State anxiety and affective physiology: effects of sustained exposure to affective pictures

Effects of sustained exposure to emotional stimuli on affective reactions and their recovery were examined to determine whether increasing exposure to a specific emotional content (e.g., unpleasant) cumulatively affects physiological responses; and whether motivational activation persists following sustained exposure. Participants viewed pleasant, neutral, and unpleasant IAPS pictures, presented in blocks separated by an inter-block interval. With increasing exposure to unpleasant pictures, startle magnitude showed greater potentiation, and corrugator EMG activity increased. Both affective startle and corrugator modulation persisted following exposure to unpleasant pictures. The cumulative effects of sustained exposure to unpleasant pictures were enhanced for those reporting higher state anxiety, consistent with the hypothesis that sustained aversive exposure leads to increased defensive activation. These findings suggest sustained exposure to unpleasant pictures may induce a short-term mood state, and may be a useful paradigm to study individuals who vary in symptoms of anxiety.

Parallel amygdala and inferotemporal activation reflect emotional intensity and fear relevance

Much research demonstrates that emotional stimuli prompt increased amygdala and visual cortical activation. Here we measure functional activity in the visual cortex and amygdala with fMRI while selected fearful and control participants view a range of neutral, emotionally arousing, and fear-relevant pictures. BOLD signal in the amygdala and inferotemporal visual cortex closely covaried during emotional picture viewing, increasing systematically with rated picture arousal. Furthermore, fearful individuals reacting to specific fear cues show parallel, heightened activation in these two structures compared with non-fearful controls. The findings suggest an individually-sensitive, positive linear relationship between the arousing quality of visual stimuli and activation in amygdala and ventral visual cortex, supporting the hypothesized functional connectivity described in the animal model.

Additive Effects of Emotional Content and Spatial Selective Attention on Electrocortical Facilitation

Affectively arousing visual stimuli have been suggested to automatically attract attentional resources in order to optimize sensory processing. The present study crosses the factors of spatial selective attention and affective content, and examines the relationship between instructed (spatial) and automatic attention to affective stimuli. In addition to response times and error rate, electroencephalographic data from 129 electrodes were recorded during a covert spatial attention task. This task required silent counting of random-dot targets embedded in a 10 Hz flicker of colored pictures presented to both hemifields. Steady-state visual evoked potentials (ssVEPs) were obtained to determine amplitude and phase of electrocortical responses to pictures. An increase of ssVEP amplitude was observed as an additive function of spatial attention and emotional content. Statistical parametric mapping of this effect indicated occipito-temporal and parietal cortex activation contralateral to the attended visual hemifield in ssVEP amplitude modulation. This difference was most pronounced during selection of the left visual hemifield, at right temporal electrodes. In line with this finding, phase information revealed accelerated processing of aversive arousing, compared to affectively neutral pictures. The data suggest that affective stimulus properties modulate the spatiotemporal process along the ventral stream, encompassing amplitude amplification and timing changes of posterior and temporal cortex.

[Solid limbal dermoid in an 80-year-old patient]

BACKGROUND

Typically solid limbal dermoids are excised in pre-school age unless a high irregular astigmatism and its risk for amblyopia lead to an earlier intervention.

CASE REPORT

An 80-year-old lady from a rural area complained about a burning, tearing and foreign body sensation of the left eye for two months. In the past two years she had recognized that an extraocular prominence which had been present since birth had shown a tendency to grow. Slit lamp examination showed a markedly prominent and vascularized limbal tumor from 3.30 to 7.00 o'clock. Paralleling the border of the mass there was a bow-shaped stromal lipoid deposit reaching from limbus to limbus. Gonioscopic examination revealed a deep penetration of the process almost into the anterior chamber. The tumor was excised and some fatty tissue adjacent to Descemet's membrane was left. Histological assessment brought us to the diagnosis of a chronically irritated, predescemetal limbal dermoid with marked secondary vascularization, epidermalization, elastoid degeneration and degenerative arcus lipoides.

CONCLUSIONS

The excision of the limbal dermoid in the described case was performed in the later stage of life. When indicated cosmetically or medically, surgery should typically take place in pre-school age and be performed as a lamellar excision.

Affective picture perception: gender differences in visual cortex?

Activity in extrastriate visual cortex is greater when people view emotional relative to neutral pictures. Prior brain imaging and psychophysiological work has further suggested a bias for men to react more strongly to pleasant pictures, and for women to react more strongly to unpleasant pictures. Here we investigated visual cortical activity using fMRI in 28 men and women during picture viewing. Men and women showed reliably greater visual cortical reactivity during both pleasant and unpleasant pictures, relative to neutral, consistent with the view that the motivational relevance of visual stimuli directs attention and enhances elaborative perceptual processing. However, men did show greater extrastriate activity than women specifically during erotic picture perception, possibly reflecting a gender-specific visual mechanism for sexual selection.

Early modulation of visual perception by emotional arousal: evidence from steady-state visual evoked brain potentials

Allocation of processing resources to emotional picture stimuli was examined using steady-state visual evoked brain potentials (ssVEPs). Participants viewed a set of 60 colored affective pictures from the International Affective Picture System, presented in a flickering mode at 10 Hz in order to elicit ssVEPs. Phase and amplitude of the 10-Hz ssVEP were examined for six picture categories: threat and mutilation (unpleasant), families and erotica (pleasant), and household objects and persons (neutral). Self-reported affective arousal and hedonic valence of the picture stimuli were assessed by means of subjective ratings. Viewing affectively arousing (unpleasant and pleasant) pictures was associated with enhanced ssVEP amplitude at parieto-occipital recording sites, as compared with neutral stimuli. Phase information suggested increased coactivation of right occipitotemporal and frontotemporal sources during processing of affectively arousing stimuli. These findings are consistent with reentrant modulation of early visual processing by distributed networks including subcortical and neocortical structures according to a stimulus's motivational relevance.

Psychopathy and Physiological Response to Emotionally Evocative Sounds

Despite considerable evidence that psychopathic criminals are deviant in their emotional reactions, few studies have examined responses to both pleasurable and aversive stimuli or assessed the role of different facets of psychopathy in affective deviations. This study investigated physiological reactions to emotional sounds in prisoners selected according to scores on the 2 factors of Hare's Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991). Offenders high on the PCL-R emotional-interpersonal factor, regardless of scores on the social deviance factor, showed diminished skin conductance responses to both pleasant and unpleasant sounds, suggesting a deficit in the action mobilization component of emotional response. Offenders who scored high only on the social deviance factor showed a delay in heart rate differentiation between affective and neutral sounds. These findings indicate abnormal reactivity to both positive and negative emotional stimuli in psychopathic individuals, and suggest differing roles for the 2 facets of psychopathy in affective processing deviations.

Startle reflex modulation, affective ratings and autonomic reactivity in incarcerated Spanish psychopaths

Startle probe modulation during affective picture viewing was assessed in a Spanish prison population. As for North American inmates, psychopaths failed to display normal blink potentiation during unpleasant slides even though their evaluative judgments and autonomic reaction to affective stimuli paralleled those of other inmate and noninmate participants. The results suggest that diminished defense activation characterizes psychopaths despite cultural differences.

Brain activation by disgust-inducing pictures in obsessive-compulsive disorder

BACKGROUND

There is growing interest in the role of disgust in the pathogenesis of obsessive-compulsive disorder (OCD).

METHODS

Eight OCD subjects with contamination preoccupations and eight gender- and age-matched healthy volunteers viewed pictures from the International Affective Picture System during functional magnetic resonance imaging scans.

RESULTS

A different distribution of brain activations was found during disgust-inducing visual stimulation in several areas, most notably the insula, compared with neutral stimulation in both OCD subjects and healthy volunteers. Furthermore, whereas activation during the threat-inducing task in OCD subjects showed a pattern similar to that in healthy volunteers, the pattern of activation during the disgust-inducing task was significantly different, including greater increases in the right insula, parahippocampal region, and inferior frontal sites.

CONCLUSIONS

This pilot study supports the relevance of disgust in the neurocircuitry of OCD with contamination-preoccupation symptoms; future studies looking at non-OCD individuals with high disgust ratings, non-contamination-preoccupied OCD individuals, and individuals with other anxiety disorders are needed.

The psychophysiology of anxiety disorder: fear memory imagery

Psychophysiological response to fear memory imagery was assessed in specific phobia, social anxiety disorder, panic disorder with agoraphobia, post-traumatic stress disorder (PTSD), and healthy controls. Heart rate, skin conductance, and corrugator muscle were recorded as participants responded to tone cues signaling previously memorized descriptor sentences. Image contents included personal fears, social fears, fears of physical danger, and neutral (low arousal) scenes. Reactions to acoustic startle probes (eyeblink) were assessed during recall imagery and nonsignal periods. Participants were significantly more reactive (in physiology and report of affect) to fear than neutral cues. Panic and PTSD patients were, however, less physiologically responsive than specific phobics and the socially anxious. Panic and PTSD patients also reported the most anxiety and mood symptoms, and were most frequently comorbidly depressed. Overall, physiological reactivity to sentence memory cues was greatest in patients with focal fear of specific objects or events, and reduced in patients characterized by generalized, high negative affect.

[Long-term results after perforating corneo-scleroplasty in a case of acute unilateral superior pellucid marginal corneal degeneration]

PURPOSE

This case report shows the long-term results after perforating corneo-scleroplasty in a rare case of superior pellucid marginal corneal degeneration with acute hydrops due to rupture of Descemet's membrane.

PATIENT

In the left cornea of a 20-year-old patient with peripheral stromal thinning from 9 to 3 o'clock a rupture in Descemet's membrane occurred followed by lamellar splitting of the mid-stromal region. Due to the decrease in visual acuity and pain from corneal edema a surgical treatment was performed consisting of a perforating/lamellar corneo-scleroplasty protecting the anterior chamber angle.

RESULTS

The status has remained stable for 17 years after surgery with nearly clear graft, best corrected visual acuity of 0.8 and no signs of recurrence or progression of the disease. Central astigmatism is regular, the endothelial cell count is 1250/mm2 in the central cornea, the central corneal thickness is 540 microm and only a mild vascularised superficial pannus and slight opacities in the predescemetal layer of the graft are found. There are no anterior synechia. On the right eye visual acuity is 0.8 due to slight amblyopia. There are no corneal changes which would indicate bilaterality of the disease.

CONCLUSIONS

Our findings must be interpreted as an atypically localised superior pellucid marginal corneal degeneration with rupture of Descemet's membrane followed by acute corneal hydrops. When reduction of visual acuity or pain occurs a surgical treatment by perforating/lamellar corneo-scleroplasty can be performed stopping the progression of the disease and achieving a stable optical rehabilitation and absence of pain even after decades.

Activation of the visual cortex in motivated attention

Functional activation (measured with fMRI) in occipital cortex was more extensive when participants view pictures strongly related to primary motive states (i.e., victims of violent death, viewer-directed threat, and erotica). This functional activity was greater than that observed for less intense emotional (i.e., happy families or angry faces) or neutral images (i.e., household objects, neutral faces). Both the extent and strength of functional activity were related to the judged affective arousal of the different picture contents, and the same pattern of functional activation was present whether pictures were presented in color or in grayscale. It is suggested that more extensive visual system activation reflects "motivated attention," in which appetitive or defensive motivational engagement directs attention and facilitates perceptual processing of survival-relevant stimuli.

Large-scale neural correlates of affective picture processing

Hemodynamic and electrophysiological studies indicate differential brain response to emotionally arousing, compared to neutral, pictures. The time course and source distribution of electrocortical potentials in response to emotional stimuli, using a high-density electrode (129-sensor) array were examined here. Event-related potentials (ERPs) were recorded while participants viewed pleasant, neutral, and unpleasant pictures. ERP voltages were examined in six time intervals, roughly corresponding to P1, N1, early P3, late P3 and a slow wave window. Differential activity was found for emotional, compared to neutral, pictures at both of the P3 intervals, as well as enhancement of later posterior positivity. Source space projection was performed using a minimum norm procedure that estimates the source currents generating the extracranially measured electrical gradient. Sources of slow wave modulation were located in occipital and posterior parietal cortex, with a right-hemispheric dominance.

Looking at facial expressions: Dysphoria and facial EMG

Previous research on interpersonal deficits among dysphoric individuals has been equivocal, with some studies finding that dysphoric persons show an increase in negative behavior and other studies finding no group differences. Most studies in this area have employed self-report instruments and behavioral coding systems to examine interpersonal displays. Using a different approach, we examined facial electromyography (EMG) reactivity to pictures of happy and unhappy expressions among dysphoric persons. Dysphoric and non-dysphoric persons viewed happy and unhappy facial expressions while zygomatic EMG and corrugator EMG activity was recorded. Results indicated that both groups showed the appropriate increase in corrugator EMG to unhappy expressions; however, dysphoric persons did not show the expected increase in zygomatic EMG activity to happy expressions while the control participants did show this response. Unexpectedly, the dysphoric group displayed an increase in corrugator EMG activity (e.g. frown response) to the happy facial expressions. These findings indicate that dysphoric persons have impaired interpersonal reactivity that is specific to happy facial displays.

Emotion and motivation I: defensive and appetitive reactions in picture processing

Emotional reactions are organized by underlying motivational states--defensive and appetitive--that have evolved to promote the survival of individuals and species. Affective responses were measured while participants viewed pictures with varied emotional and neutral content. Consistent with the motivational hypothesis, reports of the strongest emotional arousal, largest skin conductance responses, most pronounced cardiac deceleration, and greatest modulation of the startle reflex occurred when participants viewed pictures depicting threat, violent death, and erotica. Moreover, reflex modulation and conductance change varied with arousal, whereas facial patterns were content specific. The findings suggest that affective responses serve different functions-mobilization for action, attention, and social communication-and reflect the motivational system that is engaged, its intensity of activation, and the specific emotional context.

Emotion and motivation II: sex differences in picture processing

Adhering to the view that emotional reactivity is organized in part by underlying motivational states--defensive and appetitive--we investigated sex differences in motivational activation. Men's and women's affective reactions were measured while participants viewed pictures with varied emotional and neutral content. As expected, highly arousing contents of threat, mutilation, and erotica prompted the largest affective reactions in both men and women. Nonetheless, women showed a broad disposition to respond with greater defensive reactivity to aversive pictures, regardless of specific content, whereas increased appetitive activation was apparent for men only when viewing erotica. Biological and sociocultural factors in shaping sex differences in emotional reactivity are considered as possible mediators of sex differences in emotional response.

Affective startle modulation in anticipation and perception

Startle modulation was investigated as participants first anticipated and then viewed affective pictures in order to determine whether affective modulation of the startle reflex is similar in these different task contexts. During a 6-s anticipation period, a neutral light cue signaled whether the upcoming picture would portray snakes, erotica, or household objects; at the end of the anticipatory period, a picture in the signaled category was viewed for 6 s. Male participants highly fearful of snakes were recruited to maximize emotional arousal during anticipation and perception. Results indicated that the startle reflex was potentiated when anticipating either unpleasant (phobic) or pleasant (erotic) pictures, compared to neutral stimuli, whereas during perception, reflexes were potentiated when viewing unpleasant stimuli, and reduced when viewing pleasant pictures. The startle reflex is modulated by hedonic valence in picture perception, and by emotional arousal in a task context involving picture anticipation.

Food deprivation and emotional reactions to food cues: implications for eating disorders

Two studies examined emotional responding to food cues. In experiment 1, normal college students were assigned to 0-, 6- or 24-h of food deprivation prior to presentations of standard emotional and food-related pictures. Food deprivation had no impact on responses elicited by standard emotional pictures. However, subjective and psychophysiological reactions to food pictures were affected significantly by deprivation. Importantly, food-deprived subjects viewing food pictures showed an enhanced startle reflex and increased heart rate. Experiment 2 replicated the food deprivation effects from experiment 1, and examined participants reporting either a habitual pattern of restrained (anorexia-like) or binge (bulimia-like) eating. Food-deprived and binge eater groups showed startle potentiation to food cues, and rated these stimuli as more pleasant, relative to restrained eaters and control subjects. The results are interpreted from the perspective that startle modulation reflects activation of defensive or appetitive motivation. Implications of the data for understanding eating disorders are considered.

Affective reactions to briefly presented pictures

Affective reactions to briefly presented pictures were investigated to determine whether fleeting stimuli engage the motivational systems mediating emotional responses. Emotional and neutral pictures were presented for 500 ms; heart rate, skin conductance, corrugator EMG, and the evoked startle reflex were measured. The time course of reflex modulation was similar to that obtained with longer (6 s) presentations, suggesting that picture processing continues in the absence of a sensory stimulus. Affective reactions found with more sustained presentation were also obtained, with more corrugator EMG activity for unpleasant pictures, and greater skin conductance reactivity for emotional pictures. Heart rate modulation, however, appears to rely on the presence of a sensory stimulus. The data also suggest that brief presentations of unpleasant pictures may result in less defensive activation than sustained presentation.

Emotional reactions in children: verbal, physiological, and behavioral responses to affective pictures

Many studies have shown a consistent pattern in adults' responses to affective pictures and there is growing evidence of gender differences, as well. Little is known, though, about children's verbal, behavioral, and physiological responses to affective pictures. Two experiments investigated children's responses to pictures. In Experiment 1, children, adolescents, and adults viewed pictures varying in affective content and rated them for pleasure, arousal, and dominance. Results indicated that children and adolescents rated the pictures similarly to adults. In Experiment 2, physiological responses, self-report, and viewing time were measured while children viewed affective pictures. As with adults, children's responses reflected the affective content of the pictures. Gender differences in affective evaluations, corrugator activity, skin conductance, startle modulation, and viewing time indicated that girls were generally more reactive to unpleasant materials.

Fleeting images: a new look at early emotion discrimination

The visual brain quickly sorted stimuli for emotional impact despite high-speed presentation (3 or 5 per s) in a sustained, serial torrent of 700 complex pictures. Event-related potentials, recorded with a dense electrode array, showed selective discrimination of emotionally arousing stimuli from less affective content. Primary sources of this activation were over the occipital cortices, extending to right parietal cortex, suggesting a processing focus in the posterior visual system. Emotion discrimination was independent of formal pictorial properties (color, brightness. spatial frequency, and complexity). The data support the hypothesis of a very short-term conceptual memory store (M. C. Potter, 1999)-shown here to include a fleeting but reliable assessment of affective meaning.

Fear and anxiety: animal models and human cognitive psychophysiology

The aim of this paper is to explicate what is special about emotional information processing, emphasizing the neural foundations that underlie the experience and expression of fear. A functional, anatomical model of defense behavior in animals is presented and applications are described in cognitive and physiological studies of human affect. It is proposed that unpleasant emotions depend on the activation of an evolutionarily primitive subcortical circuit, including the amygdala and the neural structures to which it projects. This motivational system mediates specific autonomic (e.g., heart rate change) and somatic reflexes (e.g., startle change) that originally promoted survival in dangerous conditions. These same response patterns are illustrated in humans, as they process objective, memorial, and media stimuli. Furthermore, it is shown how variations in the neural circuit and its outputs may separately characterize cue-specific fear (as in specific phobia) and more generalized anxiety. Finally, again emphasizing links between the animal and human data, we focus on special, attentional features of emotional processing: The automaticity of fear reactions, hyper-reactivity to minimal threat-cues, and evidence that the physiological responses in fear may be independent of slower, language-based appraisal processes.

The psychopath as observer: emotion and attention in picture processing

This study extended prior work showing abnormal affect-startle modulation in psychopaths. Male prisoners viewed specific categories of pleasant (erotic or thrilling) and unpleasant (victim or direct threat) slide pictures, along with neutral pictures. Acoustic startle probes were presented early (300 and 800 ms) and late (1,800, 3,000, and 4,500 ms) in the viewing interval. At later times, nonpsychopaths showed moderate and strong reflex potentiation for victim and threat scenes, respectively. For psychopaths, startle was inhibited during victim scenes and only weakly potentiated during threat. Psychopaths also showed more reliable blink inhibition across pleasant contents than nonpsychopaths and greater heart rate orienting to affective pictures overall. These results indicate a heightened aversion threshold in psychopaths. In addition, deficient reflex modulation at early times suggested a weakness in initial stimulus evaluation among psychopaths.

Brain potentials in affective picture processing: covariation with autonomic arousal and affective report

Emotionally arousing picture stimuli evoked scalp-recorded event-related potentials. A late, slow positive voltage change was observed, which was significantly larger for affective than neutral stimuli. This positive shift began 200-300 ms after picture onset, reached its maximum amplitude approximately 1 s after picture onset, and was sustained for most of a 6-s picture presentation period. The positive increase was not related to local probability of content type, but was accentuated for pictures that prompted increased autonomic responses and reports of greater affective arousal (e.g. erotic or violent content). These results suggest that the late positive wave indicates a selective processing of emotional stimuli, reflecting the activation of motivational systems in the brain.

Affective reactions to acoustic stimuli

Emotional reactions to naturally occurring sounds (e.g., screams, erotica, bombs, etc.) were investigated in two studies. In Experiment 1, subjects rated the pleasure and arousal elicited when listening to each of 60 sounds, followed by an incidental free recall task. The shape of the two-dimensional affective space defined by the mean ratings for each sound was similar to that previously obtained for pictures, and, like memory for pictures, free recall was highest for emotionally arousing stimuli. In Experiment 2, autonomic and facial electromyographic (EMG) activity were recorded while a new group of subjects listened to the same set of sounds; the startle reflex was measured using visual probes. Listening to unpleasant sounds resulted in larger startle reflexes, more corrugator EMG activity, and larger heart rate deceleration compared with listening to pleasant sounds. Electrodermal reactions were larger for emotionally arousing than for neutral materials. Taken together, the data suggest that acoustic cues activate the appetitive and defensive motivational circuits underlying emotional expression in ways similar to pictures.

Affective picture processing: the late positive potential is modulated by motivational relevance

Recent studies have shown that the late positive component of the event-related-potential (ERP) is enhanced for emotional pictures, presented in an oddball paradigm, evaluated as distant from an established affective context. In other research, with context-free, random presentation, affectively intense pictures (pleasant and unpleasant) prompted similar enhanced ERP late positivity (compared with the neutral picture response). In an effort to reconcile interpretations of the late positive potential (LPP), ERPs to randomly ordered pictures were assessed, but using the faster presentation rate, brief exposure (1.5 s), and distinct sequences of six pictures, as in studies using an oddball based on evaluative distance. Again, results showed larger LPPs to pleasant and unpleasant pictures, compared with neutral pictures. Furthermore, affective pictures of high arousal elicited larger LPPs than less affectively intense pictures. The data support the view that late positivity to affective pictures is modulated both by their intrinsic motivational significance and the evaluative context of picture presentation.

Parapapillary atrophy in the chronic open-angle glaucomas

BACKGROUND

A study was carried out to evaluate whether parapapillary atrophy varies among different chronic open-angle glaucomas.

METHODS

The study included 625 Caucasian patients with primary open-angle glaucoma (POAG), 123 patients with secondary open-angle glaucoma (pseudoexfoliative glaucoma n=86; pigmentary glaucoma n=37), and 481 normal subjects. POAG was differentiated into highly myopic POAG (n=32), juvenile POAG (n=33), focal normal-pressure glaucoma (n=46), "sclerotic POAG" with marked fundus tesselation (n=89), and "ordinary POAG" comprising the remaining POAG eyes (n=425). Color stereo optic disc photographs were morphometrically evaluated.

RESULTS

The beta zone of parapapillary atrophy was significantly larger in sclerotic POAG (1.00+/-1.37 mm(2)) than in pseudoexfoliative glaucoma (0.65+/-0.93 mm(2)), pigmentary glaucoma (0.42+/-0.58 mm(2)), ordinary POAG (0.66+/-1.06 mm(2)), and focal normal-pressure glaucoma (0.34+/-0.36 mm(2)). In ordinary POAG, the beta zone was significantly larger than in juvenile POAG (0.33+/-0.72 mm(2)). Compared with all glaucoma groups, the beta zone was significantly the smallest in the normal eyes (0. 18+/-0.57 mm(2)). The alpha zone of parapapillary atrophy was significantly larger in the glaucoma groups than in the normal control group, with no significant difference between the glaucoma groups. The myopic crescent (4.11+/-3.42 mm(2)) present in the highly myopic eyes was significantly larger than the beta zone in any other group.

CONCLUSION

The beta zone of parapapillary atrophy varies by a factor of more than 3 between the various types of chronic primary and secondary open-angle glaucomas. This may be important diagnostically and pathogenetically.

Startle potentiation: shock sensitization, aversive learning, and affective picture modulation

This study investigated the size of, and relationship between, different modulatory effects of aversive stimulation on the acoustic startle reflex. This reflex is potentiated by shock exposure and associative shock conditioning (in animals and human volunteers) and unpleasant pictures (in human volunteers). In this study, dramatic sensitization of the probe-startle response was observed after shock exposure but not after a control task. Magnitude of sensitization was significantly larger than associative shock conditioning and picture modulation effects (also significant). Sensitization and conditioning scores showed modest, significant correlations with one another but not with picture modulation scores, consistent with animal data showing that partially overlapping brain mechanisms (i.e., amygdaloid-reticular projections) mediate these effects. The present results also indicate that sensitization of startle in human volunteers is a relatively more robust defensive response to aversive stimulation.

Emotion, motivation, and anxiety: brain mechanisms and psychophysiology

The organization of response systems in emotion is founded on two basic motive systems, appetitive and defensive. The subcortical and deep cortical structures that determine primary motivated behavior are similar across mammalian species. Animal research has illuminated these neural systems and defined their reflex outputs. Although motivated behavior is more complex and varied in humans, the simpler underlying response patterns persist in affective expression. These basic phenomena are elucidated here in the context of affective perception. Thus, the research examines human beings watching uniquely human stimuli--primarily picture media (but also words and sounds) that prompt emotional arousal--showing how the underlying motivational structure is apparent in the organization of visceral and behavioral responses, in the priming of simple reflexes, and in the reentrant processing of these symbolic representations in the sensory cortex. Implications of the work for understanding pathological emotional states are discussed, emphasizing research on psychopathy and the anxiety disorders.

Startle potentiation: shock sensitization, aversive learning, and affective picture modulation

This study investigated the size of, and relationship between, different modulatory effects of aversive stimulation on the acoustic startle reflex. This reflex is potentiated by shock exposure and associative shock conditioning (in animals and human volunteers) and unpleasant pictures (in human volunteers). In this study, dramatic sensitization of the probe-startle response was observed after shock exposure but not after a control task. Magnitude of sensitization was significantly larger than associative shock conditioning and picture modulation effects (also significant). Sensitization and conditioning scores showed modest, significant correlations with one another but not with picture modulation scores, consistent with animal data showing that partially overlapping brain mechanisms (i.e., amygdaloid-reticular projections) mediate these effects. The present results also indicate that sensitization of startle in human volunteers is a relatively more robust defensive response to aversive stimulation.

Increasing fruit and vegetable consumption among callers to the CIS: results from a randomized trial

BACKGROUND

Results are reported from a large randomized trial designed to increase fruit and vegetable consumption among callers to the Cancer Information Service (CIS).

METHODS

CIS callers assigned to the intervention group received a brief proactive educational intervention over the telephone at the end of usual service, with two follow-up mailouts. Key educational messages and print material derived from the NCI 5 A Day for Better Health program were provided to intervention subjects. Subjects were interviewed by telephone at both 4-week (n = 1,672) and 4-month (n = 1,286) follow-up.

RESULTS

A single-item measure of fruit and vegetable consumption revealed a significant intervention effect of approximately 0.65 servings per day at 4-week follow-up (P < 0.001) and 0.41 servings per day at 4-month follow-up (P < 0.001). Using a seven-item food frequency measure that was also included in the 4-month interviews, a similar intervention effect of 0.34 servings per day was obtained (P = 0.006). The vast majority of CIS callers (88%) endorsed the strategy of providing 5 A Day information proactively.

CONCLUSIONS

A brief educational intervention delivered to CIS callers at the end of usual service was associated with an increase in self-reported fruit and vegetable intake.

Carcinoma of the breast in males: a multiinstitutional survey

BACKGROUND

Breast carcinoma in males is infrequent, and information regarding the results of modern treatment is limited. Cases of breast carcinoma in males were accrued from multiple hospitals in one region to determine treatment, survival, and prognostic factors.

METHODS

A retrospective review was performed of 217 cases of breast carcinoma in males accessioned at tumor registries of 18 health care institutions in eastern Wisconsin between 1953 and 1995.

RESULTS

Of the 217 cases, 215 (99.1%) were carcinomas. The majority of carcinomas were of invasive ductal type and presented as masses. Carcinoma in situ accounted for 5.5% of cases. The 5- and 10-year observed survivals for men were 50.6% and 23.7%, respectively. A high rate of post-treatment mortality from comorbid disease was found. Stage, axillary lymph node status, number of lymph nodes with metastases, and tumor hormone receptors were significant indicators of prognosis. Adjuvant systemic chemotherapy and hormone therapy improved the prognosis of patients with axillary lymph node metastases and hormone receptor positive tumors. Earlier stage at presentation and improved 5-year survival were found in cases occurring between 1986-1995 compared with those occurring in earlier years. Use of modified radical mastectomy and systemic adjuvant therapy also increased since 1986.

CONCLUSIONS

The clinical, pathologic, and prognostic features of breast carcinoma in men are similar to those reported for women. The poorer prognosis of men is related to older age at diagnosis, more advanced stage of disease at presentation, and high mortality from comorbid disease. Earlier diagnosis, less radical surgery, and use of systemic adjuvant therapy are coincident with an improved prognosis for men.