Changes In Mood States Research Articles

Perinatal Depression: A Randomized Controlled Trial of an Antenatal Education Intervention for Primiparas

Depression can be an unexpected and distressing companion for a woman during the major life transition of becoming a mother for the first time. Researchers now demonstrate that approximately 50 percent of women will experience perinatal distress. Therefore, the etiology and management of perinatal depression is essential for a quality care of childbearing women. The objectives of this study were to develop an education intervention tailored to the information needs of primiparous women about perinatal depression, to deliver this intervention antenatally, and to conduct a randomized controlled trial to determine the effect of the antenatal education intervention in the reduction of postnatal depression. A prospective, randomized controlled trial of the education intervention (n = 206) was conducted at three sites in Australia. The outcome of changes in mood state was measured by the Profile of Mood States questionnaire once antenatally (12-28 wk), and twice postnatally (8-12 and 16-24 wk); social support and demographic data were also collected. The education package was administered to the intervention group at the antenatal assessment of mood. A significant and steady reduction in scores (overall and on the subscales) was observed over time for both groups that showed significant improvement in symptoms of depression. No difference was detected when comparing the intervention group with the control group. Additional multivariate regression analyses revealed no relevant influence of social support or demographic variables. Women in both the study and control groups were more depressed antenatally than postnatally. The finding that the education intervention made no difference challenges the two strongly held tenets of health education in childbearing women-that depression can be reduced through education and that antenatal education interventions can endure into the postnatal period.

The Role of Functional Neuroimaging in the Neuropsychology of Depression

Depressed individuals show impaired performance in tests of attention and concentration. They also exhibit PET resting state abnormalities in dorsal prefrontal cortex and anterior cingulate, regions known to be substrates of attentional processing in healthy individuals. This chapter outlines a strategy to study neuropsychological mechanisms in emotional disorders using functional imaging methods. It reviews evidence strongly implicating the dorsolateral prefrontal cortex, particularly in the right hemisphere, as a key brain structure in emotion/cognition interactions in negative mood states. It will be argued that this neocortical region is a crucial convergence zone, being the substrate of sustained attention to the external environment, and the main target of limbic-cortical influences during changes in mood state across health and disease.

Relationships between mood states and performances in reaction time, psychomotor ability, and mental efficiency during a 31-day gradual decompression in a hypobaric chamber from sea level to 8848 m equivalent altitude

High altitude is characterized by hypoxic environmental conditions that may induce a set of pathological disorders, known as acute mountain sickness. In addition to the physiological symptoms, exposure to high altitude may also produce adverse changes in motor skills, mental efficiency, and mood states, including anxiety. In the present study, we investigated the relationships between mood states, including anxiety, and performance changes in reaction time, psychomotor ability and mental efficiency in eight climbers participating in the ‘Everest-Comex 97’, a 31-day gradual decompression in a hypobaric chamber from sea level to 8848 m equivalent altitude. Tests of visual reaction time, manual dexterity, and number ordination were used; anxiety responses and mood states were assessed using the Spielberger State–Trait Anxiety Inventory (STAI) and the ‘Profile of Mood States’ (POMS), respectively. A significant positive correlation was found between the climbers' performance in reaction time and changes in state-type anxiety levels, suggesting that anxiety could lead to an improved reaction time. In addition, significant negative correlations were also found between the climbers' performance in psychomotor ability, mental efficiency, and reaction time, and several POMS factors, including Tension, Hostility, Confusion, and Fatigue. Overall, these data indicate, in agreement with previous studies, that anxiety may favour, or at least not alter, the processes of information of relatively simple tasks, such as reaction time, and further suggest that adverse changes in moods could modulate performance negatively.

Mood state as a predictor of neuropsychological deficits following cardiac surgery

Objectives: mood disorders and neuropsychological deficits are both commonly reported occurrences after cardiac surgery. We examined the relationship between mood state and postoperative cognitive deficits in this population. Methods: assessments of neuropsychological functions and mood state (depression, anxiety, stress scales; DASS) were performed preoperatively and postoperatively on 147 patients undergoing cardiac surgery. Results: the incidence of preoperative depression, anxiety, and stress symptomatology was 16%, 27%, and 16%, respectively. The incidence of postoperative anxiety symptomatology significantly increased to 45% ( p<0.001), while the incidence of depression and stress symptomatology remained stable (19% and 15%, respectively; ns). Changes in mood state did not influence changes in neuropsychological performance. Preoperative mood was a strong predictor of postoperative mood, and was related to postoperative deficits on measures of attention and memory. Conclusions: an assessment of preoperative mood is critical in identifying patients at risk of postoperative mood disorders and neuropsychological deficits. Measures assessing somatic manifestations of anxiety may not be suitable for a surgical population.

Mood state changes of students enrolled in physical activity classes.

74 students enrolled in physical activity classes completed the happiness and sadness scales of the Emotional Assessment Scale each week for the 7-week course. A repeated measures analysis of variance indicated no significant change in mean mood state scores. Subjects' scores remained fairly happy throughout the length of the course, women having significantly happier scores than men.

A study of mood changes and personality during a 31-day period of chronic hypoxia in a hypobaric chamber (Everest-Comex 97).

High altitudes of more than 3,000 meters produce physiological disorders and adverse changes in mood states. In the present study, we report analyses of mood states and personality traits in eight experienced climbers participating in a 31-day period of confinement in hypobaric chamber and gradual decompression from sea level to 8,848 m (Experiment 'Everest-Comex 97'). The subjects were tested at 5,500 m and 6,500 m on Day 13, 5,000 m and 6,500 m on Day 24, and 8,000 m and 8,848 m altitude on Days 27 and 31. Adverse changes in mood states, such as Vigor and Fatigue, occurred at 8,000 m and 8,848 m, which were significantly correlated with cerebral altitude symptomatology. In addition, a significant negative correlation was found between Fatigue and Factor C, which is a personality measure of emotional stability. We suggest that individuals with low emotional stability could be more sensitive to environmental stressors than more emotionally stable subjects who face reality.

Bulimia nervosa: mood changes do have an impact on body width estimation.

This study was designed to investigate the impact of mood changes on body width estimation in women with bulimia nervosa. A pre-post controlled experimental design was chosen. Mood changes were induced in 40 women with bulimia nervosa, 20 women with panic disorder and 40 women with no diagnosis of a psychological disorder. A combination of autobiographical memory method and music induction method was used to induce positive and negative mood, respectively. Before and after mood induction a video distorting technique was used for body width estimation. Induction of negative mood increased and induction of positive mood decreased the body width estimations of women with bulimia. Patients with panic disorder and 'healthy' controls did not show these changes after mood induction. The findings suggest that change in mood state rather than the more habitual mood quality are relevant for bulimic women's body perception.

Intra-individual Change and Inter-individual Differences in Negative Mood States of Older Women

The primary purpose of this exploratory study was to examine the stability and lability of negative mood from a health perspective. Negative mood factor structure was examined in order to evaluate intra-individual change. Few studies have addressed factorial invariance across individuals and across time. The sample was comprised of four women in their 60s and four women in their 80s. Short-term intra-individual change and inter-individual differences in negative mood were assessed with a replicated single-subject design. Participants completed items from the 8SQ questionnaire for 100 consecutive days. P-technique factor analysis was used to examine the structure of negative mood factors, which were than graphed to determine level change over time. The number of factors were consistent, however, the items comprising the factors were not consistent across all participants. Patterns of intra-individual change in the negative mood factor of “ fatigue” was found to be highly individualised.

The effects of the ideal of female beauty on mood and body satisfaction.

The present study examined changes in women's mood states resulting from their viewing pictures in fashion magazines of models who represent a thin ideal. Female university students completed the Profile of Mood States (POMS), the Body Parts Satisfaction Scale (BPSS), and the Eating Disorder Inventory (EDI). They were then exposed to 20 slides; the experimental group (N = 51) viewed images of female fashion models and a control group (N = 67) viewed slides containing no human figures. All subjects then completed the POMS and the BPSS again. Women were more depressed (R2 = 0.745, p < .05) and more angry (R2 = 0.73, p < .01) following exposure to slides of female fashion models. Viewing images of female fashion models had an immediate negative effect on women's mood. This study, therefore, supports the hypothesis that media images do play a role in disordered eating.

Immune, stress, and mood markers related to recurrent oral herpes outbreaks

This was a prospective and longitudinal study designed to compare daily mood states and weekly changes in plasma levels of immune and neuroendocrine markers with recurrent herpes labialis lesion recurrences during a 3-month period among 9 subjects. Results from a paired t test showed that there was a significant decrease in plasma levels of natural killer cells and serum levels of epinephrine from the week before recurrent herpes labialis lesion occurrence (T 1,9 = 2.70; p < 0.05) to the week of recrudescence (T 1,9 = 2.41; p < 0.05). On the other hand, in the week before recrudescence the number of natural killer cells was 58 units higher than the overall group mean for natural killer cell level (227 units). In the week before outbreak, elevated natural killer cell numbers were associated with a mood of discontentment ( r = 0.64; p = 0.05). Elevated levels of epinephrine averaged across the 12 weekly blood draws were significantly correlated with higher scores on affect intensity ( r = 0.72; p < 0.05). This study provides new data on the pattern of changes in stress, mood states, and immune and neuroendocrine markers associated with the recurrence of perioral herpes lesions. Putative mechanisms linking neuroendocrine and immune function are discussed.

MOOD STATE OF RUNNERS PARTICIPATING IN AN ELITE DEVELOPMENTAL TRAINING CAMP

694 It is often assumed that environmental and social factors can influence psychological health in athletes undergoing training. This study was conducted to examine the mood state responses of athletes participating in a novel, elite developmental training camp employing the “Hi-Low” Model. Twenty-one (14 men and 7 women) elite U.S. middle and long distance runners participated in a USATF sponsored, five week training camp in Park City, Utah. The athletes lived at 2,438 m, while base and recovery workouts were performed at 1,828 - 3,048 m. Training was programmed but self-regulated at typical training levels. Mood state (POMS) was assessed at weekly intervals. Repeated measures ANOVA indicated that total mood disturbance was unchanged during training and all assessments were well below the published norm (overall mean= 107.2; S.D. = 10.69). Significant changes were, however, observed for specific POMS factors. Tension and fatigue were elevated at assessments made during major time trials. In summary, the mood state changes observed appeared to reflect responses to competitive stressors rather than living and training at moderate elevation.

Mood state and cerebral metabolism in persons with age-associated memory impairment

People undergoing medical procedures sometimes experience feelings that may influence the results. In this study, we explore the relationship between changes in mood state self-ratings and cerebral glucose metabolism during positron emission tomography (PET) in persons with age-associated memory impairment (mean age 59.4±9.8 years). Brain regions of interest involved in both mood and memory were examined. Mood ratings of increased boredom correlated significantly with mesial temporal and parietal asymmetry and decreased parietal metabolism. Mood ratings of increased fatigue correlated with basal ganglia asymmetry and the right basal ganglia and left mesial temporal metabolism. These findings suggest that subjective mood state changes during PET may influence metabolism in brain regions implicated in emotion and memory function in people with age-related memory complaints.

Neuroendocrine measures and lymphocyte subsets in depressive illness: influence of a clinical interview concerning life experiences.

The effects of a clinical interview concerning either positive or negative day-to-day events on lymphocyte subpopulations, and on plasma cortisol, ACTH and norepinephrine, were determined in depressive patients (major depressive and dysthymic) and in normal controls. Irrespective of its content, the interview provoked an elevation of circulating natural killer (NK) cells, suggesting that this effect was related to either a change in mood state (regardless of its valence) or to the stress associated with the interview procedure. Since the interview did not influence plasma cortisol, ACTH or norepinephrine, it is likely that the NK cell variations were independent of these endocrines. Although basal NK cells were elevated in the depressive group relative to controls, the extent of the NK cell increase provoked by the interview was comparable in depressive and control subjects. The failure to detect differences between these populations could not be attributed to ceiling effects precluding more pronounced alterations in the depressed subjects. Indeed, variations of circulating cell subtypes were found to be exquisitely sensitive to differences in stressor intensity. In a subset of control subjects, a more potent stressor (anticipation of an academic examination) increased the plasma endocrine levels, increased circulating NK cell number beyond that associated with the interview stress, and provoked an increase of several T cell subsets (CD3, CD4 and CD8). Evidently, while a clinical interview may be sufficiently stressful to influence circulating NK cells, the stress of such a procedure seems no greater in depressed than in control subjects. It is suggested that although depressed patients may exhibit higher basal NK levels, this effect is likely not related to increased reactivity to stressors.

A prospective study of changes in negative mood states of women undergoing surgical hysterectomy: the relationship to cognitive predisposition and familial support

Levels of anxiety and depression were documented by questionnaire response from a sample of 89 women who were to undergo surgical hysterectomy 3 weeks later. Fifty-four per cent (n = 48) of the sample reported anxiety and 26% (n = 23) reported depression at clinical levels during the preoperative period, with an additional number (n=16 anxiety; n=19 depression) at borderline status. Despite an overall significant postoperative reduction of negative mood states, clinical levels of anxiety were found in a substantial minority of women both 2 (24%) and 6 months (31%) after surgery. Levels of depression at these times were respectively 13% and 11% of the sample which provided postoperative information. These data confirm previous reports of high levels of negative mood states in patients referred for surgical hysterectomy. However, analyses of individual profiles of change confirm that there was a beneficial outcome for the large majority of the women, with 83% of those with clinical levels of anxiety showing improved status. Regression analyses indicated that postoperative outcomes with respect to negative affect could be predicted from preoperative status, and the data provide some support for the hypothesis that for a minority of women, negative mood states co-presented with gynecological symptoms may not be attenuated by surgery. Both dispositional resilience and familial cohesiveness were entered as significant variables in regression models examining postoperative status, although they provided only a limited increase to the postoperative variance prediction from measure of preoperative levels of affect. Preoperative mood status was found to be inversely related to an intrapersonal dimension of ‘dispositional resilience’ and to family cohesiveness'. It is suggested that measurement of preoperative mood status to family cohesiveness and dispositional resilience may provide useful adjunctive measures in attempts to identify women at risk of reporting an unsatisfactory surgical outcome.

Glucocorticoids and anabolic/androgenic steroids inhibit the synthesis of GABAergic steroids in rat cortex.

Cerebral side effects of therapy with glucocorticoids include mental alterations and behavioral disturbances such as nervousness, insomnia, changes in mood or psychological state and psychopathies of manic-depressive or schizophrenic type. We have investigated the effects of glucocorticoids, anabolic/androgenic steroids and the 5-alpha-reductase inhibitor N,N-bis (1-methyl)-3-oxo-4-aza-5-alpha-androstane-17-beta-carboxamide (1-MAC) on the synthesis of the GABAergic steroids 5-alpha-pregnane-3.20-dione (5-alpha-dihydroprogesterone) and 5-alpha-pregnane-3-alpha-ol-20-one (5-alpha-tetrahydroprogesterone) in rat cortex in vitro. We found potent inhibition of progesterone-3-alpha-hydroxysteroid dehydrogenase (3-alpha-HSDH) by prednisone, prednisolone, dexamethasone and fluocortolone. Inhibition of progesterone 5-alpha-reductase by glucocorticoids was not found. In addition, inhibition of 3-alpha-HSDH and 5-alpha-reductase by androgenic/anabolic steroids and inhibition of 5-alpha-reductase by 1-MAC could be demonstrated. The inhibition of progesterone metabolism in the cerebral cortex by exogenous steroids might lead to altered neuronal activity. We conclude that this mechanism could induce the cerebral side effects, such as mental modifications and behavioral disturbances, of the drugs investigated.

The Emotional, Social, and Behavioral Implications of Insulin-Induced Hypoglycemia.

Hypoglycemic episodes occur commonly in patients with insulin-dependent (Type I) diabetes and are associated with several negative sequelae. These include unpleasant symptoms, deterioration in cognitive-motor functions, embarrassment, accidents, unconsciousness, seizures, and even death. Although hypoglycemic disruptions in cognitive and motor function caused by neuroglycopenia are well-documented, the effects of hypoglycemia on other areas of psychosocial function have received less scientific attention. This paper examines the impact of hypoglycemia on emotional status, social behavior, and relationships. The physical symptoms and cognitive impairment that occur with hypoglycemia are caused primarily by hormonal changes and neuroglycopenia. These physiologic responses also seem to cause negative changes in affect and social behavior. These include changes in acute mood state, such as feelings of tension and anger, as well as negative interpersonal behavior, such as argumentiveness. Patients may also develop significant fear of hypoglycemia (FOH) and engage in behaviors aimed at avoiding low blood glucose levels, which may jeopardize metabolic control. Nondiabetic family members, who witness episodes and often must provide emergency treatment, can experience significant distress. Parents of diabetic children who have experienced unconsciousness exhibit high FOH, as do spouses of diabetic adults who have frequent episodes. Taken together, the research clearly shows that hypoglycemia can have a significant negative impact on psychosocial function and quality of life, which has important clinical and empirical implications.

Changes in psychophysiological functions during night shift in nurses. Influence of changing from a full-day to a half-day work shift before night duty.

The effects of changing from a full-day to a half-day shift work before a night duty shift on physiological and psychological functions during the night shift were investigated in 12 healthy unmarried nurses working on the same ward of a university hospital. Three shift patterns, i.e., a day shift following a day shift, a night shift following a day shift, and a night shift following a half-day shift, were studied in terms of physical activity level, sympathetic and parasympathetic activity levels, cortisol, prolactin, NK cell activity, and changes in mood states. The change to the half-day shift increased the duration of sleep before night duty by about 86 min and brought wake-up times forward by about 1 h, resulting in increases in rest and time before work. In addition, the change was revealed to reduce the influence of reversed-phase circadian rhythms on autonomic nervous activity during the night shift. The score for sleepiness was significantly lower at 0500 hours following a half-day shift. There were some marginal but not significant differences in the scores reflecting the degree of vigor, tiredness and irritation during the night shift. Although the prolactin concentration was significantly decreased at the start of the night shift after the half-day shift, there was no difference in cortisol concentration or NK cell activity between the usual night shift after a day shift and the night shift after the half-day shift. The half-day shift was not observed to cause any marked change in the fixed biorhythms of these nurses. The cortisol and NK cell activity levels were low during the night shift, suggesting that the night shift itself is a high stress level, which is prejudicial to biodefense.

Chronic sorrow: A content analysis of parental differences

Sixty-eight mothers and 64 fathers of children with a neural tube defect responded to a questionnaire about chronic sorrow. Mothers reported a mood state change in very intense category from more pessimistic at time of diagnosis to more optimistic at current time. Fathers, although indicating a mood change in the very intense category to more optimistic, also had more pessimistic responses. Parental similarities and differences were also reported in both times and events that triggered the sorrow response. Categories across times and events were primarily related to health care, school/development concerns and social significance. Clinical and research implications of these findings are discussed.

Practice Guidelines for Cancer Pain Management

Practice Guidelines for Cancer Pain Management

Adrenaline and psychometric mood factors: A controlled case study of two patients with bilateral adrenalectomy

Previous studies have suggested that adrenaline subserves many emotions and that adrenaline is the physiological basis for fear, but these observations have been difficult to replicate. Acute insulininduced hypoglycaemia can be used to induce tense arousal in normal humans, and is one of the most potent stimuli for the secretion of adrenaline. Adrenalectomized Ss do not secrete adrenaline in response to hypoglycaemia, so it was hypothesized that a study of these patients might clarify the role of circulating plasma adrenaline in the generation of changes in psychometric mood states. Measurements of mood state, and plasma catecholamine concentrations were made during hypoglycaemia induced by an intravenous infusion of insulin, in 25 healthy subjects (12 male and 13 female) and in two women who had previously undergone surgical removal of both adrenal glands. Hedonic tone fell in the control subjects, but in both adrenalectomized patients hedonic tone was unaffected. Energetic arousal decreased significantly both in the control subjects and in the two adrenalectomized patients. Tense arousal rose in the control subjects to a peak which coincided with the onset of the acute autonomic reaction, identified by the onset of symptoms and the rapid rise in heart rate and sweating. Conversely, in the adrenalectomized patients no substantial change was observed in tense arousal from basal levels and it appeared to be lower before the induction of hypoglycaemia than in the control subjects. This experimental model has demonstrated that adrenaline release from the adrenal glands is a necessary requisite for the increase in tense arousal induced by hypoglycaemia and may contribute to the change in hedonic tone. The alteration in energetic arousal was unaffected and this is probably mediated by the direct effect of glucose deprivation on cerebral functioning.