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Biomedical subjects

J Paris

Publications and source records attributed to J Paris.

At least 109 records · Page 6Linked to original sources

A critical review of recovered memories in psychotherapy: Part I--Trauma and memory.

OBJECTIVE: The theoretical basis of the use of recovered memories in psychotherapy will be critically examined. METHOD: Literature will be reviewed on the nature of normal memory, and on the relationship of trauma to memory. RESULTS: Normal memories are surprisingly inaccurate. There is little evidence that normal memories can be repressed. There is no evidence that trauma makes repression more likely. CONCLUSIONS: "Recovery" of repressed memories is not consistent with the findings of empirical research.

Humans↗

A critical review of recovered memories in psychotherapy: Part II--Trauma and therapy.

OBJECTIVE: The clinical implications of the use of recovered memories in psychotherapy will be examined. METHOD: The paper will review the relationship of trauma to psychopathology and discuss how traumatic histories might be dealt with in therapy. RESULTS: Trauma is a risk factor for psychopathology, but is only one of many etiological factors in mental disorders. The search for recovered memories in psychotherapy could present dangers for patients. CONCLUSIONS: The most reliable memories of trauma are those that have been present throughout the patient's life.

Humans↗

Psychopathology in offspring of mothers with borderline personality disorder: a pilot study.

OBJECTIVE: Children of mothers with borderline personality disorder (BPD) were hypothesized to be at greater risk for psychopathology, particularly impulse spectrum disorders, than children of mothers with other personality disorders. METHOD: Twenty-one index children were compared with 23 children of mothers with a nonborderline personality disorder. Diagnoses were obtained using the Kiddie Schedule for Affective Disorders and Schizophrenia-Episodic Version (KSADS-E) and the Child Diagnostic Interview for BPD (CDIB), and functioning was rated with the Child Global Assessment Schedule (CGAS). Physical, sexual, and verbal abuse, as well as family violence and placements, were also assessed. RESULTS: The children of the borderline mothers, as compared with controls, had more psychiatric diagnoses, more impulse control disorders, a higher frequency of child BPD, and lower CGAS scores. There were no differences between the groups for trauma. CONCLUSION: The offspring of borderline mothers are at high risk for psychopathology.

Adolescent↗

[Trauma and borderline personality disorder].

This article reviews a large body of empirical evidence concerning the relationship between traumatic experiences in childhood and the development of borderline personality disorder (BPD) in adulthood. Our present state of knowledge indicates that childhood trauma is one of several risks for BPD, but is by no means the main etiological factor accounting for the development of this disorder.

Adult↗

Estrone sulfate-sulfatase and 17 beta-hydroxysteroid dehydrogenase activities: a hypothesis for their role in the evolution of human breast cancer from hormone-dependence to hormone-independence.

The evaluation of estrogens (estrone, estradiol, and their sulfates) in the breast tissue of post-menopausal patients with breast cancer indicates high levels, particularly of estrone sulfate (E1S) which is 15-25 times higher than in the plasma. Breast cancer tissue contains the enzymes necessary for local synthesis of estradiol and it was demonstrated that, despite the presence of the sulfatase and its messenger in hormone-dependent and hormone-independent breast cancer cells, this enzyme operates particularly in hormone-dependent cells. Different progestins: Nomegestrol acetate, Promegestone, progesterone, as well as Danazol, can block the conversion of E1S to E2 very strongly in hormone-dependent breast cancer cells. The last step in the formation of estradiol is the conversion of E1 to this estrogen by the action of 17 beta-hydroxysteroid dehydrogenase. This activity is preferentially in the reductive direction (formation of E2) in hormone-dependent cells, but oxidative (E2-->E1) in hormone-independent cells. Using intact hormone-dependent cells it was observed that Nomegestrol acetate can block the conversion of E1 to E2. It is concluded, firstly, that in addition to ER mutants other factors are involved in the transformation of hormone-dependent breast cancer to hormone-independent, this concerns the enzymatic activity in the formation of E2; it is suggested that stimulatory or repressive factor(s) involved in the enzyme activity are implicated as the cancer evolves to hormone-independence; secondly, different drugs can block the conversion of E1S to E2. Clinical trials of these "anti-enzyme" substances in breast cancer patients could be the next step to investigate new therapeutic possibilities for this disease.

17-Hydroxysteroid Dehydrogenases↗

Lack of estrogenic potential of progesterone- or 19-nor-progesterone-derived progestins as opposed to testosterone or 19-nor-testosterone derivatives on endometrial Ishikawa cells.

Estrogen receptors of human endometrial cancer Ishikawa cells were found to be present in moderate amounts (160-200 fmol/mg protein), and to specifically bind moxestrol (R2858) with a very high affinity characterized by a Kd around 60 pM, when measured under equilibrium conditions. The binding specificity respected a decreasing order as follows: estradiol (E2: 100%) > 4-hydroxy-tamoxifen (4OHTAM: 52.7%) > estriol (E3: 5.7%) > estrone (E1: 2.1%) > TAM (0.2%). The induction of alkaline phosphatase activity (APase) used as an estrogen-specific response, confirmed the intrinsic estrogenicity of progestins derived from 19-nor-testosterone (19NT): norethindrone (NOR), norethynodrel and levonorgestrel, at concentrations ranging from 10(-8) to 10(-6) M. The effect of NOR was partially blocked by the antiestrogen 4OHTAM, which was also partially agonistic in this model, but neither by the antiprogestin mifepristone (RU486) nor by the aromatase inhibitor aminoglutethimide. A simulatory effect was also detected at 10(-7) or 10(-6) M with ethindrone, the testosterone- (T) derived progestin homologous to NOR, and with both androgenic parent-compounds, i.e. T and 19NT themselves. In contrast, progesterone (P) derivatives like medroxyprogesterone acetate (MPA) and chlormadinone acetate (CMA) remained totally inactive, as well as 19-nor-progesterone (19NP) itself or its progestagenic derivatives: ORG 2058 and nomegestrol acetate (NOM). Structure-activity relationships deduced from these studies suggest that it is not the absence of the 19-methyl group which can account for the estrogenic potential of the so-called "19-norprogestins", but rather their steroid structure derived from T in a broad sense (including the 19NT derivatives), as opposed to the non-estrogenic therapeutic progestins derived from P like MPA or CMA, or from 19NP like NOM.

Adenocarcinoma↗

Childhood antecedents of interpersonal problems in young adult children of divorce.

OBJECTIVE: To examine the long-term effects of parental divorce on interpersonal problems and to identify specific childhood pre- and postdivorce experiences that might be associated with these problems. METHOD: Scores on the Inventory of Interpersonal Problems in a university student population were compared for 125 subjects from divorced families, subgrouped by specific divorce experiences, and 467 subjects from intact families. RESULTS: Young adult children of divorce reported more problems with submission and overcontrol. When specific divorce experiences were examined, problems with intimacy emerged in the children of divorce. Mother never remarrying, multiple maternal remarriage, and high levels of pre- and postseparation parental discord were associated with more interpersonal problems. CONCLUSIONS: These data support the hypothesis that parental divorce is associated with interpersonal problems in young adulthood. The findings also provide evidence that specific childhood pre- and postdivorce experiences are associated with later young adult interpersonal problems, including problems with intimacy.

Adolescent↗

The five-factor model of personality in borderline and nonborderline personality disorders.

OBJECTIVE: The purpose of this study was to examine to what extent the phenomena associated with a diagnosis of borderline personality disorder (BPD) can be described by the five-factor model of personality. METHOD: The sample consisted of female patients with BPD (n = 29) and a control group with a mixture of nonborderline personality disorders (n = 30). All subjects were given the NEO-PI-R. RESULTS: Borderline patients differed from community norms on all five factors, and were particularly high on Neuroticism, and particularly low on Agreeableness. The scores on the five factors did not differ significantly between the 2 clinical groups. Two facets of the conscientiousness scale (competence and deliberation) were significantly lower in the BPD group. CONCLUSIONS: Dimensional profiles only partially account for the clinical symptomatology seen in formally diagnosed cases of BPD.

Adult↗

Antiandrogenic properties of nomegestrol acetate.

Nomegestrol acetate (NOM-Ac; TX 066, 17 alpha-acetoxy-6-methyl-19-nor-4,6-pregnadiene-3,20-dione, CAS 58652-20-3), a 19-nor-progesterone derivative showed a significant antiandrogenic effect on ventral prostate and seminal vesicles weights of immature castrated rats treated with testosterone. However, this effect was 20 times less potent than that of cyproterone acetate (CYP-Ac). In contrast to norethindrone acetate, a 19-nor-testosterone derivative. NOM-Ac was totally devoid of androgenic effect on male accessory sex organs. Relative binding affinity against 3H-testosterone for androgen receptor of rat ventral prostate showed an IC50 of 22.6 +/- 4.0 and 21.1 +/- 5.3 nmol/l for NOM-Ac and CYP-Ac, respectively, while Dixon analysis disclosed a Ki of 7.58 +/- 0.94 and 4.30 +/- 0.17 nmol/l. Then, Scatchard plot analysis of 3H-NOM-Ac binding revealed a KD of 20.9 +/- 3.1 nmol/l and a Bmax of 217 +/- 27 fmol/mg protein.

Androgen Antagonists↗

Critical residue combinations dictate peptide presentation by MHC class II molecules.

Peptides encompassing the core hen egg lysozyme HEL(52-61) peptide elongated or not and substituted or not with natural and unnatural amino acids were used to find a peptide motif for binding to the major histocompatibility complex (MHC) class II I-Ak. Using a T-cell recognition functional assay, nine out of 10 positions were found to be somehow involved in the I-Ak binding, and six out of 10 residues were involved in T-cell recognition. The deleterious effect of single substitutions could be rescued by changing peptide length and/or sequence. Thus, efficient binding to MHC class II molecules requires not only few anchoring residues correctly interspaced, but a complex, nonrandom combination of residues with appropriate orientation of the peptide backbone and some crucial side chains.

Amino Acid Sequence↗

Inhibition by nomegestrol acetate and other synthetic progestins on proliferation and progesterone receptor content of T47-D human breast cancer cells.

Progesterone receptors (PgR) of human breast cancer T47-D cells grown in an estrogenic environment (presence of phenol red, natural estrogens of foetal calf serum and insulin) were found to be present in considerable amounts (1-3 pmol/mg protein and 20 pmol/mg DNA), and to specifically bind progestins with a high affinity characterized by a Kd around 3 nM for ORG2058, and 4 nM for nomegestrol acetate (NOM; 17 alpha-acetoxy-6-methyl-19-nor-pregna-4,6-diene-3, 20-dione), when measured under equilibrium conditions. Both compounds formed an highly stable ligand-receptor complex with a dissociation constant (k-1) around 1 x 10(-5) s-1. At high pharmacological concentrations, NOM, ORG2058 and other synthetic progestins including promegestone (R5020), medroxy-progesterone acetate and norethindrone acetate (NOR), induced a dose-dependent inhibition of cell proliferation as measured by [3H]thymidine incorporation. Dexamethasone, which did not bind to PgR, did not reproduce this inhibitory effect. NOM, R5020 and NOR treatments of T47-D cells at concentrations around Kd resulted in an 80% decrease in PgR content. Our data on NOM as compared to other progestins are consistent with their antiproliferative effects on human breast cancer cells grown in estrogenic conditions.

Breast Neoplasms↗

Somatoform disorders: personality and the social matrix of somatic distress.

Personality traits that may contribute to somatization are reviewed. Negative affectivity is associated with high levels of both somatic and emotional distress. Agreeableness and conscientiousness may influence interactions with health care providers that lead to the failure of medical reassurance to reduce distress. Absorption may make individuals more liable to focus attention on symptoms and more vulnerable to suggestions that induce illness anxiety. More proximate influences on the selective amplification of somatic symptoms include repressive style, somatic attributional style, and alexithymia; however, data in support of these factors are scant. Most research on somatoform disorders confounds mechanisms of symptom production with factors that influence help seeking. Longitudinal community studies are needed to explore the interactions of personality with illness experience and the stigmatization of medically unexplained symptoms.

Adaptation, Psychological↗

Risk factors for borderline personality in male outpatients.

The purpose of the study was to examine the role of several psychological risk factors--childhood sexual abuse (CSA) and its parameters, childhood physical abuse and its parameters, early separation or loss, and abnormal parental bonding--in male patients with borderline personality disorder (BPD). Subjects with personality disorders were divided into BPD (N = 61) and non-BPD (N = 60) groups. The risk factors were measured by a developmental interview and the Parental Bonding Index. The BPD group had a higher frequency of CSA, more severe CSA, a longer duration of physical abuse, increased rates of early separation or loss, and a higher paternal control score on the Parental Bonding Index. CSA and separation or loss were significant in the multivariate analysis. The risk factors suggest that trauma and loss, as well as problems with fathers, are important for the development of BPD in males.

Adolescent↗

Do therapist experience, diagnosis and functional level predict outcome in short term psychotherapy?

The purpose of this study was to investigate the effects of clinical diagnosis, functional level and therapist experience on the outcome of brief psychotherapy. Patients (N = 123) were clinically diagnosed and assigned to either a psychiatrist, psychiatry resident, family practice resident or medical student. Global Assessment of Functioning (GAF) scores and the Global Severity Index (GSI) of the SCL-90 were rated at baseline, at the end of therapy and at six month follow-up. The Client Satisfaction Questionnaire was also scored after therapy. All groups of patients improved significantly. Neither therapist type and diagnostic category nor their interaction were related to outcome GAF or to GSI. Patients improved irrespective of their baseline symptom severity. Satisfaction with therapy was highly related ot increased functioning and decreased symptom severity. The number of therapy sessions attended by patients was modestly related to outcome and patient satisfaction. The results suggest that many diagnostic groups benefit from brief psychotherapy administered by therapists of varying experience. Furthermore, the results support the practice of having medical students conduct psychotherapy under supervision during their training.

Adjustment Disorders↗

Psychological risk factors for dissociation and self-mutilation in female patients with borderline personality disorder.

The purposes of this study were to determine whether or not dissociation in female patients suffering from personality disorder is related to sexual and physical abuse or to abuse parameters and whether or not self-mutilation in the personality disorders is related to psychological risk factors or to dissociation. The sample was divided into 78 borderline and 72 nonborderline personality disorders. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. On the diagnostic interview, 48 subjects scored positive for self-mutilation. Dissociative Experiences Scale scores were associated with a borderline diagnosis but not with childhood sexual abuse or physical abuse. The parameters of abuse were not related to dissociation. Subjects who mutilated themselves had higher rates of both childhood sexual abuse and dissociation in univariate analyses. However, in multivariate analyses only diagnosis was significant. None of the other psychological risk factors were significantly linked to self-mutilation. The findings do not support theories that dissociation and self-mutilation in borderline personality disorder are associated with childhood trauma.

Adult↗

Psychological risk factors and self-mutilation in male patients with BPD.

The purpose of this study was to determine whether or not self-mutilation in patients with personality disorders is related to other psychological risk factors, dissociation or diagnosis. The sample included 61 subjects with borderline personality disorder and 60 subjects with nonborderline personality disorder; 32 subjects with borderline personality disorder reported self-mutilation. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as through scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. There were no relationships between any of the psychological risk factors and self-mutilation. Subjects who mutilated themselves had higher scores on the Dissociative Experiences Scale in univariate analysis but the scores in multivariate analyses dissociation did not discriminate between subjects who mutilated themselves and those who did not. The results do not support the theory that abuse and dissociation account for self-mutilation in the personality disorders.

Adolescent↗