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.     

Guest Reviewers for 2000

Authors Index

Guest Reviewers for 2000     

Empathic Blushing in Friends and Strangers

Three volunteers watched a previously recorded video of one of them singing, as cheek sensors monitored their blushing. When performers watched videotapes of their performance, they blushed significantly more than strangers, but not more than their own friends, watching with them. Friends and strangers did not differ significantly in blushing, however. Skin conductance arousal responses of performers and friends, but not performers and strangers, or friends of performers and strangers, were correlated. In a second experiment, strangers who sang before watching another person sing blushed more than strangers who did not sing first, or who sang and then watched a neutral video. This suggests that performing the embarrassing act may have predisposed people to blush, perhaps empathically, later. No gender differences were seen in blushing. Embarrassability questionnaire scores did not correlate with blushing. Empathic accuracy, and associative learning, are proposed to account for the results.     

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.     

Construct-oriented Biodata Development for Selection to a Differentiated Performance Domain

This study describes the development of a multidimensional biodata form which used explicit constructs to guide item generation and rational scale development, construct validation, criterion measurement and empirical keying. These constructs were goal-orientation, teamwork, customer service, resourcefulness, learning ability and leadership. Exploratory and confirmatory factor analyses in both applicant and incumbent samples were used to identify and test the model which included the thirteen, more differentiated rational scales relating to these six, broader constructs. Empirical keying of the rationally developed scales was conducted against criterion construct scales conceptually related to each predictor construct. Empirical keying at the item level was found to result in higher validities and cross-validities than either empirical keying at the scale level, or rational keying. The item keyed instrument also demonstrated incremental validity over a test of cognitive ability for specific work performance domains as well as overall work performance.     

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.     

Corporal Punishment by American Parents: National Data on Prevalence, Chronicity, Severity, and Duration, in Relation to Child and Family Characteristics

We present data on corporal punishment (CP) by a nationally representative sample of 991 American parents interviewed in 1995. Six types of CP were examined: slaps on the hand or leg, spanking on the buttocks, pinching, shaking, hitting on the buttocks with a belt or paddle, and slapping in the face. The overall prevalence rate (the percentage of parents using any of these types of CP during the previous year) was 35% for infants and reached a peak of 94% at ages 3 and 4. Despite rapid decline after age 5, just over half of American parents hit children at age 12, a third at age 14, and 13% at age 17. Analysis of chronicity found that parents who hit teenage children did so an average of about six times during the year. Severity, as measured by hitting the child with a belt or paddle, was greatest for children age 5–12 (28% of such children). CP was more prevalent among African American and low socioeconomic status parents, in the South, for boys, and by mothers. The pervasiveness of CP reported in this article, and the harmful side effects of CP shown by recent longitudinal research, indicates a need for psychology and sociology textbooks to reverse the current tendency to almost ignore CP and instead treat it as a major aspect of the socialization experience of American children; and for developmental psychologists to be cognizant of the likelihood that parents are using CP far more often than even advocates of CP recommend, and to inform parents about the risks involved.     

Wisdom and Life Experience: How Grandfathers Mentor Their Grandchildren

This exploratory study uses qualitative methods to focus on the largely unexamined role of the grandfather and to examine men's experiences as grandfathers. We gathered information through both surveys and individual interviews to explore men's feelings and attitudes toward the grandfather role. Of the 51 grandfathers that completed a survey, 20 participated in interviews. Our examination of the data collected reveals the life lessons men teach their grandchildren. The grandfathers in this study expressed strong desires for purposeful involvement in their grandchildren's lives and indicated desires for transferring values to grandchildren and teaching interpersonal relationships. Through this involvement, they educate through life experiences and serve as mentors for their grandchildren. We suggest that this mentoring role makes a positive contribution to the lives of grandchildren and to the identity of grandfathers.