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Genital responsiveness in healthy women with and without sexual arousal disorder.

J Sex Med. 2008 Jun;5(6):1424-35

Authors: Laan E, van Driel EM, van Lunsen RH

INTRODUCTION: Most pharmacological treatments that are currently being developed for women with sexual arousal disorder are aimed at remedying a vasculogenic deficit. AIM: This study investigated whether pre- and postmenopausal women with sexual arousal disorder are less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems. METHOD: Twenty-nine medically healthy women with sexual arousal disorder (15 premenopausal and 14 postmenopausal), diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, and 30 age-matched women without sexual problems (16 premenopausal and 14 postmenopausal) were shown sexual stimuli depicting cunnilingus and intercourse. MAIN OUTCOME MEASURE: Genital arousal was assessed as vaginal pulse amplitude (VPA) using vaginal photoplethysmography. RESULTS: Results showed no significant differences between the two groups in mean and maximum VPA, nor in latency of VPA response. CONCLUSION: Women with sexual arousal disorder diagnosed according to DSM-IV criteria were not less genitally responsive to visual sexual stimuli than women without such problems. These findings are in line with previous studies. The sexual problems these women report are clearly not related to their potential to become genitally aroused. We argue that the DSM-IV criteria for sexual arousal disorder are in need of revision. In medically healthy women, impaired genital responsiveness is not a valid diagnostic criterion.

PMID: 18410301 [PubMed - indexed for MEDLINE]

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Appetitive and aversive classical conditioning of female sexual response.

J Sex Med. 2008 Jun;5(6):1386-401

Authors: Both S, Laan E, Spiering M, Nilsson T, Oomens S, Everaerd W

INTRODUCTION: There is only limited evidence for appetitive classical conditioning of female sexual response, and to date modulation of female sexual response by aversive conditioning has not been studied. AIM: The aim of this article is to study appetitive and aversive classical conditioning of sexual responses in women. MAIN OUTCOME MEASURES: Vaginal pulse amplitude was assessed by vaginal photoplethysmography and ratings of affective value were obtained. METHOD: Two differential conditioning experiments were conducted. In Experiment 1, on appetitive conditioning, neutral pictures served as conditional stimuli (CSs) and genital vibrotactile stimulation as the unconditional stimulus (US). In Experiment 2, on aversive conditioning, erotic pictures served as CSs and a pain stimulus as US. In both experiments, only one CS (the CS+) was followed by the US during the acquisition phase. Conditioned responses were assessed during the extinction phase. RESULTS: In Experiment 1, during the extinction phase, as expected vaginal pulse amplitude was higher in response to the CS+ than during the CS-. Also, the CS+ was rated as marginally more positive than the CS-. In Experiment 2, during the extinction phase, as expected vaginal pulse amplitude was lower in response to the CS+ than during the CS-, and the CS+ was rated as more negative than the CS-. CONCLUSIONS: The results provide evidence for appetitive classical conditioning of sexual response in women, and are the first to show attenuation of sexual response in women by aversive conditioning.

PMID: 18373525 [PubMed - indexed for MEDLINE]

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Risk factors of symptom underestimation by physicians.

J Psychosom Res. 2008 May;64(5):543-51

Authors: Zastrow A, Faude V, Seyboth F, Niehoff D, Herzog W, Löwe B

OBJECTIVE: The aims of this study were to characterize patient-physician agreement on various psychological and somatic symptoms in internal medicine inpatients and to identify predictors of symptom severity underestimation by physicians. METHODS: Consecutive adult inpatients of two internal medicine wards of a university hospital completed visual analogue scales (VASs) for severity of disability, anxiety, depression, somatic symptoms, and pain at the time of admission (n=639, participation rate=70%) and 5 days thereafter (n=401, participation rate=82%). In addition, the Patient Health Questionnaire 9 (PHQ-9) depression scale and the Clinical Global Impression Scale–Revised were used. At the same time, the six treating physicians independently rated the complaints of their patients using the same VAS. Rates of overestimation, concordance, and underestimation of symptom severity were analyzed. Logistic regression analyses were used to identify predictors of symptom underestimation by physicians. RESULTS: Concordance between patients and physicians regarding disability, anxiety, depression, somatic symptom severity, and pain reached 50-60%. Symptom severity of patients suffering from major depressive episode was significantly more often underestimated than that of nondepressed patients (all P<.01). Of all the variables, greater depression on the PHQ depression score was the most important risk factor for symptom underestimation by physicians (OR ranging from 1.29 to 1.57; all P<.05, except underestimation of disability). Symptom underestimation of pain severity was also associated with panic disorder symptoms (odds ratio, 2.44; P=.01). CONCLUSION: Depressed patients seem to be at greater risk of symptom underestimation by their physicians–a finding bearing implications for avoidance of underdiagnosis and insufficient treatment. Mutual understanding could be improved by better doctor-patient communication skills. Brief self-report depression screeners might help to reliably identify patients at risk for symptom underestimation by physicians.

PMID: 18440408 [PubMed - indexed for MEDLINE]

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Ocular allergies: a psychodynamic approach.

Curr Opin Allergy Clin Immunol. 2008 Oct;8(5):461-5

Authors: Burroni AG, Maio M

PURPOSE OF REVIEW: This work outlines a psychodynamic approach to ocular allergies, picking up the emotional issues related to the topic of eye out of the psychodynamic and psychosomatic literature and connecting them to a strategy of multidisciplinary treatment based on a therapeutic network that meets the unconscious patient’s distresses, particularly those relating to the anxiety of abandonment, to the emotional nonmirroring and to the aspects of envy. RECENT FINDINGS: More specifically is considered a modern psychodynamic approach able to link together the particular depth of pathology (in terms of its physiological changes) with the analogous depth of conflict and its psychological defences and able to intervene through a medical-psychological network according to the systemic criteria of the eco-bio-psychology. SUMMARY: The psychodynamic research on ocular allergy is currently poor and methodologically reductive. We tried to indicate the general aspects to be considered to implement a broader psychodynamic approach. An approach that intervenes through a medical-psychological network according to the systemic criteria of the ecobiopsychology. The collaboration between the family doctor, the medical specialist and the psychologist should be considered in terms of an environment that facilitates the psychoemotional development of the individual, catching the somatopsychic aspects which have been left dissatisfied.

PMID: 18769202 [PubMed - in process]

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Fibromyalgia: an update and immunological aspects.

Curr Pain Headache Rep. 2008 Oct;12(5):321-6

Authors: Paiva ES, Goldenberg Mariano da Costa ED, Scheinberg M

Fibromyalgia syndrome (FMS) is now understood as a chronic pain syndrome, and recent evidence indicates it is not a pure psychosomatic disorder. We review the current knowledge in FMS pain pathways, focusing on the central system sensitization phenomenon and the abnormalities in the inhibitory pain systems. Chronic headache is one of the most common symptoms in FMS, and better knowledge of their common pathophysiologic features can help us understand both conditions better. These features include the nerve growth factor actions and failure of the endocannabinoid system. In addition, we review new immunological aspects of FMS, both in their humoral (autoantibodies, antipolymer antibodies) and cytokine (interleukin-2) aspects.

PMID: 18765135 [PubMed - in process]

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[Clinical, functional and biochemical characteristics of arterial hypertension in military men under chronic stress]

Med Tr Prom Ekol. 2008;(7):24-9

Authors:

Peculiarities of military occupational activities are repeated stress and high degree of psychoemotional strain. The article deals with results of momentary study covering a select from military men cohort, with thyroid tests, renal functional tests, diurnal monitoring of blood pressure and psychologic state assessment. Course of arterial hypertension in military men subjected to chronic stress presents prevailing systolic-diastolic and diastolic variants with excessive decrease of blood pressure at night, with high values of albuminuria. Psychologic state of the military men examined, whe were subjects to chronic stress, was mostly mixed reactivity type with general overstrain and somatization of inner conflict (psychosomatic variant of dysadaptation). The authors demonstrated close correlation between intrinsic emotional strain degree with arterial hypertension type according to “hyper-dipper” variant and free T3 level.

PMID: 18763613 [PubMed - in process]

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Anorexia nervosa: selective processing of food-related word and pictorial stimuli in recognition and free recall tests.

Int J Eat Disord. 2008 Jul;41(5):439-47

Authors: Nikendei C, Weisbrod M, Schild S, Bender S, Walther S, Herzog W, Zipfel S, Friederich HC

OBJECTIVE: Maladaptive processing of food cues is considered pivotal in the psychopathology of anorexia nervosa. However, the influence of hunger and differences in processing because of the type of stimuli remain largely unclear. METHOD: Memory bias for food-related pictorial and semantic stimuli was assessed in a recognition and a free recall test in 16 anorexia nervosa (AN) patients, 16 control participants with food intake prior to the study (CG-FI) and 16 control participants with a fasting period prior to the study (CG-NF). RESULTS: Compared with CG-FI participants, both AN and CG-NF participants responded faster to food-related as compared with neutral words (p < .001) in the recognition test. Differences were found for word but not for pictorial stimuli. No group differences were observed with respect to the number of correct retrievals in either the recognition or the free recall test. CONCLUSION: The present study found behavioral indications of abnormal processing of food-related and neutral stimuli in anorectic patients similar to those found in fasted healthy controls. Results are discussed in terms of self-schemata in eating disorders, competitive interference, and levels of processing.

PMID: 18348282 [PubMed - indexed for MEDLINE]

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[Psychosomatics in patients with hypertensive disease under conditions of occupational stress]

Klin Med (Mosk). 2008;86(7):65-9

Authors:

The aim of the work–the investigation of peculiarities of psychosomatic relations in patients with different stages of hypertensive disease (HD) in conditions of direct occupation activity. The 225 workers from a number of large pharmaceutical industries, who was engaged in performance of the basic occupation activities in conditions of conveyor manufacture at the alternating working regimen, that seemed to be an origin of stresses. On grounds of blood pressure level the patients were selected into 3 groups. The 65 cases with border arterial hypertension (BAH) were included into the 1st group, 69 patients with stage 1 HB were included into the 2nd group and 61 patient–into the third group. The control group consisted of 30 health volunteers. The results of the study testify that occupational stress results in development of neurosis, stable sympathicotonia with formation of hyperkinetic and in consequent advance–hypokinetic type of circulation, gradual aggravation of changes from heart side, decrease of productiveness of mentality. One of causes of persistence of neurosis is a deficiency of a pragmatic information in conditions of complicate and strenuous process of occupational activity.

PMID: 18756752 [PubMed - in process]

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Neuronal correlates of symptom formation in functional somatic syndromes: a fMRI study.

Neuroimage. 2008 Jul 15;41(4):1336-44

Authors: Landgrebe M, Barta W, Rosengarth K, Frick U, Hauser S, Langguth B, Rutschmann R, Greenlee MW, Hajak G, Eichhammer P

Functional somatic syndromes are characterized by high morbidity due to various, fluctuating symptoms without objective somatic findings. There is increasing evidence for the contribution of emotional and cognitive functions to symptom formation, which has been well established in the perception of pain. In addition to their involvement in various other cognitive and emotional processes, the anterior cingulate and insular cortex are thought to contribute to the so-called “pain neuromatrix”. Recent data suggest that these areas appear also to be involved in symptom manifestation in multiple chemical sensitivity. Here we used functional Magnetic Resonance Imaging (fMRI) to test whether this network is also involved in the induction of unpleasant perceptions by sham mobile phone radiation in subjectively electrosensitive patients. This design enabled us to completely dissociate the unpleasant subjective perception from any real physical stimulus. Fifteen subjectively electrosensitive patients and 15 age- and gender-matched healthy controls were exposed to sham mobile phone radiation and heat as a control condition. The perceived stimulus intensities were rated on a five-point scale. During anticipation of and exposure to sham mobile phone radiation increased activations in anterior cingulate and insular cortex as well as fusiform gyrus were seen in the electrosensitive group compared to controls, while heat stimulation led to similar activations in both groups. Symptom manifestation during sham exposure to mobile phone radiation was accompanied by specific alterations of cortical activity in anterior cingulate and insular cortex in subjectively electrosensitive patients further supporting the involvement of these areas in the perception of unpleasantness and generation of functional somatic syndromes.

PMID: 18499479 [PubMed - indexed for MEDLINE]

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Patterns of Objective Physical Functioning and Perception of Mood and Fatigue in Posttreatment Breast Cancer Patients and Healthy Controls: An Ambulatory Psychophysiological Investigation.

Psychosom Med. 2008 Aug 25;

Authors: Grossman P, Deuring G, Garland SN, Campbell TS, Carlson LE

Objective: To monitor objective physiological and self-report measures among apparently disease-free breast cancer patients (n = 33) in the first 2 years of posttreatment recovery, using a cross-sectional design, and compare findings with women without histories of cancer or other serious disorders (n =33). Time-since-treatment also served as an independent variable. Few studies have examined adjustment of breast cancer patients after primary treatment or objectively characterized posttreatment, everyday patterns of functioning. Methods: A 24-hour ambulatory minute-by-minute cardiorespiratory functioning and accelerometry activity were measured during one day, together with multiple repeated assessments of mood and fatigue. Traditional retrospective measures of well-being were also evaluated. Our ambulatory methodology permitted estimation of physiological rhythms of cardiorespiratory and accelerometry activity. Results: Patients reported lower ambulatory levels of energy and poorer mood during the daytime than controls. Time-since-treatment was related directly to both momentary mood and energy as well as to objective measures of activity and respiratory parameters. Retrospective self-reports of impaired mood and symptoms persisted in patients, independently of time-since-treatment and of ambulatory physical or physiological activity. Ambulatory self-report data were associated with concurrent respiratory measures. Chemotherapy-related elevation of heart rate was found but was unrelated to self-report measures. Conclusions: Impaired sense of well being based on retrospective measures is not associated with pattern of physical or physiological functioning after treatment for breast cancer. However, ambulatory, momentary levels of mood and fatigue seem to be related to concurrent ventilatory activity and time-since-treatment. This is the first investigation that relates ambulatory and retrospective measures of affect and fatigue to concurrent, real-life physical functioning.

PMID: 18725433 [PubMed - as supplied by publisher]

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