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Connecting Prosocial Behavior to Improved Physical Health: Contributions from the Neurobiology of Parenting.
Abstract
Although a growing body of evidence suggests that giving to (helping) others is linked reliably to better health and longevity for the helper, little is known about causal mechanisms. In the present paper we use a recently developed model of caregiving motivation to identify possible neurophysiological mechanisms. The model describes a mammalian neurohormonal system that evolved to regulate maternal care, but over time may have been recruited to support a wide variety of helping behaviors in humans and other social animals. According to the model, perception of need or distress in others activates caregiving motivation, which in turn, can facilitate helping behavior. Motivational regulation is governed by the medial preoptic area of the hypothalamus, interacting with certain other brain regions, hormones, and neuromodulators (especially oxytocin and progesterone). Consideration of neurohormonal circuitry and related evidence raises the possibility that it is these hormones, known to have stress-buffering and restorative properties, that are responsible, at least in part, for health and longevity benefits associated with helping others.
Copyright © 2015. Published by Elsevier Ltd.
... In the United States, one in four adults 50 and older volunteers through an organization, generating approximately 73.5 billion dollars of economic benefits for their communities (AmeriCorps, 2021). Theoretical frameworks and empirical research demonstrate that this form of prosocial activity is also beneficial for the volunteers" health and well-being (Brown & Brown, 2015;Burr et al., 2018;Kim et al., 2020;Morrow-Howell et al., 2017). In particular, volunteer activity has a potentially "calming" effect on the cardiovascular system and is associated with better cardiovascular outcomes, including lower risk of hypertension, lipid dysregulation, chronic inflammation, heart failure, and cardiovascular diseases (CVD) (Bell et al., 2022;Burr et al., 2018;Burr et al., 2015;Kim & Ferraro, 2014;Sneed & Cohen, 2013). ...
... Volunteering for one event and actively volunteering for ten years might have different implications for CVD health (Bell et al., 2022). Theoretical frameworks and empirical studies suggest that helping behaviors directly influence the cardiovascular system (Brown & Brown, 2015). However, it is unknown whether sustained volunteering influences changes in CVD biomarkers. ...
... Then how does volunteering "get under the skin" and affect CVD biomarkers? A cogent explanation comes from the caregiving system model and similar theoretical frameworks rooted in cross-disciplinary literature on prosocial helping behaviors (Brown & Brown, 2015;Eisenberger & Cole, 2012;Inagaki, 2018). These perspectives characterize prosocial helping behaviors, including volunteering, as extensions of parental caregiving behavior provided to offspring, where a cascade of neurohormonal mechanisms are theorized to facilitate caregiving behavior and reduce stress and withdrawal (Brown & Brown, 2015;Inagaki, 2018). ...
Using data from 2006-2016 waves of the Health and Retirement Study, we investigated whether changes in volunteering were associated with seven cardiovascular biomarkers four years later. Outcome-wide approaches were used to test this link, while adjusting for demographic factors, socioeconomic status, health behaviors, chronic conditions, and baseline biomarkers and volunteering. Additionally, selection into volunteering and attrition were taken into account.
Compared to non-volunteers, volunteering more than 200 hours a year was associated with a lower risk for clinically high diastolic blood pressure. In addition, increased volunteering effort (change from 1-99 hours at t0 to >100 hours at t1) was associated with a lower likelihood of clinically high systolic and diastolic blood pressure levels. Sustained high volunteering (>100 hours at both t0 and t1) was associated with lower diastolic blood pressure.
... Nonetheless, CFT targets the specific activation and cultivation of compassion motivation as the framework for interventions because it evolved with neuroand psychophysiological regulators (e.g. oxytocin and changes to the vagus nerve; Carter et al., 2017) that have profound effects on a range of physical and mental health parameters (Brown and Brown, 2015;Mayseless, 2016;Seppälä et al., 2017;Vrtička et al., 2017). These facilitate prosocial behaviours and the building of caring supportive relationships that have health and wellbeing benefits Seppälä et al., 2017;Gilbert and Simos, 2022). ...
... Caring and compassion motives evolved for very different reasons than those for conflict competition and have very different impacts on brain states and reciprocal interactions (Gilbert, 1989(Gilbert, /2016(Gilbert, , 2020bGoetz et al., 2010;Mayseless, 2016). One of the primary functions of caring is to provide resources that support the survival of offspring into adulthood (Brown and Brown, 2015;Cassidy and Shaver, 2016;Music, 2017). The evolution of attachment behaviour brought with it competencies to be sensitive to the developmental needs of offspring, such as for feeding, thermoregulation and protection and provide for their psychophysiological maturation and development. ...
... Crucially, empathic caring stimulates important psychophysiological systems (as noted above) that enable the child to become caring of themselves and others and are linked to health and wellbeing (Brown and Brown, 2015;Mayseless, 2016;Music, 2017;Siegel, 2020;Ellis et al., 2021). Tragically when these inputs are not provided, and the child experiences non-empathic, hostile or neglectful 'caring' these impact their epigenetic profiles (Cowan et al., 2016), various neurocircuits (Lippard and Nemeroff, 2020), the basic psychophysiological core algorithms for enabling emotion and self-regulation, and the competencies to enter social life socially confident (Music, 2017;Siegel, 2020). ...
Background
Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators.Methods
Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points.ResultsAlthough changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one’s fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships.Conclusion
Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from ‘intellectually’ understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.
... The immune system can also be negatively impacted by lack of prosocial behavior (37). Studies have found that individuals who engage in prosocial activities have stronger immune system, which can help to protect against a variety of health conditions (38). Neurohormonal circuitry in caregivers, particularly oxytocin and progesterone, may contribute to the health and longevity benefits associated with helping others due to their stress-buffering and restorative properties (38). ...
... Studies have found that individuals who engage in prosocial activities have stronger immune system, which can help to protect against a variety of health conditions (38). Neurohormonal circuitry in caregivers, particularly oxytocin and progesterone, may contribute to the health and longevity benefits associated with helping others due to their stress-buffering and restorative properties (38). Engaging in prosocial activities has been shown to reduce levels of cortisol (39) and inflammation (40), which are key factors in many chronic health conditions. ...
Prosocial values play a critical role in promoting care and concern for the well-being of others and prioritizing the common good of society. Evidence from population-based reports, cognitive neuroscience, and clinical studies suggests that these values depend on social cognition processes, such as empathy, deontological moral cognition, moral emotions, and social cooperation. Additionally, indirect evidence suggests that various forms of prosocial behaviors are associated with positive health outcomes at the behavioral, cardiovascular, immune, stress-related, and inflammatory pathways. However, it is unclear whether prosociality can positively influence brain health outcomes. In this perspective, we propose that prosocial values are not only influenced by brain conditions but could also potentially play a role in protecting brain health. We review studies from various fields that support this claim, including recent reports of prosociality-based interventions impacting brain health. We then explore potential multilevel mechanisms, based on the reduction of allostatic overload at behavioral, cardiovascular, immune, stress-related, and inflammatory levels. Finally, we propose potential prosociality-based interventions for improving brain health in at-risk populations, such as psychiatric and neurological patients, and individuals exposed to poverty or violence. Our perspective suggests that prosocial values may play a role in promoting and maintaining healthy brains.
... This model was originally developed based on research regarding maternal care and its associated neurohormonal effects. Since then, this model has been generalized to other types of prosocial helping behaviors, including volunteering (Brown and Brown, 2015), and has been supported by recent studies using survey data from older adults (Han et al., 2018;Poulin, 2014). Many diseases of later adulthood, including heart disease, diabetes, Alzheimer's disease, stroke, and cancer, share chronic inflammation and immune dysregulation as risk factors (Brown and Brown, 2015). ...
... Since then, this model has been generalized to other types of prosocial helping behaviors, including volunteering (Brown and Brown, 2015), and has been supported by recent studies using survey data from older adults (Han et al., 2018;Poulin, 2014). Many diseases of later adulthood, including heart disease, diabetes, Alzheimer's disease, stroke, and cancer, share chronic inflammation and immune dysregulation as risk factors (Brown and Brown, 2015). Thus, volunteering may buffer the effects of stress on increased disease risk via decreasing the harmful impact of stress on inflammation and immune response. ...
Background
Volunteering is associated with improved health and well-being outcomes, including a reduced risk of mortality. However, the biological mechanisms underlying the association between volunteering and healthy aging and longevity have not been well-established. We evaluated if volunteering was associated with reduced epigenetic age acceleration in older adults.
Methods
We evaluated associations between volunteering and age acceleration, measured by 13 DNA methylation (DNAm) “epigenetic clocks” in 4,011 older adults (Mage=69 years; SDage=10 years) who participated in the Health and Retirement Study. We assessed nine first-generation clocks (Horvath, Hannum, Horvath Skin, Lin, Garagnani, Vidalbralo, Weidner, Yang, and Bocklandt, which predict chronological age) and four second-generation clocks (Zhang, PhenoAge, GrimAge, and DunedinPoAm, which predict future disease or longevity). We quantified the total associations between volunteering and DNAm age acceleration as well as the extent to which these associations might be attributable to potential confounding by individual demographics (e.g., race), social demographics (e.g., income), health factors (e.g., diabetes), and health behaviors (e.g., smoking).
Results
Volunteering was associated with reduced epigenetic age acceleration across 6 epigenetic clocks optimized for predicting health and longevity (False Discovery Rate [FDR] q < 0.0001 for epigenetic clocks: PhenoAge, GrimAge, DunedinPoAm, Zhang mortality, Yang mitotic; FDR q < 0.01: Hannum). These associations were mostly independent of demographic and health factors, but substantially attenuated after adjusting for health behaviors.
Conclusion
Volunteering was associated with reduced epigenetic age acceleration in 6 of 13 (mostly second-generation) epigenetic clocks. Results provide preliminary evidence that volunteering might provide health benefits through slower biological aging and implicate health behaviors as one potential mechanism of such effects.
... Prosocial behaviour refers to a kind of behaviour performed voluntarily to benefit others (Eisenberg et al., 2006;Holmgren et al., 1998). Prosocial individuals gain a series of positive outcomes, including good physical health (Brown & Brown, 2015), positive emotions (Snippe et al., 2017) and subjective well-being (Moynihan et al., 2015). ...
... In order to cope with the stress in moral situations, individuals may display prosocial behaviour (Gebauer et al., 2008;Gu et al., 2013). Although prosocial behaviour is a costly behaviour, it is still related to many positive outcomes such as good physical health (Brown & Brown, 2015), positive emotions (Snippe et al., 2017), subject well-being (Moynihan et al., 2015) and social acceptance (Greener, 2000). Prosocial behaviour can also reduce mental and physiological stress (Inagaki & Eisenberger, 2016;Li & Xie, 2017;Raposa et al., 2016). ...
Physiological studies of prosocial behaviour have indicated an association between resting heart rate variability and prosocial behaviour. Little is known about whether real-time heart rate in prosocial behavioural processes is associated with prosocial behaviour and whether their association depends on subjective experiences in prosocial behavioural processes. To clarify these issues, 60 adults were recruited in the present study and completed the dictator game, trust game and social value orientation game, which measure prosocial behaviour. Their real-time heart rate was measured with the electrocardiogram (ECG) module of Biopac MP150, and their perceived stress was self-reported. The results showed regular changes in heart rate in the prosocial behavioural processes, with heart rate reaching a peak at the prosocial decision-making stage. Moreover, only for individuals with higher perceived stress at the prosocial decision-making stage was there an inverted U-shaped relationship between heart rate at the prosocial decision-making stage and dictator game scores, which reflect altruistic prosocial behaviour. These findings revealed that real-time physiological arousal and subjective experience jointly determine altruistic prosocial behaviour.
... In addition, a growing body of evidence from several large-scale studies indicates that family caregivers may experience reduced mortality rates compared to their noncaregiving counterparts (Roth et al., 2018). This fi nding has led some researchers to posit caregiving as a potential bu er from the negative e ects of stress, complicating the picture of caregiving and its relationship with well-being (Brown & Brown, 2015;Roth et al., 2018). ...
... The research outlining potential benefi ts associated with caregiving is largely grounded in frameworks that highlight the e ects of prosocial helping behaviors on health and well-being. These studies indicate that providing emotional or practical forms of assistance improves well-being across a variety of indices, including mental, physical, and relational health ( Brown et al., 2003;Brown & Brown, 2015). The value of prosocial helping behaviors to create and maintain personal relationships manifests in several communication theories as well, including a ection exchange theory (Floyd et al., 2010), the theory of resilience and relational load ( Afi fi et al., 2016), and the idea of relational maintenance in interpersonal relationships (Canary & Sta ord, 1992). ...
This chapter explores the current research on informal caregiving, its challenges and benefits, and potential mechanisms for intervention to improve caregiving communication and outcomes.
... Importantly, unlike other forms of caring this form of caring is less tribally constrained in that (for example) in disaster areas, and even in war, people will rescue and try to heal the injured regardless of whether they know them or not. 2. A second route to care and compassion was via attachment and the care of offspring (Bowlby, 1969;Cassidy & Shaver, 2016;Gilbert, 1989;Hrdy, 2009;Narvaez & Bradshaw, 2023;Porges, 2021). The parent, primarily the mother, is highly sensitive to the distress and needs of her infants and will provide them with physical resources (food and warmth) and also psychological guidance (Mayseless, 2016). ...
The editors to this volume posed a series of fascinating questions relating to how seeing compassion as a skill can help us understand its nature, cultivation and effects within secular contexts. This paper addresses these questions by comparing evolutionary with contemplative approaches to compassion. Recent scientific approaches have explored the evolved roots and biopsychosocial manifestations of compassion and their impact on mental states and prosocial behaviour, particularly in regard to both its facilitators and inhibitors. In contrast, we discuss how the contemplative traditions have approached the origins and cultivation of compassion through observing the mind (e.g. meditation), with a focus on gaining insight into self-transcendent experiences, the nature of inter-connectivity and non-separate existence (also referred to as non-duality), through which compassion arises naturally. Both evolutionary and contemplative perspectives have the same focus which is to understand and prevent the causes of suffering, including the suffering we cause ourselves because of our harmful potentials. However, in terms of training the mind in compassion skills, this paper considers how training approaches linked to the evolutionary model often use thinking, empathising, reflecting and guided behaviour change to activate psychophysiological systems linked to caring and compassion. In contrast, the contemplative traditions focus less on thinking and reflecting and more on creating conditions for direct experiencing. A key reason for doing so is to settle the mind so that subtler levels of consciousness can enable the experience of self-transcendent compassion to arise. Thus, both evolutionary and contemplative approaches can focus on developing mind awareness and the importance of practise, but evolutionary approaches such as compassion focused therapy do not pursue transcendent wisdoms or insights.
... Specifically, the processing of emotional stimuli (e.g., emotional expressions) is essential for successful social interaction (Jack & Schyns, 2015;Keltner et al., 2019), as the human processing of social behavior is based on the constant practice of attributing mental states from emotional expressions (e.g., facial, verbal) in what has been widely called Theory of Mind (Brüne & Brüne-Cohrs, 2006;Molenberghs et al., 2016). Social affective stimuli are preferentially processed by the nervous system of the human species (Eslinger et al., 2021) because the satisfaction of most human needs involves social interaction, especially in children (Brown & Brown, 2015). ...
Images of emotional facial expressions are often used in emotion research, which has promoted the development of diferent databases. However, most of these standardized sets of images do not include images from infants under 2 years of age, which is relevant for psychology research, especially for perinatal psychology. The present study aims to validate the edited version of the Tromsø Infant Faces Database (E-TIF) in a large sample of participants. The original set of 119 pictures was edited. The pictures were cropped to remove nonrelevant information, ftted in an oval window, and converted to grayscale. Four hundred and eighty participants (72.9% women) took part in the study, rating the images on fve dimensions: depicted emotion, clarity, intensity, valence, and genuineness. Valence scores were useful for discriminating between positive, negative, and neutral facial expressions. Results revealed that women were more accurate at recognizing emotions in children. Regarding parental status, parents, in comparison with nonparents, rated neutral expressions as more intense and genuine. They also rated sad, angry, disgusted, and fearful faces as less negative, and happy expressions as less positive. The editing and validation of the E-TIF database ofers a useful tool for basic and experimental research in psychology.
... Specifically, the processing of emotional stimuli (e.g., emotional expressions) is essential for successful social interaction (Jack & Schyns, 2015;Keltner et al., 2019), as the human processing of social behavior is based on the constant practice of attributing mental states from emotional expressions (e.g., facial, verbal) in what has been widely called Theory of Mind (Brüne & Brüne-Cohrs, 2006;Molenberghs et al., 2016). Social affective stimuli are preferentially processed by the nervous system of the human species (Eslinger et al., 2021) because the satisfaction of most human needs involves social interaction, especially in children (Brown & Brown, 2015). ...
Images of emotional facial expressions are often used in emotion research, which has promoted the development of different databases. However, most of these standardized sets of images do not include images from infants under 2 years of age, which is relevant for psychology research, especially for perinatal psychology. The present study aims to validate the edited version of the Tromsø Infant Faces Database (E-TIF) in a large sample of participants. The original set of 119 pictures was edited. The pictures were cropped to remove nonrelevant information, fitted in an oval window, and converted to grayscale. Four hundred and eighty participants (72.9% women) took part in the study, rating the images on five dimensions: depicted emotion, clarity, intensity, valence, and genuineness. Valence scores were useful for discriminating between positive, negative , and neutral facial expressions. Results revealed that women were more accurate at recognizing emotions in children. Regarding parental status, parents, in comparison with nonparents, rated neutral expressions as more intense and genuine. They also rated sad, angry, disgusted, and fearful faces as less negative, and happy expressions as less positive. The editing and validation of the E-TIF database offers a useful tool for basic and experimental research in psychology.
... Having access to supportive, caring social connections brings a number of mental and physical health benefits (Brown & Brown, 2015;Ditzen & Henrichs, 2014;Slavich, 2020) and has been found to be negatively 7. Protective factors in the COVID-19 pandemic associated with depression, anxiety (Armstrong et al., 2020;Kelly et al., 2012) and post-traumatic stress (Maheux & Price, 2016). ...
... Prosocial behavior is known for impacting social relationships, life satisfaction, economic success as well as mental and physical health (14)(15)(16), and its alteration, together with socio-affective disruption, have been linked to personality, depressive and anxiety disorders (6,(17)(18)(19)(20)(21)(22)(23)(24). The propensity to act prosocially may therefore vary with psychiatric traits. ...
... For example, in the short term, the mood of helpers improves right after they help someone in need (Zhao & Epley, 2022). And in the long term, those who help others more often have better physical health (Brown & Brown, 2015) and mental health (Schwartz et al., 2003); they also have a higher level of happiness (Dunn et al., 2014) and life satisfaction (Caprara & Steca, 2005), and lower level of depression (Nantel-Vivier et al., 2014) and meaninglessness (Van Tongeren et al., 2016). ...
Background: Childhood maltreatment (CM), including physical, emotional, and sexual maltreatment, is detrimental to adolescents' psychological and behavioral outcomes. However, most studies on the relationship between CM and prosocial behavior focused on the overall experience of CM. Since different forms of CM exert various influences on adolescents, it is essential to find out which form of CM has the strongest link with prosocial behavior and the underlying mechanism behind it to fully understand this relationship and design a specific intervention for promoting prosocial behavior.
Objective: Guided by internal working model theory and hopelessness theory, this study aimed to investigate the connections of multiple forms of CM with prosocial behavior, and explore the mediating mechanism of gratitude from the perspective of the broaden-and-build theory through a 14-day daily diary study.
Participants: A total of 240 Chinese late adolescents (217 females; Mage = 19.02, SDage = 1.83) from a college volunteered for this study and completed questionnaires regarding CM, gratitude, and prosocial behavior.
Methods: A multilevel regression analysis was conducted to investigate which form of CM was correlated to prosocial behavior, and a multilevel mediation analysis was applied to examine the underlying mechanism (i.e., gratitude) behind this relationship.
Results: The results of the multilevel regression analysis showed that it was childhood emotional maltreatment, but not physical or sexual maltreatment that negatively predicted prosocial behavior. The results of the multilevel mediation analysis indicated that gratitude mediated the relationship between childhood emotional maltreatment and prosocial behavior.
Conclusions: Findings from the present study highlight the predictive effect of childhood emotional maltreatment on late adolescents' prosocial behavior and the mediating role of gratitude in this link.
... In compassion, facilitators are factors that increase the likelihood of the compassionate algorithm being activated. As such a range of approaches can facilitate compassionate behaviour [10,11], like using self-reassuring/friendly inner voice tones [10], primes of safety and security [12], and compassion meditations [10] that can stimulate physiological mechanisms (e.g. the vagus and the parasympathetic system). Improving facilitators does not necessarily result in compassionate behaviour if there are inhibitors present [13]. ...
Extensive research shows that, under the right circumstances, children are highly prosocial. Extending an already published paradigm, we aimed here to determine what factors might facilitate and inhibit compassionate behaviour. Across five experiments (N = 285), we provide new insight into the bounds of 4- to 5-year-old children's compassionate behaviour. In the first three experiments, we varied cost of compassion by changing the reward (Study 1), using explicit instructions (Study 2) and ownership (Study 3). In the final two experiments, we varied the target of the compassionate behaviour, examining adults compared with puppet targets (Study 4), and whether the target was an in-group member (Study 5). We found strong evidence that cost reduces compassionate responding. By contrast, the recipient of compassion did not appear to influence responding: children were equally likely to help a human adult and a puppet, and an in-group member and neutral agent. These findings demonstrate that for young children, personal cost appears to be a greater inhibitor to compassionate responding than who compassion is directed toward.
... The benefits of prosocial behaviors not only concern psychological health but also health in general. Some studies show the relationship between these behaviors and neurohormonal circuits (especially oxytocin and progesterone) that have a buffering effect on stress and restorative properties of the organism [9]. There is also evidence that people who informally help others experience positive mental states associated with psychological well-being, good health, and longevity [10][11][12]. ...
The Prosocial Tendencies Measure (PTM) and its revised version (PTM-R) are used internationally to measure prosocial behaviors in different life situations. To obtain accumulated evidence of the report and the reliability of its scores, a meta-analysis of the reliability of internal consistency was performed. The databases of Web of Science (WoS) and Scopus were reviewed and all the studies that applied it from 2002 to 2021 were selected. Results: Only 47.9% of the studies presented the index of reliability of PTM and PTM-R. The meta-analytic results of the reliability report of the subscales that the PTM and the PTM-R have in common were: Public 0.78 (95% CI: 0.76-0.80), Anonymous 0.80 (95% CI: 0.79-0.82), Dire 0.74 (95% CI: 0.71-0.76), and Compliant 0.71 (95% CI: 0.72-0.78). Each one of them presents high levels of heterogeneity derived from the gender of the participants (percentage of women), the continent of the population, the validation design, the incentive to participate, and the form of application. It is concluded that both versions present acceptable reliabilities to measure prosocial behavior in different groups and situations, as adolescents and young people, but their clinical use is discouraged.
... For example, in the short term, the mood of helpers improves right after they help someone in need (Zhao & Epley, 2022). And in the long term, those who help others more often have better physical health (Brown & Brown, 2015) and mental health (Schwartz et al., 2003); they also have a higher level of happiness (Dunn et al., 2014) and life satisfaction (Caprara & Steca, 2005), and lower level of depression (Nantel-Vivier et al., 2014) and meaninglessness (Van Tongeren et al., 2016). ...
Background
Prior research has reported that childhood maltreatment is associated with poor well-being, but few studies have examined the association between childhood maltreatment and well-being including hedonic and eudaimonic well-being using a daily diary method.
Objective
The present study investigated the association between childhood maltreatment and hedonic and eudaimonic well-being, and explored the mediating effects of social support and self-esteem.
Participants and setting
Data were collected applying a 14-day daily diary method in two samples. A total of 120 Chinese emerging adults (100 female; Mage = 20.48 years, age range = 18–24 years) and 229 Chinese emerging adults (187 female; Mage = 20.43 years, age range = 18–27 years) comprised the discovery sample and the replication sample, respectively.
Methods
Multilevel regression analysis and multilevel mediation analysis were conducted, while controlling for sex, age, and socioeconomic status.
Results
In the discovery sample, the multilevel regression analysis showed that childhood maltreatment had an equal effect on predicting the two types of well-being. Additionally, the multilevel mediation analysis demonstrated that social support and self-esteem acted as independent and equally important mediators of the associations between childhood maltreatment and the two types of well-being. Moreover, the total indirect effect on the childhood maltreatment–hedonic well-being link had no significant difference from that on the childhood maltreatment–eudaimonic well-being link. The replication sample reconfirmed the results of the discovery sample, which provides greater credibility to our findings.
Conclusions
Social support and self-esteem might help to improve the well-being of emerging adults who have suffered childhood maltreatment, and might therefore be important intervention targets.
... Current conceptualizations of compassion are limited by the fact that they do not consider the possibility of AI technologies as tools for compassion (except for artificial compassion, Mason, 2021Mason, , 2023. Compassion science mainly focuses on the bodily (psychological and neurobiological) and behavioral elements of compassion (Kim et al., 2020;Goldberg, 2020) and the effects of oxytocin in the body (Brown and Brown, 2015;Palgi et al., 2016;Seppälä et al., 2017). There is growing evidence about self-compassion and compassionate touch interventions (Bond, 2002;Field, 2014;Serpa et al., 2021), self-care interventions (Ehret et al., 2015;Friis et al., 2016;Brown et al., 2020), professionals' self-care and self-compassion and compassion for others (Mills et al., 2017); and resilience in caring roles (Bleazard, 2020;Baqeas et al., 2021). ...
Background
Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.
Objectives
The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?
Materials and methods
A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011–2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.
Results
Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan–Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.
Conclusion
There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.
Implications
In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.
... Aktiviti sukarela sememangnya disasarkan untuk mencipta manfaat untuk orang lain sejak beberapa dekad yang lalu. Para sarjana dalam bidang kesihatan dan sains sosial telah mengaitkan kerja sukarela dengan hasil yang menyumbang kepada pengetahuan kesihatan individu seperti kesihatan diri, batasan diri, tingkah laku kesihatan seseorang, mengenali punca kemurungan dan kematian (Brown & Brown 2015). Dari sudut teori, aktiviti ahli sukarelawan dapat meningkatkan akses kepada sumber-sumber psikologi seperti memberi harga diri, menyatukan sumber-sumber sosial, integrasi sosial, mendapat akses kepada sokongan dan maklumat serta memberi kesan positif kepada kesihatan manusia. ...
Model Pembangunan Identiti Guru: Pendekatan Pengajaran Seni
Teater Dalam Pendidikan Di Malaysia
Penulisan kertas konsep sosial sains ini dijalankan bertujuan untuk meneroka
pengetahuan lakonan, kemahiran lakonan dan amalan lakonan program
kejurulatihan utama dalam pendidikan khususnya jurulatih kesenian. Oleh itu,
dengan menyelidik kefahaman Pengetahuan Pedagogi Isi Kandungan (PPIK)
oleh Shulman (1986) melalui Kurikulum Standard Sekolah Menengah (KSSM),
Sekolah Seni Malaysia (SSeM) 2017 dalam pelaksanaan pengajaran seni teater,
dan bagaimana peserta kajian membuat transformasi ke dalam rancangan
pengajaran serta melaksanakan pengajaran dengan kurikulum tersebut. Selain
itu, kajian mengkaji pengetahuan, kemahiran dan amalan guru sebagai jurulatih
terhadap penggunaan teknik seni lakon secara mendalam melalui pendekatan
pelopor teknik seni lakon dari Stanilavki (1946). Bagi mewujudkan konteks yang
diperlukan oleh guru, sebuah pendekatan unsur seni teater untuk pengajaran
guru dirancang selari dengan model yang berdasarkan teori lakonan yang
berpengaruh. Model ini, iaitu BEING (Percaya (Believe), Pengksperimentasi
(Experiment), Penciptaan (Invent), Pemetaan (Navigate), Penjanaan (Generate))
oleh Özmen (2011). Latar belakang kajian berlandaskan pengetahuan dan
kefahaman jurulatih tentang KSSM masih tidak menepati isi pelajaran kurikulum
kerana bukan pengkhususan bidang. Perancangan, penyediaan rancangan
pengajaran dan pelaksanaan aktiviti pengajaran kurang tertumpu kepada
kemahiran dan amalan aktiviti pengajaran serta hasil pembelajaran untuk
melahirkan insan seimbang dari segi jasmani, emosi, rohani dan sahsiah. Namun
begitu, mereka masih perlu melakukan penambahbaikkan dalam amalan
pengajaran. Jurulatih berhadapan dengan cabaran-cabaran seperti kekangan
masa, kefahaman asas pengetahuan dengan lebih mendalam, kemahiran dan
latihan kurang mencukupi serta sumber dan kemudahan untuk berkarya yang
terhad. Reka bentuk kajian ini adalah bersifat kualitatif dan strategi kajian kes.
Persampelan seramai tiga orang jurulatih SSeM dipilih sebagai peserta kajian
yang bukan berlatar belakang pengkhususan dan kelayakan ikhtisas pengajian
seni persembahan khusus teater dan drama serta pengetahuan asas dan
kemahiran sedia ada hanya melalui pengalaman semata. Pengumpulan data
dilakukan melalui protokol temu bual, protokol pemerhatian pengajaran dan
analisis kandungan dokumen. Kaedah temu bual dijalankan bertujuan untuk
mengetahui latar belakang peserta kajian dan kefahaman dan pengetahuan
jurulatih tentang KSSM SSeM. Pemerhatian pengajaran bagi setiap peserta
kajian dijalankan untuk meneroka pengetahuan persediaan pengajaran dan
kemahiran serta amalan lakonan dalam pelaksanaan pengajaran serta analisis
kandungan dokumen dilakukan berdasarkan tujuan kajian yang dikemukakan.
Kajian ini juga mencadangkan konsep pembangunan identiti profesional guru
dalam kefahaman transformasi dalam pengajaran. Guru memainkan peranan
penting dalam menentukan hala tuju pengajaran dan membentuk nilai murni dan
disipin. Kajian ini juga memberi beberapa cadangan untuk menambah baik: i)
perkembangan profesionalisme kejurulatihan; ii) penyediaan sumber; iii) dan
penyediaan garis panduan dan rujukan program teater dan drama dalam
pendidikan di Kementerian Pendidikan Malaysia (KPM).
... A study based on a similar notion, namely that prosocial behavior is linked to lifespan [11][12] and that might be mediated by the pathway which implicates changes in gene expression, which consequently may affect disease development (or resistance), examined changes in CTRA in 159 adults. They were randomly divided into 4 groups and for 4 weeks, they engaged in either prosocial behavior directed towards specific people, or prosocial behavior directed towards the world in general or self-focused kindness or a neutral control task [13]. ...
The theoretical and philosophical foundations of human well-being are well-described in psychology research. Within the construct of well-being, psychologists distinguish eudemonic positive affect and hedonic positive affect, although they are not only nor mutually exclusive approaches. Empirical findings demonstrate a correlation between the general positive affect and favorable health outcomes. Recent discoveries also show a biological pattern, which underlines the correlation. Thanks to describing the conserved transcriptional response to adversity (CTRA) mechanism, a new direction of research is emerging, exploring a relationship between profile of gene expression in immune cells and positive affect. Keywords: well-being · eudemonic positive affect · hedonic positive affect · CTRA
... Four, while suffering in daily life might be assisted by multiple others, healthcare environments have a lower carer to caree ratio. Healthcare practitioners are individually responsible for a number of patients' where others cannot "take over" (Brown & Brown, 2015) and must operate within cultures that can be competitive and isolating, being unable to share challenging experiences or seek help because of fears of appearing incapable (Singh et al., 2018). Compassion may be impaired in the presence of capable others (Preston, 2013), a common scenario in healthcare. ...
Although it can be difficult to sustain, compassion is central to healthcare, offering benefits to patients, providers, and systems. So why is our care challenged in health? In considering this question, this chapter first critiques the view offered by compassion fatigue—that compassion is costly and resource depleting—arguing, instead, that many of the challenges in healthcare come from “misfits” between the contexts compassion evolved in versus those in which we try to use it. Noting that compassion in health is differentiated by expectation, remuneration, repetition, inverted carer to caree ratios, and, finally, context, we use the framework of the Transactional Model of Physician Compassion to organize the factors thought to influence compassion that can be amenable to interventions. Although data remain scarce, we suggest that understanding compassion in healthcare requires a systemic perspective, an understanding of the subjectivity of personal experiences, and a recognition of the discrepancies between historical contexts and modern-day healthcare.
... Aktiviti sukarela sememangnya disasarkan untuk mencipta manfaat untuk orang lain sejak beberapa dekad yang lalu. Para sarjana dalam bidang kesihatan dan sains sosial telah mengaitkan kerja sukarela dengan hasil yang menyumbang kepada pengetahuan kesihatan individu seperti kesihatan diri, batasan diri, tingkah laku kesihatan seseorang, mengenali punca kemurungan dan kematian (Brown & Brown 2015). Dari sudut teori, aktiviti ahli sukarelawan dapat meningkatkan akses kepada sumber-sumber psikologi seperti memberi harga diri, menyatukan sumber-sumber sosial, integrasi sosial, mendapat akses kepada sokongan dan maklumat serta memberi kesan positif kepada kesihatan manusia. ...
Kajian ini bertujuan mengukur hubungan kesediaan pengetahuan mengajar
guru pendidikan khas dengan kesediaan guru dalam mengajar kemahiran hidup
(masakan) kepada murid-murid pendidikan khas bermasalah pembelajaran di
Pahang. Reka bentuk kajian ini ialah kajian korelasi dengan menggunakan
Model Pengetahuan Guru Shulman dan Model Pengetahuan Guru Grossman.
Kajian ini adalah bersifat kuantitatif. Pengkaji memilih seramai 200 orang guru
pendidikan khas sebagai sampel kajian secara rawak. Instrumen soal-selidik
digunakan dalam bentuk skala Likert 5 poin bagi memperoleh data empirikal
tentang kesediaan pengetahuan mengajar guru pendidikan khas. Data dianalisis
dengan menggunakan analisis deskriptif dan inferens yang melibatkan ujian-t,
ANOVA dan korelasi Pearson yang menerangkan perbezaan serta hubungan
antara pemboleh ubah kajian. Analisis deskriptif menunjukkan guru-guru
bersetuju mempunyai kesediaan pengetahuan guru dalam tujuh dimensi dengan
nilai purata (M= 4.32, S.P= 0.240). Sementara itu, dalam analisis inferens
sebanyak empat hipotesis nul telah diuji dan keempat-empat hipotesis nul
tersebut telah ditolak. Hasilnya, dapat dirumuskan bahawa terdapat perbezaan
kesediaan pengetahuan mengajar guru pendidikan khas dalam mengajar mata
pelajaran kemahiran hidup (masakan) kepada murid-murid pendidikan khas
bermasalah pembelajaran berdasarkan jantina guru, kelayakan akademik dan
pengalaman guru mengajar. Analisis korelasi menunjukkan wujud hubungan
yang kuat dan signifikan (r = 0.707 ; p < 0.05) antara pengetahuan guru dengan
kesediaan pengetahuan mengajar guru pendidikan khas dalam mengajar mata
pelajaran kemahiran hidup masakan di sekolah rendah. Kesimpulannya, dapat
disimpulkan bahawa guru-guru pendidikan khas yang mengajar kemahiran
hidup percaya bahawa mereka mempunyai kesediaan pengetahuan mengajar
subjek masakan. Implikasi daripada kajian ini pihak kementerian dan juga
jabatan dapat mengetahui kesediaan pengetahuan mengajar guru serta
kesediaan guru.
... Specifically, while receiving social support reduced the risk of mortality, this effect was nullified after adjusting for the provision of social support 12 . More recent work further suggests that the provision of social support may also be associated with longevity and positive health outcomes [11][12][13] . ...
While social support has been linked to better health, most research has focused on the receipt of social support. In this study, we evaluated associations between provided support and mental health in a nationally representative cohort of 4069 US veterans. The majority (60–72%) of veterans reported providing support on a consistent basis. Veterans who scored higher on certain aspects of personality (i.e., agreeableness, conscientiousness, and extraversion) and received greater support were more likely to provide support. Further, each standard deviation increase in provided support was independently associated with 22–32% reduced odds of internalizing psychiatric disorders and suicidal ideation, and veterans who scored higher on both provided and received support had 3.5- to 14-fold lower odds of these outcomes relative to those with high received support but low provided support. Results suggest that interventions to promote the provision of support may help mitigate risk for adverse mental health outcomes in veterans.
... CMT helps clients become mindful of being caught in the threat system and of how to switch attention to a caring and compassion motivational system that re-balances the threat system by stimulating physiological systems associated with caring. These include the vagus nerve oxytocin and the frontal cortex (Brown & Brown, 2015;Carter et al., 2017;Gilbert, 2020;Porges, 2017). ...
Objectives Patients with Hashimoto thyroiditis (HT) experience mental health complaints due to the immune system
dysregulation. Preliminary evidence suggests that psychological interventions could improve patients’ quality of life.
Compassionate mind training (CMT) is part of compassion-focused therapy (CFT) and can be used to help individuals
address physical and mental health difculties. The present study sought to assess the acceptability and preliminary efcacy
of Reset Your Immune System, a 6-week CMT-based online intervention, in patients with HT.
Methods Nine women were randomly selected from a wider sample that undertook the online intervention. Upon completion,
they were interviewed with nine standard open-ended questions. Additionally, pre- and post-intervention questionnaires
were flled out.
Results Qualitative analysis indicated that participants observed improvements in symptoms, sleep quality, self-awareness,
stress-management, and self-regulation skills. Participants did experience some difculties in undertaking compassion-related
exercises. Quantitative analyses showed that negative afect, social/role limitations, and HT symptoms indicated a reliable
change from pre- to post intervention.
Conclusions Overall, Reset Your Immune System showed benefcial efects on patients with HT, suggesting that including
psychological care as part of the standard treatment of HT might have added value. It is important to assess long-term efects
in a larger sample through a randomized control trial.
... Moreover, promoting prosocial engagement can promote better health outcomes and reduces health inequities, including mental and physical health outcomes Memmott-Elison, Holmgren, Padilla-Walker, & Hawkins, 2020;Schreier et al., 2013). In addition, researchers have demonstrated that prosocial behaviors can also buffer the negative effects of stress on physical health by elevating levels of neurotransmitters, such as oxytocin, that can promote physical health (Brown & Brown, 2015;Poulin & Holman, 2013). While there is evidence that prosocial behaviors generally increase over the course of adolescents (Van der Graaff, Carlo, Crocetti, Koot, & Branje, 2018), there are also individual differences in prosocial behaviors that are important to consider. ...
Latinx youth in the United States face structural barriers that contribute to inequities across multiple domains (e.g., education, juvenile justice, healthcare systems), as racial biases permeate social institutions. The systemic oppression resulting from racism can be seen in disparities across many indicators of health, including physical health, education, socioeconomic conditions, and the overrepresentation of ethnic and racial minority individuals, including Latinx individuals, incarcerated and exposed to violence. We present an approach to combat social inequities and injustices by promoting and fostering prosocial behaviors (i.e., actions that benefit others) between majority and minority members of our society. Existing theories and research on the factors that can promote such behaviors across youth from different backgrounds is summarized though we highlight work in U.S. Latinx youth. Factors that enhance and undermine prosocial behaviors towards diverse others is also summarized. Finally, some recommendations for intervention and policy efforts are briefly presented.
... If one is sensitive to others' suffering, then one can seek to alleviate pain and devote oneself to preventing it. Connecting prosocial behavior, as well as engaging in others' suffering, brings not only many social and interpersonal benefits to one's life (Brown and Brown, 2015) but also many self-related advantages and benefits (Wang et al., 2014). The process of the evolution of this sensitivity to compassion has been explained using a model that includes the two psychologies engagement and action . ...
Aim
This study aims to translate the Compassionate Engagement and Action Scales (CEAS) into Turkish and to test their subsequent validity, reliability, and psychometric properties. Turkey is one of the blended cultures with eastern and western elements under the influence of traditional religion. This cultural diversity brings about a rich context to study compassion and its relationship to mental health. The scales assess the ability to be sensitive to suffering and engage and then take helpful actions in compassion. The motivation for compassionate engagement and action is measured at three ‘flows’ as follows: (1) compassion for others; (2) compassion from others; and (3) compassion for self.
Methods
The sample consists of 525 college students aged 18 years or older. The participants completed the CEAS Turkish Form for Others, Self and from Others, Self-Compassion Scale Short Form, Compassionate Love Scale, and Self-Criticism Scale.
Results
The confirmatory factor analyses were conducted using AMOS version 27 to examine the validity of the three scales with two different factor structures each. All the three models show good fits to the data. The Cronbach’s alpha coefficient for the CEAS for Others and for Self and from Others are good to excellent (between 0.70 and 0.95 for all subscales). Compassion for self, compassion for others, and compassion from others correlated modestly.
Conclusion
It can be concluded that the Turkish version of the Compassionate Engagement and Action Scales for Others and Self and from Others has sufficient psychometric properties and can be used as a reliable and valid measure to assess compassionate engagement and action.
... Schultheiss et al., 2004), as well as increased sharing behavior (Strojny et al., 2021), social closeness (Brown et al., 2009), and social feedback sensitivity (Wang et al., 2021). Moreover, both endogenous and exogenous rise in progesterone have been found in relation to enhanced general social cognition, increased altruistic motivation, and suppression of self-interests, further supporting our conclusions (e.g. Brown et al., 2009;Brown and Brown, 2015;Duffy et al., 2017;Jones et al., 2005;Maner et al., 2010;Maner and Miller, 2014;Schultheiss et al., 2004;Strojny et al., 2021). In addition to this evidence, our social discounting task allowed us to detect differences between increased prosocial behavior toward close individuals and (relatively) stable prosocial attitude toward more remote individuals. ...
The human tendency to share goods with others at personal costs declines across the perceived social distance to them, an observation termed social discounting. Cumulating evidence suggests that social preferences are influenced by the agent’s neurohormonal state. Here we tested whether endogenous fluctuations in steroid hormone compositions across the menstrual cycle were associated with differences in generosity in a social discounting task. Adult healthy, normally-cycling, women made incentivized decisions between high selfish rewards for themselves and lower generous rewards for themselves but also for other individuals at variable social distances from their social environment. We determined participants’ current levels of menstrual-cycle-dependent steroid hormones via salivary sampling. Results revealed that the increase in progesterone levels as well as the decrease in estradiol levels, but not changes in testosterone or cortisol, across the menstrual cycle, accounted for increased generosity specifically toward socially close others, but not toward remote strangers.
... However, while these behaviors will-by de nition-provide bene ts to the recipient, they come at a cost to the benefactor (e.g., time, effort, money). Although prosocial behaviors can also provide material, social, psychological, or even physical gains (Brown & Brown, 2015 Importantly, while behaving prosocially may come at personal costs, refusing to do so is not without its own toll. Not helping someone in need may lead to social reproach. ...
Covering the face with masks in public settings has been recommended since the start of the pandemic. Because faces provide information about identity, and that face masks hide a portion of the face, it is plausible to expect individuals who wear a mask to consider themselves less identifiable. Prior research suggests that perceived identifiability is positively related to prosocial behavior, and with two pre-registered field studies (total N = 5706) we provide a currently relevant and practical test of this relation. Our findings indicate that mask wearers and non-wearers display equivalent levels of helping behavior (Studies 1 and 2), although mask wearers have a lower level of perceived identifiability than those without a mask (Study 2). Overall, our findings suggest that claims that face masks are related to selfish behavior are not warranted, and that there is no practical link between perceived identifiability and prosocial behavior.
... 14 More recent work further suggests that provision of social support may also be associated with longevity and positive health outcomes. [13][14][15] For example, a longitudinal study of 1,492 men and 1,177 women older adults in Taiwan revealed that individuals who provided social support had an 11 percent lower mortality rate (hazard ratio=0.89; 95% con dence interval [CI] 0.83-0.96), ...
While social support has been linked to better health, most research has focused on the receipt of social support. In this study, we evaluated associations between provided support and mental health in a nationally representative cohort of 4,069 US veterans. The majority (60-72%) of veterans reported providing support consistently. Veterans who scored higher on aspects of personality (i.e., agreeableness, conscientiousness, and emotional stability) and received support were more likely to provide support. Further, each standard deviation increase in provided support was independently associated with 15-40% reduced odds of internalizing psychiatric disorders and suicidality, and veterans who scored higher on both provided and received support had 3.5- to 14-fold lower odds of these outcomes relative to those with high received support but low provided support. Results suggest that separate from the receipt of social support, the provision of support may be a potential pathway to mitigate adverse mental health conditions.
... On parle beaucoup de la fatigue des mères et des proches aidants en donnant l'impression que, de la famille ou du travail, c'est toujours la famille qui est trop exigeante (Hochschild, 1997). Il existe pourtant une pléthore d'études démontrant que les gestes de soin offerts à autrui comportent aussi des bienfaits pour le donneur (Boerner et al., 2004;Brown et al. 2015;Haley et al., 2003et Raposa et al., 2016. Il n'est pas ici question de nier le degré d'exigence du travail de soin, mais plutôt d'insister sur le fait qu'il n'est pas que fardeau. ...
Bu çalışmada ebeveynlik tutumunun yeni bir bakış açısıyla ele alınması ve merhametli ebeveynlik tutumu konusunda aileler, aile danışmanları, aile-çocuk ruh sağlığı çalışanları ve araştırmacılar açısından farkındalık oluşturulması amaçlanmıştır. Bu amaç kapsamında alanyazındaki mevcut ebeveyn tutumlarından hareketle ebeveynliğin farklı stillerinden bahsedilmiştir. Ebeveynliğin çeşitli sınıflandırmalar bağlamında incelendiği anlaşılmakla birlikte genel anlamda otoriter, izin verici, kararsız, aşırı koruyucu, ihmalkâr ve demokratik tutum olmak üzere altı ebeveynlik yaklaşımının bulunduğu ortaya konulmuştur. Ayrıca ebeveyn tutumlarıyla ilişkili olan ebeveynlik uygulamaları ele alınmıştır. Ebeveynlik uygulamaları içinde özellikle ebeveyn desteği ve ebeveyn kontrolünün önemine değinilmiştir. Ardından ebeveynlerin kendilerini geliştirebilmeleri, çocuk eğitimi ve yetiştirme açısından farkındalık kazanmaları, aile içi sorunları sağlıklı bir zeminde çözüme kavuşturmaları ve çocuklarını geleceğe hazırlamada yeni yaklaşımlar edinmeleri amacıyla birtakım eğitim ve programların hazırlanıp sunulduğu tespit edilmiştir. Bu çalışmada merhamet kavramının, bir ebeveynlik tutumu çerçevesinde işlenmesi önemli görülmüştür. Merhametli ebeveynlik tutumunun anlaşılması noktasında bilgi sunulmuştur. Bu bağlamda, merhametli ebeveynlik, bir ebeveynin olayları ve durumları çocuğun bakış açısından ele alabilmesi, çocuğa gerekli sevgi, ilgi ve şefkati sunabilmesi ve çocuğun hata, başarısızlık ve yetersizliklerine karşı duyarlılık ve anlayış gösterebilmesi şeklinde özetlenmiştir. Merhametli ebeveynlik davranışsal, duygusal ve bilişsel olmak üzere üç yönden ele alınmıştır. Merhametli bir ebeveynin, merhamet içeren hedeflere sahip olabileceği göz önünde bulundurularak merhametli hedeflerin öneminden bahsedilmiştir. Bununla birlikte merhametli ebeveynlik sürecinde ortaya çıkabilecek muhtemel engeller ele alınmıştır. Söz konusu engeller, ebeveynlerin merhamet korkusu yaşayabilmeleri ve merhamet yorgunluğunu deneyimleyebilmeleri ile açıklanmıştır. Bu engeller dikkate alınarak merhametli ebeveynlik tutumunda yer alması gerekli görülen önemli bir kavramdan, öz-merhametten bahsedilmiştir. Öz-merhametli ebeveynlerin hem kendilerine karşı hem de çocuklarına yönelik merhametli duygu, düşünce ve eylemler geliştirebilmesinin mümkün olabileceği belirtilmiştir. Böylece merhametli ebeveynlik tutumunun önemli bir parçasının, ebeveynlerin kendilerine karşı merhametli olmalarıyla açıklanabileceği anlaşılmıştır. Son olarak ebeveynlerin merhametli ebeveynlik tutumunu geliştirebilmeleri noktasında katkı sağlayabilecek potansiyel eğitimler ve programlar önerilmiştir.
Experiences during the early stages of life have profound and lasting effects on human development, shaping the skills that the individual will have available to meet various challenges. In particular, sparse evidence has shown that early care contributes to the ability to sense, interpret, and integrate signals about the physiological condition of the body. That is the process of interoceptive learning in infants. Interoceptive learning is of relevance, given its important role in the development of various socioemotional skills. However, given the existing gap in this field of knowledge, the present chapter aims to develop a theoretical and empirical review of how early experiences impact the interoceptive learning process, proposing an innovative pathway that integrates both interoceptive and emotional learning processes in early childhood. This initiative is considered key to unraveling the influence of early experiences and their resonance in the different learning processes throughout the life cycle.
This paper explores the overlap and relationship between Compassion-Focused Therapy (CFT) as an evolution-informed, biopsychosocial approach to the mind and two Buddhist approaches to the development of insight and meditation. We present this exploration in terms of a three-way exposition between PG (Paul Gilbert), a clinical psychologist and compassion-focused therapist, MH (Malcolm Huxter), also a clinical psychologist and long-term meditation practitioner, primarily in the Theravada Buddhist traditions, and CH (Choden), a long-term meditation practitioner and monastic of Mahayana Buddhism. We share overlapping but different approaches to the processes of insight, understanding, and the training of compassion.
Prosociality is a multifaceted concept referring to the many ways in which individuals care about and benefit others. Human prosociality is foundational to social harmony, happiness, and peace; it is therefore essential to understand its underpinnings, development, and cultivation. This handbook provides a state-of-the-art, in-depth account of scientific, theoretical, and practical knowledge regarding prosociality and its development. Its thirty chapters, written by international researchers in the field, elucidate key issues, including: the development of prosociality across infancy, childhood, adolescence, and beyond; the biological, cognitive, emotional, and motivational mechanisms that underlie and influence prosociality; how different socialization agents and social contexts can affect children's prosociality; and intervention approaches aimed at cultivating prosociality in children and adolescents. This knowledge can benefit researchers, students, practitioners, and policy makers seeking to nurture socially responsible, caring youth.
This chapter takes an evolutionary approach to self-compassion. As such, it considers the evolution of compassion as it emerged out of mammalian caring behavior and is transformed into compassion by the evolution of a range of complex cognitive competencies. These include competencies to reason, mentalize, and have consciousness of being conscious that support self-awareness. These competencies are used in specialist ways for different types of social relationship (social mentalities) and are crucial for our abilities to understand the nature of our suffering and how to address it compassionately, that is, deliberately, courageously, and wisely.KeywordsCompassionEvolutionMentalityMentalizationSelf-awarenessSelf-compassion
Evidence on the relationship between psychosocial well-being and physical activity (PA) is insufficient, especially in young adults between 18 and 29 years. Identifying protective factors for psychosocial well-being as well as factors that may promote PA behaviour in this specific age group is crucial.
The aim of the present study was to explore the association between self-reported leisure time physical activity (LTPA) and a number of measures of psychosocial well-being in a large sample of Finnish young men. The sample used for this study is based on registers of the Finnish Defence Forces and consist of questionnaire-based data collected from 159,776 young healthy men (18–29 years, mean age 19 years) who started their military service during the period from 2015 to 2021. Sum scores were calculated for self-esteem and prosocial behaviour. Physical activity, number of friends and the relationship with the parents were each measured with a single question. Unadjusted and adjusted (education, financial situation of the family, family structure) logistic regression models were calculated.
A multinominal logistic regression analysis showed that a higher level of LTPA was associated with a higher level of both prosocial behaviour (OR 6.12, 95% CI 5.88–6.36) and self-esteem (OR 4.41 95% CI 4.28–4.54). Further, LTPA had a positive relationship with good social relations, both with peers and parents. The odds ratio for participation in any LTPA weekly was higher (OR 2.74; CI 2.27–3.20) among those who had a close and trustworthy relationship with their parents compared to those men with more challenging relationships with their parents (OR 1.77; CI 1.46–2.14). An inactive lifestyle (PA less than once a week) seemed to be most common among men with no friends. About one third (31%) of men with no friends reported to engage in LTPA less than once a week, while only 10% of men with very many good friends reported to engage in similarly inactive LTPA behaviour.
LTPA seems to be positively associated with self-esteem, prosocial behaviour and good social relations among young adult men. Actions aimed at promoting LTPA may have a positive impact on psychosocial well-being among young men, or vice versa. The relationship between PA and psychosocial well-being is complex and interrelated.
Purpose:
The school climate, which refers to the quality and character of school life, is associated with a wide range of developmental outcomes. Although researchers have shown considerable interest in uncovering the links between school climate and prosocial behavior, the mechanisms underlying this association remain unclear. Therefore, the current study was designed to investigate the mediating role of gratitude between school climate and adolescents' prosocial behavior.
Methods:
A sample of 632 Chinese adolescents (363 girls and 269 boys; Mage = 16.83 years at time 1, SD = 0.68 years) completed a battery of sociometric and self-report questionnaires that measured school climate, gratitude, and prosocial behavior in three waves.
Results:
Correlation analysis showed that school climate, gratitude, and prosocial behavior were all significantly and positively intercorrelated across the three waves. Importantly, gratitude completely mediated the relationship between school climate and prosocial behavior (β = 0.005 [95% confidence interval = 0.001, 0.013]) in the three-wave longitudinal mediation model.
Conclusion:
As a positive disposition, gratitude fosters prosocial behavior and serves as a mediator between school climate and prosocial behavior. This study provides a theoretical explanation for cultivating adolescents' prosocial behavior and theoretical guidelines for interventions of schools and other socializing agents.
One of education’s primary goals is to cultivate citizens who want to contribute to society. However, surprisingly little research has been conducted on how students’ desire to contribute to society is related to crucial learning-related outcomes. The aim of this study was to examine how the desire to contribute to one’s society, which we call societal motivation for shorthand, is associated with optimal learning-related outcomes such as self-regulated learning, deep learning, and achievement. The sample included 8,773 secondary school students from Hong Kong. The mean age of the students was 13.28 (SD = 1.09) years old. Students were asked to respond to self-reported surveys and answer achievement tests across two-time points, one year apart. Structural equation modeling was used to analyze the data. Results indicated that Time 1 societal motivation positively predicted Time 2 self-regulated learning and deep learning. These associations held despite controlling for auto-regressive effects and other relevant covariates such as Time 1 goals (mastery, performance, social, and extrinsic) and demographic variables. Our results showed that societal motivation is associated with optimal learning-related outcomes. This paper has theoretical implications for educational research by showing that societal motivation is an important yet neglected aspect of student motivation.
There is increasing evidence to show that compassion and altruism are highly beneficial when cultivated from an early age. In the present study we explore the benefits of an intervention programme that seeks to develop affective empathy, compassion and altruism in 9-year-old children from a school of Buenos Aires, Argentina. A pretest-posttest controlled study was carried out with 48 children, half of whom carried out the intervention. The remaining children, who constituted the waitlist group, participated in academic tutoring activities conducted by the same research team. The intervention was successful in promoting children's altruistic and compassionate attitudes, evidenced by the results obtained in the universal altruism test, social integration, and affective response. Effect sizes ranged from medium to large in the intervention group. These positive findings were not observed in the waitlist group (non-significant effect sizes). This study shows that children's self-awareness and awareness of others tend to foster compassion and affective empathy, contributing to individual and collective well-being.
This book is a collection of all the papers published in the special issue “Philosophy and Meaning in Life Vol.4: Selected Papers from the Pretoria Conference,” Journal of Philosophy of Life, Vol.12, No.1, 2022, pp.1-115.
We held the Fourth International Conference on Philosophy and Meaning in Life online at the University of Pretoria, Pretoria, South Africa, on January 17–19, 2022. This conference was hosted by the University of Pretoria and supported by the Waseda Institute of Life and Death Studies. We accepted about 50 presentations from around the world. Professor Cheshire Calhoun, Professor Guy Kahane, and Professor Berit Brogaard gave keynote lectures.
After the conference, we called for papers for publication from the speakers, and we accepted six papers for the special issue of the Journal of Philosophy of Life. We would like to give special thanks to the anonymous referees who kindly reviewed the submitted manuscripts. The accepted papers deal with a variety of topics, such as the methodology of ethics, the meaning of affirmation, Simone de Beauvoir, and subjectivism, and they are all discussed from the perspective of the philosophy of life’s meaning.
In January 2022, we were still in the midst of the Covid19 pandemic. Professor Thaddeus Metz, the chair of the conference, and supporting staff members decided to hold the conference online, and with the help of their devotion we were able to hold the three–day meeting successfully. We had many participants from around the world and we had lively discussions online. I would like to sincerely thank them for their contributions.
As the editor-in-chief, I hope that readers will enjoy the stimulating papers in this volume.
Dozens of studies, most conducted in the last four decades, have implicated oxytocin, as well as vasopressin and their receptors, in processes that mediate selective sociality and the consequences of early experience. Oxytocin is critical for the capacity to experience emotional safety and healthy sexuality. Oxytocin also plays a central role in almost every aspect of physical and mental health, including the coordination of sociality and loving relationships with physiological reactions to challenges across the lifespan. Species, including prairie voles, that share with humans the capacity for selective social bonds have been a particularly rich source of insights into the behavioral importance of peptides. The purpose of this historical review is to describe the discovery of a central role for oxytocin in behavioral interactions associated with love, and in the capacity to use sociality to anticipate and cope with challenges across the lifespan – a process that here is called “sociostasis.”
Deel 3 behandelt de vragen die AIOS huisartsopleiding hebben over verschillende aspecten van empathie. In verschillende focusgroepen tijdens onze studie kwamen deze vragen aan de orde. Soms waren ze heel praktisch inhoudelijk, soms meer beschouwend. Elk onderdeel van dit hoofdstuk start met een quote van een AIOS, waarna de vraag die deze daarin stelt wordt beantwoord.
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
Fears of compassion are associated with harmful mental health effects, with research increasing worldwide. As a measure to assess this construct, the Fears of Compassion Scales were developed, with adapted versions in several countries. This study aimed to perform the cultural adaptation and search for evidence of validity of the Fears of Compassion Scales for use in Brazil. After the translation and cultural adaptation process, two online surveys were conducted. In the first, 284 adults (mean age = 36.47) answered the Fears of Compassion Scales and a sociodemographic questionnaire. Through Exploratory Factor Analysis and Cronbach’s alpha and McDonald’s omega tests, the three scales showed good internal consistency indices and confirmed the original format of the instrument, with a one-factor solution. One item of scale 1 did not fit and was excluded, while a new item in scale 2, developed through focus groups, showed good fit indices. In the second data collection, 381 women (mean age = 31.56) answered the Fears of Compassion Scales, the Self-Compassion Scale, and the Psychological Well-Being Scale. Confirmatory factor analyses corroborated the format proposed in the first analysis, and convergent and divergent validity data were confirmed. The results indicate that the Fears of Compassion Scales are suitable for use in Brazil. The instrument tends to contribute to studies on the theme, providing a better understanding of its functioning and enabling future interventions to improve access to compassion and all its benefits.
Covering the face with masks in public settings has been recommended since the start of the pandemic. Because faces provide information about identity, and that face masks hide a portion of the face, it is plausible to expect individuals who wear a mask to consider themselves less identifiable. Prior research suggests that perceived identifiability is positively related to prosocial behavior, and with two pre-registered field studies (total N = 5706) we provide a currently relevant and practical test of this relation. Our findings indicate that mask wearers and non-wearers display equivalent levels of helping behavior (Studies 1 and 2), although mask wearers have a lower level of perceived identifiability than those without a mask (Study 2). Overall, our findings suggest that claims that face masks are related to selfish behavior are not warranted, and that there is no practical link between perceived identifiability and prosocial behavior.
Objective
Prosocial behavior has been linked to improved physical health, but the biological mechanisms involved remain unclear. This study tested whether a 4-week kindness intervention could reduce expression of a stress-related immune response gene signature known as the Conserved Transcriptional Response to Adversity (CTRA).
Methods
In a diverse sample of community adults (N = 182), study participants were randomly assigned to perform 3 kind acts for other people, to perform 3 kind acts for themselves, or to list daily activities (control), on one day per week over 4 weeks. CTRA gene expression was measured by RNA sequencing of dried blood spots (DBS) collected at baseline and 5 weeks later (1 week after completing study assignments). Participants’ descriptions of their kind acts were coded for protocol adherence and act content.
Results
Participants who were randomized to perform kind acts for others showed significant reductions in CTRA gene expression relative to controls. Participants who were randomized to perform kind acts for themselves also showed significant reductions in CTRA gene expression relative to controls, but this pattern emerged only for those who failed to perform the requested self-kind acts (protocol non-adherent). Those who fully adhered to the self-kindness protocol showed no change in CTRA gene expression and did not differ from controls. Act content analyses implicated self-stress-reducing behavior in the paradoxical effects of self-kindness and the physical presence of others in the effects of prosocial behavior.
Conclusions
Prosocial engagement—doing something kind for others rather than oneself—reduces CTRA gene expression. The nature of kind acts and their intended recipient plays a key role in shaping the genomic impact of kindness.
Mencius 孟子 is famous for arguing that human nature is good (xingshan 性善). In this article, I offer a reading of Mencius’ argument which can be evaluated in terms of empirical psychology. In this reading, Mencius’ argument begins with three claims: (1) humans naturally have prosocial inclinations, (2) prosocial inclinations can be cultivated into mature forms of virtue, and (3) the growth of prosocial inclinations is more natural than the growth of their alternatives. I also argue that each of these claims is well supported by empirical psychology. The relevant studies demonstrate, for example, that humans’ prosocial inclinations are not merely products of social conditioning or egoistic concerns; that prosocial inclinations can be cultivated by environmental factors and personal effort; that humans—even preverbal infants—have a natural inclination to prefer prosociality over its alternatives; and that growth in prosociality is positively associated with human health. Finally, I suggest we interpret Mencius’ expression “human nature is good” as a rhetorical tool to capture the totality of such empirically minded claims.
The concept of compassion as a virtue is thousands of years old. The last 20 to 30 years have seen a major growth of scientific research on exploring compassion’s psychological, physiological and social processes. This chapter traces compassion back to its evolutionary roots in child parent caring and attachment systems and explores how “motives to care” evolved to texture many forms of caring behavior. Humans are different from other animals to the extent that we have advanced cognitive competencies that allow for high-level forms of reasoning, self-awareness, and mindfulness. It is when the motivation to care is channeled through these competencies and is wisely and intentionally pursued that caring becomes compassion, and thus a virtue, partly because it can be chosen and cultivated.
The functional characteristics of binding sites for the neuropeptide oxytocin (OT) detected by radioautography in laminae I and II of the dorsal horn (DH) and on cultured neonatal DH neurons were studied on the latter using perforated patch-clamp recordings. The neurons were identified by their spike discharge properties and on the basis of the presence of met-enkephalin-like and glutamate decarboxylase-like immunoreactivities. OT (100 n m ) never induced any membrane current at a holding potential of −60 mV but increased the frequency of spontaneously occurring AMPA receptor-mediated EPSCs or the mean amplitude of electrically evoked EPSCs in a subset (35%) of neurons. The frequency of miniature EPSCs (m-EPSCs) recorded in the presence of 0.5 μ m tetrodotoxin was also increased by OT (100 n m ) without any change in their mean amplitude, indicating an action at a site close to the presynaptic terminal. The decay kinetics of any type of EPSC were never modified by OT. The effect of OT was reproduced by [Thr ⁴ ,Gly ⁷ ]-OT (100 n m ), a selective OT receptor agonist, and blocked by d(CH 2 ) 5 -[Tyr(Me) ² ,Thr ⁴ ,Tyr-NH 2 ⁹ ]-ornithine vasotocin (100 n m ), a specific OT receptor antagonist. Reducing the extracellular Ca ²⁺ concentration from 2.5 to 0.3 m m in the presence of Cd ²⁺ (100 μ m ) reversibly blocked the effect of OT on m-EPSCs. The OT receptors described here may represent the substrate for modulatory actions of descending hypothalamo-spinal OT-containing pathways on the nociceptive system.
The ventral striatum is considered an interface between limbic and motor systems. We followed the orbital and medial prefrontal circuit through the monkey basal ganglia by analyzing the projection from this cortical area to the ventral striatum and the representation of orbitofrontal cortex via the striatum, in the globus pallidus and substantia nigra. Following injections of Lucifer yellow and horse radish peroxidase into the medial ventral striatum, there is a very densely labeled distribution of cells in areas 13a and 13b, primarily in layers V and VI, and in medial prefrontal areas 32 and 25. Injections into the shell of the nucleus accumbens labeled primarily areas 25 and 32. The reaction product in the globus pallidus and the substantia nigra supports previous studies demonstrating that efferent projections from the ventral striatum are represented topographically in the ventral pallidum and nontopographically in the substantia nigra, pars compacta. Tritiated amino acid or PHA-L tracer injections into orbitofrontal cortex produce dense patches of terminal labeling along the medial edge of the caudate nucleus and the dorsal part of the nucleus accumbens. These results demonstrate that the orbital prefrontal cortex projects primarily to the medial edge of the ventral striatum and to the core of the nucleus accumbens. The arrangement of terminals in the globus pallidus and substantia nigra show two different patterns. Thus, the orbital and medial prefrontal cortex is represented in a confined region of the globus pallidus but throughout an extensive area of the dorsal substantia nigra. Terminals are extensive throughout the region of the dopaminergic neurons, suggesting that this input may influence a wide area of both the striatum and frontal cortex.
There is increasing evidence that experimental interventions that alter adrenal corticosteroid plasma concentrations can modulate aging changes in the rodent hippocampus. However, there still is very little evidence that elevation of endogenous corticosteroid levels within physiological ranges, such as occurs during chronic stress, can accelerate hippocampal aging-like changes. In addition, almost all prior intervention studies of corticosteroid effects on brain biomarkers of aging have utilized morphologic measures of aging, and it is not yet clear whether electrophysiologic biomarkers of hippocampal aging can also be accelerated by conditions that elevate corticosteroids. In the present studies, specific pathogen-free rats of three ages (4, 12, and 18 months at the start) were trained for 6 months (4 hr/d, 5 d/week) in a two-way shuttle escape task, using low intensity foot shock. This task induces “anxiety” stress, because animals receive little actual shock, but chronic training in the task has been shown to elevate plasma corticosteroids and to downregulate hippocampal corticosteroid receptors. At the end of 6 months, animals were allowed to recover for 3 weeks and were then assessed in acute, anesthetized preparations on a battery of hippocampal neurophysiological markers known to separate young from aged animals (frequency potentiation, synaptic excitability thresholds, EPSP amplitude). The brains were then fixed and sectioned for quantification of neuronal density in field CA1 (a highly consistent anatomic marker of hippocampal aging). The pattern of stress effects differed considerably across age groups. The two younger stress groups exhibited increased evidence of aging-like neurophysiologic change, but exhibited no indications of accelerated neuronal loss.(ABSTRACT TRUNCATED AT 250 WORDS)
In the laboratory rat and guinea pig, glucocorticoids (GCs), the adrenal steroids that are secreted during stress, can damage the hippocampus and exacerbate the hippocampal damage induced by various neurological insults. An open question is whether GCs have similar deleterious effects in the primate hippocampus. In fact, we showed that sustained and fatal stress was associated with preferential hippocampal damage in the vervet monkey; however, it was not possible to determine whether the excessive GC secretion that accompanied such stress was the damaging agent. The present study examines this possibility. Pellets of cortisol (the principal GC of primates) were stereotaxically implanted into hippocampi of 4 vervet monkeys; contralateral hippocampi were implanted with cholesterol pellets as a control. One year later at postmortem, preferential damage occurred in the cortisol-implanted side. In the cholesterol side, mild cell layer irregularity was noted in 2 of 4 cases. By contrast in the cortisol-exposed hippocampi, all cases had at least 2 of the following neuropathologic markers: cell layer irregularity, dendritic atrophy, soma shrinkage and condensation, or nuclear pyknosis. Damage was severe in some cases, and was restricted to the CA3/CA2 cellfield. This anatomical distribution of damage, and the cellular features of the damage agree with that observed in instances of GC-induced toxicity in the rodent hippocampus, and of stress-induced toxicity in the primate hippocampus. These observations suggest that sustained GC exposure (whether due to stress, Cushings syndrome or exogenous administration) might damage the human hippocampus.
Background: Anemia and oral mucositis are main side effects of radiotherapy (RT) and are important factors affecting the quality of life (QOL) in head and neck cancer (HNC) patients treated with RT. This study aimed to explore the safety and therapeutic efficacy of Tianwang Buxin Mini-pills (TWBXM) for the prevention of acute RT toxicity in HNC patients by using a randomized, double-blind and placebo-controlled study design. Patients and Methods: Seventy-three HNC patients participated the study. They were randomized into a treatment group (n = 38) and a control group (n = 35). All patients received daily either TWBXM treatment or placebo starting from the initiation of RT until 1-month follow-up after RT completion. All patients were evaluated for QOL, acute RT toxicities and laboratory data (hemoglobin [Hgb], white blood cell and platelet) at 3 time points: Pre-RT, upon RT completion and at TWBXM completion. Results: The TWBXM group maintained normal levels of Hgb during the duration of the study while the placebo group showed a decrease in Hgb (P = 0.035). Conclusions: This study demonstrated the safety and efficacy of TWBXM applied in the HNC patients receiving RT. It prevented the decrease of Hgb in HNC patients undergoing RT treatment as well 1-month-post-RT treatment. Further studies are needed to assess the effects of TWBXM for the prevention of other RT toxicities.
In this essay we describe the essential features of a neurobiological system whose purpose is to provide the motivation needed to bestow resources on others-the &"caregiving system.&" After presenting a brief review of the evolutionary theoretical background, we describe how insights from selective investment theory and animal models of maternal care can be used to identify caregiving neural circuitry that may be involved in human helping behavior. At a minimum, we suggest that caregiving neural circuitry should be responsive to need in others, manage motivational conflict, and be selectively attuned to cues that there is a low risk of exploitation. We conclude with some implications of this model, including challenges it poses to views of human motivation that emphasize self-interest.
In this article we introduce AMR's Special Topic Forum on Understanding and Creating Caring and Compassionate Organizations. We outline why the time is right for such a forum, uncover scholarly and philosophical roots of a focus on compassion and care, and provide a brief introduction to the diverse and rich set of articles contained in this forum. We describe the innovative theorizing uncovered by the special issue articles and summarize the rich set of possibilities they suggest for the practice of organizing.
Background:
Progesterone has been associated with robust positive effects in animal models of traumatic brain injury (TBI) and with clinical benefits in two phase 2 randomized, controlled trials. We investigated the efficacy and safety of progesterone in a large, prospective, phase 3 randomized clinical trial.
Methods:
We conducted a multinational placebo-controlled trial, in which 1195 patients, 16 to 70 years of age, with severe TBI (Glasgow Coma Scale score, ≤8 [on a scale of 3 to 15, with lower scores indicating a reduced level of consciousness] and at least one reactive pupil) were randomly assigned to receive progesterone or placebo. Dosing began within 8 hours after injury and continued for 120 hours. The primary efficacy end point was the Glasgow Outcome Scale score at 6 months after the injury.
Results:
Proportional-odds analysis with covariate adjustment showed no treatment effect of progesterone as compared with placebo (odds ratio, 0.96; confidence interval, 0.77 to 1.18). The proportion of patients with a favorable outcome on the Glasgow Outcome Scale (good recovery or moderate disability) was 50.4% with progesterone, as compared with 50.5% with placebo. Mortality was similar in the two groups. No relevant safety differences were noted between progesterone and placebo.
Conclusions:
Primary and secondary efficacy analyses showed no clinical benefit of progesterone in patients with severe TBI. These data stand in contrast to the robust preclinical data and results of early single-center trials that provided the impetus to initiate phase 3 trials. (Funded by BHR Pharma; SYNAPSE ClinicalTrials.gov number, NCT01143064.).
The neurobiology of stress and the neurobiology of social behavior are deeply intertwined. The social environment interacts with stress on almost every front: social interactions can be potent stressors; they can buffer the response to an external stressor; and social behavior often changes in response to stressful life experience. This review explores mechanistic and behavioral links between stress, anxiety, resilience, and social behavior in rodents, with particular attention to different social contexts. We consider variation between several different rodent species and make connections to research on humans and non-human primates.
The links among mothers' compassionate love for their child, autonomic nervous system activity, and parenting behavior during less and more challenging mother-child interactions were examined. Mothers expressed and reported less negative affect when they exhibited autonomic patterns of increased parasympathetic dominance (high parasympathetic and low sympathetic activation) or autonomic coactivation (high parasympathetic and high sympathetic activation) during the less challenging interaction and autonomic coactivation during the more challenging interaction. Compassionate love predicted less reported and observed negativity in mothers who showed increased sympathetic nervous system dominance (high sympathetic and low parasympathetic activation). Compassionate love appeared to help mothers, and particularly those who experienced strong physiological arousal during difficult parenting situations, establish positive socialization contexts for their children and avoid stress-induced adverse parenting. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
This article reviews the brain of ants in the context of their behavior. Division of labor underlies the social lifestyle of ants; it results not only in behavioral specialization, but also in some adaptations of ant brains. The structure and function of major brain neuropils is described (visual and olfactory centers and central multi-sensory integrative brain compartments) together with some of their neurons. Unlike social vertebrates, which have larger brains and cerebral cortices than soli-tary species, ant brains are not bigger than those of solitary insects, but they are more specialized. The biological suc-cess of ants is probably not so much the result of an individual's brain as of the concerted action of a colony's hundreds or thousands of brains.
Parents know the transformative nature of having and caring for a child. Among many mammals, giving birth leads from an aversion
to infant stimuli to irresistible attraction. Here, we review the biological mechanisms governing this shift in parental motivation
in mammals. Estrogen and progesterone prepare the uterus for embryo implantation and placental development. Prolactin stimulates
milk production, whereas oxytocin initiates labor and triggers milk ejection during nursing. These same molecules, interacting
with dopamine, also activate specific neural pathways to motivate parents to nurture, bond with, and protect their offspring.
Parenting in turn shapes the neural development of the infant social brain. Recent work suggests that many of the principles
governing parental behavior and its effect on infant development are conserved from rodent to humans.
This study examined the role of compassionate love (CL) in shaping cognitive, emotional, physiological, and behavioral responses to partner distress (N 1⁄4 56 couples). One member of each couple (the support provider) observed his/her partner perform an easy or difficult stress task (designed to vary signals of partner distress). Support providers in the difficult (vs. easy) condition showed more partner focus, emotional distress, and blood pressure reactivity during the task and expressed more support afterward. Sup- port providers high (vs. low) in CL showed greater partner focus and emotional empathy and sent more caring messages. Additional analyses suggest that CL increases sensitivity to a partner’s distress and that the link between CL and support behavior is mediated by increases in empathy and attention to one’s partner.
Mothers need to make caregiving decisions to meet the needs of children, which may or may not result in positive child feedback. Variations in caregivers' emotional reactivity to unpleasant child-feedback may be partially explained by their dispositional empathy levels. Furthermore, empathic response to the child's unpleasant feedback likely helps mothers to regulate their own stress. We investigated the relationship between maternal dispositional empathy, stress reactivity, and neural correlates of child feedback to caregiving decisions. In Part 1 of the study, 33 female participants were recruited to undergo a lab-based mild stressor, the Social Evaluation Test (SET), and then in Part 2 of the study, a subset of the participants, 14 mothers, performed a Parenting Decision Making Task (PDMT) in an fMRI setting. Four dimensions of dispositional empathy based on the Interpersonal Reactivity Index were measured in all participants-Personal Distress, Empathic Concern, Perspective Taking, and Fantasy. Overall, we found that the Personal Distress and Perspective Taking were associated with greater and lesser cortisol reactivity, respectively. The four types of empathy were distinctly associated with the negative (vs. positive) child feedback activation in the brain. Personal Distress was associated with amygdala and hypothalamus activation, Empathic Concern with the left ventral striatum, ventrolateral prefrontal cortex (VLPFC), and supplemental motor area (SMA) activation, and Fantasy with the septal area, right SMA and VLPFC activation. Interestingly, hypothalamus-septal coupling during the negative feedback condition was associated with less PDMT-related cortisol reactivity. The roles of distinct forms of dispositional empathy in neural and stress responses are discussed.
In order to survive after birth, mammalian infants need a caretaker, usually the mother. Several behavioral strategies have evolved to guarantee the transition from a period of intense caregiving to offspring independence. Here, we examine a selection of literature on the genetic, epigenetic, physiological, and behavioral factors relating to development and mother-infant interactions. We intend to show the utility of comparisons between rodent and human models for deepening knowledge regarding this key relationship. Particular attention is paid to the following factors: the distinct developmental stages of the mother-pup relationship as relating to behavior; examples of key genetic components of mammalian mother-infant interactions, specifically those coding for the hormones oxytocin and vasopressin; and the possible functions of gene imprinting in mediating interactions between genetics and environment in the mother-infant relationship. As early mother-infant attachment seems to establish the basic parameters for later social interactions, ongoing investigations in this area are essential. We propose the importance of interdisciplinary collaboration in order to better understand the network of genes, gene regulation, neuropeptide action, physiological processes, and feedback loops essential to understand the complex behaviors of mother-infant interaction.
The ovarian steroid hormone, progesterone, and its nuclear receptor, the progesterone receptor, are implicated in the progression of breast cancer. Clinical trial data on the effects of hormone replacement therapy underscore the importance of understanding how progestins influence breast cancer growth. The progesterone receptor regulation of distinct target genes is mediated by complex interactions between the progesterone receptor and other regulatory factors that determine the context-dependent transcriptional action of the progesterone receptor. These interactions often lead to post-translational modifications to the progesterone receptor that can dramatically alter receptor function, both in the normal mammary gland and in breast cancer. This review highlights the molecular components that regulate progesterone receptor transcriptional action and describes how a better understanding of the complex interactions between the progesterone receptor and other regulatory factors may be critical to enhancing the clinical efficacy of anti-progestins for use in the treatment of breast cancer.
The health and socioeconomic outcomes from being a caregiver are well described. In contrast, the long-term trajectories of caring undertaken by women, and the demographic, socioeconomic status, health status and health behaviour characteristics associated with these trajectories is not well known.
The data were from the Australian Longitudinal Study on Women's Health. Participants were 14,202 women born 1973-78 followed for 13 years, and 12,282 women born 1946-1951 followed for 9 years. Latent class analyses and multinomial logistic regression were used.
Five distinct trajectories of caring were identified for the younger women: these represented 'ongoing', 'starting', 'never' and 2 types of 'transitional' caring. While traditional indicators of poorer socioeconomic status were associated with trajectories representing 'ongoing' and 'starting' caring, they were not associated with 'transitional' caring trajectories. Three distinct trajectories of caring were identified for the mid-age women: these represented 'ongoing', 'starting' and 'never' caring. For the mid-age women, poorer socioeconomic status indicators were associated with the 'ongoing' caring, but not 'starting' caring.
Women in the 1973-78 cohort showed more varying and transitional caring trajectories compared to those in the 1946-51 cohort, and these trajectories were not associated with traditional socioeconomic indicators. An 'opportunity cost' theory for who become carers does not support young transitional carers or mid-aged women beginning new caring. Health policies, education and awareness campaigns for women carers need to target outside previously identified populations.
Modern theories of the evolution of human cooperation focus mainly on altruism. In contrast, we propose that humans’ species-unique forms of cooperation—as well as their species-unique forms of cognition, communication, and social life—all derive from mutualistic collaboration (with social selection against cheaters). In a first step, humans became obligate collaborative foragers such that individuals were interdependent with one another and so had a direct interest in the well-being of their partners. In this context, they evolved new skills and motivations for collaboration not possessed by other great apes (joint intentionality), and they helped their potential partners (and avoided cheaters). In a second step, these new collaborative skills and motivations were scaled up to group life in general, as modern humans faced competition from other groups. As part of this new group-mindedness, they created cultural conventions, norms, and institutions (all characterized by collective intentionality), with knowledge of a specific set of these marking individuals as members of a particular cultural group. Human cognition and sociality thus became ever more collaborative and altruistic as human individuals became ever more interdependent.
Recent studies suggest that parental caregiving is associated with adaptive changes in neurocognitive responses to emotional cues and oxytocin function, possibly reflecting the increased need of parents to monitor infants’ emotional states. In the current study, we investigated whether the changes associated with motherhood and oxytocin receptor genetic variation rs53576 are specific to the processing of infant cues as opposed to a more general increase in responsiveness to emotional cues. We measured event-related brain potentials (ERPs) and behavioral recognition responses from mothers of young infants (n = 48) and nulliparous females (n = 46) to infant and adult faces displaying strong and mild intensity emotional expressions. Mothers and GG allele carriers of the OXTR gene showed an early-latency (~100 ms) differential frontal ERP response to strong intensity facial expressions, and mothers also showed modulation of the posterior EPN waveform by negative valence. The early frontal ERP modulation was associated with faster emotion recognition performance across participants. Most importantly, these effects were highly specific to infant facial expressions. The results point to a dissociable neurocognitive system that is involved in monitoring infants’ emotional cues and may be important in supporting parental caregiving in humans.
Competition among males for access to reproductive opportunities is a central tenet of behavioural biology that has critical implications for studies of mating systems, sexual selection and the evolution of numerous phenotypic traits. Given the expectation that males should compete vigorously for access to females, it may at first seem paradoxical that males in some species cooperate to reproduce, often resulting in the apparent sacrifice of direct fitness by some members of these cooperative partnerships. Because this form of cooperation lies at the interface between natural, sexual and kin selection, studies of the adaptive consequences of male reproductive cooperation may yield important insights into how complex and sometimes conflicting selective pressures shape individual behaviour. Here, we define and review examples of reproductive cooperation among male animals. We take an integrative approach to reviewing the potential causes of maleemale cooperation, including potential adaptive hypotheses, ecological correlates, phylogenetic patterns and physiological mechanisms. The impact of male reproductive cooperation on sexual selection theory is also discussed. We conclude by outlining several important directions for future research, including efforts to improve understanding of the ecological and demographic contexts in which male reproductive cooperation occurs. Collectively, such analyses promise to improve our understanding of multiple fundamental concepts in evolutionary biology.
Traumatic brain injury is the leading cause of morbidity and mortality in young adults. The secondary injury in traumatic brain injury consists of a complex cascade of processes that simultaneously react to the primary injury to the brain. This cascade has been the target of numerous therapeutic agents investigated over the last 30 years, but no neuroprotective treatment option is currently available that improve neurological outcome after traumatic brain injury. Progesterone has long been considered merely a female reproductive hormone. Numerous studies, however, show that progesterone has substantial pleiotropic properties as a neuroprotective agent in both animal models and humans. Here, we review the increasing evidence that progesterone can act as a neuroprotective agent to treat traumatic brain injury and the mechanisms underlying these effects. Additionally, we discuss the current progress of clinical studies on the application of progesterone in the treatment of traumatic brain injuries.
Oxytocin (OXT) is a hypothalamic neuropeptide composed of nine amino acids. The functions of OXT cover a variety of social and nonsocial activity/behaviors. Therapeutic effects of OXT on aberrant social behaviors are attracting more attention, such as social memory, attachment, sexual behavior, maternal behavior, aggression, pair bonding, and trust. The nonsocial behaviors/functions of brain OXT have also received renewed attention, which covers brain development, reproduction, sex, endocrine, immune regulation, learning and memory, pain perception, energy balance, and almost all the functions of peripheral organ systems. Coordinating with brain OXT, locally produced OXT also involves the central and peripheral actions of OXT. Disorders in OXT secretion and functions can cause a series of aberrant social behaviors, such as depression, autism, and schizophrenia as well as disturbance of nonsocial behaviors/functions, such as anorexia, obesity, lactation failure, osteoporosis, diabetes, and carcinogenesis. As more and more OXT functions are identified, it is essential to provide a general view of OXT functions in order to explore the therapeutic potentials of OXT. In this review, we will focus on roles of hypothalamic OXT on central and peripheral nonsocial functions.
Wound healing capability is inextricably linked with diverse aspects of physical fitness ranging from recovery after minor injuries and surgery to diabetes and some types of cancer. Impact of the microbiome upon the mammalian wound healing process is poorly understood. We discover that supplementing the gut microbiome with lactic acid microbes in drinking water accelerates the wound-healing process to occur in half the time required for matched control animals. Further, we find that Lactobacillus reuteri enhances wound-healing properties through up-regulation of the neuropeptide hormone oxytocin, a factor integral in social bonding and reproduction, by a vagus nerve-mediated pathway. Bacteria-triggered oxytocin serves to activate host CD4+Foxp3+CD25+ immune T regulatory cells conveying transplantable wound healing capacity to naive Rag2-deficient animals. This study determined oxytocin to be a novel component of a multi-directional gut microbe-brain-immune axis, with wound-healing capability as a previously unrecognized output of this axis. We also provide experimental evidence to support long-standing medical traditions associating diet, social practices, and the immune system with efficient recovery after injury, sustained good health, and longevity.
The bond between a parent and an infant often appears to form effortlessly and intuitively, and this relationship is fundamental to infant survival and development. Parenting is considered to depend on specific brain networks that are largely conserved across species and in place even before parenthood. Efforts to understand the neural basis of parenting in humans have focused on the overlapping networks implicated in reward and social cognition, within which the orbitofrontal cortex (OFC) is considered to be a crucial hub. This review examines emerging evidence that the OFC may be engaged in several phases of parent-infant interactions, from early, privileged orienting to infant cues, to ongoing monitoring of interactions and subsequent learning. Specifically, we review evidence suggesting that the OFC rapidly responds to a range of infant communicative cues, such as faces and voices, supporting their efficient processing. Crucially, this early orienting response may be fundamental in supporting adults to respond rapidly and appropriately to infant needs. We suggest a number of avenues for future research, including investigating neural activity in disrupted parenting, exploring multimodal cues, and consideration of neuroendocrine involvement in responsivity to infant cues. An increased understanding of the brain basis of caregiving will provide insight into our greatest challenge: parenting our young.
Previous studies have provided conflicting evidence on whether being a family caregiver is associated with increased or decreased risk for all-cause mortality. This study examined whether 3,503 family caregivers enrolled in the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study showed differences in all-cause mortality from 2003 to 2012 compared with a propensity-matched sample of noncaregivers. Caregivers were individually matched with 3,503 noncaregivers by using a propensity score matching procedure based on 15 demographic, health history, and health behavior covariates. During an average 6-year follow-up period, 264 (7.5%) of the caregivers died, which was significantly fewer than the 315 (9.0%) matched noncaregivers who died during the same period. A proportional hazards model indicated that caregivers had an 18% reduced rate of death compared with noncaregivers (hazard ratio = 0.823, 95% confidence interval: 0.699, 0.969). Subgroup analyses by race, sex, caregiving relationship, and caregiving strain failed to identify any subgroups with increased rates of death compared with matched noncaregivers. Public policy and discourse should recognize that providing care to a family member with a chronic illness or disability is not associated with increased risk of death in most cases, but may instead be associated with modest survival benefits for the caregivers.
A sand-dwelling Mediterranean ant, Cataglyphis cursor, recently was discovered to engage in two new forms of rescue behaviour, behavioural patterns that require would-be rescuers to recognize what, exactly, holds nestmates in place. That is, when sand digging and limb pulling, two well-known forms of rescue in ants, did not result in release of victims ensnared with nylon thread and partially buried beneath the sand, rescuers next began to transport sand away from the snare and to direct their behaviour to the snare in particular, biting and tugging at the snare itself. To determine whether these new forms of precisely directed rescue behaviour, as well as their exclusive delivery to nestmates, as in C. cursor, were characteristic of other ants occupying similar ecological niches, we conducted experiments with five sand-dwelling Mediterranean ant species: Cataglyphis floricola, Lasius grandis, Aphaenogaster senilis, Messor barbarus and Messor marocanus. Our experiments revealed the full range of rescue behaviour, including snare biting and sand transport, in two species, C. floricola and L. grandis. Both species directed rescue exclusively towards nestmates, treating other individuals, even conspecifics, with aggression, thus highlighting the ants' discriminative capacities. Differences in the performance of rescue behaviour between these and the remaining species mirror differences in their ecology, including the threat of predatory antlions. Finally, because this precisely directed and exclusively delivered rescue behaviour in ants resembles behaviour that has been labelled empathy in rats, our results demonstrate that what can appear to be complex, cognitively motivated behaviour might come about through much simpler mechanisms.
The cytokine interleukin-6 (IL-6) is produced by a variety of cells, including macrophages, T-cells, and B-cells. Recent studies have confirmed a neuroendocrine role for IL-6 in the regulation of anterior pituitary (AP) hormone release. Because the neurointermediate pituitary lobe (NIL) may modulate AP hormone release, we investigated the production of IL-6 by NIL cells in vitro. NIL tissue removed from pituitary glands of male Long-Evans rats was enzymatically and mechanically dispersed, and the cells were subsequently cultured in 96-well tissue culture plates for 4-6 days in 10% serum-containing RPMI-1640. Test incubations were performed in serum-free RPMI-1640, and IL-6 concentrations were determined using the 7TD1 cell bioassay. Preliminary studies revealed a cell-dependent release of IL-6: increasing the number of NIL cells per well from 6.25 to 50 x 10(3) revealed detectable basal release of IL-6 between 25-50 x 10(3) cells/well. The endotoxin lipopolysaccharide (LPS; 100 ng/ml) and IL-1 beta (100 n...
Moving Beyond Self-Interest is an interdisciplinary volume that discusses cutting-edge developments in the science of caring for and helping others. Contributors raise foundational issues related to human caregiving. They advance new theories and data to show how natural selection might have shaped a genuinely altruistic drive to benefit others, how this drive intersects with the attachment and caregiving systems, and how it emerges from a broader social engagement system made possible by symbiotic regulation of autonomic physiological states. The contributors propose a new neurophysiological model of the human caregiving system and present arguments and evidence to show how mammalian neural circuitry that supports parenting might be recruited to direct human cooperation and competition, human empathy, and parental and romantic love. Some contributors show how an evolutionary perspective helps us better understand parental investment in and empathic concern for children at risk for, or suffering from, various health, behavioral, and cognitive problems. Other contributors identify circumstances that differentially predict caregiver benefits and costs, and raise the question of whether extreme levels of compassion are actually pathological. The section concludes with a discussion of semantic and conceptual obstacles to the scientific investigation of caregiving. Contributors also discuss possible interfaces between new models of caregiving motivation and economics, political science, and social policy development. They show how the new theory and research discussed in this volume can inform our understanding of economic utility, policies for delivering social services (such as health care and education), and hypotheses concerning the origins and development of human society, including some of its more problematic features of nationalism, conflict, and war. The contributions in this volume help readers appreciate the human capacity for engaging in altruistic acts, on both a small and large scale.
This chapter discusses the progress that has been made in the study of maternal behavior in the rat with special focus on the research that has been carried out at the Institute of Animal Behavior. It describes how maternal behavior arises from the hormonal conditions that exist during pregnancy, particularly around parturition when maternal behavior normally begins. The chapter demonstrates that the maternal behavior cycle is a developmental product of hormonal events during pregnancy, especially at its termination, and of behavioral stimulation received during interactions between the mother and her young. Investigation of females whose pregnancies were terminated prematurely by hysterectomy and/or ovariectomy has shown that the rise in estrogen, primarily, is responsible for the onset of maternal behavior under these conditions. To be effective this rise must occur free of the inhibiting influence of high levels of progesterone and that the decline in progesterone in addition to its permissive action with respect to estrogen may itself facilitate a short-term increase in maternal responsiveness. The chapter further deals with postpartum stimulus factors, which regulate maternal behavior and are involved in its maintenance and eventual decline.
Background:
Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Progesterone has been shown to improve neurologic outcome in multiple experimental models and two early-phase trials involving patients with TBI.
Methods:
We conducted a double-blind, multicenter clinical trial in which patients with severe, moderate-to-severe, or moderate acute TBI (Glasgow Coma Scale score of 4 to 12, on a scale from 3 to 15, with lower scores indicating a lower level of consciousness) were randomly assigned to intravenous progesterone or placebo, with the study treatment initiated within 4 hours after injury and administered for a total of 96 hours. Efficacy was defined as an increase of 10 percentage points in the proportion of patients with a favorable outcome, as determined with the use of the stratified dichotomy of the Extended Glasgow Outcome Scale score at 6 months after injury. Secondary outcomes included mortality and the Disability Rating Scale score.
Results:
A total of 882 of the planned sample of 1140 patients underwent randomization before the trial was stopped for futility with respect to the primary outcome. The study groups were similar with regard to baseline characteristics; the median age of the patients was 35 years, 73.7% were men, 15.2% were black, and the mean Injury Severity Score was 24.4 (on a scale from 0 to 75, with higher scores indicating greater severity). The most frequent mechanism of injury was a motor vehicle accident. There was no significant difference between the progesterone group and the placebo group in the proportion of patients with a favorable outcome (relative benefit of progesterone, 0.95; 95% confidence interval [CI], 0.85 to 1.06; P=0.35). Phlebitis or thrombophlebitis was more frequent in the progesterone group than in the placebo group (relative risk, 3.03; CI, 1.96 to 4.66). There were no significant differences in the other prespecified safety outcomes.
Conclusions:
This clinical trial did not show a benefit of progesterone over placebo in the improvement of outcomes in patients with acute TBI. (Funded by the National Institute of Neurological Disorders and Stroke and others; PROTECT III ClinicalTrials.gov number, NCT00822900.).
The Neurobiology of Parental Behavior takes an integrative approach that analyzes the neural underpinnings of parental behavior in mammals, including humans.