Beginning with the work of Cameron (1944), the concept of overinclusive thinking has been used to describe or account for the thought disorder observed in schizophrenic patients. This is usually defined as an inability to preserve conceptual boundaries, perhaps based on a cerebral input dysfunction which causes difficulty in filtering stimuli (Payne et al., 1959; McGhie, 1970; Epstein, 1953; Broadbent, 1958). This leads the schizophrenic to make remote associations and to overgeneralize or overabstract.
Using PET with [(15)O]H2O, we examined age in relation to regional cerebral blood flow (rCBF) among young to mid-life adults. Previous work has largely contrasted rCBF between young and elderly age groups dichotomously. This study maps the continuum of normal age-related changes in rCBF from early to mid-adulthood. We obtained images from 37 healthy volunteers between 19 and 50 years of age during an eyes-closed resting baseline condition. There was a negative correlation between age and rCBF in mesial frontal cortex, involving the anterior cingulate region (r = 0.63, p<0.001). These findings reflect differences in the distribution of rCBF evident in early to mid-adulthood that may be associated with subsequent changes in memory and executive functioning in later life.
The relationship of a variety of premorbid emotional and physical factors to the adjustment of burn patients during hospitalization is examined. Patients were considered to have adjusted poorly if they developed marked regression, severe depression, delirium or unmanageable behavior. Prior physical problems and premorbid psychopathology were found to be significantly more frequent among those who adjusted poorly than those who adjusted well, while greater severity of burn appeared to contribute to development of psychiatric complications less significantly. Further, the group who adjusted poorly tended to have a greater frequency of changes or stresses in their life situation prior to injury, suggesting that recent experience may also contribute to psychiatric morbidity during hospitalization.
The neuropsychiatric problems which burn patients experience may occur either during hospitalization or after discharge. Some of these may be considered “normal” in that they occur in many patients and are not pathological or life-threatening if handled appropriately. Others tend to interfere with the recovery process and are associated with a poor prognosis. Normal reactions which occur during hospitalization include anxiety reaction, mild depression, fear of deformity, and a steadily decreasing pain threshold. Potentially pathological reactions during hospitalization, which occur in 20 to 30 per cent of all patients, include severe depression, severe regression, and delirium. After discharge most patients, especially those with severe burns, face further adjustment problems. Follow-up study indicates that during the first year many patients continue to have symptoms of depression, anxiety, and phobic behavior. Most patients who have a normal adjustment prior to injury, however, eventually learn to deal with these problems without psychiatric help. The psychiatric prognosis for children is somewhat poorer, however, with approximately 80 per cent showing complications and sequelae such as fearfulness, suspiciousness, poor school performance, and difficulty in relating to other children.
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