Regulation of protein function by glycosaminoglycans--as exemplified by chemokines.

Immune modulators such as cytokines and growth factors exert their biological activity through high-affinity interactions with cell-surface receptors, thereby activating specific signaling pathways. However, many of these molecules also participate in low-affinity interactions with another class of molecules, referred to as proteoglycans. Proteoglycans consist of a protein core to which glycosaminoglycan (GAG) chains are attached. The GAGs are long, linear, sulfated, and highly charged heterogeneous polysaccharides that are expressed throughout the body in different forms, depending on the developmental or pathological state of the organ/organism. They participate in many biological functions, including organogenesis and growth control, cell adhesion, signaling, inflammation, tumorigenesis, and interactions with pathogens. Recently, it was demonstrated that certain chemokines require interactions with GAGs for their in vivo function. The GAG interaction is thought to provide a mechanism for retaining chemokines on cell surfaces, facilitating the formation of chemokine gradients. These gradients serve as directional cues to guide the migration of the appropriate cells in the context of their inflammatory, developmental, and homeostatic functions. In this review, we discuss GAGs and their interaction with proteins, with a special emphasis on the chemokine system.

Contraindications and dangers of psychotherapy.

Psychotherapy, like any other effective treatment in medicine, may lead to negative effects either in the patient or those around him. The source of these unwanted effects may be in the patient's or the therapist's personality, in the patient-therapist interaction, in faulty therapy technique or in the patient's unresolvable social situation. The possibility of negative effects should be anticipated during the descriptive and psychodynamic assessment of the patient and before establishing the therapeutic contract. The technique of a trial of psychotherapy should be more frequently used than it is in cases where the therapist is in doubt. If negative effects do develop, these should be minimized by decreasing the frequency of psychotherapy sessions and depth of exploration. This may be done by allowing greater therapist "transparency", by making fewer psychodynamic interpretations and by altering the focus of therapy from problems of early development to problems of current living.

Communication and abnormal behaviour.

In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

Male homosexuality: perversion, deviation or variant?

Male homosexuality has complex determinants: biological, psychological, social, cultural and situational factors may be relevant, either inhibiting hetereosexuality or leading towards homosexuality. Environmental factors seem paramount, particularly significant early relationships, usually within the family. Especially implicated are the personalities and interaction of the parents, recent interest being especially in the father's role. Also relevant is the family as a complex social system and the modes of communication within it, both verbal and non-verbal. Social research and sociopolitical pressures have helped to liberalize attitudes to homosexually 'deviant' behaviour but have not added significantly to its understanding. Many factors are involved in determining whether homosexual men seek therapy and reach a particular therapist. These factors relate to the patient's and therapist's personalities; to different therapeutic philosophies and therapeutic goals; and to the formal and informal referral networks in society.

Personality correlates of study difficulty and academic performance in university students. I. The Middlesex Hospital Questionnaire and Dynamic Personality Inventory.

The personality correlates of study difficulty and academic performance in university students have been measured in terms of psychiatric symptomatology and premorbid characteristics. The UCLSQ, MHQ and DPI were administered to two groups of male and female students presenting at an health centre: one (n = 72) of patients seeking psychological help, the other (n = 73) a control group. Significant differences between the two groups were formed on the MHQ, confirming previous results; and these were supplemented by differences on the DPI. Motivational and psychoneurotic components of study difficulty were significantly related to MHQ scores in both groups. DPI scores were more closely related to study difficulty in the patients than controls; and served particularly to characterize their sylbism and work satisfaction. The DPI added to the picture of a subgroup of students observed both in an earlier and the present study: academically successful patients scoring high on phobic anxiety.

Personality correlates of study difficulty and academic performance in university students. II. Conscience and self-esteem.

Scales measuring self-esteem and conscience have been included in a further study of work-related symptoms in students. Two groups were tested: a group of patients attending the UCL Student Health Centre for psychological reasons, and a group of normal controls. Conscience and self-esteem were inversely related to one another. Both tests were reliable and differentiated between the groups. The patients tend to have low self-esteem, high conscience, and to score higher than controls both on neurotic symptoms as such as measured by a personality inventory (MHQ) and as assessed on work-related symptoms measured by our study difficulty questionnaire (UCLSQ). In terms of academic performance, an interesting subgroup of students was delineated who are rated highly by their tutors but who appear subjectively troubled with phobic anxiety, low self-esteem and a harsh conscience structure. The conscience and self-esteem scales, in view of their brevity, acceptable reliability, and in terms of the relationships discussed in this paper, will be retained for further research.

Further observation on study difficulty in university students including 'syllabus-boundess'.

The UCLS questionnaire, in a form modified to include a measure of syllabus-boundness, and a questionnaire to measure psychiatric symptomatology (the MHQ) were administered to two groups of students, one seeking help for emotional problems, the other a control group. Groups were compared on tests, test findings were inter-correlated, and scores were related to academic success. The UCLSQ is confirmed as a reliable research instrument. Principal component analysis again indicates a separation of psychoneurotic and motivational components of study difficulty. Syllabus-boundness ('Sylbism') emerges as a relatively independent trait, with a significant negative relationship to work satisfaction in both groups. MHQ scores again show a positive correlation between phobic anxiety and academic attainment for patients.