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PubMed2004

Affect dysregulation in the mother-child relationship in the toddler years: antecedents and consequences.

The purpose of this study was to examine child, maternal, and family antecedents of children's early affect dysregulation within the mother-child relationship and later cognitive and socioemotional correlates of affect dysregulation. Children's affect dysregulation at 24 and 36 months was defined in the context of mother-child interactions in semistructured play and toy cleanup. Dyads were classified as dysregulated at each age based on high negative affect. Affect dysregulation was associated with less maternal sensitivity and stimulation, more maternal depressive symptoms, and lower family income over the first 36 months of life. Children with early negative mood, lower Bayley Mental Development Index scores and insecure-avoidant (15 months) or insecure-resistant attachment classifications (36 months) were more likely to be in an affect-dysregulated group. Controlling for family and child variables, affect-dysregulated children had more problematic cognitive, social, and behavioral outcomes at 54 months, kindergarten, and first grade. The findings are discussed in terms of the early role played by parents in assisting children with affect regulation, the reciprocal nature of parent-child interactions, and the contribution of affect regulation to children's later cognitive, social, and behavioral competence.

Adult↗
PubMed1999

The biological affects: a typology.

This typology of biological affects is based on developmental-interactionist theory of motivation, emotion, and cognition. Affects--subjectively experienced feelings and desires--involve interoceptive perceptual systems based on primordial molecules that characterize neurochemicals. Biological affects involve primary motivational-emotional systems (primes) associated with hierarchically organized neurochemical systems in the brain, including subcortical (reptilian) and paleocortical (limbic) brain structures. Affects fulfill individualistic (selfish) functions (arousal, approach-avoidance, agonistic) and prosocial (cooperative) functions. Selfish and cooperative functions are associated respectively with the right and left hemispheres. Biological affects constitute the physiological bases for higher level affects: social affects (e.g., pride, guilt, shame, pity, jealousy), cognitive affects (e.g., curiosity, surprise), and moral affects.

Animals↗
PubMed1994

Affectivity in cocaine and opiate abusers.

Psychoanalytic theorists concerned with substance abuse suggest that the affect tolerance and affect expression of addicts are impaired due to preverbal influences. However, psychoanalytic contributions have largely been limited to clinical speculations and case study reports. The present study investigated the hypotheses that opiate abusers will demonstrate more impaired affect tolerance and affect expression than cocaine abusers, and that both groups would appear more impaired than a sample of normals. To investigate these hypotheses, a recently developed instrument, the Epigenetic Assessment Rating System (EARS), was employed. The EARS empirically measures verbal and preverbal phenomena theoretically linked with stages of development. The subjects were 25 opiate, 25 cocaine abusers, and 25 normals, matched according to age, gender, and SES criteria. Results supported the hypotheses that opiate and cocaine abusers' affect tolerance and affect expression were significantly impaired as compared to normals. Although affect tolerance did not distinguish between opiate and cocaine abusers, affect expression did. Cocaine abusers were less impaired than opiate abusers by preverbal modes of affect expression, although under stress cocaine abusers regressed to similar states.

Adult↗
PubMed2000

Modeling the relationship between affective lability, impulsivity, and suicidal behavior in patients with borderline personality disorder.

This article reviews the concept of affective lability and suggests that new models are needed to characterize the relationship between affective states such as affective lability, impulsivity, and suicidal behavior. The association of affective lability, impulsivity, and suicidal behavior is most relevant to understanding the risk of suicide in individuals with borderline personality disorder. The relationship between affective lability and suicide might be explained as 1) a form of bipolarity, 2) a form of impulse dyscontrol, 3) a quantitative disorder of affect, or 4) an environmental reactivity. Our opinion of the relevant literature suggests that a quantitative disorder of affect accompanied by the inability to control these affects are the essential components leading to the risk of suicidal behavior. Characterizing the dyscontrol and high intensity of affect leads to a reconceptualization of depression in patients with borderline personality disorder and to a re-examination of the causal chain of events leading to suicidal behavior. The implications for clinical practice resulting from the proposed model are discussed.

Journal Article↗
PubMed1998

A quantitative immunohistochemical evaluation of inflammatory cells at the affected and unaffected sites of inflammatory bowel disease.

Levels of T lymphocytes, histiocytes and mast cells have been reported to be increased in the affected mucosa of Crohn's disease (CD) and ulcerative colitis (UC), but the colorectal distribution of these cells is not fully understood. We hypothesized that differences in cell densities between CD and UC would be characteristic, not only in the affected, but also in the unaffected mucosa. The aims of the present study were to clarify whether there were any differences in cell densities in CD, UC and infectious colitis (IC) in the affected mucosa and between CD and UC in the unaffected mucosa. Using mouse monoclonal antibodies recognizing memory T cells (OPD4), cytotoxic/suppressor T cells (C8/144B), histiocytes (PG-M1) and mast cells (AA1), we evaluated mucosal cell densities in biopsy specimens from both endoscopically affected and unaffected sites of CD (n = 12) and UC (n = 15) and from affected sites of IC (n = 10). Ten normal controls were also examined. At affected sites, all cells were significantly more abundant in UC than in the other conditions, except that the density of PG-M1+ in CD was similar to that seen in UC. Although the densities of OPD4+ and C8/144B+ cells at unaffected sites were slightly higher in both CD and UC and in UC, respectively, there was no significant difference in cell densities between CD and UC. The ratio of OPD4+ cell density at affected sites to that at unaffected sites was appreciably higher in UC than in CD. The results suggest that a common feature of UC and CD is an increase in PG-M1+ cells at the affected mucosa but that the other inflammatory cells studied are more abundant, particularly in UC, and that the difference between UC and CD is conspicuous when comparing the OPD4+ cell density of the affected mucosa with that of the unaffected mucosa.

Adult↗
PubMed1987

The affected sib method. V. Testing the assumptions.

The affected sib methods, which are used to make inferences about the genetic components of HLA associated diseases, have many underlying assumptions which may not always be realistic. These include no selective disadvantage of affected individuals, little or no recombination between the marker loci and the 'disease' locus, a single panmictic population, Mendelian segregation of the disease locus alleles and random distribution of individuals over environments. The effects of breaking these assumptions have been investigated. We have explicitly derived the haplotype sharing identity by descent (IBD) expectations for the cases of selection against affected individuals and recombination between the HLA marker loci and the 'disease' predisposing locus for affected sib trios (as was previously done for affected sib pairs). We have also derived, for both affected sib pairs and trios, the haplotype sharing expectations for non-random mating (positive assortative), admixture, meiotic drive (of disease allele carrying haplotypes), and a random versus shared environmental component for sibs. In order to assess the sensitivity of the affected sib methods to perturbations in the assumptions, the expectation spaces of haplotype sharing in affected sib pairs and sib trios under the single diallelic locus model with varying penetrances and allele frequencies are fully described. The effects on haplotype sharing and subsequent disease parameter estimation are different for each of the factors we have considered. The affected sib methods are found to be robust in many situations.

Alleles↗
PubMed2000

A child's experience of parental depression: encouraging relational resilience in families with affective illness.

In this article, we describe an approach that parents with affective illness can use to foster the emotional resilience of their children. Building on current research that emphasizes the need to formulate concepts of risk and resilience in terms of family or relational processes, we propose that affectively ill parents can promote resilience in their children by helping them express the affect they experience as a result of parental illness-related behavior. Risk and resilience are conceptualized in terms of a family's ability to process emotion or affect: a family's need to constrict affect is a risk factor, while the family's ability to elaborate affect encourages relational resilience. An object relations model is used to discuss the ways in which encouraging this elaboration of affect, especially negative affect, contributes to resilience in children. We describe ways in which a preventive intervention helps to increase parents' emotional responsiveness to their children. Using extensive narrative data from followup interviews with families and children, constriction and expansion of emotion in children concerning affectively ill parents are documented, by multiple interviewers, over a span of more than 5 years.

Adaptation, Psychological↗
PubMed1983

Sweet itch: responses of clinically normal and affected horses to intradermal challenge with extracts of biting insects.

In a study of the skin reactivity of horses with lesions of sweet itch, six clinically normal horses and seven affected horses were challenged intradermally with extracts of Culicoides, Stomoxys, Tabanidae and Culex species. All the affected horses and three of the normal horses responded strongly to the culicoides extract. The skin reactions in the affected horses reached their maxima within 4 h in the majority of animals. Skin reactivity to culicoides was transferred to normal horses with serum from affected animals confirming that the reaction was an immediate hypersensitivity reaction. Three of the seven affected animals gave both immediate and delayed reactions when challenged with the culicoides extract. When the dermal reactions of 12 clinically normal and 10 affected horses were compared at 20 mins and 1 h after challenge, the reactions produced by the culicoides extract were significantly (P less than 0.025) greater in the affected than in the normal horses. Individual horses gave strong reactions to extracts of Stomoxys, Culex and Tabanidae species, but no consistent response was evident among the affected animals. Serum from horses with sweet itch sensitised the skin of normal horses to challenge with extracts of the biting flies and the transferred antibodies remained bound to the skin of the recipient horse for 72 h or longer. Although some variation among the affected horses occurred in passive transfer experiments, the response to Culicoides species extracts was consistently greater than for the other insect extracts tested.

Animals↗
PubMed1993

Shifts in diagnostic frequencies of schizophrenia and major affective disorders at six North American psychiatric hospitals, 1972-1988.

OBJECTIVE: This study tested the impression that there have been significant shifts in the relative diagnostic frequencies of schizophrenia and major affective disorders. METHOD: Data on discharge diagnoses from 1972 to 1988 were gathered from six North American psychiatric teaching hospitals (data from one extended through 1991), and rates for schizophrenia and major mood disorders were evaluated. RESULTS: Total annual discharges increased by 6.6% during the study period. Large reciprocal shifts in the frequencies of diagnoses of schizophrenia and major affective disorders were found; schizoaffective disorder was a minor diagnosis. Beginning in the early 1970s, a gradual increase in the frequency of diagnoses of major affective disorders at all sites was accompanied by a corresponding decrease in diagnoses of schizophrenia at five of the six centers. Schizophrenia diagnoses decreased from a peak of 27% in 1976 to 9% in 1989 (a threefold decrease), and diagnoses of major affective disorders rose from a low of 10% in 1972 to 44% in 1990 (a fourfold increase). CONCLUSIONS: Several forces may have influenced these changes. 1) DSM-III narrowed the definition of schizophrenia and broadened the category of major affective disorders. 2) Treatment-oriented diagnostic bias associated with the availability of lithium and other mood-altering agents may have encouraged consideration of affective disorders. 3) Economic and social forces, including better third-party reimbursement rates, may have favored affective diagnoses. 4) True increases in the incidence of affective disorders may have occurred. 5) Although a real decrease in new cases of schizophrenia may have occurred, this effect was probably minor and dominated by a larger shift of such diagnoses to affective categories.

Canada↗
PubMed1994

Influence of clinical subtype, sex, and lineality on age at onset of major affective disorder in a family sample.

OBJECTIVE: The authors analyzed data from a family sample ascertained for a genetic linkage study of bipolar disorder to address the following questions: Do the major clinical subtypes of familial affective disorder have distinct distributions of age at onset? What factors other than clinical subtype affect these distributions? After controlling for these factors, do the differences in age at onset persist among the subtypes? METHODS: Eighty-two families were ascertained through a treated proband with bipolar disorder who had a family history of two or more affected siblings or one affected sibling and one affected parent. After participating in an interview conducted by a psychiatrist using the Schedule for Affective Disorders and Schizophrenia--Lifetime Version, 274 probands and their first-degree relatives were diagnosed as having bipolar I, bipolar II, or recurrent unipolar disorder according to Research Diagnostic Criteria. Age at first major affective episode and other clinical data were collected. RESULTS: Onset age distributions were similar for bipolar I and bipolar II disorder but significantly different for recurrent unipolar disorder. This finding persisted after adjustment for a significantly earlier onset among females. Subjects with affective disorder in both parental lines (bilineal) also experienced a significantly earlier onset. Substance abuse, physical illness, and sex of the affected parent had no significant impact on onset age. CONCLUSIONS: Although differences in age at onset may reflect several factors, these results provide indirect support for the view that bipolar I and bipolar II disorders are genetically related phenotypes and suggest that bilineal families may be more complex than previously assumed.

Adolescent↗
PubMed2005

The Addenbrooke's cognitive examination (ACE) in the differential diagnosis of early dementias versus affective disorder.

OBJECTIVE: The authors describe the profile of performance of patients whose cognitive complaint is due to dementia, affective disorder, or combinations thereof on the Addenbrooke's Cognitive Examination (ACE) test battery. METHODS: Authors tested 90 subjects with dementia (63 Alzheimer disease [AD]; 27 fronto-temporal dementia [FTD]), 60 subjects with "pure" affective disorder (23 major depression [MDD], 37 whose affective symptoms did not meet criteria for major depression [Affective]); 22 patients with symptoms of affective disorder and organic dementia (Mixed); and 127 healthy volunteers (NC). RESULTS: The total ACE scores for the AD, FTD, and Mixed groups were significantly lower than for the NC group. Likewise, on total score, the AD and FTD groups scored significantly lower than either of the "pure" affective-disorder groups. Within the dementia group, the AD group scored significantly lower than the fronto-temporal group. CONCLUSIONS: The profile of performance on the ACE of patients with dementia is different from that of patients suffering from affective illness. Mild impairment in the total ACE score, along with a low score on the memory domain tasks and letter fluency (in contrast to normal category fluency), are strongly indicative of an affective, as opposed to organic, pathology. A total score of <88 in suspected dementia patients with affective symptoms appears strongly predictive of an underlying organic disorder.

Age Factors↗
PubMed2005

Familial variation in episode frequency in bipolar affective disorder.

OBJECTIVE: Bipolar affective disorder is a familial illness characterized by recurrent episodes of mania and depression, but little is known about the familial nature of episode recurrence or its associated clinical features. The authors analyzed the recurrence frequency of affective episodes (episode frequency), along with associated clinical and demographic variables, in families with at least three members with a major affective disorder. METHOD: Members of 86 families ascertained through probands with bipolar affective disorder who had two or more first-degree relatives with a major affective disorder were interviewed by psychiatrists and assigned an all-sources diagnosis. Data for 407 subjects with a major affective disorder were analyzed. Episode frequency was estimated as the number of episodes of major depression, mania, and hypomania per year of illness. RESULTS: Episode frequency was smoothly distributed over the range of 0.02-20.2 episodes/year. Episode frequency was significantly correlated among relatives (r=0.56, p<0.004). Earlier age at onset, bipolar II disorder, hallucinations or delusions, alcoholism, and suicidal behavior were all more prevalent in the highest than in the lowest quartiles of episode frequency. Female gender and recurrent major depression were more prevalent in the lowest quartile. Panic disorder, substance abuse, and thyroid disease were all unrelated to episode frequency. Subjects with DSM-IV rapid cycling did not differ from other affected subjects for most of the variables tested. CONCLUSIONS: Episode frequency is a highly familial trait in bipolar affective disorder, associated with several indicators of severity, and may be useful in defining clinical subtypes of bipolar affective disorder with greater genetic liability. DSM-IV rapid cycling was not supported by these data as the best predictor of familiality or severity.

Adult↗
PubMed2006

How dietary arachidonic- and docosahexaenoic- acid rich oils differentially affect the murine hepatic transcriptome.

INTRODUCTION: Herein, we expand our previous work on the effects of long chain polyunsaturated fatty acids (LC-PUFA) on the murine hepatic transcriptome using novel statistical and bioinformatic approaches for evaluating microarray data. The analyses focuses on key differences in the transcriptomic response that will influence metabolism following consumption of FUNG (rich in 20:4n6), FISH (rich in 20:5n3, 22:5n3, and 22:6n3) and COMB, the combination of the two. RESULTS: Using a variance-stabilized F-statistic, 371 probe sets (out of 13 K probe sets in the Affymetrix Mu11K chip set) were changed by dietary treatment (P < 0.001). Relative to other groups, COMB had unique affects on murine hepatic transcripts involved in cytoskeletal and carbohydrate metabolism; whereas FUNG affected amino acid metabolism via CTNB1 signaling. All three diets affected transcripts linked to apoptosis and cell proliferation, with evidence FISH may have increased apoptosis and decreased cell proliferation via various transcription factors, kinases, and phosphatases. The three diets affected lipid transport, lipoprotein metabolism, and bile acid metabolism through diverse pathways. Relative to other groups, FISH activated cyps that form hydroxylated fatty acids known to affect vascular tone and ion channel activity. FA synthesis and delta 9 desaturation were down regulated by COMB relative to other groups, implying that a FA mixture of 20:4n6, 20:5n3, and 22:6n3 is most effective at down regulating synthesis, via INS1, SREBP, PPAR alpha, and TNF signaling. Heme synthesis and the utilization of heme for hemoglobin production were likely affected by FUNG and FISH. Finally, relative to other groups, FISH increased numerous transcripts linked to combating oxidative such as peroxidases, an aldehyde dehydrogenase, and heat shock proteins, consistent with the major LC-PUFA in FISH (20:5n3, 22:5n3, 22:6n3) being more oxidizable than the major fatty acids in FUNG (20:4n6). CONCLUSION: Distinct transcriptomic, signaling cascades, and predicted affects on murine liver metabolism have been elucidated for 20:4n6-rich dietary oils, 22:6n3-rich oils, and a surprisingly distinct set of genes were affected by the combination of the two. Our results emphasize that the balance of dietary n6 and n3 LC-PUFA provided for infants and in nutritional and neutraceutical applications could have profoundly different affects on metabolism and cell signaling, beyond that previously recognized.

Animals↗
PubMed1996

Mutations affecting the cardiovascular system and other internal organs in zebrafish.

In a screen for early developmental mutants of the zebrafish, we have identified mutations specifically affecting the internal organs. We identified 53 mutations affecting the cardiovascular system. Nine of them affect specific landmarks of heart morphogenesis. Mutations in four genes cause a failure in the fusion of the bilateral heart primordia, resulting in cardia bifida. In lonely atrium, no heart venticle is visible and the atrium is directly fused to the outflow tract. In the overlooped mutant, the relative position of the two heart chambers is distorted. The heart is enormously enlarged in the santa mutant. In two mutants, scotch tape and superglue, the cardiac jelly between the two layers of the heart is significantly reduced. We also identified a number of mutations affecting the function of the heart. The mutations affecting heart function can be subdivided into two groups, one affecting heart contraction and another affecting the rhythm of the heart beat. Among the contractility group of mutants are 5 with no heart beat at all and 15 with a reduced heart beat of one or both chambers. 6 mutations are in the rhythmicity group and specifically affect the beating pattern of the heart. Mutations in two genes, bypass and kurzschluss, cause specific defects in the circulatory system. In addition to the heart mutants, we identified 23 mutations affecting the integrity of the liver, the intestine or the kidney. In this report, we demonstrate that it is feasible to screen for genes specific for the patterning or function of certain internal organs in the zebrafish. The mutations presented here could serve as an entry point to the establishment of a genetic hierarchy underlying organogenesis.

Animals↗
PubMed2002

The affective beneficence of vigorous exercise revisited.

OBJECTIVES: High exercise intensity may be associated with reduced adherence to exercise programmes, possibly because it is perceived as aversive. However, several authors have suggested that an intensity as high as 60% or 70% of maximal aerobic capacity (VO(2max)) is necessary for exercise to elicit positive affective changes. To elucidate this discrepancy, the affective responses to increasing levels of exercise intensity were examined. DESIGN: In total, 30 volunteers rated their affect every minute as they ran on a treadmill while the speed and grade were progressively increased. METHOD: The methodology was unique in three respects: (1) affect was assessed in terms of the dimensions of the circumplex model instead of distinct affective states, (2) affect was assessed repeatedly before, during, and after exercise, not only before and after, and (3) exercise intensity was standardized across participants in terms of metabolically comparable phases (beginning, ventilatory threshold, VO(2max)) instead of percentages of maximal capacity. RESULTS: Pre-to-post-exercise comparisons indicated affective benefits in the form of increased energetic arousal and decreased tense arousal. During exercise, however, affective valence deteriorated beyond the ventilatory threshold and until VO(2max), a trend that reversed itself instantaneously during cool-down. CONCLUSIONS: Exercise intensity that requires a transition to anaerobic metabolism can have a transient but substantial negative impact on affect and this may, in turn, reduce adherence to exercise programmes.

Journal Article↗
PubMed2000

National and state policies influencing the care of children affected by AIDS.

The portrait of HIV-affected children and youth that emerges from this policy overview is still one of children obscured from view by the shadow of their parents' and siblings' illness and policies that only address the needs of HIV-infected individuals. In addition, the secrecy and stigma that still surround HIV and AIDS make it difficult for HIV-affected children and youth to benefit as fully as they might from policies and programs that provide more generic types of care and assistance. Our failure as a nation to better illuminate the plight of HIV-affected children and youth can only leave us with a generation of children who are at greater risk of psychiatric illness, involvement with the criminal justice system, substance abuse, and contracting HIV. To avoid these consequences, both public and private sectors must place the spotlight on the development of new policies and programs designed to specifically meet their needs. Because the solutions defy traditional disciplinary and administrative boundaries, we also need to become more skilled at interagency planning and collaboration. No one system alone can be responsive to the many social, mental health, legal, and support needs of these children and their caretakers. More specifically, recommendations for improved systems of care to HIV-affected children, youth, and their families are as follows: To promote and fund cross-disciplinary initiatives among agencies that administer child welfare services, income supports, AIDS care, and children's mental health services at the national, state, and local levels to specifically meet the mental health, psychosocial, and permanency planning needs of HIV-affected children and youth. To provide training opportunities for Ryan White Title I, II, and III case managers on assessing the needs of HIV-affected children and youth, developmental theories and concepts, principles of family-centered care, and child welfare issues. To increase funding of the Ryan White CARE Act to permit a more family-centered approach to care across Titles. To establish clearer guidelines for establishing a proportional basis for funding services to infants, children, and women under the Ryan White CARE Act. To support legislative, educational, and advocacy efforts to make managed care and welfare reform more responsive to the needs of HIV-affected children, youth, and their families. To encourage states to provide additional funding for mental health services specifically targeted to HIV-affected children and youth that are sufficiently flexible and of a long enough duration to adequately meet their needs. Surely, as we move into a new millennium with the capacity to map the human genome and clearly view distant galaxies, we should be able to marshal the will and resources necessary to formulate a sufficiently focused effort to respond compassionately and effectively to the needs of a generation of AIDS-affected children and youth.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Bond strengths of single-bottle dentin adhesives to caries-affected dentin.

There is concern that some acidic conditioners may not be strong enough to adequately etch sclerotic or caries-affected dentin. The hypothesis that was tested was that there were no significant differences in the bond strengths of single-bottle bonding systems to normal or caries-affected dentin, regardless of the strength of the phosphoric-acid conditioner. Extracted teeth with coronal caries extending into mid-dentin were prepared by grinding the occlusal surface flat. This left a central region of caries-affected dentin surrounded by normal dentin. The One-Step bonding system was used to bond dentin following etching with 10 or 32% phosphoric acid. The Single Bond system was used after etching dentin with 10 or 35% phosphoric acid. After 24 hours in water, serial vertical sections were made through the bonded teeth to create slabs 0.7 mm thick. Each tooth yielded four to five slabs, some of which included normal dentin, while others included caries-affected dentin. Each slab was trimmed into an hourglass configuration to limit the test area to normal or caries-affected dentin. The results obtained with One-Step following etching with 10% phosphoric acid showed lower (P < 0.05) tensile bond strengths to caries-affected dentin compared to normal dentin (36.9 +/- 8.0 MPa vs 47.7 +/- 6.5 MPa, respectively). This difference disappeared when using 32% phosphoric acid (49.7 +/- 6.1 MPa vs 45.0 +/- 7.2 MPa, respectively). Bonds made to caries-affected dentin with Single Bond were always lower than bonds to normal dentin regardless of the strength of the phosphoric acid. Scanning electron microscopy of polished cross sections sequentially challenged with acid and NaOCl revealed loss of the middle of the hybrid layers created by either bonding system in caries-affected dentin etched with 10% phosphoric acid. It is clear that 32-35% phosphoric acid is required to adequately etch caries-affected dentin in order to produce high bond strengths and well-infiltrated demineralized dentin.

Acid Etching, Dental↗
PubMed1989

Affectional touch in critical care nursing: a descriptive study.

The purpose of this study was to describe selected qualitative and quantitative factors present in nursing situations involving affectional touch. Natural field observation of 30 nurse-patient dyads in three hospital critical care units yielded frequency data in four categories: form of affectional touch, Weiss' qualitative factors, accompaniments, and stimulus. Frequencies of affectional touch and of proximity without touch were also obtained. Modal instances of affectional touch in a 1-hour period were 2, with a range of 0 to 17. Form of affectional touch most frequently used was sustained stationary, with stroking least frequent. The majority of instances of affectional touch were of short duration and low intensity, with visible reaction indicating comfort in approximately two thirds of the instances. Almost three fourths of the instances were accompanied by visual regard and two thirds by vocalization. Patient stimulus before affectional touch was indirect in 52% of the instances and unidentified in another 32%. This study provides clear evidence that, although the use of touch as a nursing comfort measure is widely advocated, affectional touch is infrequent. These results provide information useful to the further development of prescriptive theory for affectional touch in nursing practice situations.

Adult↗