RESUMEN
BACKGROUND: From a cognitive neuroscience perspective, the emotional attentional bias in post-traumatic stress disorder (PTSD) could be conceptualized either as emotional hyper-responsiveness or as reduced priming of task-relevant representations due to dysfunction in 'top-down' regulatory systems. We investigated these possibilities both with respect to threatening and positive stimuli among traumatized individuals with and without PTSD. METHOD: Twenty-two patients with PTSD, 21 trauma controls and 20 non-traumatized healthy participants were evaluated on two tasks. For one of these tasks, the affective Stroop task (aST), the emotional stimuli act as distracters and interfere with task performance. For the other, the emotional lexical decision task (eLDT), emotional information facilitates task performance. RESULTS: Compared to trauma controls and healthy participants, patients with PTSD showed increased interference for negative but not positive distracters on the aST and increased emotional facilitation for negative words on the eLDT. CONCLUSIONS: These findings document that hyper-responsiveness to threat but not to positive stimuli is specific for patients with PTSD.
Asunto(s)
Afecto , Atención , Trastornos por Estrés Postraumático/psicología , Adolescente , Adulto , Conducta de Elección , Femenino , Humanos , Masculino , Semántica , Índice de Severidad de la Enfermedad , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , VocabularioAsunto(s)
Clozapina/farmacocinética , Receptores de Dopamina D2/metabolismo , Risperidona/farmacocinética , Esquizofrenia/tratamiento farmacológico , Adulto , Benzamidas , Clozapina/uso terapéutico , Humanos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Pirrolidinas , Receptores de Dopamina D2/efectos de los fármacos , Risperidona/uso terapéutico , Esquizofrenia/diagnóstico , Esquizofrenia/metabolismoRESUMEN
OBJECTIVE: To explore serotonin function in patients with schizophrenia during typical and atypical neuroleptic treatment. We hypothesized that clinically relevant doses of the atypical neuroleptic clozapine would attenuate responses to the serotonin agonist m-chlorophenylpiperazine (m-CPP). DESIGN AND INTERVENTIONS: m-CPP or placebo was administered intravenously over 90 seconds to patients who had been receiving no medications for at least 3 weeks. m-CPP was also administered during treatment with the typical neuroleptic fluphenazine and the atypical neuroleptic clozapine. PATIENTS: Fifteen inpatients (two women and 13 men) who met DSM-III-R criteria for chronic schizophrenia (n = 13) or schizoaffective disorder (n = 2) participated in the study. Mean age (+/- SD) was 33.8 +/- 8.0 years. MAIN OUTCOME MEASURES: Measures of m-CPP effects included plasma cortisol and prolactin, body temperature, and the Brief Psychiatric Rating Scale (BPRS). The final BPRS total score at approximately 12 weeks of treatment was used to assess response to clozapine. RESULTS: m-CPP infusion significantly increased plasma cortisol and prolactin levels in drug-free patients. There was a range of behavioral responses while drug-free, but no statistically significant effects on BPRS total or BPRS factor scores. Clozapine treatment significantly blocked neuroendocrine responses to m-CPP, whereas fluphenazine had no effect. Clozapine also appeared to attenuate behavioral responses. CONCLUSIONS: These results demonstrate that clozapine treatment has potent serotonin antagonist effects in patients with schizophrenia. This may be related to clozapine's therapeutic effects since patients with greater cortisol response to m-CPP while drug-free had a better subsequent response to clozapine.