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Biomedical subjects

E F Kremer

Publications and source records attributed to E F Kremer.

13 recordsLinked to original sources
PubMed1986

Neuroendocrine responses in psychiatric and pain patients with major depression.

Basal and postdexamethasone concentrations of cortisol and prolactin were studied in three groups of male patients: chronic pain patients with no psychiatric diagnosis (n = 12), chronic pain patients with coexisting major depression by Research Diagnostic Criteria (RDC) (n = 24), and pain-free psychiatric patients meeting RDC criteria for major depression (n = 28). Basal cortisol concentrations were significantly higher in pain-major depression and psychiatric-major depression patients compared to pain patients without psychiatric illness. The frequency of cortisol nonsuppression after dexamethasone was significantly greater in pain patients with major depression (41.7%) compared to pain patients without psychiatric disorder (8.3%), and was comparable to that of psychiatric patients (21.4%). Prolactin concentrations, but not cortisol levels, were significantly correlated with observer-rated severity of depression in pain patients. These findings suggest that cortisol and prolactin abnormalities in chronic pain may be related to psychiatric disorder rather than to pain per se, at least in male patients, and may indicate a role for cholinergic mechanisms in the interface of pain and depression.

Adult↗
PubMed1986

MMPI subgroups and affective disorder in chronic pain patients.

Patients with chronic pain syndromes are commonly depressed. Chronic pain populations also contain distinct subgroups of personality profiles as defined by the MMPI. To assess the relevance of personality subtype to affective disorder we determined the relationship of psychiatric diagnoses defined by Research Diagnostic Criteria (RDC) to MMPI subgroups in a sample of hospitalized patients with predominantly chronic low back pain. RDC psychiatric diagnoses for the sample were major depression (44.2%), minor depression (19.2%), other psychiatric disorder (13.5%), and no mental disorder (21.6%). Patients satisfying RDC criteria for major depression were significantly associated with discrete MMPI personality subtypes. No other psychiatric diagnoses were significantly associated with distinct personality subgroups. No relationship was observed between personality profile and presence of demonstrable organic etiology for pain. These findings indicate that behavioral and pharmacological interventions directed at depression as well as pain are important in the treatment of chronic pain populations, especially in selected subgroups.

Adult↗
PubMed1984

Pain language: affect.

Pain language was examined by performing a principal components factor analysis on pain descriptors selected from the McGill Pain Questionnaire by 126 chronic pain patients. Six factors emerged with the greatest variance accounted for by an affective dimension (Factor I). Location of patients in space defined by these factors failed to differentiate medical diagnostic categories or pain intensity but revealed good differentiation on affective distress secondary to pain. Results demonstrate that affective distress is a potent variable in pain language and likely confounds efforts to relate language to medical diagnostic categories.

Affect↗
PubMed1983

Plasma measures of beta-endorphin/beta-lipotropin-like immunoreactivity in chronic pain syndrome and psychiatric subjects.

This study compared basal concentrations of plasma beta-endorphin/beta-lipotropin-like immunoreactivity and dexamethasone suppression of cortisol in seven chronic pain patients, seven psychiatric disorder patients, and seven normal volunteers. Pain patients and psychiatric patients showed significantly higher basal concentrations of beta-endorphin/beta-lipotropin-like immunoreactivity compared to normal volunteers. Pain patients also had significantly higher beta-endorphin/beta-lipotropin-like immunoreactivity than psychiatric patients, even though there was no significant difference in severity of depressive symptomatology as assessed by Beck and Hamilton scores. Resistance to dexamethasone occurred in 57% of pain patients. These results may indicate that biological markers for depression occur in populations of chronic pain patients, or may reflect levels of central nervous system arousal in response to stress, pain, or nonaffective phenomena.

Adult↗
PubMed1981

Behavioral approaches to treatment of chronic pain: the inaccuracy of patient self-report measures.

This study was designed to examine the accuracy of patient self-report of physical activity and social behavior and a 3X daily log of pain intensity. Concomitantly, staff members made unobtrusive, hourly observations of patient activity and social behavior. Results showed that some patients report significantly lower levels of physical activity and social behavior than observed by staff despite reporting decreased levels of pain. These results suggest that the efficacy of therapeutic intervention is best determined by systematic observational data rather than patient self-report.

Adult↗
PubMed1979

Effect of posttrial episodes on conditioning in compound conditioned stimuli.

The effect of signaled and nonsignaled posttrial episodes (PTEs) on conditioning to the target CS of a preceding compound CS-US trial was examined in two conditioned emotional response (CER) experiments with rats. Experiment 1 revealed that a nonsignaled PTE, a second shock US, interfered with conditioning to the preceding target CS and that the interference effect of the PTE was greater when it occurred 5 sec as opposed to 1,800 sec after the preceding compound CS-US trial. Experiment 2 revealed that if the shock PTE was signaled by a CS, its ability to interfere with conditioning was reduced. This second study also revealed that omission of an "expected" US interfered with conditioning to the target CS. The implications of these data for information processing models of Pavlovian conditioning are discussed.

Animals↗
PubMed1978

The Rescorla-Wagner model: losses in associative strength in compound conditioned stimuli.

This series of experiments demonstrated that compound conditioned stimuli (CSs) highly conditioned in isolation lose conditioned response strength when compound-CS-unconditioned stimulus (US) pairings are given. This loss in conditioned responding was a positive function of the number of compound-CS-US pairings and was greater for the more salient stimulus. Finally, if a previously neutral stimulus was compounded with two previously conditioned cues, the neutral stimulus could acquire conditioned inhibitory properties with only compound-CS-US pairings. These results provide support for some aspects of the Rescorla-Wagner model.

Acoustic Stimulation↗