The biology of family psychotherapy.

This article has presented a view of biologic psychiatry consistent with that described by Bowlby, discussed hypotheses concerning the biologic purpose of the primate brain and the human brain, and challenged standard beliefs about the identity of the patient entity in a true biologically based psychiatry. Ideas developed by Whitaker, Malone, and their colleagues almost 50 years ago are consistent with a modern biologic basis of family psychotherapy. The treatment of an anorexic family was used to illustrate possible mechanisms of psychotherapeutic treatment requiring the presence of the whole family. The role of the psychiatrist who treats a family is to understand the biologic or medical importance of treating the family as a whole, communicate this to the family, continually work toward that level of participation, suggest relevant topics for discussion, and catalyze interactions within the family. Psychotherapy with families as a whole is effective because of the power of kin selection and inclusive fitness, biologic processes not usually considered in the practice of medicine or psychiatry.

Computer simulation of clonal growth cancer models. I. Parameter estimation using an iterative absolute bisection algorithm.

Quantitative models of the relationship between exposure to chemical carcinogens and carcinogenic response are useful for hypothesis evaluation and risk assessment. The degree to which such models accurately depict the underlying biology is often a function of the need for mathematical tractability. When closed-form expressions are used, the need for tractability may significantly limit their complexity. This problem can be minimized by using numerical computer simulation methods to solve the model, thereby allowing more complex and realistic descriptions of the biology to be used. Unfortunately, formal methods of parameter estimation for numerical models are not as well developed as they are for analytical models. In this report, we develop a formal parameter estimation routine and apply it to a numerical clonal growth simulation (CGS) model of the growth of preneoplastic lesions consisting of initiated cells. An iterative bisection algorithm was used to estimate parameters from time-course data on the number of initiated cells and the number of clones of these cells. The algorithm successfully estimated parameter values to give a best fit to the observed dataset and was robust vis-à-vis starting values of the parameters. Furthermore, the number of data points to which the model was fit, the number of stochastic repetitions and other variables were examined with respect to their effects on the parameter estimates. This algorithm facilitates the application of CGS models for hypothesis evaluation and risk assessment by ensuring uniformity and reproducibility of parameter estimates.

Hyperammonemia secondary to valproic acid as a cause of lethargy in a postictal patient.

Hyperammonemia has been described as a complication of valproic acid therapy but may often be overlooked as a cause of lethargy in the postictal patient who presents to the emergency department. We present the case of a postictal patient with lethargy, hyperammonemia, otherwise normal liver function tests, and a therapeutic valproic acid level. Based on our experience and on previously published data, serum ammonia levels appear to be indicated in all ED patients on valproic acid therapy who present with altered mental status. To the best of our knowledge, this has not been reported previously in the emergency medicine literature.

Pattern generator system as a versatile visual stimulator.

We have designed and implemented a Motorola 68000 microprocessor-based pattern generator system (PGS) that uses a color video display terminal (VDT) to provide light stimuli to the intact vertebrate retina. This communication is intended for those who are considering acquisition of a commercial retinal stimulator or those who are custom designing their own pattern generator system. The discussion surveys the features to be included as well as design factors which must be considered in such a device. The memory organization of the PGS allows as stimuli multiple, complex patterns consisting of one or more disks, annuli, bars or gratings to flash or modulate in intensity according to a pre-defined function. In addition, patterns can move smoothly in any direction at selectable, uniform speeds without the re-drawing of video memory. The presence of a 12-bit A/D converter internal to the PGS allows a dynamic change in stimulus position, speed or pattern based upon physiological feedback. A physically realistic image size (0.9 cm2) and resolution (20 mu/pixel) in the retinal plane are achieved with simple intervening optics. The video field rate of 60 Hz is above the flicker fusion frequency for most vertebrate animals and does not induce artifacts in cellular responses. The PGS operating in a PC-based environment meets the requirements of a versatile optical stimulator for investigations in retinal electrophysiology.

A measure of paradigm beliefs about the social world.

This study examined the reliability and construct validity of, along with age differences in, a measure of paradigm beliefs about the social world, beliefs that have been proposed to develop across the adolescent and adult life span. The scale is a 27-item, forced-choice preference measure of absolute, relativistic, and dialectical paradigm beliefs. In a series of investigations with 445 subjects, ranging in age from 16 to 83 years, it was shown to have good internal consistency and test-retest reliability, and both convergent and discriminant validities. It predicted performance on an in-depth interview about paradigm beliefs and was related to two other measures of paradigm beliefs. It was not related to selected personality variables (i.e., social dogmatism, intolerance of ambiguity and social desirability); nor was it related to a measure of verbal intelligence. The scale also showed predicted developmental trends, supporting its utility for developmental research.

Effects of pericardial effusates of various conductivities on body-surface potentials in dogs. Documentation of the eccentric spheres model.

The purpose of this study was to discover the cause and magnitude of changes in the body-surface potentials occurring when: (1) fluids of various conductivity were added to the pericardial sac, or (2) the volume of the blood within chambers of the heart was either increased or decreased. Fluids added to the pericardium were physiological saline, whole-blood, and mineral oil. Magnitudes of body-surface potentials were compared to the predictions based on a mathematical eccentric spheres model of the heart and torso developed previously by Rudy and Plonsey. Data demonstrated conclusively that there is a nonlinear relationship between the body-surface potentials and the conductivity of the pericardial layer. This relationship is one in which the body-surface potentials of the anterior chest were found to decrease when conductivity of the pericardial layer was either increased or decreased. These changes in body-surface potentials were caused solely by alterations in the conductivity and volume of the fluid effusate. It was demonstrated that these changes were not caused by any "stretching" or "compression" of the cardiac tissue caused by the altered fluid volumes in and around the heart. Findings were accurately predicted by the eccentric spheres model, thereby confirming the model's usefulness as a predictive instrument. The model provides an explanation for the nonlinear relationship that was exhibited by the data.

Do sex-role appropriate materials influence the Piagetian task performance of older adults?

The intent of this study was to assess the influence of sex-role appropriate materials on the utilization of logical competence among older persons, and to determine how such materials interact with subject's sex-role identity to affect cognitive performance. Thirty male and 30 female Ss (mean age = 71.3 years) were administered the Short Form of the Bem Sex-Role Inventory and either a male-oriented, a female-oriented, or a traditional version of two concrete operational and two formal operational Piagetian tasks. Gender was found to influence performance on one of the concrete tasks, task orientation influenced performance on one of the formal tasks, and sex-role classification interacted with task orientation to influence performance on both of the formal operational tasks. The pattern of results suggested that subjects may perform best on those versions of the formal operational tasks that do not match their own sex type. Possible explanations for these findings are discussed.

EEG alpha slowing, refractory period, and reaction time in aging.

The present study was undertaken to determine if a model accounting for reaction time (RT) on the basis of the EEG alpha rhythm and refractory period (RP) could predict RT in young and old adult subjects. Ten male university undergraduates and ten community residing males over the age of 65 had resting EEG recorded at right and left occipital sites. Mean alpha frequency was 1.2 Hz slower in old subjects. RT and RP were assessed in a warned RT paradigm. Sixty-four trials of each of a 50, 100, 250, and 500 msec inter-stimulus interval (ISI) were presented in random order. The model was useful in predicting the magnitude of the age difference in RT and the difference in RT between the 50 and 100 msec ISI. However, old subjects were not disproportionately slowed at the 100 msec ISI as the model would predict and all RTs were underestimated. Thus, while a model using EEG alpha period and RP to predict age differences in RT has some weaknesses, it is useful enough to warrant additional examination.

The overlapping territories of psychiatry and ethology.

There have been numerous attempts since 1965 to stimulate more utilization of ethological methods and concepts in psychiatry. This literature is reviewed and an attempt is made to identify the factors which have inhibited an enhancement of this interaction to date. Most of the previous articles on this subject have appeared in edited collections, rather than in more widely circulated psychiatric or medical journals. Some of the articles focus on ethological theory, others on ethological research findings, and several on clinical analogies between animal and human situations. Regarding the specific way in which to integrate ethological thought into psychiatry, most frequently a phylogenetic approach is emphasized, however a few authors stress methodological considerations. In this paper, it is argued that artifactual differences have been the primary impediment to more interaction between these two rather similar fields. Scientific language difficulties, educational differences, and personal factors are described in this regard. Also, the real differences in approach and methodology, relative interest in normal vs. abnormal behavior, the degree of willingness to accept a phylogenetic approach, and the breadth of behavior being studied by the two fields are described. Examples of current areas of applicability of ethology to psychiatry are given: the attachment systems, early infantile autism, methodology, social psychiatry, and psychiatric education. Of these, the area where the most utilized is that of the occurred and in which the findings of ethology have been the most utilized is that of the attachment systems. Clinically applicable studies based upon the premise that attachment systems exist as understood ethologically are reviewed. These include study of extra physical contact between mothers and infants at birth, the prediction of child abuse and neglect utilizing observations from the immediate postpartum period, the treatment of failure to thrive by teaching attachment behavior, and developmental differences at 1 year correlated with differences in maternal responsiveness at 3 months. The usefulness of a biological approach to behavior is discussed, particularly in terms of utilizing operational criteria and from the point of view of differentiating etiological, phenomenological, and treatment models. A curriculum stressing the writings of Tinbergen, Lorenz, Bowlby, and Hailman is presented for possible use in psychiatric training programs interested in teaching an ethological approach to psychiatry. A briefer curriculum is also suggested from the psychiatric literature for use by ethologists. The epistemology and methodology of ethology possible will be of more use to psychiatry than the content. It is the opinion of the authors that the difficulties which have inhibited significant cooperation between psychiatry and ethology in the past are mostly artifactual, that such cooperation could be useful to both fields, and that a beginning to such interaction will require mutual familiarity with the literature.