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Objective To investigate the effect of sport climbing on a biomechanical marker of axial posture in patients with Parkinson's disease, as well as its association with age, body mass index and health-related quality-of-life outcome measures. Design Pre-planned secondary analysis of our randomized controlled, semi-blind trial (unblinded patients, blinded assessors) comparing sport climbing to unsupervised exercise. Setting Single-centre study conducted at the Department of Neurology of the Medical University of Vienna, Austria. Participants Forty-eight Parkinson's disease patients (aged 64 ± 8 years, Hoehn & Yahr stage 2–3) were included. Intervention Sport climbers ( n = 24) followed a 12-week, 90 min/week supervised top-rope sport climbing course in an indoor climbing gym. The unsupervised training group ( n = 24) independently followed the ‘European Physiotherapy Guidelines for Parkinson's Disease’ and World Health Organization recommendations for an active lifestyle for 12 weeks. Main measures Posture was assessed with the horizontal distance of the seventh cervical vertebra to the wall at baseline and after the intervention. Results Participating in the sport climbing group significantly predicted the biomechanical marker of axial posture ( P = 0.044). The improvement in the biomechanical marker did not affect the quality of life, depression, fatigue, physical activity or fear of falling. Participants in the sport climbing group showed a significantly decreased horizontal distance of the seventh cervical vertebra to the wall after the intervention (−1.7 cm (95%CI [−2.6, −0.8]). In the unsupervised training group, no difference was found (−0.5 cm; 95%CI −1.3, 0.2]). Conclusions We conclude that sport climbing improves a biomechanical marker of axial posture in Parkinson's disease.

Therapeutic climbing (TC) is a whole-body workout that stimulates and improves physical and psychosocial abilities. It has been used in neurological rehabilitation, but there is scarce evidence of specific benefits for people with Parkinson's (PwP).To investigate and evaluate self-reported differences in health and well-being among trial participants, the overall feasibility of TC and clinical changes caused as a rehabilitation measure for PwP.A 3-level Likert scale survey was completed by 26 PwP (100% response rate) after a TC course (mean 16 sessions) at the Neurological Rehabilitation Center assessing self-perceived differences in health and well-being in terms of physical, psychological, and social parameters. We investigated the feasibility of TC in terms of adherence, practicability and acceptability during a multidisciplinary inpatient rehabilitation program and determined several clinical outcomes (10-meter distance and 2-minute duration walking tests, Functional Gait Assessment, Nine-Hole-Peg tests, and Tinetti Assessment Tool).Improvements are based on self-reported perceptions of PwP. We observed an improvement of overall physical (average 65%), psychological (average 59%) and social (average 39%) aspects after TC. PwP improved strength (96%), balance (88%), range of motion (88%), body awareness (85%), physical well-being (77%), and fatigue (75%). Furthermore, they self-reported admiration in their social surrounding (42%) and felt more sociable and outgoing (40%). Concerning adherence, practicability and acceptability, TC seems to be feasible for PwP. Treatment adherence was 100%, 70% declared motivation to continue TC, and 96% intended to recommend TC to peers. Furthermore, PwP showed statistically significant improvements in 10-meter walking tests (T0: 7.5 (1.1-13.9), T1: 6.5 (0.1-12.9); p .01; n = 16), 2-minute walking tests (T0: 149.5 (-111.0-410.0), T1: 177.0 (-140.7-494.7); p .01; n = 19), Functional Gait Assessment (T0: 26.0 (-24.8-76.8), T1: 28.0 (2.6-53.4); p .01; n = 15), and Nine-Hole-Peg tests (left: T0: 26.5 (24.3-28.7), T1: 24.1 (22.0-26.3); p .01; n = 15; right: T0: 26.7 (24.1-29.2), T1: 23.3 (20.8-25.7); p .01; n = 15).The preliminary findings suggest that TC offers an effective and feasible training method that may positively affect PwP overall perceptions of physical and psychosocial health status. The methodological limitations and small sample size limit the study's interpretability. More research is needed to definitely show the scientifically significant benefits of TC to PwP.

Telehealth is a growing domain with particular relevance for remote patient monitoring. With respect to the biopsychosocial model of health, it is important to evaluate perception and satisfaction with new methods in telehealth as part of an integrative approach. The Telemedicine Perception Questionnaire (TMPQ) is a 17-item questionnaire measuring patients’ perception of and satisfaction with telecare. We translated this survey into German and determined its validity and reliability in 32 adolescents and adults. Furthermore, we derived a short version of the TMPQ, named Patient and Physician Satisfaction with Monitoring (PPSM), which is a 5-item questionnaire that can be administered to both patients and physicians. Validity and reliability were tested in 32 patients and 32 physicians. Crohnbach’s α for the translated TMPQ was 0.76, and the German version yielded high validity (intraclass correlation coefficient (ICC) 0.995). We tested the PPSM in both patients and physicians and found acceptable values for Crohnbach’s α (0.72 and 0.78) with excellent validity (ICC 0.965). We therefore concluded from this small study that both German versions of the TMPQ and PPSM can be used to investigate the acceptance of telehealth applications.

Objective To investigate higher cognitive functions after mimicry changes after facial botulinum toxin (BTX) injections, we tested verbal and nonverbal reasoning in patients with blepharospasm or hemifacial spasm before and after their long-term botulinum toxin treatment. Design Explorative, nonrandomized, clinical trial. Setting Patients receiving ambulatory care and control participants from the general community. Participants Volunteer sample (N=84) of patients (n=21) with blepharospasm or hemifacial spasm who received facial BTX injections. Control participants included patients (n=30) with cervical dystonia who received cervical BTX injections and individuals without neurological disorders (n=33). Interventions The 2 groups receiving injections were tested before and 3 weeks after their treatment. The group without neurological disorders received no injections. Main Outcome Measures Verbal and nonverbal reasoning scores. Results The key unexpected finding was that patients who received facial BTX injections perform significantly worse in nonverbal reasoning tasks, when compared with those who did not receive injections (P=.022). There was no significant difference in the baseline reasoning scores and at follow-up for verbal reasoning between the 3 groups. There was no correlation between toxin dose and reasoning scores (verbal: P=.132; nonverbal: P=.294). Conclusions Because of potential confounders, the results do not yet allow any conclusion on causality. Further research is needed to confirm our findings.

Specific language impairment (SLI) is a very common childhood disorder that is characterized by impairments in expressive and/or receptive language regarding different modalities. Part V of the German version of the Token Test was evaluated as a potential screening tool for the early detection of SLI. Forty-five male and 16 female monolingual native German-speaking preschoolers with SLI (4–6 years) and 61 age- and gender-matched typically developing controls were examined with a German version of the Token Test and an established intelligence measure. Token Test performance was significantly worse in preschoolers with SLI including greater group differences at age 4 than at ages 5 and 6. Analyses showed a detection rate of 77% for Part V of the Token Test in the whole sample as well as 85.1% at age 4, 80.6% at age 5, and a nonsignificant detection at age 6. Correctly detected preschoolers with SLI showed significantly worse performance than typically developing controls regarding nonverbal and verbal intelligence, numeracy, problem solving, working memory, visual attention, and memory. Children with SLI show worse Token Test performance, whereas at ages 4 and 5, Part V of the Token Test could potentially serve as a screening tool for the detection of SLI.

Theory of Mind (ToM) is the ability to represent and attribute mental states to oneself and others. So far, research regarding ToM processing across adolescence is scarce. Existing studies either yield inconsistent results or did not or not thoroughly investigate aspects like higher order ToM and associated neuropsychological variables which the current study tried to address. 643 typically developing early, middle, and late adolescents (age groups 13–14; 15–16; 17–18) performed cognitive and affective ToM tasks as well as neuropsychological tasks tapping the cognitive or affective domain. Regarding both ToM types, 15- to 16-year-olds and 17- to 18-year-olds outperformed 13- to 14-year-olds, whereas females were superior regarding cognitive ToM. Across adolescence, cognitive and affective ToM correlated with attention and affective intelligence, whereas working memory, language comprehension, and figural intelligence additionally correlated with cognitive ToM. In early adolescence, attention correlated with both ToM types, whereas cognitive ToM further correlated with language comprehension and affective ToM with verbal intelligence, verbal fluency, and verbal flexibility. In middle and late adolescence, affective intelligence correlated with both ToM types, whereas cognitive ToM additionally correlated with working memory, language comprehension, and figural intelligence. The current study shows a developmental step regarding cognitive and affective ToM in middle adolescence as well as gender differences in cognitive ToM processing. Associations between neuropsychological variables and ToM processing were shown across adolescence and within age groups. Results give new insights into social cognition in adolescence and are well supported by neuroscientific and neurobiological studies regarding ToM and the integration of cognitive and affective processes. Graphic abstract, Research highlights Cognitive and affective Theory of Mind (ToM) abilities increase significantly in adolescence and a developmental step in middle adolescence can be seen.Girls outperform boys regarding cognitive ToM, but not regarding affective ToM.Across adolescence, attention and affective intelligence are associated with cognitive and affective ToM; Cognitive ToM is additionally predicted by working memory, language comprehension, and figural intelligence.Associated neuropsychological variables vary across ToM type and adolescent age group.Results are supported by neuroscientific and neurobiological studies regarding ToM and the integration of cognitive and affective processes.

Physical activity is of prime importance in non-pharmacological Parkinson’s disease (PD) treatment. The current study examines the effectiveness and feasibility of sport climbing in PD patients in a single-centre, randomised controlled, semi-blind trial. A total of 48 PD patients without experience in climbing (average age 64 ± 8 years, Hoehn & Yahr stage 2–3) were assigned either to participate in a 12-week sport climbing course (SC) or to attend an unsupervised physical training group (UT). The primary outcome was the improvement of symptoms on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III). Sport climbing was associated with a significant reduction of the MDS-UPDRS-III (−12.9 points; 95% CI −15.9 to −9.8), while no significant improvement was to be found in the UT (−3.0 points; 95% CI −6.0 to 0.1). Bradykinesia, rigidity and tremor subscales significantly improved in SC, but not in the unsupervised control group. In terms of feasibility, the study showed a 99% adherence of participants to climbing sessions and a drop-out rate of only 8%. No adverse events occurred. This trial provides class III evidence that sport climbing is highly effective and feasible in mildly to moderately affected PD patients.

Conventional metaphor, irony, and literal language processing were compared. Thirty right-handed participants (21–34 years) performed a sequential-statement ERP-paradigm. A left-frontal Late Anterior Negative Slow Wave (LANSW, 450–1000 ms) was significantly greater for metaphors and by visual tendency greater for irony, compared to literal statements. A centroparietal N400 (300–450 ms) and a centroparietal right-dominant “Late N400” (450–600 ms) were by statistical and visual tendency greater for metaphors. Left PCC and left lingual gyrus activity was significantly higher in metaphors compared to literal statements (eLORETA; 450–1000 ms). A statistical trend indicated higher parahippocampal gyrus activity in metaphors and ironies. N400 results are discussed considering changing processing techniques and a renewed semantic conflict. The Late N400 was associated with the construct of “associativeness”. The LANSW was related to metaphorical mapping, frame-shifting processes, integration of meanings, and memory processes. eLORETA results were discussed considering metaphorical mapping, creation of mental images, conventionality, valence, memory processes, and divergent thinking.

Attributing mental states to others in social interactions [Theory of Mind (ToM)] often depends on visual social cues like eye gaze or mimic. This study presents an event-related potentials task (Brainy-ERP) that was developed in order to investigate the electrophysiological correlates of first-, second-, and third-order cognitive and affective ToM processing. The task was based on social visual cues and involved electroencephalographic event-related potential (ERP) analyses and exact low-resolution brain electromagnetic tomography analyses (eLORETA) source localization analyses. Results showed that in cognitive and affective conditions, first-order trials elicited greater Anterior P2 (180-370 ms) amplitudes. In the cognitive condition, third-order trials elicited greatest amplitudes in the broadly distributed early negative slow wave (eNSW, 260-470 ms) and the late NSW (LNSW, 460-1,000 ms). In the affective condition, third-order and second-order trials elicited greatest amplitudes in a broadly distributed NSW (250-1,000 ms). Regarding affective trials in the NSW time span, statistical significant differences and trends were shown regarding activation of underlying brain regions. Third-order trials elicited greatest activation in a number of regions typically associated with the ToM network, especially the posterior cingulate cortex (PCC), cuneus, and temporoparietal junction (TPJ). Furthermore, ToM low performers (participants with high accuracy but longer reaction times) showed by trend smaller Posterior N1 and significantly smaller eNSW amplitudes compared to average and high performers. This study offers new insights into electrophysiological correlates of basic and higher order cognitive and affective ToM processing and its precise time course.

Summary Continuity and discontinuity in the development of social relationships have been investigated by reviewing the course of social bonds and by analyzing the effects of a sound intimate relationship in adulthood in conjunction with recalled maternal bonding on the quality of life among students. A questionnaire-based study of 207 students was conducted. Perceptions of maternal bonding were designated as being representative of one of the two contrasting bonding types “optimal maternal bonding” and “affectionless maternal control” assessed by the Parental Bonding Instrument (PBI) and combined with perceptions of a sound intimate adult relationship measured by the Family Assessment Measure III Dyadic Relationships Scale (FAM-III-D). Quality of life and general health data were determined by using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Students who reported “optimal maternal bonding” had intimate relationships in adulthood that were of significantly higher quality than those who recalled “affectionless maternal control”. Students who recalled “optimal maternal bonding” and described their intimate relationship as sound showed significantly higher scores in all domains of quality of life and indicated having better general health than those who reported “affectionless maternal control” and a sound intimate relationship. A sound intimate relationship in adulthood does not appear to compensate the impact of a recalled maternal bonding behavior in terms of affectionless control, on quality of life. Furthermore, results seem to support the hypothesis of continuity of the development of social relationships among psychologically well individuals based on the association between maternal bonding and later intimate relationships.

Purpose: Metaphor is a specific type of figurative language that is used in various important fields such as in the work with children in clinical or teaching contexts. The aim of the study was to investigate the developmental course, developmental steps, and possible cognitive predictors regarding metaphor processing in childhood and early adolescence. Method: One hundred sixty-four typically developing children (7-year-olds, 9-year-olds) and early adolescents (11-year-olds) were tested for metaphor identification, comprehension, comprehension quality, and preference by the Metaphoric Triads Task as well as for analogical reasoning, information processing speed, cognitive flexibility under time pressure, and cognitive flexibility without time pressure. Results: Metaphor identification and comprehension consecutively increased with age. Eleven-year-olds showed significantly higher metaphor comprehension quality and preference scores than seven- and nine-year-olds, whilst these younger age groups did not differ. Age, cognitive flexibility under time pressure, information processing speed, analogical reasoning, and cognitive flexibility without time pressure significantly predicted metaphor comprehension. Conclusions: Metaphorical language ability shows an ongoing development and seemingly changes qualitatively at the beginning of early adolescence. These results can possibly be explained by a greater synaptic reorganization in early adolescents. Furthermore, cognitive flexibility under time pressure and information processing speed possibly facilitate the ability to adapt metaphor processing strategies in a flexible, quick, and appropriate way.

Specific language impairment (SLI) comprises impairments in receptive and/or expressive language. Aim of this study was to evaluate a screening for SLI. 61 children with SLI (SLI-children, age-range 4–6 years) and 61 matched typically developing controls were tested for receptive language ability (Token Test—TT) and for intelligence (Wechsler Preschool-and-Primary-Scale-of-Intelligence—WPPSI). Group differences were analyzed using t tests, as well as direct and stepwise discriminant analyses. The predictive value of the WPPSI with respect to TT performance was analyzed using regression analyses. SLI-children performed significantly worse on both TT and WPPSI (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$p \le .0001$$\end{document}p≤.0001). The TT alone yielded an overall classification rate of 79%, the TT and the WPPSI together yielded an overall classification rate of 80%. TT performance was significantly predicted by verbal intelligence in SLI-children and nonverbal intelligence in controls whilst WPPSI subtest arithmetic was predictive in both groups. Without further research, the Token Test cannot be seen as a valid and sufficient tool for the screening of SLI in preschool children but rather as a tool for the assessment of more general intellectual capacities. SLI-children at this age already show impairments typically associated with SLI which indicates the necessity of early developmental support or training. Token Test performance is possibly an indicator for a more general developmental factor rather than an exclusive indicator for language difficulties.

Humour processing is a complex information-processing task that is dependent on cognitive and emotional aspects which presumably influence frame-shifting and conceptual blending, mental operations that underlie humour processing. The aim of the current study was to find distinctive groups of subjects with respect to black humour processing, intellectual capacities, mood disturbance and aggressiveness. A total of 156 adults rated black humour cartoons and conducted measurements of verbal and nonverbal intelligence, mood disturbance and aggressiveness. Cluster analysis yields three groups comprising following properties: (1) moderate black humour preference and moderate comprehension; average nonverbal and verbal intelligence; low mood disturbance and moderate aggressiveness; (2) low black humour preference and moderate comprehension; average nonverbal and verbal intelligence, high mood disturbance and high aggressiveness; and (3) high black humour preference and high comprehension; high nonverbal and verbal intelligence; no mood disturbance and low aggressiveness. Age and gender do not differ significantly, differences in education level can be found. Black humour preference and comprehension are positively associated with higher verbal and nonverbal intelligence as well as higher levels of education. Emotional instability and higher aggressiveness apparently lead to decreased levels of pleasure when dealing with black humour. These results support the hypothesis that humour processing involves cognitive as well as affective components and suggest that these variables influence the execution of frame-shifting and conceptual blending in the course of humour processing.

Metaphor development in conjunction with verbal intelligence and linguistic competence in middle childhood and at the transition to early adolescence was investigated. 298 individuals between seven and ten years (chronological age) who attended grades two–four (mental age) were tested for metaphor processing by the Metaphoric Triads Task, for linguistic competence (HELD), and verbal intelligence (WISC-III). Chronological age significantly predicted metaphor processing with a breakpoint of 8.2 years regarding identification and comprehension, and 10.2 years regarding preference. Fourth-graders showed highest metaphor processing scores. Verbal intelligence significantly predicted metaphor processing; this effect became stronger with increasing age. Attributional metaphors were best understood and most preferred. Chronological and mental age are associated with metaphor processing in an age span that is seemingly crucial for metaphor development. Verbal analogical reasoning, concept formation, verbal abstraction, and semantic knowledge predicted metaphor comprehension. Understanding facts, principles, and social situations, and resultant inferential verbal reasoning predicted metaphor preference.

Metamemory refers to the ability to monitor and control one´s own memory processes which plays an important role in everyday life when accuracy of memory is required. The present study intends to give new insights into the complex relationship between confidence in memory and accuracy of metamemory judgments for negative emotional and neutral pictorial stimuli. Judgments of learning (JOLs) were investigated in order to provide important theoretical information for practical applications in everyday life. A balanced 2 × 2 factorial experimental design was used to explore the impact of framing in terms of remembering or forgetting as well as emotionality on JOLs. With respect to the already known complex relationship of confidence in memory and accuracy of confidence statements, the present results emphasize this complexity by showing that there is no interaction between the factors framing and emotionality but significant main effects of these two factors with respect to JOLs. Furthermore, accuracy of JOLs is not influenced by framing in terms of remembering and forgetting. Both framing conditions lead to overconfident judgments, regardless of whether confidence in memory is influenced by framing. Emotionality, on the other hand, enhances memory accuracy regardless of whether the subjective feeling of remembering influences confidence in memory or not. The present findings highlight the need to strengthen the collective consciousness about the influenceability of confidence in memory and the fact that a high confidence in memory is not inevitably accompanied by accurate memories.

Subjective emotional arousal in typically developing adults was investigated in an explorative study. 177 participants (20–70 years) rated facial expressions and words for self-experienced arousal and perceived intensity, and completed the Difficulties in Emotion Regulation scale and the Hospital Anxiety and Depression scale (HADS-D). Exclusion criteria were psychiatric or neurological diseases, or clinically relevant scores in the HADS-D. Arousal regarding faces and words was significantly predicted by emotional clarity. Separate analyses showed following significant results: arousal regarding faces and arousal regarding words constantly predicted each other; negative faces were predicted by age and intensity; neutral faces by gender and impulse control; positive faces by gender and intensity; negative words by emotional clarity; and neutral words by gender. Males showed higher arousal scores than females regarding neutral faces and neutral words; for the other arousal scores, no explicit group differences were shown. Cluster analysis yielded three distinguished emotional characteristics groups: “emotional difficulties disposition group” (mainly females; highest emotion regulation difficulties, depression and anxiety scores; by trend highest arousal), “low emotional awareness group” (exclusively males; lowest awareness regarding currently experienced emotions; by trend intermediate arousal), and a “low emotional difficulties group” (exclusively females; lowest values throughout). No age effect was shown. Results suggest that arousal elicited by facial expressions and words are specialized parts of a greater emotional processing system and that typically developing adults show some kind of stable, modality-unspecific dispositional baseline of emotional arousal. Emotional awareness and clarity, and impulse control probably are trait aspects of emotion regulation that influence emotional arousal in typically developing adults and can be regarded as aspects of meta-emotion. Different emotional personality styles were shown between as well as within gender groups.

Background Metaphors, mainly proverbs and idiomatic expressions of ordinary life are commonly used as a model for concretism. Previous studies have shown impaired metaphor comprehension in patients with schizophrenia-spectrum disorders compared to either psychiatric or non-psychiatric control subject. The aim of this study was to detect possible quantitative differences in figurative processing between patients with schizophrenia-spectrum disorders and healthy controls. Methods In order to analyse possible dissociations of different aspects of figurative speech, a range of metaphor tasks was used to distinguish between recognition of familiar metaphors, paraphrasing the meaning of the latter and generating novel metaphors: we used a standard proverb test for conventional metaphors consisting of a multiple-choice and a paraphrasing task, and the Metaphoric Triads Test for the assessment of novel metaphors. We included 40 patients with schizophrenia-spectrum disorders and 43 healthy control subjects. Results Our results showed that patients had impaired figurative speech processing regarding novel and conventional metaphors. Associations with cognitive functions were detected. Performance on the paraphrasing task was associated with the severity of negative symptoms. Conclusion We conclude that patients with schizophrenia-spectrum disorders do exhibit impairments in the recognition and paraphrasing of conventional and the generation of novel metaphors and that some cognitive domains as well the extent of negative symptoms might be associated with these deficits.

Objectives Cognitive behavioural guided self-help has been shown to be effective in mild and moderate depressive disorder. It is not known, however, if it is effective in individuals with partially remitted depressive disorder, which is a serious clinical problem in up to 50–60% of treated patients. This study is the first one to examine the clinical benefit of this intervention in this patient population. Design For the purpose of this study, a single-blind, randomized controlled design was used. Method We randomized 90 individuals with partially remitted depressive disorder either to cognitive behavioural guided self-help plus psychopharmacotherapy (n = 49) or psychopharmacotherapy alone (n = 41). They were clinically assessed at regular intervals with ratings of depressive symptoms and stress-coping strategies over a 3-week run-in period and a 6-week treatment period. Results After 6 weeks, intention-to-treat analysis (n = 90) showed that patients treated with cognitive behavioural guided self-help plus psychopharmacotherapy did not have significantly lower scores on the Hamilton Rating Scale of Depression (17-item version; HRSD-17) and on the Beck Depression Inventory (BDI) compared to patients treated with psychopharmacotherapy alone. When negative stress-coping strategies were considered, there was a significant difference between the two groups at the end of treatment with respect to the BDI but not to the HRSD-17. Conclusions Guided self-help did not lead to a significant reduction in symptom severity in patients with partially remitted depressive disorder after a 6-week intervention. However, the intervention leads to a reduction of negative stress-coping strategies. Practitioner points Cognitive behavioural guided self-help did not significantly improve depressive symptoms measured with the Hamilton Rating Scale of Depression (17-item version; HRSD-17) in patients with partially remitted depressive disorder. Improvements were found in reducing negative stress-coping strategies for those allocated to the cognitive behavioural guided self-help, which significantly improved Beck Depression Inventory but not HRSD-17. These findings suggest that cognitive behavioural guided self-help may offer some assistance in managing negative stress-coping strategies.

The present study examined the defining features of emerging adulthood, subjects' conceptions of the transition to adulthood, and the perceived adult status in Austria. The sample consisted of 775 subjects (226 adolescents, 317 emerging adults, 232 adults). Results showed that most Austrian emerging adults feel themselves to be between adolescence and adulthood. Emerging adults predominantly described this period as an age of possibilities and identity exploration, as a self-focused age, as an age of feeling in between, and of instability. Regarding important criteria for feeling adult, it was found that age groups (adolescents, emerging adults, adults) differ in individualism, family capacities, norm compliance, role transitions, and other. Thus, as was shown for other Western cultures, emerging adulthood seemed to constitute a distinct stage of life in Austria also.

Die Erforschung von Abschiedsbriefen ist eine traditionsreiche Stromung in der Suizidologie, die integriert in die Hinterbliebenenarbeit stattfinden sollte. Im folgenden Beitrag werden ein osterreichisches Textkorpus und seine Themen vorgestellt. Eine fortlaufende Serie von Suiziden wurde am Department fur Gerichtsmedizin der Medizinischen Universitat Wien zwischen Mai 2002 und April 2005 auf das Vorliegen von Abschiedsbriefen untersucht. Abschiedsbriefe und demografische Faktoren der Briefhinterlasser wurden in eine Access-Datenbank integriert. Etwa 29% der Suizidenten sind Abschiedsbriefhinterlasser. Jedoch nur von einem Viertel der Briefhinterlasser erlauben die Hinterbliebenen eine Auswertung der Briefe. Der uberwiegende Teil ist handschriftlich verfasst, an die Allgemeinheit oder Familie adressiert und unter 150 Worter lang. Die am haufigsten auftretenden Themen sind Hinterlassenschaft gefolgt von Gefuhlen, wie Hass, Selbstvorwurfe und Liebe, gefolgt von Umgebungsproblemen, wie Familie, Beruf und Freizeit, Strom-des-Lebens-Themen und Krankheit.

Despite the benign prognosis regarding the response of seizures to treatment, some evidence now exists that patients with benign childhood epilepsy with centro-temporal spikes (BCECTS) may have neuropsychological deficits sometimes leading to academic underachievement. There is, however, no general agreement on the exact profile of functions disturbed. This study was designed to identify significant deficits in spatial perception and memory in children with BCECTS (ages 6-10 years) compared with healthy controls matched for age, sex and socioeconomic status. The neuropsychological test battery administered consisted of the HAWIK-III, the "Tübinger Luria Christensen Neuropsychological Test Set for Children", the "Kaufman Assessment Battery for Children" and the "Differential Neuropsychological Test". Twenty-two patients and 22 control subjects completed all tests. Children with BCECTS exhibited significant deficits in higher functions of spatial perception, including spatial orientation, as well as in basal and complex spatial memory. Deficits were independent of the lateralization of the epileptogenic foci and independent of anti-convulsive drug treatment.

Background. Suicide notes provide direct information from suicide victims and often are written shortly before the suicide act. An important question is whether those who write such notes are representative for suicide victims who do not. Methods. A consecutive series of suicides investigated at the Department of Forensic Medicine in Vienna from April 2002 to March 2003 was examined for the existence of suicide notes. Note writers were compared with non-note writers according to the variables age, sex, family status, occupational status, psychiatric care, suicide motive, and method. Results and Conclusions. Suicide victims who leave suicide notes do not differ statistically significantly from non-note-leavers in sex, age, family status, psychiatric care, motive, or method. This means they are representative for all suicide victims concerning important demographic factors.

Psychological factors are considered for the predisposition and perpetuation of functional dysphonia. In the present study 61 patients with functional dysphonia were compared with 61 healthy controls, matched by age, sex, and occupation with respect to Cloninger’s personality model, mood, and anxiety. The patients with functional dysphonia presented significantly higher scores than the healthy controls with respect to “harm avoidance” (HA); depressive symptoms; symptoms of unspecific and general anxiety; symptoms of specific anxiety concerning “health”, “illness”, and “extraversion versus introversion”. No significant differences were found in “novelty seeking” (NS), “reward dependence” (RD), “persistence” (PE), or in state-anxiety and anxiety of social situations. These results were found considering univariate and multivariate analyses and confirm the relationship of psychological factors such as personality traits, mood, and anxiety on one hand and conversion disorder in general and functional dysphonia in particular on the other hand. This important relationship should be considered in the diagnostic and therapeutic interventions of functional dysphonia.

The authors' objective in this article was to explore the accuracy of mothers' estimates concerning their children's developmental functioning, especially with respect to vocabulary and gross motor development, by comparing the results of diagnostic tests administered to both the children and their mothers. The authors studied 55 children with disorders of language development (LD) between the ages of 3 and 6 years using several diagnostic scales concerning child development. The authors assessed the mothers' estimates regarding vocabulary and gross motor development by the same scales as those used for their children. These scales were presented as questionnaires and scored like the tests used for the children. There was a significant tendency toward a general overestimation of a child's developmental functioning regarding vocabulary and gross motor skills. Moreover, the accuracy of the mothers' estimates did not seem to be associated with several selected variables. The results did not correspond to those of other studies that have shown that mothers' estimates provide a good indication for the developmental status of a child--at least for the child's developmental status considering vocabulary and gross motor skills in children with LD. The results support the objection regarding the use of maternal estimates as the only source of information concerning the development of a child among scientific studies, especially if they deal with research on the development of vocabulary or gross motor skills.

We sought to evaluate serum concentrations of cathepsin K in peripheral blood and to determine whether they correlated with bone-mineral density (BMD) and the incidence of nontraumatic fractures. We took blood samples from 162 patients (101 with osteoporosis, 48 with osteopenia) and 13 healthy controls, then conducted quantitative measurements of cathepsin K using a commercially available enzyme-linked immunosorbent assay. Cathepsin K concentrations were correlated with the incidence of nontraumatic fracture, BMD, markers of bone turnover (alkaline phosphatase, bone-specific alkaline phosphatase, osteocalcin, parathyroid hormone, and C-telopeptide). The correlations between cathepsin K concentrations in subjects without fractures and in those with multiple nontraumatic fractures were statistically significant ( t = -2.1, degrees of freedom = 107, P = .036). The cathepsin K levels of controls and patients with osteoporosis were significantly different ( t = -3.7, degrees of freedom = 58.9, p>0.0001) These results suggest that the serum level of cathepsin K could serve as a marker for fracture prediction and BMD.

The etiology of functional dysphonia is still unclear, but psychological factors are assumed to play an important role . The purpose of this report is to investigate the impact of depression and anxiety in functional dysphonia. Sixty-one patients with functional dysphonia were screened for additional psychiatric disorders (besides 300.11) by a clinical psychiatric interview. They were then compared with healthy controls, matched by age, sex and occupation, with respect to self-reported symptoms of depression, generalized anxiety, and specific anxiety concerning health. The patients had significantly higher scores than the controls in depressive symptoms, in the symptoms of nonspecific and general anxiety, and in the symptoms of specific anxiety concerning health. Fifty-seven percent of the patients also fulfilled DSM-IV criteria for a mood disorder, an anxiety disorder, or an adjustment disorder. Multivariate analysis of covariance, performed to correct for the influence of co-morbid psychiatric diagnoses on self-rated symptoms of depression and anxiety, confirmed significant differences between patients and controls in the symptoms of depression and specific anxiety concerning "somatic complaints." Both symptoms of depression and anxiety should be taken into consideration in the diagnostic as well as the therapeutic process of patients with functional dysphonia.

The present linkage study is a follow-up within the chromosome 3q29 region in schizophrenia and bipolar affective disorder families, based on our recently published genome scan, resulting in evidence for linkage of both disorders to this region (marker D3S1265: NPL [non parametric lod] score Zall=3.74, P=0.003). Using the same family sample (five pedigrees with schizophrenic index patients and three pedigrees with index bipolar disorder patients N=86; 50 of them were available for genotyping), genotyping of eight additional markers close to D3S1265 was done. Five of those new markers (three centromeric and two telomeric of D3S1265) spanning 4.14 cM (centiMorgan) could be used for statistical analyses (“new markers”). Moreover, marker D3S1265, genotyped within the published genome scan, was used for additional calculations. Linkage analysis was performed using the GENEHUNTER program version 2.1r3. Within newly genotyped markers the highest NPL score Zall observed was 1.93296 with the telomeric SNP (single nucleotide polymorphism) rs1835669, corresponding to P=0.032166. Statistical analysis including D3S1265, located in between the newly genotyped markers, resulted in a peak NPL score Zall=4.00179 with marker D3S1265, that is P=0.000128. Doing subset analyses of the bipolar disorder and schizophrenia families separately with new markers and D3S1265, linkage signals arose substantially from bipolar disorder families, with contribution from schizophrenia families, too. The results of our follow-up study support our previous linkage finding of schizophrenia and bipolar affective disorder to chromosome 3q29.

Background Even in the age of two years toddlers with Expressive Language Impairment (SLI-E) differ regarding their phonetic inventories compared with an age-matched group developing normally. Method and patients PCC-R scores of 19 children with expressive language disorder, aged between four and six years, are compared with age and sex matched controls with normal language acquisition. Results There are significant differences between PCC-R scores, children with expressive language disorder show lower scores than children with normal language acquisition. Age, sex and nonverbal intelligence do not influence performance measured with PCC-R. Analysis regarding early, middle and late consonants shows, that expressive language disordered children show bigger problems in aquiring late than early and middle consonants.

Zusammenfassung: Die vorliegende Studie beschäftigt sich mit einem wichtigen Teilaspekt der Sprachentwicklung, dem Metaphernverständnis von Kindern im Grundschulalter und dessen Bedeutung für die Pädagogische Psychologie. In diesem Sinne wurden Altersunterschiede unter Einbeziehung der Variablen “Intelligenz”, “Sprachkompetenz” und “kognitive Entwicklung” im Verständnis metaphorischer Sprache in Form sprichwörtlicher Redensarten anhand von insgesamt 124 Kindern der 2., 3. und 4.Klassenstufe untersucht. Zwölf sprichwörtliche Redensarten wurden als Multiple-Choice- bzw. Paraphrasieraufgaben vorgelegt; Intelligenz, Sprache und kognitive Entwicklung wurden durch gebräuchliche standardisierte Testverfahren operationalisiert. Anhand einer Kovarianzanalyse mit der Variable “Alter” und den Kovariaten “verbale” und “nonverbale Intelligenz”, “kognitive Entwicklung nach Piaget” und “Bekanntheit der sprichwörtlichen Redensarten” konnte ein signifikanter Altersanstieg nachgewiesen werden. Weiters zeigt sich, dass die verbale Intelligenz eines Kindes sein Verständnis sprichwörtlicher Redensarten wesentlich beeinflusst. Hinsichtlich der sprachlichen Kompetenz erweist sich das Verständnis von Wortbedeutungen relevant, wie mittels multipler Regression nachgewiesen wurde.

— Aims: To evaluate the impact of mood, affect, and personality on predicting relapse in detoxified alcohol-dependent patients to uncontrolled drinking during a 1-year treatment study. Methods: A total of 521 patients with a DSM-III-R diagnosis of alcohol dependence, excluding those with major depressive disorder, took part in a European multicentre study (11 centres in the United Kingdom, Irish Republic, Switzerland, and Austria). Depressive symptoms were assessed using the Hamilton Depression Scale, whereas symptoms of anxiety were measured using the ‘STAI-X2’ of the self-rating scale State–Trait Anxiety Inventory and personality traits were measured by the Tridimensional Personality Questionnaire. Results: High anxiety as a stable trait, and personality traits such as high novelty seeking and low harm avoidance covering exploratory excitability, impulsiveness, extravagance, disorderliness and uninhibited optimism, predicted relapse. Conclusions: These measures could have a direct clinical application for predicting relapse to uncontrolled drinking in male and female detoxified alcohol-dependent patients. The findings indicate the importance of additional therapeutic treatment.

Objective: Bonding between mother and child is described as a complex two-way process ensuring the needs of the child for nurture and protection. As such, it is dependent on the contribution of mother and child [ 1 – 3 ] whereby characteristics of personality of the child may have consequences on maternal bonding behaviour. In the current study the perception of maternal behaviour, premorbid personality traits and relationships between maternal behaviour and personality traits were investigated in schizophrenic and schizoaffective patients and their same-sex, healthy siblings. Methods: We recruited 36 schizophrenic and schizoaffective patients and their same-sex healthy siblings. Information about maternal bonding behaviour was assessed by the Parental Bonding Instrument, information about premorbid personality traits was obtained from their mothers using the ‘Gießen-Test’. Results: Compared to their siblings, patients showed less social resonance, more permeability, less social competence and a more depressed and anxious mood. Furthermore, patients described their mothers to be less caring and to be more overprotective than their siblings described them. But there were strong associations between maternal bonding behaviour and premorbid personality traits. These findings were supported by missing significant differences in maternal care behaviour between patients and siblings when using premorbid characteristics as covariates. Significant high maternal overprotection perceived by patients with schizophrenia and schizaffective disorders still remained after correcting for the influence of premorbid personality traits. Conclusion: The results suggest that premorbid personality traits should be considered not only in analyses of maternal care behaviour in schizophrenic and schizoaffective patients but also when studying other psychiatric patient groups.

Purpose: To investigate whether short German sentences that have been developed to be highly comparable in number and length of words, as well as in difficulty and construction, are reliable and valid test items for measuring reading speed in order to use them for measuring simultaneously reading acuity and speed with the "Radner Reading Charts". Methods: Tests were performed in 198 persons: 99 university students (average age 23.6±2.8 years) and blue-collar apprentices (average age 18.4±2.5 years). Reading speed and the number of errors were determined first with 24 sentences for our recently developed German reading charts (14 words equal in difficulty, length and construction) and secondly with long paragraphs of the "Zuercher Reading Test" (ZRT; paragraphs 3–5, 261 words). Results: The overall mean reading speed obtained with short sentences was 209.6±41.0 words per minute (wpm), compared with 169.2±35.0 wpm for the ZRT (P

Obwohl die Schwächen in der Schriftsprachkompetenz bei gehörlosen Erwachsenen allgemein bekannt sind, gibt es wenige empirische Untersuchungen dazu. Ziel dieser Arbeit ist es, eine quantitative Analyse der grammatikalischen Fehler in Faxmitteilungen einer Stichprobe gehörloser Erwachsener durchzuführen. Dazu wurden 236 Faxmitteilungen aus zwei Institutionen von einer repräsentativen Stichprobe zufällig ausgewählt. Die Analyse umfasst die Bereiche Lexikon, Morphologie und Syntax. Es ergaben sich drei Schreibleistungsgruppen, die auch statistisch abzusichern waren: Schreibleistungsgruppe 1 umfasst Gehörlose, die weitgehend vollständige Regelkenntnisse des Deutschen aufweisen; Angehörige der Schreibleistungsgruppe 2 zeigen einfache Regelmuster mit geringer syntaktischer Komplexität; Schreibleistungsgruppe 3 verwendet Holophrasen, schafft nur mangelhafte Wortartunterscheidungen und zeigt nichtzielsprachliche Wortfolgeregeln.

Background: There is evidence that Tourette’s disorder (TD) is associated with abnormalities in the dopaminergic system involving the dopamine transporter (DAT). Data from [123I]-β-CIT single photon emission computed tomography (SPECT) studies and postmortem findings concerning DAT densities in TD patients are not conclusive. The objective of our study was to measure DAT densities with [123I]-β-CIT binding in TD patients who were either psychotropic drug naive or currently treated with antipsychotics (AP) and healthy controls. Method: Altogether 20 TD patients were investigated. A total of 15 patients were psychotropic drug naive and five were currently treated with AP. Ten psychotropic drug naive patients were compared with ten age and sex matched healthy subjects. Five currently treated patients were compared with five age and sex matched psychotropic drug naive TD patients. The investigation was carried out using [123I]-β-CIT (2-β-carbomethoxy-3-β(4-iodophenyl)-tropane and SPECT. Regions of interest (ROI) were drawn over the striatum and the cerebellum. Results: The DAT densities measured by the striatal/cerebellar (S/C) binding ratio did not differ between drug naive TD patients and the controls. The difference between currently AP treated and psychotropic drug naive TD patients did not reach the level of significance. There was no correlation between the ratio and severity of tics and illness. Conclusion: Our study with psychotropic drug naive TD patients contributed to clarify the inconsistent results concerning the DAT.

Objective: Schizophrenia is a relatively common, often chronic and debilitating mental illness. Evidence from various studies has clearly demonstrated that genetic factors contribute substantially to the etiology. The goal of this study was to identify chromosomal regions likely to contain schizophrenia susceptibility genes. Methods: A genome-wide map of 388 microsatellite DNA markers was genotyped in 5 schizophrenia families. Nonparametric linkage analysis (Genehunter) was used to assess the pattern of allele sharing at each marker locus relative to the presence of disease. Results: Nonparametric linkage scores did not reach a genome-wide level of statistical significance (p < 0.00002) or a p value suggestive of linkage (p < 0.007) for any marker; however, one p value suggested replicated linkage (p < 0.01) at chromosome 6p24 in region D6S309 (p = 0.0047). Furthermore, 11 markers resulted in p < 0.05 at chromosomes 6p, 6q, 10q, 12q and 14q. Conclusions: Despite the differences in diagnostic schemes, in markers used and methods of analyses between studies published so far, we think that our result supports the notion that there is possibly some consistent evidence for replicated linkage of a schizophrenia susceptibility locus around the region of D6S309 at chromosome 6p24.

Difficulties in language acquisition seem to be serious, if there are additional problems like intellectual and/or emotional/social impairment, which are often reported [10]. These additional problems and the definition of specific language impairment as a developmental disorder, restricted to language acquisition seem to be contradictory [17]. Aim of that study is to look for specific language impaired children with similar cognitive abilities and though to investigate, if there are children without additional cognitive problems considering the definition of specific language impairment. 93 children, between 4;0 and 6;6 years old, were diagnostized as specific language impaired (ICD-10) and were assessed by the "Hannover Wechsler Intelligenztest fur das Vorschulalter (HAWIVA)" [6] (german version of WPPSI). Cluster analysis showed, that 1/3 of the specific language impaired children presented no additional cognitive problems and 2/3 of them showed cognitive problems regarding nonverbal and verbal intelligence indeed. These additional cognitive problems indicate that there may be a more basic cognitive defect underlying specific language impairment [15]--at least for a group of specific language impaired children. Furthermore the nonverbal and verbal intellectual difficulties emphasize to general developmental support of specific language impaired children for optimal improvement in language acquisition.

In various genetic disorders it has been observed that the severity of illness increases and the age at onset decreases in successive generations. This phenomenon is termed anticipation. We sampled 15 families, totalling 123 individuals with at least one person affected by a disease of the schizophrenia spectrum in the index generation in each family (IG; n = 33 affected out of a total of 67 individuals) and in the parental generation (PG; n = 16 affected out of a total of 56 individuals). The pedigrees had originally been identified for linkage studies in schizophrenia. We found a significant difference between IG and PG regarding severity of illness as defined by Kendler et al's hierarchical model of categories of the schizophrenia spectrum (p = 0.001). Age at onset was significantly earlier in the IG (21.6 +/- 6.6 years) than in the PG (40.2 +/- 9.2 years) (p = 0.0001). We excluded a potential birth cohort effect by investigating a control sample consisting of two non-overlapping birth cohorts of patients with schizophrenia. Age at onset between the two groups of the control sample did not differ. Anticipation is an important aspect in the investigation of a possible genetic basis, at least for the familial form of schizophrenia. Active research on a molecular level with special emphasis on trinucleotide repeats might be able to shed further light on this phenomenon.

Several epidemiological studies have reported an association between complications of pregnancy and delivery and schizophrenia, but none have had sufficient power to examine specific complications that, individually, are of low prevalence. We, therefore, performed an individual patient meta-analysis using the raw data from case control studies that used the Lewis-Murray scale. Data were obtained from 12 studies on 700 schizophrenia subjects and 835 controls. There were significant associations between schizophrenia and premature rupture of membranes, gestational age shorter than 37 weeks, and use of resuscitation or incubator. There were associations of borderline significance between schizophrenia and birthweight lower than 2,500 g and forceps delivery. There was no significant interaction between these complications and sex. We conclude that some abnormalities of pregnancy and delivery may be associated with development of schizophrenia. The pathophysiology may involve hypoxia and so future studies should focus on the accurate measurement of this exposure.

Background Reading acuity as well as reading speed are good predictors of everyday visual function. As visual acuity tests are poor predictors of the real-world function, performance-based tests, e.g., reading speed measurements, can be used for the determination of visual function. Thus, a German reading chart was developed in order to evaluate reading acuity as well as reading speed. Methods Print size is defined as the height of a lower case x and progresses logarithmically from one phrase to another (factor: 1.25). Reading acuity is determined in LogRAD (Reading Acuity Determination). 32 short German phrases were created, comparable concerning grammatical difficulty as well as in number (n = 14), length and position of words. The reading speed parameters measured with a stop-watch in 160 persons (aged: Phi = 21a +/- 3.8a) were calculated in words per minute (w/min). Out of the 32 phrases the 24 most similar ones were selected statistically and used for the reading charts (Radner Reading Charts). With these reading charts a reading acuity score (LogRAD-score) can be calculated considering reading errors in words of different length. Reading speed can be determined at the same time. Reading acuity (LogRAD-Score) was measured in 32 normal eyes of 16 students and compared to the angular visual acuity (LogMAR). Results The mean reading speed of the test persons was 211.8 +/- 34.1 w/min. 24 phrases fulfilled the test item criteria for the reading chart: mean +/- 0.25 x SD. The reliability analyses yielded an overall Cronbach's alpha coefficient of 0.98! The mean visual acuity measured in 32 eyes was -0.115 +/- 0.097 LogMAR and the mean reading acuity score was +0.026 +/- 0.091 LogRAD. The mean difference was +0.104 +/- 0.066 and the correlation between LogMAR and LogRAD was good (r = 0.59). Conclusions With these reading charts it is for the first time possible to simultaneously determine reading acuity as well as reading speed in German. The high reliability of the 24 phrases and the high correlation between LogMAR and LogRAD leads us to expect a good reproducibility of the reading acuity evaluations. For the "Radner Reading Charts" we have shown that print size is the main reason for changes of reading speed.

Pulver et al. [1994a] reported modest linkage evidence for a dominantly (D) inherited “schizophrenia gene” in the vicinity of IL2RB on chromosome 22q12, and Coon et al. [1994] adduced moderate evidence under a recessive (R) model. We report here a replication study to test the hypothesis that one of these two models (or a third, intermediate (I) model) adequately describes the co-segregation of schizophrenia and chromosome 22q12 markers in an independent sample of 23 multiplex families. Altogether nine transmission models were evaluated. The models differed depending on whether the 15 family members with a diagnosis of schizophrenia spectrum disorders were considered unaffected (a “narrow” (N) definition), affected (a “wide” (W) definition), or declared “unknown” (U). The entire region between D22S268 and D22S307 is excluded (i.e., lod

C.R. Cloninger proposed a biosocial model for personality, linking personality traits to patterns of responses to various external stimuli, including alcohol. The Tridimensional Personality Questionnaire (TPQ) was administered in a multicenter study to detoxified alcohol-dependent patients (N = 521). The objectives of the study were to evaluate (1) the expression of the three personality dimensions, novelty-seeking (NS), harm avoidance (HA), and reward dependence (RD), of the TPQ in this sample, and (2) the influence of different variables on these personality dimensions. The following variables were selected for a multiple and a stepwise regression analysis: sex, family history for major psychiatric disorders, marital status, occupation, age at study enrollment, age of onset of alcoholism, serum cholesterol level, intake of neuroleptics or benzodiazepines for detoxification, and severity of depression and anxiety. In comparison to Austrian normative data, both sexes of detoxified alcohol addicts scored higher in HA. The variables examined explain 23% of the variance of NS and 35% of HA. Only one variable, namely age of onset, is significantly influencing NS (19% explained variance). HA is significantly influenced by three variables: anxiety state, anxiety trait, and sex (32% explained variance). RD is not influenced by any of the variables examined.

Alterations in dopamine neurotransmission and disturbed norepinephrine activity have been implicated in the pathogenesis of schizophrenia. We considered the dopamine-beta-hydroxylase (DBH) gene located on the long arm of chromosome 9 (9q34.3) as a candidate gene for schizophrenia. DBH catalyzes the synthesis of norepinephrine from dopamine in noradrenergic neurons. In addition to DBH we used in the linkage study DNA markers ABL (centromeric) and D9S114 (telomeric). The aim of this study was to test linkage and association between PCR-based genotyped markers and schizophrenia. A simulation was done to investigate the power of our sample. In 34 Austrian families we could not detect linkage between schizophrenia and schizophrenia spectrum disorders and the three genetic markers. We could not find any significant deviation in allelic or genotypic distribution from expectations. Based on our results we conclude that the DBH gene seems to have no strong contribution in the etiology of schizophrenia.

We analysed gender-concordance rates among 29 prospectively sampled schizophrenic probands and their 39 affected and 71 unaffected siblings. We did not find any unusual concordance rates. We found no same-gender concordance particularly in siblings affected by schizophrenia and related disorders. We considered unaffected siblings in an additional attempt to make valid and unbiased comparisons between genders, but this reduced the number of informative sibships to 20. We stratified the siblings of probands by sibship and by the proband's gender in order to check gender distribution within families. The data do not support hypotheses that schizophrenia is pseudo-autosomal or male-female chromosomally transmitted.