Controlled examination of effects of progressive relaxation training on seizure reduction.

We determined the efficacy of progressive muscle relaxation in reducing seizure frequency. Subjects were 24 people with epilepsy attending an urban neurology clinic. The experimental design consisted of an 8-week baseline period, a treatment period of six sessions of progressive relaxation training (PRT, n = 13) or quiet sitting (QS, n = 11) and an 8-week follow up. In the PRT group, 11 subjects reported a decrease in seizure frequency (p less than 0.01), and in the QS group, 7 reported a decrease (p greater than 0.05). The mean decrease in seizure frequency was 29% for the PRT group (p less than 0.01) but only 3% for the QS group (p greater than 0.05). This is the fifth recent report of a controlled study documenting the success of progressive relaxation therapy in seizure reduction. PRT is inexpensive and noninvasive and facilitates patient participation. Such a technique should be incorporated into clinical practice.

Maintenance of grip-induced muscle tension: a behavioral marker of schizophrenia.

A grip-induced muscle tension maintenance task distinguished between schizophrenic patients, regardless of medication or hospitalization status, and both normals and controls with affective (unipolar and bipolar) disorders. Unaffected first-degree relatives of schizophrenic patients also showed a grip deficit. Coupling the grip task with a visual discrimination task that divided attention through instruction or reinforcement contingency, increased grip error times for all groups. No group differences appeared on the discrimination task, regardless of difficulty level, and the tone used to provide corrective feedback was not implicated in the grip deficit. The results suggest that the grip task is tapping, in a systematic and reliable manner, a motor-control abnormality that may be useful as a behavioral marker of schizophrenia.

Urinary 3-methoxy-4-hydroxyphenylglycol in affective and schizophrenic patients. Behavior and symptom correlates.

The relations between urinary 3-methoxy-4-hydroxyphenylglycol, (MHPG) excretion, ward behavior in two environments (dayroom and gym), and symptomatology were examined in 58 psychiatric inpatients. In the total patient sample, idiosyncratic behaviors and body activity correlated positively with MHPG levels. Among depressed patients MHPG correlated negatively with eating lunch in the dayroom and positively with self-reported appetite loss, suggesting that appetite disturbance in major depression may be due to high norepinephrine turnover. The results support the utility of naturalistic observation instruments in exploring the relations between psychopathology and biological substrates.

Maintenance of induced muscle tension, stimulus generalization performance, and schizophrenia.

Hand-dynamometer induced muscle tension was manipulated in the context of an experimental paradigm that included tests of discrimination and generalization with rigorously defined schizophrenic and affective patients, as well as schizotypic and normal controls (total N = 44). The experiment was designed to test predictions that derive from Broen and Storms' (1967) learning/motivational analysis of schizophrenic performance deficits. The results failed to support the theoretical predictions, but did reveal that the ability to maintain induced muscle tension within prescribed limits discriminated reliably between the groups (p less than or equal to .03) and that this discriminability increased with increasing tension demands (p less than or equal to .001). The data are discussed in terms of possible relations to basic sensory/motor (i.e., neuromuscular and/or proprioceptive) mechanisms as well as to more central psychological (i.e., attentional/cognitive) mechanisms, and directions for future research are outlined.

Introversion, attention and the late positive component of event-related potentials.

Variation in P3 amplitude across normal individuals under the same experimental conditions has been routinely observed. The possibility that such variation reflects individual differences in the allocation of attention was examined by comparing P3 amplitude in introverts and extraverts, who are thought to differ in the allocation of attention during monotonous tasks. Event-related potentials were recorded while the subjects participated in a lengthy stimulus prediction task. P3 amplitude was determined by principal components analysis and it was found to be significantly larger for the introverts than for the extraverts. This finding is interpreted as evidence that P3 amplitude is sensitive to individual differences in the allocation of attention.

Urinary MHPG and ward behavior in unmedicated psychiatric patients.

The relationship between urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) and overt behaviors emitted in two hospital environments was examined in a group of 27 drug-free psychiatric patients. Depressed patients with high MHPG excretion ate less and engaged in less visual activity in the lunch environment. Schizophrenic patients but not depressive patients with high MHPG tended to have greater body activity during the gym environment. The implications of these findings for the identification of subtypes of depression and schizophrenia, and for an improved methodology in investigation of biobehavioral relations in clinical populations, are discussed.

Diagnostic accuracy of phleborheography in deep venous thrombosis.

The clinical diagnosis of acute deep thrombophlebitis of the lower extremities is notoriously grossly inaccurate, even in experienced hands. Phleborheography (PRG) is one of the noninvasive diagnostic methods developed to make diagnosis accurate, noninvasive, and easily reproducible. The records of the first 272 patients studied by this method at South Fulton Hospital were examined, beginning June 1977 and ending August 1979. In those patients who had PRG and radiologic phlebography, the two methods were compared. Phlebography was considered as the standard for comparison. There were 36 patients who had both studies performed. Of the 36 patients studied, the PRG and the x-ray studies agreed in 34. Both were normal in 21 patients; and in 13 patients both were abnormal and in agreement. The studies did not agree in two of the 36 patients. There were none where the PRG was normal and the x-ray abnormal, and two where the PRG was abnormal and the x-ray normal. The diagnostic accuracy of a normal PRG in this study was 100 per cent, with no false-negatives. There were two false-positives with an accuracy of 87 per cent. The overall accuracy was 94 per cent. There were no complications.

Platelet monoamine oxidase activity and behavioral response to pharmacotherapy in psychiatric patients.

Platelet monoamine oxidase (MAO) levels were determined for drug-free psychiatric inpatients who were subsequently treated with neuroleptics, tricyclics, or lithium. Weekly, time-sampled recordings of specific behaviors were also made during both drug-free and medication periods. Significant correlations were obtained between MAO levels and changes in behavior scores subsequent to drug administration. For six of the seven recorded behaviors, correlations for patients treated with lithium vs. tricyclics were in the opposite direction. The results suggest that MAO levels, measured during a drug-free period, can predict some of the behavioral responses to antidepressant medications.

The effects of neuroleptic drugs on the social interactions of hospitalized psychotic patients.

The frequency of social interactions emitted by two groups of hospitalized psychotic patients was studied with a time sampling procedure during lunch periods in the ward dayroom. One group was treated with neuroleptic medication upon admission to the ward, and the other group was medicated after a 2- to 3-week washout period. The data suggest that the principle effect of the medication is to produce a transient depression in social interaction frequency which returns to baseline with continued drug treatment. The results are supportive of previous research which indicated that the major impact of pharmacotherapy is on activity rather than social behaviors, and highlights the utility of including baseline measures to ensure adequate drug vs. control comparisons.

Memory function in focal epilepsy: a comparison of non-surgical, unilateral temporal lobe and frontal lobe samples.

Three well-matched groups of non-surgical, pharmacologically controlled epileptic patients with unilateral seizure foci in either the left temporal lobe, the right temporal lobe or a frontal lobe, and a normal control group were compared on several verbal and non-verbal memory tasks. Results revealed significant impairment of verbal memory in left temporal epileptic subjects, and significant impairment of non-verbal, visual memory in right temporal epileptic subjects. Seizure patients with unilateral frontal lobe foci did not differ from the control sample on any measure. Results support previous research which emphasizes the importance of temporal lobe systems in memory function. The findings are discussed with regard to the nature and specificity of the observed deficits.

Shock lung: fact or fancy?

Shock lung can be considered a relatively new pathologic syndrome. Its rapidly increasing incidence is a tribute to advanced sophistication in the salvage of severely traumatized patients and in those undergoing major surgery who would not have survived 25 years ago. No single factor can be credited as the sole precipitator of this syndrome. Alone, many of the factors may be insignificant; but combined they are often synergistic and end in a respiratory death. Although all of the mechanisms and interrelationships are not known for every case, early recognition of the specific contributing etiologies aid in both the prevention and, when that fails, in the treatment of shock lung. Today, by careful precise diagnostic monitoring, many cases of post-traumatic pulmonary insufficiency, i.e., shock lung, can be treated with resultant cure. The term shock lung is valuable only in alerting the physician to the fact that the patient is in "big trouble." The physician must then try to sort out all of the possible factors and treat each accordingly. We might compare the end result of shock lung to the end stage of renal disease. The fact is that they are both nonspecific responses of an end organ to many different and interrelated etiologies. To expect to define a single, all encompassing etiology is pure fancy.