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.     

Blood pressure reactivity to active and passive behavioral conditions in hypertensives and normotensives

Blood pressure reactivity and passive behavioral tasks was studied in patients with mild essential hypertension and normotensive controls. The passive condition included 10 presentations of a 6 sec, 78 dB, 1000 Hz tone without any response requirements. In the active condition subjects were given an additional 10 tone presentations and asked to press a push-button at tone termination. The absolute and percent increase in systolic blood pressure from rest was greater in hypertensives than normotensives in response to the active condition but similar to the passive condition. It is concluded that patients with hypertension compared to normotensive controls show exaggerated blood pressure reactivity to tasks involving active but not passive coping efforts. Since the tasks used to induce active and passive coping in the present study were identical apart from coping requirements, the notion that the activity dimension in and of itself modulates reactivity differences between patients and controls is supported.     

Marital satisfaction and family stress as predictors of classroom behaviors

The purpose of this research was to examine the relationship between parents' perceptions of marital satisfaction and family stress and their third grade children's classroom behavior. Twenty-one married couples completed questionnaires during home visits. Behavior observations were made from videotapes of children recorded in their classroom during lunch and group academic periods on each of three days. Frequencies of peer interactions, solitary behaviors, and teacher interactions were coded. Regression analyses showed that mothers' level of marital satisfaction (but not fathers') predicted their children's frequency of peer interactions during lunch. Fathers' level of perceived family stress (but not mothers') predicted their children's frequency of peer interactions during lunch. Neither measure for either parent was related to the frequency of peer interactions, solitary behaviors, or teacher interactions observed during the academic sessions. These findings highlight the importance of assessing the potential differential relation of parent variables to children's trans-situational behaviors, and the examination of these variables in relation to different social-environmental contexts in which children participate outside the home.     

Psychopathology subtypes and symptom correlates among former prisoners of war

Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma.     

The Novacco Anger Scale and Jenkins Activity Survey as predictors of cardiovascular reactivity

This study investigated the relationship among anger, the Type A construct, and cardiovascular reactivity. The Novacco Anger Scale and the Jenkins Activity Survey (JAS) were used to measure anger proneness and Type A characteristics, respectively. Twenty-four college males were selected from the upper and lower quintiles of the JAS distribution. During the study, the subjects were exposed to varying levels of experimentally induced challenge, while measurements were taken of heart-rate and blood-pressure changes. The results showed a modest but significant correlation between scores on the Novacco Anger Scale and the JAS. More importantly, scores on the Novacco Anger Scale correlated significantly with heart rate and systolic blood pressure under all challenge conditions, while those on the JAS were unrelated to cardiovascular excitability. These results raise questions about the usefulness of the JAS as a predictor of CHD risk. They are also consistent with the beliefs of other investigators that anger and hostility are the most important Type A behaviors in predisposing patients to coronary heart disease. Additional implications of the study are discussed.     

Reactivity and unreliability of husbands as participant observers

This study examined the reliability and reactivity of participant observation. Twelve couples engaged in two discussions in a laboratory, one on a conflict topic and one on a consensus topic. For the eight couples in the experimental sequences, a baseline discussion was followed by participant observation in which the husband recorded his wife's use of I while continuing to converse. The four couples in the control sequences conversed without participant observation. Compared to observations made by a trained observer, the husbands were unreliable observers, underestimating their wives' use of I. Participant observation was reactive (P<.01), with more wives decreasing their use of I in the experimental sequences than in the control sequences (p<.094). The topic of discussion did not differentially influence reliability or reactivity.This research was conducted as the first author's independent doctoral research project. We extend gratitude to the Research Council of the University of North Carolina at Greensboro for Grant 0-2-110-218-XXXXX-7548; the Statistical Consulting Center of the University of North Carolina at Greensboro; two anonymous reviewers; and our research assistants, Suzanne Brannon, Ben Hardie, Kathy Lindamood, Amy Mitchem, Regina Pierce, and Elga Wulfert. Portions of this paper were presented at the meeting of the Association for Advancement of Behavior Therapy, Washington, D.C., December 1983.     

Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic

Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (M_Age = 5.04, SD_Age = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.     

Intensive specialised multi-family therapy for multi-stressed families: Therapeutic alliance as predictor for effectiveness

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.