RESUMEN
The development of addiction and vulnerability to relapse following withdrawal is proposed to be the result of neuroadaptive processes within the central nervous system that oppose the acute reinforcing actions of drugs of abuse. These changes lead to impairment in the mechanisms that mediate positive reinforcement and the emergence of affective changes such as anxiety, dysphoria, and depression during withdrawal. Considerable evidence exists implicating perturbations in DA and 5-HT transmission in the nucleus accumbens--neurochemical systems that are activated by cocaine and ethanol self-administration and deficient during withdrawal--as potential substrates for these affective changes. In addition, growing evidence suggests that enhanced CRF release in the central nucleus of the amygdala represents a mechanism underlying the anxiogenic and stress-like consequences of withdrawal that are common to all drugs of abuse. A growing body of evidence also implicates dysregulation of the non-neuroendocrine CRF stress system within the central nucleus of the amygdala as a common factor in the anxiogenic and aversive consequences of withdrawal from drugs of abuse. Moreover, a possible link may exist between long-lasting abnormalities in CRF function in the CeA and vulnerability to relapse during protracted abstinence. Another presumably critical element contributing to the chronic relapsing nature of drug addiction is the learned responses to drug-related stimuli. The long-lasting efficacy of drug- and alcohol-associated contextual stimuli in eliciting drug-seeking behavior in animal models of relapse resembles the endurance of conditioned cue reactivity and cue-induced cocaine craving in humans and confirms a significant role of learning factors in the long-lasting addictive potential of cocaine. With cocaine, D1-dependent neural mechanisms within the medial prefrontal cortex and basolateral amygdala may be important substrates for the motivating effects of drug-related environmental stimuli. With ethanol, available data suggest a role for opioid receptors in the mediation of conditioned drug-seeking behavior. Finally, conditioning factors (i.e., exposure to drug-associated stimuli) and stress can interact to augment vulnerability to relapse. This finding emphasizes that it will be important to consider the simultaneous effects of multiple environmental triggers for relapse in the development of treatment and medication strategies.
Asunto(s)
Adaptación Fisiológica/fisiología , Depresores del Sistema Nervioso Central/farmacología , Trastornos Relacionados con Cocaína/fisiopatología , Trastornos Relacionados con Cocaína/psicología , Cocaína/farmacología , Condicionamiento Psicológico , Inhibidores de Captación de Dopamina/farmacología , Etanol/farmacología , Estrés Psicológico , Trastornos Relacionados con Sustancias/fisiopatología , Trastornos Relacionados con Sustancias/psicología , Afecto , Animales , Depresores del Sistema Nervioso Central/administración & dosificación , Cocaína/administración & dosificación , Modelos Animales de Enfermedad , Inhibidores de Captación de Dopamina/administración & dosificación , Etanol/administración & dosificación , Humanos , Núcleo Accumbens/efectos de los fármacos , Núcleo Accumbens/fisiología , Receptores Dopaminérgicos/fisiología , Receptores de Serotonina/fisiología , Recurrencia , Refuerzo en Psicología , Síndrome de Abstinencia a SustanciasRESUMEN
This study evaluated the feasibility and psychometric properties of self-completed and telephone interview versions of a patient health-related quality-of-life (HQL) questionnaire for Parkinson's disease that included the SF-36 Health Survey (SF-36), the Parkinson's Disease Questionnaire (PDQ-39), and the Medical Outcomes Study Sexual Function Survey. Parkinson's disease patients (n = 150) completed the questionnaire twice: once at the study site and once over the telephone in a randomized order. Ninety-four percent of enrolled patients completed the first HQL assessment and 88% completed both assessments. Cronbach's alpha exceeded 0.70 for all scales except for the self-completed PDQ-39 Social Support subscale (0.57) and the telephone interview PDQ-39 Social Support (0.60) and Cognitions (0.67) subscales and the SF-36 General Health (0.60) and Social Function (0.61) subscales. There were no statistically significant differences in mean HQL scale scores across the two modes of administration. Mean scores for 3 of the PDQ-39 subscales and the Summary Index were significantly poorer (p < 0.05) for patients at later clinical stages. Similarly, patients with dyskinesias reported significantly poorer scores for 4 of the PDQ-39 subscales and the Summary Index and patients with self-reported comorbidities reported poorer SF-36 Physical Function and General Health subscale scores than patients without dyskinesias and comorbidities, respectively. This study suggests that the self-completed and telephone interview versions of the patient HQL questionnaire are feasible and valid for future clinical trial applications.
Asunto(s)
Entrevistas como Asunto , Enfermedad de Parkinson/psicología , Psicometría/métodos , Calidad de Vida , Encuestas y Cuestionarios , Anciano , Análisis de Varianza , Estudios de Factibilidad , Femenino , Estado de Salud , Humanos , Masculino , Reproducibilidad de los Resultados , Teléfono , Estados UnidosRESUMEN
Locomotor activity (tremor, ataxia, immobility, epilepsy, and paralysis) in the taiep rat, which suffers from a myelin deficient disorder, has not been previously documented. This study used walking track analysis of footprints to analyze locomotor activity in the taiep rat in comparison to normal, age-matched controls. The results confirmed differences between normal and taiep rats in terms of stride length, step length, and stride width. In addition, we found significant interactions between age and condition for stride and step length. The results suggest that locomotor analysis is a sensitive indicator of myelin deficiency. The results are discussed in terms of the underlying myelin deficiency and possible treatment regimens.
Asunto(s)
Trastornos del Movimiento/fisiopatología , Vaina de Mielina/patología , Animales , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/etiología , Enfermedades Neurodegenerativas/complicaciones , Enfermedades Neurodegenerativas/patología , Ratas , Ratas Sprague-DawleyRESUMEN
Six hundred young adolescents (11 to 16 years old) from 4 countries (Guatemala, Iceland, Mexico, and the United States) ranked the importance of 10 qualities of the opposite-sex ideal person. Those from the United States responded in an individualistic fashion; they ranked being fun, being sexy, and having considerable money as important for the ideal. Those from Guatemala responded in a collectivistic fashion; they ranked liking children as important, but being fun and good looking as unimportant. Adolescents from Mexico and Iceland reported patterns of values not clearly associated with either collectivism or individualism.
Asunto(s)
Cortejo , Identidad de Género , Psicología del Adolescente , Adolescente , Conducta de Elección , Comparación Transcultural , Femenino , Guatemala , Humanos , Islandia , Masculino , México , Valores Sociales , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Physical therapists frequently evaluate and teach patients to roll from a supine to a prone position. The purposes of this study were 1) to describe the rolling movements of adults and 2) to determine whether the movement patterns used to roll might represent different developmental steps within three body regions. Thirty-six healthy adult subjects were videotaped during 10 trials of rolling from a supine to a prone position. Written descriptions of each subject's movements were reduced to general categorical descriptions of movement patterns for three body regions (upper extremities, lower extremities, and head and trunk). Stage theory criteria were used in an attempt to order the movement patterns into developmental sequences. The most common combination of movement patterns was used to describe adults' rolling action. Although stage theory criteria were not met, developmental sequences of movement patterns were proposed for the three body regions. Subjects were quite variable in their rolling movements. The most common form of rolling occurred in less than 12% of the subjects' trials. The descriptions of adults' rolling action gathered in this study provide physical therapists with a variety of movement patterns for teaching patients to roll.