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PubMed1975

The therapeutic aspects of affect.

A satisfactory psychoanalytic definition and theory of affects has not yet been evolved. In spite of this, analysts work with affects using, for practical purposes, a common-sense definition leading to a therapeutic advantage in coordinating affective and cognitive structures as they appear in the course of a prolonged analysis. Undoing of defenses facilitates this process, allowing the ego's integrative capacities to function more adequately and satisfactorily in relation to inner and outer reality. A developmental hierarchy of affects emerges in this way ranging from primitive--all or none--affective experiences to adult, modified expression of such ego experiences. A brief historical survey of the changing forms of the theory of affects is included, as are clinical vignettes illustrating the therapeutic aspects of dealing with affective expression in the psychoanalytic situation. The therapeutic gains of such work comes about through the integration of earlier affective experiences into more developed cognitive structures allowing a variety of ego functions greater control over adult experiences.

Affect↗
PubMed1980

Adaptive functions of affect and their implications for therapy.

The adaptive functions of affects are formulated in relation to hierarchical conception of ego organization based on object-relations theory. Ego states are defined as relationship paradigms, consisting of particular self- and object representations and associated affective qualities of relatedness. Affect that is integrated in a conscious ego state as part of an experience of relatedness is distinguished from affect that occurs as an isolated mental content at the structurally subordinate level of cognition. In the latter form, affect may function as a signal of disequilibrium to the ego, potentially resulting in consolidation of the ego state in consciousness and awareness of the associated relationship. The potential signal properties of the wide range of affects are best understood on the basis of the associated object-relations paradigms. Affect provides especially useful interpretive material for both therapist and patient because of its intrinsic association to ego states and object relations. However, the fashion in many current therapies of encouraging affect expression for its own sake is often misdirected; it is better to orient the work more directly toward understanding and altering object relations.

Adaptation, Psychological↗
PubMed1997

Affective responses to acute exercise: a test of opponent-process theory.

Based on Solomon's Opponent-Process theory (1980), it was predicted that individuals involved in a regimen of regular aerobic exercise (active; n = 18) would respond to an acute bout of exercise with reduced negative and/or increased positive affect compared to nonactive counterparts (nonactive; n = 12). State Anxiety (SA), positive affect (PA), negative affect (NA), and self-reported fatigue were assessed immediately prior to, every 6 min during, and every 6 min following a 24 min bout of bicycle exercise performed at an RPE of 13 (+/- 1). As expected, no significant group differences occurred for RPE (M = 13.5 for nonactive, 13.2 for active). The active group did, however, exercise at a greater absolute workload than the nonactive group (261.0 +/- 22.4 W vs 200.0 +/- 19.98 W, respectively). Analyses indicated similar changes in SA and fatigue for both groups, with significant reductions in SA occurring at 6 min post-exercise and remaining below pre-exercise levels throughout the post-exercise period, while fatigue was reduced at 12, 18, and 24 min post-exercise. A significant Group x Time interaction occurred for affective valence (PA - NA; p < .01). Post hoc analyses indicated that for the active group, affect increased modestly (i.e., more PA, less NA) during exercise; this increase was sustained post-exercise. The nonactive group evidenced a sharp drop in affect (i.e., less PA, more NA) during exercise followed by a small post-exercise rise which did not return to pre-exercise levels. The results of the present study partially support the Opponent-Process model as an explanation for exercise-related affect. Although there was no differential anxiety response as a function of activity level as the model would predict, there was a differential response for affective valence in accordance with predictions.

Adult↗
PubMed1997

Adult major affective disorder after prenatal exposure to an influenza epidemic.

BACKGROUND: We have previously reported an increase in schizophrenia diagnoses in a population exposed during the second trimester to the 1957 influenza epidemic. These basic findings together with a fair number of replications have been interpreted as supporting a neurodevelopmental contribution to the origins of schizophrenia. Recent neuroimaging findings suggest that affective illness may also have a neurodevelopmental origin. We examined the hypothesis that exposure to an influenza epidemic during the second trimester would increase the risk for adult major affective disorder. METHODS: The subjects had been exposed as fetuses to the type A2/Singapore influenza epidemic in greater Helsinki, Finland. Control subjects were born in the 6 years before the epidemic. RESULTS: We found a significant (P < .001) increase in the proportion of hospital diagnoses for major affective disorder for individuals exposed to the influenza epidemic during their second trimester of fetal development compared with control subjects (13% vs 2%). This second-trimester effect seems somewhat stronger in men (16% vs 2%) (P < .001), although the rates of major affective disorder in women (8% vs 3%) (P > .05) were similar. The second-trimester effect remained when we estimated population-based rates (2.1 vs 0.6 per 1000) (P < .05) of major affective disorder. Additional analyses revealed that the increase of major affective disorder among subjects in the index group who were exposed during the second trimester was due to a significant (P < .002) elevation of unipolar forms, although a similar though not significant (P > .05) elevation was observed for the bipolar forms of major affective disorder. CONCLUSIONS: These data are consistent with the hypothesis concerning the possible neurodevelopmental contribution to the origins of some forms of major affective disorder, especially unipolar depressive disorder. These encouraging findings, if replicated, may suggest that some mental disorders may stem, in part, from a disturbance in the development of the fetal brain during the second trimester.

Adult↗
PubMed1999

Sex of affected sibpairs and genetic linkage to type 1 diabetes.

A mouse model of diabetes shows gender dimorphism in the cumulative incidence of diabetes. Based on this, evidence for genetic linkage to IDDM13 on chromosome arm 2q was reported to be greater in type 1 diabetes families where there was a predominance of affected female offspring compared with families with a predominance of affected male offspring. Our objective was to investigate whether the sex of affected offspring affects evidence for linkage to susceptibility loci. Data from a genome scan of 356 affected sibpair families with type 1 diabetes were analysed to determine if there is differential evidence for linkage in families with affected children of a particular sex. At markers on chromosomes 3, 5, 7, 9, 11, and 19, we found a number of regions where the evidence for linkage is greater in families with affected sibpairs of a particular sex. Thus, evidence for linkage in families with affected sibpairs of the same gender suggests the presence of additional susceptibility loci. Several biological explanations are possible for these findings, including X and Y linkage, effects of sex hormones on gene expression, and quasi-linkage between sex chromosomes and autosomes.

Chromosomes↗
PubMed2006

Lithium versus antidepressants in the long-term treatment of unipolar affective disorder.

BACKGROUND: The main rationale for the use of lithium in the long-term treatment of unipolar affective disorder is its efficacy in treating bipolar affective disorder and resistant depression. However, there is considerable uncertainty about which pharmacological intervention is most effective in the long-term treatment of recurrent unipolar affective disorder. OBJECTIVES: To assess the effects of lithium versus antidepressants for the long-term treatment of recurrent affective disorder. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR-Studies and CCDANCTR-References) on 2/9/2005. Reference lists of relevant papers and major textbooks of affective disorder were checked. Experts in the field and pharmaceutical companies were contacted regarding unpublished material. SELECTION CRITERIA: Randomised controlled trials comparing lithium against antidepressant medication for the long-term treatment of patients with a diagnosis of affective disorder. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We collected adverse effects information from the trials. MAIN RESULTS: Eight trials involving 475 people were included. Two of the studies included a mixed group of participants with either bipolar or unipolar disorder. Relapse was defined as admission to hospital and when all kinds of relapses were considered (both depressive and manic), there was a statistically significant difference in favour of lithium (relative risk (RR) fixed effect 0.34, 95% CI 0.14 to 0.82). The results did not exclude the point of no effect, when the random-effects model was used (RR random effects 0.40, 95% CI 0.14 to 1.18). There were no other statistically significant differences between lithium and antidepressants according to all other outcomes considered. Manic or depressive relapse was defined as prescription of non-study medication for mood disorder, manic or depressive relapse (as defined by the study authors), quality of life, social functioning, occupational functioning, overall drop-out rate, drop-out rate due to side-effects, troublesome side-effects, mortality due to all causes and specifically suicides. AUTHORS' CONCLUSIONS: There was adequate efficacy evidence for lithium or antidepressants preventing relapse in unipolar affective disorder, however their relative efficacy was unknown. When considering lithium or antidepressant long-term therapy, patients and clinicians should take into account the patient's clinical history, the side-effects and the individual's likely adherence to the recommended treatment regime. Large-scale, long-term randomised trials in unselected groups of subjects with unipolar affective disorder are needed.

Antidepressive Agents↗
PubMed2003

A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: a receiver operator characteristic analysis.

OBJECTIVE: To compare 3 commonly used psychiatric symptom checklists (the Center for Epidemiological Studies Depression Scale [CES-D], the Positive and Negative Affect Schedule, and the Endler Multidimensional Anxiety Scales [EMAS]) to determine their sensitivity, specificity, and ability to discriminate between a disorder (Major Depression [MD], Generalized Anxiety Disorder [GAD]), and no disorder. To compare the checklists for their ability to discriminate between type of disorder (MD and GAD). To evaluate the discriminant ability of the subscales, particularly positive affect; whether the somatic items in the CES-D artificially inflate affective scores; and the optimal cut off score for the CES-D. METHODS: We compared the 3 scales to diagnostic criterion of MD, GAD, and comorbid disorder using receiver operator characteristic (ROC) and logistic regression analyses. The sample consisted of a national panel of 415 individuals with rheumatoid arthritis (RA). RESULTS: Each of the scales had high sensitivity and specificity (areas under the curve: CES-D = 0.92, negative affect = 0.88, positive affect and EMAS = 0.82). The CES-D, however, demonstrated better sensitivity and specificity than the positive affect and the EMAS, but not the negative affect scale. CONCLUSION: All 3 self-reports have high combined sensitivity and specificity as measures of affective disorders among RA patients.

Aged↗
PubMed1996

Proteoglycan alterations in skin fibroblast cultures from patients affected with pseudoxanthoma elasticum.

Proteoglycans (PGs) were investigated in fibroblast cultures from both apparently normal and involved areas of skin from two patients affected with Pseudoxanthoma elasticum (PXE) and compared to control normal cells. Biochemical analysis showed that cells from the PXE-affected patients produced a PG population with stronger polyanion properties, as well as a markedly increased amount of high hydrodynamic-size PGs. Moreover, PGs from PXE-affected cells showed abnormal hydrophobic interaction properties when examined under associative conditions and included heparan sulphate (HS)-containing populations with anomalous electrophoretic mobility. These phenomena were particularly evident in the case of PGs secreted into the growth medium. In agreement with these findings immunohistochemical study showed alterations affecting decorin and biglycan, as well as a different content and distribution of HS-PGs in PXE-affected cells. The same biochemical and morphological alterations were confirmed for both patients on different cell cultures and were present in cells from both apparently normal and affected skin areas, being more pronounced in the latter. Our results indicate that PXE-affected fibroblasts in culture exhibit an abnormal PG metabolism, which could affect the normal assembly of extracellular matrix.

Adult↗
PubMed2005

Elemental distributions and microtensile bond strength of the adhesive interface to normal and caries-affected dentin.

The aim of this study was to evaluate the microtensile bond strength (microTBS) and the elemental contents of the adhesive interface created to normal versus caries-affected dentin. Extracted human molars with coronal carious lesions were used in this study. A self-etching primer/adhesive system (Clearfil Protect Bond) was applied to flat dentin surfaces with normal and caries-affected dentin according to the manufacturer's instructions. After 24 h water storage, the bonded specimens were cross-sectioned and subjected to a microTBS test and electron probe microanalysis for the elemental distributions [calcium (Ca), phosphorus (P), magnesium (Mg), and nitrogen (N)] of the resin-dentin interface after gold sputter-coating. The microTBS to caries-affected dentin was lower than that of normal dentin. The demineralized zone of the caries-affected dentin-resin interface was thicker than that of normal dentin (approximately 3 microm thick in normal dentin; 8 microm thick in caries-affected dentin), and Ca and P in both types of dentin gradually increased from the interface to the underlying dentin. The caries-affected dentin had lost most of its Mg content. The distributions of the minerals, Ca, P, and Mg, at the adhesive interface to caries-affected dentin were different from normal dentin. Moreover, a N peak, which was considered to be the collagen-rich zone resulting from incomplete resin infiltration of exposed collagen, was observed to be thicker within the demineralized zone of caries-affected dentin compared with normal dentin.

Dental Caries↗
PubMed1998

The Impact of Positive and Negative Affect and Issue Framing on Issue Interpretation and Risk Taking.

Two studies examined the influence of transient affective states and issue framing on issue interpretation and risk taking within the context of strategic decision making. In Study 1, participants in whom transient positive or negative affective states were induced by reading a short story showed systematic differences in issue interpretation and risk taking in a strategic decision making context. Compared to negative mood participants, those in a positive mood were more likely to interpret the strategic issue as an opportunity and displayed lower levels of risk taking. Study 2 replicated and extended these results by crossing affective states with threat and opportunity frames. Results showed that framing an issue (as a threat or an opportunity) had a stronger impact on issue interpretation among negative affect participants than among positive affect participants. Affective states also moderated the impact of issue framing on risk taking: the effect of framing on risk-taking was stronger under negative rather than positive affect. These results are interpreted via information-processing and motivational effects of affect on a decision maker. Copyright 1998 Academic Press.

Journal Article↗
PubMed1989

Schizo-affective psychoses in childhood: a follow-up study.

A follow-up study of 16 schizo-affectives (part of a group of 57 children originally diagnosed as schizophrenic) is reported. All 57 patients were under 14 years. They were reinvestigated after an average follow-up period of 16 years (range 6 to 40 years). Of the 57 psychoses 28% had a typical schizo-affective character. In contrast to purely schizophrenic psychoses, we found an overrepresentation in the schizo-affective psychoses of affective psychoses and suicides in the ancestry. Further, in the schizo-affective psychoses there were more premorbidly well adjusted, harmonious personalities. In contrast, maladjusted, dishormonious, introverted characters predominated in purely schizophrenic psychoses. The schizo-affective psychoses had mainly an acute-recurrent character and followed a favorable course. The schizo-affective and affective phases were of significantly shorter duration than the schizophrenic episodes.

Adolescent↗
PubMed1988

Affect and addiction.

Prominent among theories of drug abuse are those that emphasize an effort to cope with painful, unpleasant affects and to replace them with positive affects. In this study, four subjects with varied histories of drug use and abuse rated the relevance of a list of affects to situations from their current life and past. Each subject described three situations involving drug use, three situations following the use of drugs, three in which they wanted to use drugs but did not or could not, and three unrelated to drugs. The ratings for each subject were factor analyzed to determine which groups of situations were similar in terms of their association with specific affect ratings. In addition, the ratings for the group of four subjects were factor analyzed. The group data analysis showed three clusters of situations in terms of those expressing a wish for drugs, those following the use of drugs, and those involving drugs. The individual factor analyses showed individual variation in drug preference, affects associated with the use of drugs, and affects associated with the absence of drugs. However, generally drugs appeared to be associated with the presence of positive affective states and the removal of unpleasant affects associated with other, non-drug use situations.

Adaptation, Psychological↗
PubMed2006

Electrophysiological correlates of visual affective priming.

The present study used event-related potentials (ERPs) to investigate the underlying neural mechanisms of visual affective priming. Eighteen young native English-speakers (6 males, 12 females) participated in the study. Two sets of 720 prime-target pairs (240 affectively congruent, 240 affectively incongruent, and 240 neutral) used either words or pictures as primes and only words as targets. ERPs were recorded from 64 scalp electrodes while participants pressed either "Happy" or "Sad" buttons to indicate target pleasantness. The response time (RT) results confirmed an affective priming effect, with faster responses to affectively congruent trials (659 ms) than affectively incongruent trials (690 ms). Affectively incongruent trials had larger and more negative N200 activation than those to neutral trials. Importantly, a delayed N400 for word prime-target pairs matched the RT results with larger negative amplitudes for incongruent than congruent pairs. This finding suggests that the N400 component is not only sensitive to semantic mismatches, but is also sensitive to affective mismatches for word prime-target pairs.

Adult↗
PubMed2006

Quality of life in unaffected twins discordant for affective disorder.

BACKGROUND: The disability and hardship associated with affective disorder is shared by the family members of affective patients and might affect the family member's quality of life. METHOD: In a cross-sectional, high-risk, case-control study, monozygotic (MZ) and dizygotic (DZ) twins with (High-Risk twins) and without (the control group/Low-Risk twins) a co-twin history of affective disorder were identified through nationwide registers. The aim of the present study was to investigate the hypothesis that a genetic liability to affective disorder is associated with a lower perception of quality of life. RESULTS: Univariate analyses showed that quality of life in all domains was impaired for the 121 High-Risk twins compared to the 84 Low-Risk twins. In multiple regression analyses, the differences remained significant after adjustment for sex, age, marital status and years of education. Adjusted for the effect of subclinical anxiety and depressive symptoms, the differences were significant on the domain environment and total WHOQoL-BREF and marginally significant on the domain physical health and overall quality of life. LIMITATIONS: It is not possible from the cross-sectional analyses to distinguish between subsyndromal state and trait scores. CONCLUSIONS: Perceived health related quality of life might share common familial vulnerability with affective disorders. Having a co-twin with affective disorder seem to have a negative influence on quality of life of the healthy co-twin and this influence might be due to the genetic liability to affective disorder. These findings need to be replicated in future family studies.

Adult↗
PubMedDate not supplied

Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences.

OBJECTIVES: many studies have reported a high degree of comorbidity between mood disorders, among which are bipolar disorders, and borderline personality disorder and some studies have suggested that these disorders are co-transmitted in families. However, few studies have compared personality traits between these disorders to determine whether there is a dimensional overlap between the two diagnoses. The aim of this study was to compare impulsivity, affective lability and intensity in patients with borderline personality and bipolar II disorder and in subjects with neither of these diagnoses. METHODS: patients with borderline personality but without bipolar disorder (n=29), patients with bipolar II disorder without borderline personality but with other personality disorders (n=14), patients with both borderline personality and bipolar II disorder (n=12), and patients with neither borderline personality nor bipolar disorder but other personality disorders (OPD; n=93) were assessed using the Affective Lability Scale (ALS), the Affect Intensity Measure (AIM), the Buss-Durkee Hostility Inventory (BDHI) and the Barratt Impulsiveness Scale (BIS-7B). RESULTS: borderline personality patients had significantly higher ALS total scores (P<0.05) and bipolar II patients tended to have higher ALS scores than patients with OPD (P<0.06). On one of the ALS subscales, the borderline patients displayed significant higher affective lability between euthymia and anger (P<0.002), whereas patients with bipolar II disorder displayed affective lability between euthymia and depression (P<0.04), or elation (P<0.01) or between depression and elation (P<0.01). A significant interaction between borderline personality and bipolar II disorder was observed for lability between anxiety and depression (P<0.01) with the ALS. High scores for impulsiveness (BISTOT, P<0.001) and hostility (BDHI, P<0.05) were obtained for borderline personality patients only and no significant interactions between diagnoses were observed. Only borderline personality patients tended to have higher affective intensity (AIM, P<0.07). CONCLUSIONS: borderline personality disorder and bipolar II disorder appear to involve affective lability, which may account for the efficacy of mood stabilizers treatments in both disorders. However, our results suggest that borderline personality disorder cannot be viewed as an attenuated group of affective disorders.

Adult↗
PubMed2002

Negative affect and parental aggression in child physical abuse.

OBJECTIVE: Parental negative affect is a risk factor for child physical abuse. As negative affect contributes to aggression, and because physical abuse involves an aggressive act directed at the child, we examined the relationship between negative affect and parent-to-child aggression (PTCA) in parents reported to Child Protective Services for physical abuse. METHOD: Baseline assessment data were retrospectively examined on 49 participants in a treatment study for child physical abuse. The negative affects studied were depression, anxiety, and hostility on the Beck Depression Inventory and the Brief Symptom Inventory. PTCA was assessed using the physical aggression subscales (Minor and Severe Physical Violence) of the Conflict Tactics Scale. The contribution of these negative affects to PTCA was examined after controlling individually for the effects of parental attributions and contextual variables widely regarded as etiological factors in child physical abuse. RESULTS: Contributions of negative affect to PTCA after individually controlling for other predictors were found for Minor Physical Violence but not Severe Physical Violence. Findings were strongest with depression on the Beck Depression Inventory and to a lesser extent with hostility on the Brief Symptom Inventory. CONCLUSIONS: Finding that negative affect contributed to PTCA in this sample suggests that it may be important to study the effects of emotion-focused treatments in physically abusive parents. These findings also suggest that PTCA may have qualities of impulsive aggression, a form of aggression that is conceptualized as driven by negative affect, occurs in response to aversive events, and is not planned.

Adult↗
PubMed1997

Affective instability and impulsivity in personality disorder. Results of an experimental study.

Affective instability in borderline personality disorder is due to a marked reactivity to environmental events. The present study focused on the relationship between affective instability and impulsivity in personality disorder. It used an experimental approach in the form of an affect-stimulation design based on the presentation of a short story which allowed for an analysis of affective responses in regard to quality, intensity, and alterations over time. Impulsive personalities showed a strong intensity of affective responses us well as a tendency towards rapid affect alterations supporting the theory of poor affect regulation in subjects with impulsive self-harming behaviour. Results suggest that affective instability is a crucial part of impulsive personality functioning.

Adult↗
PubMed1999

Familial rates of affective and substance use disorders in patients with first-episode mania.

BACKGROUND: One explanation for the high co-occurrence between bipolar and substance use disorders is that substance abuse may precipitate affective symptoms in patients who otherwise may have not had the genetic risk for developing an affective illness. Previous studies comparing familial rates of affective illness between bipolar patients with and without alcohol use have provided conflicting results. We hypothesized that patients with bipolar disorder and antecedent alcohol abuse would have lower familial rates of affective illness than bipolar patients without antecedent alcohol abuse. METHODS: Family history data were obtained on 275 first-degree relatives of 51 patients hospitalized for a first manic episode using the Family History Research Diagnostic Criteria. RESULTS: Patients with bipolar disorder and antecedent alcohol abuse had lower familial rates of affective illness than patients with bipolar disorder without antecedent alcohol abuse (two-tailed Fisher's exact, P = 0.003). There was no statistically significant difference in the familial rates of affective illness between bipolar patients with and without antecedent drug abuse (other than alcohol). Patients with bipolar disorder and antecedent alcohol abuse had a significantly older age of onset of affective illness (27.6 years) than patients with bipolar disorder without antecedent alcohol abuse (20.6 years, z = 3.3, df = 1, P = 0.0009). There was no statistical difference in age of onset of affective illness between the patients with antecedent drug abuse and the patients without antecedent drug abuse. LIMITATIONS: Future studies with a larger number of bipolar patients, direct structured interviews of family members and better differentiation between substance abuse and dependence syndromes are needed to extend and replicate this pilot study. CONCLUSIONS: Our study suggests that there may be a subset of bipolar patients who have antecedent alcohol abuse and a subset who develop alcohol abuse after the onset of bipolar disorder. We further speculate that alcohol abuse may precipitate mania in some patients with bipolar disorder.

Adolescent↗