摘要:

ObjectiveCoping styles are generally considered to be environmentally driven, primarily by family influences. However, because personality traits are commonly influenced by genetic effects, we hypothesized that heredity is also important for coping.MethodsWe tested this hypothesis by assessing 19 coping styles, as well as four secondary coping factors, by questionnaire in 212 pairs of monozygotic and dizygotic twins. We then examined heredity by structural Equation modeling.ResultsAll coping styles showed evidence of genetic influences. The coping styles shared one common genetic factor. In addition, each coping style was also influenced by other separate genetic factors. Shared environment had no significant influence on coping styles. Three of 19 more specific coping styles showed shared environmental effects as well as genetic influences, 14 were solely under genetic influences, and two showed only shared environment effects.ConclusionsWe suggest that hereditary effects on certain coping style preferences cannot be explained solely by genetic influences on major personality traits and temperament. An analysis of the relationships between coping and personality in twin subjects may elucidate the distinction between genetic and environmental effects.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Psychological factors are known to affect biological processes involved in the progression of coronary artery disease.This article focuses on psychological risk factors for progression of coronary artery disease and its clinical manifestations. Recent research on the adverse cardiovascular consequences of feelings of exhaustion and acute psychological arousal is reviewed, and a classification of psychological risk factors is presented distinguishing (1) chronic psychological risk factors, such as hostility; (2) episodic risk factors, such as exhaustion, with a duration ranging from several months to 2 years; and (3) acute psychological triggers, including mental activity and anger. The distinctive pathophysiological mechanisms by which these psychological risk factors promote coronary disease progression and cardiac ischemia are described, including hemodynamic reactivity, blood clotting, and inflammatory processes.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveWe tested whether the psychological components of cognitive adaptation theory would predict new coronary events after a first percutaneous transluminal coronary angioplasty (PTCA).MethodsA consecutive sample of patients treated successfully with PTCA were enrolled in the study. Of 343 patients approached, 303 (88%) agreed to participate and were interviewed shortly before hospital discharge. We measured the components of cognitive adaptation theory (optimism, self-esteem, and mastery) during the interview. Five patients were excluded from the analysis because of early, in-hospital reocclusion. New cardiac events (coronary artery bypass grafting, PTCA, myocardial infarction, or disease progression) were examined within 6 months of the first PTCA. We obtained 6-month follow-up data on 98% of patients.ResultsThe cognitive adaptation index predicted new cardiac events, even when demographic variables and medical variables thought to predict restenosis were statistically controlled (p = .02).ConclusionsThese results suggest that persons who respond to their illness by perceiving control over their futures, by having positive expectations about their futures, and by holding a positive view of themselves seem to be at less risk for a new cardiac event after a first PTCA.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to investigate whether subjective sleep quality is more strongly associated with immunocompetence than depression among women at risk for cervical cancer.MethodsParticipants were 91 women referred for colposcopy because of abnormal results on a Pap smear. On the day of the procedure, participants completed the Center for Epidemiological Studies Depression Scale, two indices of subjective sleep quality (ie, satisfaction with sleep obtained and degree of sleep restfulness), and a health behaviors assessment questionnaire. Levels of peripheral blood lymphocyte subpopulations (helper T, cytotoxic/suppressor T, NK, and B cells) were also assessed at this time. Approximately 10 days later, the presence of depressive disorder was assessed using the Structured Clinical Interview for DSM-III-R.ResultsHierarchical regression analyses revealed that satisfaction with the amount of sleep obtained was significantly associated with the circulating number and percentage of helper T cells (TH/CD4+) and the percentage of cytotoxic/suppressor T cells (TC/CD8+), after controlling for confounder variables (ie, age, smoking status, and drug use). Depression was significantly associated only with the percentage of TCcells. Sleep satisfaction remained significantly associated with the number and percentage of THcells and percentage of TCcells after controlling for the variance explained by depression.ConclusionsResults of this study suggest that subjective sleep quality shares a significant and independent portion of the variance with immunity that is not accounted for by depression. Although the long-term impact of these immune alterations on disease progression needs to be directly explored, it may be important to systematically screen for and manage sleep disturbance in women at high risk for cervical cancer.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe purpose was to study the growth of lactobacilli in subjects with depressive symptoms in the total 55-year-old population of Oulu (a medium-sized town in Finland); 780 people participated.MethodsThe dental examination included measurements of salivary lactobacillus growth with the Dentocult-LB method; measurements of salivary flow rate, pH, and buffering capacity; and assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). Participants were also asked about their health, medication, smoking, and dietary habits.Resultsor=to40) and 23% of those with an ZSDS score of <or=to39 had high counts of lactobacilli (p = .003). A logistic regression analysis with improvement of goodness of fit was made to confirm the relation between abundant lactobacilli and 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 abundant lactobacillus growth.ConclusionsThe association between high lactobacillus counts and depressive symptoms suggests that depressed subjects are at risk of having caries and possibly other dental diseases that should be recognized in the treatment of these patients.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTwo important determinants of physiological stress responses have been identified, uncontrollability of the stressor and amount of effort involved in coping with the stressor. In the present experiment, we tried to identify the specific contributions of effort and uncontrollability to immune system responses to stress.MethodsIn a 2 x 2 design, effort and uncontrollability were manipulated independently of each other. Subjects participated in one of four experimental conditions, and their endocrine, immune, and sympathetic nervous system responses to the task were assessed.ResultsEffort had a stimulating effect on enumerative immunological parameters (CD8+and CD16+cells) and on natural killer cell activity. The effect occurred immediately after the stressor and was transient. Regression models indicated that this effort effect may have been mediated by activation of the sympathetic nervous system. Uncontrollability influenced in vitro production of the cytokine interleukin-6, leading to decreased production 15 and 30 minutes after the stressor. Uncontrollability also led to an increased level of cortisol, but no evidence was found that the decrease in cytokine production was mediated by cortisol release.ConclusionThe results suggest that two major stressor characteristics, effort and uncontrollability, may have differential effects on the immune system.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveIncreased peripheral vasoconstriction (ie, total peripheral resistance, or TPR) has been implicated as playing an important role in the early development of essential hypertension. Some studies have demonstrated that Transcendental Meditation (TM) reduces high blood pressure, but the hemodynamic adjustments behind these blood pressure reductions have not been elucidated. The aim of this study was to provide a preliminary investigation of the acute effects of TM on TPR.MethodsSubjects were 32 healthy adults (16 women and 16 men; 30 white and two African American; mean age, 46.4 +/- 3.9 years). Subjects were divided into a TM group of long-term TM practitioners (eight white women, nine white men, and one African American man; mean years of twice-daily TM practice, 22.4 +/- 6.7) and a control group (eight white women, five white men, and one African American man). Hemodynamic functioning was assessed immediately before and during three conditions: 20 minutes of rest with eyes open (all subjects), 20 minutes of TM (TM group), and 20 minutes of eyes-closed relaxation (control group).ResultsDuring eyes-open rest, the TM group had decreases in systolic blood pressure (SBP) and TPR, compared with increases in the control group (SBP: -2.5 vs. +2.4 mm Hg, p < .01; TPR: -0.7 vs. +0.5 mm Hg/liter per minute, p < .004). During TM, there was a greater decrease in SBP due to a concomitantly greater decrease in TPR compared with the control group during eyes-closed relaxation (SBP: -3.0 vs. +2.1 mm Hg, p < .04; TPR: -1.0 vs. +0.3 mm Hg/liter per minute, p < .03).ConclusionsTPR decreased significantly during TM. Decreases in vasoconstrictive tone during TM may be the hemodynamic mechanism responsible for reduction of high blood pressure over time. The results of this study provide a preliminary contribution to the understanding of the underlying hemodynamic mechanisms responsible for the beneficial influence of TM on cardiovascular risk factors.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveA growing body of research has shown that there are important links between certain psychiatric disorders and health symptom reporting. Two disorders in particular (posttraumatic stress disorder (PTSD) and major depression) have been the most widely implicated to date, and this association has sometimes been used to explain the occurrence of ill-defined medical problems and increased somatic symptoms in certain groups, most recently Gulf War veterans.MethodsStructured psychiatric diagnostic interviews were used to examine the presence of major psychiatric (axis I) disorders and their relation to health symptom reporting in a well-characterized, stratified subset of Gulf War veterans and a non-Gulf-deployed veteran comparison group.ResultsRates of most psychiatric disorders were substantially lower than national comorbidity estimates, consistent with prior studies showing heightened physical and emotional well-being among active-duty military personnel. Rates of PTSD and major depression, however, were significantly elevated relative to the veteran comparison group. The diagnosis of PTSD showed a small but significant association with increased health symptom reports. However, nearly two-thirds of Gulf participants reporting moderate to high health symptoms had no axis I psychiatric diagnosis.ConclusionsResults suggest that rates of psychiatric illness were generally low with the exception of PTSD and major depression. Although PTSD was associated with higher rates of reported health problems, this disorder did not entirely account for symptoms reported by participants. Factors other than psychiatric status may play a role in Gulf War health problems.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveWe examined changes in sexual drive during weight restoration in patients with anorexia nervosa.MethodsEleven women with anorexia nervosa prospectively completed the Sexual Daydreaming Questionnaire (SDQ) and the Hospital Anxiety and Depression Scale (HADS) at five time points during inpatient treatment involving weight restoration. SDQ and HADS scores were recorded every 4 weeks until 8 weeks after subjects had reached the mean matched population weight (MMPW), which was monitored against body mass index (BMI). Histories were taken for purging, self-cutting, childhood sexual abuse, and number of sexual partners. Repeated-measures analysis of variance, regression analyses, and t tests were performed.ResultsBMI and sexual daydreaming were closely associated (p < .001). BMI and depression also achieved a statistically significant association (p = .046), with "caseness" for anxiety disorder throughout. Higher levels of sexual drive at MMPW seemed to be associated with purging, self-cutting, and childhood sexual abuse but not at low weight. Levels of sexual drive did not reflect previous sexual behavior.ConclusionsAn increase in sexual drive accompanies weight restoration in patients with anorexia nervosa, which is consistent with psychological and physiological explanations of altered sexuality. Transient depression is also associated with weight gain. Changes in sexuality should be considered in both recovery and treatment failure.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectivesThis investigation assessed motivational factors and psychosocial barriers that affect individual readiness to perform cardiopulmonary resuscitation (CPR). This is the first study to use the Transtheoretical model in assessing readiness to perform CPR.Methodsor=to45 years of age and who resided in a private residence, were randomly selected to participate in a structured telephone interview. Data on motivational readiness, emotional state, perceived psychosocial barriers, and perceived efficacy in performing CPR were collected using dichotomous and Likert-type ratings.ResultsSubjects with greater motivational readiness expected to experience significantly fewer symptoms of emotional distress during a cardiac emergency and to encounter fewer psychosocial barriers. This group also reported greater efficacy in their ability to perform CPR. These findings were independent of gender, medical history, age, and educational level.ConclusionsMeaningful differences are apparent in individual readiness to perform CPR. These findings provide additional support for the need to tailor CPR training strategies using behavioral methods that enhance motivational readiness and decrease apprehension about anticipated emotional distress and psychosocial barriers.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID