The hypothesis that the animal model of inescapable shock (IES) is an appropriate model for posttraumatic stress disorder (PTSD) predicts that re-exposure to a traumatic stressor will precipitate opioid-mediated stress-induced analgesia in people with PTSD. Eight Vietnam veterans with PTSD and eight matched veterans without PTSD viewed a combat videotape under naloxone and placebo conditions in a randomized double-blind crossover design. In the placebo condition, but not after naloxone, the PTSD subjects reported a 30 percent decrease in pain intensity ratings of standardized heat stimuli after the combat videotape. Point biserial correlations revealed that change in pain perception was the most highly correlated with PTSD of all variables tested, including biochemical, physiological, and self-report. These results suggest that a centrally mediated opioid response to traumatic stimuli is an important feature of PTSD. Possible implications of this finding for the psychobiology of PTSD are discussed.
Two experiments investigated the impact of potential supporters' relationship to a crime victim (communal—very close friend, exchange—casual acquaintance) and the victim's emotional reactions (fear, sadness, or anger) on appraisal of the victim's needs, the costs of helping, and intentions to offer assistance. Results of the first experiment (N = 246 women), which involved a robbery victim, showed that those in a communal relationship judged the victim to be more needy, whereas those in an exchange relationship judged the costs of helping to be greater. Communal participants expressed stronger intentions to offer help. The victim's emotional reaction influenced appraisals of need (anger < fear and sad) and intentions to help (anger < sad), but not appraisals of costs. Needs and costs were significantly correlated with intentions for those in the communal and exchange conditions. These results were essentially replicated in the second study, which included modifications designed to correct for alternative explanations of the results and to test the generalizability of the findings to other types of crime victims (burglary). Results from Study 2 (N = 233 women) yielded interaction effects for needs and costs, indicating that whether communal participants perceived the victim to be more needy, or whether exchange participants judged the costs of helping to be higher, depended on the type of emotion expressed by the victim. Regardless of their relationship to the victim, participants expressed the weakest intentions to assist the angry victim.
Oral symptoms of multiple myeloma are common. A patient with refractory multiple myeloma is described because of his unusual orofacial manifestations, including severe intraoral hemorrhage, a massive, erosive maxillofacial lesion with extension into the cranial fossa, and rapid growth of a large intraoral mass . Summary This case report describes the presentation and management of a patient with end‐stage multiple myeloma and severe intraoral hemorrhage. It is interesting because of the rapid growth of the mass, the extension into the para‐nasal sinuses and cranial fossa, and the threatening intraoral hemorrhage. The noninvasive management of this patient's bleeding and evaluation of the mass was essential to minimize the possibility of exacerbating the life‐threatening hemorrhage.
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