Maternal affective disorders, illness, and stress: risk for children's psychopathology.

Stressful circumstances that covary with maternal affective disorder may account for some of the risk to children for psychological dysfunction. Children (ages 8-16) of mothers with unipolar or bipolar disorders were compared with children of mothers who had chronic medical illness and children of normal mothers. Comparisons included Kiddie-SADS (Schedule for Affective Disorders and Schizophrenia) diagnoses and evaluations of behavior problems, school functioning, and social competence. Compared to the other groups, children of mothers with affective disorder (especially unipolar) had high rates of diagnosis. With the effects of chronic stress statistically controlled, psychosocial outcome variables showed fewer differences between groups but indicated particular impairment for children of unipolar mothers.

Observations of interactions of depressed women with their children.

Dysfunctional interactions between mothers with major affective disorders and their children may contribute to the children's high risk of disorder. This study investigated the behavior of mothers with recurrent unipolar depression, bipolar disorder, or chronic medical illness and of normal subjects toward their children during a directly observed conflict discussion task. In addition, lifetime history of depression, current mood, and chronic stress were investigated as predictors of maternal interaction. Unipolar depressed women displayed relatively more negative, less positive, and less task-focused behaviour toward their children. Current mood and chronic stress, more than psychiatric history, contributed to the prediction of interaction style.

Mechanisms of hypnotic and nonhypnotic forgetting.

Subjects participated in two experimental sessions designed to study laboratory-induced amnesia, one using a standard hypnosis paradigm and one using a non-hypnotic directed-forgetting paradigm. Two independent sources of variation were derived from the hypnotic amnesia data: retrieval inhibition and inhibition release. In the nonhypnotic directed-forgetting procedure, some items were cued to be forgotten shortly after presentation and some were cued to be remembered. At test, the subjects were asked to recall both the to-be-remembered and the to-be-forgotten items. Over 39% of the variance in the recall of the to-be-forgotten items could be accounted for by the inhibition and release constructs obtained with hypnosis. These relations between the two procedures were not mediated by verbal ability or cognitive style (field independence). We concluded that the mechanisms of forgetting involved in laboratory demonstrations of hypnotic and nonhypnotic amnesia are related, and the implication is that some of them are the same, namely, retrieval inhibition and inhibition release. We also argued that the possible demand characteristics that accompany the hypnosis procedure are not apparent with the nonhypnotic procedure. Therefore, the relationships observed in the present results were taken as evidence that hypnotically induced amnesia is not entirely the result of subjects' reactions to demand characteristics.

Cognitive vulnerability in children at risk for depression.

Cognitive, developmental, and psychodynamic theories all hypothesize that negative self-concepts acquired in childhood may induce vulnerability to depression. Children at risk because of maternal major affective disorder, compared with children of medically ill and normal mothers, were examined for evidence of negative cognitions about themselves, and were found to have more negative self-concept, less positive self-schemas, and more negative attributional style. It was further predicted that negative cognitions about the self would be related to maternal depression and chronic stress, and to the quality of perceived and actual interactions with the mother. In general, the predicted associations were obtained, supporting speculations about how maternal affective disorder is associated with stress and with relatively negative and unsupportive relationships with children that in turn diminish children's self-regard.

Impulse magnetic-field therapy for migraine and other headaches: a double-blind, placebo-controlled study.

This double-blind, placebo-controlled study assessed the efficacy of 4 weeks of impulse magnetic-field therapy (16 Hz, 5 microTs), delivered through a small device, for different types of headache and migraine. Eighty-two patients were randomly assigned to receive either active treatment or placebo (n = 41 each) and were characterized according to one of seven diagnoses (migraine, migraine combined with tension, tension, cluster, weather-related, posttraumatic, or other). Efficacy was assessed in terms of duration, severity, and frequency of migraine and headache attacks, as well as ability to concentrate. Data for 77 patients were analyzed. In the active-treatment group, all assessed criteria were significantly improved at the end of the study (P < .0001 vs baseline and placebo). Seventy-six percent of active-treatment patients experienced clear or very clear relief of their complaints. Only 1 placebo-patient (2.5%) felt some relief; 8% noted slight and 2% reported significant worsening of symptoms. No side effects were noted.

Impulse magnetic-field therapy for insomnia: a double-blind, placebo-controlled study.

This 4-week double-blind, placebo-controlled study assessed the efficacy of impulse magnetic-field therapy for insomnia. One hundred one patients were randomly assigned to either active treatment (n = 50) or placebo (n = 51) and allocated to one of three diagnostic groups: (1) sleep latency; (2) interrupted sleep; or (3) nightmares. Efficacy endpoints were intensity of sleep latency, frequency of interruptions, sleepiness after rising, daytime sleepiness, difficulty with concentration, and daytime headaches. In the active-treatment group, the values of all criteria were significantly lower at study end (P < .00001). The placebo group also showed significant symptomatic improvement (P < .05), but the differences between groups were highly significant (P < .00001). Seventy percent (n = 34) of the patients given active treatment experienced substantial or even complete relief of their complaints; 24% (n = 12) reported clear improvement; 6% (n = 3) noted a slight improvement. Only one placebo patient (2%) had very clear relief; 49% (n = 23) reported slight or clear improvement; and 49% (n = 23) saw no change in their symptoms. No adverse effects of treatment were reported.

The effects of current mood and prior depressive history on self-schematic processing in children.

Previous research has indicated that children display facilitated recall of personal adjectives judged to be self-descriptive; and most critically, positive and negative adjectives are differentially recalled by relatively depressed and nondepressed children. Such evidence of apparent self-schemas was explored in additional samples of children with current or past histories of diagnosable depression. As predicted, clinically depressed children showed even stronger recall of negative self-descriptive adjectives than in previous research. However, extent of previous experience with depression did not predict degree of negativity of current self-schema beyond that predicted by current mood. The results are discussed in terms of recent findings with depressed adults and are seen as compatible with a developmental model of self-schemas in which prior experience may affect accessibility of negative cognitions once the self-schema has been activated.

Fundus-controlled examination of reading in eyes with macular pathology.

The ability to read is an important parameter for the optical rehabilitation of visually handicapped patients. For the choice of the best therapy, more detailed knowledge of the physiology of reading is required. We evaluated reading velocity as well as the number of saccades in and against the direction of reading for reading plates with different character sizes (10 steps from a letter height of 3-0.25 degrees) using the scanning laser ophthalmoscope in 20 healthy eyes and 30 eyes with central and paracentral scotomas. The number of characters read during each fixation increased with decreasing size of characters from 3.2 to 4.4 in normals. However, the reading velocity decreased from 14 to 11 digits/s when digits became very small. In patients' eyes the greatest reading velocity was reached at 6.1 digits/s for a 1 degree size, and the maximal number of digits read during one rest phase was 3.2 for a 0.75 degree size. In patients we observed a high number of saccades against the reading direction and different loci of fixation. Fundus-controlled examination allows for new insights into the physiology and pathophysiology of reading. Loss of the central visual field leads to an increase in the number of saccades because the number of digits perceived during each fixation decreases. The high number of regressions may be caused by the typical shift of the center of fixation following paracentral scotoma. Saccades directed toward the scotoma have to be corrected due to failure of exact positioning.