Early parental separation experiences among patients with bipolar disorder and major depression: a case-control study

Effects of Early-Life Stress on the Brain and Behaviors: Implications of Early Maternal Separation in Rodents

Early-life stress during the prenatal and postnatal periods affects the formation of neural networks that influence brain function throughout life. Previous studies have indicated that maternal separation (MS), a typical rodent model equivalent to early-life stress and, more specifically, to child abuse and/or neglect in humans, can modulate the hypothalamic-pituitary-adrenal (HPA) axis, affecting subsequent neuronal function and emotional behavior. However, the neural basis of the long-lasting effects of early-life stress on brain function has not been clarified. In the present review, we describe the alterations in the HPA-axis activity-focusing on serum corticosterone (CORT)-and in the end products of the HPA axis as well as on the CORT receptor in rodents. We then introduce the brain regions activated during various patterns of MS, including repeated MS and single exposure to MS at various stages before weaning, via an investigation of c-Fos expression, which is a biological marker of neuronal activity. Furthermore, we discuss the alterations in behavior and gene expression in the brains of adult mice exposed to MS. Finally, we ask whether MS repeats itself and whether intergenerational transmission of child abuse and neglect is possible.

The Perfect Storm: Mapping the Life Course Trajectories of Serial Killers

Since the 1970s, scholars have produced a large body of research attempting to establish the mechanisms by which sexual serial killers come to arrive at a life of repeat fatal violence. From the standpoint of developmental psychology, however, the explanations offered are far too limited in scope. Human development is the product of complex reciprocal transactions that occur between an individual and their environment throughout their life span. This present study is meant to encourage a critical reconsideration of past knowledge (mainly static traits) in favor of the recognition of the complexity of human development. Using life span developmental psychology as a guiding framework, this study traces the developmental mechanisms that come together to shape the psychopathology that drives the motivations of sexual serial killers.

Re-traumatization Cycle: Sexual Abuse, Post-Traumatic Stress Disorder and Sexual Risk Behaviors among Club Drug Users

Background: Club drug users are high risk and vulnerable population for adverse drug-related consequences and sexual risk behaviors. Few investigations have addressed the possible interrelationship between early trauma and PTSD among young club drug using populations. Objective: Exposure to traumatic experiences - especially in childhood, has been linked to risk behaviors exposure and substance use disorder. This study aimed to assess and compare drug use patterns and the presence of childhood sexual abuse (CSA) experiences among ecstasy and LSD users with and without Posttraumatic Stress Disorder (PTSD). Method: This cross-sectional study employed targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals. The Global Appraisal of Individual Needs questionnaire was used as the primary assessment instrument. Participants were from 18 to 39 years of age, had used ecstasy and/or LSD in the 90 days prior to the interview, and were not in treatment for alcohol and other drug problems. Results: Out of the 240 participants, 123 (51.2%) presented PTSD symptoms. Those presenting PTSD were younger, less educated, with lower income, and presented higher drug use severity than those without PTSD symptoms. Moreover, a higher prevalence of sexual risk behavior was verified among those with PTSD. There was an association between PTSD symptoms and CSA history, where 64.2% of individuals with PTSD also presented CSA, compared to 47% among those without PTSD (p = .028). Individuals with co-occurring history of CSA and PTSD symptoms reported earlier use of ecstasy, LSD, and cocaine compared to individuals with a history of CSA but without PTSD. Conclusions: In the present study, participants with a history of PTSD demonstrate a history of CSA, as well as pronounced severity in several areas - precocity of use, severity of addiction, and greater exposure to situations of sexual risk. Thus, a cycle of traumatization may be established through early potential trauma, which can remain unprocessed and contribute to earlier and more severe substance use and sexual risk behaviors. Identification of PTSD symptoms and risk for HIV and other STIs among young club drug users is critical to address focused treatment approaches for this vulnerable population.

Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents

The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.

Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis

BACKGROUND

The relationship between childhood adversity and bipolar affective disorder remains unclear.

AIMS

To understand the size and significance of this effect through a statistical synthesis of reported research.

METHOD

Search terms relating to childhood adversity and bipolar disorder were entered into Medline, EMBASE, PsycINFO and Web of Science. Eligible studies included a sample diagnosed with bipolar disorder, a comparison sample and a quantitative measure of childhood adversity.

RESULTS

In 19 eligible studies childhood adversity was 2.63 times (95% CI 2.00-3.47) more likely to have occurred in bipolar disorder compared with non-clinical controls. The effect of emotional abuse was particularly robust (OR = 4.04, 95% CI 3.12-5.22), but rates of adversity were similar to those in psychiatric controls.

CONCLUSIONS

Childhood adversity is associated with bipolar disorder, which has implications for the treatment of this clinical group. Further prospective research could clarify temporal causality and explanatory mechanisms.

The nosologic relationship between generalized anxiety disorder and major depression

Generalized anxiety disorder (GAD) has undergone a series of revisions in its diagnostic criteria that has moved it, nosologically, away from its original affiliation with panic disorder (PD) and closer to major depressive disorder (MDD). This, together with its high comorbidity and putative shared genetic risk with MDD, has brought into question its place in future psychiatric nosology, prompting the planners of Diagnostic and Statistical Manual-V (DSM-V) and International Classification of Diseases-11 (ICD-11) to set up a workgroup tasked to better understand the relationship between GAD and MDD. This review attempts to summarize the extant data to compare GAD and MDD on a series of research validators to explore this relationship. Although insufficient data currently exist for GAD in several key validator classes, tentative conclusions can be drawn on the diagnostic status of GAD in relation to MDD. Although GAD possesses substantial overlap with MDD in the areas of genetics, childhood environment, demographics, and personality traits, this tends to hold true for other anxiety disorders (ADs) as well, with the strongest evidence for PD. Data from life events, personality disorders, biology, comorbidity, and pharmacology are mixed, showing some areas of similarity between GAD and MDD but some clear differences, again with a moderate degree of nonspecificity. Thus, although the bulk of evidence supports a close underlying relationship between them, the relatively nonspecific nature of these findings provides little more reason to question the nosologic validity of GAD in relation to MDD than that of some other anxiety disorders.

Genes and life-style factors in BELFAST nonagenarians: Nature, Nurture and Narrative

Understanding how to 'Age Longer and Age Well' is a priority for people personally, for populations globally and for government policy. Nonagenarians are the oldest members of our societies and survivors of their generation. Approximately 10 % of nonagenarians reach 90 years and beyond in good condition and seem to have a combination of both age-span and health-span. But what are the factors which help people reach their ninetieth birthday and beyond in good condition? Are they genetics, as in 'nature', or do they depend on 'nurture' and are related to environment, or are both factors inextricably intertwined within the concept of behavioural genetics? Nonagenarians have rich life experiences that can teach us much about ageing well; they are reservoirs of genetic, life-style and behavioural information which can help dissect out how to live not only longer but better. Personal family history and narrative are powerful tools that help to determine familial traits, beliefs and social behaviours and when used in parallel with new biotechnology methods inform and elaborate causality. Here we present themes and insights from personal narrative enquiry from nonagenarian participants from the Belfast Elderly Longitudinal Free-living Ageing STudy (BELFAST) about factors they consider important for good quality ageing and relate these insights to the emerging genetics and life-style evidence associated with healthy longevity.

A population-based study of the risk of schizophrenia and bipolar disorder associated with parent-child separation during development

BACKGROUND

There is growing interest in the role of childhood adversities, including parental death and separation, in the etiology of psychotic disorders. However, few studies have used prospectively collected data to specifically investigate parental separation across development, or assessed the importance of duration of separation, and family characteristics.

METHOD

We measured three types of separation not due to death: maternal, paternal, and from both parents, across the ages of 1-15 years among a cohort of 985 058 individuals born in Denmark 1971-1991 and followed to 2011. Associations with narrowly and broadly defined schizophrenia and bipolar disorder in the psychiatric register were assessed in terms of separation occurrence, age of separation, and number of years separated. Interactions with parental history of mental disorder were assessed.

RESULTS

Each type of separation was associated with all three outcomes, adjusting for age, sex, birth period, calendar year, family history of mental disorder, urbanicity at birth and parental age. Number of years of paternal separation was positively associated with both schizophrenia and bipolar disorder. Associations between separation from both parents and schizophrenia were stronger when separation occurred at later ages, while those with bipolar disorder remained stable across development. The first occurrence of paternal separation appeared to increase risk more when it occurred earlier in childhood. Associations differed according to parental history of mental disorder, although in no situation was separation protective.

CONCLUSIONS

Effects of parental separation may differ by type, developmental timing and family characteristics. These findings highlight the importance of considering such factors in studies of childhood adversity.

Roles of attachment and self-esteem: impact of early life stress on depressive symptoms among Japanese institutionalized children

BACKGROUND

Although exposure to early life stress is known to affect mental health, the underlying mechanisms of its impacts on depressive symptoms among institutionalized children and adolescents have been little studied.

METHODS

To investigate the role of attachment and self-esteem in association with adverse childhood experiences (ACEs) and depressive symptoms, 342 children (149 boys, 193 girls; age range 9-18 years old, mean age = 13.5 ± 2.4) living in residential foster care facilities in Japan completed questionnaires related to internal working models, self-esteem, and depressive symptoms. Their care workers completed questionnaires on ACEs.

RESULTS

Structural equation modeling (SEM) was created and the goodness of fit was examined (CMIN = 129.223, df = 1.360, GFI = .959, AGFI = .936, CFI = .939, RMSEA = .033). Maltreatment negatively predicted scores on secure attachment, but positively predicted scores on avoidant and ambivalent attachment. The secure attachment score negatively predicted depressive symptoms. The ambivalent attachment score positively predicted depressive symptoms both directly and through self-esteem, whereas the avoidant attachment score positively predicted depressive symptoms only directly. Maltreatment neither directly predicts self-esteem nor depressive symptoms, and parental illness/death and parental sociopathic behaviors did not predict any variables.

CONCLUSIONS

Results show that the adversity of child maltreatment affects depression through attachment styles and low self-esteem among institutionalized children. Implications of child maltreatment and recommendations for child welfare services and clinical interventions for institutionalized children are discussed.

Effects of early life adverse experiences on the brain: implications from maternal separation models in rodents

During postnatal development, adverse early life experiences affect the formation of neuronal networks and exert long-lasting effects on neural function. Many studies have shown that daily repeated maternal separation (MS), an animal model of early life stress, can regulate the hypothalamic-pituitary-adrenal axis (HPA axis) and affect subsequent brain function and behavior during adulthood. However, the molecular basis of the long-lasting effects of early life stress on brain function has not been fully elucidated. In this mini review, we present various cases of MS in rodents and illustrate the alterations in HPA axis activity by focusing on corticosterone (CORT). We then show a characterization of the brain regions affected by various patterns of MS, including repeated MS and single time MS at various stages before weaning, by investigating c-Fos expression. These CORT and c-Fos studies suggest that repeated early life stress may affect neuronal function in region- and temporal-specific manners, indicating a critical period for habituation to early life stress. Next, we introduce how early life stress can impact behavior, namely by inducing depression, anxiety or eating disorders, and alterations in gene expression in adult mice subjected to MS.

Perinatal programming of emotional brain circuits: an integrative view from systems to molecules

Environmental influences such as perinatal stress have been shown to program the developing organism to adapt brain and behavioral functions to cope with daily life challenges. Evidence is now accumulating that the specific and individual effects of early life adversity on the functional development of brain and behavior emerge as a function of the type, intensity, timing and the duration of the adverse environment, and that early life stress (ELS) is a major risk factor for developing behavioral dysfunctions and mental disorders. Results from clinical as well as experimental studies in animal models support the hypothesis that ELS can induce functional “scars” in prefrontal and limbic brain areas, regions that are essential for emotional control, learning and memory functions. On the other hand, the concept of “stress inoculation” is emerging from more recent research, which revealed positive functional adaptations in response to ELS resulting in resilience against stress and other adversities later in life. Moreover, recent studies indicate that early life experiences and the resulting behavioral consequences can be transmitted to the next generation, leading to a transgenerational cycle of adverse or positive adaptations of brain function and behavior. In this review we propose a unifying view of stress vulnerability and resilience by connecting genetic predisposition and programming sensitivity to the context of experience-expectancy and transgenerational epigenetic traits. The adaptive maturation of stress responsive neural and endocrine systems requires environmental challenges to optimize their functions. Repeated environmental challenges can be viewed within the framework of the match/mismatch hypothesis, the outcome, psychopathology or resilience, depends on the respective predisposition and on the context later in life.

Severe bereavement stress during the prenatal and childhood periods and risk of psychosis in later life: population based cohort study

OBJECTIVE

To examine the risk of psychosis associated with severe bereavement stress during the antenatal and postnatal period, between conception to adolescence, and with different causes of death.

DESIGN

Population based cohort study.

SETTING

Swedish national registers including births between 1973 and 1985 and followed-up to 2006.

PARTICIPANTS

In a cohort of 1,045,336 Swedish births (1973-85), offspring born to mothers exposed to severe maternal bereavement stress six months before conception or during pregnancy, or exposed to loss of a close family member subsequently from birth to 13 years of age were followed until 2006. Admissions were identified by linkage to national patient registers.

MAIN OUTCOME MEASURES

Crude and adjusted odds ratios for all psychosis, non-affective psychosis, and affective psychosis.

RESULTS

Maternal bereavement stress occurring preconception or during the prenatal period was not associated with a significant excess risk of psychosis in offspring (adjusted odds ratio, preconception 1.24, 95% confidence interval 0.96 to 1.62; first trimester 0.95, 0.58 to 1.56; second trimester 0.79, 0.46 to 1.33; third trimester 1.14, 0.78 to 1.66). Risks increased modestly after exposure to the loss of a close family member from birth to adolescence for all psychoses (adjusted odds ratio 1.17, 1.04 to 1.32). The pattern of risk was generally similar for non-affective and affective psychosis. Thus estimates were higher after death in the nuclear compared with extended family but remained non-significant for prenatal exposure; the earlier the exposure to death in the nuclear family occurred in childhood (all psychoses: adjusted odds ratio, birth to 2.9 years 1.84, 1.41 to 2.41; 3-6.9 years 1.47, 1.16 to 1.85; 7-12.9 years 1.32, 1.10 to 1.58) and after suicide. Following suicide, risks were especially higher for affective psychosis (birth to 2.9 years 3.33, 2.00 to 5.56; 6.9 years 1.84, 1.04 to 3.25; 7-12.9 years 2.68, 1.84 to 3.92). Adjustment for key confounders attenuated but did not explain associations with risk.

CONCLUSIONS

Postnatal but not prenatal bereavement stress in mothers is associated with an increased risk of psychosis in offspring. Risks are especially high for affective psychosis after suicide in the nuclear family, an effect that is not explained by family psychiatric history. Future studies are needed to understand possible sources of risk and resilience so that structures can be put in place to support vulnerable children and their families.

Early parental death and risk of hospitalization for affective disorder in adulthood

BACKGROUND

Early parental death is one of the most stressful childhood life events and may influence subsequent psychological health. We investigated the association between early parental loss and risk of hospitalization for an affective disorder in adulthood.

METHODS

Our nationwide register-based cohort study comprises 1,225,660 people born in Denmark in 1970-1990, of whom 138,893 experienced the death of a parent before the age of 30 years. Follow-up for hospitalization for an affective disorder in the period 1990-2009 yielded 15,261,058 person-years and 19,867 hospitalizations for affective disorder (bereaved n = 2,644; nonbereaved n = 17,223). A Cox proportional hazards model was used to assess hazard ratios (HRs) for hospitalization with an affective disorder according to early parental death.

RESULTS

People who experienced early parental death had an increased risk of hospitalization for a unipolar disorder (men: HR= 1.33; 95% confidence interval [CI] = 1.23-1.44; women: 1.23; 1.17-1.30). Stronger associations were observed for parental death caused by suicide than for other causes. For bipolar affective disorder, an increased risk of hospitalization was observed only after suicide.

CONCLUSIONS

People who had lost a parent had an increased risk of hospitalization for unipolar affective disorder. Although this was particularly true for bereavement due to parental suicide, it was also found for parental death from other causes. In contrast, an increased risk of hospitalization for bipolar affective disorder was observed only after parental suicide.

Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents

BACKGROUND

Stressful life events are associated with mood disorders in adults in clinical settings. Less described in the literature is the association between common life stressors and a wide range of psychopathology in young adolescents. This study uses a large non-clinical sample of young adolescents to describe the associations among worry or stress about common life events/difficulties, mental health and substance use.

METHODS

Data on lifetime stress or worry about common life events/difficulties (i.e., romantic breakups, family disruption, interpersonal difficulties, and personal stress (health, weight, school work)), symptoms of depression, conduct disorder symptoms, and substance use were collected from 1025 grade 7 students (mean age 12.9 years; 45% male). The association between each source of stress and each mental health and substance use indicator was modeled in separate logistic regression analyses.

RESULTS

The proportion of adolescents reporting worry or stress ranged from 7% for new family to 53% for schoolwork. Romantic breakup stress was statistically significantly associated with all the mental health and substance use indicators except illicit drug use. Family disruption was statistically significantly associated with depression symptoms, marijuana use, and cigarette use. Interpersonal difficulties stress was statistically significantly associated with depression symptoms. All sources of personal stress were statistically significantly related to depression symptoms. In addition, health-related stress was inversely related to binge drinking.

CONCLUSION

Young adolescents may benefit from learning positive coping skills to manage worry or stress about common stressors and in particular, worry or stress related to romantic breakups. Appropriate management of mental health symptoms and substance use related to common stressful life events and difficulties may help reduce emerging psychopathology.

Proinflammatory activity and the sensitization of depressive-like behavior during maternal separation

When guinea pig pups are isolated for a few hours in a novel environment, they exhibit a distinctive passive behavioral response that appears to be mediated by proinflammatory activity. Recently, we observed that pups separated on two consecutive days show an enhanced (sensitized) passive response on the second day. In Experiment 1, pups receiving intracerebroventricular infusion of 50 ng of the anti-inflammatory cytokine interleukin-10 prior to a first separation failed to show a sensitized behavioral response to separation the next day. In Experiment 2, pups separated on Days 1 and 2, or just 2, showed an increase in passive responding during separation on Day 5. Pups injected with the bacterial antigen lipopolysacchride (LPS; 75 μg/kg body weight, intraperitoneal) prior to separation on Day 1 showed an increase in passive behavior several days later not shown by pups injected with saline prior to Day 1 separation. However, injection of LPS without separation on the first day did not enhance responding during an initial separation on the second day. These results suggest that immune activation is necessary, but not sufficient, to account for the sensitization of passive behavior of isolated guinea pig pups the following day, that boosting proinflammatory activity during an initial separation may promote sensitization several days later, and that the sensitized response persists for at least several days.

The experience-dependent maturation of prefronto-limbic circuits and the origin of developmental psychopathology: implications for the pathogenesis and therapy of behavioural disorders

The maturation of prefronto-limbic neuronal pathways that mediate essential affective and social regulatory functions is experience dependent. Immediately after birth the infant's affective experiences, especially those embedded in the relationship with the primary caregiver, trigger the reorganization and adaptive fine-tuning of synaptic circuits. Research in humans and in animal models supports the hypothesis that socio-emotional deprivation and emotional trauma during early childhood may leave 'scars' in prefronto-limbic function, brain regions that are essential for emotional behaviour, learning, and memory. The focus of this review is to point out that mechanisms involved in structuring and optimizing neural circuits during brain development might also be used in moulding personality and behaviour during psychotherapy in the adult brain.

Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates

BACKGROUND

Early adverse experiences such as sexual, verbal, or physical abuse and parental neglect have been associated with a higher risk of weight or eating problems in adulthood, and death or prolonged separation from parents during childhood has been implicated as a correlate of adult psychiatric disorders that are widely represented in obese subjects seeking bariatric surgery.

OBJECTIVE

The aim of this study was to examine the rate of childhood parental loss in obese bariatric surgery candidates and explore its association with a psychiatric diagnosis and clinical and weight/eating-related characteristics.

METHODS

The current and lifetime psychiatric diagnoses of 120 consecutive bariatric patients undergoing pre-surgical psychiatric consultation were assessed using a modified version of the Structured Clinical Interview for DSM-IV (SCID-CV), and information relating to parental death or separation before the age of 17 years was collected using a semi-structured interview. The rate of childhood parental loss was compared with that of an always slender population sharing the same psychiatric diagnosis.

RESULTS

91.7% of the obese subjects were diagnosed as having a bipolar spectrum disorder. Overall, 28% of the patients reported a childhood parental death or separation. Early parental loss was not equally distributed in the different diagnostic subgroups, being more frequent in those with bipolar II disorders; the always slender subjects with bipolar II disorders showed a lower rate of early parental loss.

CONCLUSIONS

The study findings confirm the association between obesity and bipolar disorders and suggest that early parental loss may play a role in the development of obesity in bipolar II subjects.

Judgments of Widely Held Beliefs about Psychological Phenomena among South African and Australian Postgraduate Psychology Students

Lay understandings of human cognition, affect, and behaviour often diverge from the findings of scientific investigations. The present study compared South African and Australian fourth year psychology students' judgments about the factual correctness of statements of psychological phenomena that have been demonstrated to be incorrect by empirical research. Students enrolled in the psychology Honours programmes at two large residential universities in South Africa and one university in Australia were asked to respond to a questionnaire that required them to decide on the validity of a list of empirically untrue statements. The results show that a large proportion of all universities believed many incorrect statements to be true. Significant differences between the samples emerged that may have been due to curricular differences between the academic programmes in the two countries. These results are discussed with reference to the teaching of critical thinking skills in psychology courses and the influence of popular culture on beliefs about human behaviour. Recommendations are also made about the teaching of scientific and critical reasoning skills in academic psychology programmes.

Acupuncture for posttraumatic stress disorder: conceptual, clinical, and biological data support further research

Posttraumatic stress disorder (PTSD) is common, debilitating, and has highly heterogeneous clinical and biological features. With the exception of one published preliminary clinical trial, rationale in support of the efficacy of acupuncture, a modality of Chinese medicine (CM), for PTSD has not been well described. This is a focused review of conceptual and clinical features of PTSD shared by modern western medicine (MWM) and CM, and of biological mechanisms of acupuncture that parallel known PTSD pathology. MWM and CM both recognize individual developmental variables and interactions between external conditions and internal responses in the genesis of PTSD. There is one published and one unpublished clinical trial that preliminarily support the efficacy of acupuncture for PTSD. Although there have been no mechanistic studies of acupuncture in human PTSD, extant research shows that acupuncture has biological effects that are relevant to PTSD pathology. Conceptual, clinical, and biological data support possible efficacy of acupuncture for PTSD. However, further definitive research about simultaneous clinical and biological effects is needed to support the use of acupuncture for PTSD in health care systems.

An animal model of eating disorders associated with stressful experience in early life

Experience of childhood abuse is prevalent among patients with eating disorders, and dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in its pathophysiology. Neonatal maternal separation is considered as an animal model of stressful experience early in life. Many of studies have demonstrated its impact both on the activity of HPA axis and the development of psycho-emotional disorders later in life. In this paper, a series of our researches on developing an animal model of eating disorders is reviewed. An animal model of neonatal maternal separation was used; Sprague-Dawley pups were separated from dam daily for 180 min during the first 2 weeks of life (MS) or undisturbed. Anxiety-/depression-like behaviors were observed in MS rats at the age of two months with decreased serotonergic activity in the hippocampus and the raphe. Post-weaning social isolation promoted food intake and weight gain of adolescent MS pups, with impacts on anxiety-like behaviors. Sustained hyperphagia was observed in the MS pups subjected to a fasting/refeeding cycle repeatedly during adolescence, with increased plasma corticosterone levels. Anhedonia, major symptom of depression, to palatable food was observed in adolescent MS pups with blunted response of the mesolimbic dopaminergic activity to stress. Results suggest that neonatal maternal separation lead to the development of eating disorders when it is challenged with social or metabolic stressors later in life, in which dysfunctions in the HPA axis and the brain monoaminergic systems may play important roles.

The impact of perinatal stress on the functional maturation of prefronto-cortical synaptic circuits: implications for the pathophysiology of ADHD?

Enriched as well as impoverished or adverse perinatal environment plays an essential role in the development and refinement of neuronal pathways, which are the neural substrate of intellectual capacity and socioemotional competence. Perinatal experience and learning events continuously interact with the adaptive shaping of excitatory, inhibitory, and neuromodulatory synaptic as well as the endocrine stress systems, including the neuronal corticotropin-releasing factor (CRF) pathways. Adverse environments, such as stress and emotional deprivation can not only delay experience-dependent maturation of these pathways, but also induce permanent changes in prefronto-cortical wiring patterns. We assume that such dysfunctional connections are the neuronal basis for the development of psychosocially induced mental disorders during later life. The aim of this review is to focus on the impact of perinatal stress on the neuronal and synaptic reorganization during brain development and possible implications for the etiology and therapy of mental disorders such as ADHD.

Influence of cocaine dependence and early life stress on pituitary-adrenal axis responses to CRH and the Trier social stressor

Long-term changes in the hypothalamic-pituitary-adrenal (HPA) axis as a result of early life stress could be related to the development of substance use disorders during adulthood. In this study, the neuroendocrine, physiologic (HR), and subjective responses to corticotropin releasing hormone (CRH) and the Trier Social Stress Task (TSST) in individuals with cocaine dependence, with (n=21)/without early life stress (n=21), non-dependent individuals with early life stress (n=22), and a control group were examined (n=21). CRH increased cortisol and ACTH levels in all groups. However, a significant effect of early life stress on ACTH was observed indicating that the increase in ACTH was greatest in subjects with a history of childhood stress. Post hoc analysis indicated the early life stress/non-cocaine dependent individuals exhibited significantly higher levels of ACTH as compared to the early life stress/cocaine-dependent group. Despite the elevated ACTH response there was no difference between the groups in the cortisol response to CRH. The TSST produced a significant elevation in ACTH and cortisol all study groups. No significant group differences were observed. The subjective stress and peak heart rate responses to the TSST were greatest in cocaine-dependent subjects without early life stress. In response to CRH, subjective stress and craving were positively correlated in cocaine-dependent subjects regardless of early life stress history, while stress and craving following the TSST were correlated only in cocaine-dependent subjects without a history of early life stress. Findings support previous studies demonstrating that subjects with a history of childhood adversity exhibit elevated ACTH and blunted cortisol levels in response to stress. In contrast, HR and subjective stress in response to the TSST were greatest in cocaine-dependent subjects without a history of early life stress, suggesting that childhood adversity may desensitize autonomic and subjective responding to social stress in adults with cocaine dependence.

Voluntary exercise reduces the neurotoxic effects of 6-hydroxydopamine in maternally separated rats

Maternal separation has been associated with development of anxiety-like behaviour and learning impairments in adult rats. This has been linked to changes in brain morphology observed after exposure to high levels of circulating glucocorticoids during the stress-hyporesponsive period (P4-P14). In the present study, adult rats that had been subjected to maternal separation (180 min/day for 14 days) during the stress-hyporesponsive period, received unilateral infusions of a small dose of 6-hydroxydopamine (6-OHDA, 5 microg/4 microl saline) into the medial forebrain bundle. The results showed that voluntary exercise had a neuroprotective effect in both non-stressed and maternally separated rats in that there was a decrease in forelimb akinesia (step test) and limb use asymmetry (cylinder test). Maternal separation increased forelimb akinesia and forelimb use asymmetry and reduced the beneficial effect of exercise on forelimb akinesia. It also reduced exploratory behaviour, consistent with anxiety-like behaviour normally associated with maternal separation. Exercise appeared to reduce dopamine neuron destruction in the lesioned substantia nigra when expressed as a percentage of the non-lesioned hemisphere. However, this appeared to be due to a compensatory decrease in completely stained tyrosine hydroxylase-positive neurons in the contralateral, non-lesioned substantia nigra. In agreement with reports that maternal separation increases the 6-OHDA-induced loss of dopamine terminals in the striatum, there was a small increase in dopamine neuron destruction when expressed as a percentage of the non-lesioned hemisphere but there was no difference in dopamine cell number, suggesting that exposure to maternal separation did not exacerbate dopamine cell loss.

The role of childhood parent figure loss in the etiology of adult depression: findings from a prospective longitudinal study

The underlying question of this study is whether childhood parental loss between infancy and sixth grade is a predictor of adult depression at age 26 years when a rating of loss severity is used. The loss rating considered the length of the separation/loss, the familiarity of substitute caregivers, the primary or supporting role of the lost parent figure, and traumatic features of the loss. The study also investigated the role of gender, developmental timing of the loss, life stress, SES, prior parental care and attachment history, and follow-up family relationships in the pathways between loss and depression. Results are reported from a prospective longitudinal study of children (N = 164) born into poverty. Measures were collected prenatally through age 26 years and included multiple methods and multiple reporters. Results indicated that the most robust predictor of adult depression was loss history between 5 years old and grade 2. Earlier and later measures of loss were not related to adult depression. However, intervening loss experiences predicted change in depression scores from childhood to adulthood. Loss continued to predict adult depression after controlling for SES, maternal life stress, participant life stress, gender, early caregiving, and follow up family functioning. This study found no significant gender differences. These results suggest that loss is a risk factor for adult depression for both boys and girls and that the quality of early and later caregiving do not entirely buffer children from the effects of parental loss.

Where should bipolar disorder appear in the meta-structure?

BACKGROUND

The extant major psychiatric classifications, DSM-IV and ICD-10, are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of both risk factors and clinical history. In an effort to group mental disorders on the basis of risk factors and clinical manifestations, five clusters have been proposed. The purpose of this paper is to consider the position of bipolar disorder (BPD), which could be either with the psychoses, or with emotional disorders, or in a separate cluster.

METHOD

We reviewed the literature on BPD, unipolar depression (UPD) and schizophrenia in relation to 11 validating criteria proposed by the DSM-V Task Force Study Group, and then summarized similarities and differences between BPD and schizophrenia on the one hand, and UPD on the other.

RESULTS

There are differences, often substantial and never trivial, for 10 of the 11 validators between BPD and UPD. There are also important differences between BPD and schizophrenia.

CONCLUSION

BPD has previously been classified together with UPD, but this is the least justifiable place for it. If it is to be recruited to a 'psychotic cluster', there are several important respects in which it differs from schizophrenia, so the cluster would have a division within it. The alternative would be to allow it to be in an intermediate position in a cluster of its own.

Anti-inflammatory influences on behavioral, but not cortisol, responses during maternal separation

The present study examined the effect of anti-inflammatory agents on the behavioral and plasma cortisol responses of guinea pig pups during isolation in a novel environment. In Experiment 1, intracerebroventricular (i.c.v.) administration of interleukin-10 (IL-10), across a range of doses, significantly reduced passive behaviors of isolated pups. In Experiment 2, neither i.c.v. IL-10 nor alpha-melanocyte stimulating hormone affected the plasma cortisol response to the separation procedure. These results provide further evidence that the passive behaviors of isolated guinea pig pups are mediated by proinflammatory cytokines and indicate that cytokines do not affect behavior indirectly by means of an action on hypothalamic-pituitary-adrenal activity.

South African Psychologists' Judgments of Widely Held Beliefs about Psychological Phenomena

Lay understandings of human cognition, affect, and behaviour often diverge from those informed by the findings of scientific investigations. In the present study I examined South African psychologists' judgments about the factual correctness of statements of psychological phenomena that have been demonstrated to be incorrect by empirical research. Forty-five psychologists responded to a mail survey and completed a questionnaire that required them to decide on the validity of a list of empirically untrue statements. The results show that a large proportion of psychologists indicated that they believed many incorrect statements to be probably or definitely true. These results are discussed with reference to the curricula of South African psychology training courses and the influence of popular culture on beliefs about human behaviour.

Long-term effects of the British evacuation of children during World War 2 on their adult mental health

OBJECTIVES

This study of 870 respondents aged 62-72 years investigates possible long-term effects on adult mental health due to temporary childhood separation by evacuation in the United Kingdom during World War 2.

METHOD

Using univariate and multivariate analyses associations were examined between upbringing, evacuation experience and certain life-course variables with the lifetime incidence of depression and clinical anxiety, and also with the dependency and self-critical factors of the Depressive Experiences Questionnaire (DEQ) (Blatt, S.J., D'Affitti, J.P., & Quinlan, D.M. (1976). Experiences of depression in normal young adults. Journal of Abnormal Psychology, 85, 383-389.) were examined by univariate and multivariate analyses.

RESULTS

Those evacuated at a young age, 4-6 years, or who received poor foster care, were found to be at a greater risk of depression and clinical anxiety, with high levels of self-criticism. Compared to other groups respondents evacuated at 13-15 years age, who received good care, had reduced incidences of both affective disorders, comparable to those who were not evacuated. The quality of home nurture was also found to be significantly associated with both disorders. Structural equation models for each sex based on those variables significantly associated with depression explained 45% of the variance of the incidence of depression for males and 25% for females. The models also confirmed the relatively high levels of dependency for females and their vulnerability to these levels in terms of depression.

CONCLUSION

The study demonstrated significant associations between childhood experiences and lifespan mental health, reinforcing the importance of knowledge of childhood history in the clinical treatment of older adults.

Childhood parental loss and adult psychopathology: effects of loss characteristics and contextual factors

The purpose of this study was to determine whether childhood parental death and childhood parental separation are linked to lifetime depressive and anxiety disorders after controlling for related risk factors. Participants were 105 individuals from the community, including a group with separation/desertion from a parent, a group with childhood parental death, and a matched control group whose parents remained married and living together. Participants completed interviews and questionnaires assessing symptoms of anxiety and depression, family psychiatric history, childhood maltreatment, and childhood parental relationships. Participants with separation/desertion and those with parental death were significantly more likely than the control subjects to report the subsequent onset of symptoms of a depressive or anxiety disorder. These effects were not fully explained by parental relationships or childhood maltreatment. However, in the group with parental separation only, family history of depressive and anxiety disorders accounted for the apparent effect of parental separation. These findings indicate that parental death may be a specific risk factor for depressive and anxiety disorders. For parental separation/desertion, our results highlight the overriding influence of risk factors that commonly co-occur with this form of parental loss.

Juvenile stress induces a predisposition to either anxiety or depressive-like symptoms following stress in adulthood

Epidemiological studies indicate that childhood trauma is predominantly associated with later emergence of several stress-related psychopathologies. While most 'early-stress' animal models focus on pre-weaning exposure, we examined the consequences of exposure to stress during the early pre-pubertal period, "juvenile stress", on adulthood stress responses. Following two different juvenile stress protocols, predator scent or short-term variable stress, we examined adulthood stress responses using the elevated plus-maze and startle response or exploration and avoidance learning. Employing Cut-off Behavioral Criteria analyses of clustering symptoms on the rats' altered stress responses discriminated between different patterns of maladaptive behaviors. Exposure to either juvenile stress protocols resulted in lasting alteration of stress responses with the majority of rats exhibiting anxiety-like behaviors, while the remaining third displayed depressive-like behaviors. The results suggest that the presented "Juvenile stress" model may be relevant to the reported predisposition to develop both anxiety and depression following childhood trauma.

Depressive behaviors and decreased expression of serotonin reuptake transporter in rats that experienced neonatal maternal separation

This study was conducted to examine the pathophysiologic mechanisms of long-term adverse effects by neonatal maternal separation on neurobehaviors of the offspring. Sprague-Dawley pups were separated from dam daily for 180min during the first 2 weeks of life (MS) or undisturbed (NH), and subjected to behavioral sessions for ambulatory activity, forced swim, and elevated plus maze tests at 2 months of age. Serotonin reuptake transporter (5-HTT) mRNA levels in the raphe nucleus and the contents of serotonin (5-HT) and its metabolite 5-hydroxyindol acetic acid in the raphe and the hippocampus were examined as well. Ambulatory counts decreased and immobility duration in swim test increased in MS rats compared with NH rats. MS rats spent more time in the closed arms, less time in the open arms, of elevated plus maze, compared to NH rats. The hippocampal contents of 5-HT and the raphe expression of 5-HTT mRNA were decreased in MS rats compared with NH rats. These results suggest that neonatal maternal separation may result in the development of depression- and/or anxiety-like behaviors in later life, in which the long-term alterations in 5-HTergic neurotransmission may take a role.

The International Society for Developmental Psychobiology annual meeting symposium: Impact of early life experiences on brain and behavioral development

Decades of research in the area of developmental psychobiology have shown that early life experience alters behavioral and brain development, which canalizes development to suit different environments. Recent methodological advances have begun to identify the mechanisms by which early life experiences cause these diverse adult outcomes. Here we present four different research programs that demonstrate the intricacies of early environmental influences on behavioral and brain development in both pathological and normal development. First, an animal model of schizophrenia is presented that suggests prenatal immune stimulation influences the postpubertal emergence of psychosis-related behavior in mice. Second, we describe a research program on infant rats that demonstrates how early odor learning has unique characteristics due to the unique functioning of the infant limbic system. Third, we present work on the rodent Octodon degus, which shows that early paternal and/or maternal deprivation alters development of limbic system synaptic density that corresponds to heightened emotionality. Fourth, a juvenile model of stress is presented that suggests this developmental period is important in determining adulthood emotional well being. The approach of each research program is strikingly different, yet all succeed in delineating a specific aspect of early development and its effects on infant and adult outcome that expands our understanding of the developmental impact of infant experiences on emotional and limbic system development. Together, these research programs suggest that the developing organism's developmental trajectory is influenced by environmental factors beginning in the fetus and extending through adolescence, although the specific timing and nature of the environmental influence has unique impact on adult mental health.

Adult mood disorders and childhood psychological trauma

OBJECTIVE: To evaluate the association between adult mood disorders and childhood psychological trauma in a developing country. METHOD: Adults with and without mood disorders were assessed in a case-control study using the Mini International Neuropsychiatric Interview. Assessment of childhood trauma included physical and sexual abuse, frequent exposure to violence, and parental loss. RESULTS: In two independent multivariate analyses, after adjusting for potential confounding factors, we found a higher odds ratio for frequent exposure to violence in the community (p = .037) and for physical abuse by parents or caregivers during childhood/adolescence (p = .012) in the group with mood disorders than in the control group. In secondary analyses splitting the mood disorder group in two subgroups (manic episode, and major depressive episodes/ dysthymia), only manic patients showed significantly higher rates of frequent exposure to violence in the community (p = 0.01) and physical abuse during childhood (p = 0.02) than did patients in the control group. In addition, maniac patients had significantly higher rates of sexual abuse than did controls (p = .03). CONCLUSIONS: Our findings document an association between violence during childhood and adult mood disorders, especially for manic patients, in a developing country.

Parental death and bipolar disorder: a robust association was found in early maternal suicide

BACKGROUND

Previous studies have suggested that early parental death may be associated with the emergence of bipolar disorder in later life. However, it remains unknown whether this association applies specifically to parental death due to suicide or only to early parental death. The present study aimed to explore whether suicide as well as the non-suicidal death of father, mother, or siblings are associated with an increased risk for bipolar disorder, and whether the possible association is modified by the age at which the subject experiences such a death in the family.

METHODS

The subjects were born in 1960 or later and were first admitted to or had first contact with Danish psychiatric facilities between 1981 and 1998 with a diagnosis of bipolar disorder, and fifty age-matched controls per case were extracted. The effects of the deaths of relatives were estimated by means of a conditional logistic regression analysis.

RESULTS

Among 947 subjects with bipolar disorder and 47,350 controls, those having experienced the parental suicide were significantly associated with an increased risk for BPD (incidence rate ratios: 1.83 [95% confidence interval: 1.07 to 3.12] for paternal suicide, 3.44 [1.97 to 6.00] for maternal suicide), whereas the non-suicidal death of parents showed no such association. Those having experienced maternal suicide at some point before reaching 10 years of age were seven times as likely to develop bipolar disorder.

LIMITATIONS

The cohort members were followed until, but not exceeding, the age of 38.

CONCLUSION

Early parental, particularly maternal, suicide increases the risk for bipolar disorder in the offspring. Possible explanations include a family history of mental disorders as well as psychosocial factors.

Attachment in Coping with Bereavement: A Theoretical Integration

Researchers have deplored shortcomings in theoretically based models of coping with bereavement. Integration of cognitive stress with attachment theory is proposed to predict adjustment to bereavement, describe different forms of effective coping, and resolve ongoing debates about continuing versus relinquishing bonds. These 2 generic approaches are integrated within a bereavement-specific perspective, the dual-process model of coping ( Stroebe & Schut, 1999 ). Accordingly, (a) different coping styles are adopted by, and are differentially efficacious for, bereaved people according to their style of attachment; (b) bereaved people's ways of continuing bonds differ according to their attachment style; and (c) grief complications are associated with insecure attachment styles. The authors conclude that it is better for some bereaved individuals to work toward retaining ties and for others to work toward loosening ties.

Maternal separation in rats leads to anxiety-like behavior and a blunted ACTH response and altered neurotransmitter levels in response to a subsequent stressor

Adverse early life experiences can have a negative impact on behavior later in life. We subjected rat pups to maternal separation and determined the effect's thereof on adult behavior. We removed rat pups from their mothers for 3 h daily from postnatal days 2 to 14. While controls were reared normally on day 60, the behaviors of the rats were tested using the elevated plus-maze. Some rats were subsequently subjected to restraint stress for a 10-min period. Trunk blood was collected for basal, as well as 15- and 60-min postrestraint stress ACTH determinations. Neurotransmitter levels (noradrenaline (NA), serotonin (5HT), and their metabolites, MHPG and 5HIAA, respectively) were also determined at basal, immediately and 15-min post-restraint stress in the hypothalamus, hippocampus, and frontal cortex in another group of animals. The amount of entries into the arms of the elevated plus-maze was significantly reduced in the separated animals, indicating decreased locomotion. They spent significantly more time in the closed arms of the maze. A significant increase in defecation frequency was noted. These observations suggested anxious behavior. Basal ACTH levels were significantly higher in separated animals. At 15-min post-restraint stress, the ACTH levels were significantly lower than controls, indicating a blunted stress response. A decrease in noradrenaline was noted first in limbic regions and an increase in 5HIAA levels was found in the frontal cortex and hippocampus. We conclude that maternal separation induced abnormal behaviors and stress responses that were associated with altered neurotransmitter levels.

Juvenile emotional experience alters synaptic composition in the rodent cortex, hippocampus, and lateral amygdala

A quantitative anatomical study in the rodent anterior cingulate and somatosensory cortex, hippocampus, and lateral amygdala revealed region-, cell-, and dendrite-specific changes of spine densities in 3-week-old Octodon degus after repeated parental separation. In parentally separated animals significantly higher spine densities were found on the apical and basal dendrites of the cingulate cortex (up to 143% on apical and 138% on basal dendrite). Branching order analysis revealed that this effect is seen on all segments of the apical dendrite, whereas on the basal dendrites significantly higher spine densities were seen only on the outer branches (third to fifth dendritic segments). Increased spine densities were also observed on the hippocampal CA1 pyramidal neurons (up to 109% on the distal apical segments and up to 106% on the basal segment) compared with the control group. In contrast, significantly reduced spine densities were observed on the granule cell dendrites in the dentate gyrus (down to 92%) and on the apical dendrites in the medial nucleus of the amygdala (down to 95%). No significant changes of spine densities were seen in the somatosensory cortex (except for an increase in the proximal apical segments) and in the lateral nucleus of the dorsal amygdala (except for an increase in the proximal basal dendritic segments). These results demonstrate that repeated stressful emotional experience alters the balance of presumably excitatory synaptic inputs of pyramidal neurons in the limbic system. Such experience-induced modulations of limbic circuits may determine psychosocial and cognitive capacities during later life.

Separation-induced receptor changes in the hippocampus and amygdala of Octodon degus: influence of maternal vocalizations

Relatively little is known about the basic mechanisms that play a role in the vulnerability of the developing brain toward adverse environmental influences. Our study in the South American rodent Octodon degus revealed that repeated brief separation from the parents and exposure to an unfamiliar environment induces in the hippocampal formation of male and female pups an upregulation of D1 and 5-HT1A receptor density in the stratum radiatum and stratum lacunosum moleculare of the CA1 region. In the CA3 region, only the 5-HT1A receptors were upregulated; no changes were observed for D1 receptors in this region. GABA(A) receptor density in the hippocampus and amygdala was downregulated (nonsignificant trend) after parental separation. The acoustic presence of the mother during parental separation suppressed the D1 and 5-HT1A receptor upregulation in some regions of the hippocampus; no such suppressing influence was observed for the GABA(A) receptors. In the basomedial amygdala, the maternal calls enhanced the separation-induced 5-HT1A receptor upregulation in the male pups, whereas in the female pups the separation-induced receptor densities were not only suppressed by the maternal call but further downregulated, compared with the control group. These results demonstrate that early adverse emotional experience alters aminergic function within the hippocampus and amygdala and that the mother's voice, a powerful emotional signal, can modulate these effects in the developing limbic system.

Risk factors in relation to an emergence of bipolar disorder: a systematic review

OBJECTIVE

There is a consensus that genetic factors are important in the causation of bipolar disorder (BPD); however, little is known about other risk factors in the aetiology of BPD. Our aim was to review the literature on such risk factors - risk factors other than family history of affective disorders - as predictors for the initial onset of BPD.

METHODS

We conducted a literature search using the MEDLINE, PsycINFO and EMBASE databases. We selected factors of interest including demographic factors, factors related to birth, personal, social and family backgrounds, and history of medical conditions. The relevant studies were extracted systematically according to a search protocol.

RESULTS

We identified approximately 100 studies that addressed the associations between antecedent environmental factors and a later risk for BPD. Suggestive findings have been provided regarding pregnancy and obstetric complications, winter-spring birth, stressful life events, traumatic brain injuries and multiple sclerosis. However, evidence is still inconclusive. Childbirth is likely to be a risk factor. The inconsistency across studies and methodological issues inherent in the study designs are also discussed.

CONCLUSION

Owing to a paucity of studies and methodological issues, risk factors of BPD other than family history of affective disorders have generally been neither confirmed nor excluded. We call for further research.

Childhood parental separation experiences and depressive symptomatology in acute major depression

The aim of this study was to examine the pathoplastic effects of childhood parental separation experiences on depressive symptoms. Patients with acute major depression were identified in a large 31-center study of affective disorders in Japan. Information regarding the patients' childhood losses was collected using a semistructured interview, and their depressive symptomatology was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Patients reported significantly higher CES-D total scores when they had experienced early object loss of the same-sex parent. In terms of the CES-D subscores derived by factor analysis, early object loss significantly aggravated symptoms that people normally could cope with but could no longer cope with when depressed (e.g. 'poor appetite', 'cannot shake off the blues' and 'everything an effort.'). Once depression develops, early object loss may act as a pathoplastic factor by making it severer especially by rendering people less able to perform what they normally could do.

Associação entre trauma por perda na infância e depressão na vida adulta

Observações clínicas efetuadas por psicanalistas sugerem que psicopatologias da idade adulta podem ter sido originadas na infância. Estudos publicados na última década identificaram associação entre trauma na infância e depressão na vida adulta. Vivências traumáticas na infância, como a perda de vínculos afetivos devido à morte de pais ou de irmãos ou, ainda, a privação de um ou de ambos os pais por separação ou abandono constituem importantes fatores associados à depressão na vida adulta. O objetivo do presente artigo é revisar a literatura dos últimos dez anos, considerando os fatores associados à depressão, particularmente aqueles relacionados aos estressores presentes na infância. A metodologia utilizada foi de busca on-line nas bases de dados Medline, PsycINFO, Cochrane e Lilacs, referentes ao período de maio de 1991 a maio de 2001. A maioria dos estudos incluídos nesta revisão encontrou uma associação significativa entre trauma por perdas na infância e depressão na vida adulta, com variação na intensidade das associações observadas.

Quality of life and its correlates in a community population in a Japanese rural area

Correlations of three aspects of quality of life (QOL) (health perception, life satisfaction, and self-confidence) with personality traits and early experiences were examined. Quality of life aspects were examined using 220 inhabitants in a rural community in Japan. Health perception was better among men than among women. Life satisfaction and self-confidence were better in people aged 55 or over than in those under 55. Among the current predictor variables, the Eysenck Personality Questionnaire neuroticism score was correlated with poor life satisfaction in the younger women; the extraversion score with the older women's health perception, the older men's life satisfaction, and the women's self-confidence; and the psychoticism score with the older men's life satisfaction. Among early life predictors, self-confidence was lower among those older men who had reported early parental loss. Childhood paternal overprotection was correlated with poor health perception in younger people and with good health perception in older women. Some negative life events experienced during childhood were correlated with poorer QOL measures in some subgroups, while positive life experiences were correlated with the older women's life satisfaction. These findings suggest that the three aspects of the QOL are discrete in their psychosocial correlates and that interventions on health education and care should take into account individual's psychosocial attributes.

Non-associative fear acquisition: a review of the evidence from retrospective and longitudinal research

It is axiomatic that the capacity to experience fear is adaptive, enabling rapid and energetic response to imminent threat or danger. Despite the generally accepted utility of functional fear, the nature of maladaptive fear remains controversial. There is still no consensus about how specific fears and phobias are acquired and modulated. Two major schools of thought are apparent: those suggesting dysfunctional fear arises largely as the result of associative-conditioning processes versus those who favour more biologically based etiological explanations. In this regard, the non-associative model of fear acquisition postulates the existence of a limited number of innate, evolutionary-relevant fears, while emphasising conditioning modes of onset for evolutionary-neutral fears. Recent retrospective and longitudinal studies have tested predictions from the non-associative model. In general, findings support non-associative hypotheses and are difficult to reconcile with neo-conditioning explanations of fear acquisition. These data suggest that four pathways to fear may provide the most parsimonious theory of fear etiology. The theoretical and practical implications of adding a fourth, non-associative path to Rachman's (Behav. Res. Ther. (1977) 15, 375-387) three 'associative' pathways are discussed. Unresolved issues requiring further investigation are considered.

Stress-induced sickness behaviors: an alternative hypothesis for responses during maternal separation

During maternal separation, some primate and nonprimate species show a biphasic (active/passive) response. The second stage is characterized by reduced activity, a hunched body posture, and other behaviors. Traditionally, the second stage has been referred to as "despair" and is considered an animal model for human depression. Recent research in psychoneuroimmunology suggests an alternative hypothesis--that behaviors occurring during the second passive phase represent stress-induced "sickness behaviors." This perspective more readily accounts for findings in widely divergent species, does not require assumptions regarding the ability to express complex emotional states, is empirically testable, and aligns the separation model with recent hypotheses regarding the nature and ontogeny of depressive illness.