Рубаї в українській поезії

Рецензія на монографію: Сьомочкіна Олена. Рубаї в українській поезії: від канонізованої строфи до поліжанру. Монографія. - ІС: КиМУ, 2005. - 252 с

Attentional bias for alcohol cues in visual search—Increased engagement, difficulty to disengage or both?

Cognitive models emphasise the importance of attentional bias in addiction. However, many attentional bias tasks have been criticised for questionable psychometric properties and inability to differentiate between engagement and disengagement processes. This study therefore examined the suitability of two alternative tasks for assessing attentional bias within the context of alcohol use. Participants were undergraduate students (N = 169) who completed the Visual Search Task and Odd-One-Out Task, the latter of which is designed to differentiate between engagement and disengagement processes of attention, at baseline and one week later. Participants also completed baseline measures of alcohol consumption, craving, and alcohol use problems. Internal consistency was adequate for the Visual Search Task index, and weak for the Odd-One-Out Task indices. Test-retest reliability was weak for both tasks. The Visual Search Task index and the disengagement (but not the engagement) index of the Odd-One-Out Task showed a positive association with alcohol consumption. This study was restricted to a non-clinical student sample. The relatively high error rate of the Odd-One-Out Task might have reduced its sensitivity as an index of attentional bias. Both tasks showed some merit as attentional bias measures, and results suggested that attentional disengagement might be particularly related to alcohol use. However, the reliability of the current measures was inadequate. One potential explanation for the low reliability is that non-clinical samples may have weak and unstable attentional biases to alcohol. Future efforts should be made to improve the psychometric qualities of both tasks and to administer them in a clinical sample

DSM-5-TR prolonged grief disorder and DSM-5 posttraumatic stress disorder are related, yet distinct:confirmatory factor analyses in traumatically bereaved people

Background: Prolonged grief disorder (PGD) is newly included in the text revision of the DSM-5 (DSM-5-TR). So far, it is unknown if DSM-5-TR PGD is distinguishable from bereavement-related posttraumatic stress disorder (PTSD). Prior research examining the distinctiveness of PTSD and pathological grief focused on non-traumatic loss samples, used outdated conceptualizations of grief disorders, and has provided mixed results. Objective: In a large sample of traumatically bereaved people, we first evaluated the factor structure of PTSD and PGD separately and then evaluated the factor structure when combining PTSD and PGD symptoms to examine the distinctiveness between the two syndromes. Methods: Self-reported data were used from 468 people bereaved due to the MH17 plane disaster (N = 200) or a traffic accident (N = 268). The 10 DSM-5-TR PGD symptoms were assessed with the Traumatic Grief Inventory-Self Report Plus (TGI-SR+). The 20-item Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) was used to tap PTSD symptoms. Confirmatory factor analyses were conducted. Results: For PTSD, a seven factor, so-called ‘Hybrid’ model yielded the best fit. For PGD, a univariate factor model fits the data well. A combined model with PGD items loading on one factor and PTSD items on seven factors (associations between PGD and PTSD subscales r ≥ .50 and ≤.71), plus a higher-order factor (i.e. PTSD factors on a higher-order PTSD factor) (association between higher-order PTSD factor and PGD factor r = .82) exhibited a better fit than a model with all PGD and PTSD symptom loading on a single factor or two factors (i.e. one for PGD and one for PTSD). Conclusions: This is the first study examining the factor structure of DSM-5-TR PGD and DSM-5 PTSD in people confronted with a traumatic loss. The findings provide support that PGD constitutes a syndrome distinguishable from, yet related with, PTSD

The influence of sexual arousal on subjective pain intensity during a cold pressor test in women

Background & objectives Pain can be significantly lessened by sex/orgasm, likely due to the release of endorphins during sex, considered potent analgesics. The evidence suggests that endorphins are also present during sexual arousal (that is, prior to sex/orgasm). It follows then that pain can be modulated during sexual arousal, independent of sex/orgasm, too. Accordingly, sexual arousal induced by erotic slides has been demonstrated to lessen pain in men, but not in women. One explanation could be that for women, the erotic slides were not potent enough to elicit a lasting primed state of sexual arousal by the time pain was induced. Thus, the current study aims to optimize the means of inducing a potent state of sexual arousal and subsequently examine the potentially analgesic influence of sexual arousal on pain in women. As a subsidiary aim, the study also assesses whether the anticipated analgesic effect of sexual arousal would be stronger than that of distraction or generalized (non-sexual) arousal. Methods Female participants (N = 151) were randomly distributed across four conditions: sexual arousal, generalized arousal, distraction, neutral. Mild pain was induced using a cold pressor while participants were concurrently exposed to film stimuli (pornographic, exciting, distracting, neutral) to induce the targeted emotional states. A visual analogue scale was utilized to measure the subjective level of pain perceived by the participants. Results Sexual arousal did not reduce subjective pain. Generalized arousal and distraction did not result in stronger analgesic effects than the neutral condition. Conclusion The present findings do not support the hypothesis that sexual arousal alone modulates subjective pain in women. This might be due to the possibility that genital stimulation and/or orgasm are key in pain reduction, or, that feelings of disgust may inadvertently have been induced by the pornographic stimulus and interfered with sexual arousal in influencing pain

Latent classes of DSM-5 acute stress disorder symptoms in children after single-incident trauma: findings from an international data archive

Background: After a potentially traumatic event (PTE), children often show symptoms of acute stress disorder (ASD), which may evolve into posttraumatic stress (PTS) disorder. A growing body of literature has employed latent class analysis (LCA) to disentangle the complex structure underlying PTS symptomatology, distinguishing between homogeneous subgroups based on PTS presentations. So far, little is known about subgroups or classes of ASD reactions in trauma-exposed children. Objective: Our study aimed to identify latent classes of ASD symptoms in children exposed to a single-incident PTE and to identify predictors of class membership (gender, age, cultural background, parental education, trauma type, and trauma history). Method: A sample of 2287 children and adolescents (5–18 years) was derived from the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive, an international archive including studies from the USA, UK, Australia, and Switzerland. LCA was used to determine distinct subgroups based on ASD symptoms. Predictors of class membership were examined using a three-step approach. Results: Our LCA yielded a three-class solution: low (42%), intermediate (43%) and high (15%) ASD symptom severity that differed in terms of impairment and number of endorsed ASD symptoms. Compared to the low symptoms class, children in the intermediate or high severity class were more likely to be of female gender, be younger of age, have parents who had not completed secondary education, and be exposed to a road traffic accident or interpersonal violence (vs. an unintentional injury). Conclusions: These findings provide new information on children at risk for ASD after single-incident trauma,

睡眠発生と慣れの解除 : 末梢血管反応について

The purpose of this investigation was to determine whether finger plethysmograph response (FPR), previously habituated during pre-sleep wake state, would dishabituate with onset of sleep, and whether restored FPR could rehabituate during sleep. Twelve subjects (22-28 yrs) were divided into two groups: 1) an alert group, subjected to repetitive stimulations during pre-sleep wake and sleep, and 2) a hypnagogic group, subjected to repetitive stimulations after sleep onset. One half subjects in each group received 40db stimulus and the other half 50db. Stimuli were 70, 4-sec, 40db (A) or 50db (A) octave band noises (central frequency 1000Hz), presented at 30-40 sec interstimulus interval. EEG sleep stages were classified according to the criteria of Koga (1960) and Fujisawa (1960). FPR during waking peirod showed faster habituation to 40db stimulus than to 50db. Sleep onset played a trigger role in dishabituating FPR (Fig.5). There was, however, no or little habituation of the restored FPR during sleep (Table 2 and Fig.7). These results were interpreted in terms of Sokolov\u27s neural model. Seeming habituations were often observed during deep sleep (stage 5+6), but those were considered to be due to the decreased responsiveness of FPR in that stage of sleep. Frequency of FPR, although enhanced during sleep, varied with the stage of sleep and was highest during drowsy state (stage 2+3). In addition, the negative transfer effect of prior habituation was found only in stage 2+3, i.e. habituation elaborated during pre-sleep waking period weakened the effect of stimulus intensity and also reduced the percent occurrence of FPR in stage 2+3 (Fig.6). This effect of prior habituation seems to suggest that a memory trace of stimulus information received during waking state may still work in drowsy state

入眠時のslow eye movement(SEM) : 睡眠状態の指標としての可能性

著者らは,容積脈波の慣れの研究において,入眠前の覚醒時に慣れを形成してまったく反応が起きないようにしておいても睡眠への移行に伴い反応が回復し始め,睡眠中には慣れが生起しにくいことをみてきた(広重他,1977;広重と永村,1979;広重,1981)。その際問題となったのは覚醒から睡眠への移行状態の判定方法であった。通常,この移行状態は入眠期と呼ばれ,脳波的睡眠段階の分類に従えば睡眠段階1が概ね対応づけられる。脳波的睡眠段階とは,本来刻々と変化している脳波像を一定区間(通常20秒ないし30秒)毎に分割し,その区間内で観察されるアルファ波,睡眠紡錐とK複合,あるいはデルタ波などの基礎律動の多少に応じて脳波像をパターン分類したものをいう。しかし,睡眠段階1はRechtscheffen & Kales (1968)の定義にもあるように,「2～7c/s波の目立つ,比較的低電位でさまざまの周波数の混在する脳波」像であるため,他の睡眠段階のように特徴的な基礎律動を特定することは難しい。更に,覚醒から段階1への移行時は,覚醒時脳波の基礎律動であるアルファ波の出現が断片的となり,視察による段階判定がかなり困難な時期である。このような段階と段階の臨界点の判定には操作的方法を採用するのが通例である。例えば,APSS方式によれば,一定区間内のアルファ波の占める割合が50%未満となったときを段階1と判定する。しかしし覚醒時にアルファ波が少ししかみられない人や,まったくアルファ波を示さない人には,この判定基準はあまり有効でない。これに関連して,脳波のスペクトル構造の時間的変動から入眠期の脳波像の特徴を記述する試みがある(堀,1979)。睡眠時脳波のスペクトル分析については,脳波が非定常であるために最適なサンプル長の決め方がきわめて難しい問題として残されており(永村,1974),入眠時のように不安定な脳波像を対象とする場合は慎重でなければならないであろう。睡眠段階が脳波の基礎律動に注目したパターン分類であることは上述した通りであるが,この睡眠段階の判定には眼球運動と筋電図が補助指標として通常用いられる。睡眠時の眼球運動はレム睡眠中の急速眼球運動(rapid eye movement: REM)とオーソ睡眠時の緩徐眼球運動(slow eye movement: SEM)とに区別されており(Aserinsky & Kleitman,1955),後者のSEMが段階1の時期にしばしば観察されることは多くの睡眠研究者が経験的に知りえているところである。また,段階1直前のアルファ波期から既にSEMの出現を認めた報告もある(Foulkes & Vogel,1965;堀,1979;大久保他,1983)。これらの経験的知識や研究報告から,SEMを入眠時の随伴現象とみなし,SEMの出現から入眠状態を逆に推測するという考え方がでてこよう。しかし,他方では,SEMの出現と段階1の一致は偶然にすぎず,単なる時間効果によるものであろうとする考え方もできる。現在のところ,この時間効果を否定する証拠はなく,またSEMそのものの消長過程に関する資料も乏しいなど,SEMを入眠時随伴現象とみなすに足る資料の蓄積は十分でないように思われる。本研究は,SEMが入眠状態の判定の指標として有効であるか否かを検討する予備実験であり,覚醒から睡眠に至る経過を脳波,眼球運動,心電図,呼吸曲線,脈波および主観的な眠気反応などのポリグラフにより連続記録し,主にSEMの消長過程と脳波的睡眠経過との対応を調べた。EEG sleep stages, classified according to criteria of the Association for Psychophysiological Study of Sleep (APSS), are effective in giving an outline of over-night sleep process. But we often feel difficulties in categorizing such transitional epochs as EEG state with discontinuous and low alpha waves or that with low amplitude mixed wave frequencies. There seem at least three approaches to those difficulties. The first approach is an operational definition of sleep stages; APSS suggests that EEG state with less than 50% of subject\u27s EEG recording occupied by alpha waves should be called stage 1 (drowsy state). The second one is EEG spectral analysis to detect frequencies common to all stages as well as those unique to a specific stage of sleep. The third is a combination of EEG and other reliable indexes, such as EMG and rapid eye movements which led to a finding of stage REM sleep. The present preliminary study is one of the third approach and aims at slow eye movements (SEM), observed on horizontal eye movement recordings, to see if SEM can be used as a reliable and distinguishing index of sleep state. This study revealed that SEM, being a sine-like oscillation, was a trasient phenomenon accompanying the changes in subject\u27s state; SEM began to appear slightly in waking state, got most frequent at EEG stage 1, and decreased quickly toward the end of stage 1 and the beginning of stage 2. No visible SEM was observed at all during slow wave sleep. This process of SEM was recoverable in character; when the subject fell asleep again after he had awakened temporarily from sleep, the same development and decay process of SEM occurred repeatedly. The results of this study suggest that a time span or range of drowsy state might be detected by using SEM

入眠時の眼球運動 : SEMsと収斂性眼球運動

眼球運動は,睡眠の生理心理学的研究において,脳波と並んで重要な指標である。睡眠時に観察される眼球運動には,両眼球が素早く動く急速眼球運動(rapid eye movements; REMs)と振子様の滑らかな動きを示す緩徐眼球運動(slow eye movements: SEMs)とがある。REMsは睡眠の脳波段階と睡眠周期の判定基準として標準化されており,また夢見体験の評定にも不可欠の指標である。これに対し,SEMsは睡眠の特定の状態を判定する指標として標準化されてはいないが,睡眠初期の段階1から段階2にかけて出現することが旧くから知られている。また,脳波上にα律動を認める閉眼安静時にもその出現があり,低い意識状態や意識の混濁状態との関連性が指摘されている。これらSEMsに関する知見を総合すると,入眠の開始(傾眠)時点の判定基準としてSEMsを用いることが妥当ではないか,と推論される。著者は,就眠前覚醒期から徐波睡眠(段階3と4)に至る睡眠第1周期についてSEMsの変動性と主観的な眠気(sleepiness)との関連性を調べ,入眠期の時間的範囲の推定にSEMsが有効であるという考えを得ている。ところで,睡眠時の眼球運動は,角膜側にプラス電位,網膜側にマイナス電位がそれぞれ分布する角膜-網膜電位(corneoretinal potentials)の原理を応用したEOG (Electro-oculography)により通常記録される。また,水平方向の眼球運動のEOG記録については,耳朶あるいは乳様突起を基準電極部位として左右の眼窩外側縁部よりそれぞれ単極導出する方法がAPSS (Association for the Psychophysiological Study of Sleep)によって標準化されている。この導出方法は,左右2チャンネルのEOG曲線の位相差に着目して,左右の眼球が同一方向に回転する共役性眼球運動(conjugate eye movements)を検出することが主たる目的である。著者は,前報にてこの位相法による記録を試み,REMsとSEMsがそれぞれ2チャンネルのEOG曲線の急速な,あるいは緩やかな逆位相の偏位の記録としてあらわれる共役性運動であること,他方,基準電極に由来するアーチファクトは2チャンネルのEOG曲線および脳波曲線が共に同位相に偏位することから比較的容易に識別されることを確かめた。しかしながら,この位相法による導出記録においてEOG曲線が同位相の偏位を示した場合,それらをすべてアーチファクトとみなすことには問題がある。なぜなら,水平方向の眼球運動には共役性運動の他に,両眼球が反対方向に回転する収斂性眼球運動(convergent eye movements)があり,この眼球運動は角膜-網膜電位の原理により2チャンネルのEOG曲線が同位相の偏位を示すと期待されるからである。APSS刊行の睡眠段階の標準判定法の手引きによると,睡眠中,収斂性眼球運動の出現は共役性眼球運動に比較して少ないと記載されている。しかし,睡眠時の眼球運動に関する従来の研究は共役性運動を対象とするものが圧倒的に多く,睡眠中の収斂性運動の出現様態については十分知られていないと考えられる。本研究は,覚醒および睡眠初期における水平方向の眼球運動を位相法によりEOG記録し,収斂性眼球運動の自発的な出現様態を次の3点にわたって調べた。Slow eye movements (SEMs) and convergent eye movements, spontaneously occurring during waking, drowsy and sleep states, were studied in 23 female subjects. Horizontal EOGs were recorded monopolarly from the right and left outer canthi. Simultaneous records were obtained of EEG, vertical EOG, finger pulse volume and motor responses of sleepiness. Two types of eye movements, conjugate and convergent, were evaluated by comparing the phase difference between two monopolar horizontal EOGs. This phase method revealed that experimentally-induced eye movements produced the corresponding deflections on a pair of horizontal EOGs (Figs.1 and 2). Spontaneous convergent movements, manifested by deflections on a pair of EOGs with the same polarity, were observed few and had no relation to EEG stages of sleep (Table 2). Most of the observed deflections with the same polarity were considered as artifacts. SEMs, as one of conjugate movements and defined by slow deflections on a pair of EOGs with the opposite polarity, were very frequent and showed the certain relation to EEG stages of sleep; they occurred most frequently at stage 1, more frequently at stage W, but less at stage 2. No SEMs were found at stages 3 and 4. The results suggest that SEMs will give a useful criterion of the decline in aroual level (Table 3). AC and DC recordings of horizontal EOGs were tentatively attempted to examine the distortions of EOG wave forms. Distortions of the wave forms recorded with AC coupling (time constants 2.0 and 3.0sec) seemed small in comparison with the DC records (Figs.1, 2 and 4). Further detailed study is needed for determining the value of a time constant adequate to hold the distortions to a minimum

入眠状態と緩徐眼球運動(SEMs) : SEMsの記録方法と定量的分析について

覚醒から睡眠への移行状態とされる入眠期がいつ開始して終了するのか,その判定は容易でない。睡眠研究では,ヒトの意識水準は脳波像に基づいて複数の睡眠段階に分類され,その中,段階1が入眠期に対応づけられる。しかし,この段階1は持続性に欠け,容易に他の段階と相互移行する。また,その脳波像は,「2～7c/s波の目立つ,比較的低電位のさまざまの周波数の混在する脳波」と定義されるように,固有の基礎律動が無いため判読に苦労することが多い。このような理由から,段階1で記述される入眠期は不安定でとらえにくい性質のものとなる。睡眠段階の概念は比較的均質で定常な脳波状態を対象とするものであることを考えれば,入眠期のような過渡的状態をこの段階の概念で記述することには,本来,無理があるのではないだろうか。眼球運動は,脳波と同等にあるいはそれよりも鋭敏に,ヒトの意識水準の変動を反映すると考えられる。睡眠中の眼球運動は急速眼球運動(rapid eye movements: REMs)と緩徐眼球運動(slow eye movements: SEMs)とに分類される。REMsは,REM睡眠という夢見と関連する新しい睡眠状態を意識水準の中に位置づけた重要な指標である。一方,SEMsは,脳波像で定義される入眠期(段階1)の随伴現象として旧くから知られているが,その他,覚醒期にもその出現が認められ,くつろぎ,夢様体験,意識障害などの心理的状態との関連性が論議されている。著者は先の研究にて,段階1出現前の覚醒期から既にSEMsが出現し,このとき眠気の訴えが多いこと,また,SEMsは覚醒から睡眠への時間的推移に対応した一定の消長過程を示すことを報告した。以上の所見から,覚醒と睡眠の間に,SEMsによって特徴づけられる過渡的状態の介在を想定し,それによって入眠期の範囲を記述できるのではないかと考えられる。しかし,著者の先行研究は眼球運動の記録と波形処理が十分でなく,改善の余地があった。第1に,眼球運動を双極導出したため,電極に由来するアーチファクトの検出が不可能であった。このアーチファクトの検出には,単極導出した左右2チャンネルの眼球運動曲線の位相を比較する位相法(phase method)が有効であるとされる。即ち,電極に由来するアーチファクトは両チャンネルの同位相の振れ,あるいは一方のチャンネルのみの振れとして記録される。眼球運動自体の意味のある変化は2チャンネルの逆位相の振れとして現われる。第2に,波形処理については一定区間のSEMsの持続性を3段階に評定する方法を用いたが,波形の振幅や立上り角度などに着目した定量的分析を試みるべきであったろう。従来,SEMs波形について,そのようなパラメータを計測し,その特徴を詳細に調べた研究例はないようである。本研究は,(1)位相法による眼球運動の記録と,(2)SEMs波形の特徴抽出パラメータの計測とを行ない,覚醒から睡眠への段階移行期におけるSEMsの経時的変化の定量的記述を試みた。Slow eye movements (SEMs) were studied in 8 female subjects during waking and sleep by means of horizontal electro-oculograms (EOGs). Simultaneous records were obtained of EEG, vertical EOG, finger photo-plethysmogram (PPG) and reponse of sleepiness. Heart rates were calculated by using the pulse waves of PPG. A pair of horizontal EOGs (right & left eyes) were recorded by the phase method, which had been originally presented by Aserinsky & Kleitman (1955) and then formulated by Rechtschffen & Kales (1968). This recording method proved useful in differentiatig SEMs from artifacts. When the deflections on a pair of EOGs had the same polarity or the deflection just on either of EOGs appeared, they were considered to be artifacts. Such artifacts were sometimes observed in sleep. SEMs were easily identified by the deflections on a pair of EOGs with the opposite polarity (Figs.1 & 2). SEMs occurred from stage W, through stage 1, to the beginning of stage 2. But they were found to be prominent at the end of stage W (for 7 minutes just before the onset of stage 1), as well as stage 1. At stages 3 and 4 were found no SEMs (Figs.1, 6, 7, & 8). During waking (stage W), the association of SEMs with response of sleepiness was significantly positive (Table 2). Stage W with SEMs was frequently accompanied by responses of sleepiness, whether the time of appearance of sleepiness was nearer to stage 1 or not. In addition, stage W with SEMs showed lower heart rates than stage W without SEMs, while its rates were still higher than those of sleep stages (Table 3). These results suggested that stage W with SEMs, showing signs of drowsy state, might be located between wakefulness and sleep. Three parameters were measured to feature SEM waves: peak amplitude (PA), peak time (PT) and rising angle (RA). It was difficult to obtain an obvious tendency of PA as a function of time elapsed, except that mean PA was somewhat higher at stage 1 and lower at stage 2. The results of RA revealed that SEM waves changed from comparatively rapid deflections of EOGs to slower ones, corresponding to a decrease in arousal level; RA was comparatively higher and almost constant at stage W, whereas it lowered gradually as the time proceeded during stage 1 and became the minimum at stage 2 (Figs.6 & 7). RA was considered to be superior in characterizing SEM waves. It was discussed that SEMs might reflect the decline in arousal level more keenly than EEG

Guidelines: Recognition, assessment and treatment of social anxiety disorder: Summary of NICE guidance

Social anxiety disorder is one of the most persistent and common of the anxiety disorders, with lifetime prevalence rates in Europe of 6.7% (range 3.9-13.7%). It often coexists with depression, substance use disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder. It can severely impair a person’s daily functioning by impeding the formation of relationships, reducing quality of life, and negatively affecting performance at work or school. Despite this, and the fact that effective treatments exist, only about half of people with this condition seek treatment, many after waiting 10-15 years. Although about 40% of those who develop the condition in childhood or adolescence recover before adulthood, for many the disorder persists into adulthood, with the chance of spontaneous recovery then limited compared with other mental health problems