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PubMed1989

On a type of heterosexuality, and the fluidity of object relations.

This paper delineates a form of heterosexuality whose underlying psychological structure resembles that of perversions. It is characterized by: idealization of instinctual processes, whereby the ego subordinates the object to the actualization of the instinctual event itself; heightened narcissism in an otherwise neurotic ego organization; multiple intrapsychic uses of the object; a special kind of defensive organization; an experienced victory over the superego and associated elevation of certain aspects of the ego ideal; and a resultant alteration in the nature of close interpersonal relationships. I use clinical vignettes from both male and female patients in psychoanalysis to focus on the phenomena in question. The thinking of Chassequet-Smirgel, Freud, Khan, Rangell, Socarides, and others is used in an attempt to gain an encompassing perspective. It is emphasized that patients demonstrating this form of heterosexuality do not possess a perversion per se, but demonstrate a character neurosis which integrates certain perverse mechanisms into its defensive organization. These mechanisms can be isolated and studied in psychoanalytic treatment, with the potential for illuminating their defensive and mood-regulating functions, and eventual working through and resolution of the intrapsychic conflicts underlying them. Some comments on the implications of this form of sexuality for our contemporary culture are included.

Adult↗
PubMedDate not supplied

Multiple breeding females in captive groups of golden-headed lion tamarins (Leontopithecus chrysomelas): causes and consequences.

In Callitrichidae, reproduction in subordinate females is generally inhibited but occurs in rare cases, possibly in association with the presence of an unrelated male, important food resources or low dispersal opportunities. This study investigates the occurrence of groups with multiple breeding females in captive golden-headed lion tamarins (Leontopithecus chrysomelas), the factors leading to their formation and the consequences for the group. Information obtained from studbook data on the world captive population during 1984-1998 revealed that polygynous groups in captivity are very rare: only 7 cases were discovered. Family groups in which daughters started breeding with a related male were larger than average, had a high number of sexually mature sons and eldest offspring that were well past the age of sexual maturity. Following a breeding attempt, severe aggression frequently occurred, especially if the infants were liveborn. Polygynous groups composed of two related females and an unrelated male tended to remain stable for a longer period than families with breeding daughters. Competition for infant care is probably an important factor determining whether the polygynous situation can persist and for how long.

Age Factors↗
PubMedDate not supplied

Patterns and predictions of resident misbehavior--a 10-year retrospective look.

BACKGROUND: Surgical educators are charged with ensuring that their trainees conduct themselves in a professional manner. The authors retrospectively reviewed a 10-year experience of incident reports on surgical housestaff to determine patterns and predictors of behavior. METHODS: A retrospective review of all letters, e-mails, and incident reports was conducted for general surgery residents from 1995 to 2005. Descriptive variables were selected for binary categorization (not mutually exclusive): poor professional conduct, protocol violation, administrative deficiency, verbal mistreatment, physical boundary issues, mistreatment of superiors, and deficient medical student interaction. Resident status was defined as current, graduate, and attrition. RESULTS: Of 110 residents [90 [82%] categorical, 23 [21%] undesignated preliminary (3 overlapped both groups); 87 [79%] male, 23 [21%] female] who trained at the University of Pennsylvania during this period, 66 complaints were generated about 29 individuals. Overall, 50 of the 66 complaints (76%) were directed toward men and the remaining 16 (24%) toward women; 24% of all men and 35% of all women received 1 or more complaints. A total of 76% of complaints concerned categorical residents and 24% undesignated preliminary residents. And 26% of all categorical residents and 26% of all preliminary residents received at least 1 complaint. The most common complaints concerned professional conduct (83%), protocol violation (33%), verbal mistreatment (23%), deficiencies of administrative duties (8%), violations of physical boundaries (5%), deficient medical student interaction (5%), and mistreatment of attendings by residents (3%). Recipients of verbal mistreatment included staff nurses (27%), radiology technicians (13%), medical students (13%), environmental services employees (7%), security guards (7%), patients (7%), surgery attendings (7%), anesthesia attendings (7%), internal medicine chief residents (7%), and pharmacists (7%). A total of 31% of the complaints were regarding residents who involuntarily departed and 7% regarding residents who left voluntarily before completion. The mean PGY level at first complaint was 2.2 years. Of the 29 residents receiving complaints, 16 had recurrent offenses (range 2 to 7 total complaints, positive predictive value [PPV] 53%). CONCLUSION: Resident misbehavior manifests early and recurs often. Furthermore, it is frequently directed toward perceived subordinates. Nondesignated preliminary status, premature departure from the program, and the eventual selection of specific subspecialty fellowships seems to increase the risk for resident misbehavior. Identified residents require close surveillance and remediation.

Adult↗
PubMed1988

Control of aggression and dominance in white-throated sparrows by testosterone and its metabolites.

In three experiments, we investigated whether testosterone itself or its metabolites activate aggression and dominance in white-throated sparrows Zonotrichia albicollis. Groups of five to six sparrows, each treated with a different steroid implanted subcutaneously, were observed in outdoor aviaries during late winter to determine the birds' rates of aggression (supplantations and attacks scaled to the number of available subordinates) and dominance rankings with opponents not previously encountered. In Experiment 1, testosterone (T) had a greater effect on aggression and dominance than did androstenedione, 5 alpha-dihydrotestosterone (D), androsterone, or estradiol (E). In Experiment 2, birds with T or D + E had higher aggression scores and dominance ranks than birds with either D or E alone. Birds with T and D + E did not differ. The testosterone metabolites, D and E, thus acted synergistically to determine rates of aggression and dominance ranks. To corroborate these results, in Experiment 3 we treated T-implanted birds with the following blocking agents: ATD, expected to reduce conversion of T to E (AT birds); progesterone, expected to reduce conversion of T to D (PT birds); or both (APT birds). The APT birds had lower aggression scores and dominance ranks than did AT or PT birds, despite having higher mean levels of circulating T than AT or PT birds or birds implanted with T alone. Cyproterone acetate also reduced aggression scores and dominance in T-implanted birds. We conclude that the hormonal control of aggression and dominance in these birds requires conversion of testosterone to both androgenic and estrogenic metabolites.

Aggression↗
PubMed2004

The genesis of public health ethics.

As bioethics emerged in the 1960s and 1970s and began to have enormous impacts on the practice of medicine and research--fuelled, by broad socio-political changes that gave rise to the struggles of women, African Americans, gay men and lesbians, and the antiauthoritarianism impulse that characterised the New Left in democratic capitalist societies--little attention was given to the question of the ethics of public health. This was all the more striking since the core values and practices of public health, often entailing the subordination of the individual for the common good, seemed opposed to the ideological impulses of bioethics. Of what relevance is autonomy-focused bioethics for public health, with its mix of justifications including those that are either implicitly or explicitly paternalistic or that seek to impose strictures on individuals and communities in the name of collective welfare? To examine the deep divide between the central commitments of bioethics and the values that animate the practice of public health, we focus on a series of controversies implicating the concepts of privacy, liberty, and paternalism. Recognising the role of moral values in decision-making was a signal contribution of bioethics in its formative period. Over the past three decades a broad array of perspectives emerged under the rubric of bioethics but individualism remains central. As we commence the process of shaping an ethics of public health, it is clear that bioethics is the wrong place to start when thinking about the balances required in defence of the public's health.

AIDS Serodiagnosis↗
PubMed2001

Regulation of the hypothalamic-pituitary-adrenocortical system in mice deficient for CRH receptors 1 and 2.

Recent investigations in mouse lines either deficient for the CRH receptor 1 (CRHR1) or 2 (CRHR2) suggest that the CRH neuronal system may comprise two separate pathways that can be coordinately and inversely activated in stress-induced hypothalamic-pituitary-adrenal (HPA) response and anxiety-like behavior. We generated mice deficient for both CRHR1 (Crhr1(-/-)) and CRHR2 (Crhr2(-/-)) to investigate the HPA system regulation in the absence of known functionally active CRH receptors under basal conditions and in response to different ethologically relevant stressors. To elucidate possible gene dose effects on the action of both CRH receptors, our analysis included heterozygous and homozygous CRHR1- or CRHR2-deficient mice, mutants lacking both CRH receptors, compound mutants with homozygous and heterozygous deficiency for either of the receptors, and their wild-type littermates. Both male and female Crhr1(-/-)Crhr2(-/-) mutants were viable, fertile, and indistinguishable in size from wild-type littermates. We show that the endocrine phenotype of mice lacking both CRHRs is dominated by the functional loss of CRHR1. CRHR2 does not compensate for CRHR1 deficiency, nor does the lack of CRHR2 exacerbate the CRHR1-dependent impairment of the HPA system function. Within the intraadrenal CRH/ACTH system, our data suggest different roles for CRHR1 and CRHR2 in fine-tuning of adrenocortical corticosterone release.

Adrenal Cortex↗
PubMed1996

Reproductive suppression in subordinate, non-breeding female Damaraland mole-rats: two components to a lifetime of socially induced infertility.

The Damaraland mole-rat Cryptomys damarensis exhibits an extreme reproductive division of labour. Reproduction in the colony is restricted to a single breeding pair, resulting from a two-fold control: (i) a reduced pituitary synthesis and/or secretion of luteinizing hormone leading to a block to ovulation in non-reproductive females; and (ii) a strong inhibition to breeding with familiar kin. Circulating basal concentrations of luteinizing hormone as well as luteinizing hormone levels measured in response to a single exogenous gonadotrophin releasing hormone challenge, were significantly lower in non-reproductive females in the presence of the reproductive female than those in colonies lacking a reproductive female. Urinary progesterone concentrations before the removal of the reproductive female were significantly higher in non-reproductives than the post removal values. Behavioural studies from sib-sib and non-sib pairings provide evidence for a strong incest avoidance, probably resulting from an inhibition of breeding with familiar colony members. A total of four pairings of non-sibs resulted in copulatory activity and eventual conception. In contrast, four couples of sib-sib combinations failed to produce any sexual activity or offspring. Thus, suppression of reproduction in these non-reproductive, subterranean bathyergids is complicated by the masking effect of familiarity that prevents incest, in addition to the physiological inhibition of fertility in the presence of the reproductive female.

Animals↗
PubMed2003

Nature of the distribution of serotonin and a serotonin metabolite in brain structures and the development of immunosuppression in submissive mice.

Studies of C57BL/6J mice with acquired submissive behavior in a sensory contact model demonstrated increases in serotonin (5-HT) levels in the amygdaloid complex, hippocampus, the dopaminergic nuclei A11, A10, and A9, and in the caudate nucleus and hypothalamus, compared with controls, after 10 and 20 days of confrontations. Levels of the 5-HT metabolite 5-hydroxyindoleacetic acid (5-HIAA) in most structures were significantly higher after 20 days of confrontations than after 10 days. Increases in the 5-HIAA/5-HT ratio in the cervical nuclei of the midbrain, nucleus accumbens, A9, and hypothalamus as compared with controls were seen in mice with 10 and 20 days of confrontations. Immunization of mice on days 10 and 20 of confrontations showed suppression of immune responses as compared with controls, while immune measures reached control values by 40 days of experience of defeat. Thus, experience of 10 days of defeat led to immunosuppression on a background of activation of the 5-HT system in a series of brain structures: the cervical nuclei of the midbrain, the nucleus accumbens, and A9. As confrontations continued, there were decreases in the 5-HIAA/5-HT ratio on these structures, along with a tendency for immune responses to increase.

Animals↗
PubMed2000

Survivor guilt, submissive behaviour and evolutionary theory: the down-side of winning in social comparison.

In prior research submissive behaviour has been studied in relation to social comparison. Evolutionary theory conceptualized submissive behaviour as a fear-based self-protective strategy when in a subordinate position. In this study we hypothesized that survivor guilt, the type of guilt associated with feeling better off than others, is also linked to submissive behaviour. The Interpersonal Guilt Questionnaire, the Submissive Behaviour Inventory, the Eysenck Personality Questionnaire-Revised and the Automatic Thoughts Questionnaire were administered to a sample of 199 college students. Submissive behaviour was found to be significantly correlated with survivor guilt. Introversion, used as an indirect measure of the fear of being put down, was also correlated with submissive behaviour. A principal components analysis found two components: the first was composed of high loadings of submissiveness, survivor guilt and omnipotent responsibility guilt; the second was composed of high loadings of submissiveness and introversion. This supports the hypothesis that there may be two motivational states related to submissive behaviour, the fear of harm to the self, as described in prior studies, and the fear of harm to another or guilt-based submissive behaviour. We propose that survivor guilt has been selected by evolution as a psychological mechanism supporting group living, and that it may be considered from the perspective of inclusive fitness, reciprocal altruism, and multilevel selection theory.

Adaptation, Psychological↗
PubMed2005

Laterality of hand function in naturalistically housed chimpanzees (Pan troglodytes).

Studies of laterality of hand function in chimpanzees (Pan troglodytes) have the potential to tell us about the origins of handedness in Homo sapiens. However, the data are confusing, with discrepancies present between studies done in the field and the laboratory: the former show wild chimpanzees to be unlateralised at the population level, while the latter show captive chimpanzees as lateralised at the population level. This study of 26 semi-free ranging chimpanzees of Chester Zoo, UK, aimed to investigate a situation between the wild and captivity and provided ethological data for 43 categories of spontaneous manual use and 14 categories of tool use. Other variables recorded were subordinate hand activity, whether the subject was arboreal or terrestrial, and the identity of the subject. Using switching focal subject sampling, 23,978 bouts of hand use and 1,090 bouts of tool use were recorded. No population-level handedness was present for manual non-tool use activities in the naturalistically housed chimpanzees of Chester Zoo in a similar way to studies of wild chimpanzees. However, about half of the individuals were lateralised to one side or the other for the foraging behaviours of pick up, eat, and pluck. Using a modified version of McGrew and Marchant's (1997) Laterality Framework, these results are comparable to some wild and captive populations for similar foraging tasks. Bimanuality was rare and thus prevented comparison with captive experimental studies that have reported population right handedness. Behaviour involving contact with water elicited stronger lateralisation. Chester chimpanzees were more likely to exhibit hand preferences for manual tasks with increasing age but there were no effects of sex or rearing history on hand specialisations in adult individuals. Lateralisation was biased in tool use, which evoked significant left hand preferences in half the individuals, with no effect of age. Results are discussed comparatively with reference to methodological and developmental issues. Longitudinal studies of hand use are needed to increase our understanding of laterality of hand use in chimpanzees.

Animals↗
PubMed2001

Social, state-dependent and environmental modulation of faecal corticosteroid levels in free-ranging female spotted hyenas.

Little is known about to what extent the sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis may be state dependent and vary in the same species between environments. Here we tested whether the faecal corticosteroid concentrations of matrilineal adult female spotted hyenas are influenced by social and reproductive status in adjacent ecosystems and whether they vary between periods with and without social stress. Females in the Serengeti National Park frequently become socially subordinate intruders in other hyena territories by undertaking long-distance foraging trips to migratory herds, whereas in the Ngorongoro Crater they usually forage inside their own small territories on resident prey. The faecal corticosteroid concentrations in Serengeti females were significantly higher than in Ngorongoro females. Energy expenditure by lactation is exceptionally high in spotted hyenas and this may be reflected in their corticosteroid levels. The faecal corticosteroid levels in both populations were higher in lactating than in non-lactating females. During periods of social stability, faecal corticosteroid concentrations increased in non-lactating females but not in lactating females as social status declined. Lactating Serengeti females had significantly higher faecal corticosteroid concentrations during periods with acute severe social stress than during periods without, indicating that the HPA axis is sensitive to social stimuli even in lactating females. So far few studies have used non-invasive monitoring methods for assessing social stress in freeranging animals. This study demonstrates for the first time, to the authors' knowledge, that corticosteroid concentrations may differ between periods with and without social stress for a free-ranging female mammal and that the modulating effect of social status may depend on reproductive status.

Adrenal Cortex Hormones↗
PubMed2001

Cardiac autonomic responses to intermittent social conflict in rats.

Intermittent exposure to the same stressor can lead to a gradual decline in physiological, neuroendocrine and behavioral stress responses (habituation). We investigated possible habituation of cardiac autonomic responsiveness and susceptibility to cardiac arrhythmias in male rats exposed to either intermittent social victory (VIC) or defeat (DEF) stress (10 exposures in each case). Electrocardiograms were recorded via radiotelemetry and the sympathovagal balance at the level of the heart was evaluated via time-domain measurements of heart rate variability, namely average R--R interval (average time interval between two consecutive heart beats, RR), the standard deviation of RR (SD(RR)) and the root-mean-square of successive R--R interval differences (r-MSSD). Values of these parameters were significantly lower in DEF as compared to VIC rats in the second part of the test period (from Minute 6 to Minute 15), suggesting a more pronounced sympathetic dominance in the former group of animals. Accordingly, the occurrence of the most frequent cardiac arrhythmias (ventricular and supraventricular premature beats) was higher in DEF rats. Habituation of cardiac autonomic responsivity was observed across repeated exposure to victory, both in terms of sympathovagal balance and susceptibility to cardiac tachyarrhythmias, whereas no habituation was found in repeatedly defeated animals. A possible explanation to this discrepancy could be the different degree of controllability characterizing the two social challenging situations.

Animals↗
PubMedDate not supplied

Hostile personality and risks of peripheral arterial disease in the general population.

The relationships between personality and risks of coronary heart disease have been studied widely, but little attention has been paid to other forms of atherosclerotic disease. The objective of this study was to determine relationships in the general population between hostile personality and Type A behavior pattern with asymptomatic and symptomatic chronic peripheral arterial disease. The Edinburgh Artery Study comprises a cross-sectional random sample survey of 1592 men and women aged 55 to 74 years sampled from age-sex registers of 10 general practices throughout the city. Peripheral arterial disease was measured using the WHO questionnaire on intermittent claudication, the ankle brachial pressure index, and a reactive hyperemia test. The Bedford Foulds personality deviance questionnaire was used to elicit extrapunitiveness, intropunitiveness, and dominance (including hostile acts); and the Bortner self-administered questionnaire was used to determine Type A/B personality. Hostile acts increased with severity of peripheral arterial disease; there was a mean score of 13.9 in normals and 14.6 in claudicants (p < .05). An increased risk of claudication associated with a one SD increase in hostile acts was significant (p < .05) only in males, odds ratio, 1.41 (95% confidence interval 1.01, 1.96) and was independent of cigarette smoking, alcohol consumption, obesity, and diabetes mellitus. Dominance was also related to asymptomatic peripheral arterial disease in subjects who had neither intermittent claudication nor angina. Contrary to expectations, Type A personality behaviour scores decreased with the severity of peripheral arterial disease. We conclude that hostile personality may be an independent risk factor for chronic peripheral arterial disease in the general population, particularly among men.

Aged↗
PubMed2005

Effect of sex ratio on the immune system of Oreochromis mossambicus (Peters).

The social environment of fish has a crucial role to play on the immune system and hence on the overall health status. Stressors of social origin such as dominance, subordination, and fight for mate have a major impact on the immune system of fish. The present study was designed with the objective of finding the effect of sex ratio of the population on the immune system of Oreochromis mossambicus. Groups of fish were maintained for 28 days in three different sex ratios i.e., (i) all-male (ii) all-female (iii) equal male and female (mixed). The specific immune response of fish was assessed by antibody response to Aeromonas hydrophila by ELISA and bacterial agglutination assay, and to SRBC by plaque forming cell assay. Nonspecific immune mechanisms were assessed in terms of serum lysozyme activity, production of intracellular reactive oxygen species (ROS) and reactive nitrogen species (RNS) by peripheral blood leukocytes. Disease resistance against live, virulent A. hydrophila was performed to assess the overall functional immunity. The results showed that antibody responses and numbers of antibody producing cells were increased in fish in the equal male and female sex ratio group compared to fish in monosex ratio groups. Similar enhancement was also observed in nonspecific serum lysozyme level and the ROS and RNS production. The host resistance test revealed that enhanced immunity in equal male and female sex ratio group was protective against A. hydrophila infection. The study clearly reveals positive and negative effect of sex ratio on the immune system of O. mossambicus.

Aeromonas hydrophila↗
PubMed2003

Double dissociation of social functioning in frontotemporal dementia.

BACKGROUND: Efforts to characterize changes in social functioning in frontotemporal dementia (FTD) have failed to elicit clear dissociation between frontal and temporal variants of the disease based on behavioral measures. METHODS: This study obtained premorbid and current first-degree relative ratings using an established measure of interpersonal functioning, the Interpersonal Adjectives Scales, to measure personality change in 16 patients with frontal variant (FLV) and 13 with temporal variant (TLV) FTD, and in a control group of 16 patients with AD. RESULTS: All three groups showed significant change over time in multiple domains, including increased introversion (FG) and submissiveness (HI). However, patients with both FTD subtypes evidenced significantly greater increases in overall interpersonal pathology vector length [VL] than did patients with AD, who remained within the normal range on all scores. Patients with FLV showed a 2 SD increase in submissiveness (HI), but their cold-heartedness (DE) change scores were not significantly different from those of patients with AD. Conversely, the TLV cold-heartedness (DE) score increased 2 SD compared to minimal change for the AD and FLV groups, yet change in submissiveness (HI) did not differentiate between AD and TLV groups. CONCLUSIONS: The Interpersonal Adjectives Scales differentiated both FTD groups from patients with AD on the basis of both degree and direction of personality change. Also, the two subtypes of FTD showed distinctly different patterns of change in social functioning: patients with temporal variant shifted toward severe interpersonal coldness with mild loss of dominance, whereas patients with frontal variant showed the opposite pattern.

Alzheimer Disease↗
PubMed1991

Modifications of social conflict-induced analgesic and activity responses in male mice receiving chronic opioid agonist and antagonist treatments.

This study examined the effects of chronic (7 day) administrations of opioid agonists, via osmotic minipumps (20 micrograms/microliters/h, or 2 mg/kg/h for each agent) on: 1) nociception and activity, and 2) the analgesic and locomotor responses of subordinate male mice experiencing social conflict (aggression without defeat) and defeat in a "resident-intruder" paradigm. Chronic infusion of the mu opioid antagonist, naltrexone, resulted in a hypoanalgesic response and a decrease in basal locomotor activity on days 3-7 postimplantation which returned to the basal levels of saline-implanted control mice after termination of the infusions on day 9. Naltrexone reduced defeat-induced analgesia on the second day after implantation, but had no consistent effects on analgesia on test days 6 and 9 or on the aggression-induced (nondefeat) analgesia and increases in activity. The delta opioid antagonist ICI-154, 129, while having no significant effects on basal nociception or locomotor activity, augmented nondefeat-induced analgesia (day 2) and reduced the defeat-induced increases in activity (days 2 and 6). The mu agonist, levorphanol, resulted in a significant analgesia on the first two days after infusion, followed by the development of tolerance to the analgesic effects over days 3-7. On day 9, a hypoanalgesic response indicative of withdrawal was evident. Levorphanol also induced a marked decrease in locomotor activity over days 3-7 postimplantation, with no evidence of the development of tolerance or withdrawal following termination of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMed1998

Managerialism and the British GP: the GP as manager and as managed.

The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health insurance in the UK. From the outset it had an impact on GPs' medical role, their professional status and income. The structure created in 1911 meant that GPs operated as franchisees and, notwithstanding Labour's policy objective of creating a salaried service, this role continued, effectively unchanged, after the creation of the National Health Service (NHS) in 1948. General practice was also the poor relation in contrast to hospital medicine, a feature intensified by the priorities of the NHS. These forces meant that GPs had a dual role: that of clinician and gatekeeper to specialist hospital services, a role in which they exercised substantial clinical freedom: and running a small business, a feature which was exaggerated by the absence of grant aid to improve premises prior to the Family Doctor Charter of 1965. This structural relationship has been progressively transformed by changes in the 1980s and 1990s. On the one hand the emphasis on cost control has seen central government attempting to combine a financial with a clinical gate-keeping keeping role. The crucial change in this respect is the creation of GP fundholding which, in turn, could be seen to have implications for the subordinate status of GPs within the medical profession. However, this has been combined with trends to greater measures of control over GPs. Of central importance in this respect were the changes introduced by the 1990 GP contract. The contract involved an attempt to substantially reduce clinical autonomy by building in much more detailed contractual duties with respect, for example, to health promotion activities. This was combined with the use of financial incentives to reach, for example, immunization targets. Control over clinical autonomy has also involved constraints over prescribing and the shift from Family Practitioner Committees to Family Health Service Authorities. The rationale for this shift is the move from an administrative to a managerial body, acting as the agent of central government in enforcing the contract and imposing financial norms. GPs are thus to be made managerially accountable. The paper analyses the place of general practitioners in central government's approach to health strategy and examines the tensions generated by the combination of conferring new powers on GPs and increasing controls over them. These tensions are related to current disputes over out-of-hours working and attempts by GPs to redefine a "core of service" approach to their job. The ambiguities of reliance on professionals combined with the desire to exert greater controls is traced in the recent policy statement by the Secretary of State, Primary Care: The Future (1996). The paper thus aims to contribute to the critical discussion of the impact of central government managerialist initiative on key professional groups in the welfare state.

Community Health Planning↗
PubMed2005

Behavioral inhibition system (BIS) strength and trait dominance are associated with affective response and perspective taking when viewing dyadic interactions.

The neurophysiology underlying the Behavioral Activation and Behavioral Inhibition Systems (BAS and BIS) and the impact of the strength of these systems on affective processing have received increased attention over the last 25 years. Specifically, left-frontal brain regions have been implicated in BAS strength as well as the experience of positive-approach affect (such as happiness). Conversely, BIS strength and negative-avoidance affect (such as fear) appear to be modulated by right-frontal brain regions. Taken together, it is not surprising that BAS and BIS strength have been associated with positive and negative affective biases, respectively, to emotional stimuli that do not involve extensive human interaction. The present investigation was designed to extend these findings by assessing the relationship between BAS and BIS strength on the perception of emotional interactions. Participants (n = 67) were shown four 2-min film clips that depict an individual exerting dominance over one or more other individuals. Each participant rated the clips with regard to valence, arousal, and dominance parameters, and then indicated the person(s) in the movie with whom they identified (i.e., the dominant individual or submissive individual[s]). Consistent with a priori hypotheses, persons identifying with the submissive character scored significantly higher on BIS sensitivity. BAS strength and BIS/BAS ratio, conversely, were not associated with character identification. Also as predicted, identification with the dominant movie character was associated with increased positive affect and feelings of dominance. Interestingly, although not hypothesized, trait dominance was also associated with character identification by virtue of being positively associated with BAS and PA and negatively associated with BIS and NA.

Adolescent↗