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Biomedical subjects

P M Lehrer

Publications and source records attributed to P M Lehrer.

18 recordsLinked to original sources
PubMed1992

Panic symptoms in asthma and panic disorder: a preliminary test of the dyspnea-fear theory.

Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) dyspnea-fear theory was tested on three groups of subjects: 10 with panic disorder, 24 with asthma, and 12 who were nonanxious and nonasthmatic, using measures of pulmonary function, muscle tension; and self-report measures of generalized anxiety, dyspnea, and psychopathology. Results are supportive of dyspnea-fear theory for asthmatics but not for individuals with panic disorder. Differences between groups on panic/fear measures were explained by a combination of general anxiety and dyspnea. Within-group regression analyses showed that only generalized anxiety symptoms contributed significantly to scores on the Asthma Symptom Checklist scale of panic/fear within the panic disorder group; while only dyspnea contributed to panic/fear among asthmatics. Additional results show that panic disorder subjects performed normally on pulmonary function tests but reported respiratory symptoms as severe as did asthmatics. Compared with normal subjects, both patient groups displayed lower correlations between self-rated symptoms of bronchoconstriction and objective pulmonary measures. Panic disorder subjects showed a negative relationship between pulmonary function and hyperventilation symptoms, suggesting a heightened sensitivity to, and discomfort with, sensations associated with normal pulmonary function. Asthmatics displayed a significant relationship between degree of airway obstruction and both trapezius surface EMG and ratings of hyperventilation symptoms.

Age Factors↗
PubMed1992

The effects of suggestion on airways of asthmatic subjects breathing room air as a suggested bronchoconstrictor and bronchodilator.

Thirty-three asthmatic subjects were told they were receiving, alternately, an inhaled bronchoconstrictor and inhaled bronchodilator, although they actually were only breathing room air. No subjects showed suggestion-produced effects on FEV1, although two (of the 19 on whom FEF50 was measured) showed effects of greater than 20% on measures of maximal midexpiratory flow. The incidence of the effect is smaller than reported previously, possibly because some subjects in previous studies inhaled saline, a mild bronchoconstrictor, and reversal of effect was not required for classification as a reactor. Higher percentages of subjects in this study showed decreased MMEF in response to the 'bronchoconstrictor', but this appeared to reflect fatigue rather than suggestion effects. However, the fact that the effect occurred in a relatively non-effort-dependent measure suggests that real changes occurred in bronchial caliber, not just in test effort. Suggestion had a significant effect on perception of bronchial changes, but the correlation between actual and perceived changes was minimal. There was an increase in FVC prior to administration of the 'bronchoconstrictor', possibly reflecting a preparatory response to the expected drug. Correlations among self-report variables suggested the existence of three personality dimensions among our population related to suggestion and asthma: cognitive susceptibility to suggestion of bronchial change; feeling of physical vulnerability; and anxiety. However, there was no significant relationship between airway response to suggested changes and hypnotic susceptibility, as measured by the Harvard Group Scale of Hypnotic Susceptibility.

Airway Resistance↗
PubMed1992

Psychological approaches to the treatment of asthma.

Outcome literature on psychological treatment for asthma covers psychoeducational self-management programs, relaxation therapy, biofeedback, and family therapy. Psychoeducational approaches now being standardized in a national program are cost-effective. They produce improved adjustment, increased medication compliance, greater perceived self-competence in managing symptoms, and decreased use of medical services. Significant effects have been found for relaxation therapy, although it is not clear whether the effectiveness depends on whole-body relaxation or specifically facial- or respiratory-muscle relaxation. Family therapy is helpful to some asthmatics. Active components in these methods remain to be identified as do the populations whom they can best serve. Biofeedback for respiratory resistance, trachea sounds, and vagal tone shows promise but has not been given adequate clinical testing.

Asthma↗
PubMed1991

Psychophysics of muscle tension in psychiatric inpatients.

Twelve psychiatric inpatients and 16 control subjects each took part in a psychophysics experiment in which the method of production was used to study the perception of tension in the frontalis and forearm extensor muscles. Subjects tensed each muscle between 0% and 50% maximum effort, with 25% effort repeated every third trial, and used as a reference stimulus. Patients showed significantly lower correlations between frontalis EMG and percent effort than the control subjects, but no between-groups differences were found for forearm. Correlations were higher for differences between successive trials than for absolute values because of apparent baseline shifts in perception and/or production of muscle tension. The performance among the patients was not correlated with severity of psychiatric symptoms, antipsychotic medication, abnormal movements, or parkinsonian symptoms, although the n was small. Analysis of the regression of EMG on percent effort revealed approximately equal descriptive strength for three functions: a linear relationship, Stevens' power function, and Fechner's law. The implications of these findings for self-regulation therapies are discussed.

Adult↗
PubMed1991

Stress reactivity and perception of pain among tension headache sufferers.

Twenty-one tension headache sufferers and 21 control subjects were exposed to a series of psychological stressors and an ischemic pain task, involving a tourniquet around the arm. Compared to control subjects, headache patients showed higher heart rates and evidence of more prolonged vasoconstriction in the hands and the ear lobe. No between-group differences in EMG were found, however. Headache patients rated the tourniquet as more painful than did control subjects, and described themselves as more anxious, angry, and depressed. The pattern of results is consistent with the interpretation that headache patients are emotionally and autonomically hyperreactive to pain and to psychological stress.

Adult↗
PubMed1990

Headache versus nonheadache state: a study of electrophysiological and affective changes during muscle contraction headaches.

Seventeen carefully screened muscle contraction headache sufferers were tested in both the headache and the nonheadache state. At baseline, forehead and trapezius EMG were higher, whereas finger temperature and finger blood volume were lower in the headache than the nonheadache state. At a borderline level, physiological reactivity was greater during the headache than the nonheadache state in response to a reaction-time stressor. During the headache state, subjects also reported themselves to be more anxious, depressed, and angry than they were in the nonheadache state and said they felt themselves to be more hassled by external stressors and less able to cope with, prevent, and control their headaches. The findings are consistent with the notion that shoulder/neck tension and emotional arousal contribute to tension headaches. Evidence is less clear for the contribution of vasomotor factors and general physiological reactivity.

Adult↗
PubMed1989

Physiological response patterns to cognitive testing in adults with closed head injuries.

Physiological measures were taken from 7 closed-head-injured patients and 7 control subjects while they took a series of cognitive tests: the finger tapping test from the Halstead Reitan battery, the Digit Symbol test from the WAIS-R, a test of logical memory, and a paced arithmetic test. Physiological reactivity was assessed relative to rest periods, which occurred at the beginning and end of each session. The tests and physiological assessment were administered twice, approximately one month apart. The patient group performed more poorly on the cognitive tests, and showed less physiological reactivity during them than did the control group. This pattern was statistically significant for heart rate, frequency of electrodermal responses, and, during the initial session, respiration rate. The control group also showed greater finger pulse amplitude during the first posttest rest period in the first session, and greater constriction during a logical memory task in the second session. No significant between-groups differences emerged for state or trait anxiety. The patients showed higher frontalis EMG and respiration rate during rest. These results suggest a pattern of poor physiological modulation for task performance in the patients with closed head injuries. The therapeutic implications are discussed.

Adolescent↗
PubMed1989

Hypnotic susceptibility and its relationship to outcome in the behavioral treatment of asthma: some preliminary data.

12 subjects from an experiment on relaxation therapy for asthma were given the Harvard Group Scale of Hypnotic Susceptibility, Form A. Full scale hypnotic susceptibility scores were positively correlated, at a borderline significance, with improvement in the methacholine challenge test, a measure of asthma severity. Performance on the amnesia item of the Harvard Group Scale was correlated with improvement in self-reported symptoms of asthma.

Adult↗
PubMed1987

Gender differences in the relationship between hostility and the type A behavior pattern.

A group of 97 male and 111 female undergraduates completed the Jenkins Activity Survey, the Framingham Type A Scale, the Adjective Checklist Type A Scale, the Spielberger State-Trait Anxiety Inventory, and the Buss-Durkee Hostility Inventory. A factor analysis revealed three dimensions: Anger-Emotionality, Anger-Aggression, and Residual Pattern A. All Type A measures loaded highly on the Type A factor, with the Jenkins Activity Survey loading the highest. The Framingham Type A Scale was related to Anger-Emotionality, the Adjective Checklist Type A Scale was related to Anger-Aggression, and the Jenkins Activity Survey was related to neither of the anger dimensions. Women scored higher than men on Anger-Emotionality and the Guilt, Resentment, and Irritability subscales and lower than men on the Assaultiveness subscale. Women showed higher correlations between Type A and the Guilt subscale, and men between Type A and the Suspiciousness subscale. We conclude that Type A is a multidimensional construct that manifests itself differently in men and women.

Adult↗
PubMed1986

The effects of behavior modification vs lithium therapy on frontal lobe syndrome.

An A-B-BC-C single-subject design was used to evaluate the effects of behavior modification (i.e. a token economy program) and lithium therapy on the behavioral symptoms associated with frontal lobe damage in a 21-year-old woman. The design consisted of a baseline, token economy, token economy plus lithium, lithium alone and a 4 month follow-up. There was a significant decrease in inappropriate behaviors after treatment with the token economy program, but no additional change was noted in subsequent phases involving lithium therapy. There was evidence of generalization and maintenance in the home environment, even after lithium therapy was discontinued. The results do not support the use of a combined treatment approach.

Adult↗
PubMed1986

Relaxation decreases large-airway but not small-airway asthma.

Eleven asthmatic subjects were each offered sixteen sessions of relaxation therapy, consisting of progressive relaxation, desensitization, and EMG biofeedback to the trapezius and frontalis areas, while 9 subjects were offered a complex placebo. Subjects in the relaxation condition showed greater improvement than subjects in the placebo condition in performance on a methacholine challenge test which, as a measure of airway reactivity, reflects degree of asthma. Subjects in both conditions showed improvements in various self-report measures of asthma symptoms and psychopathology. Subject in the relaxation condition reported a significantly greater decrease in frequency of emotional precursors to asthma attacks than subjects in the control condition. Overall improvement on the methacholine challenge test was predicted almost perfectly by heliox spirometry. Only subjects showing predominant large-airway obstruction obstruction improved on the methacholine challenge test. The relative contribution of large airway obstruction to asthma was found to correlate with psychopathology.

Adult↗
PubMedDate not supplied

The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%-40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short-lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n's and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.

Airway Obstruction↗