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Pathological dissociation is relatively common in the United States and may be associated with violent or criminal behavior. Dissociative Disorders, especially Dissociative Identity Disorder, are considered controversial diagnoses by some in the psychiatric and legal professions. Individuals who offend during dissociative states may not be criminally responsible if they meet the legal standard for insanity, however, insanity pleas based on dissociative symptoms are rare. This review examined Federal appellate case law for potential legal barriers to the insanity defense for dissociative conditions and any restrictions imposed on related expert evidence. Few rulings directly addressed these questions but there do not appear to be any unique barriers for dissociation‐related insanity pleas. Some cases provided valuable insights regarding the admission of expert evidence, effective expert testimony, and the role of defense counsel. [ABSTRACT FROM AUTHOR]

Self‐induced extreme intoxication akin to automatism (SIEA) is a complicated and controversial legal concept resistant to jurisdictional consensus. In the United States, SIEA has, at times, been considered under the concept of “settled insanity.”. In the United Kingdom, the defense may be allowed for specific intent crimes, though the defendant's awareness of the foreseeability of risk is addressed at trial. In Canada, recent jurisprudence has led to legal and practice landscape changes related to self‐induced extreme intoxication. Here, we provide an overview of automatism and an update on the Canadian perspective with a review of the facts and an analysis of the Supreme Court of Canada's landmark decision in R v. Brown, where the court permitted the SIEA defense to be utilized for general intent crimes and acquitted Matthew Winston Brown, a 26‐year‐old male with no history of mental illness, with respect to two counts of “break and enter” and one count of “aggravated assault.” We review the social and legislative response to the changing case law as well as related implications for expert testimony, which may be provided by forensic mental health professionals. Given the judicial and legal implications of the recent changes for both perpetrators and victims of violent crime and given the dynamic international landscape on extreme intoxication in criminal law, the review is thought to be of interest to a broad category of stakeholders including policymakers and those working in forensic psychiatry and law. [ABSTRACT FROM AUTHOR]

Alcohol-related amnesia-alcohol blackout-is a common claim of criminal defendants. The generally held belief is that during an alcohol blackout, other cognitive functioning is severely impaired or absent. The presentation of alcohol blackout as scientific evidence in court requires that the science meets legal reliability standards ( Frye, FRE702/ Daubert). To determine whether 'alcohol blackout' meets these standards, an evidence-based analysis of published scientific studies was conducted. A total of 26 empirical studies were identified including nine in which an alcohol blackout was induced and directly observed. No objective or scientific method to verify the presence of an alcoholic blackout while it is occurring or to confirm its presence retrospectively was identified. Only short-term memory is impaired and other cognitive functions-planning, attention, and social skills-are not impaired. Alcoholic blackouts would not appear to meet standards for scientific evidence and should not be admissible. [ABSTRACT FROM AUTHOR]

Background and purpose:Atrial fibrillation (AF) is the most common electrical cardiac disorder in clinical practice. The major trigger for AF is focal ectopic activity of unknown origin in sleeves of cardiac muscle that extend into the pulmonary veins. We examined the role of noradrenaline in the genesis of ectopic activity in the pulmonary vein.Experimental approach:Mechanical activity of strips of pulmonary vein isolated from male Wistar rats was recorded via an isometric tension meter. Twitch contractions of cardiac myocytes were evoked by electrical field stimulation in a tissue bath through which flowed Krebs-Heinseleit solution warmed to 36-37°C and gassed with 95% O2 5% CO2.Key results:The superfusion of noradrenaline induced ectopic contractions in 71 of 76 different isolated pulmonary veins. Ectopic contractions in the pulmonary vein were not associated with electrically evoked twitch contractions. The effect of noradrenaline on the pulmonary vein could be replicated by the simultaneous, but not separate, application of the α adrenoceptor agonist phenylephrine and the β adrenoceptor agonist isoprenaline. The use of selective agonists and antagonists for adrenoceptor subtypes showed that ectopic activity in the pulmonary vein arose from the simultaneous stimulation of α1 and β1 adrenoceptors. The application of noradrenaline to isolated strips of left atrium did not induce ectopic contractions (n=10).Conclusions:These findings suggest an origin for ectopic activity in the pulmonary vein that requires activation of both α and β adrenoceptors. They also open new perspectives towards our understanding of the triggering of AF.British Journal of Pharmacology (2007) 150, 899–905. doi:10.1038/sj.bjp.0707177; published online 26 February 2007 [ABSTRACT FROM AUTHOR]

Summary: Purpose: To identify clinical and EEG correlates of ictal spitting automatisms and to assess their reliability in indicating the hemisphere of seizure onset. Methods: The epilepsy-monitoring database (1994–2002) of the Cleveland Clinic Foundation (CCF) was searched for patients with a definite history of ictal spitting. All available documents of the patients, particularly their original video and EEG data, were reviewed. Results: Twelve (0.3%) of the ∼4,000 patients had a documented history of ictal spitting. In seven of them, 15 seizures with spitting automatisms were recorded. All of them started with an aura or arousal out of sleep. In six of the seven patients (12 of 15 seizures), EEG onset was clearly lateralized to the right, nondominant hemisphere. Spitting occurred at a median time of 21 s after EEG seizure onset. At that time, predominantly fast, high-amplitude theta (5–7 Hz) was seen in the hemisphere of seizure onset, maximum temporal. In all but one of the total 12 patients, the epileptogenic zone was in the temporal lobe. In nine of the 12 patients, seizure onset was in the non–language-dominant hemisphere. Two patients had seizures arising from the language-dominant hemisphere; in another patient, the side of the seizure onset could not be determined. Conclusions: Ictal spitting is an uncommon feature of epileptic seizures. Although the symptomatogenic area is probably outside the temporal lobe, it is most frequently seen in temporal lobe epilepsy of the right, nondominant hemisphere. [ABSTRACT FROM AUTHOR]

Abstinent alcoholics' self-reports of distressing alcohol-associated thoughts and compulsions to drink were evaluated by the Obsessive-Compulsive Drinking Scale (OCDS). Exploratory and confirmatory factor analyses on separate subject samples revealed that subjects' OCDS responses were best described by four correlated dimensions: alcohol obsessions, alcohol consumption, automaticity, and interference due to drinking. The validity of this four-factor solution was supported by the pattern of associations with drinking and coping style measures. In particular, alcohol obsessions were positively associated with alcohol dependence and use of passive/ avoidant coping. Automaticity was positively associated with the intensity and salience of drinking, and inversely associated with use of activefapproach coping. as well as abstinence duration. The obsession and automaticity subscales of the OCDS may be useful in evaluating cognitive-motivational processes associated with recovery from alcoholism. [ABSTRACT FROM AUTHOR]

The article presents a case of a 14-year-old female with documented wide QRS complex tachycardia with left bundle branch block morphology who was referred for catheter ablation and electrophysiologic study. During the study, observation included alternation of sinus rhythm with regular wide QRS complexes with left bundle branch morphology and precordial lead transition. Also identified is a single posterolateral right atriofascicular accessory pathway (Mahaim-type accessory pathway).

Binge drinking is an increasingly prevalent pattern of alcohol consumption that impairs top-down cognitive control to a much stronger degree than automatic response generation. Even though an imbalance of those two antagonistic processes fosters the development and maintenance of alcohol use disorders (AUDs), it has never been directly investigated how binge drinking affects the interaction of those two processes. We therefore assessed a sample of n = 35 healthy young men who were asked to perform a newly developed Simon Nogo paradigm once sober and once intoxicated (~1.2‰) in a balanced within-subject design. Additionally, an EEG was recorded to dissociate controlled and automatic cognitive subprocesses. The results demonstrate that alcohol seems to reduce top-down cognitive control. This control impairment was associated with changes in S-R mapping (reflected by a reduced parietal P3 amplitude), top-down response selection (reflected by modulations of lateralized readiness potentials), and (the evaluation of) response inhibition (reflected by modulations of the Nogo P3). In sharp contrast to this, automatic processing does not seem to be equally altered, as we found neither increases nor decreases in this domain. Most importantly, we also found that the interaction between control and automatisms might be less impaired by alcohol than control alone, which may help to overcome alcohol-induced response inhibition deficits. These "carryover" effects of control from one domain to the other could potentially prove beneficial in AUDs. [ABSTRACT FROM AUTHOR]

Frequent emesis can cause substantial deleterious effects to a child's health and environment. We conducted a functional analysis of a 3-year-old girl's self-induced emesis and confirmed that emesis was maintained by automatic reinforcement. In a reversal design, we evaluated the efficacy of implementing response blocking at 100% and 50% treatment integrity levels on both attempts and successful production of emesis. One hundred percent blocking, but not 50% blocking, was successful in reducing attempts and emesis below baseline levels., (© 2017 Society for the Experimental Analysis of Behavior.)

Background: The use of alcohol is associated with various forms of automatic processing, such as approach tendencies and attentional biases, which may play a role in addictive behavior. The development of such automaticity has generally occurred well before subjects perform tasks designed to detect them. Although it seems plausible that this development involves some form of alcohol-related conditioning, this process is not usually included in the experimental procedure., Methods: The development of automaticity involving alcoholic or nonalcoholic stimuli was experimentally manipulated via a conditioning task. Subjects were presented with pairs of stimuli from a set of 4 stimuli: 2 pictures of alcoholic beverages, and 2 pictures of nonalcoholic beverages. One of the alcoholic and 1 of the nonalcoholic beverages was associated with reward, the other stimuli with punishment. Subjects had to learn to select the rewarded stimuli from pairs of 1 rewarded and 1 punished stimulus. The task, thus experimentally established reward versus punishment stimulus-response-outcome associations, for alcoholic and for nonalcoholic stimuli. Subsequently, a cued reversal task was used to test automaticity involving alcoholic versus nonalcoholic, and rewarded versus punished stimuli., Results: An association was found between heavier drinking and an alcohol-related conditioning bias: heavier drinkers had more difficulty overcoming a conditioned response when it involved selecting a previously punished nonalcoholic stimulus over a previously rewarded alcoholic stimulus., Conclusions: The study provided novel information on secondary reinforcement involving alcoholic stimuli: heavier drinkers may more easily develop automaticity related to alcohol-reward contingencies. This may have implications for interventions and the interpretation of findings concerning alcohol-related automatic processing., (Copyright © 2011 by the Research Society on Alcoholism.)

Most treatments for stereotypy involve arrangements of antecedent or consequent events that are imposed entirely by a therapist. By contrast, results of some studies suggest that self-recording, a common component of self-management interventions, might be an effective and efficient way to reduce stereotypy. Because the procedure typically has included instructions to refrain from stereotypy, self-recording of the absence of stereotypy, and differential reinforcement of accurate recording, it is unclear which element or combination of elements produces reductions in stereotypy. We conducted a component analysis of a self-management intervention and observed that decreases in stereotypy might be attributable to instructional control or to differential reinforcement, but that self-recording per se had little effect on stereotypy.

We evaluated antecedent exercise for treating the automatically reinforced problem behavior of 4 individuals with autism. We conducted preference assessments to identify leisure and exercise items that were associated with high levels of engagement and low levels of problem behavior. Next, we conducted three 3-component multiple-schedule sequences: an antecedent-exercise test sequence, a noncontingent leisure-item control sequence, and a social-interaction control sequence. Within each sequence, we used a 3-component multiple schedule to evaluate preintervention, intervention, and postintervention effects. Problem behavior decreased during the postintervention component relative to the preintervention component for 3 of the 4 participants during the exercise-item assessment; however, the effects could not be attributed solely to exercise for 1 of these participants.

Research has shown that repeated exercise of self-control leads to impaired performance on subsequent self-control tasks, a phenomenon labelled ego depletion. The current research investigates the influence of automatic processes on self-control performance. Study 1 shows that activation of persistence leads to stable self-control performance and may help to overcome effects of ego depletion. Initially depleted participants kept their physical self-control performances constant when primed with persistence. If such a prime was absent, self-control performance of depleted participants decreased indicating ego depletion. Using a different manipulation, these findings were replicated in Study 2.

Does information about other people automatically affect one's own behaviour as a function of the salience of interpersonal or intergroup contexts? Study I revealed that exposure to an intelligent comparison target led to worse performance than exposure to an unintelligent target when an interpersonal context was salient (contrast) whereas the opposite effect was found when an intergroup context was salient. Study 2 showed better performance after exposure to an intelligent in-group target and worse performance when the in-group target was unintelligent (assimilation), whereas opposite effects were found when the target was an out-group member or when no intergroup context was salient. Finally, Study 3 showed better performance after exposure to a group of intelligent targets and worse performance after exposure to a group of unintelligent targets suggesting assimilation; opposite effects were found when the group consisted of out-group targets.

The effects of noncontingent matched stimulation (NMS) and response blocking on a boy's stereotypic behavior were evaluated using a multiple schedule that contained three 15-min components (preintervention, intervention, and postintervention). Results showed that stereotypy was always higher after response blocking than before response blocking and was always lower after NMS than before NMS. These results suggest that response blocking may have produced deprivation for the product of stereotypy and that NMS may have provided stimulation that was similar to the product of stereotypy.

Leisure items (e.g., games, toys) are commonly made available as controls during attention conditions of functional analyses (Ringdahl, Winborn, Andelman, & Kitsukawa, 2002). However, Ringdahl et al. raised questions about this practice. This paper reviews research that supports and conflicts with the inclusion of leisure items as controls, including a quantitative analysis of relevant articles published in the Journal of Applied Behavior Analysis over a 10-year period. Data reviewed suggest that practitioners may consider omitting leisure items as controls or including such items strategically based on the accumulation of assessment information.

We manipulated two parameters of response blocking to reduce pica: (a) the criteria for initiating the procedure (either earlier or later in the response chain) and (b) the distance from which the procedure was initiated. Results suggested that response blocking may be effective only when implemented early in the chain and with near-perfect consistency. Further, additional treatment components may be required to eliminate all pica attempts.

In the current study, we examined the utility of a procedure consisting of noncontingent reinforcement with and without response cost in the treatment of inappropriate vocalizations maintained by automatic reinforcement. Results are discussed in terms of examining the variables that contribute to the effectiveness of response cost as treatment for problem behavior maintained by automatic reinforcement.

Pica is a life-threatening behavior displayed by many individuals with developmental disabilities. In the current study, automatic reinforcement maintained the pica of 3 participants. Following functional analyses of pica, response-effort manipulations were conducted in which the effort to obtain pica or alternative items was varied systematically. Several general relations emerged as a result of the study. First, levels of pica were reduced relative to baseline when alternative items were available independent of the effort required to obtain alternative items or pica. Second, increasing the effort for alternative items resulted in increases in pica relative to when effort for alternative items was low. Third, increasing response effort for pica produced reductions in pica relative to baseline when alternative items were unavailable. Fourth, the highest levels of pica occurred when the effort to engage in pica was low or medium and no alternative items were available. These findings are discussed in terms of the relative effects of quality of reinforcement and response effort on behavior.

In attempting to make sense of others, perceivers regularly construct and use categorical representations (e.g. stereotypes) to streamline the person perception process. A debate that has dominated recent theorizing about the nature and function of these representations concerns the conditions under which they are activated in everyday life. The present article reviews this work and considers the automaticity of category activation in person perception.