Biomedical subjects

A Baum

Publications and source records attributed to A Baum.

85 records · Page 5Linked to original sources

PubMedDate not supplied

The effects of stress and coping on daily alcohol use in women.

To evaluate the notion that perceived stress and drinking covary over time, daily logs were periodically collected over a 6-month period from 32 middle-aged women. Results indicated that significantly less alcohol was consumed on high-stress weeks than low-stress weeks. Problem-focused (P-F) coping preference moderated this relationship, with low P-F copers consuming more alcohol per occasion than did high P-F copers but only during low-stress weeks. These findings support a model of stress and alcohol use that includes coping preference as an important moderator of women's drinking. In addition, our data are consistent with the notion that stress can influence alcohol consumption but that low P-F women regulate their use, preferring to delay their drinking until after the termination of the stressor.

Adaptation, Psychological↗

PubMedDate not supplied

Adrenal cortical response to stress at Three Mile Island.

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.

Accidents↗

PubMedDate not supplied

Control and intrusive memories as possible determinants of chronic stress.

Amidst confusion about the nature and usefulness of the stress construct and distinctions between acute and chronic stress, research has begun to identify mechanisms by which stress affects health and by which stress can persist beyond the physical presence of the stressor. In addition, research has begun to identify reasons for selective vulnerability to chronic stress. One of the possible reasons for chronic stress following traumatic events is the disorganizing effect of loss of control and violation of expectations for regulating aspects of one's life normally under control. Data from a longitudinal study of chronic stress at Three Mile Island in the wake of the nuclear accident there suggest that loss of control and frequent experience of intrusive memories about the accident and its aftermath were related to persistent stress responding several years after the accident. The relationships between stress responding and conditioning and consolidation of stressful memories are considered as a basis for persistent intrusive memories and chronic stress.

Adaptation, Psychological↗

PubMedDate not supplied

Physical symptoms of chronic fatigue syndrome are exacerbated by the stress of Hurricane Andrew.

This study examined the effects of Hurricane Andrew on physical symptoms and functional impairments in a sample of chronic fatigue syndrome (CFS) patients residing in South Florida. In the months after Hurricane Andrew (September 15-December 31, 1992), 49 CFS patients were assessed for psychosocial and physical functioning with questionnaires, interviews, and physical examinations. This sample was made up of 25 CFS patients living in Dade county, a high impact area, and 24 patients in Broward and Palm Beach counties, areas less affected by the hurricane. Based on our model for stress-related effects on CFS, we tested the hypothesis that the patients who had the greatest exposure to this natural disaster would show the greatest exacerbation in CFS symptoms and related impairments in activities of daily living (illness burden). In support of this hypothesis, we found that the Dade county patients showed significant increases in physician-rated clinical relapses and exacerbations in frequency of several categories of self-reported CFS physical symptoms as compared to the Broward/Palm Beach county patients. Illness burden, as measured on the Sickness Impact Profile, also showed a significant increase in the Dade county patients. Although extent of disruption due to the storm was a significant factor in predicting relapse, the patient's posthurricane distress response was the single strongest predictor of the likelihood and severity of relapse and functional impairment. Additionally, optimism and social support were significantly associated with lower illness burden after the hurricane, above and beyond storm-related disruption and distress responses. These findings provide information on the impact of environmental stressors and psychosocial factors in the exacerbation of CFS symptoms.

Activities of Daily Living↗

PubMedDate not supplied

Posttraumatic stress symptoms, intrusive thoughts, loss, and immune function after Hurricane Andrew.

OBJECTIVE: To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures. METHODS: Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane. RESULTS: The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship. CONCLUSIONS: Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.

Adolescent↗

PubMedDate not supplied

Chronic stress and natural killer cell activity after exposure to traumatic death.

OBJECTIVE: The present study examined the effects of working at the crash site of USAir Flight 427 on psychological, cardiovascular, and immunological sequelae of stress within 2 months of the recovery work and again 6 months after the crash. METHOD: A total of 159 workers at the crash site and 41 controls were examined within 2 months of the crash and again 6 months after the crash. Subjects were initially grouped according to whether they had contact with human remains. For a finer-grained analysis of exposure to bodies, subjects were also grouped by degree of exposure, determined by the area in which the workers were stationed. Dependent measures included intrusive thoughts, coping styles, and symptom reporting, as well as heart rate and blood pressure, and NK cell number and activity. RESULTS: Workers exposed to body parts at the actual crash site, and those who were exposed to remains without expecting to be, exhibited more symptoms of stress than workers who saw bodies and body parts at the morgue and those who did not see human remains. Non-morgue workers who were exposed to bodies or body parts had the highest levels of intrusive thoughts at both time points, and the highest NK cell activity at Time 1. NK activity in this group decreased to levels comparable with other groups at Time 2. CONCLUSIONS: Increased NK activity is unusual in chronic stress situations, and may be because of acute stress experienced as a result of being asked to talk and think about the crash. The finding that the more one was exposed to human remains the less distress he or she reported is discussed in terms of adaptation, expectancy, and control.

Accidents↗

PubMedDate not supplied

Sleep as a mediator of the stress-immune relationship.

OBJECTIVE: To evaluate the role of sleep in the relationship of intrusive thoughts/avoidance behaviors to natural killer cell (NKC) number and function. METHOD: Twenty-nine individuals seeking treatment for bereavement-related depression were studied in the sleep laboratory. Background and clinical variables, including the Impact of Event Scale (IES) and the Hamilton Rating Scale for Depression (HRSD), were administered during the week preceding a 3-night sleep study. Blood samples were collected upon awakening after the second or third night of sleep. RESULTS: Greater frequency of intrusive thoughts and avoidance behaviors was associated with more time spent awake during the first non-rapid eye movement period (NREM-1) and lower NKC number (p values < .01). Greater time spent awake during NREM-1 was associated with lower NKC numbers (p < .05). Regression analyses revealed that the significant relationship between symptoms of intrusion/avoidance and NKC number was no longer significant when time spent awake during NREM-1 was entered into the regression equation. Time spent awake during NREM-1 accounted for 12% of the variance in NKC number (p < .05), whereas intrusion/avoidance accounted for 7% of the variance in NKC number (NS). CONCLUSIONS: These results suggest that EEG-assessed sleep may be a significant correlate of the stress-immune relationship.

Adult↗

PubMedDate not supplied

Assessment of characteristics of intrusive thoughts and their impact on distress among victims of traumatic events.

OBJECTIVE: This study examines the psychometric properties of the Intrusive Thoughts Questionnaire (ITQ) and its utility as a predictor of distress among trauma victims. METHOD: Victims of three types of trauma, a motor vehicle accident (N = 115), a hurricane (N = 182), and recovery work after an airline disaster (N = 159), completed the ITQ along with the Impact of Event Scale (IES) and the Symptom Checklist-90, Revised (SCL-90-R), at several different time points after their exposure. RESULTS: The ITQ was a reliable and valid instrument that was positively related to concurrent measures of distress as well as a predictor of long-term stress responding. Characteristics of intrusive thoughts reflecting the extent to which they were unwanted or controllable, were identified as key determinants of distress. CONCLUSIONS: The ITQ is a useful adjunct to current measures of intrusions, allowing for greater specificity in analyses of responses to trauma. Evaluation of characteristics of intrusions indicated that frequency of intrusions was neither the only predictor of distress nor the best predictor of trauma-related outcomes.

Adolescent↗

PubMedDate not supplied

Urinary catecholamines and cortisol in recent-onset posttraumatic stress disorder after motor vehicle accidents.

OBJECTIVE: This study examined relationships among stress hormone levels, posttraumatic stress disorder (PTSD) diagnosis and symptoms, and gender shortly after a common civilian trauma. METHODS: Levels of catecholamines and cortisol in 15-hour urine samples were examined in 55 adults who had been in serious motor vehicle accidents and in 22 age-matched control. RESULTS: Catecholamines were related to PTSD diagnosis and symptoms, but only among men: PTSD-symptomatic men who had been in an accident exhibited elevated levels of epinephrine and norepinephrine 1 month after the accident and had higher epinephrine levels 5 months later. Intrusive thoughts predicted catecholamine levels at 1 month, and avoidance of trauma-relevant stimuli was associated with higher epinephrine levels 5 months later. These effects were not significant among women. Urinary cortisol was also elevated among PTSD-symptomatic men, but not women, and only immediately (1 month) after the accident. For men and women, greater emotional numbing predicted a lower cortisol level 6 months after the accident. CONCLUSIONS: These findings were interpreted as limited support for the generalizability of findings in men with chronic, combat-related PTSD and indicate the need for additional research on psychoendocrine assessment of traumatized women and specific dimensions of PTSD symptomatology.

Accidents, Traffic↗

PubMedDate not supplied

Predictors of posttraumatic stress among victims of motor vehicle accidents.

OBJECTIVE: This study identified factors that predict individual vulnerability to psychological trauma by examining the relationships among situation and person variables and symptoms of posttraumatic stress disorder (PTSD) 1, 6, and 12 months after a serious motor vehicle accident (MVA). METHODS: Background characteristics, exposure variables (ie, injury severity and accident characteristics), and psychosocial variables (ie, perceived loss of control, social support, and coping) were used to predict symptoms of PTSD and recovery in 115 injured MVA victims. All participants were injured during the MVA and provided data prospectively over the course of a year after their accidents. RESULTS: Along with background and exposure variables, use of wishful thinking coping distinguished between victims with and without symptoms of PTSD. CONCLUSIONS: Psychosocial variables such as wishful thinking coping can be used to identify MVA victims who are at risk of developing chronic posttraumatic stress and warrant further investigation.

Accidents, Traffic↗

PubMedDate not supplied

Endocrine levels at the start of treatment are associated with subsequent psychological adjustment in cancer patients with metastatic disease.

OBJECTIVE: This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology. METHODS: Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI). RESULTS: Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores. CONCLUSIONS: Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.

Adult↗

PubMedDate not supplied

Acquisition of a new-latency conditioned nictitating membrane response--major, but not complete, dependence on the ipsilateral cerebellum.

Classical conditioning of the nictitating membrane response (NMR) of rabbits is simple associative learning of a motor response. In several two-stage experiments, reversible inactivations of the deep cerebellar nuclei in stage 1 appeared to prevent acquisition of NMR conditioning in naive rabbits--no conditioned responses (CRs) were evident after inactivations were lifted in stage 2. Results of a three-stage experiment were different. When subjects were first trained with a light conditional stimulus (CS) in stage 1, reversible cerebellar inactivations during conditioning to a different, tone CS during stage 2 did not appear to prevent new learning because CRs to the tone CS were evident when the inactivation was lifted. Results from the two-stage experiments support the suggestion that the cerebellum is essential for the acquisition of NMR conditioning, but results from the three-stage experiment do not. Here, we use a three-stage design with different interstimulus intervals (ISIs) in stages 1 and 2. Because CRs develop with latencies-to-peak dependent on the ISI, learning during stage 1 can be dissociated from that accruing in stage 2. Complete inactivation of the ipsilateral cerebellar nuclei with muscimol substantially but not completely prevented learning with the second ISI during stage 2 because small CR peaks around the stage 2 ISI could be detected in some subjects after the inactivation had been lifted in stage 3. We suggest that the weak levels of conditioning possible during unilateral inactivation depend on the contralateral cerebellum or on extracerebellar circuitry and that these may be capable of supporting transfer of conditioning in a previous three-stage experiment. But, we confirm that normal NMR conditioning is critically dependent on the ipsilateral cerebellum.

Animals↗

PubMedDate not supplied

The relationship between stealing and eating disorders: a review.

The literature exploring stealing behavior in individuals with an eating disorder is reviewed. Although epidemiological data are lacking, clinical observations and preliminary studies suggest an association between stealing behavior and eating disorders. Stealing appears to be strongly associated with bulimic symptoms in patients with eating disorders, and the presence of stealing behavior may serve as a marker of eating-disorder severity. The apparent connection between the two problems is discussed, and nine putative explanatory factors are examined: starvation-induced mental dysfunction, effects of medications, affective spectrum disorder, personality disorder, psychodynamic features, dissociative phenomena, tension reduction, pseudopubertal impulsivity, and sociocultural influences. Various combinations of these factors may operate in any particular patient. One of the challenges to our current understanding is the scarcity of information regarding the prevalence and distribution of stealing behavior in the general population. Areas for future research are suggested and include epidemiological surveys to investigate the proposed connection between stealing and eating disorders, examination of the effects of legal intervention, systematic study of the treatment of stealing in patients with eating disorders, and longitudinal studies exploring prognostic implications of stealing behavior.

Adolescent↗