Adverse childhood experiences and hormonal contraception: Interactive impact on sexual reward function

The current literature suggests that some women are uniquely vulnerable to negative effects of hormonal contraception (HC) on affective processes. However, little data exists as to which factors contribute to such vulnerability. The present study evaluated the impact of prepubertal adverse childhood experiences (ACEs) on reward processing in women taking HC (N = 541) compared to naturally cycling women (N = 488). Participants completed an online survey assessing current and past HC use and exposure to 10 different adverse childhood experiences (ACEs) before puberty (ACE Questionnaire), with participants categorized into groups of low (0-1) versus high (≥2) prepubertal ACE exposure. Participants then completed a reward task rating their expected and experienced valence for images that were either erotic, pleasant (non-erotic), or neutral. Significant interactions emerged between prepubertal ACE exposure and HC use on expected (p = 0.028) and experienced (p = 0.025) valence ratings of erotic images but not pleasant or neutral images. Importantly, follow-up analyses considering whether women experienced HC-induced decreases in sexual desire informed the significant interaction for expected valence ratings of erotic images. For current HC users, prepubertal ACEs interacted with HC-induced decreased sexual desire (p = 0.008), such that high ACE women reporting decreased sexual desire on HC showed substantially decreased ratings for anticipated erotic images compared to both high prepubertal ACE women without decreased sexual desire (p < 0.001) and low prepubertal ACE women also reporting decreased sexual desire (p = 0.010). The interaction was not significant in naturally cycling women reporting previous HC use, suggesting that current HC use could be impacting anticipatory reward processing of sexual stimuli among certain women (e.g., high prepubertal ACE women reporting HC-induced decreases in sexual desire). The study provides rationale for future randomized, controlled trials to account for prepubertal ACE exposure to promote contraceptive selection informed by behavioral evidence.

Discontinuation of hormonal contraception due to changes in mood and decreases in sexual desire: the role of adverse childhood experiences

PURPOSE

To evaluate if adverse childhood experiences are associated with hormonal contraception discontinuation due to mood and sexual side effects.

MATERIALS AND METHODS

Women, ages 18-40 (N = 826), with current and/or previous hormonal contraceptive use completed surveys on demographics, contraceptive history, and the Adverse Childhood Experiences Questionnaire. We characterised women into high (≥2 adverse experiences) and low (0 or 1) adverse childhood experience groups. We calculated risk ratios for associations between adverse childhood experiences and outcomes of interest using log binomial generalised linear models, and adjusted for relevant demographic variables.

RESULTS

Women in the high adverse childhood experiences group (n = 355) were more likely to report having discontinued hormonal contraception due to decreases in sexual desire (adjusted risk ratio 1.44, 1.03-2.00, p = .030). Covariates included age, current hormonal contraception use, and various demographic variables associated with discontinuation. Adverse childhood experiences were not associated with mood or sexual side effects among current (n = 541) hormonal contraceptive users.

CONCLUSIONS

Self-reported adverse childhood experiences were associated with greater likelihood of discontinuing hormonal contraception due to behavioural side effects, particularly decreases in sexual desire. Identification of risk factors for behavioural side effects can assist patients and clinicians in making informed choices on contraception that minimise risk of early discontinuation.

Adapting psychiatric research in the age of COVID-19: role of online studies

Virtual platforms can provide a socially distanced mechanism by which to promote ongoing research progress in the coronavirus disease 2019 (COVID-19) era and may change our approach to online research in the future. Understanding how to best utilise online research represents an important task for our field.

Evil Is More Than Banal: Situationism and the Concept of Evil

Social psychology as a discipline has given relatively little attention to the problem of evil in society, and those discussions in this field that do exist typically regard evil actions as only varieties of aggression without any characteristics that distinguish them from other forms of intentional mistreatment of others. Because of the field's situationistic perspective emphasizing the individual's susceptibility to the power of the immediate situation, social psychologists generally view the fairly high levels of obedience to authority displayed in Milgram's (1963, 1974) classic experiment as the paradigmatic example of evil behavior. For them, much evil is, in Arendt's (1963) well-known phrase, only “banal,” and Milgram's findings are often viewed as illustrating the “central dynamic” involved in the slaughter of millions of Jews and other “undesirables” in the Holocaust. This article holds that Milgram's (1974) obedience research does not represent significant features of the Holocaust, especially the sadism that occurred not infrequently, and disregards the vital difference between those who initiated the murderous policy and the others who followed their orders. Building on Darley's (1992) earlier conjectures about the features that ordinary people might consider in judging whether any given action is evil, I suggest that many persons have a prototypic conception of evil and speculate about the dimensions that could be involved in this prototype.

Primary nodal neuroendocrine (Merkel cell) tumor in a patient with HIV infection

Lymphadenopathy in the human immunodeficiency virus (HIV) can be of diverse etiology, ranging from infection to cancer. A neoplasm of epithelial origin manifested as inguinal lymphadenopathy without a primary lesion is rare. We report a case of Merkel cell tumor confined only to a lymph node in a patient with the acquired immunodeficiency syndrome (AIDS). We believe this is the first report of primary nodal Merkel cell tumor in a patient with HIV. Because Merkel cell tumor is a rare skin neoplasm with features suggestive of high malignant potential, it is important to distinguish a primary nodal Merkel cell tumor from malignant metastatic processes on the one hand and relatively benign causes of adenopathy on the other.

Initial microbiologic studies did not affect outcome in adults hospitalized with community-acquired pneumonia

Microbiologic studies (MBSs) fail to identify a specific pathogen in more than 50% of patients with community-acquired pneumonia (CAP). The 1993 American Thoracic Society guideline (ATS-GL) for the management of CAP advised selecting initial antibiotic regimens based on severity of illness and comorbidities. Our study evaluated the role of initial MBS in adult patients hospitalized with CAP and treated according to the ATS-GL. In 184 patients hospitalized at our facility for CAP in 1996, and treated according to the ATS-GL, 25 (14%) failed to respond to initial antibiotic regimens. In these nonresponders, there was no difference in mortality between those in whom antibiotics were changed empirically, and those with MBS-guided changes. We conclude that initial MBS may not be warranted in many adult patients admitted for CAP. Exceptions include patients with conditions that predispose to less common, more resistant pathogens.

Macrorestriction analysis of Caenorhabditis elegans genomic DNA

The usefulness of genomic physical maps is greatly enhanced by linkage of the physical map with the genetic map. We describe a "macrorestriction mapping" procedure for Caenorhabditis elegans that we have applied to this endeavor. High molecular weight, genomic DNA is digested with infrequently cutting restriction enzymes and size-fractionated by pulsed field gel electrophoresis. Southern blots of the gels are probed with clones from the C. elegans physical map. This procedure allows the construction of restriction maps covering several hundred kilobases and the detection of polymorphic restriction fragments using probes that map several hundred kilobases away. We describe several applications of this technique. (1) We determined that the amount of DNA in a previously uncloned region is < 220 kb. (2) We mapped the mes-1 gene to a cosmid, by detecting polymorphic restriction fragments associated with a deletion allele of the gene. The 25-kb deletion was initially detected using as a probe sequences located approximately 400 kb away from the gene. (3) We mapped the molecular endpoint of the deficiency hDf6, and determined that three spontaneously derived duplications in the unc-38-dpy-5 region have very complex molecular structures, containing internal rearrangements and deletions.

Recurrent anaphylaxis due to unrecognized latex hypersensitivity in two healthcare professionals

BACKGROUND

Anaphylaxis is a potentially fatal immediate-type reaction and intense effort may be required to identify the allergen responsible. In some cases, a "hidden" allergen may be responsible that is not apparent in spite of careful clinical assessment.

OBJECTIVES

This report describes the assessment of two cases of anaphylaxis in which a search for an allergen was initially not conclusive and the diagnosis of idiopathic anaphylaxis was considered.

METHODS

Two patients were evaluated by various physicians for anaphylaxis with no clear indication of a responsible allergen. Persistence in evaluation led to the identification of the allergen responsible.

RESULTS

In two health care workers latex was identified as the "hidden" cause of anaphylaxis. This allergen had not been considered in either case in initial evaluations. Neither patient has had a recurrence of anaphylaxis since latex was identified as the cause of anaphylaxis.

CONCLUSIONS

Although latex is widely recognized as a cause of anaphylaxis, it can still be unrecognized in some cases of recurrent anaphylaxis. Latex must be considered as a "hidden" cause of anaphylaxis, particularly in health care workers.

On the formation and regulation of anger and aggression. A cognitive-neoassociationistic analysis

Noting that a wide variety of unpleasant feelings, including sadness and depression, apparently can give rise to anger and aggression, I propose a cognitive-neoassociationistic model to account for the effects of negative affect on the development of angry feelings and the display of emotional aggression. Negative affect tends to activate ideas, memories, and expressive-motor reactions associated with anger and aggression as well as rudimentary angry feelings. Subsequent thought involving attributions, appraisals, and schematic conceptions can then intensify, suppress, enrich, or differentiate the initial reactions. Bodily reactions as well as emotion-relevant thoughts can activate the other components of the particular emotion network to which they are linked. Research findings consistent with the model are summarized. Experimental findings are also reported indicating that attention to one's negative feelings can lead to a regulation of the overt effects of the negative affect, I argue that the model can integrate the core aspect of the James-Lange theory with the newer cognitive theories of emotion.

On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis

Noting that a wide variety of unpleasant feelings, including sadness and depression, apparently can give rise to anger and aggression, I propose a cognitive-neoassociationistic model to account for the effects of negative affect on the development of angry feelings and the display of emotional aggression. Negative affect tends to activate ideas, memories, and expressive-motor reactions associated with anger and aggression as well as rudimentary angry feelings. Subsequent thought involving attributions, appraisals, and schematic conceptions can then intensify, suppress, enrich, or differentiate the initial reactions. Bodily reactions as well as emotion-relevant thoughts can activate the other components of the particular emotion network to which they are linked. Research findings consistent with the model are summarized. Experimental findings are also reported indicating that attention to one's negative feelings can lead to a regulation of the overt effects of the negative affect, I argue that the model can integrate the core aspect of the James-Lange theory with the newer cognitive theories of emotion.

Treatment of tracheobronchial granular cell myoblastomas with endoscopic bipolar cautery

Granular cell myoblastomas of the trachea and right upper lobe bronchus were discovered incidentally during therapeutic bronchoscopy. Because of their propensity to cause airway compromise and distal atelectasis, ablation of both lesions was undertaken. This is the first reported case of bipolar cautery of GCM through a flexible fiberoptic bronchoscope. Small tumor size and lack of atelectasis permitted utilization of this technique. Long-term follow-up is necessary to compare this therapy with other nonresectional therapies.

Frustration-aggression hypothesis: examination and reformulation

Examines the Dollard et al. (1939) frustration-aggression hypothesis. The original formulation's main proposition is limited to interference with an expected attainment of a desired goal on hostile (emotional) aggression. Although some studies have yielded negative results, others support the core proposition. Frustrations can create aggressive inclinations even when they are not arbitrary or aimed at the subject personally. Interpretations and attributions can be understood partly in terms of the original analysis but they can also influence the unpleasantness of the thwarting. A proposed revision of the 1939 model holds that frustrations generate aggressive inclinations to the degree that they arouse negative affect. Evidence regarding the aggressive consequences of aversive events is reviewed, and Berkowitz's cognitive-neoassociationistic model is summarized.

Frustration-aggression hypothesis: examination and reformulation

Examines the Dollard et al. (1939) frustration-aggression hypothesis. The original formulation's main proposition is limited to interference with an expected attainment of a desired goal on hostile (emotional) aggression. Although some studies have yielded negative results, others support the core proposition. Frustrations can create aggressive inclinations even when they are not arbitrary or aimed at the subject personally. Interpretations and attributions can be understood partly in terms of the original analysis but they can also influence the unpleasantness of the thwarting. A proposed revision of the 1939 model holds that frustrations generate aggressive inclinations to the degree that they arouse negative affect. Evidence regarding the aggressive consequences of aversive events is reviewed, and Berkowitz's cognitive-neoassociationistic model is summarized.

Analysis of mammalian cell growth factor receptor dynamics

We have proposed a mathematical model for the events following binding of EGF to cell surface receptors with the aim of elucidating possible mechanisms associated with a lack of responsiveness to EGF mitogenic stimulation. Comparison of our model calculations with the experiments of Schaudies et al. suggests at least two possible mechanisms: an increase in the rate of receptor synthesis, or an increase in the fraction of internalized receptors that are recycled to the cell surface. Discrimination between these alternatives requires experimental measurement of cell receptor quantities, such as the number of surface complexes or the amount of degraded receptor. At the present time, we speculate that an increase in the fraction of receptors recycled seems to be the more likely explanation.

The China diary. AMRA delegation's visit to China. Part I

In May, 22 AMRA representatives toured the People's Republic of China at the invitation of the Chinese government. Designated delegates kept a diary of the informational exchange between the AMRA delegates and their hosts, as well as a commentary on places seen during their travels. Their diary entries have been compiled into a two-part article. The first part appears in this issue, and the second part will appear in the September issue.

Dolichol kinase activity in the developing rat testis

Dolichyl phosphate concentrations, a primary factor in regulating the rate of N-glycosidically linked glycoprotein synthesis, are dependent upon a cytidine triphosphate (CTP)-dependent dolichol kinase. This study examines dolichol kinase in rat testicular microsomes and defines assay conditions. As with dolichol kinases from other tissues, addition of 2-mercaptoethanol increased activity 60%. Inclusion of NaF, an inhibitor of testicular dolichyl phosphate phosphatase activity, also resulted in a 38% increase in activity. Triton X-100 was necessary for phosphorylation of both endogenous and exogenous dolichol; however, concentrations of detergent in excess of 0.25-0.35% were inhibitory. A 2- to 5-fold stimulation of kinase activity was obtained by addition of 50-100 microM exogenous dolichol. The high level of nucleoside triphosphatase activity in testicular microsomes mandated the inclusion of high levels of uridine triphosphate (UTP) to protect the [gamma-32 P] CTP. Increasing UTP concentrations up to 50 mM resulted in increased product formation. A clear requirement for divalent cations was observed; 5 mM ethylenediaminetetraacetate (EDTA) abolished activity. The following order of cation effectiveness was observed: Mn greater than or equal to Ca greater than Cd greater than Zn much greater than Mg. Ten mM optima were established for Ca2+ and Mn2+; the presence of UTP, however, results in significantly reduced concentrations of free Ca2+. Ion combination studies demonstrated interactive inhibitory effects between Ca2+ and other stimulatory divalent cations. Addition of 2 microM brain calmodulin, in the presence of 10 mM Ca2+, resulted in a 75-100% stimulation of activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Audience effects when viewing aggressive movies

In order to examine audience effects when viewing filmed violence, male subjects watched an aggressive or a neutral movie either alone, accompanied by a passive confederate (i.e. mere presence of a co-spectator), or an active one (i.e. reacting to the movie). The subsequent behavioural measures of subjects' aggression were collected via a modified aggression apparatus. The usual instigation effect of filmed violence was found. Furthermore, the type of audience also influenced aggression: subjects accompanied by an active confederate during the violent movie displayed their aggressive behaviour most. These findings stress the importance of the social context when filmed violence is viewed. The results are discussed in terms of social facilitation and disinhibition effects. It is suggested that an active audience may promote a reduction of restraints against aggressing by showing the subject that aggression is permissible.

Victim reactions in aggressive erotic films as a factor in violence against women

The present study was designed to investigate whether the behavioral characteristics of the people in erotic films and the nature of the targets available for aggression afterward can affect subsequent aggression. In Experiment 1, male subjects were angered by a male or female confederate. They were then shown a neutral film or one of three erotic films. The erotic films differed in terms of their aggressive content (two were aggressive and one was nonaggressive) and the reactions of the female victim in the two aggressive films (positive vs. negative). Subjects were then allowed to aggress against the confederate via electric shock. Results indicated that films had no effect on male targets whereas both types of aggressive erotic films increased aggression toward the female. In Experiment 2, the effects of the above films on nonangry viewers were investigated with only female confederates. Results indicated that angered male subjects were more aggressive toward the female after viewing either aggressive erotic film but that only the positive-outcome aggressive film increased aggression in nonangered subjects. Both the theoretical and applied aspects of aggressive and nonaggressive erotica are discussed.

Physical pain and the goal of aversively stimulated aggression

Several studies have indicated that anger arousal elicits instigation to inflict injury, but there is good evidence to date that noninsulting aversive events also create a desire to hurt someone. The verbal hostility or physical aggression displayed in previous investigations of the effects of such aversive stimuli might be expressions of an instigation to hit, but not necessarily to hurt, the available target. Two experiments were designed to demonstrate that painful environmental conditions evoke aggressive inclinations directed toward doing harm even when the available target is not responsible for the suffering. In both studies university women kept one hand in a tank of water that was either painfully cold or much warmer while they delivered rewards and punishments to another woman supposedly in the course of supervising her work. Half of the subjects in each condition were informed that their punishments might hurt their partner, whereas the others were told that these punishments probably would be helpful. In the first experiment the two variables interacted to affect the subjects' behavior only during the first work period. Experiment 2 yielded interaction in both periods for the reward measure. In general, the women exposed to the warmer water tended to deliver the greatest number of rewards when they had been told punishment would hurt, whereas those in the cold-water condition were least rewarding if they had been informed punishment would injure their partner. Citing evidence that a lower number of rewards was somewhat punitive, we conclude that the aversive stimulation had evoked an instigation to do harm, and that the information about the possibility of hurting the partner served as a goal cue facilitating the overt expression of the instigation. Factor analyses of the subjects' feelings in the second study suggested that the women's feelings were organized differently the first and second times they had their hand in the water.

Physical pain and the goal of aversively stimulated aggression

Several studies have indicated that anger arousal elicits instigation to inflict injury, but there is good evidence to date that noninsulting aversive events also create a desire to hurt someone. The verbal hostility or physical aggression displayed in previous investigations of the effects of such aversive stimuli might be expressions of an instigation to hit, but not necessarily to hurt, the available target. Two experiments were designed to demonstrate that painful environmental conditions evoke aggressive inclinations directed toward doing harm even when the available target is not responsible for the suffering. In both studies university women kept one hand in a tank of water that was either painfully cold or much warmer while they delivered rewards and punishments to another woman supposedly in the course of supervising her work. Half of the subjects in each condition were informed that their punishments might hurt their partner, whereas the others were told that these punishments probably would be helpful. In the first experiment the two variables interacted to affect the subjects' behavior only during the first work period. Experiment 2 yielded interaction in both periods for the reward measure. In general, the women exposed to the warmer water tended to deliver the greatest number of rewards when they had been told punishment would hurt, whereas those in the cold-water condition were least rewarding if they had been informed punishment would injure their partner. Citing evidence that a lower number of rewards was somewhat punitive, we conclude that the aversive stimulation had evoked an instigation to do harm, and that the information about the possibility of hurting the partner served as a goal cue facilitating the overt expression of the instigation. Factor analyses of the subjects' feelings in the second study suggested that the women's feelings were organized differently the first and second times they had their hand in the water.

Effects of a stimulus associated with a victim's pain on later aggression

Male college students participated in an experiment designed to associate a neutral stimulus with a victim's pain and then to assess the impact of the paired stimulus on their aggression. The subjects were either provoked or not provoked by a confederate's shock evaluation. They then observed a flashing white light that was associated with either their former evaluator's pain or an irrelevant, affectively neutral event. The subjects then administered electric shocks to a different confederate, with whom they had not interacted previously, at the flash of both the familiar white light (the conditioned stimulus) and a novel blue light. Results supported the prediction that provoked subjects would give more intense shocks to the conditioned stimulus when it had been associated with their evaluator's pain. Unprovoked subjects were found to give less intense shocks to the light that had been associated with their evaluator's pain.

Effects of a stimulus associated with a victim's pain on later aggression

Male college students participated in an experiment designed to associate a neutral stimulus with a victim's pain and then to assess the impact of the paired stimulus on their aggression. The subjects were either provoked or not provoked by a confederate's shock evaluation. They then observed a flashing white light that was associated with either their former evaluator's pain or an irrelevant, affectively neutral event. The subjects then administered electric shocks to a different confederate, with whom they had not interacted previously, at the flash of both the familiar white light (the conditioned stimulus) and a novel blue light. Results supported the prediction that provoked subjects would give more intense shocks to the conditioned stimulus when it had been associated with their evaluator's pain. Unprovoked subjects were found to give less intense shocks to the light that had been associated with their evaluator's pain.

Effects of movie violence on aggression in a field setting as a function of group dominance and cohesion

In this quasi-experimental field study, delinquent members belonging to two cottages viewed aggressive commercial movies every evening for a week, while at the same time, subjects from two other cottages were exposed to neutral commercial movies. Behavioral observations were obtained through a nonhier-archical, minimally inferential procedure of a time-sampling nature; they were taken during a baseline week (at noon and in the evening), a treatment week (noon and evening) and a posttreatment week (noon). The main immediate effects of the violent films were an overall increase of both active behaviors and physical aggression; the effects on verbal aggression were more persistent but limited to one of the two cottages. On the other hand, more interactions occurred as an immediate consequence of viewing the films in both neutral treatment cottages; moreover, one of these two cottages also decreased its level of physical (short-term effect) and verbal (short- and long-term effects) aggression. In the aggressive treatment cottage, which was most affected, subjects who were most dominant, most popular, and least popular were influenced the most: an opposite effect was exhibited by those subjects who were judged as least aggressive by their peers. Complementary data are presented and discussed; the difference between the single individual laboratory paradigm and the existing group field paradigm is especially stressed.

Effects of movie violence on aggression in a field setting as a function of group dominance and cohesion

In this quasi-experimental field study, delinquent members belonging to two cottages viewed aggressive commercial movies every evening for a week, while at the same time, subjects from two other cottages were exposed to neutral commercial movies. Behavioral observations were obtained through a nonhier-archical, minimally inferential procedure of a time-sampling nature; they were taken during a baseline week (at noon and in the evening), a treatment week (noon and evening) and a posttreatment week (noon). The main immediate effects of the violent films were an overall increase of both active behaviors and physical aggression; the effects on verbal aggression were more persistent but limited to one of the two cottages. On the other hand, more interactions occurred as an immediate consequence of viewing the films in both neutral treatment cottages; moreover, one of these two cottages also decreased its level of physical (short-term effect) and verbal (short- and long-term effects) aggression. In the aggressive treatment cottage, which was most affected, subjects who were most dominant, most popular, and least popular were influenced the most: an opposite effect was exhibited by those subjects who were judged as least aggressive by their peers. Complementary data are presented and discussed; the difference between the single individual laboratory paradigm and the existing group field paradigm is especially stressed.

Differing "creativities" in the wit and the clown

Two different types of creativity measures—Wallach and Kogan's measure of ideational/associational creativity, and Singer's adaptive regression scale—as well as sociometric rating scales and SAT scores were obtained from members of a college fraternity. As predicted from an analysis of the processes underlying witticism and clowning, “wits” were high on ideational creativity but not on adaptive regression and “clowns” were high on adaptive regression but not on ideational creativity. Ideational creativity, adaptive regression, and SAT scores were independent of one another. These results support the value of distinguishing among channels or dimensions of creative information processing and attempting to link these to creative behavior through task analyses.

Socialization as a rehabilitative process

This paper describes a social rehabilitation project for the mentally ill which utilizes the facilities of a community center to improve social skills. Discharged patients are purposefully moved through a four-phase series of progressively broader social experiences with the goal of having these expatients become autonomously involved in community center activities in the same manner as other community center members. The paper describes the joint effort of a voluntary psychiatric hospital and a community center in New York City in implementing this program.