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Biomedical subjects

A Steptoe

Publications and source records attributed to A Steptoe.

155 records · Page 9Linked to original sources
PubMedDate not supplied

Emotional fainting and the psychophysiologic response to blood and injury: autonomic mechanisms and coping strategies.

This experiment was designed to examine the psychophysiologic response pattern associated with emotional fainting. A survey was carried out among students, from which 30 volunteers who reported that they felt faint at the sight of blood or injury were recruited, together with 26 nonfainters. Blood pressure, heart rate, and respiration rate were monitored while subjects viewed a film depicting open-heart surgery and a neutral control film. Parasympathetic cardiac control was indexed by respiratory sinus arrhythmia (RSA), and coping was assessed by questionnaire. Responders (n = 17, group FPOS) were defined by a positive survey rating plus marked lightheadedness during the surgery film, and they were compared with nonresponders (group FNEG). Group FPOS showed a classic diphasic response with increases in heart rate and systolic blood pressure early in the surgery film followed by decreases in both variables, and the pattern was significantly different from that found in group FNEG. Data from three subjects who fainted corroborate these observations, although there were marked individual differences in response. The two groups did not differ in RSA, although RSA was smaller in both groups early in the surgery film than at other points. The positive fainting response group reported focusing their attention on bodily sensations, while those who showed little distress used intellectual coping strategies. The results are discussed in terms of the psychophysiologic mechanisms involved in fainting.

Adaptation, Psychological↗
PubMedDate not supplied

Psychophysiological responses in women reporting severe premenstrual symptoms.

Sixteen women attending a Premenstrual Tension Clinic and eight control women were tested experimentally in the premenstrual and postmenstrual phases with assessments of heart rate, skin conductance level, and neck electromyogram during rest, relaxation, an emotionally upsetting film, and performance of mental arithmetic and video game tasks. All participants completed daily symptom assessments for two menstrual cycles prior to the study. The clinic attenders were divided into eight (Clinic+) who showed marked increases in symptoms premenstrually, and eight (Clinic-) who recorded only modest changes in symptom severity across the menstrual cycle. There were no marked differences in resting autonomic activity. During relaxation, skin conductance level decreased to a greater extent in the premenstrual than in the postmenstrual phase, while neck electromyogram showed the reverse pattern. Heart rate reactions to the mental arithmetic and video game tasks were smaller in the premenstrual than in the postmenstrual phase in Controls and Clinic- groups, but not in the Clinic+ group. Possible explanations of these results are discussed.

Adolescent↗
PubMedDate not supplied

Psychosocial stress and susceptibility to upper respiratory tract illness in an adult population sample.

OBJECTIVE: To assess the influence of life event stress and hassles, and the moderating effects of psychological coping style, social support, and family environment, on susceptibility to upper respiratory tract infectious illness. METHOD: One hundred seven adults aged 18 to 65 years took part in a 15-week study. Measures of life event stress were obtained for the 12 months preceding the study and for the study period itself, and social support, information seeking and avoidant coping styles, and family environment were assessed. Hassles and perceived stress were measured weekly, whereas dysphoric mood and changes in personal health practices (smoking, alcohol consumption, exercise, and sleep patterns) were assessed at three weekly intervals. Episodes of upper respiratory tract infectious illness were verified by clinical examination. RESULTS: During the study period, 29 individuals experienced at least one clinically verified episode of upper respiratory tract illness. There were no differences in cigarette smoking, sleep habits, or exercise between those who did and did not become ill but alcohol consumption was lower among those who experienced verified episodes. Risk of infectious illness was greater in those who experienced high life event stress both before and during the study period, but the impact of life events was buffered by an avoidant coping style. Strict family organization was associated with illness risk. The three weeks preceding illness onset were characterised by high levels of perceived stress, but also by a decrease in the number of hassles reported. CONCLUSIONS: Results suggest that under naturalistic conditions, the influence of stressful experience on risk of infectious illness is moderated by psychosocial resources. Variations in personal health practices do not seem to be responsible.

Adaptation, Psychological↗
PubMedDate not supplied

Ambulatory blood pressure monitoring is associated with reduced physical activity during everyday life.

OBJECTIVE: The objective of this study was to assess the impact on noninvasive ambulatory blood pressure monitoring on physical activity measured objectively by use of triaxial accelerometers. METHODS: Twenty-four working men and women performed ambulatory blood pressure plus activity monitoring for 1 working day and evening and activity monitoring alone for a separate day and evening. Blood pressure measures were taken at 20-minute intervals during the day and 30-minute intervals in the evening and were accompanied by diary assessments of mood, location, and posture. Comparisons were made of energy expenditure on the 2 days and of activity levels during the minutes surrounding each blood pressure reading and diary completion. RESULTS: Energy expenditure assessed in terms of activity calories per hour was significantly lower during blood pressure plus activity monitoring compared with activity monitoring alone (mean 37.3, SD = 16.3 vs. mean = 43.0, SD = 18.7 kcal, respectively: p = .02). Energy expenditure was lower during the 4 minutes surrounding each blood pressure reading than in the intervals between blood pressure readings. However, energy expenditure was also lower in the intervals between blood pressure readings than during comparable times on the activity only monitoring day. Blood pressure, heart rate, and physical activity were moderately correlated within individuals. CONCLUSIONS: Ambulatory blood pressure recording using automated sphygmomanometers is associated with reduced physical activity during the monitoring day. This is due partly to regular periods of immobility during cuff inflation and deflation and diary completion and partly to more general self-imposed restrictions on activity. This pattern has implications for the representativeness of ambulatory blood pressure monitoring, and the construction of ambulatory monitoring diaries.

Adult↗
PubMedDate not supplied

Job strain and anger expression predict early morning elevations in salivary cortisol.

OBJECTIVE: The objectives of this study were to test the hypothesis that high job demands and low job control (job strain) are associated with elevated free cortisol levels early in the working day and with reduced variability across the day and to evaluate the contribution of anger expression to this pattern. METHODS: One hundred five school teachers (41 men and 64 women) classified 12 months earlier as high (N = 48) or low (N = 57) in job strain according to the demand/control model sampled saliva at 2-hour intervals from 8:00 to 8:30 hours to 22:00 to 22:30 hours on a working day. Anger expression was assessed with the Speilberger State-Trait Anger Expression Inventory, and negative affect was also measured. RESULTS: Free cortisol was significantly elevated at 8:00 to 8:30 hours in the high job strain group but not at later times of the day or evening. After adjustment for age and negative affect, cortisol was an average of 21.7% higher early in the working day in the high job strain group. This effect was significantly greater in high job strain teachers, who also reported high anger-out. The cortisol decline from morning to evening was greater in the high than low job strain individuals. Independently of job strain, women had a higher cortisol concentration at 8:00 to 8:30 hours than men, whereas cortisol concentration was greater in men than women in the middle of the working day between 12:00 and 16:30 hours. CONCLUSIONS: Job strain is associated with elevated free cortisol concentrations early in the working day but not with reduced cortisol variability. The interaction with outward anger expression suggests that individual characteristics modulate the impact of chronic work stress on the hypothalamic-pituitary-adrenocortical system.

Adult↗
PubMedDate not supplied

Emotions and stress increase respiratory resistance in asthma.

OBJECTIVES: Clinical reports suggest that various emotions and types of stress can precipitate asthmatic symptoms, but there is little experimental evidence to substantiate this claim. We studied the impact of different emotional states and stress on respiratory resistance in asthmatic and nonasthmatic individuals. METHODS: Participants (24 asthmatic and 24 nonasthmatic patients) viewed short film sequences selected to induce anxiety, anger, depression, elation, happiness, contentment, or a neutral affective state and completed two stressful tasks, mental arithmetic to induce active coping efforts and viewing of medical slides to induce passive coping efforts. Oscillatory resistance, heart rate, blood pressure, baroreflex sensitivity, skin conductance level, respiration rate and volume, and self-reported affective state were measured throughout the session. RESULTS: Uniform increases in oscillatory resistance were found in all emotional states compared with the neutral state and during mental arithmetic in both groups. Asthmatic patients showed stronger reactions to the medical slides than healthy control subjects, with significant increases in oscillatory resistance, blood pressure, skin conductance level, and minute volume, as well as higher levels of self-reported depression, arousal, and shortness of breath. Changes in oscillatory resistance were inconsistently correlated with other physiological indices. CONCLUSIONS: Various emotional states and stress increase oscillatory resistance largely independently of concurrent increases in autonomic or ventilatory activity. The particular sensitivity of asthmatics to passive coping demand requires additional research.

Adult↗
PubMedDate not supplied

Emotion and pulmonary function in asthma: reactivity in the field and relationship with laboratory induction of emotion.

OBJECTIVE: We investigated the modulation of pulmonary function by mood states in the daily life of asthmatic patients and nonasthmatic control subjects and its relationship to the airway effects of laboratory induction of emotion using films. METHODS: Twenty asthmatic patients and 20 nonasthmatic control subjects participated in a laboratory session in which various emotions (ie, anxiety, anger, depression, happiness, elation, contentment, and neutrality) were induced by films. Respiratory resistance (Ros) was measured by forced oscillation. After this session, participants kept mood diaries, including regular spirometric self-assessments, for at least 3 weeks. Episodes of strong negative or positive mood were selected from these diaries and compared with conditions of relative affective neutrality. RESULTS: In asthmatic patients, negative mood states, and to a lesser degree positive mood states, were associated with a reduction in forced expiratory volume in the first second (FEV1) compared with neutral states. These effects were not observed in nonasthmatic control subjects. Self-reports of arousal varied in a reciprocal manner with FEV1, whereas physical activity did not vary systematically between mood episodes. A moderate negative relationship between changes in FEV1 during negative mood episodes and changes in Ros during viewing of the depressing film was also observed in asthmatic patients. CONCLUSION: Pulmonary function of asthmatic patients is negatively affected by strong mood states in daily life. Airway effects of negative emotion induction, particularly depression, can predict changes in pulmonary function in response to negative mood in the field.

Adult↗
PubMedDate not supplied

Blood pressure reactions to acute psychological stress and future blood pressure status: a 10-year follow-up of men in the Whitehall II study.

OBJECTIVE: The aim of this study was to examine whether blood pressure reactions to mental stress predicted future blood pressure and hypertension. METHODS: Blood pressure was recorded at an initial medical screening examination after which blood pressure reactions to a mental stress task were determined. A follow-up screening assessment of blood pressure and antihypertensive medication status was undertaken 10 years later. Data were available for 796 male public servants, between 35 and 55 years of age upon entry to the study. RESULTS: Systolic blood pressure reactions to mental stress were positively correlated with follow-up screening systolic blood pressure and to a lesser extent, follow-up diastolic pressure. In multivariate tests, by far the strongest predictors of follow-up blood pressures were initial screening blood pressures. In the case of follow-up systolic blood pressure, systolic reactions to stress emerged as an additional predictor of follow-up systolic blood pressure. With regard to follow-up diastolic blood pressure, reactivity did not enter the analogous equations. The same outcomes emerged when the analyses were adjusted for medication status. When hypertension at 10-year follow-up was the focus, both systolic and diastolic reactions to stress were predictive. However, with correction for age and initial screening blood pressure, these associations were no longer statistically significant. CONCLUSIONS: The results of this study provide modest support for the hypothesis that heightened blood pressure reactions to mental stress contribute to the development of high blood pressure. At the same time, they question the clinical utility of stress testing as a prognostic device.

Acute Disease↗