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PubMed1997

Effects of nondirective suggestions on pain tolerance, pain threshold and pain intensity perception.

In this experiment, we followed the issue whether nondirective suggestions have an effect on pain threshold, pain tolerance, and perception of pain intensity. 48 healthy subjects consented to take part. At intake into the study (t1), pain threshold and pain tolerance were assessed in all subjects using a pressure algometer. Perception of maximum pain intensity perception was rated on a scale of 0 to 25. Seven days later, the session was repeated (t2). Subjects were randomly assigned to one of two groups. One group received nondirective suggestions as pretreatment. Subjects listened to a tape of 20 min. which consisted of general information about pain theory. In this context, suggestions for coping with pain were placed. The other group served as a control and received no pretreatment. Analysis showed that pain tolerance was significantly prolonged in the group who received nondirective suggestions, while pain threshold and perception of maximum pain intensity did not differ across groups. This study demonstrates that nondirective suggestions are effective in prolonging pain tolerance. It can be stated that, beside information, cues on coping with pain may be helpful in clinical practice.

Adaptation, Psychological↗
PubMed2001

How events are reviewed matters: effects of varied focus on eyewitness suggestibility.

Witnesses to a crime or an accident perceive that event only once, but they are likely to think or talk about it multiple times. The way in which they review the event may affect their later memory. In particular, some types of review may increase suggestibility if the witness has been exposed to postevent misleading information. In Experiment 1, participants viewed a videotaped crime and then received false suggestions about the event. We found that participants who were then asked to focus on specific details when reviewing the event were more suggestible on a later source memory test than participants asked to review the main points. The findings of Experiment 2 suggest that this effect was not due to a criterion shift at test. These findings indicate that the type of rehearsal engaged in after witnessing an event can have important consequences for memory and, in particular, suggestibility.

Adult↗
PubMed2001

Contextual overlap and eyewitness suggestibility.

Studies of eyewitness suggestibility have traditionally used a paradigm that maximizes the extent to which the postevent interview overlaps with the witnessed event in terms of narrative content, narrative structure, and environmental context. The present study explored whether these dimensions of overlap contribute to people's tendency to confuse suggested details for those they have actually witnessed. We systematically manipulated the extent to which the postevent questionnaire overlapped with the witnessed event. Across two experiments, overlap in narrative content, narrative structure, or environmental context was not found to increase suggestibility effects, even though the manipulation did have other memory effects (e.g., it improved cued recall of the actual source of the suggestions, Experiment 2). These findings suggest that understanding the interaction between the structure and content of the objective context in which misinformation is encountered and various remembering contexts (e.g., recognition vs. recall) is important for advancing our understanding of source confusion in an eyewitness situation.

Adult↗
PubMed2004

5-HT5A receptor localization in the rat spinal cord suggests a role in nociception and control of pelvic floor musculature.

The 5-HT5A receptor is a seven-transmembrane receptor negatively coupled to adenylate cyclase, whose activation opens K+ channels. The 5-HT5A receptor may thus exert an inhibitory effect on neuronal activity. However, the function of this receptor is still largely unknown, in particular at the spinal level, and this is partly due to lack of specific ligands. Immunocytochemistry using specific anti-5-HT5A antibodies reveals a particularly dense labeling in the two superficial layers of the dorsal horn, suggesting that the 5-HT5A receptor may be involved in the spinal modulation of pain. In addition, a very intense staining in the lumbar dorsolateral nucleus (Onuf nucleus) in both males and females suggests that the 5-HT5A receptor is also involved in micturition through the control of urethral sphincter muscles. Colchicine pretreatment allows the staining of numerous cell bodies in lamina II. Fewer labeled cell bodies are seen in laminae I and III-VI, in the lateral spinal nucleus, and in lamina X. Electron microscope examination of 5-HT5A receptor immunoreactivity in spinal cords from untreated animals confirmed the postsynaptic labeling in all regions studied (dorsal horn, dorsolateral nucleus, and lamina X). The morphological heterogeneity of labeled dorsal horn cell bodies suggests that they belong to functionally distinct neurons (projection neurons and interneurons). In the lumbar dorsolateral nucleus, the labeling is preferentially localized on dendrites, suggesting that in this nucleus 5-HT preferentially acts at the dendritic level. Finally, the dense labeling of postsynaptic specializations suggests that the receptor may be in stock before being addressed to the synaptic differentiation.

Animals↗
PubMed2006

Distributions of two gonadotropin-releasing hormone receptor types in a cichlid fish suggest functional specialization.

Gonadotropin-releasing hormone 1 (GnRH1) from the brain controls reproduction in vertebrates via a GnRH-specific receptor in the pituitary; however, other forms of GnRH are found in all species, suggesting additional roles for this family of peptides. GnRH action depends critically on the location of its cognate receptors in the brain. To understand the potential roles of additional GnRH forms, we localized two known GnRH receptor types in a cichlid fish, Astatotilapia burtoni, in which GnRH1 is socially regulated. Using in situ hybridization, we describe the mRNA expression pattern of these GnRH receptor (GnRH-R) subtypes in the brain, specifically with respect to GnRH-producing neurons. Our data suggest that following a gene duplication, the two GnRH receptors have evolved to serve different functions. The type 1 receptor (GnRH-R1) is expressed less widely than the type 2 receptor (GnRH-R2). Specifically, GnRH-R1 is expressed in groups of neurons in the telencephalon, preoptic area, ventral hypothalamus, thalamus, and pituitary. In contrast, GnRH-R2 is expressed in many more brain areas, including the olfactory bulb, telencephalon, preoptic area, hypothalamus, thalamus, midbrain, optic tectum, cerebellum, hindbrain, and pituitary. The specific distribution of GnRH-R2 suggests that the GnRH ligands may act via this receptor to influence behavior in A. burtoni. Moreover, only GnRH-R2 mRNA is colocalized in the three known groups of GnRH-containing neurons, suggesting that any direct feedback regulation of GnRH by itself must act through this receptor type. Taken together, these data suggest that the two GnRH receptor types serve different functional roles in A. burtoni.

Animals↗
PubMed2004

A controlled trial of including symptom data in computer-based care suggestions for managing patients with chronic heart failure.

BACKGROUND: Heart failure is common and associated with considerable morbidity and cost, yet physician adherence to treatment guidelines is suboptimal. We conducted a randomized controlled study to determine if adding symptom information to evidence-based, computer-generated care suggestions would affect treatment decisions among primary care physicians caring for outpatients with heart failure at two Veterans Affairs medical centers. METHODS: Physicians were randomly assigned to receive either care suggestions generated with electronic medical record data and symptom data obtained from questionnaires mailed to patients within 2 weeks of scheduled outpatient visits (intervention group) or suggestions generated with electronic medical record data alone (control group). Patients had to have a diagnosis of heart failure and objective evidence of left ventricular systolic dysfunction. We assessed physician adherence to heart failure guidelines, as well as patients' New York Heart Association (NYHA) class, quality of life, satisfaction with care, hospitalizations, and outpatient visits, at 6 and 12 months after enrollment. RESULTS: Patients in the intervention (n = 355) and control (n = 365) groups were similar at baseline. At 12 months, there were no significant differences in adherence to care suggestions between physicians in the intervention and control groups (33% vs. 30%, P = 0.4). There were also no significant changes in NYHA class (P = 0.1) and quality-of-life measures (P >0.1), as well as no differences in the number of outpatient visits between intervention and control patients (6.7 vs. 7.1 visits, P = 0.48). Intervention patients were more satisfied with their physicians (P = 0.02) and primary care visit (P = 0.02), but had more all-cause hospitalizations at 6 months (1.5 vs. 0.7 hospitalizations, P = 0.0002) and 12 months (2.3 vs. 1.7 hospitalizations, P = 0.05). CONCLUSION: Adding symptom information to computer-generated care suggestions for patients with heart failure did not affect physician treatment decisions or improve patient outcomes.

Aged↗
PubMed2005

Patient requests and provider suggestions for alternative treatments as reported by rural and urban care providers.

OBJECTIVES: Explored the relationship between different types of care providers' willingness to suggest alternative and complementary treatments (CAM), patients' requests for CAM, and provider perceptions about CAM as barriers to effective healthcare. DESIGN: Large survey. SETTING: Alaska and New Mexico. MAIN MEASURES: Survey responses from 1528 physical and behavioral healthcare providers. RESULTS: Over 97% of providers suggested CAM; over 97% reported patients asked for CAM. Providers were more likely to suggest CAM than perceived CAM as a barrier to care. Healthcare providers who were female, from small rural areas, or specializing in behavioral healthcare were more likely to suggest CAM and less likely to perceive CAM as a barrier. Patients of physical healthcare providers asked for CAM more often than patients of behavioral healthcare providers, yet physical care providers suggested CAM less frequently. CONCLUSIONS: Healthcare providers of all disciplines, regions, and gender are sensitive to patients' desire for CAM and do not perceive CAM as a barrier to care.

Alaska↗
PubMed2004

International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions.

Researchers and clinicians worldwide share concerns that many youngsters with attention-deficit/hyperactivity disorder (ADHD) and/or disruptive behaviour disorders (DBDs) do not receive appropriate treatment despite availability of effective therapies. At the request of Johnson and Johnson (sponsor), 11 international experts in child and adolescent psychiatry were selected by Professor Stan Kutcher (chair) to address these concerns. This paper describes the experts' consensus conclusions, including treatment practice suggestions for physicians involved in the early treatment of youngsters with ADHD (or hyperkinetic disorder, in countries preferring this classification) and/or DBDs internationally: suggested first-line treatment for ADHD without comorbidity is psychostimulant medication aided by psychosocial intervention. For ADHD with comorbid conduct disorder (CD), psychosocial intervention combined with pharmacotherapy is suggested. For primary CD, suggested first-line treatment is psychosocial intervention, with pharmacotherapy considered as an 'add-on' when aggression/impulsivity is marked and persistent. Pharmacotherapy requires careful titration; full-day coverage is the suggested goal. Regular long-term follow-up is recommended.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Further evidence for a bipolar risk gene on chromosome 12q24 suggested by investigation of haplotype sharing and allelic association in patients from the Faroe Islands.

A number of studies have strongly suggested a susceptibility locus for bipolar affective disorder on chromosome 12q24. The present study investigates for a shared chromosomal segment among distantly related patients with bipolar affective disorder from the Faroe Islands, using 17 microsatellite markers covering 24 cM in the previously suggested region on chromosome 12q24. D12S342 showed possible allelic association to bipolar affective disorder (P-value using CLUMP below 0.01). Increased sharing among cases of two-marker haplotypes were suggested at D12S1614--D12S342 (P-values using CLUMP below 0.01), and D12S2075--D12S1675 (P-values using CLUMP around 0.001). The region of most interest is around 6 cM and bounded by markers D12S1614 and D12S1675 as suggested by the interesting two-marker haplotypes. This area contains the minimum interesting region between D12S342 and D12S1658 suggested by the previously reported haplotypes in the two Danish families with bipolar affective disorder.

Bipolar Disorder↗
PubMed1995

The spatial and temporal expression of the alpha 2 beta 1 integrin and its ligands, collagen I, collagen IV, and laminin, suggest important roles in mouse mammary morphogenesis.

To begin to determine the role of the alpha 2 beta 1 integrin and its ligands, collagen I, collagen IV, and laminin, in mammary epithelial differentiation in vivo, we determined the expression of these molecules by in situ hybridization and immunofluorescence in the developing mouse mammary gland. Expression of collagen I, collagen IV, and laminin mRNAs in the mammary gland during puberty corresponded to the period of greatest growth of the gland, 4-7 weeks postnatally. Collagen I expression preceded collagen IV expression, both of which preceded laminin expression, suggesting an important temporal sequence of extracellular matrix (ECM) production. When growth of the epithelium ceased in the adult virgin gland, expression of all three mRNAs became undetectable. Following the onset of pregnancy these molecules were re-expressed with the same chronology observed during puberty. Collagen I, collagen IV, and laminin were expressed by stromal cells immediately surrounding the developing ductal epithelium. Surprisingly, we found no expression of ECM components in the epithelial cells, suggesting the mammary epithelium does not synthesize its own basement membrane. The distribution of collagen I was consistent with a role in duct formation, since collagen I was strikingly abundant around larger mammary ducts, but was sparse around growing endbuds or alveoli. Conversely, there was abundant laminin near growing endbuds and around alveoli, and less around large ducts, suggesting its role is different than collagen I. The alpha 2 beta 1 integrin was present on the basal, lateral, and apical surfaces of the mammary epithelium throughout postnatal development and pregnancy. The alpha 2 beta 1 integrin expression was strongest at midpregnancy, suggesting a role for alpha 2 beta 1 integrin in the alveolar formation that occurs at this time. The alpha 2 beta 1 integrin expression decreased dramatically in the lactating gland. Our results suggest that alpha 2 beta 1 integrin interactions with its temporally and spatially regulated ligands, collagen I, collagen IV, and laminin, could play an important role in mammary morphogenesis in vivo.

Animals↗
PubMed1991

Integrin alpha 6/beta 4 complex is located in hemidesmosomes, suggesting a major role in epidermal cell-basement membrane adhesion.

The alpha 6/beta 4 complex is a member of the integrin family of adhesion receptors. It is found on a variety of epithelial cell types, but is most strongly expressed on stratified squamous epithelia. Fluorescent antibody staining of human epidermis suggests that the beta 4 subunit is strongly localized to the basal region showing a similar distribution to that of the 230-kD bullous pemphigoid antigen. The alpha 6 subunit is also strongly localized to the basal region but in addition is present over the entire surfaces of basal cells and some cells in the immediate suprabasal region. By contrast staining for beta 1, alpha 2, and alpha 3 subunits was very weak basally, but strong on all other surfaces of basal epidermal cells. These results suggest that different integrin complexes play differing roles in cell-cell and cell-matrix adhesion in the epidermis. Immunoelectron microscopy showed that the alpha 6/beta 4 complex at the basal epidermal surface is strongly localized to hemidesmosomes. This result provides the first well-characterized monoclonal antibody markers for hemidesmosomes and suggests that the alpha 6/beta 4 complex plays a major role in epidermal cell-basement membrane adhesion. We suggest that the cytoplasmic domains of these transmembrane glycoproteins may contribute to the structure of hemidesmosomal plaques. Immunoultrastructural localization of the BP antigen suggests that it may be involved in bridging between hemidesmosomal plaques and keratin intermediate filaments of the cytoskeleton.

Animals↗
PubMed2001

Accuracy and qualities of real and suggested memories: nonspecific age differences.

This study examined adult age differences in the accuracy, confidence ratings, and vividness ratings of veridical and suggested memories. After seeing either one or two exposures of a vignette depicting a theft, young adults (M = 19 years) and older adults (M = 73 years) were given misleading information that suggested the presence of particular objects in the episode. Memory accuracy was higher for younger adults than for older adults, and the frequency of falsely reporting the presence of suggested objects was greater for older adults than for young adults. Further, levels of confidence and vividness ratings of the perceptual attributes (colors, locations) of falsely recognized items were higher for older adults than for young adults. Both young adults and older adults used more perceptual references when describing veridical memories than when describing suggested memories. Age differences in the suggestibility of memory were attributed to nonspecific or nondissociated memory aging effects.

Adolescent↗
PubMedDate not supplied

Who first suggests the diagnosis of attention-deficit/hyperactivity disorder?

PURPOSE: We wanted to survey physicians in the Washington, DC, metropolitan area regarding the frequency with which physicians, teachers, parents, and others first suggest the diagnosis of attention-deficit/hyperactivity disorder (ADHD). METHODS: A questionnaire was mailed to all family physicians, primary care pediatricians, and child psychiatrists in greater Washington, DC. In answer to the question, "Who first suggests the diagnosis of ADHD?" respondents assigned percentages to primary care physicians, consultants, parents, teachers, etc. RESULTS: Teachers were most likely to be first to suggest the diagnosis of ADHD (46.4%; 95% CI, 44.1%-48.7%), followed by parents (30.2%; 95% CI, 28.3%-32.0%), primary care physicians (11.3%; 95% CI, 9.7%-12.8%), school personnel other than teachers (6.0%; 95% CI, 4.9%-7.2%), consultants such as child psychiatrists or psychologists (3.1%; 95% CI, 2.3%-3.9%) and other specified categories (3.0%; 95% CI, 2.4%-3.6%). CONCLUSIONS: Teachers and other school personnel are often the first to suggest the diagnosis of ADHD in children in the greater Washington, DC, area. Regional variations in the prescribing of medication for ADHD may be caused at least in part by variations in the likelihood of a teacher suggesting the diagnosis of ADHD.

Attention Deficit Disorder with Hyperactivity↗
PubMed1976

Possible function of human brown adipose tissue as suggested by observation on perirenal brown fats from necropsy cases of variable age groups.

In 134 out of 180 perirenal fat samples (74%) derived from Japanese necropsy cases aged from 1 month to 86 years, the brown fat tissue persisted in variable amounts. Brown fat cells were classified into 6 types: Type 1 cells are fat-depleted cells filled with granular cytoplasm and are believed to be produced after oxidation of fat for heat production. Type 2 cells are small-locular cells suitable for rapid oxidation of fat droplets. Type 3 (middle-locular) and 4 (large-locular) represent fat-storage cells containing large amounts of fat. Type 5 cells are thought to be transitional forms between multilocular brown fat cells and monolocular white fat cells. Type 6 (cytoplasm-rich multilocular) cells, usually found together with Type 1 cells, are thought to be fat-depleting or -consuming cells, since in them fat droplets are reduced in number and size probably in consequence of oxidation of fat, but by contrast granular cytoplasm is increased in amount separating the individual fat droplets by thick cytoplasmic septa. The occurrence of Types 1 and/or 6 cells that has been revealed in 65 out of the total 180 samples (36%), suggests that the oxidation of fat for the thermogenesis proceeds in the brown fat tissue and that brown fat cells partially undergo fat depletion. In the present study, the thermogenesis of human brown fat tissue was suggested chiefly with regard to the occurrence of Types 1 and/or 6 cells. In the majority of perirenal fat samples from infants (1-11 months) relatively numerous Types 1 and 6 cells were frequently revealed together with Type 2 cells, suggesting rapid and active heat production in support of the view that in human infants the brown fat tissue may be thermogenetically active to maintain body temperature. In the same manner, marked ability to produce a considerable amount of heat was evidenced in brown fat tissue of children and teenagers. In younger and elderly adults the frequency of occurrence and the amount of the perirenal brown fat tissue were decreased but Types 1 and/or 6 cells could be found in 17-40% of them, infrequently together, with Type 2 cells, suggesting persistence of the thermogenic activity with occasional large heat production especially in younger adults (20-39 years). Thus, the results obtained in this study have clarified that the human brown fat tissue can respond to stimuli given to the body by oxidation of stored fat even in the latest decades of life. In cases of death from burning, drowning, bleeding, drug poisoning etc., numerous Types 1 and/or 6 cells were found, suggesting that an active fat oxidation would take place in brown fat tissue assumedly as the result of the raised noradrenalin level in this tissue. The so-called small cytoplasmic cells found in perirenal fats from cases of death from liver cirrhosis and other causes were assumed to be atrophic fat-depleted brown fat cells.

Adipose Tissue, Brown↗
PubMed1991

Retrospective treatment of incest victims: suggested analytic attitudes.

This paper includes a brief consideration of literature relevant to childhood sexual abuse detection and prevalence. That literature indicates that such detection may be difficult and that the occurrence of childhood sexual abuse is widespread. These findings, as well as a consideration of literature relevant to trauma, stress, and the identification of survivors of sexual abuse, suggest an analytic attitude of receptivity to the hypothesis of the event of sexual abuse as well as the fantasy of sexual abuse. A second analytic attitude suggested concerns diagnosis. Childhood trauma is implicated in the development of BPD, as the majority of borderline patients have experienced the trauma of child abuse. Further, trauma can lead to dissociation as a defense against stress, and multiple personality disorder is an extreme example of dissociation. The analytic attitude suggested here is that the diagnosis of BPD or MPD may be a necessary but not a sufficient explanation when the symptomatology is a defensive reaction to the traumatic event of childhood sexual abuse. Lastly, it is suggested that the abuse may need to be central to the treatment in analytic work with sexually abused victims. This is suggested in light of the importance of recovery and integration of traumatic memories with their associated affects.

Adult↗
PubMed1986

Emotionally triggered asthma as a predictor of airway response to suggestion.

Twenty-nine male and female adults with asthma were tested to determine the relationship between perceived response to emotional triggers of asthma and bronchoconstrictive suggestion. Subjects were told that they were inhaling a bronchoconstricting agent in four increasingly potent concentrations, when in fact the solution the subjects inhaled was nebulized isotonic saline. Ten subjects responded to suggestion with a greater than 20% increase in specific airway resistance, but this response could not be predicted by the report of perceived emotional triggers of asthma. The finding that perception of asthmatic response to emotional arousal does not predict airway response to bronchoconstrictive suggestion may mean that suggestion is an invalid proxy variable for studying the role of psychological factors in provocation of asthma.

Adult↗
PubMedDate not supplied

Blood pressure responses to hypnotic and nonhypnotic suggestions in normotensive subjects.

Forty normotensive subjects participated on a voluntary basis in a study designed to compare the effect of suggestions on blood pressure (BP). Two experimental groups received suggestions presumed to be specific in lowering or raising BP after simple relaxation (relaxation group) or hypnotic induction (hypnotic group). A control group was used to record the BP changes over time. The time variable was significant for both systolic (SBP) and diastolic blood pressure (DBP). Induction procedures (hypnosis or relaxation) resulted in significant decreases in DBP in both experimental groups. In the control group there was a significant decrease in SBP. A specific suggestion to increase the BP resulted only in DBP increase in the hypnotic group. This group also gave an increase of both SBP and DBP over the entire experiment, whereas the relaxation group resulted in a significant decrease in SBP. There was no significant group variable, indicating no differences between the groups. Further research is needed to enable firm conclusions of the effect of suggestions on BP.

Adult↗
PubMed1984

Changes in rectal and mean skin temperature in response to suggested heat during hypnosis in man.

Rectal temperature, mean skin temperature and heart rate were recorded in 7 subjects during hypnosis, induced either alone or while sensations of heat were suggested. During hypnosis alone, a fall in the heart rate of about 10 beat X min-1 was the only autonomic response observed; body temperatures were unaltered. In contrast, during hypnosis with suggestion of heat, the following changes occurred: (1) Mean rectal temperature decreased 0.20 degrees C (p less than 0.05) within 50 min. Its mean time course differed significantly from that for hypnosis alone (p less than 0.001). (2) Comparison of individual rectal temperature time sequences showed that in fact this temperature only declined in 4 subjects out of 7, and tended to form a plateau located 0.35 degrees C below the value of the preceding waking state. Despite reinforcement of heat suggestion, the plateau continued until the end of the hypnotic trance. (3) Mean skin temperature tended to rise. (4) When hypnosis with suggestion ceased, both rectal and skin temperatures very slowly returned to their levels during the preceding waking state.

Adult↗