PubMed Health⌕ Search

Biomedical subjects

R Nesse

Publications and source records attributed to R Nesse.

14 recordsLinked to original sources
PubMed2001

Psychological adjustment to sudden and anticipated spousal loss among older widowed persons.

OBJECTIVES: This study examined if older adults' psychological adjustment to widowhood varies based on whether the death was sudden or anticipated and if these effects are mediated by death context characteristics (e.g., predeath caregiving, nursing home use, spouse's age at death, and couple's communication about the death). METHODS: The effects of forewarning on multiple indicators of mental health and grief were examined in a sample of 210 widowed persons who participated in the Changing Lives of Older Couples (CLOC) study. The CLOC is a probability sample of 1,532 married individuals aged 65 and older for whom baseline information was collected in 1987-88, with widowed persons reinterviewed 6, 18, and 48 months after spousal loss. RESULTS: Forewarning did not affect depression, anger, shock, or overall grief 6 or 18 months after the loss. Prolonged forewarning was associated with elevated anxiety both 6 and 18 months after the death. Sudden spousal death elevated survivors' intrusive thoughts at the 6-month follow-up only. Sudden death was associated with slightly higher levels of yearning among women but significantly lower yearning among men both 6 and 18 months after the loss. DISCUSSION: The findings call into question the widespread belief that grief is more severe if death is sudden and suggest a more complex relationship between bereavement and circumstances of spousal death.

Adaptation, Psychological↗
PubMed1998

Emotional disorders in evolutionary perspective.

Understanding emotional disorders requires understanding the evolutionary origins and functions of normal emotions. They are special states, shaped by natural selection to adjust various aspects of the organism in ways that have tended to give a selective advantage in the face of the adaptive challenges characteristic of a particular kind of situation. They are designed to maximize reproductive success, not happiness. Negative emotions such as anxiety and low mood are not disorders, but, like the capacity for pain, evolved defences. Excessive anxiety or low mood is abnormal, but we will not have confidence about what is excessive until we understand their functions better than we do. Emotional disorders arise often from social emotions because of the conflicts inherent in social life, and because of the strategic advantages of demonstrating commitments to follow through on threats and promises. An evolutionary understanding of individuals in terms of their relationship strategies and the social emotions offers great promise for psychotherapists.

Affective Symptoms↗
PubMed1986

Evaluation of plasma 3-methoxy-4-hydroxyphenylglycol.

A high-performance liquid chromatographic (HPLC) assay suitable for the evaluation of 3-methoxy-4-hydroxyphenylglycol (MHPG) in 1-ml aliquots of plasma is presented. Preparatory steps include extraction into ethyl acetate and minicolumn chromatography. Recoveries are monitored with [3H]MHPG. The HPLC procedure utilizes a C18 column, isocratic elution and amperometric detection. The assay was checked against a gas chromatographic-mass spectrometric procedure; the two procedures correlated well with a correlation coefficient of 0.99. Intra-assay reproducibility was 5.4%, inter-assay reproducibility 10.7%. Immediate changes in the orthostatic position did not affect the plasma MHPG concentration. Based on 22 normal controls the daytime plasma MHPG level was 2.98 +/- 0.66 ng/ml (mean +/- S.D.).

Blood Specimen Collection↗
PubMed1979

Plasma growth hormone: effect of anxiety during flooding in vivo.

The treatment of phobias by rapid in vivo exposure to the feared situation was accompanied by an increase in plasma growth hormone levels on at least one of two occasions in 8 of 11 subjects. The average growth hormone response was greater on the second occasion, even though subjective anxiety was less. Plasma growth hormone was not elevated during the subjects' adaptation to the laboratory. Strong subjective and behavioral anxiety responses failed to elevate plasma growth hormone levels in some subjects. The probability of a growth hormone response was the same whether or not baseline levels were elevated prior to exposure.

Adult↗
PubMed1978

Anxiety and plasma cortisol at the crest of the circadian cycle:reappraisal of a classical hypothesis.

Near-maximal anxiety by subjective and behavioral criteria was evoked and terminated in phobic patients by initiation and termination of rapid live confrontation ("flooding in vivo") with the specific stimulus that each avoided, at a time approximating the crest of the circadian cycle of adrenal cortical function. The procedure was associated with moderate, but not marked, elevations of plasma cortisol above control levels in some, but not all, subjects. Differences in anxiety levels as self-rated by the patients did not account for differences in cortisol response. The findings should stimulate further reevaluation of the hypothesis that affective arousal is the key psychological determinant of adrenal cortical function. Dissociation between subjective-behavioral arousal and plasma cortisol during flooding may be a manifestation of what behavior therapists call "desynchrony of fear."

Adult↗
PubMed1976

"Flooding in vivo" during the circadian phase of minimal cortisol secretion: anxiety and therapeutic success without adrenal cortical activation.

Seven patients with maximally severe phobias for physical objects were treated by "flooding in vivo", i.e. live confrontation with the feared object. Each reported to the laboratory for 3 hr on five separate occasions, all in the early evening during the circadian phase of minimal adrenal cortical activity. At 20-min intervals during each session, blood was taken for cortisol assay, and anxiety was self-rated on a scale of 0 to 100. Treatment was carried out during the 2nd hr of the third and fourth sessions. The remaining time provided control observations. By behavioral and subjective criteria, the treatment hours produced very intense anxiety. However, they failed to evaluate plasma cortisol levels. The remission of the phobias was 100%. Anxiety, even when intense and dramatic, does not necessarily activate the adrenal cortex, and an adrenal "stress" response is not necessary for the therapeutic effect.

Adrenal Cortex↗