Prevalence of pain flashbacks in posttraumatic stress disorder arising from exposure to multiple traumas or childhood traumatization.

BACKGROUND: Flashbacks are a form of multisensory memory that are experienced with a "happening in the present" quality. Pain flashbacks are a re-experiencing of pain felt at the time of a traumatic event. It is unclear how common pain flashbacks are. AIMS: The current study was designed primarily to assess the prevalence of pain flashbacks in a sample of patients with posttraumatic stress disorder (PTSD). METHODS: We assessed the prevalence of pain flashbacks over a period of 2 years in patients (n = 166) referred to a psychological trauma service in the UK. Patients underwent a clinical screen for PTSD and completed a self-report measure of pain flashbacks. RESULTS: Pain flashbacks were classified as present in 49% of a sample of complex trauma patients meeting criteria for PTSD. Pain flashbacks were positively associated with the extent of pain at the time of trauma. CONCLUSIONS: Pain re-experiencing in PTSD, and its relative absence in nonclinical populations, supports an account of memory in which perceptual details can be re-experienced when memories have been encoded under conditions of extreme stress. It may be possible to conceptualize some cases of unexplained pain as pain flashbacks or of having a trauma origin.

Contexte: Les flashbacks sont une forme de souvenir multisensoriel qui se manifeste en donnant l'impression de se dérouler dans le présent. Les flashbacks douleureux sont une reviviscence de la douleur ressentie au moment d'un évènement traumatique. On ne sait pas à quel point les flashbacks douleureux sont communs.But: La présente étude a été conçue principalement pour évaluer la prévalence des flashbacks douleureux au sein d'un échantillons de patients souffrant d'un trouble de stress post-traumatique (TSPT).Méthodes: Nous avons évalué la prévalence des flashbacks douleureux sur une période de deux ans chez des patients (n = 166) référés à un service spécialisé dans les traumstismes psychologiques en Grande-Bretagne. Les patients ont été soumis à un dépistage du TSPT et ont répondu à un questionnaire portant sur les flashbacks douleureux.Résultats: Les flashbacks douleureux étaient présents chez 49 % des participants d'un échantillon complexe de patients souffrant de traumatismes qui répondaient aux critères pour le TSPT. Une association positive a été observée entre les flashbacks douleureux et le degré de douleur ressenti au moment du traumatisme.Conclusions: La reviviscence de la douleur dans les cas de TSPT et son absence relative au sein de populations non cliniques semblent démontrer que les détails perceptuels d'un souvenir peuvent être revécus lorsqu'ils ont été encodés dans des conditions de stress extrême. Certains cas de douleur inexpliquée peuvent être considérés comme des flashbacks douleureux, ou comme ayant une origine traumatique.

LSD enhances suggestibility in healthy volunteers.

RATIONALE: Lysergic acid diethylamide (LSD) has a history of use as a psychotherapeutic aid in the treatment of mood disorders and addiction, and it was also explored as an enhancer of mind control. OBJECTIVES: The present study sought to test the effect of LSD on suggestibility in a modern research study. METHODS: Ten healthy volunteers were administered with intravenous (i.v.) LSD (40-80 µg) in a within-subject placebo-controlled design. Suggestibility and cued mental imagery were assessed using the Creative Imagination Scale (CIS) and a mental imagery test (MIT). CIS and MIT items were split into two versions (A and B), balanced for 'efficacy' (i.e. A ≈ B) and counterbalanced across conditions (i.e. 50 % completed version 'A' under LSD). The MIT and CIS were issued 110 and 140 min, respectively, post-infusion, corresponding with the peak drug effects. RESULTS: Volunteers gave significantly higher ratings for the CIS (p = 0.018), but not the MIT (p = 0.11), after LSD than placebo. The magnitude of suggestibility enhancement under LSD was positively correlated with trait conscientiousness measured at baseline (p = 0.0005). CONCLUSIONS: These results imply that the influence of suggestion is enhanced by LSD. Enhanced suggestibility under LSD may have implications for its use as an adjunct to psychotherapy, where suggestibility plays a major role. That cued imagery was unaffected by LSD implies that suggestions must be of a sufficient duration and level of detail to be enhanced by the drug. The results also imply that individuals with high trait conscientiousness are especially sensitive to the suggestibility-enhancing effects of LSD.

Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity. METHOD: Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores. RESULTS: Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus. CONCLUSION: The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream.

Enhancement of suggestibility and imaginative ability with nitrous oxide.

RATIONALE: Imaginative suggestibility, a trait closely related to hypnotic suggestibility, is modifiable under some circumstances. Nitrous oxide (laughing gas) is commonly used for sedation in dentistry and is reported to be more effective when combined with appropriate suggestions. OBJECTIVE: The aim of this study was to determine whether nitrous oxide inhalation alters imaginative suggestibility and imagery vividness. METHODS: Thirty participants were tested twice in a within-subjects design, once during inhalation of 25% nitrous oxide and once during inhalation of air plus oxygen. Before the study, participants' expectancies regarding the effects of nitrous oxide were assessed. Participants were blinded to drug administration. During each session, participants were verbally administered detailed measures of imagination and suggestibility: the Sheehan-Betts Quality of Mental Imagery scale and the Stanford Hypnotic Susceptibility Scale Form C, minus the hypnotic induction. RESULTS: Imaginative suggestibility and imaginative ability (imagery vividness) were both elevated in the nitrous oxide condition. This effect was unrelated to participants' expectations regarding the effects of the drug. CONCLUSIONS: Nitrous oxide increased imaginative suggestibility and imaginative ability. Possible explanations of these findings are discussed with respect to the effects of N-methyl-d-aspartate antagonists and to other pharmacological effects upon suggestibility and imagination.

Pain flashbacks following the July 7th 2005 London bombings.

Flashbacks in posttraumatic stress disorder (PTSD) are commonly experienced as visual, auditory, olfactory or tactile re-livings of a previously experienced traumatic event. We present the case report of one survivor of the July 7th 2005 London underground bombings who was diagnosed with PTSD and who experienced painful flashbacks. We present retrospective multidimensional measures of his pain using standardised instruments. The case provides further evidence that somatosensory re-experiencing of pain memories is possible. Findings are discussed with regards to memory for pain.

Report of the equine herpesvirus-1 Havermeyer Workshop, San Gimignano, Tuscany, June 2004.

Amongst the infectious diseases that threaten equine health, herpesviral infections remain a world wide cause of serious morbidity and mortality. Equine herpesvirus-1 infection is the most important pathogen, causing an array of disorders including epidemic respiratory disease abortion, neonatal foal death, myeloencephalopathy and chorioretinopathy. Despite intense scientific investigation, extensive use of vaccination, and established codes of practice for control of disease outbreaks, infection and disease remain common. While equine herpesvirus-1 infection remains a daunting challenge for immunoprophylaxis, many critical advances in equine immunology have resulted in studies of this virus, particularly related to MHC-restricted cytotoxicity in the horse. A workshop was convened in San Gimignano, Tuscany, Italy in June 2004, to bring together clinical and basic researchers in the field of equine herpesvirus-1 study to discuss the latest advances and future prospects for improving our understanding of these diseases, and equine immunity to herpesviral infection. This report highlights the new information that was the focus of this workshop, and is intended to summarize this material and identify the critical questions in the field.

A three-dimensional animation of the classical pathway of the complement cascade.

This paper describes the creation of a three-dimensional animation showing the classical pathway of the complement cascade, made in Studio Strata Pro Blitz (v1.75+) on the Macintosh computer. An analysis of two dimensional depictions of the process from the chapters of current textbooks of immunology revealed inconsistencies; animation was used to demonstrate how these difficulties can be overcome.

Time-of-flight Laue fiber diffraction studies of perdeuterated DNA.

The diffractometer SXD at the Rutherford Appleton Laboratory ISIS pulsed neutron source has been used to record high resolution time-of-flight Laue fiber diffraction data from DNA. These experiments, which are the first of their kind, were undertaken using fibers of DNA in the A conformation and prepared using deuterated DNA in order to minimise incoherent background scattering. These studies complement previous experiments on instrument D19 at the Institut Laue Langevin using monochromatic neutrons. Sample preparation involved drawing large numbers of these deuterated DNA fibers and mounting them in a parallel array. The strategy of data collection is discussed in terms of camera design, sample environment and data collection. The methods used to correct the recorded time-of-flight data and map it into the final reciprocal space fiber diffraction dataset are also discussed. Difference Fourier maps showing the distribution of water around A-DNA calculated on the basis of these data are compared with results obtained using data recorded from hydrogenated A-DNA on D19. Since the methods used for sample preparation, data collection and data processing are fundamentally different for the monochromatic and Laue techniques, the results of these experiments also afford a valuable opportunity to independently test the data reduction and analysis techniques used in the two methods.

Identification and comparative sequence analysis of a gene in equine herpesvirus 1 with homology to the herpes simplex virus glycoprotein D gene.

A homologue of the herpes simplex virus (HSV) glycoprotein D gene has been identified in the genome of equine herpesvirus-1 (EHV-1, equine abortion virus). An open reading frame in the middle of the short unique (US) region is capable of encoding a polypeptide of 402 amino acids that has 26% and 20% of its residues matching pseudorabies virus (PRV) gp50 and HSV-1 gD, respectively. Despite this low level of similarity, the positional identity of six cysteine residues and certain motifs, and the location of the EHV-1 gene, clearly define the EHV-1 polypeptide as one of a family of "gD-like" proteins. Two transcripts of 3.3-3.6 kb and 5.4-5.9 kb were identified, consistent with coterminal mRNAs for the EHV-1 gD gene and the adjacent upstream gene, respectively. Partial sequencing of other regions in US also revealed EHV-1 homologues of HSV-1 gE and gI genes, and a possible equivalent gene to PRV gX. By analogy with the ability of HSV-1 gD and PRV gp50 to induce strong anti-viral immune responses, the EHV-1 gD gene product is expected to be an excellent candidate for development as a vaccine antigen.

X-Y Exchange and the Coevolution of the X and Y Rdna Arrays in Drosophila melanogaster.

The nucleolus organizers on the X and Y chromosomes of Drosophila melanogaster are the sites of 200-250 tandemly repeated genes for ribosomal RNA. As there is no meiotic crossing over in male Drosophila, the X and Y chromosomal rDNA arrays should be evolutionarily independent, and therefore divergent. The rRNAs produced by X and Y are, however, very similar, if not identical. Molecular, genetic and cytological analyses of a series of X chromosome rDNA deletions (bb alleles) showed that they arose by unequal exchange through the nucleolus organizers of the X and Y chromosomes. Three separate exchange events generated compound X.Y( L) chromosomes carrying mainly Y-specific rDNA. This led to the hypothesis that X-Y exchange is responsible for the coevolution of X and Y chromosomal rDNA. We have tested and confirmed several of the predictions of this hypothesis: First, X. Y(L) chromosomes must be found in wild populations. We have found such a chromosome. Second, the X.Y(L) chromosome must lose the Y(L) arm, and/or be at a selective disadvantage to normal X(+) chromosomes, to retain the normal morphology of the X chromosome. Six of seventeen sublines founded from homozygous X.Y(L)bb stocks have become fixed for chromosomes with spontaneous loss of part or all of the appended Y(L). Third, rDNA variants on the X chromosome are expected to be clustered within the X(+) nucleolus organizer, recently donated (" Y") forms being proximal, and X-specific forms distal. We present evidence for clustering of rRNA genes containing Type 1 insertions. Consequently, X-Y exchange is probably responsible for the coevolution of X and Y rDNA arrays.

Content analysis of brief psychotherapy sessions.

In studying the process of psychotherapy, detailed and reliable methods of describing the components are required. Such a method for content analysis of brief psychotherapy sessions is described. It is comprehensive and has satisfactory inter-rater reliability. It proved to have predictive validity in that it identified characteristics of the treatment approach, and most of the changes in therapeutic activity during the course of treatment, that had been predicted beforehand. In addition, similar patterns in the use of therapeutic strategies were found for therapists from different professional backgrounds trained in the same treatment approach. This method of analysis is recommended for future studies of content of psychotherapeutic treatments, including investigations of the relationship between content of treatment and outcome.

The work of the psychiatrist in a rehabilitation hospital.

Over an 18 month period, 49 patients in a physical rehabilitation hospital were referred to an attached psychiatrist. Formal psychiatric disorder was uncommon, and the mood changes and behaviour disturbances observed often resulted from a poor adjustment to recent physical disability by patients or their families. The most important role of the psychiatrist in management was in helping rehabilitation staff use their own skills to deal effectively with the inevitable emotional disturbances which occur in this setting.

Stromal pigments and taxonomy of Hypoxylon.

Stromal pigments extracted with ethyl acetate from a variety of Hypoxylon species were examined by thin-layer chromatography and the results are discussed in relation to the taxonomy of the genus. Most species exhibited constant and characteristic pigment band patterns which in some cases proved to be useful in identification.