Investigating the Role of Self-Disgust in Nonsuicidal Self-Injury

Self-directed disgust, a component of self-criticism, may present an important, yet unexplored emotion in the context of nonsuicidal self-injury (NSSI). The aim of this study was to examine the role of self-disgust in NSSI, specifically as a potential mediator in the relations between depression and NSSI as well as sexual abuse and NSSI, and to also better understand characteristics that might differentiate recent and past self-injurers. A total of 549 college students completed measures assessing NSSI, self-disgust, depression, anxiety sensitivity, and physical and sexual abuse. Results indicated self-disgust fully mediated the relation between depressive symptoms and NSSI status and partially mediated the relation between sexual abuse and NSSI status. Additionally, compared to past self-injurers (4.6%; n = 25), recent self-injurers (6.4%; n = 35) endorsed significantly higher self-disgust and depressive symptoms. Self-disgust may be an important component in NSSI and should be addressed in treatment.     

Respiratory, autonomic, and experiential responses to repeated inhalations of 20% CO2 enriched air in panic disorder, social phobia, and healthy controls

Inhalation of carbon dioxide (CO₂) enriched air triggers anxiety in panic disorder (PD) patients, which is often interpreted as a sign of biological vulnerability. However, most studies have not measured respiration in these tasks. We compared patients with PD (n = 20) and social phobia (SP, n = 19) to healthy controls (n = 18) during eight inhalations of 20% CO₂, preceded and followed by two inhalations of room air, while continuously measuring subjective anxiety and dyspnea as well as autonomic and respiratory variables. PD patients showed increased reactivity and delayed recovery during CO₂ inhalations for most measures. Unlike both other groups, the PD group's tidal volume responses did not habituate across CO₂ inhalations. However, PD patients did not differ from SP patients on most other measures, supporting a continuum model of CO₂ sensitivity across anxiety disorders. Both patient groups showed continued reactivity during the last air inhalations, which is unlikely to be due to a biological sensitivity.     

High altitudes,anxiety, and panic attacks: is there a relationship?

People exposed to high altitudes often experience somatic symptoms triggered by hypoxia, such as breathlessness, palpitations, dizziness, headache, and insomnia. Most of the symptoms are identical to those reported in panic attacks or severe anxiety. Potential causal links between adaptation to altitude and anxiety are apparent in all three leading models of panic, namely, hyperventilation (hypoxia leads to hypocapnia), suffocation false alarms (hypoxia counteracted to some extent by hypocapnia), and cognitive misinterpretations (symptoms from hypoxia and hypocapnia interpreted as dangerous). Furthermore, exposure to high altitudes produces respiratory disturbances during sleep in normals similar to those in panic disorder at low altitudes. In spite of these connections and their clinical importance, evidence for precipitation of panic attacks or more gradual increases in anxiety during altitude exposure is meager. We suggest some improvements that could be made in the design of future studies, possible tests of some of the theoretical causal links, and possible treatment applications, such as systematic exposure of panic patients to high altitude.     

Morphologische und kinetische Befunde bei einer kongenitalen dyserythropoetischen Anämie

Zusammenfassung Untersucht wurde eine Patientin mit den für dyserythropoetische Anämien typischen Befunden: Anämie mit von Jugend an ineffektiver und morphologisch veränderter Erythropoese; geringgradig verkürzter Erythrozytenlebensdauer, Hypersiderinämie und Organsiderose. Kennzeichnend für den Typ I dieser Erkrankung waren Chromatinbrücken zwischen Erythroblastenpaaren. Der Säure-Serum-Test fiel, im Gegensatz zu den bisher vorliegenden Beobachtungen, positiv aus.Die Erythroblasten zeigten mikrokinematographisch schwere Kinesestörungen der Kerne und des Zytoplasmas und reiften in der Kultur verzögert aus. Der DNS-Gehalt war teilweise stark erhöht, so daß eine Häufung von Endomitosen wahrscheinlich ist. Elektronenmikroskopisch stellten sich vom basophilen Erythroblasten an, mit der Reife der Zellen zunehmend, Veränderungen dar: Kondensation des Chromatins mit Verlust des diffusen Chromatins, der Kernmembran und Eindringen von Zytoplasma in den Kernraum; Disaggregation der Polyribosomen, autolytische Veränderungen im Zytoplasma und Mikrotubuli außerhalb der Spindelbrücke.

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Summary A patient with findings typical of a dyserythropoietic anaemia was investigated. From childhood on, she had an anaemia with ineffective erythropoiesis and morphological changes in the erythropoietic cells, slightly diminished erythrocyte life span, high serum iron and tissue siderosis. As is characteristic of Type I for this disease, chromatin bridges were present in erythroblast pairs. In contrast to results previously observed, acidified-serum test was positive.Under microcinematography, the erythroblasts showed marked changes in the movements of nuclei and cytoplasm, and had a delayed development in culture. The DNA content of a large number of cells was greatly increased, probably a result of endomitosis. Electron microphotographs showed changes in the erythroblasts which were more frequent with increasing maturity of the cells. Chromatin condensation with loss of diffuse chromatin and nuclear membrane, and invasion of the nuclear space by the cytoplasm were seen; also disaggregation of the polyribosomes, autolytic changes in the cytoplasm and microtubuli outside the mitotic spindle.

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Studie im Rahmen der Assoziation Hämatologie EURATOM-GSF, Nr. 031-64-1 BIAD.     

Respiratory feedback for treating panic disorder

Panic disorder patients often complain of shortness of breath or other respiratory complaints, which has been used as evidence for both hyperventilation and false suffocation alarm theories of panic. Training patients to change their breathing patterns is a common intervention, but breathing rarely has been measured objectively in assessing the patient or monitoring therapy results. We report a new breathing training method that makes use of respiratory biofeedback to teach individuals to modify four respiratory characteristics: increased ventilation (Respiratory Rate x Tidal Volume), breath-to-breath irregularity in rate and depth, and chest breathing. As illustrated by a composite case, feedback of respiratory rate and end-tidal pCO2 can facilitate voluntary control of respiration and reduce symptoms. Respiratory monitoring may provide relevant diagnostic, prognostic, and outcome information.     

Respiratory biofeedback-assisted therapy in panic disorder

The authors describe a new methodologically improved behavioral treatment for panic patients using respiratory biofeedback from a handheld capnometry device. The treatment rationale is based on the assumption that sustained hypocapnia resulting from hyperventilation is a key mechanism in the production and maintenance of panic. The brief 4-week biofeedback therapy is aimed at voluntarily increasing self-monitored end-tidal partial pressure of carbon dioxide (PCO2) and reducing respiratory rate and instability through breathing exercises in patients' environment. Preliminary results from 4 patients indicate that the therapy was successful in reducing panic symptoms and other psychological characteristics associated with panic disorder. Physiological data obtained from home training, 24-hour ambulatory monitoring pretherapy and posttherapy, and laboratory assessment at follow-up indicate that patients started out with low resting PCO2 levels, increased those levels during therapy, and maintained those levels at posttherapy and/or follow-up. Partial dissociation between PCO2 and respiratory rate questions whether respiratory rate should be the main focus of breathing training in panic disorder.     

Monocyte Recruitment in Tuberculosis and Sarcoidosis

Monocytopoiesis and blood monocytes were investigated in nine patients with active tuberculosis and in six patients with active sarcoidosis in order to obtain information on monocyte consumption in these two types of granuloma. All patients with tuberculosis demonstrated a marked increase in proliferation activity of monocytopoiesis and premature monocyte marrow release. These changes indicate a high monocyte consumption which probably is caused by a high macrophage death rate due to the high macrophage-toxicity of tubercle bacilli. Thus, tuberculous lesions are an example of a 'high turnover granuloma'. In sarcoidosis monocytopoiesis showed no significant deviations from the normal. This indicates a low macrophage turnover or 'low turnover granuloma'. Thus, any hypothetical agent assumed to be involved in the pathogenesis of sarcoidosis would have to possess low macrophage-toxicity.