Antonia Gladys Nasello

Spirituality and Resilience in Trauma Victims

The way people process stressors is critical in determining whether or not trauma will be experienced. Some clinical and neuroimaging findings suggest that posttraumatic stress disorder patients experience difficulty in synthesizing the traumatic experience in a comprehensive narrative. Religiousness and spirituality are strongly based on a personal quest for understanding of questions about life and meaning. Building narratives based on healthy perspectives may facilitate the integration of traumatic sensorial fragments in a new cognitive synthesis, thus working to decrease post-traumatic symptoms. Given the potential effects of spiritual and religious beliefs on coping with traumatic events, the study of the role of spirituality in fostering resilience in trauma survivors may advance our understanding of human adaptation to trauma.

Sudden Darkness Induces a High Activity-Low Anxiety State in Male and Female Rats

The effects of sudden darkness on spontaneous motor activity in an open field and performance in an elevated plus-maze (EPM) were assessed in adult male and female rats. In the open field test, sudden darkness increased total locomotion, locomotion in central squares, rearing frequency (RF), and diminished defecation units (DU). In the dark, total locomotion remained elevated during the 20-min test period, while in the light total locomotion decreased significantly after the fourth minute, in both sexes. All the effects of sudden darkness in the open field test were more pronounced in female rats. In the EPM, sudden darkness increased the number of entries into the open arms, total entries, percentages of entries into the open arms, and time spent in the open arms. The changes were more significant in female than in male rats. These results show that sudden darkness increases general motor activity and suggest it diminishes habituation, fear, and anxiety. The results also suggest that this behavioral shift is sexually differentiated. Sudden darkness emerges as an experimental tool to simultaneously test physiologically-induced increases in spontaneous motor activity and decreases in anxiety.

Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study

BACKGROUND Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes. METHOD We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group. RESULTS Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe. CONCLUSIONS Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.

Police officers under attack: Resilience implications of an fMRI study

OBJECTIVE Crime is now a top-priority public-health issue in many urban areas. Sao Paulos state police force was the target of gunfire attack on an unprecedented scale. Several officers were killed or wounded, and many more were affected by psychological trauma. We investigated the brain activity underlying trauma, the coping effect of psychotherapy, and resilience in a highly homogenous sample that experienced the same traumatic event. The design applied was a between-group comparison of cerebral blood-oxygenation-level-dependent signals and symptom scores of police officers with and without partial Posttraumatic Stress Disorder (pPTSD). METHOD We used functional magnetic resonance imaging (fMRI) to investigate the retrieval of traumatic memories of 36 volunteers divided in three groups: (1) pPTSD policemen submitted to psychotherapy; (2) pPTSD policemen on the wait list; and (3) symptom-free (resilient) policemen. All participants were given a baseline fMRI scan and a follow-up scan some 40 days later. Not given psychotherapy, groups 2 and 3 were controls. RESULTS Group 1 showed 37% fewer PTSD symptoms post-psychotherapy and their scores and neural expressions were comparable to Group 3 resilient policemen. A marked increased in medial prefrontal cortex (mPFC) activity was concomitant with decreased amygdala activity during traumatic memory retrieval in both resilient and pPTSD participants (after psychotherapy) and these findings were associated with symptom attenuation. CONCLUSIONS Our results provide neurophysiological evidence of resilience in a high-risk group for PTSD. Psychotherapy may help to build narratives and resilient integrated translations of fragmented traumatic memories via mPFC, and thus weaken their sensory content while strengthening them cognitively.

HISTAMINE AND SPONTANEOUS MOTOR ACTIVITY : BIPHASIC CHANGES, RECEPTORS INVOLVED AND PARTICIPATION OF THE STRIATAL DOPAMINE SYSTEM

The time- and dose-related effects of exogenous histamine on spontaneous motor activity and receptors involved were evaluated in male rats. Intracerebroventricular administration of histamine (5.4 and 54.3 nmol) produced a biphasic effect with initial transitory hypoactivity and later hyperactivity expressed by locomotion frequency in an open-field. The rearing frequencies were only reduced by all doses of histamine used. The histamine-induced hypoactivity was inhibited by the H3-antagonist thioperamide and was also induced by the H3-agonist N-alpha-methylhistamine. The histamine-induced hyperactivity phase was blocked by the H1-antagonist mepyramine. The H2-antagonist ranitidine increased locomotion and rearing frequencies. The participation of other neurotransmitters in the persistent hypokinetic effect induced by 135.8 nmol of histamine was determined by HPLC in the striatum and hypothalamus as counter-proof. A decreased DOPAC/DA ratio was observed only in the striatum. In the hypothalamus, low levels of 5HT were detected, probably not correlated with motor activity. In conclusion, the present results suggest that the exogenous histamine-induced hypoactivity response is probably due to activation of H3-receptors as heteroreceptors reducing the activity of the striatal dopaminergic system. This effect can partially overlap with the expression of the hyperactivity induced by H1-receptor activation. The participation of H2-receptors requires further investigation.

Espiritualidade, religiosidade e psicoterapia

Crencas e praticas religiosas/espirituais constituem uma parte importante da cultura e dos principios utilizados para dar forma a julgamentos e ao processamento de informacoes. O conhecimento e a valorizacao de tais sistemas de crencas colaboram com a aderencia do individuo a psicoterapia e promovem melhores resultados. Contudo, nem todas as abordagens encontraram um ajuste desse tema em suas intervencoes e os diversos conceitos sobre religiosidade/espiritualidade dificultam essa importante interface. Neste artigo, trazemos os conceitos mais coerentes e acessiveis para facilitar o dialogo profissional no âmbito terapeutico. Discutimos o impacto da subjetividade, dos estados de consciencia e das percepcoes influenciadas pela religiosidade/espiritualidade na saude mental e a importância de a psicoterapia voltar-se a clientes e respectivos sistemas de crencas, desenvolvendo modelos que mobilizem esperanca e potencializem suas capacidades de superacao. A despeito da atual distância entre estudos controlados e praticas clinicas, discutimos a integracao das dimensoes espirituais/religiosas na psicoterapia com profissionalismo etico, conhecimento e habilidades para alinhar as informacoes coletadas ao beneficio do cliente. Considerando que apenas 7,3% da populacao brasileira nao tem religiao e a escassez de abordagens e psicoterapeutas que contemplem a religiosidade/espiritualidade, apontamos a relevância de investigacoes sobre o tema e que as propostas psicoterapicas sejam testadas em ensaios clinicos.

Dual modulation of male sexual behavior in rats by central prolactin: relationship with in vivo striatal dopaminergic activity.

Prolactin (PRL) appears to be localized in several brain structures. Central, behaviorally meaningful, neural actions of this protein have been demonstrated in a large number of studies. The present report describes sexual behavioral and in vivo neurochemical data obtained from adult male rats injected intracerebroventricularly acutely (10 micrograms) or chronically (5 days; 10 micrograms/day) with ovine prolactin (oPRL). The extracellular striatal concentrations of dopamine and serotonin metabolites were estimated by HPLC measurements in microdialysis perfusates. A single (10 micrograms) administration of oPRL facilitated sexual activity and increased extracellular striatal DOPAC, HVA and 5HIAA levels, whereas five daily intracerebroventricular injections of oPRL, decreased the sexual behavior and reduced DOPAC and HVA striatal extracellular concentrations in response to a central oPRL injection. These results show that acute and chronic central oPRL treatments have stimulatory and inhibitory effects on male sexual behavior, respectively. In addition, the results suggest that striatal dopaminergic activity is increased and decreased by acute and 5-day central oPRL treatments. These data suggest that behavioral effects of PRL occur simultaneously with changes in striatal dopaminergic activity.

Dopaminergic supersensitivity after long-term bromopride treatment

The effects of bromopride administration on open-field and apomorphine-induced stereotyped behavior of rats were studied. Bromopride induced a displacement to the right of the control dose-response curve constructed for apomorphine stereotypes. Withdrawal from long-term bromopride treatment induced not only a significant increase in ambulation and rearing frequencies for male rats observed in the open-field but also an increased sensitivity of both male and female animals to apomorphine. The results are interpreted as a consequence of the development of supersensitivity of central dopaminergic receptors, probably of the mesostriatal pathways.

Psychological dynamics affecting traumatic memories: Implications in psychotherapy

The search to understand response to trauma has turned to the contribution of personality factors. The way people process the stressor event is critical in determining whether a trauma will be configured or not. Neuroscience shows that the brain does not store memories, but traces of information that are later used to create memories, which do not always express a completely factual picture of the past experience. Whenever an event is retrieved, it may undergo a cognitive and emotional change. Psychological dynamics--emotional interpretative tendency that affects the internal dialogue related to a meaningful event--may influence the development of positive or negative outcomes after stressor events. We postulate that therapists must see beyond the traumatic event itself and work with the internal dialogues that maintain the pathological relationship with the past episode. Thus, they may better treat traumatized patients by therapeutically rebuilding the memory. A brief clinical case is presented to show how exposure-based and cognitive restructuring therapy may help trauma victims experience psychological growth from their negative experiences, by fostering healthy psychological dynamics.

Morphine pretreatment increases opioid inhibitory effects on maternal behavior

Ongoing maternal behavior in rats is under the inhibitory influence of opiates. Exposure to drugs of abuse may result in a progressive and enduring enhancement of their reinforcing effects. Little attention has been paid to the possibility that puerperal treatment with morphine may lead to sensitization to this drug, ultimately influencing the effects of opiates on maternal behavior. The aim of the present study was to investigate if the abrupt withdrawal of repeated treatment with morphine chlorhydrate (MC) during late pregnancy and early lactation may influence maternal behavior in lactating rats. The premise that a possible change in sensitivity to the inhibitory effect of MC on maternal behavior would last at least until day 17 of lactation without any reinforcement was tested. In addition, the hypothesis that the MC-induced inhibition would be reversed by the opioid antagonist naloxone was also tested. In all experiments female Wistar rats were treated with MC (5.0 mg/kg/day, subcutaneous [s.c.]) or saline for 7 days starting on the 17th day of pregnancy. After the abrupt discontinuation of long-term treatment, animals were acutely challenged with MC (5.0 mg/kg, s.c.) or saline and tested for maternal behavior in three different experimental situations: first, on days 5, 10, and 17 postpartum (Experiment 1); second, on day 17 postpartum (Experiment 2); third, on day 6 postpartum following naloxone pretreatment (1.0 mg/kg; Experiment 3). In Experiment 1, animals were treated for 7 days with morphine and acutely challenged with MC (group MM). Experimental MM animals showed significantly longer latencies for all maternal behavior parameters than all other groups during all observation days. The other groups (treated with MC for 7 days and acutely challenged with saline, group MS; treated with saline for 7 days and acutely challenged with MC, group SM; and treated with saline for 7 days and acutely challenged with saline, group SS) did not differ significantly from one another. In Experiment 2, in which rats were submitted to a single test on day 17 of lactation, the MM group showed significantly longer latencies for all behavioral parameters as compared to group SM. Previous acute naloxone treatment (Experiment 3) reversed the inhibitory effects of MC on maternal behavior in lactating rats. These data suggest that repeated administration of MC to female rats during late pregnancy sensitizes the animals to the inhibitory effects of opioids on rat ongoing maternal behavior.