Aggression, rage, and the "destructive instinct," reconsidered from a psychobiological point of view.
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Aggression↗
Biomedical subjects
M H Stone
Publications and source records attributed to M H Stone.
Health- and performance-related potential of resistance training.
Regular physical activity can improve cardiovascular fitness and may reduce the likelihood and debilitating effects of cardiovascular disease. Weight-training has generally been believed to have limited value in modifying risks of cardiovascular disease. Effects shown of resistance training on parameters associated with cardiovascular fitness and disease include: heart rate decreases for maximal work and recovery from short term weight-training, increased ventricular mass, and increased ventricular wall and septum thickness. Studies suggest that myocardial hypertrophy resulting from resistive training can be accompanied by positive myocardial adaptations. Blood pressure response considerations to resistive training include: similarity of resistive exercise peak response to other forms of high intensity exercise, highest blood pressures occur at or near exhaustion during maximum lifts, training appears to reduce the exercise blood pressure. Given the blood pressure responses caution is required for individuals with cardiovascular disease. Studies of high-volume weight-training indicate that small to moderate increases in aerobic power can occur in relatively short periods of time. The mechanisms by which weight-training increases VO2max is unclear. Resistive training may produce positive changes in serum lipids with the volume of training being the dependent factor. Cross-sectional and longitudinal studies of bodybuilders suggest that weight-training may beneficially alter glucose tolerance and insulin sensitivity. It appears that weight-training can increase short term high intensity endurance without a concomitant loss in performance. Resistive training increases power output and performance. Body composition has important relationships to cardiovascular fitness, strength and flexibility. It is likely that it can be affected and controlled by use of large body mass during exercise depending on training volume.
Cardiovascular Physiological Phenomena↗
Variation in applied force during insertion of cemented femoral prostheses.
Information is presented on forces applied to cemented prostheses during insertion. An instrumented femoral pusher was used to collect information during simulated operations on cadavers while using a laboratory test rig and during live surgery. Surgeons using flanged or collared prostheses tend to apply more force than those using collarless prostheses. There is a tendency for abrupt changes in applied force to occur when: 1) clearing cement; 2) easing hand discomfort; and 3) testing cement consistency. Tests showed that an overall impression of the force applied could be obtained from a laboratory simulation, but that clearing cement and testing cement were not modelled by this method. We discuss the implications of our observations in terms of prosthesis fixation and training of staff.
Biomechanical Phenomena↗
Comparison of audible sound transmission with ultrasound in screening for congenital dislocation of the hip.
In a comparative study ultrasound and the sound transmission test were used to seek congenital dislocation of the hip in 102 babies referred to a paediatric orthopaedic clinic. The sound transmission test correctly identified all those hips considered normal or dislocated on ultrasound. 17 babies underwent repeated ultrasound examination for hips considered abnormal but not dislocated. 12 improved and 5 required treatment. With a cut-off decibel difference between the hips of 5.8 dB the sound transmission test correctly identified the dislocated hips but did not detect some of the hips that needed treatment. A cut-off of 5.6 dB reduced the likelihood of a false-negative result while maintaining the sensitivity of the test.
Analysis of Variance↗
Anatomical distribution of soft tissue sepsis sites in intravenous drug misusers attending an accident and emergency department.
Of 77,686 case records of attendance at an accident and emergency department during 1986, 488 (0.6%) contained documented evidence of intravenous drug misuse (IDM). Clinical examination had revealed signs of soft tissue sepsis in 150 (31%) of these, the commonest sites being the wrist and forearm (31% of lesions), the antecubital fossa (19%), fingers and hand (14%) and thigh and groin (11%). These data highlight the anatomical areas to which medical and nursing staff should pay particular attention when examining patients with a background of IDM. Conversely, the presentation of soft tissue sepsis in these sites should alert clinicians to the possibility of underlying IDM.
Abscess↗
Physiological responses to resistance-exercise in athletes self-administering anabolic steroids.
Endocrine and metabolic responses to resistance exercise were compared in 5 athletes self-administering (SL) anabolic steroids and 8 athletes (L) not using these compounds. Exercise consisted of 5 sets of 10 repetitions in the squat and quarter squat. Blood samples were collected before (pre) and immediately after (post) exercise, and following 30 minutes of recovery (post-30). Except for significantly lower lactate concentrations in SL (p less than 0.015) at post-30, the responses to exercise and recovery were similar in both groups. Significantly higher hematocrits (p less than 0.0001), total androgen concentrations (p less than 0.0001), and androgen/cortisol ratios (p less than 0.0001) were observed in the SL group across all time periods. Plasma androgen concentrations increased about 22% in SL following exercise, even though plasma LH concentrations were significantly lower (p less than 0.0001) than in L. Plasma ACTH and cortisol concentrations were not significantly affected. Both groups displayed similar endocrine and metabolic responses to an acute bout of resistance exercise. The higher androgen/cortisol ratios and lower plasma lactate concentrations during recovery are two potential factors which may help explain the lower subjective level of fatigue following training sessions often reported by individuals who use anabolic steroids.
Adrenocorticotropic Hormone↗
[Follow-up data and possibility of cure of borderline cases of personality disorder with inappropriate anger].
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Adolescent↗
Treatment of borderline patients: a pragmatic approach.
Outlined in the preceding sections are what one could call the ABCDs of treating borderline patients. A = analytically informed psychotherapy; B = behavior therapy; C = cognitive therapy; and D = drug therapy. Together they add up to "E": eclectic therapy. In this pragmatic approach, the therapist will assess at the outset (1) amenability to exploratory therapy, but also (2) the need for supportive measures, including education, rehabilitation, and expansion of outside interests, (3) indications for behavioral technics (socially alienating habits, handwashing compulsions, phobias), (4) indications for cognitive measures (conflicts or fears resolvable through rational explanation or logical weighing of alternatives), and (5) indications for pharmacotherapy. All these steps involve the careful weighing of biologic/constitutional, psychodynamic, and, where present, posttraumatic factors, as well as personality assets and habitual problem-solving style. This will help assure against overreliance on a technic that does not fit with the patient's personality and against unwise persistence in a technic that is uncongenial or threatening. Patients already in stable life situations who are seeking help because of life crises may respond well to a brief course of therapy. Borderlines in late adolescence or early adult life, if self-destructive and not yet able to form lasting relationships (or to live contentedly without them), usually require sustained treatment over several years, preferably with the same therapist. Appropriate selection of medications, where indicated, should reduce impulsivity, aggressivity, and psychoticism. This, in turn, will facilitate psychotherapeutic work on maladaptive interpersonal patterns, exaggerated "all-or-none" responses to relatively innocuous stimuli, overpersonalized responses to other people's remarks, and so on. Therapists trained in identical methods will evaluate the same patient in somewhat different ways owing to their differences in personality and perception. This may lead to different sets of priorities and suggests different tactics that are still within the realm of therapeutic efficacy. Those trained primarily in one of the "ABCDs" may have equal success, yet via a different route than the one taken by therapists of a different subspecialty. Borderline patients, perhaps two out of five, often drop out of treatment no matter who the therapist. Yet two out of three patients, if followed long enough, eventually have a good result. One therapist's failure will be his colleague's success, and vice versa. Therapists, to maximize the success of their own efforts, need to be sufficiently steeped in at least one theoretical model of psychopathology/psychotherapy so as not to feel "lost" when confronted by the often bewildering dynamics and symptoms of their borderline patients.(ABSTRACT TRUNCATED AT 400 WORDS)
Borderline Personality Disorder↗
Muscle conditioning and muscle injuries.
Empirical and objective data suggest that muscle and connective tissue can undergo adaptations to physical training resulting in greater tissue mass and increased maximum tensile strength. These adaptations are especially apparent as a result of load bearing and resistive training. Furthermore, information is presented suggesting that pre-conditioning and in-season muscle conditioning, especially strength training, reduce injuries among athletes. Additionally, a theoretical model of training, "periodization", is offered as a method of increasing performance to maximum or optimal values while reducing overtraining and injury potential. Periodization of training can reduce overtraining potential and injury potential while optimizing performance by variation of volume, intensity, and exercise selection during a training program.
Animals↗
Intravenous drug misusers presenting to the accident and emergency department of a large teaching hospital. A failure of clinical management?
The records of all 77,686 attendances at or via the accident and emergency department of the Glasgow Royal Infirmary in 1986 were examined. Of these, 488 (0.6%) contained evidence of intravenous drug misuse (IDM). Most (68%) of the 354 attenders were male. The mean age of attenders in both sexes was 22 years. Over half of the presenting conditions were 'surgical' (mainly abscesses), while 'psychiatric' (including explicitly drug-related) conditions comprised about 30%. In almost two-thirds of cases, patients were discharged without specialist follow-up or care. Only 5% were referred for specialist assessment of their drug misuse. About a fifth were admitted. It is argued that these findings appear to represent a serious a serious failure of clinical management requiring an urgent remedy, particularly in the light of the growing problem of HIV transmission in this group.
Adolescent↗
Some factors affecting the strength of the cement-metal interface.
A manufacturing technique to increase the bonding between bone cement and metal prostheses has been assessed in the laboratory by "push-out" tests, and the effects of contamination of the cement and of the prosthesis with blood and intramedullary contents have been studied. The technique, known as pre-coating, increases bond strength; this increase is preserved after contamination of the cement which does, however, cause some lowering of interface shear strength. The implications for clinical practice are discussed.
Bone Cements↗
The role of pharmacotherapy in the treatment of patients with borderline personality disorder.
Most patients with borderline personality disorder (BPD), especially early in their treatment, will need pharmacotherapy along with supportive or exploratory psychotherapy. A benzodiazepine anxiolytic will suffice for some. Many require more definitive treatment with an antidepressant or a neuroleptic in low dosage. Those with bipolar II comorbidity may benefit from lithium or, if the irritability component is pronounced, from carbamazepine. In practice, a variety of personality factors and comorbid conditions, over-represented in populations of BPD patients, often complicate the clinical picture. Depending upon the mix of these factors, drugs may have to be avoided, nonstandard combinations of drugs may be necessary, or a safer but less effective drug may have to be substituted for a generally more effective drug whose abuse in a suicidal patient might have more dangerous consequences. Examples of complicating factors, namely premenstrual syndrome (PMS), bulimia, agoraphobia, major affective (including bipolar II manic-depressive) disorder, hypersomnia, and so forth are discussed.
Adult↗
Murder.
Kernberg's concept of the malignant narcissist defines a realm of pathologic personality characterized by the coexistence of marked narcissistic and antisocial traits. This realm comprises what may be seen as a continuum of cases: persons at one end whose inhumanity and propensity toward evil are of modest proportions; at the other, persons manifesting extreme degrees of these qualities. The author has used the biographies of notorious murderers in constructing a scale of malignant narcissism. This scale should aid in defining more clearly the limits of amenability to psychotherapy.
Antisocial Personality Disorder↗
The effect of the squat exercise on knee stability.
Past studies have produced conflicting results as to the effect of squat exercises on knee stability. One hundred male and female college students were measured using a knee ligament arthrometer on nine tests of knee stability. Over an 8-wk training program, full or half squats did not consistently affect knee stability compared to non-squatting controls. To measure the effect of long-term squat training 27 male powerlifters (14 Elite or Master Class) and 28 male weightlifters (8 Elite or Master Class) were measured on the same tests. Powerlifters were significantly tighter than controls on the anterior drawer at 90 degrees of knee flexion. Both powerlifters and weightlifters were significantly tighter than controls on the quadriceps active drawer at 90 degrees of knee flexion. Data on powerlifters and weightlifters were also analyzed by years of experience and skill level. No effect of squat training on knee stability was demonstrated in any of the groups tested.
Athletic Injuries↗
Individual psychotherapy with victims of incest.
In treating victims of incest, therapists need to be aware of the gamut of symptoms, personality traits, interpersonal difficulties, and clinical syndromes that occur with special frequency in this population. A list of these features is provided. Vignettes with typical therapist-patient dialogue are offered, demonstrating techniques for handling the initial consultation and opening phase of treatment. During later phases of treatment the focus will usually shift to the discussion of the pertinent symptoms (such as suicidal feelings, substance abuse, dissociative phenomena, sexual disturbances, and distorted self-image). Further on, therapy will focus on abnormal personality traits and attitudes that the incest experience may have set in motion. Examples include mistrustfulness, jealousy, seductiveness, hostility, impulsivity, defiance and emotional volatility. Many incest victims develop borderline personality disorder. Highly polarized attitudes ("splitting") toward sexual partners are characteristic of this group. Therapy relies upon supportive, re-educative, and interpretive work designed to help the victim develop more realistic and integrated views of self and other.
Adaptation, Psychological↗
Long-term follow-up of narcissistic/borderline patients.
In a long-term follow-up study of hospitalized border-line patients with narcissistic traits that either fell short of or fulfilled DSM criteria for narcissistic personality disorder (NPD), outcome was similar to outcome in the borderline group as a whole. An exception was encountered in the subgroup of narcissistic borderlines who also showed marked antisocial traits: poor outcome was the rule in this subgroup. In general, borderlines with NPD tended to be male and to be more at risk for suicide than non-NPD borderlines.
Adolescent↗
Implications for connective tissue and bone alterations resulting from resistance exercise training.
Few studies have addressed the effects of resistance training on connective tissue. Inferences from studies investigating the effects of endurance training or "loaded" exercise training can be made. The available data suggest that 1) physical activity can increase connective tissue strength and mass, 2) activation of the antigravity muscles must be accomplished to adequately stimulate connective tissue, and 3) the volume, intensity, and load-bearing nature of the exercise training are important factors in causing connective tissue adaptations. Based on the above factors, a speculative model of training for increased maximum strength of connective tissue has been developed.
Adaptation, Physiological↗
Another clinical test for congenital dislocation of the hip.
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Child, Preschool↗