Massage therapy effects on depressed pregnant women.

Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group participants received two 20 min therapy sessions by their significant others each week for 16 weeks of pregnancy, starting during the second trimester. The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule. Immediately after the massage therapy sessions on the first and last days of the 16-week period the women reported lower levels of anxiety and depressed mood and less leg and back pain. By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group (i.e. lesser incidence of prematurity and low birthweight), as well as their better performance on the Brazelton Neonatal Behavior Assessment. The data suggest that depressed pregnant women and their offspring can benefit from massage therapy.

Prenatal anger effects on the fetus and neonate.

One hundred and sixty-six women were classified as experiencing high or low anger during the second trimester of pregnancy. The high-anger women also had high scores on depression and anxiety scales. In a follow-up across pregnancy, the fetuses of the high-anger women were noted to be more active and to experience growth delays. The high-anger mothers' high prenatal cortisol and adrenaline and low dopamine and serotonin levels were mimicked by their neonates' high cortisol and low dopamine levels. The high-anger mothers and infants were also similar on their relative right frontal EEG activation and their low vagal tone. Finally, the newborns of high-anger mothers had disorganised sleep patterns (greater indeterminate sleep and more state changes) and less optimal performance on the Brazelton Neonatal Behavior Assessment Scale (orientation, motor maturity and depression). These data highlight the need for prenatal intervention for elevated angry mood during pregnancy.

Central nervous system serotonin function and cardiovascular responses to stress.

OBJECTIVE: The objective of this study was to evaluate the impact of indices of central nervous system (CNS) serotonin function on cardiovascular reactivity to mental stress. METHODS: Lumbar puncture was performed on 54 healthy volunteers to obtain cerebrospinal fluid (CSF) for determination of 5-hydroxyindoleacetic acid (5HIAA) levels. Genotypes were determined with respect to a functional polymorphism of the serotonin transporter gene promoter region (5HTTLPR). Subjects then underwent mental stress testing. RESULTS: Persons with one or two long (l) 5HTTLPR alleles had CSF levels of the major serotonin metabolite, 5HIAA, that were 50% higher than those of persons with the s/s 5HTTLPR genotype. Persons with one or two l alleles or higher CSF 5HIAA levels also exhibited greater blood pressure and heart rate responses to a mental stress protocol. CONCLUSIONS: These findings suggest the 5HTTLPR polymorphism affects CNS serotonin function, and they are consistent with the general hypothesis that CNS serotonin function is involved in the regulation of potentially health-damaging biobehavioral characteristics. In particular, the l allele could contribute, through its association with increased cardiovascular reactivity to stress, to increased risk of cardiovascular disease.

Anorexia nervosa symptoms are reduced by massage therapy.

Nineteen women (M age = 26) diagnosed with anorexia nervosa were given standard treatment alone or standard treatment plus massage therapy twice per week for five weeks. The massage group reported lower stress and anxiety levels and had lower cortisol (stress) hormone levels following massage. Over the five-week treatment period, they also reported decreases in body dissatisfaction on the Eating Disorder Inventory and showed increased dopamine and norepinephrine levels. These findings support a previous study on the benefits of massage therapy for eating disorders.

Targeting adolescent mothers with depressive symptoms for early intervention.

Infants of mothers with depressive symptoms show developmental delays if symptoms persist over the first 6 months of the infant's life, thus highlighting the importance of identifying those mothers for early intervention. In Study 1, mothers with depressive symptoms (n = 160) and mothers without depressive symptoms (n = 100) and their infants were monitored to identify variables from the first 3 months that predict which mothers would still be symptomatic at 6 months. A "dysregulation" profile was noted for the infants of depressed mothers, including lower Brazelton scores, more indeterminate sleep, and elevated norepinephrine, epinephrine, and dopamine levels at the neonatal period, and greater right frontal EEG activation, lower vagal tone, and negative interactions at the 3- and 6-month periods. A group of maternal variables from the neonatal and 3-month assessments accounted for 51% of the variance in the mothers' continuing depressive symptoms. These variables included greater right frontal EEG activation, lower vagal tone, and less positive interactions at 3 months, and elevated norepinephrine, serotonin, and cortisol levels at the neonatal stage. In Study 2, a similar sample of mothers with depressive symptoms (n = 160) and without depressive symptoms (n = 100) was recruited and followed to 3 months. Those symptomatic mothers who had values above (or below) the median (depending on the negative direction) on the predictor variables identified in Study 1 (taken from the first 3 months) were then randomly assigned to an intervention or a control group at 3 months. These groups were then compared with each other, as well as with the group without depressive symptoms, at 6 and 12 months. The intervention, conducted from 3 to 6 months, consisted of free day care for the infants and a rehab program (social, educational, and vocational) plus several mood induction interventions for the mothers, including relaxation therapy, music mood induction, massage therapy, and mother-infant interaction coaching. Although the mothers who received the intervention continued to have more depressive symptoms than did the nondepressed mothers, their interactions significantly improved and their biochemical values and vagal tone normalized. Their infants also showed more positive interations, better growth, fewer pediatric complications, and normalized biochemical values, and by 12 months their mental and motor scores were better than those of the infants in the control group.

Pregnant women benefit from massage therapy.

Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. The therapies consisted of 20-min sessions twice a week. Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).

Glucocorticoid regulation of ornithine decarboxylase in the postnatal rat lung.

Ornithine decarboxylase (ODC) is thought to play a critical role in pulmonary development. The purpose of this study was to characterize the effects of dexamethasone on ODC gene expression and enzyme activity in the lung of rat pups. Subcutaneous administration of dexamethasone (10 mg/kg) was shown to suppress ODC activity in 2-, 6- and 10-day-old rats for as long as 24 h after injection. In contrast, dexamethasone treatment stimulated liver ODC activity indicating that the inhibition of lung ODC is tissue specific. Contrary to expectation, the glucocorticoid enhanced lung ODC expression as indicated by an increased accumulation of ODC mRNA transcripts. The latter effect was associated with an heightened expression of c-myc and max mRNAs, the encoded proteins of which act as transactivators of the ODC gene. Dexamethasone did not alter lung levels of"antizyme" (AZ), an inducible protein that specifically promotes the degradation of the ODC protein enzyme. However, the lack of AZ induction does not necessarily mean that ODC degradation is not the mechanism for the decrease in lung ODC activity of dexamethasone-treated animals. The results obtained indicate that glucocorticoids can downregulate lung ODC activity, and that the effect is mediated by post-transcriptional rather than transcriptional mechanisms. These findings are consistent with the idea that endogenous glucocorticoids play an important role in the modulation of ODC activity and early pulmonary development.

Involvement of c-myc and max in CNS beta-endorphin modulation of hepatic ornithine decarboxylase responsiveness to insulin in rat pups.

Previously, we have shown that subcutaneous administration of insulin stimulates ornithine decarboxylase (ODC) mRNA expression and enzymatic activity in the liver of infant control rats, but not in those pretreated intracerebroventricularly (i.c.v.) with beta-endorphin. This finding is consistent with the hypothesis that beta-endorphin synthesized in the brain plays a prime role in the control of postnatal development, in part, by modulating ODC gene transcription. We now report that insulin induced stimulation of hepatic ODC mRNA expression is accompanied by a concomitant increase in the expression of c-myc and max mRNAs, and that this effect is also inhibited by pretreatment with i.c.v. beta-endorphin. These results suggest that CNS beta-endorphin suppresses tissue ODC responsiveness to trophic hormones by downregulating the expression of c-myc and max mRNAs, the encoded proteins of which are known to act physiologically as transcriptional activators of the ODC gene.

Bulimic adolescents benefit from massage therapy.

Twenty-four female adolescent bulimic inpatients were randomly assigned to a massage therapy or a standard treatment (control) group. Results indicated that the massaged patients showed immediate reductions (both self-report and behavior observation) in anxiety and depression. In addition, by the last day of the therapy, they had lower depression scores, lower cortisol (stress) levels, higher dopamine levels, and showed improvement on several other psychological and behavioral measures. These findings suggest that massage therapy is effective as an adjunct treatment for bulimia.

Responses to maternal separation: mechanisms and mediators.

Clinical studies indicate the predominance of psychosocial factors (nurturing environment) in the genesis of the Maternal Deprivation Syndrome. Consequences of disrupting mother-infant interactions range from marked suppression of certain neuroendocrine and physiological systems after short periods of maternal deprivation to retardation of growth and behavioral development after chronic periods. We have shown that maternal separation initiates a complex adaptive biobehavioral response in preweaning rat pups that includes (1) a decrease in the synthesis of ornithine decarboxylase, an obligatory enzyme for normal cell growth and development, (2) a reduction in DNA synthesis, an index of cell multiplication, (3) abnormal patterns of neuroendocrine secretion, and (4) a suppression of cell responses to growth hormone, prolactin and insulin, three major trophic hormones. This unique pattern of adaptation to maternal separation is not related to food or temperature changes but results from a lack of a specific type of tactile stimulation of the pup by the mother. Recently, we have shown that in the absence of "nurturing touch" the brain initiates the suppression of ornithine decarboxylase gene transcription by interfering with the cell's ability to transduce the activating signal induced by the growth promoting hormones. Studies indicate that central endorphinergic pathways may mediate this action. This is accomplished by the downregulation of specific Immediate Early Genes (c-myc and max) that normally promote the synthesis of this critical growth-regulatory enzyme. These studies of short-term maternal separation not only demonstrated that maternal care is a critical regulator of pup physiology and biobehavioral development but that there are marked similarities between this animal model of maternal separation and the delay in growth and development observed in children with the deprivation syndrome or in touch-deprived premature human neonates. Our identification of a specific type of nurturing touch as a neonatal growth requirement led us to test supplemental tactile stimulation in isolated very-premature human babies. The result of our intervention with massage was dramatic. Infants not only showed marked gains in weight and behavioral development, but also a significant enhancement in sympatho-adrenal maturation. We suggest that animal models of maternal deprivation can be used to understand the integrative processing of appropriate sensory input, CNS function and end-organ physiology required to maintain normal development.

Burn injuries benefit from massage therapy.

Twenty-eight adult patients with burns were randomly assigned before debridement to either a massage therapy group or a standard treatment control group. State anxiety and cortisol levels decreased, and behavior ratings of state, activity, vocalizations, and anxiety improved after the massage therapy sessions on the first and last days of treatment. Longer-term effects were also significantly better for the massage therapy group including decreases in depression and anger, and decreased pain on the McGill Pain Questionnaire, Present Pain Intensity scale, and Visual Analogue Scale. Although the underlying mechanisms are not known, these data suggest that debridement sessions were less painful after the massage therapy sessions due to a reduction in anxiety, and that the clinical course was probably enhanced as the result of a reduction in pain, anger, and depression.

Music shifts frontal EEG in depressed adolescents.

Recent studies have found that positive affect is associated with greater relative left frontal EEG activation and negative affect is associated with greater relative right frontal EEG activation. Further, chronically depressed adults typically display stable right frontal EEG activation. The present study investigated the effects of music on mood state and right frontal EEG activation associated with chronic depression. Fourteen chronically depressed female adolescents listened to rock music for a 23-minute session. These adolescents were compared with a control sample of chronically depressed female adolescents who were simply asked to sit and relax their minds and their muscles for the same time period. EEG was recorded during baseline, music, and postmusic for three minutes each, and saliva samples were collected before and after the session to determine the effects of the music on stress hormone (cortisol) levels. No group differences or changes were noted for observed or reported mood state. However, cortisol levels decreased and relative right frontal activation was significantly attenuated during and after the music procedure. It was concluded that music had positive effects on the physiological and biochemical measures even though observed and self-reported mood did not change.

Polydrug-using adolescent mothers and their infants receiving early intervention.

This study investigated the effects of an intervention for polydrug-using adolescent mothers. The program included educational, vocational, and parenting classes; social and drug rehab; and day care for their infants while they attended school half-day. The drug-exposed infants were similar to the nonexposed infants on traditional birth measures, although they had inferior Brazelton Neonatal Behavioral Assessment Scale scores, including habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity. The drug-exposed infants also spent less time in quiet sleep and more time crying and showing stress behaviors. Both the mothers and the infants in the drug groups demonstrated inferior interactions, and their dopamine and serotonin levels were significantly higher. As early as 3 months (following 3 months of intervention), the drug rehab mothers and their infants looked more like the nondrug group in their interactions; by 6 months, they looked similar on virtually every measure. At 12 months, the infants of drug rehab mothers (versus the drug control group) had superior Early Social Communication Scale scores and Bayley Mental scale scores, as well as significantly greater head circumference and fewer pediatric complications. The drug rehab mothers also improved on several lifestyle variables. They demonstrated a lower incidence of continued drug use and repeat pregnancy, and a greater number continued school, received a high school or general equivalency diploma, or were placed in a job. Thus, a relatively cost-effective high school based intervention had positive effects on both adolescent mothers who had used drugs and their infants.

PIP: The impact of an early childhood intervention program on polydrug-abusing US adolescent mothers and their infants was evaluated. The program, which was located in a vocational school attended by the mothers, included drug rehabilitation, social skills training, parenting classes, job training, and relaxation therapy. Outcomes in 126 drug-exposed mothers 16-21 years of age who participated in the program were compared to those recorded among non-drug-using adolescent mothers who participated in the program and drug-using control mothers who did not participate. All three groups were similar in terms of age, education, socioeconomic status, and ethnicity, but drug-abusing mothers had higher rates of depression and stress. At baseline, drug-exposed infants had lower scores on the measures of habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity on the Neonatal Behavioral Assessment Scale. Drug-exposed infants spent less time sleeping and more time crying and showing stress behaviors. The drug groups also had lower Optimal Interaction Rating Scale scores for both mothers and infants. Their dopamine and serotonin levels were higher than those recorded among non-drug-using mothers and their cortisol levels were lower. However, after 6 months of participation in the intervention program, the drug-using mothers had Beck Depression Inventory scores and interaction ratings that approached those of non-drug-using mothers and exceeded those among drug-using controls. Similar trends were observed for infants' head circumference and scores on the Early Social Communication Scale and the Bayley Mental Status Scale. Moreover, drug-using adolescent mothers who participated in the program demonstrated a lower incidence of repeat pregnancy and continued drug use than those who were not enrolled in the program; moreover, they were more likely to receive their high school diploma and be placed in jobs. Interventions such as this have the potential to attenuate the developmental delays of infants of drug-exposed adolescents.

Children with asthma have improved pulmonary functions after massage therapy.

Thirty-two children with asthma (16 4- to 8-year-olds and 16 9- to 14-year-olds) were randomly assigned to receive either massage therapy or relaxation therapy. The children's parents were taught to provide one therapy or the other for 20 minutes before bedtime each night for 30 days. The younger children who received massage therapy showed an immediate decrease in behavioral anxiety and cortisol levels after massage. Also, their attitude toward asthma and their peak air flow and other pulmonary functions improved over the course of the study. The older children who received massage therapy reported lower anxiety after the massage. Their attitude toward asthma also improved over the study, but only one measure of pulmonary function (forced expiratory flow 25% to 75%) improved. The reason for the smaller therapeutic benefit in the older children is unknown; however, it appears that daily massage improves airway caliber and control of asthma.

Neuroendocrine, cardiovascular, and emotional responses of hostile men: the role of interpersonal challenge.

OBJECTIVE: We examined the effects of hostility and harassment on neuroendocrine, cardiovascular, and emotional responses in 52 healthy white men. METHODS: Subjects were preselected on the basis of scores in the top and bottom quartiles (above 23 and below 15, respectively) on the Cook and Medley Hostility (Ho) scale. Subjects participated in a solvable anagram task. Thirty subjects were harassed by the technician during the task. RESULTS: Harassed subjects with high Ho scores exhibited enhanced and prolonged blood pressures, heart rate, forearm blood flow, forearm vascular resistance, norepinephrine, testosterone, and cortisol responses relative to low-Ho subjects in the harassed condition and high and low-Ho subjects in the nonharassed condition. Heightened physiological reactivity in high-Ho subjects was correlated with arousal of negative affects. CONCLUSIONS: The findings are consistent with the general hypothesis that high hostile men show excessive behaviorally-induced cardiovascular and neuroendocrine responsivity to interpersonal challenging situations. Moreover, in high-Ho men, the stress-induced cardiovascular and neuroendocrine hyperreactivity is associated with the arousal of negative affects such as anger.

Aromatherapy positively affects mood, EEG patterns of alertness and math computations.

EEG activity, alertness, and mood were assessed in 40 adults given 3 minutes of aromatherapy using two aromas, lavender (considered a relaxing odor) or rosemary (considered a stimulating odor). Participants were also given simple math computations before and after the therapy. The lavender group showed increased beta power, suggesting increased drowsiness, they had less depressed mood (POMS) and reported feeling more relaxed and performed the math computations faster and more accurately following aromatherapy. The rosemary group, on the other hand, showed decreased frontal alpha and beta power, suggesting increased alertness. They also had lower state anxiety scores, reported feeling more relaxed and alert and they were only faster, not more accurate, at completing the math computations after the aromatherapy session.

The relationship between hostility and beta-adrenergic receptor physiology in health young males.

OBJECTIVE: We examined the relationship between hostility and mononuclear leukocyte (MNL) beta-adrenergic receptor function in a sample of young healthy males. METHOD: Thirty subjects were selected for having scored above 20 (N = 11) and below 14 (N = 19) on the Cook-Medley Hostility (Ho) scale. MNL beta-adrenergic receptor function was characterized in terms of receptor density (Bmax) and ligand-binding affinity (Kd) in homogenized cells, and intracellular cyclic adenosine monophosphate (cAMP) responses to saline, isoproterenol, and forskolin in whole cells. Subjects also completed the Multidimensional Anger Inventory (MAI), which assesses dimensions of anger. RESULTS: Relative to men with low Ho scores, men with Ho scores above 20 showed lower receptor number and greater forskolin-stimulated cAMP. Moreover, high hostile men reported a greater frequency of anger, longer duration of anger, more frequent brooding, and a hostile outlook. CONCLUSIONS: These data indicate that adrenergic receptor down-regulation is associated with hostility. This association may be linked to hostile persons' propensity for excessive and prolonged neuroendocrine responses to either psychological stressors or the experience of chronic stress associated with frequent and prolonged bouts of anger.

Differential responsivity of monocyte cytokine and adhesion proteins in high- and low-hostile humans.

This study tested the general hypothesis that high- and low-hostile respondents would show different patterns of change in monocyte cytokine and adhesion protein (MCAP) expression in response to pharmacologically induced alterations in sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) balance. On 3 separate days, 4 high- and 4 low-hostile respondents received isoproterenol infusions after saline, atropine (PNS blockade), or neostigmine (PNS stimulation) pre-treatment. Dual color flow cytometry with fluorescently labeled monoclonal antibodies to CD 14 (monocyte market), interleukin-1, leukocyte function activator (LFA-1), Class II major histocompatibility complex (MHC-II), and tumor necrosis factor was used to quantify cytokine and adhesion protein expression on monocytes in blood samples drawn before and after the combination drug infusions on the 3 test days in each respondents. Following PNS stimulation and istoproterenol infusion there was a decrease (compared to saline pretreatment) in MHC II expression in high hostiles that was significantly (p<.02) different from an increase in low hostiles. A similar trend (p = .08) was seen for LFA-1 expression, with high hostiles showing an increase and low hostiles a decrease. These findings support the broad hypothesis that high-and low-hostile respondents will show different MCAP responses to pharmacologically induced alterations in SNS-PNS balance. Such differences could contribute to accelerated atherogenesis among high-hostile individuals.

The influence of dietary cholesterol on cardiac and hepatic Beta-adrenergic receptors in egyptian sand rats.

We examined the effects of dietary cholesterol on cardiac and hepatic beta-adrenergic receptor functioning. Age-matched adult desert rodents (Psammomys obesus) were randomized to either a 5% cholesterol diet (CD, n = 20), or normal rabbit chow (RC, n = 18). After a 2-month exposure to the diets, animals were sacrificed and tissue from both heart and liver were retained for radioligand bindings studies. In heart tissue, cholesterol fed animals, relative to controls, showed an increased production of adenosine 3,5>-cyclic monophosphate (cAMP) in response to isoproterenol. Cholesterol supplementation was not associated with an increase in heart beta-adrenergic receptor number. Animals fed the 5% cholesterol diet showed significant increases in the number of beta-adrenergic receptor sites in hepatic tissue (M = 13.2 vs. 10.4 pmol/mg protein, CD and RC, respectively). The increased number of receptor sites in the liver was accompanied by a significant increase in isoproterenol-stimulated cAMP production. Results are supportive of the hypothesis that dietary cholesterol contributes to an upregulation of beta-adrenergic receptor function in cardiac, as well as hepatic tissue. These findings may be relevant to the observations of excessive stress-induced cardiovascular reactivity in persons with high cholesterol levels.

Juvenile rheumatoid arthritis: benefits from massage therapy.

Studied children with mild to moderate juvenile rheumatoid arthritis who were massaged by their parents 15 minutes a day for 30 days (and a control group engaged in relaxation therapy). The children's anxiety and stress hormone (cortisol) levels were immediately decreased by the massage, and over the 30-day period their pain decreased on self-reports, parent reports, and their physician's assessment of pain (both the incidence and severity) and pain-limiting activities.