有偿献血HIV感染者的情绪障碍

考察有偿献血HIV感染者的情绪状况,探讨他们面临的艾滋病压力和对感染HIV的认知评价对其情绪的影响。方法：采用Beck抑郁量表、焦虑自评量表、艾滋病压力量表、认知评价量表作为测查工具,测查了185名有偿献血HIV感染者,并收集了人口学资料、症状资料和其它信息。结果：（1）92%的有偿献血HIV感染者有中、重度抑郁障碍,他们的焦虑程度高于神经衰弱者和焦虑症者;（2）艾滋病压力不仅通过认知评价而且会直接对情绪障碍产生影响;（3）认知评价在艾滋病压力和情绪障碍之间起部分中介作用。结论：有偿献血HIV感染者抑郁、焦虑情绪障碍严重,艾滋病压力和认知评价对情绪障碍的产生都有直接或间接的影响     

有偿献血艾滋病患者的情绪状况及影响因素分析

考察有偿献血艾滋病患者的情绪状况 ,探讨他们面临的艾滋病压力和家庭状况、周围环境、身体状况等对情绪的影响。采用Beck抑郁量表、焦虑自评量表、艾滋病压力量表作为测查工具 ,测查了 1 85名有偿献血艾滋病患者 ,并收集了他们的人口学资料和生理学指标信息。结果发现 :( 1 )有偿献血艾滋病患者存在着严重的情绪障碍 ,他们的焦虑程度不但显著高于正常人 ,而且显著高于神经衰弱者和焦虑症者 ,且 92 %的患者有中、重度抑郁障碍 ;( 2 )身体症状和情绪 /生存压力能够显著预测焦虑的程度 ,社会压力和情绪 /生存压力能够显著预测抑郁的程度。因此 ,有偿献血艾滋病患者抑郁、焦虑情绪障碍严重 ,症状和艾滋病压力是情绪障碍的有效预测因素。     

The Northwestern-UCLA youth emotion project: Associations of cognitive vulnerabilities, neuroticism and gender with past diagnoses of emotional disorders in adolescents

Neuroticism has been hypothesized to be a non-specific risk factor for both anxiety and unipolar mood disorders whereas some cognitive and personality-cognitive vulnerabilities have been hypothesized to be more specific to depression. Using a retrospective design with a sample of 575 high school juniors, we tested three competing models of the associations among these variables. Both neuroticism and the cognitive and personality-cognitive vulnerabilities had significant zero-order associations with rates of past diagnoses of both anxiety and unipolar mood disorders. Neuroticism had significant unique associations with past anxiety disorders and comorbid anxiety and unipolar mood disorders whereas the other vulnerabilities did not. In addition, gender interacted with neuroticism but not with the other vulnerabilities in associating with past diagnoses of mood disorders, showing that neuroticism is more highly associated with past unipolar mood diagnoses in males than in females. Finally, the cognitive and personality-cognitive vulnerabilities overlapped with substantial portions of the variance that neuroticism shared with diagnoses. These results suggest that, at least for retrospective associations with past anxiety and unipolar mood disorders, the cognitive and other personality-cognitive vulnerabilities are non-specific facets of neuroticism.     

The cycle of schizoaffective disorder, cognitive ability, alcoholism, and suicidality

In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-TV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a history of suicide attempts or suicidal ideation. Discriminant analysis was used to identify cognitive test performance measures that distinguished those with versus those without suicidal behavior. None of the cognitive measures discriminated between the two groups. The rates of suicidal behavior (suicidal ideation and suicide attempts) did not differ between participants with versus those without comorbid alcohol use. An association was found between suicidal behavior and the diagnosis of schizoaffective disorder. It was concluded that the history of prominent mood syndromes characteristic of schizoaffective disorder contributes to increased risk of suicidal behaviors. Cognitive dysfunction and/or alcoholism did not contribute additionally to risk in this study.     

Psychische Störungen bei HIV-Infektion und Aids

The human immunodeficiency virus (HIV) is the pathogen responsible for acquired immune deficiency syndrome (AIDS). Worldwide there are currently about 40 million people infected with HIV and an estimated 44,000 in Germany. If left untreated after a few years the infection leads to the manifestation of AIDS and eventually to death through opportunistic infections and malignant tumors. Infection with HIV is not curable. Nevertheless, antiretroviral treatment can slow the progress of the disease and prolong life expectancy significantly. Once antiretroviral treatment has started the medication must be taken regularly and lifelong. Serious side effects of the medication pose a significant stress on physical and psychological well-being and impair adherence. Infection with HIV means a total change in life perspectives and requires extensive adaptations in lifestyle. Problems with adaptation and mental disorders (e.g. depression, anxiety disorders, adjustment disorder) are, therefore, frequent. With disease progression neurocognitive impairments are increasingly likely. Mental disorders and neurocognitive impairments adversely affect treatment adherence, increase health risk behavior and reduce immune function. Psychological interventions contribute significantly to the reduction in health risk behavior, improve treatment adherence and are successful in the treatment of depression and anxiety.     

Substance P and Human Immunodeficiency Virus Infection: Psychoneuroimmunology

Effects on the immune system caused by changes in behavioral state or brain activity are mediated, at least in part, through neuroendocrine-immune pathways. Life stress and depression may be associated with altered blood levels of central nervous system-released neuropeptides, including substance P (SP). SP acts as a neuroregulator or neurotransmitter in the conduction of nociceptive stimuli, and is a modulator of neuroimmunoregulation. This review summarizes current knowledge regarding the role of the neuropeptide, SP, in psychoneuroimmunology, in particular as it relates to human immunodeficiency virus infection and acquired immunodeficiency disease syndrome. The association between depression, anxiety, and stress in HIV-disease progression suggests that neurobiologic and neurophysiologic factors play a role in modulating HIV infection and responses to antiretroviral therapy. Individuals with HIV or AIDS may experience stressful life circumstances that can result in increased symptoms of anxiety, stress, and/or depression. Furthermore, psychological and psychiatric symptoms, which occur in individuals with HIV and AIDS, may be related to the progression of AIDS disease. This review presents evidence from the literature, as well as findings from basic investigations conducted in the authors' laboratories, demonstrating that SP may play an important role in HIV pathophysiology. SP can impact the susceptibility of immune cells to HIV infection and modulate immune cell functions in ways that may affect the course of HIV in infected individuals. Moreover, modulation of SP activity and SP receptor is being explored for its potential as a novel therapeutic approach to the treatment of some psychological and psychiatric disorders and to the design of new anti-HIV therapy.     

Deleterious effects of alcohol intoxication: diminished cognitive control and its behavioral consequences

The authors tested the hypothesis that impaired behavioral performance during intoxication results partly from alcohol's deleterious effects on cognitive control. The impact of alcohol on perseverative behavior was examined with an n-back working memory task that included manipulations of task complexity and prepotency of inclinations to respond or withhold responding. Thirty-two social drinkers (16 men) participated in either an alcohol (.075g/100ml) or a no-alcohol condition. Alcohol increased perseveration of prepotent, task-inappropriate response patterns only under cognitively demanding (heavy memory load) conditions. This effect was evident for both commission errors (response persistence despite contingencies altered to require restraint) and omission errors (failure to respond when contingencies were revised to encourage action). Findings suggested that alcohol-induced perseveration arises from impairments in cognitive control.     

From prioritizing objects to prioritizing cues: a developmental shift for cognitive control

Emerging cognitive control supports increasingly adaptive behaviors and predicts life success, while low cognitive control is a major risk factor during childhood. It is therefore essential to understand how it develops. The present study provides evidence for an age‐related shift in the type of information that children prioritize in their environment, from objects that can be directly acted upon to cues signaling how to act. Specifically, gaze patterns recorded while 3‐ to 12‐year‐olds and adults engaged in a cognitive control task showed that whereas younger children fixated on targets that they needed to respond to before gazing at task cues signaling how to respond, older children and adults showed the opposite pattern (which yielded better performance). This shift in information prioritization has important conceptual implications, suggesting that a major force behind cognitive control development may be non‐executive in nature, as well as opening new directions for interventions.     

Functional Consequences of HIV-Associated Neuropsychological Impairment

This review focuses on the “real world” implications of infection with HIV/AIDS from a neuropsychological perspective. Relevant literature is reviewed which examines the relationships between HIV-associated neuropsychological impairment and employment, driving, medication adherence, mood, fatigue, and interpersonal functioning. Specifically, the relative contributions of medical, cognitive, psychosocial, and psychiatric issues on whether someone with HIV/AIDS will be able to return to work, adhere to a complicated medication regimen, or safely drive a vehicle will be discussed. Methodological issues that arise in the context of measuring medication adherence or driving capacity are also explored. Finally, the impact of HIV/AIDS on mood state, fatigue, and interpersonal relationships are addressed, with particular emphasis on how these variables interact with cognition and independent functioning. The purpose of this review is to integrate neuropsychological findings with their real world correlates of functional behavior in the HIV/AIDS population.     

室内照度对认知加工的影响:主观情绪和警觉性的中介作用

本研究采用单因素被试间设计,考察了白天室内照度(300 lx vs 1200 lx,眼位水平)对认知加工的影响及主观情绪和警觉性在照度水平与认知加工间的中介效应。结果发现:(1)被试在高照度照明条件下的认知加工绩效(Go/No-go,2-Back)明显好于低照度照明;(2)高照度照明对积极情绪和主观警觉性具有显著的正向影响;(3)警觉性在照度水平对Go/No-go任务的影响中起着完全中介作用,情绪的中介作用不显著。这表明警觉性在室内照度与部分认知加工间扮演着重要的"桥梁"作用。     

Cognitive processing of body and appearance words as a function of thin-ideal internalization and schematic activation

To better understand how women at risk of body image disturbance respond when their body concerns are activated, we examined attentional and memory biases in undergraduate women with high thin-ideal internalization, an identified risk factor for eating disorders, following priming of body and appearance concerns. Female undergraduates (N = 186) viewed photos of either sports cars or attractive swimsuit models, then completed the Lexical Decision Test, a word recall test, and questionnaires assessing thin-ideal internalization and eating disorder symptomatology. High thin-ideal internalizers did not exhibit cognitive biases predicted by cognitive models of eating disorders, even when their body and appearance concerns were primed by exposure to attractive models. Converging evidence suggests that high-risk non-clinical samples rarely exhibit cognitive biases characteristic of individuals with eating disorders, and, in fact, may actually incorporate ideal appearance into their schemas and preferentially attend to attractive stimuli.     

The influence of positive mood on different aspects of cognitive control

Some evidence suggests that positive mood influences cognitive control. The current research investigated whether positive mood has differential effects on two aspects of cognitive control, working memory and prepotent response inhibition. In Study 1, following either a positive or neutral mood induction, participants completed the Running Memory Span (RMS), a measure primarily of working memory storage capacity, and the Stroop task, a measure of prepotent response inhibition. Results were that the positive mood group performed worse on the RMS task but not on the Stroop task. In Study 2, participants completed the RMS and another measure of prepotent response inhibition, the Flanker task. Results were that when in a positive mood state participants performed worse on the RMS but not on the Flanker task. Overall, this research suggests that positive mood has differential effects on cognitive control, impairing working memory but having no effect on prepotent response inhibition.     

Do executive and reactive disinhibition mediate the effects of familial substance use disorders on adolescent externalizing outcomes?

The present study examined the potential mediating roles of executive and reactive disinhibition in predicting conduct problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, and substance use among adolescents with and without a family history of substance use disorders. Using data from 247 high-risk adolescents, parents, and grandparents, structural equation modeling indicated that reactive disinhibition, as measured by sensation seeking, mediated the effect of familial drug use disorders on all facets of the adolescent externalizing spectrum. Executive disinhibition, as measured by response disinhibition, spatial short term memory, and "trait" impulsivity, was associated with ADHD symptoms. Moreover, although executive functioning weakness were unrelated to familial substance use disorders, adolescents with familial alcohol use disorders were at risk for "trait" impulsivity marked by a lack of planning. These results illustrate the importance of "unpacking" the broad temperament style of disinhibition and of studying the processes that underlie the commonality among facets of the externalizing spectrum and processes that predict specific externalizing outcomes.     

HIV Infection and the Central Nervous System: A Primer

The purpose of this brief review is to prepare readers who may be unfamiliar with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and the rapidly accumulating changes in the epidemic by providing an introduction to HIV disease and its treatment. The general concepts presented here will facilitate understanding of the papers in this issue on HIV-associated neurocognitive disorders (HAND). Toward that end, we briefly review the biology of HIV and how it causes disease in its human host, its epidemiology, and how antiretroviral treatments are targeted to interfere with the molecular biology that allows the virus to reproduce. Finally, we describe what is known about how HIV injures the nervous system, leading to HAND, and discuss potential strategies for preventing or treating the effects of HIV on the nervous system.     

Social Representations of AIDS: Pictures in Abnormal Psychology Textbooks, 1984–20051

We identified 129 pictures relating to AIDS/HIV in 94 abnormal psychology textbooks published between 1984 and 2005. Pictures included 189 persons with AIDS/HIV status or risk and 134 AIDS‐related objects; they appeared in chapters on stress, sexual issues, substance abuse, and organic brain disorders. Individuals depicted were overwhelmingly male, White, adult, of unspecified sexual orientation, and undiagnosed with mental disorder. The most frequent AIDS‐related objects were signs and posters, hospital furnishings, and drug paraphernalia. Thematic motifs across pictures included patient, information source, junkie, support group, celebrity, child victim, protesters, memorials, condom dispensary, and viral attack. Images of AIDS continue to invoke concepts of “the Other,” death, victimization, and culpability. It is difficult to discuss AIDS without accessing its stereotypes.     

What do pre-adolescents and adolescents understand about HIV/AIDS?

Abstract

Pre-adolescents and adolescents (N= 80, aged 10, 12, 15, and 18 years) were tested on their knowledge of HIV/AIDS. Knowledge was assessed using a self-report questionnaire (examining levels of factual knowledge) and a semi-structured interview (examining cognitive developmental levels of understanding). Examination of the developmental shifts in understanding of HIV/AIDS revealed an increase in conceptual complexity on causal and prevention dimensions. The main conceptual changes included a shift from single cause to multiple cause solutions and a shift from identifying surface or immediate features to implicating less salient features. Additionally, with age, concepts about HIV/AIDS were increasingly organised around internal, physiological principles. Questionnaire responses yielded significant age-related increases in knowledge. Level of knowledge, as measured by the questionnaire, was higher than that assessed by the interview for the three youngest age groups. Thus, factual information acquired about HIV/AIDS is not automatically accompanied by understanding. In light of these findings the past conclusion that adolescents have high levels of knowledge of HIV/AIDS is questioned.     

Attachment,Social Support,Resilience and Posttraumatic Stress Disorder Symptoms in Chinese Adults Living with HIV/AIDS

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.     

The Role of Family Functioning in Bipolar Disorder in Families

Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured interviews. Parent report on the Family Assessment Device and the Conflict Behavior Questionnaire measured family functioning and conflict, respectively. Results revealed a small but significant indirect pathway from parental diagnosis of mood disorder to child bipolar disorder through impaired family functioning, via increased family conflict. Parental mood disorders were also significantly related to other negative outcomes in children, including unipolar depression and oppositional defiant disorder. Associations between parent diagnoses and family functioning changed depending on youth age, but not youth sex.     

Affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts

The purpose of this study was to examine affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts. Forty-seven adolescents with a history of multiple suicide attempts (MA) were compared to 74 single suicide attempters (SA) on psychiatric diagnosis, depressive symptoms, affect regulation, self-mutilation, alcohol use, and hopelessness. Results revealed that the MA group was more likely to be diagnosed with a mood disorder, and reported more severe depressive symptoms and anger, in comparison to the SA group. Behaviorally, the MA group had higher rates of disruptive behavior disorders and higher levels of affect dysregulation and serious self-mutilation than the SA group. Further, greater levels of hopelessness were reported by the MA than the SA group. After controlling for a mood disorder diagnosis, only differences in anger, affect dysregulation, and serious self-mutilation remained significant. Overall, results suggest that treatment with adolescent suicide attempters might specifically target anger and affect dysregulation to reduce risk for future suicidal behavior.     

情绪障碍及其干预:心理表象的视角

心理表象在多种情绪障碍中均表现出病理性特点。研究者基于心理表象主要对创伤后应激障碍、抑郁心境、双相障碍情绪和社交焦虑进行了心理病理学解释,尤其关注闪回和过度概化记忆等两种典型症状,并且重视心理表象在情绪症状维持中的作用。概括而言,研究者强调记忆形成与提取过程的异常、认知与行为的保护性策略的负强化、对事件及自我的认知偏差等三类因素对情绪障碍的致病作用。目前,针对或运用心理表象的干预与训练方法包括减少消极表象、改变消极表象内容、提高积极表象能力、提高记忆的具体性等四类。未来应注重侵入性表象的功能分析以及相关的心理病理学模型研究,并拓展干预与训练研究。