Why must we attribute our own action to ourselves? Auditory hallucination like-experiences as the results both from the explicit self-other attribution and implicit regulation in speech.

The sense of agency, which is the awareness that "I am the one who causes action," is important in understanding passive schizophrenic symptoms and bodily self-consciousness. However, this potential linkage between subjective self-other attribution (explicit agency) and automatic self-monitoring of an action (implicit agency) has not been examined fully. The present study included two experiments conducted with the same group of healthy participants (N=48) in order to examine explicit (Exp. 1) and implicit (Exp. 2) measures of the sense of agency in speech. Exp. 1 suggested that participants who tend not to attribute a fed-back voice to themselves (the other-attribution group) might have a stronger tendency toward auditory hallucinations, as measured by the Auditory Hallucination Experience Scale 17 (AHES-17). Furthermore, the results of Exp. 2 suggested that this other-attribution group might not utilize auditory feedback during speech production, indicating the expected link between explicit and implicit agency. These results are discussed in relation to the sense-of-agency model, wherein people are understood to construct the online "self" monitoring of action.

[Neuropsychological syndromes of non-psychotic mental disorders of youthful age].

Seventy male patients with non-psychotic mental disorders of youthful age (mean age 19.2±3.7), were studied using A.R. Luria neuropsychological syndrome analysis. Patients were stratified into 3 groups by diagnosis: cyclothymia (20 patients), pubertal decompensation of schizoid personality disorder (30 patients) and schizotypal personality disorder (20 patients). It has been shown that the neuropsychological changes indicate the dysfunction of the amygdale/temporal region in patients of the first group and frontal/thalamic/parietal connections in the patients of two other groups. There were interhemispheric differences between patients with personality disorder and schizotypal personality disorder: left hemisphere dysfunction was characteristic of schizotypal disorder and right hemisphere deficit (neurocognitive deficit) was found in patients with personality disorder.

Trastornos de la personalidad en adultos jóvenes dependientes del cannabis en tratamiento: un estudio comparativo / Personality disorders in young adult cannabis-dependent treatment seekers: a comparative study

En este artículo se determina la tasa de comorbilidad de trastornos de la personalidad en adultos jóvenes dependientes del cannabis en tratamiento. La muestra consta de 141 pacientes diagnosticados de dependencia del cannabis en el grupo experimental, de 140 pacientes no-adictos en el grupo clínico de control y de 140 sujetos, con las mismas características demográficas (edad, sexo y nivel socioeconómico), en el grupo normativo de control. Los instrumentos de evaluación para los trastornos de la personalidad son el MCMI-II y el IPDE y la entrevista con los criterios diagnósticos del DSM-IV-TR. Sólo se considera trastorno de personalidad cuando un sujeto puntúa positivo en ambas pruebas y el trastorno es coincidente. Los resultados muestran que el 32,8% de los pacientes del grupo experimental presentan trastornos de la personalidad, frente al 23,7% del grupo clínico de control y el 10% del grupo normativo de control. Los trastornos de mayor prevalencia para el grupo experimental son el trastorno narcisista (11,3%), seguido del antisocial (9,9%) y el esquizotípico (9,9%). Se comentan las líneas futuras de investigación para este tema (AU)

n this paper the most frequent personality disorders related to young adult cannabis-dependent treatment seekers are described. A sample of 141 cannabis-dependent patients was compared to 140 clinical patients with non-addictive disorders and to 140 normative subjects from the general population with the same demographic features (age, sex and socioeconomic level) to find out the prevalence of personality disorders. All subjects were assessed with the IPDE and the MCMI-II (for personality disorders) and with an interview for DSM-IV-R. According to the results, 32.8% of the clinical sample of cannabis-dependent patients and 23.7% of the general clinical sample (versus 10% of the normative sample) showed at least one personality disorder. The most prevalent ones were the narcissistic personality disorder (11.3%), followed by the antisocial and schizotypal personality disorder (9.9% each). Finally, implications of this study for clinical practice and future research in this field are discussed

Social-cognitive functioning and schizotypal characteristics.

The authors examined the relationship between social cognition and a feature of schizotypal personality referred to as magical ideation, defined broadly as the presence and intensity of illogical beliefs about causality and the nature of reality. The measures of social cognition used in this study were the Character Intention Task (CIT) and the adult version of the Reading the Mind in the Eyes Test. Regression analyses indicated that understanding of character intentions, as measured by CIT scores, and ability to identify emotions on the Eyes test were related to non-realistic beliefs. Principal components analysis of the Magical Ideation Scale generated 3 factors: Occult Beliefs, Non-Realism, and New Age Ideas. Results indicated that impaired understanding of character intentions and ability to identify emotions on the Eyes test were related to non-realistic beliefs. Understanding the cognitive impairments associated with schizotypal characteristics can facilitate development of more targeted therapeutic interventions.

Leech therapy in penile replantation: a case of recurrent penile self-amputation.

Penile amputation is a rare urologic trauma for which immediate surgical replantation is indicated. Microsurgical techniques can reduce skin and graft loss complications; nonetheless, such complications are still highly prevalent. We report a case of self-inflicted penile amputation and describe a nonmicrosurgical technique for replantation. To improve postoperative edema due to venous congestion, we applied medicinal leeches to the penis. The edema quickly resolved, but overlying skin loss occurred, which required superficial debridement. At follow-up the patient had glans re-epithelialization with normal voiding, sensation, and erections. To our knowledge, this is the first reported case of nonmicrosurgical penile replantation with leech therapy.

Victim's scalp on the killer's head. An unusual case of criminal postmortem mutilation.

A case of unusual postmortem mutilation of a victim's body is presented. After killing his father, the son decapitated his body and dissected the scalp free, forming a mask of the father's head and neck. The young man wore the scalp-mask over his own head to imitate the father. The motive of the murder was revenge, and the postmortem mutilation was the realization of the perpetrator's fantasies, symbolically representing a penalty for the reprehensible past life of his father.

"Schizoid" personality in childhood: auditory P300 and eye tracking responses at follow-up in adult life.

The auditory P300 response and smooth pursuit eye tracking were recorded from a group of 23 male adult subjects who had been diagnosed in childhood as having schizoid personality. No differences were found in these physiological measures between the study group, their matched controls of other child psychiatric patients, and a group of population controls. The essentially negative findings are discussed in the light of abnormalities of these psychophysiological responses previously found in schizophrenic patients, in some of their biological relatives, and in other groups of psychiatric patients, including autistic children and adults with a diagnosis of borderline and schizotypal personality disorder. Results suggest that "schizoid" children, despite their high scores on a measure of schizotypy, do not have schizophrenia spectrum disorder or that schizotypy is a heterogeneous condition.

[Music therapy single case process research--development and organization of a research field]. / Musiktherapeutische Einzelfall-Prozessforschung--Entwicklung und Aufbau eines Forschungsfeldes.

Music therapy yet to be discovered as a target of psychotherapy research. A first step consists in creating adequate samples of significant musical dialogues. Video-recording is an essential requirement for establishing such data. To test the clinical view that the emotional content of the musical dialogue in music therapy reflects the basic relationship issues of a patient was the objective of this study. By using ratings of significant musical dialogue sequences with the instrument of semantic differential comparing groups with varying clinical expertise (music therapists, psychoanalyts, lay persons) the results demonstrate that there is considerable stability of the judgments; however, systematic differences exists among the three groups of raters.

Hypnosis: emotions for the tin man (the schizoid personality).

Insight psychotherapy had been ineffective in helping a schizoid patient experience affect. He remained cold, aloof, and without overt expression of affect. When hypnosis was utilized, the patient overtly demonstrated affect. Hence the title for the article--hypnosis was effective in changing the tin man into a person with emotions and feelings. A discussion indicates some possible variables associated with this phenomenon.

The borderline diagnosis and integration of self.

To try to encompass what is meant by borderline with parameters that are too delineating can lead to conceptual difficulties and confusion for several reasons: The human psyche is too complex and probably has too much of the quality of a gestalt to be understood adequately by dichotomizing thinking; an individual does not experience himself as operating in discrete units, but as a unified whole; and the most characteristic manifest quality of the borderline picture is its tendency toward a chaotic functioning that somehow always spills over any defining boundaries which are set up to attain conceptual containment. If we then accept our limitations on the precision and order with which we can comprehend it, the understanding of borderline might be supplemented by seeing it in terms of the subjective experience of an integrated self. This offers a more holistic approach that tends not to be so subject to objectifying compartmentalization. It is more in tune with the subjective experiencing a person has of that which defines and moves him in the world. And it offers a referent axis along which the distance one has traveled in the borderline direction might be gleaned. Finally, the relationship of the borderline diagnosis to character disorder might be looked this way: The diagnosis does not refer to a particular character disorder or to a group of disorders. It emerges in all character pathology to the degree that the experiencing of an integrated and whole sense of self, which is at the heart of character structure, is diminished.

Lithium in the treatment of aggression.

Lithium has become a widely accepted treatment for manic-depressive psychosis. It is dramatically effective for many cases of mania and is useful in the prevention of manic and depressive episodes. Hyperaggressiveness and hypersexuality are frequent components of manic-depressive illness and abate under the influence of lithium. A brief review is presented of the behavioral and biochemical pharmacology of lithium. This documents the inhibitory role which lithium can play in several examples of animal aggressive behavior including pain-elicited aggression, mouse killing in rats, isolation-induced aggression in mice, p-chlorophenylalanine-induced aggression in rats, and hypothalamically induced aggression in cats. The use of lithium to control human aggressive behavior has resulted in controversial findings. In epileptic conditions, improvement has been reported in interseizure aggressivity, but other reports indicate the possibility of increased seizures. Improvement in aggressive behavior in childhood has occasionally been reported as well as in emotionally unstable character disorders in young female patients. Te was a single blind study and the other a large but uncontrolled study. Both studies reported an improvement in aggressiveness as indicated by fewer recorded reports (tickets) for fighting. The final study reported is a study of 12 male delinquents age 16 to 23. They received lithium or placebo for 4 months inside an institution and then a trial of lithium for 1 to 12 months on an outpatient basis. Analysis of results in terms of the number of aggressive antisocial acts showed fewer serious aggressive episodes when the lithium level was between 0.6 and 1 meq/liter than when it was between 0.0 and 0.6 meq/liter. These results must be viewed with caution and are only suggestive since the study was not double blind.