Content-specific gender differences in emotion ratings from early to late adulthood

The investigation of gender differences in emotion has attracted much attention given the potential ramifications on our understanding of sexual differences in disorders involving emotion dysregulation. Yet, research on content-specific gender differences across adulthood in emotional responding is lacking. The aims of the present study were twofold. First, we sought to investigate to what extent gender differences in the self-reported emotional experience are content specific. Second, we sought to determine whether gender differences are stable across the adult lifespan. We assessed valence and arousal ratings of 14 picture series, each of a different content, in 94 men and 118 women aged 20 to 81. Compared to women, men reacted more positively to erotic images, whereas women rated low-arousing pleasant family scenes and landscapes as particularly positive. Women displayed a disposition to respond with greater defensive activation (i.e., more negative valence and higher arousal), in particular to the most arousing unpleasant contents. Importantly, significant interactions between gender and age were not found for any single content. This study makes a novel contribution by showing that gender differences in the affective experiences in response to different contents persist across the adult lifespan. These findings support the "stability hypothesis" of gender differences across age

Schizophrénies et troubles délirants tardifs à l'âge avancé

Persistent schizophrenias and delusional disorders are classified as primary psychiatric pathologies amongst the elderly. It is crucial to distinguish them from secondary psychotic disorders associated with physical illnesses, such as acute confusion and psychotic symptoms caused by dementia or other somatic pathologies. Employing the concept of a primary psychiatric disorder occurring in an elderly patient is not simple, and each term used to define the concept refers back to an array of various criteria in clinical, psychological, biological, neurological, and cognitive fields. What about very late-onset schizophrenia, occurring after the age of 60 years, for instance? Is this a primary psychiatric illness occurring very late or a secondary pathology caused by brain disease, particularly a degenerative one? Studies reveal controversial results and it is still being debated as to whether the disease has neurodevelopmental or neurodegenerative causes. Due to the variable symptoms and psychiatric, somatic, and cognitive comorbidities associated with psychosis in elderly patients, patient healthcare must not be limited to prescribing an antipsychotic. Once it has been determined whether the psychosis is secondary or primary (old-agerelated schizophrenia, late-onset or very late-onset schizophrenia, or late-onset delusional disorder), an aetiological or symptomatic treatment must follow, including a psychotherapeutic approach, close surveillance of the drug treatment and its potential side-effects, rehabilitation steps through community-based care, and psychoeducational support for the family and other professionals in charge of the patient. Our article's aim has been restricted to summarising our understanding regarding late-onset schizophrenias and delusional disorders amongst the elderly

Autonomic nervous system reactivity within the valence-arousal affective space: modulation by sex and age

In the present study, we examined how sex and age shape cardiovascular, electrodermal, and pupillary reactivity to picture series within the valence-arousal affective space in a sample of 176 healthy younger, middle-aged, and older men and women. Across participants, heart rate (HR) decelerated with increasing self-reported unpleasantness, whereas skin conductance level (SCL) and pupil size (PS) increased with increasing self-rated arousal. Systolic (SBP) and diastolic (DBP) blood pressure increased with increasing self-rated arousal when valence was pleasant but much less when valence was unpleasant. Compared to women, men exhibited a stronger correlation between valence and HR and an SBP response characterized by larger increases for pleasant high-arousal states and lower change scores for unpleasant low- and high-arousal and pleasant low-arousal states. Men's largest SCL change scores were for pleasant high-arousal states, whereas women's largest SCL change scores were for unpleasant high-arousal states. The arousal-PS relationship was stronger among women, in particular for unpleasant series. From younger to older age, there were decreases in the strength of the valence-HR, arousal-SCL, and arousal-PS relationships. Older adults had larger overall increases in SBP and DBP than younger adults, but the relationships with self-reported valence and arousal were not age dependent. We discuss how the observed sex and age effects may reflect sex and age differences in emotional processing and in basic autonomic nervous system functioning

Best practice in the management of behavioural and psychological symptoms of dementia

Behavioural and psychological symptoms of dementia (BPSD) occur in most patients with dementia. They cause great suffering in patients and caregivers, sometimes more so than the cognitive and functional decline inherent to dementia. The clinical features of BPSD include a wide variety of affective, psychotic and behavioural symptoms and signs. The causes and risk factors for BPSD are multiple and include biological, psychological and environmental variables. Frequently, their combination, rather than any specific factor, explains the occurrence of BPSD in an individual patient. Thus, a sound etiopathogenetic investigation including the patient and the family or care team is essential. The aim is to develop an individualized treatment plan using a therapeutic decision tree modified by the individual and environmental risk profile. Still, treatment may be difficult and challenging. Clinical empiricism often steps in where evidence from controlled studies is lacking. Psychosocial treatment approaches are pivotal for successful treatment of BPSD. Often a combination of different non-pharmacological approaches precedes drug treatment (most of which is off-label). Regular assessments of the treatment plan and any prescriptions must be carried out to detect signs of relapse and to stop any medicines that may have become inappropriate. Even with optimal management, BPSD will not disappear completely in some cases and will remain challenging for all involved parties. This article is a narrative review based closely on the interprofessional Swiss recommendations for the treatment of BPSD. To establish the recommendations, a thorough research of the literature has been carried out. Evidence-based data were provided through searches of Medline, Embase, ISI and Cochrane-Database research. Evidence categories of the World Federation of Biological Societies were used. Additionally, the clinical experience of Swiss medical experts was considered

Breathing and affective picture processing across the adult lifespan

The present study investigated differences between healthy younger, middle-aged, and older adults in their respiratory responses to pictures of different valence and arousal. Expiratory time shortened and end-tidal PCO2 decreased with increasing arousal in all age groups; yet, compared to younger adults, older adults' overall change from baseline was smaller for expiratory time and larger for end-tidal PCO2. Contrary to their younger counterparts, older adults' inspiratory time did not shorten with increasing arousal. Inspiratory duty cycle did not covary with affective ratings for younger adults, increased with unpleasantness for middle-aged adults, and increased with arousal for older adults. Thoracic breathing increased with increasing unpleasantness only among older adults. Age had no effects on mean inspiratory flow and minute ventilation, which both augmented as arousal increased. We discuss how age effects on respiratory response magnitude and pattern may depend on age-associated biological changes or reflect age-related differences in emotional processing