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Psychological and Physiological Trauma Research
Seize Your Journeys
_______________________ Traumatic stress is found in many competent, healthy, strong, good people. No one can completely protect themselves from traumatic experiences. Many people have long-lasting problems following exposure to trauma. Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy. What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences. Having symptoms after a traumatic event is NOT a sign of personal weakness. Given exposure to a trauma that is bad enough, probably all people would develop PTSD. By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment. _______________________
Sleep Disorders DSMIV-R
“The sleep disorders are organized into four major sections according to presumed etiology.
Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible. Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors. Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions). Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention. Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system. Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications). That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance. Five distinct sleep stages can be measured by polysomnography: rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4). Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults. Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep. Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time. REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep. These sleep stages have a characteristic temporal organization across the night. NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation. REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes. REM sleep periods increase in duration toward the morning. Human sleep also varies characteristically across the life span. After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range. This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep. Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual. Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity. Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea. Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep. Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night. However, daytime polysomnographic studies also are used to quantify daytime sleepiness. The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day. Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness. The converse of the MSLT is also used: In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day. Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness. Standard terminology for polysomnographic measures is used throughout the test in this section. Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep. “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness. Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity). Sleep architecture refers to the amount and distribution of specific sleep stages. Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency). The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders: (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association. FUNCTIONAL NEUROANATOMY In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.
The Deep Limbic System
Functions
Problems
The Basal Ganglia System
Functions
Problems
The Prefrontal Cortex
Functions
Problems
The Cingulate Gyrus
Problems
The Temporal Lobes
Functions
Problems
Non-dominant Side (usually the right)
Secure Attachments as a Defense Against Trauma “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses. Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses. The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal. Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984). In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).” van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 185 _______________________
Sleep Disorders
“The sleep disorders are organized into four major sections according to presumed etiology. Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible. Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors. Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions). Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention. Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system. Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications). That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance. Five distinct sleep stages can be measured by polysomnography: rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4). Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults. Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep. Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time. REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep. These sleep stages have a characteristic temporal organization across the night. NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation. REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes. REM sleep periods increase in duration toward the morning. Human sleep also varies characteristically across the life span. After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range. This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep. Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual. Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity. Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea. Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep. Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night. However, daytime polysomnographic studies also are used to quantify daytime sleepiness. The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day. Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness. The converse of the MSLT is also used: In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day. Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness. Standard terminology for polysomnographic measures is used throughout the test in this section. Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep. “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness. Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity). Sleep architecture refers to the amount and distribution of specific sleep stages. Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency). The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders: (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association. _________________
Substance Dependence “Features The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence). Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period. Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance. The degree to which tolerance develops varies greatly across substances. Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects. For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates. Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser. Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine. Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking. Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals). Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances. In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely). Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances. For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination. Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance. After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening. Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes. Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis. No significant withdrawal is seen even after repeated use of hallucinogens. Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals). Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence. However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems). Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal. Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use. The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal. The following items describe the pattern of compulsive substance use that is characteristic of Dependence. The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3). The individual may express a persistent desire to cut down or regulate substance use. Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4). The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5). In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance. Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6). The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends. Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7). The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.
Specifiers Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate. Specifiers are provided to note their presence or absence: With Physiological Dependence. This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). Without Physiological Dependence. This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.
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PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com __________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373 Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. ________________ DID-PTSD-EMDR Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com
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NeuroBiology of Trauma
Affect Regulation III: The relationships among affect regulation, self-esteem, object relations, and binge drinking behavior in college freshmen.
Record: 1 Title: The relationships among affect regulation, self-esteem, object relations, and binge drinking behavior in college freshmen. Author(s): Bladt, Catherine W. , New York U., US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering , Vol 62(7-B), Feb 2002. pp. 3367. Publisher: US: Univ Microfilms International. ISSN: 0419-4217 (Print) Order Number: AAI3022141 Language: English Key Concepts: affect regulation; self esteem; object relations; binge drinking; college students Abstract: Although binge drinking among college students has been widely researched, existing studies have not been representatively conceptualized. This was an exploratory study that was designed to investigate the relationship between student characteristics and binge drinking behavior from a psychodynamic perspective. According to psychodynamic theory, deficits in the ego functions of affect regulation, self-esteem maintenance, and object relations result from developmental disappointments in the caretaker-child dyad and may predispose an individual to substance abuse. Subjects were college freshmen attending a small, private university located in the northeastern United States (n = 377). Results revealed clear differences in the relationship between ego functions and drinking behavior for male and female students. For males, no significant associations were found between any of the ego functions and drinking behavior, whereas for females, several significant associations were noted. Females who acknowledged binge drinking on a frequent basis generally reported the most pathology, while females who acknowledged binge drinking on an infrequent basis generally reported the least. Findings suggest that, within the context of the campus alcohol culture, infrequent binge drinking among women may be construed as both normative and moderate. Results also suggest that the meaning of alcohol use may differ for male and female students. For females, alcohol consumption may best be understood in the context of relationship, which is central to female identity. Accordingly, alcohol may become a de facto relational partner, and a woman's drinking style may mirror the quality of her object relations (broadly defined). It is suggested that, for males, drinking behavior cannot be interpreted in the context of relationship, because relationships are not central to their identity. Implications for methodology, theory, and practice are discussed. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Alcohol Drinking Patterns; *Alcohol Intoxication; *Emotional Control; *Object Relations; *Self Esteem; College Students Classification: General Psychology (2100) Population: Human (10)
Male (30)
Female (40) Location: US Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800) Special Feature: Peer Reviewed (600) Publication Type: Dissertation Abstract (350); Print (Paper) Release Date: 20020515 Accession Number: 2002-95002-049
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Record: 2
Title: Maternal cocaine use and infant behavior. Author(s): Eiden, Rina Das , State U New York, Research Inst on Addictions, Buffalo, NY, US
Lewis, Audra , Vanderbilt U, Dept of Psychology, Research Inst on Addictions, Nashville, TN, US
Croff, Stacy
Young, Elizabeth Address: Eiden, Rina Das, 1021 Main St, Buffalo, NY, US, 14203, eiden@ria.buffalo.edu Source: Infancy , Vol 3(1), Feb 2002. pp. 77-96. Journal URL: http://www.erlbaum.com/Journals/journals/IN/in.htm Publisher: US: Lawrence Erlbaum. Publisher URL: ISSN: 1525-0008 (Print)
1532-7086 (Electronic) Language: English Key Concepts: maternal cocaine use; risk factors; polysubstance use; maternal functioning; caregiving; affect regulation; prenatal exposure; postnatal exposure Abstract: Examined the impact of maternal cocaine use and associated risk factors such as polysubstance use, maternal functioning, and caregiving on affect regulation during infancy. Ss were 45 mother-infant dyads (19 cocaine exposed and 26 control infants) recruited at birth. Observations and maternal reports of infant behavior were obtained at 2 and 7 mo of age, along with measures of pre- and postnatal substance use, maternal functioning, and caregiving stability. Material cocaine use accounted for significant variance in infant positive affect at 2 mo. Other substance use and gestational age predicted infant distress to novelty and arousal during developmental assessments. At 7 mo, the impact of prenatal cocaine exposure on infant affect regulation was mediated by postnatal alcohol use and caregiving stability. These findings, if replicated, suggest that 1 pathway to later problem behavior reported among substance-exposed children may be through early regulatory problems and the quality of postnatal caregiving. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Cocaine; *Drug Usage; *Infant Development; *Mother Child Relations; *Prenatal Exposure; Emotional Control; Polydrug Abuse; Risk Factors Classification: Substance Abuse & Addiction (3233)
Psychosocial & Personality Development (2840) Population: Human (10)
Male (30)
Female (40) Age Group: Childhood (birth-12 yrs) (100)
Neonatal (birth-1 mo) (120)
Infancy (2-23 mo) (140)
Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800)
Longitudinal Study (0850) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print (Paper) Release Date: 20020410 Accession Number: 2002-12379-004
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Record: 3
Title: Cognitive bias and affect regulation as prospective predictors of depressive symptoms. Author(s): Beevers, Christopher Graham , U Miami, US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering , Vol 63(6-B), Jan 2002. pp. 2999. Publisher: US: Univ Microfilms International. ISSN: 0419-4217 (Print) Order Number: AAI3056617 Language: English Key Concepts: cognitive bias; affect regulation; depression vulnerability Abstract: The present study examined whether differences in automatic cognitive bias and affect regulation were associated with depression vulnerability among college students (N = 77). Responses to several standard cognitive tasks (e.g., dot-probe, Stroop, lexical decision task, scrambled sentences) were compared from before to after the negative mood induction. Affective reactivity to and recovery following a mood induction was also assessed. Remitted depressed and never depressed groups did not differ in their cognitive and affective responses to the mood induction. However, shifts in attention toward negative information (as measured by the dot-probe task) following a negative mood induction combined with higher intervening life stress to predict elevated levels of depression seven weeks later. Similarly, slower affective recovery following the mood induction combined with life stress to predict elevated depression at follow-up. Although depression groups did not differ in terms of cognitive bias or affect regulation, these variables did prospectively predict increases in depression. Results suggest that affect regulation and automatic cognitive biases may indeed have a causal role in depression susceptibility. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Cognition; *Emotional Control; *Major Depression; *Susceptibility (Disorders) Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10) Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800) Publication Type: Dissertation Abstract (350); Print Release Date: 20030728 Accession Number: 2002-95024-187
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Record: 4
Title: Emotion regulation in adolescent females with bulimia nervosa: An information processing perspective. Author(s): Sim, Leslie Ann , U Maine, US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering , Vol 63(6-B), Jan 2002. pp. 3025. Publisher: US: Univ Microfilms International. ISSN: 0419-4217 (Print) Order Number: AAI3057876 Language: English Key Concepts: emotion regulation; adolescents; girls; bulimia nervosa; information processing Abstract: Although the increased attention to affect regulation in bulimia nervosa is encouraging, most theoretical models describing the relationship between binge-eating and emotion dysregulation neglect to place their observations in the context of the growing knowledge base on normal emotional development. Because the nature of abnormal functioning is best understood in relation to normal development, integrating these fields of research would identify deficient skills in bulimia nervosa, suggesting new avenues for treatment. The present study compared 16 adolescent girls with a DSM-IV diagnosis of bulimia nervosa to 16 age- and SES-matched girls without a psychiatric disorder, on three aspects of the information processing model (Garber, Braafladt, & Zeman, 1991) of emotional regulation, a model chosen for its description of the numerous skills that comprise normative emotion regulation. Because they share conceptual characteristics, girls with bulimia were also compared to 16 age- and SES-matched girls with a DSM-IV diagnosis of unipolar depression. Diagnosed girls were recruited from treatment programs at a large Midwestern medical center and nondiagnosed participants were recruited through advertisements in a local newspaper. The study took place over a six month period. Emotion regulation skills were assessed through questionnaire and interview measures, as well as response latencies to various questions. Compared to those with depression and those without a disorder, girls with bulimia: described poor awareness of emotional states; displayed difficulty discriminating between emotional states; exhibited nonspecific verbal labels to describe their feelings; displayed a limited repertoire of emotion regulation strategies and ability to access these strategies under high emotional arousal. Compared to girls without a diagnosis, girls with bulimia: reported decreased motivation to express negative emotion to others; took longer to describe their emotional state; evaluated themselves as less competent at implementing strategies to decrease their emotional state; and, rated the expected outcome of their strategies as less effective in decreasing their emotional state. These findings suggest adolescent females with bulimia may rely on binge-eating and purging in an environment of inadequate emotion regulation skills. Treatment implications of these findings include interventions targeted towards remediating deficient skills. Longitudinal research is recommended to clarify the role of these deficiencies. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Bulimia; *Cognition; *Emotional Control; *Human Females
Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10)
Female (40) Age Group: Adolescence (13-17 yrs) (200) Form/Content Type: Empirical Study (0800) Publication Type: Dissertation Abstract (350); Print Release Date: 20030728 Accession Number: 2002-95024-205
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Record: 5
Title: Expression of anger and alexithymia in patients with psychogenic excoriation: A preliminary report. Author(s): Calikusu, Celal , Bakirkoey Research & Training Hosp, Turkey
Yuecel, Basak , byucel@superonline.com, Istanbul U, Faculty of Medicine, Istanbul, Turkey
Polat, Aslihan , Istanbul U, Faculty of Medicine, Istanbul, Turkey
Baykal, Can , Istanbul U, Faculty of Medicine, Istanbul, Turkey Address: Yuecel, Basak, Istanbul Tip Fakultesi, Psikiyatri Anabilim Dali, Millet cad Capa (34390), Istanbul, Turkey, byucel@superonline.com Source: International Journal of Psychiatry in Medicine , Vol 32(4), 2002. pp. 345-352. Journal URL: http://baywood.com/search/PreviewJournal.asp?qsRecord=7 Publisher: US: Baywood Publishing. Publisher URL: ISSN: 0091-2174 (Print)
1541-3527 (Electronic) Language: English Key Concepts: anger expression; alexithymia; psychogenic excoriation Abstract: Psychogenic excoriation (PE), which is characterized by lesions formed by self-picking, has a significant place among the dermatoses related to psychological factors. Emotions, particularly anger that cannot be expressed, may be important in the etiology. The objective of this study was to evaluate the sociodemographic characteristics of patients with PE and with another psychodermatosis, and compare them in terms of anger, manner of anger expression, and alexithymia. 31 consecutive subjects with PE (aged 18-63 yrs) and 31 patients with chronic urticaria (aged 29-52 yrs) were recruited from an outpatient dermatology clinic. All of the subjects completed Toronto Alexithymia Scale and Trait Anger and Anger Expression Scale. PE patients had higher levels of anger, tended not to show their anger, and were more alexithymic. There was also a positive correlation between anger and alexithymia scores. PE, a severe and chronic psychiatric and dermatological problem, may be related to affect-regulation, particularly anger and alexithymia. Due to the fact that it has a different place among psychodermatoses, individuals with PE might benefit from learning how to regulate their affects other than by excoriation. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Alexithymia; *Anger; *Self Inflicted Wounds; *Skin (Anatomy); *Somatoform Disorders Classification: Physical & Somatoform & Psychogenic Disorders (3290) Population: Human (10)
Male (30)
Female (40)
Outpatient (60) Location: Turkey Age Group: Adulthood (18 yrs & older) (300)
Young Adulthood (18-29 yrs) (320)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360) Form/Content Type: Empirical Study (0800) Publication Type: Peer Reviewed Journal (270); Print; Electronic Release Date: 20030616 Accession Number: 2003-03709-003
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Database: PsycINFO _____
Record: 6
Title: Biological, psychological and social processes in the conduct disorders. Author(s): Hill, Jonathan , Liverpool U, United Kingdom Address: Hill, Jonathan, Royal Liverpool Children's Hosp, University Child Mental Health, Mulberry House, Eaton Road, Liverpool, United Kingdom, L12 2AP, jonathan.hill@liverpool.ac.uk Source: Journal of Child Psychology & Psychiatry & Allied Disciplines , Vol 43(1), Jan 2002. pp. 133-164. Journal URL: http://uk.cambridge.org/journals/cpp/ Publisher: United Kingdom: Blackwell Publishers. Publisher URL: http://www.blackwellpublishing.com ISSN: 0021-9630 (Print) Digital Object Identifier: http://dx.doi.org/10.1111/1469-7610.00007 Language: English Key Concepts: aggressive behavior; disruptive behavior; conduct disorder; antisocial behavior; at risk children; childhood development; adolescent development Abstract: Reviews recent evidence on the causes and maintenance of aggressive and disruptive behaviors in childhood and adolescence. It considers the relative merits of several different ways of conceptualizing such problems, in relation to the contribution of biological, psychological and social factors. It focuses on conduct problems appearing in young childhood, which greatly increase the likelihood of persistent antisocial behaviors in adolescence and adult life in association with wider interpersonal and social role impairments. The article considers the contribution of individual factors, including impaired verbal skills, deficits in executive functions, and an imbalance between behavioral activation and inhibition systems. The roles of attributional biases, unrealistic self evaluations, and insecure attachment are considered in relation to affect regulation, and effective social action. The paper concludes that, although considerable progress has been made over the past 10 years, there is a need to further refine our conceptualization of the behaviors to be explained, to develop a coherent theory of the causal and maintaining processes, and to carry out prospective studies with adequate numbers of high risk children. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Aggressive Behavior; *Antisocial Behavior; *At Risk Populations; *Behavior Problems; *Conduct Disorder; Adolescent Development; Childhood Development Classification: Behavior Disorders & Antisocial Behavior (3230) Population: Human (10) Age Group: Childhood (birth-12 yrs) (100)
Adolescence (13-17 yrs) (200) Form/Content Type: Literature Review/Research Review (1300) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20020313 Correction Date: 20020724 Accession Number: 2002-00858-006
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Database: PsycINFO _____
Record: 7
Title: Epi-inositol regulates expression of the yeast INO1 gene encoding inositol-1-P synthase. Author(s): Shaldubina, A. , Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel
Ju, S. , Department of Biological Sciences, Wayne State University, Detroit, MI, US
Vaden, D. L. , Department of Biological Sciences, Wayne State University, Detroit, MI, US
Ding, D. , Department of Biological Sciences, Wayne State University, Detroit, MI, US
Belmaker, R. H. , Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel
Greenberg, M. L. , mlgreen@sun.science.wayne.edu, Department of Biological Sciences, Wayne State University, Detroit, MI, US Address: Greenberg, M. L., Dept of Biological Sciences, Wayne State University, 5047 Gullen Mall, Detroit, MI, US, 48202, mlgreen@sun.science.wayne.edu Source: Molecular Psychiatry , Vol 7(2), 2002. pp. 174-180. Journal URL: http://www.nature.com/mp Publisher: United Kingdom: Nature Publishing. Publisher URL: ISSN: 1359-4184 (Print) Digital Object Identifier: http://dx.doi.org/10.1038/sj.mp.4000965
Language: English Key Concepts: epi-inositol; gene expression; gene encoding; behavioral effects; psychiatric disorders; yeast INO1 gene Abstract: Myo-inositol exerts behavioral effects in animal models of psychiatric disorders and is effective in clinical trials in psychiatric patients. Interestingly, epi-inositol exerts behavioral effects similar to myo-inositol, even though epi-inositol is not a substrate for synthesis of phosphatidylinositol. We postulated that the behavioral effects of epi-inositol may be due to its effects on gene expression. Yeast INO1 expression was measured in northern blots. INM1 was determined by beta--galactosidase activity in a strain containing the fusion gene INM1-lacZ integrated into the genome. Epi-inositol affects regulation of expression of the INO1 gene (encoding inositol-1-P synthase), even though it cannot support growth of an inositol auxotroph (suggesting that, as in mammalian cells, it is not incorporated into phosphatidylinositol). However, it does not affect regulation of INM1 (encoding inositol monophosphatase). The observed regulatory effects of epi-inositol on expression of the most highly regulated gene in the inositol biosynthetic pathway may help to explain how this inositol isomer can exert behavioral effects without being incorporated into phosphatidylinositol. (PsycINFO Database Record (c) 2004 APA, all rights reserved) Subjects: *Genes; *Genetics; *Mental Disorders Classification: Genetics (2510) Form/Content Type: Empirical Study (0800)
Quantitative Study (0890)
Journal Article (2400) Publication Type: Peer Reviewed Journal (270); Print; Electronic Release Date: 20040209 Accession Number: 2003-08843-006
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Database: PsycINFO _____
Record: 8
Title: The tie that binds: Sadomasochism in female addicted trauma survivors. Author(s): Southern, Stephen , Forrest General Hosp, Hattiesburg, MS, US Address: Southern, Stephen, 2009 Hardy Street, Suite 1A, Hattiesburg, MS, US, 39401, stephensouthern@msn.com Source: Sexual Addiction & Compulsivity , Vol 9(4), 2002. Special Issue: Women and sexual addiction. pp. 209-229. Publisher: United Kingdom: Taylor & Francis. Publisher URL: ISSN: 1072-0162 (Print)
1521-0715 (Electronic) Language: English Key Concepts: life trauma; self-injurious behavior; eating disorders; addictions; sexual addiction; psychotherapy; survivors; ego states; treatment Abstract: Women who develop addictive disorders to survive life trauma present a wide array of variant and perverse behaviors. This overview of sadomasochism examines the life trauma syndrome and the survival functions of addictions including self-injurious behavior, eating disorder, and sexual addiction. The etiology of sadomasochism is found in object relations damaged by neglect or abuse. Sadomasochistic dynamics function like brainwashing to oppress women in a subordinate position. Survivors turn childhood tragedy into triumph through sadomasochistic re-enactments of life trauma. An omnibus, developmentally-based psychotherapy for treating the ego states of female addicted trauma survivors included abstinence from addictive behaviors, abreaction of unresolved trauma, information reprogramming or reprocessing of trauma-related cognitive distortions, acquisition of nonaddictive affect regulation and self-management skills, prevention of relapse, and enhancement of capacity for intimacy, creativity, and spirituality. Case studies are presented to explore the types of sadomasochism and state-dependent treatment recommendations across five life domains. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Ego; *Emotional Trauma; *Experiences (Events); *Sadomasochism; *Treatment; Addiction; Eating Disorders; Human Females; Psychotherapy; Self Inflicted Wounds; Sexual Addiction; Survivors Classification: Psychological & Physical Disorders (3200) Population: Human (10)
Female (40) Age Group: Adulthood (18 yrs & older) (300)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360) Form/Content Type: Empirical Study (0800)
Case Study (0810) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20030122 Accession Number: 2003-01090-004
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Cut and Paste: <A href="http://search.epnet.com/direct.asp?an=2003-01090-004&db=psyh">The tie that binds: Sadomasochism in female addicted trauma survivors.</A>
Database: PsycINFO _____
Record: 9
Title: Ueberlebende von folter. Eine studie zu komplexen postraumatischen belastungsstoerungen. Translated Title: Survivors of torture: A study of complex posttraumatic stress disorders. Author(s): Teegen, Frauke , U Hamburg, Psychologisches Inst III, Hamburg, Germany
Vogt, Silke , U Hamburg, Psychologisches Inst III, Hamburg, Germany Source: Verhaltenstherapie & Verhaltensmedizin , Vol 23(1), 2002. pp. 91-106. Publisher: Germany: Pabst Science Publishers. Publisher URL: http://www.pabst-publishers.de ISSN: 1013-1973 (Print) Language: German Key Concepts: torture; PTSD; survivors; screening instrument; symptoms
Abstract: The objective of this study was to question survivors of torture about the context and kind of the sustained torture and to administer a screening of lasting physical sequelae and symptoms of PTSD. Assuming that the experience of torture leads to very comprehensive trauma related syndromes, the construct of complex PTSD was additionally included. As item version was constructed on the basis of the Structured Interview of Disorders for Extreme Stress, which captures changes in affect regulation, self-perception, relationship capability, systems of meaning as well as somatic disorders. 33 survivors participated (male and female; mean age 41 yrs old). When experiencing torture for the first time, 21% were younger than 16 yrs old. 83% sustained lasting physical damage. PTSD was diagnosed in 94%. In addition to the syndrome of PTSD, two thirds exhibited the entire syndrome of a complex PTSD. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Health Screening; *Posttraumatic Stress Disorder; *Survivors; *Torture Classification: Neuroses & Anxiety Disorders (3215) Population: Human (10)
Male (30)
Female (40) Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20020807 Accession Number: 2002-01636-005
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Database: PsycINFO _____
Record: 10
Title: Alexithymie: Kompetenzdefizit oder (motivierte) Hemmung? Eine Untersuchung zur Klaerung der Konstruktvalidaet des Alexithymiekonzeptes an Patienten mit Angststoerungen. Translated Title: Alexithymia: Emotional skill deficit or inhibition of emotional experiencing? Author(s): Schaible, Ralf , Klinik fuer Psychiatrie und Psychotherapie, Rotenburg, Germany
Dahme, Bernhard , U Hamburg, Psychologisches Inst III, Hamburg, Germany
Raeithel, Arne , U fuer Psychiatrie, Wien, Germany
Bach, Michael , Universitaetsklinik fuer Psychiatrie, Wien, Germany
Lupke, Ulrike , Psychotherapiezentrum Winterhude, Hamburg, Germany
Nutzinger, Detlev O. , Medizinisch-Psychosomatische Klinik Bad Bramstedt, Bad Bramstedt, Germany Source: Zeitschrift fuer Klinische Psychologie und Psychotherapie: Forschung und Praxis , Vol 31(3), 2002. pp. 194-203. Publisher: Germany: Verlag fur Psychologie. ISSN: 1616-3443 (Print) Digital Object Identifier: http://dx.doi.org/10.1026//1616-3443.31.3.194 Language: German Key Concepts: alexithymia; affect regulation; emotional discrimination; emotional experiencing; anxiety disorders Abstract: Examined whether alexithymia is based on (cognitive) deficits in affect regulation or on a (motivated) inhibition of emotional experiencing. The following hypotheses were tested: (1) alexithymic patients would show a less differentiated semantic space for emotional discrimination, and (2) alexithymic patients would show lower acceptance of their emotions and stronger belief that they will be rejected by significant others because of their emotionality. In 39 patients with DSM-III--R anxiety disorders perceptual discrimination of emotions was assessed with a repertory-grid-technique, and attitude towards emotions was assessed with acceptance rating scales referring to basic emotions. Alexithymia was assessed with the Toronto Alexithymia Scale. Results show that alexithymic patients showed a lower degree of emotional differentiation. It is concluded that the data support a deficit model of alexithymia. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Alexithymia; *Anxiety Disorders; *Emotional Control; *Emotionality (Personality); Experiences (Events); Inhibition (Personality) Classification: Neuroses & Anxiety Disorders (3215) Population: Human (10) Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800) Special Feature: Non-English Abstracts (200)
References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20021106 Accession Number: 2002-04358-004
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Cut and Paste: <A href="http://search.epnet.com/direct.asp?an=2002-04358-004&db=psyh">Alex ithymie: Kompetenzdefizit oder (motivierte) Hemmung? Eine Untersuchung zur Klaerung der Konstruktvalidaet des Alexithymiekonzeptes an Patienten mit Angststoerungen.</A>
Database: PsycINFO _____
Record: 11
Title: Komplexe Posttraumatische Belastungsstoerung: Eine Untersuchung des diagnostischen Konstruktes am Beispiel misshandelter Frauen. Translated Title: Complex posttraumatic stress disorders: An investigation of the diagnostic construct in a sample of abused women. Author(s): Teegen, Frauke , U Hamburg, Psychologisches Inst III, Hamburg, Germany
Schriefer, Johanna , U Hamburg, Psychologisches Inst III, Hamburg, Germany Address: Teegen, Frauke, U Hamburg, Psychologisches Inst III, Von Melle Park 5, 20146, Hamburg, Germany, teegen@uni-hamburg.de Source: Zeitschrift fuer Klinische Psychologie, Psychiatrie und Psychotherapie , Vol 50(2), 2002. pp. 219-233. Publisher: Germany: Verlag Ferdinand Schoningh. ISSN: 1431-8172 (Print) Language: German Key Concepts: domestic violence; posttraumatic stress disorder; changes in affect regulation; consciousness; self experience; relationship capability; systems of meaning; somatization disorders; abused women Abstract: In the context of an investigation on the sequelae of domestic violence, the diagnostic construct of "complex posttraumatic stress disorder," which captures changes in affect regulation, consciousness, self experience, relationship capability, systems of meaning, and somatization disorders, was assessed. 71 women, who had lived in an abusive relationship for 11 years on average, participated in the study. A posttraumatic stress disorder (PTSD; PCL-C according to DSM-IV) was found in 58%, and the syndrome of complex PTSD additionally in 27%. The analysis of correlational relationships revealed that syndrome patterns of a complex PTSD were developed primarily in combination with intrusions, arousal and avoidance symptoms and that they may be an indicator for the severeness of a PTSD after the prolonged experience of violence. Correlations with the SCL-90-R provided support for the validity of the diagnostic construct. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Consciousness States; *Emotional Control; *Family Violence; *Posttraumatic Stress Disorder; *Self Concept; Battered Females; Interpersonal Interaction; Somatosensory Disorders; World View Classification: Behavior Disorders & Antisocial Behavior (3230) Population: Human (10)
Female (40) Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20020807 Accession Number: 2002-01988-005
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Database: PsycINFO _____
Record: 12
Title: Clinical implications of a psychoneurobiological model of projective identification. Author(s): Schore, Allan N. , U California, Los Angeles, Medical School, Los Angeles, CA, US Source: Alhanati, Shelley (Ed); 2002. Primitive mental states: Psychobiological and psychoanalytic perspectives on early trauma and personality development, Vol. 2. London, England: Karnac Books. pp. 1-65
ISBN: 1-892746-91-3 (hardcover) Language: English Key Concepts: projective identification; psychobiological states; right brain; neuroscience; clinical psychoanalysis; primitive mental states; unconscious transmission; intrapsychic mechanism; mind body states Abstract: Recent findings relating to projective identification (Klein, 1946) derived from clinical psychoanalysis, developmental psychology, and developmental neuroscience are presented to investigate the underlying mechanism of the process of communication from the unconscious of one person to the unconscious of another. An integrative model is proposed which suggests that projective identification is an early appearing yet enduring intrapsychic mechanism that mediates the unconscious transmission of psychobiological states between the brains of both members of an affect-communicating dyad. This model is then applied to a number of clinical issues. The author states that a major conclusion of his ongoing work on the regulation of feelings or affect regulation is that primitive mental states are much more than early appearing mental or cognitive states of mind that mediate psychological processes. Rather, they are more precisely characterized as psychobiological states suitable for the exploration of primitive states of mind-body. The chapter describes projective identification as an early organizing, unconscious, coping strategy for regulating right brain-to-right brain communications, especially of intense affective states. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Developmental Psychology; *Neurosciences; *Projective Identification; *Psychoanalysis; Consciousness States; Dualism; Mind; Nonverbal Communication; Psychobiology; Right Brain Classification: Psychoanalytic Theory (3143) Population: Human (10) Special Feature: References (300) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Chapter (160); Print(Paper) Release Date: 20030512 Accession Number: 2003-02047-001
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Database: PsycINFO _____
Record: 13
Title: Affect regulation and the gifted. Author(s): Keiley, Margaret K. , Purdue U, Dept of Child Development & Family Studies, Marriage & Family Therapy Program, West Lafayette, IN, US Source: Neihart, Maureen (Ed); Reis, Sally M. (Ed); et al; 2002. The social and emotional development of gifted children: What do we know? Waco, TX, US: Prufrock Press Inc. pp. 41-50 ISBN: 1-882664-77-9 (paperback) Language: English Key Concepts: affect regulation; gifted children; gifted adolescents Abstract: This chapter discusses affect regulation in the gifted. Research studies on various emotion-related issues for gifted children, including emotional needs, the risk for externalizing and internalizing problems, stressors, family influence, and patterns of adjustment are discussed. It is concluded that more research is needed into the specific affect-regulation strategies of gifted children who are and are not having difficulties with their social, emotional, or behavioral adjustment to assist in the development of programs and treatments aimed at assisting these children in their adjustment. Further, the author articulates the need for proposing and researching of a model of affective talent development that can identify affectively talented children. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Emotional Adjustment; *Gifted Classification: Psychosocial & Personality Development (2840) Population: Human (10) Age Group: Childhood (birth-12 yrs) (100)
Adolescence (13-17 yrs) (200) Special Feature: References (300) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Chapter (160); Print (Paper) Release Date: 20020320 Accession Number: 2002-00981-005
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Database: PsycINFO _____
Record: 14
Title: Cognitive-behavioral therapy for alcohol addiction. Author(s): O'Leary, Tracy A. , Brown U, Ctr for Alcohol & Addiction Studies, Providence, RI, US
Monti, Peter M. , Brown U, Ctr for Alcohol & Addiction Studies, Providence, RI, US Source: Hofmann, Stefan G. (Ed); Tompson, Martha C. (Ed); 2002. Treating chronic and severe mental disorders: A handbook of empirically supported interventions. New York, NY, US: Guilford Press. pp. 234-257 ISBN: 1-57230-765-X (hardcover) Language: English Key Concepts: cognitive-behavioral therapy; coping & social skills training; alcohol addiction Abstract: The core elements of cognitive-behavioral therapy for alcohol problems are coping and social skills training (CSST). There are 4 primary areas in CSST: (1) interpersonal skills for enhancing relationships; (2) cogitive-emotional coping skills for affect regulation; (3) coping skills for managing daily life events, stressful events, and high-risk situations for drinking; and (4) coping with alcohol use cues. Cognitive coping skills include strategies both to cope with psychophysiological or cognitive reactions associated with urges or cravings to drink and to increase self-efficacy in remaining abstinent from alcohol in high-risk situations. Interpersonal skills include techniques to increase positive social interactions and self-confidence, and to minimize negative social interactions and avoidance of others. In this chapter, the authors present their model of CSST for alcohol dependence. They also review the assessment and treatment interventions for the model and present empirical evidence of the effectiveness of CSST. (PsycINFO Database Record (c) 2004 APA, all rights reserved) Subjects: *Alcoholism; *Cognitive Therapy; *Coping Behavior; *Social Skills Training Classification: Cognitive Therapy (3311) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Chapter (160) Release Date: 20020724 Correction Date: 20040126 Accession Number: 2002-01781-012
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Database: PsycINFO _____
Record: 15
Title: The regulation of sleep-arousal, affect, and attention in adolescence: Some questions and speculations. Author(s): Dahl, Ronald E. , U Pittsburgh, Pittsburgh, PA, US Source: Carskadon, Mary A. (Ed); 2002. Adolescent sleep patterns: Biological, social, and psychological influences. New York, NY, US: Cambridge University Press. pp. 269-284 ISBN: 0-521-64291-4 (hardcover) Language: English Key Concepts: affect regulation; adolescent development; cognitive processes; emotional processes; sleep patterns; cognitive-emotional model Abstract: This chapter focuses on a model of affect regulation emphasizing the developing links between cognitive and emotional processes during adolescence. The bridge from sleep patterns to this cognitive-emotional model is built on 2 premises. (1) The aspects of affect regulation that require the integration of high cognitive and emotional processing are particularly sensitive to inadequate or insufficient sleep, and may represent one of the most significant consequences of poor sleep patterns. (2) These aspects of affect regulation are critically important in the development of social competence and represent a highly vulnerable period in adolescent development. Clinical studies designed to test some hypotheses directly along these lines are in progress (and some preliminary data are presented here). However, most of this chapter attempts to step back and consider a broader overview of the cognitive-emotional development, and it does not return directly to the link to sleep-arousal regulation until the end. The model is in a preliminary form, makes numerous speculative jumps across domains, and is offered not as a source of explanations, but primarily as a means to generate further questions. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Adolescent Development; *Cognitive Processes; *Emotional Control; *Models; *Sleep; Cognitive Development; Emotional Development; Emotional States; Sleep Wake Cycle Classification: Developmental Psychology (2800) Population: Human (10) Age Group: Adolescence (13-17 yrs) (200) Special Feature: References (300) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Chapter (160); Print(Paper) Release Date: 20030217 Accession Number: 2003-04411-016
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Cut and Paste: <A href="http://search.epnet.com/direct.asp?an=2003-04411-016&db=psyh">The regulation of sleep-arousal, affect, and attention in adolescence: Some questions and speculations.</A>
Database: PsycINFO _____
Record: 16
Title: Affect regulation, mentalization, and the development of the self. Author(s): Fonagy, Peter , U Coll London, Sub-Dept of Clinical Health Psychology, London, England
Gergely, Gyoergy , Hungarian Academy of Sciences, Psychology Inst, Developmental Psychology Lab, Hungary
Jurist, Elliot L. , Hofstra U, Dept of Philosophy, Hempstead, NY, US
Target, Mary , U Coll London, London, England Source: 2002. New York, NY, US: Other Press. xiii, 577 pp. ISBN: 1-892746-34-4 (hardcover) Language: English Key Concepts: psychotherapy; psychopathology; regulation; self; mentalization; development Abstract: Aimed at addressing multiple audiences: research psychologists, clinical psychologists, and psychotherapists, as well as developmentalists from across other disciplines, this book highlights the crucial importance of developmental work to psychotherapy and psychopathology. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Developmental Psychology; *Emotional Control; *Psychopathology; *Psychotherapy; *Self Concept; Clinical Psychologists; Psychotherapists Classification: Developmental Psychology (2800) Population: Human (10) Special Feature: Index (100)
References (300) Intended Audience: Psychology: Professional & Research (PS) Table of Contents: About the authors
Acknowledgements
Introduction
Part I: Theoretical perspectives
..Attachment and reflective function: Their role in self-organization
..Historical and interdisciplinary perspectives on affects and affect regulation
..The behavior geneticist's challenge to a psychosocial model of the development of mentalization
Part II: Developmental perspectives
..The social biofeedback theory of affect-mirroring: The development of emotional self-awareness and self-control in infancy
..The development of an understanding of self and agency
.."Playing with reality': Developmental research and a psychoanalytic model for the development of subjectivity
..Marked affect-mirroring and the development of affect-regulative use of pretend play
..Developmental issues in normal adolescence and adolescent breakdown
Part III: Clinical perspectives
..The roots of borderline personality disorder in disorganized attachment
..Psychic reality in borderline states
..Mentalized affectivity in the clinical setting
Epilogue
References
Index Publication Type: Authored Book (120); Print(Paper) Release Date: 20020807 Accession Number: 2002-17653-000
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Database: PsycINFO _____
Record: 17
Title: Beginnings: The art and science of planning psychotherapy. Author(s): Peebles-Kleiger, Mary Jo , Private Practice, Bethesda, MD, US Source: 2002. Hillsdale, NJ, US: Analytic Press, Inc.. ix, 334 pp. ISBN: 0-88163-313-5 (hardcover) Language: English Key Concepts: psychotherapy planning; diagnostic case formulation; therapeutic alliance; history taking Abstract: How does the psychotherapist conceptualize the needs of the patient while simultaneously enlisting him or her as an active partner in formulating an individualized working plan? And how should supervisors teach the skills needed to make the intake procedure truly the beginning of treatment? In this book, M. J. Peebles-Kleiger tackles these and other questions in a manner appropriate to the scientific and human complexity of today's therapeutic scene. Drawing on the cumulative experience of the outpatient department of the Menninger Psychiatric Clinic, the author outlines an approach that gives equal weight to the need for a diagnostic case formulation with specific treatment recommendations and the need to make the patient an active partner in the process right from the start. The author's synoptic discussions of the major categories of psychological dysfunction and the different treatment strategies appropriate to them are carefully calibrated, with actual examples, to the limits and opportunities of the first sessions. She illustrates how potential treatment obstacles--difficulties in affect regulation, in reality testing, in conscience formation, among others--can be assessed and subjected to trial interventions from the very start. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Patient History; *Psychodiagnosis; *Psychotherapy; *Therapeutic Alliance; *Treatment Planning Classification: Psychotherapy & Psychotherapeutic Counseling (3310) Population: Human (10) Special Feature: References (300) Intended Audience: Psychology: Professional & Research (PS) Table of Contents: Acknowledgments
..What do we mean by diagnosis?
..Alliance
..Focus
..History taking--Comprehensive or selective?
..Patient activity
..What material is important?
..How can we be sure?
..Trial interventions and feedback
..The concept of underlying disturbance
..Deficit
..Characterological dysfunction
..Conflict
..Trauma
..Enhancing the patient's ability to form an alliance
..Reality testing and reasoning
..Emotional regulation
..Relatedness
..Conscience
..The psychological costs of change
..The patient's learning style
..Expectations
..Priorities and modalities
References
Author index
Subject index Publication Type: Authored Book (120); Print(Paper) Release Date: 20021113 Accession Number: 2002-06374-000
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Database: PsycINFO _____
Record: 18
Title: Integrating body self and psychological self: Creating a new story in psychoanalysis and psychotherapy. Author(s): Krueger, David W. , Baylor Coll of Medicine, Houston, TX, US Source: 2002. New York, NY, US: Brunner-Routledge. xv, 268 pp. ISBN: 1-58391-054-9 (hardcover) Language: English Key Concepts: body self; psychological self; mind-body interplay; psychodynamic principles; therapeutic experience; psychoanalysis; psychotherapy Abstract: Exploring the phenomena of the mind-body matrix, D. W. Krueger advances the understanding of body self and psychological self integration in the therapeutic experience. He illustrates a novel synthesis of fundamental psychodynamic principles with evolving advances in developmental, self, neuropsychological, and attachment theories. Krueger blueprints applications in treatments with patients including those not attuned to their internal experience, not naturally insightful, verbal, or expressive. Focusing on action symptoms, self-object experiences, gender issues, embodiment, somatic symptoms, affect regulation, and ego states, the theoretical innovations are illustrated through case material. Krueger introduces treatment inroads enabling clinicians to hear and articulate arcane messages spoken in metaphor, actualized in symptoms, and encrypted in the body. This book broadens our understanding of the mind-body interplay in the clinical exchange. (PsycINFO Database Record (c) 2003 APA, all rights reserved) Subjects: *Dualism; *Psychoanalysis; *Psychodynamics; *Psychotherapy; *Self Concept Classification: Psychotherapy & Psychotherapeutic Counseling (3310) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Table of Contents: Preface
Introduction
Part I: Body self and psychological self development
..Body self in psychological self development
..Body self developmental disruptions
..The gendered body self
..Mindbrain
..Body-mind memory in development and in the clinical exchange
Part II: Developmental and clinical integration
..Somatic symptoms: Conversions, psychosomatic, somatic action, and somatic memories
..True body self/false body self
..Dissociation, trauma, and development
..Clinical considerations in dissociation
..Embodiment in psychoanalysis: The body self in development, in action symptoms, and transference-countertransference
..Psychoanalysis: The verbal exchange
..Psychoanalysis: The nonverbal exchange
..Creating a new story: Retranscripting the mindbrain
References
Index Publication Type: Authored Book (120) Release Date: 20030616 Accession Number: 2003-06051-000
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Record: 19
Title: Affect, personal strivings, and marijuana: Risk and protective factors within a self-regulation framework. Author(s): Simons, Jeffrey Scott , Syracuse U., US Source: Dissertation Abstracts International: Section B: The Sciences & Engineering , Vol 62(5-B), Dec 2001. pp. 2502. Publisher: US: Univ Microfilms International. ISSN: 0419-4217 (Print) Order Number: AAI3015021 Language: English Key Concepts: affect; personal strivings; marijuana use; risk factors; protective factors; self regulation Abstract: This study examined psychological variables that serve as risk and protective factors for marijuana use and problems in young adults. Based upon previous literature, affect dysregulation was identified as a likely risk factor for marijuana use and problems. Affect regulation qualities may be influenced by individuals' concurrent goals. Self-regulation theory highlights the importance of hierarchical organization of goals in determining regulatory options. Personal strivings are higher order goals that may influence marijuana use to the extent that they are congruent or incongruent with use. Conflict between marijuana use and personal strivings was hypothesized to be a protective factor. Factor analytic procedures were used to reduce a broad range of affect dysregulation variables to a limited number of factors. These factors and marijuana-striving conflict were used to predict three degrees of involvement: marijuana initiation, use, and problems. Marijuana-striving conflict was negatively associated with marijuana use and initiation among men and women. Among men but not women, emotional instability moderated the relationship between striving conflict and use initiation and frequency. Specifically, the relationship between striving conflict and marijuana use was greater among emotionally stable men. In contrast, affect dysregulation variables were associated with marijuana-related problems (above and beyond lifetime use) in both men and women. Among women, striving conflict moderated the relationship between problems and emotional instability and impulse control. Congruent with the protective factor hypothesis, the relationship between emotional instability and marijuana-related problems was less pronounced among women with high degrees of marijuana-striving conflict. The form of the interaction with impulse control was not congruent with theoretical predictions. Rather, it appeared that good impulse control was associated with greater congruence between participants' evaluation of the effects of use on striving attainment and their reported use behavior. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Emotions; *Marihuana Usage; *Risk Factors; *Self Management Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10)
Male (30)
Female (40) Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800)
Case Study (0810) Special Feature: Peer Reviewed (600) Publication Type: Dissertation Abstract (350); Print (Paper) Release Date: 20020417 Accession Number: 2001-95022-148
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Record: 20
Title: Dialectical behavior therapy for binge eating disorder. Author(s): Telch, Christy F. , Stanford U School of Medicine, Dept of Psychiatry & Behavioral Sciences, Stanford, CA, US
Agras, W. Stewart
Linehan, Marsha M. Address: Agras, W. Stewart, Stanford U School of Medicine, Dept of Psychiatry & Behavioral Sciences, 401 Quarry Road, Room 1326, Stanford, CA, US, 94305-5722 Source: Journal of Consulting & Clinical Psychology , Vol 69(6), Dec 2001. pp. 1061-1065. Journal URL: http://www.apa.org/journals/ccp.html Publisher: US: American Psychological Assn. Publisher URL: ISSN: 0022-006X (Print) Digital Object Identifier: http://dx.doi.org/10.1037//0022-006X.69.6.1061 Language: English Key Concepts: dialectical behavior therapy; binge eating disorder; weight; mood; eating pathology; affect regulation Abstract: This study evaluated the use of dialectical behavior therapy (DBT) adapted for binge eating disorder (BED). Women with BED (N=44) were randomly assigned to group DBT or to a wait-list control condition and were administered the Eating Disorder Examination in addition to measures of weight, mood, and affect regulation at baseline and posttreatment. Treated women evidenced significant improvement on measures of binge eating and eating pathology compared with controls, and 89% of the women receiving DBT had stopped binge eating by the end of treatment. Abstinence rates were reduced to 56% at the 6-month follow-up. Overall, the findings on the measures of weight, mood, and affect regulation were not significant. These results support further research into DBT as a treatment for BED. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Behavior Therapy; *Binge Eating; *Dialectics; *Treatment Outcomes; Body Weight; Eating Disorders; Emotional States Classification: Behavior Therapy & Behavior Modification (3312) Population: Human (10)
Female (40) Location: US Age Group: Adulthood (18 yrs & older) (300)
Young Adulthood (18-29 yrs) (320)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360)
Aged (65 yrs & older) (380) Form/Content Type: Empirical Study (0800)
Followup Study (0840)
Treatment Outcome Study (0860) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print (Paper) Release Date: 20011205 Correction Date: 20020522 Accession Number: 2001-05666-020
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Database: PsycINFO _____
Record: 21
Title: Affect regulation and the development of psychopathology. Author(s): Bradley, Susan Source: Journal of the American Academy of Child & Adolescent Psychiatry , Vol 40(12), Dec 2001. pp. 1483. Journal URL: Publisher: : Les Pluriels de Psychee. ISSN: 0890-8567 (Print) Language: English Key Concepts: affect regulation; development of psychopathology Abstract: Review of book, Affect Regulation and the Development of Psychopathology. By Susan Bradley. York, PA: Guilford Press, 2000, 324 pp. Reviewed by Beth Troutman. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Psychopathology Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10) Form/Content Type: Journal Review-Book (5900) Special Feature: Peer Reviewed (600) Publication Type: Journal Article (250); Print(Paper) Release Date: 20021218 Accession Number: 2002-08241-038
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Database: PsycINFO _____
Record: 22
Title: Deliberate self-harm in a Saudi university hospital: A case series over six years (1994-2000). Author(s): AbuMadini, Mahdi Saeed , King Faisal U, Coll of Medicine, Dept of Psychiatry, Saudi Arabia
Rahim, Sheikh I. Abdel Address: AbuMadini, Mahdi Saeed, P. O. Box 40125, Al-Khobar, Saudi Arabia, 31952, mabumadini@hospital.kfu.edu.sa Source: Arab Journal of Psychiatry , Vol 12(2), Nov 2001. pp. 22-35. Publisher: Jordan: Arab Federation of Psychiatrists. ISSN: 1016-8923 (Print) Language: English Key Concepts: deliberate self-harm; transcultural perspective; sociodemographic characteristics; clinical characteristics; behavioral characteristics Abstract: Studied the sociodemographic, clinical, and behavioral characteristics of people resorting to deliberate self-harm (DSH), and discussed these features from a transcultural perspective. Data were prospectively collected from consecutive DSH cases at the Accident and Emergency (A&E) department of a teaching hospital in Saudi Arabia for a 7-yr period, using detailed structured questionnaires and add-on information from subsequent encounters. Results show that DSH constituted 10.2% of A&E referrals to psychiatrists. 362 Ss were studied. The male:female ratio was 1:1.8. 74.3% of the Ss were below 30 yrs old. Nearly two-thirds of the Ss received a diagnosis of either personality or adjustment disorder. The most frequent method of DSH was drug overdose (71.5%), followed by self-cutting in 16.3%. Paracetamol was the most frequently ingested substance. Only 12.7% genuinely wished to die; most were resorting to the act for other personal or interpersonal ends. It is concluded that DSH is fairly frequent in this culture. Like elsewhere, it seems most cases are a form of nonverbal communication of anger, discontent, or agony in maladaptive personalities characterized by poor affect regulation, inadequate problem-solving skills, and unhealthy background in socio-environmental interactions. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Demographic Characteristics; *Self Destructive Behavior; *Self Inflicted Wounds; *Sociocultural Factors Classification: Behavior Disorders & Antisocial Behavior (3230) Population: Human (10)
Male (30)
Female (40) Location: Saudi Arabia Age Group: Adulthood (18 yrs & older) (300) Form/Content Type: Empirical Study (0800)
Longitudinal Study (0850)
Prospective Study (0851) Special Feature: References (300)
Peer Reviewed (600) Publication Type: Journal Article (250); Print (Paper) Release Date: 20020213 Accession Number: 2001-10164-003
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Record: 23
Title: Organizational principles and microcircuitry of the cerebellum. Author(s): O'Hearn, Elizabeth , Johns Hopkins School of Medicine, Dept of Neurology, Balitmore, MD, US
Molliver, Mark E. Address: O'Hearn, Elizabeth, Johns Hopkins School of Medicine, Department of Neurology, 725 N. Wolfe Stree, Hunterian 803, Balitmore, MD, US, 21205, eohearn@jhmi.edu Source: International Review of Psychiatry , Vol 13(4), Nov 2001. pp. 232-246. Journal URL: http://www.tandf.co.uk/journals/carfax/09540261.html Publisher: United Kingdom: Carfax Publishing. ISSN: 0954-0261 (Print)
1369-1627 (Electronic) Digital Object Identifier: http://dx.doi.org/10.1080/09540260120082083 Language: English Key Concepts: cerebellum; organization; circuitry; motor behavior; non-motor behavior; cognition; affect regulation Abstract: The cerebellum influences motor behavior and enables smooth, coordinated movements. Recent evidence also suggests that it contributes to non-motor behavior, including components of cognition and regulation of affective state. This review summarizes the organization and circuitry of the cerebellum as a basis for understanding newly emerging concepts about the function of this neuronal system. The cerebellum consists of several divisions with separate functions. One region is associated with the vestibular system and another with brainstem and spinal cord. A 3rd region, the cerebrocerebellum, has extensive interconnections with cerebral cortex and may be involved in motor coordination and regulation of non-motor behavior. Cerebellar circuitry exhibits a parasagittal organization based on climbing fiber input and the distributions of neuronal proteins and neuronal vulnerability to insults. This parasagittal circuitry along with the mediolateral course of parallel fibers results in a Cartesian coordinate system that may be a crucial factor in its signal processing function. Although many details of cerebellar microcircuitry, synaptic transmission and signal transduction have been determined, the functional contribution of cerebellar signalling to brain function remains enigmatic. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Subjects: *Cerebellum; *Cognition; *Emotional States; *Motor |
