Psychosocial stress impairs working memory at high loads: an association with cortisol levels and memory retrieval

Stress and cortisol are known to impair memory retrieval of well-consolidated declarative material. The effects of cortisol on memory retrieval may in particular be due to glucocorticoid (GC) receptors in the hippocampus and prefrontal cortex (PFC). Therefore, effects of stress and cortisol should be observable on both hippocampal-dependent declarative memory retrieval and PFC-dependent working memory (WM). In the present study, it was tested whether psychosocial stress would impair both WM and memory retrieval in 20 young healthy men. In addition, the association between cortisol levels and cognitive performance was assessed. It was found that stress impaired WM at high loads, but not at low loads in a Sternberg paradigm. High cortisol levels at the time of testing were associated with slow WM performance at high loads, and with impaired recall of moderately emotional, but not of highly emotional paragraphs. Furthermore, performance at high WM loads was associated with memory retrieval. These data extend previous results of pharmacological studies in finding WM impairments after acute stress at high workloads and cortisol-related retrieval impairments.     

The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain

Despite good physical prognosis, patients who receive a diagnosis of non-cardiac chest pain (NCCP) may experience persistent pain and distress. While cognitive-behavioural interventions have been found to be effective for this group, they are difficult to deliver in busy emergency department (ED) settings. Addressing the acceptability and relevance of self-help interventions is an important initial step in addressing this need. This study sought to examine the acceptability and relevance of an evidence-based self-help intervention for ED patients with persistent NCCP and anxiety. Patient (interviews: N = 11) and specialist chest pain nurse (focus group: N = 4) views on acceptability and feasibility were examined. Data were analysed using thematic analysis. Patients and nurses reported that there was a need for the intervention, as stress and anxiety are common among patients with NCCP, and provision of psychosocial support is currently lacking. Both patients and nurses reported that the intervention was relevant, acceptable, and potentially useful. Some changes to the intervention were suggested. Nurses reported that the intervention could be used within the existing staff resources available in an ED setting. This study represents an important first step towards developing a brief self-help intervention for ED patients with NCCP and anxiety. Further research should seek to determine the efficacy of the intervention in a pilot trial.     

Imageability and semantic association in the representation and processing of event verbs

This study examined the relative salience of imageability (the degree to which a word evokes mental imagery) versus semantic association (the density of semantic network in which a word is embedded) in the representation and processing of four types of event verbs: sensory, cognitive, speech, and motor verbs. ERP responses were recorded, while 34 university students performed on a lexical decision task. Analysis focused primarily on amplitude differences across verb conditions within the N400 time window where activities are considered representing meaning activation. Variation in N400 amplitude across four types of verbs was found significantly associated with the level of imageability, but not the level of semantic association. The findings suggest imageability as a more salient factor relative to semantic association in the processing of these verbs. The role of semantic association and the representation of speech verbs are also discussed.     

Moderators of the association between exercise identity and obligatory exercise among participants of an athletic event

Previous research has connected exercise identity with obligatory exercise, yet to date no empirical studies have identified moderator variables of this association. The current study included participants of an athletic event (full marathon, n = 582; half marathon, n = 1,106; shorter distance, n = 733) who completed questionnaires about exercise behaviors, obligatory exercise, and internalization of both the thin-ideal and athletic-ideal body shapes. General linear model analyses were conducted to examine the exercise identity–obligatory exercise relationship; moderator variables included gender, internalization of the thin-ideal body shape, and internalization of the athletic-ideal body shape. After controlling for the effects of body mass index, age, and distance group, the three-way interaction of exercise identity, gender, and internalization of the athletic-ideal body shape predicted obligatory exercise. Findings suggest that women who report high identification with exercise and high value on having an athletic physique may be vulnerable to obligatory exercise.     

Life stress, social support, and self-esteem in an elderly population

Findings in previous studies of the stress-buffering properties of social support have been erratic. This study suggests that at least part of the reason for those inconclusive findings may be that researchers are using oversimplified models of the stress process and limited statistical approaches to assess the effects. The findings in this study indicate that social support (a) helps to reduce the deleterious effects of stress on emotional disorder primarily by bolstering the self-esteem of older adults and (b) affects psychological well-being only indirectly through self-esteem. Two distinct approaches to the statistical estimation of stress-buffering effects are also examined.     

Physiologic reactivity to startling tones in women with posttraumatic stress disorder.

Autonomic and eyeblink reactivity to startling tones were investigated in women with histories of childhood sexual abuse (CSA). Twenty-one women with current posttraumatic stress disorder (PTSD), 23 with lifetime but not current PTSD, and 13 women who never had PTSD listened to 15 95-dB, 500-ms, 1000-Hz tones with a 0-ms rise time while heart rate (HR), skin conductance (SC), and orbicularis oculi electromyogram (EMG) responses were measured. Participants in the current and lifetime PTSD groups produced larger HR responses across tones and showed slower absolute habituation of SC response magnitude compared with the never PTSD group. EMG response magnitudes did not differ among groups. Women with CSA-related PTSD showed increased autonomic reactivity and slower habituation to high-intensity tones similar to that observed in primarily male, combat PTSD samples. This suggests that heightened autonomic responsivity to startling stimuli in PTSD is not gender or event specific.     

Depressive symptomatology during pregnancy: evidence for an association with decreased fetal growth in pregnancies of lower social class women.

The relationship between depressive symptom scores on the Center for Epidemiological Studies Depression Scale (CES-D; L. S. Radloff, 1977) at each trimester of pregnancy and a decrement in either fetal growth or gestational duration was evaluated among 666 pregnant women. There was no association overall, but among 222 women from lower occupational status households, each unit increase on the CES-D at 28 weeks gestation was associated with a reduction of 9.1 g (95% confidence interval [CI] = -16.0, -2.3) in gestational-age-adjusted birth weight. When missing data were multiply imputed, the estimate was -4.6 g (95% CI = - 10.7, 1.5). CES-D score was unrelated to fetal growth or gestational duration in analyses among other potentially high-risk subgroups: smokers, women with a history of adverse outcome, and women with social vulnerabilities. These results raise the possibility that among lower status women, depressive mood may be associated with restricted fetal growth.     

Disruptions of social relationships accentuate the association between emotional distress and menstrual pain in young women.

This study examined the effects of social support on dysmenorrhea and whether social support moderates the relationship between negative emotions and painful symptoms. Women (N = 184) completed questionnaires on menstrual symptoms, depression, anxiety, and social networks. Depression and anxiety were strongly associated with menstrual pain. Women who no longer had access to their prior support providers manifested more symptoms than did women with stable social relations. In addition, this disruption in their social networks moderated the relationship between distress and menstrual pain. Results indicate that loss of social support is a significant contributor to menstrual symptoms and point to the importance of considering specific aspects of social support in studying its effect on health.     

Traumatic stress, life events, and emotional support in women with metastatic breast cancer: cancer-related traumatic stress symptoms associated with past and current stressors.

This study examined levels of intrusion and avoidance symptoms and their relationships to past life stress, current emotional support, disease-related variables, and age in 125 women with metastatic breast cancer. The results indicate that a sizable proportion of these women experienced clinically significant levels of intrusion and avoidance symptoms related to their cancer, particularly those with both more stressful past life events and higher current levels of aversive emotional support. Additionally, both types of symptoms were associated with shorter time since recurrence, and avoidance symptoms were associated with smaller emotional support networks. These results indicate that metastatic breast cancer is an emotionally traumatic event for a significant proportion of women, particularly those with past life stressors and unsupportive social environments.     

Evidence for an association between the discriminative stimulus and the response-outcome association in instrumental learning

In 4 experiments, rats received 1 of several outcomes for engaging in various instrumental responses in the presence of discriminative stimuli. Discriminative stimuli shared some response-outcome relations but not others. When a response was subsequently extinguished in the presence of 1 discriminative stimulus, that produced relatively more decrement in responding in other stimuli that shared the same response-outcome relation. Other discriminative stimuli, in the presence of which that response had been reinforced by other outcomes and in which the original outcome had reinforced another response, were less affected. Moreover, postextinction devaluation of that outcome suggested that the particular response-outcome relation extinguished had undergone decrement. These results suggest that discriminative stimuli have relatively specific associations with the response-outcome relations that obtain in their presence.     

Life stressors, resistance factors, and improved psychological functioning: an extension of the stress resistance paradigm

This study applied a set of factors previously identified as being linked with stress resistance to the prediction of both stable and improved psychological functioning over a 1-year interval with more than 400 community-resident adults. Stable psychological functioning under high stressors is predicted at the beginning of the year by personal and social resources that are linked to functioning through their influence on increased approach coping during the year. In contrast, improved psychological functioning under low stressors is predicted directly by initial resources. As predicted by crisis theory, improved functioning under high stressors is related to an increase in resources during the year. The findings are discussed in the context of an extension of the stress-resistance paradigm beyond illness prevention toward a general, adaptively oriented health framework.     

The association of sleep disturbances with endocrine and perceived stress reactivity measures in male employees

Evidence on the relationship between stress reactivity and sleep is conflicting. This study examined the association between disturbed sleep and perceived and endocrine stress reactivity independently of age, body mass index (BMI), and chronic stress. One hundred and twenty middle-aged men were exposed to the Trier Social Stress Test for Groups. The Pittsburgh Sleep Quality Index and the Perceived Stress Reactivity Scale were used to assess sleep and perceived stress reactivity, respectively. Endocrine stress reactivity was examined by assessing salivary cortisol levels. Regression analyses showed that men with disturbed sleep had blunted overall cortisol responses (b = −18.246, p = .044), but the association did not survive adjustment for age, BMI, and chronic stress. In contrast, poor sleep was associated with heightened perceived stress reactivity independently of age and BMI (b = 0.235, p = .005), but additional adjustment for chronic stress attenuated the relationship and only chronic stress remained a significant predictor of perceived stress reactivity (b = 0.470, p < .001). Cortisol and perceived stress reactivity were uncorrelated. In summary, our study indicates associations between sleep disturbances and stress reactivity were not independent of BMI and chronic stress levels, and endocrine and perceived stress reactivity were dissociated.     

The occurrence of paraphasias in the spontaneous speech of children with an acquired aphasia

Two children with an acquired aphasia were observed during the recovery process. In the spontaneous speech, paraphasias belonging to different categories, such as neologisms, verbal paraphasias, and literal paraphasias, were found. Especially with regard to neologisms the time of investigation was very important. In addition, one child with a phonemic jargon aphasia and one child with a fluent aphasia and empty speech were observed. These observations implicate a modification of the current clinical picture of childhood aphasia. Some aspects are discussed in relation to adult aphasia.     

Unemployment among women with multiple sclerosis: the role of coping and perceived stress and support in the workplace

Unemployment is high among individuals with multiple sclerosis (MS). Certain disease variables and demographics have been found to distinguish employed and unemployed individuals. However, these variables only account for 14–20% of the variance. Other factors, such as coping, perceived stress and social support, in the workforce have been proposed, but not yet fully examined. The purpose of the present investigation was to examine the role of known factors associated with unemployment in MS, as well as coping and perceived work stress and social support. Sixty-eight women with MS were asked about their employment status and reasons for leaving. They completed a comprehensive assessment including measures of cognition, disease symptoms, psychological functioning, coping and stress. Consistent with previous findings, certain disease and demographic variables were associated with being unemployed. In particular, women who left work due to their MS were found to be older, had a longer disease duration and progressive course, reported greater disability and fatigue, and performed worse on a cognitive measure. However, we also found that coping style distinguished those who were employed from those who left work due to their MS. In particular, those who left work reported utilizing maladaptive coping mechanisms such as behavioral disengagement and substance use. With regard to perceived work stress and support, individuals who were employed reported that job security and fellow co-workers were more of an uplift than a hassle in their lives, suggesting some benefit in employment. These findings suggest that further consideration be given to role of coping and perception of the benefit of employment among individuals with MS when making recommendations regarding work decisions.     

Alcohol use and stress in women: The role of prior vs. anticipated stressors

The present study investigated stress-related drinking in women. Alcohol consumption in response to stress and in anticipation of a stressor was examined to evaluate women's use of alcohol to cope with stress. Subjects were assigned to one of four conditions in a 2 × 2 factorial design in which order of alcohol consumption and stress task as well as stress level was manipulated. Findings indicate that subjects did not consume alcohol to cope with the effects of either a prior stressor or an upcoming stressor. These results suggest the need for further refinement of notions concerning women's use of alcohol to cope with stress.     

Therapy concept and initial experiences of an inpatient department at a district hospital on the therapy of alcoholic patients

The basic therapeutic considerations underlying the establishment of an in-patient department for the treatment of alcoholic cases at district level are set forth, and the advantages and disadvantages of the move are discussed. In practice, in-hospital treatment of alcoholic cases at district level has been shown to be justified in the creation of a locally self-contained therapeutic chain.     

Development of norms for executive functions in typically-developing Indian urban preschool children and its association with nutritional status

Executive functions (EFs) are essential and important for achieving success in children’s everyday lives and play a fundamental role in children’s cognitive, academic, social, emotional and behavioral functioning. A cross-sectional study was carried out to develop age- and sex-specific norms for EFs using the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P) among 2- to 5-year-olds from urban Bangalore, India. In addition, the association between EFs and anthropometric measures, a marker of nutritional status, is also examined. Primary caregivers of 412 children, equally distributed by age and sex, participated. Raw scores for each domain and indices were converted to standard t-scores and percentiles were computed. A t-score at or above 63 corresponding to the 90th percentile was considered as the cutoff for executive dysfunction in this sample. The prevalence of executive dysfunction is 10% based on the Global Executive Composite score of the BRIEF-P. The cutoff score for identifying executive dysfunction using existing United States (US) norms is higher compared to the cutoff score obtained in the current study. Therefore, using US norms for Indian children could result in the prevalence of executive dysfunction been underestimated. Multiple linear regression analysis revealed that stunted and underweight children have significantly elevated EF scores after adjusting for age, sex and socioeconomic status (SES; p < .01). A greater understanding of EFs in preschool children is important for the early identification of executive dysfunction and implementing interventions to improve their future prospects. This study also shows that undernourished children are more likely to have executive dysfunction.