Cardiac autonomic function during sleep in psychogenic and organic erectile dysfunction

The present study investigated the sympathetic/parasympathetic balance during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in patients with psychogenic and organic erectile dysfunction. The cardiac autonomic balance was assessed from the power of the low frequency (LF) and high frequency (HF) spectral components of heart-rate variability in 11 patients with psychogenic erectile dysfunction and 11 patients with organic erectile dysfunction as determined by monitoring sleep-related erections. Spectral analysis of heart-rate variability was calculated for at least four successive 4-min epochs of electrocardiogram recordings during NREM sleep and for all available 4-min epochs during REM sleep. Statistical analysis revealed that organic patients had a significantly higher LF/HF ratio (P < 0.01) during both stages of sleep, which resulted from a significantly lower power in the HF component (P < 0.004) and higher power in the LF component (P < 0.01) in these patients, in both REM and NREM sleep stages. These results demonstrate that patients complaining of daytime sexual dysfunction and found by sleep-related erection monitoring to suffer from organic erectile dysfunction, have altered cardiac autonomic balance during both stages of sleep.     

The diagnostic use of the MMPI in organic brain dysfunction.

Investigated two problem areas: (a) difficulty in the diagnoses of some types of organic brain dysfunctions; and (b) lack of accuracy in the differentiation of patients with organic disorders from patients with nonorganic disorders. Hospitalized male Ss (N = 152) were selected by diagnoses to form one nonorganic and three organic groups. For each group, data from Ss' MMPI protocols were analyzed via Cattel's Coefficient of Profile Similarity and discriminant analysis. Both MMPI factor scales (Barker, Fowler, & Peterson, 1971) and the usual clinical scales were used and compared in all analyses. Statistically significant differences among groups were found on both scales, with a greater separation of the groups provided by the factor scales. Results suggest that the MMPI, through the use of regression formulas derived from discriminant analysis of multiple groups, may be of diagnostic utility in organic brain dysfunction.     

An MMPI evaluation of male sexual dysfunction

The present study concerned the evaluation of personality traits associated with sexual dysfunctions. The MMPI was used as a psychodiagnostic tool in male subjects (N = 37) with erectile disorder or premature ejaculation. The results tend to support some clinical observations based upon the cognitive-behavioral approach and some neurophysiological data.     

MMPI results: A comparison of trauma victims,psychogenic pain,and patients with organic disease

Made comparison using MMPI T scores on three private psychiatric subpopulations: Post-trauma patients, patients with organically based illness, and patients with psychogenic pain (complaints functional in origin) (N = 78). The standard 3 validity and 10 clinical scales were used to evaluate possible differences among the groups. Differences were presented among the groups on scales 3 (HY), 9 (MA), and (F). Individual profiles also were assessed. In patients with a 1-3/3-1 profile, the psychogenic group had significantly higher elevation over the post-trauma and organic groups. In patients with 8 (SC) or 9 (MA) high both with and without 1-3/3-1 high, differences were found; the post-trauma and organic groups showed marked elevation over those in the psychogenic group. Results indicate the MMPI to be a viable aid in distinguishing between patients with post-trauma stress disorder vs. those with functional disorders. The data suggest that MMPI profiles of patients with post-trauma stress disorder more closely resemble the MMPI profiles of patients who have organic disease with pain caused by organic pathology than the profiles of patients with psychogenic pain and/or hypochondriasis.     

The MMPI and chronic pain: The diagnosis of psychogenic pain

This study investigates the capacity of the MMPI to discriminate among groups of patients with different types of pain. When multivariate analysis of variance is used, the standard set of MMPI scales discriminates between acute pain and chronic pain but not between chronic pain of two different etiologies (surgicaliatrogenic vs. unknown). The three scales that discriminate acute from chronic pain patients are those in the neurotic triad, Hs, D, and Hy. The possibility that the unknown pain etiology group could be broken down into psychogenic pain and undetected somatogenic pathology subgroups was explored using cluster analysis. This procedure did not yield any group of patients who could be identified as having chronic pain of psychogenic origin. These results suggest that the MMPI is not a reliable tool for the differential diagnosis of chronic pain. It appears, however, that patterns of findings are partly contingent on population characteristics. Researchers should be cautious about generalizing to populations other than those from which samples are drawn.This research was supported in part by a grant from Roche Laboratories, Nutley, New Jersey, and the Anesthesiology Research Center, Grant No. GM1599-1-06, University of Washington, Seattle, Washington.     

Validation of a brain-damage vs. schizophrenia MMPI key.

Since neuropsychologic tests largely have failed to separate schizophrenic from brain-damaged patients, an MMPI key was constructed to make such a separation. When cross-validated, this key provided a 76% correct separation and achi2 significant beyond the .001 level for 50 schizophrenic and 50 brain-damaged profiles. Neuropsychologic tests should be used to separate normals from brain-damaged patients and the MMPI to separate schizophrenic from brain-damaged patients.     

Es scale level and correlates of MMPI elevation: alcohol abuse vs. MMPI scores in treated alcoholics

Examined the impact of MMPI Ego Strength (Es) level on the size of Pearson correlation coefficients computed between scores for posttreatment alcohol use and MMPI scores on standard and research scales and indices in a group of 54 (45 men, 9 women, mean age 41.3 years) treated alcoholics. In line with theoretical expectations, no significant (p greater than .05) coefficients were found in the group of high Es scorers (T scores above 50; N = 30) for any of the MMPI variables. In contrast, about one-half of the coefficients in the low Es group (T scores below 50; N = 24) were significant (p less than or equal to .05): All were in the expected direction; the more intensive the alcohol use, the higher the MMPI scores. The low and high Es groups did not significantly differ in respect to age, education, gender ratio, and posttreatment alcohol use (t-tests, p greater than .05).     

Computational tools in rehabilitation of erectile dysfunction.

Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection adequate for satisfactory intercourse. It is a common problem among approximately 50% of men between the ages of 40 and 70. Erectile dysfunction is not only stressful to both the affected individual and his partner, but it can also negatively affect self-esteem. Biomechanical models have recently been developed to study both the structural and hemodynamic factors involved in normal and pathological erectile conditions. These computational models, which are reviewed in the present paper, allow for better understanding of the mechanisms acting in ED and provide a suitable basis for development of state-of-the-art interdisciplinary treatment approaches aimed to improve the quality of life for these men.     

Problems of erectile dysfunction prevalence

According to non-clinical studies, erectile dysfunction (ED) seems to be the fastest growing among male sexual problems. Its prevalence range widened from 4%-9% in 1990 to 10%-52% in 2000. The paper is an attempt at understanding this new and rampant "epidemic". Instead of trying to pinpoint its "natural" causes, the author aims to decipher the socially constructed dynamics of the disorder. The approach is based on a qualitative investigation of the scientific conceptualization and measuring of ED. The analysis points out serious shortcomings, which contradict the much-celebrated usefulness of the 1992 NIH Panel's consensus on impotence. More importantly, the observed measurement differences call into question the usefulness of the current research on the prevalence of ED. Using data from the first Croatian study on male sexual dysfunction, the author demonstrates the seriousness of problems stemming from the use of non-standardized measures. In conclusion, the steps for reaching the necessary standardization are outlined.     

The evolutionary role of erectile dysfunction

Biologic processes that affect the ability of an organism to reproduce are subject to heavy evolutionary pressure. Erectile dysfunction (ED), a common condition in elderly males, definitely affects the ability of the organism to reproduce, and therefore, it is expected to play a significant evolutionary role. Whereas oogenesis is limited to young females, spermatogenesis is a lifelong process. As a male gets older, the number of (pre-meiotic) mitotic cell divisions during spermatogenesis increases, as does the risk of de novo gene mutations. In this paper, I examine the hypothesis that ED, in addition to decrease in fertility, are two evolutionary safety mechanisms that reduce the probability of an ovum being fertilized with genetically altered sperm from an aged or sick male. This hypothesis is supported by the parallel rise in the occurrence of ED, infertility, and risk of congenital anomalies with age; by the occurrence of these three processes in the same medical conditions; and by the presence of a theory unifying the etiologies of three processes-the "free radical theory of aging". This hypothesis can predict the occurrence of congenital anomalies under conditions associated with ED and infertility but are presently not known to be associated with congenital anomalies.     

Face validity vs. item subtlety in the MMPI D scale

The distinction between item subtlety and face validity ( Holden & Jackson, 1979) provided the basis to reevaluate findings for subtle items in the MMPI D scale (N = 214). Results indicated that the inclusion of nonpathological items in the D scale did not lead to greater predictive validity of depression criteria. The need for substantive considerations in scale construction was emphasized further.