Cocaine (2.0 milligrams per kilogram) given by the oral route is at least as effective as the same dose given intranasally. Cocaine is not detected in the plasma until 30 minutes after oral administration, but peak plasma concentrations are similar after both routes. The subjective "highs" in man are greater after oral than after intranasal administration.
32 applicants to the Drug Dependence Unit of the Connecticut Mental Health Center were administered Level of Aspiration Board Tasks. The results indicated that, relative to applicants (12 males, 4 females) who actually entered treatment programs, applicants (14 males, 2 females) who failed to enter were significantly less realistic and less cautious in terms of their achievement aspiration.
We compared the psychological effects of three doses of intranasal cocaine hydrochloride (.2, .75, and 1.5 mg/kg) with cocaine plasma concentrations in four volunteers. Intranasal lidocaine hydrochloride (.2 mg/kg) was used as a topically active placebo. Peak “high” ratings were related to both dose and peak plasma concentrations. At a given plasma concentration, “high” ratings were greater when plasma levels were increasing than when they were decreasing. This indicates that acute tolerance by tachyphylaxis occurred after single doses. The cocaine “high” was a pleasant feeling but was without distinctive sensations. The dramatic effects of intranasal cocaine on the street may be related to larger or repeated doses as well as the setting.
One hundred consecutive outpatients undergoing radiation therapy were prospectively studied using the Locus of Control Inventory designed by Rotter and a questionnaire covering various aspects of diagnosis, implications of disease, and details of therapy. The Locus of Control Inventory, which measures a person's belief that life's important events are controlled by personal effort (internality) as opposed to factors outside of one's control (externality), revealed a significant difference between men and women in this study. Although women were similar to the general healthy population, men expressed a greater sense of control as their radiation therapy progressed. Men were also more likely to characterize their illness as not very serious and to deny knowledge of their correct diagnoses or details of their treatment. With survival determined at two years following the study, it was found that living and deceased women had initially rated the seriousness of their illnesses appropriately, while deceased men had rated their illnesses as significantly less serious than women or surviving men. It is concluded that sexual differences in coping mechanisms may be accentuated by malignancy and men may actively deny their diagnosis and its implications. This amount of denial and sense of personal control in the face of a potentially fatal illness may indicate a need for more supportive clinical intervention for the radiation therapy patient.
In a prospective study to identify psychological factors affecting survival in cancer patients receiving radiation therapy, 101 consecutive patients were evaluated for anxiety, depression, and perception of the seriousness of the condition. In 3 years, the survivors were compared to the nonsurvivors. The survivors had significantly higher mean trait anxiety (p < 0.05) than the nonsurvivors. State anxiety and depression scores also tended to be higher in the survivors (p < 0.01). Self-assessment of the seriousness of their disease did not differentiate the two groups. The nonsurvivors had significantly more pain (p < 0.05). Within the nonsurvivor group, survival time was negatively correlated with state anxiety (p < 0.01), trait anxiety (p < 0.02), and depression (p < 0.01). In the nonsurvivors, women rated their condition to be significantly more serious than men (p < 0.01). Female nonsurvivors tended to rate their condition to be more serious than female survivors (p < 0.1), while male nonsurvivors rated their condition to be significantly less serious than male survivors (p < 0.01). Only among female nonsurvivors did the seriousness rating correlate significantly with anxiety (p < 0.01). The sex differences confirm our previous finding that men may tend to cope with cancer with more massive denial than women. We hypothesize that patients with higher anxiety and depression in the nonsurvivor group had a massive defensive failure, while those who had high anxiety levels in the survivor group had been more realistic about their disease. Our results imply that realistic anxiety may be adaptive in cancer patients, and that massive denial may be a poor prognostic sign, particularly among men. We also suggest, however, that anxiety per se is not necessarily a good prognostic sign in cancer patients but that if anxiety occurs in the context of massive defensive failure, it may be predictive of poorer outcome.
We compared the locus of control scores of the following groups: (1) 19 male borderline hypertensives volunteering for biofeedback treatment; (2) 100 consecutive males who were screened for hypertension; (3) 30 male cancer patients receiving radiation therapy, and (4) the normative data from college students. The biofeedback volunteer group was significantly more internal in locus of control as compared to all other groups. The locus of control of the borderline hypertensives within the screened population did not differ from the normotensives, but the screened population as a whole had a relatively internal locus of control. Our findings imply that the 'internals' may be more attracted to self-control treatments like biofeedback, and data generated from this particular population may have limited generalizability, especially in regard to 'externals'.
