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This case study investigates the phenomenon of graduate students writing with unfamiliar digital tools in semi-public writing environments. The increase in the prevalence of writing with unfamiliar tools in semi-public environments, such as networked computer classrooms and university testing centers, makes it worthy of investigation. We use phenomenological interviews to examine the writing experiences of a group of graduate students writing in a classroom on unfamiliar computers equipped with a tool that tracked their keystrokes and eye movements. Though some of the writers had positive experiences with the tool's output and their reflective conversations about writing it prompted, they all had challenging experiences adjusting to the hardware, the physical requirements of the tool, and overcoming surveillance anxiety prompted by it. Some students who wrote in the semi-public environment using an unfamiliar tool benefitted but all were challenged by situational awareness, new hardware, new haptic interactions, surveillance anxiety, and lack of control. The study indicates a need to explore and address the factors of situation awareness, an adjustment period, and surveillance anxiety in situations where individuals are writing with unfamiliar tools in semi-public environments.

This study examined information communication technologies and workplace friendship dynamics. Employees reported factors that influenced their initiation of friendship with a coworker and reported patterns and perceptions of communication with their workplace friend via different communication methods. Results indicated that personality, shared tasks, and perceived similarity are the most important factors to coworker friendship initiation, and the importance of physical proximity to workplace friendship is diminishing in the electronically connected workplace. Results confirm the primacy of face-to-face interaction for workplace friendship initiation and maintenance. E-mail, phone, and texting were also central to communication among workplace friends. The amount of time spent telecommuting affected workplace friendship initiation and communication. Finally, generational differences were identified with respect to Internet-based communication methods.

Workplace friendships are linked to many important processes and outcomes such as employee satisfaction, career development, creativity, and decision-making influence (Sias, 2009). Research has examined how workplace peer friendships develop and deteriorate, but largely ignored their maintenance. The studies reported here addressed this void. Study 1 identified communicative tactics individuals use to maintain friendships with peer coworkers. Study 2 assessed the perceived politeness/positive face threat of the tactics. Study 3 examined the extent to which perceived politeness, task interdependence and individual attachment style predict the likelihood an individual will use specific maintenance tactics.

Household disruptions – such as divorce, relocation, and parental absence – have long concerned researchers interested in the educational attainment of children. Here, we consider a plausible source of exogenous variation in work-related parental absences—military deployments to Iraq and Afghanistan in the 2002–2005 period. Combining the standardized test scores of children enrolled in Defense Department schools with their military parent's personnel data, we evaluate the effect of a soldier's deployment on the academic achievement of his or her children. We find that deployments have modest adverse effects in most academic subjects, with lengthy deployments and deployments during the month of testing associated with the largest detrimental effects. Evidence also suggests that these adverse effects may persist for several years.

Employee socialization research conceptualizes new hires as those who experience uncertainty and seek information to reduce uncertainty. Our study contributes to this research by introducing another aspect of employee uncertainty. While organizational newcomers experience uncertainty upon organizational entry, our focus shifts to uncertainty experienced by veteran employees when a newcomer joins the organization. We conceptualize organizational newcomers as a source of uncertainty and veteran employees as those who experience uncertainty and seek information to reduce uncertainty. Interviews revealed types of uncertainty veterans experience regarding new hires and tactics used to reduce uncertainty. This conceptual shift has substantial heuristic potential.

The aim of this study was to validate melanin-concentrating hormone (MCH)-1 receptor antagonism as a potential treatment of mood disorders. We attempted to replicate the effects previously reported with SNAP-7941 and expanded the investigation to three other orally bioavailable MCH-1 receptor antagonists with good brain penetration. SNAP-7941 (3–30 mg/kg, i.p.) and T-226296 (5–60 mg/kg, p.o.) (± racemate), were evaluated in the rat forced swim and mouse tail suspension tests. (+)SNAP-7941 (3–10 mg/kg, p.o.) was also tested in a modified 5-min rat forced swim protocol as previously reported. A-665798 (3–30 mg/kg, p.o.) and A-777903 (3–30 mg/kg, p.o.) were tested in mouse tail suspension and rat Vogel tests. None of the compounds showed meaningful efficacy in the paradigms tested. The lack of efficacy with four structurally different MCH-1 receptor antagonists does not support a role for therapeutic treatment of depression/anxiety via this mechanism of action.

The rat neonatal ventral hippocampal (VH) ibotenic lesion model has been proposed as a developmental model of schizophrenia, based on evidence that it encompasses aspects of the disorder including psychomotor agitation (hyperactivity), deficits in prepulse inhibition (PPI), and deficits in social interaction (SI), measures presumed to reflect positive symptoms, sensory gating deficits and negative symptoms, respectively. However, validation of the model as a predictive pharmacological screening tool has been minimal. Determine the effects of a chronic 3-week low dose treatment of clozapine or risperidone on locomotor hyperactivity, PPI and SI in lesioned and control rats. Both clozapine, 2.5 mg/kg per day IP and risperidone, 0.1 mg/kg per day IP, reversed lesion-induced locomotor hyperactivity; however, the compounds also decreased locomotor activity in the non-lesioned controls. Clozapine 2.5 mg/kg per day and risperidone 0.1 mg/kg per day significantly attenuated lesion-induced PPI deficits. Neither compound induced a significant attenuation of lesion-induced SI deficits. In order to see if SI deficits required a higher dose of an antipsychotic, the dose of clozapine was increased to 4 mg/kg per day; however this dose induced such marked decreases in the activity and startle responses in the control rats, i.e. up to 74% decrease, that the effects on the lesioned rats could not be adequately interpreted. These data add further support to the neonatal VH lesion model as a predictive pharmacological screening assay for identifying compounds effective in the treatment of positive symptoms of schizophrenia. However, the usefulness of the model in detecting compounds effective in treating negative symptoms of schizophrenia is still in question.

We examined Wada memory and neuropsychological memory function in 34 nonlesional patients who underwent anterior temporal lobectomy (ATL) and who were seizure free at 1-year follow-up. Patients who displayed a decline on verbal memory measures that exceeded 1 SD after left ATL had significantly smaller left/right Wada memory asymmetries than left ATL patients without a significant verbal memory decline. When Wada memory asymmetries were used to predict verbal memory decline after left ATL in individual patients, similar statistically significant effects were present. No significant relationship between Wada memory and postoperative memory was present in right ATL patients, and postoperative memory function was not related to Wada memory performance after either left hemisphere or right hemisphere injection alone. We conclude that Wada memory asymmetries provide one measure of the risk to material-specific decline in verbal memory after left ATL.

Summary: We report a mixed handed (L>R) patient with exclusive right cerebral language representation who de–veloped a permanent anterograde amnestic syndrome after right anterotemporal lobectomy. Preoperative neuropsychological performance consisted of impaired verbal memory and normal nonverbal memory. Wada memory performance was asymmetrical for objects presented soon after amobarbital injection in conjunction with no memory asymmetry for items presented later in the Wada evaluation. Preand postoperative magnetic resonance imaging (MRI) scans showed no structural lesions; however, postoperative MRI hippocampal volume measurements suggested decreased hippocampal volume for the nonresected temporal lobe. These results confirm the risk of anterograde amnesia after unilateral temporal lobectomy and demonstrate that baseline neuropsychological testing may falsely literalize material-specific memory functions in patients with atypical cerebral language dominance.

Anxiety disorders affect approximately 20% of the population, and women are twice as likely as men to develop anxiety disorders. Despite these findings, little is known about the effects of gender on tolerability and therapeutic efficacy of anxiolytic drugs. Sex differences are also observed in rodents, even though the majority of preclinical behavioral studies are conducted on males. The aim of this study was to investigate sex differences in anxiety-like behavior using the Vogel conflict test and the pharmacological responsiveness to a variety of psychoactive drugs in rats. Pharmacological treatments clinically used for the treatment of anxiety were tested in male and female rats. Overall, female rats accepted fewer punished responses, had lower levels of water intake even when matched for weight, and had a lower pain threshold for electrical footshock than males. Diazepam and chlordiazepoxide displayed anxiolytic-like effects in both genders. In contrast, buspirone, propranolol, fluoxetine and paroxetine showed activity only in male rats. Morphine had no anxiolytic-like activity in either gender. Analysis of the estrous cycle did not reveal any effect of cycle stage on behavioral or drug responses. This investigation highlights the importance of using female subjects in the preclinical research of anxiety and the screening of anxiolytic compounds in the drug development process.

With a critical shortage of cadaver kidneys available for transplantation worldwide, many end stage renal disease patients currently expire while they are on a cadaver transplant waiting list. There is thus a need to understand the alternative mode, live-related kidney donation, and the social circumstances affecting it. This research explores the attitudes of students in a hypothetical scenario, “Search for a Kidney Donor.” It focuses on gender stereotypes concerning who among the patient's relatives is most likely to volunteer a kidney. The subjects were female medical students in the United Arab Emirates. The findings are interpreted in relation to prominent characteristics of Arab culture: patriarchalism, familism, and pronatalism.

This case report describes a patient with reportedly new onset of tics, beginning at 21 years of age, in the context of posttraumatic stress disorder (PTSD) and comorbid alcohol abuse, with no known head injury. The setting is an American Society of Addiction Medicine intensive outpatient substance abuse rehabilitation program in an United States Army Medical Center. The patient is a 22-year-old male diagnosed with alcohol abuse and delayed PTSD who presented to the program's medical officer due to insomnia. We discovered he had a reportedly new ocular tic of ∼9 months duration, which he claimed developed at 21 years of age soon after returning from 1 year of combat duty. The patient was thoroughly evaluated, and we surmised the tic was a symptom of PTSD. After achieving full remission from alcohol, the tic persisted. However, as his PTSD symptoms remitted, so did his tic symptoms. At 6-month follow-up, the patient reported he was essentially free from PTSD symptoms, and his tic was significantly reduced.

A patient with a unilateral thalamic infarct and associated periodic lateralized epileptiform discharges is described. The implications of this for the pathophysiology of PLEDs is discussed.

Behaviorally activated EEG was recorded from each hippocampus in 17 epilepsy surgery patients with unilateral (11 left, 6 right) mesial temporal lobe (MTL) seizure onset and correlated with preoperative material-specific memory test performances. Whole-band power (1–30 Hz) was recorded and subjected to spectral analysis under three conditions: (a) eyes closed resting, (b) eyes open with a verbal task, and (c) eyes open with a nonverbal task. Significantly less EEG desynchronization was observed in the epileptogenic hippocampus during the verbal activation condition but not during the eyes-open nonverbal task. Decreased EEG reactivity in the left hippocampus during verbal activation was correlated significantly with verbal memory test impairment among patients with left MTL seizure onset. However, similar relationships were not obtained between right seizure focus patients and performance on a visuospatial learning test. Results confirm the association of left MTL structures with verbal memory functions and emphasize the difficulty in demonstrating a consistent relationship between right MTL structures and visuospatial memory performance.

Cerebral language lateralization was investigated in 103 patients undergoing intracarotid amobarbital testing as part of their diagnostic work-up for epilepsy surgery. Inclusion criteria included adequate bilateral intracarotid amobarbital studies and no radiologic lesion in areas other than the temporal lobe. Language was evaluated with respect to strict presence or absence of language representation, in which a patient was considered to have bilateral language despite potentially having asymmetric language representation, and with respect to forced relative hemispheric dominance, in which a single side could be considered dominant despite bilateral language representation. Seventy-nine patients displayed exclusive left hemisphere language representation, two patients showed exclusive right hemisphere language representation, and 22 patients had language represented in each hemisphere. In the 22 patients with bilateral language, an asymmetry was present in 17 cases (13 L greater than R, 4 R greater than L). These data indicate that language restricted only to the right hemisphere is rare, and that in the absence of purely left hemisphere language, most patients exhibit bilateral representation. Previously reported incidence of exclusive right hemisphere language may be an artifact of dichotomizing a continuous variable.

Rationale Neuroleptic dysphoria encompasses a range of unpleasant subjective responses and, as a result, is difficult to study in preclinical animal models. Objective Based on the learned helplessness model of depression, increases in escape failures (EFs) in the druginduced helplessness test (DH) are proposed to reflect druginduced depressive-like state, a contributing factor to neuroleptic dysphoria in humans. Materials and methods Effects of the typical antipsychotic haloperidol and the atypical antipsychotics risperidone, olanzapine, aripiprazole, quetiapine, and clozapine were investigated in the DH test. We further characterized this test by examining compounds affecting motor function, cognition, anxiety, and those with antidepressant activity. Results The antipsychotics haloperidol, risperidone, aripiprazole, and olanzapine, all increased EFs, while quetiapine had no effect, and clozapine reduced EFs. Amphetamine, diazepam, and ciproxifan, had no effect on EFs. Scopolamine significantly reduced EFs and MK-801 showed a trend toward reducing EFs at doses not significantly sti mulating locomotor activity. Subchronic, but not acute, imipramine and subchronic fluoxetine significantly reduced EFs at doses significantly suppressing locomotor activity. Dissociation appears to exist between performance in the DH test and compound effects on catalepsy or locomotor activity. Conclusions After discussing potential alternative interpretations of the drug-induced changes of EFs, we propose the DH test as a useful test for assessing a drug-induced, depressive-like state that may contribute to neuroleptic dysphoria.

The historical shift from infectious to chronic disease has tremendous implications for health behavior, attitudes, and expectations concerning health and illness. Exclusive reliance on the prevailing “medical model” of illness, however, tends to perpetuate a health care system that is overly attuned to acute care and intervention, often at the expense of chronic illness and its sufferers. Looking at these inconsistencies, this chapter advances a psychosocial perspective on chronic illness—one that provides a more holistic view of the social processes that take place between the ill person and the illness. Using as examples two modern-day chronic diseases—diabetes and end-stage renal disease—the chapter discusses the potentially diverse behavioral impacts of chronic illness on the illness-bearer within the contexts of the ill person’s social networks, the professional medical providers, and society in general. In particular, the chapter advances issues regarding the negotiation of roles and responsibility within the confines of the traditional doctor-patient relationship, as well as those that occur within the broader rubric of social life.

The relative effects of antiepileptic drugs (AEDs) on cognition are controversial.We compared the cognitive effects of phenobarbital, phenytoin, and valproate in 59 healthy adults using a randomized, double-blind, incomplete-block, crossover design. Cognitive assessments were conducted at baseline, after 1 month on each drug (two AEDs per subject), and at two repeat baselines 11 weeks after each AED treatment. The neuropsychological battery included 12 tests, yielding 22 variables: Choice Reaction Time, P3 Event-Related Potential, Finger Tapping, Lafayette Grooved Pegboard, Selective Reminding Test, Paragraph Memory, Complex Figures, Symbol Digit Modalities Test, Stroop Test, Visual Serial Addition Test, Hopkins Symptom Checklist, and Profile of Mood States. More than one-half of the variables exhibited AED effects when compared with nondrug baselines, and all three AEDs produced some untoward effects. Differential AED effects on cognition were present for approximately one-third of the variables. Phenobarbital produced the worst performance; there was no clinically significant difference between phenytoin and valproate. NEUROLOGY 1995;45: 1494-1499

We examined the ability of Wada memory testing to predict seizure outcome 1 year following anterior temporal lobectomy. Asymmetry scores for Wada memory performance, using amobarbital doses of 125 mg or less, were calculated for 55 patients under the age of 45 years who had no radiologic evidence of structural lesions other than gliosis. Wada memory asymmetries were significantly greater (p0.02) in patients who were seizure free compared with those who continued to experience seizures. Furthermore, patients with Wada memory score asymmetries of at least three objects (maximum = 8) were more likely to be seizure free compared with patients with Wada memory asymmetries less than three (p0.01). Of the 36 patients who had Wada memory score asymmetries of at least three objects, 32 (89%) were seizure free. In contrast, of the 19 patients whose Wada memory score asymmetries were less than three, only 12 (63%) were seizure free. These data suggest that Wada memory performance is related to seizure outcome following anterior temporal lobectomy.

Polydipsia in psychiatric patients is a common phenomenon often accompanied by long-germ complications including congestive heart failure, renal failure, seizures, coma, and death (Blum and Friedland 1983; Blum et al 1983; Delva et al 1989). A subgroup of polydipsic patients develop water intoxication with hyponatremia. The etiology of this water intoxication in schizophrenic patients is unclear, as the polydipsic behavior with massive amounts of consumed water alone is an insufficient explanation, and antidiuretic hormone (ADH) abnormalities have not been clearly established and delineated. Estimates of the prevalence of polydipsia among psychiatric patients range from 5% to ! 7% (Blum et al 1983; Shah and Greenberg 1992). The fact that these patients have a poorer prognosis is consistent with the severity of complications they experience (Viewig et al 1989). Attempts te explain polydipsia in psychiatric patients include examining the role of psychosis, neuroleptics, and physiologic studies in reference to thirst or ADH dysregulation (Delva et al 1990; Glusac et al 1990, Goldman et al 1988; lllowsky and Kirch 1988). More recently, studies have drawn an analogy between polydipsia in humans and animal models of schedule-induced or incentiveconditioning behaviors (Luchins 1990) These behaviors are propitiated by hippcgampal lesions. Given the large body of evidence incriminating temporal lobe pathology in schizophrenia (for review see Hyde et al 1991), it seems of interest to note a patient with complex partial seizures whose ictal presentation includes

Hippocampal evoked potentials were recorded using the P3 tonal oddball paradigm in 30 patients with unilateral temporal lobe seizure focus. Spectral power of the evoked potentials was decreased on the side of seizure focus, but this reduction was much greater when the focus was on the left. The effect of left/right focus does not appear to be due to group differences in age, sex, seizure duration, or operative pathology. Remote or finer left/right structural differences or differential left/right hippocampal processing for the sequential tonal task are possible explanations.

Although there has been extensive examination of the behavioral and physiologic correlates of hippocampal theta activity in animals, the human literature consists of a single case study. We investigated the differential effects of four behavioral states on human hippocampal theta activity in 16 epilepsy surgery patients. Behavioral conditions included resting eyes closed (RC), resting eyes open (RO), eyes open with auditory word activation (AW), and eyes open with visuospatial activation (VS). Hippocampal theta activity decreased during both RO and VS compared to both RC and AW. There were reciprocal changes in delta activity. Comparisons of RO to VS and of RC to AW were nonsignificant. The results demonstrate state-specific changes in human hippocampal theta and are consistent with the animal literature that relates hippocampal theta to sensorimotor integration and forebrain volitional mechanisms.

We investigated the neuropsychological effects of carbamazepine, phenobarbital, and phenytoin in 15 partial complex epilepsy patients treated with each drug for 3 months, using a randomized double-blind, triple crossover design. Neuropsychological evaluation at the end of each treatment period included Digit Span, Selective Reminding Test, Digit Symbol, Finger Tapping, Grooved Pegboard, Choice Reaction Time, P3 evoked potential, and Profile of Mood States. Employing anticonvulsant blood levels and seizure frequencies as covariates, the only significant difference was for Digit Symbol. Performance with phenobarbital was significantly worse than with the other 2 anticonvulsants despite phenobarbital's having had the lowest overall blood levels. Our data show that patients receiving carbamazepine, phenobarbital, and phenytoin have comparable neuropsychological performance on most measures. The results suggest that the differential cognitive effects of anticonvulsants may be subtle.

We examined the relationship of Wada memory performance and MRI hippocampal volume measurements to laterality of ultimate seizure localization in 20 patients with complex partial seizures who later underwent temporal lobectomy. Discriminant function analysis employing both Wada memory test asymmetries and hippocampal volume asymmetries correctly classified 100% of the patients into left and right temporal lobe groups. Wada memory asymmetries alone correctly classified 90% of the sample (80% of the sample when the discriminant function included all patients except the one being classified), and hippocampal volume asymmetries alone correctly classified 90% of the patients. A significant correlation was present between Wada memory asymmetries and hippocampal volume asymmetries (r = 0.78), indicating that structural evidence of reduced hippocampal volume has a functional correlate reflected by Wada memory performance. These data suggest that the combination of functional and structural measures is of value in the preoperative evaluation for epilepsy surgery.

We studied spectral components of human hippocampal EEG in relation to behavioral status in 19 patients with intractable complex partial seizures who had depth electrodes implanted into the anterior hippocampi as a part of their preoperative evaluations. Behavioral conditions included: eyes closed resting, eyes open resting, eyes open with a verbal task, and eyes open with a visuospatial task. Hippocampal EEG spectral power uniformly decreased during behavioral activation. EEG activation was quantitatively different among the 3 activated conditions, with the most prominent change occurring during the visuospatial task. The degree of EEG activation corresponded inversely with the site of epileptic focus during the verbal task. The results demonstrate the response of human hippocampal EEG to behavioral activation. The magnitude of EEG change may reflect the degree of functional activation of the given hippocampus.

Verbal memory performance was studied in 12 temporal lobe epilepsy (TLE) patients during unilateral stimulation of the hippocampus. Verbal memory was assessed during baseline, left hippocampal stimulation, and right hippocampal stimulation. In left TLE patients, no effect on memory performance was observe during stimulation of either left or right hippocampus. In contrast, left hippocampal stimulation in right TLE patients produced a decrement in memory performance. By producing verbal memory impairment in right TLE patients during low-level electrical stimulation of the left hippocampus, this technique may aid in the confirmation of right temporal lobe seizure onset. Furthermore, the lack of response in left TLE patients during left hippocampal stimulation confirms left hippocampal dysfunction in left TLE patients. In addition, these results suggest that verbal memory is not simply transferred to homologous regions of the right hippocampus.

Limbic evoked potentials (LEPs) were recorded from the hippocampi of three epilepsy surgery patients with unilateral medial temporal lobe seizure onset. In each patient, stable large amplitude LEPs which displayed polarity inversion across successive levels of hippocampus were present unilaterally, but were absent or rudimentary in the hippocampus corresponding to the electrographically proven seizure onset. After administration of scopolamine, LEPs in the "normal" hippocampi were markedly altered with slowing of the individual components and increased trial to trial variability. In addition, two patients developed reliable, high amplitude, polarity inverting LEPs on the side of seizure onset which had either absent or rudimentary LEPs in the baseline state. The results suggest that LEPs are under cholinergic modulation.

Sociability, measured as amount of participation i n a peer-group conversation, was examined as a function of traits, social context, and physical setting. Samesex quartets of 13- t o 17-year-old students discussed a topic selected b y an outsider and a topic of the group's own choice. Amount of participation was expected t o vary with personality (Affiliation, Defendence, and Dominance), social context (level of Acquaintance and Friendship i n the group), physical setting (Seating Arrangement), and interactions among these. Participants rate was significantly related to Affiliation, level of Friendship, a Person X Setting interaction (Seating Arrangement X Defendence) and a Person X Person interaction (Affiliation X Defendence). These relationships are discussed as they relate to a model of sociability and as they bear on the Person X Situation issue. This study investigates two overlapping problems, one concerned with understanding the conditions that influence differential participation in conversations and a second concerned with person and setting variables as determinants o f social behavior. Although these two problems each have a considerable history, few studies have addressed them jointly. Sociability, measured as participation in a leaderless peer-group discussion, has been studied for a long time (e.g., Mann, 1959). Its correlates have been reviewed and summarized (e.g., Shaw, 1976). The influences on sociability may be classed into three main categories: person-based variables, social context variables, and physical setting variables. Our simple descriptive model states that most of the variance i n sociability may b e accounted for by these three kinds of variables and interactions among them. The evidence concerning traits, a major subcategory o f person-based variables, and conversational participation is relatively clear in suggesting that various measures of dispositional sociability are significantly related to amount of participation i n small groups (Bass, McGehee, Hawkins, Young, & Gebel

Normalization has gained wide acceptance as a goal that residential institutions for the mentally retarded should strive to achieve, but many organizations have been shown to have difficulty achieving the goal. Theo ries developed from the organizational contingency perspective suggest that or ganizations with bureaucratic structures will have particular difficulty accomplish ing the nonroutine tasks associated with normalization Our major purpose was to test the usefulness of such theories for the evaluation of mental retardation facilities by ascertaining whether a less bureaucratic organization for the mentally retarded would achieve greater success than a more bureaucratic organization. The closing of a large public hospital and the subsequent transfer of most of its residents to two new facilities (one of which was more bureau cratic than the other) allowed us to exam ine bureaucracy's effect on treatment A s predicted, the analysis showed that the less bureaucratic organization produced a greater average positive change in behavior than did the more bureaucratic organi zation A number of clinical and demo graphic characteristics of the residents which could have influenced the observed changes in behavioral level were identified and controlled. They were not found to ex plain the differences between facilities Other factors, which could not be con trolled in this study, provide suggestions for future research.

Limbic evoked potentials were recorded from intracerebral electrodes bilaterally implanted in the hippocampi of 16 epileptic patients undergoing evaluation for surgical resection of a seizure focus. Spectral analysis of the limbic evoked potentials revealed consistently lower spectral power of both low-band (1-12.6 Hz) and high-band (13-20 Hz) components recorded form the hippocampus that was associated with the electrographically confirmed seizure focus as compared to the contralateral side. Limbic evoked potential recordings appear to be useful in the determination of a focal functional deficit and thus in identifying the site of epileptogenic pathology. Further, the results support the hypothesis of a local generator for limbic evoked potentials and demonstrate that limbic evoked potentials in humans include not only low-frequency, high-amplitude electric field changes, but also a high-frequency component.

This chapter aims to develop directions for health behavior research on the management of chronic illness. As the preceding chapters in this volume richly demonstrate, there has been an impressive structure of investigation within the field of health behavior research, which has elucidated how people feel, believe, and act in regard to their health. Particularly well known are the studies insnired bv the health belief model.

The relationship between limbic evoked potentials (LEPs) and memory performance was investigated in eight patients with intractable epilepsy who were candidates for temporal lobectomy. No relationship between the presence or absence of unilateral LEP and memory deficits was present. However, in both patients with bilaterally poorly developed hippocampal LEPs, verbal and visual-spatial memory tasks were impaired. In one patient with well developed LEPs bilaterally, memory function was normal. These data suggest that LEPs may assist in the evaluation of memory function during the preoperative work-up for temporal lobectomy.

Twenty-six patients were evaluated for temporal lobectomy. Fourteen underwent initial monitoring with electrodes in the amygdala and hippocampus bilaterally. Twelve had initial monitoring with scalp and sphenoidal electrodes. Four had conclusive localization without depth electrodes. Twenty-three patients underwent lobectomy. At 1-year minimum follow-up, 15 were seizure free. Five had greater than 90% reduction in seizure frequency. Complications of depth electrodes were one hemorrhage and one abscess. One patient developed impaired memory following surgery. Temporal lobectomy is effective in well-selected patients. Depth electrodes localize seizure onset from mesial temporal structures. Scalp and sphenoidal recording may be sufficient in some cases.