摘要:

ObjectiveWe investigated the modulation of pulmonary function by mood states in the daily life of asthmatic patients and nonasthmatic control subjects and its relationship to the airway effects of laboratory induction of emotion using films.MethodsTwenty asthmatic patients and 20 nonasthmatic control subjects participated in a laboratory session in which various emotions (ie, anxiety, anger, depression, happiness, elation, contentment, and neutrality) were induced by films. Respiratory resistance (Ros) was measured by forced oscillation. After this session, participants kept mood diaries, including regular spirometric self-assessments, for at least 3 weeks. Episodes of strong negative or positive mood were selected from these diaries and compared with conditions of relative affective neutrality.ResultsIn asthmatic patients, negative mood states, and to a lesser degree positive mood states, were associated with a reduction in forced expiratory volume in the first second (FEV1) compared with neutral states. These effects were not observed in nonasthmatic control subjects. Self-reports of arousal varied in a reciprocal manner with FEV1, whereas physical activity did not vary systematically between mood episodes. A moderate negative relationship between changes in FEV1during negative mood episodes and changes in Rosduring viewing of the depressing film was also observed in asthmatic patients.ConclusionPulmonary function of asthmatic patients is negatively affected by strong mood states in daily life. Airway effects of negative emotion induction, particularly depression, can predict changes in pulmonary function in response to negative mood in the field.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Millions worldwide have asthma, with the numbers succumbing increasing sharply in the past two decades. After 2000 years of scientific study, who succumbs to asthma when is as puzzling as who regains health when and how. The discipline of psychosomatic medicine and science investigates and treats diseases like asthma that typically confound general medicine. Still psychosomatic medicine, like general medicine, only manages but does not remedy asthma, which can currently only be in remission but not cured. This historical review reveals the progress and missteps that have been made in the study and treatment of asthma by comparing the general medicine approach with the major research findings on asthma published over 60 years inPsychosomatic Medicine. Research has identified antecedent, collateral, and subsequent factors to scientifically describe and control this disease in terms of diagnosis, management, and treatment. Paradoxically and regrettably, the prognosis for those with asthma is worse than ever. Curious also that a noninfectious disease should spread so rapidly and mostly for specific groups identified by variables like age, gender, ethnicity, and socioeconomic status. Furthermore, partial, not full, family concordance indicates merely genetic influence, not determination. General medicine now focuses on enumerating the range of environmental and situational triggers, or stimuli, producing asthma and describing the pathophysiology of bronchial inflammation. With a more comprehensive multifactorial approach, psychosomatic medicine seems well suited to investigate further the physiological, psychological, social, and environmental factors implicated in this medical conundrum. A future challenge for psychosomatic medicine is to stem the tide of rising prevalence and cure the disease of asthma.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveCoinfection with herpes simplex virus type 2 (HSV-2) is common in individuals infected with human immunodeficiency virus (HIV) and may have health implications. This study examined the effect of a 10-week cognitive behavioral stress management (CBSM) intervention on immunoglobulin G (IgG) antibody titers to HSV-2 in a group of mildly symptomatic HIV-infected gay men and the degree to which these effects were mediated by psychosocial and endocrine changes during the 10-week period.MethodsSixty-two HIV+gay men were randomly assigned to either a 10-week CBSM intervention (N= 41) or a wait-list control condition (N= 21). Anxious mood, social support, cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratio levels, and HSV-2 IgG antibody titers were assessed at baseline and after the 10-week period. CBSM participants also recorded their stress levels before and after at-home relaxation practice.ResultsHSV-2 IgG titers were significantly reduced in the CBSM participants but remained unchanged in the control group after the 10-week intervention period. Increases in one type of social support, perceived receipt of guidance, during the 10 weeks was associated with and partially mediated the effect of the intervention on HSV-2 IgG. Similarly, decreases in cortisol/DHEA-S ratio levels were associated with decreases in HSV-2 IgG, and lower mean stress levels achieved after home relaxation practice were associated with greater decreases in HSV-2 IgG among CBSM participants.ConclusionsThese findings suggest that behavioral and psychosocial changes occurring during CBSM interventions, including relaxation, enhanced social support, and adrenal hormone reductions, may help to explain the effects of this form of stress management on immune indices such as HSV-2 antibody titers.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectivePrior reports have pointed to an adverse effect of sexual assault on subsequent health, particularly depression and obesity, in women. The objective of this study was to determine whether there is an association between self-reported sexual assault history and objective parameters of physical health in a sample of older men and women.MethodsWe conducted a cross-sectional study of white, middle to upper middle class, older (median age 75 years) men (N= 533) and women (N= 826) within a defined community setting. Sex-specific, age-adjusted risks were calculated for 11 common chronic medical conditions (10 for each sex: coronary heart disease, hypertension, diabetes, osteoporosis, obesity, asthma, migraine, thyroid disease, and arthritis in all subjects; breast cancer in women; and prostate cancer in men) and confirmed by physical or laboratory examination or review of medical records.ResultsSexual assault was reported by 5.4% of men and 12.7% of women; repeated exposure was reported by 10.3 and 21.9% of sexually assaulted men and women, respectively. In women, a history of sexual assault was associated with an increased risk of 2 of 10 conditions: arthritis (OR = 1.76, 95% CI = 1.13–2.76) and breast cancer (OR = 2.21, 95% CI = 1.12–4.33). A “dose-response” effect was observed: Multiple episodes of sexual assault carried a two- to three-fold increased risk of these diseases compared with a single episode. In men, the only statistically significant association was between sexual assault and thyroid disease (OR = 4.68, 95% CI = 1.08–20.3).ConclusionsThese data partially replicate findings from other studies of adverse effects of sexual trauma on health, although the specific diseases are different. Causal mechanisms cannot be inferred from these data. Studies in other cohorts are warranted.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveSubjects with functional dyspepsia (FD) in most previous studies have been confined to those who sought medical consultation. The generalizability of results from these studies to individuals with FD who do not seek medical consultation is limited. This study examined 1) differences in perceptual and behavioral characteristics between “nonconsulters” and “consulters” with FD and 2) the influence of these characteristics on dyspeptic and psychological symptoms.MethodsA matched case-control design was used to compare differences among 43 nonconsulters with FD, 43 consulters with FD, and 43 healthy individuals. Subjects’ monitoring perceptual style, confrontative coping behaviors, dyspeptic symptoms, anxiety, and depression were assessed by using well-validated questionnaires.ResultsFD consulters exhibited higher levels of monitoring, confrontative coping, anxiety, and depression than FD nonconsulters and healthy subjects (pvalues < .01). Results from discriminant analysis revealed that all these variables reliably predicted the membership of the three groups. Significant Monitoring by Confrontative Coping interaction effects were also found, indicating the conjoint influences of these variables on dyspeptic and psychological symptoms.ConclusionsThese results show that FD nonconsulters are distinguishable from FD consulters by their perceptual style, coping behaviors, and psychological symptoms. Both monitoring perceptual style and confrontative coping behaviors may magnify dyspeptic and psychological symptoms in individuals with FD, especially those who seek medical consultation.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThis study investigated experimentally whether acute stress alters food choice during a meal. The study was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories of food and interactions with eating attitudes.MethodsSixty-eight healthy men and women volunteered for a study on “the effects of hunger on physiology, performance, and mood.” Eating attitudes and food preferences were measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet, salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal. Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period, when appetite for 34 foods and food intake were recorded.ResultsIncreases in blood pressure and changes in mood confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress.ConclusionsIncreased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in food choice.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveResponses to stressful events are generally regarded as reactions of the organism to accommodate to or compensate for stress. This reaction is classically described as an activation of the sympathoadrenal system and the hypothalamic-pituitary-adrenocortical (HPA) axis. Activation of the release of growth hormone and prolactin in blood also occurs during various types of stress. Assuming that the stress response is a neuroendocrine mechanism that occurs in anticipation of physical exercise, we investigated whether an incremental exercise protocol can be used as a model stressor to disclose a distinct pattern of activation in these hormonal systems, which would support the notion that these systems have different roles in preparing the organism for physical activity and recovery. Moreover, such a model may help improve our understanding of the endocrine expressions of psychological stress.MethodsAfter an overnight fast, 8 healthy men (age, 19–26 years) cycled at 40, 60, 80, and 100% of the power output at &OV0312;o2maxin successive time blocks of 10 minutes each up to exhaustion. Venous blood was sampled immediately before exercise, at the end of each block, and during the recovery phase 5 and 30 minutes after exercise. Plasma adrenalin and noradrenalin were measured by high-performance liquid chromatography; plasma adrenocorticotropic hormone, &bgr;-endorphin, cortisol, growth hormone, and prolactin were measured by specific immunoassays. Heart rate and levels of blood lactate and adrenalin were measured as markers of workload-related responses.ResultsResults showed that increases in heart rate, lactate, adrenalin, noradrenalin, and growth hormone reflected the relative workload, in contrast to increases in adrenocorticotropic hormone, &bgr; endorphin, and prolactin, which were observed only after exercise reached an intensity of 80% &OV0312;o2max. Increases in cortisol were found just after exhaustion. The delayed response of cortisol may be initiated by a drop in blood glucose levels but may also be considered preparatory to vigorous muscular effort and protective against tissue damage.ConclusionsMeasurement of the cumulative response to exercise shows that activation of stress hormones occurs at different time points, supporting the notion that these hormones have different roles in preparing the organism for physical activity and recovery: ie, workload- and effort-related adaptation on one hand and protection against disturbed homeostasis on the other. The delayed response of the HPA axis during incremental exercise contrasts with the nondelayed HPA axis response observed during psychological stress and points to involvement of different neurobiological and cognitive emotional mechanisms.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectivePrior research suggests that the diagnosis and treatment of cancer can result in the development of symptoms of posttraumatic stress disorder (PTSD). Based on Lazarus and Folkman’s model of stress, the current study examined whether trauma appraisals, coping, social support, and social constraint were associated with the severity of PTSD symptoms in cancer patients who had undergone bone marrow transplantation (BMT).MethodsParticipants were 23 males and 79 females treated with BMT an average of 20 months previously (range = 3–62 months). Past and current psychiatric diagnoses were assessed through a structured clinical interview. PTSD symptomatology and other psychological variables were assessed using standardized self-report measures.ResultsResults indicated that 5% of participants met diagnostic criteria for current PTSD. Participants reported an average of three to four symptoms of PTSD (range = 0–16). Univariate analyses confirmed predictions that increased PTSD symptomatology would be associated with more negative appraisals of the BMT experience, greater use of avoidance-based coping strategies, lower levels of social support, and greater social constraint (p< .05). Regression analyses indicated that each of these variables accounted for significant (p< .05) variability in PTSD symptomatology above and beyond relevant demographic and medical variables.ConclusionsResults of the present study confirm and extend prior research regarding the prevalence of PTSD and PTSD symptoms among patients treated for cancer. In addition, the study identified a set of theoretically derived psychological characteristics that seem to place patients at risk for greater PTSD symptomatology after BMT.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID