Similar to patients with orbitofrontal cortex lesions, substance dependent individuals (SDI) show signs of impairments in decision-making, characterised by a tendency to choose the immediate reward at the expense of severe negative future consequences. The somatic-marker hypothesis proposes that decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between abnormalities in experiencing emotions in SDI, and their severe impairments in decision-making in real-life. Growing evidence from neuroscientific studies suggests that core aspects of substance addiction may be explained in terms of abnormal emotional guidance of decision-making. Behavioural studies have revealed emotional processing and decision-making deficits in SDI. Combined neuropsychological and physiological assessment has demonstrated that the poorer decision-making of SDI is associated with altered reactions to reward and punishing events. Imaging studies have shown that impaired decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, including the ventromedial cortex, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent of which these studies support a somatic-marker model of addiction.
Daily stress, and not stressful life events, worsened the clinical symptomatology perceived by lupus erythematosus patients. This increase extended at times to 2 days, and was associated with greater lupic activity.
Background: According to previous studies, the quality of life is usually substantially altered in patients who have suffered a subarachnoid hemorrhage of an aneurysmal origin. Some studies have attempted to find out which factors predict the deterioration in quality of life. Our study will try to describe the quality of life of these patients and discover which variables may predict it in each of its dimensions. Methods: The participants were 70 patients with aneurysmal subarachnoid hemorrhage between 15 and 85 years of age. The instrument used to measure the quality of life is the SF-36 with its eight dimensions. The predictor variables introduced into the multiple linear regressions are neurological condition on admission [World Federation of Neurological Surgeons (WFNS) scale and Hunt and Hess scale], extension of the hemorrhage (Fisher scale), sex, age, physical handicaps, and the Glasgow Outcome Scale (GOS) on release. Results: The results showed that 42.9% of the patients had a deteriorated quality of life after 4 months, and that the most affected dimension was the Physical Role (60%). The two factors that predict quality of life are sex and physical handicaps. Other factors that intervene are the GOS on release and the WFNS. Conclusions: The patients who have experienced an aneurysmal subarachnoid hemorrhage show greater difficulty in performing daily activities, and they present more depression and anxiety. The absence of handicaps and being male are predictor factors for an unaffected quality of life.
Situations of war and military conflict have been linked to the development of Post-Traumatic Stress Disorder (PTSD). To our knowledge, there are no studies that have examined, within the same conflict and the same culture, exposure to different traumatic events or traumatic events of different intensity. The aim of this study was to evaluate the symptoms of PTSD among Palestinian schoolchildren in two different areas of Hebron. A total of 381 schoolchildren from different parts of Hebron participated in the study. To evaluate the symptoms of PTSD, the children were asked to complete the Child Post Traumatic Stress Reaction Index. To evaluate the traumatic events experienced, they completed the Gaza Traumatic Event Checklist. Results indicate that 77.4% of the children living in Hebron show symptoms of moderate-to-severe PTSD, and 20.5% of them meet the DSM-IV diagnostic criteria for chronic PTSD. There were no significant differences in total symptoms between the two areas of Hebron, but there were differences within the specific types of symptoms. It is clear that the traumatic events of the war lead to the development of post-traumatic stress in children and that psychological intervention is necessary.Literature suggests that exposure to the traumatic events of war is related to high levels of PTSD among the victims of military conflicts. However, there are important differences between the stressors and prevalence of PTSD in each conflict due to cultural differences, type of conflict, and PTSD instruments ad-
Retirement has been associated with cognitive decline. However, the influence of specific job characteristics like occupational complexity on post-retirement cognitive outcomes is not well understood. Data from the Midlife in the United States (MIDUS) study were used to examine occupational complexity in relation to cognitive performance and cognitive change after retirement. Initial sample included 471 workers between 45 and 75 years of age. At 9-year follow-up (T2), 149 were retired and 322 were still working. All six tasks from the Brief Test of Adult Cognition by Telephone (BTACT) were used. Hierarchical regression with workers at T1 indicated that, controlling for sociodemographic variables, complexity of work with people significantly contributed to explaining variance in overall cognitive performance (1.7%) and executive function (2%). In Latent Change Score (LCS) models, complexity of work with people was the only significant predictor of cognitive change in retirees, with those retiring from high-complexity jobs showing less decline. In conclusion, high complexity of work with people is related to better executive functioning and overall cognition during working life and slower decline after retirement. The finding that more intellectually stimulating work carries cognitive advantage into retirement fits the cognitive reserve concept, where earlier intellectual stimulation brings about lower risks of cognitive problems later. Study results also go along with the unengaged lifestyle hypothesis, whereby people may slip into so-called "mental retirement," leading to post-retirement cognitive loss, which may be most apparent among those retiring from jobs with low complexity of work with people.
The objective of this study was to investigate the possible effects of the daily stress experienced during a six-month period on the cognitive functioning of patients with systemic lupus erythematosus (SLE). For this purpose, we evaluated the daily stress of 21 patients with lupus every day for six months. Later, we carried out a neuropsychological exam that included an evaluation of attention and memory. At the same time, scores on depression and anxiety were recorded with the objective of controlling other emotional variables that might be influencing these cognitive processes. The results show that daily stress was able to predict the scores on the neuropsychological variables studied. Specifically, the daily stress experienced in the previous six months is the variable with the greatest explanatory-predictive power on the scores for delayed recall visual memory, visual fluency and attention speed. This relationship proved to be negative in all three cases (R2 corr = 0.290; t = -2.712, P < 0.014); (R2 corr = 0.318; t = -2.818, P < 0.012); (R2 corr = 0.319; t = -2.906, P < 0.009), which means that the greater the daily stress, the lower the score on visual memory, fluency and total attention speed. We can state that daily stress is related to impairments in visual memory, fluency and attention in patients with SLE. This effect was not found with other emotional variables, such as depression and anxiety.
Our results support the relationship between aPL and cognitive symptoms in SLE. Also, almost half of the patients with SLE and no aPL showed cognitive problems, pointing to the multifactorial causes of cognitive problems in SLE. Future research with larger sample size is guaranteed to replicate our results.
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