Repression: A Critical Assessment and Update of Freud's 1915 Paper.

The concept of repression has been relegated to the periphery in current psychoanalytic theorizing. This is in part due to a reflexive and ill-informed avoidance of Freudian metapsychology, and in part due to preoccupation with 'primitive' and 'deeper' states of mind, a perspective that presumes that repression operates exclusively in 'higher level' or 'neurotic' forms of psychopathology. A careful scrutiny of psychoanalytic theory and clinical practice does not uphold such compartmentalization. Repression is ubiquitous in mental life. It contributes to normality (e.g., onset of latency), undergirds the 'psychopathology of everyday life' (e.g., parapraxes), exists alongside splitting in severe character disorders (e.g., borderline patients "forgetting" their appointments) and, by permitting a modified return of exiled mental contents, gives birth to neurotic symptoms as well as creative imagination. Taking Freud's seminal discourse on repression (in: Repression. Standard Edition, vol 14. Hogarth, London, pp 141-158 1915a) as its starting point, this paper elucidates the complex, nuanced, and pervasive nature of this defense. It deconstructs Freud's unitary concept of repression into four implicit binaries and updates his proposals in the light of contemporary psychoanalytic theory. The paper offers clear guidelines for clinical applications of these ideas.

A STUDY OF ADAPTIVE REACTIONS OF THE CARDIORESPIRATORY SYSTEM IN PSYCHOEMOTIONAL STRESS CONDITIONS.

The article presents modern data on the physiological mechanisms study of the stress resistance development, which occurs in medical students in the dynamics of studying in higher educational institution in junior courses (1-3 courses). The adaptive reactions of the cardiorespiratory system in conditions of psychoemotional load were studied. Results showed that development of adaptation syndrome in those conditions greatly depends on speed of formation and intensity level of intersystem integration in cardiorespiratory system. That relation is revealed most of all on the background of physical activity (load on bicycle ergometer to the full). The variability of stages of adaptation development was found out. In first group of students the first stage of adaptive syndrome is characterized by activation of non-specific adaptive mechanisms (1st year of studies), that is naturally replaced by second stage - specific adaptive reactions, when the intellectual work capacity increases on the background of rationalization of its autonomic supply. In second group of students the second variant of adaptation development occurs - non-specific adaptive mechanisms (1st stage) on the 2nd year of study are changed by the stage of specific adaptation (2nd stage), that is accompanied by excessive psychophysiological indexes. On the 3rd year of study it leads to the depletion of adaptive capabilities (3rd stage). In third group of students the stage of activation of non-specific adaptive mechanisms was rapidly changed by their depletion, that was accompanied by decrease of intersystem integration and intellectual workability. Therefore, the formation of adaptive optimum occurs only in 40% of students. The majority (60%) of students-young women show either the initially insufficient adaptive capabilities, or excessive adaptation. Both insufficient and excessive adaptation naturally leads to psychological and autonomic disorders followed by appearance of psychosomatic neurotic manifestations. The prospects of future research from our point of view should lie in further investigation of gender peculiarities of adaptive reactions development up to psycho-emotional stress that develops in conditions of studying in university. That will make an opportunity to reveal the features of mechanisms of resistance formation depending on gender.

THE PSYCHO-PHYSIOLOGICAL STATUS IN CELIAC DISEASE.

Based on the results of a comprehensive study of 35 people aged from 19 to 52 years, among them 20 women and 15 men with celiac disease features of their physiological status were studied, reflecting the severity of the disease and quality of life. The diagnosis was based on the clinical and anamnestic data, endoscopy, histomorphological, immunological and genetic exams. Psychophysiological analysis showed that in celiac disease is characterized by the formation reactions with anxiety, anxiety-phobic, neurotic, affective, and hypochondriacal symptoms. The results of the study emphasized the importance of adaptive physiological capacity of the body to build tolerance to the development of psycho-vegetative, hypochondriacaldepressive and other disorders.

[HEALTH STATUS AND DEVELOPMENT OF CHILDREN BORN USING IVF].

In the work the analysis of incidence, the dynamics of physical development during the first year of life among 28 children born using IVF was conducted. It was found out that during the first year of life these children have certain patterns of growth and development, as well as a wide range of diagnosed pathology. Thereby observing children of this category should be optimized.

[Vasomotor Endothelial Function in Healthy Individuals: Contact Types of Character].

We studied the vascular endothelial vasomotor function in healthy young individuals, depending on the type of character accentuation, levels of neuroticism, depression and anxiety. It is shown that the types of character accentuation effect on endothelial vasomotor function in healthy men and women. Personality characteristics of a person can be a significant risk factor for disease, the pathogenesis of which is the starting element of endothelial vasomotor dysfunction.

[Neurosis and genetic theory of etiology and pathogenesis of ulcer disease].

Based on the analysis of literature data and our own research, we have developed the original concept of etiology and pathogenesis of peptic ulcer disease. An analysis of the literature shows that none of the theories of pathogenesis of peptic ulcer disease does not cover the full diversity of the involved functions and their shifts, which lead to the development of ulcers in the stomach and the duodenum. Our neurogenic-genetic theory of etiology and pathogenesis of gastric ulcer and duodenal ulcer very best explains the cause-and-effect relationships in the patient peptic ulcer, allowing options for predominance in one or the other case factors of neurosis or genetic factors. However, it is clear that the only other: combination of neurogenic factor with genetically modified reactivity of gastroduodenal system (the presence of the target organ) cause the chronicity of the sores. The theory of peptic ulcer disease related to psychosomatic pathologies allows us to develop effective schema therapy, including drugs with psychocorrective action. On the basis of our theory of the role of Helicobacter pylori infection is treated as a pathogenetic factor in the development of peptic ulcer disease.

Influence of personality on the relationship between gray matter volume and neuropsychiatric symptoms in multiple sclerosis.

OBJECTIVE: Research has revealed an association between personality traits and health outcomes, and in multiple sclerosis (MS), there are preliminary data showing a correlation between personality traits and brain volume. We examined the general hypothesis that personality influences the relationship between gray matter volume (GMV) and cognitive/neuropsychiatric MS features. METHODS: Participants were 98 patients with MS who underwent magnetic resonance imaging and were tested with the Symbol Digit Modalities Test and the Neuropsychiatric Inventory, the latter providing measures of depression and euphoria that can be characteristic of MS, that is, cheerful indifference and disinhibition. Personality traits were assessed with the NEO Five Factor Inventory. We examined the correlation between personality traits and both GMV and symptoms, and then modeled mediation and moderation influences on the relationships between GMV and cognitive/neuropsychiatric features. RESULTS: Linear regression modeling revealed that GMV (r = 0.54, p < .001) and NEO Five Factor Inventory low conscientiousness (r = 0.36, p = .001) were associated with cognitive function, but no mediator or moderator effects were observed. However, conscientiousness mediated the relationship between GMV and symptoms of euphoria (p = .002). The moderator analysis revealed a significant influence of high neuroticism on the GMV-euphoria relationship (p = .029). CONCLUSIONS: Low conscientiousness and high neuroticism are associated with neuropsychiatric complications in MS, and each influences the relationship between GMV and euphoria. The findings suggest that patients with low conscientiousness are at higher risk for MS-associated cognitive dysfunction and neuropsychiatric symptoms, a conclusion that has implications for the emerging role of personality in clinical neuroscience.

Neuroticism influences brain activity during the experience of visceral pain.

BACKGROUND & AIMS: One particularly important individual dynamic known to influence the experience of pain is neuroticism, of which little is known about in visceral pain research. Our aim was to study the relationship between neuroticism, psychophysiologic response, and brain processing of visceral pain. METHODS: Thirty-one healthy volunteers (15 male; age range, 22-38 years) participated in the study. The Eysenck Personality Questionnaire was used to assess neuroticism. Skin conductance level, pain ratings, and functional magnetic resonance imaging data were acquired during anticipation of pain and painful esophageal distention. The effect of neuroticism was assessed using correlation analysis. RESULTS: There was a wide spread of neuroticism scores (range, 0-22) but no influence of neuroticism on skin conductance level and pain tolerance or pain ratings. However, a positive correlation between brain activity and neuroticism during anticipation was found in regions associated with emotional and cognitive pain processing, including the parahippocampus, insula, thalamus, and anterior cingulate cortex. These regions showed a negative correlation with neuroticism during pain (P < .001). CONCLUSIONS: This study provides novel data suggesting higher neuroticism is associated with engagement of brain regions responsible for emotional and cognitive appraisal during anticipation of pain but reduced activity in these regions during pain. This may reflect a maladaptive mechanism in those with higher neuroticism that promotes overarousal during anticipation and avoidance coping during pain.

Gene by neuroticism interaction and cognitive function among older adults.

OBJECTIVES: Both apolipoprotein E (ApoE) ε-4 allele(s) and elevated trait neuroticism, the tendency to experience distress, are associated with cognitive function among older adults. We predicted that neuroticism moderates the association between ApoE and cognitive function and also explored whether other personality dimensions (openness to experience, agreeableness, extraversion, and conscientiousness) affect the association between ApoE status and cognitive function. METHOD: Five-hundred and ninety-seven older adults (mean age of 78 years) enrolled in the Ginkgo Evaluation of Memory study completed the NEO five-factor inventory of personality. Cognitive function was assessed via the cognitive portion of the Alzheimer's Disease Assessment Scale, and a blood sample for ApoE genotyping was drawn. RESULTS: As hypothesized, regression analysis indicated that neuroticism moderated the relationship between the presence of ApoE ε-4 and cognitive function. Individuals with high neuroticism scores had significantly lower scores on the cognitive portion of the Alzheimer's Disease Assessment Scale compared with individuals with low neuroticism scores, but this was true only among carriers of ApoE ε-4 (interaction effect ß = 0.124, p = 0.028). There was scant evidence that other personality dimensions moderate the association between ApoE ε-4 and cognitive function. CONCLUSIONS: Cognitive function may be affected by ApoE and neuroticism acting in tandem. Research on the underlying physiological mechanisms by which neuroticism amplifies the effect of ApoE ε-4 is warranted. The study of genotype by phenotype interactions provides an important and useful direction for the study of cognitive function among older adults and for the development of novel prevention programs.

Long-term cognitive complaint and post-concussive symptoms following mild traumatic brain injury: the role of cognitive and affective factors.

PRIMARY OBJECTIVE: To determine whether neuropsychological test performance or affective factors predict long-term post-concussive symptoms and cognitive complaint following mild traumatic brain injury. METHODS AND PROCEDURES: Participants included 21 individuals with mild traumatic brain injury, 19 individuals with spinal injury but no injury to the brain and 20 neurologically-normal controls. All participants completed measures of post-concussive symptoms, cognitive complaint, depression, anxiety, and personality and were administered a variety of neuropsychological tests. MAIN OUTCOMES AND RESULTS: The hypothesis that depression, anxiety and neuroticism would be better predictors of post-concussive symptoms than neuropsychological test performance for all three groups was supported. Contrary to expectations, however, neuropsychological test performance was a unique predictor of cognitive complaint for the mild traumatic brain injury group. CONCLUSIONS: It was concluded that long-term post-concussive symptoms are largely representative of psychological symptoms and not brain damage, but that genuine, albeit subtle, cognitive deficits also may be present for long-term periods following mild traumatic brain injury.

Emotional complexity and emotional well-being in older adults: risks of high neuroticism.

Older and midlife adults tend to report greater emotional complexity and greater emotional well-being than younger adults but there is variability in these factors across the lifespan. This study determined how the personality trait of neuroticism at baseline predicts emotional complexity and emotional well-being 10 years later; a goal was to determine if neuroticism is a stronger predictor of these emotion outcomes with increasing age in adulthood. Data were obtained from two waves of the MIDUS projects (N = 1503; aged 34-84). Greater neuroticism predicted less emotional complexity as indicated by associations between positive and negative affect, particularly for older participants. Neuroticism predicted lower emotional well-being and this association was stronger for older and midlife than for younger adults. Overall, high neuroticism may be a greater liability for poor emotion outcomes for older and perhaps for midlife adults than for younger persons. Clinical and theoretical implications of this conclusion are discussed.

[Fenibut and its citrate prevent psychoneurological disorders caused by chronic stress (paradoxical sleep deprivation)].

The antistress protective action of two structural analogs of GABA, fenibut and its salt with citric acid (fenibut citrate, citrocard, RGPU-147), has been studied using a model of chronic stress caused by seven-fold 24-h deprivation of paradoxical sleep phase at an interval of 24 h between the deprivations. It is established that fenibut and fenibut citrate produce a protective action by (i) reducing the intensity of emotional disorders in the open-field test and elevated plus maze test, (ii) decreasing cognitive disorders in the tests for conditioned avoidance response and extrapolatory deliverance; and (iii) limiting stress reaction due to a decrease in the intensity of adrenal hypertrophy, thymus involution, and stomach mucous membrane ulceration. Fenibut citrate surpasses fenibut in the intensity of antistress protective action.

[Peculiarities of clinical manifestations in children with the irritable bowel syndrome].

The article is devoted to the problem of clinical manifestation of irritated bowels syndrome among children. It is stated that the leading symptom of suffering - abdominal pian - is combined with the psychopathologic symptomatology such as various neurosis-like disorders, which should be taken into consideration while developing therapeutic measures among such patients.

Experiential, autonomic, and neural responses during threat anticipation vary as a function of threat intensity and neuroticism.

Anticipatory emotional responses play a crucial role in preparing individuals for impending challenges. They do this by triggering a coordinated set of changes in behavioral, autonomic, and neural response systems. In the present study, we examined the biobehavioral impact of varying levels of anticipatory anxiety, using a shock anticipation task in which unpredictable electric shocks were threatened and delivered to the wrist at variable intervals and intensities (safe, medium, strong). This permitted investigation of a dynamic range of anticipatory anxiety responses. In two studies, 95 and 51 healthy female participants, respectively, underwent this shock anticipation task while providing continuous ratings of anxiety experience and electrodermal responding (Study 1) and during fMRI BOLD neuroimaging (Study 2). Results indicated a step-wise pattern of responding in anxiety experience and electrodermal responses. Several brain regions showed robust responses to shock anticipation relative to safe trials, including the hypothalamus, periaqueductal gray, caudate, precentral gyrus, thalamus, insula, ventrolateral PFC, dorsomedial PFC, and ACC. A subset of these regions demonstrated a linear pattern of increased responding from safe to medium to strong trials, including the bilateral insula, ACC, and inferior frontal gyrus. These responses were modulated by individual differences in neuroticism, such that those high in neuroticism showed exaggerated anxiety experience across the entire task, and reduced brain activation from medium to strong trials in a subset of brain regions. These findings suggest that individual differences in neuroticism may influence sensitivity to anticipatory threat and provide new insights into the mechanism through which neuroticism may confer risk for developing anxiety disorders via dysregulated anticipatory responses.

Affected by smells? Environmental chemical responsivity predicts odor perception.

Strong negative reactions, physical symptoms, and behavioral disruptions due to environmental odors are common in the adult population. We investigated relationships among such environmental chemosensory responsivity (CR), personality traits, affective states, and odor perception. Study 1 showed that CR and neuroticism were positively correlated in a sample of young adults (n = 101), suggesting that persons high in neuroticism respond more negatively to environmental odors. Study 2 explored the relationships among CR, noise responsivity (NR), neuroticism, and odor perception (i.e., pleasantness and intensity) in a subset of participants (n = 40). High CR was associated with high NR. Regression analyses indicated that high CR predicted higher odor intensity ratings and low olfactory threshold (high sensitivity) predicted lower pleasantness ratings. However, neuroticism was not directly associated with odor ratings or thresholds. Overall, the results suggest that CR and odor thresholds predict perceptual ratings of odors and that high CR is associated with nonchemosensory affective traits.

Neuroticism mediates the relationship between childhood adversity and adult sleep quality.

This study investigated the relationship of childhood adversity and adult sleep quality in 327 college students (91 males), with a mean age of 18.9 years (SD = 2.1) and also examined whether neuroticism significantly mediated the observed association. Regression findings indicate that the relationship between childhood adversity and adult sleep quality is significant, and that there is a stronger association in men. Furthermore, a bootstrapping approach to testing the significance of the indirect effect (i.e., mediation) indicated that neuroticism mediated this relationship in both men and women. These data suggest that otherwise healthy young adults with a history of childhood adversity are at increased risk for sleep disturbance. Neuroticism may represent a potential target for change in future insomnia interventions, particularly in adults with a history of childhood adversity.

Neuroticism modulates amygdala-prefrontal connectivity in response to negative emotional facial expressions.

Neuroticism is associated with the experience of negative affect and the development of affective disorders. While evidence exists for a modulatory role of neuroticism on task induced brain activity, it is unknown how neuroticism affects brain connectivity, especially the crucial coupling between the amygdala and the prefrontal cortex. Here we investigate this relation between functional connectivity and personality in response to negative facial expressions. Sixty healthy control participants, from the Netherlands Study on Depression and Anxiety (NESDA), were scanned during an emotional faces gender decision task. Activity and functional amygdala connectivity (psycho-physiological interaction [PPI]) related to faces of negative emotional valence (angry, fearful and sad) was compared to neutral facial expressions, while neuroticism scores were entered as a regressor. Activity for fearful compared to neutral faces in the dorsomedial prefrontal (dmPFC) cortex was positively correlated with neuroticism scores. PPI analyses revealed that right amygdala-dmPFC connectivity for angry and fearful compared to neutral faces was positively correlated with neuroticism scores. In contrast, left amygdala-anterior cingulate cortex (ACC) connectivity for angry, fearful and sad compared to neutral faces was negatively related to neuroticism levels. DmPFC activity has frequently been associated with self-referential processing in social cognitive tasks. Our results therefore suggest that high neurotic participants display stronger self-referential processing in response to negative emotional faces. Second, in line with previous reports on ACC function, the negative correlation between amygdala-ACC connectivity and neuroticism scores might indicate that those high in neuroticism display diminished control function of the ACC over the amygdala. These connectivity patterns might be associated with vulnerability to developing affective disorders such as depression and anxiety.

Link between personality and cancer.

Personality refers to an individual's enduring and pervasive personal motivation, emotion, interpersonal style, attitudes and behavior that are stable over a long time after young adulthood. In relation to the cancer trajectory, three basic and one other personality traits have been studied with some frequency, namely neuroticism, extraversion, conscientiousness and optimism. The considerable stability of personality over time makes it a potential long-acting etiological factor for the development of cancer. However, the studies performed so far do not give much support to personality as a causative factor for cancer. Some studies of cancer survival have found significant associations between lower optimism and higher neuroticism with shorter survival. More mental distress and fatigue and poorer quality of life is significantly associated with higher neuroticism and lower optimism at cancer screening, diagnosis and primary treatment, short- and long-term follow-up and towards the end of life. Neuroticism is a strong predictor of post-traumatic stress disorder triggered by cancer as a life-threatening experience eventually leading to negative personality changes. To what extent cancer leads to positive personality changes (post-traumatic growth) is currently unsettled. Basic personality traits are strongly associated with lifestyle, which is considered an important etiological factor for the development of cancer. The methodological problems in the study of personality and cancer are considerable, and many research designs used so far may have been too simplistic. Studies of potential biomarkers for personality traits combined with inflammation markers of cellular carcinogenesis in longitudinal designs could be promising for the future. High neuroticism is important for the clinical management of cancer patients and should gain more attention from oncologists in the future.

Anxiety, neuroticism and oxidative stress: cross-sectional study in non-smoking college students.

AIMS: Oxidative stress has gained attention recently in psychiatric medicine and has been reported to be associated with various diseases. However, the psychosocial factors involved in oxidative stress are still not well understood. Thus, the aim of this study was to examine whether anxiety levels and neuroticism were associated with serum oxidative and anti-oxidative status in healthy college students. METHODS: Participants in this cross-sectional study were 54 non-smoking college students. Their serum oxidative status was determined by reactive oxygen metabolites (ROM) and the biological anti-oxidant potential. Anxiety levels and neuroticism were assessed using the State-Trait Anxiety Inventory and the NEO Five-Factor Inventory, respectively. RESULTS: Correlation analysis showed an association of increased ROM concentration with elevated anxiety levels (State, rho = 0.39, P = 0.046; Trait, rho = 0.44, P = 0.024) and the personality trait of neuroticism (rho = 0.47, P = 0.016) in female students. However, the ROM concentration in male students was not associated with the anxiety level or any personality trait. CONCLUSION: Although these findings suggest that neurotic and anxious female students tend to be exposed to oxidative stress, these linkages should be confirmed by multivariate analysis in future research.

Evaluating the interplay between spirituality, personality and stress.

Spirituality and the big five personality traits may be risk or protective factors for coping with stress. We hypothesized young adults who reported higher spirituality ratings would demonstrate lower sympathetic nervous system arousal and better emotional coping when exposed to a laboratory stressor compared to those who rated themselves lower in spirituality. We also compared spirituality groups on trait anger, neuroticism, conscientiousness, extraversion, agreeableness and openness to experience. Eighty participants completed trait-state anger, personality and spirituality questionnaires and were grouped into low, average and high spirituality. Participants' physiological responses were monitored before and during a stressful event. Significant differences were found between low, average and high spirituality groups' respiration rate and emotional response to the stressor. Significant differences were also found between spirituality groups in extraversion, agreeableness, conscientiousness, trait anger and neuroticism. Females reported higher levels of spirituality and conscientiousness than males.