Focusing too much on individualistic achievement may generate stress and negative emotion: Social rank theory perspective.

Individualistic achievement personality has been found to increase personal resources and reduce negative emotions. Whether individualistic achievement is protective against stress or negative emotion or indeed stress generating remains uncertain. The present study examined three models proposed to explain the interrelationship between individualistic achievement, personal resources, daily stress, and negative emotion. One hundred eighteen volunteers (aged 18-59 years; 39 males) were recruited from the community. On the first day of the study, they received copies of a questionnaire measuring daily stress to complete for the next 14 days. On the last day of the study, they filled in questionnaires measuring positive and negative affect, depression, social functioning and individualistic achievement personality. Individualistic achievement was significantly associated with positive affect and social functioning but not with negative affect, depression, and average daily stress. Structural equation modeling analysis showed a significant fit for a model indicating that individualistic achievement personality scores would be positively associated with both personal resources and daily stress, and subsequently personal resources would be negatively associated with negative emotion and daily stress positively associated with negative emotion. Individualistic achievement may be related to both advantages and disadvantages. Further investigation of the nature of individualistic achievement is warranted.

Different mechanisms of risperidone result in improved interpersonal trust, social engagement and cooperative behavior in patients with schizophrenia compared to trifluoperazine.

AIM: Atypical antipsychotic treatment (e.g. risperidone) has been found to improve social functioning more than standard antipsychotic treatment. However, it is unclear which specific social behaviors are implicated in this improvement. The current study employed an interactive puzzle game to examine how social behaviors contribute to the improvement of social functioning by comparing patients receiving risperidone with those receiving trifluoperazine. METHODS: Scores on the Positive and Negative Syndrome Scale, executive functioning, and social functioning were obtained from 24 patients with schizophrenia receiving either risperidone (n = 12) or trifluoperazine (n = 12), before their social behavior was measured in the interactive Tangrams Game. Immediately after the Tangrams Game, participants filled in two questionnaires measuring their interpersonal trust and rejection toward their game partner. RESULTS: Patients receiving risperidone showed more social engagement, cooperative behavior and interpersonal trust toward their game partners than those receiving trifluoperazine. Additional multivariate analysis of variance revealed that lower affiliative behavior was a function of positive symptoms; interpersonal trust had an impact on social engagement but executive functioning did not explain lower interpersonal trust or social disengagement. CONCLUSION: Improvement of social competence by risperidone might be related to the enhancement of both social behaviors and interpersonal trust as well as better symptom resolution.

Using a partner's facial emotion to elucidate social dominance motivation induced by an SSRI.

Previous studies independently showed that acute treatment with a selective serotonin reuptake inhibitor (SSRI) enhanced happy face recognition, and dominance behaviors which might reflect enhancement of reward sensitivity. The present study aimed to determine whether such a mechanism would be related to social resource acquisition induced by an SSRI. Forty healthy subjects were recruited for the experiment. A randomized, double-blind, placebo-controlled crossover nested within confederate type (happy, fearful, or sad) trial of a single-dose of 10mg escitalopram versus placebo was conducted with a two-week washout period. In each of the treatment groups, the subjects interacted socially with one of the three types of confederate in a waiting room for 3-minute. Then, they went to an individual laboratory and were led to believe that they played the Mixed-motive game with the confederate. The game measures punitive/cooperative behaviors by how participants allocate higher/lower game scores to the confederate and communicate cooperation/ingratiation/helplessness/sadness/blaming/extrapunitive, messages to the confederate. Significant treatment-by-confederate type interactions were observed through game score distributions and ingratiation messages to the confederate and attentive eye gaze. In the happy confederate condition, escitalopram increased ingratiation messages and lowered points awarded to the confederate. In the fearful confederate condition, escitalopram increased ingratiation messages and reduced time spent looking away from the confederate. No changes in these measures were found in the sad confederate condition. Therefore acute escitalopram treatment enhances reward sensitivity to the facial emotions of social partners which in turn increases social resource acquisition and social dominance towards happy but not fearful social partners.

A comparison of smoking behaviour characteristics between Caucasian smokers in the United Kingdom and Malay smokers in Malaysia.

OBJECTIVES: There is evidence that smoking behaviour differs by ethnicity. This study aims to compare smoking behaviour characteristics between Caucasian and Malay smokers. METHODS: A cross sectional survey, involving 175 smokers attending smoking cessation clinics at the Institute of Psychiatry, London, United Kingdom and University Malaya, Kuala Lumpur, Malaysia between May 2005 and February 2007. Data on demographics, smoking history, nicotine dependence and smoking behaviour were collected. RESULTS: All participants were males, mean age 30.7 ± 10.3 years. Caucasians initiated smoking significantly earlier (mean age 14.8 ± 2.8 years) (p = 0.001) and smoked regularly significantly earlier (mean age 17.3 ± 3.5) (p = 0.003) than Malays (mean starting age 16.9 ± 4.4 years and mean age regular use 19.5 ± 4.5 years), respectively. Caucasians smoked less for social integration than Malays (p = 0.03) but smoked more for regulation of negative affect than Malays (p = 0.008) and smoked more for hedonism than Malays (p < 0.001). CONCLUSION: Malays smoke as a means of socially integrating. This has important public health implications. Social reasons and the social environment play a role in smoking uptake, smoking maintenance and smoking cessation and this should be borne in mind for strategies planning to promote smoking cessation.

After the randomised injectable opiate treatment trial: post-trial investigation of slow-release oral morphine as an alternative opiate maintenance medication.

INTRODUCTION AND AIMS: To establish if slow-release oral morphine (SROM) is an acceptable maintenance medication in heroin users currently being prescribed injectable diamorphine, who are intolerant to supplementary methadone. DESIGN AND METHODS: Case note review of interviews and medication details before and after change in medication in 12 treatment-resistant chronic heroin users attending a supervised injecting clinic twice a day for prescribed injectable diamorphine plus supplementary oral methadone to ensure 24 h stability. SROM was substituted for oral methadone by cross-titration. The patients' experiences of methadone treatment and expectations of SROM were recorded before the switch. Their responses to SROM and changes in injectable diamorphine requirements were recorded after a mean of 10 weeks' SROM treatment. RESULTS: The patients described a dislike and intolerance of methadone but had positive expectations of SROM which they believed would allow them to reduce their diamorphine dose. The mean stable methadone : SROM maintenance dose ratio was 1:7.5. After 10 weeks' SROM treatment, the average daily diamorphine dose reduced from 382 mg to 315 mg and patients reported fewer cravings and improved sleep and well-being. DISCUSSION AND CONCLUSIONS: Alternative forms of maintenance medication are required for patients who are intolerant to methadone. SROM is a valuable alternative which enabled some patients to reduce both their dose and number of injections of diamorphine. SROM treatment may therefore represent a route to stop injecting.

Facial emotion linked cooperation in patients with paranoid schizophrenia: a test on the Interpersonal Communication Model.

BACKGROUND: Patients with schizophrenia consistently show deficits in facial affect perception and social behaviours. It is illusive to suggest that these deficits in facial affect perception cause poor social behaviours. AIM: The present research aims to study how facial affects influence ingratiation, cooperation and punishment behaviours of the patients. METHODS: Forty outpatients with paranoid schizophrenia, 26 matched depressed patients and 46 healthy volunteers were recruited. After measurement of clinical symptoms and depression, their facial emotion recognition, neurocognitive functioning and the facial affects dependent cooperative behaviour were measured using a modified version of Mixed-Motive Game. RESULTS: The depressed control group showed demographic characteristics, depression levels and neurocognitive functioning similar to the schizophrenic group. Patients with schizophrenia committed significantly more errors in neutral face identification than the other two groups. They were significantly more punitive on the Mixed-Motive Game in the neutral face condition. CONCLUSION: Neutral face misidentification was a unique emotion-processing deficit in the schizophrenic group. Their increase in punitive behaviours in the neutral face condition might confuse their family members and trigger more expressed emotion from them, thus increasing the risk of relapse. Family members might display more happy faces to promote positive relationships with patients.

Contrasting effects of a hot and a cool system in anger regulation on cooperative behaviours.

Angry mood and aggression are strongly associated. However, it is not socially acceptable to express strong aggression. Non-cooperative behaviours might be another aspect of aggressive behaviour. The present study examines the expression of non-cooperative behaviours after angry mood induction. Eighty-five university students were randomly assigned to hot or cool focus recall of a past angry event. At baseline, trait aggression and rejection sensitivity were evaluated. Just before the recall task, participants' state of angry mood was measured by the Anger Mood Scale. Then they engaged in either hot or cool focus recall of a past rejection event. Immediately after the mood induction, angry mood was measured again. They were then instructed to play the Mixed Motive game with an unknown person. Participants in both groups became angrier after the mood induction. One-way analysis of covariance, controlling for trait anger and rejection sensitivity, showed that the hot-focus participants gave significantly fewer points to the other person than the cool-focus participants. Participants high on trait aggression sent more verbally aggressive messages. The findings suggest that non-cooperative behaviour is another form of anger related aggression and might be more socially important than overt aggression.

Psychometric analysis of the Chinese version of Social Adaptation Self-evaluation Scale (C-SASS).

There are only a very limited number of scales available to measure social motivation in Chinese. Studying social motivation might help researchers to understand more of the relationship between social skills and depression. An English version of the Social Adaptation Self-evaluation Scale (SASS) is a valid measure of social motivation. A Chinese translated version of the SASS was validated in 208 healthy volunteers, who were also evaluated with the Temperament and Character Inventory (TCI) and the Beck Depression Inventory (BDI). Principal Component Analysis showed the C-SASS had a one-factor solution. The Cronbach alpha of the scale was 0.97, but no item redundancy was found. The C-SASS was negatively associated with the BDI (r=-0.39) as predicted. Furthermore, the C-SASS was positively associated with the Cooperativeness (r=0.34) and Self-directedness factors (r=0.37), but negatively associated with the Harm Avoidance factor (r=-0.36) of the TCI as predicted. C-SASS scores were not associated with the Novelty Seeking or Self-transcendence factors of the TCI. Therefore, the C-SASS had adequate construct validity, and internal consistency. The results also supported the external validity, convergent validity and divergent validity of the C-SASS.

Ecstasy (MDMA) does not have long-term effects on aggressive interpretative bias: a study comparing current and ex-ecstasy users with polydrug and drug-naive controls.

+/-3, 4-methylenedioxymethamphetamine (MDMA or ecstasy) remains a widely used recreational drug, which, in animals, can produce long-lasting changes to the brain's serotonergic system. As serotonin has been implicated in human aggression, it is possible that ecstasy users are at risk of increased aggression even after prolonged abstention from the drug. The objective of this study was to indirectly assess aggression in current and abstinent ecstasy users using an information-processing paradigm that measures cognitive bias toward material with aggressive content. The task employed has previously shown increased aggressive bias 3-4 days after ecstasy use. An interpretative bias task was administered to 105 male participants: 26 ex-ecstasy users, 25 current ecstasy users, 29 polydrug using controls, and 25 drug-naive controls. Accuracy and response times to process and recognize ambiguous sentences were tested. There were no group differences in aggressive interpretative bias. All 4 groups processed neutral sentences faster than aggressive sentences and were subsequently faster and more confident in recognizing neutral compared with aggressive sentences. Further, self-ratings of aggression also showed no group differences, even though self-rated impulsivity was significantly higher in current ecstasy users than in drug-naive controls. The findings that all groups were biased toward neutral and away from aggressive interpretations of ambiguous sentences add to the existing body of knowledge in suggesting that increased aggression found in ecstasy users a few days after taking the drug is a transient phenomenon and not a long-term, persisting effect.

Pharmacodynamics of diazepam co-administered with methadone or buprenorphine under high dose conditions in opioid dependent patients.

BACKGROUND: Benzodiazepine abuse is common among methadone- and buprenorphine-maintained patients; however interactions between these drugs under high dose conditions have not been adequately examined under controlled conditions. OBJECTIVE: To investigate the effects of co-administering diazepam with methadone or buprenorphine under high dose conditions. DESIGN: Double-blind, randomly ordered, 2 x 2 cross-over design in which the effects of diazepam dose (0mg versus 40 mg) and opioid dose (100% versus 150% normal dose) were examined over four sessions in methadone- and buprenorphine-maintained patients. PARTICIPANTS: Four methadone- and seven buprenorphine-prescribed patients without concurrent dependence on other substances or significant medical co-morbidity. MEASURES: Physiological (pulse rate, blood pressure, pupil size, respiratory rate and peripheral SpO2), subjective (ARCI, VAS ratings) and performance (reaction time, cancellation task and Digit Symbol Substitution Test, DSST) measures were taken prior to and for 6h post-dosing. RESULTS: High dose diazepam was associated with time-dependent increases in the intensity of subjective drug effects (strength of drug effect, sedation) and decreases in psychological performance (reaction time, DSST) for both methadone and buprenorphine patients. These effects were generally independent of the opioid dose administered. High dose opioid administration (150% normal dose) was associated with reductions in overall SpO2 levels and performance (reaction time, DSST) in the methadone patients, but had virtually no impact on pharmacodynamic responses in the buprenorphine group. CONCLUSION: High dose diazepam significantly alters subjective drug responses and psychological performance in patients maintained on methadone and buprenorphine.

Interactions on mixing diazepam with methadone or buprenorphine in maintenance patients.

Benzodiazepine use by patients in methadone and buprenorphine substitution treatment is common, despite safety concerns regarding these drug interactions. The relative safety of diazepam use by methadone- or buprenorphine-treated patients has not been systematically examined. This study aimed to examine the effect of single diazepam doses, within normal therapeutic range (doses: 0, 10, and 20 mg), upon physiological, subjective, and performance measures in stable methadone and buprenorphine-treated patients. In a double-blind, randomized crossover design, methadone- or buprenorphine-treated patients were administered their normal opioid dose and either placebo, 10-, or 20-mg diazepam, in balanced order over 3 sessions. Eight methadone- and 8 buprenorphine-prescribed patients with no concurrent benzodiazepine dependence or significant comorbidity were recruited from an outpatient addiction clinic in London. Measures were taken at baseline and for 6 hours after dosing, and included physiological responses (pulse rate, blood pressure, pupil size, respiratory rate, and peripheral pO2), subjective drug effects (Addiction Research Center Inventory subscales, visual analog scales of strength of drug effect, drug-liking, and sedation), and performance measures (simple reaction time, cancellation task, digit symbol substitution task, and balance). The 10- and 20-mg diazepam doses resulted in comparable subjective experiences of greater sedation and strength of drug effects in both patient groups, and had minimal impact on physiological parameters. However, diazepam had greater peak effects on performance measures (simple reaction time, digit symbol substitution task, and cancellation time) in methadone-treated than in buprenorphine-treated patients. Diazepam may significantly alter the response to opioid substitution treatment with methadone or buprenorphine.

An investigation into the sub-acute effects of ecstasy on aggressive interpretative bias and aggressive mood - are there gender differences?

The lowering of serotonin for a period following MDMA use could account for the increases in both self-rated and objective measures of aggression previously found in ecstasy users several days after taking the drug. There is some evidence of gender differences in the acute, sub-acute and long-term effects of MDMA use, and given that gender differences have been found in aggression, it is possible that men may experience more aggression mid-week than women. The aim of this study was to attempt to replicate findings showing increased bias towards aggressive material in ecstasy users several days after using the drug. In addition, to investigate possible gender differences in mid-week aggression. A total of 46 participants were tested: 19 ecstasy users and 27 controls were compared on the night of drug use and 4 days later. On day 4, a task designed to tap cognitive bias toward material with aggressive content was administered. Participants were required to process sentences that could be interpreted as either aggressive or neutral and subsequently remember them in a recognition test. This data set was then combined with the data from Curran et al.'s (2004) study that employed exactly the same procedure. Thus, the data from 107 participants was analysed to investigate gender differences. Ecstasy users recognized more aggressive sentences than controls and tended to react slower to neutral sentences than controls. Ecstasy users also rated themselves as being more aggressive and depressed than controls on day 4. No gender differences were found on any measure of aggression in the combined data set. Both male and female ecstasy users show a bias toward interpretation of ambiguous material in an aggressive manner when compared to controls 4 days after ecstasy use.

Feasibility and acceptability of an intranasal diamorphine spray as an alternative to injectable diamorphine for maintenance treatment.

An intranasal (IN) diamorphine spray was investigated as a possible alternative to injectable diamorphine for maintenance treatment. Plasma morphine and 6-monoacetylmorphine (6MAM) concentrations and pharmacodynamic responses were measured for 4 h following intravenous (IV) and IN administration of 40 mg diamorphine in 4 patients prescribed injectable diamorphine. The two routes were primarily differentiated by the significantly greater speed and magnitude of peak plasma morphine and 6MAM concentrations for IV versus IN diamorphine. Beyond this initial peak, mean ratings suggested that withdrawal suppression and positive effects were at least as strong for IN compared to IV administration. All subjects gave favourable appraisals of the IN diamorphine spray, citing advantages including ease of use, the avoidance of needle hazards, and reduced stigma. IN administration may be an alternative or supplementary form of diamorphine maintenance and deserves serious further investigation.

Antidepressant treatments and human aggression.

Aggressive behaviour is associated with negative mood and poor impulse control. Serotonin has been specifically associated with impulse regulation and deficiencies in serotonin have been linked to impulsive aggression. However, aggression occurs in a social context and noradrenaline has been implicated in social motivation. Both serotonergic and noradrenergic antidepressants may therefore be effective in reducing aggression. The evidence for the effects of antidepressants on aggression comes from a wide range of sources but there are few controlled trials or experimental studies. Current findings point to decreases in negative mood and anger attacks and positive changes in personality traits after antidepressant treatment. Clinical studies in personality disorder patients have shown some efficacy for serotonergic antidepressants in reducing irritability and impulsive aggression. Experimental work in healthy volunteers has shown both serotonergic and noradrenergic antidepressants to increase assertiveness and affiliative behaviour. Both may therefore decrease aggression through different routes.

Sex differences in cortisol response to reboxetine.

This study examined the cortisol response to reboxetine in a sample of healthy men and women. Forty healthy volunteers were randomly allocated to one of two treatment groups: placebo or 4 mg reboxetine under double-blind conditions. Saliva cortisol was measured pre, 1 and 1.5 h post-treatment. Mood and side-effects were also measured. A single oral dose of 4 mg reboxetine did not affect positive or negative mood but did produce some side-effects. It was also sufficient to increase cortisol release 1.5 h post-treatment compared to placebo. In addition, reboxetine lead to a significantly increased cortisol release in male compared to female volunteers. The results suggest that healthy male volunteers are more responsive to challenge with a noradrenergic compound than females.

Correlation between trait hostility and faster reading times for sentences describing angry reactions to ambiguous situations.

The hypothesis that trait anger is associated with an increased tendency to interpret ambiguous situations as anger-provoking was investigated in a reading time study. A total of 48 healthy volunteers read a series of short narrative passages and were asked to adopt the perspective of the main character, identified at the start of each passage. Reading times for key sentences, which described the main characters' angry or nonangry reactions to ambiguous anger-provoking situations, were recorded. Trait anger and impulsivity were negatively correlated with reading time for sentences describing both types of reaction, but anger was also correlated with relatively faster processing of sentences describing angry reactions. This study suggests that those with angrier dispositions are more likely to anticipate angry reactions from others.

Relationship between baseline cortisol, social functioning and depression: a mediation analysis.

Both elevated cortisol secretion and low social support have been commonly found in depressed patients, but their respective roles in depression remain unclear. In fact, it may not be a lack of social support but a failure to obtain it that is important. The present study used mediation analysis to study the interrelationships among cortisol, social functioning and depression. Sixty healthy volunteers were recruited from the community. Depression and social functioning were measured by the Beck Depression Inventory and the Social Adaptation Self-evaluation Scale, respectively. Salivary samples were collected to measure the cortisol. Using mediation analysis, it was found that elevated cortisol secretion was a vulnerability factor for low social functioning, leading to higher depression scores. Hypercortisolaemia may be a predisposing factor and may interact with a low level of social functioning leading to depression.

The impact of depression on social skills.

Social skills deficits are common among depressed patients, but little attention has been paid to this aspect of depression. In this review, the potential roles of different depressive factors contributing to poor social skills are examined. Specifically, the first part of the analysis is focused on how different depressive factors influence the three components of social behavior: perceptual, cognitive, and performance. In the second part, evidence is provided to support the proposition that social skills deficits are manifestations of state depressive factors. This is based on results from studies involving mood induction procedures, counter manipulation procedures, and treatment with antidepressant drugs. These deficits are therefore likely to remit with effective treatment.

Empathy and aggression: two faces of ecstasy? A study of interpretative cognitive bias and mood change in ecstasy users.

RATIONALE: As central 5-hydroxytryptamine (5-HT) is attenuated for a period following a single dose of MDMA ("ecstasy") and low 5-HT is associated with aggression, then MDMA users may be more aggressive in the days following an acute dose of the drug. OBJECTIVE: This study therefore aimed to determine if acute use of MDMA is associated with aggression 4 and 7 days later. METHODS: Twenty-nine MDMA users and 32 controls were compared on self-rated aggression and depression on the night of drug use (day 0), 4 and 7 days later. On day 4, participants performed an interpretative bias task in which they processed ambiguous sentences that could be interpreted in either an aggressive or neutral way (e.g. "The painter drew the knife"). RESULTS: MDMA users had faster response times in completing ambiguous aggressive sentences than neutral sentences; controls showed the opposite pattern of performance. In a subsequent recognition task, MDMA users were more confident in judging, and responded faster to, aggressive than neutral sentences; controls again showed the opposite pattern of effects. The level of aggressive interpretative bias positively correlated with extent of MDMA use. Midweek, MDMA users had higher self-rated aggression and depression scores than controls; on day 7, scores of both groups were similar. CONCLUSIONS: MDMA users display a cognitive bias towards interpreting ambiguous information in an aggressive way a few days after taking the drug. Self-rated mid-week low mood and mid-week aggression do not persist 7 days after use of the drug. This pattern of results is consistent both with the acute and residual effects of MDMA on central 5-HT and with the notion that 5-HT plays a role in modulating human aggression.

Angry cognitive bias, trait aggression and impulsivity in substance users.

RATIONALE: According to cognitive theory, people who are aggressive expect angry responses to ambiguous situations. Increased aggression has been reported a few days or weeks following use of MDMA (ecstasy). This may relate to low 5-HT release, and so a 5-HT challenge may increase cognitive bias towards anger differentially in MDMA users and non-users. OBJECTIVES: To investigate whether: (1) measures of anger and aggression will correlate with processing time of angry material and with generation of aggressive responses and (2) tryptophan challenge in people abstinent from MDMA and controls will affect angry cognitive bias. METHODS: Thirty-two current MDMA users abstinent for 3 weeks, 32 ex-users abstinent for longer than 1 year and 32 non-MDMA substance users were recruited. Trait measures were administered before and state measures before and 5 h after an amino acid drink, depleted or augmented with tryptophan. After the drink, subjects undertook a computer task, which involved reading ambiguous short stories. Reading times to a key sentence describing an angry or non-angry reaction were recorded and subjects wrote a continuing sentence for half the stories. RESULTS: Subjects were faster to process angry than non-angry reactions, indicating the presence of angry cognitive bias. Trait anger and aggression were correlated with processing time of angry relative to non-angry reactions, particularly in the current users. Impulsivity was correlated with non-specific speed of response. Subjects wrote more aggressive sentences after an angry reaction. Tryptophan depletion tended to increase aggressive content. Trait aggression was correlated with aggressive content following non-angry reactions. CONCLUSIONS: Evidence of angry cognitive bias was shown in this group of substance users, which was not specific to MDMA use. People high on trait aggression were more likely to expect an angry reaction to an ambiguous situation and to generate more written aggression when this did not occur.