From Lydia Pinkham to Bob Dole: what the changing face of direct-to-consumer drug advertising reveals about the professionalism of medicine

From its founding in 1847, the AMA divided drugs into "ethical" and "unethical" preparations. Those that were ethical had a known composition and were advertised only to the profession. Other, patent medicines (technically proprietary drugs, whose trademarks were protected by copyright), were sold directly to the public. In spite of the AMA's efforts to ban the advertising and sale of those nostrums, proprietary drugs flourished during the nineteenth century. Starting in 1900, however, three major societal trends combined to bolster the AMA's campaign, and by 1920 almost all advertising was directed to physicians, who would then prescribe medications to their patients. This ban on advertising pharmaceuticals directly to the public remained virtually unchanged until approximately 1980. Since then, it has slowly eroded and, as recently as 1997, the FDA created guidelines for pharmaceutical companies to advertise on television. What does this change say about the profession of medicine, the role of the physician in society, and the doctor-patient relationship? Using a comparative historical approach, this paper examines these issues.     

The role of task difficulty in the control of dynamic balance in children and adults

Although several studies have explored the development of balance control in children, few have addressed the influence of task difficulty on balance control under dynamic and ecologically valid conditions. In this study, reaching tasks in three directions to two distances enabled the examination of balance control in the context of graded task difficulty. Balance control was measured in younger (6 years) and older (10-11 years) children and adults using center of pressure (COP) measures (initial position, excursion, and amplitude) and reach distance. Measures of the initial position of the COP and the excursion of the COP revealed no age-related differences in balance control. Furthermore, balance control, measured by the amplitude of COP movement over the course of the reaching tasks, indicated no differences between the age groups for the least difficult and most difficult tasks. For tasks of moderate difficulty, however, older children displayed levels of balance control similar to younger children for some tasks and higher levels of balance control, similar to adults, for others. This study suggests that (1) process-based measures of balance control are more sensitive in detecting age-related differences, and (2) balance control depends upon both age and the difficulty of the task being performed.     

Does the proportion of associatively related pairs modulate the associative priming effect at very brief stimulus-onset asynchronies?

A number of experiments have shown that the magnitude of the associative priming effect increases substantially when there is a high proportion of associatively related pairs in the list when the stimulus-onset asynchrony (SOA) between prime and target is long (more than 400 ms). In the present series of experiments we manipulated the proportion of associatively related pairs when the SOA was very brief (less than 200 ms). If processing of a target word is facilitated automatically by the prior presentation of a related prime, the occurrence of priming should be unaffected by the proportion of related pairs in the list. Experiment 1 showed a robust relatedness proportion effect obtained in a double lexical decision task. Experiments 2-4 used the masked priming technique at several very short SOAs (66, 116, and 166 ms) in lexical decision and naming. The results showed a reliable associative priming effect in the two tasks, which did not differ as a function of the proportion of related pairs. Finally, Experiment 5 used unmasked primes at an 83-ms SOA in which the primes remained in view after the target presentation. As in Experiments 2-4, the associative effect was not modulated by the proportion of associatively related pairs. The implications of these results are discussed.     

Self-defeating personality and memories of parents' child-rearing behaviour

A group of 132 nonclinical volunteers was given the Self-defeating Personality Scale and a short version of the Egna Minnen Betr?ffande Uppfostran (EMBU) scale to explore correlations of scores for adults' self-defeating traits with memories of parents' child-rearing behaviours. For men, the recall of two rejecting parents and, for women, the memory of a nonsupportive father were significantly correlated with scores of self-defeating traits. The latter scores correlated positively with memories of both overinvolved mother and father for men, while no significant correlation was found among women.     

The effects of associative and semantic priming in the lexical decision task

Four lexical decision experiments were conducted to examine under which conditions automatic semantic priming effects can be obtained. Experiments 1 and 2 analyzed associative/semantic effects at several very short stimulus-onset asynchronies (SOAs), whereas Experiments 3 and 4 used a single-presentation paradigm at two response-stimulus intervals (RSIs). Experiment 1 tested associatively related pairs from three semantic categories (synonyms, antonyms, and category coordinates). The results showed reliable associative priming effects at all SOAs. In addition, the correlation between associative strength and magnitude of priming was significant only at the shortest SOA (66 ms). When prime-target pairs were semantically but not associatively related (Experiment 2), reliable priming effects were obtained at SOAs of 83 ms and longer. Using the single-presentation paradigm with a short RSI (200 ms, Experiment 3), the priming effect was equal in size for associative + semantic and for semantic-only pairs (a 21-ms effect). When the RSI was set much longer (1,750 ms, Experiment 4), only the associative + semantic pairs showed a reliable priming effect (23 ms). The results are interpreted in the context of models of semantic memory.     

Effects of fimbria lesions on trace two-way active avoidance acquisition and retention in rats

The fimbria-fornix (FF) is the main subcortical input to the hippocampus. It has been shown that FF lesions facilitate performance on a standard-delay two-way active avoidance task (AA2), thought to involve implicit memory. The hippocampal region is required for explicit or relational memory. It has been proposed that the hippocampus and related structures might associate events that are separated in space or time and detect elements shared in common by such discontiguous episodes. Therefore, FF lesions would be expected to impair performance on a trace paradigm, which introduces an interval between the CS (conditioned stimulus) and the US (unconditioned stimulus) and is generally considered a model of explicit memory. We predicted that FF lesions would impair memory in a trace AA2 procedure, while the same lesions would facilitate memory in a standard delay version of the task. To test this hypothesis, two experiments were carried out in 102 male Wistar rats. The first experiment characterized the trace paradigm using this kind of conditioning and demonstrated that control rats were able to acquire and retrieve (24 h and 11 days postacquisition) the association between the CS (tone) and the US (electric foot shock) when a trace interval (5, 10, or 20 s) was interposed between both stimuli. In the second experiment, we investigated the effects of FF electrolytic lesions on the same task using delay and trace (10-s trace interval) paradigms. Surprisingly, FF lesions facilitated the acquisition and the 24-h retention of the AA2 not only on the standard delay paradigm, but also with the trace paradigm. We suggest that facilitative effects could be a result of impairment in contextual learning.     

Personality and psychopathology of drug addicts in Puerto Rico

Drug abuse is one of the most pressing sociomedical problems of society. The purpose of this study was to examine the personality and psychopathology of addicts. 229 addicts in treatment programs scored high on Neuroticism and on the Lie Scale and low on Psychoticism and Extraversion on the Eysenck Personality Questionnaire for Puerto Rico. An Addiction Scale, based on a factor analysis, showed a high component of Neuroticism items.     

The difference between playing games with and without the computer: a preliminary view

The authors address the question of whether associations between video games and cognitive and metacognitive variables depend either on the features of the computer or on the content of the game that the computer allows one to play. An experiment to separate these two kinds of effects was carried out by using a traditional version and a computer-supported version of Pegopolis, a solitaire game. The two versions were exactly the same except that they were played by moving pieces either on a real board or on a virtual computer-presented board. The performance levels and strategies followed during the game by the 40 undergraduates who took part in the experiment were not significantly different in the real and virtual conditions. None of the participants transferred playing strategies or practice from one version of the game to the other. Scores were not affected by gender or by the studies pursued by participants, the habit of playing games in the traditional manner or playing video games, or intelligence. Retrospective reports did not support differences in the subjective experience between the two versions. Results showed that video games, when they do not make much use of the computer's special features, produce effects because of the situations they simulate rather than because of features of the computer itself.     

Mood changes after maximal exercise testing in subjects with symptoms of exercise dependence

Considering exercise has positive and negative reinforcing properties, the mood states of sedentary, nonexercise-dependent and exercise-dependent volunteers were compared after maximal exercise testing. Mood status was evaluated by the Beck Depression Inventory, Trait-State Anxiety Inventory, and Profile of Mood States (POMS). No differences were detected before the test or after it, indicating little possibility of positive reinforcement. However, a significant reduction in the POMS Tension-Anxiety scores was observed in both exerciser groups (greater in the exercise-dependent group) but not in the sedentary group. Only in the exercise-dependent group were significant reductions in Anger and Total Mood Disorders scores observed compared with their pre-exercise scores. These data suggest that exercising has stronger negative reinforcement properties for exercise-dependent volunteers and is a factor which could increase the odds of their becoming dependent on exercise.     

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.