Touch for socioemotional and physical well-being: A review

This review briefly summarizes recent empirical research on touch. The research includes the role of touch in early development, touch deprivation, touch aversion, emotions that can be conveyed by touch, the importance of touch for interpersonal relationships and how friendly touch affects compliance in different situations. MRI data are reviewed showing activation of the orbitofrontal cortex and the caudate cortex during affective touch. Physiological and biochemical effects of touch are also reviewed including decreased heart rate, blood pressure and cortisol and increased oxytocin. Similar changes noted following moderate pressure massage appear to be mediated by the stimulation of pressure receptors and increased vagal activity. Increased serotonin and decreased substance P may explain its pain-alleviating effects. Positive shifts in frontal EEG also accompany moderate pressure massage along with increased attentiveness, decreased depression and enhanced immune function including increased natural killer cells, making massage therapy one of the most effective forms of touch.     

Medication adherence and diabetes control in urban African Americans with type 2 diabetes.

In 181 urban African Americans with Type 2 diabetes, medication adherence was assessed using a measure designed specifically for an urban, impoverished sociodemographic population. Hemoglobin A-sub(1c), blood pressure and cholesterol levels, medication-related beliefs, and depression were assessed. Seventy-four percent of the sample reported adherence to diabetes medication. Adherence, adjusted for age, was associated with lower hemoglobin A-sub(1c). The specific behaviors associated with poorer diabetes control were forgetting to take medications and running out of medications. Knowledge of blood glucose goals differed for adherers and nonadherers. Blood pressure and cholesterol medication adherence rates were not associated with actual levels of blood pressure or lipids, respectively. These data suggest that specific medication-taking behaviors are important to diabetes control and constitute logical targets for interventions. ((c) 2005 APA, all rights reserved).     

Application of the APA ethics code for psychologists working in integrated care settings: Potential conflicts and resolutions

ABSTRACT

Increasingly, there is evidence of the potential benefits of an integrated care model. In fact, the American Psychological Association (APA) supports the role of psychologists in integrated healthcare given the positive outcomes for patients in primary care settings such as increased access to mental health services, reduced mental illness stigma, and improved health associated with recognizing the impact of psychosocial factors on physical wellbeing. Less attention has been paid, however, to ethical dilemmas that may arise for psychologists working in integrated healthcare. This paper explores considerations for resolving potential ethical conflicts that may arise for psychologists working in integrated care settings.     

Discrimination between outcomes in instrumental learning: Effects of preexposure to the reinforcers

In two experiments rats received instrumental training with two response levers, one response being reinforced by sucrose solution and the other by sucrose pellets. Prior to a test session, on which both levers were made available in the absence of reinforcement, the rats were given free access to one of the reinforcers, a procedure known to reduce its value. It was found that the rats responded at a lower rate on the lever that had produced the now-devalued reinforcer, but that this effect was substantial only in rats that had received preexposure to the two reinforcers before instrumental training was begun (Experiment 1). Experiment 2 demonstrated that this effect was obtained only when presentations of the two reinforcers were presented according to an inter-mixed schedule during preexposure. It is suggested that this result constitutes an instance of the perceptual learning effect in which intermixed preexposure to similar events enhances their discriminability.