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PubMed1983

Affective and physiological sexual response patterns: the effects of instructions on sexually functional and dysfunctional men.

To more clearly characterize the patterns of cognitive-affective and physiological responses concomitant with male sexual dysfunction, the present study compared 14 sexually dysfunctional and 16 sexually functional men. All individuals listened to two sexually explicit tapes and engaged in a self-generated fantasy, while genital, heart rate and scaled cognitive affective responses were recorded. Two types of instructions, a performance demand set and a non-demand sensate focus set, preceded the erotic tapes in counterbalanced order. As predicted, dysfunctional men showed less genital tumescence to tapes preceded by the demand than the non-demand instructions. Contrary to expectation, functional men showed greater penile tumescence to the tapes preceded by demand instructions. Self-reported sexual arousal did not follow the penile tumescence pattern but instead indicated that the dysfunctional sample was significantly less subjectively aroused to the tapes and fantasy. There were other significant differences between the groups. Dysfunctional men showed greater general psychological distress, as measured by the SCL-90, including elevated somaticism, anxiety and depression scores. During the experimental session, dysfunctional men also evidenced greater awareness of a variety of physiological responses, as well as more negative and fewer positive cognitive-affective states. These data are discussed in terms of the interaction of affective and physiological responses, differences in contextual meanings of instructional sets given the presence of a dysfunction, and theoretical and clinical conceptualizations of male sexual functioning.

Adult↗
PubMed1992

Alexithymia and somatic complaints in psychiatric out-patients.

This study investigated the prevalence of alexithymia and its relationship with somatic complaints in a sample of 118 general psychiatric out-patients. Of the sample 39.8% scored in the alexithymic range of the Toronto Alexithymia Scale. Compared with the non-alexithymic patients, the alexithymic patients scored significantly higher on several Minnesota Multiphasic Personality Inventory (MMPI) scales that collectively measure a diverse and extensive range of somatic symptoms and bodily concerns. In addition, the alexithymic patients had significantly higher levels of anxiety, depression, and general psychological turmoil. Although the alexithymic and non-alexithymic patients did not differ on the MMPI Repression and overall Hysteria Scales, which reflect the defenses of denial and repression, the alexithymic patients had significantly less ego strength and were significantly more dependent and more likely to engage in impulsive and acting out behaviours. The overall pattern of results is consistent with the view that alexithymic individuals are prone to both 'functional' somatic symptoms and symptoms of emotional turmoil because they are not well equipped psychologically.

Adult↗
PubMed1995

Biopsychosocial changes associated with cessation of cannabis use: a single case study of acute and chronic cognitive effects, withdrawal and treatment.

A 35 year old male was cognitively assessed prior to cessation of 18 years of daily cannabis use and monitored for several weeks post cessation. Brain event-related potential (ERP) measures of selective attention reflecting a difficulty in filtering out complex irrelevant information showed no indication of improvement over 6 weeks of abstinence. In contrast, when tested in the acutely intoxicated state prior to cessation of use, a dramatic normalisation of the ERP signature of this individual was observed. A treatment program based on supportive-expressive psychotherapy was administered and depression, anxiety and general psychological health were monitored over the course of withdrawal from cannabis.

Action Potentials↗
PubMed1985

A comparison of the discriminative stimulus properties of phencyclidine, given intraperitoneally or intraventricularly in rats.

Rats trained to discriminate intraperitoneally injected phencyclidine (PCP) from saline in a two-lever operant procedure distributed most of their responses on the phencyclidine lever after administration of 150 or 300 micrograms of phencyclidine into a lateral ventricle. This demonstrated that the discriminative stimulus properties of phencyclidine were centrally mediated. On the other hand, the potency of phencyclidine was increased by no more than about 7-fold from intraperitoneal to intraventricular administration. This suggests that either periventricular sites are not involved in mediating the discriminative stimulus properties of phencyclidine or that absorption of phencyclidine to relevant sites in the brain is not markedly enhanced by intraventricular administration.

Animals↗
PubMed1993

Natural history of prostatism: factors associated with discordance between frequency and bother of urinary symptoms.

The objective of this study was to assess the association between frequency and bother of urinary symptoms in a population-based cohort of men and to identify psychosocial factors that are related to reporting heightened or subdued bother relative to symptom frequency. The survey was conducted among men aged forty to seventy-nine years in Olmsted County, Minnesota, the baseline component of a prospective cohort study. Men were queried about the frequency of urinary symptom occurrence and the perceived bother associated with the symptoms. A regression analysis of American Urologic Association (AUA) bother scores on AUA frequency scores demonstrated a tight correspondence (r2 = 0.71). Men with bother scores greater than predicted from their frequency scores were more likely to have sought health care for their urinary symptoms than men whose bother was close to predicted (14 versus 5 percent, respectively). These men with heightened bother were older, poorer, more anxious, and had lower general psychologic well-being scores than the men whose bother was similar to that expected from their reported frequency. Men whose bother was lower than would be expected were less likely to have sought health care for urinary symptoms in the past year (3%) but were of similar age and socioeconomic status as compared with men whose bother was close to expected. These men, however, were more depressed than men whose bother was commensurate with reported frequency. While the men who reported greater bother than expected from their symptom frequency were more likely to have sought medical care for urinary symptoms in the past year, it is not clear whether this greater health-care-seeking behavior is because bother captures an additional component of urologic disease or is a manifestation of psychosocial differences.

Adult↗
PubMed1990

Discrimination of butorphanol and nalbuphine in opioid-dependent humans.

The purpose of the study was to evaluate the agonist and antagonist stimulus properties of the mixed opioid agonist antagonists butorphanol and nalbuphine in opioid-dependent subjects. Opioid-dependent volunteers (methadone 30 mg/day, PO) were trained in a three-choice drug discrimination procedure to discriminate between the effects of saline (2 ml), hydromorphone (10 mg/70 kg) and naloxone (0.15 mg/70 kg) administered IM. Subjects earned monetary reinforcement for correctly identifying the training drugs by letter code. Other subjective, behavioral and physiological measures were also collected. Hydromorphone and naloxone increased drug-appropriate responses and other characteristic subjective effects measures. Butorphanol and nalbuphine produced increases in naloxone-appropriate discrimination responding and in those subjective effect measures increased by naloxone. Butorphanol produced greater than 80% naloxone-appropriate responding at 1.05 mg/70 kg; nalbuphine produced 100% naloxone-appropriate responding at 2.1 mg/70 kg. Neither butorphanol nor nalbuphine showed opioid agonist-like effects in these subjects maintained at moderate levels of physical dependence. In opioid-dependent subjects, the stimulus effects of butorphanol and nalbuphine are antagonist-like.

Adult↗
PubMed1995

Discriminative stimulus properties of the stereoisomers of the phosphodiesterase inhibitor rolipram.

The discriminative stimulus properties of the specific type IV phosphodiesterase inhibitor, rolipram, and its two stereoisomers were assessed using standard two-lever drug discrimination procedures in which responding on the appropriate lever was reinforced on a FR10 schedule. In three separate drug cues based on training rats to discriminate the racemate (0.2 mg/kg, IP), the (-)-isomer (0.1 mg/kg), or the (+)-isomer (2 mg/kg) from vehicle, all forms substituted for one another, differing only in potency. In keeping with published reports, the (-)-isomer was the more potent form, the (+)-isomer being approximately 10 times less potent. Several phosphodiesterase (PDE) inhibitors were found to substitute for the racemate cue, their potencies in the behavioural measure correlating with their potency in displacing [3H]rolipram from its forebrain binding sites in vivo (r = 0.95), suggesting that the discriminative stimulus depends on an action of the drug upon this site. Because rolipram has been reported to possess antidepressant activity, the ability of the tricyclic antidepressant imipramine to substitute for rolipram was investigated; doses of 10 and 20 mg/kg did not substitute. Amphetamine (0.156-1.25 mg/kg) also was inactive. Lisuride gave rise to drug-appropriate responding in 50% of rats only at a dose of 0.078 mg/kg, which severely disrupted responding. It is concluded that the rolipram discriminative stimulus is dependent on the selective PDE inhibitory activity of the drug, and that it does not constitute a cue based on the antidepressant property of rolipram.

Animals↗
PubMed1995

Relationship between quality of life and exercise test findings after coronary artery bypass surgery.

We studied the correlation between quality of life and exercise testing in 554 patients 2 years after coronary artery bypass surgery. Quality of life constitutes a person's perceptions of physical and mental functional capacity, health and symptoms. Traditionally, evaluations after coronary bypass surgery have focused on physical performance, medication and anginal symptoms, which cannot be said to represent quality of life. We used the Physical Activity Score, the Nottingham Health Profile and the Psychological General Well-being Index for evaluation of quality of life. Significant correlations were found between quality of life and exercise capacity (P < 0.0001), and quality of life and chest pain at exercise for all questionnaires (P < 0.0001). Significant correlations, although of small or moderate magnitude, were found between exercise capacity, chest pain and most subscales of quality of life, with the highest correlation coefficients for dimensions reflecting physical abilities and pain. We conclude that quality of life correlates significantly with exercise capacity and chest pain during exercise 2 years after coronary bypass surgery. However, only dimensions of pain and physical performance are reasonably well correlated with exercise test results. Several aspects of quality of life are only weakly related to exercise test results and may escape identification in an exercise test.

Activities of Daily Living↗
PubMed1996

Interoception.

During the last two decades, research on interoception has experienced a surprising renaissance. New experimental approaches and methods have revealed much about the processing of afferent signals from the inner organs of the body, and have allowed more accurate descriptions of these processes, as well as a more accurate determination of their functional significance in the experience and behavior of humans. Besides neuromuscular, respiratory, and gastrointestinal interoceptive processes, the cardiovascular afferent influences are now known to be very important. Invariably, the central questions concern sensitivity to signals from the body, factors which may influence judgement of perception, and the degree to which conventional hypotheses regarding the interoceptive capabilities of humans may require revision. Findings from general psychological and clinical studies have shown that humans may attain remarkable levels of interoceptive performance. On the other hand, they also show how deep the chasm is between visceral processes and perception, and between that which is perceived and the reports thereof. Only interdisciplinary approaches to these complex processes promise success.

Autonomic Nervous System↗
PubMed1996

Active and passive coping strategies in chronic pain patients.

This study assessed the validity of active and passive coping dimensions in chronic pain patients (n = 76) using the Coping Strategies Questionnaire and the Vanderbilt Pain Management Inventory. The validity of active and passive coping dimensions was supported; passive coping was strongly related to general psychological distress and depression, and active coping was associated with activity level and was inversely related to psychological distress. In addition, the Coping Strategies Questionnaire was found to be a more psychometrically sound measure of active and passive coping than the Vanderbilt Pain Management Inventory.

Adaptation, Psychological↗
PubMed1992

A new methodological approach to the evaluation of quality of life in postmenopausal women.

An approach employing a range of standardized questionnaires, which included the Nottingham Health Profile (NHP), the Psychological General Well-Being (PGWB) index and the Mood Adjective Check List (MACL), was used to assess health-related quality of life (QoL) in conjunction with a study comparing two doses of transdermal oestrogen (50 or 100 micrograms/24 h) combined with an oral progestogen (5 mg medroxyprogesterone acetate for 14 days each cycle). In addition to the QoL measures, climacteric symptoms were self-rated and also summarized by means of the Kupperman index. In all, 59 women, median age 52 (39-71) years, who completed 4 months of therapy were evaluated. The use of a battery of standardized questionnaires enabled a comprehensive evaluation to be made of perceived health, well-being and day-to-day functioning. Not only was symptomatic relief, e.g. reduced frequency of sweating episodes, sleep disturbance and hot flushes, observed during treatment, but there were also improvements in terms of sleep, energy and emotions. The frequency of health-related problems associated with paid employment, housework, social life, home life and sex life decreased, indicating enhanced ability to take part in daily activities. The PGWB index showed improvement in the subscales representing well-being, anxiety, depression, vitality, health and self-control, while the mood scales indicated that the women experienced less tension and more satisfaction. Although the results of this study need to be further documented on the basis of a placebo-controlled trial, the findings nevertheless imply that the use of a battery of standardized questionnaires optimizes the possibility of evaluating climacteric complaints reliably before and after treatment.

Administration, Cutaneous↗
PubMed1992

Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women.

The long-term effect on aspects of quality of life (QoL) of treatment with transdermal oestrogen for 2 weeks followed by transdermal oestrogen/progestogen norethisterone acetate/oestradiol TTS 0.25/0.05 mg/day for the next 2 weeks was investigated in postmenopausal women within the framework of a 1-year seven-centre trial. Of the 136 women who were included (mean age 53 +/- 4.8 years), 110 completed the study. Aspects of QoL that are of relevance in the perimenopause and postmenopause were evaluated using the Psychological General Well-Being (PGWB) index, the Women's Health Questionnaire (WHQ) and the Sleep Dysfunction Scale before and after 3 and 9 months of therapy in the oestrogen phase. Climacteric complaints were also assessed by means of the Kupperman Index. Improved well-being, i.e. less anxiety and depression, increased vitality and better self-control (P less than 0.0001) were observed, as well as reduced sleep disturbance (P less than 0.0001). The WHQ showed decreased vasomotor and somatic symptoms, and improved sex life, emotions and cognitive function (P less than 0.0001). Improvement was the same at 3 and 9 months. According to the Kupperman Index, climacteric symptoms were alleviated (P less than 0.0001). Relief of vasomotor symptoms was correlated with improvement in the WHQ (r = 0.82), the PGWB index (r = 0.58, P less than 0.0001) and sleep (r = 0.51, P less than 0.0001). Because of the absence of a placebo control group, the results must be regarded with caution until confirmed in a placebo-controlled trial.

Administration, Cutaneous↗
PubMed1992

Validation of a new quality of life questionnaire for benign prostatic hyperplasia.

In planning a longitudinal study to characterize the natural history of benign prostatic hyperplasia (BPH), we validated a new disease-specific quality of life questionnaire in a pilot study. We studied 110 men in Rochester, Minnesota who spanned the severity of BPH, from men with no known BPH to men who underwent surgery for this condition. Baseline data were obtained on all men, and the 30 who underwent prostatectomy were re-interviewed to test responsiveness. Reproducibility was examined on the pre-post responses (10 weeks apart) of the 37 men with BPH who did not undergo prostatectomy. Six of twelve question domains were retained in the final questionnaire on the basis of their responsiveness to change, reproducibility, internal consistency, and validity. These were: urinary symptoms, degree of bother due to urinary symptoms, BPH-specific interference with activities, general psychological well-being, worries and concerns, and sexual satisfaction. Most of the more generic measures were deleted.

Adult↗
PubMed1996

Adverse effects of medications on urinary symptoms and flow rate: a community-based study.

The relationship between urinary symptoms and medication use was investigated in a community-based cross-sectional study involving a random sample of 2115 men 40-79 years of age in Olmsted County, Minnesota. The American Urological Association Symptom Index (AUASI) was generated from a validated self-administered questionnaire. Medication use was assessed by in-person interviews. While 1087 men reported daily medication use, only 136 reported daily use of medications known to affect urinary function adversely, including antidepressants (42), antihistamines (23), and bronchodilators (43). Age-adjusted AUASI scores were higher in men reporting daily use of antidepressants, and the association persisted after additionally adjusting for the Depression and Anxiety subscales of the General Psychological Well-Being Scale (adjusted mean difference, 2.1; 95% confidence interval (CI), 0.5-3.6; p = 0.008). The adjusted AUASI was also higher among men who took antihistamines daily (adjusted mean difference, 2.3; 95% CI, 0.3-4.3; p = 0.03). Lower age-adjusted urinary flow rates occurred with antidepressants, but not with antihistamines or bronchodilators. Clinicians evaluating men for causes of voiding dysfunction in accordance with the Agency for Health Care Policy and Research practice guideline for the diagnosis and management of benign prostatic hyperplasia should be aware that daily use of antidepressants or antihistamines may be associated with AUASI scores that are two to three points higher than in men not taking these medications.

Adult↗