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Biomedical subjects

P D Slade

Publications and source records attributed to P D Slade.

At least 19 recordsLinked to original sources
PubMed2001

Taking responsibility for cancer treatment.

One hundred and fourteen consecutive patients with early breast cancer were entered into a study on the psychological effects of involvement in treatment choice. All women were offered counselling throughout. One group of women (n = 34), were advised to undergo mastectomy, due to the nature or position of the tumour. These women fared less well psychologically when compared on a battery of measures, before and after surgery, with women who were involved in choosing their own treatment (n = 80). The latter group itself was randomly allocated into two groups for taking explicit responsibility for treatment choice, using a double-blind procedure. These were a Patient Decision Group (n = 41) and a Surgeon Decision Group (n = 39). Results support the hypothesis that over and above the benefits of receiving their preferred treatment, women can further benefit from taking explicit responsibility for their treatment choice.

Adult↗
PubMed1998

The selective 5-HT1B receptor inverse agonist 1'-methyl-5-[[2'-methyl-4'-(5-methyl-1,2, 4-oxadiazol-3-yl)biphenyl-4-yl]carbonyl]-2,3,6,7-tetrahydro- spiro[furo[2,3-f]indole-3,4'-piperidine] (SB-224289) potently blocks terminal 5-HT autoreceptor function both in vitro and in vivo.

5-HT1 receptors are members of the G-protein-coupled receptor superfamily and are negatively linked to adenylyl cyclase activity. The human 5-HT1B and 5-HT1D receptors (previously known as 5-HT1Dbeta and 5-HT1Dalpha, respectively), although encoded by two distinct genes, are structurally very similar. Pharmacologically, these two receptors have been differentiated using nonselective chemical tools such as ketanserin and ritanserin, but the absence of truly selective agents has meant that the precise function of the 5-HT1B and 5-HT1D receptors has not been defined. In this paper we describe how, using computational chemistry models as a guide, the nonselective 5-HT1B/5-HT1D receptor antagonist 4 was structurally modified to produce the selective 5-HT1B receptor inverse agonist 5, 1'-methyl-5-[[2'-methyl-4'-(5-methyl-1,2, 4-oxadiazol-3-yl)biphenyl-4-yl]carbonyl]-2,3,6, 7-tetrahydrospiro[furo[2,3-f]indole-3,4'-piperidine] (SB-224289). This compound is a potent antagonist of terminal 5-HT autoreceptor function both in vitro and in vivo.

Animals↗
PubMed1998

The behavioural effects of corticotropin-releasing factor-related peptides in rats.

The present study determined the behavioural effects of the corticotropin releasing factor (CRF)-related peptides, human/rat CRF (h/rCRF), ovine CRF (oCRF), sauvagine (SAUV), urotensin I (UT) and the recently discovered neuropeptide, rat urocortin (rUCN). All of the peptides dose-dependently increased motor activity in a familiar environment and reduced feeding in hungry rats. There was no apparent relationship between potency/affinity at CRF2 receptors and effects in these two tests. In a comparison of h/rCRF and rUCN upon discrete spontaneous behaviours, both peptides (3.0 microg i.c.v.) increased activity and grooming, induced a fore-paw tremor and reduced the incidence of motionlessness. However, h/rCRF reduced motionlessness to a greater extent and was a more potent inducer of defaecation, weight loss, oral movements and fore-paw tremor than rUCN. In the elevated X maze, both h/rCRF and rUCN (1.0 microg i.c.v.) had anxiogenic-like effects upon behaviour. In contrast, h/rCRF (1.0 microg i.c.v.), but not rUCN (1.0-10 microg i.c.v.) increased the startle response to an acoustic stimulus. In summary, all the CRF-related peptides increased motor activity and reduced feeding in rats in a similar manner and both rUCN and h/rCRF induced anxiogenesis. However, there were some behavioural differences between rUCN and h/rCRF which require further study. Further pharmacological investigation of the role of CRF receptor subtypes requires the use of subtype selective antagonists.

Animals↗
PubMed1998

A comparison of the long-term effectiveness of distraction and focusing in the treatment of auditory hallucinations.

Cognitive-behavioural interventions for patients experiencing neuroleptic resistant auditory hallucinations have fallen into two main categories: those which encourage distraction as a coping strategy, and those which encourage patients to focus on or expose themselves to their hallucinations. A 20-session distraction treatment was compared with an equal length focusing treatment for 19 patients who were experiencing chronic auditory hallucinations. Patients were followed-up for approximately 2 years. No differences were observed between the groups for outcome on symptom severity overall, although the focusers showed a greater belief that their voices were their own thoughts at the final follow-up point. When the two groups were combined, there was a significant reduction in the frequency of hallucinations and the disruption to life caused by them during treatment, although this was not maintained at follow-up. During treatment, there was a significant increase in self-esteem for focusers but a significant decrease for distracters. At 2-year follow-up, both focusers and distracters showed a reduction in self-esteem in comparison to the end of therapy. The results show no overwhelming advantage of one treatment over the other and confirm previous observations of the difficulty of treating hallucinations with cognitive-behaviour therapy (CBT). However, there was some indication that CBT influenced some important clinical variables and further investigation is warranted.

Adaptation, Psychological↗
PubMed1998

A dual process model of perfectionism based on reinforcement theory.

This article begins with a brief review of the current literature on the structure and measurement of perfectionism. It is concluded from this review that two major types can be distinguished, a normal/healthy form and a pathological form. These two forms are then defined as positive and negative perfectionism and related directly to Skinnerian concepts of positive and negative reinforcement. The positive/negative distinction is then further elaborated on in terms of approach/avoidance behavior, goal differences, self-concept involvement, emotional correlates, and the promoting environment. Finally, some of the more obvious theoretical and practical implications are briefly explored.

Cognitive Behavioral Therapy↗
PubMed1997

Chronic low back pain rehabilitation programs: a study of the optimum duration of treatment and a comparison of group and individual therapy.

STUDY DESIGN: Eighty-four patients with chronic low back pain were treated using cognitive behavioral principles on a pain management program. Outcome data were collected at four points: 10 weeks before treatment, immediately before and immediately after treatment, and 6 months after treatment. In part 1 of the study, patients were assigned randomly to group or individual treatment contexts. In part 2 of the study, patients were assigned randomly to programs of 15, 30, or 60 hours duration. OBJECTIVES: To identify the differences in outcome between programs that treated patients as part of a group and those that treated patients individually and the effects of duration of treatment on outcome. SUMMARY OF BACKGROUND DATA: Cognitive behavioral programs have been shown to be an effective means of managing chronic low back pain. The literature is concerned with group programs, however, the duration of which vary widely. METHOD: Psychological and functional variables were measured before and after treatment and at the 6-month follow-up visit. Changes in these variables were measured, and comparisons were made between group and individual programs and between 15-, 30-, and 60-hour programs. RESULTS: Data analysis showed a significant, beneficial effect of intervention in terms of the majority of variables; however, these changes were generally independent of whether patients were treated as part of a group or individually and whether patients completed a 15-, 30-, or 60-hour program. CONCLUSIONS: Cognitive behavioral rehabilitation programs have been demonstrated to be an effective means of reducing psychological distress, of changing cognition, and of improving the function of patients with chronic low back pain; however, the length of program and whether patients were treated individually or as part of a group did not affect outcome. This finding has clinical and economic implications.

Activities of Daily Living↗
PubMed1997

Stimulation of 5-HT1B receptors causes hypothermia in the guinea pig.

The selective, brain penetrant, 5-HT(1B/D) (formerly 5-HT(1D beta/alpha)) receptor agonist SKF-99101H (3-(2-dimethylaminoethyl)-4-chloro-5-propoxyindole hemifumarate) (30 mg/kg i.p.) causes a dose related fall in rectal temperature in guinea pigs which previous studies have shown to be blocked by the non-selective 5-HT(1B/D) receptor antagonist GR-127935 (N-[4-methoxy-3-(4-methyl-1-piperazinyl) phenyl]-2'-methyl-4'-(5-methyl-1,2,4-oxadiazol-3-yl) [1,1'biphenyl]-4-carboxamide oxalate). The present study shows that the hypothermic response to SKF-99101H is dose-dependently blocked by SB-224289G (1'-methyl-5-(2'-methyl-4'-[(5-methyl-1,2,4-oxadiazol-3-yl)bipheny l-4-yl]carbonyl)-2,3,6,7-tetrahydrospiro[furo[2,3-f]indole-3,4'-pi peridone] hemioxalate) (0.3-10.0 mg/kg p.o.) (ED50 3.62 mg/kg), which is the first compound to be described which is more than 60 fold selective for the 5-HT1B receptor over the 5-HT1D receptor. SB-216641A (N-[3-(2-dimethylamino) ethoxy-4-methoxy-phenyl] 2'-methyl-4'-(5-methyl-1,2,4-oxadiazol-3-yl)-(1,1'-biphenyl)-4-car boxamide hydrochloride) (0.6-20.0 mg/kg i.p.), which is somewhat less selective (30 fold) for the 5-HT1B receptor over the 5-HT1D receptor had a similar effect (ED50 4.43 mg/kg). The brain penetrant 5-HT1D selective receptor antagonist, BRL-15572 (4-(3-chlorophenyl)-alpha-(diphenylmethyl)-1-piperazineethanol+ ++ dihydrochloride) (0.3-100.0 mg/kg i.p.) was inactive. When administered alone neither BRL-15572 (0.1-10 mg/kg i.p.) nor SB-224289G (2.2-22 mg/kg p.o.) had an effect on body temperature. These data demonstrate that 5-HT1B (formerly 5-HT(1D beta)) and not 5-HT1D (formerly 5-HT(1D alpha)) receptors mediate the hypothermic response to SKF-99101H (30 mg/kg i.p.) in guinea pigs. The compounds described are useful pharmacological tools for distinguishing responses to 5-HT1B and 5-HT1D receptors.

Animals↗
PubMed1997

Dental erosion, oral hygiene, and nutrition in eating disorders.

OBJECTIVE: To determine the influence of oral hygiene practices and additional fluoride on erosive tooth wear in eating disorders. The proportional dietary intake of carbohydrates, fats, and proteins was also investigated. METHOD: Tooth wear was measured with the use of the tooth wear index (TWI). All subjects completed a questionnaire on past dental history as well as a 1-week diet sheet. A total of 33 subjects participated in the study, 20 of whom were follow-ups, allowing the progress of dental erosion to be made. All subjects were referred from the Department of Clinical Psychology. RESULTS: Oral hygiene practices between subjects with and without severe erosion were not significantly different. Only 8 bulimics spent more time brushing after vomiting than at other times. The pH of vomitus from 6 subjects ranged between 2.9 and 5.0, with a mean of 3.8, well below the critical pH for enamel demineralization to occur. Of the 20 follow-up subjects, 12 (60%) exhibited worsening tooth wear. The mean values for daily carbohydrate, protein, and fat intake were not significantly different at baseline and at recall, and the proportional dietary intake was similar to recommended energy provision at 47%, 40%, and 13%, respectively. DISCUSSION: The contribution by toothbrush abrasion to the overall wear in the eroded dentition of bulimics is not significant. Therefore, immediate post-vomiting oral hygiene practices can be recommended. The proportional nutritional intake values of carbohydrates, fats, and proteins in this group of bulimics are acceptable.

Adult↗
PubMed1996

A computer-controlled apparatus for measuring and analysing myoclonic jerk activity in guinea pigs.

Guinea pigs respond to 5-hydroxytryptophan (5-HTP) with a complex behavioural syndrome which includes distinctive whole-body jerks (myoclonic jerks). These are species-specific, involve all major muscle groups, are highly rhythmic and can occur with relatively high frequency (1-2/s). Current methods of quantifying the response, which rely on observer ratings are unsatisfactory. We report the development of a fully automated, PC-based system for detecting and analysing myoclonic jerks. Floor-mounted accelerometers generate a movement signal and detection is performed by an algorithm based on a detailed analysis of the topography of myoclonic jerk responses. The system can monitor the output from 10 purpose-built test enclosures and it provides for pseudorandom treatment allocation, flexible control of experimental parameters and automated data output to a spreadsheet which generates appropriate graphs, statistical summaries and data analysis. This robust response provides a useful means of exploring the role of novel 5-HT receptor subtypes in guinea-pig behaviour.

Algorithms↗
PubMed1995

The role of 5-HT1D and 5-HT1A receptors in mediating 5-hydroxytryptophan induced myoclonic jerks in guinea pigs.

Systemic administration of 5-hydroxytryptophan (5-HTP) to guinea pigs causes species-specific, rhythmic, whole body jerks (myoclonic jerks), the frequency and amplitude of which were measured in an automated apparatus. The brain penetrant 5-HT1D receptor agonist 3-(2-dimethylaminoethyl)-4-chloro-5-propoxyindole hemifumarate (SKF 99101H) (3-30 mg/kg i.p.) and the selective 5-HT1A receptor agonist (+/-)8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) (0.3-3 mg/kg s.c.) dose dependently potentiated the frequency and intensity of myoclonic jerks caused by 5-HTP (100 mg/kg). Cotreatment of guinea pigs with 8-OH-DPAT (3 mg/kg s.c.) and SKF 99101H (30 mg/kg i.p.), which were inactive when given alone, gave a marked myoclonic jerk response. Conversely, the myoclonic jerk response to higher doses of 5-HTP (150 mg/kg i.p.) was dose dependently blocked by the 5-HT1D receptor antagonist GR 127935 (N-[4-methoxy-3-(4-methyl-1-piperazinyl)phenyl]-2'-methyl-4'-(5-methyl-1 ,2,4-oxadiazol-3-yl)[1,1'-biphenyl]4-carboxamide oxalate) (ED50 0.32 mg/kg i.p.) and the selective 5-HT1A receptor antagonist WAY 100635 (N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-(2-pyridinyl) cyclohexanecarboxamide trihydrochloride) (ED50 0.33 mg/kg i.p.). The response to 5-HTP (150 mg/kg i.p.) was also blocked by ritanserin (0.01-0.3 mg/kg i.p.). Our data therefore confirm previous reports concerning the effects of 5-HT2A/2C receptor blockade on 5-HTP induced myoclonic jerks and suggest that both 5-HT1D and 5-HT1A receptors play an important role in mediating this behavioural response.

5-Hydroxytryptophan↗
PubMed1995

The prediction of chronicity in patients with an acute attack of low back pain in a general practice setting.

STUDY DESIGN: Three hundred patients, attending their general practitioners with attacks of acute low back pain, formed the subject population for a study of fear avoidance and other variables in the prediction of chronicity. Follow-up was at 2 and 12 months. OBJECTIVE: The hypothesis to be tested was that evidence of psychological morbidity, particularly fear-avoidance behavior, would be manifest from the outset of the presenting attack in susceptible subjects. SUMMARY OF BACKGROUND DATA: While back pain is an almost universal human experience, only about 5% of sufferers seek medical advice. Most of these respond to conservative treatment. However, approximately 10% of those who experience an acute attack of low back pain go on to become chronic sufferers. METHODS: Psychosocial and physiological data (including fear-avoidance measures) were collected from a sample of 300 acute low back pain patients within 1 week of presentation and at 2 months, to try to predict 12 month outcome. RESULTS: Data analysis showed that subjects who had not recovered by 2 months were those who went on to become chronic low back pain patients (7.3%). Using multiple regression analyses, fear-avoidance variables were the most successful in predicting outcome. Using multiple discriminant function analyses, the results suggest that the outcome in terms of the future course of low back pain can be correctly classified in 66% from fear-avoidance variables alone and in 88% of patients from all variables. CONCLUSIONS: The results suggest that, at the earliest stage of low back pain, fear of pain should be identified by clinicians and, where this is severe, pain confrontation should arguably form part of the approach to treatment.

Acute Disease↗
PubMed1994

Body-image perception in pre- and postadolescent females.

The purpose of this study was to examine both perceived and ideal body-image to establish if the process of adolescence was a contributory factor. A distorting mirror and silhouette pictures were used to examine the image in two groups of 59 pre- and 41 postadolescent girls. The girls' perception of themselves was reasonably accurate yet both groups had a significantly slimmer mean ideal image, irrespective of adolescent status. The differences between the two groups were nonsignificant whether using the distorting mirror or the pictures. The only difference to be observed was when using a body-satisfaction scale. The postadolescents were significantly less satisfied about their nonhead body parts. Scores from the mirror and the pictures question the assumption that body-image dissatisfaction is a postadolescent phenomenon. This should be a cause for concern as eating disorders, which appear to be linked to body-image, are being observed in younger children. The comparability between scores for the pictures and the distorting mirror opens the possibility of home-based therapy in the treatment of perceptual and eating disorders.

Adolescent↗
PubMed1992

An application of the fear avoidance model to three chronic pain problems.

The Fear Avoidance Model of Exaggerated Pain Perception was developed in an attempt to explain how, and why, some individuals develop a more substantial psychological overlay to their low back pain problem than do others. The present paper describes a study in which three chronic pain groups, consisting of Post-Herpetic neuralgia patients, Reflex Sympathetic Dystrophy patients and chronic low back pain patients were compared with three pain-free comparison groups using the Fear Avoidance Model of Exaggerated Pain Perception. The results show statistically significant differences between the chronic groups and the recovered comparison groups. These results demonstrate the usefulness of the Fear Avoidance Model as an explanation of psychological overlay in chronic pain conditions regardless of pathology.

Adaptation, Psychological↗
PubMed1992

A follow-up study of problem drinkers offered a goal choice option.

Patients (N = 100) who had been admitted to behaviorally oriented residential treatment for their drinking problems were followed up for 1 year. A treatment goal option of controlled drinking was explicitly catered for. Overall outcome, in which 27% of those available for follow-up were categorized as "successful," 35% as "equivocal" and 38% as "failure," does not appear to be markedly dissimilar to that reported from other agencies. The distribution of approximately equal abstinent and nonabstinent successful outcomes is similar to that found following treatment programs that promote a single goal. Sociodemographic variables were less influential in predicting outcome than were treatment variables--with frequency of aftercare attendance being particularly significant. Those who had received previous hospital treatment for their problem, those who habitually drank in company and those who had abnormal blood test results prior to entering treatment had poorer outcome.

Adult↗
PubMed1991

Motivation to comply with infection control procedures.

This paper addresses the critical issue of motivating hospital staff to comply with standard infection control procedures. Previous psychological assessment of infection control knowledge, attitudes and behaviour has indicated that the reasons for non-compliance are very basic and reflect inter alia a low perception of the importance of the measures and a lack of motivation. It is argued that, although staff have a theoretical awareness of the value of complying with such procedures, in practice these seem to have a low priority. Compliance levels, therefore, are variable and generally of a low order. If recent advances in the fields of social psychology, behavioural psychology and clinical psychology could be imported to hospital medicine, they could have a dramatic impact in infection control. The Elaboration Likelihood Model, an effective theoretical approach to message-based persuasion, and the energizing effects of intrinsic and extrinsic motivational processes are defined. Finally, the implications of these concepts for persuasive intra-hospital communication in infection control are highlighted. They can provide a framework for developing effective infection prevention programmes.

Health Knowledge, Attitudes, Practice↗
PubMed1991

An experimental analysis of perfectionism and dissatisfaction.

The striving after perfection has been often mentioned in clinical literature; however, there have been few systematic analyses of the concept. In the present study, a questionnaire measure of Perfectionism and General Dissatisfaction (the SCANS) together with the Eysenck Personality Questionnaire and measures thought to gauge aspects of perfectionistic thinking, were administered to a mixed group of 148 subjects, including 25 eating disorder patients. Perfectionism was found to correlate negatively with Psychoticism (as measured by the EPQ) and positively with the Lie scale. Thus Perfectionism appears to be associated with a tendency to deny personally deviant behaviour and to present oneself in the best possible light. It is also associated with greater accuracy in a visual search task. General Dissatisfaction was correlated significantly with Neuroticism, Introversion and Psychoticism. It thus appears to be related to a combination of 'neurotic introversion' and 'personality deviance'. It is also associated with a tendency to be under-inclusive, that is to find difficulty in ruling out irrelevant stimuli when forming categories. Dissatisfaction was also associated with increased reaction time in the visual search task, perhaps also a reflection of an inability to ignore irrelevant stimuli. Only the EPQ N and P scales successfully differentiated neurotic or dissatisfied perfectionists from normal or satisfied perfectionists, although several measures derived from the visual search task produced results which were approaching significance.

Adult↗