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The neurobiology of pleasure, reward processes, addiction and their health implications.

Modern science begins to understand pleasure as a potential component of salutogenesis. Thereby, pleasure is described as a state or feeling of happiness and satisfaction resulting from an experience that one enjoys. We examine the neurobiological factors underlying reward processes and pleasure phenomena. Further, health implications related to pleasurable activities are analyzed. With regard to possible negative effects of pleasure, we focus on addiction and motivational toxicity. Pleasure can serve cognition, productivity and health, but simultaneously promotes addiction and other negative behaviors, i.e., motivational toxicity. It is a complex neurobiological phenomenon, relying on reward circuitry or limbic activity. These processes involve dopaminergic signaling. Moreover, endorphin and endogenous morphinergic mechanisms may play a role. Natural rewarding activities are necessary for survival and appetitive motivation, usually governing beneficial biological behaviors like eating, sex and reproduction. Social contacts can further facilitate the positive effects exerted by pleasurable experiences. However, artificial stimulants can be detrimental, since flexibility and normal control of behavior are deteriorated. Additionally, addictive drugs are capable of directly acting on reward pathways. Thus, the concrete outcome of pleasant experiences may be a question of dose. Moderate pleasurable experiences are able to enhance biological flexibility and health. Hence, pleasure can be a resistance resource or may serve salutogenesis. Natural rewards are mediated by sensory organ stimulation, thereby exhibiting a potential association with complementary medical approaches. Trust and belief can be part of a self-healing potential connected with rewarding stimuli. Further, the placebo response physiologically resembles pleasure phenomena, since both involve brain's reward circuitry stimulation and subjective feelings of well-being. Pleasurable activities can stimulate personal growth and may help to induce healthy behavioral changes, including stress management. However, more research is needed to better understand the nature, neurobiology and maybe dangerous aspects of pleasure. Also, a possible involvement of endogenous morphinergic signaling has to be studied further.

Behavior, Addictive↗

The ethics of safe sex.

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Acquired Immunodeficiency Syndrome↗

Project Redirection: evaluation of a comprehensive program for disadvantaged teenage mothers.

An evaluation of Project Redirection, a two-year demonstration program designed to help pregnant teenagers and teenage mothers, shows that teenagers from a comparison group, who were not enrolled in the demonstration program, were significantly more likely than project participants to experience a repeat pregnancy after one year, but that after two years the difference was small and nonsignificant. Likewise, at 12 months into the program, the project participants proved more likely to be using contraceptives, but by 24 months the comparison group had caught up. After one year of participation, the project teenagers were more likely than the others either to be in school or to have graduated (56 and 49 percent, respectively). However, this differential also disappeared by 24 months. Nonetheless, even at that point, project teenagers who had dropped out prior to joining the program and those who had had a repeat pregnancy were more likely to be in school or to have completed school than were similar comparison teens. Project teenagers also were somewhat more likely to have held a job during the two-year period than were teenagers not enrolled in the program. All in all, the evaluation demonstrated that teenagers who participated in the project and remained in it for more than a year had consistently better outcomes in education, employment and repeat pregnancy than any other group had. Comparison teenagers who had never participated in any special program for pregnant teenagers, on the other hand, demonstrated consistently poorer outcomes than any other group.

Adolescent↗

Effects of chronic lead ingestion on social development in infant rhesus monkeys.

The social behavior of infant rhesus monkeys during the first year of life was examined under a variety of lead (Pb) exposure conditions in four separate experiments. Daily ingestion of PB acetate in milk for one year elevated blood Pb levels to 30-100 microgram/dl, suppressed play, increased social clinging, and exacerbated the disruption of social behavior caused by changing the play environment midway through the year of observation. The presence of control monkeys in social test-groups reduced the magnitude of Pb-induced social behavior changes. In contrast to daily postnatal Pb exposure, chronic exposure to Pb during gestation had no measurable effect on postnatal social development, and acute, transient postnatal Pb exposure (producing blood Pb levels > 200 microgram/dl during month 2 of life) affected only the monkeys' response to the change in the plan environment. These data suggest that daily ingestion of Pb, and not a previously-acquired tissue burden, was responsible for the long-term changes in social development observed. The results are discussed in the general context of primate social development, which is thought to require adequate interactive play for appropriate social integration and reproductive behavior at maturity.

Aging↗

The development of menstrual-related beliefs and behaviors during early adolescence.

Adolescent girls' menstrual-related beliefs and behaviors are examined from a developmental perspective. 2 studies, 1 cross-sectional and 1 longitudinal, were conducted. In the first, 639 girls in grades 5-6, 7-8, and 11-12 were seen. In the second, 46 pairs of girls were seen twice: all were premenarcheal at the first testing; at the second testing, one-half had begun to menstruate in the last few months and one-half were a matched premenarcheal comparison group. Girls answered questions on menstrual symptomatology, menstrual-related attitudes, and potential informational sources. 3 questions were asked in the present study: (1) What are the expectations for menstrual symptoms that girls hold prior to menstruation and when do these develop? (2) How do expectations for menstrual symptoms and beliefs relate to the actual experience of menarche? (3) What are the sources of information for menstruation and do they relate to subsequent menstrual-related behavior? First, as early as fifth grade, premenarcheal girls had clear expectations regarding menstrual symptoms; their expectation that cycle-related changes would occur paralleled the changes reported by adult and older adolescent women. Second, girls who had begun to menstruate reported experiencing less severe menstrual distress (less pain, water retention, negative affect, and behavioral changes, and more concentration) than the premenarcheal comparison group expected to experience. In addition, early symptom expectations were positively related to later-reported menstrual distress (pain, water retention, and behavioral change) in the changing-menarcheal-status group. Third, there were few changes in the amount learned from various sources as a function of menarcheal status. However, correlational analyses indicate that girls who learned more from male sources rated menstruation as more debilitating and negative than those girls who learned less from male sources. The importance of socialization in the emergence of menstrual distress and negative menstrual attitudes is discussed.

Adolescent↗

AIDS in sub-Saharan Africa: the epidemiology of heterosexual transmission and the prospects for prevention.

As the epidemic of the acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa enters its second decade, much has been learned about the distribution and determinants of the disease and its causative agent, the human immunodeficiency virus (HIV). Over 6 million people, or 2.5% of the adult population, are thought to be infected with HIV. The distribution of HIV is largely determined by sexual behavior; as for other sexually transmitted diseases, the characteristics of sexual networks determine the extent and rate of spread of HIV. Female sex workers and their male clients are at high risk for HIV and have been important in initiating the epidemic in many African countries. The dynamics of HIV in the rest of the population are complex; men with multiple sexual partners are largely responsible for transmission of HIV to women in the general population. Other sexually transmitted diseases and lack of male circumcision may increase the probability of transmission of HIV during sexual intercourse and probably are partially responsible for the rapid diffusion of HIV in Africa. Interventions among high-risk groups are needed, but they must be accompanied by attempts to induce behavior change among men and women in the general population. Epidemiologic studies of the determinants of sexual behavior and sexual contact patterns, as well the design and evaluation of interventions, are urgently needed. Key areas for development are the study of behavioral exposures and outcomes, the evaluation of interventions, developing new methods for conducting interventions in resource-poor environments, and increasing the number of African scientists with the skills and resources to conduct epidemiologic studies.

Acquired Immunodeficiency Syndrome↗

Influence of tapeworm infection on the production of aggregation pheromone and defensive compounds in Tribolium castaneum.

Recent studies suggest that parasites affect host development, reproduction, and behavior through alterations of host hormones and pheromones, or other hormone-triggered biochemical events. We previously reported that Hymenolepis diminuta infection affects surface-seeking and cannibalism behaviors, and reduces male sperm precedence of Tribolium castaneum beetles. This study examined the quantitative effects of H. diminuta on the production of aggregation pheromone and 3 defensive compounds in male T. castaneum beetles, using 2 wild-caught, geographically distinct T. castaneum strains. For the c-Madison strain, infected beetles exhibited a 2- to 22-fold increase in defensive compounds; conversely, no changes were observed in strain c-Africa. Parasite infection did not significantly influence aggregation pheromone secretion in either strain. Because defensive compounds function as repellents or deterrents to other insects, parasite-induced increases in the secretion of defensive compounds may be a physiologic clue for the behavioral changes in infected T. castaneum beetles. Significant among-strain variation in defensive compound production seen in infected beetles suggests that caution is needed before generalizing about changes in volatile production and in host behavior induced by a parasite.

Analysis of Variance↗

Men's behavior change following infection with a sexually transmitted disease.

An analysis of data on 20-39-year-old men participating in the 1991 National Survey of Men finds that of 466 respondents who had ever had a sexually transmitted disease (STD), 25% had sex while infected. However, 85% of these men informed their partner of their infection before having intercourse. Black men were significantly less likely than whites to have had sex while infected. Overall, 29% of men with an STD did not modify their sexual behavior or condom use. Blacks, married men and men who were affiliated with a religious group were less likely than whites, single men and those with no religious affiliation to maintain the same behavior subsequent to the diagnosis of an STD infection as before. Black men were more likely than whites to start using condoms; blacks, religious men, less-educated men and those who were older when they had their first sexual experience were the most likely to stop having sex with casual partners once they learned that they were infected with an STD.

Adult↗