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Biomedical subjects

W Linden

Publications and source records attributed to W Linden.

51 records · Page 3Linked to original sources
PubMed1983

Essential hypertension and social coping behavior: experimental findings.

The present study investigated the hypothesis that mild hypertensives display a distinctive response pattern to interpersonal stress that includes: inadequate social skills, negative cognitive set and cardiovascular hyperreactivity. After completing a set of questionnaires measuring anxiety and cognitive style, subjects monitored interpersonal stress in the natural environment. Following this, blood pressure and heart rate were recorded while subjects interacted with trained role-players in two types of role-play situations: individualized high distress and low distress situations. Hypertensives reported comparable anxiety and were evaluated as equally skilled when compared to normotensives. The cognitive reaction pattern however, discriminated between the groups with hypertensives perceiving less stress and displaying a 'repressive-defensive' cognitive style. Hypertensives displayed a hyperresponse on systolic blood pressure but not on heart rate. With regard to diastolic pressure, controls reacted according to prediction with high distress situations resulting in greater diastolic change than low distress situations. Hypertensives, however, showed the reverse of this pattern with no increase in diastolic pressure during the high distress situations.

Adult↗
PubMed1981

Exposure treatments for focal phobias. A review.

The effectiveness of in vivo exposure is evaluated in a comprehensive review of outcome studies on phobia treatments. A strictly data-based analysis focuses on issues of analog vs clinical research, methodological quality of designs, utilization of generalized measures, and maintenance of therapeutic change. In vivo exposure appears to be an effective treatment, both short- and long-term, and some decision rules for the clinical application are provided. However, from a researcher's point of view many methodological weaknesses (such as frequent lack of follow-up; unrealistic behavioral measures; and the utilization of unnecessarily complicated, and at times confusing, designs) are noted. A considerable consensus on the major procedural variables and on positive overall outcome justifies the clinical utility of the procedure. Detailed suggestions for further treatment comparisons are outlined, and a cautionary note on the potential of such a data-based review are added.

Behavior Therapy↗
PubMed1981

Essential hypertension and social coping behavior.

Experimental studies of personality as a psychological risk factor in essential hypertension are reviewed. While no single personality trait has been found to be consistently and specifically related to hypertension, a certain behavior pattern emerges from this literature. This pattern, which includes increased anxiety, inappropriate coping behaviors in socially distressing situations and, possibly, a negative cognitive set, is compared with experimental findings from social competence research. Considerable overlap between the pattern of behavioral characteristics of hypertensives and individuals who display deficits in social skills is noted. The flight/fight concept in stress research, the differentiation of assertion from aggression and inhibition and their physiological equivalents are integrated in a three-dimensional model of social functioning in hypertensives. The clinical implications of this conceptualization are discussed in reference to the need for more comprehensive behavioral approaches to hypertension management.

Adaptation, Psychological↗
PubMed1981

[Transplantation of human renal adenocarcinoma tissue on the nude mouse (author's transl)].

Tissues of human renal cell carcinoma and of its lymph-node metastases were transplanted between the 1st and the 4th passage on 80 nu/nu mice. Growth of tumor was observed in all cases. Chromosomal analyses proved the tumor origin of the transplants. The primary tumor showed two histological patterns: a granular solid cell carcinoma and sarcomatoid elements. The lymph nodes showed only sarcomatoid tissue of the primary tumor. Light-and electron-microscopic examinations showed that the transplanted tumor contained only the sarcomatoid tissue of the original tumor. The solid carcinomatous tissue was not found and, therefore, probably not transplanted. Flow cytometric investigations of the primary tumor revealed two cell populations with a DNA content of 6 and 10.8 pg. Both cell colonies were also discovered in the transplanted tumors as well. The transplants of the primary tumors grew significantly slower than those of the lymph-node metastases. After an initial inert phase, the transplanted tumors grew more rapidly in the male than in the female animals. Neither hematogenous nor lymphatic metastases were observed. After local excision, recurrent tumor development was found in 80% of the experimental animals.

Adenocarcinoma↗
PubMed1975

Volvulus of the cecum.

A series of 37 patients with cecal volvulus treated at three different Swedish hospitals during the years 1952-1973 is presented. The symptoms, physical findings and radiologic features are presented. The associated factors found at operation are described and their possible role in provoking torsion is discussed. In 5 patients the idagnosis did not become clear untio autopsy. Thirty-two patients were subjected to operation. The operation consisted of detorsion in 11 cases, cecopexy in 10, cecostomy in 3 and cecopexy plus cecostomy in 3 patients. The remaining 5 patients were subjected to right sided hemicoloectomy. Of these 5 patients one died postoperatively. There were 6 postoperative deaths after other forms of surgery. The survivors were followed, and the mean followup period was 7 years. There was recurrence in only two patients, both treated with cecopexy. The controversial problem of the preferable surgical method is discussed and a review is given of results in series reported during the last 15 years. It was concluded that when the bowel is viable, cecopexy is the treatment of choice while hemicolectomy should be performed in cases with gangrene.

Adolescent↗
PubMedDate not supplied

Psychological treatments in cardiac rehabilitation: review of rationales and outcomes.

OBJECTIVE: In this review, the place of psychological interventions in cardiac rehabilitation and differences in underlying rationales are presented. Treatment approaches vary in that some practitioners favor biobehavioral approaches with strong relaxation/breathing components, whereas others offer unstructured support, psychoeducation to maximize compliance, or psychological interventions directed at reducing emotional distress. METHODS: The effectiveness of psychosocial rehabilitation for endpoints like mortality, recurrence, emotional distress, and intermediate hard endpoints is reviewed by integrating conclusions from narrative and meta-analytic reviews as well as recent major clinical trials. RESULTS: The aggregated findings support the use of psychosocial interventions and they also help to explain critical differences in outcome in that studies which fail to reduce distress also fail to lead to reduced mortality or reduced event recurrence. CONCLUSION: Gender differences in outcome and recent trends in cardiology are discussed because both have distinct consequences for the effective delivery of psychological services to cardiac patients.

Behavior Therapy↗
PubMedDate not supplied

Stress management for patients with heart disease: a pilot study.

OBJECTIVE: To conduct a feasibility study on stress management for patients with heart disease; more specifically, to test the availability of patients, determine dropout rates, and investigate the sensitivity to change of a large number of psychologic and biologic stress indexes. DESIGN: Random assignment, two-group clinical trial. SETTING: Pacific Northwest university-affiliated teaching hospital. PATIENTS: Forty-five patients with heart disease (mean age 56 years), who either had a myocardial infarction or coronary bypass surgery. OUTCOME MEASURES: Hostility, subjective distress, resting electrocardiogram, resting blood pressure and blood pressure reactivity to a psychologic stressor, and blood lipid, cortisol, and catecholamine levels. INTERVENTION: Patients were randomly assigned to either (1) exercise rehabilitation (ER) and an 8-week stress management (SM) program (ER + SM) or (2) ER only. Although the recruitment rate was satisfactory, 67% of patients assigned to the control condition and 40% of the SM subjects were not available for posttesting. RESULTS: Computed effect sizes indicated that blood pressure reactivity to a psychologic challenge was reduced after treatment in the ER + SM group but not in ER group. The ER + SM group showed improvement in perceived health status and had clinically meaningful reductions in triglyceride levels, whereas the ER group did not. The ER group had a reduction in high-density lipoproteins, whereas the high-density lipoprotein levels of the ER + SM group did not change. CONCLUSIONS: Patients randomly assigned to a control condition may be less willing to participate in time-consuming and invasive posttests than treated patients. Reducing the invasiveness of measurement may increase cost-effectiveness and reduce the dropout rate under controlled conditions. Blood pressure reactivity to a psychologic stress test and changes in serum lipid levels may be sensitive and cost-effective measures to include in future studies of cardiac rehabilitation.

Adult↗
PubMedDate not supplied

A microanalysis of autonomic activity during human speech.

The objective of the current study was to untangle the effects of a number of variables likely to affect autonomic activation during human speech. Thirty-one young adults completed four tasks: 1) talking aloud with an experimenter about a personally relevant topic; 2) counting aloud with the experimenter present; 3) counting aloud while alone; and 4) counting subvocally while alone. Cardiovascular activity was monitored with a digitized, real-time microcomputer-based signal-processing system. Measures included systolic and diastolic blood pressures, heart rate, blood volume pulse, T-wave amplitude monitoring of ECG signals, as well as respiration rate and amplitude. Overall, the measures consistently indicated that 1) the motor efforts required for speech production in a truly low-distress situation were associated with a low level of autonomic activation that exceeded baseline levels only on blood volume pulse and respiration amplitude; 2) experimenter presence significantly enhanced the blood volume pulse response but did not affect any other autonomic index; and 3) talking about personally relevant material triggered dramatically larger responses on nearly all autonomic indices. It is concluded that the motor efforts required for speech production are of minor importance in predicting autonomic responses to tasks involving speech. Speech content (i.e., affect related vs. neutral) has, however, significant impact on autonomic activation during speech.

Adult↗
PubMedDate not supplied

Gender, anger expression style, and opportunity for anger release determine cardiovascular reaction to and recovery from anger provocation.

This study represents an extension of Hokanson's research, which showed that for men anger release after provocation tends to accelerate cardiovascular recovery. The objective of this study was to investigate how gender and habitual style for anger-in or anger-out behavior modulate the effect of anger provocation and release. Male and female subjects (N = 105) were classified as anger-in/anger-out only when a double criterion (i.e., self-report and peer evaluation) was satisfied. Following a state anger rating at pre-test, subjects were harassed during the performance of a 12-minute math task. After task completion, subjects were randomly assigned to one of two 10-minute recovery protocols a) having an opportunity to release negative affect, and b) not not having such an opportunity. All groups (including the anger-ins) that had an opportunity to express negative affect did in fact express similar levels of anger. Men reacted more strongly to the math task performed under anger provocation on all cardiovascular indices. Anger expression style as a trait-type disposition was important for the recovery process in women whereas the situational manipulation (i.e., the opportunity to release anger) had specific effects on the recovery process of men. Opportunity to release anger facilitated heart rate recovery (and to a lesser degree diastolic pressure recovery) in men but not in women. Women with anger-in tendencies on the other hand displayed better systolic pressure recovery than female anger-outs whereas no such effects were observed in men.

Adjustment Disorders↗
PubMedDate not supplied

Social support effects on cardiovascular reactivity: is a stranger as effective as a friend?

OBJECTIVE: We investigated whether the effects on cardiovascular reactivity of social support from an audience member depend only on the behavior of that person or also depend on the relationship between the audience and the actor. That is, is there any added reduction in physiological response if the person who is nodding and smiling supportively is also a friend? METHOD: Ninety subjects gave a speech to an observer. In two of the conditions, this observer was a confederate of the experimenter and a stranger to the subject. This confederate acted in either a supportive or neutral manner during the speech. In the final condition, this observer was a friend, brought by the subject, who was then trained to show support in the same manner as the supportive confederate. The comparison of the two confederate conditions tested the effect of support, holding the relationship constant. The comparison of friend and confederate supportive conditions tested the effect of the relationship, holding the supportive behaviors constant. All participants were female. RESULTS: Both supportive conditions produced significantly smaller cardiovascular increases than the confederate-neutral condition, and the friend-supportive condition produced significantly smaller systolic blood pressure increases than the confederate-supportive (friend-supportive: 7.9 mm Hg: confederate-supportive: 14.9 mm Hg; confederate-neutral: 22.9 mm Hg). Differences for diastolic pressure and heart rate were not significant, although the data followed the same pattern. CONCLUSIONS: Social support from a friend attenuated cardiovascular reactivity in a laboratory setting to a greater degree than support from a stranger. The subjects' construal of the supportive behaviors can have an effect on reactivity, over and above the effects of the actual behaviors themselves.

Adolescent↗
PubMedDate not supplied

Psychological risk factors may moderate pharmacological treatment effects among ischemic heart disease patients. Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) Investigators.

BACKGROUND: Numerous research findings support the proposed connection between such psychological characteristics as stress and hostility and the manifestation of disease. However, less evidence is available concerning the role(s) psychological factors might play in the process of disease recovery. METHODS: Eighty patients with known coronary disease and exercise-induced ischemia underwent treadmill exercise testing and 48-hour ambulatory electrocardiographic monitoring and completed a battery of standardized psychological tests assessing hostility, depression, and daily stress on four occasions during a 12-week pharmacological treatment study. After withdrawal of antiischemic drugs at baseline, patients returned for subsequent tests at 3-week intervals. During the second and third intervals, patients were prescribed one of two antiischemic medications, atenolol or amlodipine, or given a placebo. All patients were then placed on a combination treatment protocol for the 3 weeks before the final testing date. RESULTS: The combination treatment produced highly significant benefits across all measured cardiac variables (20.3% improvement in exercise performance, 13% reduction in reported angina, 64.0% reduction in the frequency of ischemic episodes; for all, p < .01). However, results showed that high baseline levels of daily stress were associated with reliably smaller treatment effects on measures of ischemia frequency and treadmill exercise time and with a significantly greater likelihood of reporting angina after treatment (r = -0.24, -0.25, and -0.33, respectively; p <.05). In addition, high baseline hostility predicted significantly smaller diastolic blood pressure improvements (r = -0.29, p < .05). CONCLUSIONS: These results indicate that psychological risk factors may have globally negative effects on the course of treatment and suggest particular factors that may warrant attention in trials targeting cardiac symptom reduction.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Cardiovascular recovery from acute laboratory stress: reliability and concurrent validity.

OBJECTIVE: We assessed the value of laboratory measures of cardiovascular recovery across four criteria: reliability across multiple tasks, reliability across a 3-year time interval, ability to predict daily ambulatory blood pressure, and interrelationships with coronary risk factors and psychosocial variables. METHODS: Three hundred twenty-nine healthy adults (mean age = 27.1 years) completed a two-part protocol consisting of 1 day of laboratory testing and 1 day of ambulatory monitoring. The laboratory protocol included a 15-minute baseline assessment followed by three 5-minute laboratory challenges (mental arithmetic, speech, and handgrip). Five-minute recovery periods followed each exercise. One hundred twenty-five participants returned after 3 years to repeat the protocol. RESULTS: When aggregated across tasks, cardiovascular recovery showed acceptable levels of internal consistency (alpha values = 0.7) and proved relatively stable across time (r values = 0.22-0.35). Recovery values statistically improved the prediction of daily ambulatory readings above baseline and stress reactivity laboratory values (p values < .001) but were largely unrelated to coronary risk factors or psychosocial measures. CONCLUSION: These results suggest that cardiovascular recovery from acute laboratory stress can be treated as a stable individual difference variable that can -improve standard laboratory-based predictor models of ambulatory readings.

Acute Disease↗
PubMedDate not supplied

The psychology of men and women recovering from coronary artery bypass surgery.

BACKGROUND: Little is known about the differences between men's and women's cardiac rehabilitation processes. What helps men during recovery may not necessarily aid women's recovery. Psychosocial variables are known to impact recovery in positive and negative ways. Unfortunately, it is not clear what variables are the most effective predictors of recovery outcomes for men and women. METHODS: Ninety coronary artery bypass graft patients (60 men, 30 women) completed a battery of psychological questionnaires on or after the third day after surgery. RESULTS: Results showed that women reported significantly more depressive symptoms than men. For women, pain was correlated positively with depressive symptomatology and functional impairment. For men, pain and functional impairment were correlated negatively with social support. In addition, the results of a multiple regression of pain on age, severity of disease, and two psychosocial variables (depressive symptomatology and social support) for the women showed that after controlling for age and severity of disease, depressive symptomatology and social support accounted for a significant 43% increment in the variance in pain. The psychosocial variables accounted for much less variance in pain in men. However, in a multiple regression of functional impairment on the same variables, depressive symptomatology and social support accounted for a significant 14% increment in the variance in pain in men but a nonsignificant increment for the women. CONCLUSIONS: The results support the notion that psychosocial variables play different roles in the recovery paths of men and women. In consequence, cardiac rehabilitation programs would be more effective with gender-specific tailoring.

Aged↗