The development of interpersonal relationships in individuals with schizophrenia.

Three research assistants developed 2-week-long relationships with 15 patients with schizophrenia hospitalized at an inpatient psychiatric facility. Research assistants were assigned to no more than six patients during any one 2-week period. At the beginning and end of each 2-week relationship period, interactions between research assistants and patients were videotaped, and research assistants' negative and positive responses to patients were measured. Interaction partners' negative responses to patients increased over time. There were stable individual differences among patients in the degree to which they were liked by the research assistants and in how frequently research assistants made negative comments about patients. There were individual differences among research assistants in the degree to which they responded positively to patients. Patient strangeness and lack of pleasant conversational content were associated with the negative responses of research assistants.

Residential caregiver attitudes toward seriously mentally ill persons.

Previous research has found that caregiver attitudes are associated with the course of illness of seriously mentally ill (SMI) persons. This study examined whether variation in caregiver attitudes could be accounted for by (a) staff caregivers and/or (b) SMI persons. Group home staff were asked to describe each SMI group home resident and to describe the relationship they had with each resident. We recorded the number of positive and negative statements made by each staff member about each resident's character, behaviors, and the interactions staff had with them. Overall, the variation in positive staff statements about group home residents was significantly accounted for by the residents. In general, the variation in negative staff statements was significantly accounted for by staff. However, the variation in negative staff statements about the character of residents was accounted for by both staff and residents.

Action-monitoring dysfunction in obsessive-compulsive disorder.

Evidence suggests that a hyperactive frontal-striatal-thalamic-frontal circuit is associated with the symptoms of obsessive-compulsive disorder (OCD), but there is little agreement about the function of the exaggerated activity. We report electrophysiological evidence suggesting that part of this system monitors events and generates error signals when the events conflict with an individual's internal standards or goals. Nine individuals with OCD and 9 age-, sex-, and education-matched control participants performed a speeded reaction time task. The error-related negativity, an event-related brain potential component that reflects action-monitoring processes, was enhanced in the individuals with OCD. The magnitude of this enhancement correlated with symptom severity. Dipole modeling suggested that the locus of the enhancement corresponded to medial frontal regions, possibly the anterior cingulate cortex.

Interpersonal interactions in individuals with schizophrenia: individual differences among patients and their partners.

We examined 60 face-to-face ten-minute interactions between individuals with schizophrenia and college students. We studied patient responses to the students and student responses to the patients. Following each interaction, participants provided reports of their current mood and how well they liked their interaction partner. The interactions were audio- and video-taped, which allowed us to measure the frequency of patient and student smiles and eye contact, patient strangeness, and the pleasantness of the conversational content. We found individual differences among patients in the degree to which they were liked by students. Patient strangeness was associated with interaction partner negative responses to patients. In addition, the pleasantness of the conversational content was associated with how well patient and student were liked by one another. Sixteen percent of the variance in patient smiling was accounted for by the particular student with whom the patient interacted. The results of this study highlight the importance of attending to both intrapersonal and interactional factors for understanding patient interpersonal functioning.

The nature and prevalence of anxiety disorders in primary care.

Primary goals of this study were to 1) establish the prevalence, nature, and correlates of anxiety disorders in primary care, and 2) examine the comorbidity of anxiety disorders with major depressive disorder. A weighted sample of 425 patients drawn from the waiting rooms of primary care physicians was used. Anxiety disorders were highly prevalent, relatively mild, and often comorbid with depression. Anxiety disorders aided physicians in their detection of depression. However, anxiety disorders were also misdiagnosed as depression. Although anxiety disorders are common in primary care, their relative mildness may generally not warrant increased attention by primary care physicians to detection and treatment. Instead, efforts should be focused on the more severe and impairing cases of anxiety disorder.

Collaboration between the hemispheres of a callosotomy patient. Emerging right hemisphere speech and the left hemisphere interpreter.

Split brain patients who are initially unable to produce speech in their right hemispheres sometimes develop the ability to do so. Patient J.W., the subject of this report, is such a patient. At the time of his callosotomy, J.W. had a language dominant left hemisphere; his right hemisphere could understand both spoken and written language, but he was unable to speak. Fourteen years after his surgery, we found that J.W. was capable of naming approximately 25% of the stimuli presented to his left visual field (LVF). Now, 1 year later, we find that he can name about 60% of such stimuli. This late-developing speech ability appears to be consequence of long-term neural plasticity. However, the subject's extended verbal responses to LVF stimuli seem to result from a collaboration between the hemispheres and to involve the left hemisphere interpreter.

Left hemisphere representations of emotional facial expressions.

Researchers have suggested that the right hemisphere is superior at processing emotional facial expressions because it contains stored perceptual 'templates' of facial expressions. We tested each hemisphere of a split-brain patient on two tasks involving emotional facial expressions. Both hemispheres performed equally well and significantly above chance matching facial expressions with emotion words. The subject's right hemisphere consistently performed well judging whether two facial expressions were the same or different. His left hemisphere performed poorly on this discrimination task at first, but showed a sharp improvement when the instructions were changed slightly, emphasizing verbal labels for the facial expressions. Results suggest that 'facial expression templates' may not be stored only on the right.

Platelet monoamine oxidase activity and deficit syndrome schizophrenia.

Measures of affective flattening that combine self-reported emotional experience with observed affect may identify deficit syndrome patients better than ratings based on observed affect alone. In this study, we examined 23 clinically stable but chronically ill schizophrenic patients, 15 of whom were found to have a deficit syndrome. After exclusion of patients with self-reported depressed mood from the deficit syndrome group, the remaining patients with a deficit syndrome not accompanied by self-reported depressed mood showed a strikingly homogeneous distribution of platelet monoamine oxidase activity. Results suggest that inclusion of self-reported emotional experience in clinical definitions of the deficit syndrome will increase the specificity of diagnosis.