Threat Impairs the Organization of Memory Around Motivational Context.

Previous work highlighted a critical role for top-down goals in shifting memory organization, namely, through studying the downstream influences of event segmentation and task switching on free recall. Here, we extend these frameworks into the realm of motivation, by comparing how threat motivation influences memory organization by capturing free recall dynamics. In Study 1, we manipulated individuals' motivation to successfully encode information by the threat of exposure to aversive sounds for forgetting.

Epidemiology of compassion: A literature review.

Psychology and neuroscience have contributed significantly to advances in understanding compassion. In contrast, little attention has been given to the epidemiology of compassion. The human experience of compassion is heterogeneous with respect to time, place, and person.

Value restructures the organization of free recall.

A large body of research illustrates the prioritization of goal-relevant information in memory; however, it is unclear how reward-related memories are organized. Using a rewarded free recall paradigm, we investigated how reward motivation structures the organization of memory around temporal and higher-order contexts. To better understand these processes, we simulated our findings using a reward-modulated variant of the Context Maintenance and Retrieval Model (CMR; Polyn et al.

Children show adult-like hippocampal pattern similarity for familiar but not novel events.

The ability to detect differences among similar events in our lives is a crucial aspect of successful episodic memory performance, which develops across early childhood. The neural substrate of this ability is supported by operations in the medial temporal lobe (MTL). Here, we used representational similarity analysis (RSA) to measure neural pattern similarity in hippocampus, perirhinal cortex, and parahippocampal cortex for 4- to 10-year-old children and adults during naturalistic viewing of clips from the same compared to different movies.

Qualifying for bariatric surgery: is preoperative weight loss a reliable predictor of postoperative weight loss?

Background: Over the last 20 years, bariatric surgery has emerged as a highly effective weight loss intervention that can also improve co-morbid medical conditions. However, some payors have required preoperative supervised diets and weight loss.

Objective: To determine if preoperative weight loss is the best predictor of postoperative weight loss.

Pharmacologic management of difficult-to-treat depression in clinical practice.

Objective: This article reviews the concept of difficult-to-treat depression and outlines some principles of pharmacologic management.

Methods: The authors conducted a MEDLINE review for the years 1999 to 2004, using the key words refractory, resistant, and difficult-to-treat depression.

Results: Only a small body of evidence-based literature exists to guide the management of difficult-to-treat depression.

The epidemiology and cross-national presentation of obsessive-compulsive disorder.

One of the challenges facing modern psychiatry is to determine to what extent the diagnostic categories clinicians have represent valid constructs. Epidemiologic studies are helpful in this regard when their findings are consistent across various cultural or geographic settings or with those of clinical studies. The cross-national epidemiologic data on OCD reviewed in this article are remarkable for their consistency in rates, age at onset, and comorbidity across diverse countries, a fact which lends additional support to the validity of the diagnosis of OCD.

Familial aggregation of delusional depression: re-examination in a recent family study.

Background: Delusional (D-MDD) and nondelusional depression (ND-MDD) differ in clinical presentation, biological abnormalities, course of illness, and treatment response. Family data, however, have been less consistent regarding differential risk both for any major depression (MDD) and specifically D-MDD in relatives of D-MDD probands. In an earlier family study, we observed a 1.

Familial aggregation and phenomenology of 'early'-onset (at or before age 20 years) panic disorder.

Background: While early age at onset has been associated with increased familial risk, increased clinical severity, and distinctive patterns of comorbidity in a range of psychiatric disorders, it has received limited attention in panic disorder, both in family studies and with respect to clinical presentation.

Methods: A family study of 838 adult first-degree relatives of 152 probands in 3 diagnostic groups (panic disorder with or without major depression, subdivided by age at onset at or before 20 and after 20 years, and screened normal controls) was used to examine familial aggregation of panic disorder by proband age at panic disorder onset. Phenomenology of panic disorder in ill probands and their affected adult first-degree relatives was investigated as a function of proband panic disorder onset at or before 20 vs after 20 years of age.

Panic disorder with smothering symptoms: evidence for increased risk in first-degree relatives.

Klein's (1993: Arch Gen Psychiatry 50:306-317) "false suffocation alarm" theory of spontaneous panic attacks posits that central receptors compare CO2, O2, and lactate levels and trigger panic when an impending "false" state of suffocation is detected. Several investigators have found abnormalities of respiratory physiology in subjects with panic disorder. Twin and family studies have suggested that both panic disorder and tidal volume response to CO2 are inherited.

Illicit-drug injection among psychiatric patients without a primary substance use disorder.

Objective: To increase understanding of HIV infection risk among patients with severe mental illness, the study sought to identify predictors of injection drug use among patients who did not have a primary substance use disorder.

Methods: A total of 192 patients recruited from inpatient and outpatient public psychiatric facilities were interviewed by trained mental health professionals using the Structured Clinical Interview for DSM-III-R (SCID), the Positive and Negative Syndrome Scale, and the Parenteral Drug Use High-Risk Questionnaire.

Results: Sixty percent of the sample met SCID criteria for lifetime substance abuse or dependence.

Comparison of RDC, DSM-III, DSM-III-R diagnostic criteria for generalized anxiety disorder.

The diagnosis of generalized anxiety disorder (GAD) has been controversial since its inception. It remains unclear whether more stringent diagnostic criteria, such as in DSM-III-R, have improved the validity of GAD. Family studies suggest that GAD aggregates at least weakly in families of probands with GAD, and support the separation of panic disorder (PD) and GAD.

Is the comorbidity between social phobia and panic disorder due to familial cotransmission or other factors?

Background: We previously reported significantly elevated rates of social phobia in relatives of probands with panic disorder compared with relatives of other proband groups. This study further investigates the relationship between social phobia and panic disorder.

Method: This sample is from a family study that included 193 probands from four mutually exclusive groups (patients with panic disorder, patients with panic disorder and major depression, patients with early-onset major depression, and normal controls) and 1047 of their adult first-degree relatives.

Psychiatric disorders in relatives of probands with panic disorder and/or major depression.

Background: Panic disorder and major depression (MDD) are both highly familial disorders that co-occur in individuals but do not cosegregate in families. Evidence concerning their familial aggregation with other psychiatric disorders, including phobias, substance abuse, and antisocial personality, has been contradictory. In part, the contradictory findings may be due to failure to account for the effects of proband comorbidity on risks in relatives.

Sexual activity and risk of HIV infection among patients with schizophrenia.

Objective: This study sought to determine the frequency and types of sexual behavior among patients with schizophrenia and to assess the behavior with respect to risk of HIV infection.

Method: Ninety-five inpatients and outpatients with a research diagnosis of schizophrenia underwent a series of face-to-face interviews to determine their sexual activity and correlate it with demographic characteristics, psychopathology, and medication side effects.

Results: Forty-four percent of the patients had been sexually active in the preceding 6 months, and 62% of these had had multiple partners.

HIV-1 infection at two public psychiatric hospitals in New York City.

Seroprevalence for HIV-1 was anonymously evaluated between November 1989 and July 1991 among severely mentally ill patients at two public psychiatric hospitals in New York City. The study population consisted of new admissions and long-stay patients aged 18-59. Of 1116 eligible patients, usable samples were obtained from routine blood drawings on 971 (87%).

What are the public health implications of subclinical depressive symptoms?

Longitudinal data from a community study of 9900 adults in the United States show that persons with depressive symptoms, as compared to those without such symptoms, were 4.4 times more likely to develop a first onset major depression over one year. The attributable risk, a measure which reflects both the relative risk associated with depressive symptoms (4.

The familial aggregation of panic disorder by source of proband ascertainment.

Estimates of familial aggregation of psychiatric disorder obtained from relatives of probands ascertained in treatment settings may differ from estimates obtained from relatives of probands ascertained from the general population. In this paper we investigate this hypothesis for panic disorder, by comparing the degree of familial aggregation of panic disorder in relatives of probands with panic disorder ascertained from either a specialty anxiety clinic, a specialty depression clinic or a population survey, respectively. Results for panic disorder do not suggest that familial rates are associated with source of proband ascertainment.

Agoraphobia without panic: clinical reappraisal of an epidemiologic finding.

Objective: In the United States, the consensus among clinicians and researchers, reflected in DSM-III-R, is that agoraphobia is a conditioned response to panic attacks and almost never occurs without panic attacks. The predominant view in the United Kingdom is that agoraphobia frequently occurs in the absence of panic. While clinicians report that they rarely see patients with agoraphobia who have no history of panic disorder, community studies report that agoraphobia without panic disorder is common.

The relationship between panic disorder and major depression. A new family study.

Objective: The comorbidity between panic disorder and major depression (MDD) in individuals has been amply documented. However, data from family studies to determine whether panic disorder and MDD aggregate separately or together in families have been inconclusive, in part because of the absence of studies with the full range of proband groups. This report presents results from a family study with the necessary mutually exclusive groups: panic disorder without MDD, panic disorder with MDD, MDD without panic disorder, and normal controls.

Asceticism: creative spiritual practice or pathological pursuit?

Asceticism in a religious context refers to a voluntary and sustained practice of self-denial in which immediate or sensual gratifications are renounced in order to attain a higher spiritual state (Kaelber 1987). Virtually all of the major world religions have within them a way in which the individual, through ascetic practices, can strive to achieve a more thorough absorption in the sacred. Although many psychiatrists might consider any ascetic or religious practice to be pathological, others take a more neutral view by emphasizing that religious or mystical practice can also be adaptive and creative (Group for the Advancement of Psychiatry 1976).

Epidemiology of panic disorder in African-Americans.

Objective: The authors investigated the prevalence and clinical characteristics of panic disorder among African-Americans and whites in a community study.

Method: A total of 4,287 African-American and 12,142 white subjects were interviewed at five sites as part of the Epidemiologic Catchment Area study. Panic disorder and other diagnoses were made using the National Institute of Mental Health Diagnostic Interview Schedule and DSM-III criteria.