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Monsell tentatively argued that the interconnection between the speech production and recognition systems happens at a sublexical level such as the phonological buffer used in memory-span tasks cholesterol conversion chart uk us fenofibrate 160mg generic. In summary score cholesterol esc fenofibrate 160mg overnight delivery, experimental data from people without brain damage suggests that spoken and visual word recognition make use of different mechanisms diet chart cholesterol patients buy fenofibrate 160mg low cost. There are distinct input and output lexicons cholesterol test during pregnancy order fenofibrate 160mg otc, perhaps sharing some sublexical mechanisms. Neuropsychological data relevant to lexical architecture and a model There are very many neuropsychological dissociations found between reading, writing, and visual and spoken word recognition. In this section I will examine data from patients whose behaviour is consistent with damage to some routes of a model of lexical processing while other routes are intact. Several theorists, drawing on many sources, have tried to bring all this material together to form some idea of the overall structure of the language system. The neuropsychological data strongly suggest that there are four different lexicons, one each for speaking, writing, and spoken and visual word recognition, although these systems must clearly communicate in normal circumstances. This conclusion is consistent with the data from experiments on people without brain damage. At the heart of the model is a system where word meanings are stored and that interfaces with the other cognitive processes. The four most important language behaviours are speaking, listening, reading, and writing. Speaking involves going from the semantic system to a store of the sounds of words. As we saw in Chapter 12, most theorists in speech production think that speech production is a two-stage process, where the phonological output lexicon containing the phonological word forms can only be accessed through a store of lemmas. We could just split the phonological output lexicon into a lemma store and a phonological form store, but this would mean that the phonological output lexicon is structured differently from the other three. It is possible that the speech lemma system is unnecessary, or that other links to lemmas need to be introduced. Failure to access items in one modality only would then result in a failure of mapping from lemmas to modalityspecific representations (Roelofs et al. Understanding speech necessitates the auditory analysis of incoming speech in order to access a representation of stored spoken word forms. People with anomia have difficulty in retrieving the names for objects, yet can show perfect comprehension of those words. People with pure word deafness can speak, read, and write quite normally, but cannot understand speech (Chapter 8). However, there are a few patients with word deafness who still have intact repetition, a condition called word meaning deafness. Word meaning deafness is rare, but has been reported by Bramwell (1897/1984) and Kohn and Friedman (1986). Second, there is a lexical repetition route from the input phonological lexicon to the output phonological lexicon. Third, there is a sublexical repetition route from the input phonological buffer to the output phonological buffer that by-passes lexical systems altogether. Disentangling precisely which is impaired depends on the pattern of word and nonword repetition performance along with the effect of semantic variables such as imageability. Obviously (assuming that they can be distinguished) if either the input or output buffer is disrupted, repetition should be impaired; I discuss this later. We should also be able to see disruptions resulting from selective damage to and preservation of our three repetition routes. If both the sublexical and lexical routes are destroyed, then the person will be forced to rely on repetition through the semantic route. If the semantic route is intact, there will be an imageability effect in repetition, with more imageable words repeated more readily. If there is also some damage to the semantic route, patients will make semantic errors in repetition (for example, repeating “reflection” as “mirror”). He was severely impaired at single word and nonword repetition, but was good at the matching span task. If only the lexical repetition route is left intact, then patients will be able to repeat words but not nonwords (as nonwords do not have a lexical entry). They will not be able to comprehend the words they repeat (as there is no link with semantics), and they will probably have difficulty in understanding and producing speech (because of the disruption to semantics). Nor should they show the effects of semantic variables such as imageability in repetition. He could however repeat spoken words quite well (80%) but was very poor at nonword repetition (7%). If only the sublexical repetition route is left intact, patients will be able to repeat both words and nonwords, but will have no comprehension of the meaning of the words. Damage to the sublexical route alone would lead to an impairment of repetition with particularly poor repetition of nonwords, as they cannot be repeated through the direct and semantic repetition routes. As damage to the lexical route alone should result in relatively good repetition of both words and nonwords (through the sublexical repetition route) and good comprehension (through the semantic route), a deficit of this type will be difficult to detect. The important conclusion, however, is that the patterns of repetition impairment found can be explained by this sort of model. Bramwell’s patient could not comprehend spoken words, but could still write even irregular words to dictation. This is incompatible with any general system mediating lexical stores, and with obligatory phonological mediation of orthographic-to-cognitive 13. We also saw in Chapter 7 that phonological mediation does not appear to be necessary for writing single words. There is a great deal of neuropsychological evidence that there are distinct phonological and orthographic output lexicons. Beauvois and Derouesne (1981) reported a patient showing impaired spelling yet intact lexical reading. When given a picture of peppers, he wrote “tomato” but said “artichoke” (Miceli, Benvegnu, Capasso, & Caramazza, 1997). Some patients are better at written picture naming than spoken picture naming (Rapp, Benzing, & Caramazza, 1997; Shelton & Weinrich, 1997). This evidence suggests that different output lexicons are involved in speaking and writing, and that writing does not require the generation of a phonological representation of the word. Behrmann & Bub, 1992), most studies suggest that multiple lexical systems are involved. However, it is likely that they interact, as damage to word meaning usually leads to comparable difficulties in both written and spoken output (Miceli & Capasso, 1997). The exact number is controversial, as connectionist models suggest that the direct and indirect lexical routes should be combined. The direct route goes from abstract letter identification to an orthographic input lexicon and then to the semantic system. The direct lexical reading route then goes straight on to the phonological output lexicon (or lemma store). The indirect or sublexical route (which as we saw in Chapter 7 might in turn be quite complex) bypasses the orthographic input lexicon and the semantic system, giving us a direct link between letter identification and speech. We saw that non-semantic reading means that the semantic system can sometimes be bypassed. Allport and Funnell (1981) argued that we cannot have a separate amodal lexicon mediating between systems. They reviewed evidence from word- meaning deafness, phonological dyslexia, and deep dyslexia. They described a number of studies of patients that argue for a dissociation of cognitive and lexical functions. The semantic paraphasias of deep dyslexics rule out any model where translation to a phonological code is a necessary condition to be able to access a semantic code (as these patients can access meaning without retrieving sound). It makes sense to retrieve a word in one go rather than having to access the lexicon afresh each time we need to produce a letter or sound. This means that we have to store the word while we speak out its constituent sounds or write out its constituent letters in order.

I could teach you How to cholesterol test results ratio generic fenofibrate 160mg with visa choose right can cholesterol levels change quickly buy fenofibrate 160 mg online, but then I am forsworn; So will I never be; so may you miss me; But if you do you’ll make me wish a sin cholesterol lowering foods omega 3 fenofibrate 160mg with amex, That I have been forsworn cholesterol test do it yourself cheap fenofibrate 160mg mastercard. Beshrew your eyes, They have o’erlooked me, and divided me; One half of me is yours, the other half yours, Mine own, I would say; but if mine, then yours, And so all yours. The Psychopathology Of Everyday Life 1187 In view of the interest that is lent to our theory of slips of the tongue by support of this nature from great writers, I feel justified in citing a third such instance which has been reported by Ernest Jones (1911b, 496): ‘In a recently published article Otto Rank drew our attention to a pretty instance of how Shakespeare caused one of his characters, Portia, to make a slip of the tongue which revealed her secret thoughts to an attentive member of the audience. I propose to relate a similar example from the Egoist, the masterpiece of the greatest English novelist, George Meredith. The plot of the novel is, shortly, as follows: Sir Willoughby Patterne, an aristocrat greatly admired by his circle, becomes engaged to a Miss Constantia Durham. She discovers in him an intense egoism, which he skilfully conceals from the world, and to escape the marriage she elopes with a Captain Oxford. Some years later Patterne becomes engaged to a Miss Clara Middleton, and most of the book is taken up with a detailed description of the conflict that arises in her mind on also discovering his egoism. External circumstances, and her conception of honour, hold her to her pledge, while he becomes more and more distasteful in her eyes. She partly confides in his cousin and secretary, Vernon Whitford, the man whom she ultimately marries; but from loyalty to Patterne and other motives he stands aloof. In another passage the same lapsus occurs, and is followed by the spontaneous hesitation and sudden change of subject that one is familiar with in psycho-analysis and in Jung’s association experiments when a half-conscious complex is touched. I was going to ask you, surely men witnessing a marked admiration for someone else will naturally be discouragedfi The Psychopathology Of Everyday Life 1188 the view of slips of the tongue which is advocated here can meet the test even in the most trivial examples. I have repeatedly been able to show that the most insignificant and obvious errors in speaking have their meaning and can be explained in the same way as the more striking instances. A woman patient who was acting entirely against my wishes in planning a short trip to Budapest, but who was determined to have her own way, justified herself by telling me that she was going for only three days; but she made a slip of the tongue and actually said ‘only three weeks’. She was betraying the fact that, to spite me, she would rather spend three weeks than three days there in the company which I considered unsuitable for her. When I reached the theatre I found the entrance-hall in darkness and the theatre empty. But I decided to make my case out more favourable when I got home and to say it had been ten to ten. Unfortunately, my slip of the tongue spoilt my plan and revealed my disingenuousness, by making me confess more than there was to confess. The Psychopathology Of Everyday Life 1189 this leads on to those speech-disturbances which cannot any longer be described as slips of the tongue because what they affect is not the individual word but the rhythm and execution of a whole speech: disturbances like, for instance, stammering and stuttering caused by embarrassment. But here too, as in the former cases, it is a question of an internal conflict, which is betrayed to us by the disturbance in speech. I really do not think that anyone would make a slip of the tongue in an audience with his Sovereign, in a serious declaration of love of in defending his honour and name before a jury in short, on all those occasions in which a person is heart and soul engaged. Even in forming an appreciation of an author’s style we are permitted and accustomed to apply the same elucidatory principle which we cannot dispense with in tracing the origins of individual mistakes in speech. A clear and unambiguous manner of writing shows us that here the author is at one with himself; where we find a forced and involved expression which (to use an apt phrase) is aimed at more than one target, we may recognize the intervention of an insufficiently worked- out, complicating thought, or we may hear the stifled voice of the author’s self-criticism. As was to be expected they have found that the laws governing parapraxes are independent of the linguistic material; and they have made the same interpretations that have been exemplified here in instances coming from speakers of the German language. Of countless examples I include only one: Brill (1909) reports of himself: ‘A friend described to me a nervous patient and wished to know whether I could benefit him. I remarked: "I believe that in time I could remove all his symptoms by psycho-analysis because it is a durable case" wishing to say "curable"! The Psychopathology Of Everyday Life 1190 In conclusion, for the benefit of readers who are prepared to make a certain effort and to whom psycho- analysis is not unfamiliar, I will add an example which will enable them to form some picture of the mental depths into which the pursuit even of a slip of the tongue can lead. She had got ready to go out with her daughter to pay a visit, and had asked her daughter a case of dementia praecox then in remission to change her blouse; and this she in fact did, in the adjoining room. On re-entering, the daughter found her mother busy cleaning her nails, and the following conversation ensued: ‘Daughter: "There! She answered equally quickly and definitely: "Twelve means nothing to me it is not the date of anything (of importance). When our children were born they were immediately examined to see if they had six fingers. For about the last twenty years I have been sending congratulations to my husband’s elderly uncle on his birthday which is to-day, and I have always written him a letter on the 11th. Thus, for instance, it was he, or rather his death, that had immediately sprung to her mind a few days before when an acquaintance of hers had predicted from cards that she would receive a large sum of money. It flashed through her mind at once that the uncle was the only person from whom money could possibly come to her or her children; and this same scene also instantly reminded her of the fact that this uncle’s wife had once promised to remember the lady’s children in her will. But in the meanwhile she had died intestate; had she perhaps given her husband appropriate instructionsfi The Psychopathology Of Everyday Life 1191 ‘The death-wish against the uncle must clearly have emerged with very great intensity, for she said to the friend who made the prophecy: "You encourage people to make away with others. Not surprisingly, therefore, in view of the intensity of her wish for his death, the event and the date of the birthday he was about to celebrate were so strongly suppressed that not only was a resolution which had been carried out for years forgotten in consequence, but even my colleague’s question failed to bring them to consciousness. I say "helped to determine", for the striking association to "finger" leads us to suspect the existence of some further motivations. It also explains why the "twelve" had falsified precisely this most innocent phrase, "ten fingers". The association ran: "Some members of my husband’s family were born with six fingers on their feet. Thus six fingers mean one abnormal child and twelve fingers two abnormal children. The lady had married at a very early age; and the only legacy left her by her husband, a highly eccentric and abnormal person who took his own life shortly after their marriage, were two children whom the doctors repeatedly pronounced to be abnormal and victims of a grave hereditary taint derived from their father. The elder daughter recently returned home after a severe catatonic attack; soon afterwards, the younger daughter, now at the age of puberty, also fell ill from a serious neurosis. For her husband had taken his life on the 13th one day, that is, after the uncle’s birthday; and the uncle’s wife had said to the young widow: "Yesterday he was sending his congratulations, so full of warmth and kindness and to- day. On this occasion she had in fact gone to exceptional lengths to avoid putting the daughter with whom she was going to pay the visit in a bad mood; and it may be imagined what demands this makes on anyone’s patience and self-denial where the case is one of dementia praecox, and how many angry impulses have to be suppressed in the process. I shall confine myself here to reporting a few carefully analysed examples, and shall make no attempt to cover every aspect of the phenomena. My thoughts at once turned to a book by Ruths (1898), Experimentaluntersuchungen uber Musikphantome. The author promised that he would shortly be bringing out a book to be called ‘Analysis and Principles of Dream Phenomena’. Seeing that I have just published an Interpretation of Dreams it is not surprising that I should await this book with the keenest interest. In Ruths’ work on music phantoms I found at the beginning of the list of contents an announcement of a detailed inductive proof that the ancient Greek myths and legends have their main source of origin in phantoms of sleep and music, in the phenomena of dreams and also in deliria. Thereupon I at once plunged into the text to find out whether he also realized that the scene in which Odysseus appears before Nausicaa was derived from the common dream of being naked. A friend had drawn my attention to the fine passage in Gottfried Keller’s Der Grune Heinrich which explains this episode in the Odyssey as an objective representation of the dreams of a sailor wandering far from home; and I had pointed out the connection with exhibitionist dreams of being naked. In this instance it is obvious that my thoughts were occupied with questions of priority. The first associations, it is true, indicated that it must have been the tub of Diogenes that I had in mind; and I had recently been reading about the art of the age of Alexander in a history of art. From there it was easy to recall Alexander’s celebrated remark: ‘If I were not Alexander I should like to be Diogenes. But the train of associations declined to run on further, and I did not succeed in rediscovering the page in the history of art on which the remark had caught my eye. It was not till months later that the problem, which I had meanwhile set aside, suddenly sprang to my mind once more; and this time it brought its solution with it. I recalled the comment of a newspaper article on the strange means of transport that people were then choosing in order to go to Paris for the International Exhibition; and the passage, I believe, went on with a joking account of now one gentleman intended to get himself rolled in a tub to Paris by another gentleman. Needless to say the only motive of these people would be to draw attention to themselves by such folly. Hermann Zeitung was in fact the name of the man who had provided the first instance of such extraordinary methods of transport. It then struck me that I once treated a patient whose pathological anxiety about reading newspapers was to be explained as a reaction against his pathological ambition to see himself in print and to read of his fame in the newspapers. Alexander of Macedon was undoubtedly one of the most ambitious men that ever lived.

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In order to cholesterol test labcorp cheap fenofibrate 160 mg overnight delivery provoke punishment from this last representative of the parents cholesterol molecule purchase fenofibrate 160 mg amex, the masochist must do what is inexpedient percent of cholesterol in shrimp fenofibrate 160mg low cost, must act against his own interests cholesterol in shrimp vs salmon buy fenofibrate 160mg lowest price, must ruin the prospects which open out to him in the real world and must, perhaps, destroy his own real existence. The Economic Problem Of Masochism 4082 the turning back of sadism against the self regularly occurs where a cultural suppression of the instincts holds back a large part of the subject’s destructive instinctual components from being exercised in life. We may suppose that this portion of the destructive instinct which has retreated appears in the ego as an intensification of masochism. The phenomena of conscience, however, lead us to infer that the destructiveness which returns from the external world is also taken up by the super-ego, without any such transformation, and increases its sadism against the ego. The sadism of the super-ego and the masochism of the ego supplement each other and unite to produce the same effects. It is only in this way, I think, that we can understand how the suppression of an instinct can frequently or quite generally result in a sense of guilt and how a person’s conscience becomes more severe and more sensitive the more he refrains from aggression against others. One might expect that if a man knows that he is in the habit of avoiding the commission of acts of aggression that are undesirable from a cultural standpoint he will for that reason have a good conscience and will watch over his ego less suspiciously. The situation is usually presented as though ethical requirements were the primary thing and the renunciation of instinct followed from them. The first instinctual renunciation is enforced by external powers, and it is only this which creates the ethical sense, which expresses itself in conscience and demands a further renunciation of instinct. Thus moral masochism becomes a classical piece of evidence for the existence of fusion of instinct. Its danger lies in the fact that it originates from the death instinct and corresponds to the part of that instinct which has escaped being turned outwards as an instinct of destruction. But since, on the other hand, it has the significance of an erotic component, even the subject’s destruction of himself cannot take place without libidinal satisfaction. After that, its dissolution takes place; it succumbs to repression, as we say, and is followed by the latency period. It has not yet become clear, however, what it is that brings about its destruction. The little girl likes to regard herself as what her father loves above all else; but the time comes when she has to endure a harsh punishment from him and she is cast out of her fool’s paradise. The boy regards his mother as his own property; but he finds one day that she has transferred her love and solicitude to a new arrival. Reflection must deepen our sense of the importance of those influences, for it will emphasize the fact that distressing experiences of this sort, which act in opposition to the content of the complex, are inevitable. Even when no special events occur, like those we have mentioned as examples, the absence of the satisfaction hoped for, the continued denial of the desired baby, must in the end lead the small lover to turn away from his hopeless longing. In this way the Oedipus complex would go to its destruction from its lack of success, from the effects of its internal impossibility. Another view is that the Oedipus complex must collapse because the time has come for its disintegration, just as the milk-teeth fall out when the permanent ones begin to grow. Although the majority of human beings go through the Oedipus complex as an individual experience, it is nevertheless a phenomenon which is determined and laid down by heredity and which is bound to pass away according to programme when the next pre-ordained phase of development sets in. This being so, it is of no great importance what the occasions are which allow this to happen, or, indeed, whether any such occasions can be discovered at all. The Dissolution Of the Oedipus Complex 4086 the justice of both these views cannot be disputed. There is room for the ontogenetic view side by side with the more far-reaching phylogenetic one. It is also true that even at birth the whole individual is destined to die, and perhaps his organic disposition may already contain the indication of what he is to die from. Nevertheless, it remains of interest to follow out how this innate programme is carried out and in what way accidental noxae exploit his disposition. We have lately been made more clearly aware than before that a child’s sexual development advances to a certain phase at which the genital organ has already taken over the leading role. But this genital is the male one only, or, more correctly, the penis; the female genital has remained undiscovered. This phallic phase, which is contemporaneous with the Oedipus complex, does not develop further to the definitive genital organization, but is submerged, and is succeeded by the latency period. Its termination, however, takes place in a typical manner and in conjunction with events that are of regular recurrence. When the (male) child’s interest turns to his genitals he betrays the fact by manipulating them frequently; and he then finds that the adults do not approve of this behaviour. More or less plainly, more or less brutally, a threat is pronounced that this part of him which he values so highly will be taken away from him. Usually it is from women that the threat emanates; very often they seek to strengthen their authority by a reference to the father or the doctor, who, so they say, will carry out the punishment. In a number of cases the women will themselves mitigate the threat in a symbolic manner by telling the child that what is to be removed is not his genital, which actually plays a passive part, but his hand, which is the active culprit. It happens particularly often that the little boy is threatened with castration, not because he plays with his penis with his hand, but because he wets his bed every night and cannot be got to be clean. Those in charge of him behave as if this nocturnal incontinence was the result and the proof of his being unduly concerned with his penis, and they are probably right. In any case, long-continued bed-wetting is to be equated with the emissions of adults. It is an expression of the same excitation of the genitals which has impelled the child to masturbate at this period. The Dissolution Of the Oedipus Complex 4087 Now it is my view that what brings about the destruction of the child’s phallic genital organization is this threat of castration. Not immediately, it is true, and not without other influences being brought to bear as well. Psycho-analysis has recently attached importance to two experiences which all children go through and which, it is suggested, prepare them for the loss of highly valued parts of the body. These experiences are the withdrawal of the mother’s breast at first intermittently and later for good and the daily demand on them to give up the contents of the bowel. But there is no evidence to show that, when the threat of castration takes place, those experiences have any effect. It is not until a fresh experience comes his way that the child begins to reckon with the possibility of being castrated, and then only hesitatingly and unwillingly, and not without making efforts to depreciate the significance of something he has himself observed. The observation which finally breaks down his unbelief is the sight of the female genitals. Sooner or later the child, who is so proud of his possession of a penis, has a view of the genital region of a little girl, and cannot help being convinced of the absence of a penis in a creature who is so like himself. With this, the loss of his own penis becomes imaginable, and the threat of castration takes its deferred effect. The Dissolution Of the Oedipus Complex 4088 We should not be as short-sighted as the person in charge of the child who threatens him with castration, and we must not overlook the fact that at this time masturbation by no means represents the whole of his sexual life. As can be clearly shown, he stands in the Oedipus attitude to his parents; his masturbation is only a genital discharge of the sexual excitation belonging to the complex, and throughout his later years will owe its importance to that relationship. The Oedipus complex offered the child two possibilities of satisfaction, an active and a passive one. He could put himself in his father’s place in a masculine fashion and have intercourse with his mother as his father did, in which case he would soon have felt the latter as a hindrance; or he might want to take the place of his mother and be loved by his father, in which case his mother would become superfluous. The child may have had only very vague notions as to what constitutes a satisfying erotic intercourse; but certainly the penis must play a part in it, for the sensations in his own organ were evidence of that. But now his acceptance of the possibility of castration, his recognition that women were castrated, made an end of both possible ways of obtaining satisfaction from the Oedipus complex. For both of them entailed the loss of his penis the masculine one as a resulting punishment and the feminine one as a precondition. If the satisfaction of love in the field of the Oedipus complex is to cost the child his penis, a conflict is bound to arise between his narcissistic interest in that part of his body and the libidinal cathexis of his parental objects. In this conflict the first of these forces normally triumphs: the child’s ego turns away from the Oedipus complex. The authority of the father or the parents is introjected into the ego, and there it forms the nucleus of the super-ego, which takes over the severity of the father and perpetuates his prohibition against incest, and so secures the ego from the return of the libidinal object-cathexis. The libidinal trends belonging to the Oedipus complex are in part desexualized and sublimated (a thing which probably happens with every transformation into an identification) and in part inhibited in their aim and changed into impulses of affection. The whole process has, on the one hand, preserved the genital organ has averted the danger of its loss and, on the other, has paralysed it has removed its function.

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Third cholesterol test can i drink coffee buy discount fenofibrate 160 mg on-line, in the phonemic blending stage the sounds are assembled into a phonological representation cholesterol medication for life order 160 mg fenofibrate visa. There are patients whose behaviour can best be explained in terms of disruption of each of these stages (Lesch & Martin cholesterol levels nursing mothers discount fenofibrate 160mg overnight delivery, 1998) cholesterol and menopause cheap fenofibrate 160 mg with amex. Patients with disrupted graphemic analysis find nonwords in which each grapheme is represented by a single letter easier to read than nonwords with multiple correspondences. People with phonological dyslexia show complex phonological problems that have nothing to do with orthography. Indeed, it has been proposed that phonological dyslexia is a consequence of a general problem with phonological processing (Farah, Stowe, & Levinson, 1996; Harm & Seidenberg, 2001; Patterson, Suzuki, & Wydel, 1996). If phonological dyslexia arises solely as the ability to translate orthography into phonology, then there must be brain tissue dedicated to this task. This implies that this brain tissue becomes dedicated by school-age learning, which is an unappealing prospect. The alternative view is that phonological dyslexia is just one aspect of a general impairment to phonological processing. This impairment will normally be manifested in performance on other non-reading tasks such as rhyming, nonword writing, phonological short-term memory, nonword repetition, and tasks of phonological synthesis (“what does “ca—t spell outfi This proposal also explains why pseudohomophones are read better than non- pseudohomophones. An important piece of evidence in favour of this hypothesis is that phonological dyslexia is never observed in the absence of a more general phonological deficit (but see Coltheart, 1996, for a dissenting view). A general phonological deficit makes it difficult to assemble pronunciations for nonwords. Words are spared much of this difficulty because of support from other words and top-down support from their semantic representations. Repeating words and nonwords is facilitated by support from auditory representations, so some phonological dyslexics can still repeat some nonwords. However, if the repetition task is made more difficult so that patients can no longer gain support from the auditory representations, repetition performance declines markedly (Farah et al. This idea that phonological dyslexia is caused by a general phonological deficit is central to the connectionist account of dyslexia, discussed later. There is, however, another even more surprising type of dyslexia called deep dyslexia. Patients have great difficulty in reading nonwords, and considerable difficulty in reading the grammatical, function words. However, the defining characteristic of deep dyslexia is the presence of semantic reading errors or semantic paralexias. Note that just an imageability effect in reading does not mean that patients with deep dyslexia are better at all tasks involving more concrete words. Coltheart (1980) listed 12 symptoms commonly shown by deep dyslexics: they make semantic errors, they make visual errors, they substitute incorrect function words for the target, they make derivational errors, they can’t pronounce nonwords, they show an imageability effect, they find nouns easier to read than adjectives, they find adjectives easier to read than verbs, they find function words more difficult to read than content words, their writing is impaired, their auditory short-term memory is impaired, and their reading ability depends on the context of a word. There has been some debate about the extent to which deep dyslexia is a syndrome (a syndrome is a group of symptoms that cluster together). Coltheart (1980) argued that the clustering of symptoms is meaningful, in that they suggest a single underlying cause. However, although these symptoms tend to occur in many patients, they do not apparently necessarily do so. A few patients make semantic errors but very few visual errors (Caramazza & Hillis, 1990). Such patients suggest that it is unlikely that there is a single underlying deficit. Like phonological dyslexics, deep dyslexics obviously have some difficulty in obtaining non-lexical access to phonology via grapheme- phoneme recoding, but they also have some disorder of the semantic system. One possibility is that the different symptoms of deep dyslexia arise because of an arbitrary feature of brain anatomy: different but nearby parts of the brain control processes such as writing and auditory short-term memory, so that damage to one is often associated with damage to another. As we will see, a more satisfying account is provided by recent connectionist modelling. Shallice (1988) argued that there are three subtypes of deep dyslexia that vary in the precise impairments involved. Input deep dyslexics have difficulties in reaching the exact semantic representations of words in 7. Central deep dyslexics have a severe auditory comprehension deficit in addition to their reading difficulties. Output deep dyslexics can process words up to their semantic representations, but then have difficulty producing the appropriate phonological output. In practice it can be difficult to assign particular patients to these subtypes, and it is not clear what precise impairment of the reading systems is necessary to produce each subtype (Newton & Barry, 1997). The right-hemisphere hypothesis Does deep dyslexia reflect attempts by a greatly damaged system to read normally, as has been argued by Morton and Patterson (1980), among othersfi Or does it instead reflect the operation of an otherwise normally suppressed system coming throughfi Instead, people with deep dyslexia might use a reading system based in the right hemisphere that is normally suppressed (Coltheart, 1980; Saffran, Bogyo, Schwartz, & Marin, 1980; Zaidel & Peters, 1981). This right-hemisphere hypothesis is supported by the observation that the more of the left hemisphere that is damaged, the more severe the deep dyslexia observed (Jones & Martin, 1985; but see Marshall & Patterson, 1985). Furthermore, the reading performance of deep dyslexics resembles that of split-brain patients when words are presented to the left visual field, and therefore to the right hemisphere. Under such conditions they also make semantic paralexias, and have an advantage for concrete words. After recovery she retained some reading ability, but her performance resembled that of deep dyslexics. In spite of these points in its favour, the righthemisphere reading hypothesis has never won wide acceptance. In part this is because the hypothesis is considered a negative one, in that if it were correct, deep dyslexia would tell us nothing about normal reading. In addition, people with deep dyslexia read much better than split-brain patients who are forced to rely on the right hemisphere for reading. The right- hemisphere advantage for concrete words is rarely found, and the imageability of the target words used in these experiments might have been confounded with length (Ellis & Young, 1988; Patterson & Besner, 1984). Finally, Roeltgen (1987) described a patient who suffered from deep dyslexia as a result of a stroke in the left hemisphere. He later suffered from a second left hemisphere stroke, which had the effect of destroying his residual reading ability. If the deep dyslexia had been a consequence of right hemisphere reading, it should not have been affected by the second stroke in the left hemisphere. Summary of research on deep dyslexia There has been debate as to whether the term “deep dyslexia” is a meaningful label. The crucial issue is whether or not its symptoms must necessarily co-occur because they have the same underlying cause. So far they seem to be; in all reported cases semantic paralexias have been associated with all the other symptoms. In terms of the dual-route model, there would need to be damage to both the semantic system (to explain the semantic paralexias and the imageability effects) and the non-lexical route (to explain the difficulties with nonwords). We would also then have to specify that for some reason damage to the first is always associated with damage to the second. We have seen that the dual-route model readily explains surface and phonological dyslexia, and that their occurrence is as expected if we were to lesion that model by removing one of the routes. Hence it is reasonable to make inferences about normal reading on the basis of data from such patients. There is some doubt, however, as to whether we are entitled to do this in the case of deep dyslexia; if the right-hemisphere hypothesis were correct, deep dyslexia would tell us little about normal reading. The balance of evidence is at present that deep dyslexia does not reflect right-hemisphere reading, but does indeed reflect reading by a greatly damaged left hemisphere. Deep dyslexia suggests that normally we can in some way read through meaning; that is, we use the semantic representation of a word to obtain its phonology.

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The practicing in diagnosis cholesterol hdl ratio normal value fenofibrate 160mg lowest price, one of the best things a cognitive profile can pro- neuropsychologist must weigh multiple factors cholesterol in eggs nutrition facts generic fenofibrate 160 mg otc, including injury vide is a picture of the person’s pattern of strengths and weak- severity cholesterol test strips cardiochek buy fenofibrate 160mg fast delivery, age cholesterol test machine price in india buy fenofibrate 160mg without a prescription, previous level of functioning, available resources, as nesses, and an estimation of degree of decline from former abili- well as the patient’s psychological state and level of motivation in ties. This picture is a “snapshot in time,” but it serves to educate predicting potential for recovery. This remains an inexact science, patients and caretakers about the degree to which the person is Answers to Critical Thinking Questions 549 currently able to manage independently and in what areas he or a patient with Parkinson’s disease is more likely to demonstrate she is likely to need assistance. The neuropsychological profile the correct movement, but may have trouble initiating the can also serve as a planning aid for future caretaking and treat- movement or show slowness in performing the movement ment needs. First, the hierarchy theory states that the primary motor sum, the neuropsychological profile helps show the problematic cortex sits at the top and is the funnel for all bodily informa- brain functioning, educate regarding strengths and weaknesses, tion. A competing theory suggests that the motor system works plan for individualized caretaking needs, and suggest possible in a parallel processing mode with several motor processing behavioral treatments. Although these theories remain debatable, we also know disease change with the progression of the diseasefi The dorsolateral is evident, how do you think this would affect a person’s self- prefrontal cortex (contained within) is not a “movement cen- conceptfi New learning deficits and declarative memory loss are ter” in and of itself, but it is instrumental in deploying move- hallmarks of the disease. Much of the input to this area comes from the subcorti- of our selves are built on memories of our own experiences, do cal motor centers. Therefore, the subcortical and cortical you think a person’s self-concept would change as he or she lost motor functions must coordinate and may do so through the aspects of his or her memory, as the person has increasing trou- dorsolateral prefrontal cortex. Although there appears to be ble learning, or as the person is having trouble doing certain some hierarchy of functioning, it may also be that parallel cir- things he or she once did wellfi These treatments include drug, behavioral, Would you want to be tested for the possibility of future de- and even surgical interventions. Also, to what extent should society seek almost certain manifestation of the disease. What other neurologic diseases, where a positive test could indicate are the costs versus the benefitsfi Would you want to know about your tendency toward a certain dis- What is the biological or psychological function of “rhythms” easefi This chapter discusses the idea that there are preset circadian How is the behavioral quality of subcortical motor disorders rhythms of human consciousness. It also discusses how these presented in this chapter similar or different from the corti- operate in normal waking, sleeping, and dreaming. Also, the rare circa- son’s, Huntington’s, or Creutzfeldt–Jakob disease different from dian rhythm disorder can be life threatening (see “The Case of that of, say, apraxia (see Chapter 7)fi With subcortical motor problems, the movement is usually what you know of this, can you speculate on the biological rea- not orchestrated or regulated well, but apraxia is a problem of sons for daily and 90-minute periods of relatively more active to not “knowing. Does this somehow “tone” the brain, and serving tea,” an apraxic patient may have no idea of how to as some suggestfi Psychologically, is it adaptive for humans to al- demonstrate this or may mime an incorrect action. Do you think that people with motor problems will conscious awareness, which have been presented throughout the also have motor problems in their dreamsfi To approach this issue, first one must conceptualize to treatments for people with sleep disorders or epilepsyfi Can one the disorders presented in this chapter, you can see that a num- demonstrate awareness just through performance of an actionfi For example, memory When one is in a state of consciousness, which is other than and concentration problems are common in sleep apnea and, to being “fully awake,” what sense of awareness can there befi Do you think strategies that aid does your knowledge of the functional and dysfunctional brain memory will be useful for sleep apnea patientsfi These areas are ripe for abnormalities in dreaming from global cessation of dreaming, to future investigation. See Alcohol-related neurodevelopmental Alzheimer’s patients, 415 Alzheimer’s patients, 421 disabilities damage to, 217–218 anterior cirgulate circuit role, 257–258 Arousal. See Dysarthrias Auras, 348, 464–465 disruptive (See Disruptive behavioral Articulatory phonologic loop, 238, 302 epileptogenic focus, 465 disorders) Artificial grammar, 236 sensory, 472 impulsive displays, 357 Ascending spinal-thalamic tract, 181 tactile, 473 utilization, 256 Asociality, 320 Autism Behavioral examinations, 56–57 Asperger’s syndrome, 311 assessment, 318–320 Behavioral therapies, 396–397 autism versus, 313 brain size and, 316 Behavioral-adaptive scales, 68 case study, 314–316 characterization, 311 Bell-shaped curve. See Brainstem auditory-evoked Brady, James, 373 neuropsychology of, 240 response Bradykinesia, 427 subcortical structures infiuencing, 240–241 Balint’s syndrome, 208 Bradyphrenia, 418 Attention-deficit/hyperactive disorder Basal forebrain, 107 Brain. See Brain electrical activity mapping chromosomal disorders, 281–291 Auditory processing. See Conduct disorder lead exposure and, 271–272 integrated theories, 20–24 Cell bodies, 95, 99 lobular, 118–119 localization theory, 13–20 Cell doctrine, 7, 8 plasticity, 270–273 non-Western attitudes, 12–13 Cells, 94 postnatal, 120 nonscientific theories, 4 nerve (See Neurons) regional, 118 Brain hypothesis, 6 receptor, 177, 184 ventricular, 119–120 Brain injuries. See Dopamine Chlorinated hydrocarbons, 365, 367 Conceptual apraxia, 195 Data interpretation, 79–89 Cholesterol, 351 Concussions. See Galveston Orientation and Executive planning, 319 injury to, 396 Amnesia Test Explicit memory, 227–228 orbitofrontal circuit, 254–257 Golgi stain, 34 Expressive aphasia, 219 stroke-damage, 352 Gonadotropins, 284 Extended paraphasia. See Fetal alcohol syndrome properties of, 109 Guanfacine (Tenex), 336 Fear conditioning, 261 seizures and, 468, 472 Gunshot wounds, 373 Feelings. See Huntington’s disease clinical features, 291–292 examples of, 167 Head injuries. See also Brain injuries comorbid conditions, 293 sex hormone’s role, 171–175 adaptation, 388–389 development course, 294 studies of, 167–171 mild, 379–385 incidence, 292 math skills, 172 impact of, 380 neuropathogenesis, 292–293 meningioma incidences, 359 postconcussional syndrome, 385 treatment, 294–295 sexual hormones and, 171–175 postconcussive syndromes, 381 Subject Index 567 research on, 379–380 obstructive, 277 Insomnia, 450 sports-related, 381–382 physiological dynamics, 277 Intelligence traumatic (See Traumatic brain injury) treatment, 278, 281 aging and, 401–403 Headaches. See Migraines Hyperacusis, 286 Alzheimer’s patients, 417–418 Hematomas, 346, 377 Hypercalcemia, 286 autism and, 312 Hemianopia blindness, 203 Hyperdensity, 38 tests, 68 Hemiplegia, 386 Hyperserotonemia, 316 verbal scales of, 401 Hemispheres. See Pacemaker cells characterization, 434 Impulsiveness, 357 Karyotype, 282 clinical presentation, 435–436 Infarctions, 345–346 Kennard principle, 272 development, 237 aneurysms, 347 Kennedy, John F. See Diencephalon Parkinson’s patients, 430 neuropathogenesis, 277 Insecticides, 365 pragmatics of, 308 568 Subject Index Language (continued) MacCracken, Henry M. See Magnetoencephalography relationship, 445–447 Lobotomies, 22–24 Membrane potential. See Resting potential Mirror self-misidentification syndrome, Lobular development, 118–119 Memory. See Norepinephrine rehabilitation programs, 390 state of consciousness during, 452, 454 Neanderthals, 156–157 websites, 89–90 Noncommunicating hydrocephalus. See Necrosis, 341, 351–352 Neuropsychological tests, 67–79, Obstructive hydrocephalus Neglect 75–76 Nondeclarative memory, 227 case study, 211 attention, 71–72 amnesia and, 235–236 clinical presentation, 212–213 base rates, 68 brain circuitry governing, 236–237 neuropathology of, 211–212 concentration, 71–72 characterization, 231 theories of, 213–214 data interpretation, 79–84 implicit priming, 235–236 Neocortex, 448 defined, 68 learning and, 234–235 Neologism, 311 false positives, 67–68 Parkinson’s patients, 430 Neoplasms. See Premotor area Object permanence, 247 Partial seizures, 444, 466–467 Pneumoencephalography. See Secondary association Organs, definitions of, 13 demographics, 311–312 Primary auditory cortex. See Phenylketonuria Pruning, 95, 118 motor system, 427–428 Planum temporale, 163, 302 Pseudopsychopathic sociopathy. See Acquired personality changes, 430–431 Plaques sociopathy Subject Index 571 Psychoactive drugs, 104 Restless leg syndrome. See Supravalvar aortic stenosis characterization, 187 protection of, 125–127 Sydenham’s chorea, 335 disorders of, 189 segmentation of, 120 Sylvian (lateral) fissure, 118 olfactory system, 187–189 structure of, 123 Sylvian aqueduct. See Traumatic brain injury Songbirds, 109 Striatal complex, 196 Tectum, 138 Soul Striate cortex, 203 Tegmentum, 138 non-Western views, 12 Striatum, 107, 148 Telencephalon, 118, 147–152 parts, Plato’s views, 6 Strokes. See Single-photon emission computed Subcortical motor processing, 195–197, 448 Terrorism, 28–29 tomography Subdural hematomas, 377 Test battery, 69 Subject Index 573 Tests Transcortical motor aphasia, 221 Validity, 67 apperceptive agnosia, 209 Transcortical sensory aphasia, 221 Vascular disorder. See Spatial ability; Visual clinical presentation, 332–333 neuropathogenesis, 283–284 processing comorbid conditions, 334 treatment, 285 Visuospatial organization, 74–75 effects of, 337 Turner, Tina, 401 Visuospatial sketch pad, 238 pathogenesis, 334–335 Vitalism, 4 prevalence, 333 Ultradian, 449 Vocational inventories, 69 treatment, 336–337 Ultrasonography, 281 Tower of Hanoi, 326 Umami, 185 Wada technique. See Ventral processing intellectual performance and, 287–288 dyslexia and, 302 Where systems. See Wechsler Memory Scale dorsal processing and, 289 Word decoding, 301 Zentralorgan, 104 emotionality and, 290 Word salad, 220. Books Published/Distributed Pattern, control, and contrast in beginning speech: A case study in the development of word form and word function. Articles Published in refereed journals, books, or proceedings Phonotactic rules in beginning speech. Revised as Early strategies for the perception and production of words and sounds.

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