Reduced audiovisual integration in synesthesia--evidence from bimodal speech perception.

Recent research suggests synesthesia as a result of a hypersensitive multimodal binding mechanism. To address the question whether multimodal integration is altered in synesthetes in general, grapheme-colour and auditory-visual synesthetes were investigated using speech-related stimulation in two behavioural experiments. First, we used the McGurk illusion to test the strength and number of illusory perceptions in synesthesia. In a second step, we analysed the gain in speech perception coming from seen articulatory movements under acoustically noisy conditions. We used disyllabic nouns as stimulation and varied signal-to-noise ratio of the auditory stream presented concurrently to a matching video of the speaker. We hypothesized that if synesthesia is due to a general hyperbinding mechanism this group of subjects should be more susceptible to McGurk illusions and profit more from the visual information during audiovisual speech perception. The results indicate that there are differences between synesthetes and controls concerning multisensory integration--but in the opposite direction as hypothesized. Synesthetes showed a reduced number of illusions and had a reduced gain in comprehension by viewing matching articulatory movements in comparison to control subjects. Our results indicate that rather than having a hypersensitive binding mechanism, synesthetes show weaker integration of vision and audition.

Is synesthesia more common in patients with Asperger syndrome?

There is increasing evidence from case reports that synesthesia is more common in individuals with autism spectrum conditions (ASC). Further, genes related to synesthesia have also been found to be linked to ASC and, similar to synaesthetes, individuals with ASC show altered brain connectivity and unusual brain activation during sensory processing. However, up to now a systematic investigation of whether synesthesia is more common in ASC patients is missing. The aim of the current pilot study was to test this hypothesis by investigating a group of patients diagnosed with Asperger Syndrome (AS) using questionnaires and standard consistency tests in order to classify them as grapheme-color synaesthetes. The results indicate that there are indeed many more grapheme-color synaesthetes among AS patients. This finding is discussed in relation to different theories regarding the development of synesthesia as well as altered sensory processing in autism.

Synaesthesia and sexuality: the influence of synaesthetic perceptions on sexual experience.

INTRODUCTION: Synaesthesia is a phenomenon in which a certain stimulus induces a concurrent sensory perception; it has an estimated prevalence of 4%. Sexual arousal as an inducer for synaesthetic perceptions is rarely mentioned in the literature but can be found sometimes in case reports about subjective orgasmic experiences. AIMS: To examine whether synaesthetic perceptions during sexual intercourse have an impact on the sexual experience and the extent of sexual trance compared to non-synaesthetes. METHODS: In total, 19 synaesthetes with sexual forms of synaesthesia (17 female; 2 male) were included as well as corresponding control data of 36 non-synaesthetic subjects (n = 55). Two questionnaires were used to assess relevant aspects of sexual function and dysfunction (a German adaption of the Brief Index of Sexual Functioning, KFSP) as well as the occurrence and extent of sexual trance (German version of the Altered States of Consciousness Questionnaire, OAVAV). Additionally qualitative interviews were conducted in some subjects to further explore the nature of sexual experiences in synaesthetes. MAIN OUTCOME MEASURES: Sexual experience and extent of sexual trance during intercourse. RESULTS: Synaesthetes depicted significantly better overall sexual function on the KFSP with increased scores for the subscale "sexual appetence" but coevally significant lower subscale scores for "sexual satisfaction." Sexual dysfunction was not detected in this sample. Synaesthetes depicted significantly higher levels of the subscales "oceanic boundlessness" and "visionary restructuralization" than controls using the OAVAV. Qualitative interviews revealed varying synaesthetic perceptions during the different states of arousal. Furthermore, synaesthetes reported an unsatisfactory feeling of isolation caused by the idiosyncratic perceptions. CONCLUSIONS: Synaesthetes with sexual forms of synaesthesia seem to experience a deeper state of sexual trance without, however, enhanced satisfaction during sexual intercourse.

Reduced audio-visual integration in synaesthetes indicated by the double-flash illusion.

It has been suggested that synaesthesia is the result of a hyper-sensitive multimodal binding-mechanism. To address the question whether multi-modal integration is altered in synaesthetes in general, grapheme-colour and auditory-visual synaesthetes were studied using the double-flash illusion. This illusion is induced by a single light flash presented together with multiple beep sounds, which is then perceived as multiple flashes. By varying the separation of auditory and visual stimuli, the hypothesis of a widened temporal window of audio-visual integration in synaesthetes was tested. As hypothesised, the results show differences between synaesthetes and controls concerning multisensory integration, but surprisingly other than expected synaesthetes perceive a reduced number of illusions and have a smaller time-window of audio-visual integration compared to controls. This indicates that they do not have a hyper-sensitive binding mechanism. On the contrary, synaesthetes seem to integrate even less than controls between vision and audition.

Genuine and drug-induced synesthesia: a comparison.

Despite some principal similarities, there is no systematic comparison between the different types of synesthesia (genuine, acquired and drug-induced). This comprehensive review compares the three principal types of synesthesia and focuses on their phenomenological features and their relation to different etiological models. Implications of this comparison for the validity of the different etiological models are discussed. Comparison of the three forms of synesthesia show many more differences than similarities. This is in contrast to their representation in the literature, where they are discussed in many respects as being virtually similar. Noteworthy is the much broader spectrum and intensity with the typical drug-induced synesthesias compared to genuine and acquired synesthesias. A major implication of the phenomenological comparison in regard to the etiological models is that genuine and acquired synesthesias point to morphological substrates, while drug-induced synesthesia appears to be based on functional changes of brain activity.

Anomalous Auditory Cortex Activations in Colored Hearing Synaesthetes: An fMRI-Study.

Color percept induction in synaesthetes by hearing words was previously shown to involve activation of visual and specifically color processing cortex areas. While this provides a rationale for the origin of the anomalous color percept the question of mechanism of this crossmodal activation remains unclear. We pursued this question with fMRI in color hearing synaesthetes by exposing subjects to words and tones. Brain activations in word condition accompanied by highly reliable color percepts were compared with activations in tone condition with only occasional color percepts and both contrasted to activations in normal subjects under the same stimulus conditions. This revealed that already the tone condition similar to the word condition caused abnormally high activations in various cortical areas even though synaesthetic percepts were more rare. Such tone activations were significantly larger than in normal subjects in visual areas of the right occipital lobe, the fusiform gyrus, and the left middle temporal gyrus and in auditory areas of the left superior temporal gyrus. These auditory areas showed strong word and tone activation alike and not the typically lower tone than word activation in normal subjects. Taken together these results are interpreted in favour of the disinhibited feedback hypothesis as the neurophysiological basis of genuine synaesthesia.

Swallowing foreign bodies as an example of impulse control disorder in a patient with intellectual disabilities: a case report.

Objective. Foreign body ingestion can be a challenge to multiprofessional approaches involving medical, surgical, neurological, and psychiatric teams.Case presentation. A 41-year-old male patient with intellectual disabilities presented after having swallowed approximately 20 sharp objects. While admitted to a psychiatric ward, surgeons removed a glove from his stomach endoscopically and pharmacologically facilitated the objects' complication-free bowel passage. The patient explained the swallowing as a means to release himself from tension induced by stress. His aberrant behavior also seemed to serve as a means to exert pressure on psychosocial workers. Other deviations included the pushing of sharp objects under the skin and multiple paraphiliae. As a child, the patient suffered from early psychological and physical traumatization. Both parents were allegedly physically abusive alcoholics.Conclusion. Apart from possible alcohol embryopathy and traumatic brain damage, meningitis, which the patient had at the age of three, is discussed as the most likely reason for his oligophrenia, associated with left-sided, temporo-parietal atrophy and epilepsy.

Pathological Internet use and psychiatric disorders: Across-sectional study on psychiatric phenomenology and clinical relevance of Internet dependency

Background and Objectives: With the Cyberspace’s exponential growth of influence questions arise about its mental impacts. The presented study examines the question whether the dependent use of the Internet can be understood as an impulse control disorder, an addiction or as a symptom of other psychiatric conditions. Methods: Internet dependent patients seeking for psychiatric assistance and fulfilling the criteria for pathological Internet use (PIU) were examined with the Structured Clinical Interview according to DSM-IV (SCID), and a variety of questionnaires including the Barratt Impulsiveness Scale (BIS), the Beck Depression Inventory (BDI) and the Dissociative Experience Scale (DES). The patient group was compared to a matched group of healthy controls. Results: The adult patient-group consisted of 25 subjects, 76% male, with a mean age of 29.36 years. Average time spent in Cyberspace was 6.47 h/d, mostly in online-role playing games. According to SCID I and BDI, 19 patients (76%) suffered from a depressive syndrome, with 10 cases of major depressive disorder (40%) and 8 cases of adjustment disorder with depression (32%). Six patients (24%) suffered from a comorbidanxiety disorder. Compared to controls, the patient group presented significantly higher levels of depression (BDI), impulsivity (BIS) and dissociation (DES). Conclusions: PIU shares common psychopathological features and comorbidities with substance related disorders. Therefore, it might be seen as a diagnostic entity in itself in aspectrum of behavioural and substance dependencies. Especially Internet role play may contain an addictive potential for adolescents and adults with subclinical psychopathology (AU)

Comorbidity of alcohol and substance dependence with attention-deficit/hyperactivity disorder (ADHD).

AIMS: Attention-deficit/hyperactivity disorder (ADHD) is of great clinical importance not only because of its high prevalence but also due to the frequent comorbid illnesses that are connected with this disorder. Several studies were able to demonstrate that ADHD constitutes a significant risk factor for the exacerbation of habit-forming illnesses, i.e. addictions. METHODS: We conducted a study on 152 adult patients with alcohol dependence (n = 91) or multiple substance addiction (n = 61) to determine whether or not these patients were affected by ADHD. For retrospective assessment of childhood ADHD, the WURS-k was used as well as the DSM-IV symptom checklist for ADHD. The CAARS was used to assess the persisting symptoms of ADHD in adults. RESULTS: 20.9% (WURS-k) or 23.1% (DSM-IV diagnostic criteria) of the alcohol-dependent patients showed evidence of retrospective ADHD affliction in childhood. With the help of CAARS, ADHD was proved to be persistent in 33.3% of the adult patients. In the group of substance-addicted patients 50.8% (WURS-k) and 54.1% (DSM-IV) presented with diagnostic criteria for ADHD in childhood and 65.5% (CAARS) showed evidence of ADHD persisting in adulthood. CONCLUSIONS: These results reveal that habit-forming illnesses can be associated with a high comorbidity with ADHD, expressed in the form of alcohol abuse and also in consumption of illegal drugs. The results underline the great importance of early and adequate diagnostics and therapy of ADHD for the prevention of habit-forming illnesses.

[Internet dependency as a symptom of depressive mood disorders]. / Internetabhängigkeit als ein Symptom depressiver Störungen.

OBJECTIVE: In psychiatric contexts, the quick distribution of virtual techniques in private and professional everyday life gives rise to the question, if these can evoke a psychological addiction. Yet, the diagnostic assessment of internet or computer game dependency remains problematic. METHODS: Within a study with 23 internet-dependent patients with significant psychological strain, 18 (77.8%) were diagnosed with a depressive mood disorder by thorough clinical examination and structured interviews. The presented work compares psychometric test results of the depressed subpopulation with healthy controls matched for age, sex and school education. RESULTS: In the Barrat Impulsiveness Scale patients with internet dependency scored significantly higher than the control group (p < or = 0.05), while there was no significant correlation to the Internet Addiction Scale. Becks Depression Inventory and the Symptom-Checklist subscale for depression revealed significantly higher scores within the patient group as compared to controls (p < or = 0.001). And in the Dissociative Experience Scale, the Sense of Coherence Scale and the Inventory for Interpersonal Problems the internet dependent subjects showed significantly more pathological scores than the healthy subjects (p < or = 0.05). CONCLUSIONS: Since internet dependency can be understood as a novel psychopathology of well known psychiatric conditions, every psychiatrist should be able to detect and treat it adequately, as long as there is a willingness to deal with the contents and impacts of cyberspace. Especially with depressed patients, it seems to be crucial to include questions about media usage in psychiatric examination taking.

Effects of methylphenidate in ADHD adults on target evaluation processing reflected by event-related potentials.

Attention deficit/hyperactivity disorder (ADHD) is a widely examined disease in childhood. There is evidence that the disease responds well to medication with methylphenidate (MPH). The effect of MPH in adults with ADHD is a question that is often raised, because many adults request such therapy today. As yet, there is a lack of studies on event-related potentials (ERPs) and MPH in ADHD adults. In the present study we examined 10 adults diagnosed with ADHD, with and without MPH medication (30 mg daily), by means of ERP in a visual Go/NoGo experiment to gain information about target evaluation processing in these patients and about the effects on these attentional processes during medication with MPH. Visually, there seem to be differences in the frontal electrodes for the N2 and in the parietal electrodes for the P300. But these differences do not achieve statistical significance. There are also no statistically relevant differences for the N1 or the slow wave. MPH does not seem to have an effect on target evaluation processing, when comparing the ERPs of non-medicated and medicated ADHD adults. Especially the P3 does not appear to be modulated by medication with MPH in these ADHD adults, in contrast to findings in ADHD children.