No abstract

Patients with premenstrual dysphoric disorder (PMDD) respond therapeutically to sleep deprivation and light therapy. They have blunted circadian rhythms of melatonin. The authors sought to test the hypothesis that these disturbances are a reflection of a disturbance in the underlying circadian pacemaker or, alternatively, that they reflect a disturbance in the input pathways to the clock. To test these hypotheses, after a 2-month diagnostic evaluation, 8 patients who met DSM-IV criteria for PMDD and 5 normal control (NC) subjects underwent two studies to determine whether PMDD subjects showed (1) altered melatonin sensitivity to light suppression (Study 1) and (2) altered phase-shift responses to morning light as a measure of the functional capacity of the underlying pacemaker (Study 2). In both studies, measurements were made during asymptomatic follicular and symptomatic luteal menstrual cycle phases in PMDD patients. The results of Study 1 showed no significant effect of group or menstrual cycle phase on the amount or percentage of suppression of melatonin by light. The results of Study 2 showed that with respect to the variable of offset time, PMDD subjects, when symptomatic, showed a reduced and directionally altered melatonin phase-shift response to a morning bright light stimulus; in 4 of 5 NC subjects, melatonin offset was advanced by bright morning light, whereas in PMDD subjects, it was delayed (3 subjects) or not shifted (5 subjects) (group effect, p = .045). Study 2 also revealed that area under the curve also changed differentially in PMDD versus NC subjects. In summary, the primary findings from this pilot study suggest that in PMDD there is a maladaptive (directionally altered and blunted) response to light in the symptomatic luteal phase. Because the suppressive effects of light were similar in PMDD and NC subjects, the previously observed low melatonin levels in this disorder do not likely represent a disturbance in pineal reactivity to suprachiasmatic nucleus efferents. Instead, the findings support a possible disturbance in PMDD in the clock itself or its coupling mechanisms.

This article presents a new method that can compare lexical priming (word–word) and sentential priming (sentence–word) directly within a single paradigm. We show that it can be used to address modular theories of word comprehension, which propose that the effects of sentence context occur after lexical access has taken place. Although lexical priming and sentential priming each occur very quickly in time, there should be a brief time window in which the former is present but the latter is absent. Lexical and sentential priming of unambiguous words were evaluated together, in competing and converging combinations, using time windows designed to detect an early stage where lexical priming is observed but sentential priming is not. Related and unrelated word pairs were presented visually, in rapid succession, within auditory sentence contexts that were either compatible or incompatible with the target (the second word in each pair). In lexical decision, the additive effects of lexical priming and sentential priming were present under all temporal conditions, although the latter was always substantially larger. In cross-modal naming, sentential priming was present in all temporal conditions; lexical priming was more fragile, interacting with timing and sentential congruence. No evidence was found for a stage in which lexical priming is present but sentential priming is absent – a finding that is difficult to reconcile with two-stage models of lexical versus sentential priming. We conclude that sentential context operates very early in the process of word recognition, and that it can interact with lexical priming at the earliest time window.