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Pasteuria penetrans is a Gram-positive endospore-producing bacterium that is a parasite of root-knot nematodes. Attachment of endospores to the cuticle of the nematode is the first stage in the infection process. Western blot analysis with monoclonal and polyclonal antibodies that recognize the 30 kDa heparin-binding domain (HBD) and the 45 kDa gelatin-binding domain (GBD) fragments of human fibronectin (Fn) revealed a series of polypeptides of approximately 40, 45 and 55 kDa present in crude cuticle extracts of Meloidogyne javanica 2nd-stage juveniles. The results suggest that the structure of the nematode fibronectin is different to the fibronectins so far characterized. Pre-treatment of endospores of Pasteuria with either the HBD or the GBD was found to inhibit binding to the nematode cuticle. The larger GBD fragment was the most effective at blocking adhesion. Pre-treatment of the GBD fragment with gelatin prevented the GBD fragment from inhibiting endospore attachment to the nematode cuticle.
Seventy-eight psychiatric in-patients were allocated to personal illness classes by means of the Delusions-Symptoms-States Inventory (DSSI). Paper and pencil measures of psychomotor speed and scatter of tapping were administered with an immediate retest. It is suggested that from a social desirability position one would have to predict that the more personally ill (i.e. those endorsing the more socially undesirable items) would be slower and more diffuse on these measures. We found, however, such patients to be more constricted and slower. It is concluded that such a combination adds to the utility and validity of the hierarchy of classes of personal illness.
An attempt was made to extend and cross-validate Mayo's (1969) study of ‘normals with symptoms' using the new Personal Illness measures. Groups of psychiatric patients and symptom-free normals were matched with a ‘normals with symptoms' group for age and sex. The two symptom groups were similarly matched on the number of symptoms as assessed by the Delusions-Symptoms-States Inventory. On the Personality Deviance Scales the ‘normals with symptoms' were found to be the most Extrapunitive group, the symptom-free normals had the lowest Intropunitive scores, whilst the patient group were the lowest scorers on Dominance.
In a recent article a hierarchy of classes of personal illness was proposed (Foulds and Bedford, 1975), consisting of four classes, each with its constituent groups, apart from the highest class. These were: Class 4—Delusions of Disintegration (with, as yet, no groups); Class 3—Integrated Delusions (the groups being ‘Delusions of Contrition’; ‘Delusions of Grandeur’ and ‘Delusions of Persecution’); Class 2—Neurotic Symptoms (Conversion; Dissociative; Phobic; Compulsive and Ruminative symptoms); Class 1—Dysthymic States (states of Anxiety; of Depression and of Elation).
Sixty-eight psychiatric in-patients who had completed the Delusions-Symptoms-States Inventory (D.S.S.I.) on admission were retested after one month. On first testing 92.6 per cent conformed to the hierarchy of classes of personal illness model, and on the second occasion 91.2 per cent. Of those who could improve, 72 per cent did so, most commonly by moving down one hierarchy class, e.g. from the Neurotic Symptoms class to the Dysthymic States class. (On the other hand only 30 per cent of the 61 patients who originally reported symptoms did not do so after one month.) Thus although it is clear that the patients as a group changed markedly, they have not departed from the hierarchy. These results indicate that either the symptoms further up the hierarchy remit before those lower in the hierarchy or they remit together. Certainly those lower in the hierarchy do not go first. It is suggested that the results would be difficult to accommodate within strict disease-entity models, and that they have different implications for both treatment and the assessment of change in current state.
A hierarchy of classes of personal illness model is proposed and was assessed using a new self-report measure, the Delusions-Symptoms-States Inventory (DSSI). Of 480 psychiatric patients 93.3% had symptom patterns conforming to the model. It was additionally found that single syndrome patterns, within a particular class, occurred significantly more often in those not classifiable in any higher class. Finally, the relationship between each possible pair of the 12 syndromes was examined. Some of the implications of the model and the data are discussed in terms of the development, remission, assessment, and treatment of personal illness.
In discussion of the wider issue of the characteristics of, and the relationship between, the classes ‘psychosis' and ‘neurosis', Maxwell (1972) wrote: ‘… the majority of all patients tend to have a basic core of symptoms, neurotic in type, which lend themselves to a dimensional description, but one whose prominence decreases somewhat as we pass from neurotic through affective psychotics to schizophrenics. In addition there are the psychotic type symptoms, which are rare and haphazard in occurrence. These are virtually absent in neurotics: they are most common in schizophrenics, but still not sufficiendy numerous or patterned to support a clear-cut typology or to lend themselves to a dimensional description.’
Within a framework of Kelly's Personal Construct Theory (Kelly, 1955; Bannister, 1962a), Bannister (1960, 1962b) considers thought-process disorder (formal thought disorder) to be a loosening of the associations between the constructs of the patient's conceptual system, and an instability over time of whatever pattern of association remains. The disorder appears to be maximal in that construct subsystem which subsumes discriminations relating to psychological attributes (Bannister and Salmon, 1966; McPherson and Buckley, 1970).
It is argued that personality deviance and personal symptomatology fall within different universes of discourse and that any individual may belong to either, neither, or both classes. In order to develop suitable measurements, distinctions are drawn between symptoms, states, deviant and normal traits, which have implications for the distributions of scores and for their stability or change over time. Measures likely to meet the criteria are illustrated. A classification is developed which incorporates those with and without the ability to cope with personal symptomatology and/or personality deviance. Some uses of the classificatory scheme and the measurements are suggested.
In an earlier investigation, Hassall and Foulds (1968) demonstrated certain differences between a group of alcoholics of 30 years and under and a matched control group. Such a group is not, of course, representative even of those alcoholics who come to psychiatric treatment. The present investigation was concerned to assess a wider range of such alcoholics, and try to determine whether any differences which might be found within this group could be attributed to chronological age, to age of onset of excessive drinking, or to length of time during which excessive drinking had been taking place.
A psychotic v. neurotic scale has been presented in the manual of the Symptom-Sign Inventory (Foulds and Hope, 1968). This scale was constructed after comparing each of four female neurotic groups with each of four female psychotic groups and each of four male neurotic groups with each of four male psychotic groups. For an item to be included in the scale 14 of the 16 comparisons within each sex had to show differences significant at least at the 5 per cent. level. On 18 items the psychotic groups had frequencies in excess of the neurotic; on only one item was it the other way round. The scale score is the sum of these 18 items minus the one.
As part of a larger study of cognitive disorder among the schizophrenias (Foulds et al., 1967a, 1967b), aspects of retardation were investigated. The relation of retardation to other forms of thought disorder in schizophrenia has been extensively investigated by Payne (Payne, 1960, 1962; Payne, Ancevich and Laverty, 1963; Payne, Caird and Laverty, 1964; Payne and Caird, 1967) who has used the three Babcock tests (Babcock and Levy, 1940), and the Wechsler Digit Symbol test as his measuring instruments.
Several workers have suggested that important differences exist in the cognitive disorders shown by patients in the various sub-groups of schizophrenia (Shakow, 1962, Lothrop, 1961). In this report the cognitive disorders investigated are those measured by the following tests: the Bannister-Fransella test (1966), which aims to measure “looseness and inconsistency in the use of constructs (concepts)” and two tests from the Payne-Friedlander (1962) battery intended to measure “over-inclusive thinking”—the Payne Object Classification test (Payne, 1962) and a modification of Benjamin's Proverbs (Benjamin, 1944). The differences among the schizophrenics which are considered are those between the acute and chronic stages of the illness and between paranoid schizophrenia and the non-paranoid varieties of the illness—hebephrenia, catatonia and simple schizophrenia.
This is the first of a series of papers reporting studies of various cognitive disorders in schizophrenia. The present paper deals with the validity of certain tests as measures of thought-process disorder: subsequent papers will relate type of disorder to various sub-categories of schizophrenia, as diagnosed clinically and by the Symptom-Sign Inventory (Foulds, 1965).