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PubMed1981

The partial reinforcement extinction effect after treatment with chlordiazepoxide.

Two experiments are reported, in which rats were run in a straight alley for food reward with or without injections of the anti-anxiety drug, chlordiazepoxide (CDP). The experiments were directed to two questions. (1) Can one predict the effects of CDP from knowledge of the effects of a second anti-anxiety drug, sodium amylobarbitone (SA) (2) can the effects of CDP be predicted from the hypothesis that anti-anxiety drugs attenuate responses to conditioned frustrative stimuli? The experiments examined the effects of CDP on the partial reinforcement extinction effect (PREE) at one trial a day. CDP injected throughout acquisition and extinction reduced the PREE. This effect was probably due to the presence of the drug during acquisition. Injected during extinction only, CDP increased resistance to extinction in both continuous and partial reinforcement groups. These effects of CDP were closely similar to those previously reported for SA, thus answering question (1) in the affirmative. The effects of CDP on the PREE were also consistent with the conditioned-frustration hypothesis (question 2).

Amobarbital↗
PubMed1985

Date rapists: differential sexual socialization and relative deprivation.

Deviant sexual behavior has often been portrayed as the consequence of the frustration of legitimate sexual outlets. This study of date rapists reveals that these men, as a result of a hypersexual socialization process, are sexually very active, successful, and aspiring. These exaggerated aspiration levels are seen as responsible for instituting a high degree of sexual frustration. This acute relative deprivation, it is hypothesized, is a significant process responsible for precipitating these rape episodes.

Family↗
PubMed2005

Acute insulin response of donors is correlated with pancreatic islet isolation outcome in the pig.

AIMS/HYPOTHESIS: Unpredictability of islet isolation outcome remains a frustrating and costly issue in the clinical implementation of islet transplantation. The aim of this experimental study was to test the hypothesis that the donor's insulin secretory reserve, an in vivo surrogate of functional pancreatic mass, is correlated with the outcome of islet isolation. METHODS: Insulin secretory reserve was evaluated in 28 healthy adult minipigs prior to pancreatectomy and islet isolation. Blood glucose and insulinaemia were measured before and 1, 3, 5, 10, 15, 30, 60 and 90 min after glucose infusion. Following total pancreatectomy, islet isolation was performed according to Ricordi's semi-automated method, and the total number of islets obtained was determined. Fasting blood glucose, insulinaemia, acute insulin response (AIR), maximal insulinaemia and the glucose decay constant (K(G)) were calculated, and possible associations with the outcome of islet isolation were assessed. RESULTS: AIR and maximal insulinaemia after glucose injection were correlated with the outcome of islet isolation (p<0.01). Mean values for AIR and maximal insulinaemia were significantly different between animals in which islet isolation was successful (n=11) vs those in which it was unsuccessful (n=17) (77.6+/-13.7 microU/ml vs 42.3+/-7.8 microU/ml, p<0.05; 144.7+/-21.6 microU/ml vs 71.9+/-10.4 microU/ml, p<0.05, respectively). CONCLUSIONS/INTERPRETATION: This study suggests that the donor's pancreatic endocrine mass, as estimated by AIR, is a major determinant of the outcome of islet isolation in large mammals. Our results may explain the frustrating variability of human islet isolation outcome and could lead to a new approach for optimising the selection of brain-dead and/or living pancreas donors.

Animals↗
PubMed1999

Hostility and coping capacity as risk factors of elder mistreatment.

In the present study we investigate whether, in addition to established risk factors, some personality traits of the victims are associated with elder mistreatment. Identified victims of chronic verbal aggression (n = 37), physical aggression (n = 38) and financial mistreatment (n = 55) as well as equal-sized control groups were interviewed. The control groups were matched on age, gender, and the characteristics that have been identified as risk factors for the types of elder mistreatment listed above. All respondents were over 65 years of age. In a standardised interview, commonly used instruments were utilised to assess coping style, locus of control, perceived self-efficacy and hostility. To analyse the data multivariate logistic regression analyses were performed. The study found that, chronic verbal aggression was associated with having less control over problem situations and a higher tendency to react aggressively when feeling angry or frustrated. Physical aggression was associated with a passive and avoidant way of handling problems. Financial mistreatment was associated with having negative beliefs of self-efficacy and a tendency to turn aggression and frustration on themselves. These results indicate that in addition to the established risk factors, some personality traits of the victims have to be considered as risk factors of elder mistreatment. The way people handle problems makes them more or less vulnerable to becoming victims of elder mistreatment. Furthermore, the results indicate that elder mistreatment may be associated to some extent with long-standing interaction patterns among family members. These findings are important for prevention of an intervention in cases of elder mistreatment.

Adaptation, Psychological↗
PubMed1999

Survey of patient satisfaction after total arthroplasty of the hip.

We have carried out a prospective study based on a series of interviews and written questionnaires completed by 45 patients who underwent surgery, in an effort to evaluate subjective patient satisfaction while recovering from total hip arthroplasty. These patients all had operation for primary osteoarthrosis and none had previously experienced orthopaedic procedures or psychiatric pathology. Our study demonstrated that using standard quality-of-life questionnaires to evaluate patient's subjective assessments is difficult, if not impossible. It also established the need to combine questionnaires and open-ended interviews in order to reveal subjective elements that should be taken into consideration by the surgeon before deciding upon the need to operate. The analysis of the data collected in this study highlights the fact that 50% of the patients express feelings of frustration during a three month-long period following the operation, in spite of their experiencing actual improvements of the operated hip. This phase of temporary frustration winds down easily but it is only a year after undergoing arthroplasty that some patients will enjoy all the subjective benefits of the operation.

Adult↗
PubMed2002

Intractable hiccup: an odd complication after laparoscopic fundoplication for gastroesophageal reflux disease.

Intractable hiccup can be an unbearable circumstance and its treatment is often frustrating. More than 100 causes for hiccup have been described in the literature; the most common cause is gastroesophageal reflux disease (GERD). We report a case of a 31-year-old patient who suffered from intractable hiccup starting 3 weeks after laparoscopic Nissen fundoplication for GERD, a potential surgical complication that has not been described. After frustrating medical treatment, the patient underwent computed tomography and nerve stimulator-guided blockade of vagal and phrenic nerves on each side separately. Hiccup ceased only after blockade of the right phrenic nerve with 4 ml/h l% ropivacaine and relapsed soon after discontinuation. He underwent thoracoscopic right phrenicectomy, which rendered him symptom free for well over 2 months, at the time of this writing.

Adult↗
PubMed2006

Temperament as a predictor of internalising and externalising problems in adolescent children of parents diagnosed with cancer.

OBJECTIVE: This study examined the relationship between temperament and internalising and externalising problems among children of parents diagnosed with cancer, beyond the effects of socio-demographics, illness-related variables and life events. MATERIALS AND METHODS: Three hundred and forty adolescent children and their 212 parents diagnosed with cancer participated. Children and parents completed the Youth Self Report and the Child Behaviour Checklist, respectively. Children completed also the Early Adolescent Temperament Questionnaire. MAIN RESULTS: Daughters of parents with cancer were reported as having more internalising problems than their counterparts did. Prevalence of problems did not depend on children's and parents' age or educational level. Recurrent disease and number of life events experienced by children and parents affected the problems reported. The most important temperament dimensions in the prediction of internalising problems in children were shyness and fear/worry, to a lesser extent, frustration and perceptual sensitivity (children only) and lower scores on pleasure intensity (parents only). Externalising problems were associated with effortful control and in children's reports with frustration. Temperament seemed to be a more important predictor of problems reported by children than parents. CONCLUSION: Findings suggest that temperament is useful in determining the relative vulnerability of children of parents who have been diagnosed with cancer. Social workers may help parents to recognise individual differences between children and to support children by using techniques that are compatible with the temperament of children.

Adolescent↗
PubMed2000

Context-dependent genetic effects in hypertension.

There is a growing frustration with the limitations and inconsistencies of single locus candidate gene association and linkage studies. This frustration is exacerbated by the knowledge that a large influx of genotypic and gene expression data is expected to emerge over the next 5 years, and we are not prepared for the type of multigenic conceptual framework that will be necessary to analyze that data. A review of the hypertension genetic literature reveals substantial evidence for the importance of both genetic and environmental contexts on the mapping between single locus polymorphisms and risk of disease. These trends indicate that the current reliance on simple single gene studies to elucidate the complex etiology of hypertension needs to undergo some kind of transformation. It is suggested that even a minor shift to a more systematic investigation of context-dependent effects will increase our understanding of the multidimensional genetic and environmental realities underneath current studies. This shift is also necessary if we are to gain a deeper understanding of the specific ways in which an individual's risk of hypertension is a consequence of the inter- actions among genes and environments.

Causality↗
PubMed2002

Similarities between interstitial cystitis and male chronic pelvic pain syndrome.

Few clinical conditions encountered by the urologist cause more patient and clinician frustration than interstitial cystitis and male chronic pelvic pain syndrome, also know as nonbacterial prostatitis. This frustration is fueled by the chronicity of often disabling urogenital (and often associated systemic) symptoms coupled with delayed care, misdiagnosis, and suboptimal clinical responses. Basic research and therapeutic trials for these syndromes have historically taken two separate paths. However, mounting evidence suggests that significant overlap may exist between them in epidemiology, pathophysiology, and even therapy. This discussion reviews some of the common features of these clinical problems and makes a case that they might in fact represent different manifestations of the same disease process.

Autoimmunity↗
PubMed2003

Approach to the Patient with Severe, Refractory Irritable Bowel Syndrome.

Defining which patients with irritable bowel syndrome (IBS) are "refractory" is a highly subjective undertaking. Duration of symptoms, severity of symptoms, type of symptoms, and a host of other medical, epidemiologic, and psychosocial variables all play a role in this determination. It is safe to say that a long duration of disease per se does not constitute a refractory patient. A number of studies have given us some suggestion of what constitutes refractoriness in IBS. Patients who have a predominant pain complaint as opposed to those who are mainly concerned about their bowel habit (either diarrhea or constipation) are more likely to be disabled by their IBS. However, at a clinical level, patients who are considered refractory are usually seen as individuals who fail to improve on a variety of drug therapies or who have high healthcare utilization despite aggressive treatment of their IBS. Finally, patients who are unhappy about their care and/or are assertive in their request to "be cured" can also be seen as refractory because of unrealistic expectations they set for both themselves and the physician. The key to effectively dealing with patients with "refractory" IBS is to understand that their behaviors most often have correlates and underlying issues that need to be dealt with in order to effectively address the patient's concerns. Unfortunately, most patients who fall into this category are quickly identified as "difficult," "unpleasant," or even "crazy" and are not infrequently dismissed by their treating physician. This leads to an ever-enlarging circle of healthcare utilization, with patients seeking out physicians and other practitioners looking for the elusive cure. A key component of this process is an increasing frustration and cynicism regarding the healthcare system and physicians in particular, which does no good for anyone involved. It is clearly critical for the physician dealing with a patient with IBS and a history of poor response to treatment to understand these correlates. Failure to do so creates a continuation of the cycle of treatment failure and frustration that so often characterizes these patients' care.

Journal Article↗
PubMed2006

Treatment of the severe refractory irritable bowel patient.

Determining which patients with irritable bowel syndrome (IBS) are "refractory" is highly subjective. The duration, severity, and type of symptoms and a host of other epidemiologic and psychosocial factors play a role in this determination. Long duration of symptoms alone does not portray the severe IBS patient. Several studies have shown that patients concerned with pain rather than altered bowel habits (diarrhea and constipation) are more likely to be disabled by their disease. Pragmatically, refractory patients can be defined as those who fail to improve on multiple drug regimens and who have high health care utilization despite aggressive therapy. In some cases, psychosocial and psychiatric comorbidity can also contribute to an inability to improve despite reasonable medical management. Finally, IBS patients who are unhappy about their care and who have the unrealistic expectation of "cure" may become refractory. The key to dealing with so-called "refractory" IBS patients is to understand that their behaviors often relate to underlying needs that the patients may have difficulty communicating to the physician. Unfortunately, these patients are often labeled as "difficult," "unpleasant," or "crazy," and are often dismissed by their treating physicians. This leads to a continued cycle of pain, frustration, and health care over-utilization, with patients seeking the elusive "cure." Failure to understand these correlates leads to continued frustration and treatment failure, which unfortunately often characterizes the care of these patients.

Journal Article↗
PubMed1995

The anger recall interview and cardiovascular reactivity in women: an examination of context and experience.

Recent research has focused on the role of hostility as a risk factor for coronary heart disease. Hostility has been linked independently to cardiovascular mortality and, as a component of Type A behavior, to atherogenesis and myocardial infarction; however, the mechanisms by which hostility manifests its effects on the cardiovascular system have not been determined. In addition, hostility has been evaluated as a trait measure, with little emphasis on how anger-provoking episodes may be perceived by individuals. The present study seeks to evaluate the affective experience of hostility, through an anger recall interview, and relate qualities of that experience to one potential mechanism of cardiovascular risk, cardiovascular reactivity. Fifty-eight women, classified by structured interview as Type A or B, participated in an anger recall interview while their heart rate and blood pressure were monitored. Type A women manifested greater systolic reactivity when their anger was in response to frustration of autonomy needs, while Type B women exhibited greater heart rate reactivity in response to frustration of affiliation needs. All women who suppressed anger expression experienced higher pressor responses than women who expressed anger assertively. Future investigations may find the content of an interview as useful as the procedure itself in studies of cardiovascular reactivity.

Adolescent↗
PubMed1986

Dietary tryptophan supplements attenuate amphetamine self-administration in the rat.

Previously, it had been shown that lesions of cerebral 5-hydroxytryptamine (5-HT)-containing neurons and injections of drugs affecting 5-HT synthesis or receptor mediated function would alter amphetamine self-administration in the rat. The present study sought to ascertain whether diets enriched in L-tryptophan (L-TRY), the amino acid precursor to 5-HT, would: elevate cerebral 5-HT concentrations and affect amphetamine self-administration behavior. Diets containing 2.0 and 4.0% L-TRY increased cerebral 5-HT concentrations above those of rats on normal rat chow (0.26% L-TRY). The 4.0% diet elevated brain 5-HT to the same degree in rats exposed to the diet for 1, 2 or 3 days. When normal diets were restored, brain 5-HT concentrations rapidly returned to normal. Animals trained to self-administer d-amphetamine, when given access to the L-TRY enriched diets, significantly reduced their daily amphetamine self-injection during exposure periods. When normal rat chow was restored a delay in recovery to pre-diet amphetamine self-administration was observed: 1 day with the 2.0% L-TRY diet and 2 days with the 4.0% L-TRY diet. The 4.0% L-TRY diet failed to alter saline-frustration responding indicating the diet did not produce decrements in motor performance. When animals were placed on the 4.0% L-TRY diet and allowed access to amphetamine for 1 day then exposed to saline, a profound decrease in saline-frustration responding was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1982

Some challenges in the management of community health education.

Health Educators are often expected to fill managerial roles yet are not always trained in management skills. The Health Educator's role is constantly changing but training has not always kept up, especially in the area of management. Job descriptions are often less than adequate and coordination between the jobs and the training institution could be better. Health Educators, due to frustration caused by inadequate role definition, may choose administration as a career as it is easier identified. Barriers to successful management can also be frustrating for the Health Educator, i.e., political constraints, lack of skills, etc. Planning should be a major activity of any Health Education program in order to ensure a successfully managed Health Education project.

Health Education↗
PubMed1994

Exorcists, psychiatrists, and the problems of possession in northwest Madagascar.

For the Sakalava of northwest Madagascar, spirit possession and madness occupy opposing poles on a spectrum of experiences which, in indigenous terms, range from a good, powerful, and inescapable state to a destructive, dangerous, and frightening illness. While possession by the most powerful spirits is honorable and permanent, the excessive suffering that some mediums experience leads them to seek a way out; in other cases, chronic madness frustrates the afflicted and their kin who search for, but rarely find, a cure. Psychiatrists and protestant exorcists offer last resort options to these individuals, but the efficacy of their treatments varies greatly. While patients and healers are all Malagasy, sub-ethnic divisions are, nevertheless, crucial to defining the tensions that arise within these two alternative therapeutic contexts. The relevance of each approach and efficacy of its associated treatments hinge on the success of the psychiatrist and exorcist to mediate between these ethnic divisions. In turn, each practitioner is faced with the task of integrating conflicting epistemological realities surrounding illness. While exorcisms may be painful and frustrating to patients, the exorcists are more successful as healers, since they first accept and then transform the patients' explanations for and experiences of possession and madness. During protestant healing rituals, possession is viewed as an appropriate idiom for describing illness, and madness is redefined as normative, not deviant, behavior. Failure among psychiatrists can be traced to their inability to comprehend or accept their patients' experiences, a disjunction exacerbated by their acceptance of a cognitive model based on western sensibilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The effects of caffeine and nicotine consumption on mood and somatic variables in a penitentiary inmate population.

A sample of 144 inmates from a maximum security penitentiary responded to a request for information regarding their average daily intake of nicotine and caffeine. They also rated the quality of their appetite and sleep, their level of concentration, their mood and specific feelings of anger, anxiety, frustration, and irritability. Factor analysis generated a two-factor solution of these variables, namely general mood state (mood, anxiety, anger, frustration, and irritability) and a somatic state (appetite, concentration, and sleep). Analysis of variance showed an interaction between level of smoking (nonsmokers, low and high cigarette smokers) and caffeine use (moderate vs. high) on the general mood factor. Nonsmokers who consumed high levels of caffeine experienced poorer general mood than any other group. There was a main effect of cigarette smoking status on the somatic factor, such that greater dissatisfaction was associated with greater consumption. Caffeine consumption was generally high, averaging 800 mg of caffeine per day, per inmate, well above the amount considered to be potentially damaging to health.

Adult↗
PubMed2006

Variation of bar-press duration: where do new responses come from?

Instrumental learning involves both variation and selection: variation of what the animal does, and selection by reward from among the variation. Four experiments with rats suggested a rule about how variation is controlled by recent events. Experiment 1 used the peak procedure. Measurements of bar-press durations showed a sharp increase in mean duration after the time that food was sometimes given. The increase was triggered by the omission of expected food. Our first explanation of the increase was that it was a frustration effect. Experiment 2 tested this explanation with a procedure in which the first response of a trial usually produced food, ending the trial. In Experiment 2, unlike Experiment 1, omission of expected food did not produce a large increase in bar-press duration, which cast doubt on the frustration explanation. Experiments 3 and 4 tested an alternative explanation: a decrease in expectation of reward increases variation. Both used two signals associated with different probabilities of reward. Bar presses were more variable in duration during the signal with the lower probability of reward, supporting this alternative. These experiments show how variation can be studied with ordinary equipment and responses.

Animals↗
PubMed2006

Stress, personality and depressive symptoms in a 6.5 year follow-up of subjects at familial risk for affective disorders and controls.

BACKGROUND: The aim of the study was to identify risk factors in subjects at risk for depressive disorders and controls. METHODS: In a 6.5 year follow-up study we examined the effects of personality (neuroticism, frustration intolerance, rigidity, melancholic type), adverse life events and chronic difficulties on depressive symptoms in 89 high-risk subjects (HRS, siblings and children of patients suffering from an affective disorder), without any mental illness at wave 1 (T1), and 49 controls without any personal and family history of psychiatric disorder at T1. To this end, regression analysis and path analysis using a structural equation model (only for HRS) were performed. RESULTS: Risk factors for depressive symptoms at wave 2 (T2) in HRS comprised acute adverse life events, frustration intolerance (T1) and depressive symptoms (T1). Risk factors for depressive symptoms in controls included chronic difficulties, neuroticism and rigidity. HRS had less stressful life events and the same risk for chronic difficulties, but perceived adverse events as more stressful. LIMITATION: The sample size of the control group is too small for identifying slight effects. CONCLUSION: Our results indicate that the impact on the emergence of depressive symptoms of various risk factors is different in high-risk subjects and controls. High-risk subjects are more sensitive to the depressogenic effects of acute stress and thus avoid potential stressful changes in their life to a higher extent. On the other hand, the influence of persistent factors such as personality traits (neuroticism, rigidity) and chronic difficulties on subsequent depressive symptoms was less pronounced in HRS as compared to controls.

Adult↗