RESUMO
Plasma cells (PCs) are terminally differentiated antibody-secreting cells, derived from activated B-lymphocytes in response to either T-independent or T-dependent antigens. The plasma cell population is scarce in circulation in non-immunized individuals. It is established that neonates are incapable of mounting an efficient immune response due to the immaturity of the immune system. However, this disadvantage is well overcome through the antibodies neonates receive from breastmilk. This implies that neonates will be only protected against antigens the mother had previously encountered. Thus, the child might be potentially susceptible to new antigens. This issue prompted us to seek for the presence of PCs in non-immunized neonate mice. We found a PC population identified as CD138+/CD98+ cells since day one after birth. These PCs were positive for Ki67 and expressed Blimp-1, B220, and CD19, which suggests the populations are plasmablasts and PCs with heterogeneous phenotype. These PCs were also determined to secrete antibodies, although mainly isotype IgM. Altogether, the results indicated that neonate PCs can produce antibodies against antigens they encounter in the first weeks of life, most likely coming from food, colonizing microbiota, or the environment.
Assuntos
Linfócitos B , Plasmócitos , Animais , Camundongos , Anticorpos , Antígenos CD19 , Sistema Imunitário , Proteína-1 Reguladora de FusãoRESUMO
The objective of this article is to review the literature on neuroimaging in small vessel disease. A review was carried out through the Pubmed search engine, without a filter of years, using terms such as: cerebral small vessel disease; white matter hyperintensity; brain microbleed; WBC. Small vessel disease is the most common vascular pathology. Its basis is in the affectation of the small cerebral vessels that eventually causes an alteration in the blood-brain barrier. Its clinical implication is highly relevant. Using magnetic resonance imaging, different expressions of the disease have been observed, such as white matter hyperintensities, microbleeds or lacunar infarcts. Other more recent techniques, such as brain blood flow measurements, are helping to increase understanding of the pathophysiology of this disease.
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Doenças de Pequenos Vasos Cerebrais , Acidente Vascular Cerebral Lacunar , Humanos , Neuroimagem/métodos , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagemRESUMO
BACKGROUND AND PURPOSE: Temporal bones in some patients with Ménière disease have demonstrated small vestibular aqueducts; however, the prevalence and clinical importance of small vestibular aqueducts remain unclear in patients without Ménière disease. This study correlates the presence of a small vestibular aqueduct with cochleovestibular symptoms. MATERIALS AND METHODS: Consecutive temporal bone CTs in adults from January to December 2020 were reviewed. The midpoint vestibular aqueduct size in the 45°-oblique Pöschl view was measured by 2 reviewers independently in 684 patients (1346 ears). Retrospective chart review for the clinical diagnosis of Ménière disease, the presence of cochleovestibular symptoms, and indications for CT was performed. RESULTS: Fifty-two of 684 patients (7.6% of patients, 62/1346 ears) had small vestibular aqueducts. Twelve patients (15/1346 ears) had Ménière disease. Five of 12 patients with Ménière disease (5 ears) had a small vestibular aqueduct. There was a significant correlation between a small vestibular aqueduct and Ménière disease (P < .001). There was no statistical difference between the small vestibular aqueduct cohort and the cohort with normal vestibular aqueducts (0.3-0.7 mm) regarding tinnitus (P = .06), hearing loss (P = .88), vertigo (P = .26), dizziness (P = .83), and aural fullness (P = .61). CONCLUSIONS: While patients with Ménière disease were proportionately more likely to have a small vestibular aqueduct than patients without Ménière disease, the small vestibular aqueduct was more frequently seen in patients without Ménière disease and had no correlation with hearing loss, vertigo, dizziness, or aural fullness. We suggest that the finding of a small vestibular aqueduct on CT could be reported by radiologists as a possible finding in Ménière disease, but it remains of uncertain, and potentially unlikely, clinical importance in the absence of symptoms of Ménière disease.
Assuntos
Surdez , Perda Auditiva Neurossensorial , Perda Auditiva , Doença de Meniere , Aqueduto Vestibular , Adulto , Humanos , Doença de Meniere/diagnóstico por imagem , Tontura/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Aqueduto Vestibular/diagnóstico por imagem , VertigemRESUMO
There are currently no reliable biological markers to identify antidepressant responders in patients suffering from major depressive disorder. In this longitudinal pilot study, we measured skin conductance response (SCR) to assess patients' emotional reactivity after antidepressant treatment initiation. Fifty-four adult patients with a major depressive episode were recruited and followed up for 3 months. After one day of antidepressant treatment (D1) and then at day 7 (D7), emotional stimuli were presented on a computer screen while SCR and subjective emotional response were recorded. Three months later, we used Montgomery and Åsberg Depression Rating Scale (MADRS) to screen patients for treatment response, and distinguished responders (N = 28) from non-responders (N = 15). While SCR at D1 did not differ between responders and non-responders, SCR at D7 was higher in responders for both positive, negative and neutral stimuli. Skin conductance rates at D7 had a relatively poor negative predictive value (38%) but a strong positive predictive value (95%). Further studies are needed to replicate in a larger sample, and validate, these preliminary results which suggest that electrodermal activity after treatment initiation could help predict antidepressant efficacy.
Assuntos
Transtorno Depressivo Maior , Adulto , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Emoções , Humanos , Projetos Piloto , Valor Preditivo dos Testes , Escalas de Graduação PsiquiátricaRESUMO
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a cognitive behavioral therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED. METHODS: Sixty-eight 7- to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 1-h sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the "Aggression" sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children's Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder). DISCUSSION: Children with ADHD and ED are at risk of functional impairment and poor outcomes and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population. TRIAL REGISTRATION: Clinicaltrials.gov. NCT03176108 . Registered on June 5, 2017.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Terapia Cognitivo-Comportamental , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Emoções , Humanos , Poder Familiar , Pais , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
Cerebral malaria (CM) is a neurological complication derived from the Plasmodium falciparum infection in humans. The mechanisms involved in the disease progression are still not fully understood, but both the sequestration of infected red blood cells (iRBC) and leukocytes and an exacerbated host inflammatory immune response are significant factors. In this study, we investigated the effect of Monocyte Locomotion Inhibitory Factor (MLIF), an anti-inflammatory peptide, in a well-characterized murine model of CM. Our data showed that the administration of MLIF increased the survival and avoided the neurological signs of CM in Plasmodium berghei ANKA (PbA) infected C57BL/6 mice. MLIF administration down-regulated systemic inflammatory mediators such as IFN-γ, TNF-α, IL-6, CXCL2, and CCL2, as well as the in situ expression of TNF-α in the brain. In the same way, MLIF reduced the expression of CD31, CD36, CD54, and CD106 in the cerebral endothelium of infected animals and prevented the sequestration of iRBC and leucocytes in the brain microvasculature. Furthermore, MLIF inhibited the activation of astrocytes and microglia and preserved the integrity of the blood-brain barrier (BBB). In conclusion, our results demonstrated that the administration of MLIF increased survival and conferred neuroprotection by decreasing neuroinflammation in murine CM.
Assuntos
Anti-Inflamatórios/administração & dosagem , Malária Cerebral/prevenção & controle , Fármacos Neuroprotetores/administração & dosagem , Oligopeptídeos/administração & dosagem , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/imunologia , Encéfalo/efeitos dos fármacos , Encéfalo/imunologia , Encéfalo/patologia , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/imunologia , Feminino , Humanos , Mediadores da Inflamação/antagonistas & inibidores , Mediadores da Inflamação/metabolismo , Malária Cerebral/imunologia , Malária Cerebral/parasitologia , Malária Cerebral/patologia , Camundongos , Microglia/efeitos dos fármacos , Microglia/imunologia , Plasmodium berghei/imunologiaRESUMO
The experiment presented is the result of a partnership between the Paris-Nanterre University (CLIPSYD laboratory, EA 4430) and the CSAPA Imagine (Simone Veil Hospital, GH Eaubonne-Montmorency). Virtual reality immersion exposure for pathological gamblers is beneficial in the context of cognitive and behavioral interventions. It can be used to evoke the desire to play and to have access to automatic thoughts and mistaken beliefs of the players when they find themselves in a gambling context. Exposure is used until the urge to play diminishes and disappears which is the process of desensitization or extinction. OBJECTIVE: The objective of the study was to investigate the possibilities implemented by virtual reality in the case of an exhibition for pathological gamers to create a desire to play and work with the patient in an environment identical to the ecological one. Two hypotheses were proposed. On the one hand, the virtual reality exhibition will help to change the desire to play in relation to the game. On the other hand, virtual exhibition sessions associated with cognitive restructuring will have a greater impact on the perception of reality. METHOD: After a diagnosis was made, participation in the study was offered to patients (n=10) in routine care and able to participate (exclusion criteria). It consisted of four virtual reality exposure sessions integrated with traditional care. Exposure did not exceed 20minutes. To carry out this study we used the virtual reality headset "Oculus Rift CV1" and the headphones measuring EEG waves, "Emotiv Epoc". A battery of questionnaires were proposed to evaluate gambling-related behaviors (ICJP, GRCS, UPPS), to analyze the interest of the virtual reality exhibition (SIS, CGI, TEI, EVA), and to glimpse the immersion abilities (QEP and QPI). RESULTS: Ten participants aged 25 to 60 agreed to participate in the study. The results of this study demonstrated the viability of RV gamers' exposure as a tool that can help reduce pathological gambling symptoms and the severity perceived by therapists (CPI: t=1.6, P=0.001; CGI: t=4.87, P=0.001) between the beginning of the care and the end of the care and at D+1. We were also able to observe significant results (P<0.05) concerning a decrease in cognitive distortions (GRCS tot, Illusion of control, Power of prediction, Favorable interpretation). CONCLUSION: The feasibility study shows that the desire to play is very present during the virtual reality exhibition in accordance with literature studies. The results also demonstrate the utility of virtual reality to allow the patient to elaborate on the cognitive distortions associated with the practice of pathological gambling. From a therapeutic point of view, the results suggest that virtual reality can increase the effectiveness of cognitive restructuring and increase understanding of the urge to play related to stimuli in the environment of play.
Assuntos
Jogo de Azar/terapia , Realidade Virtual , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Eletroencefalografia , Estudos de Viabilidade , Feminino , Jogo de Azar/psicologia , Humanos , Comportamento Impulsivo , Masculino , Pessoa de Meia-Idade , Motivação , Testes Neuropsicológicos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
Obesity has become a public health problem. But care, mainly diets, is often ineffective over the long term. Emotional therapies seem to be an interesting track especially for emotional eating. After defining two key concepts of emotional eating and acceptance, the theoretical frameworks of the different emotional therapies used in the treatment of overweight or obesity will be presented: Mindfulness-Based for Eating Disorder (MB-EAT), Acceptance and Commitment Therapy, and Acceptance-Based Behavioral Treatment for Weight Loss (ABT). The goal is to understand their usefulness in the treatment of overweight or obesity and perhaps avoid using contradictory techniques such as dieting with mindfulness. If current results are promising, the effectiveness of these therapies needs to be confirmed by new studies. Finally, the article points to the emergence of new "integrative" therapies that resemble the others presented and are related but are in fact the exact opposite. Control and acceptance are indeed antithetical.
Assuntos
Emoções , Obesidade/psicologia , Obesidade/terapia , Sobrepeso/psicologia , Sobrepeso/terapia , Terapia de Aceitação e Compromisso , Terapia Comportamental , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Humanos , Atenção Plena , PsicoterapiaRESUMO
To prevent risks associated with online gambling, many jurisdictions propose self-exclusion strategies as a part of a responsible gambling policy. To protect online gamblers, French law provides for a 7-day temporary non-reducible and voluntary self-exclusion measure that applies only to select websites. The objective of our study was to evaluate the effectiveness of this self-exclusion measure for at-risk online gamblers. It was an experimental randomized controlled trial targeted at risk prevention. The main outcomes were the money wagered and time spent gambling assessed 15 days (short-term) and 2 months (medium-term) after the implementation of the self-exclusion measure. The effectiveness of self-exclusion was also compared according to the gambling type (pure chance games, such as lottery or scratch tickets, skill and chance bank games such as sports betting or horserace betting, and skill and chance games such as poker). Sixty participants were randomly assigned to the experimental condition (n = 30; with the implementation of a self-exclusion measure) or control condition (n = 30). The randomization was stratified according to their favorite game [pure chance games (n = 20), skill and chance bank games (n = 20), and skill and chance social games (n = 20)]. The results revealed that self-exclusion had no short-term impact-but did have a medium-term impact-on gambling habits. After 2 months, the gambling-related cognitions ("illusion of control" and "the perceived inability to stop gambling") and the subscale "desire" of the Gambling Craving Scale (GACS) have decreased. Participants' opinions about the impact and effectiveness of self-exclusion were discussed. To conclude, it appeared that temporary self-exclusion is an interesting tool to protect online gamblers from excessive practices, but several modifications have to be made to improve its effectiveness and use.
Assuntos
Comportamento Aditivo/prevenção & controle , Jogo de Azar/prevenção & controle , Internet , Adolescente , Adulto , Análise de Variância , Comportamento Aditivo/psicologia , Feminino , Jogo de Azar/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Adulto JovemRESUMO
It is now recognized that emotions can influence food intake. While some people report eating less when distressed, others report either no change of eating or eating more in the same condition. The question whether this interindividual variability also occurs in response to positive emotions has been overlooked in most studies on Emotional Eating (EE). Using the Emotional Appetite Questionnaire (EMAQ) and Latent Profile Analysis, this study aimed to examine the existence of latent emotion-induced changes in eating profiles, and explore how these profiles differ by testing their relations with 1) age and sex, 2) BMI and risk for eating disorders (ED) and 3) factors that are known to be associated with EE such as perceived positive/negative feelings, depression, anxiety, stress symptoms and impulsivity. Among 401 university students (245 females) who completed the EMAQ, 3 profiles emerged (P1:11.2%, P2:60.1%, P3:28.7%), with distinct patterns of eating behaviors in response to negative emotions and situations but few differences regarding positive ones. Negative emotional overeaters (P1) and negative emotional undereaters (P3) reported similar levels of emotional distress and positive feelings, and were at greater risk for ED. However, the people in the former profile i) reported decreasing their food intake in a positive context, ii) were in majority females, iii) had higher BMI and iv) were more prone to report acting rashly when experiencing negative emotions. Our findings suggest that a person-centred analysis of the EMAQ scores offers a promising way to capture the inter-individual variability of emotionally-driven eating behaviors. These observations also add to the growing literature underscoring the importance of further investigating the role of different facets of impulsivity in triggering overeating and to develop more targeted interventions of EE.
Assuntos
Apetite , Ingestão de Alimentos/psicologia , Emoções , Inquéritos e Questionários , Adolescente , Adulto , Ansiedade/complicações , Ansiedade/psicologia , Índice de Massa Corporal , Depressão/complicações , Depressão/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Hiperfagia/etiologia , Hiperfagia/psicologia , Comportamento Impulsivo , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estudantes , Adulto JovemRESUMO
There is now a large body of evidence suggesting a significant association between emotional discomfort management, disordered eating behaviors and weight status. In the field of overweight and obesity, emotionally driven eating habits that resemble addictive behaviors are considered as a risk factor. This study aimed to investigate in a large sample of French university students 1) the associations between self-reported levels of psychological distress (PD), emotional eating (EE), food addiction (FA) and Body Mass Index (BMI); and 2) the potential mediation effect of eating behaviors (EE and FA) between PD and BMI. The responses of 1051 students (76.3% females) to self-reports assessing PD (Perceived Stress Scale, Hospital Anxiety and Depression Scale), EE (Intuitive Eating Scale-2) and FA (modified Yale Food Addiction Scale) were analysed. Associations between variables (Spearman correlation) and group comparisons by sex and BMI categories (Student's t tests/ANOVA) were tested, followed by Structural Equation Modeling (SEM) by sex. Among females and males, EE and FA scores were positively inter-related and correlated with PD scores and BMI. Moreover, among females and males, SEM showed that both EE and FA acts as mediators between PD and BMI. Hence, among educated young adults, using food consumption for down-regulating negative mood places the individual at risk for overweight and obesity. This study further emphasizes the necessity to take into account emotionally driven and addictive-like eating behaviors in interventions for promoting healthy eating and weight management.
Assuntos
Comportamento Aditivo , Peso Corporal , Ingestão de Alimentos/psicologia , Emoções , Comportamentos Relacionados com a Saúde , Estresse Psicológico/psicologia , Adolescente , Adulto , Comportamento Aditivo/complicações , Índice de Massa Corporal , Estudos Transversais , Depressão/dietoterapia , Depressão/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Obesidade/etiologia , Obesidade/psicologia , Sobrepeso/etiologia , Sobrepeso/psicologia , Fatores Socioeconômicos , Estresse Psicológico/complicações , Estudantes , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: There is some evidence that eating disorders (ED) and Attention-deficit/hyperactivity disorder (ADHD) share common clinical features and that ADHD might contribute to the severity of eating disorders. A greater understanding of how the presence of comorbid ADHD may affect the psychopathological framework of eating disorder seems of primary importance. The aim of our study was to evaluate rates of ADHD in three ED subgroups of inpatients: anorexia nervosa restricting type (AN-R), anorexia nervosa binge-eating/purging type (AN-BP) and bulimia nervosa (BN). The secondary aim was the evaluation of the associated psychological characteristics. METHOD: The sample consisted of 73 females inpatients (mean age 28.07 ± 7.30), all with longstanding histories of eating disorder (ED). The presence of a diagnosis of ADHD was evaluated in a clinical interview based on DSM-IV-TR criteria. The following psychometric instruments were used: the eating attitude test (EAT-40), the Bulimic Investigatory Test, Edinburgh (BITE), the Eating Disorder Inventory (EDI-2), the Wender Utah Rating Scale (WURS), the Brown Attention Deficit Disorder Scale (BADDS), the Hamilton scales for Anxiety (HAM-A) and Depression (HAM-D), and the Barrat Impulsivity Scale (BIS-10). RESULTS: Among the three ED subgroups, 13 patients reported comorbidity with ADHD; three in the AN-R subtype, nine in the AN-BP and one in the BN. The remaining 60 patients (n = 34 AN-R; n = 19 AN-BP; n = 7 BN) presented only a diagnosis of ED. The EAT (p = 0.04) and HAM-A (p = 0.02) mean scores were significantly higher in patients with comorbid ADHD. CONCLUSIONS: In our study the comorbidity between ADHD and ED appeared to be frequent, particularly among patients with AN-BP. ED inpatients with higher level of anxiety and more abnormal eating attitudes and bulimic symptoms should be assessed for potentially associated ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Feminino , Humanos , Psicometria , Avaliação de Sintomas , Adulto JovemRESUMO
INTRODUCTION: Mental illness such as schizophrenia is a major public health concern. In France, the economic cost of schizophrenia represents 2% of total medical expenditures. Schizophrenia has an impact on health and quality of life not only for patients but also for relatives. Family psychoeducation is a complementary therapeutic intervention to ordinary clinical care deigned to alleviate the burden of care among relatives of patients with schizophrenia. Literature suggests such programs including the patients' family members reduce the risk of relapse. Current studies also suggest that negative emotions expressed by family members have negative consequences on patients' mental health and need to be addressed. However, family psychoeducation is still underdeveloped in France. The objective of this study was to assess the longitudinal outcome on depression level of a psychoeducation program for relatives of schizophrenic patients. The program was held in Paris and Région Île-de-France "Cluster ProFramille Île-de-France" between 2012 and 2014. METHODS: Level of participant's depression was assessed by the Center for Epidemiologic Studies - Depression Scale (CES-D). Measures of depression were made for four time points: 2 months before joining the program (T1), at the beginning of the program (T2), at midpoint of the first program module (3 months, T3) and at the end of the first program module (6 months, T4). Repeated-measures ANOVA were performed to assess longitudinal change in a participant's level of depression. Type of coping strategies, knowledge about the disease, dominant thoughts and emotional progress are assessed by the program. Univariate correlation with CES-D differences between T1 and T4 were assessed. Variables with a significant association were included in a multivariate linear model to explain CES-D difference. RESULTS: Sixty-five relatives participated to the "Cluster ProFramille Île-de-France" between 2012 and 2014 and terminated with the first module of the program. Repeated-measures ANOVA on CES-D scores between T1 and T4 (8 months) showed a significant decrease in average scores for all participants. The mean of decrease was 7 points, equivalent to a 26.6% pre-post decrease level of depression. Significant univariate correlations with depression decrease over 8 months were with "psychomotor tiredness", "frequent worries" and "dealing with worries". Multivariate linear regression only confirmed the significant role of diminishing fatigue in relation to the decrease of depression. CONCLUSION: Our study's results showed that the ProFamille program was efficient in reducing the level of depression for its participants over an 8 month period. As the participants progressed on managing their fatigue, their depressed moods improved.
Assuntos
Depressão/etiologia , Depressão/terapia , Família/psicologia , Esquizofrenia , Adaptação Psicológica , Adulto , Idoso , Efeitos Psicossociais da Doença , Depressão/psicologia , Emoções , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Escalas de Graduação Psiquiátrica , Psicologia do Esquizofrênico , Resultado do TratamentoRESUMO
Rodent models of auditory fear conditioning are often used to understand the molecular mechanisms regulating fear- and anxiety-related behaviors. Conditioning and extinction memories are influenced by contextual cues, and the reinstatement of conditioned fear occurs when the conditioning stimulus is presented in a context different from the extinction context. Although it has been proposed that internal state is a feature of context that could influence extinction, contributions of interoception to conditioning have not been experimentally addressed. Here we use ethanol (EtOH) to show that interoceptive cues are encoded through the hippocampus by mechanisms that involve increased phosphorylation of GluR1 on serine 845, and biophysical alterations in neuronal membranes that facilitate stabilization of surface-located calcium-permeable n-2-amino-3-(5-methyl-3-oxo-1,2-oxazol-4-yl) propanoic acid (AMPA) receptor (AMPAR) into membrane microdomains. Conflicting interoceptive cues during extinction and fear relapse testing resulted in a failure to consolidate extinction that was reversed by the administration of AMPAR antagonists immediately following the retrieval cue.
Assuntos
Comportamento Animal/efeitos dos fármacos , Membrana Celular/efeitos dos fármacos , Depressores do Sistema Nervoso Central/farmacologia , Condicionamento Psicológico/efeitos dos fármacos , Etanol/farmacologia , Extinção Psicológica/efeitos dos fármacos , Medo , Hipocampo/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Receptores de AMPA/efeitos dos fármacos , Animais , Benzodiazepinas/farmacologia , Membrana Celular/metabolismo , Células Cultivadas , Depressores do Sistema Nervoso Central/administração & dosagem , Sinais (Psicologia) , Etanol/administração & dosagem , Hipocampo/citologia , Hipocampo/metabolismo , Masculino , Camundongos , Neurônios/metabolismo , Nitrilas , Piridonas/farmacologia , Receptores de AMPA/antagonistas & inibidores , Receptores de AMPA/metabolismo , AutoadministraçãoRESUMO
BACKGROUND: Studies have shown that patients with borderline personality disorder are often misdiagnosed to have bipolar disorder and conversely. Indeed, a number of characteristics common to both disorders could explain this problem: emotional instability as well as impulsivity represent confounding factors and contribute to the risk of misdiagnosis. However, it appears that these characteristics manifest themselves in different ways according to the pathology. The aim of the study is to show differences between affective lability, emotional intensity and impulsivity dimensions. The clinical aim is to refine bipolar disorder and borderline personality disorder diagnosis, to improve psychological care for these patients in the long-term. METHOD: We compared the emotional and impulsive dimensions in two groups of patients: a group of 21 patients with bipolar disorder and a group of 19 patients with borderline personality disorder. Tools: ALS, a self-report questionnaire to evaluate affective lability, AIM, a self-report questionnaire to see affective intensity, and UPPS, a self-report questionnaire to measure impulsivity according to several dimensions. RESULTS: The results indicate that borderline patients scored significantly higher than bipolar patients at the ALS and AIM scales. Regarding the UPPS, borderline patients scored significantly higher than bipolar patients for the dimensions "lack of premeditation" and "lack of perseverance"; however, bipolar patients had significantly higher scores than borderline patients for the dimension "negative emergency". CONCLUSION: This study shows that bipolar disorder and borderline personality can be differentiated thanks to emotional dimensions as well as different dimensions of impulsivity: borderline patients appear to have an affective lability and intensity more important than bipolar patients; it also appears that impulsivity manifests itself differently according to the disorder.
Assuntos
Transtorno Bipolar/psicologia , Transtorno da Personalidade Borderline/psicologia , Emoções , Comportamento Impulsivo , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Transtorno Bipolar/diagnóstico , Transtorno da Personalidade Borderline/diagnóstico , Depressão/etiologia , Depressão/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Inquéritos e QuestionáriosRESUMO
BACKGROUND/OBJECTIVE: Appetitive traits and general temperament traits have both been correlated with adiposity and obesity in children. However, very few studies have tested structural models to identify the links between temperament, appetitive traits and adiposity in children. A validated structural model would help suggesting mechanisms to explain the impact of temperament on body mass index (BMI). In this study, we used Rothbart's heuristic definition of temperament as a starting point to define four appetitive traits, including two appetite reactivity dimensions (Appetite Arousal and Appetite Persistence) and two dimensions of self-regulation in eating (Self-regulation In Eating Without Hunger and Self-regulation in Eating Speed). We conducted a cross-sectional study in young adolescents to validate a structural model including these four appetitive traits, Effortful Control (a general temperament trait) and adiposity. SUBJECTS/METHODS: A questionnaire assessing the four appetitive trait dimensions and Effortful Control was completed by adolescents from 10 to 14 years old (n=475), and their BMI-for-age was calculated (n=441). In total, 74% of the study participants were normal weight, 26% were overweight and 8% were obese. We then used structural equation modelling to test the structural model. RESULTS: We identified a well-fitting structural model (Comparative Fit Index=0.91; Root Mean Square Error of Approximation=0.04) that supports the hypothesis that Effortful Control impacts both dimensions of self-regulation in eating, which in turn are linked with both appetite reactivity dimensions. Moreover, Appetite Persistence is the only appetitive trait that was significantly related to adiposity (B=0.12; P<0.05). CONCLUSIONS: Our model shows that Effortful Control is related to adiposity through the mediation of an individual's 'eating temperament' (appetite reactivity and self-regulation in eating). Results suggest that young adolescents who exhibit high appetite reactivity but a low level of self-regulation in eating are at higher risk for excess adiposity.
Assuntos
Comportamento do Adolescente , Apetite/fisiologia , Índice de Massa Corporal , Comportamento Infantil , Comportamento Alimentar , Temperamento/fisiologia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Comportamento Infantil/psicologia , Estudos Transversais , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Feminino , França/epidemiologia , Humanos , Masculino , Modelos Teóricos , Relações Pais-Filho , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
UNLABELLED: For several years, the learning of mindfulness has developed in a psychological intervention perspective, particularly in the field of addiction. Presently, the management of addictions with substances is centered on two questions: the motivation in the change of behaviour and in a significant change in alcohol consumption. Concerning alcohol dependence, the evolution of behaviour is variable and characterized by forgiveness episodes and relapses. Over many years, a treatment for the abuse of substance associated with techniques based on full consciousness (Kabat-Zinn, 1990; Segal et al., 2002) Mindfulness-based relapse prevention (MBRP) was developed by Marlatt et al. (2011). The prevention of the relapse therapy, based on full consciousness, is a program of eight sessions integrating techniques of "mindfulness" into the techniques of prevention of the relapse. However, not much research has focused on the MBRP, the publication of the manual regarding this intervention is too recent (Bowen S et al., 2011). OBJECTIVE: We are interested in the active mechanisms, which are at stake in the MBRP. Indeed, the meditation acts presents many mechanisms in the addicting disorders. Our non-controlled research was based on a protocol in order to evaluate the alcohol consummation, mindfulness, impulsiveness, automatic thoughts, anxiety and abilities to cope. The first results are interesting: reduction of alcohol consummation, increase of mindfulness, reduction of trigger relapse, increasing cognitive flexibility and high degree of satisfaction among participants. METHODOLOGY: An intervention MBRP was proposed to 26 patients who were assigned to three groups. They were questioned about their alcohol consumption and assessed by a protocol of seven evaluations before and after the group MBRP: Five Facets Mindfulness (FFMQ), Impulsive Behavior Scale (UPPS), Acceptance and Action Questionnaire (AAQ II), State Trait Anxiety Inventory (STAI-A, STAI-B), Questionnaire of the automatic thoughts (QPA), and The Drug-Taking Confidence Questionnaire (DTCQ-8). This study exposes the preliminary results of an intervention for substance use disorders called mindfulness-based relapse prevention (mbrp) administered to five groups of alcohol dependent patients in a psychiatric department and a department of alcohol science in France. RESULTS: The results show maintained abstinence and a moderation leading to abstinence for the still consuming patients. According to our evaluations, we obtained several significant results after the therapy, despite our small cohort: patients accepted their thoughts and feelings better (FFMQ-judgment); the tendency to give in to the impulses decreased (urgency-UPPS), and their tolerance to anxiety increased (STAI-YA-YB). Moreover, this study appears to confirm that the MBRP program allows an improvement of self-efficiency. The study continues in order to confirm these results on a larger sample and to explore the long-term results, so as to propose a new work-tool for patients and caregivers.
Assuntos
Alcoolismo/reabilitação , Atenção Plena/métodos , Adaptação Psicológica , Alcoolismo/psicologia , Comportamento Aditivo/psicologia , Escalas de Graduação Psiquiátrica Breve , Feminino , França , Humanos , Masculino , Motivação , RecidivaRESUMO
Attention deficit disorder with or without hyperactivity (ADD/ADHD) is a neurodevelopmental disorder that can be exacerbated by psychosocial factors. Various studies confirm that the severity of a psychiatric disorder, particularly when it comes to ADHD, is strongly correlated with the amount of use. This study (1) evaluated the association between ADHD and gambling among young students; (2) determined which symptom among ADHD's three symptoms (attention deficit, hyperactivity, or impulsivity) had the strongest association with video game addiction and gambling; and (3) determined the impact of the association between ADHD and video game addiction and gambling on self-esteem and academic performance of students. A total of 720 students (445 males and 274 females) were recruited from eight higher educational institutions of Ile de France. They all completed a battery of questionnaire consisting of Canadian Problem Gambling Index, UPPS Impulsive Behavior Scale, Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS) and Rosenberg scales, and socio-demographic data. 13.33% of the participants had symptoms of ADHD during childhood (WURS scale score) and 40.41% of them have symptoms of ADHD in adulthood (ASRS score). Finally, among the participants, 37.5% had excessive gambling addiction, have positive results on WURS and ASRS scales, thus having a probable ADHD, whereas 14.55% had no gambling addiction. The results demonstrated that adult ADHD was associated with gambling addiction. Significant associations were observed between ADHD and impulsivity, academic difficulties and gambling addiction. The association between ADHD and gambling seems to be common among vulnerable populations such as adolescents and could be related to variables such as self-esteem, which appears to potentially worsen the prognosis. Further research on this relationship is needed to optimize prevention strategies and effective treatment.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Jogo de Azar/psicologia , Comportamento Impulsivo , Estudantes/psicologia , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comportamento Aditivo/psicologia , Feminino , França/epidemiologia , Jogo de Azar/epidemiologia , Humanos , Masculino , Autorrelato , Índice de Gravidade de Doença , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents. It is characterized by age-inappropriate inattention/impulsiveness and/or hyperactivity symptoms. ADHD shows a high comorbidity with oppositional defiant disorder (ODD), a disorder that features symptoms of emotional lability. Due to this comorbidity, emotional lability was long considered a secondary consequence of ADHD, which could arise under the influence of environmental factors such as inefficient parenting practices, as part of an ODD diagnosis. In this model of heterotypic continuity, emotional lability was considered not to play any causal role regarding ADHD symptomatology. LITERATURE FINDINGS: As opposed to this view, it is now well established that a large number of children with ADHD and without any comorbid disorder exhibit symptoms of emotional lability. Furthermore, recent studies have found that negative emotionality accounts for significant unique variance in ADHD symptom severity, along with motor-perceptual and executive function deficits. Barkley proposed that ADHD is characterized by deficits of executive functions, and that a deficiency in the executive control of emotions is a necessary component of ADHD. According to this theory, the extent to which an individual with ADHD displays a deficiency in behavioral inhibition is the extent to which he or she will automatically display an equivalent degree of deficiency in emotional inhibition. However, not all children with ADHD exhibit symptoms of emotional lability, and studies have found that the association between emotional lability and ADHD was not mediated by executive function or motivational deficits. Task-based and resting state neuroimaging studies have disclosed an altered effective connectivity between regions dedicated to emotional regulation in children with ADHD when compared to typically developing children, notably between the amygdala, the prefrontal cortex, the hippocampus and the ventral striatum. Morphological alterations of the amygdala have also been reported in previous structural studies in children with ADHD. DISCUSSION: Emotional lability can result from different neurobiological mechanisms. In particular, bottom-up and top-down processes can be opposed. Bottom-up related emotional dysregulation involves an increased emotional reactivity, and is thought to be linked to the automatic evaluative activity of the amygdala. Top-down mechanisms are associated with the regulation of such activity, and rely on a prefrontal network including the lateral prefrontal cortex, the anterior cingulate cortex and the orbitofrontal cortex. Since various neuropsychological impairments and alterations in multiple brain networks have been implicated in the etiology of ADHD, contemporary models emphasize its neuropsychological heterogeneity. It is therefore likely that some but not all children with ADHD will exhibit neurobiological alterations in circuits dedicated to emotional regulation, possibly at different levels. Future research will have to identify the different causal pathways and to decide whether emotional lability represents a criterion to subtype ADHD diagnoses. CONCLUSION: Emotional dysregulation is now known to play a causal role regarding ADHD symptomatology. Along with executive functioning, reaction time variability and potentially delay aversion, emotional dysregulation should therefore be included in future theoretical models of ADHD, as well as in clinical practice when identifying the major impairments in this diagnostic group and when deciding therapeutic strategies.
Assuntos
Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Adolescente , Sintomas Afetivos/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Encéfalo/fisiopatologia , Criança , Comorbidade , Inteligência Emocional/fisiologia , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Vias Neurais/fisiopatologia , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/fisiopatologia , Transtornos Psicomotores/psicologiaRESUMO
INTRODUCTION: Cyberbullying is a relatively new form of bullying. This bullying is committed by means of an electronic act, the transmission of a communication by message, text, sound, or image by means of an electronic device, including but limited to, a computer phone, wireless telephone, or other wireless communication device, computer, games console or pager. Cyberbullying is characterized by deliberately threatening, harassing, intimidating, or ridiculing an individual or group of individuals; placing an individual in reasonable fear of harm; posting sensitive, private information about another person without his/her permission; breaking into another person's account and/or assuming another individual's identity in order to damage that person's reputation or friendships. LITERATURE FINDING: A review of the literature shows that between 6 and 40% of all youths have experienced cyberbullying at least once in their lives. Several cyberbullying definitions have been offered in the literature, many of which are derived from definitions of traditional bullying. In our study we asked clear definition of cyberbullying. Few studies explicate the psychosocial determinants of cyberbullying, and coping mechanisms. The authors of the literature recommend developing resiliency, but without analyzing the resilience factor. OBJECTIVES: The first aim of this study was to determine the prevalence of adolescents and adults engaged in cyberbullying. The second aim was to examine the coping mechanisms and comorbidity factors associated with the cyberbullied people. METHODOLOGY: The sample was composed of 272 adolescents (from a high school) and adults (mean age=16.44 ± 1). The Olweus Bully/Victim Questionnaire was used to identify profiles of cyberbullying. Coping mechanisms were investigated using the Hurt Disposition Scale (HDS) and the Brief Resilience Scale (BRS). Comorbidities were assessed using the Hospital Anxiety and Depression Scale (HAD), Liebowitz's Social Anxiety Scale (LSAS), and the Bermond-Vorst Alexithymia Questionnaire (BVAQ). RESULTS: Almost one student in three was involved in cyberbullying (34.9% as cyber-victim, 16.9 as cyberbully); 4.8% of our sample was concerned by bullying as a victim. The victims of bullying were also victims of cyberbullying. The mean age of victims of cyberbullying was 17.84 ± 5.9 years, and the mean age of victims of bullying was 16.3 ± 4.5 years. Correlation coefficient was significant for HAD, LSAS, BVAQ scales with CQ. The retaliatory variable of HDS scale was not significant. Finally, the coping strategies of students who reported victimization were explored. These strategies include coping, telling someone, figuring out the situation, and avoidant coping. The results showed for the victims of cyberbullying, that they take longer to recover from a stressful event, compared to victims of bullying. CONCLUSION: Results have indicated the importance of further study of cyberbullying because its association with comorbidities was distinct from traditional forms of bullying. The biggest risk factor for the adolescents is the severity of the consequences. These are: the adoption of the avoidance coping strategy, the occurrence of offline bullying during the situation, the adoption of the self-control coping strategy, the variety of cyberbullying acts, the victim's level of self-blame, the victim's perception of the duration of the situation, and the frequency of cyberbullying victimization.