The neuroendocrinology of posttraumatic stress disorder: new directions

Studies of the hypothalamic-pituitary-adrenal (HPA) axis in persons with posttraumatic stress disorder (PTSD) have produced variable findings. This review focuses on the factors likely to have affected the outcome of these studies, including population characteristics and experimental design. Also discussed is a possible role for the adrenal neurosteroid dehydroepiandrosterone (DHEA) as a mediator of HPA axis adaptation to extreme stress and the psychiatric symptoms associated with PTSD. The antiglucocorticoid properties of DHEA may contribute to an upregulation of HPA axis responses as well as mitigate possible deleterious effects of high cortisol levels on the brain in some PTSD subpopulations. The neuromodulatory effects of DHEA and its metabolite DHEAS at gamma-aminobutyric acid and N-methyl-D-aspartate receptors in the brain may contribute to psychiatric symptoms associated with PTSD. The possible importance of other neurohormone systems in modulating HPA axis and symptom responses to traumatic stress is also discussed. Understanding the complex interactions of these stress-responsive neurosteroid and peptide systems may help explain the variability in patterns of HPA axis adaptation, brain changes, and psychiatric symptoms observed in PTSD and lead to better targeting of preventive and therapeutic interventions.     

Fluency disruption in speech and in wind instrument playing

A case of an adult who stutters and complains of a similar fluency problem when playing the trombone is reported. This is the fourth such report, with previous cases involving trumpet, flute, and horn playing.     

Fleeting Signs of the Course of Life: Facial Expression and Personal Adjustment

In this article, we consider whether facial expressions of emotion relate in theoretically interesting ways to personal adjustment. We first consider the conceptual benefits of this line of inquiry. Then, to anticipate why brief samples of emotional behavior should relate to personal adjustment, we review evidence indicating that facial expressions of emotion correspond to intrapersonal processes and social outcomes. We then review studies showing that facial expressions relate in theoretically significant ways to adjustment after the death of a spouse, in long-term relationships, and in the context of chronic psychological disorders.     

Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.     

Training Japanese listeners to identify English /r/and /l/: Long-term retention of learning in perception and production

Previous work from our laboratories has shown that monolingual Japanese adults who were given intensive high-variability perceptual training improved in both perception and production of English /r/-/l/ minimal pairs. In this study, we extended those findings by investigating the long-term retention of learning in both perception and production of this difficult non-native contrast. Results showed that 3 months after completion of the perceptual training procedure, the Japanese trainees maintained their improved levels of performance on the perceptual identification task. Furthermore, perceptual evaluations by native American English listeners of the Japanese trainees’ pretest, posttest, and 3-month follow-up speech productions showed that the trainees retained their long-term improvements in the general quality, identifiability, and overall intelligibility of their English /r/-/l/ word productions. Taken together, the results provide further support for the efficacy of high-variability laboratory speech sound training procedures, and suggest an optimistic outlook for the application of such procedures for a wide range of “special populations.” nt]mis|This work was supported by NIDCD Training Grant DC-00012 and by NIDCD Research Grant DC-00111 to Indiana University.     

Performance Monitoring as a Moderator of the Relations Between Two Conscientiousness Measures and Task Performance

The present study investigated the moderating effects of performance monitoring on the relations between two measures of conscientiousness (general and business-oriented) and performance on a data entry task. A significant interaction was evidenced between conscientiousness and performance monitoring in predicting task performance for the general measure of conscientiousness; however, it was opposite than expected. No significant interaction was evidenced between conscientiousness and performance monitoring in predicting task performance for the business-oriented measure of conscientiousness. Possible explanations for these findings are suggested. Implications and limitations of the present research are identified and various suggestions for future research in this area are recommended.     

Stepfamilies Doing Family: A Meta‐Ethnography

The present review examines how stepfamily members without a shared history co‐construct a shared family identity and what family processes are relevant in this stepfamily formation. Three databases (Web of Science, PsycInfo, and ProQuest) were systematically searched, resulting in 20 included qualitative studies. The meta‐ethnography approach of Noblit and Hare allowed synthesizing these qualitative studies and constructing a comprehensive framework of stepfamilies doing family. Three interdependent family tasks were identified: (a) honoring the past, (b) marking the present, and (c) investing in the future. Stepfamily members’ experiences of these family tasks are strongly affected by the dominant societal perspectives and characterized by an underlying dialectical tension between wanting to be like a first‐time family and feeling the differences in their family structure at the same time. These findings clearly demonstrate the family work that all stepfamily members undertake and provide a broader context for interpreting stepfamilies’ co‐construction of a new family identity.     

Talkin’ ‘Bout My Generation: Existentialism,Aging, and Newly Emerging Issues in Group Therapy

This paper seeks to generate existentialist ideas about emerging issues of aging and its treatment in group therapy for the generations now entering their 60s and 70s. Group therapy had its heyday in the 1970s, and one could say that group therapy has never returned to the level of popularity that it had at that time. Using existential concepts, this paper will explore ways of rejuvenating work with this population now that they are growing older. Rather than just focusing on the common existential themes of death and dread, this article will focus on time, overcoming isolation, finding meaning, and what it means to be in the world now that we are older.