Living in high expressed emotion (EE) environments tends to increase the relapse rate in schizophrenia (SZ). At present, the neural substrates responsible for high EE in SZ remain poorly understood. Functional near-infrared spectroscopy (fNIRS) may be of great use to quantitatively assess cortical hemodynamics and elucidate the pathophysiology of psychiatric disorders. In this study, we designed novel low- (positivity and warmth) and high-EE (criticism, negative emotion, and hostility) stimulations, in the form of audio, to investigate cortical hemodynamics. We used fNIRS to measure hemodynamic signals while participants listened to the recorded audio. Healthy controls (HCs, [Formula: see text]) showed increased hemodynamic activation in the major language centers across EE stimulations, with stronger activation in Wernicke's area during the processing of negative emotional language. Compared to HCs, people with SZ ([Formula: see text]) exhibited smaller hemodynamic activation in the major language centers across EE stimulations. In addition, people with SZ showed weaker or insignificant hemodynamic deactivation in the medial prefrontal cortex. Notably, hemodynamic activation in SZ was found to be negatively correlated with the negative syndrome scale score at high EE. Our findings suggest that the neural mechanisms in SZ are altered and disrupted, especially during negative emotional language processing. This supports the feasibility of using the designed EE stimulations to assess people who are vulnerable to high-EE environments, such as SZ. Furthermore, our findings provide preliminary evidence for future research on functional neuroimaging biomarkers for people with psychiatric disorders.
Introduction: Nursing is an emotionally stressful occupation where nurses themselves are at risk of internalizing negative emotions when caring for patients who are suffering, in pain, anguish, and facing death. Studies indicate an individual`s ability to emotionally express or vent these internalize negative emotions is associated with intrinsic happiness and well-being. Similarly, in the context of UMS, student nurses are at times exposed to overwhelming negative emotions during clinical postings and raise the question to what extent students use emotional expressive- ness to vent such emotions. This study is to assess perceived happiness and emotional expressiveness and determine correlates of these attributes among student nurses in UMS. Methods: This study entails a cross-sectioned design involving 90 (N) participants selected through convenient stratified sampling from 1st year (n=30), 2nd year (n=30) and 3rd year (n=30) student nurses. Ethical clearance for this study was obtained from REC UMS and the respon- dent’s consent. Two validated instruments, the Intrinsic Happiness Index (IHI, with 10 Likert scaled items, α =0.78) and Emotional Expressiveness Scale (EES, 17 Likert scaled item α =0.82) were used in this study. Results: Among 90 nursing students in this study, 81%(n=72) scored high and 19% (n=18) scored low in the happiness index. On emotional expressiveness ratings, 68% scored high with 32% scoring low. Higher happiness index scores correlated positively with high emotional expressive scores. First year students had significantly higher perceived happiness score (p=0.02) and higher emotional expressiveness score (p=0.03) compared to 2nd or 3rd-year students. Conclu- sion: Finding in this study imply that although the majority of student had good emotional disposition, but a small percentage of students have lower perceived happiness and emotional expressiveness, which may affect long term psychological well-being. This paper will discuss some remedial strategies to address the issue.
The leaves from Mitragyna speciosa (Korth.) trees, also known as kratom, are traditionally used in Southeast Asia as a mild psychotropic agent. We investigated the demographic characteristics of persons who used both kratom cocktail and benzodiazepines (BZO) in a sample drawn from a rural area in Penang, Malaysia, and the reasons for BZO use. Seventy-seven participants who currently use a kratom cocktail along with BZO were recruited through snowball sampling for this cross-sectional study. The participants were male, and the majority were Malays (99%, n = 76/77), single (57%, n = 44/77) and employed (91%, n = 70/77). BZO was used with kratom cocktail 1) to increase euphoria; 2) to reduce dependence on methamphetamine; 3) to promote sleep; 4) to ease methamphetamine-associated psychological symptoms and 5) to decrease the craving for kratom. There were no significant differences in the intake of kratom use (p = .751), BZO use duration (p = .259), frequency (p = .188) and quantity (p = .888) of BZO use in the last 7 days, and quantity of BZO use in the last 30 days (p = .337) between kratom users and kratom poly-drug users. An awareness of the health consequences of the co-use of kratom with BZO is needed to prevent untoward health incidents.
Objective: Individuals with ADHD are known to have more risk of developing substance use disorder (SUD). However the underlying mechanisms behind it are not straightforward. Method: We report a case of an adult with ADHD, who has a long standing history of polysubstance use, since the age of 10. He had multiple relapses, even after numerous efforts undertaken to keep him drug-free. Result: ADHD symptoms were not optimally treated during admission. He had preference towards opioid-based and amphetamine-type substances in order to attain euphoria. Conclusion: Taking into account the biological and psycho-social condition of this man, we discussed the role of ADHD from the perspective of dysfunctional rewards system and other possible factors in explaining his drug-craving behavior.
Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes.
Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected.
Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery.
Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.