ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Several studies have shown that hostility, as measured by the Minnesota Multiphasic Personality Inventory–derived Cook-Medley Hostility Scale (Ho), is positively associated with several cardiovascular risk factors, possibly accounting for the relationship between Ho scores and cardiovascular mortality. This study was undertaken to examine associations between hostility and cardiovascular risk factors representing the metabolic syndrome in 1081 older men who participated in the Normative Aging Study.Methods:Subjects included men who completed the Minnesota Multiphasic Personality Inventory in 1986 and who participated in a subsequent laboratory examination within 1 to 4 years. Total and subscale Ho scores were computed, and associations with anthropometric data, cigarette smoking, dietary information, serum lipids, blood pressure, and fasting glucose and insulin levels were examined.Results:The total Ho score was positively associated with waist/hip ratio, body mass index, total caloric intake, fasting insulin level, and serum triglycerides. The Ho score was inversely related to education and high-density lipoprotein cholesterol concentration. Path analysis also suggested that the effects of hostility on insulin, triglycerides, and high-density lipoprotein cholesterol were mediated by its effects on body mass index and waist/hip ratio, which, in turn, exerted their effects on lipids and blood pressure through insulin.Conclusions:The results are consistent with those of prior research and also suggest that, in older men, hostility may be associated with a pattern of obesity, central adiposity, and insulin resistance, which can exert effects on blood pressure and serum lipids. Furthermore, effects of hostility on the metabolic syndrome appear to be mediated by body mass index and waist/hip ratio.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Existing research indicates that hostility is associated with enhanced blood pressure responses during social stress, but little is known about the hemodynamic patterns underlying these blood pressure increases, particularly in women. The present study examined hemodynamic responses to a low-anger interpersonal stressor, testing the hypotheses that hostile individuals show enhanced vascular responses and that low hostile individuals show enhanced myocardial responses.Methods:Eighty undergraduate men and women were categorized as high or low in hostility on the basis of median splits of Cook-Medley Hostility Scale scores. Participants discussed a controversial topic with a confederate who disagreed with them, and hemodynamic responses were assessed with impedance cardiography.Results:High hostile individuals exhibited greater increases in diastolic blood pressure and total peripheral resistance and smaller increases in cardiac output during an interpersonal stressor than did low hostile individuals. Systolic blood pressure and heart rate increases were greater among high hostile relative to low hostile females and comparable among low and high hostile males. Affective responses and task perceptions were generally similar for high and low hostile participants, but the relationship between task perception and hemodynamic responses varied on the basis of hostility level.Conclusions:These findings suggest that hostility in both men and women is associated with heightened vascular and dampened cardiac responsivity to interpersonal stress that is not deliberately anger provoking. Moreover, they indicate that the associations between task perception and hemodynamic responses vary between high and low hostile individuals.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Recent studies have found evidence of the presence and role of intrusive traumatic memories in depressed patients. In this study, we attempted to replicate these findings, examining the full range of early and later traumatic events, as well as comorbid posttraumatic stress disorder, in male and female depressed patients.Methods:Sixty-nine outpatients meeting criteria of theDiagnostic and Statistical Manual of Mental Disorders, fourth edition, for major depressive episode were recruited from the outpatient department of an academic hospital.Results:Seventy-five percent of the depressed patients were found to have had one or more early and/or more recent traumatic experiences. The symptom category of reexperiencing was diagnosed in 48% of these trauma-exposed respondents. Comorbid posttraumatic stress disorder was diagnosed in 13% of the total sample.Conclusions:The findings show that depressed patients are highly likely to have experienced traumatic events and intrusive traumatic recollections. Future research should focus on the direction of any causal relationship between trauma, reexperiencing, posttraumatic stress disorder, and depression.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:A patient-centered model of communication has often been advocated in preference to a doctor-centered model. The aim of the present study was to assess in an experimental setting how subjects’ general level of anxiety affects their reactions to these two communication styles as measured by emotional reactions and satisfaction immediately after consultation.Methods:Twenty students with low trait anxiety and 21 students with high trait anxiety each had a single consultation with a physician who performed the consultation using either a patient-centered or doctor-centered style of communication. Questionnaires about emotional state were completed by the students before and after the consultation, and a questionnaire about satisfaction was completed after the consultation.Results:Students with low trait anxiety were significantly more satisfied with a patient-centered than a doctor-centered style of communication. There were no significant differences in emotional response to the two styles of communication. Students with high trait anxiety reacted emotionally more positively to a doctor-centered communication style, with significant and nearly significant change scores for the emotions of tension/anxiety and vigor/activity, respectively. No significant difference was found between satisfaction scores.Conclusions:Data indicate that differences between subjects’ emotional traits may be of importance for a differentiated response to patient-centered and doctor-centered communication styles. Subjects’ trait anxiety seems to be a significant factor that should be taken into account when assessing the effects of different communication styles.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Biochemical host defenses at mucosal sites, such as the oral cavity, play a key role in the regulation of microbial ecology and the prevention of infectious disease. These biochemical factors have distinct features, some of which benefit the host and some that benefit bacteria. We investigated the effects of acute stress on the salivary levels of the carbohydrate structure sulfo-Lewisa(sulfo-Lea), which is linked to the mucosal glycoprotein MUC5B. Sulfo-Leawas recently identified as an adhesion molecule forHelicobacter pylori; therefore, we also measured saliva-mediated adherence (ex vivo) ofH. pylori. The oral cavity is suspected to be involved in the transmission ofH. pylori.Methods:Saliva was collected from 17 undergraduates before (baseline), during (stress), and after (recovery) exposure to a video showing surgical procedures. In addition, blood pressure, an impedance cardiogram, and an electrocardiogram were recorded.Results:During stressor exposure, participants reported increased state anxiety. In addition, stroke volume increased and heart rate decreased. The stressor induced a strong increase in salivary sulfo-Leaconcentration (U/ml), sulfo-Leaoutput (U/min), sulfo-Lea/total protein ratio (U/mg protein), and saliva-mediated adherence (ex vivo) ofH. pylori. As expected, sulfo-Leaconcentration correlated with the adherence ofH. pylori(r= 0.72,p< .05). It was demonstrated that the observed adherence was induced by MUC5B and that the carbohydrate structure sulfo-Leacontributed to this process.Conclusions:Our study demonstrated a direct link between stress-mediated biochemical changes and altered host-microbe interactions in humans. Increased bacterial adherence may be a contributing factor in the observed relationship between stress and susceptibility to infectious disease.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:The validity of prior studies on the menstrual cycle and suicide attempts assumes that suicidal women accurately describe their cycles. The three objectives of this study were 1) to explore whether prior inconsistencies are due to the effects of sample selection and method of assessment of the menstrual cycle, 2) to assess the relationship between the menstrual cycle phase and suicide attempts, and 3) to establish the role of sexual hormones in suicide attempts.Methods:The original sample included 134 women who came to the emergency room of a general hospital after a suicide attempt. One hundred eight female blood donors were recruited as control subjects. The menstrual cycle was divided into follicular, midcycle, and luteal phases using two clinical methods and serum hormonal assessment. Dividing the follicular phase into menstrual and nonmenstrual phases was also considered.Results:Two of 11 previously used sampling methods produced a sample size similar to that of the hormonal assessment. &kgr; values between the two clinical and the endocrinological methods were low (0.40–0.50). The number of suicide attempts during the follicular phase (particularly during the menstrual phase) was significantly higher than expected.Conclusions:Despite the inability to control for other variables and limitations, the results of this study suggest that sample selection could introduce biases and that studies relating psychiatric symptomatology and menstrual cycle phases need to use hormonal determinations. New studies are needed to verify that suicide attempts are more frequent during the follicular phase (particularly during the menstrual phase).

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:This study examined the within-person relations between transitory changes in mood, asthma symptoms, and peak expiratory flow rate (PEFR).Methods:Thrice-daily for 21 consecutive days, 48 adults with moderate to severe asthma entered information in palm-top computers about their mood and asthma symptoms. A multidimensional model of mood, ie, the mood circumplex, informed the assessment of mood arousal and mood pleasantness. At each observation, participants also recorded their PEFR with peak flow meters that stored blinded data. Albuterol doses were also monitored electronically. Before and after the 21-day study, spirometric measures of airways obstruction were taken under controlled conditions.Results:Random effects regression models revealed a significant, but weak, within-person relation between symptoms and PEFR. Changes in mood vectors with an arousal component were significantly related to PEFR changes, whereas changes in mood vectors with a pleasantness component tracked changes in asthma symptom reports, even after adjustment for contemporaneous PEFR and after controlling for time of day and albuterol dosing. Comparison of spirometric assessments with unsupervised PEFR suggested that part of the relation between mood arousal and PEFR may be attributable to the “effort-dependence” of peak flow self-monitoring.Conclusions:Different dimensions of mood were associated with transitory changes in asthma symptoms and PEFR. This may be one reason why individuals with asthma misperceive the severity of their symptoms in relation to underlying airways obstruction.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:The objective of this study was to evaluate whether biopsychosocial functioning differences exist between samples of patients with temporomandibular disorder (TMD) who differ in coping profiles as assessed by the Multidimensional Pain Inventory.Methods:A total of 322 patients who presented with TMD were administered a comprehensive biopsychosocial assessment battery, and the acute or chronic status of their disorder was determined. A follow-up evaluation was conducted 6 months later to determine the status of their pain.Results:TMD patients with dysfunctional and interpersonally distressed coping profiles demonstrated more acute and chronic psychosocial difficulties than patients with adaptive coper profiles. The data also suggest that having a dysfunctional/distressed coping profile on the Multidimensional Pain Inventory has some predictive value in determining the likelihood of developing chronicity in the absence of treatment.Conclusions:The presence of a dysfunctional/distressed coping profile in patients with TMD is likely to provide clinicians with important information about the biopsychosocial functioning of those patients, which, in turn, will help to determine the most effective treatment modalities to use with TMD patients.

ISSN:0033-3174    

出版商:OVID    

年代:2000

数据来源: OVID