A Psychoneuroimmunologic Perspective on AIDS Research: Questions,Preliminary Findings,and Suggestions1

Starting with the premise that research questions emanating from the fields of psychoneuroimmunology and behavioral medicine may provide critical information for understanding and treating acquired immune deficiency syndrome (AIDS), we provide brief backgrounds on psychoneuroimmunology and on AIDS. Previously, Solomon had generated 25 hypotheses based on the thesis that the immune and central nervous systems are intimately linked. Eight hypotheses from his list are presented as particularly relevant to AIDS. From these hypotheses, we derived a set of 12 new questions to be addressed in research on AIDS. Evidence and illustrations from studies in the literature, from our own research on psychoimmunologic relationships and psychosocial factors related to outcome, and from clinical examples is discussed for each question. Finally, suggestions are offered to address some of the problems in conducting psychoneurologic research.     

Neuroticism,Somatic Complaints,and Disease: Is the Bark Worse than the Bite?

Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.     

Implications of memory and language dysfunction in the naming deficit of senile dementia

Young normals, elderly normals, and patients with either mild-to-moderate or severe senile dementia of the Alzheimer type (SDAT) were administered several tests of language function and remote memory. On all of the language tests examined, elderly normals exhibited a mild, nonsignificant performance decrement relative to the young normals. Advanced SDAT patients were markedly impaired on all of the tests. Early dementia patients were most impaired, relative to aged normals, on tests of object naming, category instance fluency, and remote memory. The deficit was smaller on the WAIS vocabulary subtest, on selecting the name of a visually presented object, and on recalling the function of an object. Early SDAT patients were least impaired in selecting the picture of an object after its name had been provided and in selecting objects that belong to a specified functional category. The results are consistent with the notion that the language dysfunction in early SDAT is due to a deficit in semantic memory function in which general, categorical information remains available whereas information about specific attributes becomes less accessible. The object naming test might be useful in the assessment of treatment effects upon SDAT because of its sensitivity and specificity to dementia, its high face validity, and its independence of recent memory.     

Accelerated development of cardiac sympathetic responses in spontaneously hypertensive (SHR) rats

The functional development of cardiac and adrenal medullary responses to reflex activation of the sympathetic nervous system was studied in preweanling spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) normotensive rats. Pups of the two strains received injections of insulin or saline at 2, 4, 8, 12, or 16 days of age and were sacrificed 3 h later. Insulin administration produces a significant decrease in circulating levels of glucose which in turn results in a centrally mediated increase in sympathetic outflow. The induction of ornithine decarboxylase (ODC) in heart and the depletion of epinephrine from the adrenal medulla served as tissue markers of functional sympathetic neurotransmission. WKY and SHR pups had comparable levels of ODC activity in heart under basal conditions. In contrast, levels of catecholamines in the adrenals were greater in SHR pups at 2 and 4 days of age. Following insulin administration, SHR pups exhibited a greater induction of cardiac ODC activity at 2, 4, and 8 days of age compared to age-matched WKY controls. However, there were no differences between SHR and WKY pups in the magnitude of the adrenal medullary response to insulin-induced hypoglycemia. These alterations in sympathetic-target tissue development during the first postnatal week of life may contribute in part to the higher arterial pressures maintained by SHRs throughout the lifespan.     

Sexual experience and preference for males or females in the female rat

The influence of sexual experience on preference behavior was investigated in adult female rats. In the first experiment, preference behavior for sexually active males versus estrous females was investigated in female rats who were experienced with mounting behavior. Preference of these mount experienced females was compared to preference of females who were naive in this respect. Mount experience with estrous females induced a female-directed preference in ovariectomized female rats, irrespective of whether the females were treated with OIL or with testosterone-propionate (500 micrograms TP, injected once 48 h prior to testing). Sexually naive, OIL-treated females did not show a preference for males or females, but TP induced a preference for a male. Individual differences in mount frequency were not correlated with preference behavior. In the second experiment, the influence of experience with feminine sexual responses on preference behavior was investigated. OIL-treated and TP-treated females oriented equally toward males and females when they had been given the opportunity to copulate with males prior to the preference tests. The results strongly suggest that prior sexual experience is an important determinant of preference behavior. The female's behavior during sexual interactions was, however, not predictive of later preference.     

Perceptual organization of acoustic stimuli by budgerigars (Melopsittacus undulatus): II. Vocal signals

Operant conditioning and multidimensional scaling procedures were used to study auditory perception of complex sounds in the budgerigar. In a same-different discrimination task, budgerigars learned to discriminate among natural vocal signals. Multidimensional scaling procedures were used to arrange these complex acoustic stimuli in a two-dimensional space reflecting perceptual organization. Results show that budgerigars group vocal stimuli according to functional and acoustical categories. Studies with only contact calls show that birds also make within-category discriminations. The acoustic cues in contact calls most salient to budgerigars appear to be quite complex. There is a suggestion that the sex of the signaler may also be encoded in these calls. The results from budgerigars were compared with the results from humans tested on some of the same sets of complex sounds.     

Further observational data on the behavioral and social world of institutions for the aged

This study is an extension of previous observational work on the social ecology of dependence and independence in the institutionalized elderly. Observations of everyday, naturally occurring interactions between elderly residents of two different long-term institutions and their social partners were extended such that, aside from the identification of type of behavior, the dyadic form and continuity of each behavior was specified. The following were among the major results: (a) Previously found interaction patterns between elderly residents and their social partners, replicated in both a nursing home and a home for the chronically ill, supported the notion of discrepant social ecologies for dependent versus independent behaviors of residents: (b) specification of each behavioral act as to its dyadic form underscored the fact that the interactions were controlled largely by social partners and not by the elderly residents; (c) coding continuity or discontinuity of behavior suggested that independent behaviors were maintained by chaining; and (d) elderly residents in the home for the chronically ill evinced, as expected, more dependence-related behaviors.     

A brief neuropsychological screening battery to detect brain damage in a psychiatric population

Seventy-five patients admitted to the psychiatric unit of a general hospital were administered a brief neuropsychological screening battery. Discharge diagnoses obtained from the medical records revealed that 20% had brainbased pathology. A discriminant function analysis resulted in a five-variable model (Symbol-Digit Modalities Test, educational level, Psychiatric-Organic subscale of the MMPI, and Shipley Vocabulary and Abstraction scores) which correctly classified 84% of the subjects, with 87% correct identification of the brain-damaged group. A jackknife cross-validation procedure resulted in comparable hit rates.     

Counseling in Malaysia: An Emerging Profession

The emergence of counseling in Malaysia illustrates the importance of a strong professional association and counseling training programs at the university level.