How the Mind Creates the Body and What Can Go Wrong: Case Studies of Misperceptions of the Body.

The review brings together a wealth of case studies, both from the authors' patients and from the literature, about people whose bodies do not feel as they really should. Body parts suddenly become longer or shorter, heavier or lighter and there may be a loss of body control to the point where individuals feel as if they no longer have a body at all. The article differentiates by type of causes: mental disorders (e.g., psychosis), the influence of drugs on body perception and neurological causes. Depending on the type of body change, examples are given from the categories of sexually toned changes in body perception, out-of-body experiences and near-death experiences. Since there are countless types of body image disorders, the article is limited to a selective selection of the most interesting and sometimes obscure deviations.

The Girl Who Wants to Get Rid of Her Left Leg-Body Identity Dysphoria.

INTRODUCTION: One of the strangest kinds of misperceptions of the body is "Body Integrity Dysphoria" (BID), formerly named as "Body Identity Integrity Disorder" (BIID). The affected people have the feeling that a limb is not part of their body. They can feel it, they can use it, they can move it, but they cannot get along with the fact that it is a part of their own body. Most feel the need for an amputation of a leg, others of both legs, some want a palsy and use a wheelchair. Still discussed is whether other disablements such as blindness, dumbness, deafness or a desire to have an incontinency can be included in this diagnosis. This review discusses parallels and differences to transgender/trans identity, body dysmorphic disorder, alien limb syndrome, hemineglect, and self-induced amputations in schizophrenic patients. The cause for the need to be disabled is still unknown; the review gives an overview about psychological and neurological theories of explanation and what kind of therapy may help. METHODS: This is a narrative review of about 20 years of research about Body Integrity Dysphoria by the author. RESULTS: Overall, no psychopathological deviations were found, none of the affected persons examined by us were actually delusional or schizophrenic, which underlines that there is a neurological malfunction in the brain that has existed since birth. However, psychological mechanisms intensify the symptoms. There are clear parallels to other forms of interference between the external body and mental body representation. Different types of therapies have been able to provide help to better deal with BID, but there has been little to bring about a real cure. In contrast, BID-affected persons who achieved amputation (or other desired forms of disability) were satisfied and able to return to work. CONCLUSIONS: BID remains an enigmatic disorder. We have learned a lot over the past 20 years that the mental and physical bodies do not have to match.

The scrotum: A comparison of men's and women's aesthetic assessments.

BACKGROUND: Cosmetic surgery is a growing trend. Opportunities for an individual to attain their personal aesthetic ideal via plastic surgery have now extended as far as the genital area. Adaptive surgery on intimate areas of the body may take place for physical complaints, but may instead be due to a desire to conform to a particular ideal. Breast operations, labia reductions, and penis lengthening are long-established interventions, the motives for which a number of previous studies have examined. Tightening of the scrotum, by contrast, is a new trend in the aesthetic surgery market. Notwithstanding its rapid increase, studies have yet to investigate aesthetic preferences as regards the scrotum. AIMS: Accordingly, the aim of the present study is to compare men's and women's evaluation of various sizes of scrotum, to the end of assisting people opting to undergo this procedure in taking decisions on their visual preferences. MATERIAL AND METHODS: The participants in this study rated a number of photographs of scrotums, in nine different lengths and widths, and completed a questionnaire whose aim was to determine whether assessments differed by gender. Further, we considered whether the variables of age, extraversion, openness to experience, and consumption of pornography influenced participants' evaluations. RESULTS: We found no significant differences in evaluation of the aesthetic of scrotums in relation to any of these personality traits. The results show what sizes (lengths and widths) of scrotum the participants judged to be the most and least attractive. DISCUSSION: The esthetics of the scrotum is little explored. In this study, only normal deviations were considered, i.e. within one standard adjustment. Further studies should consider extremes. CONCLUSION: Ultimately, it was barely possible to identify a "beautiful" scrotum; we must instead speak of the least ugly.

Finished with Life Anyway and Then Stigmatized for Attempting Suicide-An Overview.

This article provides an overview of suicide and how society deals with it. Starting from early societal imprints through historical, religious and political influences, the origins of stigmatization are addressed. Even today, suicidal people experience stigmatization not only from society but also from the health system that treats suicidal people. This has far-reaching consequences for the people affected and runs counter to optimal treatment. Different approaches to a possibly improved handling of suicidality will be discussed.

Core Competencies in Clinical Neuropsychology as a Training Model in Europe.

The multitude of training models and curricula for the specialty of clinical neuropsychology around the world has led to organized activities to develop a framework of core competencies to ensure sufficient expertise among entry-level professionals in the field. The Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists' Associations is currently working toward developing a specialty certification in clinical neuropsychology to establish a cross-national standard against which to measure levels of equivalency and uniformity in competence and service provision among professionals in the field. Through structured interviews with experts from 28 European countries, we explored potential areas of core competency. Specifically, questions pertained to the perceived importance of a series of foundational, functional, and other competencies, as well as current training standards and practices, and optimal standards. Our findings revealed considerable agreement (about three quarters and above) on academic and clinical training, despite varied actual training requirements currently, with fewer respondents relegating importance to training in teaching, supervision, and research (a little over half), and even fewer to skills related to management, administration, and advocacy (fewer than half). European expert clinical neuropsychologists were in agreement with previous studies (including those conducted in the United States, Australia, and other countries) regarding the importance of sound theoretical and clinical training but management, administrative, and advocacy skills were not central to their perspective of a competent specialist in clinical neuropsychology. Establishing a specialty certificate in clinical neuropsychology based on core competencies may enable mobility of clinical neuropsychologists across Europe, and, perhaps, provide an impetus for countries with limited criteria to reconsider their training requirements and harmonize their standards with others.

Clinical Neuropsychology in Germany.

Clinical neuropsychologists have been working in Germany since the 1980s, and specific training in the discipline has been available since 1993. The qualification currently requires 3 years of practical training, 400 h of theoretical learning, 100 h of supervision, five reports on patients and an oral examination. After its completion, neuropsychologists can work as employees in clinical settings. For a substantial period of time, neuropsychologists working in their own practices faced complex challenges in working with outpatients, whose health insurers did not cover the cost of this treatment. State approval of neuropsychological diagnostic procedures and therapy was achieved in 2011, on the basis of evidence showing the method's high effectiveness; statutory health insurers therefore now pay out for delivery of these services on an outpatient basis, too. In Germany, neuropsychologists work in all areas of the diagnosis of functional disorders, with children, adolescents, adults and older adults, and carry out treatment. Clinical neuropsychologists provide patients with individualized tools for managing their brain damage, supply exercises and tasks for them to undertake at home, and give input on administrative matters, such as determining the degree of a patient's disability. Treatment takes place in close collaboration with members of related professions, such as physiotherapists, occupational therapists and speech therapists. Neuropsychologists also work as assessors, investigating, for example, the extent of a patient's ability to work after sustaining CNS damage or the need for medical retirement. The earnings of clinical neuropsychologists vary widely, currently averaging between €3,000 and €4,000 gross per month for employed neuropsychologists; self-employed neuropsychologists in their own practices can currently bill statutory health insurers for around €100.00 per hour. Despite the generally good working conditions in this discipline, Germany is suffering from a shortage of clinical neuropsychologists. An approximate total of 800 psychologists have completed training in this field, while around 50,000 patients could benefit from neuropsychological treatment every year.

Comparison of Stigmatization of Suicidal People by Medical Professionals with Stigmatization by the General Population.

Stigmatization of suicide (SOS) affects help-seeking for suicidality and impedes successful treatment. This study aimed to identify different types of stigmatization and understand the causes and glorification of suicide by comparing three groups; within each of the following groups, the impact of age and gender was explored: (1) practicing medical professional in direct contact with suicidality (psychotherapists, psychiatrists, related medical professions (nurses, etc.)), (2) future medical professionals still in training, (3) and the general population with no professional contact with suicidality. German adults completed an online survey with a total of 742 participants. A MANCOVA was calculated with age and gender being controlled as covariates, due to different distribution. Practicing professionals showed significantly higher levels of SOS than the other groups, while the future professionals showed no differences in SOS from the general population. The understanding of suicide causes was similar across all groups. Men showed higher levels of SOS than women, while women scored higher at understanding of causes and glorification of suicide. Within the individual groups, female professionals in the age group "36-65 years" stigmatized suicide most, while showing the least glorification. The results suggest that tendencies towards SOS are promoted by practical experience with suicidality. Therefore, special training is recommended to reduce SOS.

European Clinical Neuropsychology: Role in Healthcare and Access to Neuropsychological Services.

This study analyzed aspects of the work of clinical neuropsychologists across Europe. There are no published comparisons between European countries regarding the nature of clinical neuropsychologists' work. Forty-one national psychological and neuropsychological societies were approached, of which 31 (76%) responded. Data from seven countries with less than 10 neuropsychologists were excluded. A license is required to practice clinical neuropsychology in 50% of the countries. Clinical neuropsychologists work independently in 62.5%. Diagnostic/assessment work is the most frequently reported activity (54%). Most neuropsychologists work in public hospitals, followed by health centers. Adult neuropsychology was the most frequent area of activity. Services in public institutions are covered by public entities (45.8%), or by a combination of patient funds and public entities (29.2%) and only 4.2% by the patient; whereas services in private institutions are covered by the patient (26.1%) and the combination of patient, public entities (21.7%) or patient and private entities (17.4%). The data suggest that the number of neuropsychologists working across European countries is considerably low in comparison to other medical professionals. The results of the survey identified similar aspects of neuropsychologists' work, despite variations in terms of reimbursement and mechanisms, reflecting economic and healthcare differences. Estimates on the number of clinical neuropsychologists suggest insufficient access to neuropsychological services.

Neuropsychiatric and Psychological Symptoms in Patients with Lyme Disease: A Study of 252 Patients.

This study examined the relationship between neuropsychiatric and psychological symptoms in patients with Lyme borreliosis. We collected data from an experimental group of 252 Lyme disease patients and a control group of 267 healthy individuals. The quality of life and sleep, attention and memory performance were assessed in both groups. Additionally, we investigated depressive symptoms in patients with Lyme disease to examine whether the duration of the disease had an influence on the severity of symptoms shown. Furthermore, various data on the diagnostics and treatment carried out in the patient group were recorded. On average, patients visited almost eight physicians to obtain a diagnosis, and eight years passed between the tick bite and diagnosis (SD ± 7.8); less than half of the sample (46%) received their diagnosis within the first five years after the development of symptoms. It became clear that Lyme disease is often diagnosed very late. It appears that people suffering from Lyme disease have significantly lower quality of life and sleep and show cognitive impairments when it comes to attention and memory. This study shows that 3.1% of Lyme patients were satisfied with their lives and that 37% scored in the lower third of the quality-of-life scale. It was also shown that Lyme patients tend to have depressive symptoms.

How Defined Is Gender Identity in People with Body Integrity Dysphoria?

OBJECTIVE: Body integrity dysphoria (BID) is an intense need/desire to live in a disabled body, particularly due to a limb amputation or paraplegia. The investigators observed that significantly more people affected by BID wish to change their gender compared with the average population. The aim of this study was to find out whether gender identity (ie, typical male or female behavior) was less pronounced in a group of participants with BID than in a parallel control group of non-BID participants. The central hypothesis was that individuals in the BID group have a weak identification with their innate gender compared with the non-BID group and act more gender-neutral or contrary to their innate gender. METHODS: Study participants included 25 female and 25 male individuals with BID in the BID group and 25 female and 25 male individuals in a parallel control group. RESULTS: Compared with the control group, in the Minnesota Multiphasic Personality Inventory test, males with BID leaned more towards female, and females with BID leaned more toward typical male behavior. In addition, 8% of the BID group and 0% of the control group achieved the cut-off value on a test for gender dysphoria (GD). This result supports the hypothesis that BID-affected participants showed more gender-neutral behavior than the control participants. CONCLUSIONS: The results indicate that gender identity in the BID group is not as defined as in the control group. These results indicate a comprehensive disruption of identification with one's own body, which is not limited to legs or arms, but also affects the gender identity of many affected individuals.

Clinical Neuropsychology as a Specialist Profession in European Health Care: Developing a Benchmark for Training Standards and Competencies Using the Europsy Model?

The prevalence and negative impact of brain disorders are increasing. Clinical Neuropsychology is a specialty dedicated to understanding brain-behavior relationships, applying such knowledge to the assessment of cognitive, affective, and behavioral functioning associated with brain disorders, and designing and implementing effective treatments. The need for services goes beyond neurological diseases and has increased in areas of neurodevelopmental and psychiatric conditions, among others. In Europe, a great deal of variability exists in the education and training of Clinical Neuropsychologists. Training models include master's programs, continuing education courses, doctoral programs, and/or post-doctoral specialization depending on the country, with no common framework of requirements, although patients' needs demand equal competencies across Europe. In the past 5 years, the Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists' Association has conducted a series of surveys and interviews with experts in the field representing 30 European countries. The information, along with information from the existing literature, is used in presenting an overview of current and relevant topics related to policy and guidelines in the training and competencies in Clinical Neuropsychology. An option for the way forward is the EuroPsy Specialist Certificate, which is currently offered in Work and Organizational Psychology, and in psychotherapy. It builds upon the basic certificate and complements national standards without overriding them. General principles can be found that can set the basis for a common, solid, and comprehensive specialty education/training, sharpening the Neuropsychologists' competencies across Europe. The requirements in Clinical Neuropsychology should be comparable to those for the existing specialty areas in the EuroPsy model. Despite the perceived challenges, developing a specialist certificate appears a step forward for the development of Clinical Neuropsychology. Recommendations are proposed toward a shared framework of competencies by the means of a common level of education/training for the professionals in Europe. Benchmarking training standards and competencies across Europe has the potential of providing protection against unqualified and ethically questionable practice, creating transparency, raising the general European standard, and promoting mobility of both Clinical Neuropsychologists and patients in Europe, for the benefit of the professional field and the population.

[Cognitive and Affective Processes in Body Integrity Dysphoria (BID): A Pilot Study]. / Kognitive und affektive Prozesse bei Body Integrity Dysphoria (BID): Eine Pilotstudie.

Individuals suffering from Body Integrity Dysphoria (BID) have the longstanding desire for amputation (BID-A) or palsy (BID-P). Most findings on mental aspects of BID are based on self-reports from sufferers. The aim of this pilot study is to examine cognitive and affective processes beyond what is accessible by self-reports. Therefore, n=5 BID-A, n=3 BID-P-sufferers, n=22 healthy controls and n=8 patients with body dysmorphic disorder (a further group with a strong desire for body modification) were tested. Selective attention bias (eye-tracking), tendency towards false memory (DRM-paradigm) and lack of affective involvement in the unwanted body part (induction and destruction of a rubber-hand/foot-illusion) were examined. Descriptive comparison of the groups showed that BID-A-sufferers fixated amputation stumps faster and longer than any other group and showed a reduced fear response when the body illusion was destroyed. There was no indication of a higher tendency towards false memory in either BID-group. Due to the small sample size, these results cannot be generalized. However, findings showed that BID-symptoms and underlying processes can be accessed in more ways than through self-reports. Moreover, results indicate that BID-A-sufferers selective attention and affective involvement differ from people not desiring an amputation. Understanding these processes may help developing an etiological model, identifying subtypes, and deriving treatment approaches.

Training models and status of clinical neuropsychologists in Europe: Results of a survey on 30 countries.

OBJECTIVE: The aims of the study were to analyze the current European situation of specialist education and training within clinical neuropsychology, and the legal and professional status of clinical neuropsychologists in different European countries. METHOD: An online survey was prepared in 2016 by a Task Force established by the European Federation of Psychological Associations, and representatives of 30 countries gave their responses. Response rate was 76%. RESULTS: Only three countries were reported to regulate the title of clinical neuropsychologist as well as the education and practice of clinical neuropsychologists by law. The most common university degree required to practice clinical neuropsychology was the master's degree; a doctoral degree was required in two countries. The length of the specialist education after the master's degree varied between 12 and 60 months. In one third of the countries, no commonly agreed upon model for specialist education existed. A more systematic training model and a longer duration of training were associated with independence in the work of clinical neuropsychologists. CONCLUSIONS: As legal regulation is mostly absent and training models differ, those actively practicing clinical neuropsychology in Europe have a very heterogeneous educational background and skill level. There is a need for a European standardization of specialist training in clinical neuropsychology. Guiding principles for establishing the common core requirements are presented.

TATTOOS: What Do People Really Know About the Medical Risks of Body Ink?

Background: Tattoos have become increasing popular; however, medical complications and health risks can occur when getting a tattoo. Aim: The objective of this study is to determine whether people are properly informed about the medical risks and complications associated with tattoos and how the level of knowledge differs between those who have gotten tattooed and those who have not. Method: A cross-sectional online survey was performed. One-hundred participants had tattoos (32% male, 67% female) and 111 had no tattoos (53% male, 47% female); the average age was 26.9 years; level of education of both groups was comparable. There was a considerable (but not significant) difference between the two randomly selected samples with respect to sex and age, but both variables had no significant influence on the knowledge about medical risks, so no adjustment of the groups was carried out. The following variables were examined: demographics, characteristics of the tattoo, the intensity of the decision-making process that participants underwent before getting a tattoo, and the knowledge of medical risks and complications of tattoos. Results: More than 50 percent of the answers from both groups were incorrect (i.e., 55% of the answers from tattooed subjects were incorrect, and 58% of the non-tattooed group were incorrect). Neither sex (t-test, p=0.81) nor age (t-test, p=0.11) had any significant influence on the presence of knowledge. No significant correlations between sociodemographic variables and knowledge of medical risks of tattoos were found. No differences were found between characteristics of the tattoo and knowledge of medical risks apart from the size of the tattooed area (i.e., the larger the tattoo, the more information was sought by the person being tattooed). Differences were also found between educational levels and the knowledge of medical risks and complications of tattoos. Conclusions: Educating the public on the medical risks of tattoos might assist individuals in making more optimally informed decisions regarding whether to get a tattoo.

An Overwhelming Desire to Be Blind: Similarities and Differences between Body Integrity Identity Disorder and the Wish for Blindness.

BACKGROUND: The urge to be permanently blind is an extremely rare mental health disturbance. The underlying cause of this desire has not been determined yet, and it is uncertain whether the wish for blindness is a condition that can be included in the context of body integrity identity disorder, a condition where people feel an overwhelming need to be disabled, in many cases by amputation of a limb or through paralysis. OBJECTIVE: The aim of this study is to test the hypothesis that people with a desire for blindness suffer from a greater degree of visual stress in daily activities than people in a healthy visual control group. METHOD: We created a Likert scale questionnaire to measure visual stress, covering a wide range of everyday situations. The wish for blindness is extremely rare and worldwide only 5 people with an urge to be blind were found to participate in the study (4 female, 1 male). In addition, a control group of 35 (28 female, 7 male) visually healthy people was investigated. Questions addressing issues that may be experienced by participants with a desire to be blind were integrated into the questionnaire. RESULTS: The hypothesis that people with a desire for blindness suffer from a significantly higher visual overload in activities of daily living than visually healthy subjects was confirmed; the significance of visual stress between these groups was p < 0.01. In addition, an interview with the 5 affected participants supported the causal role of visual overload. CONCLUSIONS: The desire for blindness seems to originate from visual overload caused by either ophthalmologic or organic brain disturbances. In addition, psychological reasons such as certain personal character traits may play an active role in developing, maintaining, and reinforcing one's desire to be blind.

Motivational changes of cannabis use prior to and during the course of schizophrenia.

BACKGROUND AND OBJECTIVES: We investigated subjective reasons/motivation for cannabis use in patients with schizophrenia (n = 51) compared to otherwise healthy cannabis users (n = 109). Moreover, we explored possible changes in the motivational patterns of both groups over time. METHODS: A questionnaire was developed with six dimensions of motivations to use cannabis: affect regulation, relaxation, habit, structuring everyday life, creativity, and sociability. Participants filled out the instrument regarding their present and initial use of cannabis. RESULTS: At the time of onset of consumption, groups only differed significantly in habit with higher ratings for patients with schizophrenia and cannabis use (SCH+CAN group) and in sociability with higher ratings for otherwise healthy users (CAN group). In respect of present use, the motivation to consume cannabis was significantly higher for affect regulation and structuring everyday life in the SCH+CAN group and for relaxation and sociability in the CAN group. With reference to time-based variations, the SCH+CAN group reported increased relevance of structuring everyday life over time. Furthermore, the CAN group reported increased importance of habit over time, whereas the SCH+CAN patients showed decreased ratings of habit over time. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Our findings must be considered preliminary because of the retrospective nature of the assessment. Nevertheless, the present study provides an indication of the time-dependent variation of cannabis-use motivation in schizophrenia, which may provide a better understanding of the functions of cannabis use within the population. Results argue for specific motivational based interventions for the group of schizophrenia patients with regular cannabis use. (Am J Addict 2017;26:122-128).

What's Preventing Us to Get More Attraction: The Fear of Aesthetic Surgery.

BACKGROUND: Nowadays, with the help of cosmetic surgery almost every woman and man can achieve a highly attractive appearance. The question is, why so many people do not take advantage of these opportunities? This pilot-study investigates individual attitudes of people towards aesthetic plastic surgery. METHODS: A questionnaire was developed which combined self-developed items for a measurement of attitudes towards plastic surgery. In addition, items of the "Freiburger Personality Inventory" (FPI-R) were used. The study was conducted in Hamburg/Germany. 104One hundred and four test persons participated in the survey (81 females, 23 males, age 20-30 years). Eighty six of the participants (82.7%) had an A-level as degree of education, 14.4% achieved the secondary school certificate and 2.9% had completed their bachelor on a high school. RESULTS: The data supported the hypothesis that people who are unsatisfied with their body appearance showed more willingness for a surgical intervention. On the other hand, fear of complications and pain as far as anxiety before an unsatisfactory result hinders them from a decision for an intervention. Significant correlations with regard to extraversion-introversion and the education level were not found. Females showed more willingness regarding an intervention than men. Gender-specific differences concerning the cost factor were not found. CONCLUSION: Interestingly more than 65% of the total sample felt dissatisfaction with a specific body part and are thus target of aesthetic surgery. The yellow press often reports about failed cosmetic surgery, especially in VIP-persons. Aesthetic surgery should keep working to reduce unwarranted fears of people toward these kinds of operations.

Health related quality of life of immigrant children: towards a new pattern in Germany?

BACKGROUND: To study Health related quality of life (HRQoL) of a sample of kindergarten children with migration background. METHODS: Five kindergartens in Frankfurt/Main and Darmstadt (Germany) participated. HRQoL was measured with the Kiddy-KINDL (KK) in 3 to 5 year old children. We examined the associations of HRQoL with socio-demographic variables, positive development and resilience, socio-emotional and motor development. Linear regression models were applied to examine differences in HRQoL between migrant and native-born German children. RESULTS: The response rate was 90.5% (N = 283). The children had predominantly migrant background (81.35%). Perceived health was slightly higher in migrants (69.85, SD 17.00) compared to native-born German children (68.33, SD 17.31, p > 0.05), even though migrant children were characterized by a lower socio-economic status (p < 0.01). CONCLUSIONS: Results suggest that HRQoL at early ages in our study exhibits a different pattern than reported previously in studies among older individuals. We attribute the discrepancy partly to a possible changing pattern of migration in Europe with more migrants capable to migrate with healthy profiles, and to the age of our population. Our findings underscore the need to study the life course trajectory of HRQoL among young immigrants and replication in representative samples.

Psychological stress in first year medical students in response to the dissection of a human corpse.

OBJECTIVES: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students. METHODS: The study was carried out with a group of 155 first year medical students (112 female, 43 male, 21.4±2.9 years). Self-composed questionnaires were used to distinguish between concerns related to dissection and individual experiences and anxiety because of deceasing or death. In order to detect the changes of attitudes towards the dissection course, one questionnaire was answered by participants in the beginning of the course and one in the end (n=94, 66 female, 28 male). Additionally, personality traits of the students were analyzed using two scales of the "Freiburger Persönlichkeitsinventar (FPI-R)". RESULTS: The self-composed questionnaires showed high reliability. For some students dissection was emotional stress; about 50% became anxious when coping the first confrontation, however, only 12% to large extent. Concerning the anxiety of dissection of individual body parts it was less for limbs, internal organs and skin and increased for head and genitals. Although hypothesized before, the correlation between age, extraversion, emotionality and the extent of anxiety were small. Almost 90% of the students approve the early beginning of the gross anatomy course. The follow-up study showed a marked decline of anxiety. CONCLUSION: Our results show that about 50% of the students started the course with emotional stress and about one-tenth of them were very worried about the confrontation with corpses. Furthermore, personality tests were shown to be only partly reliable for selecting affected people in advance. With regard to these results capabilities to provide support to the first year medical students should be discussed.

Spatially specific and non-lateralised attention deficits in patients with perceptual and premotor neglect.

BACKGROUND: The relationship of spatially specific and non-lateralised attentional deficits to perceptual and premotor neglect was explored in 25 patients with chronic neglect. The association between severity of neglect and attention deficits was also studied. METHODS: Alertness, selective attention and exploration performance were assessed using a battery of computerised and paper-pencil tests. RESULTS: Perceptual and premotor neglect groups differed in the manifestation of attention deficits in the contralesional and ipsilesional hemispace. Differences in the performance time and accuracy were observed to be a function of neglect severity. CONCLUSION: Paper-pencil tests were more sensitive to assess attention deficits in patients with different neglect types and severities of neglect than computerised tests. Therefore, diagnostic evaluation should include both paper-pencil and computerised assessments in order to identify spatially specific as well as non-lateralised attentional deficits.