Effects of daily and acute restraint stress during lactation on maternal aggression and behavior in mice

A decreased reactivity to stressors during lactation might heighten the expression of maternal care (including defense of offspring) by minimizing the extent to which stress can impact maternal care. Although stressors applied during pregnancy have variable effects on maternal aggression (or defense of offspring), to date no study has examined the effects of stress applied during the postpartum period on maternal aggression. In this study, we examined the effects of both daily and acute restraint stress (30 min) applied postpartum on maternal aggression and other maternal behaviors. Daily restraint (ending 2 h before testing) did not alter any measure of maternal behavior, including nursing, licking and grooming of pups and pup retrieval, or any measure of maternal aggression. In contrast, acute stress significantly impaired total time aggressive and number of attacks, but pup retrieval was normal. c-Fos levels were significantly elevated in a number of brain regions in association with acute stress, including lateral septum (LS), caudal periaqueductal gray and medial amygdala (MeA), suggesting possible sites where stress reactivity could alter aggression. Together, the results indicate that acute restraint stress impairs maternal aggression and provide a starting point for future studies examining how stress reactivity pathways may intersect with maternal aggression pathways.     

A randomized controlled trial of cognitive behavior therapy for borderline personality disorder: rationale for trial, method, and description of sample

This paper describes the rationale for a randomized controlled trial, comparing cognitive behavior therapy in addition to treatment as usual with treatment as usual alone, for borderline personality disorder. Previous pioneering randomized controlled trials of psychotherapies have suffered from methodological weaknesses and have not always been reported clearly to allow adequate evaluation of either the individual study or comparisons across studies to be undertaken. We report on the recruitment and randomization, design, and conduct of an ongoing randomized controlled trial of one hundred and six patients with borderline personality disorder. Primary and secondary hypotheses and their planned analyses are stated. The baseline characteristics of 106 patients meeting diagnostic criteria for borderline personality disorder are described.     

Forgetting of prior remembering in persons reporting recovered memories of childhood sexual abuse

Case studies of individuals reporting recovered memories of childhood sexual abuse suggest that some overestimate their prior forgetting of the abuse. People reporting recovered or continuous memories of childhood sexual abuse and control subjects reporting no history of abuse participated in two experiments examining this "forgot it all along" phenomenon. Participants in Experiment 1 were more likely to forget that they had previously recalled a studied item if they were cued to think of it differently on two recall tests than if they were cued to think of it in the same way on the two tests. This effect was stronger for recovered-memory participants than for continuous-memory and control participants. In Experiment 2, participants recalled autobiographical events three times over a period of 4 months. Much as in Experiment 1, they underestimated prior remembering when the events had been recalled in a different emotional frame (positive vs. negative) on the previous occasion. This underestimation was more pronounced for recovered-memory participants than for continuous-memory and control participants.     

Brain network dysfunction in bipolar disorder

Bipolar disorder is a common psychiatric condition with significant associated morbidity and mortality. Despite its significance, the neurophysiology and neuropathology of this illness is incompletely understood. Recent advances in neuroimaging techniques have helped to begin clarifying these areas. Specifically, bipolar disorder appears to arise from abnormalities within discrete brain networks (eg, the anterior limbic network). The expression of the symptoms of bipolar disorder does not appear to result from single, localized brain lesions, but rather are emergent properties of dysfunction of these brain networks. As neuroimaging techniques continue to improve, the underlying neural basis of bipolar disorder will be clarified.     

Recognizing Racit Knowledge in Medical Epistemology

The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic treatment of clinical judgment is examined, and a Polanyian critique of this position demonstrates that tacit knowledge is necessary for understanding how clinical judgment and medical decisions involve persons. An adequate medical epistemology requires much more qualitative research relevant to the clinical encounter and medical decision making than is currently being done. This research is necessary for preventing an uncritical application of evidence-based medicine by health care managers that erodes good clinical practice. Polanyi’s epistemology shows the need for this work and provides the structural core for building an adequate and robust medical epistemology that moves beyond evidence-based medicine.An erratum to this article can be found at     

A model for outpatient care

Chaplains have seriously discussed outpatient care for a number of years. This article describes a model of thorough and intentional outpatient care that is practiced in conjunction with an inpatient care to cancer populations. Rationales, values, institutional dynamics, and clinical care are discussed. Although the focus is on outpatient care where slightly more than 50% of personnel resources are invested, the care also occurs in the context of both inpatient care and follow-up care after discharge to home. A general model of spiritual and religious care and more specific models pertinent to hematopoietic stem cell transplant populations and general oncology populations are described. The models attend times of distress and times of "ordinary" and celebratory experiences, attend care of patient, caregiver, and staff.     

An investigation of appearance motives for tanning: The development and evaluation of the Physical Appearance Reasons For Tanning Scale (PARTS) and its relation to sunbathing and indoor tanning intentions

Motives for UV exposure have been shown to be related to appearance concerns, yet little research has examined specific tan appearance attitudes. Given this lacuna, Study 1 involved the identification of six factors among college female tanners: general attractiveness, media influence, family/friends influence, physical fitness appearance, acne reasons, and skin aging concerns. In Study 2, a separate sample of college female tanners were used to validate a higher order factor model, which demonstrated acceptable fit. Additionally, the factors converged in the expected directions, with the general attractiveness and skin aging concerns being the best correlate of UV exposure and sun-protection intentions. The relevance of these findings to skin cancer prevention is discussed.     

Examining the effects of differential item (functioning and differential) test functioning on selection decisions: when are statistically significant effects practically important?

Item response theory differential test functioning (DTP) methods are often used to address issues in personnel selection, but the results are frequently difficult to interpret because statistically significant findings may have little practical importance. In this article, the authors proposed 2 effect size measures for DTP. One related DTP to mean raw score differences across groups: the other related DTP to the 4/5th rule for adverse impact at successive cut scores. The effects of DTP were examined in the context of personality assessment, professional licensure, and college admissions. Overall, the result indicated that although many items exhibited bias in analyses of the large samples, the net magnitudes of effect on potential selection decisions were nugatory.