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Fatemi SH, Otte ED, Folsom TD, Eschenlauer AC, Roper RJ, Aman JW, Thuras PD. Early Chronic Fluoxetine Treatment of Ts65Dn Mice Rescues Synaptic Vesicular Deficits and Prevents Aberrant Proteomic Alterations. Genes (Basel) 2024; 15:452. [PMID: 38674386 PMCID: PMC11049293 DOI: 10.3390/genes15040452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Down syndrome (DS) is the most common form of inherited intellectual disability caused by trisomy of chromosome 21, presenting with intellectual impairment, craniofacial abnormalities, cardiac defects, and gastrointestinal disorders. The Ts65Dn mouse model replicates many abnormalities of DS. We hypothesized that investigation of the cerebral cortex of fluoxetine-treated trisomic mice may provide proteomic signatures that identify therapeutic targets for DS. Subcellular fractionation of synaptosomes from cerebral cortices of age- and brain-area-matched samples from fluoxetine-treated vs. water-treated trisomic and euploid male mice were subjected to HPLC-tandem mass spectrometry. Analysis of the data revealed enrichment of trisomic risk genes that participate in regulation of synaptic vesicular traffic, pre-synaptic and post-synaptic development, and mitochondrial energy pathways during early brain development. Proteomic analysis of trisomic synaptic fractions revealed significant downregulation of proteins involved in synaptic vesicular traffic, including vesicular endocytosis (CLTA, CLTB, CLTC), synaptic assembly and maturation (EXOC1, EXOC3, EXOC8), anterograde axonal transport (EXOC1), neurotransmitter transport to PSD (SACM1L), endosomal-lysosomal acidification (ROGDI, DMXL2), and synaptic signaling (NRXN1, HIP1, ITSN1, YWHAG). Additionally, trisomic proteomes revealed upregulation of several trafficking proteins, involved in vesicular exocytosis (Rab5B), synapse elimination (UBE3A), scission of endocytosis (DBN1), transport of ER in dendritic spines (MYO5A), presynaptic activity-dependent bulk endocytosis (FMR1), and NMDA receptor activity (GRIN2A). Chronic fluoxetine treatment of Ts65Dn mice rescued synaptic vesicular abnormalities and prevented abnormal proteomic changes in adult Ts65Dn mice, pointing to therapeutic targets for potential treatment of DS.
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Affiliation(s)
- S. Hossein Fatemi
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Elysabeth D. Otte
- Department of Biology, Indiana University, Indianapolis, IN 46202, USA;
| | - Timothy D. Folsom
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Arthur C. Eschenlauer
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Randall J. Roper
- Department of Biology, Indiana University-Purdue University, Indianapolis, IN 46202, USA;
| | - Justin W. Aman
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Paul D. Thuras
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School and VA Health Care System, One Veterans Drive, Minneapolis, MN 55417, USA
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Weber-Main AM, Thomas-Pollei KA, Grabowski J, Steer CJ, Thuras PD, Kushner MG. The Proposal Preparation Program: A Group Mentoring, Faculty Development Model to Facilitate the Submission and Funding of NIH Grant Applications. Acad Med 2022; 97:53-61. [PMID: 34380935 DOI: 10.1097/acm.0000000000004359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article describes the University of Minnesota Medical School Proposal Preparation Program (P3). P3 is designed to develop grant-writing skills for assistant professors preparing their first K- or R-series application to the National Institutes of Health (NIH). Three 4-month P3 cycles are conducted annually. For each cycle, a cohort of around 10 assistant professor participants and 5 regular faculty mentors meet for ten ~2-hour group sessions. Participants receive iterative oral and written feedback on their proposals in development within a small, interdisciplinary, group mentoring setting providing structure, accountability, guidance, and support. Between sessions, 1 peer and 1 mentor are assigned (on a rotating basis) to critique each participant's developing application. The sessions include a brief mentor-led presentation on a particular grant section followed by discussion of each participant's application conducted by the assigned reviewers. The cycle concludes with a mock NIH review session, in which each participant is matched with a University of Minnesota faculty content expert who critiques their completed application using NIH guidelines. In a survey sent to all past P3 participants as of 2018 (n = 194), 88% of respondents reported having submitted their P3-developed NIH grant, and 35% of these submitters reported funding success. A separate analysis of institutional data for all past P3 participants as of 2016 (n = 165) showed that 73% submitted at least 1 NIH proposal since completing P3 and that 43% of these had acquired NIH funding, for a combined total of $193 million in funding awarded. The estimated rate at which participants obtained funding for their P3-developed grant application (~35%) exceeds the national annual NIH grant funding rates (~20%) by approximately 50%. This article provides the practical information needed for other institutions to implement a P3-like program and presents a cost-benefit analysis showing the advantages of doing so.
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Affiliation(s)
- Anne Marie Weber-Main
- A.M. Weber-Main is associate professor, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Kimberly A Thomas-Pollei
- K.A. Thomas-Pollei is adjunct assistant professor, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - John Grabowski
- J. Grabowski is retired professor, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Clifford J Steer
- C.J. Steer is professor, Departments of Medicine and Genetics, Cell Biology and Development, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Paul D Thuras
- P.D. Thuras is research associate, Department of Psychiatry, University of Minnesota Medical School, and health science specialist, Minneapolis VA Health Care System, Minneapolis, Minnesota
| | - Matt G Kushner
- M.G. Kushner is professor, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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3
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Bishop JR, Lee AM, Mills LJ, Thuras PD, Eum S, Clancy D, Erbes CR, Polusny MA, Lamberty GJ, Lim KO. Corrigendum: Methylation of FKBP5 and SLC6A4 in Relation to Treatment Response to Mindfulness Based Stress Reduction for Posttraumatic Stress Disorder. Front Psychiatry 2021; 12:642245. [PMID: 33746798 PMCID: PMC7970629 DOI: 10.3389/fpsyt.2021.642245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/08/2021] [Indexed: 11/26/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2018.00418.].
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Affiliation(s)
- Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Adam M Lee
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Lauren J Mills
- University of Minnesota Supercomputing Institute, Minneapolis, MN, United States
| | - Paul D Thuras
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Seenae Eum
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Doris Clancy
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Christopher R Erbes
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Melissa A Polusny
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Gregory J Lamberty
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States.,Defense Veterans Brain Injury Center, Minneapolis, MN, United States
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Johnston BD, Thuras PD, Johnson JR. Activity of ceftazidime-avibactam against Escherichia coli isolates from U.S. veterans (2011) in relation to co-resistance and sequence type 131 (ST131) H30 and H30Rx status. Diagn Microbiol Infect Dis 2020; 97:115034. [PMID: 32331800 DOI: 10.1016/j.diagmicrobio.2020.115034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/05/2020] [Indexed: 12/29/2022]
Abstract
Escherichia coli ST131, with its multidrug-resistance-associated H30R1 and H30Rx clonal subsets within the H30R subclone, causes most antimicrobial-resistant E. coli infections. The activity of ceftazidime-avibactam (CZA) against ST131 strains is undefined. We determined CZA MICs for 595 E. coli clinical isolates from 24 Veterans Affairs Medical Centers (2010-2011). Resistance status and MICs were compared with study resistance category (fluoroquinolone-susceptible, fluoroquinolone-resistant, and extended-spectrum beta-lactamase (ESBL)-producing); ST131, H30R1, and H30Rx status; blaCTX-M-15-like genotype; and MICs for piperacillin-tazobactam, levofloxacin, gentamicin, ceftazidime, and meropenem. Proportion resistant ranged from zero (CZA, meropenem) to 61% (levofloxacin). MICs generally increased by resistance category (from fluoroquinolone-susceptible through fluoroquinolone-resistant to ESBL), clonal subgroup (from non-ST131-H30 through H30R1 to H30Rx), and blaCTX-M-15-like status. CZA MICs were slightly but significantly greater in association with resistance (or elevated MICs) to each comparator yet remained in the susceptible range. CZA was reliably active and outperformed noncarbapenem comparators, so it should prove useful as a carbapenem-sparing alternative.
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Affiliation(s)
- Brian D Johnston
- VA Medical Center, Minneapolis, MN; University of Minnesota, Minneapolis, MN.
| | - Paul D Thuras
- VA Medical Center, Minneapolis, MN; University of Minnesota, Minneapolis, MN
| | - James R Johnson
- VA Medical Center, Minneapolis, MN; University of Minnesota, Minneapolis, MN
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Atkinson DM, Doane BM, Thuras PD, Leskela MR, Shiroma PR. Mental Health Diagnoses in Veterans Referred for Outpatient Geriatric Psychiatric Care at a Veterans Affairs Medical Center. Mil Med 2020; 185:e347-e351. [PMID: 31621886 DOI: 10.1093/milmed/usz288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Nearly half of the U.S. veterans are over 65 years of age. Older veterans are at higher risk for mental health (MH) conditions, which are associated with increased mortality and health care costs. Given the deficit of specialty-trained geriatric providers, we are conducting a Quality Improvement initiative to improve MH services for older veterans at Minneapolis Veterans Affairs Health Care System. Our first step is to understand the demographic and diagnostic characteristics of veterans referred for geriatric MH specialty treatment. MATERIALS AND METHOD We conducted a retrospective chart review of demographics and psychiatric diagnoses in veterans seen for outpatient geriatric MH intake between May 1, 2011 and April 30, 2016. We used chi-square and Spearman's rho tests to examine age, diagnoses, and service-time era variables. RESULTS 1,059 veterans were evaluated, average age of 73.5 years. Depressive (47%), neurocognitive (42%), and anxiety disorders (22%) were the most common MH conditions. Vietnam veterans showed higher prevalence of depressive (56%), post-traumatic stress (11%), and alcohol use (10%) disorders. World War II veterans showed higher prevalence of neurocognitive disorders (71%). Neurocognitive disorder prevalence was significantly correlated with age. CONCLUSIONS Prevalence and comorbidity of major MH conditions is high in veterans referred for geriatric MH services. Future work will examine challenges faced by non-specialty providers in caring for older veterans, with the goal of developing targeted educational and clinical interventions to better address aging veterans' MH needs.
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Affiliation(s)
- David M Atkinson
- Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN 55417.,Department of Psychiatry, University of Minnesota, 2312 S. 6th St. Floor 2, Suite F-275, Minneapolis, MN 55454
| | - Bridget M Doane
- Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Paul D Thuras
- Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN 55417.,Department of Psychiatry, University of Minnesota, 2312 S. 6th St. Floor 2, Suite F-275, Minneapolis, MN 55454
| | - Mitch R Leskela
- Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Paulo R Shiroma
- Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Minneapolis, MN 55417.,Department of Psychiatry, University of Minnesota, 2312 S. 6th St. Floor 2, Suite F-275, Minneapolis, MN 55454
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Donaldson MT, Polusny MA, MacLehose RF, Goldsmith ES, Hagel Campbell EM, Miron LR, Thuras PD, Krebs EE. Patterns of conventional and complementary non-pharmacological health practice use by US military veterans: a cross-sectional latent class analysis. BMC Complement Altern Med 2018; 18:246. [PMID: 30185182 PMCID: PMC6125945 DOI: 10.1186/s12906-018-2313-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/28/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Non-pharmacological therapies and practices are commonly used for both health maintenance and management of chronic disease. Patterns and reasons for use of health practices may identify clinically meaningful subgroups of users. The objectives of this study were to identify classes of self-reported use of conventional and complementary non-pharmacological health practices using latent class analysis and estimate associations of participant characteristics with class membership. METHODS A mailed survey (October 2015 to September 2016) of Minnesota National Guard Veterans from a longitudinal cohort (n = 1850) assessed current pain, self-reported overall health, mental health, substance use, personality traits, and health practice use. We developed the Health Practices Inventory, a self-report instrument assessing use of 19 common conventional and complementary non-pharmacological health-related practices. Latent class analysis was used to identify subgroups of health practice users, based on responses to the HPI. Participants were assigned to their maximum-likelihood class, which was used as the outcome in multinomial logistic regression to examine associations of participant characteristics with latent class membership. RESULTS Half of the sample used non-pharmacological health practices. Six classes of users were identified. "Low use" (50%) had low rates of health practice use. "Exercise" (23%) had high exercise use. "Psychotherapy" (6%) had high use of psychotherapy and support groups. "Manual therapies" (12%) had high use of chiropractic, physical therapy, and massage. "Mindfulness" (5%) had high use of mindfulness and relaxation practice. "Multimodal" (4%) had high use of most practices. Use of manual therapies (chiropractic, acupuncture, physical therapy, massage) was associated with chronic pain and female sex. Characteristics that predict use patterns varied by class. Use of self-directed practices (e.g., aerobic exercise, yoga) was associated with the personality trait of absorption (openness to experience). Use of psychotherapy was associated with higher rates of psychological distress. CONCLUSIONS These observed patterns of use of non-pharmacological health practices show that functionally similar practices are being used together and suggest a meaningful classification of health practices based on self-directed/active and practitioner-delivered. Notably, there is considerable overlap in users of complementary and conventional practices.
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Affiliation(s)
- Melvin T. Donaldson
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
- University of Minnesota Medical Scientist Training Program, Minneapolis, MN 55455 USA
| | - Melissa A. Polusny
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
- University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - Rich F. MacLehose
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454 USA
| | - Elizabeth S. Goldsmith
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454 USA
| | | | - Lynsey R. Miron
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
| | - Paul D. Thuras
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
| | - Erin E. Krebs
- Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 USA
- University of Minnesota Medical School, Minneapolis, MN 55455 USA
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Bishop JR, Lee AM, Mills LJ, Thuras PD, Eum S, Clancy D, Erbes CR, Polusny MA, Lamberty GJ, Lim KO. Methylation of FKBP5 and SLC6A4 in Relation to Treatment Response to Mindfulness Based Stress Reduction for Posttraumatic Stress Disorder. Front Psychiatry 2018; 9:418. [PMID: 30279666 PMCID: PMC6153325 DOI: 10.3389/fpsyt.2018.00418] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 08/15/2018] [Indexed: 01/18/2023] Open
Abstract
Mindfulness Based Stress Reduction (MBSR) is an effective non-pharmacologic treatment for veterans with PTSD. Extensive work has identified epigenetic factors related to PTSD disease risk and pathophysiology, but how these factors influence treatment response is unclear. Serotonin signaling and hypothalamic-pituitary-adrenal (HPA) axis functioning may be perturbed in PTSD and are molecular pathways targeted by PTSD treatments. To identify potential biomarkers for treatment response, we utilized genomic DNA isolated from peripheral blood samples from veterans with PTSD who were responders (n = 11) or non-responders (n = 11) to MBSR as part of a clinical trial. We assessed methylation levels at CpG sites in regions of the serotonin transporter (SLC6A4) previously associated with expression and depression outcomes, as well as the Intron 7 region of the FK506 binding protein 5 (FKBP5) containing known glucocorticoid response elements suggested to regulate this gene. Selected subjects were matched across MBSR responder status by baseline symptoms, age, sex, current smoking status, and current antidepressant use. Percent methylation was compared between responders and non-responders at baseline (pre-MBSR treatment). Additionally, percent change in methylation from baseline to post-treatment was compared between responders and non-responders. There was a significant time x responder group interaction for methylation in FKBP5 intron 7 bin 2 [F (1, 19) = 7.492, p = 0.013] whereby responders had a decrease in methylation and non-responders had an increase in methylation from before to after treatment in this region. Analyses of the three CpG sites within bin 2 revealed a significant time x responder group interaction for CpG_35558513 [F (1, 19) = 5.551, p = 0.029] which resides in a known glucocorticoid response element (GRE). Decreases in FKBP5 methylation after treatment in responders as compared to increases in non-responders suggest that effective meditation intervention may be associated with stress-related pathways at the molecular level. These preliminary findings suggest that DNA methylation signatures within FKBP5 are potential indicators of response to meditation treatment in PTSD and require validation in larger cohorts.
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Affiliation(s)
- Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Adam M Lee
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Lauren J Mills
- University of Minnesota Supercomputing Institute, Minneapolis, MN, United States
| | - Paul D Thuras
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Seenae Eum
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Doris Clancy
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Christopher R Erbes
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Melissa A Polusny
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Gregory J Lamberty
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States.,Defense Veterans Brain Injury Center, Minneapolis, MN, United States
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Khawaja IS, Dickmann PJ, Hurwitz TD, Thuras PD, Feinstein RE, Douglass AB, Lee EK. The State of Sleep Medicine Education in North American Psychiatry Residency Training Programs in 2013: Chief Resident's Perspective. Prim Care Companion CNS Disord 2017; 19. [PMID: 28906605 DOI: 10.4088/pcc.17br02167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022] Open
Abstract
Objective To assess the current state of sleep medicine educational resources and training offered by North American psychiatry residency programs. Methods In June 2013, a 9-item peer-reviewed Sleep Medicine Training Survey was administered to 39 chief residents of psychiatry residency training programs during a meeting in New York. Results Thirty-four percent of the participating programs offered an elective rotation in sleep medicine. A variety of innovative approaches for teaching sleep medicine were noted. The majority of the chief residents felt comfortable screening patients for obstructive sleep apnea (72%), half felt comfortable screening for restless legs syndrome (53%), and fewer than half were comfortable screening for other sleep disorders (47%). Conclusions This is the first report in the last decade to provide any analysis of current sleep medicine training in North American psychiatry residency training programs. These data indicate that sleep medicine education in psychiatry residency programs is possibly in decline.
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Affiliation(s)
- Imran S Khawaja
- University of Texas Southwestern Medical Center, 4500 S Lancaster Rd, Dallas, TX 75216. .,Center for Sleep Medicine, Department of Neurology, Veterans Affairs Medical Center, Dallas, Texas, USA.,Department of Psychiatry and Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Patricia J Dickmann
- Department of Psychiatry, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Thomas D Hurwitz
- Department of Psychiatry, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Paul D Thuras
- Department of Psychiatry, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | | | - Alan B Douglass
- Department of Psychiatry, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Elliott Kyung Lee
- Department of Psychiatry, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
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Atkinson DM, Rodman JL, Thuras PD, Shiroma PR, Lim KO. Examining Burnout, Depression, and Self-Compassion in Veterans Affairs Mental Health Staff. J Altern Complement Med 2017; 23:551-557. [PMID: 28590766 DOI: 10.1089/acm.2017.0087] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Burnout, a state of emotional exhaustion associated with negative personal and occupational outcomes, is prevalent among healthcare providers. A better understanding of the psychological factors that may be associated with resilience to burnout is essential to develop effective interventions. Self-compassion, which includes kindness toward oneself, recognition of suffering as part of shared human experience, mindfulness, and nonjudgment toward inadequacies and failures, may be one such factor. The purpose of this study was to examine the relationships between burnout, depression, and self-compassion in Veterans Affairs (VA) mental health staff. DESIGN Cross-sectional study. SETTING VA medical center and affiliated community-based clinics. PARTICIPANTS VA mental health staff. OUTCOME MEASURES The 19-item Copenhagen Burnout Inventory, the 26-item Self-Compassion Scale, and the Patient Health Questionnaire 2-item depression screen. Demographic information included age, sex, years worked in current position, and number of staff supervised. RESULTS One hundred and twenty-eight of a potential 379 individuals (33.8%) responded. Clerical support, nursing, social work, psychology, and psychiatry were the major professions represented. Self-compassion was inversely correlated with burnout (r = -0.41, p < 0.001), and inversely correlated with depression (rpb = -0.39, p < 0.001). The inverse relationship between self-compassion and burnout remained significant even after accounting for depressive symptoms and demographic variables in a multiple linear regression model. Of all the variables examined, self-compassion was the strongest predictor of burnout. CONCLUSIONS The results of this study support the hypothesis that self-compassion may be associated with resilience to burnout. Alternatively, decreased self-compassion may be a downstream effect of increased burnout. Prospective, longitudinal studies are needed to determine the directional relationship between these factors, and whether interventions that cultivate self-compassion may decrease burnout and/or protect against its negative personal and professional outcomes.
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Affiliation(s)
- David M Atkinson
- 1 Minneapolis VA Health Care System , Minneapolis, MN.,2 Department of Psychiatry, University of Minnesota , Minneapolis, MN
| | - John L Rodman
- 1 Minneapolis VA Health Care System , Minneapolis, MN
| | - Paul D Thuras
- 1 Minneapolis VA Health Care System , Minneapolis, MN.,2 Department of Psychiatry, University of Minnesota , Minneapolis, MN
| | - Paulo R Shiroma
- 1 Minneapolis VA Health Care System , Minneapolis, MN.,2 Department of Psychiatry, University of Minnesota , Minneapolis, MN
| | - Kelvin O Lim
- 1 Minneapolis VA Health Care System , Minneapolis, MN.,2 Department of Psychiatry, University of Minnesota , Minneapolis, MN
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10
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Fatemi SH, Folsom TD, Thuras PD. GABA A and GABA B receptor dysregulation in superior frontal cortex of subjects with schizophrenia and bipolar disorder. Synapse 2017; 71. [PMID: 28316115 DOI: 10.1002/syn.21973] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/21/2017] [Accepted: 03/14/2017] [Indexed: 11/12/2022]
Abstract
Schizophrenia and bipolar disorder are complex psychiatric disorders that affect millions of people worldwide. Evidence from gene association and postmortem studies has identified abnormalities of the gamma-aminobutyric acid (GABA) signaling system in both disorders. Abnormal GABAergic signaling and transmission could contribute to the symptomatology of these disorders, potentially through impaired gamma oscillations which normally occur during cognitive processing. In the current study, we examined the protein expression of 14 GABAA and two GABAB receptor subunits in the superior frontal cortex of subjects with schizophrenia, bipolar disorder, and healthy controls. Analyses of Variance (ANOVAs) identified significant group effects for protein levels for the α1, α6, β1, β3, δ, ɛ, and π GABAA receptor subunits and R1 and R2 GABAB receptor subunits. Follow-up t tests confirmed changes for these subunits in subjects with schizophrenia, subjects with bipolar disorder, or both groups. Alterations in stoichiometry of GABA receptor subunits could result in altered ligand binding, transmission, and pharmacology of GABA receptors in superior frontal cortex. Thus, impaired GABAergic transmission may negatively contribute to symptoms such as anxiety or panic as well as impaired learning and information processing, all of which are disrupted in schizophrenia and bipolar disorder. Taken together, these results provide additional evidence of GABAergic receptor abnormalities in these disorders.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St. SE, MMC 392, Minneapolis, Minnesota, 55455.,Department of Neuroscience, University of Minnesota Medical School, 321 Church St. SE, Minneapolis, Minnesota, 55455
| | - Timothy D Folsom
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St. SE, MMC 392, Minneapolis, Minnesota, 55455
| | - Paul D Thuras
- Department of Psychiatry, VA Medical Center, 1 Veterans Drive Minneapolis, Minnesota, 55417-2399
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Fatemi SH, Folsom TD, Liesch SB, Kneeland RE, Karkhane Yousefi M, Thuras PD. The effects of prenatal H1N1 infection at E16 on FMRP, glutamate, GABA, and reelin signaling systems in developing murine cerebellum. J Neurosci Res 2016; 95:1110-1122. [PMID: 27735078 DOI: 10.1002/jnr.23949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/30/2016] [Accepted: 09/06/2016] [Indexed: 12/28/2022]
Abstract
Prenatal viral infection has been identified as a potential risk factor for the development of neurodevelopmental disorders such as schizophrenia and autism. Additionally, dysfunction in gamma-aminobutyric acid, Reelin, and fragile X mental retardation protein (FMRP)-metabotropic glutamate receptor 5 signaling systems has also been demonstrated in these two disorders. In the current report, we have characterized the developmental profiles of selected markers for these systems in cerebella of mice born to pregnant mice infected with human influenza (H1N1) virus on embryonic day 16 or sham-infected controls using SDS-PAGE and Western blotting techniques and evaluated the presence of abnormalities in the above-mentioned markers during brain development. The cerebellum was selected in light of emerging evidence that it plays roles in learning, memory, and emotional processing-all of which are disrupted in autism and schizophrenia. We identified unique patterns of gene and protein expression at birth (postnatal day 0 [P0]), childhood (P14), adolescence (P35), and young adulthood (P56) in both exposed and control mouse progeny. We also identified significant differences in protein expression for FMRP, very-low-density lipoprotein receptor, and glutamic acid decarboxylase 65 and 67 kDa proteins at specific postnatal time points in cerebella of the offspring of exposed mice. Our results provide evidence of disrupted FMRP, glutamatergic, and Reelin signaling in the exposed mouse offspring that explains the multiple brain abnormalities observed in this animal model. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, Minnesota.,Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Timothy D Folsom
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Stephanie B Liesch
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Rachel E Kneeland
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mahtab Karkhane Yousefi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, Minnesota.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Paul D Thuras
- VA Medical Center, Department of Psychiatry, Minneapolis, Minnesota
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Strom TQ, Arbisi P, Thuras PD, Leskela J, Finn J, Anderson C, Siegel W. Summative intern performance evaluations: A wealth of information or a gathering of “two cents”? Training and Education in Professional Psychology 2016. [DOI: 10.1037/tep0000114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kramer MD, Arbisi PA, Thuras PD, Krueger RF, Erbes CR, Polusny MA. The class-dimensional structure of PTSD before and after deployment to Iraq: Evidence from direct comparison of dimensional, categorical, and hybrid models. J Anxiety Disord 2016; 39:1-9. [PMID: 26896605 DOI: 10.1016/j.janxdis.2016.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 12/16/2015] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
The assumption of specific etiology in posttraumatic stress disorder (PTSD) differentiates the disorder from most other psychiatric conditions. A 'risky test' of the assumption of specific etiology and resultant trauma-related symptom dimensions was conducted through structural modeling of PTSD symptoms in soldiers before (N=522) and after (n=423) a combat deployment to Iraq. If PTSD represents a discrete diagnostic entity that emerges after trauma exposure, we hypothesized either the number of latent classes should increase from pre- to post-deployment or symptom dimensions should qualitatively distinguish affected from unaffected classes following trauma exposure. Comparison of latent structural models revealed best fitting hybrid models for PTSD and depression with strong invariance of symptom dimensions across classes both before and after deployment and only quantitative (i.e., severity) differences between classes. These findings suggest PTSD is generally well-conceptualized as a dimensional syndrome worsened but not necessarily elicited by trauma exposure.
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Affiliation(s)
- Mark D Kramer
- Center for Chronic Disease Outcome Research, Minneapolis VA Healthcare System, B9-152, One Veterans Drive, Minneapolis, MN 55417, USA; Minneapolis VA Healthcare System, B68-2, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota-Department of Psychiatry, F282/2A West, 2450 Riverside Ave S, Minneapolis, MN 55454, USA.
| | - Paul A Arbisi
- Minneapolis VA Healthcare System, B68-2, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota-Department of Psychiatry, F282/2A West, 2450 Riverside Ave S, Minneapolis, MN 55454, USA; University of Minnesota-Department of Psychology, N218 Elliott Hall, 75 E River Rd, Minneapolis, MN 55417, USA.
| | - Paul D Thuras
- Minneapolis VA Healthcare System, B68-2, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota-Department of Psychiatry, F282/2A West, 2450 Riverside Ave S, Minneapolis, MN 55454, USA.
| | - Robert F Krueger
- University of Minnesota-Department of Psychology, N218 Elliott Hall, 75 E River Rd, Minneapolis, MN 55417, USA.
| | - Christopher R Erbes
- Center for Chronic Disease Outcome Research, Minneapolis VA Healthcare System, B9-152, One Veterans Drive, Minneapolis, MN 55417, USA; Minneapolis VA Healthcare System, B68-2, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota-Department of Psychiatry, F282/2A West, 2450 Riverside Ave S, Minneapolis, MN 55454, USA.
| | - Melissa A Polusny
- Center for Chronic Disease Outcome Research, Minneapolis VA Healthcare System, B9-152, One Veterans Drive, Minneapolis, MN 55417, USA; Minneapolis VA Healthcare System, B68-2, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota-Department of Psychiatry, F282/2A West, 2450 Riverside Ave S, Minneapolis, MN 55454, USA.
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Fatemi SH, Reutiman TJ, Folsom TD, Rustan OG, Rooney RJ, Thuras PD. Downregulation of GABAA receptor protein subunits α6, β2, δ, ε, γ2, θ, and ρ2 in superior frontal cortex of subjects with autism. J Autism Dev Disord 2014; 44:1833-45. [PMID: 24668190 DOI: 10.1007/s10803-014-2078-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We measured protein and mRNA levels for nine gamma-aminobutyric acid A (GABAA) receptor subunits in three brain regions (cerebellum, superior frontal cortex, and parietal cortex) in subjects with autism versus matched controls. We observed changes in mRNA for a number of GABAA and GABAB subunits and overall reduced protein expression for GABAA receptor alpha 6 (GABRα6), GABAA receptor beta 2 (GABRβ2), GABAA receptor delta (GABRδ), GABAA receptor epsilon (GABRε), GABAA receptor gamma 2 (GABRγ2), GABAA receptor theta (GABRθ), and GABAA receptor rho 2 (GABRρ2) in superior frontal cortex from subjects with autism. Our data demonstrate systematic changes in GABAA&B subunit expression in brains of subjects with autism, which may help explain the presence of cognitive abnormalities in subjects with autism.
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Affiliation(s)
- S Hossein Fatemi
- Division of Neuroscience Research, Department of Psychiatry, University of Minnesota Medical School, 420 Delaware St SE, MMC 392, Minneapolis, MN, 55455, USA,
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Fatemi SH, Folsom TD, Rooney RJ, Thuras PD. Expression of GABAA α2-, β1- and ε-receptors are altered significantly in the lateral cerebellum of subjects with schizophrenia, major depression and bipolar disorder. Transl Psychiatry 2013; 3:e303. [PMID: 24022508 PMCID: PMC3784760 DOI: 10.1038/tp.2013.64] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/17/2013] [Accepted: 07/10/2013] [Indexed: 12/15/2022] Open
Abstract
There is abundant evidence that dysfunction of the γ-aminobutyric acid (GABA)ergic signaling system is implicated in the pathology of schizophrenia and mood disorders. Less is known about the alterations in protein expression of GABA receptor subunits in brains of subjects with schizophrenia and mood disorders. We have previously demonstrated reduced expression of GABA(B) receptor subunits 1 and 2 (GABBR1 and GABBR2) in the lateral cerebella of subjects with schizophrenia, bipolar disorder and major depressive disorder. In the current study, we have expanded these studies to examine the mRNA and protein expression of 12 GABA(A) subunit proteins (α1, α2, α3, α5, α6, β1, β2, β3, δ, ε, γ2 and γ3) in the lateral cerebella from the same set of subjects with schizophrenia (N=9-15), bipolar disorder (N=10-15) and major depression (N=12-15) versus healthy controls (N=10-15). We found significant group effects for protein levels of the α2-, β1- and ε-subunits across treatment groups. We also found a significant group effect for mRNA levels of the α1-subunit across treatment groups. New avenues for treatment, such as the use of neurosteroids to promote GABA modulation, could potentially ameliorate GABAergic dysfunction in these disorders.
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Affiliation(s)
- S H Fatemi
- Division of Neuroscience Research, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA,Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA,Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA,Division of Neuroscience Research, Department of Psychiatry, University of Minnesota Medical School, 420 Delaware St SE, MMC 392, Minneapolis, MN 55455, USA. E-mail:
| | - T D Folsom
- Division of Neuroscience Research, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - P D Thuras
- Department of Psychiatry, VA Medical Center Minneapolis, MN, USA
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Fatemi SH, Folsom TD, Kneeland RE, Yousefi MK, Liesch SB, Thuras PD. Impairment of fragile X mental retardation protein-metabotropic glutamate receptor 5 signaling and its downstream cognates ras-related C3 botulinum toxin substrate 1, amyloid beta A4 precursor protein, striatal-enriched protein tyrosine phosphatase, and homer 1, in autism: a postmortem study in cerebellar vermis and superior frontal cortex. Mol Autism 2013; 4:21. [PMID: 23803181 PMCID: PMC3702477 DOI: 10.1186/2040-2392-4-21] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 05/14/2013] [Indexed: 12/18/2022] Open
Abstract
Background Candidate genes associated with idiopathic forms of autism overlap with other disorders including fragile X syndrome. Our laboratory has previously shown reduction in fragile X mental retardation protein (FMRP) and increase in metabotropic glutamate receptor 5 (mGluR5) in cerebellar vermis and superior frontal cortex (BA9) of individuals with autism. Methods In the current study we have investigated expression of four targets of FMRP and mGluR5 signaling - homer 1, amyloid beta A4 precursor protein (APP), ras-related C3 botulinum toxin substrate 1 (RAC1), and striatal-enriched protein tyrosine phosphatase (STEP) - in the cerebellar vermis and superior frontal cortex (BA9) via SDS-PAGE and western blotting. Data were analyzed based on stratification with respect to age (children and adolescents vs. adults), anatomic region of the brain (BA9 vs. cerebellar vermis), and impact of medications (children and adolescents on medications (n = 4) vs. total children and adolescents (n = 12); adults on medications (n = 6) vs. total adults (n = 12)). Results There were significant increases in RAC1, APP 120 kDa and APP 80 kDa proteins in BA9 of children with autism vs. healthy controls. None of the same proteins were significantly affected in cerebellar vermis of children with autism. In BA9 of adults with autism there were significant increases in RAC1 and STEP 46 kDa and a significant decrease in homer 1 vs. controls. In the vermis of adult subjects with autism, RAC1 was significantly increased while APP 120, STEP 66 kDa, STEP 27 kDa, and homer 1 were significantly decreased when compared with healthy controls. No changes were observed in vermis of children with autism. There was a significant effect of anticonvulsant use on STEP 46 kDa/β-actin and a potential effect on homer 1/NSE, in BA9 of adults with autism. However, no other significant confound effects were observed in this study. Conclusions Our findings provide further evidence of abnormalities in FMRP and mGluR5 signaling partners in brains of individuals with autism and open the door to potential targeted treatments which could help ameliorate the symptoms of autism.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St SE, MMC 392, Minneapolis, MN 55455, USA.
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17
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Fatemi SH, Yousefi MK, Kneeland RE, Liesch SB, Folsom TD, Thuras PD. Antismoking and potential antipsychotic effects of varenicline in subjects with schizophrenia or schizoaffective disorder: a double-blind placebo and bupropion-controlled study. Schizophr Res 2013; 146:376-8. [PMID: 23507358 DOI: 10.1016/j.schres.2013.02.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/08/2013] [Accepted: 02/11/2013] [Indexed: 11/17/2022]
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Strom TQ, Leskela J, James LM, Thuras PD, Voller E, Weigel R, Yutsis M, Khaylis A, Lindberg J, Holz KB. An exploratory examination of risk-taking behavior and PTSD symptom severity in a veteran sample. Mil Med 2012; 177:390-6. [PMID: 22594128 DOI: 10.7205/milmed-d-11-00133] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The present study conducted an exploratory examination of the relationship between self-reported symptoms of post-traumatic stress disorder and an expanded definition of risk-taking behaviors among 395 veterans at a large Midwestern Veterans Affairs Medical Center. Post-traumatic stress disorder symptoms were associated with elevated rates of substance use, thrill seeking, aggression, risky sexual practices, and firearm possession. Results indicated that suicidal ideation and aggressive driving behavior were among the most frequently reported. The present findings hold significant public health implications and highlight the need to attend to risk-taking behaviors in treatment planning.
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Affiliation(s)
- Thad Q Strom
- Minneapolis VA Medical Center (116A), One Veterans Drive, Minneapolis, MN 55417, USA
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Fatemi SH, Folsom TD, Thuras PD. Deficits in GABA(B) receptor system in schizophrenia and mood disorders: a postmortem study. Schizophr Res 2011; 128:37-43. [PMID: 21303731 PMCID: PMC3085603 DOI: 10.1016/j.schres.2010.12.025] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/14/2010] [Accepted: 12/20/2010] [Indexed: 11/15/2022]
Abstract
Postmortem and genetic studies have clearly demonstrated changes in GABA(B) receptors in neuropsychiatric disorders such as autism, bipolar disorder, major depression, and schizophrenia. Moreover, a number of recent studies have stressed the importance of cerebellar dysfunction in these same disorders. In the current study, we examined protein levels of the two GABA(B) receptor subunits GABBR1 and GABBR2 in lateral cerebella from a well-characterized cohort of subjects with schizophrenia (n=15), bipolar disorder (n=14), major depression (n=13) and healthy controls (n=12). We found significant reductions in protein for both GABBR1 and GABBR2 in lateral cerebella from subjects with schizophrenia, bipolar disorder and major depression when compared with controls. These results provide further evidence of GABAergic dysfunction in these three disorders as well as identify potential targets for therapeutic intervention.
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Affiliation(s)
- S. Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St SE, MMC 392, Minneapolis, MN 55455
- Department of Pharmacology, University of Minnesota Medical School, 310 Church St. SE, Minneapolis, MN 55455
- Department of Neuroscience, University of Minnesota Medical School, 310 Church St. SE, Minneapolis, MN 55455
| | - Timothy D. Folsom
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St SE, MMC 392, Minneapolis, MN 55455
| | - Paul D. Thuras
- VA Medical Center, Department of Psychiatry, 1 Veterans Drive, Minneapolis, MN 55417
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Fatemi SH, Reutiman TJ, Folsom TD, Rooney RJ, Patel DH, Thuras PD. mRNA and protein levels for GABAAalpha4, alpha5, beta1 and GABABR1 receptors are altered in brains from subjects with autism. J Autism Dev Disord 2010; 40:743-50. [PMID: 20066485 DOI: 10.1007/s10803-009-0924-z] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We have shown altered expression of gamma-aminobutyric acid A (GABA(A)) and gamma-aminobutyric acid B (GABA(B)) receptors in the brains of subjects with autism. In the current study, we sought to verify our western blotting data for GABBR1 via qRT-PCR and to expand our previous work to measure mRNA and protein levels of 3 GABA(A) subunits previously associated with autism (GABRalpha4; GABRalpha5; GABRbeta1). Three GABA receptor subunits demonstrated mRNA and protein level concordance in superior frontal cortex (GABRalpha4, GABRalpha5, GABRbeta1) and one demonstrated concordance in cerebellum (GABBetaR1). These results provide further evidence of impairment of GABAergic signaling in autism.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota School of Medicine, 420 Delaware St SE MMC 392, Minneapolis, MN 55455, USA.
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Abstract
BACKGROUND Whether the development of tardive dyskinesia leads to an increase in mortality is still unclear. AIMS To explore the relationship between tardive dyskinesia and mortality over a 10-year period, using the National Death Index. METHOD Death certificates were obtained from the National Death Index on 1621 people repeatedly assessed for tardive dyskinesia by trained raters. Variables with the potential for influencing survival time were also investigated. RESULTS Tardive dyskinesia was significantly associated with an increase in mortality (P<0.001), but this association became non-significant when drug course and age were entered in the regression analysis. Those who had taken only conventional antipsychotics were twice as likely to die compared with those taking atypical agents (P<0.02). For those aged 53-65 years, conventional agents were associated with a sevenfold increase in mortality. CONCLUSIONS Older individuals with tardive dyskinesia treated with conventional antipsychotics appear to have a shortened survival time.
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Affiliation(s)
- Charles E Dean
- Mental Health Service Line, 116A, One Veterans Drive, Minneapolis, MN 55417, USA.
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Donahue CB, Kushner MG, Thuras PD, Murphy TG, Van Demark JB, Adson DE. Effect of quetiapine vs. placebo on response to two virtual public speaking exposures in individuals with social phobia. J Anxiety Disord 2009; 23:362-8. [PMID: 19157776 DOI: 10.1016/j.janxdis.2008.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 12/08/2008] [Accepted: 12/09/2008] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Clinical practice and open-label studies suggest that quetiapine (an atypical anti-psychotic) might improve symptoms for individuals with social anxiety disorder (SAD). The purpose of this study was to provide a rigorous test of the acute impact of a single dose of quetiapine (25mg) on SAD symptoms. METHOD Individuals with SAD (N=20) were exposed to a 4-min virtual reality (VR) public speaking challenge after having received quetiapine or placebo (double-blind) 1h earlier. A parallel VR challenge occurred 1 week later using a counter-balanced cross-over (within subject) design for the medication-placebo order between the two sessions. RESULT There was no significant drug effect for quetiapine on the primary outcome measures. However, quetiapine was associated with significantly elevated heart rate and sleepiness compared with placebo. CONCLUSION Study findings suggest that a single dose of 25mg quetiapine is not effective in alleviating SAD symptoms in individuals with fears of public speaking.
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Abstract
Autism is a neurodevelopmental disorder that is often comorbid with seizures. Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in brain. GABA(B) receptors play an important role in maintaining excitatory-inhibitory balance in brain and alterations may lead to seizures. We compared levels of GABA(B) receptor subunits GABA(B) receptor 1 (GABBR1) and GABA(B) receptor 2 (GABBR2) in cerebellum, Brodmann's area 9 (BA9), and BA40 of subjects with autism and matched controls. Levels of GABBR1 were significantly decreased in BA9, BA40, and cerebellum, while GABBR2 was significantly reduced in the cerebellum. The presence of seizure disorder did not have a significant impact on the observed reductions in GABA(B) receptor subunit expression. Decreases in GABA(B) receptor subunits may help explain the presence of seizures that are often comorbid with autism, as well as cognitive difficulties prevalent in autism.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
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Fatemi SH, Reutiman TJ, Folsom TD, Thuras PD. GABA(A) receptor downregulation in brains of subjects with autism. J Autism Dev Disord 2008; 39:223-30. [PMID: 18821008 DOI: 10.1007/s10803-008-0646-7] [Citation(s) in RCA: 310] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Accepted: 06/27/2008] [Indexed: 11/28/2022]
Abstract
Gamma-aminobutyric acid A (GABA(A)) receptors are ligand-gated ion channels responsible for mediation of fast inhibitory action of GABA in the brain. Preliminary reports have demonstrated altered expression of GABA receptors in the brains of subjects with autism suggesting GABA/glutamate system dysregulation. We investigated the expression of four GABA(A) receptor subunits and observed significant reductions in GABRA1, GABRA2, GABRA3, and GABRB3 in parietal cortex (Brodmann's Area 40 (BA40)), while GABRA1 and GABRB3 were significantly altered in cerebellum, and GABRA1 was significantly altered in superior frontal cortex (BA9). The presence of seizure disorder did not have a significant impact on GABA(A) receptor subunit expression in the three brain areas. Our results demonstrate that GABA(A) receptors are reduced in three brain regions that have previously been implicated in the pathogenesis of autism, suggesting widespread GABAergic dysfunction in the brains of subjects with autism.
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Affiliation(s)
- S Hossein Fatemi
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55455, USA.
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Abstract
BACKGROUND Although studies have detailed biological abnormalities in schizophrenia patients and their first-degree biological relatives, few studies have directly compared the utility of biological indices in these individuals. METHODS Measures of global smooth-pursuit ocular motor (OM) function, low frequency and alpha band electroencephalogram (EEG) power, and nonspecific fluctuations (NSF) in electrodermal activity and visibility of the plexus in the nailfold were collected from 136 schizophrenia patients and 67 of their first-degree biological relatives, 71 affective disorder psychotic patients and 68 of their first-degree biological relatives, and 169 nonpsychiatric comparison subjects. We conducted receiver operator characteristic (ROC) analyses to determine how well each index differentiated the patient groups and the groups of first-degree relatives. RESULTS Smooth-pursuit ocular motor function, low frequency and alpha band EEG power, and nailfold plexus visibility differentiated schizophrenia patients from nonpsychiatric comparison subjects. Nailfold plexus visibility was the only measure that significantly differentiated schizophrenia patients from both nonpsychiatric controls and affective patients. Smooth-pursuit ocular motor function and the number of electrodermal nonspecific fluctuations differentiated relatives of schizophrenia patients from nonpsychiatric comparison subjects. CONCLUSION Increased nailfold plexus visibility may mark a process associated with abnormal brain development leading to schizophrenia. Smooth-pursuit dysfunction may mark genetic vulnerability that is relatively specific to schizophrenia.
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Affiliation(s)
- Scott R Sponheim
- Veterans Affairs Medical Center, 116B One Veterans Drive, Minneapolis, MN 55417, USA.
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26
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Abstract
The objectives were to conduct a 1-year follow-up of daily caffeine-using adolescents to further describe caffeine dependence symptoms and to determine whether caffeine dependence is associated with other substance dependence disorders. Twenty-one of 36 (58.3%) adolescents who participated in a study of caffeine dependence returned for follow-up. The previous study was a case series of adolescents who consumed caffeine daily and met some Diagnostic and Statistical Manual of Mental Disorders (fourth edition) substance dependence criteria as applied to caffeine. At follow-up, caffeine consumption from beverages was 179.9 +/- 151.8 mg/day. Of the 21 teenagers, 23.8% (n = 5) met criteria for caffeine dependence. Four of these participants developed caffeine dependence during the follow-up period. Other substance dependence disorders were not overrepresented in the caffeine dependent group compared to the caffeine nondependent group. The most commonly reported withdrawal symptoms in dependent teenagers (at baseline and follow-up combined) were feeling drowsy/tired, fatigued, or sluggish/slowed down (83.3% each) and headache (75.0%). Caffeine dependence occurs in some adolescents who drink caffeine daily and is marked by symptoms similar to those found in adults.
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Affiliation(s)
- Joel V Oberstar
- Harvard Longwood Psychiatry Residency Training Program, Boston, Massachusetts, USA
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27
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Abstract
This study identifies and characterizes symptoms of caffeine dependence in adolescents. Thirty-six adolescents who consumed caffeine daily and had some features of caffeine dependence on telephone screen were scheduled for outpatient evaluation. Evaluation included the Diagnostic Interview Schedule for Children-IV-Youth Version (DISC-IV) and modified DISC-IV questions that assessed caffeine dependence based on DSM-IV substance dependence criteria. Of 36 subjects, 41.7% (n=15) reported tolerance to caffeine, 77.8% (n=28) described withdrawal symptoms after cessation or reduction of caffeine intake, 38.9% (n=14) reported desire or unsuccessful attempts to control use, and 16.7% (n=6) endorsed use despite knowledge of physical or psychological problems associated with caffeine. There was no significant difference in the amount of caffeine consumed daily by caffeine dependent versus non-dependent teenagers. These findings are important due to the vast number of adolescents who drink caffeinated beverages.
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Affiliation(s)
- Gail A Bernstein
- Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, F256/2B West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
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Abstract
Although classification of mental disorders using more than clinical description would be desirable, there is scant evidence that available laboratory tests (i.e. biological indices) would provide more valid classifications than current diagnostic systems (e.g. DSM-IV). We used cluster analysis of four biological variables to classify 163 psychotic patients and 83 nonpsychiatric comparison subjects. Analyses revealed a three-cluster solution with the first cluster reflecting electrodermal deviance, the second cluster representing nondeviant biological function, and the third cluster reflecting increased nailfold plexus visibility and ocular motor dysfunction. To assess the construct validity of proband clusters we examined ocular motor performance in 156 first-degree relatives as a function of proband cluster membership. First-degree relatives of third cluster probands exhibited worse ocular motor performance than relatives of other cluster probands. Additionally, better classification sensitivity and specificity were obtained for the relatives when they were grouped by proband cluster than by proband DSM-IV diagnosis. When a single proband characteristic (i.e. eyetracking performance) was used to group relatives, classification sensitivity and specificity failed to significantly increase over grouping by proband DSM-IV diagnosis. Multivariate biologically defined clusters may offer an advantage over DSM-IV classification when examining nosology and etiology of psychotic disorders.
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Affiliation(s)
- S R Sponheim
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
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Bernstein GA, Borchardt CM, Perwien AR, Crosby RD, Kushner MG, Thuras PD, Last CG. Imipramine plus cognitive-behavioral therapy in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 2000; 39:276-83. [PMID: 10714046 DOI: 10.1097/00004583-200003000-00008] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the efficacy of 8 weeks of imipramine versus placebo in combination with cognitive-behavioral therapy (CBT) for the treatment of school-refusing adolescents with comorbid anxiety and major depressive disorders. METHOD This was a randomized, double-blind trial with 63 subjects entering the study and 47 completing. Outcome measures were weekly school attendance rates based on percentage of hours attended and anxiety and depression rating scales. RESULTS Over the course of treatment, school attendance improved significantly for the imipramine group (z = 4.36, p < .001) but not for the placebo group (z = 1.26, not significant). School attendance of the imipramine group improved at a significantly faster rate than did that of the placebo group (z = 2.39, p = .017). Over the 8 weeks of treatment, there was a significant difference between groups on attendance after controlling for baseline attendance; mean attendance rate in the final week was 70.1% +/- 30.6% for the imipramine group and 27.6% +/- 36.1% for the placebo group (p < .001). Defining remission as 75% school attendance, 54.2% of the imipramine group met this criterion after treatment compared with only 16.7% from the placebo group (p = .007). Anxiety and depression rating scales decreased significantly across treatment for both groups, with depression on the Children's Depression Rating Scale-Revised decreasing at a significantly faster rate in the imipramine group compared with the placebo group (z = 2.08, p = .037). CONCLUSIONS Imipramine plus CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school-refusing adolescents with comorbid anxiety and depression.
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Affiliation(s)
- G A Bernstein
- Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, USA
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Abstract
The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was administered to 46 adolescents with comorbid anxiety and major depressive disorders and to their parents in a treatment study of school refusal. FACES II measures cohesion and adaptability dimensions, as well as family type (balanced to extreme). Generally, adolescents and parents reported low cohesion (i.e.. disengagement) and low adaptability (i.e.. rigidity) on FACES II. Adolescents and parents described their ideal families as significantly less disengaged and less rigid than their own families. Fifty percent of adolescents, 38% of fathers, and 24% of mothers classified their families as the extreme type. Adolescents in extreme families, when compared with adolescents in more balanced families, reported significantly higher scores on two of three depression instruments and on a measure of somatic symptoms. Family therapy to improve cohesion and adaptability and treatments focused on improving depression and somatic symptoms may improve family functioning and decrease the severity and course of school refusal.
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Affiliation(s)
- G A Bernstein
- University of Minnesota Medical School, Minneapolis, USA
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Abstract
BACKGROUND Conflicting data have been published regarding pain threshold in subjects with anorexia nervosa (AN), with some studies indicating elevated pain threshold and others indicating normal thresholds. Previous research has indicated the presence of elevated pain threshold in eating disorder subjects with binge-eating behavior. METHODS In this study pressure pain detection thresholds (PDT) (assessed by a pressure analgesiometer) in binge-eating/purging and restricting subtypes of AN subjects were compared to control subjects. RESULTS PDT was elevated in AN compared to control subjects at baseline. There was no difference in PDT between the subgroups of AN subjects. CONCLUSIONS The etiology of elevated PDT in AN subjects is most likely different from the etiology of elevated PDT in bulimia nervosa subjects.
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Affiliation(s)
- N C Raymond
- Department of Psychiatry, University of Minnesota, Minneapolis 55455, USA
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Raymond NC, Eckert ED, Hamalainen M, Evanson D, Thuras PD, Hartman BK, Faris PL. A preliminary report on pain thresholds in bulimia nervosa during a bulimic episode. Compr Psychiatry 1999; 40:229-33. [PMID: 10360620 DOI: 10.1016/s0010-440x(99)90009-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Subjects with bulimia nervosa (BN) have been shown to exhibit abnormal satiety responses. Short-term satiety is largely mediated by afferent vagal activity. Activation of afferent vagal fibers has also been found to stimulate a descending pain inhibitory pathway that leads to elevation in somatosensory pain thresholds. Therefore, the study of pain thresholds in BN subjects may lead to a better understanding of afferent vagal function in this disorder. In this preliminary study, pressure pain thresholds were assessed in nine subjects with BN on 3 consecutive days during a binge-eating and vomiting (B/V) episode, during a normal meal, and after an overnight fast. A significant time versus condition effect was found with a significant change in the pain threshold in BN subjects under the B/V condition only. These data are consistent with the hypothesis that vagal afferent activation by a B/V episode also activates the descending pain inhibitory pathway.
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Affiliation(s)
- N C Raymond
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis 55455, USA
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Abstract
OBJECTIVE To identify the most common physical complaints in a sample of adolescent school refusers with comorbid anxiety and depressive disorders. Whether somatic symptoms are more likely to be associated with high levels of anxiety or high levels of depression was also explored. METHOD Forty-four adolescents in a treatment study were evaluated at baseline with structured psychiatric interviews and measures of anxiety, depression, and somatization. RESULTS The most common somatic complaints were in the autonomic and gastrointestinal categories. In simple regression analyses, anxiety level as measured with the Revised Children's Manifest Anxiety Scale and depression level as measured with the Beck Depression Inventory each significantly predicted the severity of somatic symptoms. The correlation between percentage of days absent from school and severity of somatic symptoms approached significance (r = .27, p = .074). CONCLUSIONS Knowledge that somatic complaints are commonly an expression of underlying anxiety and depression may facilitate more rapid referral for psychiatric assessment and treatment and thereby help avoid unnecessary medical workups and sequelae from school refusal.
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Affiliation(s)
- G A Bernstein
- Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, USA
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Abstract
OBJECTIVE To evaluate the validity of the Cumulative Illness Rating Scale (CIRS) in a geriatric institutional population by examining its associations with mortality, hospitalization, medication usage, laboratory findings and disability. DESIGN A validation of the CIRS using self- and physician-report surveys, with archival data drawn from medical charts and facility records. SETTING Long-term care facility with skilled nursing and congregate apartments. PARTICIPANTS Four hundred thirty-nine facility residents selected on the basis of completeness of self-report data and physician ratings. PRIMARY MEASURES Composite measures of illness severity and comorbidity, based on physicians' CIRS ratings; time to death or acute hospitalization after assessment; medication use, drawn from pharmacy records; medical chart data on laboratory tests; self-reported functional disability. RESULTS CIRS illness severity and comorbidity indices, as well as individual CIRS items, were significantly associated with mortality, acute hospitalization, medication usage, laboratory test results, and functional disability. The CIRS showed good divergent validity vis a vis functional disability in predicting mortality and hospitalization. CONCLUSIONS The CIRS appears to be a valid indicator of health status among frail older institution residents. The illness severity and comorbidity composites performed equally well in predicting longitudinal outcomes. Item-level analyses suggest that the CIRS may be useful in developing differential illness profiles associated with mortality, hospitalization, and disability.
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Abstract
Most research on older adults' social networks has focused on the support-providing function of social relationships. Little gerontological research has addressed social control, or the role of social bonds in regulating deviant or risky behavior. Drawing on sociological theory, this study examined the hypothesis that social control discourages risky health practices while provoking psychological distress. Structured interviews conducted with 162 community-residing older adults assessed social control (direct attempts by other to influence participants' health practices and the existence of significant role obligations to others), health risk taking (medication misuse, alcohol consumption, cigarette smoking, and the overall level of unsound health practices), psychological functioning (depression, loneliness, and self-esteem), and interpersonal satisfaction (satisfaction with friends and family members). Analyses revealed little support for the hypothesis. Social control was only weakly related to participants' health practices and, contrary to expectation, was generally related to less psychological distress and to greater interpersonal satisfaction. Implications for social control theory and for further research are addressed.
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Affiliation(s)
- K S Rook
- Program in Social Ecology, University of California, Irvine 92717
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Abstract
Most research on older adults' social networks has focused on the support-providing function of social relationships. Little gerontological research has addressed social control, or the role of social bonds in regulating deviant or risky behavior. Drawing on sociological theory, this study examined the hypothesis that social control discourages risky health practices while provoking psychological distress. Structured interviews conducted with 162 community-residing older adults assessed social control (direct attempts by other to influence participants' health practices and the existence of significant role obligations to others), health risk taking (medication misuse, alcohol consumption, cigarette smoking, and the overall level of unsound health practices), psychological functioning (depression, loneliness, and self-esteem), and interpersonal satisfaction (satisfaction with friends and family members). Analyses revealed little support for the hypothesis. Social control was only weakly related to participants' health practices and, contrary to expectation, was generally related to less psychological distress and to greater interpersonal satisfaction. Implications for social control theory and for further research are addressed.
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Affiliation(s)
- K S Rook
- Program in Social Ecology, University of California, Irvine 92717
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