H. George Nurnberg

Effects of trifluoperazine, chlorpromazine, and haloperidol upon temporal information processing by schizophrenic patients

Healthy controls, unmedicated, actively symptomatic schizophrenics, and similar patients undergoing treatment with either trifluoperazine, chlorpromazine, or haloperidol were studied with tests of temporal discrimination and measures of transmitted information shown previously to be sensitive to various kinds of brain dysfunction, including haloperidol effects in a nonpsychotic population. Variations in psychophysical method, cognitive load, discrimination complexity, and sense-mode conditions permitted representative sampling of the temporai processing. Untreated, actively psychotic patients showed no impairment of temporal processing while all three antipsychotic medications were associated with significant deficit; trifluoperazine and haloperidol produced the most deficit, with chlorpromazine in the middle between the higher potency drugs on the one hand and unmedicated patients and healthy controls on the other.

Psychopathology: a primary feature of myotonic dystrophy.

Abstract A review of the literature on the psychopathologic manifestations of myotonic dystrophy reveals that most authors consider them to be secondary aspects of the disease. The authors believe this view to be too restrictive; they offer clinical evidence that altered mental functioning is a basic feature of myotonic dystrophy. Moreover, a group of patients may exist with primary psychiatric disease and little or no myotonic or systemic dystrophies. Myotonic dystrophy should be considered in differential diagnosis of conditions producing alterations in mental function.

Time-limited treatment of hospitalized borderline patients: Considerations

Abstract Patients with a diagnosis in the spectrum of “borderline personality organization” represent a significant proportion of inpatient hospital admissions. An intensive, psychodynamically-oriented treatment environment may induce further behavioral disturbances and regressions in such patients. 1,2 Among iatrogenic elements in the therapeutic milieu, which promote ego dedifferentiation and regression, are overgratification of pathologic dependency needs by a permissive supportive staff or inexperienced trainee therapists enmeshed in a quagmire of transference-countertransference difficulties. Borderline patients are often unable to keep a part of their ego available for observation in a therapeutic or working alliance, show marked senses of entitlement, and, by primitive projective mechanisms, protect themselves from seeing the implications of their actions on others. On admission and during a hospitalization, they often present difficult diagnostic and management problems, precipitate endemic psychotic regressions among other patients, or provoke critical staff conflicts. The literature on the “borderline patient”, though clarifying dynamic issues, has tended to emphasize chronicity of the condition and the need for intensive long-term psychotherapy by highly experienced analytically oriented therapists. 3,4 However, limited hospitalization funds and an unavailability of the prescribed outpatient treatment are often issues which generate an atmosphere of therapeutic nihilism. This atmosphere should be metabolized by treatment designs that integrate theory with reality constraints, and allow borderline patients to return to the community in a more functional mode than when they entered the hospital. It is the purpose of this article to identify features important for time-limited hospital treatment of patients with borderline character pathology.

EFFECT OF ALCOHOL ON TEMPORAL INFORMATION PROCESSING

Although it has been assumed that alcohol alters temporal judgment, studies have not produced consistent effects. A recent report (Goldstone, et al., 1977) showed less transmitted information, U(,: , ) , in the time judgments of sober alcoholics and suggested that this measure might reflect acute effeces of alcohol. Data from prior studies (Ehrensing, et al., 1970; Goldstone & Kirkham, 1968) were reexamined to test this hypothesis; auditory and visual durations were judged shorter or longer than one clock second. Measures of U(,: , ) were computed for 30 social drinking young adults tested twice in three equal-sized groups: ( 1 ) Before and after IV 0.75 cc, 95% ethanol per kg of body weight with mean blood alcohol level at 79 mg/100 rnl; ( 2 ) Before and after IV saline; ( 3 ) Test-retest without intervention. A series of seven durations from 0.15 to 1.95 sec. (0.30-sec. interval) was administered ten times with haphazard disuibucion and separate blocks of lights and sounds producing four 7 )( 9 stimulusresponse matrices, each with 70 entries. The first and second, auditory and visual U(,:,, measures were analyzed with analysis of variance. Unlike alcoholics, there was no degradation in temporal processing during intoxication; alcohol did not reduce U(,: , ) . It is possible that a practice effect may have eliminated impairment due to alcohol requiring confirmation with similar samples tested oltce after placebo or alcohol. However, these data suggest that reduced transmitted information may only be a product of enduring misuse of alcohol.