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Brugnera A, Zarbo C, Tarvainen MP, Carlucci S, Tasca GA, Adorni R, Auteri A, Compare A. Higher levels of Depressive Symptoms are Associated with Increased Resting-State Heart Rate Variability and Blunted Reactivity to a Laboratory Stress Task among Healthy Adults. Appl Psychophysiol Biofeedback 2020; 44:221-234. [PMID: 31041646 DOI: 10.1007/s10484-019-09437-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Laboratory stress tasks induce strong changes in linear and non-linear indices of heart rate variability (HRV) among healthy adults, due to a task-induced parasympathetic withdrawal. Previous findings suggested that negative affectivity and its correlates (i.e., depressive symptoms, anxiety, hostility, type D personality, and situational stress) could profoundly affect autonomic activity. However, to date no studies considered these psychological dimensions simultaneously while trying to disentangle their acute effects on HRV during a laboratory stress task. A total of 65 healthy participants completed a battery of questionnaires and later underwent a psychosocial stress protocol, which involves a stressful and a non-stressful mental arithmetic task, with the latter serving as a control condition for the former. During the entire procedure, autonomic activity was recorded through a portable ECG device. We analysed longitudinal changes in HRV indices using Mixed Models, taking into account respiration rates and the associations between psychophysiological variables through bivariate Pearson's r (partial) correlation indices. We found significant changes in linear (e.g., HF power, RMSSD) and non-linear (e.g., Poincaré Plot and Correlation Dimension D2) HRV indices during the procedure, with the lowest point reached during the stressful mental arithmetic task. Interestingly, only depressive symptomatology was significantly and positively related to a higher resting-state HRV and to a blunted reactivity to the stress task, even after controlling for baseline values. Results suggest that healthy individuals with higher levels of depressive symptoms could experience atypical cardiovascular responses to stressful events: several speculative interpretations, considering autonomic, behavioral, and motivational dysregulations, are discussed.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy.
| | - Cristina Zarbo
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Mika P Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | | | | | - Roberta Adorni
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Adalberto Auteri
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
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Abstract
Forgiveness may serve as an essential positive resource to help individuals cope emotionally with stressful events, ultimately influencing health. Examination of how individuals forgive within the context of close relationships can provide useful information about positive aging. In this study, we examine how the severity of a recent transgression committed by a spouse/partner or other close social relationship is associated with self-reported physical health among older adults. We also examine how state forgiveness (i.e., in context of a specific event) can offset the potentially negative impact of transgressions on health and further compare the impact when the transgressor is a spouse/partner versus another close social relationship. Data are from the Detroit Community Survey, a cross-sectional survey of social relations, forgiveness, humility, and health in the Detroit Metropolitan Area. Respondents age 50 and older were selected for analysis (N=380). Structural equation models indicated that greater transgression severity was associated with worse self-rated health. Further, state forgiveness was found to play a significant moderating role. Among older adults who were more likely to forgive their transgressor, experiencing a more severe transgression was associated with worse health. In contrast, among older adults less likely to forgive, there was no association between transgression severity and self-rated health. Additionally, among older adults less likely to forgive, the transgressor being a close other social relationship was associated with worse health compared to when it was a spouse/partner. In contrast, when more likely to forgive there was no association between who the transgressor was and self-rated health. This study contributes to a better understanding of how interpersonal stress, specifically a recent transgression experienced within the context of close social relationships, can be harmful to older adults’ health. Findings highlight the importance of forgiveness as a resource that can help facilitate positive aging.
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Affiliation(s)
- Noah J Webster
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States
| | - Kristine J Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States.,Department of Sociology, Anthropology, Criminology, Eastern Michigan University, Ypsilanti, Michigan, United States
| | - Toni C Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States.,Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States
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Karademas EC, Barouxi E, Mavroeides G. Positive and negative affect and well-being in cardiac patients and their spouses: the mediating role of illness representations. Psychol Health 2018; 34:289-305. [PMID: 30588842 DOI: 10.1080/08870446.2018.1525490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine whether illness representations of control and consequences mediate the relation of cardiac patients' affect to well-being. A further aim was to examine this indirect relationship at a dyadic level (i.e. patient and spouse). DESIGN AND MAIN OUTCOME MEASURES One hundred and four patients with a cardiovascular disease and their spouses participated in the study. Positive and negative affect was assessed at baseline; illness representations were assessed 2 months later, and physical and psychological well-being 4 months later. RESULTS Illness representations generally mediated the impact of patients' and spouses' affect on well-being, while several actor and partner effects were found. However, it was only positive affect that was indirectly related to well-being, while the representations of personal and treatment control chiefly acted as mediators. The effects were stronger for patients than spouses, as well as for physical well-being. CONCLUSION The results underline the strong connection between illness-related self-regulation and the overall person/environment interaction as depicted by affect. They also indicate the need to integrate theories on adaptation to illness, with models describing adaptation of couples to stressful conditions, and specific theories about the role of emotion in adaptation to illness.
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Affiliation(s)
| | - Eirini Barouxi
- a Department of Psychology , University of Crete , Rethymno , Greece
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Karademas EC, Dimitraki G, Papastefanakis E, Ktistaki G, Repa A, Gergianaki I, Bertsias G, Sidiropoulos P, Mastorodemos V, Simos P. Emotion regulation contributes to the well-being of patients with autoimmune diseases through illness-related emotions: A prospective study. J Health Psychol 2018; 25:2096-2105. [PMID: 29992828 DOI: 10.1177/1359105318787010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This prospective study aimed to examine whether illness-related negative emotions mediate the relationship of cognitive reappraisal and expressive suppression to the well-being of 99 patients with rheumatoid arthritis or multiple sclerosis. After adjusting for disease and patient-related parameters, only cognitive reappraisal was associated with physical and psychological well-being through emotions. Expressive suppression was associated with psychological well-being only for patients reporting less use of cognitive reappraisal. These results underscore the need for prospective studies that will investigate the long-term impact of emotion regulation on adaptation to chronic illness and the conditions under which this impact takes place.
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Brugnera A, Zarbo C, Adorni R, Tasca GA, Rabboni M, Bondi E, Compare A, Sakatani K. Cortical and cardiovascular responses to acute stressors and their relations with psychological distress. Int J Psychophysiol 2017; 114:38-46. [DOI: 10.1016/j.ijpsycho.2017.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/20/2016] [Accepted: 02/03/2017] [Indexed: 11/25/2022]
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Coughlan BM, Thornton LM, Murphy N, Tait MA, Flanagan PC, Kenny-Walsh EE, O'Lorcain PP. The use of complementary and alternative medicine in an Irish cohort of people with an iatrogenic hepatitis C infection: results from a health and lifestyle survey. Complement Ther Med 2014; 22:683-9. [PMID: 25146073 DOI: 10.1016/j.ctim.2014.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/20/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION A cohort of people with iatrogenic HCV infection, current or resolved, in Ireland have access to primary and secondary health care services, including specified complementary and alternative medicine (CAM) services, free of charge. OBJECTIVES Information about their pattern of CAM usage and its association with various demographic and lifestyle factors, and current HCV status, was sought as part of a health and lifestyle survey, in order to provide information for health service planning. DESIGN AND METHODS The survey was carried out by self-administered postal questionnaire. The level of CAM usage was compared to an age- and sex-matched sample of the general population. RESULTS The response was 48% (720/1485). Compared to the general population, the HCV population was significantly more likely to have attended a CAM practitioner (50.1% vs 23.9%, OR 3.2; 95% CI 2.7-3.9). Within the HCV population, multivariate analysis showed that females (OR 3.1; 95% CI 1.9-4.9), those who reported fibromyalgia (OR 2.7; 95% CI 1.8-3.9) and those who reported anxiety (OR 1.4; 95% CI 1.0-2.0) were significantly more likely to have used CAM, and smokers significantly less likely (OR 0.6; 95% CI 0.4-0.8). CAM attendance did not vary by current HCV status. Reflexology, acupuncture and massage were the most commonly used forms of CAM. CONCLUSIONS This study demonstrates that CAM services are used by a high proportion of people with iatrogenic chronic HCV. A more holistic approach to health care, using a biopsychosocial model framework, may better meet the physical and psychological health needs of this group.
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Affiliation(s)
- Barbara M Coughlan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Lelia M Thornton
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | - Niamh Murphy
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | - Michele A Tait
- Hepatitis C National Office, Health Service Executive, Ireland
| | - Paula C Flanagan
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | | | - Piaras P O'Lorcain
- Health Protection Surveillance Centre, Health Service Executive, Ireland
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Skodova Z, Lajciakova P. The effect of personality traits and psychosocial training on burnout syndrome among healthcare students. NURSE EDUCATION TODAY 2013; 33:1311-5. [PMID: 23545453 DOI: 10.1016/j.nedt.2013.02.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 05/16/2023]
Abstract
AIMS The aims of this paper were to explore the influence of personality factors on student burnout syndrome and to explore the effect of psychosocial training on burnout and personality predictors among university students in health care professions. DESIGN AND METHOD A quasi-experimental pre-test/post-test design was used to evaluate the effect of psychosocial training. A sample of 111 university students were divided into experimental and control groups (average age 20.7 years, SD=2.8 years; 86.1% females). The School Burnout Inventory (SBI), Sense of Coherence (SOC) questionnaire, and Rosenberg's Self-esteem scale were employed. Linear regression and analysis of variance were applied for statistical analysis. RESULTS The results show that socio-psychological training had a positive impact on the level of burnout and on personality factors that are related to burnout. After completing the training, the level of burnout in the experimental group significantly decreased (95% confidence interval: 0.93, 9.25), and no significant change was observed in the control group. Furthermore, respondents' sense of coherence increased in the experimental group (95% confidence interval: -9.11, 2.64), but there were no significant changes in respondents' self-esteem levels in either group. CONCLUSIONS Psychosocial training positively influenced burnout among students in health care professions. Because the coping strategies that were used during the study are similar to effective work coping strategies, psychosocial training can be considered to be an effective tool to prevent burnout in the helping professions.
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Affiliation(s)
- Zuzana Skodova
- Comenius University, Jessenius Faculty of Medicine, Department of Non-medical Study Programmes, Martin, Slovakia.
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Stiller AL, Drugan RC, Hazi A, Kent SP. Stress resilience and vulnerability: the association with rearing conditions, endocrine function, immunology, and anxious behavior. Psychoneuroendocrinology 2011; 36:1383-95. [PMID: 21530089 DOI: 10.1016/j.psyneuen.2011.03.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 03/21/2011] [Accepted: 03/21/2011] [Indexed: 01/28/2023]
Abstract
BACKGROUND The current study explored the underlying behavioral, endocrine, and immune markers of vulnerability to stress-induced depression, and the impact of rearing environments on adult functioning. METHOD Adult Sprague-Dawley rats (n=195) were reared in either Maternal Separation (MS), Early Weaning and Isolation (EWI), or Non-Handled (NH) conditions. Anxiety behavior was assessed using the emergence test at mean postnatal day (PND) 60. Stress-induced depressive behavior was measured at mean PND 86 using an intermittent cold water swim stress and swim escape test (SET) paradigm. Immediately following the SET, and in a sample of naïve controls (N=31), trunk blood was collected to assay for serum corticosterone (CORT) and spleens were removed for determination of Concanavalin A (Con-A) stimulated T-cell proliferation. RESULTS Stress vulnerable rats (top tertile of SET swim time) were characterised by increased anxiety-like behavior, greater post-stress CORT concentrations, and a significantly higher Con-A induced T-cell proliferative response compared to stress resilient rats (bottom tertile of SET swim time). The EWI rearing condition was a contributing factor in predicting total swim escape time, however MS was not. MS offspring did have double the basal level of CORT than NH offspring, suggestive of a hyperfunctioning HPA axis. CONCLUSION The swim stress animal model enabled observation of stress vulnerability and resilience; results point towards the existence of distinct behavioral, endocrine, and immunological profiles of the vulnerable and resilient animal, which may have important implications for mental health and stress research.
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Affiliation(s)
- Anna L Stiller
- School of Psychological Science, La Trobe University, Bundoora, Victoria 3086, Australia
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Tilvis RS, Laitala V, Routasalo P, Strandberg TE, Pitkala KH. Positive life orientation predicts good survival prognosis in old age. Arch Gerontol Geriatr 2011; 55:133-7. [PMID: 21764146 DOI: 10.1016/j.archger.2011.06.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 06/22/2011] [Accepted: 06/23/2011] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to investigate the value of life orientation as a screening tool and survival indicator in old age. A postal questionnaire answered by 2490 random older people (>75 years) included six questions concerning satisfaction with life, feeling needed, plans for future, zest for life, lack of feelings of depression and loneliness. The vital status was followed for 57 months. All-cause mortality rate was 19.1% and 30.3% among elderly with (22%) and without (78%) positive life orientation, respectively (p<0.001). The difference in mortality increased over time. After controlling for age, gender, and subjective health, the protective value of positive life orientation remained significant (hazard ratio, HR=0.78, 95%CI=0.63-0.98, p<0.03). Feeling needed was the strongest independent predictor (HR=0.72, p<0.001). A six-question life orientation identifies old people at risk. Positive life orientation predicts good survival prognosis independently of subjective health.
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Affiliation(s)
- Reijo S Tilvis
- Clinics of General Internal Medicine and Geriatrics, Helsinki University Hospital, Box 340, 00290 Helsinki, Finland.
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Sirois F. [Brief intervention in psychiatric consultation]. SANTE MENTALE AU QUEBEC 2010; 34:237-54. [PMID: 20361117 DOI: 10.7202/039134ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This essay presents a perspective on intervention in psychiatric consultation based on the patient's subjective experience as supported by Kendler in 2005 in the American Journal of Psychiatry in his position against biological reductionism in psychiatry, distinguishing the psychic approach from the biological. The paper presents aspects of the setting and major features of the assessment in the consultation process, then proceeds to discussing principles of intervention as to specify dimensions of the psychiatric intervention in this particular context.
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Affiliation(s)
- François Sirois
- Département de Psychiatrie de l'Université Laval, Québec, Canada
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Adler RH. Engel's biopsychosocial model is still relevant today. J Psychosom Res 2009; 67:607-11. [PMID: 19913665 DOI: 10.1016/j.jpsychores.2009.08.008] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 08/18/2009] [Accepted: 08/18/2009] [Indexed: 02/08/2023]
Abstract
In 1977, Engel published the seminal paper, "The Need for a New Medical Model: A Challenge for Biomedicine" [Science 196 (1977) 129-136]. He featured a biopsychosocial (BPS) model based on systems theory and on the hierarchical organization of organisms. In this essay, the model is extended by the introduction of semiotics and constructivism. Semiotics provides the language which allows to describe the relationships between the individual and his environment. Constructivism explains how an organism perceives his environment. The impact of the BPS model on research, medical education, and application in the practice of medicine is discussed.
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Affiliation(s)
- Rolf H Adler
- Medical School, University of Berne, Berne, Switzerland.
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Laursen B, Hafen C. Future Directions in the Study of Close Relationships: Conflict is Bad (Except When It's Not). SOCIAL DEVELOPMENT 2009; 19:858-872. [PMID: 20953335 DOI: 10.1111/j.1467-9507.2009.00546.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Beneficial and detrimental correlates of interpersonal disagreement have been postulated and documented. The conclusion: Conflict is both bad and good. The evidence for these paradoxical effects is summarized. In this essay, we argue that the consequences of conflict for individuals depends on its frequency, the way in which it is managed, and the quality of the relationship in which it arises. Nonlinear patterns of association are hypothesized such that constructive conflicts, particularly those arising in supportive relationships, should (up to a limit) predict more beneficial and fewer detrimental outcomes. In contrast, coercive conflicts, particularly those arising in unsupportive relationships, should predict more adverse and fewer favorable outcomes.
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Abstract
BACKGROUND Vital exhaustion has been shown to be a significant risk factor contributing to coronary heart disease, as well as a predictor of a worse prognosis among coronary patients. Socioeconomic differences in vital exhaustion may be part of the causal mechanism in the health and mortality inequalities connected with socioeconomic disadvantage. Our aim was to explore socioeconomic inequalities in vital exhaustion among coronary patients. METHODS We included 362 patients (32% women, mean age 56+/-7.3 years) who were referred for coronary angiography. The Maastricht interview for vital exhaustion was conducted with each patient. Level of income and education were used as indicators of socioeconomic status. Functional status was assessed with the NYHA (dyspnoe symptoms) and CCS (chest pain) scales. RESULTS Logistic regression showed significant socioeconomic inequalities in vital exhaustion among patients. Participants with low and middle income and education had a higher probability of being exhausted in comparison with patients with high income and education [odds ratio (95% confidence interval): 13.31 (4.67-37.94) and 2.10 (1.19-3.64), respectively]. Associations remained statistically significant after controlling for the effect of functional status and seriousness of disease. Socioeconomic differences were more salient among men than among women. CONCLUSION Low education and income seem to be strongly associated with higher vital exhaustion among patients; a significant factor contributing to worse prognosis and lower quality of life among patients with coronary heart disease.
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Saeki U, Nasermoaddeli A, Sekine M, Kagamimori S. [Relationships of positive and negative affectivity to sleep quality in Japanese civil servants: 3-year follow-up study]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2008; 50:219-25. [PMID: 18957834 DOI: 10.1539/sangyoeisei.b8002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We conducted this longitudinal study to evaluate the relationships of positive and negative affectivity (Affect Balance Scale) to sleep quality among civil servants. For this study we evaluated 827 civil servants of T city in Toyama prefecture in the springs of 2001 (Baseline) and 2004 with complete information in both phases of the study. Based on the median score at each phase, we divided Affect Balance Scale (ABS) scores into high and low groups. We conducted logistic regression analysis to determine the odds ratios (OR) of 3-yr follow-up sleep quality by baseline and follow-up ABS scores. After adjusting for baseline sleep quality scores, age, sex, employment, job strain, and exercise habits, participants who had high ABS scores were more likely (OR: 3.13, 95% confidence interval (CI): 1.78-5.53) to have better sleep quality than those with low ABS scores at both phases. In addition, participants with low ABS scores at baseline and high ABS scores 3 yr later had better sleep quality (OR: 1.81, 95%CI: 1.02-3.20) than those with low ABS scores at both phases. These findings substantiate the relationships of positive and negative affectivity to sleep quality. Improving the affect balance condition as well as maintaining good affect balance condition may be important determinants of sleep quality in civil servants.
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Affiliation(s)
- Urara Saeki
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
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Munafò MR, Brown SM, Hariri AR. Serotonin transporter (5-HTTLPR) genotype and amygdala activation: a meta-analysis. Biol Psychiatry 2008; 63:852-7. [PMID: 17949693 PMCID: PMC2755289 DOI: 10.1016/j.biopsych.2007.08.016] [Citation(s) in RCA: 505] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 08/22/2007] [Accepted: 08/24/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND We evaluated the magnitude of the reported associations between amygdala activation and the serotonin transporter gene linked polymorphic region (5-HTTLPR) and the likely effect size of this relationship. METHODS We used meta-analytic techniques to combine data from existing published and unpublished studies. We also tested for possible publication bias and explored possible moderating influences on any association, such as sample ancestry. RESULTS Our results provide support for the association of the 5-HTTLPR polymorphism and amygdala activation and suggest that this locus may account for up to 10% of phenotypic variance. Although we did not observe evidence for potential publication bias in our main analysis, this was due in part to efforts to obtain unpublished data pertinent to this meta-analysis, and when three unpublished data sets were excluded we did observe evidence of such bias. We also observed evidence that the first published study may provide an overestimate of the true effect size, which is consistent with findings from genetic association studies of other phenotypes. CONCLUSIONS Although our analysis provides support for the association of the 5-HTTLPR polymorphism and amygdala activation, it also suggests that most studies to date are nevertheless lacking in statistical power. Increasing the sample sizes of future imaging genetics studies will allow a more accurate characterization of any true effect size and afford adequate power to examine the impact of multiple polymorphisms that likely work in concert to affect gene function and, in turn, bias neural processes mediating dispositional traits such as temperament and personality.
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Affiliation(s)
- Marcus R. Munafò
- Department of Experimental Psychology (MRM), University of Bristol, United Kingdom; Departments of Psychiatry and Psychology (SMB, ARH), University of Pittsburgh, Pennsylvania
| | - Sarah M. Brown
- Department of Experimental Psychology (MRM), University of Bristol, United Kingdom; Departments of Psychiatry and Psychology (SMB, ARH), University of Pittsburgh, Pennsylvania
| | - Ahmad R. Hariri
- Department of Experimental Psychology (MRM), University of Bristol, United Kingdom; Departments of Psychiatry and Psychology (SMB, ARH), University of Pittsburgh, Pennsylvania
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Abstract
The biopsychosocial model has been used to describe the intertwined factors that may act as mechanisms in cardiovascular disease, as well as those found in pain conditions. This model may also prove useful in understanding a diagnosis that overlaps these two areas, angina. This article reviews the literature related to biological, psychological, and social mechanisms of painful ischemic episodes and discusses the interactions of those variables. We propose an integrated model that incorporates the biopsychosocial mechanisms that may be responsible for the variability in pain reporting with ischemic episodes. We show how sex differences manifested in various biopsychosocial factors may interact to influence the presence of painful versus silent myocardial ischemia. We present a plan for future research to elucidate this interaction.
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Affiliation(s)
- Susan E Hofkamp
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 193, Baltimore, MD 21287, USA.
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Kreibig SD, Wilhelm FH, Roth WT, Gross JJ. Cardiovascular, electrodermal, and respiratory response patterns to fear- and sadness-inducing films. Psychophysiology 2007; 44:787-806. [PMID: 17598878 DOI: 10.1111/j.1469-8986.2007.00550.x] [Citation(s) in RCA: 233] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Responses to fear- and sadness-inducing films were assessed using a broad range of cardiovascular (heart rate, T-wave amplitude, low- and high-frequency heart rate variability, stroke volume, preejection period, left-ventricular ejection time, Heather index, blood pressure, pulse amplitude and transit time, and finger temperature), electrodermal (level, response rate, and response amplitude), and respiratory (rate, tidal volume and its variability, inspiratory flow rate, duty cycle, and end-tidal pCO(2)) measures. Subjective emotional experience and facial behavior (Corrugator Supercilii and Zygomaticus Major EMG) served as control measures. Results indicated robust differential physiological response patterns for fear, sadness, and neutral (mean classification accuracy 85%). Findings are discussed in terms of the fight-flight and conservation-withdrawal responses and possible limitations of a valence-arousal categorization of emotion in affective space.
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Affiliation(s)
- Sylvia D Kreibig
- Department of Psychology, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
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Schiffer AA, Denollet J, Widdershoven JW, Hendriks EH, Smith ORF. Failure to consult for symptoms of heart failure in patients with a type-D personality. Heart 2007; 93:814-8. [PMID: 17344329 PMCID: PMC1994460 DOI: 10.1136/hrt.2006.102822] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Self-management and adequate consultation behaviour are essential for the successful treatment of chronic heart failure (CHF). Patients with a type-D personality, characterised by high social inhibition and negative affectivity, may delay medical consultation despite increased symptom levels and may be at an increased risk for adverse clinical outcomes. AIM To examine whether type-D personality predicts poor self-management and failure to consult for evident cardiac symptoms in patients with CHF. Design/methods/ PATIENTS 178 outpatients with CHF (aged < or =80 years) completed the type-D Personality Scale at baseline, and the Health Complaints Scale (symptoms) and European Heart Failure Self-care Behaviour Scale (self-management) at 2 months of follow-up. Medical information was obtained from the patients' medical records. RESULTS At follow-up, patients with a type-D personality experienced more cardiac symptoms (OR 6.4; 95% CI 2.5 to 16.3, p<0.001) and more often appraised these symptoms as worrisome (OR 2.9; 95% CI 1.3 to 6.6, p<0.01) compared with patients with a non-type-D personality. Paradoxically, patients with a type-D personality were less likely to report these symptoms to their cardiologist/nurse, as indicated by an increased risk for inadequate consultation behaviour (OR 2.7; 95% CI 1.2 to 6.0, p<0.05), adjusting for demographics, CHF severity/aetiology, time since diagnosis and medication. Accordingly, of 61 patients with CHF who failed to consult for evident cardiac symptoms, 43% had a type-D personality (n = 26). Of the remaining 108 patients with CHF, only 14% (n = 16) had a type-D personality. CONCLUSION Patients with CHF with a type-D personality display inadequate self-management. Failure to consult for increased symptom levels may partially explain the adverse effect of type-D personality on cardiac prognosis.
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Affiliation(s)
- Angélique A Schiffer
- Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
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