Showing papers in "Psychosomatic Medicine in 1984"

Psychosocial modifiers of immunocompetence in medical students.

Abstract: This study addressed the effects of a naturally occurring stressor on components of the immune response. Blood was drawn twice from 75 first-year medical students, with a baseline sample taken one month before their final examinations and a stress sample drawn on the first day of final examinations. Median splits on scores from the Holmes--Rahe Social Readjustment Rating Scale and the UCLA Loneliness Scale produced a 2 X 2 X 2 repeated measures ANOVA when combined with the trials variable. Natural killer (NK) cell activity declined significantly from the first to the second sample. High scorers on stressful life events and loneliness had significantly lower levels of NK activity. Total plasma IgA increased significantly from the first to second sample, while plasma IgG and IgM, C-reactive protein, and salivary IgA did not change significantly.

Depression in hospitalized cancer patients.

Abstract: The study of depression in cancer patients has been hampered by difficulty in establishing diagnostic criteria, since neurovegetative signs and symptoms may be attributable either to depression or physical illness. Confusion has also arisen in defining the boundary between "normal" grieving with illness, and "abnormal" clinical depression. We studied 62 oncology inpatients applying DSM-III diagnostic criteria, patient self-report, and interview report rating scales. Forty-two percent met criteria for nonbipolar major depression: 24% with severe and 18% with moderately severe symptoms. Fourteen percent of the sample had depressive symptoms that did not meet criteria for a major depression. Forty-four percent had no depressed affect. Medical and demographic variables were evaluated for relationship to depression; only greater degree of physical disability was clearly associated. Other negative life events and poor quality of social supports were additionally associated with depression in the less disabled patients. The use of clearly defined criteria for diagnosis of depression in cancer patients provides a basis for the study and implementation of specific therapeutic interventions.

Relationships as regulators: a psychobiologic perspective on bereavement.

Abstract: In the spirit of adventure that has been characteristic of our Society, I am going to ask you to join me in a mental journey. The purpose is to try to look at something familiar in a new way. We are going to be looking at bereavement—something you all know a lot about—and I am going to try to get a different perspective on it by using information gathered in very different contexts and by trying to imagine what it is that experiments on infant separation in animals might be telling us about adult human bereavement. First, I would like to persuade you that there is still a mystery concerning bereavement. Actually it puzzles us on many accounts: is it a disease or a natural function, a temporary insanity or a mobilization of creative energy? The mystery I would like to examine, however, is its place in natural history, its biologic basis, particularly how the experience comes to produce biologic changes in bereaved people. George Engel asked us, in his presidential address more than 20 years ago (lj, is grief a disease? However, medicine at large

Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients.

Abstract: This study examined the associations among loneliness, stressful life events, urinary cortisol levels, and immunocompetency. Blood and urine were obtained from 33 psychiatric inpatients on the day after admission, at which time the patients completed the UCLA Loneliness Scale, the Psychiatric Epidemiology Research Interview Life Events Scale (PERI), and the MMPI. Patients who scored above the median on loneliness had significantly higher urinary cortisol levels. The high loneliness group also had significantly lower levels of natural killer cell activity, as well as a poorer T-lymphocyte response to phytohemagglutinin. The high loneliness subjects descibed themselves as more distressed than the low loneliness group on the MMPI. There were no consistent significant effects on either the immunologic measures or the MMPI associated with the PERI.

Comparison between weight-preoccupied women and anorexia nervosa.

Abstract: Psychological traits of patients with anorexia nervosa (AN) were compared to those of weight-preoccupied (WP) and not-weight-preoccupied ( NWP ) women drawn from samples of college and ballet students. Weight-preoccupied subjects were selected on the basis of extreme scores on the Drive for Thinness subscale of the Eating Disorder Inventory ( EDI ). Results indicated that the WP and AN groups were best differentiated by Ineffectiveness, Interpersonal Distrust, and lack of Interoceptive Awareness subscales. Using cluster analysis procedures, weight preoccupied women were divided into two subgroups. Cluster One was characterized by elevated scores on all EDI subscales indicating significant psychopathology. Cluster Two had elevated scores only on Drive for Thinness, Body Dissatisfaction, and Perfectionism and could be described as "normal dieters." These findings were interpreted as indicating that, although there are some highly weight-preoccupied females who display psychopathology quite similar to anorexia nervosa, others only superficially resemble patients suffering from serious eating disorders. These results underscore the importance of a multidimensional evaluation of psychopathology in those suspected of anorexia nervosa.

Life change stress, psychiatric symptoms, and natural killer cell activity.

Abstract: Previous research has linked stress with adverse health change; however, the immunologic mechanisms mediating these changes remain poorly understood. To test whether "stress" was associated with alterations in cell-mediated immunity, we examined the correlations of self-reported life change stress (LCS) and psychiatric symptoms with natural killer cell activity (NKCA) among 114 healthy undergraduate volunteers. Although the bivariate correlation between LCS and NKCA was not significant, subjects reporting few psychologic symptoms in the face of large amounts of LCS ("good copers") had significantly higher NKCA than those experiencing high levels of both symptoms and LCS ("poor copers"). Furthermore, self-reported psychiatric symptoms were found to inversely correlate with NKCA, suggesting that symptoms such as anxiety and depression may negatively affect immunity.

Behavioral response demands, cardiovascular reactivity, and essential hypertension.

Abstract: Psychophysiologic reactions to behavioral challenges were examined in men aged 55 or less with no prior history of cardiovascular disorder. Three age-matched groups of twelve were recruited through factory screening: mild hypertensives (blood pressure in the range 175/105-145/90 persisting on retest), transient hypertensives (blood pressure above criterion on screening, falling on retest), and normotensives. Clinical examination, a laboratory rest session and period of blood pressure self-monitoring were followed by a laboratory stress session. The latter involved performance of two tasks demanding active behavioral coping (the Stroop interference task and video game) and one passive condition (a distressing movie). Mild hypertensives showed significantly greater pressor reactions (both in absolute and percentage terms) than normotensives to tasks requiring active behavioral coping, but not to the passive condition. The transient hypertension group produced heightened reactions in diastolic but not systolic pressure. Greater heart rate and pulse transit time reactions were also observed in the transient group, suggesting that exaggerated cardiac responsiveness to active challenges may be characteristic of the prehypertensive profile. No differences were recorded in electrodermal or respiratory variables, or in self-reported tension. Exaggerated pressor responses were also associated with high scores on the Hostility and Direction of Hostility questionnaire, and an absence of coronary-prone behavior. Implications for the etiology of essential hypertension are considered.

What does the word "psychosomatic" really mean? A historical and semantic inquiry.

Abstract: Semantics and history of psychosomatic medicine are not popular topics nowadays, if they ever were; yet both of them constitute indispensable facets of any discipline that lays claim to a separate identity, as psychosomatics does. The latter, being an inchoate and inherently complex field of study, is especially in need of repeated efforts to clarify the meaning of its key terms, to delineate its scope, and to chart its development over time. Such efforts should pay off in improved teaching of this subject and in more effective communication with workers in other disciplines and with the general public. I have tried in this paper to sketch the historic development of psychosomatic conceptions and address some relevant semantic issues. It appears that early in this century, the convergence of two ancient conceptions, the holistic and the psychogenic, prepared the ground for the emergence in the 1930s of psychosomatic medicine as an organized scientific discipline and a counterreformation against the mechanistic view of man and medicine. Those two conceptions came to be subsumed by the word "psychosomatic" and thus contributed its two distinct connotations. The latter have not usually been clearly distinguished; hence, the ambiguity of the term. I have argued that only the holistic connotation should be retained, as it properly conveys the contemporary viewpoint. It is unfortunate that the word "holistic" has been appropriated recently by an anti-scientific and antiintellectual so-called "holistic health movement" (67), with resulting increment in semantic confusion and, in the eyes of many, loss of credibility for the misappropriated term. However, to retain it has merit as it is short, simple, and derived from the Greek - as were the very conceptions it has come to connote. Moreover, "holistic" has been part of the basic vocabulary of psychosomatic medicine from the beginning and conveys its core premises and purpose faithfully. As a historian aptly put it, the historic function of the psychosomatic movement has been to "vitalize the whole of medicine, psychiatry no less . . . with the holistic and ecologic viewpoint" (59, p. 9).(ABSTRACT TRUNCATED AT 400 WORDS)

Adrenal cortical response to stress at Three Mile Island.

Abstract: The present study examined the relationship between biochemical, psychologic, and behavioral components of chronic stress associated with living near the damaged nuclear power plant at Three Mile Island (TMI). Relative to control subjects, TMI subjects had higher levels of urinary cortisol, which correlated significantly with urinary catecholamines, self-report of physical and mental symptoms, and decrements in task performance. Further, it was found that males had higher urinary cortisol levels than females at TMI, while at the control sites, levels of cortisol were comparable between males and females. Finally, no significant relationship between coping style and urinary cortisol was detected. Levels of stress response among TMI are residents, though significantly greater than control subjects, were within normal ranges and thus should be considered subclinical in intensity. Their persistence over 17 months, however, suggests some cause for concern.

Electrophysiologic characteristics of respiratory suspension periods occurring during the practice of the Transcendental Meditation Program.

Abstract: In a study designed to identify the electrophysiologic characteristics of the Transcendental Meditation Program, 52 periods of spontaneous respiratory suspension (RS) were observed in 18 subjects during the practice of this program. These periods were correlated with some but not all the subjective experiences of pure consciousness. Nineteen RS periods (belonging to 11 subjects) free from any artifact were selected for EEG analysis. The mean total EEG coherence over all frequencies and over nine derivations for TM subjects showed a significant increase during the RS periods as compared to pre- and post-RS control periods. There was no significant change in mean total EEG coherence in a control group of 30 subjects voluntarily holding their breath. The heart rate showed a significant decrease during the RS periods in both the experimental and control groups, whereas there was no significant change in EEG alpha power in either group. These findings extend those of previous studies and help characterize the physiologic correlates of the state of pure consciousness during the TM program.

Generalizing from laboratory studies to field studies of human stress physiology.

Abstract: In studying physiologic responses to behavioral stressors, there are two competing strategies. Laboratory studies offer greater experimental control but less provocation. Field studies provide poorer experimental control but potentially greater provocation. Despite these differences, comparison within subjects of neuroendocrine responses to these different settings has not been performed. We studied 11 healthy young men in the field during public speaking and in the laboratory during carefully controlled mental arithmetic calculations. There were marked differences in self-report and in plasma levels of catecholamines in the two settings.

The effects of a cognitive-behavioral treatment program on temporo-mandibular pain and dysfunction syndrome.

Abstract: Sixty-one patients clearly diagnosed as suffering from Temporo-Mandibular Pain and Dysfunction Syndrome (TMPDS) were randomly assigned to one of three groups, 1) hypnosis and cognitive coping skills, 2) relaxation and cognitive coping skills, or 3) a no-treatment control group. All patients were evaluated with a standard hypnotic susceptibility scale before treatment. The two treatment groups received four weekly sessions of their respective treatments. Patients in the hypnosis and relaxation groups reported equivalent decrements in pain, abnormal sounds in the temporomandibular joint, and limitations of jaw mobility. Hypnotic susceptibility was significantly correlated with reductions in reported pain for the treatment groups. Patients' age and the duration of pain before treatment were not related to treatment outcome. Patients who dropped out of treatment had fewer limitations in jaw movement but did not differ in any other variable from patients who remained in treatment. These findings are discussed in relation to the hypothesis that Temporo-Mandibular Pain and Dysfunction Syndrome is stress-related muscular pain and dysfunction.

Stress and metabolic control in diabetes: psychosomatic evidence and evaluation of methods.

Abstract: Psychosomatic research findings correlating psychologic stress with diabetic control fail as yet to provide valid conclusions. Investigators have presented many contradictory findings. The two major pathways by which stress could affect control, a) changes in compliance behavior, and b) a neurohumoral axis, have not been clearly distinguished from each other. The study of adolescent cohorts is associated with the problem of heterogeneity, limiting the application of results to other diabetic populations. Methods of determining diabetic control have been incomplete and the definition and measurement of stress have major inadequacies for the analysis of such a complex psychosomatic problem. Existing evidence is comprehensively reviewed and evaluated. The authors use a modified definition of stress to construct a stress scale specific to pregnant diabetics.

Biochemical changes in two subjects succumbing to syncope.

Abstract: Biochemical data are presented of two subjects who fainted during a psychophysiologic experiment. Both subjects showed similar postfaint reactions for heart rate, noradrenaline, glucose, human growth hormone, and cortisol. Heart rates showed rather low values, returning to the normal range after about 45 min. Noradrenaline plasma levels were also very low. However, levels of human growth hormone, cortisol, and glucose were very high in comparison to the control values. Taking into account psychologic prefaint data of previous studies and the present biochemical findings, it is argued that the onset of fainting involves the rapid succession of two stress reactions: the fight--flight reaction and the conservation--withdrawal reaction.

Cardiovascular responses of boys exhibiting the type A behavior pattern.

Abstract: Two experiments measured the cardiovascular responses of fourth- and fifth- grade boys to tasks that were relevant to Type A characteristics. Boys were classified as Type A or Type B by the Adolescent Structured Interview (ASI) and Matthews Youth Test for Health (MYTH). Results showed that ASI and MYTH assessments were significantly and moderately correlated--a finding similar to the association among Type A measures in adulthood. During the competition induced by Experiment 1 tasks, ASI Type As showed greater elevations in heart rate than did Type Bs. During the second game of this experiment, the more extreme the Type A behavior, the greater the elevation in systolic and diastolic blood pressure. In contrast, MYTH Type As exhibited enhanced systolic blood pressure in response to the difficult, frustrating, and slow-paced tasks presented in Experiment 2. They also increased in heart rate with increasing exposure to the tasks. These results resemble the findings from the adult Type A psychophysiologic studies and suggest that the cardiovascular responses associated with the Type A pattern may begin in childhood.

Can the type A behavior pattern be altered after myocardial infarction? A second year report from the recurrent coronary prevention project

Abstract: The feasibility of altering a Type A style of life was investigated in 1012 nonsmoking predominantly male postinfarction volunteers in the San Francisco Bay area. A total of 862 were randomly allocated into an experimental section receiving a combination of Type A and cardiac counseling, or a control section receiving cardiac counseling alone. The remaining 150 formed a nonrandom but statistically equivalent comparison section. Assessments of change in Type A behavior were made by the participant, his or her spouse, a work colleague, and an independent rater of a videotaped structured interview. Psychometric analyses indicated that these instruments were valid and reliable measures of Type A behavior. After 24 months, participants receiving Type A/cardiac counseling exhibited a significantly greater reduction in Type A behavior than the other two sections, and had a lower cardiovascular recurrence rate than the comparison section only. No differences among the three sections were observed in total cholesterol or resting blood pressure. The results suggest that Type A behavior can be altered by group counseling in postinfarction volunteers and that such alteration is superior to no group counseling at all in the secondary prevention of coronary heart disease.

Stress management at the worksite for hypertension: compliance, cost-benefit, health care and hypertension-related variables.

Abstract: The blood pressure-lowering effects of a group stress management program conducted with hypertensive employees at the worksite were assessed and replicated. Both systolic (SBP) and diastolic (DBP) blood pressure were significantly reduced from a baseline period to the end of a 10-week stress management training period (Group T1, N = 22). A control Group, T2 (N = 18), showed no significant SBP and DBP reduction over a comparable time period. When Group T2 was then given stress management training, the resulting SBP and DBP reductions were significant. When BP was recorded 3 years later, there were significant reductions for both SBP and DBP. Thirty percent of the subjects who had a medication regimen responded with BP judged to be a clinically significant reduction. The frequency of relaxation practice and the amount of BP reduction achieved during relaxation practice were significantly correlated with BP reduction after the stress management program. It was also found that the stress management program lowered health care costs and increased health supportive behavior.

growing Older with Cystic Fibrosis: Psychologic Adjustment of Patients More Than 16 Years Old

Abstract: The 79 female and 147 male patients constituting the population with cystic fibrosis (CF) aged 16 years and older attending The Hospital for Sick Children were asked to complete the Cornell Medical Index (CMI) and Tennessee Self-Concept Scale (TSCS); 64 female (81%) and 112 male (76%) subjects participated. Analysis of CMI results showed 43% of female subjects to have moderate to severe emotional disturbance compared to 19% of male subjects. This female : male ratio for severity of emotional disturbance is found in ostensibly healthy groups, but the percentages of disturbance approach values for medical patient populations. The frequency of emotional disability is greater in those more than 20 than in those 16-19 years old. The TSCS results portray a generally normal self-concept except for scores of positive physical self and psychosis for patients aged 20 years and older; these scores approach psychiatric values, suggesting that some reality distortion facilitates emotional adjustment to adult life with CF. The TSCS and CMI results correlate significantly, indicating a connection between self-concept and emotional status. However, TSCS and CMI scores do not correlate with measures of disease severity except for correlations between lung function and physical self-concept in older male patients. These results suggest that psychologic functioning is independent of the degree of physical impairment in older patients with CF, with the long-surviving male patients more realistically appraising the limitations their disease imposes and utilizing denial and minimization to a lesser degree. Demographic data on the clinic population reveal that most patients aged 16 years and older cope with their intellectual, developmental, and socioeconomic tasks commensurate with normal age expectations.

Elevated daytime urinary excretion of testosterone glucuronide in men with the type A behavior pattern.

Abstract: Urinary excretion of testosterone glucuronide was compared in 13 men with typical Type A behavior pattern (as determined by structured interviews) and 10 age-matched men with typical Type B behavior pattern. Twenty-four hour urine collections were divided into three periods: 9AM - 6PM , 6PM to bedtime, and bedtime to 9AM . Type A men showed a significantly higher excretion than Type B men in the daytime ( 9AM - 6PM ); the geometric mean value was 24 micrograms in Type A and 15 micrograms in Type B (P less than 0.05). There were no significant differences between Type A and Type B men for the other two time periods. Indicating an elevated daytime testosterone secretion in Type A men, this finding is consistent with a recent report that exposure to laboratory tests of reaction time causes an increase in plasma testosterone levels in Type A but not Type B men. Since a role for testosterone in the genesis of coronary heart disease (CHD) is suggested by the much higher incidence of CHD in men and the acceleration of murine atherogenesis by testosterone, the findings of this and the previous report may represent a mechanism for the elevated incidence of CHD in Type A men.

Denial predicts favorable outcome in unstable angina pectoris.

Abstract: Denial may be prognostically favorable in patients with acute myocardial infarction. We analyzed the significance of denial in 26 patients referred to a tertiary care center for advanced therapy of unstable angina. Group A comprised 14 patients characterized as deniers on the Hackett--Cassem Denial Scale. Group B comprised 12 nondeniers. There were no differences between groups in multiple baseline social and demographic characteristics, cardiac history, or risk factors. Similarly, there were no differences in the number of diseased vessels or left ventricular function in those patients catheterized (11 Group A patients, 9 Group B patients). Group B, however, had a longer hospitalization until medically stabilized (pain-free for 36 hr) than Group A (5.9 +/- 3.6 days vs. 3.0 +/- 1.6 days; p = 0.02) despite similar treatment regimens. There were no significant differences in incidence of myocardial infarction or need for surgery. There were two deaths--both in Group B patients. We conclude that denial independently predicts rapid medical stabilization in unstable angina patients. Whether it predicts better longterm outcome requires further study.

Familial resemblance in components of the type A behavior pattern: a reanalysis of the California type A twin study.

Abstract: Rosenman and colleagues reported no heritability of global Type A behavior assessed by the Structured Interview (SI) method, although some of the self-report scales correlated with global Type A behavior did have heritable components. Recent factor analyses of coded SI responses revealed four independent dimensions: clinical ratings, primarily of speech stylistics; and self-reports of pressured drive, anger, and competitiveness. It may be that some of these dimensions have a heritable base, whereas others do not. We report here reanalyses of the available SI responses from the Rosenman sample. In this subsample, tape recorded interviews with 80 monozygotic and 80 dizygotic twin pairs were scored for the extent of self-reported Type A behaviors, the major speech stylistics considered to be indicative of Pattern A, and the observable Type A behaviors (e.g., signs of hostility). Then scores for the major dimensions measured by the SI were calculated and scores for which there were sufficient data were subjected to twin analyses by the method of Christian et al. These analyses showed that individual differences in the clinical ratings factor and certain ratings loading on it--specifically, loudness of speech, competition for control of the interview, and potential for hostility--might have a heritable component. These results are discussed in the context of the importance of hostility as a predictor of subsequent coronary heart disease events as well as of total mortality, other data on the heritability of emotionality, and a temperament approach to understanding the origins of the Type A behavior pattern.

Sleep-related myoclonus in rheumatic pain modulation disorder (fibrositis syndrome) and in excessive daytime somnolence.

Abstract: We describe a new syndrome, Rheumatic Pain Modulation Disorder (RPMD) ("fibrositis syndrome") with sleep-related myoclonus (involuntary periodic leg movements). Measures of sleepiness, fatigue and pain, before and after sleep, and aspects of sleep of nine subjects (Ss) with RPMD and sleep-related myoclonus were compared to nine subjects with excessive daytime somnolence and sleep-related myoclonus. In eight of the RPMD with sleep-related myoclonus and three of those with daytime sleepiness, an alpha (7.5-11 Hz) EEG Non-Rapid Eye Movement sleep disorder was demonstrated. The RPMD with sleep-related myoclonus group contained a greater number of women, more pain, morning fatigue, and disturbances in sleep (more stage changes and alpha EEG sleep prior to leg myoclonus); but in comparison to the sleep-related myoclonus, daytime somnolent group, there were no differences in evening and morning sleepiness, number of limb movements, movement arousals, awakenings after sleep onset, sleep duration, and percent sleep stages.

Urinary-free cortisol excretion in relation to age in acutely stressed persons with depressive symptoms.

Abstract: We examined the relationship between age and urinary excretion of free cortisol in acutely stressed middle-aged and elderly persons. We observed that elderly persons under stress excreted larger amounts of urinary-free cortisol than did middle-aged persons; Pearson's r between age and cortisol = 0.38, p less than 0.05. When the sample was stratified by severity of depressive symptoms, the relationship between age and cortisol excretion was strongly accentuated among those with severe depressive symptoms (r = 0.62, p = 0.01) and diminished among those with milder symptoms (r = 0.25, N.S.). Potentially confounding factors such as diet, use of medications, and physical stature were controlled and did not explain the observations. The high depression scores in this acutely stressed sample were indicative of a higher severity of stress response and also a higher risk of occurrence of depressive syndromes. The depressive syndromes did not resemble depressive disorder of an endogenous nature.

Behavioral assessment of the type A behavior pattern.

Abstract: The present study attempted to assess systematically a set of behavioral subcomponents associated with the Type A behavior pattern. Sixty middle-aged men underwent the structured interview (SI) and a repeated version of the SI after a four-month interval. A high degree of interrater reliability was established for a number of behavioral components including speed and volume of speech, motoric activity, expiratory sighs, response latency, interruptions, unevenness of speech, plosive words, and potential for hostility. In general, these behaviors were stable over the four-month interval, although they did not all distinguish Type As from Type Bs. Only four behaviors successfully discriminated Type As and Bs at both interview sessions: speed of speech, volume of speech, number of interruptions, and potential for hostility. The results are discussed in terms of how these behavioral subcomponents may contribute to increased risk of premature coronary disease.

The Type A behavior pattern and carotid artery atherosclerosis.

Abstract: The Type A behavior pattern has been identified as an important precursor of coronary atherosclerosis. However, atherosclerosis is a disease process that occurs throughout the arterial system. The present research examined the hypothesis that the Type A pattern may also be related to disease in other arteries such as the carotid arteries. Men (n = 21) and women (n = 23) from 40 to 65 years of age were examined for carotid artery atherosclerosis using doppler ultrasonography. Subjects also completed the Jenkins Activity Survey (JAS) to measure the Type A pattern. The results indicated that the diseased individuals were more likely to be classified as Type A (71%) than as Type B (29%), Z = 2.08, p less than 0.05. The nondiseased individuals were not more likely to be Type A (53%) than Type B (47%). The results are consistent with the hypothesis that atherosclerosis in Type A individuals is not limited to the coronary arteries but the disease is likely to occur throughout the arterial system.

Psychological correlates of growth hormone response to stress.

Abstract: A stressful interview was conducted in 52 older people to determine whether a stress provoked change in growth hormone (GH) is correlated with anxiety and "defensiveness." The interview was referred to events surrounding the potential loss of a spouse hospitalized two months previously: in 29 instances, the spouse had died before this interview. GH was measured before and, in 23 subjects, during the interview. After the interview, in addition to GH, anxiety was measured using the Taylor Manifest Anxiety Scale (MAS), and defensiveness using the Crowne Marlowe Social Desirability Scale (SD). An elevation of at least 2.0 ng/ml in GH was used to classify subjects as GH responders (Rs) and nonresponders (NRs). Although the Rs and NRs had similar mean scores on defensiveness (SD), the Rs scored higher on anxiety (MAS) (14.9 vs. 10.2, p less than 0.05). Using a median cutoff with anxiety (MAS) alone, only 59% of the Rs were correctly classified as Rs. However, combining both scales in a discriminant function analysis (DFA) improved the ability of either scale alone to distinguish the Rs from the NRs. Using the DFA, 73% of the 29 NRs were correctly classified and 70% of the 23 Rs were correctly classified (p less than 0.005). With higher levels of defensiveness (SD), relatively low levels of anxiety were needed to provoke a GH response. This finding supports previous studies of GH response to stress and provides a multivariate model for the interaction of anxiety and "defensiveness."

Rapid communication whole blood serotonin and the type A behavior pattern.

Abstract: In 72 young males, whole blood serotonin is shown to have a pronounced relationship with the Type A behavior pattern. The relationship is explored with multivariate statistical techniques.

Behavioral control of intractable idiopathic seizures: I. Self-regulation of end-tidal carbon dioxide.

Abstract: Eleven women and seven men with moderate to severe chronic hyperventilation and idiopathic seizures refractory to therapeutic serum levels of anticonvulsant medication were given diaphragmatic respiration training with percent end-tidal CO2 biofeedback. The training had a rapid correcting effect on their respiration, making it comparable to that of 18 asymptomatic control subjects. Ten of the seizure-group subjects were in the study at least 7 months and following treatment, 8 showed EEG power spectrum "normalization", restoration of cardio-respiratory synchrony (RSA), and their seizure frequency and severity were significantly reduced.

Home relaxation techniques for essential hypertension.

Abstract: A 10-week relaxation treatment focused on home practice and self-monitoring of blood pressure for the purpose of lowering blood pressure in patients with essential hypertension. Comparisons were made among relaxation (n = 13), relaxation in combination with electromyographic biofeedback (n = 14), and a control condition in which patients simply monitored their blood pressure (n = 14). These three groups of patients, all of which received antihypertensive medication, were compared with a fourth group that practiced relaxation without drug therapy (n = 17). Relaxation and relaxation/biofeedback were equally effective in reducing blood pressure recorded at home in the morning and evening and produced greater decreases than in the control group. Relaxation without drugs, although somewhat more effective than self-monitoring, did not reduce blood pressure as much as the two conditions in which medication was combined with relaxation. Although reductions over the course of treatment were noted in blood pressure recorded in the laboratory, the four treatment conditions did not differ significantly from one another.