摘要:

The objectives of this study were to a) replicate our prior finding of a decreased number (Bmax) of platelet alpha2-adrenoreceptors in panic disorder, b) determine if binding is also decreased in asymptomatic first-degree relatives of panic patients (known to be at increased risk for developing panic), and c) evaluate the effect of treatment on the presumptive decrease in binding (ie, is the decrease a state or a trait marker for panic?). Panic patients had clonidine and yohimbine platelet-binding assays, symptom ratings, and measurement of lying and standing plasma epinephrine, norepinephrine, systolic and diastolic blood pressure, and heart rate before treatment, after approximately 2 months of medication (fluoxetine, tricyclics, or alprazolam) and/or cognitive behavioral treatment, and after symptom remission while drug free; normal subjects had determinations of the same measures at approximately the same time intervals. Relatives of both groups had one determination only of all measures. Tritiated clonidine binding was decreased and lying heart rate was increased in patients before treatment. Magnitude of binding decrease was correlated with symptom severity and standing norepinephrine. No binding abnormality was seen in first-degree relatives of patients. Treatment increased clonidine binding in patients. Both patients and relatives of patients showed significantly increased standing plasma norepinephrine in comparison to controls. There is a state-related decrease in binding, associated with symptom severity and norepinephrine, in panic disorder. Abnormal reactivity of norepinephrine to standing might be a marker for increased likelihood of panic development in individuals at risk.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The goals of this study were toa) confirm prior evidence that the respiratory stimulant doxapram induces panic attacks and produces excessive hyperventilation in patients with panic disorder and b) explore the impact of cognitive mediators on symptom and respiratory responses. Method: Thirty-two subjects (16 patients and 16 controls) received doxapram (0.5 mg/kg) and placebo infusions while symptom, respiratory, and heart rate responses were monitored. Subjects were randomly assigned to receive either a standard introduction or a cognitive intervention designed to reduce the panic responses of panic patients to laboratory challenges. Results: Doxapram was a potent and specific panicogenic agent, inducing panic in 75% of patients and 12.5% of controls. Compared with controls, patients also showed a greater decrease in end tidal carbon dioxide (CO2) and greater increases in minute ventilation, respiratory frequency, and heart rate. The cognitive intervention substantially attenuated the excessive hyperventilatory response of patients but did not fully normalize their breathing patterns. Tidal volume was the only respiratory measure not significantly altered by the cognitive intervention. Conclusions: In patients with panic disorder, doxagram (0.5 mg/kg) triggers panic attacks about as potently as 7% CO2and more potently than 5% CO2or lactate. Psychological factors can modulate the appearance of ventilatory abnormalities in panic patients, but persistent respiratory disturbances were still seen. Psychological factors and respiratory physiology both appear to be important phenomena in laboratory panic.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The relationship between hypochondriacal concerns, as assessed by the Illness Attitude Scales, and depressive symptoms was examined in a sample of 100 drug-free outpatients with major depressive disorder. These patients were treated with fluoxetine for 8 weeks, and the effect of treatment on hypochondriacal symptoms was examined. All patients were administered the Structured Clinical Interview for DSM-III-R, the Hamilton Depression Rating Scale, the Symptom Questionnaire, and the Personality Disorders Questionnaire-Revised. We found little relationship between severity of depressive symptoms and hypochondriacal concerns. Measures of anxiety, somatic symptoms, and psychological distress were more consistently related to these concerns. Similarly, patients with either histrionic personality disorder or a lifetime history of panic disorder had greater hypochondriacal concerns than patients without these diagnoses. After open treatment with fluoxetine, the degree of hypochondriacal concern showed statistically significant decreases, which were only partly related to the degree of change in depression and anxiety severity. Our findings suggest that the presence of hypochondriacal concerns among depressed outpatients is more closely related to the presence of anxiety than depressive symptoms. The relatively small impact of an acute course of antidepressant treatment on hypochondriacal concerns in our sample suggests that these concerns may be enduring characteristics modulated only to a limited extent by short term pharmacological alterations of affective state.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The object of this study was to examine the changes in women's eating habits and attitudes in the 6 months after childbirth, focusing particularly on eating-disorder psychopathology. A general population sample of 97 primigravid women originally studied during pregnancy were followed for 6 months postpartum to describe their changes in eating and weight after childbirth with particular reference to the behaviors and attitudes characteristic of clinical eating disorders. Assessment was by standardized interview. It was found that eating disorder symptoms increased markedly in the 3 months postpartum and then plateaued over the next 6 months. This overall plateauing masked substantial variation in different domains; in particular, weight concern continued to increase to the 6-month assessment, although shape concern decreased. Concern about residual weight gain after the birth of a child was described by many mothers as particularly distressing and seemed to precipitate a clinical eating disorder in a few cases. Many women would have welcomed educational advice about how to deal with changes in eating, weight, and shape after pregnancy. It was concluded, therefore, that overall, there is evidence of an increase in eating-disorder psychopathology in the 6 months after childbirth. It is argued that education about how to deal with the changes in weight and shape after pregnancy might decrease the risk of developing frank eating disorder psychopathology.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Recent research suggests that resting blood pressure is inversely related to pain sensitivity, even among normotensives; however, most of these studies have included only male participants.To determine whether this hypoalgesic effect of blood pressure was also present in females, we investigated thermal and ischemic pain responses in a group of age-matched, normotensive females and males as a function of resting blood pressure. Thermal pain threshold and tolerance were determined, and a cross-modality thermal magnitude matching procedure was conducted, after which ischemic pain threshold and tolerance were determined using the submaximal effort tourniquest procedure. Systolic pressure, diastolic pressure, and heart rate were obtained using an automated blood pressure monitor with a pneumatic cuff positioned around the left ankle. Females provided higher normalized thermal magnitude estimates and a shorter time to ischemic pain tolerance, but no gender differences emerged on other pain measures. Systolic, diastolic, and mean arterial pressures were significantly correlated with thermal and ischemic pain responses among males but not females, with higher blood pressure being associated with lower pain sensitivity. After adjusting for resting blood pressure, the gender difference in normalized magnitude estimates was only marginally significant, and the gender difference in ischemic pain tolerance became nonsignificant. These findings are consistent with previous research indicating an inverse relationship between blood pressure and pain sensitivity. Additionally, the findings also suggest that blood pressure may partially moderate gender differences in pain sensitivity. Potential mechanisms and clinical implications of the current findings are discussed.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study was conducted to examine the pain-ameliorating and pain-sensitizing effects of exposure to emotionally engaging drama. Specifically, the consequences for pain sensitivity of exposure to dramatic expositions differing in both excitatory and hedonic qualities were determined. Hedonically negative, neutral, and positive affective states were induced in male respondents by exposure to excerpts from cinematic drama. Pain sensitivity was assessed by the cuff-pressure procedure before and after exposure and by the cold pressor test after exposure only. When compared against the control condition, pain sensitivity diminished under conditions of hedonically positive affect. An inverse effect was suggested for hedonically negative conditions, but proved tentative and statistically unreliable. The findings are consistent with earlier demonstrations of mood effects on pain sensitivity. Unlike inconclusive earlier findings concerning the magnitude of directional effects, however, they suggest an asymmetry that emphasizes the pain-ameliorating effect of positive affects while lending little, if any, support to the proposal of a pain-sensitizing effect of negative affects. The investigation did not accomplish the intended creation of conditions necessary to test the proposal that heightened sympathetic activity diminishes pain sensitivity. The utility of a rigorous determination of this hypothesized relationship is emphasized, and procedures for a viable test of the proposal are suggested.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The objective of this study was to examine associations in youth between antisocial behavior and cardiovascular profile.Younger brothers of adjudicated delinquents (N = 120) received a standardized psychiatric assessment and an assessment of three factors often studied in behavioral cardiology research: family history of hypertension, resting blood pressure, and obesity. As a group, relative to population norms, these youth exhibited signs of obesity and elevated blood pressure, with 30% of the sample appearing clinically obese and 24% having a blood pressure above the 90th percentile for national norms in their age cohort. Within the sample, score on the Child Behavior Checklist (CBCL) Delinquency scale correlated with blood pressure (r =.29-.34) and an index of obesity, weight/height3(r =.20). Further, scores on the CBCL Delinquency, Aggression, and Externalizing scales were elevated in boys with a positive family history of hypertension. Among boys at risk for delinquency, disruptive psychopathology relates to factors often studied in behavioral cardiology research. Relationships between risk factors for ischemic cardiovascular disease and hostile behavior may be manifested with measures of disruptive psychopathology.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study asked whether individual differences in four personality traits (cynical hostility, anger out, anxiety, and defensiveness) would predict waking and sleeping ambulatory blood pressure and heart rate and whether information about these traits would provide a source of racial and gender differences in these measures.Ambulatory blood pressure and heart rate were recorded over a 24-hour period in 58 black and 86 white college students equally divided by gender. Waking and sleeping values were examined as a function of gender, race, and personality factors. Independent of personality factors, women had lower ambulatory blood pressure and higher heart rate than men, and black subjects had higher blood pressure levels and less of a decrease in heart rate from waking to sleeping than white subjects. The above differences were associated with personality factors. Black subjects scoring high on cynical hostility had elevated daytime and nighttime systolic pressure. Black subjects scoring high on both anxiety and defensiveness had higher waking diastolic blood pressure. Additional effects were shown for heart rate as a function of anger out, anxiety, and defensiveness. Given the special significance of ambulatory blood pressure for cardiovascular disease, these findings underscore the importance of personality factors for cardiovascular risk and their relevance for race and gender differences in this risk.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

These analyses examined the relationship between fasting plasma lipids and several psychosocial factors in a healthy cohort of 5115 black and white men and women between the ages of 18 and 30.Primary analyses were performed within race/gender subgroups and were supplemented with analyses examining consistency of associations across these groups. After controlling for age, high density lipoprotein (HDL) decreased, triglycerides increased, low density lipoprotein (LDL) increased, and the total cholesterol/HDL cholesterol ratio increased with increasing level of education in black men. This pattern is, in general, opposite to that found in other groups, particularly white women, whose lipid profile was found to be less atherogenic the higher the education. These associations were strongly confounded with health behaviors. There was also a positive association between hostility and triglycerides in women but not in men. No significant association with any plasma lipid for either race or gender was found for Type A behavior, social support, or life events. Despite a narrow plasma lipid range in these young adults, these data support the conclusion that increasing education is associated with a less atherogenic plasma lipid profile, except in black men, for whom education is associated with a less favorable plasma lipid profile. Among other psychosocial factors, the only consistent finding was an inverse association between hostility and triglycerides in women.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Several pathologies of the oral cavity have been associated with stress, so we investigated salivary-induced aggregation during psychological stress. In addition, salivary total protein, alpha-amylase, and secretory immunoglobulin A (s-IgA) were assessed. In this longitudinal study, 28 dental students provided unstimulated whole saliva during 10 minutes before an academic examination and subsequently 2 weeks and 6 weeks later in a nonstress situation. The effect of whole saliva on the aggregation of Streptococcus gordonii (HG 222) was determined spectrophotometrically. The results show a significant stress-mediated increase of salivary total protein concentration, alpha-amylase activity, amylase/protein ratio, alpha-amylase output, s-IgA concentration, and s-IgA output. There was also a trend for increased total protein output, whereas salivary flow rate was unchanged. The aggregation of S. gordonii in whole saliva collected before examination was 13.1%, whereas the aggregation in whole saliva collected during nonstress was 23.3%. This reduction was statistically significant (p <.01). Furthermore, the decrease in bacterial aggregation was related to the increase in state-anxiety (p <.05). The reduction in aggregation of S. gordonii under stress was not correlated with changes in salivary flow rate, s-IgA concentration, total protein concentration, or alpha-amylase activity. These results suggest that acute psychological stress exerts its influence on both salivary composition and salivary function. Reduced bacterial aggregation may be a contributing factor in the often reported relationship between stress and impaired oral health.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID