We examined the causal relationship between playing violent video games and increases in aggressiveness by using implicit measures of aggressiveness, which have become important for accurately predicting impulsive behavioral tendencies. Ninety-six adults were randomly assigned to play one of three versions of a computer game that differed only with regard to game content (violent, peaceful, or abstract game), or to work on a reading task. In the games the environmental context, mouse gestures, and physiological arousal-as indicated by heart rate and skin conductance-were kept constant. In the violent game soldiers had to be shot, in the peaceful game sunflowers had to be watered, and the abstract game simply required clicking colored triangles. Five minutes of play did not alter trait aggressiveness, yet an Implicit Association Test detected a change in implicit aggressive self-concept. Playing a violent game produced a significant increase in implicit aggressive self-concept relative to playing a peaceful game. The well-controlled study closes a gap in the research on the causality of the link between violence exposure in computer games and aggressiveness with specific regard to implicit measures. We discuss the significance of importing recent social-cognitive theory into aggression research and stress the need for further development of aggression-related implicit measures.
The study was a qualitative investigation aimed at therapists' responses to working with a population of incestuous sexual abusers. Semi-structured interviews were conducted with nine therapists who were recruited from psychotherapy, psychology, and forensic psychology services in the National Health Service (NHS) in the UK. The predominant therapeutic model was psychodynamic; however, cognitive-behavioural and integrative approaches were practiced by some therapists. The data were analyzed using interpretative phenomenological analysis (Smith, 1996). Results suggested that the therapists experienced a considerable amount of negative and difficult feelings and that they tended to experience feeling controlled and deceived, which seemed to influence their ability to create and maintain the therapeutic relationship. It was suggested that the dynamics of incestuous sexual abuse played a part in these difficulties. The results are discussed with reference to the clinical therapeutic literature.
Background:Intracranial hypertension is a well-known life-threatening complication of bacterial meningitis. Investigations on decompressive craniectomy after failure of conservative management are scarce, but this surgical treatment should be considered and performed expeditiously, as it lowers the intracranial pressure and improves brain tissue oxygenation. Early cranioplasty can further aid the rehabilitation.Case Description:A 15-year-old boy was admitted to our emergency department because of sudden onset of neurologic decline and consecutive loss of consciousness. Clinical examination and imaging showed elevated intracranial pressure, leading to the suspected diagnosis of meningitis. Intracranial pressure monitoring was installed, but the initiated conservative management failed. Finally, the patient underwent bilateral decompressive craniectomy. The microbiological test showed growth of Neisseria meningitidis. After full neurologic recovery, cranioplasty with two CAD/CAM titanium implants was conducted successfully.Conclusions:This unique report shows that decompressive craniotomy with duroplasty may be a crucial therapeutic approach in bacterial meningitis with refractory increased intracranial pressure and brainstem compression. Early cranioplasty with a patient-specific implant allowed the early and full reintegration of the patient.
In recent years, intrathecal baclofen (ITB) has attained an important role in the treatment of severe spasticity and dystonia in children. There are principal differences between the use of ITB in children and its use in neurology and oncology in adults. Here, we present a consensus report on best practice for the treatment of severe spastic and dystonic movement disorders with ITB. Using a problem-orientated approach to integrate theories and methods, the consensus was developed by an interdisciplinary group of experienced ITB users and experts in the field of movement disorders involving 14 German centers. On the basis of the data pooled from more than 400 patients, the authors have summarized their experience and supporting evidence in tabular form to provide a concise, but still a comprehensive information base that represents our current understanding regarding ITB treatment options in children and adolescents.
Longterm scalp recording of early SEP components triggered by peroneal or tibial nerve stimulation detects functional disturbances of spinal cord transmission due to mechanical trauma. We confirm previous observations that preoperative SEP patterns reflect neurological deficits and clearly show functional disturbances even on the side where they are not manifest. Peroneal nerve SEP have a well-known P40-peak corresponding to activities of neurons at the postcentral cortical layers. The P40-peak was identified in only 55% of our recordings. We therefore, tried to use the P50-peak that could be identified in 100% of the recordings under the difficult recording circumstances in the operating room. Other authors demonstrate that the P40 component varies spontaneously about 7 ms during operations; we found variation of P50-latencies of 9 ms. We found the P50 component to be a valid and reproducable SEP event for intraoperative monitoring. Decline of SEP amplitudes during the operation occurred especially during dissection of the tumor. We once found intermittent loss of the P50 component with complete recovery after several minutes. This study shows that peroneal nerve SEP monitoring during intraspinal tumor operations is a feasible and valid measure. It provides the surgeon with a new alarm parameter for spinal cord lesions.
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