Louis A. Gottschalk

D2 dopamine receptor polymorphism and brain regional glucose metabolism

Positron emission tomography (PET) studies have shown decreased glucose metabolism in brain regions of detoxified alcoholics and cocaine abusers. However, it is not clear whether this decrease is due to chronic drug abuse or a pre-existing condition. Molecular genetic studies have found an association of the D2 dopamine receptor (DRD2) A1 allele with alcoholism and drug abuse. Moreover, reduced central dopaminergic function has been suggested in subjects who carry the A1 allele (A1+) compared with those who do not (A1-). In the present study, using 18F-deoxyglucose, regional glucose metabolism was determined in healthy nonalcohol/nondrug-abusing subjects with the A1+ or A1- allele. The mean relative glucose metabolic rate (GMR) was significantly lower in the A1+ than the A1- group in many brain regions, including the putamen, nucleus accumbens, frontal and temporal gyri and medial prefrontal, occipito-temporal and orbital cortices. Decreased relative GMR in the A1+ group was also found in Brocas area, anterior insula, hippocampus, and substantia nigra. A few brain areas, however, showed increased relative GMR in the A1+ group. Since polymorphism of the DRD2 gene is commonly observed in humans, the importance of differentiating A1+ and A1- alleles subjects in PET studies is suggested.

Risperidone for the treatment of stuttering.

A randomized, double-blind, placebo-controlled study was conducted to assess the efficacy of risperidone in the treatment of developmental stuttering in 16 adults. Eight subjects received placebo and eight received risperidone at 0.5 mg once daily at night, increased to a maximum of 2 mg/day. After 6 weeks of treatment, decreases in all measures of stuttering severity were greater in the risperidone group than in the placebo group; the between-treatment difference was significant (p < 0.05) on the most important measure, the percentage of syllables stuttered. In the risperidone group, reductions from baseline in scores for the percentage of syllables stuttered, time stuttering as a percentage of total time speaking, and overall stuttering severity were significant (p < 0.01); changes in scores on the fourth measure of stuttering, duration, were not significant. No significant decreases occurred in the placebo group. Among the eight patients in the risperidone group, five responded best to 0.5 mg/day, with stuttering recurring at higher doses. The remaining three patients responded better with increasing doses of risperidone. Risperidone was generally well tolerated. The results of this small study indicate that risperidone may be effective in the treatment of developmental stuttering. This finding needs to be confirmed in a larger trial.

Content analysis of verbal behavior : new findings and clinical applications

Contents: Introduction. Review of Reliability and Validity Studies Using the Gottschalk-Gleser Method of Content Analysis. Range of Some Types of Applications of This Method of Verbal Content Analysis. Psychosocial Research Using This Method. Content Analysis Studies Involving the Neurosciences, Neuropsychopharmacology, and Biological Psychiatry. Applications of New Findings Involving the Content Analysis of Verbal Behavior to Clinical Medicine and Clinical Psychiatry. Measurement of the Content Analysis of Natural Language by Computerized Artificial Intelligence as a Means of Facilitating and Speeding Up Verbal Behavior Analysis.

The emotional impact of mastectomy

To learn about the effects of unilateral mastectomy, the emotional responses of four groups of women were compared 1-3 and 10-12 months after surgery: (1) mastectomy group (n = 125)--women who had a unilateral mastectomy for stage I or II breast cancer; (2) biopsy group (n = 65)--women who had a biopsy revealing benign breast disease; (3) cholecystectomy group (n = 75)--women who had a cholecystectomy; (4) healthy group (n = 84)--women who had not had a major surgical intervention. Measures of emotions were: (1) the SCL-90 Analogue; (2) the Global Assessment Scale (GAS); and (3) the Gottschalk-Gleser Content Analysis Scale. The mastectomy group had significantly higher mean Gottschalk-Gleser scores for total anxiety, death and mutilation anxiety, ambivalent hostility, total denial and anxiety denial, and hopefulness. Significant reductions were found in mean total anxiety, mutilation, and shame anxiety in the mastectomy group and in total, death, and mutilation anxiety in the cholecystectomy group between the two postsurgical assessments. The mastectomy group had a significantly higher mean anxiety and depression score than the healthy group on the SCL-90 at both time points. The mastectomy and cholecystectomy groups had lower emotional well-being scores on the GAS than the healthy group over both testing periods. The groups also differed in their amount of change on the GAS over time. All measures, especially the Gottschalk-Gleser scales, showed significantly more psychopathological emotional responses in the mastectomy group, somewhat less in the cholecystectomy group, and the least in the biopsy group.

A context analysis of psychological states prior to petit mal EEF paroxysms.

This is the first report in the literature of an application of the rigorous symptom-context method for determining the nature of the psychological antecedents of petit mal EEG paroxysmal activity. The activity is defined by the presence of a 3 cycle/second spike and wave on the EEG which is recorded concurrently while the patient is speaking his thoughts freely during interviews. The content of the patients speech before each petit mal episode is compared with the content of speech during non-paroxysmal periods. Three petit mal patients were examined in this way for four sessions each. (Total petit mal EEG paroxysms for patient no. 1 were 19, patient no. 2 were 25, and patient no. 3 were 55.) For the first patient, strong psychological antecedents were found before petit mal EEG paroxysms as compared with comparison periods from the same patient. These consisted of such usual negative affects as feeling depressed and blocked. For the two other patients, only a few psychological antecedents discriminated significantly and these were not of the same type across the three patients. We conclude that the patients differ in amount and type of psychological antecedents. The differences may be attributed to differences in the type of petit mal and/or differences in the psychological component to the petit mal. The differences among the patients are probably not related to the average length of the paroxysms since we have shown that the relationships with the duration were generally insignificant. The paroxysms occurred more often during the patients silence than during the patients speech (for two of the three patients) — talking probably requires more focused attention than silence; more focused attention or activity tends to reduce these episodes.

Abnormalities in hair trace elements as indicators of aberrant behavior

There are long-standing viewpoints that impulsive and violent behavior may stem from brain dysfunction or damage secondary to head injury, disease, or toxic chemical substances. This research has aimed to examine the relationship between potentially toxic metals and aberrant behavior, especially violent activity, through the nonintrusive technique of hair analysis for trace elements. In an initial study, phase I, it was not possible to replicate findings of others who reported high levels of lead, cadmium, and copper in violent offenders. However, high levels of manganese were found in prison versus control groups. In phase II, the possibility of artifactual results arising from prison cooking utensils was controlled for by sampling early after incarceration. Phase III was included to substantiate the initial post hoc findings in an additional jail population. In both latter phases, significantly elevated manganese levels were found in the hair of violent versus nonviolent subjects (P less than .0001). A review of the effects of manganese at deficient and toxic levels does not provide a simple answer as to why manganese levels are elevated in the hair of individuals who have been incarcerated for violent behavior. Our study does not implicate the prison environment or soaps and shampoos used in California prisons. Other factors, such as alcohol, dietary, or psychosocial factors, might influence manganese levels in hair, or any of these factors might function in combination with mild manganese toxicity to contribute to aberrant behavior.

Anxiety Levels in Dreams: Relation to Changes in Plasma Free Fatty Acids

Blood samples for determination of plasma free fatty acids were obtained throughout the night by means of an indwelling catheter. The first sample was drawn at the onset of rapid eye movements and a second after 15 minutes of these movements. Subjects were then awakened and asked to relate their dreams; a third sample was drawn 15 to 25 minutes later. Anxiety scores derived from 20 dreams of nine subjects had significant positive correlations with changes in free fatty acids occurring during REM sleep. No statistically significant relation was found between anxiety and the changes in free fatty acids occurring from the time just before awakening to 15 to 25 minutes later. Presumably, anxiety in dreams triggers the release of catecholamines into the circulation, and these catecholamines mobilize proportional amounts of free fatty acids from body fat.

Thioridazine plasma levels and clinical response.

Summary o 1. The relationship between indices of plasma thioridazine concentration (half-life, area under curve, peak level) and clinical response was examined over a 10-day period in 25 patients with severe to moderately severe acute schizophrenia following a single oral dose (on day one) of a placebo and of thioridazine, 4 mg/kg (on day 6). This was a preliminary study, and the findings obtained here are being tested in continuous dose studies of schizophrenic patients. 2. Significant improvement in only 2 of 18 Overall-Gorham BPRS items occurred predrug (days 1–6), namely, in Guilt ( p p 3. Following the single dose of thioridazine, a significant average decrease was noted within 24 hr in the social alienation-personal disorganization scores, and within 48 hr in nine subscales of the BPRS, two of four factor scores of the BPRS, three of four Hamilton Depression Rating Scale factors, and one of six Wittenborn Rating Scale factors. The manifestations of the schizophrenic syndrome showing such significant improvement included Thought Disorder, Conceptual Disorganization, Apathy, Anxiety, and Depression. 4. Significant correlations were found between indices of plasma thioridazine levels and favorable clinical responses on certain behavioral and psychologic features of the schizophrenic syndrome. 5. Suggestive evidence was obstained which points to some predrug behavioral and clinical laboratory data that may serve as predictors of thioridazine pharmacokinetics.

peripheral Versus Central Mechanisms Accounting for Antianxiety Effects of Propranolol

&NA; A &bgr;‐adrenergic blocking agent, propranolol (60 mg orally in three divided doses over a 12‐hr period), significantly reduced basal anxiety scores in 12 healthy, nonanxious subjects as compared to a placebo in another 12 similar subjects. In response to a 10‐min stress interview, anxiety scores increased to equal levels, whether subjects were on propranolol or a placebo. On placebo, anxiety scores correlated positively (+0.70) with average plasma FFA. On propranolol, anxiety scores correlated negatively (‐0.55) with plasma FFA and the average pulse rate was significantly lowered. The experimental findings suggest that basal or resting anxiety may be maintained by peripheral afferent autonomic biofeedback, and the latter can be reduced by &bgr;‐adrenergic blocking agents; whereas, the magnitude of acutely aroused anxiety is mediated more through the central nervous system.

The measurement of anxiety through the computer analysis of verbal samples

METHOD for measuring both labile emotional and more permanent psychological events through content analysis of verbal behavior has been developed by Gottschalk and Gleser.‘~’ Its research and clinical applications have been reviewed elsewhere.3.4*5.6.7 A variety of psychological dimensions can be measured, including anxiety, hostility, social alienation-personal disorganization, cognitive and intellectual impairment, human relations, and hope. The method identifies concepts and actions signifying relevant emotional and psychological states or traits, and scoring of a speech sample involves detecting references to these concepts and actions. These references in verbal samples may take many forms, ranging from a direct reference by a single word to a metaphorical reference over several clauses. Detecting such references accurately and uniformly requires careful and time-consuming training, even for technicians well versed in the language. Content analysis by this method is an expert task, requiring a great deal of training and constant rechecking of skills. As an expert task, it provides an interesting challenge for “artificial intelligence,” the study of thought and action in forms that can be expressed in computer programs.’ Creating a computer system which can perform as well as a trained human scorer, in effect replacing such a scorer, is a major task. Fortunately, there are extensive records of past human performances and established standards to draw upon to measure the success of any computer system. Beyond the challenge of an expert task, there are more specific problems to be solved in the areas of natural language processing, such as, knowledge representation, and inference. Speech, as uttered by people, is quite different than the clean formal theories of competence often proposed by linguists.‘,” People simply do not speak in well formed, self-contained sentences. This places the task beyond the bounds of any present grammatically based computer system. Since syntax does not provide a total solution, the appropriate step is to consider semantics. While some natural language processing systems incorporate semantic markers associated with individual words, such an approach is insufficient for this task. Successful computer analysis requires recognition of themes and concepts underlying the surface form of expressions. At the least, any proposed computer system must be able to recognize and