Fear Reduction Research Articles

Cannabidiol in low back pain: scientific rationale for clinical trials in low back pain

ABSTRACT Introduction The pooled worldwide prevalence of low-back pain-related presentations in primary care varies between 6.8% and 28.4% in the high-income countries rendering it a major healthcare/economy problem. To best manage this complex bio-psycho-social condition a 360-degree approach is needed, as the psycho-social components are often more important than the scant pathophysiology. Pattern analysis of cannabis users suggested that attempts to alleviate musculo-skeletal pain is often seen as a major drive to use cannabinoids. Areas covered Unlike NSAIDs/opioids, cannabidiol might directly affect more than one modality of pain signaling/perception. The 2019 guideline of the National Institute for Clinical Excellence recommended further studies with cannabidiol in pain medicine because of its excellent safety profile and presumed therapeutic potential. Therefore, we have researched relevant databases for pharmaco-physiological papers published between 2000 and 2021 to collate evidence in a narrative fashion to determine the clinical rationale for this cannabinoid in low-back pain. Expert opinion Observational research reported good results with CBD in pain and fear reduction, which are both key factors in low-back pain. Given the paucity of high-quality evidence, further research is needed to determine the efficacy/non-inferiority of CBD in primary/emergency care setting, using multimodal assessment of various patient-reported outcomes.

Rescripting Social Trauma: A Pilot Study Investigating Imagery Rescripting as an Adjunct to Cognitive Behaviour Therapy for Social Anxiety Disorder

The current pilot study aimed to investigate the benefit of imagery rescripting (IR) as an adjunct to Group Cognitive Behavioural Therapy (GCBT) for SAD, given recent research suggesting that IR is beneficial in the treatment of social anxiety disorder (SAD). Fifteen participants with SAD completed eight sessions of GCBT and two additional individual sessions of IR to address negative meanings embedded in memories of traumatic social experiences. As expected, participants reported significant reductions in fear of negative evaluation and identification of negative core beliefs as valid/accurate over the course of the two session IR intervention. Moreover, IR yielded significant improvements in negative affect and maladaptive appraisals associated with self-imagery and aversive memories, as well as depressive symptoms. However, unexpectedly, IR did not yield significant additive reductions in social anxiety symptoms over and above GCBT. Results indicate that IR appears to be a beneficial adjunct to GCBT, and lack of improvement in social anxiety symptoms across IR sessions may be due to methodological limitations. Outcomes suggest that IR may also benefit patients with comorbid depression, given high rates of comorbid unipolar depression for people with SAD, presenting an exciting area for further investigation. Taken together, findings suggest that IR may be a valuable adjunct to GCBT for SAD, especially among patients with comorbid unipolar depression. However, further research including a follow up period is indicated.

Vagus nerve stimulation enhances fear extinction as an inverted-U function of stimulation intensity

Studies in rodents indicate that pairing vagus nerve stimulation (VNS) with extinction training enhances fear extinction. However, the role of stimulation parameters on the effects of VNS remains largely unknown. Identifying the optimal stimulation intensity is a critical step in clinical translation of neuromodulation-based therapies. Here, we sought to investigate the role of stimulation intensity in rats receiving VNS paired with extinction training in a rat model for Posttraumatic Stress Disorder (PTSD). Male Sprague-Dawley rats underwent single prolonged stress followed by a severe fear conditioning training and were implanted with a VNS device. After recovery, independent groups of rats were exposed to extinction training paired with sham (0 mA) or VNS at different intensities (0.4, 0.8, or 1.6 mA). VNS intensities of 0.4 mA or 0.8 mA decreased conditioned fear during extinction training compared to sham stimulation. Pairing extinction training with moderate VNS intensity of 0.8 mA produced significant reduction in conditioned fear during extinction retention when rats were tested a week after VNS-paired extinction. High intensity VNS at 1.6 mA failed to enhance extinction. These findings indicate that a narrow range of VNS intensities enhances extinction learning, and suggest that the 0.8 mA VNS intensity used in earlier rodent and human stroke studies may also be the optimal in using VNS as an adjuvant in exposure therapies for PTSD.

Neural activity during response inhibition associated with improvement of dysphoric symptoms of PTSD after trauma-focused psychotherapy\u2014an EEG-fMRI study

Although trauma-focused cognitive behavioural therapy (TF-CBT) is the frontline treatment for posttraumatic stress disorder (PTSD), up to one half of patients do not respond optimally to this treatment. Inhibitory functions are important for successful management of PTSD, yet there is a dearth of knowledge regarding the extent to which neural mechanisms unpinning response inhibition are associated with TF-CBT response. Treatment-seeking PTSD patients (n = 40) were assessed during a response inhibition task (the Go/No-Go task) while undergoing functional magnetic imaging (fMRI) and event-related potentials (ERP) in separate sessions. PTSD symptom severity was assessed with the Clinician-Administered PTSD Scale, before undergoing nine sessions of TF-CBT. They were then reassessed post-treatment to estimate reduction in fear and dysphoric symptoms of PTSD. Although neural responses during the inhibitory task did not predict overall symptom change, reduced activation in the left precuneus and the right superior parietal cortex predicted greater improvement in dysphoric symptoms. ERP responses during response inhibition indicated that lower P3 peak latency predicted greater reduction of dysphoric symptoms. There were no significant predictors of changes of fear symptoms. These findings indicate that neural activity associated with response inhibition can act as a predictive biomarker of TF-CBT response for PTSD symptoms. This pattern of findings underscores the importance of delineating the role of biomarkers to predict remission of subtypes of PTSD.

Third generation cognitive-behavioral therapies and genital pain

IntroductionGenital pain is a heterogeneous chronic pain condition and the relationship between biological, psychological and social factors sets a complex clinical challenge. The importance of negative thoughts and emotions has opened up an opportunity for the role of third generation cognitive-behavioral therapies (CBT). While the majority of evidence revolves around female sexual desire and arousal problems, research on genital pain disorders is beginning to take shape.ObjectivesTo review the evidence of third generation CBT on genital pain disorder.MethodsReview of literature using the Pubmed platform.ResultsWe identified 21 publications. Evidence shows that mindfulness-based CBT (MbCBT) improves reduction of fear linked to sexual activity, pain acceptance, catastrophizing and decentering. MbCBT shows significant improvements on secondary outcomes (overall sexual function, sexual satisfaction, depression and anxiety) while reduction of genital pain has yielded contradictory results. Acceptance and commitment therapy (ACT) has been studied for chronic pain disorders with improvements on pain acceptance, psychological flexibility, anxiety, depression and functioning. Compassion-focused therapy (CFT) has yielded favorable results on pain distress and intensity, self-efficacy, self-acceptance, anxiety and depression. Self-compassion may be a promising protective factor in genital pain. Both ACT and CFT have not yet been studied specifically for genital pain.ConclusionsThird generation CBT are most commonly used for depressive, anxiety and chronic pain disorders which signals the logical role that these interventions may have in genital pain. While MbCBT has started to present favorable results in treating genital pain (as well other sexual problems), ACT and CFT require more research.

Intranasal oxytocin compensates for estrus cycle-specific reduction of conditioned safety memory in rats: Implications for psychiatric disorders

Stress and anxiety disorder patients frequently fail to benefit from psychotherapies which often consist of inhibitory fear learning paradigms. One option to improve the therapy outcome is medication-enhanced psychotherapy. Research in humans and laboratory rodents has demonstrated that oxytocin (OT) reduces fear and facilitates fear extinction. However, the role of OT in conditioned safety learning, an understudied but highly suitable type of inhibitory fear learning, remains to be investigated. The present study aimed at investigating the effect of intranasal OT on conditioned safety. To test this, Sprague Dawley rats (♂n = 57; ♀n = 72) were safety conditioned. The effects of pre-training or pre-testing intranasal OT on conditioned safety and contextual fear, both measured by the acoustic startle response, and on corticosterone plasma levels were assessed. Furthermore, the involvement of the estrous cycle was analyzed. The present data show that intranasal OT administration before the acquisition or recall sessions enhanced conditioned safety memory in female rats while OT had no effects in male rats. Further analysis of the estrus cycle revealed that vehicle-treated female rats in the metestrus showed reduced safety memory which was compensated by OT-treatment. Moreover, all vehicle-treated rats, regardless of sex, expressed robust contextual fear following conditioning. Intranasal OT-treated rats showed a decrease in contextual fear, along with reduced plasma corticosterone levels. The present data demonstrate that intranasal OT has the capacity to compensate deficits in safety learning, along with a reduction in contextual fear and corticosterone levels. Therefore, add-on treatment with intranasal OT could optimize the therapy of anxiety disorders.

Wildfire Response Operations: Intentional Fear Reduction through Social Media Updates

The increase in extreme weather disasters over the past ten years, combined with the increased usage of social media in transmitting information during these disasters, has led to a growing need to understand the implications and best practices in utilizing social media to inform those at-risk. People panic during natural disasters, and a first method to enable rational response is to reduce fear and anxiety. We examine whether the information provided from an organization with an authoritative, reliable reputation through social media could help reduce public fear. Two studies form our research. First, through an exploratory study on wildfires in California, we find empirical evidence that increased operational transparency, i.e., informing the public about the operation activities, does negatively influence fear, such that fear decreases when information is posted by the premier authority on wildfire fighting. Second, drawing from operational transparency theory and theories on expertise and reputation, we conduct an online experiment to reveal underlying mechanisms that are effective in reducing fear. Our results suggest that highlighting expertise in social media posts reduces fear. This same information also increases user intention to heed warnings from this authority. Our findings provide actionable strategies to relief organizations. Of particular import is that this intervention requires little or no additional cost to organizations, making it a feasible solution for agencies that face budget shortages while they struggle to fight the consequences of climate change.

Across the wide prairie: Exploring fear of crime in a small Canadian municipality

Although fear of crime is well-researched in urban domains, the predictors of fear of crime in non-urban contexts are less established. Using a sample of 559 people, this study aims to address this gap by evaluating the role of individual and ecological-level predictors on fear of crime in a small Canadian municipality. Key findings of this study include support for the influence of social cohesion, informal social control and social and physical disorder on fear in a small municipality. However, no clear relationship is found between gender and fear of crime. Additionally, nuanced relationships between social predictors and fear emerge that may be uniquely explained by non-metropolitan context. The findings have implications for the use of urban-based criminological theories of fear and for the use of crime prevention and fear reduction strategies in non-metropolitan contexts.

Effects of a Poetry Intervention on Emotional Wellbeing in Hospitalized Pediatric Patients.

The hospital is often a challenging and unfamiliar environment for families. Hospitalization can increase stress and anxiety among children and caregivers. In this study, we are the first to explore the possible therapeutic effects of poetry on hospitalized pediatric patients' emotional wellbeing. Patients aged 8 to 17 years old admitted to the inpatient pediatric ward and their parents or guardians were eligible for inclusion. With the validated Pediatric Quality of Life Present Functioning Visual Analogue Scales, 6 items were measured before and after the poetry intervention for each participant: fear, sadness, anger, worry, fatigue, and pain in the present moment. The intervention itself consisted of poetry-based reading and writing exercises. Participants and parents also completed an open-ended qualitative survey on their experience. Data from 44 participants were analyzed. Using the Wilcoxon signed rank test, we showed that the poetry intervention had a statistically significant reduction in 5 of the 6 Pediatric Quality of Life Present Functioning Visual Analogue Scales symptom measures: fear (P = .021), sadness (P = .004), anger (P = .039), worry (P = .041), and fatigue (P < .001). Reduction in pain was not statistically significant (P = .092). Six coded themes emerged from qualitative analysis: the poetry intervention facilitated (1) happiness and (2) family involvement, was viewed as a (3) good distraction and (4) screenless activity, and cultivated (5) creativity and (6) self-reflection. The poetry intervention led to statistically significant reductions in fear, sadness, anger, worry, and fatigue but not in pain. The study reveals promising results and serves as a starting point for future investigations on the therapeutic impact of poetry on hospitalized pediatric patients.

Virtual Reality as a Nonpharmacological Strategy in Pediatric Pain Control During Procedures With Needle Use

Introduction Needle procedures can be very painful for children and generate stress and anxiety. Virtual reality (VR) has been used to enhance a child's distraction for pain control during these procedures. This study aims to identify the advantages and limitations of VR used for pain control in procedures using needles in pediatrics. Methods Studies were limited to children aged 4–18 years undergoing a procedure involving needles and the use of VR with goggles, headset, or helmet. A comprehensive search strategy using CINAHL Complete, MedicLatina, Medline Complete, B-on, LILACS, and SciELO databases was undertaken to find relevant studies published from January 2015 to April 2020. The retained studies included experimental and quasi-experimental, randomized controlled trials and nonrandomized controlled trials as well as prospective and retrospective studies. Results The search yielded 80 articles. Of these, six articles met the inclusion criteria. Advantages found with the use of VR were (a) decrease of pain; (b) improvement of communication; (c) increased probability of success in performing the procedures; (d) reduction of anxiety, stress, distress, and fear; (e) easier handling of equipment; (f) almost complete isolation of external noise; and (g) low cost, lightness, and ease of transportation. Disadvantages reported were goggles' size and annoyance from repeated play and the occasional side effect of nausea. Discussion VR is considered an interactive digital therapeutic toy used with positive effects in clinical practice. As children become calmer, VR can also reduce nursing stress and improve communication between children and nurses.

The Dynamic Interplay of Hope vs Fear Appeals in a Referendum Context

This article makes a contribution by articulating, for the first time, how hope and fear appeals were constructed as a rhetorical media device in a political advertising campaign context, specifically the 2014 Scottish independence referendum. Based on a qualitative content analysis of both sides’ campaigning materials, an understanding of the fluid, responsive and symbiotic nature of these emotional appeals and how they are utilized against the other is outlined. The research reveals core dimensions for constructing persuasive media appeals. While, fear appeals should strive to create a threat perceived to be relevant, and significant, the deployed hope appeals should focus on generating alternative positive visions and be goal congruent. By understanding contested (political) campaigns, new types of hybrid hope and fears appeal emerge (i.e. hope and fear reduction appeals). Taking these findings together, allows the authors to provide prescriptions on how certain message appeal types might be used to induce particular emotional effects in the audience.

Effect of SARS-CoV-2 (COVID-19) Pandemic and Lockdown on Body Weight, Maladaptive Eating Habits, Anxiety, and Depression in a Bariatric Surgery Waiting List Cohort

PurposeOn January 30, 2020, the World Health Organization declared COVID-19 as a “public health emergency of international concern.” The primary aim of the study was to evaluate weight and food habit changes during COVID-19 outbreak. The secondary endpoint was to explore the psychological factors, arising during the pandemic, influencing weight and dietary variations.Materials and MethodsA survey composed of four different items was conducted by telephone interview: (1) anthropometric data and type of procedure, (2) Hospital Anxiety and Depression Scale (HADS), (3) maladaptive eating behaviors, and (4) personal feelings moved by the COVID-19 spread and lockdown.ResultsFifty-six patients were enrolled. No significant changes in weight, BMI, and maladaptive eating habits were observed. A significant reduction in the anxiety index score was observed. In 17.8% of cases, a change in obesity class was reported, and among these patients, a substantial modification in bariatric procedures was planned (60%).ConclusionThis study showed no effect on weight and BMI nor on rates of maladaptive eating habits associated with quarantine/social isolation among severely obese individuals waiting for the bariatric surgery. At the end of lockdown, a considerable proportion of patients modified their initial obesity class, and in selected cases, it could represent a criteria for rearrangement of the planned bariatric procedure. In obese patients, the lockdown and social distancing generated a reduction of fear of confronting and being negatively judged by others. This psychological aspect was assessed with the reduction of the HADS score.

Smart-Glass Guided Exposure for Anxiety Disorders: A Proof-of-Concept Study

Exposure is a highly effective treatment for pathological fear and anxiety, but rarely used in routine care. Issues of practicability and lack of therapists in rural areas are main barriers for the dissemination of exposure. Smartglass devices may enable therapists to guide exposure from their own office via real-time feedback and may thereby increase practicability. The present study explored the technological usability and clinical feasibility of Smartglass-guided exposure in a behavioral approach test in spider-fearful individuals (N = 40).Fearful individuals were asked to start the Smartglass themselves and established a connection to a therapist, who guided the exposure test from afar. Clinical severity of spider fear was assessed via questionnaire. Technological usability was assessed with established measures of usability, user experience, and user acceptance. Exploratory, individual characteristics of exposure were collected (e.g., within-session fear reduction, duration, safety behavior).Overall, fearful individuals (94.9%) and therapists (100%) were able to establish a connection. Usability of Smartglass-guided exposure was evaluated as positive. Within-session fear reduction was large (d = 1.91). Adverse events were minimal. There were, however, some associations between exposure characteristics and usability evaluation (e.g., lower user-friendliness and exposure duration). Two case examples further highlight chances and risks of Smartglass-guided exposure.These findings provide first evidence that Smartglass-guided exposure could be useful in exposure therapy. Smartglass-guided exposure may ultimately help to increase practicability of exposure and increase dissemination, also in rural areas. These findings are promising for future research on the long-term outcome of evidence-based exposure in treatment seeking patients.

Effectiveness of acceptance and commitment therapy for mental illness in cancer patients: A systematic review and meta-analysis of randomised controlled trials.

Disease awareness is an important aspect of psychological adjustment in cancer patients; however, there is limited evidence that acceptance and commitment therapy (ACT) is recommended for the treatment of mental illness in cancer patients. To assess the effectiveness of ACT for cancer patients with mental illness. Ten databases were searched for publications up to July 25, 2020, using combinations of search terms related to mental health, cancer, and randomised controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the quality of the study. Seventeen RCTs (877 cancer patients) were mainly of low quality, compared with control group, ACT was associated with improved outcomes after treatment completion and at 1-3months and at 3-6months of follow-up for depression (Standardised mean difference [SMD]=-0.93, 95% CI, -1.36 to -0.51, P<.001), anxiety (SMD=-1.22, 95% CI, -2.16 to -0.29, P=.01), quality of life (SMD=0.85, 95% CI, 0.17 to 1.11, P=.01), psychological distress (SMD=-0.80, 95% CI, -1.24 to 0.35, P<.001), and stress (SMD=-0.54, 95% CI, -1.02 to -0.07, P=.03). After 6months of follow-up, depression, anxiety, quality of life, and stress were still significant. ACT was associated with psychological flexibility and was not associated with a reduction in fear at treatment completion. However, psychological flexibility (1-3months) decreased and fear (1-6months) decreased, and the longer-term effect was still significant. ACT can be an important component of future cancer care, as it may alleviate depression, anxiety, stress, and fear, and improve quality of life. However, further research is required to determine long-term treatment effects. High-quality RCTs are needed to more reliably estimate treatment effects.

Cost-effectiveness of a novel hybrid closed-loop system compared with continuous subcutaneous insulin infusion in people with type 1 diabetes in the UK

Aims The MiniMed 670 G insulin pump system is the first commercially available hybrid closed-loop (HCL) insulin delivery system and clinical studies have shown that this device is associated with incremental benefits in glycemic control relative to continuous subcutaneous insulin infusion (CSII) with or without continuous glucose monitoring (CGM). The aim was to evaluate the long-term cost-effectiveness of the MiniMed 670 G system versus CSII alone in people with type 1 diabetes (T1D) in the UK. Materials and methods Cost-effectiveness analysis was performed using the IQVIA CORE Diabetes Model. Clinical input data were sourced from a clinical trial of the MiniMed 670 G system in 124 adults and adolescents with T1D. The analysis was performed over a lifetime time horizon and both future costs and clinical outcomes were discounted at 3.5% per annum. The analysis was performed from a healthcare payer perspective. Results The use of the MiniMed 670 G system led to an improvement in quality-adjusted life expectancy of 1.73 quality-adjusted life years (QALYs), relative to CSII. Total lifetime direct costs were GBP 35,425 higher with the MiniMed 670 G system than with CSII resulting in an incremental cost-effectiveness ratio (ICER) of GBP 20,421 per QALY gained. Sensitivity analyses revealed that the ICER was sensitive to assumptions around glycemic control and assumptions relating to the quality-of-life benefit associated with a reduction in fear of hypoglycemia. Limitations Long-term projections from short-term data are inherently associated with uncertainty but represent arguably the best available evidence in lieu of long-term clinical trials. Conclusions In the UK, over patient lifetimes, the incremental clinical benefits associated with the use of MiniMed 670 G system means that it is likely to be cost-effective relative to the continued use of CSII in people with T1D, particularly for those with a fear of hypoglycemia or poor baseline glycemic control.

An Argument for Reconsidering the Role of Social Support in Treating Anxiety Disorders.

Reminders of loved ones have long been avoided during extinction-based treatments because of their assumed status as safety signals, which, by inhibiting fear in the moment, impair the long-term outcomes of fear extinction. Yet, recent work has demonstrated that in contrast to standard safety signals, social support reminders actually enhance fear extinction and lead to lasting reduction of fear, suggesting that they may have beneficial effects during exposure therapy that have before-now been overlooked. Here, we argue for a revision of the assumption that social support is detrimental to fear extinction processes and propose that future work should focus on the potential of social support reminders to improve treatment outcomes in those with anxiety disorders.

Особенности использования технологий виртуальной реальности при коррекции и лечении депрессии в клинической психологии

The work focused on the examining the use of virtual reality (VR) technologies in the reduction of depression in Europe. More than 70 issues of the journals “Cyberpsychology, Behavior, and Social Networking”, “European Psychologist” were analyzed. We used the bibliometric analysis, the "keyword method" to analyze the text, which is understood as a search for typical terms, content analysis of the content of articles that used VR and depression. In the journal "European Psychologist" the term VR has not been mentioned for the last 2 years, which indicates the secondary importance of this issue for general psychology. In cyberpsychology, on the contrary, since 2019 in Europe, the interest of researchers in the use of VR technologies in clinical psychology has increased. By the content of the journal articles. "Cyberpsychology, Behavior, and Social Networking" VR technologies are used primarily for the correction of anxiety disorders, and secondly, for the correction of depression. These technologies are used in various ways. The first option is to create VR programs with a direct impact on depression reduction. Here, VR is used as a symptom awareness tool, to create an avatar environment for client dialogue in a non- judgmental environment. Research has shown that such VR programs are rated by users as a useful tool for informing and emotionally responding to depressive states. The second option is an indirect effect on reducing the level of depression through the reduction of fears, phobias; increased activation, tone, euphoria in mental states; the development of a positive mood, cognitive motivation; an increase in indicators of field independence (cognitive style). A study based on the methods of psychosemantics is presented, which has demonstrated the effect of a specially created VR program with an avatar on changing the unconscious attitudes of the personality, reducing phobia of darkness. The effectiveness of using of VR technologies in reducing depression is determined by modeling of mental experiences and actions in VR, creating a virtual ontology, the influence of VR on conscious and unconscious attitudes, the possibility of responding to unconscious experiences through the user's identification with an avatar.

Academic and Social Effects of Inclusion on Students without Disabilities: A Review of the Literature

In many countries, educational practices are changing to inclusive education. Inclusive education is educating students with disabilities in general education classrooms with their peers without disabilities. If inclusive education is spreading, research needs to investigate the effects of inclusion not only for students with special needs but also for typically developing students. However, there is more research on the outcomes of inclusion for students with disabilities and less for students without disabilities in inclusive settings. Research shows academic and social gains for students with disabilities, but there is less clarity regarding the influence of inclusion on general education students. Therefore, the purpose of this review is to summarize and organize the literature on the academic and social outcomes of inclusion on students without disabilities. Academic effects of inclusion on students without disabilities are mixed, and the levels of schooling may have a differential impact on the achievement of students without disabilities. The literature indicates mostly positive or neutral effects of inclusion on the academic achievement of typically developing students in the lower grades, whereas neutral or negative influence is indicated for later grades. Additionally, students without disabilities have socially benefited from being in inclusive classrooms with students with disabilities. Mainly, the social effects of inclusion are reduction of fear, hostility, prejudice, and discrimination as well as increase of tolerance, acceptance, and understanding.

ВЛИЯНИЕ ОБОГАЩЕННОЙ СРЕДЫ И СОЦИАЛЬНОЙ ИЗОЛЯЦИИ НА УСЛОВНОРЕФЛЕКТОРНЫЙ СТРАХ У КРЫС, ПЕРЕНЕСШИХ РАННИЙ ПРОВОСПАЛИТЕЛЬНЫЙ СТРЕСС

In rats exposed to neonatal proinflammatory stress (lipopolysaccharide, LPS, injection on the 3rd and 5th neonatal days; 50 µg/kg), the effect of housing under conditions of social isolation or enriched environment at the age of 1.5 to 4 months on fear conditioning and extinction was studied. Testing 24 h after training showed that social isolation impairs fear conditioning both in males and females, as manifested in reducing the freezing time. A maximum sensitivity to social isolation was detected in rats that were exposed to LPS-induced proinflammatory stress in the early neonatal period: their freezing time was reduced both to a cue and a context. Fear reduction is assumed to be associated with memory deficit. Environmental enrichment also reduced the freezing time but to a lesser extent than social isolation, while reducing fear only to a context. Fear extinction in males of the LPS group accelerated after social isolation and environmental enrichment compared to rats of the same group housed under standard conditions. Our results demonstrate that adult animals that were exposed to neonatal proinflammatory stress are more vulnerable to changes in housing conditions.

The impact of Peyronie's disease on Portuguese men's mental health and sexual functioning

Purpose: The purpose of this study was to assess the impact of Peyronie's disease (PD) on Portuguese men's mental health and sexual functioning. Materials and Methods: Study participants included 103 men diagnosed with PD who had attended urology appointments at two hospitals in Portugal. The participants' average age was 34.38 years old (SD = 13.77). The study utilized a variety of measurement instruments, encompassing a sociodemographic questionnaire, the Portuguese version of the Brief Symptoms Inventory-18, the Portuguese version of the Massachusetts General Hospital-Sexual Functioning Questionnaire, and a Questionnaire measuring PD concerns. Results: Overall results showed that the men surveyed presented higher levels of mental health symptoms (somatization, depression, and anxiety) and lower levels of sexual functioning than the community sample (the general Portuguese population without clinical disorders). Correlation coefficients showed a strong and positive correlation between mental health symptoms and a loss of sexual confidence and stress, while finding a strong and negative correlation between sexual functioning and stress. Most PD concerns exhibited strong and positive mutual correlations. The study also found strong and positive correlations between penile curvature and a perceived reduction in penis attractiveness and discrimination fears. Multiple regression analyses showed that PD concerns and penile curvature explained 34.3% of the overall mental health variance and 21% of the overall sexual functioning variance. Conclusions: These results are consistent with those of previous studies that have shown that experiencing PD can increase mental health symptoms and diminish sexual functioning.