conversion

    SciTech Connect

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

    2016-06-24

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

  5. Roadmap on optical energy conversion

    NASA Astrophysics Data System (ADS)

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

    2016-07-01

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

  6. Roadmap on optical energy conversion

    SciTech Connect

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

    2016-06-24

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

  7. Roadmap on optical energy conversion

    DOE PAGES

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

    2016-06-24

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

  8. Energy conversion and storage program

    NASA Astrophysics Data System (ADS)

    1990-12-01

    The Energy Conversion and Storage Program applies chemical and chemical engineering principles to solve problems in (1) production of new synthetic fuels; (2) development of high-performance rechargeable batteries and fuel cells; (3) development of advanced thermochemical processes for energy storage; (4) characterization of complex chemical processes; and (5) the application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, and advanced methods of analysis. The following five areas are discussed: electrochemical energy storage and conversion; microstructured materials; biotechnology; fossil fuels; and high temperature superconducting processing. Papers have been processed separately for inclusion on the data base.

  9. NASA thermionic-conversion program

    NASA Technical Reports Server (NTRS)

    Morris, J. F.

    1977-01-01

    Technological processes in out-of-core thermionic energy conversion are described. The emphasis was on high temperature electrode materials and system engineering of converter geometries to produce practical power densities.

  10. A Conversation Well Worth Remembering

    ERIC Educational Resources Information Center

    Woolven-Allen, John

    2009-01-01

    To mark the 200th anniversary of Charles Darwin's birth, a special event was held at Oxford, which included a "Conversation" between Professor Richard Dawkins and Bishop Richard Harries. Here we present a personal reminiscence of the event.

  11. Enzymes for improved biomass conversion

    DOEpatents

    Brunecky, Roman; Himmel, Michael E.

    2016-02-02

    Disclosed herein are enzymes and combinations of the enzymes useful for the hydrolysis of cellulose and the conversion of biomass. Methods of degrading cellulose and biomass using enzymes and cocktails of enzymes are also disclosed.

  12. Effective communication during difficult conversations.

    PubMed

    Polito, Jacquelyn M

    2013-06-01

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

  13. Energy conversion at dipolarization fronts

    NASA Astrophysics Data System (ADS)

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

    2017-02-01

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

  14. Dynamic Conversion Working Group Summary

    NASA Technical Reports Server (NTRS)

    Chaffee, N.; Sovie, R. J.

    1984-01-01

    The potential of dynamic conversion devices for use in solar and nuclear dynamic space power systems was addressed. Conversion systems considered were based on the use of Brayton, Stirling and Rankine cycles. Both organic and liquid metal Rankine cycles were included. The basic system considerations were: mission requirements, system attributes, system options, technology issues and constraints, and priorities of needed technology development. Mission requirements, where dynamic conversion was considered enabling technology, were identified along with the associated power levels and potential energy sources. When considering the system options special attention was given to recommend operating temperatures and other significant discriminators. A list of prioritized tasks considered important for the successful development of dynamic conversion systems for 1995 and beyond was compiled.

  15. Conversational topics in transsexual persons.

    PubMed

    Van Borsel, John; Cayzeele, Miet; Heirman, Eva; T'sjoen, Guy

    2014-06-01

    Abstract In general, speech language therapy for transsexual persons focuses on pitch and pitch variation and more recently also on resonance. Other communicative aspects are dealt with far less often, especially language. This study investigated to what extent conversational topics might need attention in therapy for transsexual persons. A total of 111 males, 116 females, 28 male-to-female and 18 female-to-male transsexuals were asked to indicate on a list with 34 topics how often they speak about each topic (never, sometimes, often) in conversations with males, with females and in a gender mixed group. Results showed that transsexual persons behave in accordance with the desired gender. However, they also tend to adopt a position depending on the gender of their conversational partner. It can be concluded that in general it is not necessary to pay attention to conversational topics in therapy for transsexual persons.

  16. Virginia Hamilton: Continuing the Conversation.

    ERIC Educational Resources Information Center

    Mikkelsen, Nina

    1995-01-01

    Relates the latest installment of a continuing conversation between the author and Virginia Hamilton. Discusses ethnicity and identity, environmental issues, the creative process, and the way heritage, history, and family storytelling affect a writer's work. (RS)

  17. A Conversation Well Worth Remembering

    ERIC Educational Resources Information Center

    Woolven-Allen, John

    2009-01-01

    To mark the 200th anniversary of Charles Darwin's birth, a special event was held at Oxford, which included a "Conversation" between Professor Richard Dawkins and Bishop Richard Harries. Here we present a personal reminiscence of the event.

  18. Development of Geodetic Conversion Routines

    DTIC Science & Technology

    2001-09-01

    horizontal and vertical datums in the United States. It provides examples to invoke the Dynamic Link Library and use conversion functions in various programming languages, such as Visual Basic , C, and C++.

  19. The relationship between borderline personality disorder and bipolar disorder

    PubMed Central

    Zimmerman, Mark; Morgan, Theresa A.

    2013-01-01

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

  20. The relationship between borderline personality disorder and bipolar disorder.

    PubMed

    Zimmerman, Mark; Morgan, Theresa A

    2013-06-01

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

  1. Direct Energy Conversion Literature Abstracts

    DTIC Science & Technology

    1962-12-01

    HOMOPOLAR Apparatus needed to fabricate and test MOTOR , by G. J. Bukow. 46p., Jan. 1961. candidate junction materials and modules (ASD TR-61-101...small homopolar motor as a 3085 component of a thermoelectric energy- NEW TYPE OF THERMOELECTRIC GENER- conversion system, utilizing the low- ATOR...CONVERSION AND HEAT-TRANSFER are silent outboard motors and power FLUIDS FCR SPACE APPLICATIONS, by lawnmiowers. W. D. Weatherford, J.C. Tyler and P. M

  2. Frequency conversion of structured light

    PubMed Central

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

    2016-01-01

    Coherent frequency conversion of structured light, i.e. the ability to manipulate the carrier frequency of a wave front without distorting its spatial phase and intensity profile, provides the opportunity for numerous novel applications in photonic technology and fundamental science. In particular, frequency conversion of spatial modes carrying orbital angular momentum can be exploited in sub-wavelength resolution nano-optics and coherent imaging at a wavelength different from that used to illuminate an object. Moreover, coherent frequency conversion will be crucial for interfacing information stored in the high-dimensional spatial structure of single and entangled photons with various constituents of quantum networks. In this work, we demonstrate frequency conversion of structured light from the near infrared (803 nm) to the visible (527 nm). The conversion scheme is based on sum-frequency generation in a periodically poled lithium niobate crystal pumped with a 1540-nm Gaussian beam. We observe frequency-converted fields that exhibit a high degree of similarity with the input field and verify the coherence of the frequency-conversion process via mode projection measurements with a phase mask and a single-mode fiber. Our results demonstrate the suitability of exploiting the technique for applications in quantum information processing and coherent imaging. PMID:26875448

  3. Frequency conversion of structured light.

    PubMed

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

    2016-02-15

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

  4. Frequency conversion of structured light

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

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

  5. Prion protein and its conformational conversion: a structural perspective.

    PubMed

    Surewicz, Witold K; Apostol, Marcin I

    2011-01-01

    The key molecular event in the pathogenesis of prion diseases is the conformational conversion of a cellular prion protein, PrP(C), into a misfolded form, PrP(Sc). In contrast to PrP(C) that is monomeric and α-helical, PrP(Sc) is oligomeric in nature and rich in β-sheet structure. According to the "protein-only" model, PrP(Sc) itself represents the infectious prion agent responsible for transmissibility of prion disorders. While this model is supported by rapidly growing experimental data, detailed mechanistic and structural aspects of prion protein conversion remain enigmatic. In this chapter we describe recent advances in understanding biophysical and biochemical aspects of prion diseases, with a special focus on structural underpinnings of prion protein conversion, the structural basis of prion strains, and generation of prion infectivity in vitro from bacterially-expressed recombinant PrP.

  6. Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

    ERIC Educational Resources Information Center

    Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

    2005-01-01

    Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

  7. Monolimb Paralysis after Laparoscopic Appendectomy Due to Conversion Disorder

    PubMed Central

    Song, Sung Hyuk; Lee, Kyeong Hwan

    2014-01-01

    Limb paralysis can develop for various reasons. We found a 13-year-old patient who became paralyzed in her lower extremities after laparoscopic appendectomy. Some tests, including electrodiagnostic studies and magnetic resonance imaging, were performed to evaluate the cause of lower limb paralysis. None of the tests yielded definite abnormal findings. We subsequently decided to explore the possibility of psychological problems. The patient was treated with simultaneous rehabilitation and psychological counseling. Paralysis of the patient's lower extremity improved gradually and the patient returned to normal life. Our findings indicate that psychological problems can be related to limb paralysis without organ damage in patients who have undergone laparoscopic surgical procedures. PMID:25426280

  8. Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

    ERIC Educational Resources Information Center

    Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

    2005-01-01

    Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

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

    PubMed

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

    2016-09-01

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

  10. Cerebellar Disorders

    MedlinePlus

    ... balance. Problems with the cerebellum include Cancer Genetic disorders Ataxias - failure of muscle control in the arms and legs that result in movement disorders Degeneration - disorders caused by brain cells decreasing in ...

  11. Mood Disorders

    MedlinePlus

    ... they're in a bad mood. A mood disorder is different. It affects a person's everyday emotional ... ten people aged 18 and older have mood disorders. These include depression and bipolar disorder (also called ...

  12. Schizoaffective disorder

    MedlinePlus

    ... disorder is thought to be less common than schizophrenia and mood disorders. Women may have the condition ... Possible Complications Complications are similar to those for schizophrenia and major mood disorders. These include: Drug use ...

  13. Genetic Disorders

    MedlinePlus

    ... This can cause a medical condition called a genetic disorder. You can inherit a gene mutation from ... during your lifetime. There are three types of genetic disorders: Single-gene disorders, where a mutation affects ...

  14. Serious Illness Conversations in ESRD.

    PubMed

    Mandel, Ernest I; Bernacki, Rachelle E; Block, Susan D

    2016-12-28

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

  15. Dissociative disorders in medical settings.

    PubMed

    MacPhee, Edward

    2013-10-01

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

  16. Energy Conversion and Storage Program

    NASA Astrophysics Data System (ADS)

    Cairns, E. J.

    1993-06-01

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

  17. Overview of Movement Disorders

    MedlinePlus

    ... and Throat Disorders Eye Disorders Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and Urinary Tract Disorders Liver ...

  18. Borderline Personality Disorder

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  19. The ethics of conversion therapy.

    PubMed

    Murphy, Timothy F

    1991-04-01

    ... Both the past and present have seen a number of methods being used to extinguish homoerotic desire and behavior and to inaugurate heteroeroticism in their place, methods I will here call conversion therapies... The typical defense of such therapy holds that even if homoeroticism is not necessarily a disease or evil, neither is it a universal good... Conversion therapy is morally defensible, on such a view, because some people suffer from the perceived consequences of homoerotic orientations despite the freedom and toleration extended to gay men and lesbians in certain areas... Against the view that conversion therapy is morally defensible as a matter of personal preference, I here argue that such therapy is morally suspect and should be resisted for a number of reasons....

  20. Asymptotic cost in document conversion

    NASA Astrophysics Data System (ADS)

    Blostein, Dorothea; Nagy, George

    2012-01-01

    In spite of a hundredfold decrease in the cost of relevant technologies, the role of document image processing systems is gradually declining due to the transition to an on-line world. Nevertheless, in some high-volume applications, document image processing software still saves millions of dollars by accelerating workflow, and similarly large savings could be realized by more effective automation of the multitude of low-volume personal document conversions. While potential cost savings, based on estimates of costs and values, are a driving force for new developments, quantifying such savings is difficult. The most important trend is that the cost of computing resources for DIA is becoming insignificant compared to the associated labor costs. An econometric treatment of document processing complements traditional performance evaluation, which focuses on assessing the correctness of the results produced by document conversion software. Researchers should look beyond the error rate for advancing both production and personal document conversion.

  1. Mode conversion experiments in TFTR

    NASA Astrophysics Data System (ADS)

    Majeski, R.; Hosea, J. C.; Phillips, C. K.; Rogers, J. H.; Schilling, G.; Wilson, J. R.; Batha, S.; Darrow, D.; Fisch, N. J.; Herrmann, M. C.; Ignat, D.; Levinton, F.; Mazzucato, E.; Murakami, M.; Nazikian, R.; Rasmussen, D.; Valeo, E. J.

    1996-02-01

    In the Tokamak Fusion Test Reactor (TFTR) the mode converted ion Bernstein wave (IBW) has been shown to heat electrons, drive current (both on and off axis), and to interact with fusion products. D-3He and D-T-3He plasmas have been used as mode conversion targets. On-axis mode conversion heating increased Te(0) from 3 keV to 10 keV with 4 MW of ICRF. On-axis currents of 125 kA with 2 MW of ICRF, and off axis currents of 100 kA with 4 MW of ICRF, have been driven. A strong interaction of the IBW with fusion products has been observed. Mode conversion current drive (MCCD) for TPX is briefly discussed.

  2. Differential diagnosis of emotional disorders that cause weight loss.

    PubMed Central

    Garfinkel, P. E.; Garner, D. M.; Kaplan, A. S.; Rodin, G.; Kennedy, S.

    1983-01-01

    Recently, anorexia nervosa has received much attention in the scientific and lay press. As a result there is a danger that the other emotional disorders that can present with weight loss and vomiting will be overlooked. Case examples are presented for anorexia nervosa, conversion disorder, schizophrenia and depression. The presentation and treatment of these four disorders are compared. PMID:6367916

  3. Conversations with Environmental Educators: A Conversation with Four Classroom Teachers

    ERIC Educational Resources Information Center

    Volk, Trudi L.

    2003-01-01

    This article includes a conversation with four environmental education classroom teachers. The author introduces the four classroom teachers, Marie Marrs, Barb Pietrucha, Vicki Newberry, and Dara Lukonen. In the interview, the four environmental education classroom teachers describe the environmental education in their classrooms. Three of these…

  4. Des documents authentiques pour la conversation (Authentic Documents for Conversation)

    ERIC Educational Resources Information Center

    Mariet, Jacqueline

    1978-01-01

    A description of two conversation courses (elementary and advanced) given during a summer session at Middlebury College. The materials used were tapes and slides made in France by the instructors to realize the course objectives--use of authentic spoken French and cultural education. (Text is in French.) (AMH)

  5. Conversations with Environmental Educators: A Conversation with Four Classroom Teachers

    ERIC Educational Resources Information Center

    Volk, Trudi L.

    2003-01-01

    This article includes a conversation with four environmental education classroom teachers. The author introduces the four classroom teachers, Marie Marrs, Barb Pietrucha, Vicki Newberry, and Dara Lukonen. In the interview, the four environmental education classroom teachers describe the environmental education in their classrooms. Three of these…

  6. La Conversation par le theatre (Conversation through Theater).

    ERIC Educational Resources Information Center

    Bayoff, Marie-Jose

    1986-01-01

    A successful advanced college-level French conversation course using French theater as a basis for students to learn oral skills has six phases: an overview of the history of French theater, reading, adaptation of the text, rehearsal-readings, final rehearsals, and performance. (MSE)

  7. Pronunciation models for conversational speech

    NASA Astrophysics Data System (ADS)

    Johnson, Keith

    2005-09-01

    Using a pronunciation dictionary of clear speech citation forms a segment deletion rate of nearly 12% is found in a corpus of conversational speech. The number of apparent segment deletions can be reduced by constructing a pronunciation dictionary that records one or more of the actual pronunciations found in conversational speech; however, the resulting empirical pronunciation dictionary often fails to include the citation pronunciation form. Issues involved in selecting pronunciations for a dictionary for linguistic, psycholinguistic, and ASR research will be discussed. One conclusion is that Ladefoged may have been the wiser for avoiding the business of producing pronunciation dictionaries. [Supported by NIDCD Grant No. R01 DC04330-03.

  8. Recirculation in multiple wave conversions

    SciTech Connect

    Kaufman, A. N.; Brizard, A.J.; Kaufman, A.N.; Tracy, E.R.

    2008-07-30

    A one-dimensional multiple wave-conversion model is constructed that allows energy recirculation in ray phase space. Using a modular eikonal approach, the connection coefficients for this model are calculated by ray phase-space methods. Analytical results (confirmed numerically) show that all connection coefficients exhibit interference effects that depend on an interference phase, calculated from the coupling constants and the area enclosed by the intersecting rays. This conceptual model, which focuses on the topology of intersecting rays in phase space, is used to investigate how mode conversion between primary and secondary waves is modified by the presence of a tertiary wave.

  9. Power conversion in electrical networks

    NASA Technical Reports Server (NTRS)

    Wood, J. R.

    1974-01-01

    Aspects of dc to dc conversion were studied in terms of a class of switching voltage regulators from a stability viewpoint. Background concepts of nonlinear system theory were considered, including the problem of obtaining suitable realizations for a class of positive operators. It is shown that the state evolution equations for a power conversion network are in general of bilinear form, and that the theory of lie groups and lie algebras is useful in analyzing such systems. The feedback stabilization of a class of bilinear systems whose state space is a manifold is also discussed.

  10. [Hydroxylamine conversion by anammox enrichment].

    PubMed

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

    2010-04-01

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

  11. Review of betavoltaic energy conversion

    NASA Technical Reports Server (NTRS)

    Olsen, Larry C.

    1993-01-01

    Betavoltaic energy conversion refers to the generation of power by coupling a beta source to a semiconductor junction device. The theory of betavoltaic energy conversion and some past studies of the subject are briefly reviewed. Calculations of limiting efficiencies for semiconductor cells versus bandgap are presented along with specific studies for Pm-147 and Ni-63 fueled devices. The approach used for fabricating Pm-147 fueled batteries by the author in the early 1970's is reviewed. Finally, the potential performance of advanced betavoltaic power sources is considered.

  12. 16 CFR 1012.7 - Telephone conversations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are...

  13. 16 CFR 1012.7 - Telephone conversations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are...

  14. 16 CFR 1012.7 - Telephone conversations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are...

  15. 16 CFR 1012.7 - Telephone conversations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are...

  16. 16 CFR 1012.7 - Telephone conversations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Telephone conversations. 1012.7 Section 1012... AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.7 Telephone conversations. (a) Telephone conversations... meet with Agency employees. However, because telephone conversations, by their very nature, are...

  17. Calculation Methods and Conversions for Pesticide Application.

    ERIC Educational Resources Information Center

    Cole, Herbert, Jr.

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

  18. Calculation Methods and Conversions for Pesticide Application.

    ERIC Educational Resources Information Center

    Cole, Herbert, Jr.

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

  19. Effects of a random spatial variation of the plasma density on the mode conversion in cold, unmagnetized, and stratified plasmas

    SciTech Connect

    Jung Yu, Dae; Kim, Kihong

    2013-12-15

    We study the effects of a random spatial variation of the plasma density on the mode conversion of electromagnetic waves into electrostatic oscillations in cold, unmagnetized, and stratified plasmas. Using the invariant imbedding method, we calculate precisely the electromagnetic field distribution and the mode conversion coefficient, which is defined to be the fraction of the incident wave power converted into electrostatic oscillations, for the configuration where a numerically generated random density variation is added to the background linear density profile. We repeat similar calculations for a large number of random configurations and take an average of the results. We obtain a peculiar nonmonotonic dependence of the mode conversion coefficient on the strength of randomness. As the disorder increases from zero, the maximum value of the mode conversion coefficient decreases initially, then increases to a maximum, and finally decreases towards zero. The range of the incident angle in which mode conversion occurs increases monotonically as the disorder increases. We present numerical results suggesting that the decrease of mode conversion mainly results from the increased reflection due to the Anderson localization effect originating from disorder, whereas the increase of mode conversion of the intermediate disorder regime comes from the appearance of many resonance points and the enhanced tunneling between the resonance points and the cutoff point. We also find a very large local enhancement of the magnetic field intensity for particular random configurations. In order to obtain high mode conversion efficiency, it is desirable to restrict the randomness close to the resonance region.

  20. Energy Conversion and Storage Program

    SciTech Connect

    Cairns, E.J.

    1992-03-01

    The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes, and (5) application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Topics include identification of new electrochemical couples for advanced rechargeable batteries, improvements in battery and fuel-cell materials, and the establishment of engineering principles applicable to electrochemical energy storage and conversion. Chemical Applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing waste streams from synfuel plants and coal gasifiers. Other research projects seek to identify and characterize the constituents of liquid fuel-system streams and to devise energy-efficient means for their separation. Materials Applications research includes the evaluation of the properties of advanced materials, as well as the development of novel preparation techniques. For example, the use of advanced techniques, such as sputtering and laser ablation, are being used to produce high-temperature superconducting films.

  1. Coaching Conversations: Enacting Instructional Scaffolding

    ERIC Educational Resources Information Center

    Gibson, Sharan A.

    2011-01-01

    This study analyzed coaching conversations and interviews of four coach/teacher partnerships for specific ways in which kindergarten and first-grade teachers, and coaches, conceptualized instructional scaffolding for guided reading. Interview transcripts were coded for coaches' and teachers' specific hypotheses/ ideas regarding instructional…

  2. Technology for satellite power conversion

    NASA Technical Reports Server (NTRS)

    Campbell, D. P.; Gouker, M. A.; Summers, C.; Gallagher, J. J.

    1984-01-01

    Techniques for satellite electromagnetic energy transfer and power conversion at millimeter and infrared wavelengths are discussed. The design requirements for rectenna receiving elements are reviewed for both coherent radiation sources and Earth thermal infrared emission. Potential power transmitters including gyrotrons, free electron lasers, and CO2 lasers are assessed along with the rectification properties of metal-oxide metal diode power converters.

  3. Conversion events in gene clusters

    PubMed Central

    2011-01-01

    Background Gene clusters containing multiple similar genomic regions in close proximity are of great interest for biomedical studies because of their associations with inherited diseases. However, such regions are difficult to analyze due to their structural complexity and their complicated evolutionary histories, reflecting a variety of large-scale mutational events. In particular, conversion events can mislead inferences about the relationships among these regions, as traced by traditional methods such as construction of phylogenetic trees or multi-species alignments. Results To correct the distorted information generated by such methods, we have developed an automated pipeline called CHAP (Cluster History Analysis Package) for detecting conversion events. We used this pipeline to analyze the conversion events that affected two well-studied gene clusters (α-globin and β-globin) and three gene clusters for which comparative sequence data were generated from seven primate species: CCL (chemokine ligand), IFN (interferon), and CYP2abf (part of cytochrome P450 family 2). CHAP is freely available at http://www.bx.psu.edu/miller_lab. Conclusions These studies reveal the value of characterizing conversion events in the context of studying gene clusters in complex genomes. PMID:21798034

  4. Conversation at the Intermediate Level

    ERIC Educational Resources Information Center

    Dunlop, Ian

    1975-01-01

    Discusses the use of free conversation, especially with regard to vocabulary. Recommends group discussion in the FL, using, at the intermediate level, limited, familiar vocabulary. At a higher level, words from a special technical vocabulary may be introduced, aurally and visually. A teaching example ("Traffic") is given with thorough…

  5. Semester Conversion. 1983 Implementation Guide.

    ERIC Educational Resources Information Center

    Atlanta Public Schools, GA.

    This update is designed to provide information on the conversion in the Atlanta public school system from a quarter to a semester plan. The major tasks, the semester schedule, and the recommended grading system are all outlined. A section on kindergarten provides material on proposed curriculum and support materials, the suggested weekly block of…

  6. Ten Commandments of System Conversions.

    ERIC Educational Resources Information Center

    Chabotar, Kent John

    1998-01-01

    Administrators at Bowdoin College (Maine) have translated lessons learned from the process of administrative software conversion into ten commandments for other small colleges undertaking such changes. Three approaches to management information systems are outlined, with advantages and limitations highlighted, as well as the ten recommendations,…

  7. Spin conversion on the nanoscale

    NASA Astrophysics Data System (ADS)

    Otani, Yoshichika; Shiraishi, Masashi; Oiwa, Akira; Saitoh, Eiji; Murakami, Shuichi

    2017-09-01

    Spins can act as mediators to interconvert electricity, light, sound, vibration and heat. Here, we give an overview of the recent advances in different sub-disciplines of spintronics that can be associated with the developing field of spin conversion, and discuss future prospects.

  8. INDOOR EMISSIONS FROM CONVERSION VARNISHES

    EPA Science Inventory

    Conversion varnishes are two-component, acid-catalyzed varnishes that are commonly used to finish cabinets. They are valued for their water- and stain-resistance, as well as their appearance. They have been found, however, to contribute to indoor emissions of organic compounds. F...

  9. Turbulence and energy conversion research

    SciTech Connect

    Hutchinson, R.A.

    1985-07-01

    This report examines the role of fluid mechanics research (particularly turbulence research) in improving energy conversion systems. In this report two of the listed application areas are selected as examples: fluidization and cavitation. Research needs in general, and research possibilities for ECUT in particular, are examined.

  10. Conversations to Transform Geometry Class

    ERIC Educational Resources Information Center

    Szydlik, Jennifer Earles; Parrott, Amy; Belnap, Jason Knight

    2016-01-01

    Classroom culture is negotiated and established through both conversations and practices. Traditionally, teachers and researchers have focused primarily on the individual and social construction of mathematical content--that is, students' conceptual understanding and procedural skills--through mathematical actions and practices. This article…

  11. Direct digital conversion detector technology

    NASA Astrophysics Data System (ADS)

    Mandl, William J.; Fedors, Richard

    1995-06-01

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

  12. Taking the Grading Conversation Public

    ERIC Educational Resources Information Center

    Reeves, Douglas B.

    2011-01-01

    To manage effective grading reform, education leaders must engage teachers, parents, communities, and policymakers in a rational discussion about grading. Doug Reeves suggests that leaders start the conversation with a discussion of the principles on which all stakeholders can agree; make clear what will not change under the new grading policy; be…

  13. A Conversation with Edwin Shneidman

    ERIC Educational Resources Information Center

    Pestian, John

    2010-01-01

    This article is a transcript of a conversation that took place with Edwin Shneidman, PhD, on August 19, 2008. Recent advances in machine learning, particularly neurocognitive computing, have provided a fresh approach to the idea of using computers to analyze the language of the suicidal person. Here this notion and many others are discussed.

  14. A conversation with Edwin Shneidman.

    PubMed

    Pestian, John

    2010-10-01

    This article is a transcript of a conversation that took place with Edwin Shneidman, PhD, on August 19, 2008. Recent advances in machine learning, particularly neurocognitive computing, have provided a fresh approach to the idea of using computers to analyze the language of the suicidal person. Here this notion and many others are discussed.

  15. Ocean thermal energy conversion (OTEC)

    SciTech Connect

    Lockerby, R.W.

    1981-01-01

    Ocean thermal energy conversion (OTEC) is reviewed briefly. The two types of OTEC system (open and closed) are described and limitations are pointed out. A bibliography of 148 references on OTEC is given for the time period 1975 to 1980. Entries are arranged alphabetically according to the author's name. (MJJ)

  16. Ocean Thermal Energy Conversion (OTEC)

    NASA Technical Reports Server (NTRS)

    Lavi, A.

    1977-01-01

    Energy Research and Development Administration research progress in Ocean Thermal Energy Conversion (OTEC) is outlined. The development program is being focused on cost effective heat exchangers; ammonia is generally used as the heat exchange fluid. Projected costs for energy production by OTEC vary between $1000 to $1700 per kW.

  17. INDOOR EMISSIONS FROM CONVERSION VARNISHES

    EPA Science Inventory

    Conversion varnishes are two-component, acid-catalyzed varnishes that are commonly used to finish cabinets. They are valued for their water- and stain-resistance, as well as their appearance. They have been found, however, to contribute to indoor emissions of organic compounds. F...

  18. Pronominal Chains in English Conversation.

    ERIC Educational Resources Information Center

    Thavenius, Cecilia

    A study of the functions and structure of referential third- person pronominal chains in spontaneous English conversation as compared to those in written English is discussed. The study found the frequencies of these pronouns and of their chains to be generally much higher in the spoken corpus than in the written corpus. In the spoken corpus,…

  19. Batteries: Beyond intercalation and conversion

    NASA Astrophysics Data System (ADS)

    Grimaud, Alexis

    2017-01-01

    Conventional positive electrode materials for lithium-ion batteries, such as intercalation and conversion compounds, feature a host structure to reversibly insert and conduct lithium ions. Now, electrochemically activated transition metal oxide-lithium fluoride composite materials are shown to be a promising class of positive electrodes.

  20. Photovoltaic conversion of laser energy

    NASA Technical Reports Server (NTRS)

    Stirn, R. J.

    1976-01-01

    The Schottky barrier photovoltaic converter is suggested as an alternative to the p/n junction photovoltaic devices for the conversion of laser energy to electrical energy. The structure, current, output, and voltage output of the Schottky device are summarized. The more advanced concepts of the multilayer Schottky barrier cell and the AMOS solar cell are briefly considered.

  1. A Conversation with Edwin Shneidman

    ERIC Educational Resources Information Center

    Pestian, John

    2010-01-01

    This article is a transcript of a conversation that took place with Edwin Shneidman, PhD, on August 19, 2008. Recent advances in machine learning, particularly neurocognitive computing, have provided a fresh approach to the idea of using computers to analyze the language of the suicidal person. Here this notion and many others are discussed.

  2. Religious stigmata, magnetic fluids and conversion hysteria: one survival of 'vital force' theories in scientific medicine?

    PubMed

    Littlewood, Roland; Bartocci, Goffredo

    2005-12-01

    A study of Natuzza Evolo, a contemporary Roman Catholic stigmatic in southern Italy, raises certain questions of mechanism and evidence. Was this a miracle, hysterical conversion or contrived? The medical interpretation of the phenomenon as conversion disorder raises questions about the popularity of hysteria as a medical diagnosis and the ways in which it functions like 'vital force', as a metaphoric mediator between the natural world, human agency, and the ultrahuman.

  3. Anxiety disorders.

    PubMed

    Craske, Michelle G; Stein, Murray B; Eley, Thalia C; Milad, Mohammed R; Holmes, Andrew; Rapee, Ronald M; Wittchen, Hans-Ulrich

    2017-05-04

    Anxiety disorders constitute the largest group of mental disorders in most western societies and are a leading cause of disability. The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks. Although the neurobiology of individual anxiety disorders is largely unknown, some generalizations have been identified for most disorders, such as alterations in the limbic system, dysfunction of the hypothalamic-pituitary-adrenal axis and genetic factors. In addition, general risk factors for anxiety disorders include female sex and a family history of anxiety, although disorder-specific risk factors have also been identified. The diagnostic criteria for anxiety disorders varies for the individual disorders, but are generally similar across the two most common classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Tenth Edition (ICD-10). Despite their public health significance, the vast majority of anxiety disorders remain undetected and untreated by health care systems, even in economically advanced countries. If untreated, these disorders are usually chronic with waxing and waning symptoms. Impairments associated with anxiety disorders range from limitations in role functioning to severe disabilities, such as the patient being unable to leave their home.

  4. Generation of diverse neural cell types through direct conversion

    PubMed Central

    Petersen, Gayle F; Strappe, Padraig M

    2016-01-01

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

  5. Growth Disorders

    MedlinePlus

    ... because their parents are. But some children have growth disorders. Growth disorders are problems that prevent children from developing ... or other features. Very slow or very fast growth can sometimes signal a gland problem or disease. ...

  6. Tooth Disorders

    MedlinePlus

    ... include eating, speaking and even smiling. But tooth disorders are nothing to smile about. They include problems ... your teeth. Fortunately, you can prevent many tooth disorders by taking care of your teeth and keeping ...

  7. Blood Disorders

    MedlinePlus

    ... blood cells, white blood cells and platelets. Blood disorders affect one or more parts of the blood ... They can be acute or chronic. Many blood disorders are inherited. Other causes include other diseases, side ...

  8. Movement Disorders

    MedlinePlus

    ... want them to. If you have a movement disorder, you experience these kinds of impaired movement. Dyskinesia ... and is a common symptom of many movement disorders. Tremors are a type of dyskinesia. Nerve diseases ...

  9. Tailbone Disorders

    MedlinePlus

    ... the bottom of your backbone, or spine. Tailbone disorders include tailbone injuries, pain, infections, cysts and tumors. ... cause of such injuries. Symptoms of various tailbone disorders include pain in the tailbone area, pain upon ...

  10. Eosinophilic Disorders

    MedlinePlus

    ... produce more of them in response to Allergic disorders Skin conditions Parasitic and fungal infections Autoimmune diseases Some cancers Bone marrow disorders In some conditions, the eosinophils can move outside ...

  11. Peritoneal Disorders

    MedlinePlus

    ... peritoneal fluid, lubricates the surface of this tissue. Disorders of the peritoneum are not common. They include ... fluid to diagnose the problem. Treatment of peritoneal disorders depends on the cause.

  12. Pituitary Disorders

    MedlinePlus

    ... of other glands in the body. With pituitary disorders, you often have too much or too little ... one of your hormones. Injuries can cause pituitary disorders, but the most common cause is a pituitary ...

  13. Bleeding Disorders

    MedlinePlus

    ... as clotting factors. If you have a bleeding disorder, you either do not have enough platelets or ... don't work the way they should. Bleeding disorders can be the result of other diseases, such ...

  14. Voice Disorders

    MedlinePlus

    ... on the vocal cords. Other causes of voice disorders include infections, upward movement of stomach acids into ... become an effort to talk Treatment for voice disorders varies depending on the cause. Most voice problems ...

  15. Conduct disorder

    MedlinePlus

    ... activity. Causes Conduct disorder has been linked to: Child abuse Drug or alcohol abuse in the parents Family ... 2016:chap 23. Read More Antisocial personality disorder Child abuse - physical Review Date 3/4/2015 Updated by: ...

  16. Hoarding disorder

    MedlinePlus

    ... the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This ... In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; ...

  17. Anxiety Disorders

    MedlinePlus

    ... making life feel overwhelming or out of control. Obsessive compulsive disorder (OCD) . For a person with OCD, anxiety takes ... For Kids For Parents MORE ON THIS TOPIC Obsessive-Compulsive Disorder Taking Your Child to a Therapist Posttraumatic Stress ...

  18. Anxiety Disorders

    MedlinePlus

    ... making life feel overwhelming or out of control. Obsessive compulsive disorder (OCD). For a person with OCD , anxiety takes ... For Kids For Parents MORE ON THIS TOPIC Obsessive-Compulsive Disorder Social Phobia 5 Ways to Deal With Anxiety ...

  19. Personality Disorders

    MedlinePlus

    ... will only review a few in each cluster. Cluster A: Schizoid Personality Disorder. Schizoid personalities are introverted, ... into the future or read other people’s minds. Cluster B: Antisocial Personality Disorder . People with antisocial personality ...

  20. Neurocognitive disorder

    MedlinePlus

    Organic mental disorder (OMS); Organic brain syndrome ... Beck BJ, Tompkins KJ. Mental disorders due to another medical condition. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical ...

  1. Swallowing Disorders

    MedlinePlus

    ... disorder, but it is more likely in the elderly. It often happens because of other conditions, including Nervous system disorders, such as Parkinson's disease and cerebral palsy Problems with your esophagus, ...

  2. Personality disorders

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000939.htm Personality disorders To use the sharing features on this page, please enable JavaScript. Personality disorders are a group of mental conditions in ...

  3. Personality Disorders

    MedlinePlus

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  4. Rumination disorder

    MedlinePlus

    ... Katzman DK, Kearney SA, Becker AE. Feeding and eating disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. ... and the A.D.A.M. Editorial team. Eating Disorders Read more Latest Health News Read more Health ...

  5. Eating disorders.

    PubMed

    Erzegovesi, Stefano; Bellodi, Laura

    2016-08-01

    Twenty years have passed from the International Classification of Diseases, Tenth Revision (ICD-10) to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and, in the meanwhile, a lot of research data about eating disorders has been published. This article reviews the main modifications to the classification of eating disorders reported in the "Feeding and Eating Disorders" chapter of the DSM-5, and compares them with the ICD-10 diagnostic guidelines. Particularly, we will show that DSM-5 criteria widened the diagnoses of anorexia and bulimia nervosa to less severe forms (so decreasing the frequency of Eating Disorders, Not Otherwise Specified (EDNOS) diagnoses), introduced the new category of Binge Eating Disorder, and incorporated several feeding disorders that were first diagnosed in infancy, childhood, or adolescence. On the whole, the DSM-5 revision should allow the clinician to make more reliable and timely diagnoses for eating disorders.

  6. Eating Disorders

    MedlinePlus

    Eating disorders are serious behavior problems. They can include severe overeating or not consuming enough food to stay ... concern about your shape or weight. Types of eating disorders include Anorexia nervosa, in which you become too ...

  7. Phonological disorder

    MedlinePlus

    This disorder is more common in boys. The cause in children is often unknown. Close relatives may have had speech and language problems. Other risk factors may include poverty and coming from a large family. Phonological disorders ...

  8. [Learning disorders].

    PubMed

    Gérard, Christophe-Loïc

    2008-04-15

    Learning disorders are the center of medical process used for the assessment of school failure. We argue here that medical diagnosis is based on analysis of the interaction of three symptomatic clusters: cognitive symptoms, emotional symptoms, conduct disorders.

  9. Bipolar Disorder

    MedlinePlus

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go ... The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  10. Bipolar Disorder

    MedlinePlus

    Bipolar disorder Overview By Mayo Clinic Staff Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows ( ...

  11. Mathematics disorder

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001534.htm Mathematics disorder To use the sharing features on this page, please enable JavaScript. Mathematics disorder is a condition in which a child's ...

  12. Complexity matching in dyadic conversation.

    PubMed

    Abney, Drew H; Paxton, Alexandra; Dale, Rick; Kello, Christopher T

    2014-12-01

    Recent studies of dyadic interaction have examined phenomena of synchronization, entrainment, alignment, and convergence. All these forms of behavioral matching have been hypothesized to play a supportive role in establishing coordination and common ground between interlocutors. In the present study, evidence is found for a new kind of coordination termed complexity matching. Temporal dynamics in conversational speech signals were analyzed through time series of acoustic onset events. Timing in periods of acoustic energy was found to exhibit behavioral matching that reflects complementary timing in turn-taking. In addition, acoustic onset times were found to exhibit power law clustering across a range of timescales, and these power law functions were found to exhibit complexity matching that is distinct from behavioral matching. Complexity matching is discussed in terms of interactive alignment and other theoretical principles that lead to new hypotheses about information exchange in dyadic conversation and interaction in general.

  13. Coal conversion products Industrial applications

    NASA Technical Reports Server (NTRS)

    Warren, D.; Dunkin, J.

    1980-01-01

    The synfuels economic evaluation model was utilized to analyze cost and product economics of the TVA coal conversion facilities. It is concluded that; (1) moderate yearly future escalations ( 6%) in current natural gas prices will result in medium-Btu gas becoming competitive with natural gas at the plant boundary; (2) utilizing DRI price projections, the alternate synfuel products, except for electricity, will be competitive with their counterparts; (3) central site fuel cell generation of electricity, utilizing MBG, is economically less attractive than the other synthetic fuels, given projected price rises in electricity produced by other means; and (4) because of estimated northern Alabama synfuels market demands, existing conventional fuels, infrastructure and industrial synfuels retrofit problems, a diversity of transportable synfuels products should be produced by the conversion facility.

  14. Conversation, speech acts, and memory.

    PubMed

    Holtgraves, Thomas

    2008-03-01

    Speakers frequently have specific intentions that they want others to recognize (Grice, 1957). These specific intentions can be viewed as speech acts (Searle, 1969), and I argue that they play a role in long-term memory for conversation utterances. Five experiments were conducted to examine this idea. Participants in all experiments read scenarios ending with either a target utterance that performed a specific speech act (brag, beg, etc.) or a carefully matched control. Participants were more likely to falsely recall and recognize speech act verbs after having read the speech act version than after having read the control version, and the speech act verbs served as better recall cues for the speech act utterances than for the controls. Experiment 5 documented individual differences in the encoding of speech act verbs. The results suggest that people recognize and retain the actions that people perform with their utterances and that this is one of the organizing principles of conversation memory.

  15. Ratios of internal conversion coefficients

    SciTech Connect

    Raman, S.; Ertugrul, M.; Nestor, C.W. . E-mail: CNestorjr@aol.com; Trzhaskovskaya, M.B.

    2006-03-15

    We present here a database of available experimental ratios of internal conversion coefficients for different atomic subshells measured with an accuracy of 10% or better for a number of elements in the range 26 {<=} Z {<=} 100. The experimental set involves 414 ratios for pure and 1096 ratios for mixed-multipolarity nuclear transitions in the transition energy range from 2 to 2300 keV. We give relevant theoretical ratios calculated in the framework of the Dirac-Fock method with and without regard for the hole in the atomic subshell after conversion. For comparison, the ratios obtained within the relativistic Hartree-Fock-Slater approximation are also presented. In cases where several ratios were measured for the same transition in a given isotope in which two multipolarities were involved, we present the mixing ratio {delta} {sup 2} obtained by a least squares fit.

  16. Electrocatalysts for carbon dioxide conversion

    DOEpatents

    Masel, Richard I; Salehi-Khojin, Amin

    2015-04-21

    Electrocatalysts for carbon dioxide conversion include at least one catalytically active element with a particle size above 0.6 nm. The electrocatalysts can also include a Helper Catalyst. The catalysts can be used to increase the rate, modify the selectivity or lower the overpotential of electrochemical conversion of CO.sub.2. Chemical processes and devices using the catalysts also include processes to produce CO, HCO.sup.-, H.sub.2CO, (HCO.sub.2).sup.-, H.sub.2CO.sub.2, CH.sub.3OH, CH.sub.4, C.sub.2H.sub.4, CH.sub.3CH.sub.2OH, CH.sub.3COO.sup.-, CH.sub.3COOH, C.sub.2H.sub.6, (COOH).sub.2, or (COO.sup.-).sub.2, and a specific device, namely, a CO.sub.2 sensor.

  17. Conversion of heavy petroleum oils

    SciTech Connect

    Farcasiu, M.

    1982-03-02

    Heavy petroleum oils, such as vacuum resids, and heavy fractions of tar sands and shale oil, are partially converted to more volatile hydrocarbons by mixing with light aromatic hydrocarbons and treatment of the mixture with a friedel-crafts catalyst such as aluminum chloride. It is believed that the conversion found is essentially a transalkylation, I.E. The resid undergoes dealkylation with concurrent alkylation of the light aromatic hydrocarbon.

  18. Observation of Thermoacoustic Energy Conversion

    NASA Astrophysics Data System (ADS)

    Tashiro, Yusuke; Biwa, Tetsushi; Yazaki, Taichi

    In order to understand thermoacoustic phenomena from a point of view of thermodynamics, oscillating pressure, velocity and temperature were measured in the tube having a temperature gradient. By converting the measured Eulerian quantities to the Lagrangian quantities associated with a given gas parcel, we determined the local energy conversion rate per unit volume and time. The obtained data demonstrate the validity of the thermodynamic approach to thermoacoustic phenomena.

  19. Materials for thermoelectric energy conversion

    NASA Technical Reports Server (NTRS)

    Wood, C.

    1988-01-01

    The field of thermoelectric energy conversion is reviewed from both a theoretical and an experimental standpoint. The basic theory is introduced and the thermodynamic and solid state views are compared. An overview of the development of thermoelectric materials is presented with particular emphasis being placed on the most recent developments in high-temperature semiconductors. A number of possible device applications are discussed and the successful use and suitability of these devices for space power is manifest.

  20. Explicit Polymorphism and CPS Conversion,

    DTIC Science & Technology

    1992-10-01

    programming language design , the concepts of polymorphism [14, 28, 39] and continuation-passing [38, 41, 43] are of particular interest. The use of...Principles of Programming Languages, January 1991. [9] Matthias Felleisen . The Calculi of X.-CS Conversion: A Syntactic Theory of Control and State in...Imperative Higher-Order Programming Languages. PhD thesis, Indiana University, Bloomington, IN, 1987. 18 [10] Matthias Felleisen and Daniel Friedman