摘要:

ObjectivesThe objectives of the study described here were to 1) examine the coping style of patients with functional dyspepsia (FD) and 2) adopt a new interview questionnaire to examine the extent of discriminativeness in the use of coping strategies across different stressful situations.MethodsA matched case-control design was adopted to compare differences among a target group of 30 patients with FD, a pain control group of 30 patients with rheumatism, and a control group of 30 healthy persons. A new interview questionnaire, the Coping Flexibility Interview Schedule, was used to assess subjects’ experience of stressful life events, use of coping strategies, and perceived severity of major FD symptoms.ResultsSubjects with FD perceived their experienced stressors as more uncontrollable and as having a greater impact (p< .05). They also used more direct-action strategies but fewer divert attention, acceptance, social support, and relaxation strategies when handling stressful life events (p< .05). A significant group-by-controllability interaction effect was found (p< .001), indicating that FD subjects tended to use coping strategies nondiscriminatively, whereas both rheumatic and healthy subjects tended to use coping strategies more discriminatively across stressful life events of different extents of controllability.ConclusionsThese results indicate that FD patients are characterized by a nondiscriminative, action-oriented coping style. The implications of this finding for the extant body of research and the advantages of using our interview questionnaire, which has a more flexible format, are discussed.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveA high level of work stress has been associated with cardiovascular disease. However, the pathophysiological mechanisms underlying this association remain unclear. This study examined the effect of work stress on a cluster of metabolic and hemostatic risk factors.MethodsBlood was collected three times, on the first, third, and fifth day of a work week, from 124 middle-aged, white-collar workers. Metabolic measures were insulin, glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and total cholesterol. Hemostatic measures were fibrinogen, tissue-type plasminogen activator activity, tissue-type plasminogen activator antigen, and type 1 plasminogen activator inhibitor antigen. Chronic work stress was defined according to Siegrist’s model as 1) a combination of high effort and low reward at work (effort-reward imbalance) or 2) high overcommitment (an exhaustive work-related coping style).ResultsOvercommitment, but not imbalance or the imbalance-overcommitment interaction, was associated with an impaired fibrinolytic system, as reflected in decreased tissue-type plasminogen activator activity levels and increased type 1 plasminogen activator inhibitor antigen levels on all three measurement occasions. After controlling for body mass index, total cholesterol, triglycerides, high-density lipoprotein/low-density lipoprotein cholesterol ratio, glucose, and insulin, the relation between overcommitment and the fibrinolytic factors was attenuated but remained significant.ConclusionsThe results suggest that individuals with an exhaustive coping style at work have an impaired fibrinolytic capacity that is possibly due to the effects of chronic stress on insulin resistance.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to assess the impact on noninvasive ambulatory blood pressure monitoring on physical activity measured objectively by use of triaxial accelerometers.MethodsTwenty-four working men and women performed ambulatory blood pressure plus activity monitoring for 1 working day and evening and activity monitoring alone for a separate day and evening. Blood pressure measures were taken at 20-minute intervals during the day and 30-minute intervals in the evening and were accompanied by diary assessments of mood, location, and posture. Comparisons were made of energy expenditure on the 2 days and of activity levels during the minutes surrounding each blood pressure reading and diary completion.ResultsEnergy expenditure assessed in terms of activity calories per hour was significantly lower during blood pressure plus activity monitoring compared with activity monitoring alone (mean 37.3, SD = 16.3 vs. mean = 43.0, SD = 18.7 kcal, respectively:p= .02). Energy expenditure was lower during the 4 minutes surrounding each blood pressure reading than in the intervals between blood pressure readings. However, energy expenditure was also lower in the intervals between blood pressure readings than during comparable times on the activity only monitoring day. Blood pressure, heart rate, and physical activity were moderately correlated within individuals.ConclusionsAmbulatory blood pressure recording using automated sphygmomanometers is associated with reduced physical activity during the monitoring day. This is due partly to regular periods of immobility during cuff inflation and deflation and diary completion and partly to more general self-imposed restrictions on activity. This pattern has implications for the representativeness of ambulatory blood pressure monitoring, and the construction of ambulatory monitoring diaries.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis study examined the effects of “tanden breathing” by Zen practitioners on cardiac variability. Tanden breathing involves slow breathing into the lower abdomen.MethodsEleven Zen practitioners, six Rinzai and five Soto, were each studied during 20 minutes of tanden breathing, preceded and followed by 5-minute periods of quiet sitting. During this time, we measured heart rate and respiration rate.ResultsFor most subjects, respiration rates fell to within the frequency range of 0.05 to 0.15 Hz during tanden breathing. Heart rate variability significantly increased within this low-frequency range but decreased in the high-frequency range (0.14–0.4 Hz), reflecting a shift of respiratory sinus arrhythmia from high-frequency to slower waves. Rinzai practitioners breathed at a slower rate and showed a higher amplitude of low-frequency heart rate waves than observed among Soto Zen participants. One Rinzai master breathed approximately once per minute and showed an increase in very-low-frequency waves (<0.05 Hz). Total amplitude of heart rate oscillations (across frequency spectra) also increased. More experienced Zen practitioners had frequent heart rhythm irregularities during and after the nadir of heart rate oscillations (ie, during inhalation).ConclusionsThese data are consistent with the theory that increased oscillation amplitude during slow breathing is caused by resonance between cardiac variability caused by respiration and that produced by physiological processes underlying slower rhythms. The rhythm irregularities during inhalation may be related to inhibition of vagal modulation during the cardioacceleratory phase. It is not known whether they reflect cardiopathology.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThere is evidence that depression and panic disorder are both associated with an increased frequency of clinical pain complaints. A change in pain sensitivity is alleged to be involved in this phenomenon. However, few studies have assessed clinical pain complaints and pain sensitivity in the same group of patients.MethodsThirteen patients with a major depressive disorder, 13 patients with a panic disorder (diagnoses based on theDiagnostic and Statistical Manual of Mental Disorders,fourth edition), and 13 healthy control subjects were investigated. None of the subjects were taking medications. Body maps were used to measure the number of painful sites as well as the intensity and unpleasantness of pain complaints in the previous 6 months. Furthermore, pain thresholds for pressure, cold, and heat were assessed at the forearm or hand.ResultsPatients with depression and panic disorder had significantly more frequent, more intense, and more unpleasant pain complaints than healthy control subjects. Despite this similarity, patients with depression had significantly higher pain thresholds than patients with panic disorder in two (pressure and cold) of three stimulus modalities and significantly higher pressure pain thresholds than the healthy control subjects. There were no differences between the pain thresholds of patients with panic disorder and healthy control subjects. The correlations between clinical pain measures and pain thresholds were generally weak.ConclusionsThese findings suggest that the clinical pain complaints of patients with depression and panic disorder cannot simply be explained by changes in pain sensitivity.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis study examined whether burnout at work is associated with leukocyte adhesiveness/aggregation (LAA), a phenomenon known to be affected by stress.MethodsThe LAA levels of 179 employees (68 men and 111 women) of Tel Aviv University were determined when the employees underwent their annual routine medical checkup. Blood pressure and toxic chemical exposure were also measured, and background data were retrieved from medical records. Information on burnout and somatic complaints (known to be a general marker of stress) was collected through a self-report questionnaire.ResultsTotal burnout and each of its subcomponents, emotional exhaustion, chronic fatigue, and cognitive weariness, was significantly associated with LAA levels, even after controlling for age, sex, and educational level. Burnout and somatic complaints intercorrelated positively, but somatic complaints were not significantly associated with LAA levels before or after controlling for the above possible confounders.ConclusionsBurnout was positively associated with LAA levels. This finding is consistent with the growing evidence of the negative impact of burnout on physical health. The lack of an association between somatic complaints and LAA levels reinforces the claim that burnout and stress are two different concepts.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

BackgroundNumerous research findings support the proposed connection between such psychological characteristics as stress and hostility and the manifestation of disease. However, less evidence is available concerning the role(s) psychological factors might play in the process of disease recovery.MethodsEighty patients with known coronary disease and exercise-induced ischemia underwent treadmill exercise testing and 48-hour ambulatory electrocardiographic monitoring and completed a battery of standardized psychological tests assessing hostility, depression, and daily stress on four occasions during a 12-week pharmacological treatment study. After withdrawal of antiischemic drugs at baseline, patients returned for subsequent tests at 3-week intervals. During the second and third intervals, patients were prescribed one of two antiischemic medications, atenolol or amlodipine, or given a placebo. All patients were then placed on a combination treatment protocol for the 3 weeks before the final testing date.ResultsThe combination treatment produced highly significant benefits across all measured cardiac variables (20.3% improvement in exercise performance, 13% reduction in reported angina, 64.0% reduction in the frequency of ischemic episodes; for all,p< .01). However, results showed that high baseline levels of daily stress were associated with reliably smaller treatment effects on measures of ischemia frequency and treadmill exercise time and with a significantly greater likelihood of reporting angina after treatment (r= −0.24, −0.25, and −0.33, respectively;p<.05). In addition, high baseline hostility predicted significantly smaller diastolic blood pressure improvements (r= −0.29,p< .05).ConclusionsThese results indicate that psychological risk factors may have globally negative effects on the course of treatment and suggest particular factors that may warrant attention in trials targeting cardiac symptom reduction.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveOur objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.MethodsThis study was a case-crossover study within the Stockholm Heart Epidemiology Program. Exposure in the period immediately preceding MI was compared with exposure during a control period for each case. From April 1993 to December 1994, 699 patients admitted to coronary care units in Stockholm County were interviewed.ResultsDuring a period of 1 hour after an episode of anger, with an intensity of at least “very angry,” the relative risk of MI was 9.0 (95% CI, 4.4–18.2). In patients with premonitory symptoms, the time of disease initiation may be misclassified. When restricting the analyses to those without such symptoms, the trigger risk was 15.7 (95% CI, 7.6–32.4). The possibility of examining effect modification was limited by a lack of statistical power (eight exposed cases). Results of the analyses suggested, however, an increased trigger effect among subjects reporting nonhostile usual behavior patterns, nonovert strategies of coping with aggressive situations (not protesting when being treated unfairly), and nonuse of &bgr;-blockers.ConclusionsThe hypothesis that anger may trigger MI is further supported, with an increased risk lasting for approximately 1 hour after an outburst of anger. It is suggested that the trigger risk may be modified by personal behavior patterns.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID