Motilin- and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia.

BACKGROUND: The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment. METHOD: 25 patients (12 men, 13 women), age 24-50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects' self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms. RESULTS: Mean plasma MOT-LI concentration was 7.3 (CI: 5.7-9.4) pmol/L in the patient group, and 7.9 (CI: 6.1-10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3-16.4) pmol/L in the patient group, and 13.4 (Cl: 11.8-15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05). CONCLUSION: During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.     

The functional state of the central nervous system in chemical stress

The psychosocial and physical factors, including chemical ones, which affect the human organism are considered by some authors to be stress factors which affect the functional state (FS) of the central nervous system (CNS). We calculated correlations among the clinical, psychological/psychometric, and quantitative electropsychological (QEEG) variables of the functional changes of the CNS in chemical stress. These data were based on occupational contact with lead as experienced by 402 workers, with styrene by 96, with shale-oil products by 252, with organic solvents by 77 workers, and a control group of 145 workers in different age groups. The QEEG data of 77 patients were analyzed to determine the chronic neurotoxic effects of industrial chemical substances by diagnosing the functional changes at the syndrome level. We concluded that occupational chemical factors impact the functional state of the CNS. During chemical stress -activity and total cerebral bioelectrical activity (BA) decreases. The use of psychometric/ psychological and QEEG methods makes it possible to diagnose the changes of the CNS as hypersthenic, hyposthenic, and organic psychosyndromes.     

Associations of perceived stress and state anger with symptom burden and functional status in patients with heart failure

Abstract

Background: Psychosocial stress and anger trigger cardiovascular events, but their relationship to heart failure (HF) exacerbations is unclear. We investigated perceived stress and anger associations with HF functional status and symptoms.

Methods and Results: In a prospective cohort study (BETRHEART), 144 patients with HF (77% male; 57.5?±?11.5 years) were evaluated for perceived stress (Perceived Stress Scale; PSS) and state anger (STAXI) at baseline and every 2 weeks for 3 months. Objective functional status (6-min walk test; 6MWT) and health status (Kansas City Cardiomyopathy Questionnaire; KCCQ) were also measured biweekly. Linear mixed model analyses indicated that average PSS and greater than usual increases in PSS were associated with worsened KCCQ scores. Greater than usual increases in PSS were associated with worsened 6MWT. Average anger levels were associated with worsened KCCQ, and increases in anger were associated with worsened 6MWT. Adjusting for PSS, anger associations were no longer statistically significant. Adjusting for anger, PSS associations with KCCQ and 6MWT remained significant.

Conclusion: In patients with HF, both perceived stress and anger are associated with poorer functional and health status, but perceived stress is a stronger predictor. Negative effects of anger on HF functional status and health status may partly operate through psychological stress.     

Failure to alter psychophysiological reactivity in type a men with physical exercise or stress management programs

Abstract

Psychophysiological reactivity has been associated with heightened risk of coronary heart disease. Since behavioral processes may contribute to disease etiology, the possibility arises that they might also contribute to disease prevention. The capability of behavioral interventions to modify exaggerated reactivity in Type A men. was therefore, brought under experimental scrutiny. Subjects were 107 male managers. who met the following criteria: (1) no history or current signs of heart disease. (2) presence of Type A behavior pattern, and (3) exaggerated psychophysiological reactivity to mental stress. After matching for age and physical fitness level. participants were randomly assigned to one of three 10-week intervention programs: aerohic training, weight training and cognitive-behavioral stress management. Heart rate and blood pressure were monitored while challenging mental tasks were performed in pre-training and post-training laboratory sessions before and after the intervention programs. Although participants in the two physical activity programs showed the expected physical adaptations, no changes in psychophysiological reactivity were seen in the three groups. This negative result may indicate either that reactivity was not altered owing to the conditions of the present experiment, or that these behavioral interventions are truly without effect.     

The girlfriend's effect on perceived stress in sample containing males of different ages from Attock and Sargodha,Pakistan: with moderating role of Islamic religious values

This paper analysed the relation of girlfriend’s effect (GFE) with perceived stress (PS), and also considered Islamic religious values (RVs) as a moderating variable. The selection technique used was convenience sampling that helped the investigation to select 90 respondents who filled self-report measures about various constructs. Linear regression was employed to test different conceptual linkages material to this work. The results show that there is no significant relation present between RVs and PS. Moderating hypothesis was also rejected. However, GFE predicted notable degree of PS in the sample. Limitations and future directions are also discussed.     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set

Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.     

Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.     

The impact of balance‐focused attitudes on job stress: Gender differences evidenced in American and Chinese samples

Based on gender role expectations model, we examined how balance‐focused attitudes would affect job stress by influencing individuals' perceptions of family interference with work (FIW), and investigated whether a gender difference would exist in the relationships among balance‐focused attitudes, FIW and job stress. Using two independent samples from the United States and China, we found support for the indirect influence of balance‐focused attitudes on job stress, through FIW. Participants with balance‐focused attitudes experienced lower levels of job stress as they perceived less interference from family to work. As expected, such indirect effect was more pronounce among male participants, meaning that the male participants benefited more from having balance‐focused attitudes. Discussion, theoretical and practical implications are provided.     

Accuracy of retrospective memory and covariation estimation in patients with obsessive-compulsive disorder

Assessment methods relying on biased or inaccurate retrospective recall may distort knowledge about the nature of disorders and lead to faulty clinical inferences. Despite concerns about the accuracy of retrospective recall in general and in particular with obsessive–compulsive disorder (OCD) patients, the accuracy of retrospective recall for one's own symptoms assessed in vivo is unknown in this population. This study used a prospective ecological momentary assessment (EMA) methodology to create a criterion against which to assess recall accuracy in OCD patients. Although results indicated that patients’ retrospective recall of OCD symptoms was fairly accurate, they consistently overestimated the magnitude of OCD symptom covariation with non-OCD facets (e.g., sleep duration, contemporaneous stress level, etc.). Findings suggest that even when recall of OCD symptoms is accurate, patients may be inaccurate in estimating symptom covariation. The findings have implications for the research, case conceptualization, and assessment of OCD, and may extend to other disorders.     

Intrusive images in PTSD and in traumatised and non-traumatised depressed patients: a cross-sectional clinical study

Although intrusive images are a hallmark of post-traumatic stress disorder (PTSD) and also occur in depression, little is known about the differences and similarities of such images in these conditions. Our study focuses on the qualities and triggers of intrusive images and responses to them in three groups--patients with PTSD, and depressed patients with and without trauma (n=65)-to highlight the diagnostic specificity of intrusive images for PTSD and depression. We distinguished intrusive images from verbal intrusive cognitions such as rumination and intrusive (brief) lexical thoughts. Consistent with the literature, the intrusive images of PTSD patients had a more "here-and-now quality" and were perceived more visually compared to those of both depressed groups. The groups showed a good deal of similarity concerning other image qualities. Most importantly, the intrusive images in PTSD and depressed patients with and without trauma were perceived as similarly distressing. Rumination and intrusive (brief) lexical thoughts were two of the five most named triggers of intrusive images. Limitations, such as the lack of a control group, and the clinical implications of these results are discussed, demonstrating the need to help non-PTSD patients with and without trauma to deal with intrusive images.     

Emotion regulation mediates the effects of temperament traits and posttraumatic stress disorder symptoms on affect in motor vehicle accident survivors

ObjectivesThe aim of the present study was to investigate the associations among temperament traits postulated by the Regulative Theory of Temperament (RTT), posttraumatic stress disorder symptoms (PTSD symptoms), emotion regulation strategies, and affect in the 280 motor vehicle survivors (MVA).MethodsTemperament was measured with the Formal Characteristics of Behaviour–Temperament Inventory (FCB-TI), the level of posttraumatic stress disorder symptoms was assessed by the PTSD Clinical Inventory (PTSD-C), emotion regulation was tested with the Polish adaptation of the Inventory of Cognitive Affect Regulation Strategies (ICARUS), and affect was evaluated by the Polish version of the Positive and Negative Affect Scale (PANAS).ResultsGreater emotional reactivity was associated with grater negative affect (also by maladaptive regulation) and lower positive affect whereas greater activity was linked to grater positive affect (also via adaptive regulation). Furthermore, greater PTSD symptoms were related to greater negative affect (also through maladaptive regulation) and lower positive affect. However, PTSD symptoms were not linked to adaptive regulation strategies.ConclusionThe findings significantly extends our current knowledge on the associations among temperament traits, PTSD symptoms, emotion regulation strategies, and affect in the motor vehicle survivors.     

Self-efficacy and planning strategies can improve physical activity levels in women with a recent history of gestational diabetes mellitus

Introduction: Regular physical activity can reduce the risk of developing diabetes in high risk populations including in women with gestational diabetes mellitus (GDM). This study applied the Health Action Process Approach (HAPA) to determine the motivational and volitional factors important in increasing physical activity among women with previous GDM.

Methods: Women with GDM receiving obstetric care at a teaching hospital in Sri Lanka were invited to participate in a survey 6–36 months post-delivery. At baseline and 8 weeks later, 152 women completed postal and telephone surveys that collected socio-cognitive and physical activity data. The study hypotheses were tested using structural equation modelling.

Results: The modified model fit the data well (CFI = .95, TLI = .94, RMSEA = .057) and explained 11% of the variance in behaviour. Action self-efficacy was the only important predictor of intention to be physically active. Intention as well as maintenance self-efficacy predicted planning, which, in turn, predicted physical activity. Planning mediated the effect of intention and self-efficacy (maintenance and recovery) on physical activity.

Conclusion: This study has identified predictors of physical activity among women with previous GDM that can inform intervention studies. Interventions targeting this population need to include planning strategies and enhance self-efficacy.     

Cognitive control of a simple mental image in patients with obsessive--compulsive disorder

The nature of obsessions has led researchers to try to determine if the main problem in obsessive-compulsive disorder (OCD) is impaired inhibitory control. Previous studies report that the effort to suppress is one of the factors that increase the frequency of obsessive thoughts. Based on these results and those of the present study that suggest inferior parietal lobe (IPL) abnormality in OCD and findings of a recent study that reported the importance of the right posterior parietal cortex in cognitive control of a simple mental image, the present cognitive control paradigm study aimed to determine whether there is a difference in brain dynamics between OCD patients and non-obsessive controls while performing tasks that necessitate cognitive control of a simple mental image, and whether the right posterior parietal region is one of the regions in which a difference in activity between the OCD patients and controls would be observed. Functional brain imaging was performed while the participants attempted to suppress, imagine, or manipulate a mental image. The general linear model showed that there was a main effect of group and main effect of task. Accordingly, in all contrasts (suppression minus free-imagination, erasing minus free-imagination, and imagination minus free-imagination), the right IPL, right posterior cingulate cortex, and right superior frontal gyrus activity were lower in the OCD patients than in the healthy controls. These results and the observed correlations between activity levels, and symptom and subjective performance scores are discussed. In conclusion, the results of the present study and those of previous studies suggest that the main problem in OCD might be difficulty activating the right frontoparietal networks during tasks that require cognitive control, which might result in the intrusiveness of obsessive thoughts.