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Biomedical subjects

H Benson

Publications and source records attributed to H Benson.

At least 19 recordsLinked to original sources
PubMed1995

Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators.

BACKGROUND: Many anecdotes and several uncontrolled case series have suggested that emotionally stressful events, and more specifically, anger, immediately precede and appear to trigger the onset of acute myocardial infarction. However, controlled studies to determine the relative risk of myocardial infarction after episodes of anger have not been reported. METHODS AND RESULTS: We interviewed 1623 patients (501 women) an average of 4 days after myocardial infarction. The interview identified the time, place, and quality of myocardial infarction pain and other symptoms, the estimated usual frequency of anger during the previous year, and the intensity and timing of anger and other potentially triggering factors during the 26 hours before the onset of myocardial infarction. Anger was assessed by the onset anger scale, a single-item, seven-level, self-report scale, and the state anger subscale of the State-Trait Personality Inventory. Occurrence of anger in the 2 hours preceding the onset of myocardial infarction was compared with its expected frequency using two types of self-matched control data based on the case-crossover study design. The onset anger scale identified 39 patients with episodes of anger in the 2 hours before the onset of myocardial infarction. The relative risk of myocardial infarction in the 2 hours after an episode of anger was 2.3 (95% confidence interval, 1.7 to 3.2). The state anger subscale corroborated these findings with a relative risk of 1.9 (95% confidence interval, 1.3 to 2.7). Regular users of aspirin had a significantly lower relative risk (1.4; 95% confidence interval, 0.8 to 2.6) than nonusers (2.9; 95% confidence interval, 2.0 to 4.1) (P < .05). CONCLUSIONS: Episodes of anger are capable of triggering the onset of acute myocardial infarction, but aspirin may reduce this risk. A better understanding of the manner in which external events trigger the onset of acute cardiovascular events may lead to innovative preventive strategies aimed at severing the link between these external stressors and their pathological consequences.

Adrenergic beta-Antagonists↗
PubMed1995

Chronic psychological effects of exercise and exercise plus cognitive strategies.

Psychological changes associated with 16-wk moderate and low intensity exercise training programs, two of which possessed a cognitive component, were evaluated. Subjects were healthy, sedentary adults, 69 women (mean age = 54.8 +/- 8.3 yr) and 66 men (mean age = 50.6 +/- 8.0 yr). Participants were randomly assigned to a control group (C), moderate intensity walking group (MW), low intensity walking group (LW), low intensity walking plus relaxation response group (LWR), or mindful exercise (ME) group-a Tai Chi type program. Women in the ME group experienced reductions in mood disturbance (tension, P < 0.01; depression, P < 0.05; anger, P < 0.008; confusion, P < 0.02; and total mood disturbance, P < 0.006) and an improvement in general mood (P < 0.04). Women in the MW group noted greater satisfaction with physical attributes (body cathexis, P < 0.03), and men in MW reported increased positive affect (P < 0.006). No other differences were observed between groups on measures of mood, self-esteem, personality, or life satisfaction. Equivocal support is provided for the hypothesis that exercise plus cognitive strategy training programs are more effective than exercise programs lacking a structured cognitive component in promoting psychological benefits.

Adaptation, Psychological↗
PubMed1992

A comparison of case retrieval times: film versus picture archiving and communications systems.

One of the advantages that a picture archiving and communications system (PACS) is supposed to provide over a film-based operation is improved performance in retrieving images. Although it seems self-evident that this should be so, this experiment was intended to verify this and to provide some time comparisons for the two methods. The experiment consisted of randomly selecting ultrasound and computed tomography cases and determining how long it took to retrieve files at a PACS workstation or in person from the file room. To simulate actual retrieval volumes, a total of 40 cases from current to 6 months old, 20 cases from the past year, and 10 cases more than 1 year old was selected. Results indicate that PACS retrieval can indeed be faster than file room retrieval. However, the difference is less for recent cases than for older cases. For cases 6 or fewer months old, the workstation retrieval was approximately 2.5 minutes faster per case than the film file room. This time difference increased markedly when extended to the 1-year and older-than-1-year groups. This report details the results of this study and provides information about the reliability of the two archives.

Filing↗
PubMed1992

Psychological improvement in infertile women after behavioral treatment: a replication.

OBJECTIVE: To replicate previously reported psychological improvements in infertile women attending a group behavioral treatment program. DESIGN: Psychological and demographic data were collected before entering and again upon completion of a behavioral medicine program on a second cohort of patients. SETTING: The program was offered in the Division of Behavioral Medicine, an outpatient clinic of the Department of Medicine at New England Deaconess Hospital. All patients were receiving care from infertility specialists not affiliated with this hospital. PATIENTS: Fifty two self-referred women receiving medical treatment for infertility attended the program. INTERVENTION: A 10-week group behavioral treatment program. MAIN OUTCOME MEASURES: Three validated psychological instruments. RESULTS: Psychological improvement was statistically significant (Profile of Mood States Tension/Anxiety: P less than 0.0001; Depression/Dejection: P less than 0.0122; Vigor/Activity: P less than 0.0431; Confusion/Bewilderment: P less than 0.0057; Spielberger Anger Expression: P less than 0.0013; Spielberger State Anxiety: P less than 0.0037, and Trait Anxiety: P less than 0.0001). CONCLUSIONS: Behavioral treatment is associated with significant decreases in negative psychological symptoms.

Adult↗
PubMed1991

Picture archiving and communication in radiology: an American perspective.

A comprehensive image management and communication (IMAC) network has been installed at Georgetown University Hospital (GUH) for an extensive clinical evaluation. The network is based on the AT&T CommView system and includes interfaces to 12 imaging devices, 15 workstations (inside and outside the radiology department), a teleradiology link to an imaging center, an optical jukebox, and a number of advanced image display and processing systems. Two years of clinical experience with the network enable us to develop a plan for future activities from an American perspective. The IMAC project is not just a technical challenge, but also a professional, organizational, and administrative one. Several obstacles remain, but they are gradually being overcome as more cost-effective and streamlined technologies become available and as users and developers gain more operational experience in managing diagnostic images in an electronic environment.

Computer Communication Networks↗
PubMed1991

An Inventory of Positive Psychological Attitudes with potential relevance to health outcomes: validation and preliminary testing.

This article describes the validation of an Inventory of Positive Psychological Attitudes that has potential relevance to health outcomes and its preliminary testing with chronic pain patients. The inventory taps two attitudinal domains: (1) life purpose and satisfaction and (2) self-confidence during potentially stressful situations. It also provides a total score. The inventory scales, developed using factor analysis, were found to have a strong degree of internal reliability and concurrent validity. Preliminary testing suggested that positive change on these scales correlates with positive changes in the health status of chronic pain patients. Multiple regression analyses suggested that the interactions of these positive psychological attitudes with health status are not fully accounted for by the interactions of negative psychological attitudes with health status.

Adaptation, Psychological↗
PubMed1991

Decreased clinic use by chronic pain patients: response to behavioral medicine intervention.

The treatment of chronic pain is costly and frustrating for the patient, health care provider, and health care system. This is due, in part, to the complexity of pain symptoms which are influenced by behavior patterns, socioeconomic factors, belief systems, and family dynamics as well as by physiological and mechanical components. Assessment of treatment outcomes is often limited to the patient's subjective, multidimensional, self-reports. Outcome measures based on data about return to work or clinic use can provide more objective assessments of intervention benefits. In this study, a 36% reduction in clinic visits in the first year postintervention was found among the 109 patients who participated in an outpatient behavioral medicine program. Decreased clinic use continued in the first 50 patients followed 2 years postintervention. Decreased use projected to an estimated net savings of $12,000 for the first year of the study posttreatment and $23,000 for the second year.

Adult↗
PubMed1990

The mind/body program for infertility: a new behavioral treatment approach for women with infertility.

There is increasing evidence that a behavioral treatment approach might be efficacious in the treatment of the emotional aspects of infertility and may lead to increased conception rates. The first 54 women to complete a behavioral treatment program based on the elicitation of the relaxation response showed statistically significant decreases in anxiety, depression, and fatigue as well as increases in vigor. In addition, 34% of these women became pregnant within 6 months of completing the program. These findings established a role for stress reduction in the long-term treatment of infertility. They further suggest that behavioral treatment should be considered for couples with infertility before or in conjunction with reproductive technologies such as intrauterine insemination and gamete intrafallopian transfer.

Cognition↗
PubMed1990

Three case reports of the metabolic and electroencephalographic changes during advanced Buddhist meditation techniques.

To examine the extent to which advanced meditative practices might alter body metabolism and the electroencephalogram (EEG), we investigated three Tibetan Buddhist monks living in the Rumtek monastery in Sikkim, India. In a study carried out in February 1988, we found that during the practice of several different meditative practices, resting metabolism (VO2) could be both raised (up to 61%) and lowered (down to 64%). The reduction from rest is the largest ever reported. On the EEG, marked asymmetry in alpha and beta activity between the hemispheres and increased beta activity were present. From these three case reports, we conclude that advanced meditative practices may yield different alterations in metabolism (there are also forms of meditation that increase metabolism) and that the decreases in metabolism can be striking.

Arousal↗
PubMed1990

A study of the effectiveness of two group behavioral medicine interventions for patients with psychosomatic complaints.

This randomized, prospective study investigated the effectiveness of two group behavioral medicine interventions for primary care patients experiencing physical symptoms with a psychosocial component (eg, palpitations, gastrointestinal disturbances, headaches, malaise, sleep disorders). The subjects were 80 volunteers at a health maintenance organization (HMO) in the greater Boston area. Both interventions focused on the mind/body relationship and used didactic material, relaxation-response training, awareness training, and cognitive restructuring. The two behavioral medicine intervention groups were compared with a group that focused exclusively on information about stress management and its relation to illness. Measures of visits to the HMO and of distress from physical and psychological symptoms were obtained before the interventions and again 6 months afterward. At the 6-month follow-up, patients in the behavioral medicine groups showed significantly greater reductions in visits to the HMO and in discomfort from physical and psychological symptoms than did the patients in the information group. The results suggest that when the relationship among thoughts and behaviors and symptoms of patients with psychosomatic dysfunction is actively addressed, the patients' discomfort level and the cost of medical care can be reduced.

Adaptation, Psychological↗
PubMed1990

Relaxation response in femoral angiography.

Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.

Angiography↗
PubMed1990

Alleviation of premenstrual syndrome symptoms with the relaxation response.

During a 5-month study, we examined the effects of the relaxation response on premenstrual syndrome in 46 women who were randomly assigned to one of three groups: a charting group, a reading group, and a relaxation response group. The relaxation response group showed significantly greater improvement than the charting and the reading groups on physical symptoms (P less than .025 for both comparisons). There was a significant group-by-severity effect for charting versus relaxation response and for reading versus relaxation response on symptoms measured daily (P less than .01 for both comparisons), on emotional symptoms measured retrospectively (P less than .001 and P less than .025, respectively), and on symptoms of social withdrawal measured retrospectively (P less than .01 and P less than .025, respectively). Women with severe symptoms in the relaxation response group showed a 58.0% improvement, compared with a 27.2% improvement for the reading group and a 17.0% improvement for the charting group. We conclude that regular elicitation of the relaxation response is an effective treatment for physical and emotional premenstrual symptoms, and is most effective in women with severe symptoms.

Adult↗
PubMed1989

The efficacy of the relaxation response in preparing for cardiac surgery.

This study evaluated the efficacy of the relaxation response on the post-operative recovery of 27 cardiac surgery patients randomly assigned to one of two groups. Thirteen experimental group patients received educational information and practiced eliciting the relaxation response before and after surgery. The 14 patients in the control group received only information. Experimental and control groups were compared before and after surgery on both physiological and psychological recovery variables. There were no initial differences between experimental and control groups on demographic, physiological, and most psychological variables. The experimental group had lower incidence of postoperative supraventricular tachycardia (SVT) than the control group (p = .04) despite having had the same occurrence previously. Experimental and control groups did not significantly differ over the course of study on any other physiological variables. Patients practicing the relaxation response had greater decreases in psychological tension (p = .04) and anger (p = .04) than those who received only educational information. The decreases in psychological tension may have been a result of regression to the mean because the experimental group started with elevated tension relative to the control group (p = .04). We conclude that practicing the relaxation response before and after surgery may reduce SVT, tension, and anger.

Aged↗
PubMed1989

Disorders of arousal and the relaxation response: speculations on the nature and treatment of stress-related diseases.

The classification of diseases represents an important, yet often enigmatic, process. This is especially true in the case of stress-related diseases. Until the 1980s, stress-related diseases were categorized on the basis of the target organ system affected. A merger of 20 years of clinical data with research and theoretical formulations from the neurosciences gave us the opportunity to reformulate, or at least add a fresh perspective to, the understanding of the nature and treatment of stress-related diseases. Based upon over two decades of research and clinical trials, one such reformulation is presented here. It is contended that many psychiatric and somatic stress-related diseases are but manifest variations on a theme of limbicogenic neurological hypersensitivity and resultant pathogenic arousal. The resultant stress-related diseases are, therefore, viewed as "disorders of arousal." From the reformulation offered herein emerges a neurologically-based rationale for the clinical use of the "relaxation response" in the treatment of stress-related diseases.

Arousal↗
PubMed1987

The preoperative use of the relaxation response with ambulatory surgery patients.

The efficacy of the regular elicitation of the relaxation response in reducing surgical anxiety and pain in an ambulatory surgery setting was studied in a population of patients scheduled for the surgical removal of a skin cancer. Forty-nine patients with skin cancer were enrolled in the study immediately after being informed of the ned for surgery; 21 of these patients elicited the relaxation response 20 minutes per day until the day of surgery, 21 read for 20 minutes per day, and 7 were noncompliant and were excluded from the study. Contrary to expectations, neither group of patients showed any increase in anxiety immediately before or after surgery on either psychological or physiological measures. Thus, there were no differences between the two groups on any of the psychological or physiological measures of anxiety, nor were there any differences in pain perception. There were statistically significant subjective differences; the experimental patients stated that the relaxation-response technique had reduced their anxiety several days before surgery and reportedly experienced their highest levels of anxiety prior to entering the study, while the controls experienced their highest levels of anxiety during and after surgery. This suggests that (1) minor outpatient surgery does not lead to detectable increased anxiety levels on the day of surgery and (2) regular elicitation of the relaxation response can alter subjective reports of distress associated with surgery.

Ambulatory Surgical Procedures↗