ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveThere is an increasing amount of literature pointing to a relationship between sexual and/or physical abuse history and poor health status, although few studies provide evidence concerning which aspects of abuse may impact on health. In female patients with gastrointestinal (GI) disorders, the present study examined the effects on health status of: 1) history of sexual abuse and physical abuse, 2) invasiveness or seriousness of sexual abuse and physical abuse, and 3) age at first sexual and physical abuse. Method: The sample included 239 female patients from a referral gastroenterology clinic who were interviewed to assess sexual and physical abuse history. Results: We found the following: 1) 66.5% of patients experienced some type of sexual and/or physical abuse; 2) women with sexual abuse history had more pain, non-GI somatic symptoms, bed disability days, lifetime surgeries, psychological distress, and functional disability compared to those without sexual abuse; 3) women with physical abuse also had worse health outcome on most health status indicators; 4) rape (intercourse) and life-threatening physical abuse seem to have worse health effects than less serious physical violence, and sexual abuse involving attempts and touch; and 5) those with first abuse in childhood did not appear to differ on health from those whose first abuse was as adults. Conclusions: The authors conclude that asking about abuse should be integrated into history taking within referral-based gastroenterology practices.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Relationships between self-reported psychological distress (Symptom Checklist) and experience with two earthquakes are presented for a group of male factory workers (N = 772) from Naples, Italy, participating in the 1987 follow-up of the Olivetti Heart Study. Although all were exposed to the 1980 earthquake that racked southern Italy, only men residing in the Naples suburb of Pozzuoli experienced the continuing swarm of earthquakes ("bradyseism") of 1983-1984, allowing for the observation of a "natural experiment" of sorts.Levels of psychological distress were found to be higher 7 years after the first earthquake for those men who reported damage from that earthquake.Overall, findings were similar for those who were evacuated, or suffered financial loss from the 1983-1984 bradyseism earthquakes. Stratification by 1980 earthquake damage revealed that 1983-1984 evacuation or financial loss was associated with increased distress reporting only for those men who had not reported damage from the 1980 earthquake. Overall, however, distress scores tended to be higher for men evacuated in 1983-1984 if they had also reported damage from the prior earthquake (only the F ratio for anxiety reached criterion for statistical significance). These findings suggest that the psychological consequences of earthquake exposure are long lasting and seem to be related to the consequences of the earthquake in terms of damage/loss.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Heart rate increases during psychological stress are the product of cardiac sympathetic activation and parasympathetic withdrawal.Levels of plasma epinephrine (E) and norepinephrine (NE) have a long history as indicators of cardiac adrenergic activity and, accordingly, generally increase in response to psychological challenge. Recently, several investigators have suggested that indices derived from power spectral analysis of heart period variability (HPV) also may provide estimates of cardiac sympathetic nervous system activity. These indices include power in the low frequency band (0.04-0.15 Hz, LF), and the ratio of low to high frequency (0.15-0.50 Hz, HF) power (LF/HF). The relationship between spectral and neurohumoral indices during psychological stress has not been investigated.This issue was addressed by studying spectrally defined measures of HPV and levels of plasma E and NE in 34 normal subjects who participated in a study of responsiveness to a psychologically challenging arithmetic task.Heart rate (HR), LF and HF power, the LF/HF ratio, and blood pressure were measured during the 5-minute baseline and 5-minute task periods. Integrated samples of forearm venous blood were collected for both periods. E and NE were analyzed by high performance liquid chromatography. The task produced significant increases in HR, systolic and diastolic pressures, and NE. Of the 12 Pearson correlation coefficients used to examine the relationships between power spectral measures and catecholamines for the baseline, task, and delta values, none achieved statistical significance, suggesting little relationship between neurohumoral and spectral estimates of cardiac sympathetic activity. We conclude that under conditions of psychological stress, LF power provides no useful information about cardiac sympathetic activity, both because power in this frequency band falls whereas HR rises and because there is no relationship between LF power and plasma NE.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The present study was designed to examine the effect of voluntarily slowed respiration on the cardiac parasympathetic response to a threat:the anticipation of an electric shock. Thirty healthy college students were randomly assigned to the slow, fast, and nonpaced breathing groups (10 subjects each). Subjects in the slow and fast paced breathing groups regulated their breathing rate to 8 and 30 cpm, respectively, and those in the nonpaced breathing group breathed spontaneously. Immediately after the period of paced or nonpaced breathing for 5 minutes, the subjects were exposed for 2 minutes to the anticipation of an electric shock during breathing paced at 15 cpm. The amplitude of the high frequency (HF) component of the heart rate variability, an index of cardiac parasympathetic tone, significantly decreased during the threat in the fast and nonpaced breathing groups, whereas it was unchanged in the slow paced breathing group. No significant difference was observed among the three groups in the amplitude of respiration during the threat. Results suggest that a slowed respiration decreases the cardiac parasympathetic withdrawal response to the threat. This study provides a rationale for the therapeutic uses of the slowed respiration maneuver in attenuating the cardiac autonomic responses in patients with anxiety disorder.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The present study had two objectives1) to determine the characteristics that differentiated subjects with multiple chemical sensitivities (MCS), chemical sensitivities (CS), and chronic fatigue syndrome (CFS); and 2) to evaluate the psychiatric and neuropsychological complaints of these groups relative to normal controls. A cross-sectional comparison was made of the following groups matched for age, sex, and education: 1) patients whose sensitivities to multiple low level chemical exposures began with a defined exposure (MCS; N = 23); 2) patients with sensitivities to multiple chemicals without a clear date of onset (CS; N = 13); 3) patients meeting CDC criteria for Chronic Fatigue Syndrome (CFS; N = 18); and 4) normal controls (N = 18). Subjects with sensitivities to chemicals (MCS and CS) reported significantly more lifestyle changes due to chemical sensitivities and significantly more chemical substances that made them ill compared with chronic fatigue and normal controls. MCS, CS, and CFS patients had significantly higher rates of current psychiatric disorders than normal controls and reported significantly more physical symptoms with no medical explanation. Seventy-four percent of MCS and 61% of CFS did not qualify for any current Axis I psychiatric diagnosis. Chemically sensitive subjects without a defined date of onset (CS) had the highest rate of Axis I psychiatric disorders (69%). On the MMPI-2, 44% of MCS, 42% of CS, 53% of CFS, and none of the controls achieved clinically significant elevations on scales associated with somatoform disorders. With the exception of one complex test of visual memory, no significant differences were noted among the groups on tests of neuropsychological function. Standardized measures of psychiatric and neuropsychological function did not differentiate subjects with sensitivities to chemicals from those with chronic fatigue. Subjects with sensitivities to chemicals and no clear date of onset had the highest rate of psychiatric morbidity. Standardized neuropsychological tests did not substantiate the cognitive impairment reported symptomatically. Cognitive deficits may become apparent under controlled exposure conditions.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study was conducted to examine the rates of somatization disorder (SD) in the chronic fatigue syndrome (CFS) relative to other fatiguing illness groups.It further addressed the arbitrary nature of the judgments made in assigning psychiatric vs. physical etiology to symptoms in controversial illnesses such as CFS. Patients with CFS (N = 42), multiple sclerosis (MS) (N = 18), and depression (N = 21), were compared with healthy individuals (N = 32) on a structured psychiatric interview. The SD section of the Diagnostic Interview Schedule (DIS) III-R was reanalyzed using different criteria sets to diagnose SD. All subjects received a thorough medical history, physical examination, and DIS interview. CFS patients received diagnostic laboratory testing to rule out other causes of fatigue. This study revealed that changing the attribution of SD symptoms from psychiatric to physical dramatically affected the rates of diagnosing SD in the CFS group. Both the CFS and depressed subjects endorsed a higher percentage of SD symptoms than either the MS or healthy groups, but very few met the strict DSM-III-R criteria for SD. The present study illustrates that the terminology used to interpret the symptoms (ie, psychiatric or physical) will determine which category CFS falls into. The diagnosis of SD is of limited use in populations in which the etiology of the illness has not been established.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID