Moving from tube to oral feeding in medically fragile nonverbal toddlers.

The current article describes a 14-week outpatient protocol for transitioning from gastrostomy tube to oral feeding in toddlers with medical complications. The team ensured that eating skills were mastered before treating patients for 8 weeks with continuous gastrojejunal drip tube feedings and low-dose tricyclic antidepressant and/or gabapentin. We prescribed 6 weeks of megestrol for hunger provocation while withdrawing tube feedings. A chart review after treatment demonstrated 9 subjects were eating exclusively orally and 1 was eating 50% orally.

Understanding cognitive failures: what's dissociation got to do with it?

Intuitively, cognitive failures and dissociation seem to encompass overlapping mental phenomena. This study used a large sample to examine the nature of the relationship between these constructs. Exploratory factor analysis (EFA) and confirmatory factor analyses were performed on the Cognitive Failures Questionnaire (CFQ). The single factor resulting from the EFA of the CFQ correlated significantly with all factors from the Dissociative Experiences Scale (DES). A conjoint item-level factor analysis using all items from both measures was performed, and two factors resulted. The first included all items from the CFQ and appeared to describe an absorption-like phenomenon. The second factor's highest positively loading items assessed more pathological forms of dissociation. Based on our results, we conclude that the CFQ and DES are assessing similar cognitive processes and that cognitive failures, as measured by the CFQ, overlap with nonpathological dissociation.

Longitudinal study of the symptom checklist 90-revised in multiple sclerosis patients.

The current study examined the 3-year longitudinal course of psychopathology reported by 53 definite MS patients, then assessed for clinical elevations. Across SCL-90-R scales, only 9-21% of patients' scores changed. Intercorrelations among Time 1 and Time 2 were significant (p < .01). Clinical elevations on the scales ranged from 26% (anxiety) to 52% (somatization). Consistent with studies of depression, results demonstrated that other types of psychopathology are very stable over time. Because a relatively high percentage of patients displayed clinical elevations across the scales over time, this study suggests that the stability of psychopathology in MS patients is of clinical concern.

The relationship between executive functioning and dissociation.

Although dissociation by definition affects cognition, few studies have used neuropsychological measures to examine dissociative phenomena. This study compared 33 high and 32 low dissociators based on the Dissociative Experiences Scale, on self-report and neuropsychological measures of executive function, including the Dysexecutive Questionnaire, Iowa Gambling Task, Operation Span task, and Wisconsin Card Sorting Test-64. High dissociators endorsed significantly more executive difficulties than did low dissociators, but these difficulties were not related to their performance on neuropsychological measures. Results suggest that dissociative individuals' perceptions of executive impairments may be divorced from objective deficits, revealing an important process underlying the clinical manifestations of dissociation.