Hypothalamic-pituitary-adrenal axis function and the metabolic syndrome X of obesity

Obesity has negative health consequences related to fat distribution, particularly the central or visceral accumulation of fat. The major complications associated with visceral obesity, termed the "Metabolic Syndrome of Obesity," or "Syndrome X," are type II diabetes, hypertension, and dyslipidemia. As with certain mood disorders, the syndrome may be a consequence of neuroendocrine perturbations typically associated with chronic stress. Our work with bonnet macaque monkeys provides an animal model for the relationship between early stress, behavioral and hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and Syndrome X. During their infant's first half-year, mothers face a variable foraging demand (VFD), in which ample food varies unpredictably in the difficulty of its acquisition, and the offspring show persistent abnormalities in systems known to modulate stress and affective regulation. Early work on the bonnet macaque noted the emergence of a sample of spontaneously obese subjects as they matured. Using the VFD model, the current study showed that there was a clear relationship between early cerebrospinal fluid corticotropin-releasing factor levels and subsequently measured body mass index, supporting the hypotheses regarding the interactive roles of early experience and HPA axis dysregulation in the ontogeny of both metabolic and mood disorders.     

Stress, peer affiliation, and transforming growth factor-beta1 in differentially reared primates

A bidirectional regulatory interaction between the central nervous system and the immune system is largely provided by cytokines and their specific receptors, which are expressed by cells of both systems. Transforming growth factor-beta1 (TGF-beta1), produced by glial cells and lymphocytes and regulated by steroid hormones, is one such cytokine. In the current study, we examined the relationship between TGF-beta1 and peer affiliation in bonnet macaques (Macaca radiata) either reared normally or exposed as infants to conditions in which their mothers faced fluctuating requirements for food procurement (variable foraging demand [VFD]). Rearing under VFD conditions has been previously shown to produce dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in these animals. Serum levels of TGF-beta1 after exposure to a moderate stressor had no correlation with peer affiliation under baseline conditions (r=.07), but were highly correlated with affiliation after subsequent challenge with a fear stimulus (r=.62). Affiliation after the fear stimulus also was inversely correlated with baseline levels of affiliation (r=-.71). These data suggest that changes in peripheral TGF-beta1 may be reflective of latent behavioral and biochemical propensities possibly related to affect. Further examination of the effects of early adversity will improve our understanding of the relationship between the HPA axis and immune function.     

The persistence of a misconception about vision after educational interventions

Children and adults, like many ancient philosophers, believe that seeing involves emissions from the eye. Several experiments tested the strength of these “extramission” beliefs to determine whether they, like other scientific misconceptions, are resistant to educational experiences. Traditional college-level education had little impact. Presenting a simplified lesson, stressing visual input, and a lesson directly counteracting the vision misconception had an impact, but for older participants the effect was evident only on short-term tests. Despite some gain due to learning, overall the results demonstrated the robustness of extramission beliefs.     

The ethical group psychotherapist: a coda

This concluding article of a two-part special section on the ethical group psychotherapist are highlighted: (1) the importance of the cultivation of the skill and knowledge base of the group psychotherapist in terms of pertinent legal statutes and ethical guidelines; (2) the criticalness of certain personality features related to the concept of virtue; (3) a therapist's self-awareness contributes to the capacities to think and respond ethically; (4) ethical decision making is most likely to occur when the group psychotherapist attends comprehensively to all dimensions that define the setting in which a dilemma emerges; and (5) that in the service of positive ethics, attention to the ethical dimensions of group psychotherapy practice should be continuously present. In agreement with other contributions to this section, I conclude that the commitment to the ethical practice of group psychotherapy must be made not only by the individual practitioner but also by educational and training programs and professional organizations.     

Well-Being and Social Justice Among Moroccan Migrants in Southern Spain

The decision to migrate is normally based on expectations of improving one’s actual living conditions and therefore, one’s well-being. However, these expectations are not usually met in receiving contexts that relegate newcomers to lower power positions. From a liberating community psychology approach, this study aims to develop a predictive model of the well-being of Moroccan migrants living in southern Spain. Data were collected from a survey sample of 633 migrants (the average age was 31.9 years and 51.8 % were women) from 20 territorial units of Andalusia. Through a process of multilevel regression analysis, this study reveals that the well-being of the Moroccan community is closely determined by the following: (a) the level of social justice in the receiving context (openness to diversity of receiving communities, cultural sensitivity of community services, and residential integration); and (b) the individual strengths of the population (use of active coping strategies, satisfaction with the receiving context, and temporal stability in the new environment). These results empirically support the impact that different ecological levels of analysis have on well-being. Major theoretical contributions of the model and useful suggestions for improving migrant well-being are discussed.     

Romantic Bonds,Binds, and Ruptures: Couples on the Brink

“Bill and Jane,” a couple I saw many years ago, are placeholders for all the anguished, angry, exhausting, and poignant partners who have made their mark on my work as a clinician and theorist. They inspired and defeated me in equal measure, and they ground this essay, which attempts to bring together many of the theories I have fallen in love with over the years. Psychoanalysis, feminist theory, and systems theory, of course, but also developmental and attachment theory, Fonagy’s work on mentalization, the strategic family therapies, and containing all of these, the relational turn. I have tried to capture the intellectual synergy of putting all these discourses to work, and to work on each other, all of which is necessary when treating couples on the brink.