Left orbital frontal activation in pathological anxiety

Twelve patients with anxiety disorder were studied with respect to regional cerebral blood flow (rCBF) using a 32-detector system with the 133 Xe inhalation technique. Measurements were taken during a rest condition and during anxiety induction. Anxiety relevant to the patient's psychological disorder was induced with a projective test, the meta-contrast technique (MCT). Increased blood flow in the orbital frontal region of the left hemisphere was observed in each of the 11 subjects who showed evidence of experiencing anxiety during the procedure. In a second study four additional anxiety patients were studied with a high-resolution (254-detector)Xe rCBF system. In addition to the anxiety and resting conditions, a neutral verbalization condition was added to control for the verbal aspects of the anxiety induction procedure. The results again showed the experience of anxiety to be accompanied by increased blood flow in the left orbital frontal region, with the patients showing this flow increase to be greater in the posterior, paralimbic, areas of the region. These results are consistent with previous suggestions of left hemisphere involvement in anxiety. They also suggest that imaging methods may allow research into what appears to be exaggerated corticolimbic activity in this disorder.     

The relationship between blushing propensity, social anxiety and facial blood flow during embarrassment

To investigate blushing in relation to blushing propensity scores and core elements of social anxiety, facial blood flow was monitored in 86 normal volunteers during an embarrassing task (singing a children's song). Increases in facial blood flow were greater in women than men, as were scores on the Blushing Propensity and Fear of Negative Evaluation scales. In addition, high scores on the Blushing Propensity and Social Interaction Anxiety scales were associated with large increases in facial blood flow during singing. However, this appeared to be due primarily to social anxiety because the association between blushing propensity scores and changes in facial blood flow disappeared when social interaction anxiety scores were taken into account. These findings suggest that people generally base their beliefs about blushing on cues other than changes in facial blood flow. Social anxiety may augment increases in facial blood flow during embarrassment, independently of expected or perceived blushing.     

The relationship between blushing propensity,social anxiety and facial blood flow during embarrassment

To investigate blushing in relation to blushing propensity scores and core elements of social anxiety, facial blood flow was monitored in 86 normal volunteers during an embarrassing task (singing a children's song). Increases in facial blood flow were greater in women than men, as were scores on the Blushing Propensity and Fear of Negative Evaluation scales. In addition, high scores on the Blushing Propensity and Social Interaction Anxiety scales were associated with large increases in facial blood flow during singing. However, this appeared to be due primarily to social anxiety because the association between blushing propensity scores and changes in facial blood flow disappeared when social interaction anxiety scores were taken into account. These findings suggest that people generally base their beliefs about blushing on cues other than changes in facial blood flow. Social anxiety may augment increases in facial blood flow during embarrassment, independently of expected or perceived blushing.     

Cerebral blood flow and anxiety in older men: an analysis of resting anterior asymmetry and prefrontal regions

Asymmetric resting blood flow in prefrontal and hemispheric regions, assessed by single photon emission computed tomography (SPECT), was examined as a potential biological marker for enhanced trait and state anxiety in 30 older men (ages 55-81). Average and asymmetric perfusion in dorsolateral, medial, and orbital regions of the prefrontal lobes was also assessed. Results indicated a significant association between lower levels of resting dorsolateral blood flow and greater state anxiety responses to a series of stressful provocations (measured on a separate occasion). A significant curvilinear (U-shaped) relation between asymmetric dorsolateral perfusion and state anxiety was also identified; increased asymmetric blood flow favoring either the right or the left dorsolateral region related to higher levels of state anxiety. However, this association was attenuated by age and systolic blood pressure. Resting perfusion in the dorsolateral region may represent a more reliable biological marker for state anxiety than trait anxiety in older men.     

Comparison of flooding procedures in animals and man

Avoidance behavior in animals and man is contrasted in the context of “flooding” or “response prevention”. Some experimentally established parameters affecting fear reduction in rats are examined with a view to their relevance in modifying phobic behavior in man. Two case reports of patients treated by flooding are cited to illustrate the absence of avoidance or escape responses when these patients were exposed to situations they considered highly anxiety arousing before treatment.     

Psychogenic and neurogenic effects on the intact forearm vein of man

By means of an elegant venous preparation the behavior of intact veins of man can be studied decisively. The superficial veins of man are extremely sensitive to the environment and the autonomic and central nervous systems. This report illustrates the response of an isolated venous segment of the forearm to various psychogenic and neurogenic stimuli, with change in tone of the smooth muscle of the venous segment being reflected by change in segmental venous pressure. It is shown that the superficial forearm veins can be conditioned and that they are extremely dynamic and certainly not passive conduits for returning blood to the heart.     

Game Birds: The Ethics of Shooting Birds for Sport

This paper aims to provide an ethical assessment of the shooting of animals for sport. In particular, it discusses the use of partridges and pheasants for shooting. While opposition to hunting and shooting large wild mammals is strong, game birds have often taken a back seat in everyday animal welfare concerns. However, the practice of raising game birds for sport poses significant ethical issues. Most birds shot are raised in factory-farming conditions, and there is a considerable amount of evidence to show that these birds endure extensive suffering on these farms. Considering the fact that birds do have interests, including interests in life and not suffering, what are the ethical implications of using them for blood sports? Indeed, in the light of the suffering that game birds endure in factory farms, it may be that shooting such birds for sport is more morally problematic than other types of hunting and shooting which many people are often fiercely opposed to, for while it seems plausible to say that some animals may be harmed more by death than others (due to, say, their greater capacities), there may be harms that are worse than death (such as a life of intolerable suffering). The objective of this paper is to assess the ethics of shooting animals for sport, and in particular the practice of raising game birds for use in blood sports, by applying principles commonly used in ethics; specifically the principle of non-maleficence and equal consideration of (like) interests.     

The effects of prenatal maternal stress on children's cognitive development: Project Ice Storm

There exists considerable research on the effects of prenatal maternal stress on offspring. Animal studies, using random assignment to experimental and control groups, demonstrate the noxious effects of prenatal maternal stress on physical, behavioural and cognitive development. The generalizability of these results to humans is problematic given that cognitive attributions moderate reactions to stressors. In humans, researchers have relied upon maternal anxiety or exposure to life events as proxies for the stressors used with animals. Yet, the associations between maternal anxiety or potentially non-independent life events and problems in infants are confounded by genetic transmission of temperament from mother to child. We summarize the literature on prenatal maternal stress and infant cognitive development, leading to the conclusion that the human literature lacks the ability to separate the effects of the objective exposure to a stressor and the mother's subjective reaction. We then describe our prospective Project Ice Storm in which we are following 150 children who were exposed in utero to a natural disaster. We demonstrate significant effects of the objective severity of exposure on cognitive and language development at age two years with important moderating effects of the timing during pregnancy. The implications of our findings are discussed.     

Physiological changes during operations on the limbic system in man

The limbic system is a phylogenetically old part of the brain which is concerned with a variety of emotional and viscerosomatic functions. It has been found that small discrete lesions, placed by stereotaxis in this system during limbic leukotomy, may result in marked clinical improvement in severely incapacitated psychiatric patients who have failed to respond to any other type of treatment. In one patient, electrical stimulation of the anterior cingulate gyrus was carried out under local anesthesia to locate a suitable site for a limbic lesion. Physiological arousal was produced, as evidenced by changes in heart rate, forearm blood flow, sweat gland activity and respiration. Bilateral lesions, 8 mm in diameter, produced by freezing this site, resulted in marked clinical improvement. Peripheral physiological changes are now being used to aid in the selection of target sites in various parts of the limbic system. Under general anesthesia marked respiratory changes have been found on stimulation of the lower medial quadrant of the frontal lobe, anterior cingulate gyrus, above the roof of the lateral ventricle, and in the amygdala nucleus of the temporal lobe. Lesions are made with a cryogenic probe at sites of maximum physiological response. It is postulated that physiological monitoring during electrical stimulation of target areas will improve the accuracy of lesion placement. Some of the results of this procedure are described.     

Brief owner absence does not induce negative judgement bias in pet dogs

Humans in a negative emotional state are more likely to judge ambiguous stimuli as negative. In recent years, similar judgement biases have been found in some non-human animals that were exposed to long-term or short-term treatments aimed at influencing their affective states. Here we tested pet dogs in the presence and absence of their owners in a judgement bias test with an established go/no-go procedure. Even though owner absence is thought to induce a state of anxiety in dogs that have formed an attachment bond with their primary caretakers, we found no difference between the dogs' responses to ambiguous stimuli in the presence or absence of their owners. This result may be explained by the absence of anxiety in dogs that are accustomed to brief periods of separation from their owners, or by a sensitivity limit of the customary judgement bias tests in non-human animals when only a moderate, short-term state of anxiety is induced. In addition, we found significant differences between individuals and populations in the responses to ambiguous stimuli, which give impetus for further research.     

The effects of muscle tension on cerebral circulation in blood-phobic and non-phobic subjects

This study aimed to assess whether (1) a muscle tensing procedure which has been found to be useful in the treatment of blood-phobic patients produces an increase in heart rate and cerebral blood flow and (2) whether this increase is greater than that produced by mental effort alone. Subjects were 17 volunteers with a history of fainting in response to blood-injury stimuli, (12 were phobic) and 8 volunteers with no fainting history. They were required to (a) rest, (b) do mental arithmetic, and (c) repeatedly tense and release their arm and leg muscles. It was found that Ss, heart rate and cerebral blood flow velocity were significantly greater during the muscle tensing procedure than during mental arithmetic or resting conditions. The increased cerebral blood flow produced by muscle tensing may enable blood phobic patients to prevent fainting during exposure treatment.     

Negative perfectionism increases the risk of fatigue following a period of stress

Abstract

There is a considerable amount of research concerning (he relationship between psychological variables and the postoperative outcome of surgery. However, little attention has been paid to the potential influence of psychological factors on infra-operative variables, most notably on anaesthetic requirement. The present study investigates the influence of surgery-related trail and slate anxiety as well as of dispositional and surgery-related actual coping on several indicators of intra- and postoperative adjustment. In addition, a possible mediating effect of stress-induced analgesia on the relationships between anxiety, coping, and intraoperative anaesthetic requirements was evaluated. Sixty-one patients undergoing elective lumbar iniclcotomy completed questionnaires regarding anxiety and coping variables one day before surgery. Intraoperative adjustment was assessed by measuring EEG-controlled anaesthetic requirements for induction and maintenance of anaesthesia, β-endorphin plasma concentration was collected preoperatively in the induction room. Postoperative outcome was assessed on the third day after surgery by questionnaires regarding pain experience, physical condition and emotional state. For preoperative anxiety as well as vigilant coping behaviour, there were opposite relationships with subjective measures of adjustment (e.g. self-reported postoperative pain experience), on the one side, and objective measures on the other (e.g., intraoperative anaesthetic requirement). Stress-induced analgesia was found for the subgroup of high-anxious patients. The results indicate that psychological programmes aimed at facilitating patients' perioperative adjustment should consider the different effects of anxiety and coping on subjective and objective measures.     

Emotion- and intrusion-based reasoning in Vietnam veterans with and without chronic posttraumatic stress disorder.

Patients suffering from anxiety disorders other than posttraumatic stress disorder (PTSD) interpret anxiety responses themselves as evidence that threat is impending: "if anxiety, then threat" (Arntz, Rauner, & van den Hout, 1995, Behaviour Research and Therapy, 33, 917-925). This "emotion-based reasoning" (ER) may render a disorder self-perpetuating. Analogous to ER, danger might also be inferred from the presence of intrusions: "intrusion-based reasoning" (IR). The aims of this study were to test whether ER and IR are involved in chronic PTSD. Vietnam combat veterans with or without PTSD or other anxiety disorders rated perceived danger of brief scenarios in which information about objective danger (danger vs safety) and response (anxiety/intrusions vs non-distressing emotion) was systematically varied. Two series were administered: ER-scenarios were non-specific for PTSD and IR-scenarios were specific for PTSD. Relative to control participants, PTSD patients engaged in both ER and IR: whereas veterans without PTSD inferred the danger of scenarios from objective stimulus information, veterans with PTSD also inferred danger from the presence of anxiety or intrusions. Further analyses showed that these effects were largely mediated by perceived uncontrollability.     

To be or not to be at risk: Spontaneous reactions to risk information

Rheumatoid arthritis (RA) is a chronic disease, which can lead to considerable psychological distress. The present study evaluated anxiety and depression symptoms for this chronic and painful illness within the framework of the conservation of resources (COR) theory. Coping strategies, coping self-efficacy, religiousness and social support are very important personal resources, which have been found to protect individuals from psychological distress. The aim of the present study was to examine the predictive values of socio-demographic and illness-related variables, perceived social support, ways of coping, religiousness, arthritis self-efficacy and resource loss for psychological distress in a sample of 117 RA patients from Turkey, a secular, Islamic, non-western developing country. The results revealed that RA patients experience considerable anxiety and depressive symptoms. The results of the regression analysis showed that gender, helplessness coping and resource loss are significant predictors of anxiety, whereas arthritis self-efficacy and resource loss are significant predictors of depression. Resource loss appeared as an important predictor for both anxiety and depression. This finding was consistent with the COR theory. The clinical implications of these findings are discussed.     

The concepts of depression,anxiety, and neuroticism in questionnaires

In this study, the relations among depression, anxiety, and neuroticism measured by self-report questionnaires were investigated. Subjects were 207 psychiatric patients. High correlations were found among self-report scales purporting to measure depression, anxiety, and neuroticism. Results of a content analysis showed considerable overlap among these scales. A division of items into six content categories did not result in lower correlations compared to the original scales.     

Extent and nature of anxiety experienced during physical examination of chronic low back pain

There is strong evidence to suggest that anxiety is a common problem for many chronic pain patients and can exacerbate a patient's pain condition. Notwithstanding, there is little information about the extent and nature of anxiety experienced during physical examination of pain, or the primary factors associated with anxiety in this context. In the present study, 45 chronic low back pain patients completed a questionnaire battery at the time of intake to an interdisciplinary treatment program. After approximately four weeks on program, patients underwent a routine standardized physiotherapy review of their condition following which they completed a second questionnaire battery. The examination was videotaped and coded for pain behavior. Physiotherapists provided objective scoring of non-organic signs and physical impairment. Results suggested that participants experienced substantial anxiety at the point of examination with scores on the Beck Anxiety Inventory (M = 30.47, S.D. = 6.96) comparable to scores that have been found with DSM-IV panic disorder patients. Regression analyses revealed that catastrophic cognitions, behavioral displays of pain and somatic sensations measured during examination uniquely predicted anxiety experienced during examination. Demographic, injury-related, personality, and patient-practitioner variables did not significantly contribute to explaining examination anxiety. Findings support cognitive-behavioral formulations of anxiety and strongly suggest that anxiety may complicate the assessment process. Implications for the assessment and treatment of pain are presented along with future research directions.     

Stress regulation and incision in borderline personality disorder-a pilot study modeling cutting behavior

Emotion dysregulation in Borderline Personality Disorder (BPD) is characterized by high baseline negative intensity, high reactivity, and slow return to baseline. Patients with BPD often engage in self-injurious behavior because it leads to immediate relief of stress levels. We aimed to assess stress regulation as well as the influence of tissue damage on subjective (aversive tension) and objective (heart rate) stress correlates in BPD. In 14 unmedicated patients with BPD and 18 healthy controls, a stress induction was followed by an incision into the forearm conducted by an investigator. For aversive tension, we found elevated baseline levels as well as slower return to baseline in BPD. In controls, incision resulted in a short-term increase of aversive tension, whereas tension and heart rate decreased in the BPD group. Our preliminary results support the hypothesis that tissue damage may play a role in disturbed stress regulation in BPD.