Mental illness self-disclosure among college students: a pre-requisite of social support or a booster of social support benefits?

BACKGROUND: Self-disclosing a concealable stigmatized identity (CSI) such as mental illness is generally associated with enhanced psychological well-being. Research also supports the link between social support and psychological well-being. Yet, few theoretical explanations exist for the role that mental illness disclosure plays in the association between social support PWB. AIMS: To test two competing models linking self-disclosure to psychological well-being: a mediator model in which self-disclosure indirectly contributes to psychological well-being via social support quality (i.e., self-disclosure is a pre-requisite of social support), and a moderator model in which self-disclosure enhances social support benefits (i.e., self-disclosure is a "booster" of social support benefits). METHOD: College students (N = 174) who identified as being diagnosed with a mental illness completed an online survey. RESULTS: Structural equation modeling results largely supported both the mediator and the moderator models; however, which model statistically outperformed the other depended on the confidant (e.g., mother, friends). CONCLUSIONS: These findings suggest the validity of conceptualizing social support as both pre-requisite of social support and the "booster" of social support benefit on psychological well-being.

Pyrrolinone derivatives as a new class of P2X3 receptor antagonists. Part 3: Structure-activity relationships of pyrropyrazolone derivatives.

The P2X3 receptor is an attractive target for the treatment of pain and chronic coughing, and thus P2X3 antagonists have been developed as new therapeutic drugs. We previously reported selective P2X3 receptor antagonists by derivatization of hit compound 1. As a result, we identified hit compound 3, the structure of which was similar to hit compound 1. On the basis of SAR studies of hit compound 1, we modified hit compound 3 and compound 42 was identified as having analgesic efficacy by oral administration.

Pyrrolinone derivatives as a new class of P2X3 receptor antagonists Part 2: Discovery of orally bioavailable compounds.

Some P2X3 receptor antagonists have been developed as new therapeutic drugs for pain. We discovered a novel chemotype of P2X3 receptor antagonists with a pyrrolinone skeleton. Because of SAR studies to improve bioavailability of lead compound 2, compound (R)-24 was identified, which showed an analgesic effect against neuropathic pain by oral administration. We constructed a human P2X3 homology model as a template for the zebrafish P2X4 receptor, which agreed with SAR studies of pyrrolinone derivatives.

Mediating Role of Social Competence: Family Communication and Body Satisfaction among Male College Students.

This study examined whether social competence mediates the association between family communication and undergraduate males' body satisfaction. Male undergraduate students (N = 442) completed an online survey assessing their perceptions of mothers' as well as fathers' family communication patterns (FCPs), social competence, and body satisfaction. Results generally supported the hypothesized model. Conversation orientation, regardless of whether mothers' or fathers', was positively associated with social competence, which, in turn, was positively related to body satisfaction. On the other hand, the role of conformity orientation in predicting males' body satisfaction varied by parental sex (mothers or fathers): Mothers' conformity orientation was associated with body satisfaction through social competence in an expected manner, whereas fathers' conformity orientation was related to none of the endogenous variables. However, once mothers' FCPs were eliminated from the model, fathers' conformity orientation became a direct as well as indirect predictor of sons' body satisfaction through social competence. Interpretations of the findings, practical implications, and a future direction are discussed.

Loss of cellular cohesion in cytology composes a special subgroup of breast tumors - analysis of 37 cases.

OBJECTIVE: We analyzed smears by fine needle aspiration (FNA) from 37 cases that displayed numerous dissociated cells and correlated the results with histological findings. STUDY DESIGN: Between 1996 and 2005, 1,583 patients underwent breast FNA and resection. Loss of cellular cohesion was observed in 37 of these cases. RESULTS: From the cytological findings, we classified cases into 3 groups according to cell size and shape. Type A: numerous isolated spindle cells with a necrotic background. Four cases were classified into this group (3 cases of intraductal papilloma and 1 case of adenomyoepithelioma). Type B: lymphocytes and large isolated cells such as medullary carcinoma. Five cases were classified into this group [1 case of classic medullary carcinoma, 1 case of ductal carcinoma in situ (DCIS) and 3 cases of invasive carcinoma of no special type (NST)]. Type C: numerous uniform small round cells. Twenty-eight cases were classified into this group (2 cases of lobular carcinoma, 1 case of DCIS, 22 cases of invasive carcinoma NST, and 3 cases of solid papillary carcinoma). CONCLUSION: Numerous isolated cells are sometimes seen in both benign and malignant cytology.

Distinct histopathological features of Hashimoto's thyroiditis with respect to IgG4-related disease.

A form of Hashimoto's thyroiditis with lymphoplasmacytic sclerosing changes and increased numbers of IgG4-positive plasma cells has recently been reported in the literature. These histopathological features suggest that this subtype of Hashimoto's thyroiditis may be closely related to IgG4-related disease. Therefore, this unique form of IgG4-related Hashimoto's thyroiditis, which is referred to as IgG4 thyroiditis, has its own clinical, serological, and sonographic features that are distinct from those associated with non-IgG4 thyroiditis. IgG4 thyroiditis shares similarities with the well-known fibrous variant of Hashimoto's thyroiditis; however, the detailed histopathological features of IgG4 thyroiditis have not been well established. Based on immunostaining results, 105 patients with Hashimoto's thyroiditis were divided into an IgG4 thyroiditis group (n=28) and a non-IgG4 thyroiditis group (n=77). As in our previous reports, IgG4 thyroiditis was associated with a patient population of a younger age, a lower female-to-male ratio, rapid progression, higher levels of thyroid autoantibodies, subclinical hypothyroidism, and diffuse sonographic echogenicity. Histopathologically, this group revealed severe lymphoplasmacytic infiltration, dense stromal fibrosis, marked follicular cell degeneration, numerous micro-follicles, and notable giant cell/histiocyte infiltration. Importantly, the IgG4-related group did not completely overlap with fibrous variant of Hashimoto's thyroiditis. Four cases (14%) in the IgG4 thyroiditis group presented only mild fibrosis in the stroma, whereas 29 cases (38%) in the non-IgG4 thyroiditis group met the diagnostic criteria for fibrous variant of Hashimoto's thyroiditis. Furthermore, we observed three patterns of stromal fibrosis in Hashimoto's thyroiditis: interfollicular fibrosis, interlobular fibrosis, and scar fibrosis. The IgG4 thyroiditis group was significantly associated with the presence of predominant interfollicular fibrosis. In conclusion, IgG4 Hashimoto's thyroiditis presents histopathological features quite distinct from its non-IgG4 counterpart.

IgG4-related disease of the thyroid glands.

Recent reports on Hashimoto's thyroiditis (HT) with increased numbers of IgG4-positive plasma cells suggest that this type of HT may have a close relationship to IgG4-related disease (IgG4-RD). This unique subgroup of HT is termed as IgG4 thyroiditis and reveals distinct clinical, serological, and sonographic features from the non-IgG4 thyroiditis group. On the basis of immunostaining for IgG4, HT was divided into an IgG4 thyroiditis group and a non-IgG4 thyroiditis group. Clinically, IgG4 thyroiditis was associated with younger age group, lower female-male ratio, higher levels of thyroid autoantibodies, diffuse low echogenicity, more rapid progress requiring surgical treatment and more subclinical hypothyroidism. Serum IgG4 concentrations elevated in IgG4 thyroiditis and decreased significantly after a thyroidectomy. Histopathologically, IgG4 thyroiditis showed a higher grade of stromal fibrosis, lymphoplasmacytic infiltration, and follicular cell degeneration than non-IgG4 thyroiditis. IgG4 thyroiditis may represent IgG4-RD of thyroid gland, because it shares common histopathological characteristics with IgG4-RD in other organs. The identification of IgG4-RD of the thyroid gland opens new insights not only for patient's treatment with HT but also for the development of new therapeutic approaches for this rapidly progressive destructive subtype of HT. This article mainly focuses on reviewing the unique histopathological, clinical, and serological features of IgG4 thyroiditis group of HT. The etiology and genetic changes of HT are also discussed.

Cytological features of well-differentiated tumors of uncertain malignant potential: Indeterminate cytology and WDT-UMP.

The purpose of this study was to clarify the cytopathological features of well-differentiated tumors of uncertain malignant potential (WDT-UMP), a possible borderline lesion of thyroid follicular cell tumor. We analysed the cytopathological findings of fine needle aspiration (FNA) smears from 6 cases histologically diagnosed as WDT-UMP. WDT-UMP, benign and malignant lesions were compared retrospectively and morphologically. No (0%) nuclear pseudoinclusions were found in adenomatous goiter (AG), follicular adenoma (FTA) and WDT-UMP. Nuclear pseudoinclusions were increased in number in papillary thyroid carcinoma (PTC) with indeterminate cytology (0.8%) and PTC with malignant cytology (1.2%). The incidence of nuclear grooves increased gradually from AG/FTA (0%), WDT-UMP (4.5%), PTC with indeterminate cytology (6.2%) and PTC with malignant cytology (6.5%). The nuclear area of WDT-UMP, an average of 40.0 µm(2), was between that for benign AG/FTA and PTC with malignant cytology. The maximum/minimum axis of WDT-UMP (0.934) lied between that of AG/FTA and PTC. The degree of the nuclear circularity of WDT-UMP was less than that for PTC. WDT-UMP belong to indeterminate category between PTC and follicular adenoma morphologically, and this is one of the major reasons why some of PTC can be found in the indeterminate category. Questionable PTC-N including questionable nucler inclusions (artifact vacuole) may be seen in WDT-UMP, but absolute or definite nuclear inclusions with sharp border are not found in our 6 cases. Therefore this group of thyroid tumors (EnFVPTC and WDT-UMP) may be found in indeterminate category more often, because of intermediate nuclear morphology and incomplete nuclear vacuoles.

College students' mental illness disclosure and self-esteem: a moderating role of self-image goals.

Objective: A link between the disclosure of a concealable stigma such as mental illness and enhanced psychological well-being tends to be weak and sometimes non-significant, pointing to the importance of examining potential moderators. This study aims to examine how self-image goals moderate the effect of mental illness disclosure on self-esteem. Participants and Methods: College students who self-identified as having been diagnosed with mental illness (N = 174) completed an online survey regarding their mental illness disclosure, self-image goals, and self-esteem. Results: Self-image goals and mental illness disclosure interacted to predict self-esteem such that the positive association between disclosure and self-esteem was significant only among those who had low self-image goals (i.e., not overly focused on protecting idealized self-image). Conclusions: The relationship between mental illness disclosure and self-esteem is dependent on students' self-image goals. Goal-setting may be a promising target for future intervention programs for students living with mental illness.

The roles of mental illness disclosure and disclosure strategies on well-being among college students.

ObjectivesTo examine how the degree of mental illness disclosure and disclosure strategies are associated with psychological and physical well-being among college students. Participants: Participants were 181 undergraduate students from two American universities who self-identified as having been diagnosed with mental illness. Method: Participants completed an online survey, which included measures of mental illness disclosure and a range of outcome measures (e.g., life satisfaction, self-report somatic complaints). Results: The degree of mental illness disclosure was positively related to well-being outcomes. After controlling for the effect of the degree of self-disclosure, a direct disclosure strategy was positively associated with well-being outcomes, whereas disclosure strategies involving entrapment, humor, and indirect medium were related to poorer well-being outcomes. Conclusions: Results suggest that the degree of mental illness disclosure and the manner in which individuals disclose their mental illness to others may have implications to the well-being of individuals living with mental illness.

Encapsulated follicular thyroid tumor with equivocal nuclear changes, so-called well-differentiated tumor of uncertain malignant potential: a morphological, immunohistochemical, and molecular appraisal.

There is a continuous debate regarding the classification of thyroid follicular lesions and the term "well-differentiated tumor of uncertain malignant potential (WDT-UMP)" was recently introduced to cover this problematic spectrum of tumors. The objective of this study was to reappraise WDT-UMP using morphological, immunochemical, and molecular analysis and to shed more light on encapsulated thyroid follicular-patterned tumors. A total of 30 cases of WDT-UMP with equivocal papillary thyroid carcinoma-type nuclear changes (PTC-N) or focal unequivocal PTC-N were examined. As a control, follicular adenoma (n = 29), follicular carcinoma (n = 8), hyalinizing trabecular adenoma (n = 5), and PTC (n = 48) were included. HBME-1, cytokeratin 19, and galectin-3 were positive in 12 (40.0%), 10 (33.3%) and 11 (36.7%) cases of WDT-UMP, respectively. According to the positivity of those markers, significant differences were obtained between WDT-UMP and PTC encapsulated common type (P = 0.028, 0.010, and 0.004, respectively), infiltrative follicular variant (P = 0.020, 0.026, and 0.008, respectively), and infiltrative common type (P = 0.004, 0.001, and 0.005, respectively), but not between WDT-UMP and follicular adenoma or follicular carcinoma. BRAF(V600E) mutation was absent but RET/PTC1 rearrangement was found in only two (6.7%) cases of WDT-UMP. None of the 20 patients with WDT-UMP developed recurrence, with an average follow-up of 80 months. These findings indicate that WDT-UMP has a favorable outcome and is distinct from PTC in morphological, immunohistochemical, and molecular characteristics. We propose that WDT-UMP should be classified as "well-differentiated tumor with uncertain behavior".

Squamous cell components in a thyroid follicular adenoma: significant evidence of follicular cell origin by histomorphological, immunohistochemical and molecular analyses.

Squamous cells in the thyroid appear in a variety of conditions, including adenomatous goiters, malignant neoplasms, inflammatory diseases, and embryonic remnants. However the origin of the squamous cells is still under dispute. Here we report a case of an encapsulated follicular cell tumor consisting of follicular cells, basaloid squamous cells, and morphologically intermediate cells. The patient was a 66-year-old man presenting with a progressively enlarged painless lump in the right side of his neck. A solid tumor with encapsulation in the right lobe was confirmed by simple right lobe thyroid lobectomy. This tumor demonstrated heterogeneous immunoreactions for Ki-67, thyroglobulin, thyroid transcription factor-1, and pan-cytokeratin (AE1/AE3), in that the intermediate cells had intermediate immunoreactivity between follicular and basaloid squamous cells. p63 was positive in the periphery layer of tumor cell nests of the intermediate and squamous cells. A completely negative immunoreaction was noted for high molecular weight cytokeratin (34ßE12), calcitonin, CEA, p53, CD5, and rearranged in transformation (RET). Mutational analysis of BRAF and RAS were negative. These results strongly suggest that this tumor is a follicular adenoma, and that the squamous component originated from follicular cells undergoing squamous metaplasia. The patient has been disease free more than 40 months after surgery.

Role of parental confirmation in body dissatisfaction and body change behaviors among college men.

OBJECTIVE: To examine how the components of confirmation (i.e., acceptance and challenge) from mother and father have an indirect effect on college men's body dissatisfaction through self-concept, and if body dissatisfaction, in turn, is related to body change behaviors. Participants: College men (N = 237) aged 18-25 from two large universities completed an online survey. Methods: Structural equation modeling was conducted to test hypothesized mediation model. Results: Maternal acceptance had negative indirect effects on body dissatisfaction through self-concept, and body dissatisfaction, in turn, was positively related to body change behaviors. Mother challenge emerged as a near-significant direct and positive predictor of muscularity enhancement behaviors. None of the paternal variables significantly contributed to the model. Conclusions: Mother acceptance may contribute to sons' positive view of self and their appearance, potentially reducing the likelihood of their engagement in body change behaviors. Intervention can target parent-child communication and enhancement of college men's self-concept.

Are one's attachment avoidance toward a particular person and his/her placement of this particular person in the attachment hierarchy inversely overlapping? Four bifactor-analysis studies.

Do one's hierarchical preference for attachment support from a particular person over other people (attachment hierarchy) and his/her discomfort with closeness and uneasiness about being dependent on that particular person (attachment avoidance) inversely overlap? These two constructs have been distinctly conceptualized. Attachment hierarchy has been regarded as a normative characteristic of attachment relationships, while attachment avoidance has been considered to reflect an individual difference of relationship quality. Employing bifactor analyses, we demonstrated a unidimensional general factor of these two concepts in four studies exploring Czech young adults' relationships with mother, father, friends, and romantic partner (Study 1); U.S. young adults' relationships with a romantic partner (Study 2); Czech adolescents' relationships with mother, father, and friends (Study 3); and Japanese young adults' relationships with mother, father, and romantic partner (Study 4). These convergent results provide the replicable and generalizable evidence that one's attachment avoidance toward a particular person and her/his placement of that particular person in the attachment hierarchy are inversely overlapping.

Non-solid type thyroid carcinoma: a case report of moderately differentiated adenocarcinoma of the thyroid.

We report the case of a common type papillary thyroid carcinoma (PTC) patient who developed early recurrence and persistent disease even after ablation therapy. The patient was an 80-year-old man that was incidentally found to have a mass lesion in the left lower lobe of his thyroid. A total thyroidectomy and a left side modified radical neck dissection were performed; histological examination revealed a common type PTC. The patient underwent lymph node dissection twice for recurrence and (131)I-Na ablations for fluctuated elevation of serum thyroglobulin. The resected tumor and recurrence in lymph nodes revealed non-solid type papillary carcinoma with mixed features of less well-differentiated morphology, which we suggest included loss of cellular polarity/cohesiveness, tall cells and columnar cells. Immunohistochemistry revealed high a MIB-1 labeling index (15-20%) in both the primary tumor and the metastatic tumor in the lymph nodes. p53 immunoreaction was found positive at very low level (<5%). E-cadherin was faintly positive in a few cells of the primary tumor and negative in the metastatic site. We recently proposed a new classification for follicular cell tumors of the thyroid gland, and this case is an example of moderately-differentiated adenocarcinoma according to our classification.

Survival impact of psammoma body, stromal calcification, and bone formation in papillary thyroid carcinoma.

The presence of calcification is the most significant ultrasonographic finding in evaluating thyroid nodules. Calcifications are more frequently detected in papillary thyroid carcinoma than in other thyroid lesions. However, the clinical significance of calcification, including clinical correlations and impact on survival, and the molecular mechanism responsible for calcification in papillary thyroid carcinoma remain uncertain. We performed a retrospective study of patients with primary common-type papillary thyroid carcinoma to determine the clinical correlations of calcification and its impact on survival. Histologically, calcification was classified as either psammoma bodies, stromal calcification, or bone formation. They were identified in 25, 47, and 13% of all 229 cases of papillary thyroid carcinoma, respectively. The presence of psammoma bodies was significantly correlated with gross lymph node metastasis and stage grouping. Both stromal calcification and bone formation were significantly correlated with patient age. In addition, stromal calcification was associated with pT classification and gross lymph node metastasis. Papillary thyroid carcinoma with, compared to that without, psammoma bodies was associated with poorer disease-free survival. We examined the quantitative expression of BMP-1, a metalloproteinase that is reported to be involved in bone and extracellular matrix formations, and found that its expression was significantly higher in tumors with psammoma bodies or with stromal calcification (P=0.0464 and 0.0272, respectively). These results suggest that the presence of psammoma bodies is a useful predictor of outcome for patients suffering from papillary thyroid carcinoma.

Microwave cell death: molecular analysis using DNA electrophoresis, PCR amplification and TUNEL.

Microwave cell death (MCD) is unique in that microscopic morphology and antigenicity are well preserved, while enzymatic activity is lost. The aim of the present study was to carry out DNA electrophoresis, polymerase chain reaction (PCR) amplification and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) examination of MCD. DNA electrophoresis indicated only a thick band of large DNA immediately after microwave treatment, which became a smear 6 h later and indicated a delayed type of DNA degradation over 2 weeks. Neither a DNA smear characteristic of oncosis nor DNA ladder patterns characteristic of apoptosis were found in MCD. PCR of p53 in MCD showed a single band at the same level of control of non-microwave treated cells. MCD was negatively stained on TUNEL. These results provide further evidence that MCD is distinct from oncosis and apoptosis, in addition to showing unique morphological and antigenic preservation and enzymatic inactivation.

Immunohistochemistry of IgG4 can help subclassify Hashimoto's autoimmune thyroiditis.

IgG4-related sclerosing disease has been recently recognized as a systemic disease entity characterized by an elevated serum IgG4 level, sclerosing fibrosis and diffuse lymphoplasmacytic infiltration by many IgG4-positive plasma cells. Similar histopathological features have often been noted in the fibrous variant of Hashimoto's autoimmune thyroiditis, but thyroid gland involvement has been only briefly mentioned with regard to IgG4, and no immunohistochemistry for IgG4 has been reported in Hashimoto's autoimmune thyroiditis. Herein, the purpose of the present study was to investigate the infiltration of IgG- and IgG4-positive plasma cells on immunohistochemistry for a panel of thyroiditis samples (Hashimoto's autoimmune thyroiditis, n= 13; subacute thyroiditis, n= 2; lymphocytic thyroiditis, n= 2). Cases of Hashimoto's thyroiditis could be classified into two groups based on immunostaining of IgG4: IgG4 thyroiditis (IgG4-related, IgG4-positive plasma cell-rich thyroiditis) and non-IgG4 thyroiditis (non-IgG4-related, IgG4-positive plasma cell-poor thyroiditis). IgG4 thyroiditis presents with severe lymphoplasmacytic infiltration, dense fibrosis, marked follicular cell degeneration, oxyphilic change and lymphoid follicle formation, while non-IgG4 thyroiditis presents with relatively mild or absent histopathological characteristics. In conclusion, immunostaining of IgG4 can help subclassify Hashimoto's thyroiditis; and IgG4 thyroiditis may have a close relationship with IgG4-related sclerosing disease.

Adrenomedullin, Bcl-2 and microvessel density in normal, hyperplastic and neoplastic endometrium.

Adrenomedullin (ADM) is a multifunctional 52-amino acid peptide involved in numerous physiological and pathological processes, including angiogenesis, growth regulation, differentiation, and vasodilation. ADM is thought to act through the G protein-coupled receptor calcitonin receptor-like receptor, with specificity being conferred by receptor-associated modifying protein 2. The aim of the present study was to clarify the roles of ADM status, and tumor vessels in endometrium. Specimens were examined for ADM, microvessel density (MVD), area of venules (AV) and Bcl-2 oncoprotein using an immunoperoxidase method. The difference of ADM between normal proliferative phase and hyperplasia without atypia was significant (P < 0.05). The level of Bcl-2 was significantly different between hyperplasia without atypia and hyperplasia with atypia (P < 0.05). ADM, MVD and AV in the endometrium increased in a stepwise manner from normal, simple or complex hyperplasia with or without atypia to grade 1 adenocarcinoma. In contrast, expression of Bcl-2 oncoprotein was decreased. These parameters identify the role of ADM expression and Bcl-2 protein in relation to cell growth and vasodilating in the neoplastic changes.

Muscle Talk Online and Impression Formation Based on Body Type: Comparisons Between Asian American and Caucasian American Males.

This study aimed to investigate how individuals form impressions about the self-esteem and life satisfaction of a male who engages in muscle talk on Facebook. The study examined (a) how a target's body build and peer-generated comments influence observers' impression of him, and (b) how such influences might be moderated by the cultural backgrounds of observers (Asian Americans and European Americans). A mock-up Facebook profile page was created in which two factors were manipulated: the target's body build (muscular, average, and overweight) and peer-generated messages (muscle encouraging and muscle discouraging), creating six different conditions. Male college students ( N = 508) were randomly assigned to one of the conditions. After viewing a mock-up Facebook page online, participants completed an online questionnaire assessing their impressions of the target's self-esteem and life satisfaction. Results showed that a muscular target was perceived as possessing higher levels of self-esteem and life satisfaction. Observers rated the target as having higher self-esteem when the target received muscle-encouraging messages than when the target received muscle-discouraging messages. No cultural differences were identified. Findings suggest the existence of weight bias when forming psychological impressions of others online. Findings also confirmed the important role of peer-generated messages in the impression formation process online.