Neural dysfunction in ADHD with Reading Disability during a word rhyming Continuous Performance Task.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous, neurodevelopmental disorder which co-occurs often with Reading Disability (RD). ADHD with and without RD consistently have higher inattentive ratings compared with typically developing controls, with co-occurring ADHD and RD also demonstrating impaired phonological processing. Accordingly, inattention has been associated with greater phonological impairment, though the neural correlates of the association are poorly understood from a functional neuroimaging perspective. It was postulated that only the co-occurring subgroup would demonstrate hypoactivation of posterior, left hemispheric, reading-related areas and, to a lesser extent, alterations in right hemispheric, attention areas compared with controls. METHODS: A novel word rhyming Continuous Performance Task assesses functional activation differences in phonology- and attention-related areas between three groups: ten boys with ADHD and RD, fourteen boys with ADHD without RD, and fourteen typically developing controls. Subjects respond to words that rhyme with a target word as mono- and disyllabic, English words are visually presented over 90s blocks. RESULTS: Behavioral performance was not different between groups. Some hypoactivation of left hemispheric, reading-related areas was apparent in ADHD and RD, but not ADHD without RD, compared with controls. Right hemispheric, attention areas showed alterations in both ADHD subgroups relative to controls; however, the differences for each subgroup were dissimilar. CONCLUSIONS: The dorsal decoding subnetwork may not be grossly compromised in ADHD with Reading Disability. The role of cognitive impairments, including the level of inattention, on phonology requires clarification from a neuroimaging perspective.

Discriminating among incarcerated sexual offenders by their perception of interpersonal problems and experience-related anxiety.

Fifty-seven (57) incarcerated sex offenders were assessed for their capacity to perceive interpersonal difficulties and experience related anxiety. The findings suggest that the men who have sexually transgressed against minors view themselves as easily exploitable and nurturant, and those who have sexually aggressed against adult females demonstrated minimal regard for external negative views of them. These two groups did not differ significantly from each other along social avoidance and non assertiveness dimensions. Assertiveness was found to decrease as a consequence of multiple incarcerations in both groups. Furthermore, perception of interpersonal difficulties and experience related anxiety in our study correctly classified 72% of high and low violent sexual offenders.

Wrapped in silence: psychotherapists and confidentiality in the courtroom.

The impact of the Austrian Psychotherapy Act, which, in contrast to legal provisions in the United States, does not provide for any exceptions to breach confidentiality, is compared with the effects of U.S. law on dealing with confidentiality. The authors investigated the impact of this law in light of three common situations in psychotherapy that may jeopardize strict confidentiality: treating potentially dangerous patients, giving testimony, and serving as a psychotherapist in prison. Under the strict provisions of the Austrian Psychotherapy Act, a breach may be excusable in the case of a highly probable danger, but Austrian psychotherapists cannot be obliged to serve as witnesses or as experts in civil or criminal cases, as American psychotherapists can. Psychotherapy in prison, where release is contingent on the success of the therapy and the divulging of information could be in the interests of the patient as well as the court and the public, requires a modified dealing with confidentiality.

[Questions directed to the open-line telephone sex counseling service]. / Henvendelser til åben sexologisk telefonrådgivning.

Inquiries to the open telephone-counselling service of the sexological clinic were registered from January 1st 1988 to January 1st 1990; a total of 168 calls, 29 of which were from professional therapists. The P-LI-SS-IT (Permission, Limited Information, Specific Suggestions, Intensive Therapy) model can be used to classify the calls, which fall within the first three categories of this model. Examples of these are given. The pattern and complaints in the inquiries are, by and large, identical with those in a Swedish sexological telephone-counselling. Contrary to a Dutch counselling service only a few telephonesex calls were registered. The use of resources is minimal and the capacity is estimated to fulfil the need. The inquiries correspond entirely to the original intentions of a telephone-counselling service.

[Intersex: which gender should be chosen?]. / Intersex: hvilket køn skal vaelges?

A newborn infant with ambiguous genitalia is a medical emergency, and the choice of gender must take into account both the chromosomal and the gonadal sex, the hormonal milieu during fetal life, surgical aspects, the anatomy of the internal genitalia, as well as the prospects for future fertility, normal psychosexual development, and sexual function as an adult. Counselling requires paediatric endocrine, surgical, and psychological expertise, but the lack of knowledge of the long-term consequences of an intersex condition hampers rational treatment. It has long been customary to assign the child a female gender, whereas recent research points to a choice of a gender compatible with the chromosomal sex, if at all possible. This article reviews our knowledge in this field.

Sound transmission in the nose of the sperm whale Physeter catodon. A post mortem study.

During a sperm whale stranding at Rømø, the Wadden Sea, Denmark, on 4 December 1997, we were notified in time to start acoustic transmission measurements in the spermaceti complex 1 h after the specimen was seen alive. Frequency-modulated sound pulses, sweeping from 30 kHz to 10 kHz in 25 ms, were injected at the frontal surface at two positions: at the distal sac, and at the center of the junk (a compartmentalized structure below the spermaceti organ). A hydrophone next to the projector served as receiver. The analyses of the recordings show a repetitive, decaying reflection pattern at both projection sites, reminiscent of the multi-pulse click peculiar to sperm whales, although with minor differences in the duration of the intra-click intervals. This experimental evidence supports the Norris and Harvey (1972) theory of click generation in the spermaceti organ. Accordingly, the click is composed of a primary event, followed by a train of reflected pulses, spaced by the time required for the event to travel back and forth between air sacs (reflectors) at each end of the organ. The results also show that the junk readily transmits sound and probably is in acoustic contact with the spermaceti organ.

The detection of phantom targets in noise by serotine bats; negative evidence for the coherent receiver.

Using a target simulator three serotine bats, Eptesicus serotinus, were trained to judge whether a phantom target was present or absent. The echolocation sounds emitted by the bats during the detection were intercepted by a microphone, amplified and returned by a loudspeaker as an artificial echo, with a delay of 3.2 ms and a sound level determined by the overall gain and cry amplitude. The cry level of each pulse was measured and the echo level received by the bat was calculated. The target was presented in 50% of the trials and the gain adjusted using conventional up/down procedures. Under these conditions between 40 and 48 dB peSPL were required for 50% detection (Figs. 2, 3). In a subsequent experiment the phantom target was masked with white noise (No) with a spectrum level of -113 dB re. 1 Pa X Hz-1/2. The thresholds were increased by 7-14 dB. Energy density (S) of a single pulse was measured and used to estimate S/No, which ranged from 36-49 dB at threshold. Theoretically the coherent receiver model predicts the ratio between hits and false alarms observed for the bats at a S/No of ca. 1-2 dB. Since the bats require 40-50 dB higher S/No (Fig. 3), this is taken as negative evidence for coherent reception (cross correlation). Furthermore, a strong sensitivity to clutter was found since there seemed to exist a fixed relationship between thresholds and clutter level.

Bat sonar: an alternative interpretation of the 10-ns jitter result.

In 1990 Simmons et al. reported evidence of a time resolution hitherto unknown in any animal, namely a 10-ns jitter detection threshold in echolocating bats. This result is discussed. The calibration data from the original papers are examined. Observations indicating other cues than delay being presented to the bats are given. We offer an alternative explanation for the psychometric jitter function, based on the assumption of a subtle distortion due to impedance mismatch in the delay-producing apparatus. We also report that effects of impedance mismatch are detectable by a human subject in a model experiment.

Vaginismus--iatrogenic precipitation and maintenance.

Four cases of vaginismus are presented. Two of them illustrate an iatrogenic precipitation of vaginismus, one misdiagnosis of vaginismus, and one shows the use of unnecessary hymenectomy as the first choice of treatment of vaginismus. The etiology of vaginismus and the indications of first pelvic examinations are discussed.

Sperm whales (Physeter catodon L. 1758) do not react to sounds from detonators.

A number of observations show that sperm whales (Physeter catodon L. 1758) react to various man-made pulses with moderate source levels. The behavioral responses are described to vary from silence to fear. Click rates of five submerged male sperm whales were measured during the discharge of eight detonators off Andenes, northern Norway. In addition, the behavioral response of a surfaced specimen was observed. Click rates of the submerged whales and the behavior of the surfaced specimen did not change during the discharges with received sound levels of some 180 dB re 1 microPa peRMS. The apparent lack of response to the discharges could be due to similarity between sperm whale clicks and detonations. Accordingly, it can be speculated that the discharges may have been perceived as isolated clicks from conspecifics.

Sperm whale sound production studied with ultrasound time/depth-recording tags.

Delphinoids (Delphinidae, Odontoceti) produce tonal sounds and clicks by forcing pressurized air past phonic lips in the nasal complex. It has been proposed that homologous, hypertrophied nasal structures in the deep-diving sperm whale (Physeter macrocephalus) (Physeteridae, Odontoceti) are dedicated to the production of clicks. However, air volumes in diving mammals are reduced with increasing ambient pressure, which seems likely to influence pneumatic sound production at depth. To study sperm whale sound production at depth, we attached ultrasound time/depth-recording tags to sperm whales by means of a pole and suction cup. We demonstrate that sperm whale click production in terms of output and frequency content is unaffected by hydrostatic reduction in available air volume down to less than 2% of the initial air volume in the nasal complex. We present evidence suggesting that the sound-generating mechanism has a bimodal function, allowing for the production of clicks suited for biosonar and clicks more suited for communication. Shared click features suggest that sound production in sperm whales is based on the same fundamental biomechanics as in smaller odontocetes and that the nasal complexes are therefore not only anatomically but also functionally homologous in generating the initial sound pulse.

Sperm whale clicks: directionality and source level revisited.

In sperm whales (Physeter catodon L. 1758) the nose is vastly hypertrophied, accounting for about one-third of the length or weight of an adult male. Norris and Harvey [in Animal Orientation and Navigation, NASA SP-262 (1972), pp. 397-417] ascribed a sound-generating function to this organ complex. A sound generator weighing upward of 10 tons and with a cross-section of 1 m is expected to generate high-intensity, directional sounds. This prediction from the Norris and Harvey theory is not supported by published data for sperm whale clicks (source levels of 180 dB re 1 microPa and little, if any, directionality). Either the theory is not borne out or the data is not representative for the capabilities of the sound-generating mechanism. To increase the amount of relevant data, a five-hydrophone array, suspended from three platforms separated by 1 km and linked by radio, was deployed at the slope of the continental shelf off Andenes, Norway, in the summers of 1997 and 1998. With this system, source levels up to 223 dB re 1 microPa peRMS were recorded. Also, source level differences of 35 dB for the same click at different directions were seen, which are interpreted as evidence for high directionality. This implicates sonar as a possible function of the clicks. Thus, previously published properties of sperm whale clicks underestimate the capabilities of the sound generator and therefore cannot falsify the Norris and Harvey theory.

Dolphin hearing: relative sensitivity as a function of point of application of a contact sound source in the jaw and head region.

The auditory input area of the dolphin head was investigated in an unrestrained animal trained to beach itself and to accept noninvasive electroencephalograph (EEG) electrodes for the recording of the auditory brain-stem response (ABR). The stimulus was a synthetic dolphin click, transmitted from a piezo-electric transducer and coupled to the skin via a small volume of water. The results conform with earlier experiments on acute preparations that show best auditory sensitivity at the middle of the lower jaw. Minimum latency was found at the rear of the lower jaw. A shaded receiver configuration for the dolphin ear is proposed.

Does changing the heart mean changing personality? A retrospective inquiry on 47 heart transplant patients.

Heart transplantation is not simply a question of replacing an organ that no longer functions. The heart is often seen as source of love, emotions, and focus of personality traits. To gain insight into the problem of whether transplant patients themselves feel a change in personality after having received a donor heart, 47 patients who were transplanted over a period of 2 years in Vienna, Austria, were asked for an interview. Three groups of patients could be identified: 79% stated that their personality had not changed at all postoperatively. In this group, patients showed massive defense and denial reactions, mainly by rapidly changing the subject or making the question ridiculous. Fifteen per cent stated that their personality had indeed changed, but not because of the donor organ, but due to the life-threatening event. Six per cent (three patients) reported a distinct change of personality due to their new hearts. These incorporation fantasies forced them to change feelings and reactions and accept those of the donor. Verbatim statements of these heart transplant recipients show that there seem to be severe problems regarding graft incorporation, which are based on the age-old idea of the heart as a centre that houses feelings and forms the personality.

The gender gap in depression reconsidered: the influence of marital and employment status on the female/male ratio of treated incidence rates.

BACKGROUND: The consistently observed predominance of female over male rates in depression - in treated as well as in untreated populations - has never been satisfactorily explained. Among the many possible biological and psychosocial explanations, marital and employment status have not been extensively studied and virtually nothing is known about the combined effect of these variables on sex differences in depression. A main reason for this lack of knowledge is the limited number of cases available in epidemiological studies. METHODS: The present paper examines the combined effects of marital and employment status on sex differences in depression rates by analysing in-patient admission rates of all depressed patients aged 18-67 admitted for the first ever time to the Department of Psychiatry of the University of Vienna from a strictly defined catchment area over a period of 42 months. Stepwise Poisson regression analyses were carried out in order to identify the relative contribution of these variables to the variance of first ever in-patient admission rates for depression. RESULTS: A total of 2599 depressed patients fulfilled the inclusion criteria. When analysed separately, sex, marital status and employment status were shown to have distinct influences, with the "not married" carrying a two-fold higher risk than the married (2:1), and female sex (1.7:1) as well as not being employed (1.7:1) showing similar but smaller effects. In the detailed combined analysis, marriage was significantly less advantageous for women than for men, while sex differences disappeared completely in the widowed group. Also, there was no sex difference in the employed divorced; in the employed widowed there was even a slight preponderance in men. The highest rates were found in not employed divorced women, the lowest in employed married men. CONCLUSION: While in-patient admissions are certainly selective in relation to epidemiological data, the large sample made it possible to perform combined analyses of sex, marital status and employment status. It was shown that the statement of a female preponderance in depression, which was found for the total sample, is a gross oversimplification. If marital and employment status are considered simultaneously, the sex differences disappear in some subgroups and in some are even reversed. We suggest that the combined influence of marital and employment status should be studied in epidemiological studies as well before conclusions about the influence of sex on depression rates are drawn.