Future Directions in Overactive Bladder Treatment

Overactive bladder (OAB) remains a remarkably common urologic condition resulting in significant clinical and economic sequelae. Although likely underestimated, the overall prevalence of overactive bladder is projected to be between 15% and 38%. The mainstay of therapy for decades has revolved around anticholinergic pharmaceuticals. However, recent advances in bladder and urothelial physiology have dramatically expanded the treatment options available for OAB management. Herein we present an overview of several emerging options for OAB therapy and review the available literature regarding these therapies. Despite substantial investment into OAB treatment, we are witness to but the genesis of research on detrusor function and urothelial biology that will guide practitioner interventions in the coming decades. Immense opportunity exists for future evaluation of OAB pathophysiology to advance our knowledge regarding management of this multifactorial urologic disorder.     

Latent structure of intermittent explosive disorder in an epidemiological sample

Intermittent explosive disorder (IED) is characterized by distinct periods of impulsive aggression marked by assaultive acts or destruction of property. However, impulsive aggression is also a feature of other disorders, all of which are viewed in diagnostic nomenclature as qualitatively distinct from IED. This state of affairs is problematic for categorical models unless it is demonstrated empirically that IED-related impulsive aggression is qualitatively distinct from impulsive aggression observable in other axis I and II disorders. The current study addresses this question using taxometric methods to examine the latent structure of IED. Participants were respondents on the Collaborative Psychiatric Epidemiological Surveys, which obtained data on a range of disorders including intermittent explosive disorder (N = 20,013) and a range of psychological variables. Indicator variables used were drawn from the survey items and submitted to select taxometric methods (MAMBAC and MAXEIG) to determine the relative fits of a taxonic versus dimensional model. The results of taxometric analyses provided support for a taxonic, rather than dimensional, structure for IED symptoms in the epidemiological sample. Taxon group membership was associated with treatment seeking, family history of anger attacks, lower age of onset of anger attacks, and male biological sex, providing strong support for the validity of the IED taxon.     

Inhibited temperament and parent emotional availability differentially predict young children's cortisol responses to novel social and nonsocial events

Preschool‐aged children (n = 274) were examined in the laboratory to assess behavioral and cortisol responses to nonsocial and social threat. Parents also responded to scales on the Children's Behavior Questionnaire reflecting exuberant approach to novel/risky activities (reversed scored) and shyness. Multi‐method measures of Nonsocial and Social Inhibition were computed. Parents and children were observed engaging in a series of interactive tasks and the Emotional Availability scales were scored for parental sensitivity, nonintrusiveness, nonhostility, and structuring. These scores were factored to yield one measure of Parenting Quality. Analyses revealed that Nonsocial and Social Inhibition could be distinguished and that associations with cortisol response were stressor specific. Moderation analyses revealed that parenting quality buffered cortisol elevations for extremely socially, but not nonsocially inhibited children. These findings are consistent with evidence that sensitive, supportive parenting is an important buffer of the HPA axis response to threat in infants and toddlers, and extends this finding to the preschool period. © 2009 Wiley Periodicals, Inc. Dev Psychobiol 51: 521–532, 2009.     

Ultrasound and the IRB

The purpose of this paper is to assist researchers in writing their research protocols and subject consent forms so that both the Institutional Review Board (IRB) and subjects are assured of the minimal risk associated with diagnostic B‐scan ultrasound as it is used in speech research. There have been numerous epidemiological studies on fetal ultrasound and laboratory studies on the effects of ultrasound on various types of tissue, and the American Institute of Ultrasound in Medicine and the World Federation for Ultrasound in Medicine and Biology have concluded that B‐scan diagnostic ultrasound procedures are safe if conducted in a prudent manner. To this end, this paper will present a list of potential risks associated with diagnostic ultrasound so that researchers can explain to the IRB and subjects why diagnostic ultrasound, and B‐scan in particular, is minimal risk.     

Substance Use and Sexual Risk Behavior in HIV-Positive Men Who Have Sex With Men: An Episode-Level Analysis

Men who have sex with men (MSM) make up nearly half of all people living with HIV in the United States. The prevalence of the epidemic in this population makes it vitally important to understand the transmission of the infection and to develop methods to prevent its spread. The current study uses longitudinal diary methods to examine relationships between substance use and unprotected anal intercourse in a sample of 158 HIV-positive, mostly ethnic minority MSM. Results indicate that both general substance use and use of specific drugs (i.e., inhalants, cocaine, crack, and club drugs) have a substantial impact on the sexual risk behavior of this population.