Vicki E. Pollock

A Metaanalysis of Controlled Trials of Neuroleptic Treatment in Dementia

Prior qualitative literature reviews about the use of neuroleptics in dementia suggest that they are “modestly effective” in treating agitation and that no single neuroleptic is better than another. To develop a more precise concept of the clinical efficacy of neuroleptics, a meta‐analytic review of the existing literature was performed. From double‐blind clinical trials that compared a neuroleptic with a placebo in agitated dementia patients, P values and effect‐size estimates were obtained, and were assessed by metaanalytic techniques. Results indicated that neuroleptics were significantly more effective than placebo (one‐tailed P = .004) and had a small effect size (r = .18). Clinically, neuroleptic treatment changed the improvement rate in agitated dementia patients from .41 to .59 (binomial effect‐size display). This indicates that 18 of 100 dementia patients benefited from neuroleptic treatment (beyond that of placebo) and is consistent with the modest efficacy described in previous qualitative reviews. In six studies comparing thioridazine with another neuroleptic, and in five studies comparing haloperidol with another neuroleptic, metaanalysis results did not show that these two medications differed significantly from the comparison medications, which is not inconsistent with the opinion that no single neuroleptic is better than another.

Meta-analysis of P300 amplitude from males at risk for alcoholism.

The P3(00) event-related brain potential (ERP) is used to study the development of alcoholism by comparing males who have a positive family history of alcoholism with control Ss who have no such familial history. Meta-analysis indicated that overall, smaller P3 amplitudes were obtained from males with family histories of alcoholism compared to controls. Moderator analysis indicated that paradigms using difficult visual tasks yielded the most reliable effects. Furthermore, no differences in outcomes were obtained among studies that recruited positive family history Ss exclusively from among individuals whose father had received treatment for alcoholism as compared with other studies. These findings are discussed in the context of using ERPs as an evaluative tool in the study of psychopathology.

Alcohol and aggression: a meta-analysis on the moderating effects of inhibitory cues, triggering events, and self-focused attention

The authors conducted a meta-analysis of 49 studies to investigate 2 explanations of how alcohol increases aggression by decreasing sensitivity to cues that inhibit it. Both the level of anxiety and inhibition conflict moderated the difference between the aggressive behavior of sober and intoxicated participants, but neither level adequately accounted for variation in effect sizes. Additional analyses of 3 social psychological moderating variables-provocation, frustration, and self-focused attention-showed that the aggressiveness of intoxicated participants relative to sober ones increased as a function of frustration but decreased as a function of provocation and self-focused attention. The authors also examined the moderating effects of dose.

A Theoretical Model of Triggered Displaced Aggression

A tit-for-tat matching rule (Axelrod, 1984) describes much interpersonal behavior. Yet, in daily lift a retaliatory aggressive response to a trivially mild provocation often inappropriately exceeds that expected from the matching rule. The concept of triggered displaced aggression can explain these exceptions to the matching principle. Building from the Cognitive Neoassociationistic model of aggressive behavior (Berkowitz, 1989, 1990, 1993), we developed a theoretical framework of social and personality factors that moderate and mediate the disjunctively escalated retaliation that can result from triggered displaced aggression. Major explanatory factors in our analysis of such effcts are as follows: (a) aspects of the Time 1 provocation and the immediate situation in which it occurred; (b) characteristics of initial provocations and personality factors of the actor that produce the ruminative thought that will temporally extend the effects of a Time 1 provocation, allowing them to interact with a delayed Time 2 minor triggering event; and (c) actions and attributes of the target of displaced aggression that augment these effects.

Quantitative, waking EEG research on depression

Research published in the past decade that used quantitative indices to evaluate the waking EEG characteristics of depressed patients is reviewed. Methodological problems that make results of different research laboratories difficult to compare include diagnostic heterogeneity of depressed groups, lack of inclusion of control subjects, and differences in the EEG techniques. Despite interpretive problems that arise from such substantial variation, consistencies nevertheless emerge. Unmedicated, actively depressed patients appear to exhibit elevated EEG alpha and beta compared to control subjects. Delta and theta distinguished depressed patients from controls in some single studies, but variation in age, specific diagnostic depression categories, and EEG acquisition and analysis techniques rendered these results less definitive. Quantitative EEG differences that may distinguish depressed subject samples from those with other psychiatric disorders are considered. Factors that limit comparability of the findings are discussed in conjunction with strategies that deserve systematic study in future research.

The Geriatric Depression Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population.

Older adult outpatients with major depression (n=25) and healthy control subjects (n=25) were compared using the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI). Both measures were sensitive in detecting clinical depression. Subjects were, however, more likely to endorse multiple responses in BDI items, suggesting that the GDS is simpler for older adults to complete. Viewed within the context of previous relevant research that used these instruments to compare older dults, our results yield additional evidence of cross-study consistency in the functional efficiency of both measures

Reliability of topographic quantitative EEG amplitude in healthy late-middle-aged and elderly subjects☆

Reliabilities of quantitative measures of absolute and relative EEG amplitudes were assessed in healthy older adults under the eyes closed (n = 46) and eyes opened (n = 45) conditions. For the theta, alpha, beta 1, and beta 2 bands, reliabilities of 28 scalp derivations were stable over the 4.5 month test interval. Reliabilities of delta were lower. When appropriate transformations were applied, the reliabilities of absolute EEG amplitude measures tended to exceed those of relative measures. There were not, however, striking differences in reliabilities under the eyes closed, as compared to eyes opened condition. We concluded that when coupled with the criterion of interpretability, the generally higher reliabilities of absolute, as opposed to relative, amplitude measures render them preferable in clinical research.

Profile of Mood States: the factors and their physiological correlates.

Spontaneously occurring mood states and various physiological indices were evaluated on three occasions in a group of eight healthy males. Results reveal that significant positive correlations exist among five of the six factors comprising the Profile of Mood States (POMS). This finding is related to previous research on the POMS and varied methodologies utilized in those reports. Reliable positive correlations of the POMS factors Depression and Tension with heart rate and diastolic blood pressure were obtained. The Anger factor of the POMS also correlated positively and significantly with heart rate. These findings are discussed in terms of the relationship between POMS factors and anxiety.

EEG amplitudes in healthy, late-middle-aged and elderly adults: normality of the distributions and correlations with age.

The interindividual distributions of EEG amplitudes were evaluated in 60 healthy subjects, aged 56-76. Skew and kurtosis were used to assess the normality of the amplitude distributions in 5 frequency bands (delta, theta, alpha and 2 beta ranges) and 28 scalp derivations while the subjects were awake and rested with their eyes closed and opened. Most of the interindividual EEG amplitude distributions were not normally distributed. Two transformations were applied to the EEG amplitudes: the square root and the natural logarithm. Evaluation of skew and kurtosis indicated that the natural logarithmic transformation was more effective than the square root in reducing the positive skew and leptokurtosis that characterized the untransformed interindividual EEG amplitude distributions. For all frequency bands except theta, the log transformation rendered the distributions approximately normal in form. Correlations between log transformed EEG amplitudes and age were not statistically significant. These findings are discussed in the context of previous research, aging, and methodological features.

Sex of parent and offspring in the transmission of alcoholism. A meta-analysis.

Familial studies of alcoholism were reviewed to evaluate the role of sex of parent and offspring in alcoholism transmission. Data from 32 familial alcoholism studies were evaluated by meta-analysis. The results indicated that both male and female alcoholic patients more frequently come from homes in which their father, rather than their mother, is alcoholic, even when sex differences in alcoholism prevalence rates are taken into account. Although female offspring of alcoholic mothers show alcoholism rates that are elevated relative to those expected in the general population, male offspring of alcoholic mothers do not.