摘要:

Psychological stress is thought to undermine host resistance to infection through neuroendocrine-mediated changes in immune competence. Associations between stress and infection have been modest in magnitude, however, suggesting individual variability in stress response. We therefore studied environmental stressors, psychobiologic reactivity to stress, and respiratory illness incidence in two studies of 236 preschool children. In Study 1, 137 3- to 5-year-old children from four childcare centers underwent a laboratory-based assessment of cardiovascular reactivity (changes in heart rate and mean arterial pressure) during a series of developmentally challenging tasks. Environmental stress was evaluated with two measures of stressors in the childcare setting. The incidence of respiratory illnesses was ascertained over 6 months using weekly respiratory tract examinations by a nurse. In Study 2, 99 5-year-old children were assessed for immune reactivity (changes in CD4+, CD8+, and CD19+ cell numbers, lymphocyte mitogenesis, and antibody response to pneumococcal vaccine) during the normative stressor of entering school. Blood for immune measures was sampled 1 week before and after kindergarten entry. Environmental stress was indexed with parent reports of family stressors, and a 12-week respiratory illness incidence was measured with biweekly, parent-completed symptom checklists. The two studies produced remarkably similar findings. Although environmental stress was not independently associated with respiratory illnesses in either study, the incidence of illness was related to an interaction between childcare stress and mean arterial pressure reactivity (beta =.35, p <.05) in Study 1 and to an interaction between stressful life events and CD19+ reactivity (beta =.51, p <.05) in Study 2. In both studies, reactive children sustained higher illness rates under high-stress conditions, but lower rates in low-stress conditions, compared with less reactive peers. Stress was associated with increased rates of illnesses, but only among psychobiologically reactive children. Less reactive children experienced no escalation in illness incidence under stressful conditions, suggesting that only a subset of individuals may be susceptible to the health-altering effects of stressors and adversity.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study determines, in a population of older adults with diagnosed hypertension, the concurrent association between depressive symptomatology and blood pressure control and the longitudinal association between depressive symptomatology and blood pressure control, stroke, and cardiovascular-related mortality. Data are from the East Boston, Massachusetts; New Haven, Connecticut; and Iowa sites of the Established Populations for Epidemiologic Studies of the Elderly, conducted between 1982 and 1988. Age-adjusted site-and gender-specific analyses were conducted, unadjusted and adjusted for baseline health status. There was no consistent association, cross-sectionally or longitudinally, between depressive symptoms and blood pressure control. Rates of stroke were 2.3 to 2.7 times higher in most subgroups with high depressive symptomatology in contrast to their nondepressed counterparts. Rates of cardiovascular disease-related death were also elevated in most subgroups, achieving statistical significance in women from New Haven and Iowa. This study presents evidence that high depressive symptoms in older adults with diagnosed hypertension may place them at increased risk of stroke and possibly cardiovascular-related death relative to other elderly persons with diagnosed hypertension. Because the rate of stroke in this subpopulation was exceptionally high, further evaluation of the role of depressive symptoms in the progression of hypertensive disease seems warranted.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized Finnish town), 780 of whom (77%) were examined. The purpose was to determine the possible associations between depressive symptoms and subjective and clinical symptoms of the temporomandibular joint pain and dysfunction syndrome (PDS). The PDS symptoms were determined using Helkimo's Clinical Dysfunction Index. Depressive symptoms in 768 subjects were determined using Zung's self-rating depression scale. The prevalences of high rates of depressive symptoms, subjective symptoms of PDS, and clinical symptoms of PDS in the population were 12.2%, 12.0%, and 4.9%, respectively. Subjective symptoms of PDS were more common in depressed dentate men and women than in nondepressed dentate men and women. There was a significantly higher prevalence of subjective symptoms of PDS in depressed edentulous women than in nondepressed edentulous women. There were significantly more moderate or severe clinical symptoms of PDS in depressed dentate women than in nondepressed dentate women. A similar trend was seen in dentate men. An integrated approach is of crucial importance in the diagnosis and treatment of depression and the temporomandibular joint pain and dysfunction syndrome.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Daily ratings of depression, pain, and menstrual blood loss, as well as past history of treated depression, were analyzed in 210 women attending a Premenstrual Syndrome Clinic.Severity and duration of perimenstrual depression was strongly associated with the severity of premenstrual and menstrual pain, raising the possibility of a causal relationship. It is not yet clear whether the occurrence of depression alters a woman's perception of pain, pain aggravates a tendency to perimenstrual depression, or some common factor aggravates both. A relationship between depression and subjective ratings of blood loss was also observed but was less marked than the relationship with pain. Both relationships had been reported in an earlier study using retrospective ratings. A relationship between past history of treated depression and severity and timing of current perimenstrual depression, observed previously, was not found in this study. This discrepancy was not due to differences between retrospective and prospective methods of assessment, but may have partly resulted from differences in the reporting of premenstrual pain in the two studies. Further studies of this association should control for the confounding effect of pain.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The recently developed Tridimensional Personality Questionnaire (TPQ) was used to examine personality correlates in women diagnosed with premenstrual syndrome (PMS).The hypotheses were that the TPQ scores, specifically harm avoidance (HA), would be higher in PMS subjects than in the general population but lower than in depressed populations because major mood disorder is an exclusion from the PMS diagnosis; harm avoidance would have the strongest association with PMS, but other TPQ factors might characterize nondysphoric subgroups in the PMS population. The sample included 157 women who sought medical treatment and met clearly defined criteria for PMS. Two comparison groups of age-matched women with major depression (MDD, N = 20) and premenstrual exacerbation of major depression (MDD + PMS, N = 24) were also evaluated. TPQ scores were significantly higher for PMS subjects on all three dimensions compared with external normative TPQ data. The TPQ dimensions of HA and novelty seeking (NS) were modestly correlated with the premenstrual symptom scores. The HA dimension correlated with premenstrual depression and physical aches; high NS scores correlated with premenstrual food cravings, headache, and mood swings. As hypothesized, the HA scores were significantly higher in the comparison groups diagnosed with major depression; the NS and reward dependence (RD) dimensions did not differ between the PMS and MDD groups. PMS was associated with only modest nonnormative personality correlates, as assessed by the TPQ. Elevations of the HA and NS dimensions were associated with a tendency for the PMS to present with specific symptom patterns: depressive symptoms for the HA factor and food cravings and mood swings for the NS factor. Further research employing other assessment methods is needed to confirm these findings.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study examined the effect of chronic stress associated with unemployment on the magnitude of salivary cortisol excretion, on the diurnal rhythm of cortisol, and on cortisol reactivity to acute naturalistic stressors using Experience Sampling Methodology (ESM).Employed (N = 60) and unemployed (N = 60) subjects were studied for 2 days. Subjects were beeped 6 times per day by a preprogrammed wristwatch to assess acute stressors; 25 minutes after each ESM-beep, subjects were beeped a second time for saliva samples. The groups did not differ in their overall cortisol excretion or in cortisol reactivity to acute daily stressors. Compared to employed subjects, unemployed subjects had a diurnal pattern of cortisol excretion with relatively higher morning and lower evening levels. Subjects' daily activities and their locations were associated with diurnal rhythm differences.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The present study tested the hypothesis that some subjects may not readily show habituation of adrenocortical stress responses to repeated psychological stress.Twenty healthy male subjects were each exposed five times to the same, brief psychosocial stressor (public speaking and mental arithmetic in front of an audience) with one stress session per day. Salivary cortisol levels were assessed as an index of adrenocortical stress responses. For the total group, cortisol levels were significantly elevated on each of the 5 days. The mean response decreased from day 1 to day 2; however, no further attenuation could be observed on the remaining days. Cluster analysis revealed two groups of subjects who showed completely different response kinetics. In the first group (N = 13), termed "low responders," cortisol levels were elevated on day 1 only. Day 2 to 5 cortisol levels were unaltered. In contrast, subjects in the second group ("high responders") displayed large increases to each of the five experimental treatments. This group had no significant response decrement from day 1 to day 2 to 4 and only a marginal response difference between day 1 and day 5. Discriminant analysis revealed that a combination of five personality scales plus the scores on a symptoms checklist significantly discriminated between high and low responders. With this discriminant function, all 20 subjects were correctly classified to the two groups. These results are discussed with a focus on the possible impact of adrenocortical response types on health and disease.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study examined the hypothesis that instructing patients to focus on their sensations (sensory focus) during root canal therapy reduces painful response.Before dental treatment, patients were randomly assigned to one of four audiotaped conditions: sensory focus with and without procedural information, procedural information, or no-intervention. Patients were categorized as to how much control they desired and felt. The "high desire for control/low felt control" subgroup's sensory pain intensity scores in the sensory focus condition were significantly lower than the "high desire for control/low felt control" subgroup's sensory intensity scores in the no-intervention comparison condition. This was true immediately after treatment (F(1,303) = 13.37; p less than or equal to.001) and 1 week after treatment (F(1,303) = 14.30; p less than or equal to.001). Immediately after treatment, the high desire for control/low felt control subgroup in the sensory/procedural condition was significantly lower on sensory pain intensity scores than the high desire/low felt subgroup in the no-intervention condition (F(1,303) = 3.75; p less than or equal to.001). This difference was not observed on the 1-week recall of pain. Adding procedural information to the instructions to focus on sensation did not increase the pain-reducing effects. Results extend prior findings that sensory focus significantly reduces sensory pain intensity only among patients who are classified as having a high desire for control and low perceived control. These results are congruent with theoretical arguments that coping preferences moderate the reaction of patients to various therapeutic strategies.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID