115 research outputs found

    An fMRI study of unconditioned responses in post-traumatic stress disorder

    Get PDF
    BACKGROUND: Both fear and pain processing are altered in post-traumatic stress disorder (PTSD), as evidenced by functional neuroimaging studies showing increased amygdala responses to threats, and increased insula, putamen and caudate activity in response to heat pain. Using psychophysiology and functional magnetic resonance imaging, we studied conditioned and unconditioned autonomic and neuronal responses in subjects with PTSD versus trauma-exposed non-PTSD control (TENC) subjects. A design using an electric shock selected by subjects to be 'highly annoying but not painful' as an unconditioned stimulus (US) with partially reinforced cues allowed us to partly disentangle the expectancy- and prediction-error components from sensory components of the unconditioned response. RESULTS: Whereas responses to the conditioned stimulus (CS) were similar in PTSD and TENC, the former displayed higher putamen, insula, caudate and amygdala responses to the US. Reactivity to the US in the anterior insula correlated with PTSD symptom severity. Functional connectivity analyses using the putamen as a seed region indicated that TENC subjects had increased amygdala-putamen connectivity during US delivery; this connection was disengaged in PTSD. CONCLUSIONS: Our results indicate that although neural processing of fear learning in people with PTSD seems to be comparable with controls, neural responses to unconditioned aversive stimuli in PTSD seem to be increased

    Neurological Soft Signs in Individuals with Pathological Gambling

    Get PDF
    Increased neurological soft signs (NSSs) have been found in a number of neuropsychiatric syndromes, including chemical addiction. The present study examined NSSs related to perceptual-motor and visuospatial processing in a behavioral addiction viz., pathological gambling (PG). As compared to mentally healthy individuals, pathological gamblers displayed significantly poorer ability to copy two- and three-dimensional figures, to recognize objects against a background noise, and to orient in space on a road-map test. Results indicated that PG is associated with subtle cerebral cortical abnormalities. Further prospective clinical research is needed to address the NSSs' origin and chronology (e.g., predate or follow the development of PG) as well as their response to therapeutic interventions and/or their ability to predict such a response

    Screening for dissociative disorders in psychiatric out- and day care-patients

    Full text link
    Dissociative disorders are frequent and clinically relevant conditions in psychiatric populations. Yet, their recognition in clinical practice is often poor. This study evaluated the performance of three well known and internationally used dissociation scales in screening for dissociative disorders. Consecutively treated out- and day care-patients (n = 160) from several psychiatric units in Switzerland completed the Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ-20), and Multidimensional Inventory for Dissociation (MID). The Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R) was then administered. Test performance of the scales was analyzed by receiver operating characteristic curves. The diagnostic accuracy, represented by the area under the curve, did not differ significantly between the three summary scales. Cut-off scores for detecting at least 80 % of any dissociative disorder and dissociative disorder-not-otherwise-specified/dissociative identity disorder, respectively, were 12 and 20 for the DES, 30 and 33 for the SDQ-20, and 28 and 28 for the MID summary scale. The diagnostic accuracy of the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ was equal or slightly lower than the corresponding summary scale. The DES, SDQ-20, and MID summary scales are suitable in screening for dissociative disorders in general psychiatric out- and day care-patients. Adequate cut-off scores in the German-adapted DES are lower than in non-German versions. Screening with the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ could be more efficient without the loss of diagnostic accuracy
    • 

    corecore