Effects of stress and relaxation on capsaicin-induced pain. Childhood methylphenidate treatment of ADHD and response to affective stimuli Dissociated effects of amphetamine on arousal and cortical blood flow in humans Relapse rate and subsequent parental reaction after successful treatment of children suffering from nocturnal enuresis: a 2 1/2 year follow-up of bibliotherapy. Caffeine effects on resting-state arousal The reinforcing effects of nicotine and stimulant medication in the everyday lives of adult smokers with ADHD: A preliminary examination. Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial Does EEG-neurofeedback improve neurocognitive functioning in children with attention-deficit/hyperactivity disorder? A systematic review and a double-blind placebo-controlled study. Attentional effects of noradrenaline vary with arousal level: selective activation of thalamic pulvinar in humans Being deluded after being excluded? How emotion regulation deficits in paranoia-prone individuals affect state paranoia during experimentally induced social stress. Genital and subjective measurement of the time course effects of an acute dose of testosterone vs. placebo in postmenopausal women. Arousal in patients with gastro-oesophageal reflux and sleep apnoea. Caffeine effects on resting-state electrodermal levels in AD/HD suggest an anomalous arousal mechanism Acute tryptophan depletion attenuates conscious appraisal of social emotional signals in healthy female volunteers Making choices: why parents present to the emergency department for non-urgent care Processing of the Arousal of Subliminal and Supraliminal Emotional Stimuli by the Human Amygdala The effects of arousal reappraisal on stress responses, performance and attention Patient-ventilator interaction and sleep in mechanically ventilated patients: Pressure support versus proportional assist ventilation* Anti-Intrusion Effect of Lorazepam: An Experimental Study The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients. Pleasant music improves visual attention in patients with unilateral neglect after stroke An Exploratory Study on the Effects of Tele-neurofeedback and Tele-biofeedback on Objective and Subjective Sleep in Patients with Primary Insomnia Interacting Effects of Trait Anger and Acute Anger Arousal on Pain: The Role of Endogenous Opioids
A sizable body of research has been devoted to underst and ing the relationship between  pain sensitivity  and the psychological state of the individual . Considerable disagreement as to the direction of the association still exists . This study examines the effects of 2 experimental manipulations , cognitive/emotional stress and relaxation , on capsaicin-induced pain . Subjects were pretrained in relaxation and then r and  omized to experimental stress produced by a 20-minute Stroop test , relaxation ( tape ) , or a control condition ( neutral video ) , followed by a capsaicin injection in the forearm . Cardiovascular measures were taken at regular intervals , and cortisol , norepinephrine ( NE ) , and self-reports of arousal ( relaxation index ) were taken immediately before and after the experimental task . The manipulation significantly interacted with sex to predict capsaicin-induced maximum pain . Women in the stress condition reported greater pain than both men in the stress condition and women in the relaxation condition . Pain was correlated negatively with task-induced changes in NE and cortisol and positively with self-reported arousal ( decreased relaxation ) . However , separate analyses showed that some physiologic indexes of heightened arousal ( increased blood pressure and NE ) predicted lower pain only in men , whereas subjective increases in arousal predicted higher pain only in women . Multiple hierarchical regression analyses confirmed that physiologic and self-reported arousal predicted pain independently and in opposite directions , and a model including both accounted for 56 % of the overall variance . These findings suggest that a unidimensional model of arousal may be insufficient to explain the effects of stress on pain and that these effects operate differently in men and women Neural correlates of emotional dysregulation in attention-deficit/hyperactivity disorder ( ADHD ) and persisting influence of Methylpheni date ( MPH ) still remain insufficiently understood . Decreased activation in the subgenual cingulate and the ventral striatum were found during the perception of positive and negative affective pictures in drug-naïve males with ADHD during childhood ( n=10 ) . Males with ADHD during childhood treated with MPH ( n=10 ) did not show any significant differences compared to healthy controls ( n=10 ) . Further prospect i ve studies need to clarify direct and indirect mechanisms of MPH treatment that may contribute to emotional processing , which is dysfunctional in males without pharmacological treatment in childhood The effects of intravenous amphetamine infusion ( 0.3 mg/kg ) on cerebral blood flow ( CBF ) and measures of autonomic and behavioral arousal were studied in 12 normal male volunteers in a placebo-controlled crossover design . Nonsignificant decreases were seen in CBF ( measured by 133Xe inhalation ) , despite significant increases in autonomic and behavioral arousal . The apparent dissociation of CBF and arousal appears to be compatible with other human experiments suggesting that amphetamine decreases CBF and metabolism , as well as with neurobiological findings on the effects of catecholamines on resting cortical activity and mechanisms of increased attention . The results differ substantially , however , from findings of increased CBF and metabolism in animals . Although the larger doses used in animals most likely explain the discrepancy , technical limitations in human brain imaging can not be excluded Results 2 1/2 years after an enuresis nocturna training  are presented , including rate of success , percentage and duration of relapse for 113 children ( mean age 11.6 year at the start of the training ) . The bibliotherapeutic treatment by parents did not require any intervention by a professional . Behaviour of parents in the event of a relapse differed between training conditions . Children in the Arousal condition recovered faster from a relapse , 90 % of their parents used the  Arousal training  again at relapse or did not intervene at all and none of them consulted a professional . Clearly they had confidence in the method of Arousal training : combining the alarm device with reinforcement for correct behaviour at the time the alarm goes off . Parents in control conditions did not use the  alarm device as often as the parents in the Arousal condition , but tried other means with less success , including consulting professionals OBJECTIVE This study examined the use of caffeine to manipulate arousal level without the confounds associated with task-related activation . From previous work in our laboratory , an increase in skin conductance level ( SCL ) and EEG alpha frequency , together with a global decrease in alpha power , were used as markers of arousal increase , and we sought to identify these effects with caffeine ingestion . METHODS We examined the effect of a single oral dose of caffeine ( 250 mg ) in a r and omised double-blind placebo-controlled repeated- measures cross-over study . Eighteen healthy university students ( mean age 21 years ; 13/18 females ) participated in two sessions 1 week apart . EEG and autonomic data ( SCL , heart rate , systolic and diastolic blood pressure , and respiration rate ) from a 2 min eyes-closed epoch , commencing approximately 30 min after ingestion of caffeine or placebo , were examined . RESULTS Caffeine was associated with increased SCL , a global reduction in EEG power in the alpha b and , and a global increase in alpha frequency . There were no cardiovascular effects . CONCLUSIONS The positive results are consistent with recent electrodermal and EEG studies of arousal and suggest that caffeine may be utilised as a task-free means of manipulating arousal in future investigations . Further work is necessary to clarify the absence of cardiovascular effects , and to integrate those data with emerging conceptualisations of arousal and activation . SIGNIFICANCE The present data support the use of caffeine as a simple tool to explore the role of arousal in both normal and atypical functioning , and this may be useful in determining the validity and importance of supposed hyper- or hypo-arousal in such syndromes as attention-deficit/hyperactivity disorder ( AD/HD ) Whereas the smoking prevalence rates in the general population are declining , rates among people diagnosed with attention-deficit/hyperactivity disorder ( ADHD ) continue to be elevated . Previous research has shown that nicotine may improve attention and mood , suggesting that nicotine may help ameliorate the attentional and emotional problems associated with ADHD . The present study examined the effects of nicotine with and without stimulant medication on ADHD symptoms , moods , and arousal in the everyday lives of smokers with ADHD . A total of 10 smokers with ADHD who were being treated with stimulant medication  were asked to abstain from smoking while participating in the study . Participants underwent four conditions in r and omized order : ( a ) Nicotine patch+stimulant medication , ( b ) nicotine patch only , ( c ) placebo patch+stimulant medication , and ( d ) placebo patch only . Each condition continued for 2 days , during which self-reports of ADHD symptoms and moods were obtained using electronic diaries . Lightweight ambulatory monitors recorded cardiovascular activity at each diary entry . Smoking abstinence was verified by expired carbon monoxide and salivary cotinine analysis . Results showed that nicotine patches and stimulant medication alone and in combination reduced difficulty concentrating and core ADHD symptoms compared with placebo patch only . Borderline improvement in impatience and self-control was seen with nicotine patch administration primarily on day 1 . Nicotine patches also tended to elevate systolic and diastolic blood pressure compared with placebo patch during day 2 . The findings suggest that smokers with ADHD experience nicotine-related reductions in ADHD symptoms during their everyday lives Evidence suggests aerobic exercise has anxiolytic effects ; yet , the treatment potential for posttraumatic stress disorder ( PTSD ) and responsible anxiolytic mechanisms have received little attention . Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit . Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested . Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise ( six sessions ) . To assess the effect of attentional focus , participants were r and omized into three exercise groups : group 1 ( attention to somatic arousal ) received prompts directing their attention to the interoceptive effects of exercise , group 2 ( distraction from somatic arousal ) watched a nature documentary , and group 3 exercised with no distractions or interoceptive prompts . Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity ( AS ; i.e. , fear of arousal-related somatic sensations ) during treatment . Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores , wherein group 1 , receiving interoceptive prompts , experienced significantly less symptom reduction than other groups . Most participants ( 89 % ) reported clinical ly significant reductions in PTSD severity after the two-week intervention . Findings suggest , regardless of attentional focus , aerobic exercise reduces PTSD symptoms BACKGROUND The number of placebo-controlled r and omized studies relating to EEG-neurofeedback and its effect on neurocognition in attention-deficient/hyperactivity disorder ( ADHD ) is limited . For this reason , a double blind , r and omized , placebo-controlled study was design ed to assess the effects of  EEG-neurofeedback  on neurocognitive functioning in children with ADHD , and a systematic review on this topic was performed . METHODS Forty-one children ( 8 - 15 years ) with a DSM-IV-TR diagnosis of ADHD were r and omly allocated to EEG-neurofeedback or placebo-neurofeedback treatment for 30 sessions , twice a week . Children were stratified by age , electrophysiological state of arousal , and medication use . Neurocognitive tests of attention , executive functioning , working memory , and time processing were administered before and after treatment . Research ers , teachers , children and their parents , with the exception of the neurofeedback-therapist , were all blind to treatment assignment . Outcome measures were the changes in neurocognitive performance before and after treatment . CLINICAL TRIAL REGISTRATION www . clinical trials.gov : NCT00723684 . RESULTS No significant treatment effect on any of the neurocognitive variables was found . A systematic review of the current literature also did not find any systematic beneficial effect of EEG-neurofeedback on neurocognitive functioning . CONCLUSION Overall , the existing literature and this study fail to support any benefit of neurofeedback on neurocognitive functioning in ADHD , possibly due to small sample sizes and other study limitations Subjects se date d by noradrenergic alpha2 agonists can switch rapidly from a state of extremely low to almost full consciousness following phasic increases in arousal or cognitive dem and . Such flexibility is not displayed by traditional sedatives , such as the benzodiazepine diazepam . Experimentally , the phasic modulation of alpha2 effect by arousing or distracting stimuli can counteract the deleterious cognitive effects of alpha2 agonists . We used behavioural and fMRI indices of brain function to investigate the phasic modulatory effect that presentation of loud white noise would have on attentional dysfunction induced by administration of  dexmedotomidine , an alpha2 agonist . Dexmedotomidine and midazolam were compared to placebo during performance of a target detection task , which was presented in the presence or absence of white noise . Compared to placebo , both dexmedotomidine and midazolam impaired task performance . This impairment was significantly attenuated by presentation of white noise in the dexmedotomidine condition only . This functional improvement corresponded to selective increase in activity of left medial pulvinar nucleus of the thalamus . This regional increase is suggested to index increases in phasic arousal , which counteract dexmedotomidine 's detrimental attentional effects . Finally , despite sedating subjects to equivalent degrees , dexmedotomidine and midazolam had strikingly different regional effects on task-induced brain activity . Therefore , for the same level of sedation , the behavioural and anatomical attributes identifying the quality of sedation can vary Emotion  regulation ( ER ) has become a relevant construct to underst and ing paranoia . While the ER strategy called expressive suppression ( e.g. , poker face ) may foster state paranoia by increasing arousal , another strategy called re appraisal ( e.g. , changing the perspective on situations ) may reduce negative emotions and state paranoia when adaptively used . However , if re appraisal fails , this could increase paranoia . The aim of this study was to test the proposed effects of the ER strategies on state paranoia in the socially stressful situation of being excluded in paranoia-prone individuals . We conducted an experimental online study with N=116 participants who were r and omized to a social inclusion or an exclusion condition using a virtual Cyberball ball-tossing game .  They completed question naires on paranoia proneness and habitual ER strategies . Before and after the Cyberball task , participants rated their level of state paranoia . The impact of habitual ER strategies , paranoia proneness , and social stress on changes in state paranoia was investigated using linear regression analysis . The three-way interaction of social stress , paranoia proneness , and habitual re appraisal use significantly predicted state paranoia , t(114)=2.62 , p=0.010 . The decomposition of the interaction term revealed that in the social stress condition , the impact of re appraisal on state paranoia was moderated by the level paranoia proneness . Specifically , in high paranoia-prone individuals the use of re appraisal predicted higher state paranoia . The findings regarding habitual use of suppression were not significant . Although re appraisal is generally considered a functional strategy , its use in distressing social situations seems to be impaired in persons with higher paranoia proneness . A working model of emotion dysregulation in delusions is presented and possible implication s for cognitive therapy of psychosis are discussed INTRODUCTION Recent research on the impact of testosterone ( T ) on female sexual function has yielded inconsistent results , and few studies have used physiological measures of genital arousal . AIM This study examined the effects of an acute dose of methyltestosterone ( MT ) on physiological ( genital ) and subjective sexual response in postmenopausal women . MAIN OUTCOME MEASURES Vaginal pulse amplitude ( VPA ) and self-reported sexual response . METHODS R and omized , double-blind , crossover , placebo-controlled trial of 5 mg MT , consisting of two separate 8-hour visits . Participants were 10 postmenopausal women without sexual dysfunction . Participants viewed both neutral and erotic video segments during five post-dose trials while their genital and subjective responses were monitored . RESULTS The Wilcoxon signed rank test indicated a significant difference in VPA between the T ( M = 0.018 , SD = 0.018 ) and placebo ( M = 0.016 , SD = 0.017 ) conditions at 4.5 hours post-dose ( P = 0.03 ) . Higher difference scores were noted for 80 % of subjects during the T condition at 4.5 hours , in contrast with only 50 % of subjects responding to T at the other four time points . No differences were found on VPA relative change scores or subjective sexual arousal scores . When summed across all five time points , genital and subjective measures were correlated regardless of medication condition ( 0.62 and 0.60 for self-reported physical and mental sexual arousal scores , respectively ) . CONCLUSIONS These findings in postmenopausal women combined with those of two previous investigations in premenopausal women demonstrate a probable acute-dose time delay for genital sexual effects of exogenous T with no change in self-reported sexual arousal . Further investigation is needed to determine whether acute dosing of T has a consistent and predictable impact on genital arousal that has promise for the treatment of any subgroup of women with sexual disorders Nocturnal gastro-oesophageal reflux has been observed in patients with obstructive sleep apnoea ( OSA ) . Negative intrathoracic pressure during apnoeas and arousal have been suggested as the underlying mechanisms . In order to evaluate this hypothesis , the coincidence and sequence in time of arousal , apnoea and reflux events were analysed . Fifteen patients with OSA or heavy snoring were studied by means of st and ard polysomnograpy with parallel recording of 24-h oesophageal pH.  Reflux events during the day were present in all patients , five of whom had symptoms of reflux . In three of these and in five other patients , a total of 69 nocturnal reflux events were found . In 68 events , arousal was found with the reflux event . Only one reflux without arousal was found ( sleep stage 2 ) . Seventeen events occurred during wakefulness after sleep onset . The percentage of time with a pH of < 4 during wakefulness after sleep onset was significantly higher than the percentage of time with a pH of < 4 during total sleep time ( p<0.05 ) . In 37 of the 52 reflux events which occurred during sleep , either an apnoea or a hypopnoea was found prior to the event . The investigation of sequence in time did not prove a causal relation between respiratory events and reflux events . The results indicate that gastro-oesophageal reflux and obstructive sleep apnoea are two separate disorders , which both have a high prevalence in obese patients The effect of a single oral dose of caffeine was examined in a r and omised double-blind placebo-controlled repeated- measures cross-over study . Eighteen children with AD/HD , aged between 8 and 13 years , were individually age- and gender-matched with a control group . All children participated in two sessions , one week apart . Skin conductance level ( SCL ) from a 3 min eyes-closed epoch , commencing 30 min after ingestion of caffeine or placebo , was examined . Across conditions , mean SCL was lower in the AD/HD group than controls , confirming hypoarousal in AD/HD . Caffeine produced an increase in SCL , and this increase did not differ between the groups . However , arousal increases were dose-dependent in controls , but not in AD/HD . Rather , caffeine-induced arousal increases in the AD/HD group were positively related to their hyperactivity/impulsivity levels . This suggests an anomalous arousal mechanism in AD/HD functionally related to impairment in one symptom dimension Rationale Acute tryptophan depletion ( ATD ) decreases levels of central serotonin . ATD thus enables the cognitive effects of serotonin to be studied , with implication s for the underst and ing of psychiatric conditions , including depression . Objective To determine the role of serotonin in conscious ( explicit ) and unconscious/incidental processing of emotional information . Material s and methods A r and omized , double-blind , cross-over design was used with 15 healthy female participants . Subjective mood was recorded at baseline and after 4 h , when participants performed an explicit emotional face processing task , and a task eliciting unconscious processing of emotionally aversive and neutral images presented subliminally using backward masking . Results ATD was associated with a robust reduction in plasma tryptophan at 4 h but had no effect on mood or autonomic physiology . ATD was associated with significantly lower attractiveness ratings for happy faces and attenuation of intensity/arousal ratings of angry faces . ATD also reduced overall reaction times on the unconscious perception task , but there was no interaction with emotional content of masked stimuli . ATD did not affect breakthrough perception ( accuracy in identification ) of masked images . Conclusions ATD attenuates the attractiveness of positive faces and the negative intensity of threatening faces , suggesting that serotonin contributes specifically to the appraisal of the social salience of both positive and negative salient social emotional cues . We found no evidence that serotonin affects unconscious processing of negative emotional stimuli . These novel findings implicate serotonin in conscious aspects of active social and behavioural engagement and extend knowledge regarding the effects of ATD on emotional perception Objectives : This study aims to provide a better underst and ing of the motivations and actions of parents of children with non-urgent injury or illness who attend the emergency department at a tertiary paediatric hospital seeking care . Design : A prospect i ve question naire-based survey of 355 parents aim ed to ascertain information about parent care-giving and care-seeking behaviours prior to presentation at the emergency department with their child . Results : A total of 355 parents were surveyed , representing 8 % of the parents/carers presenting to the emergency department in a 3-month period for non-urgent ( Australasian Triage System 4 and 5 ) care of their child . The factors identified were : parents rated their child ’s condition as moderate to very serious ( 242 ( 68 % ) ) ; two-thirds of parents ( 234 ( 66 % ) ) had sought advice prior to attending the emergency department ; 54 % ( 77 ) of the 137 children who attended with an injury presented promptly to emergency ( ie , within 4 h of injury ) whereas of the 216 presenting with an illness , 41 % ( 88 ) presented within 2–7 days of the onset of the illness . Conclusions : This study displayed the accuracy of “ parental triage , ” that is , parents assess their child ’s health and generally engage in appropriate care-giving and care-seeking behaviours before presenting to a paediatric emergency department . Highlighted are the deficiencies in current primary care services available to families and the perception that not all cases deemed as non-urgent by the emergency department are able to be dealt with in a primary care setting The amygdala is known to play an important role in conscious and unconscious processing of emotional and highly arousing stimuli . Neuroanatomical evidence suggests that the amygdala participates in the control of autonomic responses , such as skin conductance responses ( SCRs ) , elicited by emotionally salient stimuli , but little is known regarding its functional role in such control . We investigated this issue by showing emotional visual stimuli of varying arousal to patients with left ( n = 12 ) , right ( n = 8) , and bilateral ( n = 3 ) amygdala damage and compared their results with those from 38 normal controls .  Stimuli were presented both subliminally ( using backward masking ) and supraliminally under lateralized presentation to one visual hemifield . We collected SCRs as a physiological index of emotional responses . Subjects subsequently rated each stimulus on valence and arousal under free viewing conditions . There were two key findings : ( 1 ) impaired overall SCR after right amygdala damage ; and ( 2 ) impaired correlation of SCR with the rated arousal of the stimuli after left amygdala damage . The second finding was strengthened further by finding a positive correlation between the evoked SCR magnitude and postsurgery amygdala volume , indicating impaired autonomic responses with larger tissue damage . Bilateral amygdala damage result ed in severe impairments on both of the above measures . Our results provide support for the hypothesis that the left and right amygdalae subserve different functions in emotion processing : the left may decode the arousal signaled by the specific stimulus , whereas the right may provide a global level of autonomic activation triggered automatically by any arousing stimulus ABSTRACT Background and Objectives : This study examined the effects of arousal re appraisal on cardiovascular responses , dem and and re source evaluations , self-confidence , performance and attention under pressurized conditions . A recent study by Moore et al. [ 2015 . Reappraising threat : How to optimize performance under pressure . Journal of Sport and Exercise Psychology , 37(3 ) , 339–343 . doi:10.1123/jsep.2014 - 0186 ] suggested that arousal re appraisal is beneficial to the promotion of challenge states and leads to improvements in single-trial performance . This study aim ed to further the work of Moore and colleagues ( 2015 ) by examining the effects of arousal re appraisal on cardiovascular responses , dem and and re source evaluations , self-confidence , performance and attention in a multi-trial pressurized performance situation . Design and Methods : Participants were r and omly assigned to either an arousal re appraisal intervention or control condition , and completed a pressurized dart throwing task . The intervention encouraged participants to view their physiological arousal as facilitative rather than debilitative to performance . Measures of cardiovascular reactivity , dem and and re source evaluations , self-confidence , task performance and attention were recorded . Results : The re appraisal group displayed more favorable cardiovascular reactivity and reported higher re source evaluations and higher self-confidence than the control group but no task performance or attention effects were detected . Conclusion : These findings demonstrate the strength of arousal re appraisal in promoting adaptive stress responses , perceptions of re sources and self-confidence Objectives : To underst and the role of patient-ventilator asynchrony in the etiology of sleep disruption and determine whether optimizing patient-ventilator interactions by using proportional assist ventilation improves sleep . Design : R and omized crossover clinical trial . Setting : A tertiary university medical-surgical intensive care unit . Patients : Thirteen patients during weaning from mechanical ventilation . Interventions : Patients were r and omized to receive pressure support ventilation or proportional assist ventilation on the first night and then crossed over to the alternative mode for the second night .  Polysomnography and measurement of light , noise , esophageal pressure , airway pressure , and flow were performed from 10 pm to 8 am . Ventilator setting s ( pressure level during pressure support ventilation and resistive and elastic proportionality factors during proportional assist ventilation ) were set to obtain a 50 % reduction of the inspiratory work ( pressure time product per minute ) performed during a spontaneous breathing trial . Measurements and Main Results : Arousals per hour of sleep time during pressure support ventilation were 16 ( range 2–74 ) and 9 ( range 1–41 ) during proportional assist ventilation ( p = .02 ) . Overall sleep quality was significantly improved on proportional assist ventilation ( p < .05 ) due to the combined effect of fewer arousals per hour , fewer awakenings per hour ( 3.5 [ 0–24 ] vs. 5.5 [ 1–24 ] ) , and greater rapid eye movement ( 9 % [ 0–31 ] vs. 4 % [ 0–23 ] ) , and slow wave ( 3 % [ 0–16 ] vs. 1 % [ 0–10 ] ) sleep . Tidal volume and minute ventilation were lower on proportional assist ventilation , allowing for a greater increase in Paco2 during the night . Patient-ventilator asynchronies per hour were lower with proportional assist ventilation than with pressure support ventilation ( 24 ± 15 vs. 53 ± 59 ; p = .02 ) and correlated with the number of arousals per hour ( R2 = .65 , p = .0001 ) . Conclusions : Patient ventilator discordance causes sleep disruption . Proportional assist ventilation seems more efficacious than pressure support ventilation in matching ventilatory requirements with ventilator assistance , therefore result ing in fewer patient-ventilator asynchronies and better quality of sleep Objective Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system . And among benzodiazepines , only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes . The aim of this study was to investigate the effects of single doses of lorazepam , diazepam , and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes . Methods Under prospect i ve , r and omized , and double-blind conditions , we compared the anti-intrusion effect of a single dose of lorazepam ( n=22 ) with that of diazepam ( n=22 ) and a placebo ( n=21 ) in young healthy Korean college students following exposure to a traumatic videotape . Results We present the first finding for an anti-intrusion effect of lorazepam . One day after the medication , lorazepam , rather than diazepam or the placebo , significantly reduced the extent of intrusion and data -driven processing of the traumatic information . There were no differences among the three conditions in state anxiety , depression , and an arousal scale throughout the experiment . Conclusion Results from this study suggest the possibility of lorazepam as a c and i date anti-intrusion drug , as well as the cautious use of diazepam in the treatment of PTSD patients . The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes . The present study provides support for the enhanced perceptual priming hypothesis of PTSD OBJECTIVE The diagnosis of incurable cancer may evoke physiological arousal in patients . Physiological arousal can negatively impact patients ' recall of information provided in the medical consultation . We aim to investigate whether clinicians ' affective communication during a bad news consultation will decrease patients ' physiological arousal and will improve recall . METHODS Healthy women ( N=50 ) , acting as analogue patients , were r and omly assigned to watch one out of the two versions of a scripted video-vignette of a bad news consultation in which clinician 's communication differed : st and ard vs. affective communication . Participants ' skin conductance levels were obtained during video-watching , and afterwards their recall was assessed . RESULTS While the diagnosis increased skin conductance levels in all analogue patients , skin conductance levels during the remainder of the consultation decreased more in the affective communication condition than in the st and ard condition . Analogue patients ' recall was significantly higher in the affective condition . CONCLUSION Breaking bad news evokes physiological arousal .  Affective communication can decrease this evoked physiological arousal and might be partly responsible for analogue patients ' enhanced information recall . PRACTICE IMPLICATION S Although our findings need to be translated to clinical patients , they suggest that clinicians need to deal with patients ' emotions before providing additional medical information Objective : To investigate whether listening to pleasant music improves visual attention to and awareness of contralesional stimuli in patients with unilateral neglect after stroke . Methods : A within-subject design was used with 19 participants with unilateral neglect following a right hemisphere stroke . Participants were tested in three conditions ( pleasant music , unpleasant music and white noise ) within 1 week . All musical pieces were chosen by the participants . In each condition , participants were asked to complete three sub-tests of the Behavioural Inattention Test  ( the Star Cancellation Test , the Line Bisection Test and the Picture Scanning test ) and a visual exploration task with everyday scenes . Eye movements in the visual exploration task were recorded simultaneously . Mood and arousal induced by different auditory stimuli were assessed using visual analogue scales , heart rate and galvanic skin response . Results : Compared with unpleasant music and white noise , participants rated their moods as more positive and arousal as higher with pleasant music , but also showed significant improvement on all tasks and eye movement data , except the Line Bisection Test . Conclusion : The findings suggest that pleasant music can improve visual attention in patients with unilateral neglect after stroke . Additional research using r and omized controlled trials is required to vali date these findings Insomnia is a sleeping disorder , usually studied from a behavioural perspective , with a focus on somatic and cognitive arousal . Recent studies have suggested that an impairment of information processes due to the presence of cortical hyperarousal might interfere with normal sleep onset and /or consolidation . As such , a treatment modality focussing on CNS arousal , and thus influencing information processing , might be of interest . Seventien insomnia patients were r and omly assigned to either a tele-neurofeedback ( n = 9 ) or an electromyography tele-biofeedback ( n = 8) protocol . Twelve healthy controls were used to compare baseline sleep measures . A  polysomnography  was performed pre and post treatment . Total Sleep Time ( TST ) , was considered as our primary outcome variable . Sleep latency decreased pre to post treatment in both groups , but a significant improvement in TST was found only after the neurofeedback ( NFB ) protocol . Furthermore , sleep logs at home showed an overall improvement only in the neurofeedback group , whereas the sleep logs in the lab remained the same pre to post training . Only NFB training result ed in an increase in TST . The mixed results concerning perception of sleep might be related to method ological issues , such as the different locations of the training and sleep measurements Objective : Elevated trait anger ( TRANG ; heightened propensity to experience anger ) is associated with greater pain responsiveness , possibly via associations with deficient endogenous opioid analgesia . This study tested whether acute anger arousal moderates the impact of TRANG on endogenous opioid analgesia . Methods : Ninety-four chronic low back pain ( LBP ) participants and 85 healthy controls received opioid blockade ( 8 mg of naloxone ) or placebo in a r and omized , counterbalanced order in separate sessions . Participants were r and omly assigned to undergo either a 5-minute anger recall interview ( ARI ) or a neutral control interview across both drug conditions . Immediately after the assigned interview , participants engaged sequentially in finger pressure and ischemic forearm pain tasks .  Opioid blockade effects were derived ( blockade minus placebo condition pain ratings ) to index opioid antinociceptive function . Results : Placebo condition TRANG by interview interactions ( p values < .05 ) indicated that TRANG was hyperalgesic only in the context of acute anger arousal ( ARI condition ; p values < .05 ) . Blockade effect analyses suggested that these hyperalgesic effects were related to deficient opioid analgesia . Significant TRANG by interview interactions ( p values < .05 ) for both pain tasks indicated that elevated TRANG was associated with smaller blockade effects ( less endogenous opioid analgesia ) only in the ARI condition ( p values < .05 ) . Results for ischemic task visual analog scale intensity blockade effects suggested that associations between TRANG and impaired opioid function were most evident in LBP participants when experiencing anger ( type by interview by TRANG interaction ; p < .05 ) . Conclusions : Results indicate that hyperalgesic effects of TRANG are most prominent when acute anger is aroused and suggest that endogenous opioid mechanisms contribute . TRANG = trait anger ; ARI = anger recall interview ; NCI = neutral control interview ; LBP = low back pain ; BDI = Beck Depression Inventory ; STAI = State-Trait Anxiety Inventory ; MPQ-S = McGill Pain Question naire-Sensory subscale ; MPQ-A = McGill Pain Question naire-Affective subscale ; BP = blood pressure ; FP = finger pressure ; ISC = ischemic
Our literature review identified ANS dysfunction in individuals with ADHD , more often in the direction of hypo-arousal than hyper-arousal , particularly at rest and during tasks requiring response regulation and sustained attention .
Stimulant medications  increased ANS activity and , in some studies , reinforcers and rewards produced a similar effect , suggesting that ANS function can be modified in ADHD .
Although arousal mechanisms have frequently been found to be atypical in ADHD , these findings usually emerged from indirect behavioural measures which give only a limited underst and ing of arousal dysregulation in this condition .