Biomedical subjects

A Steptoe

Publications and source records attributed to A Steptoe.

At least 19 recordsLinked to original sources

PubMed1997

The perception of bodily sensations, with special reference to hypochondriasis.

Bodily sensations are relevant to problems such as hypochondriasis, but the issue of whether people are accurate in their perception remains unclear. The accuracy of perception of bodily sensations was analysed in 20 male and 20 female volunteers using two methods: a heart beat tracking procedure and the within-S correlational approach described by Steptoe and Vögele (1992, Behaviour Research and Therapy, 30, 597-607). The correlational approach involved monitoring of heart rate, skin conductance level and total respiratory resistance during relaxation and task periods, and computing correlations between appropriate physiological parameters and ratings of heart rate, sweaty hands and difficulty with breathing. In general, subjective ratings of bodily sensations were tied more closely with feelings of distress than with objective physiological state. Error scores on the heart beat tracking procedure showed no association with hypochondriacal concerns or with vigilant and avoidant coping styles measured with the Mainz Coping Inventory. Individuals varied considerably in accuracy as assessed with the correlational approach. However, there was a significant negative association between hypochondriacal concerns and accuracy of perception of sweat gland activity. The results are discussed in relation to measures of somatic perception and the experience of bodily sensations.

Adolescent↗

PubMed1997

Perceptions of control over work: psychophysiological responses to self-paced and externally-paced tasks in an adult population sample.

This experiment tested the hypothesis that perceptions of control over work pace would modulate cardiovascular reactions to mental stress tests. One hundred and thirty two adults aged 30-65 years (64 men and 68 women) were randomized to self-paced and externally-paced task conditions. The self-paced group carried out visual matrix problem solving and mirror tracing tasks at their own pace. Work pace requirements were imposed on the externally-paced group, with performance requirements being set to equate those in the self-paced condition. This was done to equate work demands. Blood pressure (assessed with the Finapres), heart rate, cardiac baroreceptor reflex sensitivity, skin conductance, respiration rate and tidal volume were monitored. Behavioural performance of the mirror tracing task was comparable in the two conditions, but the externally-paced group attempted more problems and made more errors on the visual matrix task. Systolic blood pressure reactions to mirror drawing were greater in the external than self-paced conditions (mean increases of 27.5 +/- 16.1 vs. 23.1 +/- 18.5 mmHg, P < 0.025), and electrodermal responsivity was also heightened in the externally-paced group (P < 0.05). No differences were recorded in diastolic blood pressure, heart rate, baroreflex sensitivity or respiratory parameters. Results are discussed in relation to the literature on control and physiological stress responsivity, and their implications for understanding the health consequences of lack of control at work are considered.

Adult↗

PubMed1997

Healthy dietary practices among European students.

Predictors of 5 healthy dietary habits were examined in data from the European Health and Behaviour Survey (A. Steptoe & J. Wardle, 1996), a study of over 16,000 students from 21 European countries. The level of practice of these healthy dietary habits was low. Significant univariate associations with healthy dietary habits were identified for gender, weight, dieting status, dietary health beliefs, nutrition knowledge, and health locus of control. In multivariate analyses, only gender, dieting status, and dietary health beliefs were significant predictors of healthy dietary habits. The practical implications of these results for dietary health promotion are discussed.

Adult↗

PubMed1997

Assessment of maternal anxiety following neonatal screening and investigation for occult spinal dysraphism.

The objective was to determine maternal anxiety and attitudes associated with a programme of neonatal screening and investigation for occult spinal dysraphism. Questionnaires were completed after diagnostic investigation (time 1) and 6 months later (time 2) by 83 mothers of babies with possible markers of occult spinal dysraphism who were normal on spinal ultrasound. Outcome measures were: attitudes to the programme; maternal adjustment and attitudes to the baby; the State-Trait Anxiety Inventory. Fifty-four other postnatal mothers formed the comparison group for maternal adjustment. No significant differences were found between investigation group (time 1) and comparisons on measures of maternal adjustment. Anxious mothers gave more negative responses to some maternal adjustment items but not to attitudes to the programme. Mean state anxiety at time 1 (33.66) and time 2 (33.69) and mean trait anxiety (36.23) were not higher than in mothers of normal babies. It can be concluded that a programme of investigation for neonatal abnormalities that pays attention to detail need not cause excessive maternal anxiety. However, some mothers remain anxious even after receiving normal results. Anxiety can be assessed during appraisal of a new investigation programme, but refinements are needed.

Adaptation, Psychological↗

PubMed1997

Health related quality of life and psychological wellbeing in patients with hypertrophic cardiomyopathy.

OBJECTIVE: To assess the health related quality of life and psychological wellbeing of patients with hypertrophic cardiomyopathy, to correlate these with symptoms, clinical, and psychosocial factors. DESIGN: Questionnaire distributed to 171 hypertrophic cardiomyopathy patients aged at least 14 years, selected at random from a dataset of 480 patients. Assessments included the Short Form 36 (SF-36) Health Survey, the Hospital Anxiety and Depression questionnaire, and measures of adjustment, worry, and patient satisfaction. RESULTS: There was an 80.1% response rate to the questionnaire. Patients had severe limitations in all eight dimensions of quality of life assessed by the SF-36: physical functioning, role limitations owing to physical problems, role limitations owing to emotional problems, social functioning, mental health, general health perceptions, vitality, and bodily pain. Levels of anxiety and depression were also high compared with population norms. Quality of life was particularly impaired in patients with chest pain and dyspnoea, but was less consistently related to clinical cardiological measures. Adjustment to the condition and patient satisfaction were generally good. In multivariate analysis, quality of life was associated with a combination of symptom patterns and psychosocial factors. No differences in quality of life, anxiety or depression were observed between patients with no known family history, those with familial cardiomyopathy, and patients with a family history of premature sudden death. CONCLUSIONS: Hypertrophic cardiomyopathy is associated with substantial restrictions in health related quality of life. Symptoms, adjustment, and quality of interactions with clinical staff contribute to these limitations. Recognition of the problems confronted by patients with hypertrophic cardiomyopathy requires continued efforts at education both of the public and health professionals.

Adaptation, Psychological↗

PubMed1996

Sports participation and emotional wellbeing in adolescents.

BACKGROUND: Regular physical activity may have psychological benefits. Our study assessed the association between extent of participation in regular sport or vigorous recreational activity and emotional wellbeing in adolescents aged 16 years. METHODS: Data were collected from a cohort of adolescents, born between April 5 and April 11, 1970, in England, Scotland, and Wales, who took part in the follow-up assessment at age 16 years. Emotional wellbeing was assessed by the general health questionnaire (GHQ) and the malaise inventory (divided into psychological and somatic subscales). Information was obtained about participation in ten team and 25 individual sports and vigorous recreational activities during the previous year. Non-vigorous recreations, such as darts and snooker, were assessed separately. Social class and health status (recent illness and use of hospital services) were included in our analyses as possible confounding factors. 2223 boys and 2838 girls with a mean age of 16.3 years (SD 0.38) were included in our analysis. Statistical analysis was by multiple linear and logistic regression. FINDINGS: The sport and vigorous recreational activity index was positively associated with emotional wellbeing independently of sex, social class, health status, and use of hospital services. These associations were significant for the psychological symptom subscale of the malaise inventory (regression coefficient -0.024, 95 percent Cl -0.036 to -0.011, p<0.001) and the GHQ (odds ratio of emotional distress per unit increase in vigorous physical activity 0.992, 95 percent Cl 0.985-0.998, p<O.O1). By contrast, participation in non-vigorous activities was associated with high psychological and somatic symptoms on the malaise inventory. INTERPRETATION: We conclude that emotional wellbeing is positively associated with extent of participation in sport and vigorous recreational activity among adolescents. Although causal associations cannot be assumed in this cross-sectional analysis, our results are consistent with experimental evidence that vigorous exercise has favourable effects on emotional state.

Adolescent↗

PubMed1996

Cigarette smoking and psychophysiological stress responsiveness: effects of recent smoking and temporary abstinence.

Studies comparing the cardiovascular function and stress responsiveness of regular smokers and non-smokers have produced mixed results, possibly because of variable intervals between stress tests and recency of smoking. This experiment compared the cardiovascular, cortisol and affective responses to a problem solving task of non-smoking young men (n = 16) and regular smokers randomised to overnight abstinence (n = 14) and smoking 30 min prior to testing (n = 19). Smoking status was validated biochemically. Overnight abstinence was associated with reduced diastolic blood pressure at rest and with enhanced diastolic pressure and emotional responses to the task compared with other conditions. Recent smokers showed elevated heart rates, suppressed cardiac baroreceptor reflex sensitivity and reduced cortisol responsiveness, but did not differ from non-smokers in blood pressure responses. The behavioral performance of the abstinent group was impaired, and their craving was greater than that of recent smokers. Both groups of smokers reported more dysphoric mood than non-smokers, and showed only limited recovery of emotional equilibrium following tests. The results are discussed in relation to mechanisms linking smoking, stress responsiveness and cardiovascular disease risk. The methodological implications for including regular smokers in psychophysiological studies are also considered.

Adult↗

PubMed1996

Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise.

The effects of academic examination stress on health behavior was assessed in university students. It was hypothesized that the anticipation of examinations would lead to increases in cigarette smoking and alcohol consumption, and to decreases in physical activity, and that effects would be particularly salient in students with low social supports. One hundred eighty students were divided into exam-stress (51 women, 64 men) and control (49 women, 16 men) groups, and were assessed at baseline and then within 2 weeks of exams, or an equivalent point for the control group. Perceived stress, emotional well-being and health behaviors were assessed by questionnaire and interview. The exam-stress group reported significant increases in perceived stress and emotional distress between baseline and exam sessions, but responses were not affected by social support availability. The controls showed no systematic changes in health behaviors. In the exam-stress group, smoking increased by an average of 54.7% between sessions in women with few social supports, but remained stable in men. There was a decrease in alcohol consumption of 17.5% in students with high social support between sessions, while those with low social supports showed an average increase of 18.5%. Physical activity decreased between baseline and exam sessions in the exam-stress group, but was not affected by social support. The results are discussed in relation to the effects of naturally occurring episodic stress on health behaviors, and the role of social support in moderating responses.

Adaptation, Psychological↗

PubMed1996

The effects of stress management on the quality of life of patients following acute myocardial infarction or coronary bypass surgery.

The objective of this study was to assess the impact of group-based stress management training on emotional well-being, functional status, social activity and chest pain in cardiac patients, within a randomized controlled trial. Fifty acute myocardial infarction and 50 coronary artery bypass patients were randomized to experimental (27 myocardial infarction and 23 coronary artery bypass) and control (23 myocardial infarction and 27 coronary artery bypass) groups 3 months after infarction or surgery. Experimental patients underwent a 10-week relaxation-based stress management programme, while the controls received normal care. Following assessment at the end of the treatment period, controls were offered the stress management programme. Follow-up data were collected 6 months post-treatment from both groups. Significantly greater improvements in emotional well-being as assessed on the Hospital Anxiety and Depression scale (P < 0.005) and the Psychological General Well-being Index (P < 0.001) were found in the experimental than control groups, and improvements were maintained at 6 month follow-up. Greater improvements were also recorded in experimental than control groups in activities of daily living (P < 0.005), satisfaction with health (P < 0.025), reports from spouses or relatives of patients' emotional state (P < 0.001), and in disruption due to chest pain (P < 0.001). Similar responses to stress management were observed in myocardial infarction and coronary artery bypass patients. When controls underwent treatment, they too showed significant reductions in anxiety and depression, but no changes in social or functional status. We conclude that stress management training may lead to improvements in the quality of life of myocardial infarction and coronary artery bypass patients. Such programmes might usefully be made available even to patients who have participated in formal rehabilitation.

Activities of Daily Living↗

PubMed1996

Blood pressure publication guidelines. Society for Psychophysical Research.

Blood pressure is one of the most commonly recorded functions in physiology and medicine, and it has become a major variable in recent psychophysiological and behavioral medicine research. Many methods have been developed for the measurement of blood pressure in clinical, laboratory, and natural settings. The broad objectives of this report are to summarize the most critical methodological issues in the measurement of blood pressure and to present principles and recommendations for the evaluation of blood pressure methods and findings in published studies.

Blood Pressure↗

PubMed1996

Cardiovascular risk and responsivity to mental stress: the influence of age, gender and risk factors.

BACKGROUND: Exaggerated cardiovascular and neuroendocrine responses to mental stress may enhance cardiovascular disease risk. Coronary heart disease and hypertension increase in prevalence with advancing age, whereas the excess male/female ratio declines in later middle age. Psychosocial factors may contribute to these changing risk profiles. The hypothesis that cardiovascular and neuroendocrine stress responses are associated with age and gender differences in cardiovascular disease risk was tested. METHOD: 132 healthy men and women from younger (30-40 years) and older (55-66 years) age bands were selected at random from general practice lists. They performed a series of mental stress tests during which blood pressure, heart rate, cardiovascular baroreflex sensitivity, cortisol, respiration patterns and electrodermal activity were monitored. A submaximal exercise test was performed and psychological characteristics were assessed by questionnaire. RESULTS: At rest, systolic and diastolic blood pressure was higher in men than in women, while cardiac baroreflex sensitivity was greater in younger than in older participants. Blood pressure responses to tasks were substantial, with changes from the baseline averaging 18.6/8.11, 26.0/13.5 and 40.7/19.0 mmHg for computerized problem solving, mirror drawing and speech tasks, respectively. Men and women in the older age band did not differ from each other in blood pressure, heart rate or baroreflex sensitivity responses. Systolic blood pressure responses (mean +/- SEM) were larger in older than in younger women (mean peak difference 6.87 +/- 2.67 mmHg), and in the younger male compared with the younger female groups (mean peak difference 7.20 +/- 2.97 mmHg). Diastolic blood pressure and heart rate responses to mental stress were larger in younger than in older age participants of both sexes. Baroreflex sensitivity was inhibited during behavioural tasks, with significantly greater suppression in younger than in older groups (5.28 +/- 0.52 and 2.62 +/- 0.35 ms/mmHg, respectively). Cortisol responses were greater in men than in women, but did not vary with age. Across the entire sample, systolic blood pressure responsivity was negatively related to the expression of anger. Among older men, heightened blood pressure responses were associated with elevated fasting low-density lipoprotein cholesterol levels, and with lower concentrations of high-density lipoprotein cholesterol. CONCLUSIONS: Systolic blood pressure stress responsivity increases with age in women but not in men. Other data do not support the notion that stress responsivity mediates age and gender differences in cardiovascular disease risk. However, in middle-aged men, ex-aggerated cardiovascular stress responsivity is associated with an unfavourable risk profile.

Adult↗

PubMed1995

Development of a measure of the motives underlying the selection of food: the food choice questionnaire.

A number of factors are thought to influence people's dietary choices, including health, cost, convenience and taste, but there are no measures that address health-related and non-health-related factors in a systematic fashion. This paper describes the development of a multidimensional measure of motives related to food choice. The Food Choice Questionnaire (FCQ) was developed through factor analysis of responses from a sample of 358 adults ranging in age from 18 to 87 years. Nine factors emerged, and were labelled health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity and ethical concern. The questionnaire structure was verified using confirmatory factor analysis in a second sample (n = 358), and test-retest reliability over a 2- to 3-week period was satisfactory. Convergent validity was investigated by testing associations between FCQ scales and measures of dietary restraint, eating style, the value of health, health locus of control and personality factors. Differences in motives for food choice associated with sex, age and income were found. The potential uses of this measure in health psychology and other areas are discussed.

Adolescent↗

PubMed1995

Tobacco smoking in young adults from 21 European countries: association with attitudes and risk awareness.

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.

Adolescent↗

PubMed1995

Cardiovascular stress reactivity and job strain as determinants of ambulatory blood pressure at work.

OBJECTIVE: To test the hypothesis that cardiovascular reactivity to laboratory mental stressors interacts with job strain in predicting blood pressure at work. DESIGN: Ambulatory monitoring of blood pressure and heart rate was carried out for an 8-h period on a work day and on an equivalent non-work day in 49 male firefighters. METHODS: Participants were recruited from a larger cohort (n = 90) on the basis of showing high or low systolic reactions to mental arithmetic 15-24 months previously, coupled with high or low ratings of perceived job strain (high demand-low control). Four groups were tested: low job strain-low systolic reactors (n = 12), low job strain-high systolic reactors (n = 12), high job strain-low systolic reactors (n = 12) and high job strain-high systolic reactors (n = 13). RESULTS: Systolic blood pressure (SBP) was higher on work than non-work days, and diastolic blood pressure and heart rate were higher at work in the morning but not in the afternoon. These effects were due partly to posture and physical activity differences between the two days. Neither job strain nor laboratory reactivity independently predicted ambulatory blood pressure. However, SBP was significantly higher during the afternoon at work in the high job strain-high systolic reactors than in the other groups. This was independent of baseline SBP, and was not due to differences in posture or activity at the time of recordings. Ambulatory SBP reactivity (difference between ambulatory values and workplace resting levels) in the afternoon at work was also elevated significantly in high job strain-high systolic reactors compared with in the other groups. CONCLUSIONS: The results support the hypothesis that individual differences in the appraisal of work stress modulate the relationship between stress reactivity and ambulatory blood pressure.

Adult↗

PubMed1995

Breast self-examination: attitudes and practices among young women in Europe.

Breast self examination (BSE) is recommended for the early detection of breast cancer in the European Code against Cancer. Evidence from North America suggests that there is reasonable public awareness of its importance, but compliance with regular BSE is reported by only a minority of young women. Attitudes to and practice of BSE has rarely been studied outside North America. In the present study, attitudes to BSE were evaluated by questionnaire in a sample of 16,486 students aged 17-30 from 20 European countries. Frequency of BSE practice was reported by the 9,181 women in the sample. Information on public recommendations concerning BSE was obtained from cancer organizations in each country. The data were collected as part of the European Health Behaviour Survey, an international study on health beliefs and health behaviour. The results showed that BSE was recommended in 16 countries and 'breast awareness' in two, while two countries did not recommend self-examination. 54% of women reported as never having practiced BSE. Regular practice (monthly) was reported by only 8% of the sample, with another 36% reporting occasional BSE. Significant differences emerged between centres in different countries ranging from 6% to 15% reporting regular BSE. Attitude towards BSE was a significant predictor of BSE practice within each centre and across all centres combined. Attitudes towards BSE were significantly less positive in the two centres from countries without BSE recommendations than in the others, but levels of practice were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Weight concerns and eating patterns: a survey of university students in Europe.

OBJECTIVE: To assess a wide range of health-related behaviours, beliefs and knowledge in educated young adults. DESIGN: A standardized questionnaire was developed, translated, and administered in university classes. SUBJECTS: 16,486 university students in 21 European countries. DEPENDENT VARIABLES: Reported and self-perceived body size, eating practices and weight concerns. RESULTS: Body Mass Index (BMI; weight (kg)/height (m)2) was slightly different between countries, and rather low overall (20.5 in women and 22.0 in men). These low values can be attributed to the young age of respondents (21.4 years) and to their presumably high socio-economic status. Very few were overweight (8%) and less than 1% were obese. In spite of the low BMI, many perceived themselves as overweight, especially among women. Trying to lose weight (44% of women, 17% of men) and dieting (14% in women and 3% in men) were not uncommon, although large differences existed between countries. Dieting affected snack and meal patterns: dieters reported fewer snacks and female dieters also reported fewer meals than non-dieters. Breakfast was skipped by almost twice as many dieters as non-dieters. Some evidence of anorexia nervosa (dieting in very underweight individuals) appeared. CONCLUSION: The data suggest excessive responses to weight loss pressures and imperfect translation of nutritional advice into behaviours.

Adolescent↗

PubMed1994

Testicular self-examination: attitudes and practices among young men in Europe.

BACKGROUND: Testicular self examination (TSE) is recommended for the early detection of testicular cancer. Evidence from North America suggests there is only limited public awareness of its importance among the young male population. Compliance with regular TSE is found in only a small minority of young men. Attitudes toward and practice of TSE have rarely been studied outside North America. METHOD: Attitudes to TSE were evaluated by questionnaire in a sample of 16,486 students. Frequency of TSE practice was reported by the 7,304 men in the sample. The data were collected as part of the European Health Behavior Survey, an international study on health beliefs and health behavior. RESULTS: Eighty-seven percent of men reported never having practiced TSE. Regular practice (monthly) was reported by only 3% of the sample, with another 10% reporting occasional TSE. Significant differences emerged between countries, ranging from 76% of German men to 98% of Icelandic men reporting no TSE. Men rated TSE as less important to health than women. Attitude toward TSE among men was a significant predictor of TSE practice. CONCLUSION: Both the low levels of TSE and the low ratings of the importance of TSE suggest that young men in Europe are unaware of the value of this comparatively simple method of early detection of cancer. If a highly educated population group in the "at risk" age category is not carrying out the recommendations, it is unlikely that there are higher levels of compliance in other groups. These results suggest an important role for health education in the early detection of testicular cancer.

Adolescent↗

PubMed1994

What the experts think: a European survey of expert opinion about the influence of lifestyle on health.

This paper describes an assessment of expert medical and epidemiological opinion about the role of lifestyle in health, carried out by means of a questionnaire survey of senior members of academic departments of public health, epidemiology and social medicine in Western European universities. Estimates were made of the influence of eight lifestyle factors--smoking, alcohol consumption, exercise, stress, body weight, dietary fat, fibre and salt--on the aetiology or course of five disorders: heart disease, high blood pressure, lung cancer, breast cancer and diabetes. One hundred and fifty responses were received from scientists and clinicians from 16 countries. Respondents had an average of 17.8 years experience in their discipline (range 5-40 years). The only links to be endorsed as definite by over 90% of respondents were those between smoking and both heart disease and lung cancer. However, more than 70% considered alcohol consumption, exercise, stress body weight and dietary fat to be definite or probable influences on heart disease. Smoking, alcohol, exercise, stress, body weight and salt intake were endorsed as relevant to high blood pressure by more than 70%. Opinions differed widely about the influence of lifestyle on breast cancer and diabetes. Experts from the United Kingdom and Republic of Ireland were less positive than respondents from other countries about the influence of stress, dietary fat, fibre and salt on disease. The results indicate that comparatively few lifestyle factors were believed to be unequivocally related to any of the five disorders. Experts from the UK and Ireland were generally les likely to endorse lifestyle-disease links than those from other European countries.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗