Pituitary apoplexy is often misdiagnosed because the majority of patients have undetected pituitary adenomas, and the presentation is often mistaken for subarachnoid hemorrhage. Most cases of pituitary apoplexy occur spontaneously, although precipitating factors have been suggested. Magnetic resonance imaging is the imaging modality of choice. Treatment includes high-dose corticosteroid administration and surgery. Transsphenoidal surgery is indicated in patients with diminished levels of consciousness, hypothalamic dysfunction, and visual deterioration. Conservative management for patients with isolated cranial nerve palsies has been advocated but remains controversial.

This study modeled associations between gender, ruminative cognitive style, alcohol use, and the time course of negative affect over the course of 43,111 random assessments in the natural environment. Participants (N=263) completed 49-days of experience sampling over 1.3 years. The data indicated that rumination at baseline was positively associated with alcohol dependence symptoms at baseline as well as higher negative affect over the course of the study. Consistent with negative reinforcement models, drinking served to decrease the persistence of negative affect from moment to moment. However, this ameliorative effect of drinking was evident only among women, suggesting an increased risk for negative reinforcement driven drinking behavior. In addition, rumination appeared to counteract the desired effects of alcohol on mood among women. This suggests that women who ruminate more may be motivated to consume larger amounts of alcohol to achieve the desired effects. Overall, the results indicate that ruminative cognitive style and the persistence of negative affect from moment to moment may reflect an individual vulnerability for the development of alcohol use disorder especially among women.

This study tested a multiple group path model in a sample of young adults (n = 402; 233 university participant pool/169 Amazon MTurk) linking positive and negative affect to alcohol consumption and problems via enhancement and coping motives, respectively. Motivational models of alcohol use suggest that individuals drink in order to alleviate negative affective states or to enhance positive moods or feelings. Deficits in modulating attention toward emotional experience (i.e., involuntary attention to emotion [IAE]); and poor distress tolerance may contribute to maladaptive patterns of substance use (i.e., negative reinforcement). As negative affect increases, those with deficits in the ability to efficiently attend to emotions as well as the inability to withstand distress may seek more external means of regulating unwanted or intrusive emotional experiences via alcohol. It was hypothesized that involuntarily attending to one’s emotions would contribute to negative reinforcement drinking and problems. Coping motives were directly associated with alcohol-related problems, while enhancement motives were directly associated with problems both directly and indirectly via alcohol consumption. The hypothesized interaction between negative affect and IAE to coping motives was conditional upon levels of distress tolerance, with the moderating effect of involuntary attention being significant at high but not low levels of distress tolerance. Distress tolerance exhibited direct, inverse associations with alcohol-related problems. This pathway was significant over and above the direct effects of both coping motives and alcohol consumption. This suggests that while tolerance for emotional distress may reduce negative reinforcement drinking, it also fosters adaptive regulation when intoxicated.