Are alexithymia and emotional characteristics of disclosure associated with blood pressure reactivity and psychological distress following written emotional disclosure?

OBJECTIVES

This study had three aims: 1) to investigate whether cardiovascular responses to laboratory stress and levels of emotional distress were attenuated following written emotional disclosure; 2) to test, in addition to the potential main effects, whether levels of alexithymia moderated the impact of writing; and 3) to examine whether alexithymics who successfully disclosed emotion in their essays would experience positive effects following writing.

DESIGN AND METHODS

Eighty-seven participants wrote about their most stressful life experience or about a non-stressful experience, for 15 minutes, over 3 consecutive days. Two weeks later, blood pressure (BP) responses to laboratory stress and levels of emotional distress were assessed. Emotional characteristics of the disclosure essays were analysed with the Linguistic Inquiry and Word Count programme and alexithymia was assessed at baseline using the Toronto Alexithymia Scale-20.

RESULTS

Analyses found no evidence in support of the main effects of disclosure on cardiovascular responses to stress or on emotional distress. However, alexithymia was found to moderate the impact of writing such that non-alexithymic participants in the experimental condition reported significantly lower emotional distress 2 weeks later. In addition, alexithymic participants who disclosed a greater number of negative when compared with positive emotion words exhibited reduced systolic and diastolic responses to stress. Conversely, non-alexithymic participants who disclosed more positive and less negative emotion words displayed attenuated BP reactivity to stress.

CONCLUSIONS

The results of this exploratory study are important as they highlighted, in the absence of main effects, the importance of examining potential moderators of the emotional writing process. These findings may have implications for the development of cardiovascular health interventions.

Daily hassles and eating behaviour: the role of cortisol reactivity status

Previous research has shown high cortisol reactors to consume a greater amount of snack foods than low reactors following a laboratory stressor. The current study tested whether high cortisol reactors also consume more snacks than low reactors in response to field stressors. Fifty pre-menopausal women completed a laboratory stressor, provided saliva samples to assess cortisol reactor status and then completed daily hassles and snack intake diaries over the next fourteen days. Hierarchical multivariate linear modelling showed a significant association between daily hassles and snack intake within the overall sample, where an increased number of hassles was associated with increased snack intake. This significant positive association between number of hassles and snack intake was only observed within the high cortisol reactors and not within the low cortisol reactors. These findings suggest that high cortisol reactivity to stress promotes food intake. Furthermore, the eating style variables of restraint, emotional eating, external eating and disinhibition were more strongly associated with snack intake in high reactors than in low reactors. This suggests that cortisol reactivity may in part account for the moderating role of eating style on stress-induced eating. The results are discussed within the context of future health risk.

The influence of morningness-eveningness on anxiety and cardiovascular responses to stress

The relationship between cardiovascular responses to stress and health outcomes is inconsistent. In this study, the effects of morningness-eveningness and time of day upon cardiovascular activity at rest and in response to stress were examined. Sixty morning-types and evening-types completed two testing sessions (one morning, one afternoon) that comprised a battery of three stress tasks and a measure of anxiety. The results failed to support a time of day effect upon cardiovascular activity, but there was evidence of an interaction between time of day and morningness-eveningness upon heart rate (HR) and rate pressure product (RPP; HRxSBP). Evening-types exhibited higher HR and RPP in the afternoon, both at rest and during stress. A time of day effect was shown for mood, with anxiety levels higher in the morning than the afternoon. These results are discussed in terms of their health and methodological implications.

Effects of testosterone on mood, aggression, and sexual behavior in young men: a double-blind, placebo-controlled, cross-over study

The prospects of wider application of testosterone (T) in novel indications such as male contraception have prompted renewed interest in the investigation of nonreproductive actions and safety of androgens. This study investigated potential changes in mood and behavior in response to elevations in circulating T concentrations produced by the new long-acting preparation, T undecanoate (TU). Twenty-eight eugonadal men were randomized into one of two treatment groups: A1) active, receiving 1000 mg TU i.m. followed by A2) washout, followed by A3) placebo, receiving 4 ml castor oil i.m.; B1) placebo, 4 ml castor oil i.m.; B2) washout followed by B3) active, receiving 1000 mg TU i.m.. Mood, self- and partner-reported physical and verbal aggression, anger, hostility, irritability, assertiveness, self-esteem, and sexual function were assessed. A single injection of 1000 mg TU i.m. increased plasma T concentrations from 20.7 +/- 1.5 to 37.5 +/- 2.2 nmol/liter at wk 1 and 31.6 +/- 1.5 nmol/liter at wk 2, and estradiol from 74.0 +/- 4.9 to 120.4 +/- 10.7 pmol/liter at wk 1, and 100.0 +/- 6.3 pmol/liter at wk 2. The T increment was associated with detectable but minor mood changes. Increased circulating T was associated with significant increases in anger-hostility from baseline (mean score = 7.48) to wk 2 (mean score = 10.71) accompanied by an overall reduction in fatigue-inertia (treatment = 6.21 vs. placebo = 7.84). TU treatment did not increase aggressive behavior or induce any changes in nonaggressive or sexual behavior. Changes in estradiol were not associated with any behavioral alterations. Our results suggest that exogenous TU-induced elevation of circulating T, to the range likely to be used in hormonal male contraception, has limited psychological effects. Future research should investigate the implications of these minor mood changes.

Exogenous testosterone, aggression, and mood in eugonadal and hypogonadal men

To investigate (1) the effects of exogenous testosterone (T) on self- and partner-reported aggression and mood and (2) the role of trait impulsivity in the T-aggression relationship. Thirty eugonadal men with partners were randomized into two treatment groups to receive: (1) 200 mg im T enanthate weekly for 8 weeks or (2) 200 mg im sodium chloride weekly for 8 weeks. Eight hypogonadal men received 200 mg im T enanthate biweekly for 8 weeks. All groups completed a battery of behavior measures at baseline (Week 0) and at Weeks 4 and 8. Cognitive and motor impulsivity were the only predictors of self-reported total aggression (over and above age and T levels) at Weeks 0, 4, and 8. No significant changes in aggression or mood levels were found in the eugonadal-treated group. Significant reductions in negative mood (tension, anger, and fatigue) followed by an increase in vigor were found in response to T treatment in the hypogonadal group. These results demonstrate that inability to control one's behavior when such control is required by a particular situation (impulsivity) was found to significantly predict levels of aggression over and above age and T level. These data do not support the hypothesis that supraphysiological levels of T (within this range) lead to an increase in self- and partner-reported aggression or mood disturbances. Instead, for the first time, this study has identified the high level of negative affect experienced by hypogonadal patients. These findings have implications for T replacement therapy and male contraception.

Activational effects of testosterone on cognitive function in men

OBJECTIVES

The effect of testosterone (T) on sexual function in men is well established. However, less is known about its effects on cognitive function. The aim of this study is to investigate the relationship between T levels and sex-typed cognitive abilities in both eugonadal and hypogonadal men.

DESIGN

A single-blind placebo-controlled design was employed in this study.

METHODS

Thirty healthy eugonadal men and seven hypogonadal men participated in the study. Eugonadal men were randomised into one of two treatment regimens: (1) active group--receiving 200 mg of T enanthate i.m. weekly for 8 weeks (raising T levels into the supraphysiological range) or (2) placebo group--receiving 200 mg of sodium chloride i.m. weekly for 8 weeks. The hypogonadal group received the physiological replacement dose of 200 mg T enanthate i.m. bi-weekly for 8 weeks. All groups underwent a battery of neuropsychological tests and had circulating T measured at baseline, and at weeks 4 and 8 during treatment.

RESULTS

A significant time by group interaction effect was found in the measure of spatial ability (i.e., block design test) indicating that the active group's performance declined significantly at week 4, compared to placebo group (F(4,64)=3.78, P<0.01). Conversely, the active group performed significantly better than the placebo group in the measure of verbal fluency (i.e., the Controlled Oral Word Association Test) at week 4 (F(4,64)=2.54, P<0.05). No significant changes were found on any of the other tests. Generally, the hypogonadal group performed less well than the eugonadal groups on all tests.

CONCLUSIONS

These results offer support to the notion that increased T has a differential effect on cognitive function, inhibiting spatial abilities while improving verbal fluency in eugonadal men.

A novel male contraceptive pill-patch combination: oral desogestrel and transdermal testosterone in the suppression of spermatogenesis in normal men

This study investigated the effect of transdermal T and oral desogestrel on the reproductive axis of healthy men. Twenty-three men were randomized to 1 of 3 treatment groups and received a daily transdermal T patch plus oral desogestrel at a dose of 75, 150, or 300 microg/d for 24 wk. Baseline blood and semen samples were obtained and then every 4 wk thereafter for 32 wk. The outcome measures were sperm density and plasma levels of FSH, LH, total and free T. The results show a dose-dependent suppression of spermatogenesis and gonadotropins. Seven of the 17 subjects became azoospermic. Desogestrel (300 microg daily) in combination with 5 mg daily transdermal T was the most effective (57% azoospermic), whereas a dose of 75 microg was ineffective (0% azoospermic). Total and free plasma T were reduced by approximately 30%. High density lipoprotein cholesterol was significantly reduced. No serious side-effects were encountered. We conclude that daily self-administered desogestrel with transdermal T is capable of suppressing the male reproductive axis, although the efficacy was less marked and less consistent than injectable regimens. The lower efficacy is likely to be due to failure of the transdermal T system to maintain circulating T levels consistently in the required range.

Are occupational stress levels predictive of ambulatory blood pressure in British GPs? An exploratory study

BACKGROUND

Occupational stress has been implicated as an independent risk factor in the aetiology of coronary heart disease and increased hypertensive risk in a number of occupations. Despite the large number of studies into GP stress, none have employed an objective physiological stress correlate.

OBJECTIVES

We conducted an exploratory study to investigate whether self-reported occupational stress levels as measured by the General Practitioner Stress Index (GPSI) were predictive of ambulatory blood pressure (ABP) using a Spacelabs 90207 in a sample of British GPs.

METHOD

Twenty-seven GPs (17 males, 10 females) participated in the study. Each GP wore an ABP monitor on a normal workday and non-workday. All GPs completed the GPSI before returning the ABP monitors. Demographic data were also collected.

RESULTS

Stress associated with 'interpersonal and organizational change' emerged from the stepwise multiple regression analysis as the only significant predictor of ABP, explaining 21% of the variance in workday systolic blood pressure, 26% during the workday evening and 19% during the non-workday. For diastolic blood pressure, the same variable explained 29% of the variability during the workday and 17% during the non-workday. No significant gender differences were found on any of the ABP measures.

CONCLUSIONS

For the first time in GP stress research, our findings established that higher levels of self-reported occupational stress are predictive of greater ABP in British GPs. More detailed psychophysiological research and stress management interventions are required to isolate the effects of occupational stress in British GPs.

A thematic analysis of suicide notes

The analysis of suicide notes is an integral part of understanding suicidal behaviour. To this end, Leenaars (1996, 1992) has developed the Thematic Guide to Suicide Prediction (TGSP) for profiling the psychological correlates of suicide. The utility of this tool in suicide prevention, however, is not known. This study applied the TGSP to suicide notes (n = 45), interpreted in the light of coroner's inquest papers, drawn from a Northern Irish population. The results yielded support for the existence of psychological suicidal correlates. Moreover, qualitative differences between depressed and not depressed notewriters and those with and without a previous suicidal attempt were identified. For example, depressed suicides were more likely to communicate difficulties in developing attachments, or to exhibit cognitive constriction than nondepressed notewriters. Analysis of age differences was limited because of the paucity of suicide notes (in this sample, written by individuals aged 65 years or older). This research has further helped to identify psychological differences that should be beneficial in the prevention of suicide. Such differences should be integrated into existing risk assessment schedules. It is also argued that the analysis of suicide notes should form one strand in an integrated research framework.

A thematic analysis of suicide notes

The analysis of suicide notes is an integral part of understanding suicidal behaviour. To this end, Leenaars (1996, 1992) has developed the Thematic Guide to Suicide Prediction (TGSP) for profiling the psychological correlates of suicide. The utility of this tool in suicide prevention, however, is not known. This study applied the TGSP to suicide notes (n = 45), interpreted in the light of coroner's inquest papers, drawn from a Northern Irish population. The results yielded support for the existence of psychological suicidal correlates. Moreover, qualitative differences between depressed and not depressed notewriters and those with and without a previous suicidal attempt were identified. For example, depressed suicides were more likely to communicate difficulties in developing attachments, or to exhibit cognitive constriction than nondepressed notewriters. Analysis of age differences was limited because of the paucity of suicide notes (in this sample, written by individuals aged 65 years or older). This research has further helped to identify psychological differences that should be beneficial in the prevention of suicide. Such differences should be integrated into existing risk assessment schedules. It is also argued that the analysis of suicide notes should form one strand in an integrated research framework.

Time-resolved absorption and magnetic circular dichroism spectroscopy of cytochrome c3 from Desulfovibrio

The UV-visible absorption and magnetic circular dichroism (MCD) spectra of the ferric, ferrous, CO-ligated forms and kinetic photolysis intermediates of the tetraheme electron-transfer protein cytochrome c3 (Cc3) are reported. Consistent with bis-histidinyl axial coordination of the hemes in this Class III c-type cytochrome, the Soret and visible region MCD spectra of ferric and ferrous Cc3 are very similar to those of other bis-histidine axially coordinated hemeproteins such as cytochrome b5. The MCD spectra indicate low spin state for both the ferric (S = 1/2) and ferrous (S = 0) oxidation states. CO replaces histidine as the axial sixth ligand at each heme site, forming a low-spin complex with an MCD spectrum similar to that of myoglobin-CO. Photodissociation of Cc3-CO (observed photolysis yield = 30%) produces a transient five-coordinate, high-spin (S = 2) species with an MCD spectrum similar to deoxymyoglobin. The recombination kinetics of CO with heme Fe are complex and appear to involve at least five first-order or pseudo first-order rate processes, corresponding to time constants of 5.7 microseconds, 62 microseconds, 425 microseconds, 2.9 ms, and a time constant greater than 1 s. The observed rate constants were insensitive to variation of the actinic photon flux, suggesting noncooperative heme-CO rebinding. The growing in of an MCD signal characteristic of bis-histidine axial ligation within tens of microseconds after photodissociation shows that, although heme-CO binding is thermodynamically favored at 1 atm CO, binding of histidine to the sixth axial site competes kinetically with CO rebinding.

Magnetic circular dichroism study of cytochrome ba3 from Thermus thermophilus: spectral contributions from cytochromes b and a3 and nanosecond spectroscopy of CO photodissociation intermediates

Near-UV-vis magnetic and natural circular dichroism (MCD and CD) spectra of oxidized, reduced, and carbonmonoxy-complexed cytochrome ba3, a terminal oxidase from the bacterium Thermus thermophilus, and nanosecond time-resolved MCD (TRMCD) and CD (TRCD) spectra of the unligated species formed after photodissociation of the CO complex are presented. The spectral contributions of individual cytochromes b and a3 to the Soret region MCD are identified. TRMCD spectroscopy is used to follow the spin state change (S = 0 to S = 2) in cytochrome a3(2+) following photodissociation of the CO complex. There is prompt appearance of the high-spin state after photolysis, as found previously in mammalian cytochrome oxidase [Goldbeck, R. A., Dawes, T. D., Einarsdóttir, O., Woodruff, W. H., & Kliger, D. S. (1991) Biophys. J. 60, 125-134]. Peak shifts of 1-10 nm appear in the TRMCD, TRCD, and time-resolved UV-vis absorption spectra of the photolyzed enzyme throughout its observable lifetime, indicating that the photolyzed enzyme does not relax to its equilibrium deliganded form before recombination with CO occurs hundreds of milliseconds later. Direct heme-heme interaction is not found in cytochrome ba3, but red-shifts in the MCD and absorption spectra of both cytochromes b and (photolyzed) a3 are correlated with a CO-liganded form of the protein. The long time (tau approximately greater than 1 s) needed for relaxation of the cytochrome b and a3 peaks to their static positions suggests that CO binding to a3 induces a global conformational change in the protein that weakly perturbs the MCD and absorption spectra of b and photolyzed a3. Fea3 binds CO more weakly in cytochrome ba3 than in cytochrome aa3. The MCD spectrum of reduced enzyme solution placed under 1 atm of CO contains a peak at 446 nm that shows approximately 30% of total cytochrome a3 remains pentacoordinate, high-spin.