Clinical judgment and affective disorders.

Addresses 3 limitations of previous work on counselor clinical judgment by the 1st author et al (see record 1983-11141-001) and R. F. Haase et al (see record 1983-26503-001). Results of the study of 20 practicing counselors suggest that the judgment process used by experienced counselors to make diagnoses of affective disorders differs depending on the type of diagnostic judgment and that attributions may play a role in at least certain types of judgments. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mechanisms linking employee affective delivery and customer behavioral intentions.

Past empirical evidence has indicated that employee affective delivery can influence customer reactions (e.g., customer satisfaction, service quality evaluation). This study extends previous research by empirically examining mediating processes underlying the relationship between employee affective delivery and customer behavioral intentions. Data were collected from 352 employee-customer pairs in 169 retail shoe stores in Taiwan. Results showed that the influence of employee affective delivery on customers' willingness to return to the store and pass positive comments to friends was indirect through the mediating processes of customer in-store positive moods and perceived friendliness. The study also indicated that employee affective delivery influences customers' time spent in store, which, in turn, influences customer behavioral intentions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Seasonal affective disorders

Seasonal affective disorder is a pattern of major depressive episodes that occur and remit with changes in seasons. It may be seen in major depressive or bipolar disorders, as described in the Diagnostic and Statistical. Manual of Mental Disorders (DSM-IV). The most recognized form of seasonal affective disorder, "winter depression," is characterized by recurrent episodes of depression, hypersomnia, augmented appetite with carbohydrate craving, and weight gain that begin in the autumn and continue through the winter months. Physicians have many options for treating seasonal affective disorder. While questions regarding the validity of seasonal affective disorder as a syndrome and the mechanism of action of light therapy continue to be investigated, the established effectiveness of light therapy in patients with winter depression supports the usefulness of assessment for this seasonal pattern and consideration of light therapy as an option in addition to existing treatment choices.     

Acute acid-base disorders. 2. Specific disturbances

Evaluation of the acid-base status of the body requires measurement of bicarbonate (total carbon dioxide) concentration, pH, and partial pressure of CO2 in arterial blood. Calculation of standard bicarbonate and base excess or deficit is not necessary. The normal concentration of free hydrogen ions (H+) is approximately 40 millimoles/liter, which is equivalent to a pH of 7.4. The normal load of fixed acids is 50 to 80 millimoles in 24 hours. A steady state is maintained by excretion of an equal amount of H+ by the kidneys, which at the same time regenerate bicarbonate to replenish buffer stores. Renal excretion of H+ is in the form of titratable acid and ammonium. Synthesis of ammonia can increase severalfold under the stimulus of acidosis. This is the chief mechanism of long-term compensation. Metabolic acidosis can be due to an excessive acid load (endogenous or exogenous), impaired renal excretion of H+, or bicarbonate loss. Determination of the "anion gap" (unmeasured anions) helps to establish the mechanism of acidosis. Acidosis with a normal anion gap is due to either bicarbonate loss or ingestion of certain chloride salts. A gap larger than normal indicates the presence in the body of acids other than acidfying chloride salts. Management of metabolic acidosis requires accurate diagnosis, clear understanding of the mechansim, and individualized treatment. Metabloic alkalosis is due to loss of H+ (usually from stomach or kidneys) or ingestion of alkali. Measurement of urinary chloride helps establish the mechanism of alkalosis. In saline-responsive alkalosis, the urinary chloride level is very low. This is usually due to gastric loss of H+, and the condition responds to administration of saline solution. When the urinary chloride level is only moderately low, the alkalosis is probably not due to gastric loss of H+. This form of alkalosis (saline-resistant) does not respond well to administration of saline solution and requires use of potassium in treatment. Apprpriate compensatory responses to acidosis or alkalosis are critical to survival. Compensation for metabloic acidosis consists of hyperventilation and enhanced renal excretion of H+, chiefly as ammonium. In metabolic alkalosis, compensation is mainly renal excretion of bicarbonate. Respiratory acidosis is due to alveolar hypoventilation. In chronic situations, a compensatory rise in serum bicarbonate concentration is expected. Management consists of treatment of the cause of hypoventilation. Respiratory alkalosis is due to hyperventilation. Treatment requires identification and correction of the cause of hyperventilation.     

Phototherapy. An alternative for seasonal affective disorders or sleep disorders

Although clinicians have observed for centuries that som depressed patients become worse in the winter, it was first in 1984 that Norman Rosenthal and co-workers described a syndrome which they called seasonal affective disorder (SAD), characterised by winter depression, lethargy and a craving for carbohydrate. Phototherapy was proved to be an effective treatment right from the start. Recently it has been reported that not only depression, but also panic disorder and obsessive compulsive disorders may exhibit a seasonal pattern and thus benefit from phototherapy. Phototherapy may also benefit patients suffering from "sun-downing", a syndrome of confusion and agitation in the evening in persons with Alzheimer's disease. Based on the observation that bright light may both elevate brain serotonin and ameliorate sleep abnormalities, the authors report the results of phototherapy for treatment of non-seasonal depressions, either alone or in combination with antidepressants or sleep deprivation.     

Neuropsychobiology of affective disorders. Some methodological considerations

Amine hypothesis is neither an adequate nor a sufficient postulate in understanding the neuropsychobiology of affective disorders. Interactions and balance between various mechanisms and factors may be important. Better techniques and methodology need to be used and a more comprehensive approach seems to be necessary in formulating meaningful research strategies. The present paper reexamines someaspects of the available data and suggests a few approaches in the sutdy and elucidation of neruophychobiology of affective disorders.     

Anticipated affective consequences of physical activity adoption and maintenance.

Objective: The expected emotional consequences of future actions are thought to play an important role in health behavior change. This research examined whether anticipated affective consequences of success and failure vary across stages of physical activity change and differentially predict physical activity adoption as compared to maintenance. Design: Using a prospective design over a 3-month period, a community sample of 329 healthy, middle-aged adults were assessed at 2 time points. Main Outcome Measures: Anticipated positive and negative emotions, stage of behavior change (precontemplation [PC], contemplation [C], preparation [P], action [A], maintenance [M]), and level of physical activity. Results: At baseline, anticipated positive emotions were greater in C versus PC, whereas anticipated negative emotions were greater in M versus A and in M versus P. Higher anticipated positive but not negative emotions predicted physical activity adoption and maintenance after 3 months. Conclusion: Although the expected affective consequences of future success and failure differentiated among individuals in the early and later stages of physical activity change, respectively; only the anticipated affective consequences of success predicted future behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnosis and treatment of affective disorders

The rates of major depression (5-12%) are considerably higher than for bipolar disorder (ca. 1%). Depressive disorder is most frequent in general practice. Although general practitioners recognise and manage efficiently a large number of depressed patients, at any consultation about half the patients are not diagnosed. Recognising depression is made difficult by the frequency in general practice of presentations with somatic symptoms (masked depression) and of depression related to physical disorder. The best method for the general practitioner to overcome these problems is by using a relatively direct interview for the main specific symptoms of depression. The general practitioner has a key role in the management of depression and as a gatekeeper with a prime responsibility to make appropriate referrals to specialists. Counselling members of the family or friends and recommending self-help groups are important to improve the therapeutic compliance of the patients.     

Comparative affective reactivity of different types of communication disturbances in schizophrenia.

Twenty-nine schizophrenic outpatients provided speech samples on affectively positive and negative topics. These samples were assessed for several different types of communication failures by using the Communication Disturbances Index. Frequencies of overinclusive references, ambiguous word meanings, and ambiguous referents increased in the affectively negative condition; frequencies of missing referents and instances of syntactic unclarity did not change across affective conditions. Degree of overall affective reactivity of speech was associated with severity of the core positive schizophrenic syndrome. These findings support the idea that different types of schizophrenic communication disturbances are associated with different underlying pathophysiological processes, that some are more reactive to affect than others, and that affective reactivity of these symptoms is associated with the positive schizophrenic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways linking L-phenylalanine and 2-phenylethylamine with p-tyramine in rabbit brain

Concentrations of labeled p-tyramine and 2-phenylethylamine were measured in rabbit brain 10 min after the intraventricular administration of either radioactive amine. In both cases the recoveries of the newly synthesized amine and of the unchanged precursor were significantly increased in animals pretreated with the monoamine oxidase inhibitor pargyline. Significant amounts of both amines were present in rabbit brain 10 min after the intraventricular injection of labeled L-phenylalanine. Pretreatment with pargyline increased their recoveries, whereas alpha-methyldopa (an L-aromatic amino acid decarboxylase enzyme inhibitor, L-AAADI) decreased them considerably, and no significant alteration was found in L-alpha-methyldopa hydrazine (a peripheral L-AAADI) pretreated animals. These results provide evidence for a new biochemical pathway in brain for p-tyramine biosynthesis, with L-phenylalanine (bypassing the formation of L-tyrosine) or 2-phenylethylamine as precursors. The significance and implications of these metabolic routes are discussed, especially considering that p-tyramine itself can be converted to catecholamines.     

Mood-congruent vs. mood-incongruent psychotic symptoms in affective psychotic disorders

General dentists are frequently called upon to manage maxillofacial infections. Such infections are usually well localized in their initial stages but can spread to become severe and potentially life-threatening. This paper discusses the anatomical basis of the spread of these infections and techniques relevant to the rational management of these serious conditions.     

Appearance-reality distinction: Children's understanding of the physical and affective domains.

The relation between children's performance on physical and affective appearance–reality (AR) tasks was investigated with a within-Ss design. Children participated in a standard color physical task (a color cutout behind a filter) and an affective measure that used stories and pictures depicting characters who were judging their emotions. The performance of 147 4–8 yr olds was examined under conditions of varying task similarity. As expected, older children performed better than younger children on both tasks. More important, children's physical and affective AR performance differed significantly only when the affective task required a greater use of inference than the physical task. Results are discussed in terms of the general representational ability underlying AR performance across domains and the ecological validity of these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Origins of comorbidity between conduct and affective disorders

OBJECTIVE: This analysis used methods of structural equation modeling to assess the extent to which comorbidity between conduct and affective disorders could be explained by (1) common or correlated causal factors that influenced both outcomes or (2) reciprocal causation between these conditions. METHOD: Data were obtained during the course of a 16-year longitudinal study of a birth cohort of New Zealand children. The data analyzed comprised measures of conduct and affective disorders at ages 15 and 16 years and data on a series of antecedent childhood factors. RESULTS: Structural equation modeling suggested that a substantial component of the comorbidity between conduct and affective disorders arose because the risk factors associated with the development of conduct disorders in teenagers overlapped and were correlated with the risk factors for adolescent affective disorders; of the shared variance between conduct disorder and affective disorders, more than two thirds was explained by common risk factors. These conclusions were replicated using diagnostically scored measures and methods of categorical data analysis. Model extensions suggested an absence of direct causal pathways between conduct and affective disorders. CONCLUSIONS: A substantial amount of the correlation and comorbidity between conduct and affective disorders arises because the risk factors and life pathways that predispose adolescents to one outcome are also associated with the risk factors and life pathways that predispose adolescents to the other outcome. Nonetheless, even after control for common causal factors, there was evidence of some unexplained comorbidity between conduct and affective disorders.     

Relation of verbal, affective, and physical intimacy to marital satisfaction.

Explored the relation of verbal, affective, and physical intimacy—to marital satisfaction in 43 couples (aged 18–59 yrs). The majority of Ss had sought counseling for marital problems. Ss completed questionnaires on intimacy and marital satisfaction and were then audiotaped during a discussion of their relationship. The 3 types of intimacy were highly predictive of both perceived marital satisfaction and a measure of thought and behaviors indicative of potential for divorce. Measures of verbal and affective intimacy made stronger contributions to the prediction of marital satisfaction than did physical intimacy. The interactions among the 3 types of intimacy did not contribute significantly to the prediction of satisfaction, nor was there any evidence of a curvilinear relation between measures of intimacy and measures of satisfaction. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic transmission of major affective disorders: Quantitative models and linkage analyses.

We comprehensively reviewed 2 types of studies aimed at specifying the mode of inheritance of major affective disorders: quantitative models and linkage analyses. Quantitative models attempt to represent the genetic mechanism responsible for the familial distribution of a disorder. Despite efforts to refine models by incorporating the bipolar–unipolar distinction or the sex effect, consistent support for a specific mode of transmission has not been found. Some mixed genetic models support single major locus inheritance, but transmission probabilities do not conform to Mendelian expectations. Linkage analysis is a more powerful technique used for testing the single gene hypothesis. Linkage results have also been inconsistent, showing moderate support for an X-linked variant of bipolar-related disorder and equivocal support for linkages to Chromosomes 6 and 11. However, relatively few genetic loci have been examined. Methodological factors, genetic heterogeneity, and phenotypic heterogeneity are discussed as potential explanations for inconsistent findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eye tracking in patients with unipolar and bipolar affective disorders in remission.

Examined patients (20–66 yrs old) with a history of recurrent affective disorder on a variety of smooth-pursuit and saccadic eye-tracking tasks and on psychomotor analogs of these tasks. The 25 unipolar and 24 bipolar Ss were compared to 24 schizophrenics; all Ss were in remission. Results indicate that the performance of the 2 affective-disorder groups was not significantly different from that of the controls on any of these tasks. Smooth-pursuit tracking error was greater for Ss receiving Li and for those with a higher frequency of prior episodes of the disorder. When the pursuit eye movements of these Ss were compared to those of the schizophrenics, the latter produced more tracking error than both affective-disorder groups but significantly so only with respect to unipolar Ss. Although findings are consistent with the interpretation that tracking dysfunction is not a trait characteristic of affective disorders, further investigations contrasting remitted patients with bipolar and schizophrenic disorders are needed to determine the specificity of deviant tracking to schizophrenia. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of carbamazepine in affective disorders

The normothymic effect of carbamazepine administered alone or in combination with lithium in patients with affective disorders was studied. The incidence and time-course of carbamazepine-induced side effects was analyzed.     

Linguistic analysis of speech in affective disorders

Various aspects of speech and language were compared, using psycholinguistic techniques, in a group of 15 depressed patients and 16 manic patients: lexical diversity, syntactical complexity, syntactical elements, and content analysis. Contrary to anticipation, the manic patients did not show more varied word choice or complexity of sentence structure than the depressives. In particular, they did not differ significantly in type-token ratio. The greatest difference was in syntactical elements, with manics using more action verbs, adjectives, and concrete nouns, while the depressed patients used more state of being verbs, modifying adverbs, first-person pronouns, and personal pronouns. When compared by content analysis, the manics used more words reflecting a concern with power and achievement. These results imply that depressive speech tends to be more vague and qualified and to show considerable self-preoccupation, while manic speech tends to be colorful and concrete and to show more concern with things than with people.