Heightened but Inefficient Thought-Action Fusion in Obsessive-Compulsive Disorder: New Insight From a Multiple Trial Version of the Classic Thought-Action Fusion Experiment

Objective@#Thought-action fusion (TAF), which is a tendency to make the relationship between one’s thoughts and external consequences, is a dysfunctional belief linked to obsessive-compulsive disorder (OCD). While the TAF is commonly evaluated using the Thought-Action Fusion Scale (TAFS), it cannot fully reflect the actual experience of experimentally evoked TAF. In the present study, we applied a multiple-trial version of the classic TAF experiment and evaluate two variables, reaction time (RT) and emotional intensity (EI). @*Methods@#Ninety-three patients with OCD and 45 healthy controls (HCs) were recruited. The participants were asked to read the name of a close or neutral person embedded in different positive (PS) or negative (NS) TAF statements. During the experiments, RT and EI were gathered. @*Results@#The OCD patients presented with longer RT and lower EI in the NS condition than HCs. In each group, the HCs showed a significant relationship between RT in the NS condition and TAFS scores, whereas the patients did not, although they had higher TAFS scores than the HCs. In contrast, the patients showed a trend toward a correlation between RT in the NS condition and guilt. @*Conclusion@#These findings may indicate our multiple-trial version of the classical TAF showed reliable results of the two new variables, especially RT, in the task and allow to newly identify paradoxical patterns in which the TAFS scores are high but actual performance is impaired, that is, the inefficient activation of TAF in OCD.

Alterations in Functions of Cognitive Emotion Regulation and Related Brain Regions in Maltreatment Victims

Objectives@#Maltreatment experiences can alter brain function related to emotion regulation, such as cognitive reappraisal. While dysregulation of emotion is an important risk factor to mental health problems in maltreated people, studies reported alterations in brain networks related to cognitive reappraisal are still lacking. @*Methods@#Twenty-seven healthy subjects were recruited in this study. The maltreatment experiences and positive reappraisal abilities were measured using the Childhood Trauma Questionnaire-Short Form and the Cognitive Emotion Regulation Questionnaire, respectively. Twelve subjects reported one or more moderate maltreatment experiences. Subjects were re-exposed to pictures after the cognitive reappraisal task using the International Affective Picture System during fMRI scan. @*Results@#The maltreatment group reported more negative feelings on negative pictures which tried cognitive reappraisal than the no-maltreatment group (p 20). @*Conclusions@#We found that paradoxical activities in semantic networks were shown in the victims of maltreatment. Further study might be needed to clarify these aberrant functions in semantic networks related to maltreatment experiences.

Reconciliation of Two Cognitive Models in Obsessive-Compulsive Disorder: An fMRI Study

Objective@#Although cognitive models of obsessive-compulsive disorder (OCD) fall into two categories: cognitive deficit models and dysfunctional belief models, these approaches have their own ways and have hardly been reconciled. Therefore, this study aimed to investigate the potential relationships between cognitive deficit (using the Wisconsin Card Sorting Task, WCST) and dysfunctional belief (measured by scales of dysfunctional beliefs) mediated by neural activity in OCD patients. @*Methods@#Thirty OCD patients and 30 healthy participants performed the WCST condition and a baseline MATCH condition during the 3T-functional magnetic resonance imaging (fMRI) acquisition. @*Results@#Engagement of additional frontoparietal networks with poorer performance of WCST was found during the fMRI scan in OCD patients. Selected regions of interest from activated regions have positive relationships with dysfunctional beliefs and with the unacceptable thoughts symptom dimension in the OCD group. @*Conclusion@#Findings suggest that alteration in frontoparietal networks related to cognitive deficits can be associated with dysfunctional beliefs while performing conventional neurocognitive tasks and this association with dysfunctional beliefs may be pronounced in the unacceptable thoughts domain-dominant OCD patients.

Reconciliation of Two Cognitive Models in Obsessive-Compulsive Disorder: An fMRI Study

Objective@#Although cognitive models of obsessive-compulsive disorder (OCD) fall into two categories: cognitive deficit models and dysfunctional belief models, these approaches have their own ways and have hardly been reconciled. Therefore, this study aimed to investigate the potential relationships between cognitive deficit (using the Wisconsin Card Sorting Task, WCST) and dysfunctional belief (measured by scales of dysfunctional beliefs) mediated by neural activity in OCD patients. @*Methods@#Thirty OCD patients and 30 healthy participants performed the WCST condition and a baseline MATCH condition during the 3T-functional magnetic resonance imaging (fMRI) acquisition. @*Results@#Engagement of additional frontoparietal networks with poorer performance of WCST was found during the fMRI scan in OCD patients. Selected regions of interest from activated regions have positive relationships with dysfunctional beliefs and with the unacceptable thoughts symptom dimension in the OCD group. @*Conclusion@#Findings suggest that alteration in frontoparietal networks related to cognitive deficits can be associated with dysfunctional beliefs while performing conventional neurocognitive tasks and this association with dysfunctional beliefs may be pronounced in the unacceptable thoughts domain-dominant OCD patients.

A 45degrees set Square Method for Accurate Needle Insertion in Ultrasound-guided Internal Jugular Venous Catheterization

PURPOSE: Until now, there has been no standardized method for insertion of the introducer needle in ultrasound-guided internal jugular venous catheterization (IJVC). The needle insertion site and angle have been determined by the performer's experiences. In an effort to improve first attempt success rates and reduce complications, we designed a new standardized approach (called the 45degrees set square method) for determination of the site and angle of needle insertion during ultrasound-guided IJVC. This study investigated that the clinical usefulness of the novel 45degrees set square method for ultrasound-guided IJVC in the emergency department. METHODS: We conducted a prospective study in the emergency department (ED) of a tertiary teaching hospital. Forty one patients requiring central venous catheterization were enrolled in the study. They were randomized to either the conventional ultrasound guidance group or the 45degrees set square group. The primary outcome measure was success rate within three attempts and secondary measures were the number of trials, first-attempt success, puncture time, complications, and technical difficulty score. RESULTS: All 41 participants completed this study successfully. Twenty one consecutive patients were enrolled in the 45degrees set square group and 20 were enrolled in the conventional group. The 45degrees set square group (100%) was superior to the conventional group (60%) in overall success rate within three attempts (p=0.001) and the number of attempts (p<0.001). Significant differences in puncture time (p=0.004), hematoma (p=0.048), and technical difficulty score (p<0.001) were observed between the groups. CONCLUSION: The 45degrees set square method is an effective and safe method for ultrasound-guided internal jugular venous catheterization.

Clinical Features of Fitz-Hugh-Curtis Syndrome in the Emergency Department

PURPOSE: Fitz-Hugh-Curtis Syndrome (FHCS) is a clinical entity characterized by inflammation of the liver capsule associated with genital tract infection. The aim of this study is to provide physicians with clinical suggestions for diagnostic approaches based on a series of patients who were diagnosed with FHCS. MATERIALS AND METHODS: We conducted a retrospective study of patients who were diagnosed with FHCS after presenting to the emergency department (ED). The symptoms, physical examinations, laboratory findings, radiological findings, and progress of the patients were reviewed. RESULTS: During the four-year study period, a total of 82 female patients received a final diagnosis of FHCS in the ED. Chlamydia trachomatis was identified as a pathogen in 89% of the patients. Their clinical characteristics and laboratory findings were described. Fifty-two patients (63.4%) were admitted to the hospital. All of the admitted patients improved after treatment combining antibiotic therapy with conservative care. CONCLUSION: FHCS should be considered as a differential diagnosis for female patients of childbearing age with right upper abdominal pain. Timely diagnosis using biphasic computed tomography (CT) with arterial and portal phases may help ensure adequate medical treatment as well as avoid invasive procedures.