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Biomedical subjects

A Steptoe

Publications and source records attributed to A Steptoe.

At least 127 records · Page 7Linked to original sources
PubMed1986

Concern about cancer in women undergoing elective gynaecological surgery.

Interviews were conducted with 63 women aged 18-75 shortly after their admission to hospital for routine non-cancer gynaecological surgery. Three groups were studied: major surgery, chiefly hysterectomy, carried out for benign conditions (n = 25); minor surgery such as dilatation and curettage (n = 29); fertility investigations and sterilisations (n = 9). Women were asked whether they worried if they were suffering from seven serious illnesses including heart disease, breast cancer and gynaecological cancer (cancer of the cervix, womb or ovaries). Significantly more women were concerned that they suffered from gynaecological cancer than any other illness. When asked why they were worried, over 85% of those expressing concern believed that their current gynaecological problem stemmed from cancer. Worry about gynaecological cancer was positively associated with psychiatric status and gynaecological knowledge, and negatively with satisfaction with treatment. A link with presenting clinical symptoms was also identified. This study revealed high levels of unwarranted distress in women undergoing routine surgery. Such fears may not be allayed, since surgeons and staff may not consider cancer to be relevant to the patient's clinical condition.

Adolescent↗
PubMed1986

Placebo responses: an experimental study of psychophysiological processes in asthmatic volunteers.

This study evaluated the effects of placebo medication on pulmonary responses in asthmatics, and investigated the roles of expectancy and anxiety. Twelve adult asthmatics were recruited for a laboratory experiment described as a study of the effectiveness of a new bronchodilator. Distilled nebulized water was inhaled in each session. The solution was described as water in session 1 (control), while in sessions 2 and 3 subjects were told that the nebulizer contained a chemical likely to cause chest tightness and wheezing (bronchoconstrictive suggestion). Prior to the inhalation sequence in sessions 2 and 3, subjects inhaled from an aerosol that they were told contained either a powerful new drug (placebo) or a non-active substance (neutral). Pulmonary function was measured with the forced oscillation technique and spirometry, while autonomic parameters, anxiety and expectancies were also monitored. Pulmonary function deteriorated following the inhalations accompanied by bronchoconstrictive suggestion, and this effect was abolished by pre-treatment with placebo. Neither subject expectations nor changes in anxiety were associated with the experimental manipulations. The implications of these results for theories of placebo action are considered.

Adult↗
PubMed1986

Are stress responses influenced by cognitive appraisal? An experimental comparison of coping strategies.

An investigation of the role of cognitive appraisal in emotional responses was carried out, in which psychological and physiological reactions to a distressing film were recorded in three groups of volunteers. Subjects in the intellectualization condition were given instructions to appraise the film in a detached, analytic fashion. The sensation-focusing group were asked to focus on physical sensations and to experience them fully, and controls were given no specific instructions. Heart rate, skin conductance and respiration rate were monitored continuously, while ratings of psychological distress and physical sensations were collected periodically. No significant differences were found in the subjective or physiological reactions of the intellectualization and control groups, thus failing to replicate previous reports. Sensation focusing led to a diminution of cardiac and electrodermal reactions, but did not affect subjective experience. Limitations to the concept of cognitive appraisal are suggested, while explanations of the results are offered in terms of external vs. internal deployment of attention, and desynchrony of emotional responses.

Adaptation, Psychological↗
PubMed1986

Stress mechanisms in hypertension.

Recent studies of stress mechanisms in hypertension have focussed on the cardiovascular and neuroendocrine reactions to challenging or threatening psychosocial stimuli. Fixed hypertension may develop in some animal models following chronic exposure to psychosocial conflict. Acute experiments in humans show that marked sympathetically-mediated cardiovascular reactions accompany the performance of challenging tasks. Responses are more accentuated in hypertensives and in people at high risk for developing the disorder. The working hypothesis to emerge is that the haemodynamic responses that accompany attempts to cope with challenging environments may promote the spiral towards sustained hypertension in susceptible individuals.

Animals↗
PubMed1985

Negative transfer of heart rate control following biofeedback training: a partial replication.

Ability to raise and lower heart rate (HR) on instruction was tested before and after unidirectional biofeedback training in two groups of 10 male volunteers. Instructional control was assessed in 2-min trials before training, and after 5 and 10 biofeedback trials of increasing (Group I) and decreasing (Group D) HR. The magnitude of HR elevations produced by Group D diminished following training, while modifications in Group I were unchanged. This negative transfer effect is discussed in relation to whether voluntary speeding and slowing HR reflect distinct capacities.

Adolescent↗
PubMed1985

Mood and pulmonary function in adult asthmatics: a pilot self-monitoring study.

The relationship between mood and fluctuations in peak expiratory flow rate (PEF) was studied in seven mildly asthmatic adult men and seven non-asthmatic controls. Participants completed visual analogue mood scales and measured PEF four times per day for 24 days, and the Profile of Mood States was also filled in at the end of each day. Significant correlations between mood and PEF were found in six of the asthmatics. No specific asthma-related profile was identified, since each person showed idiosyncratic associations between mood and pulmonary function. The non-asthmatics did not show consistent correlations above a level expected by chance. Possible explanations of these results and their relevance to the management of asthma are discussed.

Adolescent↗
PubMed1985

The pattern and prevalence of symptoms during the menstrual cycle.

One hundred volunteers completed a modified version of the Moos Menstrual Distress Questionnaire daily for 35 days. The purpose of the study was disguised. None of the participants was taking oral contraceptives. Significantly more symptoms were reported in the premenstrual and menstrual phases and fewer during the follicular phase of the cycle, but the pattern of response varied considerably between subjects. Symptom reporting was higher, in all phases of the cycle, in women with high trait anxiety or psychiatric morbidity (indexed by the General Health Questionnaire) but these measures did not relate to fluctuations of symptoms around the menstrual cycle. The need for prospective longitudinal studies of menstrual cycle symptomatology is emphasised.

Adolescent↗
PubMed1985

Type-A coronary-prone behaviour.

The aetiology of coronary heart disease is still uncertain, and the standard risk factors have limited power to predict who will succumb to the disease. The hypothesis that psychological factors play a part has received fresh impetus with the results of research into type-A behaviour.

Behavior Therapy↗
PubMed1983

Stress, helplessness and control: the implications of laboratory studies.

Limitations on the concept of stress, including unwarranted inferences about the non-specificity of responses, are illustrated through examination of the effects of behavioural control over aversive stimulation. Laboratory and clinical research indicates that control is beneficial, attenuating the magnitude of subjective, autonomic and neuroendocrine reactions. However, there are circumstances in which control is harmful, and is associated with heightened reactivity. This is particularly apparent in the cardiovascular system, and when attempts at control involve active, effortful coping behaviours. These distinctions are relevant to current theories concerning psychosocial influences on the aetiology of essential hypertension. They highlight the dangers of glib generalisations about the impact of demanding environmental conditions.

Adaptation, Psychological↗
PubMed1982

Voluntary control of cardiovascular reactions to demanding tasks.

Three groups of 10 normotensives participated in a study exploring voluntary control of cardiovascular reactions to cognitive tasks. Pulse transit time (TT), interbeat interval (IBI), skin conductance level, and respiratory variables were monitored throughout one introductory and four experimental sessions. The groups were matched on the basis of initial TT and IBI responses to the taxing arithmetic and reasoning tasks. During experimental sessions, one group (FB) was provided with visual analogue TT feedback, while the REL group was given detailed relaxation instructions. A third group (CON) performed the same sequence of tasks but was not instructed to modify cardiovascular reactions at any point. Training in voluntary control was carried out in resting (no-task) conditions, and during task administration. Both treatment groups showed lower cardiovascular reactions than controls in task trials. Only REL subjects lengthened TT in no-task conditions, while both FB and REL groups showed smaller cardiovascular reactions than CON during the tasks. Effects were confined to cardiovascular variables, since respiratory and electrodermal reactions during task administration were similar in all groups. The effects of treatments were especially marked among the most reactive subjects.

Adult↗
PubMed1982

Instructed heart rate control in the presence and absence of a distracting task: the effects of biofeedback training.

Twenty volunteers participated in a single-session experiment in which bi-directional heart rate (HR) control was assessed before and after brief unidirectional HR biofeedback. Subjects attempted to raise (INC) and lower (DEC) HR while performing mental arithmetic, as well as in no-task conditions. Biofeedback training was also carried out in the presence and absence of mental arithmetic. Subjects were divided into two groups on the basis of initial HR reactivity to mental arithmetic. Group U received feedback and instructions to raise HR during the training period, while group D attempted to lower HR. Significant differences in HR modifications during INC and DEC trials were observed prior to any biofeedback training in no-task conditions. Following training, however, ability to raise HR deteriorated in group D, while HR decelerations were impaired in group U. Unidirectional training in HR control thus handicapped subsequent attempts to modify HR in the reverse direction. The pattern of HR change was generally paralleled by respiration rate. Subjects were also able to influence the cardiac reactions to mental arithmetic even before the administration of biofeedback. The data nevertheless suggest that training affects the magnitude of HR reactions after the biofeedback is withdrawn. In the biofeedback phase itself, the HR increases and decreases produced by groups U and D, respectively, were diminished on simultaneous mental arithmetic performance.

Adolescent↗
PubMed1982

Essential hypertension and psychological functioning: a study of factory workers.

This study was designed to examine the links between psychological characteristics and mild essential hypertension. Hypertensives were identified through mass screening of industrial populations. Sixteen men under the age of 56 whose blood pressure remained above 145/90 (145/95 for the 45-55 age group) on three separate occasions were compared with 13 age-matched normotensives from the same population. Participants completed a series of personality questionnaires, and carried out concurrent mood ratings and blood pressure self-monitoring four times daily for 14 days. Subjects remained unaware of their diagnostic status until the procedure was completed. No differences between groups were found on measures of trait anxiety, total hostility or direction of hostility. State anxiety and Type A (coronary-prone) scores were significantly higher in normotensives than in hypertensives. Analysis of mood and self-monitored blood pressure revealed consistent correlations between negative mood and higher pressure in both groups. Comparison of correlations between blood pressure, tension and anger with the correlations of pressure with a control mood scale permitted spurious associations based on expectancies or reporting biases to be distinguished from genuine effects. Only the correlation between tension and systolic pressure in the hypertensive group exceeded the correlation with the control mood scale. Self-monitored pressure also correlated with pressure levels recorded in the laboratory. These results suggest that examination of blood pressure variations and psychological factors on a longitudinal basis may be valuable, particularly in the development of self-management procedures for essential hypertensives.

Adaptation, Psychological↗