Effect of academic psychological stress in post-graduate students: the modulatory role of cortisol on superoxide release by neutrophils

Experimental and clinical evidence shows that neutrophils play an important role in the mechanism of tissue injury in immune complex diseases through the generation of reactive oxygen species. In this study, we examined the influence of academic psychological stress in post-graduate students on the capacity of their blood neutrophils to release superoxide when stimulated by immune complexes bound to nonphagocytosable surfaces and investigated the modulatory effect of cortisol on this immune function. The tests were performed on the day before the final examination. The state-trait anxiety inventory questionnaire was used to examine whether this stressful event caused emotional distress. In our study, the psychological stress not only increased plasma cortisol concentration, but it also provoked a reduction in superoxide release by neutrophils. This decrease in superoxide release was accompanied by diminished mRNA expression for subunit p47(phox) of the phagocyte superoxide-generating nicotinamide adenine dinucleotide phosphate-oxidase. These inhibitory effects were also observed by in vitro exposure of neutrophils from control volunteers to 10(- 7) M hydrocortisone, and could be prevented by the glucocorticoid receptor antagonist RU-486. These results show that in a situation of psychological stress, the increased levels of cortisol could inhibit superoxide release by neutrophils stimulated by IgG immune complexes bound to nonphagocytosable surfaces, which could attenuate the inflammatory state.     

Intensive Transactional Analysis Psychotherapy (ITAP): A case series study

Intensive Transactional Analysis Psychotherapy (ITAP) is a new therapeutic approach based on the integration of Transactional Analysis and brief psychodynamic approaches. ITAP is based on two key therapeutic tools—the intrapsychic triangle and the interpersonal triangle—which the therapist uses to focus patients’ attention on moment‐by‐moment therapy processes. The aim of the present study was to provide early empirical documentation of ITAP effectiveness. To this aim, six patients (four females, two males) were longitudinally evaluated using an A‐B‐A mixed quantitative and qualitative design, with evaluations at Baseline, Treatment and Follow‐up phases. Each patient received 16 50‐min weekly sessions of ITAP therapy over 4 months. For quantitative evaluations, patients filled out the Clinical Outcome in Routine Evaluation‐Outcome Measure (CORE‐OM) at each evaluation. Effects size values were estimated to evaluate quantitative changes comparing mean scores of Baseline, Treatment and Follow‐up phases. At the first follow‐up, the Change Interview was used to qualitatively evaluate patients’ perceived changes. In the quantitative data, four of the six patients reported a very good outcome, with large to very large effect sizes in Baseline versus Treatment and/or Baseline versus Follow‐up scores comparisons, whereas two patients reported variable fluctuations within the non‐clinical range of outcome scores. In the qualitative evaluations, all patients reported several moderately to extremely important perceived changes attributed to psychotherapy.     

The cognitive foundations of visual consciousness: Why should we favour a processing approach?

How can we investigate the foundations of consciousness? In addressing this question, we will focus on the two main strategies that authors have adopted so far. On the one hand, there is research aimed at characterizing a specific content, which should account for conscious states. We may call this the content approach. On the other hand, one finds the processing approach, which proposes to look for a particular way of processing to account for consciousness. . Our aim, in this paper, is to develop arguments for the latter approach. We focus on a criticism of Jesse Prinz’s AIR theory of consciousness. We have chosen Prinz’s theory because it incorporates features of both the content and processing approaches, and discussing it will therefore allow us to compare the advantages and downsides of both. Our argument will focus in particular on the notion of intermediate-level. We will discuss how Prinz characterizes the intermediate-level according to a content approach, and argue that such a characterization is inadequate. Finally, we will argue in favor of processing approach to the problem of consciousness, which also accounts for the massive interaction of top-down and bottom-up processes in the brain. Even though consciousness remains an unsolved riddle, we claim that this is the best path towards a solution.     

Identifying violence among women patients attending family practices: the role of research in community change

Violence against women has serious consequences. Although victims use health facilities more frequently than others, violence is still not recognized in most services and in the larger community. This study had three aims: (1) to estimate the prevalence of violence among women patients in primary care, (2) to evaluate the feasibility of asking all women about violence, and (3) to make violence visible, and thereby initiate a process of professional and community change on the issue of violence against women. The study was carried out in a small Italian town, at the initiative of a local family doctor. We conducted a cross‐sectional survey among patients of six family practices and 444 women responded to a self‐administrated questionnaire. Five per cent of respondents experienced physical or sexual violence in the last year, and 25% had experienced it in the past. Nineteen per cent had experienced psychological violence in the last 12 months. Risk factors for current violence were: younger age, being pregnant or with young children, being separated or divorced, or lack of stable employment. Most women were in favour of being asked about violence by their doctor. The study's results were disseminated in public meetings, with good press coverage. This resulted in a dramatic increase in the visibility of victims of violence, the development of a training course for health professionals, and the creation of the first women's group in the town. Along with advocacy work, the group has prepared a booklet on violence addressing women, and is now raising funds to start an ‘anti‐violence’ telephone line. Overall, the study has become a tool for change within the health services and the community. Copyright © 2004 John Wiley & Sons, Ltd.     

Recall of mental sleep experience with or without prior verbalization.

We investigated whether verbalization of contents of mental sleep experience (MSE), just after awakening provoked during rapid eye movement (REM) sleep, facilitates subsequent recall in the morning. Twelve subjects were awakened four times in each of two experimental nights and alternately asked to recall, with or without concurrent verbalization, MSE contents preceding the awakening. In the morning, the subjects were asked to report MSEs both verbalized and nonverbalized during the night. If subjects were unable to provide a spontaneous morning report, they were prompted using a probe, which was the title given by the subjects to each MSE at the end of its verbalization or covert recall at night. Frequencies of spontaneous reports were high, regardless of whether MSEs had been previously verbalized or not. The proportions of spontaneous and probed reports were similar for verbalized and nonverbalized MSEs, but spontaneous morning reports were longer than probed ones, regardless of their previous verbalization. Spontaneous and probed morning reports corresponding to night reports shared similar linguistic structures (i.e., length of sentences and proportions of waking-related utterances, which are indicative of difficulty of retrieval for MSE contents) and had similar percentages of contents common to night and morning reports. These findings support the hypothesis that verbalization does not directly influence the further accessibility of MSE contents.     

Noun verb dissociation in Parkinson's disease

A noun/verb dissociation with a relative verb deficit was found in patients affected by Parkinson's disease, even in relatively early stages, when mental deterioration is not severe. This finding is compatible with earlier observations, according to which verbs are dealt with in more anterior regions with respect to nouns. It also supports the speculation that the co-ordination and the manipulation of information associated with a verb world rely on the frontostriatal system.