Prefrontal function and activation in bipolar disorder and schizophrenia
ABSTRACT Distinctive patterns of speech and language abnormalities are associated with bipolar disorder and schizophrenia. It is, however, unclear whether the associated patterns of neural activation are diagnosis specific. The authors sought to determine whether there are differences in language-associated prefrontal activation that discriminate bipolar disorder and schizophrenia.
Forty-two outpatients with bipolar I disorder, 27 outpatients with schizophrenia, and 37 healthy comparison subjects were recruited. Differences in blood oxygen level-dependent activity were evaluated using the Hayling Sentence Completion Test and analyzed in Statistical Parametric Mapping (SPM) 2. Differences in activation were estimated from a sentence completion versus rest contrast and from a contrast of decreasing sentence constraint. Regional activations were related to clinical variables and performance on a set shifting task and evaluated for their ability to differentiate among the three groups.
Patients with bipolar disorder showed differences in insula and dorsal prefrontal cortex activation, which differentiated them from patients with schizophrenia. Patients with bipolar disorder recruited the orbitofrontal cortex and ventral striatum to a greater extent relative to healthy comparison subjects on the parametric contrast of increasing difficulty. The gradient of ventral striatal and prefrontal activation was significantly associated with reversal errors in bipolar disorder patients.
Brain activations during the Hayling task differentiated patients with bipolar disorder from comparison subjects and patients with schizophrenia. Patients with bipolar disorder showed abnormalities in frontostriatal systems associated with performance on a set shifting task. This finding suggests that bipolar disorder patients engaged emotional brain areas more than comparison subjects while performing the Hayling task.
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Article: Normal Narcissism and Its Pleasures[Show abstract] [Hide abstract]
ABSTRACT: Normal narcissistic functioning has to do with the regulation of a coherent set of meta-representations of the acting agent. That set of meta-representations has its own interior architecture and dynamics. Normal narcissistic functioning is an adaptive form of inter-psychic processing which can be given a general account by integrating views of it drawn from the clinical traditions of psychoanalysis, empirical psychology, and contemporary cognitive and neurosciences. This is not to be confused with any form of organized psy-chopathology, though pathological forms of narcissism are relevant to understanding normal narcissism. Neural correlates of normal narcissism, as also the characteristic emotions and pleasures/displeasures that accompany its operations, are also explored. It is proposed that this allostatic regulatory system plays a prominent role in a wide range of human behaviors. It also closes the gap between social norms governing such behaviors and the minds of the agents performing them. This integrative interpretation of the scientific material is offered as an exercise in " philosophy in cognitive science " and belongs to the tradition of naturalistic philosophical accounts of the human mind.Journal of Mind & Behavior 01/2010; 31(2):85-126. · 0.23 Impact Factor
Article: The Pleasures of Revenge[Show abstract] [Hide abstract]
ABSTRACT: Revenge is universal in human cultures, and is essentially personal and retributive. Its moral status is contested, as is its rationality. Revenge is traditionally associated with pleasure, but this association is not accounted for in contemporary philosophical treatments of revenge. Here I supply a theory of normal narcissistic functioning that can explain this association. Normal narcissism is an adaptive form of inter-psychic processing which has to do with the regulation of a coherent set of meta-representations of the agent. It can be given a general account by integrating views drawn from clinical traditions, empirical psychology, and contemporary cognitive neuroscience. I explore the neural correlates of normal narcissism, its characteristic accompanying emotions and pleasures/displeasures, and its fundamental dynamics. It is proposed that this allostatic regulatory system plays a prominent role in retributive behavior, including revenge. Revenge is understood as a form of narcissistic repair, and a variety of puzzles concerning revenge (e.g., delay, urgency, pleasure) are solved from this point of view. Late in his great novel Moby Dick, Herman Melville has his hero Ishmael comment on Captain Ahab's intentions. His comment focuses on the vast difference between what Ahab's financial partners were expecting from his final voyage and what Ahab himself expected. His comments are worth quoting at length because they perspicuously introduce a number of fundamental features (and puzzles) about the nature of revenge: They were bent on profitable cruises, the profit to be counted down in dollars from the mint. He was intent on an audacious, immitigable, and supernatural revenge. Here, then, was this grey-headed, ungodly old man, chasing with curses a Job's whale round the world, at the head of a crew, too, made up of mongrel renegades, and castaways, and cannibals . .. . Such a crew, so officered, seemed specially picked and packed by some infernalJournal of Mind & Behavior 01/2010; 31(4):195-236. · 0.23 Impact Factor
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ABSTRACT: Affective disorders are a subject of interest to clinicians for more than a century. The awareness of an urgent need for an evidence-based “personalized” approach of treatment is growing in the field of psychiatry. This book brings together leading experts to create a volume of equal interest and usefulness to students, clinicians and researchers alike, which should serve as common knowledge. Specific themes of major depression, bipolar disorder, and schizoaffective disorder are critically reviewed, addressing topics such as neurobiological mechanisms underlying the pathogenesis, treatment resistant depression, translational research and challenging stigma of serious mental illness. Particular emphasis is put on novel developments in Cognitive-Behavioral Therapy and on attention to causal mechanisms of behaviour change in the Cognitive Behavioral Analysis System of Psychotherapy. Contributors: Peter Falkei, Berend Malchow, Andrea Schmitt, Lauren B. Ozbolt, Charles B. Nemeroff, Tom K. Birkenhäger, Henricus G. Ruhe, Carsten Diener, Michele Wessa, Julia Linke, Larissa Wolkenstein, Martin Hautzinger, Dieter Schoepf, Viola Oertel-Knöchel, Liliane Sayegh, Giustavo Turecki, J. Kim Penberthy, Christopher J. Gioia, Andrea König, Aaron M. Martin, Stephanie A. Cockrell, Todd K. Favorite, Kayla J. Conrad, Adrie Seldenrijk, Nicole Vogelzangs, Patricia van Oppen, Brenda Pennix, Anneke vam Schaik, Susan L. Renes.Edited by Dieter Schoepf, 05/2013; INTECH OPEN ACCESS PUBLISHER., ISBN: 978-953-51-1147-4