Indiana University-Purdue University Indianapolis (IUPUI) / Marijuana use is associated with many health risks, but is increasingly becoming more accepted; thus, use rates, as well as negative consequences, are growing. There is a need to better understand marijuana use behaviors so as to reduce its negative effects. The current study sought to test the viability of applying urgency theory to marijuana use behaviors by examining several pathways among negative urgency, marijuana-related attentional bias, coping motives, and marijuana use behaviors, across men and women. Participants (n=120, mean age= 26.61 years (SD=9.28), 50% women, 63% White/Caucasian) were recruited from the Indianapolis, IN area to participate in a cross-sectional study in which they completed self-report measures and a visual-probe computer task with eye-tracking following negative mood induction. Regression analyses and the PROCESS macro were used to examine study hypotheses. Several pathways were supported: Negative urgency was significantly associated with coping motives (β=0.24, p=0.01), coping motives were significantly associated with marijuana use behaviors (ΔR2= 0.55, p<0.01), and a serial mediation model was supported, in which the relationship between negative urgency and negative marijuana consequences was mediated by coping motives and then by marijuana use frequency (c’= 0.20, 95%CI= 0.06 to 0.50). Competing models were examined and not supported. There were no statistically significant pathways involving the attentional bias measures; although there was a pattern of small effect sizes demonstrating that attentional biases may relate to marijuana use behaviors in men and not in women. Findings from the current study serve as preliminary support for applying urgency theory to marijuana use behaviors. Overall, these findings suggest that negative urgency is a distal risk factor that influences the development of other, more proximal, predictors of marijuana use and negative marijuana consequences. Future studies should examine the time order of these relationships longitudinally to replicate and provide more confidence in the causal order of the model supported in the present study.

No description available.

Background: Storage lower urinary tract symptoms (LUTS) including overactive bladder (OAB) and urinary incontinence (UI) affect millions of people worldwide, significantly impacting quality of life. Plant based medicines have been documented both empirically and in emerging scientific research to have varying benefits in reducing bladder symptoms. We assessed the efficacy of Urox (R), a proprietary combination of phytomedicine extracts including, Cratevox (TM) (Crataeva nurvala) stem bark, Equisetem arvense stem and Lindera aggregata root, in reducing symptoms of OAB and UI. Methods: Efficacy of the herbal combination on a variety of bladder symptoms compared to an identical placebo, were documented in a randomised, double-blind, placebo controlled trial conducted at two primary care centres. Data were collected at baseline, 2, 4 and 8 weeks, with the primary outcome being self-reported urinary frequency. Statistical analysis included mixed effects ordered logistic regression with post hoc Holm's test to account for repeated measures, and included an intention-to-treat analysis. Results: One hundred and fifty participants (59% female, aged; mean +/- SD; 63.5 +/- 13.1 years) took part in the study. At week 8, urinary day frequency was significantly lower (OR 0.01; 95%CI 0.01 to 0.02; p < 0.001) in response to treatment (mean +/- SD; 7.69 +/- 2.15/day) compared to placebo (10.95 +/- 2.47/day). Similarly, episodes of nocturia were significantly fewer (OR 0.03; 95%CI 0.02 to 0.05) after 8 weeks of treatment (2.16 +/- 1.49/night) versus placebo (3.14 +/- 1.36/night). Symptoms of urgency (OR 0.02; 95%CI 0.01 to 0.03), and total incontinence (OR 0.03; 95%CI 0.01 to 0.06) were also lower (all p < 0.01) in the treatment group. Significant improvements in quality of life were reported after treatment in comparison to placebo. No significant side effects were observed resulting in withdrawal from treatment. Conclusions: The outcome of this study demonstrated both statistical significance and clinical relevance in reducing symptoms of OAB, urinary frequency and/or urgency and incontinence. The demonstrated viability of the herbal combination to serve as an effective treatment, with minimal side-effects, warrants further longer term research and consideration by clinicians.

Indiana University-Purdue University Indianapolis (IUPUI) / Negative urgency, defined as a tendency to act rashly under extreme negative emotion, is strongly associated with tobacco use. Despite the robust cross-sectional and experimental evidence linking negative urgency and tobacco use, neural correlates of negative urgency in tobacco use have not been studied. The purpose of the current study was to 1) identify neural circuits that differ between tobacco users and non-tobacco users and 2) explore the relationship between resting-state seed-based functional connectivity (rsFC) and negative urgency, both in the overall group and between tobacco users and non-tobacco users. Using negative urgency-related brain regions as seed regions (voxel level p = .005, cluster-level a < .05), compared to non-tobacco users (n = 21; mean age = 36.57, 62% female, 76% white), tobacco users (n = 22; mean age = 37.50, 64% female, 77% white) had stronger rsFC strengths in the right amygdala – left medial orbitofrontal cortex/ventromedial prefrontal cortex circuit and the right nucleus accumbens – right temporoparietal junction circuit. Additionally, rsFC in the bilateral temporal pole – left supramarginal gyrus circuits was positively correlated with negative urgency (Left temporal pole: r = .55, p < .001; Right temporal pole: r = .51, p < .001). The current study extends previous neuroimaging findings, which have mainly focused on how negative urgency is related to brain responses in localized, segregated brain regions, by examining the network-level interactions between different brain regions. This study provides prime preliminary data for future neuroimaging studies of negative urgency by providing potential target networks that would aid the development of novel intervention strategies for negative urgency-based maladaptive behaviors.

Indiana University-Purdue University Indianapolis (IUPUI) / The relationship between positive urgency, a personality trait reflecting rash action during extreme positive emotional states, and risk-taking has previously been experimentally examined. However, how positive urgency is related to risk-taking while under the acute influence of alcohol has not been examined. The overarching goal of this dissertation was to generate behavioral evidence concerning how the interaction between positive urgency and alcohol consumption influences risk-taking via changes in emotional arousal. In this study, 59 community dwelling adults (mean age = 29.45 (SD = 10.96), 32.2% women, 78% White) completed mood induction procedures (positive or neutral) while consuming a beverage (alcohol or placebo) and then completed the Balloon Analogue Risk Task (BART) as a measure of risk-taking. The positive mood induction was effective in inducing high arousal positive emotions. Overall, study hypotheses were not supported; however, because of low power, effect sizes and patterns of relationship are reported. The relationship between positive urgency and risk-taking was positive and small in the positive mood condition but negative and small in the neutral mood condition. The alcohol group and the placebo group showed similar patterns of risk-taking that are positive and small. Finally, the relationship between positive urgency changes in emotional arousal was positive and small only in the positive/alcohol condition; however, there was no relationship between changes in emotional arousal and risk-taking. These findings suggest that, while changes in emotional arousal may result from a combination of positive urgency and alcohol consumption, it may not be a focal mechanism that explains the relationship between positive urgency and risk-taking. Further, positive urgency is a risk factor whether or not alcohol consumption is present. Although the small sample size limited the power to test the hypotheses, the effect size estimates obtained in this study provide preliminary data for a more properly powered future study. The pattern of findings suggests the viability of further developing the current positive mood induction to establish a lab-based paradigm for positive urgency and the use of a different experimental risk-taking task to examine positive emotion-based risk-taking.

Indiana University-Purdue University Indianapolis (IUPUI) / Two impulsivity-related traits, negative and positive urgency (i.e., the tendency to act rashly in the face of extreme negative and positive emotions, respectively) are important risk factors for alcohol use escalation during college and for problematic and disordered level alcohol use, in part through increasing motives for alcohol use. The majority of research to date has focused on the causal direction from trait to motives to alcohol consumption. The goal of the current study was to conduct an initial test of how continued and escalating alcohol use may drive increases and shifts in positive and negative urgency, and how such changes drive subsequent increased drinking motives over the first year of college. Data were analyzed using an archival dataset of 418 first-year college students (age 18-21) enrolled in an introduction to psychology course at a large Midwestern university. Participants were sampled at three timepoints: at the beginning of the fall semester, the end of the fall semester, and the end of the spring semester. A series of hierarchical multiple regression and mediation analyses were used to test study hypotheses. Changes in alcohol use did not predict later changes in positive and negative urgency. Results did replicate previous research showing that changes in positive and negative urgency predicted later changes in drinking motives. Finally, there was some evidence that alcohol use at baseline predicted changes in enhancement drinking motives through changes in positive urgency; but this pattern was not seen with negative urgency. This work extends existing work with urgency theory, which has primarily focused on the effects of urgency on subsequent alcohol consumption and not the inverse. The fact that alcohol use drives subsequent changes in positive urgency and drinking motives can help to better identify mechanisms contributing increased risk for transition to problematic levels of alcohol consumption, can lead to better identification of those at risk for problematic alcohol use and can set the stage to better integrate urgency theory with other well-established alcohol risk models.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O dispositivo da emergência psiquiátrica, com o predomínio do discurso médico, apresenta uma tendência a responder à crise de maneira a adotar condutas previamente estabelecidas e de rápida ação, como a medicalização, contenção e internação. A presente dissertação se propõe a trazer as contribuições que a psicanálise pode ofertar a este campo clínico, no sentido de favorecer a emergência do sujeito em uma ocasião de crise. Nesta perspectiva, trabalhamos alguns conceitos clínicos fundamentais ao estudo do tema proposto, tais como: sujeito da psicanálise, angústia, sintoma, passagem ao ato, acting out, entre outros. Todos estes perpassam esta clínica tão específica e podem contribuir para que o atendimento na emergência deixe de ter como exclusivo objetivo a eliminação da crise. Afinal, levar em conta a urgência subjetiva é trabalhar com a direção de que a crise pode ser um momento rico, na medida em que o sujeito pode vir a se responsabilizar e se reposicionar frente ao que o acomete. / Psychiatric urgency, with a predominance of the medical discourse, shows a tendency of responding to crises by adopting previously defined quick-action medical conducts, such as medication, immobilization and hospitalization. The purpose of the present dissertation is to present the contributions offered by psychoanalysis to this clinical field, so as to favor the urgency of the subject in the event of a crisis. From this perspective, we have worked on a few fundamental clinical concepts for the study of the proposed theme, such as the psychoanalysis subject, anguish, symptom, passage to act, acting out, among others. All these permeate such a specific clinic and may contribute for the understanding that urgency care shall not exclusively aim at the elimination of the crisis. After all, considering subjective urgency is to assume a direction in which the crisis may be an important moment, as the subject may hold a new position and take the responsibility for what is going on.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O dispositivo da emergência psiquiátrica, com o predomínio do discurso médico, apresenta uma tendência a responder à crise de maneira a adotar condutas previamente estabelecidas e de rápida ação, como a medicalização, contenção e internação. A presente dissertação se propõe a trazer as contribuições que a psicanálise pode ofertar a este campo clínico, no sentido de favorecer a emergência do sujeito em uma ocasião de crise. Nesta perspectiva, trabalhamos alguns conceitos clínicos fundamentais ao estudo do tema proposto, tais como: sujeito da psicanálise, angústia, sintoma, passagem ao ato, acting out, entre outros. Todos estes perpassam esta clínica tão específica e podem contribuir para que o atendimento na emergência deixe de ter como exclusivo objetivo a eliminação da crise. Afinal, levar em conta a urgência subjetiva é trabalhar com a direção de que a crise pode ser um momento rico, na medida em que o sujeito pode vir a se responsabilizar e se reposicionar frente ao que o acomete. / Psychiatric urgency, with a predominance of the medical discourse, shows a tendency of responding to crises by adopting previously defined quick-action medical conducts, such as medication, immobilization and hospitalization. The purpose of the present dissertation is to present the contributions offered by psychoanalysis to this clinical field, so as to favor the urgency of the subject in the event of a crisis. From this perspective, we have worked on a few fundamental clinical concepts for the study of the proposed theme, such as the psychoanalysis subject, anguish, symptom, passage to act, acting out, among others. All these permeate such a specific clinic and may contribute for the understanding that urgency care shall not exclusively aim at the elimination of the crisis. After all, considering subjective urgency is to assume a direction in which the crisis may be an important moment, as the subject may hold a new position and take the responsibility for what is going on.

Negative emotions can be challenging to regulate, and for some individuals can lead to failures of behavior regulation. The present study is an initial effort to explore the role that mindfulness may play in fostering effective behavior regulation among those prone to high negative urgency (NU). Eighty undergraduate students were recruited based on their high or low scores of NU. First, participants completed a self-report measure of mindfulness (Mindful Attention Awareness Scale; MAAS), an Emotional Go/No Go task in an fMRI scanner, and then reported alcohol consumption. Results showed that those with high in NU had low levels of mindfulness compared to those low in NU. Mindfulness predicted substance use at the one- month follow-up after controlling for the predictive roles of NU and gender. Further exploration of the underlying neural mechanisms of mindfulness is needed to better understand its impact on emotion- and self-regulatory processes, especially during difficult emotional experience.

A triagem de emergência tem como objetivo dar prioridade aos pacientes mais graves e melhorar a prestação do serviço de emergência, garantindo atendimento no momento adequado, melhor fluxo e segurança. Os objetivos deste trabalho foram traduzir e validar a parte referente às emergências odontológicas do instrumento para triagem de emergência Manchester Triage System (MTS) na língua portuguesa, avaliar a confiabilidade interobservadores e o impacto da aplicação do MTS no Setor de Urgência Odontológica da Faculdade de Odontologia da Universidade de São Paulo. O MTS foi traduzido através do método padrão de tradução/ retrotradução. A versão foi submetida à validação semântica e idiomática e também conceitual e cultural, feita por um comitê de juízes. Em ambas, a concordância final observada após os ajustes realizados foi superior a 80%. Na concordância interobservadores, 200 pacientes participaram das entrevistas realizadas por 2 voluntários independentes com conhecimentos em odontologia e a pesquisadora. Os coeficientes kappa foram de 0.58 e 0.60. Inicialmente foram entrevistados 120 pacientes sem a aplicação do MTS e em seguida 139 pacientes categorizados de acordo com a prioridade clínica. Houve diminuição no tempo médio de espera para atendimento, de 79.96 min para 36.86 min (Mann-Whitney (MW), p=0.00) e aumento do tempo médio de duração do atendimento, de 29.11 min para 34.78 min (MW, p=0.05). Dentre os pacientes categorizados segundo o MTS, os não-urgentes eram mais velhos (MW, p=0.01), tiveram menor duração de atendimento (MW, p=0.00) e menor intensidade de dor (MW, p=0.00). A versão traduzida e validada do MTS mostrou-se adequada e sua aplicação e útil no atendimento de pacientes do Setor. / The emergency triage aims to assign clinical priority to the patients and to improve emergency services, ensuring attendance at the right time, better patient flow and safety. The objectives of this study were to translate and validate part of the Manchester Triage System (MTS) related to dental emergency in Portuguese, to assess the inter-rater reliability and to evaluate the impact of implementation of triage at Setor de Urgência Odontológica of Faculdade da Odontologia of Universidade de São Paulo. The MTS was translated using the standard translation/ back-translation method. The instrument was then submitted to semantic and idiomatic validation, as well as conceptual and cultural validation by a committee of judges. In both, the final concordance after the adjustments was higher than 80%. In the inter-rater agreement, 200 patients were interviewed by two independent volunteers with some knowledge of dentistry and the researcher. The kappa coefficients were 0.58 and 0.60. Then 120 patients were interviewed without the application of the MTS and 139 patients were categorized according to their clinical priority. There was a reduction in the mean waiting time, from 79.96 min to 36.86 min (Mann-Whitney test (MW), p=0.00) and an increase in the mean of treatment duration, from 29.11 min to 34.78 min (MW, p=0.05). Among triaged patients, the non-urgent were older (MW, p=0.01), had shorter duration of treatment (MW, p=0.00) and lower pain intensity (MW, p=0.00). The translated and validated version of the MTS showed to be appropriate and useful in categorization of patients with dental emergencies in this setting.