Social relationships and relational pain in brain tumor patients and their partners.

Partners play an important role in both the general well-being and the care needs of patients. The dynamic between brain tumor treatment and patients' families is a complex bidirectional relationship. Cancer diagnosis and treatments which leave patients compromised impact the nature and quality of their relationships, and these in turn impact the ability of their partners to care for them. This paper will review the nature of the impact of diagnosis and treatment on relationships and how couples and families respond to the disruption of cancer treatments. The impact of how emotional and social pain effect their relationships and their ability to engage in care will be addressed.

Hormone-Dependent Tumors and Sexuality in the Neuro-Oncology of Women (N.O.W.): Women's Brain Tumors, Gaps in Sexuality Considerations, and a Need for Evidence-Based Guidelines.

PURPOSE OF REVIEW: While females make up almost 60% of all brain and spinal cord tumors in adults, guidelines that address women's issues in neuro-oncology are lacking. This review sheds light on two common women's issues in neuro-oncology. RECENT FINDINGS: Neuro-oncology providers are often faced with patient questions about fertility and pregnancy maintenance or prevention and typically respond with generic cancer chemotherapy recommendations, based on the paucity of evidence on the use of common neuro-oncology chemotherapies and pregnancy. While these remain important gap issues, there are several other poorly researched issues in the Neuro-Oncology of Women (N.O.W.) including recommendations around endogenous and iatrogenic hormone exposure and female sexuality in cancer. As a significant percentage of cancers are hormone-dependent, it is important to understand how changes in hormone levels impact tumor biology over the course of a woman's lifespan. Furthermore, greater attention should be given to the impact of tumors and tumor treatments on female sexuality. This article is intended to serve as an introduction to these two specific subjects within the vast expanse of N.O.W. subject matter.

A Preliminary Report on Quality of Life and Sexual Function in Brain Tumor Patients.

BACKGROUND: As tumor treatment has advanced, patients are surviving and returning to productive lives. Quality of life (QoL) has become a significant consideration in the care of survivors. The 2005 Institute of Medicine Cancer Survivorship Care Planning requires the inclusion of information on the possible effects of cancer on marital/partner relationship and sexual functioning, among other factors related to QoL. AIM: The purpose of this study is to explore the quality of life and the rates and types of sexual dysfunction among brain tumor patients. METHODS: Patients were recruited from a neuro-oncology practice and given a QoL questionnaire (FACT-Br). Women were given the Female Sexual Function Index (FSFI). Men were given scales to assess premature ejaculation (PE), erectile dysfunction (ED), and Peyronie's disease. In addition, information about the site and type of tumor and treatment (surgery, radiation, chemotherapy) was collected. Descriptive statistics, as well as T-tests and ANOVAs, were used to analyze the data. OUTCOMES: Study outcomes were obtained utilizing clinical cutoff scores for the sexual function questionnaires. RESULTS: Data were collected on 50 patients. The most common form of brain tumor in this sample was glioblastoma. The frontal lobe was the most common location of tumors. There was significantly more sexual dysfunction than previously reported, with 66% of the sexually active women meeting the criteria for total FSFI. Of the men who were sexually active, 60% reported some ED, and 80% reported PE. CLINICAL TRANSLATION: The current findings contribute to supporting the assertion that it is important for physicians to discuss with their cancer patients the issues related to sexual function. STRENGTHS & LIMITATIONS: A primary strength of this study is the utilization of validated assessments of sexual function. The primary limitation is the sample size, particularly for men. CONCLUSION: Our capacity to address the sexual function concerns of patients is dependent on our understanding of the types of difficulties encountered. This study contributes information about sexual function, a major contributor to QoL, in patients with brain tumor diagnosis and treatment. Boccia ML, Anyanda EI, Fonkem E. A Preliminary Report on Quality of Life and Sexual Function in Brain Tumor Patients. J Sex Med 2021;18:737-742.

Parental divorce in childhood is related to lower urinary oxytocin concentrations in adulthood.

Oxytocin has been shown to be important for social behavior and emotional attachments in early life and may also mediate effects of early experiences on social motivation in adulthood. In animal models, early maternal separation results in alterations in the oxytocin system, with effects on sexual, maternal, and stress reactivity behaviors in adulthood. Studies of children experiencing parental divorce find effects on mood disorders, substance abuse, and other behaviors in adulthood. Here, we examine the effect of divorce on adult urine oxytocin levels. To stimulate oxytocin release, participants, aged 18 to 62, were asked to complete a set of questionnaires on attachment style, parental history of divorce (age at parental divorce ranged from 0 to 20), and other measures. A sample of urine was then collected for the oxytocin assay. Urine oxytocin concentrations were substantially lower (p = .016) in subjects who experienced parental divorce (M = 3.70, Standard Error of the Mean = 0.73), compared to those who did not (M = 8.00, Standard Error of the Mean = 1.21), and correlated with responses on several attachment instruments. These results suggest that oxytocin levels are adversely affected by parental divorce in humans and may be related to attachment measures in adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Variations in Maternal Behavior in C57BL/6J Mice: Behavioral Comparisons between Adult Offspring of High and Low Pup-Licking Mothers.

The amount of maternal licking received by newborn rats affects their adult stress reactivity and maternal behavior. Mouse studies in which litters were cross-fostered between strains that exhibit high vs. low amounts of maternal behavior also suggest that rearing conditions affect adult outcomes. The current study is the first to compare within a single mouse strain (C57BL/6J) behavioral responses between adult animals reared by mothers that exhibited frequencies of pup-licking (PL) at the high end and the low end of the normal distribution within the strain. Maternal behaviors were coded during 10-s intervals every 3 min during five 1-h periods (two light, three dark cycle) on postpartum days 2, 4, 6, and 8 in 36 unrelated C57BL/6J mothers. The distribution of mean frequencies/h for PL, still crouched nursing, hovering over pups, self-grooming, and no contact with pups were determined. Offspring (6-12 weeks of age) from the eight mothers who exhibited the highest mean frequencies of PL and the seven mothers who exhibited the lowest PL frequencies underwent the following tests over three consecutive weeks: (1) elevated plus-maze (EPM) and 1-h open field on three successive days, (2) 3-h open field with an acute stressor (IP saline injection) at the 1-h time point, and (3) acoustic startle and prepulse inhibition. Females reared by low PL mothers exhibited significantly more time in the closed arms of the EPM, less locomotion, center time, and rearing during the first test in the open field, greater reactivity to an acute stressor, and reduced prepulse inhibition, an index of sensorimotor gating. Male offspring from low PL dams had reduced reactivity to an acute stressor, but no other altered performance in the behavioral tests. PL frequencies of C57BL/6J mothers appear to selectively alter behavior outcomes, primarily in female offspring.

Differential recall of consent information and parental decisions about enrolling children in research studies.

In the present simulation research, the authors examined the relations between the type of information that low-income parents (N = 116) recalled from informed-consent materials and their hypothetical decision to enroll a child in a clinical study. The authors gave parents or guardians of Head Start children information about a medical protocol involving high risk and significant potential benefit to child participants. Differential recall of the various categories of information (procedures, benefits, risks and costs, rights, and other) showed that relative to all consent information conveyed to them, participants recalled most about procedures and least about their child's rights as a study participant. Relative to their own recall, they also recounted most about procedures, slightly more about benefits than risks, and least about research rights. The pattern of recall differed among those who agreed to enroll and those who declined. The ratio of recalled risks to benefits predicted enrollment decisions.

Peripherally administered non-peptide oxytocin antagonist, L368,899, accumulates in limbic brain areas: a new pharmacological tool for the study of social motivation in non-human primates.

Central administration of oxytocin (OT) antagonists inhibits maternal and sexual behavior in non-primates, providing the strongest experimental evidence that endogenous OT facilitates these behaviors. While there have been a few reports that ICV administration of OT increases social behaviors in monkeys, no studies to date have assessed the effects of OT antagonists. Therefore, we studied in rhesus monkeys whether L368,899, a non-peptide antagonist produced by Merck that selectively blocks the human uterine OT receptor, penetrates the CNS after peripheral administration and alters female maternal and sexual behavior. In two studies in four male monkeys, L368,899 was injected iv (1 mg/kg) after which (1) CSF samples were collected at intervals over 4 h and (2) brains were collected at 60 min. Assay of samples confirmed that iv-administered L368,899 entered CSF and accumulated in the hypothalamus, septum, orbitofrontal cortex, amygdala and hippocampus, but not other areas. An adult female monkey was tested for interest in either an infant or sexual behavior, receiving a different iv treatment prior to each test (1 or 3 mg/kg of L368,899 or saline). OT antagonist treatment reduced or eliminated interest in the infant and sexual behavior. These results, although preliminary, are the first to directly implicate endogenous OT in activation of primate maternal interest and sexual behavior. While it remains to be empirically demonstrated that peripherally administered L368,899 blocks central OT receptors, our behavioral findings suggest that this non-peptide antagonist may facilitate testing OT involvement in a variety of social and other behaviors in primates.

Repeated long separations from pups produce depression-like behavior in rat mothers.

Long maternal (LMS) versus brief maternal (BMS) daily separations of rat pups from their mothers have contrasting effects on their adult stress responses and maternal behavior by, respectively, decreasing and increasing licking received from their mothers. We hypothesized that LMS decreases pup-licking in mothers by inducing learned helplessness, creating a depression-like state. We subjected postpartum rats to LMS (3 h), BMS (15 min) or no separation (NMS) on postpartum days 2-14. After weaning, mothers were given a forced swim test (FST). LMS mothers exhibited more immobility and fewer escape attempts than BMS or NMS mothers. These results suggest that LMS induces a depression-like state, which may account for the reductions in maternal behavior seen in LMS mothers. Immobility in the FST is recognized as an animal model of depression. Therefore, LMS may be a model of maternal depression.

Temperament and vagal tone in boys with fragile X syndrome.

Physiological hyperarousal, an elevated state of physiological arousal and poor modulation, has been postulated to be a significant source of behavior problems in children with fragile X syndrome (FXS). Temperament has been associated with behavior problems and may also reflect biological reactivity. Young boys with FXS display poorly modulated and low levels of vagal tone (Roberts, Dev Psychobiol 2001;39:107-123) and high activity, poor attention, low adaptability, poor persistence, and low intensity when compared with a reference sample of typically developing (Hatton, Dev Med Child Neurol 1991;41:625-632). In this study, we integrated physiological indices of vagal tone with temperament ratings and compared a sample of 29 young boys with FXS to 31 typically developing boys matched on chronological age and ethnicity. Boys with FXS were more active, less adaptable, and less persistent than the comparison group. Boys with FXS also showed lower baseline levels and less suppression of vagal tone in response to changing task demands. A relationship between baseline vagal tone and persistence was shown across both groups. However, group differences in temperament dimensions did not appear to be mediated or moderated by vagal tone.

The effect of format modifications and reading comprehension on recall of informed consent information by low-income parents: a comparison of print, video, and computer-based presentations.

A randomized trial comparing the amount of knowledge orally recalled from four different presentations of the same consent information was conducted in a non-clinic sample of 233 low-income parents who displayed a range of reading comprehension skill. The study simulated recruitment of children into one of two actual studies underway at another location: one involved high risk to participants, the other did not. Use of a non-clinic sample controlled for prior knowledge of the conditions, and avoiding discussion of the information further assured that differences in recalled information could be attributed more confidently to the format itself. The formats included the original written forms, enhanced print (simpler language, topic headings, pictures), narrated videotapes, and self-paced PowerPoint presentations via laptop computer with bulleted print information, pictures, and narration. No format-related differences in recalled information were found in the full sample but for the 124 individuals with reading comprehension scores at or below the 8th grade level, the enhanced print version tended to be more effective than either the original form or the video. Across all formats, more information was recalled about the low-risk study. The findings emphasize the necessity for clinicians and researchers to verify understanding of consent information, especially when there is risk of reduced literacy skill. Reliance on video to convey information in preference to well-done print media appeared questionable.

Oxytocin antagonism alters rat dams' oral grooming and upright posturing over pups.

Studies involving intracerebral administration of antiserum or antagonists have demonstrated that central oxytocin (OT) plays a prominent role in initiating but not maintaining postpartum maternal behavior in rats. There has been little investigation, however, of OT's influence on the levels of maternal behavior exhibited during the maintenance phase. We measured rat dam behavior during the 105-min observation periods preceding and beginning 2 h after intracerebroventricular infusion of the selective OT antagonist (OTA) (1 microg), or normal saline (NS) vehicle (5 microl) on postpartum days 2-3 and 6-7. Compared to NS, OTA significantly decreased pup licking as a proportion of dams' total oral grooming, increased self-grooming, decreased the frequency of elevated upright posture over pups and increased the frequency of lying prone on pups. Quiescent, kyphotic nursing was also significantly lower in OTA-treated dams. Other components of maternal behavior were not significantly affected by OTA or NS treatment. These findings suggest that central OT may shift the focus of the dams' oral grooming from self to pups and may also facilitate elevation of dams' upright posture over pups. Acute stress responses, maternal behavior and central OT receptor binding in adult rats have been linked to the amount of maternal licking and arched back, upright nursing received during infancy. OT activity in dams' brains may influence these developmental outcomes in their offspring by selectively regulating their pup licking and crouching posture.

Oxytocin links mothering received, mothering bestowed and adult stress responses.

We review recent discoveries that implicate oxytocin in the intergenerational transmission of similar levels of maternal behavior and acute stress responses in female rats. First, ICV-infused oxytocin antagonist decreased the display by nursing dams of pup-licking (PL) and arched-back nursing (ABN), but not other components of maternal behavior, and increased maternal self-grooming suggesting that oxytocin may shift the balance of oral grooming by dams away from themselves and toward pups. Second, oxytocin receptor concentrations in areas of the adult brain where oxytocin stimulates maternal behavior or diminishes anxiety and adrenal axis responses to acute stress were positively related to PL-ABN received during infancy. Third, oxytocin and oxytocin antagonist treatments of pups on postnatal days 2-10, respectively increased and decreased PL by the treated rats when adult and themselves nursing dams. This indicates that oxytocin activity in female pups, which may be regulated by PL-ABN received from their mothers, influences their adult levels of PL. These three lines of evidence suggest that oxytocin selectively enhances PL-ABN by rat dams, which then increases oxytocin activity in female pups and, thereby, facilitates their expression of central oxytocin receptors (and perhaps other aspects of central oxytocin systems) and, consequently, their adult PL-ABN frequencies and acute stress responses.

Oxytocin maintains as well as initiates female sexual behavior: effects of a highly selective oxytocin antagonist.

In previous studies, central administration of the oxytocin (OT) antagonist d(CH2)5[Tyr(Me)2, Thr4, Tyr-NH(9)2]OVT (OTA1) blocked receptive and proceptive components of female sexual behavior (FSB) and increased male-directed agonistic behavior when given before progesterone (P) treatment in estradiol-primed female rats but not when given shortly before behavioral testing 4-6 h after P. Because the considerable V(1a) antagonist potency of OTA1 may have contributed to these results, we tested the effects of the far more selective OT antagonist desGly-NH2, d(CH2)5[d-Tyr2, Thr4]OVT (OTA2). In ovariectomized, estradiol benzoate-primed (1 microg x 2 days sc) rats, icv infusion of OTA2 (1 microg) prior to P injection (250 microg sc) significantly suppressed lordosis and hops and darts and trended toward significantly increasing male-directed kicks during testing at 4 and 6 h. Infusion of OTA2 3 h and 40 min after P did not alter behavior at 4 and 6 h after P but significantly decreased lordosis as well as hops and darts and increased male-directed kicks 8-12 h after P. These results provide further evidence that central OT receptor activation shortly after P treatment contributes to the subsequent onset and early expression of FSB and demonstrate, for the first time, that OT receptor activation at later time points also contributes to maintaining FSB. The FSB-stimulating effect of central OT appears to persist for several hours.

Some observations on psychosocial stressors, immunity, and individual differences in nonhuman primates.

Many studies would appear to support an important relationship between behavior and the regulation of the immune response, at the core of the developing field of psychoneuroimmunology (PNI). However, wide variations are noted in the strength of this relationship, even for the same species under very similar circumstances. The present paper reviews work from our laboratory in both young and adult pigtail and bonnet macaques describing the ranges of variability in both behavioral and immunological responses to social separation and social conflict. It is shown that the magnitude of immune changes that follow a social stressor often covary with the magnitude of the behavioral changes that are observed. Second, there is support for the observation that there are specific behaviors such as social affiliation that may mitigate untoward behavioral and immunological consequences of social stressors. Finally, studies are reviewed which suggest that assessment of autonomic reactivity as reflected in cardiovascular regulation might provide an important clue to the relative risk for immune modulation under challenge. © 1996 Wiley-Liss, Inc.

Food distribution, dominance, and aggressive behaviors in bonnet macaques.

Resource availability or distribution may affect interindividual competition in species such as primates, which forage in social groups, and several field studies suggest that dominance status predicts access to restricted food sources. Increased competition due to restricted resources may result in the intensification of aggressive behaviors. The study reported here examines the impact of manipulation of the distribution of food resources in a laboratory-housed group of bonnet macaques to assess the impact of distribution on aggressive behaviors. Food was restricted to a space which allowed access to only one or two individuals at a time or was dispersed throughout the living enclosure to allow universal access in alternating periods. During periods of clumped distribution, the monkeys obtained access to the food in order of their dominance status in the group. In addition, overall levels of aggressive behaviors increased, submissive behavior increased, and play decreased during periods of clumped distribution of food. These results confirm the findings from field studies indicating increases in agonism with restriction of food resources. These findings also have implications for primate colony management, in terms of developing strategies for minimizing intragroup aggression in captive groups.

The influence of rank on affect perception by pigtailed macaques (Macaca nemestrina).

Previous studies of affect perception in nonhuman primates have involved young animals and/or manipulations of early experience. Based upon data suggesting that middle-ranked monkeys in small social groups show patterns of behavior different from their low- or high-ranked counterparts, the current study examined the role of social rank in affect perception by normally reared, adult female pigtailed macaques. Employing color videotapes as the presentation medium, we observed animals as they watched unfamiliar animals display social (aggressive or submissive) or nonsocial behavior. Virtually all threats were recorded as the subjects watched the submissive presentations, and most submissive signals occurred while watching aggressive behavior tapes. Middle-ranked monkeys were most attentive during all presentations, and levels of disturbance behavior were related to rank of the watcher and type of presentation observed. The results suggest that dominance status is an influence in the process of affect perception.

A test of the generalizability of the interval scale developed for social behavior of rhesus monkeys.

An interval scale of behavior would be useful in the study of social relations because it would allow the whole behavioral repertory to be used simultaneously and would allow greater flexibility in statistical manipulation. Maxim has developed such a scale using isolated dyads of unfamiliar monkeys. The typical social environment of monkeys, however, consists of familiar monkeys in mixed age and sex groups. This study replicates Maxim's procedure and tests the applicability of a scale developed with isolated dyads to groups of familiar monkeys. The scale developed here differed substantially from Maxim's. Behavior of monkeys in these groups was much more variable than behavior of monkeys in Maxim's isolated dyads. Behaviors at the extremes of the scale were similarly arranged in both scales, but behaviors in the central region were more labile and disordered. Distances between behaviors at the extreme of this scale were significantly larger than those in the central region whereas there were no differences in Maxim's scale. While some of these differences may be accounted for by group size and familiarity, several difficulties remain. Some behaviors may change meaning across different contexts and social relationships. The generalizability of these scales, therefore, may be limited to the behavior of groups of similar composition and familiarity.