Sad reflections of happy times: depression vulnerability and experiences of sadness and happiness upon retrieval of positive autobiographical memories

Instructed retrieval of positive autobiographical memories typically improves mood for healthy individuals, but not always for depressed individuals. No mood improvement may occur when depressed individuals retrieve positive memories that are self-incongruent, or when they ruminate upon positive memory retrieval. Mindfulness is associated with lower self-incongruency and rumination. The present study examined whether recurrent depression predicted emotional experience upon involuntary and voluntary retrieval of positive memories, and whether recurrent depression and trait mindfulness were associated with emotional experience upon positive memory retrieval through state rumination and self-incongruency. Recurrently and never-depressed individuals completed measures of depression, trait mindfulness, and a diary for reporting on everyday positive memories. Recurrently depressed individuals reported diminished happiness upon retrieving involuntary and voluntary positive memories compared to never-depressed individuals; and greater sadness upon involuntary positive memory retrieval, independent of current depression. Recurrent depression was associated with diminished happiness upon involuntary memory retrieval and greater sadness upon involuntary and voluntary positive memory retrieval, through state brooding, self-incongruency, or both. Higher trait mindfulness was associated with lower sadness upon involuntary and voluntary positive memory retrieval through state brooding and reflection. These findings highlight potential mechanisms in the relationship between depression vulnerability and emotional processing of positive autobiographical memories.

Autobiographical memory functions and posttraumatic stress symptoms across adulthood

Previous research has documented robust individual differences in the functions served by autobiographical memories, and shown that different autobiographical memory functions are related to both positive and negative indicators of psychological well-being, and that their frequency varies with age. In this study, we examined the unique relationship between autobiographical memory functions and posttraumatic stress symptoms (PTSS) and whether such relationships varied with age across adulthood. A representative sample of 1040 adult Danes (20-70 years old) reported the frequency with which they recall autobiographical memories for different purposes as well as their level of posttraumatic stress disorder (PTSD) symptoms. Higher reflective and ruminative functions, as well as lower social function, predicted higher levels of PTSS. There were no moderating effects of age. The results suggest that although the frequency of various autobiographical functions varies throughout the adult years, their association with PTSS is similar across adulthood.

Negative autobiographical memories in social anxiety disorder: A comparison with panic disorder and healthy controls

BACKGROUND AND OBJECTIVES

Empirical interest in mental imagery in social anxiety disorder (SAD) has grown over the past years but still little is known about the specificity to SAD. The present study therefore examines negative autobiographical memories in participants with social anxiety disorder (SAD), compared to patients with panic disorder (PD), and healthy controls (HCs).

METHODS

A total of 107 participants retrieved four memories cued by verbal phrases associated with either social anxiety (SA) or panic anxiety (PA), with two memories for each cue category.

RESULTS

PA-cued memories were experienced with stronger imagery and as more traumatic. They were also rated as more central to identity than SA-cued memories, but not among participants with SAD, who perceived SA-cued memories as equally central to their identity. When between-group effects were detected, participants with anxiety disorders differed from HCs, but not from each other.

LIMITATIONS

Central limitations include reliance on self-report measures, comorbidity in the anxiety disorder groups, and lack of a neutrally cued memory comparison.

CONCLUSIONS

The findings align with models of SAD suggesting that past negative social events play a central role in this disorder. Future research is suggested to further explore the function of negative memories, not only in SAD, but also in other anxiety disorders.

Involuntary and voluntary autobiographical memory specificity as a function of depression

BACKGROUND AND OBJECTIVES

This study tests the hypothesis derived from the CaR-FA-X model (Capture and Rumination, Functional Avoidance and Executive Function model, Williams et al., 2007), that depressed individuals will be less specific during voluntary than involuntary autobiographical memory retrieval and looks at the relative contributions of rumination, avoidance and executive function to memory specificity.

METHODS

Twenty depressed and twenty never depressed individuals completed a memory diary, recording 10 involuntary and 10 voluntary autobiographical memories. Psychiatric status (assessed with the Structured Clinical Interview for DSM-IV, SCID-1), psychopathology, rumination, avoidance and executive function were assessed prior to completion of the memory diary.

RESULTS

Both groups were more specific during involuntary than voluntary memory retrieval. No overall group differences were identified. However, when non-remitted depressed participants were compared to partially remitted and never depressed participants the expected interaction was identified; non-remitted depressed individuals were less specific during voluntary, but not during involuntary recall. Consistent with theory, negative correlations between memory specificity, rumination and avoidance were also present.

LIMITATIONS

The study presents an important yet preliminary finding which warrants further replication with a larger sample size.

CONCLUSIONS

The findings provide support for a number of models of autobiographical memory retrieval in particular the CaR-FA-X model of memory specificity.

The characteristics of involuntary and voluntary autobiographical memories in depressed and never depressed individuals

This study compares involuntary and voluntary autobiographical memories in depressed and never depressed individuals. Twenty depressed and twenty never depressed individuals completed a memory diary; recording their reactions to 10 involuntary and 10 voluntary memories over 14-30 days. Psychiatric status (Structured Clinical Interview for DSM-IV, SCID-1), psychopathology, rumination and avoidance were assessed. For both groups, involuntary memories more frequently lead to strong reactions than voluntarily memories. For both modes of retrieval, depressed individuals reported more frequent negative reactions than never depressed individuals and rated memories as more central to identity with higher levels of rumination and avoidance. Depressed individuals retrieved both positive and negative memories during involuntary retrieval. These findings support the view that involuntary memory retrieval represents a basic mode of retrieval during healthy and disordered cognition, and that during depression, both involuntary and voluntary memories are central to identity and associated with rumination and avoidance.

Thoracic outlet syndrome part 1: clinical manifestations, differentiation and treatment pathways

Thoracic outlet syndrome (TOS) is a challenging condition to diagnose correctly and manage appropriately. This is the result of a number of factors including the multifaceted contribution to the syndrome, the limitations of current clinical diagnostic tests, the insufficient recognition of the sub-types of TOS and the dearth of research into the optimal treatment approach. This masterclass identifies the subtypes of TOS, highlights the possible factors that contribute to the condition and outlines the clinical examination required to diagnose the presence of TOS.

Seeing yourself in a positive light: Brain correlates of the self-positivity bias

Individuals are found to have better recall for self-referent information than other types of information. However, attribution research has shown that self-reference is highly correlated with emotional valence. The present study attempted to identify and separate the processing of self-reference and emotional valence using ERPs. Participants performed a two-choice task, judging the self-referential content of positive and negative words. Reaction times revealed an interaction between self-reference and emotional valence. Faster responses occurred after self-positive and non-self negative words as compared to self-negative and non-self-positive words. A similar interaction was identified in ERP waveforms in the time range of the N400 component at fronto-central electrode sites, with larger N400 amplitudes for words outwith the self-positivity bias. Thus, the size of the N400 may indicate the extent to which information is discrepant with the individual's self-concept.

C-D(0) (D(0) = pi-donor, F) Cleavage in H(2)C=CH(D(0)) by (Cp(2)ZrHCl)(n): mechanism, agostic fluorines, and a carbene of Zr(IV)

Consistent with the C-O cleavage behavior of vinyl ethers, vinyl fluoride reacts with Cp(2)ZrHCl to give Cp(2)ZrFCl and C(2)H(4) as primary products. DFT (B3PW91) calculations show this reaction to be highly exoenergetic (-55 kcal/mol), and reveal a sigma-bond metathesis mechanism to be unfavorable compared to a Zr-H addition across the C=C bond, with regiochemistry placing F on C(beta) of the resulting fluoroethyl ligand. beta-F elimination (onto Zr) then completes the reaction. There is no eta(2)-olefin intermediate on the reaction path. DFT calculations seeking the energy and structure of the two carbenes Cp(2)ZrHCl[CF(CH(3))] and Cp(2)ZrFCl[CH(CH(3))] are also described.

Base deficit level indicating major injury is increased with ethanol

Analyses were performed to determine whether ethanol increases base deficit, independent of major injury, in blunt trauma patients from two Level I trauma centers. In 2140 Baltimore patients, base deficit was significantly higher in ethanol-positive patients (blood level > or =0.01%), independent of blood pressure (BP), Injury Severity Score (ISS), and blood loss. In 139 Youngstown, Ohio, patients, base deficit was significantly higher in ethanol-positive patients, independent of ISS and RBC units given. In 1796 awake Baltimore patients, major injury was defined as an ISS >10, presence of blood loss, or need for RBC transfusion. A base deficit < or =-4.1 for ethanol-positive and < or =-1.1 for ethanol-negative patients had higher rates of major injury (odds ratio 3.2 and 2.1, respectively) and abdominal trauma (odds ratio 3.6 and 3.2, respectively). In blunt trauma patients, base deficit is increased with ethanol, independent of major injury. A base deficit of < or =-4.1 for ethanol-positive and < or =-1.1 for ethanol-negative awake patients may be an early warning for occult injury and suggest the need for an abdominal computed tomography (CT) scan or ultrasound.

Impact of a Web-based clinical information system on cisapride drug interactions and patient safety

BACKGROUND

Most commercially available drug-interaction screening systems have important limitations that fail to protect patients from dangerous drug combinations. We attempted to overcome the limitations of our commercial program by developing a Web-based clinical information system to serve as a safety net. This system identifies drug interactions with newly marketed medications not screened by our commercial program, and generates a second alert on dangerous interactions that were overridden during order processing.

METHODS

The Web-based system uses patient-specific pharmacy, laboratory, and demographic data to generate detailed alerts on patients receiving potentially dangerous drug combinations. The system's impact on the use of dangerous drug combinations and related adverse events was evaluated by a retrospective analysis of patients receiving cisapride with contraindicated medications in the 2 years before and after implementation.

RESULTS

The rate of dangerous drug combinations declined by 66% after implementing the system, from 9.0% of cisapride orders in 1994 and 1995 to 3.1% in 1996 and 1997 (P<.001). The mean [SD] duration of contraindicated therapy (4.1 [3.8] vs 1.6 [1.4] days, P<.001) and proportion of patients being discharged under treatment with a dangerous drug combination (36.2% vs 7.7%, P<.001) was also significantly reduced during the study period. Three patients (1.7%) during the control period experienced serious adverse events that may have been related to the targeted drug interactions. No symptomatic cardiac events were identified during the study period (P = .21).

CONCLUSIONS

An automated system running as a safety net can be an efficient method of detecting contraindicated drug combinations and serves an important role in the avoidance of potentially serious adverse drug events.

Research or quality improvement? Making the decision

Deciding if a project is one of research or quality improvement is a dilemma frequently faced by nursing administrators. Guidelines have been established to help administrators and practitioners overcome this dilemma and, at the same time, consider the rights and responsibilities of the patient, the hospital, and the investigator.

Prevalence of corrective lens wear in Royal Australian Air Force flight crews

This study was undertaken to determine what effect the Royal Australian Air Force's (RAAF) restrictive entry visual standards have on the prevalence of corrective lens wear in its aircrew. A 100% review of RAAF aircrew medical documents was conducted to determine the prevalence of corrective lens wear (spectacles and contact lenses) among pilots, navigators, flight engineers, loadmasters, and airborne electronics analysts. The prevalence of corrective lens wear by aircrew in the RAAF was then compared to that published for their counterparts in the USAF. Entry visual refraction standards for the RAAF and USAF were compared and related to the prevalence of corrective lens wear in each Service. Age data for RAAF aircrew were also compared to the requirement to wear corrective lenses. The study's findings indicate that the RAAF's restrictive visual refraction standards for entry into aircrew training programs significantly reduced the prevalence of corrective lens wear among all crew positions when compared to the USAF. A discussion is presented which relates the medical wastage associated with a restrictive visual standards policy and the operational implications of such a policy.

Inner ear barotrauma: a case for exploratory tympanotomy

A case of inner ear barotrauma (IEBT) due to an hypobaric chamber experience is presented. IEBT is an exceedingly rare condition in aviation. In the case described, the diagnosis was initially unsuspected due to accompanying middle ear barotrauma. The underlying etiology, the diagnosis, and management of IEBT are discussed.

Total peripheral parenteral nutrition in pregnancy

Twenty pregnant patients needing nutritional support for various indications received hypercaloric, hyperosmotic, "3 in 1," peripheral parenteral nutrition as a bridge to enteral therapy. This system, named total peripheral parenteral nutrition, was evaluated as to tolerance and efficacy in pregnant patients. Patients were in various stages of pregnancy and had an average weight loss of 10.4 pounds prior to admission. Patients were maintained on total peripheral parenteral nutrition for an average of 5 days and gained an average of 4.1 pounds. Good tolerance with minimal side effects of the treatment was noted. Intravenous sites were changed an average of 1.1 times per patient during the course of therapy and only one serious complication was noted in 20 patients. Patients were followed through delivery and this information is presented. Total peripheral parenteral nutrition appears to be an acceptable alternative to conventional total parenteral nutrition to pregnant patients needing nutritional support. These hypertonic solutions can supply total caloric/metabolic needs without unacceptable side effects.

The use of tympanometry in predicting otitic barotrauma

Static acoustic impedance tympanometry was used to examine 80 subjects prior to and after exposure to decreased ambient pressure in a hypobaric chamber. The predictive value of tympanometry in detecting those individuals likely to suffer from otitic barotrauma (aerotitis media) was evaluated. The results suggest that testing prior to altitude exposure is of no value in identifying those individuals who will suffer from otitic barotrauma during flight. Tympanometry however proved a useful tool in confirming the presence of barotrauma following flight, but it was no more useful than taking a history and performing an ear examination.

Calcium antagonists in the prevention of motion sickness

Flunarizine is a calcium antagonist which has proved clinically useful in controlling chronic vertigo. In a double blind crossover trial 10 subjects were used to compare the electronystagmic responses to motion in patients taking flunarizine, prochlorperazine maleate, or placebo. Flunarizine is shown to be a powerful peripherally acting labyrinthine suppressant, with application in the prevention of motion sickness. Flunarizine produces none of the central depressive side effects characteristic of antihistamines and anticholinergics, which are the conventional anti-motion sickness drugs.

An Mr 29000 protein is essential for mini-F maintenance in E. coli

Plasmids consisting of mini-F inserted into multicopy vectors were constructed. Derivatives of these hybrid replicons were isolated which contained the transposon Tn5. The polypeptides encoded by these plasmids were identified by Escherichia coli minicell analysis. We show that a previously unidentified polypeptide of 29000 Mr is encoded by the mini-F gene E between 45.1 and 46.2 F kb on the mini-F plasmid map, and that this coding sequence (E gene) is transcribed rightward. Hybrid plasmids carrying Tn5 inserted into the E gene are unable to replicate in a polA- strain. Hence the E protein is essential for mini-F replication. Mutations in the A and B genes of mini-F affect E gene expression, and the results suggest that E protein synthesis is stimulated by A protein.

Campylobacter enteritis and Yersinia enterocolitica infection in New Zealand

A three-month survey was undertaken to determine the incidence of Campylobacter jejuni and Yersinia enterocolitica in diarrhoeal disease and acute abdominal disease in Palmerston North. C. jejuni was isolated from five domiciliary patients and one hospitalised patient with acute diarrhoea but there were no isolations from patients suffering from acute abdominal disease. The isolation rates for C. jejuni in domiciliary and hospitalised patients with acute diarrhoea were 7.8 percent and 1.7 percent respectively. Y. enterocolitica was not isolated.