Using individual items to clarify OCD symptom structure: the case for five factors.
Using individual items to clarify OCD symptom structure: the case for five factors.
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使用单个项目来阐明强迫症症状结构：五个因素的案例。
DOI：
10.1176/appi.ajp.2009.09020287
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Rasmussen,StevenA
中科院分区：
文献类型：
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作者：
Pinto,Anthony;Greenberg,BenjaminD;Murphy,DennisL;Nestadt,Gerald;Rasmussen,StevenA
致编辑：Serby博士质疑我们对气味特异性阈值缺陷的观察是否意味着camp介导的信号转导是精神分裂症嗅觉缺陷的病理生理机制。这种担忧的基础是发现精神分裂症患者检测香叶醇的能力受损(1)，香叶醇是一种气味剂，与我们研究中的柠檬醛类似，是一种相对较强的腺苷环化酶激活剂。这一批评有两个方面需要评论。第一个问题涉及支持香叶醇阈值缺陷的证据的力度。第二个问题是，如果有这样的发现，是否真的会破坏我们的解释。香叶醇缺乏症的证据来自一项对14名患者的研究，该研究报告发表在给《编辑》的一封信中。重要的细节，如患者的临床状况或吸烟史，可以强烈影响嗅觉表现，没有提出。评估检测阈值的程序依赖于单一的极限上升方法，很少有刺激呈现，没有关于实际气味浓度的信息。极限检测阈值上升方法的有效性受到质疑，因为它会导致受试者之间和受试者内部的大量变异（2,3）。我们使用的程序，一个单阶梯，七个需要的反转，是更可靠和一致的，并没有表现出明显的内部和主体之间的波动与上升方法的极限程序(4)。这些方法上的缺陷要求在香叶醇阈值缺陷的发现可以被自信地接受之前，使用更成熟的程序来重复这项研究。
TO THE EDITOR: Dr. Serby questions whether our observation of an odor-specific threshold deficit implicates cAMP-mediated signal transduction as a pathophysiological mechanism underlying olfactory deficits in schizophrenia. The basis of this concern is the finding that schizophrenia patients are impaired in their ability to detect geraniol (1), an odorant that, similar to citralva in our study, is a relatively strong activator of adenyl cyclase. There are two aspects of this critique that require comment. The first concerns the strength of the evidence supporting a geraniol threshold deficit. The second is whether such a finding, if present, actually undermines our interpretation.The evidence for a geraniol deficit was derived from a study of 14 patients reported in a letter to the Editor (1). Important details such as the clinical status or smoking history of the patients, which can strongly affect olfactory performance, were not presented. The procedure to assess detection thresholds relied upon a single ascending method of limits, with very few stimulus presentations and no information concerning the actual odor concentrations. The validity of an ascending method of limits detection threshold procedure in which the apparent limen is crossed only once has been called into question, since it results in substantial inter-and intra-subject variability (2, 3). The procedure we used, a single staircase with seven required reversals, is more reliable and consistent and does not exhibit the marked intra-and inter-subject fluctuations seen with the ascending method of limits procedure (4). These methodological shortcomings require that the study be replicated using more established procedures before the finding of a geraniol threshold deficit can be accepted with confidence.