ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveAlthough many studies have focused on the relationship between stress and health, few have examined the impact of multiple types of stressors. The current study investigated the health impact of four stressors: sexual and physical abuse history, lifetime losses and traumas, turmoil in childhood family, and recent stressful life events.MethodThe sample included 239 female patients from a referral-based gastroenterology clinic.ResultsWe found that the four stressors (abuse history, lifetime traumas, turmoil in childhood family, and recent stressful life events) were related to poor health status (eg, more pain, symptoms, bed disability days, physician visits, functional disability, and psychological distress); together, these stressors accounted for 32% of the variance in overall current health. Furthermore, women who scored high on one type of stressor also tended to have experienced other types. Unlike many previous studies, we did not find that social support buffered the effects of stress.ConclusionsThis study provides evidence that many different types of stressors independently contribute to poor health outcome. Such findings suggest that health practitioners and researchers should question patients about histories of traumatic events, in addition to the examination of the biological aspects of illness, inasmuch as both may have notable effects on health status.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveAlthough psychological stress and smoking have been proposed as contributing factors to Graves' disease, their independent roles in the pathogenesis of this disease have not been determined. We assessed the association between Graves' disease and psychological stress and smoking by using multivariate analysis.MethodsBy a matched case-control method, we investigated the association between Graves' disease and stressful life events, daily hassles, smoking, drinking habits, coping skills, and social support in 228 patients (182 women and 46 men) with newly diagnosed Graves' disease; we used the conditional maximum likelihood method.ResultsAfter data were adjusted for daily hassles, smoking, drinking habits, social support, and coping skills, we found that stressful life events were significantly associated with the risk of Graves' disease in women. The relative risk was 7.7 for women with the highest stress score compared with women with the lowest stress score (95% confidence interval, 2.2 to 27, p for trend < .001). Smoking was also independently associated with the risk of Graves' disease in women. The relative risk for women with the highest number group compared with women with the lowest number group for smoking cigarettes was 5.1 (95% confidence interval, 1.0 to 27; p for trend < .001). These factors were not significantly associated with Graves' disease in men.ConclusionsPsychological stress and smoking were associated with Graves' disease in women, but not in men.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThis study was undertaken to determine the relationship between heightened reactivity of blood pressure (BP) during stress and 5-year changes in blood pressure and hypertensive status, using the CARDIA study.Methodor=to8 mm Hg, thought to represent a clinically significant increase) over the next 5 years. Logistic regression models were used to control for potential covariates. Significant BP change and the development of hypertension (BP greater than 140/90 or taking medication for hypertension) over the 5-year follow-up were examined in separate analyses.ResultsIncreased systolic blood pressure (SBP) reactivity to the video game was associated with a significant 5-year SBP increase among the entire cohort, independent of resting SBP (p < .0001). Subsequent analyses showed that this relationship held for men but not for women. Reactivity to the star-tracing task or the cold pressor test did not predict significant BP change. Among black men only, new hypertensives (N = 36) had greater diastolic blood pressure (DBP) reactivity to the video game (p = .01). Conclusions: Although BP reactivity to all physical and mental stressors used in this study did not consistently predict 5-year change in BP in this young cohort, the results indicate that reactivity to a video game stressor predicts 5-year change in BP and early hypertension among young adult men. These findings are consistent with other studies showing the usefulness of stressors producing a primarily beta-adrenergic response in predicting BP change and hypertension. The results may be limited by the shortened initial rest and recovery periods used in the CARDIA protocol.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveResearch has confirmed substantial links between OCD and AN. Not only are there psychopathological similarities between the two syndromes, but a marked neurochemical correspondence. Extensive exercising is a common feature of AN and also has relevance in its links with OCD. There is evidence from the exercise-induced weight-loss syndrome in animals that exercise and caloric restriction, in combination, tend to increase serotonergic activity in a synergistic manner. This syndrome has been proposed as a valid model of OCD as well as for AN. To date, little research has directly tested this theory in the human condition.MethodFifty-three AN patients were categorized as high-level exercisers (N = 22) or moderate/nonexercisers (N = 31) based on the frequency of their physical activity over the year before assessment.ResultsExercisers scored significantly higher on a measure of OC personality characteristics, OC symptomatology, and perfectionism-a personality factor associated with the development of Obsesssive-Compulsive Personality Disorder. On the other hand, there were no group differences on other salient eating disorder characteristics such as body esteem, self-esteem, or weight preoccupation. There were also no differences in degree of emaciation as indicated by Body Mass Index.ConclusionsFindings suggest that among AN patients obsessional personality characteristics are linked to high-level exercising, and that exercising is associated with a greater degree of OC symptomatology. Results are discussed in the context of current theories of AN, OCD, and some biological mechanisms.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThis study investigates psychological and psychobiological processes in patients with somatization syndrome.MethodWe compared physiological measures (heart rate, finger pulse volume, electrodermal activity, electromyography), cortisol levels, and subjective well-being during rest and during a mental stress task as well as selective attention and memory for illness-related words in 58 patients with somatization syndrome and 21 healthy controls.ResultsThe somatization group had higher morning salivary cortisol concentrations, higher heart rates, and lower levels of finger pulse volume. During the mental stress task, patients with somatization syndrome felt more distressed and had higher heart rates, whereas controls showed habituation to the experimental situation. We were unable to demonstrate an attention or memory bias specific for somatization.ConclusionsThe results point to several psychological, psychophysiological, and psychobiological mechanisms that might be involved in the maintenance of somatization syndrome. These results are discussed from a cognitive-psychobiological perspective.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveWe have previously reported decreases in dysphoria, anxiety, and total mood disturbance in symptomatic HIV seropositive gay men after a 10-week cognitive behavioral stress management (CBSM) group intervention. This structured intervention was designed a) to increase cognitive and behavioral coping skills related to managing the distress of symptomatic HIV, and b) to increase social support among group members. Here we examine the relative contribution of changes in coping skills and social support during the intervention period to reductions in dysphoria, anxiety, and distress-related symptoms in this sample.MethodsParticipants were randomized to a 10-week CBSM group intervention or to a wait-list control condition. Coping, social supports, and mood were measured before and after the intervention period.ResultsMembers of the CBSM group (N = 22) showed significant improvement in cognitive coping strategies involving positive reframing and acceptance, and in social supports involving attachment, alliances, and guidance at the end of the 10-week CBSM program compared with controls (N = 18) who showed decrements in these coping abilities and no changes in social support. Improved cognitive coping, specifically acceptance of the HIV infection, was strongly related to lower dysphoria, anxiety, and total mood disturbance in both conditions. Changes in social support and in cognitive coping skills seem to mediate the effects of the experimental condition on the changes in distress noted during the intervention.ConclusionsThese results suggest that cognitive coping and social support factors can be modified by psychosocial interventions and may be important determinants of the changes in psychological well-being and quality of life during symptomatic HIV infection that can be achieved through this form of intervention.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThe purpose of this survey was to study the sensation of oral dryness and its underlying factors in the 55-year-old population of Oulu (a medium-sized Finnish town), 780 of whom (77%) participated.MethodIn addition to the examination of oral health status and salivary flow rate measurements, depressive symptoms were determined on the basis of the Zung Self-Rating Depression Scale (ZSDS). The participants were also interviewed about their health, medication, physical health, physical activity, smoking habits, alcohol consumption, and factors related to their work.ResultsThe prevalence of subjective sensations of dry mouth was 25.8% among men and 33.3% among women (p = 0.025). A statistically significant association was found between a subjective sensation of dry mouth and a low unstimulated flow rate, regular smoking, xerogenic medication, and the presence of at least one illness connected with dry mouth. Those who had a sensation of dry mouth also thought their physical condition and their health to be poorer and more often had a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with the sensation of oral dryness.ConclusionsWhen evaluating the causes of the sensation of dry mouth, the possibility of depression as an underlying factor should be considered.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThe present study was undertaken to elucidate possible mechanisms underlying sex differences in cardiovascular measures or reactivity to challenge. Because there is vastly diverging literature on the issue, we tried to control for endocrine and psychological factors, which might contribute to some of the apparent discrepancies.MethodsBlood pressure, heart rate, adrenaline, and noradrenaline in women (N = 24) and men (N = 14) were examined during baseline and challenge (Stroop Test and Cold Face Test). Adrenoceptor density on lymphocytes (beta2) and platelets (alpha2) were determined to examine possible sex differences in underlying cardiovascular mechanisms. Gender effects were controlled by assessing gender role orientation and task appraisal. Women were tested during either the follicular (N = 12) or the luteal (N = 12) phase of the menstrual cycle (verified by estradiol, progesterone, and luteinizing hormone).ResultsFollicular and luteal phase women did not differ in any parameter except progesterone. We observed sex-related differences in absolute levels of physiological parameters, the male group having higher systolic blood pressure levels, higher adrenaline plasma concentrations, and significantly more alpha2-adrenergicreceptors. Both challenges elicited pronounced cardiovascular and endocrine responses. Men and women did not differ in response magnitude, in task appraisal, or gender role orientation.ConclusionsThe assumption that female sex hormones reduce reactivity to challenge is not supported by our data. The frequently reported male/female differences in reactivity may be caused by an interaction of gender and task characteristics.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveLaboratory experiments suggest that endogenous opioids inhibit blood pressure responses during psychological stress. Moreover, there seem to be considerable individual differences in the efficacy of opioid blood pressure inhibition, and these differences may be involved in the expression of risk for cardiovascular disease. To further evaluate the possible role of opioid mechanisms in cardiovascular control, the present study sought to document the effects of the long-lasting oral opioid antagonist naltrexone (ReVia, DuPont, Wilmington, DE) on ambulatory blood pressure responses during naturally occurring stress.MethodThirty male volunteers participated in a laboratory stress study using naltrexone followed by ambulatory blood pressure monitoring during the subsequent 24-hour period. Within-subject analyses were performed on ambulatory blood pressures under placebo and naltrexone conditions.ResultsLaboratory results indicate no significant group effects of naltrexone on blood pressure levels or reactivity. Ambulatory results indicate that during periods of low self-reported stress, no effect of opioid blockade was apparent. In contrast, during periods of high stress, opioid blockade increased ambulatory blood pressure.ConclusionsThese findings suggest that naltrexone-sensitive opioid mechanisms inhibit ambulatory blood pressure responses during naturally occurring stress.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID