Subjective and physiological responses to the 35% carbon dioxide challenge in healthy and non-clinical control populations: a meta-analysis and systematic review

Background/Rationale: The carbon dioxide (CO₂) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO₂ challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations.

Method: A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review.

Results: Both the meta-analysis and systematic review found the CO₂ challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling.

Discussion: Findings highlight the CO₂ challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO₂ challenge and its anticipated effects in healthy and non-clinical control populations are discussed.     

The presence of the absence in Kjell Westö’s novel: “Hägring 38”

ABSTRACT

The word ‘hägring’ (in English. ‘mirage’) can be understood in different ways: as an unrealistic hope or wish that cannot be achieved (wishful thinking); as an image in a mirror of something that is not there, but in another place, and as a sign of something that has not yet become visible, for instance, the first rays of sunlight on the horizon before the sun has risen. These meanings represent different ways in which presence and absence interplay, and are all illustrated in Kjell Westö’s impressive novel from 2013 for which he received the Nordic Literature Prize in 2014.

The action of the novel takes place during eight months in Helsinki from March to November 1938 and unravels how the past and present are woven together on a historical, societal and individual level. The present article will try to illustrate this.     

Telling the Truth About Power

SUMMARY

In this culture, those in power do not usually talk about it and the rest of us tend not to recognize it either. A similar situation exists in therapy, where the therapist herself may not be aware of her own power-over tactics. This article suggests methods that may help therapists to acknowledge their power and also to change from power-over actions to mutually empowering relationships. From this line of thinking, there follows an exploration of altering the concept of boundaries in therapy into mutually constructed agreements between patient and therapist. This article was presented at the Summer Training Institute of the Jean Baker Miller Training Institute, June, 2003.