Context-specific freezing and associated physiological reactivity as a dysregulated fear response

The putative association between fear-related behaviors and peripheral sympathetic and neuroendocrine reactivity has not been replicated consistently. This inconsistency was addressed in a reexamination of the characterization of children with extreme fearful reactions by focusing on the match between distress behaviors and the eliciting context. Eighty 24-month-old children were observed in 4 mildly threatening contexts, and the relations among different measures of fear-related behaviors, reactive and basal cortisol levels, and baseline cardiac measures of heart rate, respiratory sinus arrhythmia, and preejection period (PEP) were examined. The hypothesis that only behaviors under the less threatening context would be associated with higher cortisol and sympathetic cardiac activity was confirmed; only task-specific freezing behavior predicted higher reactive and basal cortisol levels and resting PEP measured 1 week later. Implications for the conceptualization of dysregulated fear behaviors in the classification of extremely fearful children are discussed.     

Acute cortisol elevations cause heightened arousal ratings of objectively nonarousing stimuli

To test the effects of cortisol on affective experience, the authors orally administered a placebo, 20 mg cortisol, or 40 mg cortisol to 85 men. Participants' affective responses to negative and neutral stimuli were measured. Self-reported affective state was also assessed. Participants in the 40-mg group (showing extreme cortisol elevations within the physiological range) rated neutral stimuli as more highly arousing than did participants in the placebo and 20-mg groups. Furthermore, within the 20-mg group, individuals with higher cortisol elevations made higher arousal ratings of neutral stimuli. However, cortisol was unrelated to self-reported affective state. Thus, findings indicate that acute cortisol elevations cause heightened arousal in response to objectively nonarousing stimuli, in the absence of effects on mood.     

Depression and literacy are important factors for missed appointments

Multiple variables are related to missed clinic appointments. However, the prevalence of missed appointments is still high suggesting other factors may play a role. The purpose of this study was to investigate the relationship between missed appointments and multiple variables simultaneously across a health care system, including patient demographics, psychiatric symptoms, cognitive functioning and literacy status. Chart reviews were conducted on 147 consecutive patients who were seen by a primary care psychologist over a six month period and completed measures to determine levels of depression, anxiety, sleep, cognitive functioning and health literacy. Demographic information and rates of missed appointments were also collected from charts. The average rate of missed appointments was 15.38%. In univariate analyses, factors related to higher rates of missed appointments included younger age (p = .03), lower income (p = .05), probable depression (p = .05), sleep difficulty (p = .05) and limited reading ability (p = .003). There were trends for a higher rate of missed appointments for patients identifying as black (p = .06), government insurance (p = .06) and limited math ability (p = .06). In a multivariate model, probable depression (p = .02) and limited reading ability (p = .003) were the only independent predictors. Depression and literacy status may be the most important factors associated with missed appointments. Implications are discussed including regular screening for depression and literacy status as well as interventions that can be utilized to help improve the rate of missed appointments.     

A new look at Copernicus and Kant

Continental Philosophy Review -