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Young women and depression. Origin, outcome, and nursing care.

Depression in young women occurs at a rate twice that of men. Physiologic, psychological, and social phenomena contribute to the development of this multifactorial disorder that interferes with the productivity of women at the height of their work and family careers. Neuroendocrine factors, both menstrually linked and independent of menstrual functioning, have been implicated in gender-biased distribution of affective disorder. Equally salient for women are environmental and cognitive factors that contribute to loss of hope and a sense of helplessness in managing day-to-day responsibilities. Social discrimination and the social roles performed by women may expose them to more stresses or those that are not easily managed. Each of these factors may leave women more vulnerable to the onset of affective disorder. Despite this, there is much nurses can do in the prevention and treatment of depression using a biopsychosocial strategic approach. Psychoeducation, physiologic assessment and intervention, and a maintained caring interaction with the client can promote a return to normal mood and effective functioning for most women with affective illness.

Adult↗

A low dose alcohol drug discrimination in social drinkers: relationship with subjective effects.

RATIONALE: Although well characterised in animals, relatively little is known about alcohol discriminative stimulus effects in humans. OBJECTIVE: The study was carried out to investigate the correspondence of subjective effects and the discriminative response during the acquisition of a low dose alcohol discrimination in humans. METHODS: Healthy volunteers completed an Alcohol Use Questionnaire and were then trained to discriminate a dose of 0.2 g/kg alcohol from placebo using a money reinforced technique. Subjects sampled drinks during training, but also completed rating scales measuring Taste, Like/Dislike and Subjective Effects for each drink. RESULTS: Thirty-two subjects learned the discrimination (discriminators; Ds). In these subjects, differences between placebo scores and alcohol scores for Lightheadedness, Relaxed, Arousal and Fatigue were greater following acquisition of the discrimination, compared with differences at the start of training. Differences in other measures remained consistent. Twenty-six of the volunteers failed to learn the discrimination (non-discriminators; NDs). These subjects reported drinking approximately twice as much alcohol during the preceding 6 months, as the Ds (4.35+/-0.53 g/kg per week versus 2.08+/-0.19 g/kg per week, respectively, P<0.001). There were no alcohol specific differences in ratings for Lightheadedness, Relaxed, Arousal or Fatigue between the Ds and the NDs. However, Dislike scores did differentiate between the Ds and the NDs in that the NDs had reduced ratings for the alcohol drink only compared with the Ds (P<0.02). CONCLUSIONS: These results support the suggestion from animal studies, that the alcohol stimulus is a compound, and characterise the subjective effects which contribute to a low dose cue in humans. In addition, the data suggest that previous drinking experience may selectively alter aversive responses to alcohol and that this, in addition to differences in general arousal levels, may have affected subjects' ability to learn the discrimination.

Adolescent↗

Experiencing satisfaction and stress as an AIDS care provider. The AIDS caregiver scale.

Health care workers (n = 342) completed items examining their emotional experiences working with HIV-positive patients. Factor analysis produced two subscales: Personal Satisfaction and Emotional Stress. A subset of these care workers (n = 251) claimed increased stress and depression after 6 months. In a second study, 91 volunteer AIDS caregivers ("buddies") completed the inventory and the Attitude Toward AIDS Scale. Satisfaction subscores were related to frequent contact and Stress subscores were related to length of illness of persons with AIDS. Satisfaction subscores were related negatively to prejudice towards PWA, social discrimination against PWA, and positively to pro-attitudes toward PWA. Stress subscores were related to social discrimination and punishment for PWA.

Acquired Immunodeficiency Syndrome↗

Right hemisphere advantage for social recognition in the chick.

Recognition of familiar and unfamiliar conspecifics was studied in pair-reared chicks tested binocularly or with only one eye in use. Chicks were tested on day 3 in pairs composed of either cagemates or strangers. Social discrimination, as measured by the ratio "number of pecks at the strangers/total number of pecks" was impaired in right-eyed chicks with respect to left-eyed and binocular chicks. Male chicks showed higher levels of social pecking than females, and chicks that used both eyes showed higher pecking than monocular chicks. There were no significant differences in the total number of pecks (i.e. pecks at companions plus pecks at strangers) between right- and left-eyed chicks: the impairment in social discrimination of right-eyed chicks seemed to be due partly to a reduction in pecking at strangers and partly to an increase in pecking at companions. It is suggested that neural structures fed by the left eye (mainly located at the right hemisphere) are better at processing and/or storing of visual information which allows recognition of individual conspecifics. This may be part of a wider tendency to respond to small changes in any of a variety of intrinsic stimulus properties.

Animals↗

Affiliation and aggression as related to gender in domestic chicks (Gallus gallus).

Social discrimination in male and female domestic chicks (Gallus gallus) was investigated by using (a) latencies of approach response, (b) simultaneous free choice, and (c) intersubject aggressive-pecking tests. In approach-response tests, females showed shorter latencies when tested with cagemates than when tested with strangers, whereas males showed shorter latencies when tested with strangers than when tested with cagemates. In simultaneous-choice tests, females spent more time near a cagemate, whereas males spent more time near a strange chick. In aggressive-pecking tests, both sexes pecked more at strangers than at cagemates; aggressive pecking at strangers, however, was higher in males than in females. It is argued that gender effects in social discrimination can be accounted for in terms of stronger social attachment in females and aggressive responses in males.

Aggression↗

Quality of life in HCV-infection: lack of association with ALT levels.

OBJECTIVES: To examine the impact of HCV infection in an Australian clinic population and identify the relationships between morbidity, psychosocial variables and one clinical indicator of HCV activity, alanine aminotransferase (ALT). METHOD: Ninety-five untreated HCV-infected patients (21-69 years) in infectious and liver diseases clinics who were all positive for HCV-RNA and had no significant comorbidities or coinfections completed a survey containing the Short Form 36 (SF36), as well as the six-item Social Support Questionnaire (SSQ6), demographic items and questions concerning respondents' perceptions of their mode and duration of infection. Nine volunteers from this group participated in semi-structured qualitative interviews aimed at exploring the social impact of HCV status. These data were compared with serum ALT levels. SF36 scores were compared to population norms and according to participant variables. RESULTS: Mean SF36 scores were significantly lower, across all modalities, than population norms. SF36 scores differed significantly according to age, sex, mode of infection, alcohol and methadone use, and satisfaction with social support. They did not differ significantly according to perceived or actual ALT level or pattern of ALT activity. Worry about ALT was prevalent (>50%) and this was independent of perceived ALT level. CONCLUSIONS AND IMPLICATIONS: HCV-infection is associated with significantly reduced quality of life and includes the perception of substantial social discrimination. ALT levels are of limited usefulness in ascertainment of a person's sense of wellbeing and quality of life in HCV-infection. Increased support and information for affected individuals and measures aimed at countering social discrimination are important recommendations of the current study.

Adult↗

The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities.

OBJECTIVES: This study assessed the relation between experiences of social discrimination (homophobia, racism, and financial hardship) and symptoms of psychologic distress (anxiety, depression, and suicidal ideation) among self-identified gay and bisexual Latino men in the United States. METHODS: Data were collected from a probability sample of 912 men (self-identified as both Latino and nonheterosexual) recruited from the venues and public social spaces identified as both Latino and gay in the cities of Miami, Los Angeles, and New York. RESULTS: The study showed high prevalence rates of psychologic symptoms of distress in the population of gay Latino men during the 6 months before the interview, including suicidal ideation (17% prevalence), anxiety (44%), and depressed mood (80%). In both univariate and multivariate analyses, experiences of social discrimination were strong predictors of psychologic symptoms. CONCLUSIONS: The mental health difficulties experienced by many gay and bisexual Latino men in the United States are directly related to a social context of oppression that leads to social alienation, low self-esteem, and symptoms of psychologic distress.

Adult↗

Improving the long-term adjustment of spinal cord injured persons.

STUDY DESIGN: The study involved the long-term assessment of persons with spinal cord injury (SCI) who previously participated in a nonrandomized longitudinal controlled trial. OBJECTIVES: The objective was to report on the effectiveness of early psychological intervention in improving some aspects of adjustment to SCI 2 years post injury. SETTING: The study was conducted in Sydney, Australia. METHODS: Twenty-eight SCI persons who had participated in group Cognitive Behaviour Therapy (CBT) during hospital rehabilitation were assessed for drug usage, hospital readmissions, relationships, perceived adjustment and social discrimination 2 years after treatment. The intervention group's responses on the measures were compared with a control group of 31 SCI persons who only received traditional rehabilitation services during their hospitalization. RESULTS: Subjects in the treatment group experienced less hospital re-admissions, used less drugs and reported higher levels of adjustment compared to the control group. Relationships were stable for both groups and there were no suicides in either group up to 2 years. There were no differences in perceived social discrimination between the two groups. CONCLUSION: The study suggests the long-term adjustment for SCI persons is encouraging for the majority. However, the provision of group CBT for SCI persons appears to improve significantly some aspects of adjustment to the injury in the long-term.

Adolescent↗

Incentives and disincentives to participate in prophylactic HIV vaccine research.

An anonymous cross-sectional paper-and-pencil survey was used to assess incentives and disincentives to participate in a Phase I preventive human immunodeficiency virus (HIV) vaccine trial in a potential Thai target population. A total of 255 persons employed in health care service and research settings completed questionnaires after attending informational briefings regarding the proposed vaccine product and the planned trial procedures. Willingness to participate was related to self-perceived benefits from joining a preventive vaccine trial, as well as to concerns about product safety and social discrimination that might result from participation. The distinction between positive results of enzyme-linked immunosorbent assay from vaccine administration and positivity from HIV infection was unclear for many participants. Men were more willing to participate than women, and there was a trend toward greater willingness to participate in those who were less educated. Preparations for preventive vaccine trials may be more successful if they emphasize personal benefits of trial participation, clearly address safety issues, and consider ways to prevent social discrimination against participants.

AIDS Vaccines↗

Long-term behavioral effects of repetitive pain in neonatal rat pups.

Human preterm neonates are subjected to repetitive pain during neonatal intensive care. We hypothesized that exposure to repetitive neonatal pain may cause permanent or long-term changes because of the developmental plasticity of the immature brain. Neonatal rat pups were stimulated one, two, or four times each day from P0 to P7 with either needle prick (noxious groups N1, N2, N4) or cotton tip rub (tactile groups T1, T2, T4). In groups N2, N4, T2, T4 stimuli were applied to separate paws at hourly intervals;each paw was stimulated only once a day. Identical rearing occurred from P7 to P22 days. Pain thresholds were measured on P16, P22, and P65 (hot-plate test), and testing for defensive withdrawal, alcohol preference, air-puff startle, and social discrimination tests occurred during adulthood. Adult rats were exposed to a hot plate at 62 degrees C for 20 s, then sacrificed and perfused at 0 and 30 min after exposure. Fos expression in the somatosensory cortex was measured by immunocytochemistry. Weight gain in the N2 group was greater than the T2 group on P16 (p < 0.05) and P22 (p < 0.005); no differences occurred in the other groups. Decreased pain latencies were noted in the N4 group [5.0 +/- 1.0 s vs. 6.2 +/- 1.4 s on P16 (p < 0.05); 3.9 +/- 0.5 s vs. 5.5 +/- 1.6 s on P22 (p < 0.005)], indicating effects of repetitive neonatal pain on subsequent development of the pain system. As adults, N4 group rats showed an increased preference for alcohol (55 +/- 18% vs. 32 +/- 21%; p = 0.004); increased latency in exploratory and defensive withdrawal behavior (p < 0.05); and a prolonged chemosensory memory in the social discrimination test (p < 0.05). No significant differences occurred in corticosterone and ACTH levels following air-puff startle or in pain thresholds at P65 between N4 and T4 groups. Fos expression at 30 min after hot-plate exposure was significantly greater in all areas of the somatosensory cortex in the T4 group compared with the N4 group (p < 0.05), whereas no differences occurred just after exposure. These data suggest that repetitive pain in neonatal rat pups may lead to an altered development of the pain system associated with decreased pain thresholds during development. Increased plasticity of the neonatal brain may allow these and other changes in brain development to increase their vulnerability to stress disorders and anxiety-mediated adult behavior. Similar behavioral changes have been observed during the later childhood of expreterm neonates who were exposed to prolonged periods of neonatal intensive care.

Adrenocorticotropic Hormone↗

Sex discrimination in social work careers.

Although the social work profession has expressed a commitment to equal opportunity in employment for women, this study notes that inequities in salary and status still exist between male and female social workers. A major cause of these differences appears to be the process of promotion within public agencies, which introduces inequities early in the careers of social workers.

Career Choice↗