Student nurses' attitudes to psychiatry: the influence of training and personality

Fifty-one second-year students completed the Attitudes to Treatment Questionnaire (ATQ), the Conservatism Scale (CS), the Defence Style Questionnaire (DSQ) and an open-ended questionnaire before and after components of their psychiatric training programme, which included a 1-week placement in a psychiatric hospital. CS scores indicated that the nurses were moderately conservative. ATQ scores and CS scores correlated significantly, with the more conservative nurses reporting more traditional attitudes to psychiatric nursing. ATQ scores fell significantly after psychiatric hospital placement, indicating more progressive attitudes. Mean scores on the DSQ were within normal limits, although men scored significantly higher than women on the Immature Defences Scale immediately after placement. The open-ended questionnaire revealed mainly positive comments about the psychiatric hospital placement. Almost half the nurses expressed surprise at the relaxed, informal atmosphere on the wards, and as many stated that personal interaction with the patients rapidly removed any stereotyped attitudes that they held previously. Over 40% of nurses stated that the patients were much less aggressive or dangerous than they had expected, although nearly 20% said they were concerned about the levels of aggression that they observed.

Alkaline nuclease activity in cells infected with herpes simplex virus type 1 (HSV-1) and HSV-1 temperature-sensitive mutants

An in situ assay has been adapted to the herpes simplex virus type 1 (HSV-1) system which can detect alkaline nuclease activity in infected cell lysates following sodium dodecylsulfate polyacrylamide gel electrophoresis. Lysates of cells infected with HSV-1 temperature-sensitive (ts) mutants possessing mutations in the genes for an immediate-early transcriptional regulatory protein (ICP4), viral DNA polymerase (pol), and the major HSV-1 DNA binding protein (ICP8) exhibited altered alkaline nuclease profiles relative to that of wild-type virus-infected cells at 39 degrees C. Infections with a control mutant defective in the gene for glycoprotein B yielded wild-type nuclease profiles. The diverse effects on alkaline nuclease expression of mutants with lesions in different viral proteins involved directly in viral DNA synthesis provides evidence for the cooperative interaction between HSV-encoded viral DNA replication components.

In situ detection of alkaline nuclease activity in cells infected with herpes simplex virus type 1 (HSV-1)

An in situ assay for detection of alkaline nuclease activities has been adapted to the herpes simplex virus type 1 (HSV-1) system. Six major nuclease activities which migrate with molecular weights of 90,000, 85,000, 80,000, 76,000, 71,000 and 65,000, and six minor species of molecular weights 87,000, 81,000, 57,000, 18,500, 17,500 and 16,500 were detected in lysates of HSV-1 infected cells following SDS-polyacrylamide gel electrophoresis and enzyme activation in situ. An ELISA assay and an immunoprecipitation study indicated that the six major HSV-induced nuclease species are virus-specific. Moreover, a reconstruction experiment in which 14C-labelled protein markers were incubated with mock- and HSV-infected cell lysates demonstrates that the nuclease fractions detected in situ were not due to endogenous proteolytic activity. The 80,000, 76,000, 71,000 and 65,000 species were first detected at 4 h post-infection, whereas all others were detectable by 6 h post-infection. The activities of the major cellular nucleases of molecular weights 50,000. 48,000 and 45,000 decreased as a function of time post-infection. The level of expression of each of the virus-induced species was dependent upon the multiplicity of infection, and all virus-induced activities exhibited biochemical properties characteristic of purified HSV-1 alkaline nuclease, including activation and inhibition by specifications. The 76,000 HSV-induced alkaline nuclease species was also demonstrated to possess endonucleolytic activity.

The outcome of behavior therapy for agoraphobia in relation to marital adjustment

After intensively treating 18 agoraphobic patients with 13 1/2 hours of exposure in vivo, we examined the effects on both patients and their spouses over a period of six months, using questionnaire measures of symptoms and marital adjustment. Those patients whose marriages were rated as unsatisfactory before treatment improved less during treatment, and were significantly more likely to relapse during follow-up, than those patients with satisfactory marriages. The marriages of nine patients appeared to be adversely influenced by their symptomatic improvement, and two distinct types of marital interaction were observed in relation to this. In one pattern, the patients' symptoms appeared to strengthen aspects of largely affectionless "compulsory" marriages; in the other, the patients' symptoms appeared to protect their spouses from recognizing or examining aspects of their own personal and interpersonal problems.

Biofeedback in the treatment of detrusor instability

Detrusor instability has remained resistant to conventional forms of treatment. An attempt to use biofeedback methods in its management is described. Six female patients with symptoms of frequency, urgency and urge incontinence due to detrusor instability were conditioned to auditory and visual stimuli for 6 to 8 1 h sessions. They were assessed clinically and urodynamically. The results are presented as well as detailed case studies of 3 patients. Subjectively, 3 were cured, 2 improved and 1 remained the same; objectively, 3 were cured, 1 improved and 2 remained the same. No significant side effects were encountered.

The influence of propranolol on the exposure in vivo of agoraphobics

This study examines the influence of 40 mg of propranolol on agoraphobics throughout 5-hour periods of exposure in vivo on 3 alternate days. Twenty-three patients were studied using a double-blind parallel design and 19 followed up for 3 months. The propranolol group spent significantly less time than the placebo group travelling alone in the month after treatment, and had improved significantly less on a measure of general symptoms at 3 months. The adverse influence of propranolol on treatment outcome appeared mainly due to a waning effect in the last hour of exposure. Attempts to measure coping with panics as an independent variable were largely unsuccessful.

Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation

Fifty-seven chronic agoraphobic outpatients were treated by 12 hours of exposure in vivo on four days over two weeks to check the effects of oral diazepam versus placebo during group exposure, group versus individual exposure, and high versus medium anxiety arousal during individual exposure. The controlled parallel design allowed comparative evaluation of each treatment condition to six months follow-up. Assessment was blind with respect to drug and psychological treatment. Patients in all treatment conditions improved significantly in phobias and in related life areas. Outcome to group exposure on phobias and other measures was similar in all three drug conditions (placebo, waning diazepam, peak diazepam) with no significant differences between them. Diazepam patients had significantly less discomfort than placebo patients during group exposure treatment. Group exposure patients improved slightly but significantly more than individual exposure patients on non-phobic measures, though group exposure was accompanied by more panics during treatment yet was easier to run by the therapist. Individual exposure under high anxiety arousal was no more therapeutic than with lower anxiety. Diazepam is a mild palliative during group exposure but does not facilitate outcome to treatment. Group exposure in vivo is mildly facilitatory for outcome compared with individual exposure. Anxiety evocation during treatment was not therapeutically helpful.

Nocturnal activity and enuresis. A study of a 35 year old male

A significant relationship between nocturnal enuresis and motility is demonstrated in a 35 year old male patient who had chronic nocturnal enuresis. After further treatment this relationship disappeared and the enuresis progressively diminished.