Glutathione S-transferase P1 Ile105Val polymorphism modulates allergen-induced airway inflammation in human atopic asthmatics in vivo

BACKGROUND

Glutathione S-transferase P1 is a Phase II cytoprotective and detoxifying enzyme that is widely expressed in human airways. The glutathione S-transferase P1 Ile105Val polymorphism has been linked with atopic disorders and asthma. Yet, little remains known about the regulation of allergic inflammation by glutathione S-transferase P1 in human asthmatics.

OBJECTIVE

To establish the effect of the glutathione S-transferase P1 Ile105Val polymorphism on allergen-induced airway inflammation and oxidant stress, and non-specific bronchial hyperresponsiveness to methacholine and reactivity to specific allergen in mild human atopic asthmatics in vivo.

METHODS

Five Val(105)/Val(105) , twelve Val(105)/Ile(105) and twenty Ile(105)/Ile(105) mild atopic asthmatics underwent methacholine challenge, inhaled allergen challenge and endobronchial allergen provocation through a bronchoscope. A panel of inflammatory cytokines and chemokines, F2 -isoprostanes and isofuranes, markers of oxidative stress, thromboxane B2 and immunoglobulin E were measured in bronchoalveolar lavage fluid at baseline and 24 h after allergen instillation.

RESULTS

Asthmatics with glutathione S-transferase P1 Val(105)/Val(105) compared with asthmatics with the glutathione S-transferase P1 Val(105)/Ile(105) and Ile(105)/Ile(105) had greater generation of acute phase cytokines (TNF-α, IL-6, CXCL8), IL-12, CCL11, thromboxane B2 and immunoglobulin E at 24 h after local allergen challenge. The GSTP1 genotype had no effect on airway hyperresponsiveness to methacholine and the reactivity to specific allergen.

CONCLUSION

The glutathione S-transferase P1 Ile105Val polymorphism markedly modifies allergen-provoked airway inflammation in atopic asthmatics in vivo. Modulation of the biochemical milieu in response to allergen provides a mechanistic explanation for regulatory effects of glutathione S-transferase P1 polymorphism on airway pathophysiology, and may guide improvement of future therapeutic methods in human atopic asthmatics. These findings must me confirmed in a larger study population of asthmatics with various ethnicities.

[Non-invasive, spatially resolved determination of tissue properties of the crystalline lens with regard to rheology, refractive index, density and protein concentration by using Brillouin spectroscopy]

The confocal Brillouin spectroscopy is an innovative measurement method that allows the non-invasive determination of the rheological properties of materials. Its application in ophthalmology can offer the possibility to determine in-vivo the deformation properties of sections of transparent biological tissue such as the cornea or eye lens with spatial resolution. This seems to be a promising approach concerning current presbyopia research. Due to the spatially resolved detection of the viscoelastic lens properties, a better understanding of the natural aging process of the lens and the influences of different lens opacities on the stiffness is expected. From the obtained spectral data the relative protein levels, the relative refractive index profile and the relative density profile within the lens tissue can be derived in addition. A measurement set-up for confocal Brillouin microscopy based on spectral analysis of spontaneous Brillouin scattering signals by using a high-resolution dispersive device is presented. First in-vitro test results on animal and human lenses are presented and evaluated concerning their rheological significance. These data are compared with known research results.

The vibrant soundbridge for conductive and mixed hearing losses: European multicenter study results

BACKGROUND/AIMS

The Vibrant Soundbridge (VSB) is an active middle ear implant, 'direct-drive' hearing system for the treatment of hearing loss. Recently, the VSB has been applied to conductive and mixed hearing losses. The aim of this study is to evaluate aided benefit, speech recognition in quiet and noise, subjective benefits, changes in residual hearing, and medical and surgical complications in adults with conductive or mixed hearing losses implanted with the VSB using Round Window (RW) Vibroplasty.

METHODS

Twelve German-speaking adults participated in a single-subject, repeated measures study design comparing their performance using the VSB with their own unaided preoperative performance. Hearing performance and changes in residual hearing were assessed using routine audiometric measures, sound field thresholds, and word and sentence recognition in quiet and in noise. Subjective benefits, including subjective hearing performance, device satisfaction, and quality of life were evaluated using the Abbreviated Profile of Hearing Aid Benefit, the Hearing Device Satisfaction Scale, and the Glasgow Benefit Inventory, respectively.

RESULTS

Aided hearing thresholds, word recognition at conversational levels, and sentence recognition in quiet and noise were significantly improved without significant changes in residual cochlear hearing and without major medical and surgical complications. One subject required repositioning surgery to improve transducer coupling with the RW membrane. Subjective benefit and device satisfaction were good, as were overall and general quality of life.

CONCLUSION

The VSB, implanted using RW vibroplasty, is a safe and effective treatment for adults with conductive and mixed hearing losses who may have few, if any, other options.

[Differential diagnosis of anorexia nervosa and depression. A case report of Addison's disease in a female patient]

Similar symptoms make the differential diagnosis of anorexia nervosa and Addison's disease difficult at times: vomiting, weight loss, hypotension, depressed mood, reduced drive, and increased irritability can occur in both disorders. Psychological factors are then frequently presumed to be causative, so that the diagnosis of Addison's disease is made only years after the onset of the disease. Against this background, our case report presents important differential features, particularly with regard to consultative psychiatry.

Non-TBI stem cell transplantation protocol for Fanconi anaemia using HLA-compatible sibling and unrelated donors

Allogeneic haemopoietic stem cell transplantation (SCT) is the only curative option for severe bone marrow (BM) failure in patients with Fanconi anaemia (FA). We have developed a non total body irradiation (TBI) conditioning protocol consisting of fludarabine (120-150 mg/m(2)), low dose of cyclophosphamide (40 mg/kg) and antilymphocyte globulin (45 mg/kg). Graft-versus-host disease (GVHD) prophylaxis was with cyclosporin alone for sibling allografts but also included Campath-1 H (days 1-5 post SCT) for the unrelated allografts. We have performed two sibling and two unrelated BM transplants with a follow-up of 11-51 months. All patients experienced minimal toxicity and were discharged from hospital 28-32 days post SCT. Neutrophil and platelet engraftment occurred from days 11 to 19 and 15 to 34, respectively. All patients achieved stable full donor haemopoiesis with normalisation of the peripheral blood count despite one of them having myelodysplasia (MDS) with 8% blasts prior to the SCT. The only site of acute GVHD was in the skin (grade I-II) and only one patient progressed to limited chronic GVHD. This protocol is associated with reduced toxicity and prompt engraftment in FA patients with AA and/or MDS undergoing SCT using sibling or unrelated donors.

Improvement in cognition associated with novel antipsychotic drugs: a direct drug effect or reduction of EPS?

BACKGROUND

Administration of novel, versus classic, antipsychotic agents to patients suffering from psychosis is associated both with moderately better scores on cognitive tests, and with fewer extrapyramidal symptoms (EPS). Because improved motor functioning may enable better performance on some components of cognitive test batteries, and because the advantages of the novel antipsychotics on cognitive performance are not very large, it is sometimes difficult to discern if improvement in a given cognitive task is due to a direct effect of the novel antipsychotic drug, or is secondary to the novel drug's decreased propensity to induce EPS. In an attempt to distinguish between these two possibilities, the present study examined the ability of patients suffering from schizophrenia receiving classic, versus novel antipsychotics, to perform a computerized visuo-motor test (VMT). VMT assesses planning capabilities, attention and executive functions known to be impaired in schizophrenia, which are suggested to be affected by novel antipsychotics.

METHODS

Seventy-six patients suffering from schizophrenia or schizophreniform disorder, receiving haloperidol (23 patients, mean dose 10.01+/-6.1mg/day), olanzapine (26 patients, mean dose 10.56 +/- 4.9 mg/day) or risperidone (27 patients, mean dose 4.35 +/- 1.7 mg/day) were assessed for EPS using the parkinsonian subscale of the Extrapyramidal Symptom Rating Subscale (ESRS), and with the VMT.

RESULTS

Cognitive functioning as measured by the VMT was better for patients receiving risperidone or olanzapine, compared with those receiving haloperidol (F=6.636, df=2,67, P=0. 002), while the patients receiving haloperidol or risperidone suffered from more severe EPS compared with the patients receiving olanzapine (F=3.996, df=2,71, P=0.023).

DISCUSSION

Although the patients receiving risperidone suffered from EPS similar in severity to the EPS of the patients receiving haloperidol, their performance on a task involving visuo-motor and attentional skills was similar to that of the patients receiving olanzapine. This finding implies that there is a dissociation between the antipsychotic drug's ability to affect cognitive functioning, and EPS. This dissociation indirectly suggests that the advantages offered by novel antipsychotics on cognitive performance are a direct effect, rather than being entirely mediated by improved movement abilities.

Preparation of surface modified protein nanoparticles by introduction of sulfhydryl groups

The objective of the present study was to establish several methods for the introduction of thiol groups onto the surface of human serum albumin (HSA) nanoparticles. Besides the epsilon-amino groups of lysine, the carboxyl groups of asparaginic and glutaminic acid, and the carbonyl groups of the cross-linker glutaraldehyde, sulfhydryl groups are possible targets for the covalent linkage of drugs to particle surfaces. In principle, the thiol groups were introduced by the reaction with dithiotreitol (DDT) or 2-iminothiolane, by quenching reactive aldehyde residues with cystaminiumdichloride or by coupling L-cysteine and cystaminiumdichloride by the aqueous carbodiimide reaction. The resulting nanoparticulate systems were characterised concerning the number of available sulfhydryl groups, particle size and particle density. It was shown, that by variation of the reaction conditions, e.g., the concentration of the coupling reagent or the sulfhydryl containing component as well as the reaction time, the proposed methods enabled the preparation of HSA nanoparticles with a well defined surface characteristic. Stability studies showed that the introduced thiol groups were relatively stable and lost their reactivity with a half-life of 28.2 days independently of the method used for the sulfhydryl group introduction. Besides the quantification of free sulfhydryl groups the covalent attachment of cystaminiumdichloride by the carbodiimide reaction was used to calculate the amount of free carboxyl groups on the surface of the nanoparticles. The toxicity of the modified nanoparticles was evaluated in cell culture experiments.

[A structured course for primary care physicians on breaking bad news]

Physicians are frequently required to break bad news to their patients. Previous research has shown that inconvenience, incompetence, and difficulty in dealing with patients' feelings are the main complaints expressed by physicians after such an encounter. Current educational programs dealing with breaking bad news are usually short, given in lecture format, and are inadequate in addressing essential issues such as knowledge, personal beliefs and attitudes, and previous personal experiences of physicians in such situations. In the past 8 years our Dept. of Family Medicine has implemented a course in breaking bad news that addresses these issues. A senior family practitioner and a medical social worker conduct 14 sessions of discussions and role-playing for small groups of residents and primary care physicians. The program is based on: theory dealing with methods of managing stress and crisis intervention, clarifying personal attitudes, discussions of previous personal encounters of the participants, various modalities of communication, methods of addressing patients' feelings and emotions, and coping with the emotions of the one breaking the bad news. On a 1-5 Likert scale questionnaire the course received an overall score of 4.47 (SD 0.51). Participants noted that they gained relevant communication skills for future patient encounters. A reliable examination of practitioners' competence in breaking bad news is mandatory in order to assess the efficiency of such courses.

Sensitivity, functional analysis, and behavior genetics: a response to Freeman et al

Freeman et al. (1998) asserted that sensitivity theory is circular, unsupported by empirical evidence, and represents an "either/or" decision in regard to applied behavior analysis. We reply by showing that sensitivities are objectively measured and that our theory permits testable predictions. Further, we briefly summarize the results of recent studies that support our theory, including investigations that link sensitivities to genes and challenging behavior. Finally, we reject the idea that sensitivity theory and functional analysis represent an "either/or" viewpoint and call again for research to integrate these approaches.

Inductively coupled surface acoustic wave device for sensor application

We present a new type of surface acoustic wave device for sensor applications where the need for bonding wires is eliminated. Instead the device is coupled inductively to the RF circuitry. The impedance of such devices and the necessary matching have been investigated both theoretically and experimentally. The devices have repeatedly been operated at temperatures up to 400 degrees C and have shown a good temperature resistance. In order to test the suitability of the new concept for sensor applications, several devices with an operating frequency of 363 MHz were coated with copper phthalocyanine for the detection of NO(2). From these measurements we derive a detection limit of these devices below 1 ppb for NO(2).

The international consensus process on psychopharmacology and intellectual disability

The present authors invited 115 scientists, practitioners and consumers from 11 nations to form an international consensus panel on best practices and clinical effects regarding psychoactive medicines and intellectual disability. Co-sponsors included the American Association on Mental Retardation, the American Psychiatric Association, the American Psychological Association, the National Institute of Mental Health, the National Association on Dual Diagnosis and The Arc of the United States. The panel developed 21 reports that were revised to reflect comments from 351 participants at a 1995 Ohio State University conference in Columbus, OH, USA. The reports will be published as chapters in a forthcoming book entitled Psychotropic Medication and Developmental Disabilities: The International Consensus Handbook. The need for research and training programmes is discussed.

The Reiss Screen for Maladaptive Behavior: confirmatory factor analysis

We tested the factorial stability of the Reiss Screen for Maladaptive Behavior (Reiss, 1988a, The Reiss Screen for Maladaptive Behavior test manual). Reasonable fit was demonstrated in a geographically diverse sample of 448 individuals with mild, moderate, severe and profound mental retardation according to four measures of overall fit: RMSEA, ECVI, NNFI, and NFI. The results confirm Reiss' (1988a) factor solution of this widely used dual diagnosis (mental retardation and mental illness) screening instrument.

Comments on the Reiss screen for maladaptive behaviour and its factor structure

Sturmey's factor analysis of the Reiss Screen for Maladaptive Behavior is based upon several significant errors, some of which are of general interest because misuse of factor analysis is common (Ford et al. 1986). In this commentary, the author discusses; the concept of factor robustness; appropriate samples for evaluating the factor structure of a dual diagnosis instrument, the differences between exploratory and confirmatory analyses; and how the Reiss Screen was intended to fulfill its purpose. In the Sturmey study, the Reiss Screen may have actually performed well under adverse conditions. The criteria for conducting valid factor analytic studies of dual diagnosis instruments are identified in order to encourage future research evaluating the Reiss Screen and other instruments.

Sensitivity theory and mental retardation: why functional analysis is not enough

Sensitivity theory holds that aberrant behavior is a function of aberrant contingencies (direct reinforcement of maladaptive behavior), aberrant motivation (a desire for an excessive amount of reinforcement), and aberrant environments (situations in which most people cannot satiate their fundamental desires by behaving appropriately). Applied behavior analysts are almost exclusively concerned with aberrant contingencies and, to a lesser extent, aberrant environments. Because they do not treat people for aberrant motivation, behaviorists tend to treat the same people repeatedly. When a person craves an excessive amount of attention, this desire must be reduced for a durable and generalized treatment outcome, but behaviorists do not even try to do this. Implications for communication theory, assessment, and treatment strategies were discussed.

Trait anxiety: it's not what you think it is

Trait anxiety began as a psychodynamic concept, poorly tied to observables, and requiring Freudian defense mechanisms to explain recurrent anxiety episodes. Spielberger's thoughtful efforts improved the concept, but some important limitations remained. Lilienfeld, Turner, and Jacob (1989, 1993, 1996) uncritically accepted Spielberger's work on trait anxiety and asserted that it is the standard against which the concept of anxiety sensitivity should be judged (see also Lilienfeld, 1996). Taylor (1996) and McNally (1989, 1996) distinguished anxiety sensitivity from trait anxiety by noting that, whereas trait anxiety predicts future anxiety generally, anxiety sensitivity predicts future fear to anxiety sensations specifically. An important additional difference is that the two constructs use different indicators (past anxiety experiences versus ASI beliefs) to predict future anxiety and fear. Furthermore, only anxiety sensitivity implies that some phobics perceive the feared object to be harmless; what they fear is an uncontrollable anxiety/panic reaction to the stimulus, not the dangerous nature of the stimulus itself.

The sensitivity theory of motivation: implications for psychopathology

Sensitivity theory holds that people differ in both the types of reinforcement they desire and in the amounts of reinforcement they need to satiate. People who crave too much love, too much attention, too much acceptance, too much companionship, or too much of some other fundamental reinforcer are at risk for aberrant behavior because normative behavior does not produce the desired amounts of reinforcement. People who are intolerant of even everyday amounts of anxiety or frustration also are at risk for aberrant behavior. Individual differences in desired amounts of particular reinforcers may predict person-environment interactions, risk factors for psychopathology, and the occurrence of generalized and durable therapy effects versus the occurrence of relapses. Parallel predictions are made for individual differences in tolerance of aversive stimuli. Implications are discussed for applied behavior analysis, the development of psychopathology, and treatment strategies.

Composite versus multiple-rating scales in the assessment of psychopathology in people with mental retardation

This study tested the hypothesis that separate ratings of frequency and duration add significant information to ratings of problem severity in the assessment of psychopathology in people with mental retardation. The Reiss Screen was modified to require ratings of problem severity, frequency and duration for each of 38 maladaptive behaviours. The 171 adolescents and adults were rated by caretakers and supervisory staff on the modified Reiss Screen. The three ratings were found to be very highly intercorrelated. Moreover, multiple linear regression analyses revealed that the ratings of frequency and duration did not add significant information to that provided by ratings of problem severity in the prediction of psychiatric diagnosis in the person's case file. The results support the use of composite scaling over multiple-ratings in the assessment of psychopathology in persons with mental retardation.

Impact of heavy metals on mass and energy flux within the decomposition process in deciduous forests

: Laboratory experiments on microbial decomposition and on the contribution of diplopods to organic matter decomposition in soil were combined with field studies to reveal the major points of heavy metal effects on the leaf litter decomposition process. The study focused on the accumulation of organic litter material in heavy metal-contaminated soils. Microbial decomposition of freshly fallen leaves remained quantitatively unaffected by artificial lead contamination (1000 mg kg(-1)). The same was true for further decomposed leaf litter material, provided that the breakdown of this material was not influenced by faunal components. Although nutrient absorption in diplopods is affected by high lead contents in the food, this effect alone, however, was shown not to be sufficient for the massive deceleration of the decomposition process under heavy metal influence which could not only be observed in the field but occurred in microcosm studies as well. Reduced reproduction and lower activity of the diplopods most likely were responsible for the observation that lead-influenced diplopods enhanced microbial activity in soil only in a lesser degree than uncontaminated animals did. This effect is assigned to represent the main reason for decreased decomposition rates and the subsequent accumulation of organic material in heavy metal-contaminated soils.

Development of a psychopathology rating scale for children with mental retardation

A total of 583 children and adolescents with mental retardation were rated on a new psychometric instrument designed to screen for dual diagnosis (psychopathology in individuals with mental retardation). Two psychiatrists and two clinical psychologists judged the items to have face validity as expressions of psychopathology in children and adolescents with mental retardation. Cronbach's alpha coefficient was .91 for the total score and varied between .57 and .86 for 10 psychometric scales. Children and adolescents who had a dual diagnosis obtained total scores approximately 1 standard deviation higher than those who did not have a dual diagnosis. Each of 4 diagnostic groupings had test profiles in accordance with expectation. The results suggest that the instrument is particularly well suited for use in screening and for help in the analysis of the relationships between certain behavior problems and psychopathology.

Issues in defining mental retardation

Responses were made to MacMillan, Gresham, and Siperstein's (1993) criticisms of the new AAMR definition. The new AAMR definition does not raise the IQ limit and is not intended to increase the number of people considered to have mental retardation. There is no intent to change who is and who is not considered to have mental retardation. Instead, the intent is to change how people think about mental retardation: The old deficiency model is replaced with a new support model. MacMillan et al.'s criticisms are based on unfortunate misstatements of both the 1983 and the 1992 AAMR definitions of mental retardation and on misunderstandings of psychometric science. On the one hand, they argued that intelligence tests are culturally biased. On the other hand, they criticized the AAMR for not making greater use of inflexible IQ cutoffs in defining mental retardation. They misunderstood that cultural bias is an argument for, not against, flexibility in the interpretation of intelligence tests.

The changing conception of mental retardation: implications for the field

The 1992 American Association on Mental Retardation's (AAMR) definition and classification of mental retardation is different from the previous classification system in that: (a) a single diagnostic code of mental retardation is used if the person meets the three criteria of age of onset (18 or under), significantly subaverage abilities in intellectual functioning, and related limitations in two or more adaptive skills areas; (b) the person's strengths and weaknesses are described in reference to four dimensions: intellectual functioning and adaptive skills; psychological and emotional well-being; health, physical well-being, and etiology; and life activity environments; and (c) a profile of needed supports is developed across the four dimensions. In this article we discussed six major implications of the 1992 System for the field of mental retardation.

Development of a psychopathology rating scale for children with mental retardation

A total of 583 children and adolescents with mental retardation were rated on a new psychometric instrument designed to screen for dual diagnosis (psychopathology in individuals with mental retardation). Two psychiatrists and two clinical psychologists judged the items to have face validity as expressions of psychopathology in children and adolescents with mental retardation. Cronbach's alpha coefficient was .91 for the total score and varied between .57 and .86 for 10 psychometric scales. Children and adolescents who had a dual diagnosis obtained total scores approximately 1 standard deviation higher than those who did not have a dual diagnosis. Each of 4 diagnostic groupings had test profiles in accordance with expectation. The results suggest that the instrument is particularly well suited for use in screening and for help in the analysis of the relationships between certain behavior problems and psychopathology.

Development of a new injury cost scale

The Automobile Technique Research Association at Frankfurt, the Institute for Forensic Medicine at Mainz, the Federal Highway Research Institute at Bergisch-Gladbach, the German Motor Vehicle Inspection Association at Stuttgart, and the German Worker's Compensation at St. Augustin have completed a joint research project dealing with injury costs due to automobile accidents. The data for this social cost analysis were based on costs for administrative expenses, medical treatment, rehabilitation measures, social security payment, and loss of income, which were all paid by Worker's Compensation for single, well-documented injuries to the working population in West Germany (15 to 65 years old). The data base used included 15,407 injured and 1,026 fatal road accident victims. Tables are presented which show the costs associated with various injury levels. The result is an injury cost scale (ICS) that might be a base for establishing priorities of safety measures. The ICS has to be seen as supplemental to the AIS.

Joint occurrence of depression and aggression in children and adults with mental retardation

The relationship between aggression and depression was evaluated for 528 adults, adolescents and children, who were rated on either the adult or child versions of the Reiss instruments for dual diagnosis (Reiss 1988; Reiss & Valenti-Hein 1990). Criterion levels of depression were evident in about four times as many aggressive as nonaggressive subjects. Anger was significantly associated with both aggression and depression. Although anger may play a mediational role in the correlation between aggression and depression, in this study there was a significant correlation even after the effects of anger were held constant. The findings provide an initial step toward improving diagnostic specificity when evaluating aggressive behaviour in people with mental retardation.

Assessment of a man with a dual diagnosis

This case assessment of a man with dual diagnosis exemplifies the use of recent psychological measures, computerized programs, and structured assessment, including the Reiss Screen for Maladaptive Behavior, the Psychopathology Inventory for Mentally Retarded Adults, the Apperceptive Personality Test, and the Residential Services Indicator. In this case, computerized scoring of two very different tests (the Reiss Screen and the Apperceptive Personality Test) yielded very similar results.

Doctors and AIDS

Just a year ago most authorities considered the chances of patients contracting AIDS from doctors and other healthcare workers a virtual impossibility. But last week a Florida woman who got AIDS from her dentist lay near death, and two Minneapolis physicians admitted they had treated hundreds of patients since being diagnosed with the virus. Although doctors are at far greater risk than patients, the Minneapolis cases renewed the debate over the right of sides to know each other's HIV status.

Identifying danger and anxiety expectancies as components of common fears

The hypothesis was the common fears can be analyzed into separate factors for danger and anxiety expectancies. Six scales were constructed to measure danger and anxiety expectancies for the fears of flying, heights, and public speaking. The internal reliabilities of the scales were assessed in Study 1. The unreliable items were then deleted, and the revised scales were assessed in Study 2. The revised scales were found to have a satisfactory degree of internal consistency and test/retest reliability. For each fear, the items of the danger and anxiety expectancy scales were pooled and then submitted to a factor analysis. The danger and anxiety expectancy scales formed separate factors for each fear. The results were near-perfect; 51 of 53 items had factor loadings that were consistent with the distinction between danger and anxiety expectancies. It also was found that danger and anxiety expectancies are specific for each fear; that is, a person can have one fear that is danger-based and another that is anxiety-based. The findings have implications for understanding fears. Future research is suggested to test Reiss and McNally's (1985) hypothesis that desensitization might be more effective than credible placebo in the treatment of danger-based fear but that both desensitization and credible placebo are about equally effective in the treatment of anxiety-based fear.

Social skill deficiencies associated with depressed mood of mentally retarded adults

Specific social skill deficiencies associated with depressed mood were identified in a group of 45 mentally retarded adults with mixed or no psychiatric diagnoses. Self-report and informant-rated measures of social skills, social support, and depressed mood were obtained. One set of results replicated previous findings that high levels of depressed mood are associated with poor social skills and low levels of social support. Another set of findings identified 30 social skill deficits associated with depressed mood. We found that the retarded subjects with depressed mood were withdrawn and interacted less with others and that their social interactions were more inappropriate and ineffective. Some instances of antisocial behavior might be motivated by depressed mood.

Psychosocial correlates of depression in mentally retarded adults: II. Poor social skills

This is the second report on the results of an investigation of the psychosocial correlates of depression in mildly mentally retarded adults. Results of the present study showed that depression was associated with informant ratings of poor social skills. The results of the entire investigation suggest that further research is necessary on the associations among poor social skills, low levels of social support, and the occurrence of depression in mentally retarded adults.

Surfactants: a survey of short-term genotoxicity testing

The available results for tests on over 200 surfactants in nine short-term genotoxicity assay systems were reviewed. These tests included the Salmonella/microsome mutation assay, bacterial DNA repair tests, mitotic recombination in Saccharomyces cerevisiae, the mouse lymphoma cell-mutation assay, unscheduled DNA synthesis and sister chromatid exchange assays in mammalian cells, mammalian chromosome damage tests in vitro and in vivo, the dominant lethal test in rodents, and mammalian cell-transformation tests. The collected data cover all four major classes of surfactants: anionic, cationic, nonionic and amphoteric. The results of these genotoxicity tests were overwhelmingly negative. Although there were occasional positive results in bacterial or cell-transformation systems, the testing performed to date indicates that surfactants have negligible potential to cause genetic damage. The available data also indicate that none of the assays were incompatible with testing surfactants for genotoxicity.

Awareness of negative social conditions among mentally retarded, emotionally disturbed outpatients

Many mentally retarded people experience negative social conditions for long periods in their lives. These include the stigmatizing effects of being labeled mentally retarded, rejection and ridicule, segregation, infantilization, social disruption, restricted opportunities, and victimization. Many mildly and some moderately retarded people are highly aware of these negative social realities and can articulate them in detail during psychotherapy interviews; the authors describe three such patients. There is a need for research on the possible effect of prolonged exposure to negative social conditions on the mental health of mentally retarded persons.

Diagnostic overshadowing and professional experience with mentally retarded persons

Possible associations between professional experience with mentally retarded people and diagnostic overshadowing were evaluated. In a 3 X 2 factorial experiment, psychologists at state developmental disabilities facilities (high-experience group), psychologists at state mental health facilities (moderate-experience group), and clinical graduate students (low-experience group) rated a case history of a person with schizophrenia on 11 scales of psychopathology. For approximately half of the subjects within each group, the client was mentally retarded in addition to schizophrenic; for the remaining subjects, the client had average intelligence. Professional experience was associated with diagnostic ratings but not with overshadowing. We concluded that diagnostic overshadowing is unrelated to a broad range of professional experience with retarded people.

Generality of diagnostic overshadowing across disciplines

In a 2 X 2 experimental design, advanced students in social work and clinical psychology rated the same case description of a debilitating fear on eight scales of psychopathology and need for therapy. The fear was rated as less neurotic, less irrational, and less likely to require desensitization therapy when the client was mentally retarded vs. of average intelligence. There were no significant differences in the ratings of the students in clinical psychology vs. social work. The results suggest that diagnostic overshadowing is not specific to the discipline of psychology and point to the need for explicit training of future mental health professionals in diagnosing emotional disturbances accompanying mental retardation.

Emotional disturbance and mental retardation: diagnostic overshadowing

Two experiments evaluated the effects of the condition of mental retardation on psychologists' impressions of emotional problems of a retarded subject. In Experiment 1 we found that the same debilitating phobia was less likely to be considered an example of a neurosis or an emotional disturbance when the subject also was suggested to be mentally retarded as compared to intellectually average. Experiment 2 provided a conceptual replication of the results of Experiment 1 and extended findings of diagnostic overshadowing to cases involving schizophrenia and personality disorder. The magnitude of these effects did not differ significantly as a function of whether the case description suggested schizophrenia or personality disorder. The results validate the existence of a diagnostic overshadowing phenomenon.

Bronchial effects of aerosolized delta 9-tetrahydrocannabinol in healthy and asthmatic subjects

Effects on airway dynamics, heart rate, and the central nervous system of various doses of delta9-tetrahydrocannabinol administered in a random, double blind fashion using a Freon-propelled, metered-dose nebulizer were evaluated in 11 healthy men and 5 asthmatic subjects. Effects of aerosolized delta9-tetrahydrocannabinol were compared with aerosolized placebo and isoproterenol and with 20 mg of oral and smoked delta9-tetrahydrocannabinol. In the normal subjects, after 5 to 20 mg of aerosolized delta9-tetrahydrocannabinol, specific airway conductance increased immediately, reached a maximum (33 to 41 per cent increase) after 1 to 2 hours, and remained significantly greater than placebo values for 2 to 3 hours. The bronchodilator effect of aerosolized delta9-tetrahydrocannabinol was less than that of isoproterenol after 5 min, but significantly greater than that of isoproterenol after 1 to 3 hours. The magnitude of bronchodilatation after all doses of aerosolized delta9-tetrahydrocannabinol was comparable, but 5 mg of delta9-tetrahydrocannabinol caused a significantly smaller increase in heart rate and level of intoxication than the 20-mg dose. Smoked delta9-tetrahydrocannabinol produced greater cardiac and intoxicating effects than either aerosolized or oral delta9-tetrahydrocannabinol. Side effects of aerosolized delta9-tetrahydrocannabinol included slight cough and/or chest discomfort in 3 of the 11 normal subjects. Aerosolized delta9-tetrahydrocannabinol caused significant bronchodilatation in 3 of 5 asthmatic subjects, but caused moderate to severe bronchoconstriction associated with cough and chest discomfort in the other 2. These findings indicate that aerosolized delat9-tetrahydrocannabinol, although capable of causing significant bronchodilatation with minimal systemic side effects, has a local irritating effect on the airways, which may make it unsuitable for therapeutic use.