A Psychoneuroimmunologic Perspective on AIDS Research: Questions,Preliminary Findings,and Suggestions1

Starting with the premise that research questions emanating from the fields of psychoneuroimmunology and behavioral medicine may provide critical information for understanding and treating acquired immune deficiency syndrome (AIDS), we provide brief backgrounds on psychoneuroimmunology and on AIDS. Previously, Solomon had generated 25 hypotheses based on the thesis that the immune and central nervous systems are intimately linked. Eight hypotheses from his list are presented as particularly relevant to AIDS. From these hypotheses, we derived a set of 12 new questions to be addressed in research on AIDS. Evidence and illustrations from studies in the literature, from our own research on psychoimmunologic relationships and psychosocial factors related to outcome, and from clinical examples is discussed for each question. Finally, suggestions are offered to address some of the problems in conducting psychoneurologic research.     

A NEUROBIOLOGICAL ALTERNATIVE TO THE PERCEPTUAL REINFORCEMENT HYPOTHESIS OF STEREOTYPED BEHAVIOR: A COMMENTARY ON “SELF-STIMULATORY BEHAVIOR AND PERCEPTUAL REINFORCEMENT”

A perceptual reinforcement theory of stereotyped movements is advanced by Lovaas, Newsom, and Hickman (1987) in an effort to integrate a number of diverse observations about the origins and maintenance of this behavior. We, in turn, argue that the theory, as presented, is logically flawed and fails to take into account important biological findings and theory concerning pathological stereotyped acts. An alternative theory, derived primarily from neurological concepts, is briefly described.     

ALTERNATIVE WORK SCHEDULES: TWO FIELD QUASI-EXPERIMENTS

In the first ( N = 140) of two quasi-experimental field studies, trial group employees were changed from a 5/40 to a 4/40 work schedule for four months then returned to a 5/40 schedule. In a second study ( N = 102), trial group employees were changed from 5/40 to flextime. Reactions were evaluated using a model for understanding the impact of work schedules. The effects of schedule changes matched those anticipated by pre-intervention surveys of employees. Factors related to organizational effectiveness were enhanced where specific organizational needs were met. Interference with personal activities was reduced where employees had experienced specific difficulties. The most powerful effect, however, was on worker attitudes toward specific work schedules. In addition, a mild positive (perhaps Hawthorne) effect was evident for a wide range of general worker reactions.     

Accelerated development of cardiac sympathetic responses in spontaneously hypertensive (SHR) rats

The functional development of cardiac and adrenal medullary responses to reflex activation of the sympathetic nervous system was studied in preweanling spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) normotensive rats. Pups of the two strains received injections of insulin or saline at 2, 4, 8, 12, or 16 days of age and were sacrificed 3 h later. Insulin administration produces a significant decrease in circulating levels of glucose which in turn results in a centrally mediated increase in sympathetic outflow. The induction of ornithine decarboxylase (ODC) in heart and the depletion of epinephrine from the adrenal medulla served as tissue markers of functional sympathetic neurotransmission. WKY and SHR pups had comparable levels of ODC activity in heart under basal conditions. In contrast, levels of catecholamines in the adrenals were greater in SHR pups at 2 and 4 days of age. Following insulin administration, SHR pups exhibited a greater induction of cardiac ODC activity at 2, 4, and 8 days of age compared to age-matched WKY controls. However, there were no differences between SHR and WKY pups in the magnitude of the adrenal medullary response to insulin-induced hypoglycemia. These alterations in sympathetic-target tissue development during the first postnatal week of life may contribute in part to the higher arterial pressures maintained by SHRs throughout the lifespan.     

Sexual experience and preference for males or females in the female rat

The influence of sexual experience on preference behavior was investigated in adult female rats. In the first experiment, preference behavior for sexually active males versus estrous females was investigated in female rats who were experienced with mounting behavior. Preference of these mount experienced females was compared to preference of females who were naive in this respect. Mount experience with estrous females induced a female-directed preference in ovariectomized female rats, irrespective of whether the females were treated with OIL or with testosterone-propionate (500 micrograms TP, injected once 48 h prior to testing). Sexually naive, OIL-treated females did not show a preference for males or females, but TP induced a preference for a male. Individual differences in mount frequency were not correlated with preference behavior. In the second experiment, the influence of experience with feminine sexual responses on preference behavior was investigated. OIL-treated and TP-treated females oriented equally toward males and females when they had been given the opportunity to copulate with males prior to the preference tests. The results strongly suggest that prior sexual experience is an important determinant of preference behavior. The female's behavior during sexual interactions was, however, not predictive of later preference.     

Modification of Type A behavior through aerobic exercise

This psychophysiological evaluation of an aerobic exercise program examined specifically whether aerobic training modified Pattern A for those individuals at behavioral risk for developing coronary heart disease, i.e., young Type A individuals. At pretest and posttest of this secondary prevention study, Type A and Type B subjects were assessed in three conditions: aerobic exercise program, nonaerobic activity (Aikido, a martial art) control, and notreatment control. After 10 weeks, Type A but not Type B subjects exhibited lower Pattern A behavior in the aerobic program than in control conditions. Average workout pulse rates and differentially reliable increases in aerobic capacity indicated that aerobic training was indeed aerobic, whereas aikido activity was not. Even though selected nonaerobic factors, such as locus of control and group participation, did not mediate the Pattern A decrease for Type A's when comparing aikido and aerobic conditions, changes in aerobic capacity may have been the mediator. Generalizability of the results and implications for theoretical development and clinical intervention are discussed.     

Anger and irrational thought: Questionnaire and interview ratings

From an initial pool of 96 students, 36 subjects were selected based on Novaco Anger Scale scores to form high-, moderate-, and low-anger groups (n=12). They completed self-report questionnaires and participated in a structured interview designed to elicit cognitive and affective responses to hypothetical situations involving interpersonal conflict. High- and moderate-anger groups scored significantly higher than low-anger subjects on a questionnaire measure of irrational thinking. High-anger subjects scored higher than low-anger subjects on general anxiety, suspiciousness, fear of negative evaluation, hostility, and criticism of themselves and others. Interview ratings showed that there were no group differences in self-reports of anger or ability to cope with conflict, yet raters judged high-anger subjects to display more anger than low-anger subjects in their stated response actions. Estimates of coping ability varied inversely with reports of anger experienced. Generally, results support a relationship between irrational thinking patterns and anger in feeling and action. Implications for treatment are discussed.