Escape deficits induced by inescapable shock and metabolic stress are reversed by adenosine receptor antagonists.

We examined the relationship between metabolic stress, brain adenosine regulation, and the learned helplessness effect in four experiments in rats. Glucoprivation and metabolic inhibition were induced by treating previously restrained (nonshocked) rats with 2-deoxy-D-glucose (2DG) shortly before escape testing. Experiment 1 demonstrated that 2-deoxy-D-glucose impairs escape performance in a dose-dependent manner. Experiment 2 showed that 2-deoxy-D-glucose and shock induced escape deficits are completely reversed by peripheral administration of the adenosine receptor antagonist caffeine. This result indicates that both inescapable shock and 2-deoxy-D-glucose result in compensatory adenosine regulation which, in turn, mediates the behavioral impairment. Experiment 3 determined that 8-[p-sulfophenyl]-theophylline, a peripheral adenosine receptor antagonist, fails to reverse the escape deficit resulting from metabolic stress, whereas centrally acting theophylline does. Experiment 4 showed that the behavioral impairments from both 2-deoxy-D-glucose and inescapable shock are reversed by intracranial ventricular (icv) caffeine treatment. The results of Experiments 3 and 4 indicate that the enhanced adenosine regulation and the ensuing performance deficit resulting from 2-deoxy-D-glucose treatment occurred in the central nervous system. These data are discussed in terms of the metabolic demands of neuronal over-activation during escape testing in inescapably shocked rats and the loss of normal behavioral function due to compensatory adenosine regulation in the brain.

Reactivity to interoceptive cues in nocturnal panic.

In this study, patients with panic disorder (PD) who suffered nocturnal panic (NP) attacks were compared with PD patients who never experienced NP attacks and healthy controls. Three tasks were chosen to evaluate attention to cardiac cues, reactivity to induction of respiratory cues, and reactivity to relaxation cues. Relative to healthy controls, PD groups reported more fear of all three tasks and showed more physiological arousal in response to the hyperventilation task. The only task on which the two PD groups differed was the relaxation task, where nocturnal panickers were significantly more distressed. These findings are consistent with the notion that nocturnal panickers are fearful of states involving a diminution of conscious awareness or vigilance.

Quality of life among women undergoing hysterectomies.

OBJECTIVE: To measure the association between gynecologic conditions and quality of life in women before hysterectomy. METHODS: We retrospectively identified 482 women who had hysterectomies for nononcologic and nonemergency indications in one of nine capitated medical groups in Southern California between 1993 and 1995. Their symptoms and quality of life before hysterectomy were assessed by medical record review and telephone interview. Women were placed into four symptom-based groups (pain, bleeding, pelvic discomfort, and asymptomatic groups) and compared across six quality-of-life scales. RESULTS: Women with primary pain conditions reported the highest average role impairment compared with women with primary bleeding, pelvic discomfort, or asymptomatic conditions (8.6 days/month versus 5.0, 2.5, and 1.9 days/month, respectively; P < .05). On the five 0 to 100-point quality-of-life scales, women with primary pain conditions, compared with women with bleeding, pelvic discomfort, or asymptomatic conditions, had the highest mean levels of sexual impairment (71.5 versus 54.1, 29.6, and 17.9, respectively; P < .05) and mood impairment (55.2 versus 45.2, 34.6, and 38.1, respectively; P < .05), the poorest perception of general health (74.4 versus 60.7, 44.1, and 49.4, respectively; P < .05), and the greatest increase in severity of symptoms before hysterectomy (77.2 versus 68.7, 61.5, and 57.1, respectively; P < .05). CONCLUSION: Women's primary symptoms before hysterectomy are associated differentially with varying levels of impairment. Standardized measurement of quality of life among women with gynecologic complaints that lead to hysterectomy might help in the development of treatment guidelines and in the assessment of appropriateness and outcomes of care for those women.

Effects of an expanding-spaced vs massed exposure schedule on fear reduction and return of fear.

The current investigation assessed the relative benefits of a massed vs an expanding-spaced exposure schedule. The study was a 2 (distribution of sessions) x 3 (assessment occasion) design, in which two spider-fearful groups (N = 31) were compared across three different occasions: pre-training, post-training, and follow-up. Four exposure trials were conducted within the same day for participants in the massed exposure (ME) group, whereas sessions were distributed over the course of 1 week (inter-trial intervals doubled between sessions) for the expanding-spaced exposure (ESE) group. As predicted, although the ME group demonstrated significantly more habituation than the ESE group across exposure trials, they also showed a clear return of fear (ROF) in response to the training spider at a 1-month follow-up assessment, whereas the ESE group showed no increase in fear. Additionally, the ME group showed ROF in response to novel spiders post-training and at the 1-month follow-up, whereas ESE participants did not. These findings offer support for the beneficial effects of an expanding-spaced schedule and challenge the reliance on indices of fear activation and habituation as accurate signals of the permanence of fear reduction.

Effects of varied-stimulus exposure training on fear reduction and return of fear.

The current investigation assessed the relative treatment benefits of persistence with one specific stimulus vs exposure to multiple versions of a stimulus. The study was a 2 (type of stimulus) x 3 (assessment occasion) design, in which two spider-fearful groups (N = 28) were compared across three different occasions: pre-treatment, post-treatment, and follow-up. Exposure trials were conducted with the same tarantula for participants in the control group, whereas experimental participants were exposed to four novel tarantulas. As predicted, the control group demonstrated significantly more habituation than the experimental group across exposure trials, yet showed a clear return of fear in response to a control spider at a 3-week follow-up assessment whereas the experimental group showed no increase in fear. These findings offer support for the beneficial effects of varying the stimulus during exposure, and challenge the reliance on indices of fear activation and habituation as accurate signals of the permanence of fear reduction.