Social Anxiety Disorder (SAD) is known as the most common type of Anxiety Disorder. In recent studies, it was suggested the cost and probability bias is considered to be a maintaining factor of SAD ...symptoms. Especially, previous research revealed that the reduction of cost bias was highly related to the improvement of SAD symptoms. In SAD, previous studies also suggested that depressive symptoms often occur secondarily. It was also reported that depressed patients held irrational belief and it could lead to their negative mood. However, the difference of correlationship among cost bias, irrational belief, and SAD symptoms has not been understood in detail. In this study, the purpose was to examine the difference of correlationship among cost bias, irrational belief, and social anxiety. Undergraduate students (n=201) completed a set of questionnaires : the Social Cost/Probability scale (SCOP) ; the Short Fear of Negative Evaluation scale (SFNE) ; the Liebowitz Social Anxiety Scale (LSAS); the Japanese Irrational Belief Test (JIBT) ; and the Self-Rated Depression Scale(SDS). First, correlation analysis revealed that there was a moderate positive correlationship among each measure. Second, partial correlation coefficients among each measure by controlling JIBT were calculated. The results indicated that cost bias related to social anxiety independently. Third, partial correlation coefficients between each measure by controlling SCOP indicated that there was a weak relationship between irrational belief and social anxiety. These results indicated that cost bias which is the specific cognitive bias in social anxiety is strongly rerated to SAD symptoms. On the other hand, it was a suggested that there was a spurious correlation between irrational belief and social anxiety. Based on these findings, the importance to assess and improve the specific cognitive bias in SAD was indicated.
Objectives : This study attempts to examine the healing and recovery process of irritable bowel syndrome (IBS), focusing on psychosocial factors affecting symptoms. It is not uncommon for patients ...being treated for IBS to require long-term treatment. They also have been reported to have secondary problems such as depressive tendency and avoidance of social opportunities. In particular, since the quality of life of patients with severe IBS symptoms are associated with non-digestive rather than digestive symptoms, it is important to investigate the psychosocial factors that often prolong the course of the disease. However, the medium-long-term course, healing, and recovery process of IBS-affected individuals have not been investigated. Identifying major factors moving the IBS healing and recovery processes forward will contribute to development of efficient treatment and self-management. Subjects and method : The interview data were collected from 7 subjects (4 men, 3 women, mean age 35, type of IBS : 1 diarrhea, 6 alternate) affected by and recovered from IBS. Semi-structured interviews were conducted from July 2014, to October 2014. In the interview, we mainly focused on subjective experiences of the IBS healing and recovery process. The interview data were analyzed using the qualitative method of Trajectory equifinality model (TEM). Results : We found 3 types of healing and recovery processes for IBS. The final point of the process was set as state of subjective healing. At the beginning, every type took the same process : affected with IBS, obsessed with symptoms, and coping behavior. Next, they reached partial healing as a bifurcation point. After that point, there were two directions : faced psychological problems or environmental control. Through these processes, every type received some kind of support factor and then experienced the cognitive changes of perfectionism, outlook on life, and meaning of IBS experience. It was also suggested that the concept of resignation, related with perfectionism, is one of the core factors move the process forward. In addition, it was also suggested that both “acceptance” and “change” factors given from medical professions, family members, and peer groups have the potential to move the process forward. * : Extracted concepts in the process models Conclusion : Through the analysis of the IBS healing and recovery process in this study, we found 3 types of healing and recovery processes. As a common finding of all types, cognitive changes in the meaning of IBS experience, perfectionism tendency, and outlook on life were key concepts to reach subjective healing in the process. Further study on the process may be required using a larger sample.
Depressive patients often visit a primary care physician due to various physical symptoms. Though it is necessary to differentiate organic diseases, it is also important to approach from a viewpoint ...of psychosocial background and psychiatric disorders. Especially, as mild depression is seen widely in general practice, early diagnosis and early treatment is essential for its good prognosis and medical economics. So, primary care physician is expected to understand its symptomatology and treat depressive patients appropriately. Finally, I want to say that the cooperation between primary physician and psychiatrist is important, because typical bipolar disorders and severe depressive patients should be refer to psychiatry clinic.
La dopamine (DA) et la noradrénaline (NA) jouent un rôle primordial dans de nombreuses fonctions cérébrales. Elles agissent par l’intermédiaire de récepteurs couplés aux protéines G qui régulent la ...voie de signalisation cAMP/PKA. La NA est libérée dans tout le néocortex par les neurones du locus coeruleus (LC). Les projections DA des neurones de l’aire tegmentale ventrale sont présentes dans des régions restreintes du cortex. Le but de ce projet est de caractériser les effets de la NA et de la DA exogènes mais aussi de la libération des catécholamines endogènes sur la voie AMPc/PKA en utilisant l’imagerie de sondes fluorescentes. J’ai montré que la NA, l’isoprotérénol, la DA ou le SKF 38393 stimulent l’activité PKA dans les cellules pyramidales, notamment dans les régions peu innervées par les fibres DA. Les réponses NA et isoprotérénol sont inhibées par les antagonistes β-adrénergiques et les réponses DA par un antagoniste des récepteurs D1/D5. La contribution inhibitrice des récepteurs D2 dopaminergiques et α2-adrénergiques a été mise en évidence. Les récepteurs NA et DA sont donc fonctionnellement exprimés bien au delà du territoire innervé par les fibres DA. L’expression sélective du canal photosensible channelrhodopsine (ChR2) dans les neurones NA combinée à l’imagerie PKA dans le cortex m’a permis de montré que la libération endogène de NA induite par photostimulation augmente réversiblement l’activité PKA. Ces réponses sont inhibées par les antagonistes β- adrénergiques et leur amplitude augmentée par un bloquant de la recapture de la NA. Cette approche permet donc de caractériser en temps réel la transmission catécholaminergique avec une résolution subcellulaire.
Dopamine (DA) and noradrenalin (NA) are critically involved in multiple brain functions. NA and DA modulate neuronal functions via G protein coupled receptors and cAMP/PKA signaling. NA is released in the entire neocortex by axons of locus coeruleus (LC) neurons. DA projections to the neocortex, which originate in the ventral tegmental area, innervate more restricted areas. The aim of this project is to characterize the effect of exogenous and endogenously released NA and DA on cAMP/PKA signaling by using PKA sensitive fluorescent sensors. I showed PKA activation in pyramidal neurons in response to bath application of NA, isoproterenol, DA and SKF38393. Responses were observed throughout the cortex even in areas poorly innervated by DA fibers. Responses to NA and isoproterenol were inhibited by β-receptors antagonists while responses to DA and SKF38393 were blocked by a D1/D5 receptor antagonist. The negative contribution of D2-like and α2-adrenoceptor to PKA signaling was also demonstrated using specific antagonists. These results show a widespread distribution of functional NA and DA receptors in the neocortex that extends far beyond the territory of DA fiber innervations. The selective expression of the light activated Channelrhodopsin2 in NA neurons combined with cortical PKA imaging allowed demonstrating that release of endogenous NA reversibly increases PKA activity. These responses were blocked by β-receptors antagonists while a NA transporter inhibitor increased responses. These results demonstrate that endogenous NA released from LC fibers activates the cAMP/PKA pathway in cortical neurons, providing a means to characterize catecholaminergic transmission events.
The influence of hostility on cortisol levels in saliva was investigated in 47 university students (27 males and 20 females). The students were divided into high and low hostility groups by cluster ...analyses based on their scores on the Buss-Perry Aggression Questionnaire and the Müller Anger Coping Questionnaire. Their saliva was collected twice, in the morning immediately after awakening at a two week interval. On the day before saliva collection, they completed questionnaires about stressful events and their moods in the previous two weeks. The results of the ANOVA showed higher cortisol levels and higher frequencies of stressful events and negative moods in the high hostility group. The effect of hostility on cortisol levels was diminished by controlling for stressful events and negative moods, which suggests that stressful events and negative moods are mediators between hostility and cortisol. The results are discussed in relation to the association between hostility and coronary heart disease.
Objective. To investigate the relationship between subtypes of irritable bowel syndrome (IBS) and severity of symptoms associated with panic disorder (PD). Material and methods. The study comprised ...178 consecutive new PD outpatients. Sixty-four patients met the Rome-II criteria for IBS (IBS+; 29 diarrhea-predominant IBS (IBSD), 14 constipation-predominant IBS (IBSC), 21 other types of IBS). Results. IBSD patients with agoraphobia avoided a greater number of scenes owing to fear of panic attack than did PD patients without IBS (IBS−) and with agoraphobia. IBS+ patients with avoidant behavior due to fear of IBS symptoms had significantly higher Beck Depression Inventory (BDI) scores and avoided a larger number of scenes owing to fear of panic attack than IBS+ patients with agoraphobia and without avoidant behavior due to fear of IBS symptoms or IBS− patients with agoraphobia. Conclusions. The results suggest that the presence of IBSD or avoidant behavior because of fear of IBS symptoms may be associated with a more severe form of agoraphobia, and the latter may also be associated with depression.
Although biofeedback has been reported to be efficacious in the treatment of hypertension, the degree of response has varied. This study investigated the mechanisms of blood pressure reduction by ...biofeedback.
Thirty outpatients with essential hypertension (10 men and 20 women) aged 38 to 65 years were studied. Subjects were randomly assigned to group A or B. Subjects in group A underwent biofeedback treatment once a week for a total of four sessions. Those in group B self-monitored their blood pressure during the sessions as the control period and later underwent the same biofeedback treatment.
Blood pressure measured by doctor was reduced by 17 +/- 18/8 +/- 7 (p < .01) and elevation of pressure induced by mental stress testing was suppressed by 8 +/- 9 (p < .05)/4 +/- 8 during the treatment period in group A (mm Hg). In group B, both blood pressure measured by doctor and elevation of pressure by mental stress testing remained unchanged during the control period and they were later suppressed by 20 +/- 15/9 +/- 7 (p < .01) and 11 +/- 10(p < .05)/5 +/- 9 by the biofeedback treatment. Self-monitored pressure in both groups tended to decrease by the biofeedback treatment. Systolic and diastolic pressures as well as pulse rate decreased, skin temperature increased, and alpha-wave amplitude on electroencephalography increased during the therapy (p < .05).
This treatment was effective in suppressing the pressor response to stress. Patients whose blood pressure increases with stress may be suited for biofeedback intervention.
Background: The aim of this study was to investigate the clinical features of psychosomatic disorders in Japan. Methods: A total of 1,432 outpatients (515 males and 917 females; 9–95 years of age, ...mean age 36) attending a psychosomatic clinic for the first time were assessed by the DSM-III-R or DSM-IV semistructured interview. Results: Major ICD-10 diagnoses found were eating disorder, other anxiety disorders, autonomic nervous dysfunction, somatoform disorders, and irritable bowel syndrome. The most frequent diagnosis on the DSM-III-R and DSM-IV axis I was ‘somatoform disorders not otherwise specified’, followed by bulimia nervosa, ‘depressive disorder not otherwise specified’, anorexia nervosa, conversion disorder, major depression or depressive disorder, ‘panic disorder with agoraphobia‘, and ‘psychological factors affecting physical or medical condition’. On axis II, 11–17% of the patients met the criteria for personality disorder. On axis IV, 78–80% had mild or moderate psychosocial stress; major psychosocial and environmental problems classified by the DSM-IV were the problems with primary supports and occupation. Conclusions: The results seem to reinforce the belief that the diagnoses on the DSM-III-R and DSM-IV axis I are inadequate for describing psychosomatic phenomena. A new diagnostic system in combination with the multidimensional assessments by the DSM-III-R and DSM-IV is needed to form the common guidelines of diagnoses and therapies in psychosomatic medicine.
Objectives (Background): Chronic pain patients are thought to suffer from persistent intensive anxiety as they experience physical pain and emotional distress such as depressive symptoms, stress and ...social dysfunction simultaneously. This study aimed to investigate the mental health conditions and the states of depression of chronic pain patients who underwent pain clinic treatments using General Health Questionnaire (GHQ) and Hamilton's Rating Scale for Depression (HRSD) according to their primary diseases of pain. Subjects: Among chronic pain patients, 125 patients (54 male, 71 female; mean age=58.4±16.0 years) who have visited the pain clinic and agreed with the aim of the study were recruited. Each subject was given proper oral and documented informed consent. Method: Subjects were asked to complete psychological questionnaires which included GHQ. As depressive symptoms are common complications of chronic pain patients, a semi-structured interview was adopted to make detailed objective evaluations of their mental conditions. The primary diseases of the subjects were classified into the following five different diseases; thalamic pain, postherpetic neuralgia (PHN), spinal illness, complex regional pain syndrome (CRPS: post-traumatic pain, postoperative pain), fibromyalgia syndrome (FMS). The level of pain was scaled by using Visual Analog Scale (VAS); also the time from the onset of pain to the pain clinic visit was observed. Results: Both the GHQ and HRSD scores of chronic pain patients were significantly high. As a result of one-way factional analysis of variance (ANOVA), GHQ total score showed significant differences among the 5 diseases. In GHQ, thalamic pain patients, CRPS patients, FMS patients had significantly higher scores than spinal illness patients, meanwhile FMS patients scored significantly higher than PHN patients. Also HRSD total score showed significant differences among 5 diseases. In HRSD, CRPS patients scored significantly higher than PHN patients and spinal illness patients, also FMS patients scored significantly higher than thalamic pain patients, PHN patients, spinal illness patients. Conclusion: The evaluation using GHQ and HRSD showed that the mental health condition of chronic pain patients is restricted by the level of pain. Meanwhile, the study also showed that there were different features of patients' mental health according to the primary disease they have. Along with the consideration for the strength of pain they experience, it is necessary to consider the various influences brought by the primary disease, and it would also be required to seek suitable approaches for each primary disease.
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