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PubMed2000

The effect of periaqueductal gray lesions on responses to age-specific threats in infant rats.

During early ontogeny infant rats show specific responses to a variety of age-dependent threatening situations. When isolated from nest and dam, they emit ultrasonic vocalizations and show decreased reactivity to noxious stimulation, or analgesia. When exposed to an unfamiliar adult male, they become immobile and analgesic. The midbrain periaqueductal gray (PAG) is an important area within the circuitry that controls responses to threatening stimuli in the adult. Little is known about the functions of the PAG in early life. It was hypothesized that the PAG mediates the responses to the age-specific threats social isolation and male exposure in the infant rat. Rat pups were lesioned electrolytically either in the lateral or the ventrolateral PAG on postnatal day 7, tested in social isolation on day 10, and exposed to a male on day 14. On day 10 during isolation, ultrasonic vocalizations and isolation-induced analgesia were decreased in both lesion groups. On day 14, male-induced immobility and analgesia were decreased in ventrally lesioned animals. In conclusion, the PAG seems to play a developmentally continuous role in age-specific responses to threat such as ultrasonic vocalization, analgesia, and immobility.

Aging↗

PubMed2000

Gender and tuberculosis control: perspectives on health seeking behaviour among men and women in Vietnam.

This study explores the perspectives of tuberculosis patients on which factors influenced their health seeking behaviour, with special reference to gender differentials in terms of delays in health seeking. In 1996, a multi-disciplinary research team carried out 16 focus group discussions. The study was done in four districts in Vietnam, both in the south and north of the country and in urban and rural areas. Qualitative analysis of data was performed following general principles of modified grounded theory technique. Participants in the focus groups described three main factors as contributing to delay in health seeking. These were fear of social isolation, economic constraints and inadequate staff attitudes and poor quality of health services. A model illustrating different factors influencing health seeking was elaborated and served as a basis for discussion of the findings. The main factor contributing to delay among women was described as fear of social isolation from the family or the community. Stigma was described as closely related to contextual factors such as gender-roles, socio-economic status and level of education and seemed to be mediated via denial and concealment of tuberculosis diagnosis and disease, thus causing delay. The main factor contributing to delay among men was described as fear of individual costs of diagnosis and treatment. Staff attitudes and quality of health service facilities were described as not always corresponding to people's expectations of appropriate health services. Women saw themselves and were seen by others as being more sensitive than men to poor service conditions and staff attitudes. A typical feature of the described health seeking behaviour of men was that they neglected symptoms until the disease reached a serious stage, by which time they tended to go directly to public health services without first visiting private health practitioners. Women, on the other hand, were described as having a tendency to seek out private services and practice self-medication before seeking care at public services. In conclusion, there is a need for better understanding of behavioural factors and for developing strategies, that take these into account. Health workers need to better understand gender and social aspects of tuberculosis control, particularly aspects that influence the likelihood for achieving equity in diagnosis and cure.

Adolescent↗

PubMed2005

Intranasal oxytocin administration attenuates the ACTH stress response in monkeys.

Social relationships protect against the development of stress-related psychiatric disorders, yet little is known about the neurobiology that regulates this phenomenon. Recent evidence suggests that oxytocin (OT), a neuropeptide involved in social bond formation, may play a role. This experiment investigated the effects of chronic intranasal OT administration on acute stress-induced hypothalamic-pituitary-adrenal (HPA) axis activation in adult female squirrel monkeys. Subjects were randomized to one of two experimental conditions. Monkeys were intranasally administered either 50 microg oxytocin (N = 6 monkeys) or 0 microg oxytocin (N = 6 monkeys)/300 microl saline once a day for eight consecutive days. Immediately after drug administration on the eighth day, all monkeys were exposed to acute social isolation. Blood samples for determinations of adrenocorticotropic hormone (ACTH) and cortisol concentrations were collected after 30 and 90 min of stress exposure. Consistent with an anti-stress effect, OT-treated monkeys exhibited lower ACTH concentrations compared to saline-treated monkeys after 90 min of social isolation (F(1,7) = 6.891; P = 0.034). No drug-related differences in cortisol levels were observed, indicating that OT does not directly attenuate the adrenal stress response. Intranasal peptide administration has been shown to penetrate the central nervous system, and research must determine whether intranasally delivered OT exerts its effect(s) at a pituitary and/or brain level. This primate model offers critical opportunities to improve our understanding of the anti-stress effects of OT and may lead to novel pharmacological treatments for stress-related psychiatric disorders.

Administration, Intranasal↗

PubMedDate not supplied

Quality of life in coronary artery disease.

BACKGROUND: Coronary artery disease (CAD) constitutes a considerable financial burden on society in Finland; it is the cause of death of approximately 7,500 men and 6,500 women annually in a population of 5 million. OBJECTIVES: The purpose of this study was to assess the changes in the quality of life (QOL) of patients with CAD treated by medication, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass surgery (CABS) during 1 year. METHOD: The study population consisted of 280 patients with CAD. One hundred patients had been referred to CABS and another 100 to PTCA, whereas 80 patients were on drug therapy. The patients assessed their health status and QOL in terms of functional capacity and aspects of distress using self-completed questionnaires with the Nottingham Health Profile (NHP) instrument before the operation and 6and 12 months afterwards. RESULTS: The QOL of the patients who had undergone CABS and PTCA was significantly better on the dimensions of energy, pain, and mobility 1 year after the intervention. In the medication group, the only improvement took place on the dimension of social isolation, whereas both energy and mobility deteriorated. CONCLUSIONS: The results on QOL obtained in this study support the notion that patients continue to have many problems even after medical treatment with a good outcome. The problems occur in different areas compared with the pretreatment situation as on the dimensions of social isolation and emotional reaction. The rehabilitation of CAD patients is therefore important because the new problems are manifested differently from those seen before the illness or the treatment. The patient's QOL and personal preference for a treatment modality should be important criteria in the choice of treatment.

Activities of Daily Living↗

PubMed2003

The schizophrenia prodrome revisited: a neurodevelopmental perspective.

Despite the widespread acceptance of the neurodevelopmental model of schizophrenia, its application to research concerned with the prodromal phase of illness is limited. Little recognition has been given to the concept of an enduring biological vulnerability to illness that may be responsive to early intervention. Rather, the focus of most prodromal studies is on emerging positive symptoms. The Recognition and Prevention (RAP) program follows the strategy of being equally concerned with the nonspecific symptoms reflecting the core of schizophrenia and those directly related to psychosis. Data were collected from 62 adolescents (mean age = 16.4 years) during the initial 3-year pilot phase of the RAP program (1998-2001). Subjects were divided into three clinical high-risk groups, characterized by (1) negative and nonspecific symptoms (e.g., social isolation, school failures), the earliest prodrome stage; (2) emerging attenuated positive symptoms of moderate intensity; and (3) severe attenuated (but subpsychotic) positive symptoms, considered most proximal to psychosis. Four risk factors, derived from the neurodevelopmental literature, were selected to reflect the vulnerability core: cognitive deficits, affective disturbances, social isolation, and school failure. All four domains were equally impaired across the three risk groups, supporting the presence of the underlying vulnerability core regardless of the magnitude of emerging positive symptoms. An observational pilot study was also conducted to identify the medications typically used to treat emerging positive symptoms. Antidepressants were used as frequently as antipsychotics to treat adolescents presenting with moderate attenuated positive symptoms. Regardless of type of medication, moderately symptomatic youngsters did quite well over the approximately 1-year followup period. By contrast, adolescents presenting with more severe (but nonpsychotic) attenuated symptoms were treated with antipsychotics, often in combination with other agents. Outcome for the more symptomatic youngsters was, however, more guarded, with nearly half (i.e., 47%) of the group converting to a schizophrenia spectrum psychotic disorder. Nonadherence to medication appeared to be a major risk factor in this group. We conclude that a neurodevelopmental model of schizophrenia is supported by our data and that a range of novel treatment strategies may be neuroprotective by directly affecting the disorder's vulnerability core.

Adolescent↗

PubMed2003

Going home: the complex effects of reunification on internalizing problems among children in foster care.

When children in fostercare are reunified with their families of origin they encounter changes that may influence their well-being in both positive and negative ways. We examined the effects of reunification among 218 children in foster care to test an integrative model of the effects of reunification using structural equation modeling. We hypothesized that reunification would exert indirect effects on subsequent child adjustment via changes in adverse life events, perceived social isolation, and mental health service utilization. Results indicated no direct effect of reunification on subsequent internalizing problems, but reunification was related to increased adverse life events that, in turn, were related to elevated symptoms. Second, reunification was negatively associated with mental health service use. Finally, reunification was associated with decreased child perceptions of social isolation. In summary, reunification with biological parents is associated with multiple environmental changes, with most but not all effects indicating negative consequences.

Adolescent↗

PubMedDate not supplied

The antistress effect of majonoside-R2, a major saponin component of Vietnamese ginseng: neuronal mechanisms of action.

Majonoside-R2 (MR2), an ocotillol-type saponin, is a dominant saponin component of Vietnamese ginseng. We have investigated the effect of MR2 on behavioral and pathophysiological changes caused by psychological stress such as the communication box paradigm-induced psychological stress (CBP stress), conditioned fear stress and social isolation stress in laboratory animals, and elucidated the possible neuronal mechanisms underlying the action of this compound. MR2 attenuated CBP stress- and conditioned fear stress-induced antinociception, had a protective effect against CBP stress-induced gastric lesions, and restored the hypnotic activity of pentobarbital decreased by CBP stress or social isolation stress to the level of the unstressed controls. Accumulating evidence strongly suggests the involvement of the central opioid, GABAA receptor and corticotropin-releasing factor mechanisms in the effect of MR2. Here we review the antistress effect of Vietnamese ginseng, especially focusing on the effect of MR2 on psychosomatic disorders caused by psychological stress.

Analgesics↗

PubMed1995

Examination of drug-induced and isolation-induced disruptions of prepulse inhibition as models to screen antipsychotic drugs.

Prepulse inhibition (PPI) of an acoustic startle response is impaired in schizophrenics. PPI can also be studied in the rat, and is impaired by dopamine (DA) D2/3 receptor agonists such as apomorphine. This disruption is reversed by DA antagonists, leading to proposals that this approach may be a useful means to identify novel antipsychotics. There is also evidence to suggest a role of serotonergic (5-HT) and glutamatergic systems in schizophrenia, and accordingly PPI can be disrupted by the 5-HT2 agonist DOI, and the non-competitive NMDA antagonist, dizocilpine. In the present study we have examined the effect of four antipsychotic drugs, haloperidol (0.1-0.3 mg/kg), raclopride (0.03-0.3 mg/kg), risperidone (0.3-3 mg/kg) and clozapine (0.0001-10 mg/kg), against the PPI disruptions induced by apomorphine (0.5 mg/kg), DOI (3 mg/kg) and dizocilpine (0.15 mg/kg). Furthermore, these drugs have been examined for their ability to restore a PPI deficit produced by housing rats under conditions of social isolation. All drugs except clozapine reversed an apomorphine-induced disruption. However, clozapine and risperidone, but not raclopride and haloperidol, reversed a DOI-induced disruption. Only risperidone was effective in restoring a PPI deficit produced by dizocilpine. In contrast to the drug-induced disruptions which were differentially sensitive to the various neuroleptics, isolation-induced disruptions were restored by each drug. These results support the idea that non-drug induced disruptions of PPI, such as social isolation, may be a more viable approach to identify novel antipsychotics.

Animals↗

PubMed1996

Couples' experiences of infertility: a phenomenological study.

If nurses are to work effectively with families in contemporary society, their practice activities must be appropriately informed. Families exposed to new technologies, such as in vitro fertilization (IVF) require care that is sensitive to their particular experience. Infertile couples have been the subject of a substantial body of research, however, most studies to date focus on the physiological effects of infertility and do not take into account the context in which the experience takes place, or the meanings that people assign to this experience. The purpose of this study was to examine in-depth the experience of couples undergoing IVF treatment for infertility. A phenomenological approach was adopted for the study. A purposive sample of six couples was selected for interview. Data were generated from taped interviews and the researcher's observational field notes. Data analysis was in accordance with the procedure outlined by Colaizzi (1978). Interview responses were categorized by examining the participants' transcripts and identifying significant statements and meanings. Themes which emerged from the statements were then identified, and cross-case comparisons were made to confirm or modify these themes. Four key themes emerged from the data: life changes; powerlessness; hope-disappointment cycle; and social isolation. All couples undergoing infertility treatment experienced life changes which included: lifestyle changes, various physical and emotional changes, and changes in their relationships. There was a perceived loss of control over many aspects of their lives. Couples also described a cycle, alternating feelings of hope and disappointment. Most of the couples reported feelings of social isolation associated with being infertile, that were intensified by having to deal with the inappropriate responses of others. Findings from this study will add to the knowledge base on infertility, and contribute to recommendations for improving the way nurses guide, counsel, and support infertile couples.

Adult↗

PubMed2005

Are pregnant adolescents stigmatized by pregnancy?

PURPOSE: To identify prevalence and correlates, including substance use and exposure to violence, of feeling stigmatized by being pregnant as an adolescent. METHODS: A total of 925 low-income African-American, Mexican-American, and Caucasian pregnant adolescents aged </= 18 years were interviewed on the postpartum ward of a university hospital within 48 hours of delivery. Correlates of stigma were identified among self-reported behaviors such as substance use, exposure to violence, family support and criticism, as well as reproductive and sociodemographic characteristics. RESULTS: Two out of five adolescents (39.1%) reported feeling stigmatized by their pregnancy. As compared with their nonstigmatized peers, stigmatized adolescents were more likely to report having seriously considered abortion, being afraid to tell parents about pregnancy, feeling that parents/teachers thought pregnancy a mistake, and feeling abandoned by the fathers of their babies. Stepwise logistic regression revealed the following correlates independently associated with feeling stigmatized: white race/ethnicity, not being legally/common-law married or engaged to the baby's father, feelings of social isolation, aspirations to complete college, experiencing verbal abuse or being fearful of being hurt by other teenagers, and experiencing family criticism. In contrast, greater self-esteem and having dropped out of school before conception were protective of reporting feelings of stigma. CONCLUSIONS: Significant proportions of pregnant adolescents feel stigmatized by pregnancy and are at increased risk of social isolation and abuse. These young women may need special attention during and after pregnancy to develop concrete strategies to care for themselves and their children to complete their education and avoid becoming clinically depressed.

Adolescent↗

PubMed1998

Social adjustment in adult males affected with progressive muscular dystrophy.

Adult male patients affected with Becker (BMD, N = 22), limb girdle (LGMD, N = 22) and facioscapulohumeral (FSHMD, N = 18) muscular dystrophy were interviewed to assess for the first time how the disease's severity and recurrence risk (RR) magnitude alter their social adjustment. BMD (X-linked recessive) is the severest form and confers an intermediate RR because all daughters will be carriers, LGMD (autosomal-recessive) is moderately severe with a low RR in the absence of consanguineous marriage, and FSHMD (autosomal-dominant) is clinically the mildest of these three forms of MD but with the highest RR, of 50%. Results of the semistructured questionnaire [WHO (1988): Psychiatric Disability Assessment Schedule] showed no significant difference between the three clinical groups, but more severely handicapped patients as well as patients belonging to lower socioeconomic levels from all clinical groups showed poorer social adjustment. Taken together, myopathic patients displayed intermediate social dysfunction compared to controls and schizophrenics studied by Jablensky [1988: WHO Psychiatric Disability Assessment Schedule]. Since the items of major dysfunction proportion among myopathic patients concern intimate relationships (70%), interest in working among those unemployed (67%), and social isolation (53%), emotional support and social and legal assistance should concentrate on these aspects. Interestingly, the results of this study also suggest that high RRs do not affect relationships to the opposite sex.

Adult↗

PubMed2002

Circulating human heat shock protein 60 in the plasma of British civil servants: relationship to physiological and psychosocial stress.

BACKGROUND: The Whitehall cohort studies (I and II) of British civil servants have identified sociodemographic, psychosocial, and biological risk factors for coronary heart disease (CHD). To identify mechanisms responsible for susceptibility to CHD, specific biological markers of stress are increasingly being measured. One marker linked to susceptibility to CHD is heat shock protein (Hsp) 60. METHODS AND RESULTS: Blood was taken from 229 civil servants (126 men and 103 women) in the Whitehall II cohort drawn equally from the range of employment grades. Plasma was assayed for levels of Hsp60, tumor necrosis factor alpha (TNFalpha), C-reactive protein, von Willebrand factor, high density lipoprotein (HDL), total cholesterol, and total/HDL ratio. Psychosocial measures included socioeconomic status, psychological distress, and social isolation. The majority of the participants had Hsp60 in their plasma, and approximately 20% had >1000 ng/mL of this protein (a concentration likely to induce biological effects). A positive association between plasma Hsp60 and TNFalpha and a negative association with von Willebrand factor was found. There was also a significant association between elevated Hsp60 levels, low socioeconomic status, and social isolation, together with an association with psychological distress in women. CONCLUSIONS: The majority of participants exhibited Hsp60 in their plasma, and there was evidence of an association between levels of this stress protein and the proinflammatory cytokine, TNFalpha, and with various psychosocial measures.

Biomarkers↗

PubMed2002

The relative contribution of war experiences and exile-related stressors to levels of psychological distress among Bosnian refugees.

This study examined the relative contribution of 2 exile-related variables--social isolation and daily activity level--and war experiences of violence and loss, to levels of PTSD and depressive symptomatology in 2 groups of Bosnian refugees, 1 clinical group (N = 59) and the other a nonclinical community (N = 40) group. As hypothesized, exposure to war-related violence was highly predictive of PTSD symptoms in both groups; in addition, social isolation was significantly related to PTSD symptomatology in the community group. In contrast, depressive symptomatology was accounted for primarily by the exile-related stressors. For the clinical group, depressive symptoms were also accounted for by experiences of war-related loss. The implications of these findings for mental health interventions with refugees are considered.

Activities of Daily Living↗

PubMed1992

Effects of early environmental experience on self-administration of amphetamine and barbital.

Rats were housed after weaning in isolation, with a same-sex sibling, or in a group in an enriched environment for 60 days. Then, subjects were trained to consume all of their fluids during a daily 2-h drinking session, habituated to drinking solutions of both d-amphetamine sulfate and sodium barbital, and then given a choice between drinking water, the stimulant amphetamine and the depressant barbital. Drug choice was affected by both sex and previous housing condition. Males raised in social isolation preferred the stimulant, while females raised in isolation preferred the depressant. Both males and females raised in enriched environments expressed no drug preference, and had the lowest overall drug intake. These results suggest that individual differences in rates of initiation, choice of abusing agent, and maintenance of drug self-administration may be partially determined by pre-existing differences in central nervous system functioning due to early experiences. Differential early experience, particularly the stress of social isolation, can influence drug self-administration behaviour, but the effect may be sex-dependent.

Amphetamine↗

PubMed2000

Sleep complaints and depression in an aging cohort: A prospective perspective.

OBJECTIVE: Most research on the association between sleep disturbances and depression has looked at cross-sectional data. The authors used two waves of data from a panel study of community residents aged 50 years or more to investigate this issue prospectively. METHOD: Data on symptoms of major depressive episodes and sleep problems were examined for a subgroup of the 1994 and 1995 surveys of the Alameda County (California) Study (N=2,370). The authors examined the effects of age, gender, education, marital status, social isolation, functional impairment, financial strain, and alcohol use. Depression was measured with 12 items that covered the DSM-IV diagnostic criteria for major depressive episodes, including insomnia and hypersomnia. RESULTS: The prevalences were 23. 1% for insomnia and 6.7% for hypersomnia in 1994. Sleep was a significant correlate of depression, as were being female, older age, social isolation, low education, financial strain, and functional impairment. When sleep problems and depression were examined prospectively, with controls for the effects of the other variables, sleep problems in 1994 predicted depression in 1995. However, other symptoms of major depressive episodes-anhedonia, feelings of worthlessness, psychomotor agitation/retardation, mood disturbance, thoughts of death-were much stronger predictors of future major depression. CONCLUSIONS: Sleep disturbance and other symptoms that are diagnostic for major depression are strongly associated with the risk of future depression. Sleep disturbance appears to be a less important predictor of depression. More epidemiologic research is needed on the relative contributions of the range of depressive symptoms to the risk of clinical depression.

Age Factors↗

PubMed2001

The units of perception in the antiphonal calling behavior of cotton-top tamarins (Saguinus oedipus): playback experiments with long calls.

We investigated how the acoustic structure of the cotton-top tamarin monkey's (Saguinus oedipus) combination long call relates to the antiphonal calling behavior of conspecifics. Combination long calls can function as contact calls and are produced by socially isolated individuals. Often conspecifics respond to these calls with their own long calls. Structurally, these calls are always composed of one or more 'chirps' followed by two or more 'whistles'. We compared the antiphonal calling responses to playbacks of complete, naturally produced long calls versus single whistles or single chirps. Subjects responded significantly more to whole calls than to either syllable-type alone. Thus, our data suggest that, in terms of the antiphonal calling behavior of socially isolated conspecifics, the whole long call is the unit of perception.

Animals↗

PubMed2005

Social structure influences effects of pair-housing on wound healing.

Chronic stress or noxious stimuli delay wound healing in humans and rodents. The effects of stress on wound healing appear to be mediated by the hypothalamic-pituitary-adrenal (HPA) axis and, in particular, increases in corticosteroids. As previously shown, positive social interaction faciltiates wound healing through suppression of corticosteroids. In the present study, we investigated the effects of pair-housing on wound healing and corticosteroid concentrations in three mouse species, the monogamous Peromyscus californicus, the facultative-monogamous Peromyscus eremicus, and the polygynous Peromyscus leucopus. Pair-housed P. californicus and P. eremicus had significantly smaller wounds than socially isolated cohorts. However, wound healing in P. leucopus was not affected by housing condition. P. californicus and P. eremicus mice that were pair-housed for 2 weeks, then separated from their partners 48h prior to wounding also had wounds comparable to socially isolated mice. The benefits of social housing diminished when P. californicus and P. eremicus pairs were prevented from interacting physically via a double screen barrier. Two hours of daily restraint did not affect basal corticosterone concentrations or wound healing in either P. californicus or P. eremicus. In contrast, restraint facilitated wound healing in P. leucopus. Taken together, these data suggest that social contact facilitates wound healing in two monogamous, but not a polygynous, mouse species.

Analysis of Variance↗

PubMedDate not supplied

Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto.

OBJECTIVES: A survey was conducted to measure psychological stress in hospital workers and measure factors that may have mediated acute traumatic responses. METHODS: A self-report survey was completed by 1557 healthcare workers at three Toronto hospitals in May and June 2003. Psychological stress was measured with the Impact of Event Scale. Scales representing attitudes to the outbreak were derived by factor analysis of 76 items probing attitudes to severe acute respiratory syndrome. The association of Impact of Event Scale scores to job role and contact with severe acute respiratory syndrome patients was tested by analysis of variance. Between-group differences in attitudinal scales were tested by multivariate analysis of variance. Attitudinal scales were tested as factors mediating the association of severe acute respiratory syndrome patient contact and job role with total Impact of Event Scale by linear regression. RESULTS: Higher Impact of Event Scale scores are found in nurses and healthcare workers having contact with patients with severe acute respiratory syndrome. The relationship of these groups to the Impact of Event Scale score is mediated by three factors: health fear, social isolation, and job stress. CONCLUSIONS: Although distress in response to the severe acute respiratory syndrome outbreak is greater in nurses and those who care for patients with severe acute respiratory syndrome, these relationships are explained by mediating variables that may be available for interventions to reduce stress in future outbreaks. In particular, the data suggest that the targets of intervention should include job stress, social isolation, and health fear.

Adult↗