摘要:

ObjectiveThe objective of this study was to examine the effects of partner interactions on ambulatory blood pressure in a sample of 120 healthy adults who were monitored over a 6-day period.MethodsAfter each blood pressure measurement, participants rated characteristics of ongoing social interactions, along with emotional activation, physical activity, talking, posture, and other covariates, with computer-assisted self-report assessments.ResultsUsing multilevel modeling, we showed that blood pressure was significantly lower during social interactions with one’s partner relative to social interactions with any other person and relative to periods of not interacting. Interactions with partners also were characterized by significantly less talking and emotional activation and more intimacy and perceived emotional support; however, these differences did not mediate the partner effect on blood pressure. In addition, the relative benefits of interacting with a partner were not moderated by relationship quality, gender, or race.ConclusionsThe effects of social situations on ambulatory blood pressure may represent one pathway through which social relationships affect cardiovascular health.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveAlthough considerable evidence implicates hostility in the development of coronary artery disease (CAD), the pathogenic mechanisms remain poorly understood. We have developed a psychophysiological model that holds that altered autonomic nervous system function links psychological traits with CAD outcomes. In laboratory studies, stressors reduce high-frequency (HF) heart period variability, an index of cardiac vagal modulation. With ambulatory electrocardiographic recording, we demonstrated in a predominantly male sample that hostility was inversely associated with HF power, but only during waking hours. These findings are consistent with the hypothesis that hostile individuals experience multiple stressful interpersonal transactions each day, resulting in overall lower HF power during the day but not at night.MethodsTo further evaluate this hypothesis, we screened 96 subjects using the Cook-Medley Hostility Scale and selected 15 men and 15 women representing a wide distribution of hostility. These subjects were studied in a laboratory session assessing reactivity to psychological and orthostatic challenges with continuous electrocardiographic, blood pressure, and respiration monitoring. We predicted that for men and women, hostility would be inversely related to reductions in HF power in response to challenge.ResultsIn response to mental stressors, all measures of heart period variability change were inversely related to hostility as predicted. No such relationships were found for responses to tilt. The data suggested a possible effect of gender on these relationships.ConclusionsThese data add to the growing body of evidence showing that hostility influences vagal modulation of the cardiovascular system and suggest that altered autonomic control is a pathogenic mechanism linking hostility and CAD.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis cross-sectional study was conducted to estimate the prevalence of somatic and psychological complaints (SPCs) and to investigate the association of SPCs with insomnia in a sample of the general adult population of Japan.MethodsWe randomly selected 4000 adult residents (≥20 years old) from five areas of Japan using stratified sampling and conducted interviews using a structured questionnaire. The questionnaire solicited information about eight somatic symptoms, eight psychological symptoms, three sleep problems, and demographic and health-related information. A total of 3030 subjects completed questionnaires, giving a response rate of 75.8%.ResultsStiff neck/shoulder (45.3%), backache (35.1%), and fatigue (31.4%) were the most common complaints in this population. In general, SPCs were more prevalent in younger persons and in women. Logistic regression analyses, controlling for other factors, showed that insomnia was significantly associated with a number of SPCs: backache (odds ratio [OR] = 1.4, 95% confidence interval [CI] = 1.1–1.6), epigastric discomfort (OR = 1.7, 95% CI = 1.3–2.2), weight loss (OR = 2.0, 95% CI = 1.2–3.3), headache (OR = 1.7, 95% CI = 1.3–2.2), fatigue (OR = 1.7, 95% CI = 1.4–2.1), worrying (OR = 1.6, 95% CI = 1.1–2.3), irritability (OR = 1.4, 95% CI = 1.1–1.7), and loss of interest (OR = 1.8, 95% CI = 1.2–2.7).ConclusionsSPCs were common and were largely associated with insomnia in the general adult population of Japan. Further study is needed to examine the causal links between SPCs and insomnia.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveVasovagal reactions experienced by some blood donors (eg, faintness, lightheadedness, and dizziness) have been shown to be related to a decreased likelihood of future blood donations. This study evaluated the efficacy of audiovisual distraction as a means of reducing self-reported physiological reactions in first-time blood donors. Because interventions that are consistent with an individual’s preferred coping style have been shown to be more effective at reducing physiological and psychological responses to stressful medical procedures, coping style (monitoring vs. blunting) was assessed as a possible moderating variable.MethodsFirst-time blood donors were randomly assigned to one of two conditions: audiovisual distraction or no-treatment control. Participants in the distraction group donated blood at an American Red Cross blood drive while watching a three-dimensional video presentation on a personal visor and headset. The control group donated blood according to standard American Red Cross procedures. Score on a self-reported measure of physiological reactions completed immediately after donation served as the dependent variable.ResultsIndividuals who typically use blunting coping strategies to cope with stress reported an attenuation of vasovagal reactions to blood donation in the distraction vs. the control condition (t(49) = 2.29,p< .05), whereas donors who prefer a monitoring coping style did not benefit from distraction.ConclusionsAmong first-time blood donors, audiovisual distraction may be an effective means of reducing vasovagal reactions in donors who prefer to cope with stress using such strategies as distraction, denial, and reinterpretation.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis study examined the effects of pain and stress associated with a dental procedure, root canal treatment (RCT), on natural killer cell cytotoxicity (NKCC) and the subsequent development of symptoms of upper respiratory illness during the following month.MethodsPatients (N= 33) were recruited from those scheduled for RCT appointments. Subjects for a non-RCT comparison group (N= 14) were also recruited from dental clinic patients. Peripheral blood was drawn by use of an indwelling catheter three times: just before RCT, 30 minutes after injection of a local anesthetic, and 30 minutes after RCT (a parallel time course was followed for the comparison group.) Blood was assayed for cortisol and NKCC. Subjects completed a health diary in the month after RCT.ResultsPatients showed a significant increase in NKCC between baseline and RCT and a significant decrease from RCT to after RCT, whereas the comparison group did not. The NKCC following the RCT was negatively correlated with the pain level during RCT (r= −0.48,p< .01) and pain levels 2 and 6 hours after RCT (r= −0.43,p< .05;r= −0.44p< .05, respectively). The patient group reported significantly more illness episodes 2 weeks after RCT than the comparison group (Wilcoxon rank sum = 4.78,p= .03). Discriminant function analysis correctly classified 88% of the subjects into the illness category using predictor variables of post-RCT NKCC, stress, and pain levels during RCT (F(3,21) = 8.23,p< .001).ConclusionsTransitory changes in NKCC associated with pain and stress may be implicated in the development of infectious disease episodes after an acute stressful event.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveResearch and theory link an interpersonal conflict model to cardiovascular disease. Specifically, persons scoring high on cynical hostility and social defensiveness are thought to manifest a defensive need for approval while harboring basic distrust and hostility toward those who could provide such approval. The objective of this study was to assess whether angiographically determined coronary artery disease (CAD) was associated with this combination of high cynical hostility and high social defensiveness.MethodsFifty-nine male patients of a Veterans Administration Medical Center (86% white, mean age = 59.9 years) participated in the study on the day before their angiographic procedure; these men filled out the Cook-Medley Hostility Scale and the Marlowe-Crowne Social Desirability Scale (social defensiveness). They subsequently were categorized as having defensive hostility (DH), high hostility (HH), high social defensiveness (SD), or low psychosocial risk (LRisk; low on both scales).ResultsThe four groups did not differ significantly on risk factor status or health status. As predicted, a preplanned contrast showed that the DH group’s mean number of arteries with at least 50% blockage (mean = 2.5) differed significantly from the combined means of the other groups. The HH and SD groups did not differ from the LRisk group.ConclusionsWhen combined with other reports, the approach-avoidance interpersonal conflict model holds the promise of providing additional information about the psychosocial factors contributing to CAD development among men with high cynical hostility.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveHigh resting end-tidal CO2(PetCO2) has been shown to be an independent predictor of systolic blood pressure (SBP) in women, particularly older women. The study reported in this article investigated whether the tendency to experience, express, and/or suppress anger contributes to the association of PetCO2and SBP in women and in men.MethodsThe Spielberger Anger Expression Inventory was administered to 403 healthy male and female participants in the Baltimore Longitudinal Study on Aging. Resting PetCO2was obtained by means of a respiratory gas monitor, and resting blood pressure was obtained with an oscillometric device. The associations of resting PetCO2and the anger scales with SBP and diastolic blood pressure (DBP) were investigated using multivariate regression analyses.ResultsPetCO2, as well as age and body mass index, was an independent predictor of SBP in women with low, but not high, trait anger and in women with low, but not high, anger-out. PetCO2was not an independent predictor of SBP in men with either high or low anger. In addition, PetCO2was not an independent predictor of DBP in either men or women.ConclusionsThe results of this study indicate that inhibition of anger potentiates the relationship of high PetCO2with SBP in women but not men. Additional studies are needed to determine the origins of the observed gender differences and the psychophysiological pathways by which high resting PetCO2contributes to elevated resting blood pressure in women.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveDespite numerous case reports on “psychogenic fever,” it remains uncertain how psychological stress raises core temperature and whether the rise in core temperature is a real fever or a hyperthermia. This article reviews studies on the psychological stress–induced rise in core temperature (PSRCT) in animals with the aim to facilitate studies on the mechanisms of so-called psychogenic fever in humans.MethodsTo address this question, we reviewed the mechanisms and mediators of the PSRCT and classic conditioning of the fever response in animals.ResultsThe PSRCT is not due to the increased locomotor activity during stress, and the magnitude of the PSRCT is the same in warm and cold environments, indicating that it is a centrally regulated rise in temperature due to an elevated thermoregulatory “set point.” The PSRCT caused by conventional psychological stress models, such as open-field stress, is attenuated by cyclooxygenase inhibitors, which block prostaglandin synthesis. On the other hand, the PSRCT elicited by an “anticipatory anxiety stress” is not inhibited by cyclooxygenase inhibitors but by benzodiazepines and serotonin Type 1A receptor agonists. The febrile response can be conditioned to neutral stimuli after paired presentation with unconditioned stimuli such as injection of lipopolysaccharide, a typical pyrogen.ConclusionsMost findings indicate that the PSRCT is a fever, a rise in the thermoregulatory set point. The PSRCT may occur through prostaglandin E2–dependent mechanisms and prostaglandin E2–independent, 5-HT–mediated mechanisms. The febrile response can be conditioned. Thus, these mechanisms might be involved in psychogenic fever in humans.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to determine whether cognitive appraisals of stress level and hypertensive responses to ambulatory ophthalmic surgery can be ameliorated by patient-selected music.MethodsWe studied 40 elderly individuals requiring ophthalmic surgery, 20 in an experimental group (mean age, 74 years) and 20 in a control group (mean age, 77 years). All patients had an established resting blood pressure <140/90 mm Hg. In the experimental group self-selected music was provided by headphones throughout the preoperative, surgical, and postoperative periods. In the control group patients had neither headphones nor music. All patients received similar (weight-determined) doses of alfentanil and midazolam during surgery. Heart rate, blood pressure, and patient-reported stress and coping levels were the dependent variables.ResultsIn both groups, blood pressure values were normal (approximately 129/82 mm Hg) during screening examinations 1 week before surgery. On the day of surgery both groups displayed increased preoperative blood pressures (approximately 159/92 mm Hg) associated with increases in heart rate (by approximately 17 beats/min). Intraoperative blood pressures in the experimental group returned quickly to screening baseline values, whereas the control group experienced persistent elevations in intraoperative blood pressure similar to preoperative levels. Over the course of the surgical experience, patients with music reported significant reductions in perceived stress and increases in coping abilities (p< .001), whereas those without music did not.ConclusionsThe perceived stress of ambulatory surgery in geriatric patients is associated with a clinical hypertensive response that is ameliorated by self-selected perioperative music, which also decreases perceived stress and increases patients’ sense of personal control and well-being.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe primary objective of the present study was to identify neuroendocrine and immunological correlates of cardiovascular reactivity to an acute laboratory stressor.MethodsSubjects were 56 healthy volunteers. Heart rate and blood pressure were assessed at regular intervals during a 30-minute adaptation period and a 6-minute videotaped speech task. Blood was drawn before and after the task and was assayed for natural killer cell activity (NKCA), cortisol production, in vitro interferon gamma (IFN-&ggr;) and interleukin 10 production by peripheral blood mononuclear cells (PBMC), and antibody titers to the Epstein-Barr virus. Psychological measures were also administered.ResultsNKCA increased significantly in response to the task, and this increase was significantly and positively correlated with heart rate reactivity. IFN-&ggr; production by PBMC also increased in response to the task, but these increases were unrelated to heart rate reactivity. In addition, baseline cortisol levels were found to be predictive of heart rate reactivity. Finally, questionnaire data were modestly related to various aspects of stress-induced reactivity.ConclusionsConsistent with the task-related increases in NKCA and IFN-&ggr;, acute stress may signal an increase in at least some aspects of the cell-mediated, or TH1-driven, immune response. Furthermore, the finding that heart rate reactivity was related in part to baseline individual differences in cortisol production suggests that short-term cardiovascular responses to stress may be directly related to longer-term neuroendocrine modulation. Finally, the present results also help to highlight the influence of both sympathetic and nonsympathetic pathways in the response to acute stressors and suggest tentative links between certain psychological traits and various aspects of stress-induced reactivity.

ISSN:0033-3174    

出版商:OVID    

年代:2001

数据来源: OVID