Eye Movements

BACKGROUND: A propensity to attend to other people's emotions is a necessary condition for human empathy. AIMS: To test our hypothesis that psychopathic disorder begins as a failure to attend to the eyes of attachment figures, using a `love' scenario in young children. METHOD: Children with oppositional defiant disorder, assessed for callous-unemotional traits, and a control group were observed in a love interaction with mothers. Eye contact and affection were measured for each dyad. RESULTS: There was no group difference in affection and eye contact expressed by the mothers.

Psychopathy is not included in either of the main classification systems (ICD-10 or DSM-IV). Research has now extended the concept of psychopathy to childhood and has produced evidence that it is meaningfully distinct from antisocial behaviour. It is proposed that psychopathy should be accepted as a meaningful diagnosis in childhood.

Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder, is currently recognized as a treatable condition. It is considered the paradigmatic dissociative condition and carries with it extreme posttraumatic symptomatology. Therapists skilled in the treatment of DID are typically fluent in the uses of hypnosis for stabilization, affect management, building a safe place and grounding to name of few. EMDR, which has come to the forefront of clinical awareness in the last ten years, seems aptly suited for the treatment of trauma, but can be destabilizing.

Subjects instructed to imagine a beating pendulum develop pursuit eye movements of a frequency comparable to the frequency of a previously visualized real pendulum. The appearance of pursuit rather than saccadic movements supports an "outflow" theory for central control of eye movement and suggests an objective technique for the identification of certain types of visual imagery.

Hypnotized subjects who report hallucinating a visual situation which would ordinarily elicit optokinetic nystagmus demonstrate nystagmus under these conditions. They and control subjects are unable to feign nystagmus in the waking state, either by imagining the situation or by direct efforts to simulate the eye movements. Thus an objective criterion is provided for the presence of visual hallucinations.