Suicide compared to other causes of mortality in physicians

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study, we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortality experience across medical specialties. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.     

Rejection sensitivity and the defensive motivational system: insights from the startle response to rejection cues

Rejection sensitivity (RS) is the disposition to anxiously expect, readily perceive, and intensely react to rejection. This study used the startle probe paradigm to test whether the affect-based defensive motivational system is automatically activated by rejection cues in people who are high in RS. Stimuli were representational paintings depicting rejection (by Hopper) and acceptance (by Renoir), as well as nonrepresentational paintings of either negative or positive valence (by Rothko and Miro, respectively). Eyeblink startle magnitude was potentiated in people high in RS when they viewed rejection themes, compared with when they viewed nonrepresentational negative themes. Startle magnitude was not attenuated during viewing of acceptance themes in comparison with nonrepresentational positive themes. Overall, the results provide evidence that for people high in RS, rejection cues automatically activate the defensive motivational system, but acceptance cues do not automatically activate the appetitive motivational system.     

Differential effects of arousal in positive and negative autobiographical memories

Autobiographical memories are characterised by a range of emotions and emotional reactions. Recent research has demonstrated that differences in emotional valence (positive vs. negative emotion) and arousal (the degree of emotional intensity) differentially influence the retrieved memory narrative. Although the mnemonic effects of valence and arousal have both been heavily studied, it is currently unclear whether the effects of emotional arousal are equivalent for positive and negative autobiographical events. In the current study, multilevel models were used to examine differential effects of emotional valence and arousal on the richness of autobiographical memory retrieval both between and within subjects. Thirty-four young adults were asked to retrieve personal autobiographical memories associated with popular musical cues and to rate the valence, arousal and richness of these events. The multilevel analyses identified independent influences of valence and intensity upon retrieval characteristics at the within- and between-subject levels. In addition, the within-subject interactions between valence and arousal highlighted differential effects of arousal for positive and negative memories. These findings have important implications for future studies of emotion and memory, highlighting the importance of considering both valence and arousal when examining the role emotion plays in the richness of memory representation.     

Midlife Sexuality Among Thai Adults: Adjustment to Aging in the Thai Family Context

The objective of the study is to assess views of age related changes in sexual behavior among married Thai adults age 53–57. Results are viewed in the context of life course theory. In-depth interviews were conducted with 44 Thai adults in Bangkok and the four regions of Thailand. Topics covered include changing sexual behavior with age, adjustment to this change, gender differences in behavior, attitudes toward commercial sex and other non-marital sexual partners, and condom use. Most respondents were aware of this change and saw a decrease in sexual activity and desire more often among women compared to men. At the same time, many respondents viewed sexuality as important to a marriage. Some respondents accepted the decrease in sexual activity and focused more on work, family and temple activities. Thai Buddhism was seen as an important resource for people who were dealing with changes due to aging. Other persons turned to other partners including both commercial and non-commercial partners. The influence of the HIV epidemic that began in the 1990s was seen in concerns about disease transmission with extramarital partners and consequent attitudes toward condom use. The acceptability of extramarital partners in the family and community ranged from acceptance to strong disapproval of extramarital relationships.     

Error monitoring dysfunction across the illness course of schizophrenia

Response monitoring abnormalities have been reported in chronic schizophrenia patients, but it is unknown whether they predate the onset of psychosis, are present in early stages of illness, or are late-developing abnormalities associated with illness progression. Response-synchronized event-related potentials (ERP) recorded during a picture-word matching task yielded error-related negativity (ERN), correct-response negativity (CRN), and error positivity (Pe) from 84 schizophrenia patients (SZ), 48 clinical high risk patients (CHR), and their age-matched healthy controls (HC; n = 110 and 88, respectively). A sub-sample of 35 early illness schizophrenia patients (ESZ) was compared to 93 age-matched HC and the CHR patients (after statistically removing the effects of normal aging). Relative to HC, 1) SZ, ESZ, and CHR had smaller ERNs, and 2) SZ and ESZ had larger CRNs and smaller Pes. Within the SZ, longer illness duration was associated with larger CRNs but was unrelated to ERN or Pe. CHR and ESZ did not differ on ERN or CRN, although Pe was smaller in ESZ than CHR. These results indicate that while ERN, CRN, and Pe abnormalities are present early in the illness, only the ERN abnormality is evident prior to psychosis onset, and only the CRN abnormality appears to worsen progressively over the illness course. Brain regions subserving response monitoring may be compromised early in the illness and possibly during its clinical prodrome.     

Perceived unfairness and employee health: a meta-analytic integration

A growing body of research has suggested that the experience of injustice, psychological contract breach, or unfairness can adversely impact an employee's health. We conducted a meta-analysis to examine the effects of unfairness perceptions on health, examining types of fairness and methodological characteristics as moderators. Results suggested that perceptions of unfairness were associated with indicators of physical and mental health. Furthermore, psychological contract breach contributed to the prediction of strain-related indicators of health above and beyond that accounted for by injustice alone.