RESUMO
This study examined trait anxiety and sexual cognitions in 610 men with premature ejaculation (PE) (DSM-IV-TR criteria) and in 107 partners of these men, and compared their scores to normative data. Sexual anxiety, intravaginal ejaculatory latency time, feeling of control over ejaculation, and PE-related distress were also assessed. The scores of 343 participants (56.23%) with clearly identifiable subtypes of PE according to Waldinger's classification system (lifelong, acquired, variable, and subjective subtypes) were compared in these domains. Finally, the predictive value of these factors in determining PE-related distress was explored. The following conclusions can be summarized from the results: (1) Men affected by PE are more distressed by the problem than their partners; (2) there is no evidence that levels of trait anxiety in individuals with PE are dissimilar to those found in the general population; (3) "dysfunctional" sexual cognitions likely play a role in PE, especially with regard to PE-related distress; (4) different subtypes of PE have similar profiles on measures of trait anxiety, sexual anxiety, and sexual cognitions; (5) differences between subtypes are only apparent with regard to feeling of control over ejaculation, with men with lifelong or acquired PE scoring significantly lower than those with a subjective form of the problem.
Assuntos
Ansiedade/psicologia , Coito/psicologia , Ejaculação Precoce/psicologia , Parceiros Sexuais/psicologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
Very preterm birth (VPT; <32 weeks of gestation) has been associated with impairments in memory abilities and functional neuroanatomical brain alterations in medial temporal and fronto-parietal areas. Here we investigated the relationship between structural connectivity in memory-related tracts and various aspects of memory in VPT adults (mean age 19) who sustained differing degrees of perinatal brain injury (PBI), as assessed by neonatal cerebral ultrasound. We showed that the neurodevelopmental consequences of VPT birth persist into young adulthood and are associated with neonatal cranial ultrasound classification. At a cognitive level, VPT young adults showed impairments specific to effective organization of verbal information and visuospatial memory, whereas at an anatomical level they displayed reduced volume of memory-related tracts, the cingulum and the fornix, with greater alterations in those individuals who experienced high-grade PBI. When investigating the association between these tracts and memory scores, perseveration errors were associated with the volume of the fornix and dorsal cingulum (connecting medial frontal and parietal lobes). Visuospatial memory scores were associated with the volume of the ventral cingulum (connecting medial parietal and temporal lobes). These results suggest that structural connectivity alterations could underlie memory difficulties in preterm born individuals.
Assuntos
Fórnice/patologia , Lactente Extremamente Prematuro , Transtornos da Memória/patologia , Vias Neurais/patologia , Substância Branca/patologia , Cognição , Imagem de Difusão por Ressonância Magnética , Imagem de Tensor de Difusão , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Transtornos da Memória/etiologia , Testes Neuropsicológicos , Adulto JovemRESUMO
Alterations in cortical development and impaired neurodevelopmental outcomes have been described following very preterm (VPT) birth in childhood and adolescence, but only a few studies to date have investigated grey matter (GM) and white matter (WM) maturation in VPT samples in early adult life. Using voxel-based morphometry (VBM) we studied regional GM and WM volumes in 68 VPT-born individuals (mean gestational age 30 weeks) and 43 term-born controls aged 19-20 years, and their association with cognitive outcomes (Hayling Sentence Completion Test, Controlled Oral Word Association Test, Visual Reproduction test of the Wechsler Memory Scale-Revised) and gestational age. Structural MRI data were obtained with a 1.5 Tesla system and analysed using the VBM8 toolbox in SPM8 with a customized study-specific template. Similarly to results obtained at adolescent assessment, VPT young adults compared to controls demonstrated reduced GM volume in temporal, frontal, insular and occipital areas, thalamus, caudate nucleus and putamen. Increases in GM volume were noted in medial/anterior frontal gyrus. Smaller subcortical WM volume in the VPT group was observed in temporal, parietal and frontal regions, and in a cluster centred on posterior corpus callosum/thalamus/fornix. Larger subcortical WM volume was found predominantly in posterior brain regions, in areas beneath the parahippocampal and occipital gyri and in cerebellum. Gestational age was associated with GM and WM volumes in areas where VPT individuals demonstrated GM and WM volumetric alterations, especially in temporal, parietal and occipital regions. VPT participants scored lower than controls on measures of IQ, executive function and non-verbal memory. When investigating GM and WM alterations and cognitive outcome scores, subcortical WM volume in an area beneath the left inferior frontal gyrus accounted for 14% of the variance of full-scale IQ (F = 12.9, p < 0.0001). WM volume in posterior corpus callosum/thalamus/fornix and GM volume in temporal gyri bilaterally, accounted for 21% of the variance of executive function (F = 9.9, p < 0.0001) and WM in the posterior corpus callosum/thalamus/fornix alone accounted for 17% of the variance of total non-verbal memory scores (F = 9.9, p < 0.0001). These results reveal that VPT birth continues to be associated with altered structural brain anatomy in early adult life, although it remains to be ascertained whether these changes reflect neurodevelopmental delays or long lasting structural alterations due to prematurity. GM and WM alterations correlate with length of gestation and mediate cognitive outcome.
Assuntos
Encéfalo/crescimento & desenvolvimento , Encéfalo/patologia , Recém-Nascido Prematuro , Nascimento Prematuro/diagnóstico , Adolescente , Encéfalo/metabolismo , Cognição/fisiologia , Estudos de Coortes , Função Executiva/fisiologia , Feminino , Seguimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro/metabolismo , Recém-Nascido Prematuro/psicologia , Imageamento por Ressonância Magnética/métodos , Masculino , Memória/fisiologia , Nascimento Prematuro/metabolismo , Adulto JovemRESUMO
Several studies have reported changes in emotional memory and processing in people with ALS (pwALS). In this study, we sought to analyse differences in emotional processing and memory between pwALS and healthy controls and to investigate the relationship between emotional memory and self-reported depression. Nineteen pwALS and 19 healthy controls were assessed on measures of emotional processing, emotional memory, verbal memory and depression. Although pwALS and controls did not differ significantly on measures of emotional memory, a subgroup of patients performed poorly on an emotional recognition task. With regard to emotional processing, pwALS gave significantly stronger ratings of emotional valence to positive words than to negative words. Higher ratings of emotional words were associated with better recall in controls but not pwALS. Self-reported depression and emotional processing or memory variables were not associated in either group. In conclusion, the results from this small study suggest that a subgroup of pwALS may show weakened 'emotional enhancement', although in the current sample this may reflect general memory impairment rather than specific changes in emotional memory. Nonetheless, different patterns of processing of emotionally-salient material by pwALS may have care and management-related implications.
Assuntos
Esclerose Lateral Amiotrófica/complicações , Depressão/etiologia , Transtornos da Memória/etiologia , Reconhecimento Psicológico/fisiologia , Análise de Variância , Depressão/diagnóstico , Feminino , Humanos , Inteligência , Masculino , Transtornos da Memória/diagnóstico , Rememoração Mental , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Aprendizagem Verbal/fisiologiaRESUMO
Very preterm birth (before 33 weeks gestation) is associated with the white matter damage, and a common sequel is reduced size and altered shape of the corpus callosum. We used diffusion tensor MRI to assess the corpus callosum in 63 very preterm and 45 term-born young adults. Indices of white matter microstructure [fractional anisotropy (FA) and mean diffusivity (MD)] were obtained for the genu, body and splenium. Very preterm females had higher MD in the genu than term-born females, indicating altered white matter microstructure. This was associated with lower performance IQ. The groups demonstrated different patterns of correlations between verbal learning and tract-specific FA and MD, consistent with the reorganization of white matter structure in adults born very preterm.
Assuntos
Cognição , Corpo Caloso/anatomia & histologia , Corpo Caloso/fisiologia , Recém-Nascido Prematuro , Adolescente , Anisotropia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Recém-Nascido , Inteligência/fisiologia , Aprendizagem/fisiologia , Masculino , Caracteres Sexuais , Adulto JovemRESUMO
INTRODUCTION: Very preterm birth (VPT; <33 weeks' gestation) is associated with later neuromotor and cognitive impairment, reduced school performance, and psychiatric morbidity. Several follow-up studies have demonstrated increased anxiety and social rejection and reduced self-esteem in preterm children and adolescents, but few studies have examined the effects of preterm birth on adult personality. METHODS: We assessed 108 VPT individuals and 67 term-born controls at ages 18 to 19 years with the Eysenck Personality Questionnaire-Revised, short form (EPQ-RS). This questionnaire rates 3 dimensions of personality: extraversion (sociability, liveliness, sensation seeking); neuroticism (anxiety, low mood, low self-esteem); and psychoticism (coldness, aggression, predisposition to antisocial behavior). A fourth scale, "lie," which measures dissimulation, is also derived. RESULTS: VPT individuals had significantly lower extraversion scores, higher neuroticism scores, and higher lie scores than term-born controls, after controlling for age at assessment and socioeconomic status. P scores were not significantly different between the 2 groups. There was a gender difference in that the increased neuroticism and decreased extraversion scores were accounted for mainly by VPT females. Associations between EPQ-RS scores and neonatal status, adolescent behavioral ratings, and body size at 18 to 19 years were assessed by using Kendall partial correlations, correcting for age at assessment and socioeconomic status. Gestational age, indices of neonatal hypoxia, and neonatal ultrasound ratings were not correlated with EPQ-RS scores. Birth weight was weakly associated with increased lie scores. Rutter Parents' Scale score, a measure of adolescent psychopathology, was associated with an increased neuroticism score. Poor social adjustment in adolescence was associated with an increased lie score. Height and weight at 18 to 19 years were not associated with EPQ-RS, but reduced occipitofrontal circumference was associated with both decreased extraversion and increased lie scores. CONCLUSIONS: Young adults who are born VPT have different personality styles from their term-born peers. This may be associated with an increased risk of psychiatric difficulties.
Assuntos
Recém-Nascido Prematuro , Desenvolvimento da Personalidade , Adolescente , Adulto , Feminino , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Determinação da PersonalidadeRESUMO
BACKGROUND: While general population studies indicate an increase in the rate of psychiatric disorder in adolescence, little is known about the course of mental health and behaviour problems between childhood and adolescence in young people with severe intellectual disabilities. METHOD: From a sample of 111 children with severe intellectual disability who had been identified from the registers of six special schools at 4-11 years of age, 82 were traced and reassessed 5 years later at the age of 11-17 years. Behaviour problems were assessed by means of parental interviews conducted in the family home and parent and teacher questionnaires. Parental reports of psychiatric diagnoses were checked against health records. RESULTS: With most behaviour problems, including aggression, destructive behaviour and self-injury, there was little difference in rates between the two assessment occasions. However, in spite of this overall pattern of stability, the rates of some behaviour problems, including overactivity, showed significant reductions between childhood and early adolescence. Persistence rates for most behaviour problems appeared comparable to those reported for similar behaviours in general population studies of children. There was no significant difference in the proportion of cases with psychiatric diagnoses between the two assessment occasions, although brief psychotic episodes emerged in three cases in adolescence. CONCLUSIONS: The findings suggest that the prevalence of mental health and behavioural problems in young people with severe learning disabilities remains relatively stable between childhood and adolescence, although some specific behaviour problems diminish. However, a small minority of children may develop severe psychiatric disorders in adolescence.