Asher Shiber

Traumatic stress is linked to a deficit in associative episodic memory

Individuals with posttraumatic stress disorder (PTSD) are haunted by persistent memories of the trauma, but ironically are impaired in memories of daily life. The current set of 4 experiments compared new learning and memory of emotionally neutral content in 2 groups of patients and aged- and education-matched controls: 20 patients diagnosed with chronic posttraumatic stress disorder (C-PTSD) and 20 patients diagnosed with acute stress disorder (ASD). In all experiments, participants studied a list of stimuli pairs (words or pictures) and were then tested for their memory of the items, or for the association between items in each pair. Results indicated that both types of patients showed associative memory impairment compared to a control group, although their item memory performance was relatively intact. Potential mechanisms underlying such associative memory deficits in posttraumatic patients are discussed.

Associative memory impairment in acute stress disorder: Characteristics and time course

Stress and episodic memory impairment have previously been associated. Acute stress disorder (ASD) is a maladaptive stress response, which develops in some individuals following traumatic life events. Recently, the authors demonstrated a specific deficit in associative memory for emotionally neutral stimuli in ASD and posttraumatic stress disorder (PTSD). This study further tested the relationship between this memory impairment and the course of ASD. We assessed new learning and memory for item and associative information in patients diagnosed with ASD (n=14) and matched trauma naïve controls (n=14). Memory performance and posttraumatic symptoms were examined for approximately 1 and 10 week periods following the traumatic experience. In the two experiments, participants studied a list of stimuli pairs (verbal or visual) and were then tested for their memory of the items (item recognition test), or for the association between items in each pair (associative recognition test). In both experiments, ASD patients showed a marked associative memory deficit compared to the control group. After 10 weeks, ASD symptoms were resolved in most patients. Interestingly, their performance on associative recognition for verbal stimuli improved, while the associative deficit for visual stimuli remained unchanged. Potential mechanisms underlying such an associative memory deficit in post-trauma patients are discussed.

A case of mirtazapine-induced spontaneous orgasms in a female patient

This is a case report of a 51-year-old woman admitted as a psychiatric outpatient with symptoms of moderate to severe depression and anxiety. She had received anti-depressants prior to her admission. The patient did not have a medical history of mania or hypomania, and did not complain of any sexual side-effects when taking prior medications. She was diagnosed in our clinic with mixed anxiety-depressive disorder. Due to lack of improvement she was commenced on mirtazapine and after three days complained of spontaneous orgasms and increased libido. The sexual symptoms resolved gradually after a few days and reappeared upon every dosage increase. On discontinuation of mirtazapine the side effects subsided. To the best of the authors knowledge this is the first report of spontaneous orgasms following treatment with mirtazapine.

Names and Narcissism: A Clinical Perspective on How Parents Choose Names for Their Newborn

Abstract Parents express themselves through the names they give to their children. This article, based on clinical background and practice, looks at the names parents give their children in order to examine the emotional and psychological processes motivating these parents. Specifically, we will look at narcissism, since patients with narcissistic deprivation, in particular, tend to give their children names which often reflect their own deprivations. After a short presentation of healthy and pathological narcissism, and an onomastic-linguistic description of Hebrew given names as the semantic and morphological product of condensation and displacement, we merge the two presentations. We analyze authentic clinical cases to illustrate the interplay within this framework between early self, self-object experiences, and conflicts that emerge in the process of providing names and vice versa. The data for this paper is drawn from psychotherapeutic encounters with Israeli — Jewish patients.

2629 – Impaired emotional processing is reflected in long latency event related potentials during visual emotional stimulation in post-traumatic patients

Introduction PTSD patients display abnormal emotional processing and bias towards negative emotion. Long latency eventrelated potentials (ERP’s) are composed of the P300 and subsequent slow wave activity. These ERP’s are hypothesized to be relevant for attentional and initial memory storage events as well as emotional processing. objectives: This study tested the hypothesis that abnormal emotional processing in PTSD is reflected in altered brain activity, as measured via ERP’s. Aims Detect differences in cortical activity and emotional processing in PTSD patients as compared to controls. Methods ERP’s were recorded from 14 PTSD and 14 control subjects while viewing emotion-laden pictures. Subjects were instructed to press a button depending on the presence of a person or human part in the picture and response time was recorded. Results Long latency ERP data (300-1035 msec) showed valence dependent activity in control subjects distinguishing negative vs. positive and neutral pictures. PTSD patients, however, lacked differential activation and had similar brain activity across all picture valances, which resembled the pattern observed in controls only for negative stimuli. Download : Download full-size image [Late ERP’s 980-1035msec] PTSD patients also exhibited longer response time. Conclusions Our results demonstrate abnormal cognitive-emotional processing in PTSD patients and may underlie overgeneralization processes that are part of this disorder.

Serotonin Blockade Does Not Affect Nonarticular Tenderness in Healthy Volunteers

Objectives: To investigate the role of serotonergic pathways as a potential factor modulating pain in general and nonarticular tenderness in particular. Methods: Twenty healthy volunteers were given metergoline [a nonspecific serotonin blocker] once and placebo once, in a double blind, placebo-controlled, randomized cross over design. The administrations were separated by atleast one week. In each session a count of 18 tender points was conducted by thumb palpation just before and 90 minutes after capsule ingestion. Tenderness of nine of the tender points as well as four control points was further assessed with a Chatillon dolorimeter. Results: There was no significant difference in the point count or in tenderness in the presence or absence of serotonin blockade. Conclusions: Serotonin blockade in healthy individuals has no effect on the point count or on tender point sensitivity. This suggests that involvement of serotonergic path ways does not contribute to pain syndromes associated with nonarticular tenderness, or, alternatively, that studies of nonarticular tenderness in healthy volunteers are not relevant to the same phenomenon in clinical syndromes.