Chronic Stress in Cognitive Processes: Cortisol Dynamic Range of Secretion is Associated with Perception of Unsafety Environment in a Venezuelan Population

2020 ◽  
pp. 1-14
Author(s):  
Carlos Ayala-Grosso ◽  
Fátima Torrico ◽  
Margot Ledezma-Ruiz ◽  
Maria Busolo-Pons
Keyword(s):  
Social Interaction ◽  
Chronic Stress ◽  
Hpa Axis ◽  
Cognitive Processes ◽  
Dynamic Range ◽  
World Health ◽  
Cortisol Secretion ◽  
Saliva Cortisol ◽  
Health Organization ◽  
Behavioral Attitudes

Background: Understanding diurnal secretion of cortisol in association with behavioral attitudes as a result of perception of unsafety environment is a main interest in prospective studies establishing the impact of chronic stress in cognitive processes. Adaptive secretion of cortisol, a biomarker of the hypothalamic-hypophysis-adrenal (HPA) axis, has been correlated with perception of uncertainty in surroundings as a consequence of perseverative cognition and unconscious thoughts. Objective: To determine whether diurnal secretion pattern of cortisol was associated with behavioral attitudes indexes generated from answers to standardized questionnaires from Panamerican Health Organization/World Health Organization (PAHO/WHO) agencies. Methods: Saliva cortisol dynamic range was evaluated by immuno-essay. Cortisol awakening response (CAR) and total secreted cortisol was established in a cross-sectional study of four saliva samples per day from volunteers (n = 135) between 19 and 65 years old. Results: Saliva cortisol dynamic range followed a significant decay along the day. Reduction of social interaction and increase of defensive behavioral attitude was associated with older groups of age. In this study, two subgroups of subjects with a steeper cortisol secretion (slope significant non-zero), and flatter cortisol secretion (slope no significant non-zero) were detected. Noticeable, we detected and association between measurements of cortisol secretion from subjects with a flatter cortisol dynamic range and behavioral defensive and inhibition of social interaction indexes. Conclusion: These findings suggested chronical dysregulation of HPA axis as a result of perseverative cognitive perception of unsafety environment which may be precedent to cognitive impairment in the population.

scholarly journals A-135 The Interceding Effects of Social Cognition and “Cold” Cognition in Emotional Functioning Post-TBI.

2020 ◽  
Vol 35 (6) ◽  
pp. 928-928
Author(s):  
Ream D ◽  
Suarez V ◽  
Tourgeman I
Keyword(s):  
Social Cognition ◽  
Brain Injury ◽  
Cognitive Processes ◽  
Emotional Functioning ◽  
World Health ◽  
Data Synthesis ◽  
Post Traumatic ◽  
Health Organization ◽  
Attention And Perception ◽  
The Relationship

Abstract Objective This review examines studies that have identified both social and “cold” cognition in moderating emotional functioning as an outcome in individuals post-traumatic brain injury (TBI). Data Selection A systematic search of the literature was conducted using the keywords: social cognition, hot cognition, cognitive processes, emotions, emotional functioning, TBI, ABI, brain injury. The search included five databases: (1) EBSCOhost, (2) Google Scholar, (3) ScienceDaily, (4) PubMed, (5) World Health Organization. Inclusion criteria consisted of peer-reviewed articles published in English between 2013–2019 that utilized measures examining aspects of “cold cognition,” measures that investigated social cognition, and, outcome measures of emotional functioning in individuals who sustained a TBI. Data Synthesis A total number of 27 studies were identified through database searching with 16 papers selected. Three studies explained the function and implication of social cognition in individuals post-TBI. Additionally, 4 articles integrated statistical and demographic analyzes on individuals who suffered a TBI, and 9 studies exposed the relationship between “hot” and “cold” cognitions after sustaining a TBI. Conclusions Our results suggest that individuals with a TBI often exhibit difficulties in social cognition that is linked to changes in emotional functioning. Several studies pointed to the limbic system as an area influenced by both social and “cold” cognition regarding emotional output and experiences. Conversely, this system is often impacted in TBI. Other studies emphasized the relationship between attention and perception regarding one’s ability to adequately engage in empathy, emotional resonance, and sensitivity. Additionally, these studies outlined how impaired executive functioning influences empathy, attention, decision-making, and Theory of Mind.

Obstacles to Claiming Permanence and Injury-Relatedness for “Posttraumatic” Headache

2009 ◽  
Vol 14 (3) ◽  
pp. 3-6
Author(s):  
Robert J. Barth
Keyword(s):  
Complete Recovery ◽  
World Health ◽  
Related Factors ◽  
Posttraumatic Headache ◽  
Sixth Edition ◽  
Causative Relationship ◽  
Short Period ◽  
The One ◽  
Health Organization ◽  
Subjective Reports

Abstract “Posttraumatic” headaches claims are controversial because they are subjective reports often provided in the complex of litigation, and the underlying pathogenesis is not defined. This article reviews principles and scientific considerations in the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) that should be noted by evaluators who examine such cases. Some examples in the AMA Guides, Sixth Edition, may seem to imply that mild head trauma can cause permanent impairment due to headache. The author examines scientific findings that present obstacles to claiming that concussion or mild traumatic brain injury is a cause of permanent headache. The World Health Organization, for example, found a favorable prognosis for posttraumatic headache, and complete recovery over a short period of time was the norm. Other studies have highlighted the lack of a dose-response correlation between trauma and prolonged headache complaints, both in terms of the frequency and the severity of trauma. On the one hand, scientific studies have failed to support the hypothesis of a causative relationship between trauma and permanent or prolonged headaches; on the other hand, non–trauma-related factors are strongly associated with complaints of prolonged headache.

Sixth Edition: the New Standard

2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
World Health ◽  
International Classification Of Functioning ◽  
Revision Process ◽  
Sixth Edition ◽  
Impairment Ratings ◽  
Health Organization ◽  
Impairment Severity

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.

The Historical Development of Burden of Treatment Compliance

2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter
Keyword(s):  
Internal Medicine ◽  
Treatment Compliance ◽  
World Health ◽  
International Classification Of Functioning ◽  
Sixth Edition ◽  
Burden Of Treatment ◽  
Specific Goal ◽  
Surrogate Measure ◽  
Health Organization

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

Alexithyme Patientenmerkmale und Lebensqualität – Eine Querschnittsstudie an 79 ambulanten Patienten mit Angststörungen

2013 ◽  
Vol 61 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Katrin Leenen ◽  
Michael Rufer ◽  
Hanspeter Moergeli ◽  
Hans-Jörgen Grabe ◽  
Josef Jenewein ◽  
...  
Keyword(s):  
Quality Of Life ◽  
World Health ◽  
Life Questionnaire ◽  
World Health Organization Quality ◽  
Fand Sich ◽  
Quality Of Life Questionnaire ◽  
Organization Quality ◽  
Health Organization ◽  
Tas 20

Aus Untersuchungen in der Normalbevölkerung ist bekannt, dass Menschen mit erhöhten Alexithymiewerten eine verminderte Lebensqualität (LQ) aufweisen. Für Patienten mit psychischen Störungen wurde dieser Zusammenhang jedoch kaum untersucht. Ziel dieser Studie war es, den möglichen Zusammenhang zwischen alexithymen Patientenmerkmalen und der LQ bei Patienten mit Angststörungen zu überprüfen. Bei 79 ambulanten Patienten mit Angststörungen wurden alexithyme Charakteristika mit der Toronto Alexithymia Scale (TAS-20), die LQ mit der Kurzversion des World Health Organization Quality of Life Questionnaire 100 (WHOQOL-BREF) erfasst. Darüber hinaus fand eine Erhebung der psychischen Symptombelastung (SCL-90-R) und depressiven Symptomatik (MADRS) statt. Mittels hierarchischer Regressionsanalysen wurde der Zusammenhang zwischen der alexithymen Charakteristika und den unterschiedlichen LQ-Domänen berechnet. Die Patienten zeigten eine im Vergleich zur Normalbevölkerung deutlich verminderte LQ. Als Hauptergebnis fand sich, auch nach Kontrolle von Depression, Ängstlichkeit und Geschlecht, ein signifikanter Zusammenhang zwischen den beiden TAS-20 Subskalen Schwierigkeiten, Gefühle zu identifizieren und zu beschreiben und vor allem der psychischen LQ. Unsere Ergebnisse sprechen dafür, bei der Diagnostik und Therapieplanung von Patienten mit Angststörungen alexithyme Merkmale einzubeziehen. Im Falle von ausgeprägten alexithymen Merkmalen sollten psychotherapeutische Interventionen zur Verbesserung der Schwierigkeiten Gefühle wahrzunehmen und zu kommunizieren in Betracht gezogen werden.

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