A política brasileira sobre drogas e a rede de atenção psicossocial / The brazilian drug policy and the psychosocial attention network

No Brasil, a temática das drogas tem sido abordada por diferentes tendências teóricas, em especial, pelo prisma da saúde pública em oposição ao proibicionismo. Tais tendências perpassam a construção da política nacional dessa área no contexto brasileiro, o qual tem sofrido com o desmonte das políticas sociais e a mercantilização da saúde. O presente artigo versa sobre uma pesquisa, na qual foram realizadas entrevistas com usuários de drogas, familiares, profissionais e gestores, nos diferentes níveis da rede de atenção psicossocial. Tal estudo permitiu discorrer sobre os avanços e entraves da efetivação das políticas na área além de evidenciar a importância da integralidade na oferta e acesso às políticas, bem como a intersetorialidade como pilar para atingir a atenção integral aos usuários de drogas. Reforça, também, a importância da luta popular por uma política fundamentada nos direitos humanos e que compreenda o uso de drogas em sua complexidade.

In Brazil, the theme of drugs has been approached by different theoretical trends, in particular, from the perspective of public health as opposed to prohibitionism. Such trends permeate the construction of national policy in this area in the Brazilian context, which has suffered from the dismantling of social policies and the commodification of health. This article is about a research in which interviews were conducted with drug users, family members, professionals and managers, at different levels of the psychosocial care network. This study allowed to discuss the advances and obstacles to the implementation of policies in the area, in addition to highlighting the importance of integrality in the offer and access to policies, as well as intersectoriality as a pillar to achieve comprehensive care for drug users. It also reinforces the importance of the po-pular struggle for a policy based on human rights and that understands the use of drugs in their complexity.

Assessment of SIBALERA Neck Pillow With Autonomous Sensory Meridian Response (ASMR) to Attention Function Among Medical Students in Indonesia

@#Introduction: The quality parameter of a country’s education is closely related with learning achievement, where attention plays an important role. In support of learning achievement, individuals often enforce their study time till induce stress or physical fatigue over a long term. Neck pillow is often used as a media at rest for body’s relaxation. The Autonomous Sensory Meridian Response (ASMR) can also provide relaxation and can trigger the release of dopamine hormone which functions as a neurotransmitter in the attention process. Based on these problems, we design a research on SIBALERA; a portable neck pillow with ASMR stimulation can improve attention function. Methods: This research used an experimental design of three parallel groups pre and post-test design. The participant (n=48) was randomly divided into three groups. The control group was not given any intervention (n=16), intervention group 1 was given regular neck pillow without ASMR stimulation (n=16), and intervention group 2 was given SIBALERA (n=16). ASMR stimulation was given by hearing twenty minutes before the participants went to sleep at night for two weeks.The attention function were measured used the Attention Network Test (ANT) the day before and after the intervention. Results: The result showed a significant difference scores of attention functions including alerting, orienting, and executive in the intervention group 2 (p<0.001) than the other two groups. Conclusion: In summary, SIBALERA with ASMR stimulation can effectively improve the attention function.

A study on the attention networks dysfunction and its influencing factors in the patients with alcohol use disorder / 中华行为医学与脑科学杂志

Objective To explore the impairment of attention network function in male patients with alcohol use disorder(AUD) and the main influencing factors of attention network function. Methods Forty-one patients with AUD after withdrawal therapy and 34 healthy controls (HC) matched with their demograph-ic data were selected as subjects of study. Attention function were assessed by attention network test (ANT). Results Compared with the healthy control group((30. 62±19. 74)ms,(98. 59±1. 46)%),there were sig-nificant differences in the reaction time of alerting network(t=-2. 479,P=0. 015) and the correct rate of the attention network test(t=-2. 074,P=0. 044) in the AUD group((17. 02±26. 42)ms,( 95. 07±10. 73)%). Pearson correlation analysis showed the alert network of AUD was negatively correlated with the age of first drinking(r=-0. 316,P=0. 044) and was positively correlated with the score of Penn alcohol craving scale (PACS) (r=0. 364,P=0. 019). The correct rate of attention network function in patients with AUD was negatively correlated with the years for education ( r=-0. 343, P=0. 028) and years for addiction ( r=-0. 337,P=0. 031). Linear regression analysis showed the attention network function of AUD patients was affected by the age of first drinking(β=0. 432,t=2. 079,P=0. 046),the years for addiction(β=-0. 555,t=-3. 127,P=0. 004) and years for uncontrol drinking(β=0. 309,t=2. 074,P=0. 047). Conclusion The AUD patients were demonstrated deficit in the alerting network. The impairment of attention function of AUD patients were influenced by their drinking condition.

Andando na contramão: o destino dos indivíduos com transtorno mental que cometem crimes no Brasil / Going Backwards: The fate of the individual with mental disorder that commit crimes in Brazil

Resumo A reforma psiquiátrica no Brasil possibilitou, entre outros benefícios, a substituição do modelo médico psiquiátrico pelo modelo de atenção psicossocial. A internação psiquiátrica passou a ser contraindicada, exceto nos casos em que os recursos extra-hospitalares forem insuficientes ou quando indicada judicialmente. Nesses casos, a assistência aos portadores de sofrimento mental autores de delito é realizada nos Estabelecimentos de Custódia e Tratamento Psiquiátrico (ECTP), onde esses indivíduos são internados para o cumprimento da medida de segurança imposta. Entre os anos de 2015 e 2016, o Mecanismo Nacional de Combate e Prevenção à Tortura (MNCPT) realizou a inspeção de unidades de privação de liberdade, divulgando relatórios através dos quais descreve sua atual realidade. Até o momento, foram visitados cinco estabelecimentos de custódia, nos estados do Pará, Paraíba, Rio Grande do Sul, Rondônia e São Paulo. Este artigo discute o direito à saúde no contexto dos ECTPs. Circulando entre os domínios do direito e da medicina, essa população tem seus direitos humanos violados e, apesar de distantes geograficamente, a opinião é unânime: os avanços na assistência em saúde mental não contemplaram os ECTPs, que ainda preservam características asilares.

Abstract Psychiatric reform in Brazil made it possible, among other benefits, to replace the psychiatric medical model with the psychosocial care model. Psychiatric hospitalization is now contraindicated, except in cases in which extra-hospital resources are inadequate or when judicially indicated. In such cases, assistance to mentally ill people who are perpetrators of crime is carried out in the Custody and Psychiatric Treatment Facilities (ECTP), where these individuals are hospitalized for compliance with the security measure imposed. Between 2015 and 2016, the National Mechanism for Combating and Preventing Torture (Mecanismo Nacional de Combate e Prevenção à Tortura - MNCPT, in Portuguese) carried out the inspection of detention units, releasing reports describing its current situation. To date, five custody establishments have been visited in the states of Pará, Paraíba, Rio Grande do Sul, Rondônia and São Paulo. This article discusses the right to health in the context of ECTPs. Circulating between the domains of law and medicine, this population has their human rights violated and, although geographically distant, it is unanimous that advances in mental health care have not addressed ECTPs, which still preserve asylum characteristics.

Attention and Working Memory Task-Load Dependent Activation Increase with Deactivation Decrease after Caffeine Ingestion

PURPOSE: Caffeine is the most widely consumed psychostimulant. It is often adopted as a tool to modulate brain activations in fMRI studies. However, its pharmaceutical effect on task-induced deactivation has not been fully examined in fMRI. Therefore, the purpose of this study was to examine the effect of caffeine on both activation and deactivation under sustained attention. MATERIALS AND METHODS: Task fMRI was acquired from 26 caffeine naive healthy volunteers before and after taking caffeine pill (200 mg). RESULTS: Statistical analysis showed an increase in cognition-load dependent task activation but a decrease in load dependent de-activation after caffeine ingestion. Increase of attention and memory task activation and its load-dependence suggest a beneficial effect of caffeine on the brain even though it has no overt behavior improvement. The reduction of deactivation by caffeine and its load-dependence indicate reduced facilitation from task-negative networks. CONCLUSION: Caffeine affects brain activity in a load-dependent manner accompanied by a disassociation between task-positive network and task-negative network.

Selective Enhancement of Open-skill Exercise on Attention Network of College Students / 中国运动医学杂志

Objectives To investigate the relationship between different exercise types and the attention network.Methods A total of 75 university students were enrolled and randomly divided into an open-skill exercise group,a closed-skill exercise group and an irregular exercise control group,each of 25.They underwent the exercise as their group names implied.Then the attention network test was performed to evaluate their functions of the alerting network,orienting network and executive control network.Results Significant differences were found in the function of the executive control network among the 3 groups,while no significant difference was found among the 3 groups in the functions of the alerting network and orienting network.Conclusions Both open-and closed-skill exercise are associated with better function of executive control network.Furthermore,open-skill exercise showes more benefits than closed-skill exercise in promoting the function of the executive control network.Neither opennor closed-skill exercise bring benefits to the function of the alerting or orienting network.

Test–Retest Reliability of Attention Network Test Scores in Schizophrenia / 정신신체의학

OBJECTIVES: Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. METHODS: Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test–retest reliability was analyzed with Pearson and Intra-class correlations. RESULTS: Patients with schizophrenia showed high test–retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test–retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. CONCLUSIONS: The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test–retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.

A produção do cuidado clínico e/ou cirúrgico a sujeitos com transtorno mental grave

A presente pesquisa tem como objetivo analisar a produção de sentidos de sujeitos comtranstorno mental grave sobre os cuidados clínicos e/ou cirúrgicos recebidos por conta de seusprocessos de adoecimento. Para tanto, o estudo orientou-se pela abordagem clínica psicossociológica,tendo como ferramentas de pesquisa entrevistas em profundidade e observação participante,com uso do diário de campo. O campo selecionado foi um CAPS II do município doRio de Janeiro. Os resultados da investigação foram organizados em quatro eixos: produçõesde sentidos sobre o próprio adoecimento; sobre as produções de cuidado; sobre as relações comos profissionais do cuidado; e sobre os resultados das intervenções. As experiências singularesdos sujeitos da pesquisa apontam para conclusões de outras pesquisas sobre cuidado em saúde,que destacam que os usuários consideram que os cuidados são mais efetivos e satisfatóriosquando produzidos de forma mais dialógica, considerando as subjetividades de todos os atoresenvolvidos.

The present research aims to analyze the production of senses of subjects with severe men-tal disorder on the clinical and / or surgical care received due to their illness processes. For this, the study was oriented by the clinical psychosociological approach, having as research tools in-depth interviews and participative observation, using the field diary. The selected field was a CAPS II of the municipality of Rio de Janeiro. The results of the investigation were organized in four axes: productions of meanings about the own illness; on care productions; on relation-ships with care professionals; and on the results of the interventions. The unique experiences of the research subjects point to conclusions from other researches on health care, which point out that the users consider that care is more effective and satisfactory when produced in a more dialogical way, considering the subjectivities of all the actors involved.

A gestão dos processos de desinstitucionalização e a implantação da rede de atenção psicossocial em um município da região metropolitana II do Estado do Rio de Janeiro / The management of deinstitutionalization processes and the implementation of the psychosocial care network in a municipality in the metropolitan region II of the State of Rio de Janeiro

Este trabalho se refere a uma pesquisa de mestrado cujo objeto era a gestão dos processos de desinstitucionalização a partir do fechamento de um macro hospital psiquiátrico e sua influência na implantação da Rede de Atenção Psicossocial no munícipio de Rio Bonito na Região Metropolitana II do estado do Rio de Janeiro. Objetivo: analisar os processos de desinstitucionalização a partir do fechamento do Hospital Colônia de Rio Bonito (HCRB). Metodologia: estudo qualitativo. Participaram da pesquisa cinco gestores envolvidos na gestão pública nos âmbitos municipal e estadual. A coleta de dados se deu por meio de pesquisa documental e por narrativas de atores do processo de desinstitucionalização ocorrido no município. Resultados: a pesquisa documental possibilitou o conhecimento de informações sobre os usuários após sua saída do hospital, como o número de altas por ano, a motivação da alta e a distribuição de pacientes por município de origem. As narrativas foram gravadas e transcritas e apresentadas em cenas que representaram o processo de desinstitucionalização, objeto desse estudo. Os resultados foram trabalhados a partir do encontro dessas cenas com o que traz a legislação do Sistema Único de Saúde (SUS) sobre regionalização e rede de atenção psicossocial. Discussão: em conformidade com os achados da investigação, é possível trabalhar na perspectiva da alta em um cenário pouco animador e desacreditado por profissionais, gestores e até mesmo pelos pacientes. Os principais impasses identificados foram: falta de rede nos municípios; muitos profissionais sem experiência e com pouca ou nenhuma formação no campo da Saúde Mental; resistência diante do fato de pacientes graves viverem fora do hospício; lentidão nos processos burocráticos de gestão; falta de documentação dos pacientes; falta de renda; suporte familiar precário; alta rotatividade de profissionais. Conclusão: O processo de desinstitucionalização apresentou grande potencial em relação à construção da RAPS. Os municípios que tinham pacientes na instituição precisaram organizar e montar suas redes. Muitos pacientes foram encaminhados para residências terapêuticas; alguns municípios só implementaram esses dispositivos a partir da desinstitucionalização do Hospital Colônia de Rio Bonito. Alguns pacientes ainda precisaram ser transinstitucionalizados, e outros retomaram para o cuidado de seus familiares. Podemos afirmar que a RAPS se fortaleceu a partir desse processo, mas a luta por sua manutenção e aprimoramento, é diária. Esse estudo traz como produto um vídeo com narrativas sobre o processo de desinstitucionalização, promovendo reflexão sobre ele

Master's research wherein the object is to manage the processes of deinstitutionalization after the closure of a macro psychiatric hospital and its influence on the implementation of the Psychosocial Care Network in the city of Rio Bonito in the Metropolitan II region of the state of Rio de Janeiro. Objective: to analyze the processes of deinstitutionalization after the closure of the Hospital Colônia de Rio Bonito (HCRB). Methodology: qualitative study. The subjects were five managers involved in public management at the municipal and state levels. Data collection was done through documentary research and through narratives, with actors of the deinstitutionalization process which has occurred in said city. Results: documentary research allowed the knowledge of the destination of these users after leaving the hospital, such as the number of discharges per year; the motivation of discharge and the distribution of patients by city of origin. The narratives were recorded and transcribed and presented in scenes that represented the deinstitutionalization process, object of the present study. The results were worked from the meeting of these scenes with the Sistema Único de Saúde (SUS) legislation on regionalization and psychosocial care network. Discussion: According to the research findings, it is possible to work in the perspective of discharge in a scenario that is not very encouraging and discredited by professionals, managers and even patients. The main impasses identified were: lack of network in the cities; many professionals with no experience and little or no training in the field of mental health; resistance upon the fact that serious patients live outside the hospice; slowness in bureaucratic management processes; lack of patient documentation; lack of financial income; precarious family support; high turnover of professionals. Conclusion: The deinstitutionalization process presented great power in relation to the RAPS construction. The cities that had patients in the institution needed to organize and set up their networks. Many patients went to therapeutic residences; some cities only implemented these measures from the deinstitutionalization of the Hospital Colônia de Rio Bonito. Some patients have to be trans-institutionalized yet, and other patients have returned to the care of their families. We can say that RAPS has strengthened from this process, but the struggle for its maintenance and improvement is daily. This study brings as a product a video with narratives about the process of deinstitutionalization, helping its reflection

O encontro com a saúde mental: uma perspectiva ético-estética do cuidado / The encounter with Mental Health: an ethical-aesthetic perspective of care

A formulação de uma nova caminhada para o cuidado em saúde mental está sendo estruturada com base na evidenciação do sujeito e na construção de um sistema que viabilize alternativas adequadas ao vivenciar humano na dimensão cidadã e que supere a lógica tradicional do diagnóstico e tratamento previamente estabelecido segundo abordagens expertises. Este é um desafio que está colocado para os trabalhadores da saúde que buscam respaldar suas práticas em teorias objetivantes e protocolos bem estabelecidos na procura pela segurança de se ter um papel definido e garantido. O risco que se corre nesta dimensão "segura" encontra-se na contramão que se insere em relação à necessidade do cuidado individual, sobretudo, no campo da Saúde Mental. Dentre os desafios colocados à rede de Atenção Psicossocial no cenário contemporâneo, este trabalho propôs potencializar a construção do conhecimento a partir do reconhecimento das singularidades dos usuários para complexificar o olhar sobre o cuidado através de um discurso menos reducionista da vida. A partir do problema disparador, esta pesquisa teve como objeto de estudo "o encontro com o usuário no âmbito da Atenção Psicossocial". Considera-se a noção de encontro pelo referencial da esquizoanálise como algo que é resultante da afetação dos corpos, em detrimento da indiferença. Os objetivos do estudo foram: Experimentar a pesquisa por meio da análise de implicações do pesquisador como legitimação dos afetos na produção de conhecimento; Avaliar a produção de cuidado a partir do regime ético-estético; Produzir sentidos para o encontro com a Saúde Mental a partir das singularidades dos usuários. Evitou-se enrijecer o processo da pesquisa; ao contrário, procurou-se caminhar junto com as mobilizações e potências, dificuldades, elaborações e propostas a cada momento. A partir da experimentação da pesquisadora no campo de pesquisa junto aos usuários do Centro de Atenção Psicossocial, o estudo trouxe a produção de dados sobre o cuidado a partir das produções dos encontros com os usuários. Propôs-se experimentar novos sentidos e olhares através da pesquisa em sua perspectiva estética, ressaltando-se a multiplicidade do ser que sente, pensa e age a partir das noções de diferença e singularidade, buscando recolher alguns efeitos dos encontros na pesquisa provocados nos participantes e em mim, a partir das interferências e dos encontros na pesquisa. O cerne das minhas considerações finais está no movimento, nos fluxos, e não em uma resposta com ponto final. Desta forma, não justifiquei ou legitimei neste estudo um conhecimento a respeito do cuidado, mas sim busquei (re)inventar, junto aos usuários co-pesquisadores uma noção de cuidado sob o prisma da diferença, da multiplicidade, e não da unificação ou totalização. Na produção dos dados emergiram intercessores para o encontro com a saúde mental e foram discutidas experimentações que apontaram para as ações da Rede de Atenção Psicossocial sob uma nova pensabilidade, a qual força a produção do cuidado em sua perspectiva imanente, em detrimento de perspectivas capitalísticas da totalização das formas do cuidado junto à pessoa portadora de transtorno psíquico grave. O tema da escuta foi algo que se produziu no estudo como algo que requer uma clínica menor para utilizarmos a plasticidade equilibrando-nos entre o extremo da surdez, o canto da sereia e o extremo da música gritante, para dar passagem às singularidades dos usuários. A partir dos dados produzidos na experimentação dos encontros no presente estudo, proponho para estudos futuros para a Saúde Mental uma "Produção do cuidado Órgão-sensível". Para superar a sobrecodificação das singularidades, devemos utilizar um movimento de produção de cuidado pela diferença: rizoma e não somente arborescência. Há que se compor a transversalidade rizoma-decalque nas ações da Atenção Psicossocial. O decalque instituído preservará os "órgãos" minimamente necessários. Mas, este "órgão" não será totalitário ou fascista se houver a composição com vertentes rizomáticas, as quais colocarão os "órgãos" em função da promoção da vida e não do organismo, à medida que são nômades, espontâneas, abertas à multiplicidade. Assim, aponta-se que há a necessidade de articularmos elementos da Saúde Mental com a perspectiva do cuidado pela diferença, e não apenas por referências teorizantes especulativas produtoras do achatamento produtivo-desejante dos encontros. Além disto, a partir das singularidades destacadas nos dados desta pesquisa, recomenda-se que estudos futuros adentrem também especificamente a ciência da enfermagem utilizando-se por dentro dela as noções de plasticidade e de rizoma como máquinas de guerra que adensem o tema da prática da enfermagem em saúde mental. A partir da convivência com estas pessoas que foram co-pesquisadoras, aponta-se, em algumas situações, que a loucura nem mesmo deva estar instituída obrigatoriamente como tema da psiquiatria, o que nos aponta a antipsiquiatria como um caminho possível e necessário para as reflexões na RAPS. Nesta perspectiva, a RAPS se desinstituir-se do poder que ainda possui e exerce na vida das pessoas ­ apesar da sociedade moderna ainda preferir que o louco esteja nos serviços e lugares instituídos especificamente para ele e que os demais modos de vida e saúde não pertencem a ele ­ significará para a RAPS a possibilidade de sustentar a proposta da desinstitucionalização da loucura: libertá-la

The formulation of a new pathway for mental health care is being structured based on the evidence of the subject and on the construction of a system that allows adequate alternatives to the human experience in the citizen dimension and that surpasses the traditional logic of diagnosis and treatment previously established according to approaches. This is a challenge for health workers who seek to support their practices in objectifying theories and well-established protocols in the search for the security of having a defined and guaranteed role. The risk that runs in this "safe" dimension is contrary to the need for individual care, especially in the field of Mental Health. Among the challenges posed to the network of Psychosocial Care in the contemporary scenario, this work proposed to potentialize the construction of knowledge from the recognition of the singularities of the users to complexify the look about care through a less reductionist discourse of life. From the triggering problem, this research had as object of study "the encounter with the user in the scope of Psychosocial Attention". The notion of encounter by the frame of schizoanalysis is considered as something that results from the affectation of the bodies, to the detriment of indifference. The objectives of the study were: To experiment the research by analyzing the implications of the researcher as legitimation of the affections in the production of knowledge; To evaluate the production of care from the ethical-aesthetic regime; To produce meanings for the encounter with Mental Health from the singularities of the users. The process of research was avoided; On the contrary, it was tried to walk along with the mobilizations and powers, difficulties, elaborations and proposals at each moment. Based on the researcher's experimentation in the field of research with users of the Center for Psychosocial Care, the study brought the production of data about care from the productions of encounters with users. It was proposed to experience new senses and looks through research in its aesthetic perspective, highlighting the multiplicity of the being that feels, thinks and acts from the notions of difference and singularity, seeking to gather some effects of the encounters in research provoked in the participants and in me, from the interferences and encounters in the research. The crux of my endings considerations is in the movement, in the flows, and not in a response with the final point. In this way, I did not justify or legitimize in this study a knowledge about care, but rather I sought to (re)invent, together with the co-researchers, a notion of care under the prism of difference, of multiplicity, not of unification or totalization. In the production of the data emerged intercessors for the encounter with mental health and were discussed experiments that pointed to the actions of the Network of Psychosocial Attention under a new pensabilidad, which forces the production of care in its immanent perspective, to the detriment of capitalist perspectives of the totaling the forms of care with the person with severe psychiatric disorder. The subject of listening was something that was produced in the study as something that requires a smaller clinic to use the plasticity balancing us between the extreme of the deafness, the siren's song and the extreme of the screaming music, to give way to the singularities of the users. From the data produced in the experimentation of the meetings in the present study, I propose for future studies for Mental Health a "Production of organ-sensitive care". To overcome the overcoding of the singularities, we must use a movement of production of care for difference: rhizome and not only arborescence. It is necessary to compose the rhizome-decal transversality in the actions of Psychosocial Attention. The decal instituted will preserve the "organs" minimally needed. But this "organ" will not be totalitarian or fascist if there is composition with rhizomatic slopes, which will place the "organs" in function of the promotion of life and not of the organism, as they are nomadic, spontaneous, open to multiplicity. Thus, it is pointed out that there is a need to articulate elements of Mental Health with the perspective of care for difference, and not only by speculative theorizing references producing the productive-desiring meeting of the meetings. In addition, from the singularities highlighted in the data of this research, it is recommended that future studies also specifically enter nursing science using the notions of plasticity and rhizoma as war machines that add to the theme of the practice of Nursing in mental health. From the coexistence with these people who were co-researchers, it is pointed out, in some situations, that madness should not even be established as a subject of psychiatry, which points us to antipsychiatry as a possible and necessary way for reflections in the Network of Psychosocial Attention. In this perspective, Network of Psychosocial Attention deinstitute itself from the power it still possesses and exerts in people's lives - although modern society still prefers that the insane person is in the services and places specifically instituted for him and that other ways of life and health do not belong to it - will mean for Network of Psychosocial Attention the possibility of sustaining the proposal of the deinstitutionalization of madness: to liberate it

An fMRI study on the dorsal attention network of heroin addicts and heroin abstainers / 中华行为医学与脑科学杂志

Objective To explore the functional imaging alteration of dorsal attention network (DAN) between heroin addicts and heroin abstainers and probe into its influence on attentional function.Methods Attention-related neuropsychological assessments were applied to evaluate the difference of attentional function between heroin addicts and heroin abstainers.With the functional magnetic resonance imaging (fMRI) data obtained from 17 heroin addicts and 15 heroin abstainers at resting state,we extracted the DANs of heroin withdrawal group and heroin dependence group respectively by using independent component analysis (ICA) and analysed the differences of intra-group and inter-group,then correlation analysis was performed among brain areas which have significant difference between groups and Stroop interference effect test.Results Compared with the heroin dependence group,there was a better result of attentional function in the heroin withdrawal group (P＜0.05),especially at the digit span test(backward) (P=0.0363),digit symbol test (writing) (P =0.0195),Stroop test C (reaction) (P =0.0379),Stroop test C (error) (P=0.0014) and Stroop interference effect test (P=0.0002).Neuroimaging findings demonstrated that there was a similar DAN in the heroin withdrawal group and heroin dependence group which mainly included the bilateral intraparietal suleus,postcentral gyrus and frontal eye field.Compared with the DAN of heroin addicts,significantly enhanced functional connectivity within the DAN of heroin abstainers was observed in the left superior parietal lobule (MIN:-24,-75,48),right inferior parietal lobule (MIN:39,-54,45) and left inferior parietal lobule (MIN:-33,-51,57).Significant negative correlations were observed between these brain areas and Stroop interference effect test in the heroin dependence group (r=-0.79,-0.69,-0.64,P＜0.01),but not in the heroin withdrawal group.Conclusions Heroin addiction can impair attentional function,compared with the DAN of heroin addicts,significantly enhanced functional connectivity in the left superior parietal lobule as well as bilateral inferior parietal lobule are observed in the heroin abstainers at resting state,which may be one of the neural mechanisms of attentional function improvement.

A study of attention networks in the patients with obsessive-compulsive disorder and generalized anxiety disorder / 中华行为医学与脑科学杂志

Objective To investigate the attention network in patients with obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD).Methods 31 GAD patients,31 OCD patients and 30 healthy controls (HC) were tested with attention network test.Results There were significant differences in the main effects with respect to the alerting network(15.87±5.24,26.77±4.33,34.87±3.47) (F=4.619,P=0.012)) and the executive network(114.84±9.64,122.45±5.57,96.57±5.45) (F=3.388,P=0.038) among the OCD,GAD and HC groups.The three groups did significantly differ in RT of the attention network (F=19.808,P=0.000).For the HC group,there was significant main effects with respect to cue conditions(F=29.699,P=0.000).There was a significant correlation between the executive network and Hamilton anxiety scale (r=0.351) and also a significantly negative correlation between the alerting network and Hamilton depression scale (r=-0.267).Conclusion There are attention network damages in patients with OCD and GAD,which may be involved in the impairment of emotion.

Effects of acupuncture at ST36 (Zusanli) on attention networks in healthy subjects / 中华行为医学与脑科学杂志

Objective To investigate the effects of acupuncture at bilateral ST36 (Zusanli) on attention networks in healthy subjects.Methods The attention network test was used to compare the effects of after acupuncture at ST36 with the effects of before acupuncture on the efficiency of three anatomically defined attention networks:alerting,orienting,and executive control in 40 health university students.Results The alerting network effect was significantly higher (t=4.125,P＜0.001) after acupuncture ((45.60±3.49) ms) than before acupuncture ((33.20±2.88) ms).The executive control network efficiency was significantly higher (t=2.638,P＜0.05) after acupuncture ((87.97±4.21) ms) than before acupuncture ((97.67±4.66) ms).The orienting network efficiency was higher after acupuncture than before acupuncture,but there was no significant difference (P＞0.05).The average reaction time was significantly lower (t=4.848,P＜0.001) after acupuncture ((559.13 ± 10.66) ms) than before acupuncture ((590.57±12.80) ms).Conclusions These results suggest that there are selective enhancements of the alerting and executive control networks after acupuncture,while the orienting network is spared.

A study of error monitoring and attention networks in the patients with obsessive-compulsive disorder / 中华行为医学与脑科学杂志

ObjectiveTo investigate the error monitoring and attention network in patients with obsessive-compulsive disorder (OCD).Methods 33 OCD patients and 31 healthy subjects were tested with the error monitoring task and attention network test.ResultsThere wcrc significant differences between the patients with OCD and heath controls on Full Correct(FC),Full Error(FE),the numbers of uncertain,the numbers of dropout in the error monitoring task ( FC ( 121.03 ± 4.41 ) / ( 135.61 ± 3.28 ),FE ( 19.30 ± 3.69 ) / ( 9.45 ± 2.33 ),the numbets of uncertain( 8.27 ± 2.16) / ( 2.87 ± 0.70),the numbers of dropout ( 13.70 ± 2.60 ) / (4.26 ± 1.24 ) ) (P ＜0.05 ).In the attention network test,the comparison between the patients with OCD and healthy subjects on the RT of the alerting network was significant differences (P ＜ 0.05 ).There was a significant correlation between attention network and error monitoring.ConclusionThe impairment of the error monitoring as well as attention network in patients with OCD may be involved in the dysfunction of anterior cingulate cortex.

Neural mechanism of salient target processing in college students / 中华行为医学与脑科学杂志

ObjectiveTo investigate the neural mechanism of processing the salient target during the visual search task with spatiotemporal patterns of event-related potential(ERP).MethodsSixteen subjects were asked to judge the existence of a low or high salient target from 4 items,in which one distractor might be also salient or not.A two-way repeated-measure ANOVA was carried out for behavioral performance and ERP data( distractor saliency:YES,NO)*( target:none,low salient,high salient).ResultsSignificant interaction was found between target and distractor for the reaction time (F( 1.99,29.79) =21.56,P=0.00).For the low salient target,significant difference of reaction time was found between the YES (552.57 ± 82.32 ms) and NO (540.47 ± 75.68 ms)of distractor saliency( t (15) =- 2.489,P =0.025 ).However,such difference of reaction time was not significant for the high salient target.The statistical parametric mapping of F-value of ERP suggested the effect of the distractor saliency revealed in the right fronto-parietal-temporal areas related to stimulus novelty and the effect of the target saliency appeared in the parietal-occipital regions related to visual processing during the same stage ( 350 ～ 450ms ).The significant interaction occurred in the left temporal regions (450 ～ 600 ms ) related to stimulus familiarity and its classification.ConclusionDue to both mechanisms of the parallel processing for the target and the distractor during the perceptual stage and the effective classification of the familiar network within left hemisphere during the stage of pattern classification,the salient target can be processed quickly in spite of the interference from the salient distractor.

Visuospatial attention deficit in patients with frontoparietal network lesions: Evidence from the attention network test / 中华物理医学与康复杂志

Objective To probe deficits in visuospatial attention using an attention network test (ANT) in patients with frontoparietal network lesions. Methods The ANT was used to measure the alertness, orienting and executive control abilities of 25 patients with local brain lesions, including 13 with frontal and 12 with parietal damage. Their results were compared with those of health adults. Results During ANT tasks, the patients' responses were significantly slower on each cue and target condition than controls', and showed deficits in their alerting and orienting networks. The efficiency of executive control was impaired in patients with frontal lesions, but increased with parietal lesions. Conclusions These findings suggest that the frontoparietal network is involved in alerting and orienting, but the executive control function may be selectively associated with the frontal lobe. ANT is an efficienttool for studying visual attention and cognition.

Research about attention network of patients with amphetamine-induced psychiatric disorders / 中华行为医学与脑科学杂志

Objective To investigate the characteristics of the cognitive impairment about attentional network among amphetamine-induced psychiatric disorders. Methods Amphetamine-induced psychiatric disorders ( n = 100) and normal controls ( n = 100) were assessed with Attentional Network Test(ANT) in the first week and the fourth week. Results Compared with the control group, the first ANT's response time was significantly increased, and the correct rate, orienting and executive control network were significantly reduced in Amphetamineinduced psychiatric disorders( eg:response time ( 867. 37 ± 272.24 ) ms vs ( 668.56 ± 136. 20 ) ms, correct rate (0.88 ±0.06 ) ms vs (0.88 ±0.06) ms ,orienting( - 217.86 ± 198.00 ) ms vs ( -59.67 ± 85.07 ) ms and executive control network ( 184.74 ± 66.61 ) ms vs ( 74.71 ± 50.77 ) ms, P ＜ 0.01 ), but the alerting network was higher ( ( 151.17 ± 198.27 ) ms vs (50.60 ± 67.47 ) ms). In the second ANT results, there was no significant difference between two groups. Compared with the first ANT results of amphetamine-induced psychiatric disorders, the second ANT had shorten response time ,that the correct rate, orienting and executive control network were significantly increased(P ＜ 0.01 ). Conclusion These results suggest that amphetamine-induced psychiatric disorders have impairment in cognitive function, but these impairment can be recovered within one month.

The effect of tonic pain stimulation on the attention network test in young males / 中华行为医学与脑科学杂志

Objective To investigate the effect of tonic pain stimulation on the attention network test (ANT) . Methods Twenty healthy males recruited from university were enrolled in this study, and laboratory pain was induced by cuff pressure stimulation on the upper arm. All subjects performed the task separately under pain, no-pain and pressure conditions. The reaction time and accuracy rate of the ANT were quantified. The subjective pain perception was assessed by the short-form McGill Pain Questionnaire ( SF-MPQ) . Results Across three conditions, the executive network showed significant pain effect (F = 76.31 , P< 0.001) : no-pain condition at (92.51 ±35.71 )ms, pressure condition at (94.06 ±25. 28) ms, pain condition at ( 120.24 ± 18.21 )ms. Furthermore, the average reaction time and the A-scores (i. e. affective words) in SF-MPQ caused by pain was positively correlated ( r = 0.11, P = 0.03) . Conclusion Pain can result in deficit in the executive network for attention regulation. The negative affections caused by pain can interfere with attention.