Chronic pelvic pain: A meta-analytic review

Abstract

Chronic pelvic pain (CPP) in women of reproductive age is a common complaint; for many women no identifiable pathology can be found. Research has suggested that women who have chronic pelvic pain without obvious pathology differ on a range of psychological characteristics, such as anxiety and depression, compared with those with identified pathology. A meta-analysis of 22 studies was undertaken to clarify these issues. Results showed that there were no significant differences on a range of psychological variables between women who were identified, via laparoscopy and clinical judgement, as having organic disorders and those who were not so identified. When women with chronic pelvic pain were compared with pain-free groups a profile of elevated depression, anxiety, neuroticism and psychopathology was found which is consistent with findings from studies of other painful conditions.     

Pity or peanuts? Oxytocin induces different neural responses to the same infant crying labeled as sick or bored

The neuropeptide oxytocin plays an important role in mother–infant bonding. However, recent studies indicate that the effects of oxytocin on prosociality are dependent on perceived social context. Using functional magnetic resonance imaging, we examined differential effects of intranasally administered oxytocin on neural responding to 500 and 700 Hz crying that was indicated as emanating from a sick infant and 500 and 700 Hz crying emanating from a bored infant. We found that oxytocin significantly increased insula and inferior frontal gyrus responding to sick infant crying, but decreased activation in these brain regions during exposure to crying of an infant that was labeled as bored. In addition, oxytocin decreased amygdala responding to 500 Hz crying, but increased amygdala responding to 700 Hz crying. These findings indicate that labeling the same infant crying as ‘sick’ or as ‘bored’ drastically changes neural activity in response to intranasal oxytocin administration. Oxytocin increases empathic reactions to sick infants' crying, but lowers the perceived urgency of crying of an infant perceived as bored, thus flexibly adapting adult responses to infant crying labeled in various ways.     

A Qualitative Study of Healthcare Providers’ Perspectives on the Implications of Genome-Wide Testing in Pediatric Clinical Practice

The utilization of genome-wide chromosomal microarray analysis (CMA) in pediatric clinical practice provides an opportunity to consider how genetic diagnostics is evolving, and to prepare for the clinical integration of genome-wide sequencing technologies. We conducted semi-structured interviews with 15 healthcare providers (7 genetic counselors, 4 medical geneticists, and 4 non-genetics providers) to investigate the impact of CMA on clinical practice, and implications for providers, patients and families. Interviews were analyzed qualitatively using content analysis. Most providers reported that genomic testing enhanced their professional experience and was beneficial to patients, primarily due to the improved diagnostic rate compared with earlier chromosomal studies. Other effects on practice included moving towards genotype-first diagnosis and broadening indications for chromosomal testing. Opinions varied concerning informed consent and disclosure of results. The duty to disclose incidental findings (IFs) was noted; however concerns were raised about potential psychosocial harms of disclosing pre-symptomatic findings. Tensions were revealed between the need for comprehensive informed consent for all families and the challenges of communicating time-consuming and potentially anxiety-provoking information regarding uncertain and incidental findings that may be relevant only in rare cases. Genetic counselors can play an important role in liaising with families, health professionals and testing laboratories, providing education and guidance to non-genetics providers, and enabling families to receive adequate pre-and post-test information and follow-up care.     

Children’s strategy use when playing strategic games

Strategic games require reasoning about other people’s and one’s own beliefs or intentions. Although they have clear commonalities with psychological tests of theory of mind, they are not clearly related to theory of mind tests for children between 9 and 10 years of age “Flobbe et al. J Logic Language Inform 17(4):417–442 (2008)”. We studied children’s (5–12 years of age) individual differences in how they played a strategic game by analyzing the strategies that they applied in a zero, first, and second-order reasoning task. For the zero-order task, we found two subgroups with different accuracy levels. For the first-order task, subgroups of children applied different suboptimal strategies or an optimal strategy. For the second-order task only suboptimal strategies were present. Strategy use for all tasks was related to age. The 5- and 6-year old children were additionally tested on theory of mind understanding and executive functioning. Strategy-use in these children was related to working memory, but not to theory of mind after correction for age, verbal ability and general IQ.     

Stress and emotional memory: a matter of timing

Stressful events activate the amygdala and a network of associated brain regions. Studies in both humans and rodents indicate that noradrenaline has a prominent role in this activation. Noradrenaline induces a hypervigilant state that helps to remember the event. This mnemonic effect is enhanced when the situation is so stressful that substantial amounts of corticosteroids are released and reach the amygdala. The combination of the two hormones leads to optimal strengthening of contacts and thus memory. Yet, rises in corticosteroid levels that are not precisely synchronized with noradrenaline release do not act synergistically but rather prevent or suppress the effect of noradrenaline. This dynamic interaction illustrates the adaptive and potentially protective capacity of corticosteroids regarding traumatic memories.     

Completed suicides in Colorado: differences between Hispanics and non-Hispanic Whites

All suicides by Hispanics (n = 434) and non-Hispanic Whites (n = 3,370) in Colorado from 2004 to 2008 using the Violent Death Reporting System were examined. Hispanic victims were significantly younger. Adjusting for age and gender, Hispanic victims were less likely to have reported depressed mood [odds ratio (OR) 0.78; 95% confidence interval (CI) 0.63-0.97], mental health diagnosis (OR 0.53; 95% CI 0.41-0.7), or current psychiatric treatment (OR 0.47; 95% CI 0.43-0.77). There were no differences in reports of financial, relationship, job, or legal stresses. Hispanic suicides were equally likely to be by overdose, firearm, or hanging, but more likely to be in jail (OR 2.68; 95% CI 1.55-4.65). To prevent suicides, stronger partnerships are needed among public health, medical, mental health, and criminal justice professionals.     

Persistent effect of incubation temperature on stress-induced behavior in the Yucatan banded gecko (Coleonyx elegans)

Although variability in behavioral traits within animal populations is well documented, the mechanisms maintaining that variability are still insufficiently known. In this study, we examined whether differences in thermal environment during egg incubation can permanently organize nonsocial behavior across different contexts and situations in a lizard species. We incubated eggs of the Yucatan banded gecko, Coleonyx elegans (Squamata: Gekkota: Eublepharidae) at 3 constant temperatures (26, 28, and 30 °C) and raised juveniles separately under the same conditions until adulthood. We then subjected them to 3 behavioral tests within 2 different contexts: an open-field test and a test of antipredator behavior (stressful context) as well as a test of feeding behavior (nonstressful context). Individuals of both sexes incubated at 30 °C were consistently less active and showed lower frequencies of several stereotypic behaviors in the stressful contexts than did individuals incubated at 26 and 28 °C. The test of feeding behavior revealed no significant effect of incubation temperature on geckos' behavior. Thus, our study demonstrates that developmental plasticity may play an important role in producing variability in stress-induced behavior in lizards.     

Work–nonwork boundary management profiles: A person-centered approach

The goal of this paper is to advance the measurement and theory of work–nonwork boundary management styles. Boundary management styles are defined as the approaches individuals use to demarcate boundaries and attend to work and family and other nonwork roles, given identity centralities and perceived boundary control. We argue that research should be augmented with a person-centered approach, which examines how psychological measures are integrated into configurations. Integrating role and boundary theories, we identify three main characteristics of work-nonwork boundary management: (1) cross-role interruption behaviors (work to nonwork, and nonwork to work interruptions); (2) identity centrality of work and family roles, and (3) perceived control of boundaries. Using a variable-centered approach, we refined and validated these measures to create an assessment (Work–Life Indicator) that captured boundary management profiles. The profiles reflect how interruption behaviors, identity centralities, and boundary control interrelate to cluster into profiles, a set of psychological characteristics organized into a pattern of work–nonwork boundary functioning. We identify boundary management profiles and examine their relationships to key work-family outcomes. Regardless of the level and direction of interruption behaviors and centrality of work–family identities, we found that low control boundary management profiles (reactors, job warriors) tended to experience more negative work and family outcomes than did high control profiles (fusion lovers, dividers, family guardians, eclectics).     

Asymmetric frontal brain activity and parental rejection predict altruistic behavior: Moderation of oxytocin effects

Asymmetric frontal brain activity has been widely implicated in reactions to emotional stimuli and is thought to reflect individual differences in approach–withdrawal motivation. Here, we investigate whether asymmetric frontal activity, as a measure of approach–withdrawal motivation, also predicts charitable donations after a charity’s (emotion-eliciting) promotional video showing a child in need is viewed, in a sample of 47 young adult women. In addition, we explore possibilities for mediation and moderation, by asymmetric frontal activity, of the effects of intranasally administered oxytocin and parental love withdrawal on charitable donations. Greater relative left frontal activity was related to larger donations. In addition, we found evidence of moderation: Low levels of parental love withdrawal predicted larger donations in the oxytocin condition for participants showing greater relative right frontal activity. We suggest that when approach motivation is high (reflected in greater relative left frontal activity), individuals are generally inclined to take action upon seeing someone in need and, thus, to donate money to actively help out. Only when approach motivation is low (reflected in less relative left/greater relative right activity) do empathic concerns affected by oxytocin and experiences of love withdrawal play an important part in deciding about donations.     

Neural correlates of metacognitive monitoring during episodic and semantic retrieval

Activity in the posterior parietal cortex (PPC) has been shown to be a strong correlate of successful recognition performance. We assessed the degree to which the PPC mediates metacognitive judgments by assessing the feeling of knowing (FOK) for recently learned (episodic) and well-learned (semantic) facts (e.g., "The sport that is associated with Wimbledon is . . ."). Activity in ventral regions of the PPC was observed for strong FOKs for both sets of facts, although greater activity was observed for episodic than for semantic facts. Strong semantic FOKs activated anterior temporal regions. Weaker FOK ratings, when contrasted with strong FOKs, activated dorsal parietal regions, a finding that parallels contrasts during explicit tests in which low-confident responses were compared with high-confident responses. These findings demonstrate retrieval-related parietal activity during metacognitive judgments. Furthermore, they show that the ventral PPC is particularly engaged during context-specific, episodic retrieval, as compared to semantic retrieval.