Out-patient behaviour therapy in alcoholism: relapse rates after 6 months

OBJECTIVE

In spite of the increasing interest in out-patient treatment programmes for alcoholics, there still exist only a few experimental studies on this issue. In this still ongoing study the efficacy of different behaviour therapy strategies is to be examined.

METHOD

One hundred and twenty patients were assigned randomly to non-specific supportive therapy or to two forms of behavioural therapy (coping skills training and cognitive therapy). Behavioural treatment comprised 26 weekly sessions; follow-up examinations will take place every 6 months over 2 years.

RESULTS

Patients undergoing behavioural therapy showed less drop-outs and significantly higher rates of abstinence compared with supportive treatment. Nevertheless, statistically significant differences between the two behavioural therapy strategies could not be established so far.

CONCLUSION

Preliminary results demonstrate the feasibility and efficacy of behaviour therapy programmes in the out-patient treatment of alcoholism. Furthermore, they stress the importance of professional psychiatric and psychotherapeutic engagement in the field of addiction.

Electrophysiological correlates of emotional and structural face processing in humans

In order to study brain potentials related to decoding of facial expressions of emotions and those, related to basic perception of faces 16 right-handed subjects performed tasks on facial emotion recognition and perception of blurred faces and objects. Electroencephalograph (EEG) recordings during performance of the tasks revealed similar event-related potentials during the presentation of faces at 120 and 170 ms after stimulus onset in both of the tasks but significant differences in amplitudes between 180 and 300 ms. Whereas faces in the emotion recognition task produced high amplitudes in that latency range, potentials in response to faces in the blurred object condition were virtually absent. These data point to the assumption that decoding of facial expressions starts early in the brain and might be processed separately from basic stages of face perception.

Neurophysiological correlates of the recognition of facial expressions of emotion as revealed by magnetoencephalography

MEG correlates of the recognition of facial expressions of emotion were studied in four healthy volunteers. Subjects performed a facial emotion recognition task and a control task involving recognition of complex objects including faces. Facial emotion recognition activated inferior frontal cortex, amygdala and different parts of temporal cortex in a relatively consistent time sequence. The characteristics of these activations were clearly different from those recorded during the control task. Most interesting was the fact that faces evoked different MEG responses as a function of task demands, i.e., the activations recorded during facial emotion recognition were different from those recorded during simple face recognition in the control task. These findings support the assumption that MEG is able to specifically identify the activation pattern of the brain when recognition of the emotional expression of a face is performed.

Influence of Scanning Eye Movements on the Scintillating-Grid Illusion

The scintillating grid is an example of a brightness contrast illusion in which bright disks are superimposed on a Hermann grid. Dark spots are perceived within the bright disks as flashing with each flick of the eye (Schrauf et al Vision Research in press). With steady fixation, stimulation must be brief for the illusion to occur. Varying exposure duration with steady fixation, we found the maximum illusion at durations between 210–350 ms (Schrauf et al, 1996 Perception25 Supplement, 78).

In the present study voluntary saccadic eye movements were used to produce brief exposures during fixations. The task of 5 trained subjects was to scan scintillation grids of five different spacings (0.5 – 2.0 deg separation of grid elements, observation time 60 s) in a manner yielding a maximum scintillating effect. Eye movements were recorded binocularly at 100 Hz with the Demel Debic 90 infrared corneal reflection tracker (resolution: 6 min arc). For each fixation we calculated latency and position. Durations and amplitudes of the saccades increased with decreasing angular separation of grid elements. When the illusion was maximal, roughly 60% of fixation durations were between 250 and 550 ms. These durations overlap with those obtained with steady fixation combined with variable exposure durations. Unlike the Hermann grid illusion, where illusory dark spots can be perceived at very brief exposure durations, the scintillating grid illusion takes much more time to develop. The long optimal durations found here are discussed in relation to mechanisms of scanning eye movements.

Facial-affect recognition and visual scanning behaviour in the course of schizophrenia

The performance of schizophrenic in-patients in facial expression identification was assessed in an acute phase and in a partly remitted phase of the illness. During visual exploration of the face stimuli, the patient's eye movements were recorded using an infrared-corneal-reflection technique. Compared to healthy controls, patients demonstrated a significant deficit in facial-affect recognition. In addition, schizophrenics differed from controls in several eye movement parameters such as length of mean scan path and mean duration of fixation. Both the facial-affect recognition deficit and the eye movement abnormalities remained stable over time. However, performance in facial-affect recognition and eye movement abnormalities were not correlated. Patients with flattened affect showed relatively selective scan pattern characteristics. In contrast, affective flattening was not correlated with performance in facial-affect recognition. Dosage of neuroleptic medication did not affect the results. The main findings of the study suggest that schizophrenia is associated with disturbances in primarily unrelated neurocognitive operations mediating visuomotor processing and facial expression analysis. Given their time stability, the disturbances might have a trait-like character.

Facial affect recognition in the course of schizophrenia

Deficits in facial affect recognition have been shown repeatedly in schizophrenia. However, the stability of this deficit over time remains to be clarified. A total of 36 remitted, 32 acutely ill schizophrenic patients and 21 healthy volunteers participated in a cross-sectional and longitudinal study. All subjects were assessed twice within 4 weeks (acute schizophrenics and normal controls), or 12 weeks, respectively (remitted schizophrenics). Subjects had to identify six basic emotions from corresponding facial expressions shown as photographs on a video screen. Both acute and remitted schizophrenics demonstrated a stable deficit over time in facial affect recognition unrelated to psychopathology and medication. This suggests that deficits in facial affect recognition in schizophrenia reflect a trait-like, rather than a state-dependent, characteristic.

Facial expression and emotional face recognition in schizophrenia and depression

Twenty-three acute schizophrenics, 21 acute major depressives (Research Diagnostic Criteria), and 15 normal controls participated in a study on facial expression and emotional face recognition. Under clinical conditions, spontaneous facial expression was assessed according to the affective flattening section of the Scale for the Assessment of Negative Symptoms. Under experimental laboratory conditions involuntary (emotion-eliciting interview) and voluntary facial expression (imitation and simulation of six basic emotions) were recorded on videotape, from which a raterbased analysis of intensity or correctness of facial activity was obtained. Emotional face recognition was also assessed under experimental conditions using the same stimulus material. All subjects were assessed twice (within 4 weeks), controlling for change of the psychopathological status in the patient groups. In schizophrenics, neuroleptic drug influence was controlled by random allocation to treatment with either haloperidol or perazine. The main findings were that schizophrenics and depressives are characterized by different quantitative, qualitative, and temporal patterns of affect-related dysfunctions. In particular, schizophrenics demonstrated a trait-like deficit in affect recognition and in their spontaneous and voluntary facial activity, irrespective of medication, drug type and dosage, or extrapyramidal side-effects. In depressives a stable deficit could be demonstrated only in their involuntary expression under emotion-eliciting interview conditions, whereas in the postacute phase a reduction in their voluntary expression became apparent. Differences in patterns of affect-related behavioral deficits may reflect dysfunctions in different underlying psychobiological systems.