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Biomedical subjects

M H Antoni

Publications and source records attributed to M H Antoni.

At least 37 records · Page 2Linked to original sources

Coping self-efficacy buffers psychological and physiological disturbances in HIV-infected men following a natural disaster.

The importance of coping self-efficacy (CSE) appraisals on psychological and physiological functioning for HIV seropositive patients facing a severe environmental stressor was tested comparing 37 HIV-infected gay men and 42 healthy male control participants following Hurricane Andrew. Results suggested that greater levels of CSE were related to lower emotional distress and posttraumatic stress disorder (PTSD) symptoms in both groups. In addition, greater CSE was associated with lower norepinephrine to cortisol ratios in the HIV group but not in the healthy control group. Results are discussed in relation to the coping process for HIV-infected individuals specifically and chronically ill populations in general who face severe environmental stressors.

Adaptation, Psychological↗

Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults.

Healthy adults (N = 28) participated in a randomized trial of Bonny Method of Guided Imagery and Music (GIM; a depth approach to music psychotherapy) sessions on mood and cortisol. Participants in both GIM and wait-list control conditions completed the Profile of Mood States (POMS) and donated 15 cc of blood before and after the 13-week intervention period and again at a 6-week follow-up. Split-plot factorial and post hoc analyses demonstrated that after 6 biweekly sessions GIM participants reported significant decreases between pre- and postsession depression, fatigue, and total mood disturbance and had significant decreases in cortisol level by follow-up. Pretest to follow-up decrease in cortisol was significantly associated with decrease in mood disturbance. A short series of GIM sessions may positively affect mood and reduce cortisol levels in healthy adults. Such changes in hormonal regulation may have health implications for chronically stressed people.

Adult↗

Relations of plasma ACTH and cortisol levels with the distribution and function of peripheral blood cells in response to a behavioral challenge in breast cancer: an empirical exploration by means of statistical modeling.

This study explores by means of statistical modeling the relations between adrenocorticotrophin hormone (ACTH) and cortisol levels and distribution and function of peripheral blood cells in response to an acute stressor consisting of a standardized speech task in breast cancer patients with axillary lymph node metastases and distant metastases. As a control group age-matched women participated in this study. The preliminary findings show that the effect of ACTH on immunoreactivity is related to the health of the doctor. In node-positive breast cancer patients and healthy women, ACTH has a modest positive effect on T lymphocyte percentages and on pokeweed-induced proliferation at baseline and in response to the speech task. In contrast, in breast cancer patients with distant metastases, ACTH has a negative effect on T lymphocyte and function at baseline and in response to the stressor. Interestingly, neither ACTH nor cortisol levels were related to natural killer (NK) cell percentages and natural killer cell activity (NKCA). In addition, it appeared that cortisol had a positive effect on CD3 cell percentages when the health of the donor was taken into account. This effect was most distinct on CD3 cells measured at baseline. If replicated on a larger scale, these findings may indicate that the hypothalamic pituitary adrenal axis plays a role in the adaptation of the host defenses in reaction to acute stress, particularly those involving T lymphocytes. Moreover, these findings may suggest that the health of the donor may be an important effect modification factor in the relations between neuroendocrines and immunoreactivity.

Journal Article↗

The efficacy of the health belief model for predicting condom usage and risky sexual practices in university students.

This investigation examined the ability of the health belief model (HBM) to predict condom usage and risky sexual practices in 122 white heterosexual college students (ages 17 to 33 years). The HBM did not significantly explain condom usage in the 58 men and 64 women surveyed; rather it partially explained the variance in sexual risk behaviors. Results were not consistent for men and women. The HBM components significantly explained 18% of the variance in multiple sexual partnerships in men and 22% of the variance in this behavior in women. The HBM constructs also explained 9% of the variance in the likelihood of women being intoxicated or high during sex and 18% of the variance in the number of sexual risk behaviors endorsed by women. These findings suggest that the HBM has differential and limited utility for predicting sexual practices in university students. Future research is needed to examine more comprehensive models of behavior change.

Acquired Immunodeficiency Syndrome↗

Characteristics of African-Americans with multiple risk factors associated with HIV/AIDS.

Multiple risk factors in young African-Americans have tremendous implications for the spread of AIDS. Two hundred forty-two heterosexual college students were classified as having low, moderate, or high risk for HIV infection based upon their self-reported sexual practices. Results indicated that subjects differed in AIDS knowledge and attitudes toward condoms with respect to both Gender and Risk level, with men and High Risk individuals being less knowledgeable and having more negative attitudes than their female and Low Risk counterparts respectively. Interaction effects revealed that High Risk men were less knowledgeable than both Low Risk men and High Risk women. High Risk men as well as High and Low Risk women reported more anger surrounding condom usage than Low Risk men. Low perceptions of vulnerability for AIDS were reflected in the entire sample. The implications of this study for primary prevention and future research are discussed.

Adult↗

Elevated basal cortisol levels and attenuated ACTH and cortisol responses to a behavioral challenge in women with metastatic breast cancer.

Hormones of the hypothalamic-pituitary-adrenal system were studied in 31 patients with early stage breast cancer and patients with metastatic breast cancer. Both groups received tamoxifen as first-line treatment. As a control group 15 age-matched healthy women participated in the study. The results showed that breast cancer patients had significant elevations in basal cortisol levels compared to controls. Metastatic breast cancer patients had higher cortisol levels than early stage breast cancer patients. No significant differences between breast cancer patients and controls were found in basal plasma ACTH and prolactin levels. These data provide evidence that breast cancer is associated with a hyperactive adrenal gland, which may be due to the physiological stress associated with the presence of (micro)metastases or tumor cells in the circulation, in combination with administration of tamoxifen. In response to a behavioral challenge increases were observed in plasma ACTH and prolactin. Metastatic breast cancer patients had a faster prolactin response to acute stress than healthy women. However, metastatic breast cancer patients showed a blunted ACTH response compared to healthy women. Stress-induced ACTH responses and basal cortisol levels were negatively correlated in the metastatic group only. Thus, the blunted ACTH response to the behavioral challenge might be related to hypercortisolemia suggesting that the pituitary corticotroph cell in metastatic cancer is appropriately restrained possibly by the negative feedback effects of chronic cortisol elevations. Interestingly, the behavioral challenge induced decreases in cortisol levels in all three groups. However, metastatic breast cancer patients had a faster cortisol decline compared to healthy women. We hypothesize that this is caused by increased metabolic clearance of cortisol due to increased utilization of metabolic substrates often observed in the presence of a tumor.

Adrenocorticotropic Hormone↗

Active confrontational coping predicts decreased clinical progression over a one-year period in HIV-infected homosexual men.

The association between stressful life events, psychiatric symptoms, coping, and social support and HIV disease progression one year later were studied in 51 HIV-infected asymptomatic and early symptomatic homosexual men. Dependent variables were CD4 counts and clinical progression. No associations between the psychosocial parameters and CD4 counts were found. Active confrontation with HIV infection as a coping strategy was predictive of decreased clinical progression at one year follow-up, after taking into account baseline biomedical and behavioral variables. These results show that active coping strategies may have an effect on disease progression, possibly mediated by greater compliance with medical treatments or by psychoneuroimmunological mechanisms.

Adaptation, Psychological↗

Psychosocial group intervention and the rate of decline of immunological parameters in asymptomatic HIV-infected homosexual men.

The aim of the study was to determine changes in the rate of decline of immunological parameters after psychosocial group intervention. Subjects were 26 asymptomatic HIV-infected homosexual men who participated in a cognitive-behavioral group therapy (CBT; n = 14), or an experiential group therapy program (ET; n = 12), both of 15 weeks duration. The outcome measures were changes in the decline of CD4 cell counts, and T cell proliferative responses to anti-CD3 monoclonal antibodies from preintervention to 24 months postintervention. No differences in the rate of decline of CD4 cells or T cell responses between the CBT and ET condition were found, and there were no significant changes in CD4 cell count from pre- to postintervention. However, those subjects who showed larger decreases in distress showed a smaller decline in CD4 cell counts. While the rate of decline in T cell responses was significantly less after both interventions, a similar positive change in T cell responses was found in a comparison group of 149 HIV-infected men with similar demographic, psychosocial and immunological characteristics who did not participate in one of the interventions. We conclude that the psychosocial intervention programs tested here did not cause changes in CD4 cell decline or T cell responses and that decreases in distress were related to increases in CD4 cell counts.

Adaptation, Psychological↗

Changes in cognitive coping strategies predict EBV-antibody titre change following a stressor disclosure induction.

Previous research has shown that emotional disclosure of traumatic or stressful events is associated with facilitating insight into the experience, improving mood, and modulating some aspects of the immune system. The current study examined how cognitive changes and experiential involvement during an emotional disclosure induction protocol relate to immune functioning, as measured by IgG antibody titres to the Epstein-Barr virus viral capsid antigen (EBV-VCA). Seventy-six college undergraduates were randomly assigned to either a disclosure induction or an assessment-only control condition. Experimental subjects met with an experimenter for three weekly 20-min individual sessions during which time they were asked to discuss a stressful or traumatic topic which they had previously discussed only minimally with others. Blood was drawn a week prior to the first session and at one week following the third session. Subjects completed the Impact of Event Scale (IES) after session 1 and at followup, and the extent of experiential involvement in disclosure during each session was assessed by means of the Experiencing Scale. Mood was assessed before and after each disclosure using the Nowlis Mood Adjective Checklist. Although the disclosure induction did not directly affect EBV-VCA antibody titres, individual differences in subjects' ability to involve themselves in the disclosure process and abandon their avoidance of the stressful tropic during the course of the 3-wk period were predictive of antibody decrements. These associations were more pronounced for individuals who disclosed older and more troublesome events.

Adaptation, Psychological↗

Psychosocial counseling to improve quality of life in HIV infection.

Psychosocial interventions such as cognitive behavioral stress management (CBSM), may enhance coping and social support which contribute to an improvement of quality of life factors such as emotional functioning, social functioning, and sense of well-being, for HIV-infected men during several phases of HIV spectrum disease. These phases include the acutely stressful period immediately following notification of HIV+ status, the adjustment period following this news, and the process of dealing with chronic symptomatic HIV infection. Normalization of some aspects of immunological status were found to accompany some of these psychosocial changes in the short-run. Longer-term follow-up indicated relationships between psychosocial factors and improved immunological status and physical functioning up to 2 years later. Factors such as an increased use of active coping strategies, including relaxation exercises, use of more functional appraisals and elicitation of social support, and decreased use of denial/avoidance coping strategies, may be key predictors of longer-term emotional well-being, social functioning, and physical functioning in HIV-infected populations. Special issues need to be addressed in emerging models of quality of life assessment in HIV populations. For example, the way resurgence of stigmatization and self-doubt affects sense of identity and well-being need to be addressed in quality of life research as well as in psychosocial interventions. Loss of employment and its financial and existential consequences are also factors which impact sense of self and well-being, and need to be addressed both in research as well as in interventions. The effect of repeated HIV-related bereavements upon an individual's social network and the emotional, social, and physical sequelae of bereavement have implications for HIV quality of life research as well. Quality of survival time has become a paramount issue in the context of HIV spectrum disease. Examining the relationships among coping strategies, social support, emotional well-being, realistic appraisals of one's functioning in comparison to their aspirations, and the influence of psychosocial functioning on disease course are central missions of our research program.

Adult↗

Emotional disclosure through writing or speaking modulates latent Epstein-Barr virus antibody titers.

Healthy Epstein-Barr virus (EBV) seropositive undergraduates (N = 57) completed a personality inventory, provided blood samples, and were randomly assigned to write or talk about stressful events, or to write about trivial events, during three weekly 20-min sessions, after which they provided a final blood sample. Individuals assigned to the verbal/stressful condition had significantly lower EBV antibody titers (suggesting better cellular immune control over the latent virus) after the intervention than those in the written/stressful group, who had significantly lower values than those in the written/trivial control group. Subjects assigned to the written/stressful condition expressed more negative emotional words than the verbal/stressful and control groups and more positive emotional words than the verbal/stressful group at each time point. The verbal/stressful group expressed more negative emotional words compared with the control group at baseline. Content analysis indicated that the verbal/stressful group achieved the greatest improvements in cognitive change, self-esteem, and adaptive coping strategies.

Adaptation, Psychological↗

Effects of aerobic exercise training on lymphocyte subpopulations.

This study was conducted to determine the effects of an aerobic exercise training program on subpopulations of lymphocyte phenotypes. Fourteen healthy but sedentary males, 18-40 years of age, were randomly assigned to either an aerobic exercise training or control condition. Aerobic exercise training consisted of three 45-minute sessions of cycle ergometry exercise per week at 70-80% of age-predicted maximum heart rate for ten weeks. The aerobic exercise training resulted in a significant decrease in submaximal heart rate from 176 to 150 beats per minute to a fixed work rate of 150 watts (p < .01). This training effect was accompanied by increases in the resting level of the following lymphocyte subpopulations: CD2 (1717 vs 2183 mm3; p < .01), CD4 (942 vs 1280 mm3; p < .01), CD45RA+CD4+ (312 vs 595 mm3; p < .01), CD8 (655 vs 816 mm3; p < .05), and CD20 (162 vs 244 mm3; p < .01) cell counts. These findings indicate that several lymphocyte subpopulations are increased following a 10-week program of aerobic exercise training.

Adolescent↗

Psychosocial correlates of illness burden in chronic fatigue syndrome.

We related reported physical symptoms, cognitive appraisals (e.g., negative style of thinking), and coping strategies (e.g., denial/disengagement strategies) with illness burden across several functional domains separately in subsets of chronic fatigue syndrome (CFS) patients with (n = 26) and without (n = 39) concurrently diagnosed major depressive disorder (MDD). In regard to cognitive appraisal measures, automatic thoughts and dysfunctional attitudes were strongly associated with a higher illness burden, as indicated in sickness impact profile (SIP) scores. Active-involvement coping strategies measured on COPE scales (active coping, planning, and positive reinterpretation and growth) were not associated with SIP scores, while other coping strategies (mental disengagement, behavioral disengagement, and denial) were positively correlated with psychosocial and physical SIP scales, especially those pertaining to interpersonal life-style arenas. After we accounted for the number of different CFS-specific physical complaints reported and DSM-III-R depression diagnosis status, cognitive appraisals and coping strategies predicted a substantial proportion of the variance in the severity of illness burden. For the most part, the magnitude of these relationships between our predictor model variables and illness burden severity was similar in the MDD and non-MDD subgroups.

Adaptation, Psychological↗

Exercise and psychoneuroimmunology.

Psychoneuroimmunology is the study of the interrelationships among psychological, neuroendocrine, and immunological parameters and is concerned with how these relationships may affect an individual's health. Substantial evidence indicates that exercise is associated with improvements in mental health, neuroendocrine, and immune functioning. We synthesize these effects of exercise and propose an "exercise and psychoneuroimmunology" model by which exercise may benefit the psychologic and immunologic sequelae of several chronic diseases. For the past several years we have been investigating exercise training interventions, based on our model, for individuals infected with the human immunodeficiency virus type 1 (HIV-1). These studies indicate that a moderate exercise training program may attenuate the adverse stressor-induced psychologic and immunologic changes for asymptomatic HIV-1 seropositive individuals. In addition, our research indicates that continued aerobic exercise training may result in increased CD4 cell counts, immune surveillance, and a potential for a slowing of disease progression. Other researchers have demonstrated similar beneficial effects of exercise for individuals infected with HIV-1 who are at more advanced stages of disease. Exercise within the context of psychoneuroimmunology appears to be a very promising approach to the treatment of illness and promotion of health.

Acquired Immunodeficiency Syndrome↗

Patient-reported erectile dysfunction: a cross-validation study.

Previous work highlighting a significant correspondence between patient-reported sex history information and physiological indices of erectile functioning was cross-validated. The matched sample comprised of 46 older male veterans presenting with erectile dysfunction, with many experiencing chronic physical illnesses. All subjects underwent a comprehensive medical and psychological evaluation, followed by 2 consecutive nights of in-hospital Rigiscan diagnostic monitoring, to evaluate penile rigidity, tumescence, and duration of erectile episodes. Stringent criteria were employed to control for confounding of Rigiscan results, with elimination from the study for affective, thought, or sleep disorders. Results from the multiple regression analyses showed that patient reports of AM erections and erectile quality accounted for significant proportions of the variance in the Rigiscan criterion measures, with 3 of the 4 R2 values falling within the Herzberg criterion for cross-validation. Results confirm the diagnostic significance of patient self-report for the population of older, chronically ill men who present with impaired erectile functioning.

Adult↗