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PubMed2002

Airway response of healthy individuals to affective picture series.

We studied the effects of viewing pictures in three series of homogeneous affects on respiratory resistance. Results from prior studies had been equivocal with respect to modulation of resistance by affective valence or arousal. Forty-two healthy participants viewed three series of affective slides preselected for global categories of positive, neutral and negative valence. Oscillatory resistance (R(os)), time, volume and flow parameters of respiration, cardiac interbeat-interval, respiratory sinus arrhythmia, and skin conductance were measured throughout the picture series, and individual pictures were rated in pleasure, arousal and interest. During the slide presentation, R(os) increased with decreasing picture valence. Other physiological parameters did not parallel these changes. R(os) changes were restricted to the expiratory portion of the breathing cycle, thus suggesting a contribution of upper airway sites to the response. It is concluded that R(os) is modulated by affective valence when pictures are selected in global categories of positive, neutral and negative affect. Observed airway responses are probably less informative with respect to affect-induced exacerbation in lower airway disease.

Adult↗
PubMed2003

Negative affect: effects on an evaluative measure of human pain.

Prior work indicates that exposure to fear-inducing shock inhibits finger-withdrawal to radiant heat in humans (hypoalgesia), whereas anxiety induced by threat of shock enhances reactivity (hyperalgesia; Pain 84 (2000) 65-75). Although finger-withdrawal latencies are thought to reflect changes in pain sensitivity, additional measures of pain are needed to determine whether pain perception is altered. The present study examined the impact of negative affect on visual analog scale (VAS) ratings of fixed duration thermal stimuli. One hundred twenty-seven male and female human subjects were randomly assigned to one of three emotion-induction conditions: (1) negative affect induced by exposure to three brief shocks; (2) negative affect elicited by the threat of shock without presentation; and (3) neutral affect, with no intervention. VAS ratings were tested before and after emotion-induction. Results suggest that both negative affect manipulations reduced pain. Manipulation checks indicated that the emotion-induction treatments induced similar levels of fear but with different arousal levels. Potential mechanisms for affect induced changes in pain are discussed.

Adult↗
PubMed1999

Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant.

PURPOSE: To investigate whether different procedure variables involved in the delivery of fractionated total body irradiation (TBI) impact on prognosis of patients affected by acute lymphoblastic leukemia (ALL) receiving allogeneic bone marrow transplant (BMT). METHODS AND MATERIALS: Ninety-three consecutive patients with ALL receiving a human leukocyte antigen (HLA) identical allogeneic BMT between 1 August 1983 and 30 September 1995 were conditioned with the same protocol consisting of cyclophosphamide and fractionated TBI. The planned total dose of TBI was 12 Gy (2 Gy, twice a day for 3 days). Along the 12-year period, variations in delivering TBI schedule occurred with regard to used radiation source, instantaneous dose rate, technical setting, and actual total dose received by the patient. We tested these different TBI variables as well as factors related to patient, state of disease, and transplant-induced disease to investigate their influence on transplant-related mortality, leukemia relapse, and survival. RESULTS: At median follow-up of 7 years (range 3-15 years) the probabilities of leukemia-free survival (LFS) and overall survival (OS) for the 93 patients were 60% and 41%, respectively. At univariate analysis, chronic graft versus host disease (cGvHd) (p = 0.0005), age (p = 0.01), and state of disease (p = 0.03) were factors affecting LFS whereas chronic GvHd (p = 0.0005), acute GvHd (p = 0.03), age (p = 0.0001), and GvHd prophylaxis (p = 0.01) were factors affecting overall survival. The occurrence of chronic GvHd was correlated with actually delivered TBI dose (p = 0.04). Combined stratification of prognostic factors showed that patients who received the planned total dose of TBI (12 Gy) and were affected by chronic GvHd had higher probabilities of LFS (p = 0.01) and OS (p = n.s.) than patients receiving less than 12 Gy and/or without occurrence of chronic GvHd. Moreover, TBI dose had a significant impact on LFS in patients transplanted in first remission (p = 0.05). At multivariate analysis, TBI dose was an independent factor affecting overall survival (p = 0.05) as well as chronic GvHd (p = 0.001) and age (p = 0.04). CONCLUSIONS: This retrospective analysis showed that different variables involved in TBI delivery may influence the occurrence of cGvHd and affect prognosis of patients with ALL receiving allogeneic BMT. The total dose of 12 Gy, administered in six fractions over 3 days, appears to be an effective and low toxic regimen for ALL patients transplanted in first remission.

Adolescent↗
PubMed1996

Affect instability in adults with a borderline personality disorder.

This study describes the pattern of affect instability in adults with borderline personality disorder (BPD). Clinical histories and the Diagnostic Inventory for Borderlines were used to identify 3 groups: 1) BPD (N = 15), 2) Asymptomatic (N = 10), and 3) Non-BPD, Anorexia Nervosa Clinical Control (N = 4). An experience sampling procedure (Hormuth, 1986) was used to obtain 50 measures of affect over 10 days. The findings showed that BPD subjects experienced higher levels of unpleasant affects and greater short-term fluctuations in unpleasant affects than the asymptomatic subjects. However, BPD and asymptomatic subjects experienced more fluctuations in the pleasant affects than the AN subjects. These findings support the hypothesis that BPD is associated with a unique pattern of affect dysregulation.

Adult↗
PubMed1988

Negative affect smoking and smoking relapse.

This study examined linkages between negative affect smoking and relapse. A sample of 669 smokers treated in smoking cessation clinics completed the Horn Motives for Smoking Scale at baseline and were followed at 3 and 12 months posttreatment. Negative affect (NA) smoking scores were unrelated to initial cessation or to maintenance at 3 months. Negative affect accounted for 8% of the variance in 12-month outcomes. The findings support the conceptual distinction between cessation and maintenance and suggest the need to distinguish stages within maintenance. The study also examined whether NA was associated with experiencing relapse crises in negative affect situations. Reports of relapse crises (situations leading to smoking or to the verge of smoking) were obtained from 572 subjects at the 3-month follow-up. Negative affect smokers were more likely to report that the crises were precipitated by negative affect. Although weak, this link between baseline smoking patterns and relapse situations suggests the possibility of individually tailored treatments.

Adolescent↗
PubMed2002

The dichotomy of schizophrenia and affective disorders in extended pedigrees.

The paper reports the first controlled family study investigating not only 1st but also 2nd and 3rd degree relatives of patients with schizophrenia by direct diagnostic interviews. Regardless of their degree of relationship, all biological relatives of the patients were found to be at an elevated risk of schizophrenia (5.0% in 1st, 3.1% in 2nd, 1.5% in 3rd degree relatives compared to 0.8% among controls). Schizoaffective and affective disorders have also been found to be more common in the three groups of relatives but without a monotone decline of prevalence rates across the groups. Other psychiatric disorders were not found to be at an elevated risk in relatives of patients compared to controls. Thus, our findings support the hypothesis that psychotic, as well as affective disorders, aggregate in families of individuals with schizophrenia.However, in our study, the risk of schizophrenia and the risk of affective disorders correlated. Particularly, the magnitude of the risk of schizophrenia among relatives of probands with schizophrenia varied with the occurrence of affective disorders in relatives. In relatives, the risk of schizophrenia was maximal in absence of a family history of affective disorder. This constellation holds true even if only families of index cases without any affective syndrome during lifetime are considered.

Adult↗
PubMed1998

Facial affect recognition and information processing in schizophrenia and bipolar disorder.

This study assessed facial affect recognition and visual attention in a sample of 40 individuals with schizophrenia, at hospitalization and 3 months later during an out-patient phase of relative remission. Secondly, at the out-patient phase the performance of the individuals with schizophrenia on tasks of visual attention, facial affect recognition and facial recognition was compared to the performances of a non-psychiatric control group and a bipolar group on these tasks. Attention was measured with the Continuous Performance Test and the Span of Apprehension task. Facial affect recognition was measured with a discrimination task and an identification task. A measure of facial recognition was also used. The schizophrenia patients performed more poorly on measures of facial affect recognition and facial recognition than both control groups. Despite a significant improvement in symptoms over time, there was no change in facial affect recognition for the schizophrenia subjects. For the schizophrenia subjects there were significant associations between attention tasks and the facial tasks. These results suggest that for individuals with schizophrenia, deficits in facial affect recognition are stable deficits that are related to other impairments in neurocognition. This has implications for psychosocial treatments.

Adult↗
PubMed2001

Modelling suicide risk in affective disorders.

BACKGROUND: The lifetime risk of suicide in affective disorders is commonly quoted as 15%. This stems from hospital populations of affective disorders. AIMS: To model the lifetime prevalence of suicide using data on completed suicides from one English Health District and community-based rates of prevalence of affective disorders. METHODS: A secondary analysis of a primary data set based on 212 suicides in North Staffordshire was undertaken. The population rates of psychiatric morbidity were obtained from the National Comorbidity Survey. RESULTS: The model suggests a lifetime prevalence rate of suicide for any affective disorder at 2.4%, with a rate for those uncomplicated by substance abuse, personality disorder or non-affective psychosis at 2.4%, and a rate for uncomplicated cases who had no mental health service contact at 1.1%. CONCLUSIONS: Lifetime prevalence rates of suicide in subgroups of affective disorders may be lower than the traditional rates cited for hospital depression. This has implications for primary care projects designed to investigate the occurrence of and the prevention of suicide.

Cause of Death↗
PubMed1979

The use of the Visual Analogue Mood and Alert Scales in diagnosing hospitalized affective psychoses.

A consecutive series of 90 admissions of functional patients was examined with the Present State Examination (PSE). Based primarily on PSE findings together with previously published diagnostic criteria, we identified 11 clear or index cases of schizophrenia, 12 of affective psychoses, and 12 of neurotic/personality disorders. All patients were given daily 2 analogue scales, one measuring mood and the other alertness. Among the index cases, the depressives were distinguished by low scores on both scales and the manics by high scores. There was little overlap in the distribution of the scores among the diagnostic groups, suggesting that these scales might be effective psychological markers of clear affective versus clear non-affective functional disorders. Among the undiagnosed cases, those with low or high scores on both scales resembled index affectives phenomenologically, clinically, and demographically. The scores of the 'affective-like' patients overlapped little with those of the 'non-affective-like' patients. The scales therefore might be practical diagnostic aids.

Adult↗
PubMed2003

Directionality of affective priming: effects of trait anxiety and activation level.

Among the most influential models of automatic affective processing is the spreading activation account (Fazio, Sanbonmatsu, Powell, & Kardes, 1986). However, investigations of this model by different research groups using the pronunciation task in an affective priming paradigm yielded contradictory results. Whereas one research group reported congruency effects, another obtained reversed priming effects (contrast effects), and still another found null effects. In Experiment 1, we were able to show an influence of trait anxiety on the direction of the affective priming effect. By using a multiple priming paradigm in Experiment 2, we were able to link the occurrence of reversed priming effects to increased levels of activation of affective representations. We propose that this relation might underlie the influence of trait anxiety on the direction of affective priming effects. Both experiments indicate that automatic evaluation in an affective network is substantially moderated by personality traits and activation level.

Adult↗
PubMed2003

Affective disorders in neurological diseases: a case register-based study.

OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two control group diagnoses were followed for up to 21 years. The incidences of affective disorders in the different groups were compared with the control groups, using competing risks to consider the risk of affective disorder and the risk of death in the same analysis. RESULTS: We found an increased incidence of affective disorders in dementia, Parkinson's disease, epilepsy, stroke and intracerebral haemorrhage compared with control groups. The association was found to be the strongest for dementia and Parkinson's disease. In hospitalized patients, with incident multiple sclerosis, the incidence of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases).

Adolescent↗
PubMed2000

Positive affect and the other side of coping.

Although research on coping over the past 30 years has produced convergent evidence about the functions of coping and the factors that influence it, psychologists still have a great deal to learn about how coping mechanisms affect diverse outcomes. One of the reasons more progress has not been made is the almost exclusive focus on negative outcomes in the stress process. Coping theory and research need to consider positive outcomes as well. The authors focus on one such outcome, positive affect, and review findings about the co-occurrence of positive affect with negative affect during chronic stress, the adaptive functions of positive affect during chronic stress, and a special class of meaning-based coping processes that support positive affect during chronic stress.

Adaptation, Psychological↗
PubMed1993

Expressed emotion, social skill, and response to negative affect in schizophrenia.

The social skills and social perception of schizophrenia patients in response to negative affect was examined as a function of family expressed emotion (EE). Patients participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, patients with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but patients with highly critical relatives did not. Patients with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and patients during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. Patient ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between patients with high and low EE relatives. The results support the validity of the EE construct as an index of relatives' affective behavior and suggest that patients' social skills, such as assertiveness, may mediate negative affective exchanges in their families.

Adaptation, Psychological↗
PubMed1994

The role of negative affectivity in the association between attributions and marital satisfaction.

Structural equation modeling with latent variables was used to test whether negative affectivity, or the cross-situational tendency to experience and express negative thoughts and feelings, correlates with spouses' attributions for relationship events and accounts for the association between attributions and satisfaction. Eighty married couples completed measures of marital satisfaction, attributions, and negative affectivity. Spouses high in negative affectivity tended to make maladaptive attributions, but spouses' attributions were unrelated to the level of negative affectivity reported by the partner. Attributions and marital satisfaction remained associated among husbands and wives after controlling for negative affectivity. These findings clarify the link between attributions and marital satisfaction and raise the possibility that negative affectivity contributes to the attributions that spouses make for negative events in marriage.

Adaptation, Psychological↗
PubMed2002

Evidence for familial cosegregation of major affective disorder and genetic markers flanking the gene for Darier's disease.

Darier's disease is a rare autosomal dominantly inherited keratosis.(1) We have previously reported a family in which major affective disorder co-segregated with Darier's disease, consistent with linkage between the Darier gene and a susceptibility locus for affective illness (max lod = 2.1).(2) The Darier gene has been mapped to 12q 23-q24.1 and identified as ATP2A2, a gene encoding SERCA2-a sarcoplasmic/endoplasmic reticulum calcium pump that plays a role in intracellular calcium signalling.(3) A number of groups have reported independent evidence of linkage between bipolar disorder and markers in this region.(4) We here describe a further Caucasian family of European origin in which there is co-occurrence of Darier's disease and major affective disorder including bipolar disorder and report the results of linkage analysis employing genetic markers flanking the Darier's gene. The pedigree includes two individuals with mood disorder from a branch of the family not affected with Darier's disease. However, there is a new mutation in the Darier (ATP2A2) gene in this family and all individuals affected by mood disorder show co-segregation with a haplotype in the region of the Darier's gene (max lod = 3.58). The family provides strong evidence against the Darier-causing mutation itself playing a major role in affective disorder but strongly supports the existence of a bipolar disorder susceptibility gene in the Darier region.

Bipolar Disorder↗
PubMed1996

The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests.

OBJECTIVE: Cognitive and affective functioning is sensitive to changes in thyroid hormones. We have sought to determine: (1) the prevalence of thyroid function abnormalities in a psychiatric population on admission (as compared to the prevalence in a normal population), and (2) whether such thyroid function abnormalities are associated with the occurrence or development of cognitive and affective disorders. DESIGN: Serum was collected 2-3 weeks after hospitalization in 3 major clinics from 3756 psychiatric patients in 1987-1990, stored, and assayed in 1993 for the presence of antibodies against the TSH-receptor and thyroperoxidase (TPO-Ab) and for TSH levels. The psychiatric cohort was matched with a control population of healthy individuals living in the same area (n = 1877). The prevalence study was followed by a case-control study involving patients from one clinic that had routinely assigned a DSM-IIIR classification to its patients. Cases were those admissions with thyroid abnormalities and three subgroups of cases were randomly formed demonstrating either TSH less than 0.4 mU/l (n = 44) or over 4.0 mU/l (n = 44), or TPO-Ab positivity (n = 50). Cases were compared to random controls from the same psychiatric population, viz patients without thyroid abnormalities (n = 83). Comparison was with respect to their psychiatric follow-up diagnosis (the investigator was blinded to the thyroid test results). RESULTS: Prevalence study. The percentage of patients positive for TSH-receptor-Ab was 0.26 (9/3504), for TPO-Ab was 10.0 (331/3316) and outside the TSH range of 0.4-4.0 mU/l was 10.0 ((332/3316): 5.9% (198/3316) > 4.0 mU/l and 4.1% (134/3316) < 0.4 mU/l). Abnormal total thyroxine levels were found in only 9.8% of subjects with abnormal TSH, indicating the predominantly subclinical character of the thyroid alteration. In comparison, the healthy area controls over 55 years of age showed the same prevalence of positive TPO-antibodies and TSH under 0.4 mU/l, but a higher prevalence of TSH over 4.0 mU/l. CASE-CONTROL STUDY: In the case control analysis differences could not be noticed with regard to prevalences of dementia, schizophrenia or other psychiatric illnesses apart from the prevalence of affective disorders which were more prevalent in TPO-Ab positive patients and patients with a low serum TSH. Since prior use of lithium, carbamezapine, carbimazole and/or thyroxine could be a factor of importance in this association, analyses were also carried out excluding patients with such prior drug use. In these analyses affective disorders were still more prevalent in patients with a low serum TSH (particularly in males, 40% in cases vs 9% in controls, P < 0.05). The most significant association was however between TPO-antibody positivity (and in particular with high titre and/or with TSH > 4.0 mU/l) and a subgroup of the affective disorders, viz with a rapid cycling of bipolar disorder (18% in cases vs 0% in controls, P < 0.001). CONCLUSION: Though causal relations cannot be determined from this cross-sectional study, this admission survey found early forms of autoimmune thyroid disease, sometimes characterized only by TPO-Abs, highly significantly associated with rapid cycles of a bipolar disorder. It also found a weak association between subclinical hyperthyroidism (low serum TSH without TPO-Ab positivity) and affective disorder.

Adult↗
PubMed1997

Psoriasis and sex: a study of moderately to severely affected patients.

BACKGROUND: Psoriasis can have a significant impact upon sexual functioning for 30%-70% of patients. We examined the dermatologic and psychologic factors associated with the effect of psoriasis on this important dimension of quality of life. METHODS: One hundred and twenty consenting psoriasis patients (63 men and 57 women; mean +/- SD age, 46.8 +/- 15.7 years; mean +/- SD total body surface area affected, 53.4% +/- 22.9%) completed a battery of questionnaires which included their response (endorsed with a "Yes" or "No") to the following question: "Do you believe that since the onset of psoriasis your sexual activity has declined?" The differences in dermatologic and psychologic measures between the subgroup that endorsed a "Yes" response and the subgroup that endorsed a "No" response were examined. RESULTS: Forty-nine out of 120 patients (40.8%) were sexually affected, i.e. they endorsed a "Yes." There were no significant differences between the affected and unaffected groups with respect to marital status, age, sex, and duration of psoriasis. The affected group reported more joint pains (P = 0.01), marginally greater psoriasis severity affecting the groin region (P = 0.07), greater scaling (P = 0.06), and greater pruritus severity (P = 0.07). Psychologically, the affected group had higher depression scores (P = 0.02) which were in the range for clinical depression, a greater tendency (P = 0.02) to seek the approval of others, and a marginally greater tendency (P = 0.08) to drink alcohol. A decline in sexual activity was related to a decrease in the patient's sex drive for 42.6% of patients; however, only 14.9% of these patients attributed the decline in their sexual activity to decreased sex drive of their spouse/partner. CONCLUSION: In addition to some dermatologic factors, comorbid psychologic factors, such as depression and a tendency for alcohol use, may be important determinants of decreased sexual functioning in psoriasis.

Alcoholism↗
PubMed1997

Information provided by pairs of distantly affected relatives to search for genes involved in rare autosomal dominant diseases.

When dominant mutations of different genes may lead to the same disease, it is often difficult to detect in a particular patient which gene is involved. A strategy is to make genealogical extensions to find affected relatives that should have inherited the same mutation. In particular, for diseases with late age of onset or short survival time, only poor information may be obtained from close relatives of probands and it can be particularly efficient to make genealogical extensions to detect pairs of distantly related affected individuals. Such a pair of affecteds may provide information concerning the region of the genome where the mutated gene should map. Two situations may be encountered depending on whether or not prior information on the location of mutated genes involved in the disease are available. If we already know, from previous linkage studies, that a gene located in a given region R of the genome may be involved in the disease, the problem is then to confirm that it is indeed a mutation of this gene that is involved in the affected pair. Once the implication of a gene in region R has been confirmed the affected pair of relatives may give information to restrict the length of this region R. In this paper we discuss these two points by deriving analytically first the lod score expected and second the expected reduction of the length of the region where the mutation is suspected to map as a function of the number of meioses between the two affected individuals and of the polymorphism of the markers available in the region.

Chromosome Aberrations↗