Constitutional Traits Research Articles

Hypoxic pressor response, cardiac size, and natriuretic peptides are modified by long-term intermittent hypoxia.

We investigated whether the effect of long-term intermittent hypoxia (LTIH) on cardiovascular function may be modified by preexisting genetic traits. To induce LTIH experimentally, cycles of 90-s hypoxia (nadir 6%) followed by 90-s normoxia were applied to six Wistar-Kyoto and six spontaneously hypertensive rats during 8 h daily. Comparison with the same number of control animals after 70 days revealed no alteration of intra-arterial blood pressure or heart rate. Blood pressure responsiveness to a brief hypoxic stimulus was enhanced in the LTIH animals, regardless of strain, whereas the hypoxia-induced increase in heart rate was abolished. In the spontaneously hypertensive but not the Wistar-Kyoto rats, LTIH increased left ventricular weight-to-body weight ratio and content of atrial natriuretic peptide mRNA. Expression of B-type natriuretic peptide was unchanged (Northern blot). Slightly increased right ventricular weight-to-body weight ratios in the LTIH animals were associated with higher right ventricular atrial natriuretic peptide and B-type natriuretic peptide mRNA amounts. Consequently, the effects of LTIH on different components of cardiovascular function appear incompletely related to each other and differentially influenced by constitutional traits.

Generalized anxiety disorder with early and late onset of anxiety symptoms

Some generalized anxiety disorder (GAD) patients experience subclinical or clinical levels of anxiety before adulthood, whereas others have a later onset. To determine whether patients who experienced subclinical or clinical anxiety in the first two decades of life differed from those with a later onset, we reviewed the history, ratings on various scales, and psychophysiological recordings obtained from 103 GAD patients. Early-onset patients were younger and more likely to develop GAD without a precipitating stressful event. With the exception of depression in the early-onset group, present-state measures did not differentiate the two groups. During childhood, patients in the early-onset group were exposed to more domestic disturbances, experienced more childhood fears, and were more inhibited and socially maladjusted. As adults, they scored higher on trait anxiety and neuroticism, tended to have obsessional traits, were more sensitive in interpersonal relationships, and experienced more marital difficulties. These findings may be explained by (1) constitutional traits that make earlyonset GAD patients more vulnerable to stressors; (2) a more disturbed environment during childhood that adversely affects personality development; or (3) a more severe disorder with an early subclinical onset that also affects personality development.

P300 and conceptual loosening in normals: An event-related potential correlate of “thought disorder?”

Reduced amplitude of the P300 component of the event-related potential (ERP) has frequently been reported in schizophrenic patients and their first-degree relatives. The present study examined the relationship between this ERP measure of attentional processing and loosening of associations in normal university students (termed “allusive thinking”). Among male subjects, scores reflecting increased conceptual loosening, measured using the Lovibond scoring method for the Goldstein-Scheerer Object Sorting Test (OST), were significantly correlated with smaller P300 amplitude recorded during an auditory target detection task. There was no association between OST score and either performance of the target detection task of self-reported psychopathology. It is suggested that reduced P300 amplitude could reflect altered attentional processing in individuals with a constitutional trait factor of thought disorder.

CONVERGENCES AND DISCREPANCIES, AMONG MOTHERS' AND PROFESSIONALS' ASSESSMENTS OF DIFFICULT NEONATAL BEHAVIOUR

The idea that difficult newborn behaviour reflects an inborn disposition was tested by comparing measures from different circumstances, occasions and observers. Correlations between researcher measures from separate settings and occasions were statistically significant but modest, indicating a "rudimentary" constitutional trait contribution to difficult newborn behaviour. Little evidence of a discrete subgroup of particularly difficult newborns was obtained. Maternal assessments were internally consistent but weakly explained by baby constitutional factors or nurses' reports. The importance of contextual and development variables is discussed. Alternative methodological strategies for studying constitutional and social-developmental contributions to difficult behaviour are needed.

Concentration and uptake of 5-hydroxytryptamine in platelets from cluster headache and migraine patients.

Concentrations of 5-hydroxytryptamine (5-HT) in platelets were determined in 33 cluster headache patients (17 males) and in 34 migraine patients (16 males) outside attacks. The 5-HT uptake into platelets was measured and the kinetic constants Vmax and Km determined in 26 cluster patients (14 males) and in 30 migraine patients (13 males). Significantly lower 5-HT concentrations in whole blood were found in cluster headache and migraine patients than in 50 healthy controls (19 males). The Vmax and Km values of the 5-HT uptake were significantly lower in cluster headache and migraine patients compared with 22 healthy controls (9 males). The 5-HT concentrations and the kinetics of the 5-HT uptake did not differ between cluster headache and migraine. In healthy controls a significant positive correlation was found between the 5-HT uptake rate at 0.25 microM and Km but not in cluster headache and migraine patients. The 5-HT concentrations in whole blood correlated positively with Vmax and Km, respectively, in cluster headache and with Km in healthy controls but not with Vmax nor with Km in migraine. There was no obvious relation between the kinetics of platelet monoamine oxidase (MAO) and the 5-HT uptake except for an increased incidence of low Vmax of MAO and low Km of the 5-HT uptake in cluster headache. The kinetics of the 5-HT uptake was apparently not related to the state of migraine. The results indicate a possible constitutional trait in cluster headache and migraine expressed as low 5-HT concentrations in whole blood and low Vmax and Km of the 5-HT uptake into platelets.

The determinants of actinic skin damage: problems of confounding among environmental and constitutional variables.

Constitutional and environmental determinants of actinic skin damage, assessed by cutaneous microtopography, were evaluated in 1,216 subjects attending the 1981 Busselton Health Survey in Western Australia. Increasing age, male sex, the tendency to burn on exposure to sunlight and outdoor occupation were found to have independent predictive value for the presence of actinic skin damage. Crude positive and inverse associations of actinic skin damage with several other factors were shown to arise from confounding. Effect measures for outdoor leisure pursuits and sunscreen use were underestimated due to inverse associations of these factors with older age, and inverse associations of high-exposure outdoor activities with poor skin response to sunlight. Associations of constitutional traits typical of fair individuals and sunscreen use with the tendency to burn resulted in overestimation of effect measures. Empirical relationships of actinic skin damage with certain leisure activities and with use of sunscreens were also confounded by sex. The results indicate a need for greater attention to confounding in nonexperimental skin cancer research.

Koch's postulates and the search for the AIDS agent.

For a brief period during the Romantic Age, consumption became a mark of tragic beauty. The English poets Keats and Shelley symbolized the romantic and consumptive youth of the 19th century. Mimi in Puccini's La Boheme represented the melancholy ideal, a portrait drawn from an actual young lady who died of tuberculosis. Decay and disease are often beautiful, like ... the hectic glow of consumption, said Thoreau on seeing the first brilliant colors of maple trees in the autumn of New England. And Elizabeth Barrett Browning once remarked, Is it possible, Robert, that genius is just a matter of phthisis? Romantics believed that consumption was a trait often associated with gifted and talented people. For it was both professional and popular opinion, during this time prior to the germ theory of disease, that consumption was a constitutional trait. The disease frequently struck young men and women in their prime, condemning many of them to early death. Wrote Keats in the spring of 1819: Youth grows pale, and spectre thin, and dies. He could have been describing acquired immune deficiency syndrome (AIDS) in 1984. Such notions concerning the beauty and genius of the tuberculous patient were swept away in 1882 when Koch discovered that tuberculosis was an in-

Family history and schizophrenia: characteristics of groups with and without positive family histories.

Social and demographic characteristics were examined retrospectively in a sample of 475 hospitalized schizophrenics to test the hypothesis that they can be meaningfully distinguished by the presence or absence of psychiatric disorders in their relatives. Cases with a positive family history of psychiatric disorders (FHP cases) were significantly more likely to have been born in the United Kingdom and to have had older mothers. Those who had relatives with psychiatric disorders other than schizophrenia were significantly more likely to have been diagnosed as schizo-affective. The findings are thought to reflect a constitutional trait in parents of FHP cases leading to delayed child bearing. They also support the 'environmental stress' theory of immigrant psychosis and the hypothesized genetic link between schizo-affective and affective disorders.

Family thinking in prevention of alcoholism

Prevention of alcoholism is considered through family therapy interfering with the transgenerational transmission. A theoretical structure is offered which argues that unless alcoholism is a strictly constitutional trait, genetically transmitted (for which there is inconclusive evidence), then intervention in the family through treatment offers a potential for breaking the chain. Evidence that alcoholism is familial is reviewed in terms of physiologic predisposition and family structure. The history and theoretical base for family thinking and family therapy are presented. The way in which these concepts apply to alcoholic families and the way alcoholic families reflect and reinforce symptoms of alcoholism are described. How intervention in family process can interrupt the continuation of alcohol abuse and change unhealthy patterns that promote alcohol abuse is described in terms of actual experience as well as theory. It is recommended that family thinking be introduced and encouraged in treatment programs, alcohol education, and public information about alcoholism.

Current status of therapy in coronary artery disease.

Coronary atherosclerosis occurs to some extent almost universally in human beings. It is now the leading cause of death in persons past middle life in the United States. Significant coronary artery disease is found much earlier and in a more severe form in men than in women. Coronary atherosclerosis is also more pronounced in association with conditions in which hypercholesteremia is present, such as diabetes and hypothyroidism. Undoubtedly a constitutional trait predisposes certain families, and possibly certain racial stocks, to premature coronary atherosclerosis although the latter has not been proved. To what extent the physical and emotional stresses of life influence the development of this disease has not yet been discovered. Most cardiologists, however, are of the opinion that coronary insufficiency, as manifested either by pain or by myocardial failure, may be hastened by such stresses. The clearest example of this is the precipitation of attacks of angina pectoris by

A Study of Asthmatic and Rheumatic Children with Special Reference to Physical Type

A Study of Asthmatic and Rheumatic Children with Special Reference to Physical Type

The incidence of rheumatic heart disease among diabetic patients

The usual frequency of acute infectious diseases as they occurred in a group of 1530 patients coming under my observation is recorded. Special care was exercised in obtaining a correct history of these patients. In the diabetics studied here, a history of rheumatic fever prior to the diabetes, was obtained with the same frequency as in nondiabetics. In 350 diabetics, we found that 37 gave a history of having had rheumatic fever at some time prior to their diabetes. In 37 nondiabetics, the expected number of cases of valvular disease of the heart would be about 18 or 19. In 37 diabetics who had suffered rheumatic fever, only one case of valvular disease of the heart was discovered. In the light of our present knowledge, only one explanation can be offered for this extraordinary find, and that is, individuals with certain hereditary constitutional traits have tendencies to certain diseases and at the same time, immunities to other diseases or their complications.