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1.
Attach Hum Dev ; 21(1): 57-69, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30406721

RESUMO

Individuals' social experiences are associated with their mental health, physical health, and even mortality. Over the last 30 years, researchers have examined the ways in which these social experiences might be associated with chronic inflammation - a component underlying many of the chronic diseases of aging. Little research, however, has examined the role of adults' attachment style as a specific social component that might be associated with inflammation. In the present study, we utilized data from a sample of 59 African-American adults from the Maryland Adolescent Development in Context Study (MADICS) to examine the links between attachment avoidance and attachment anxiety and C-reactive protein (CRP) and interleukin (IL)-6. After controlling for demographic characteristics, body mass index, and depressive symptoms, attachment avoidance and anxiety were associated with IL-6 but not CRP. This study adds to the growing body of research identifying the wide range of social experiences associated with inflammation and further suggests that attachment relationship experiences may have implications for biological processes relevant to many chronic diseases of aging.


Assuntos
Ansiedade/fisiopatologia , Negro ou Afro-Americano , Proteína C-Reativa/biossíntese , Interleucina-6/biossíntese , Apego ao Objeto , Adulto , Ansiedade/etnologia , Depressão/etnologia , Depressão/fisiopatologia , Feminino , Humanos , Inflamação/metabolismo , Relações Interpessoais , Estudos Longitudinais , Masculino
2.
Brain Behav Immun ; 73: 331-339, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29842903

RESUMO

OBJECTIVE: Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e. CD4+ T-cell counts) and psychological outcomes in persons with HIV-1 infection. METHODS: We randomly assigned participants with HIV-1 infection and CD4 T-cell counts >350 cells/µl who were not on antiretroviral therapy in a 1:1 ratio to either an MBSR group (n = 89) or an HIV disease self-management skills group (n = 88). The study was conducted at the University of California at San Francisco. We assessed immunologic (CD4, c-reactive protein, IL-6, and d-dimer) and psychological measures (Beck Depression Inventory for depression, modified Differential Emotions Scale for positive and negative affect, Perceived stress-scale, and mindfulness) at 3, 6 and 12 months after initiation of the intervention; we used multiple imputation to address missing values. RESULTS: We observed statistically significant improvements from baseline to 3-months within the MBSR group in depression, positive and negative affect, perceived stress, and mindfulness; between group differences in change were significantly greater in the MBSR group only for positive affect (per item difference on DES-positive 0.25, 95% CI 0.049, 0.44, p = .015). By 12 months the between group difference in positive affect was not statistically significant, although both groups had trends toward improvements compared to baseline in several psychological outcomes that were maintained at 12-months; these improvements were only statistically significant for depression and negative affect in the MBSR group and perceived stress for the control group. The groups did not differ significantly on rates of antiretroviral therapy initiation (MBSR = 39%, control = 29%, p = .22). After 12 months, the mean decrease in CD4+ T-cell count was 49.6 cells/µl in participants in the MBSR arm, compared to 54.2 cells/µl in the control group, a difference of 4.6 cells favoring the MBSR group (95% CI, -44.6, 53.7, p = .85). The between group differences in other immunologic-related outcomes (c-reactive protein, IL-6, HIV-1 viral load, and d-dimer) were not statistically significant at any time point. CONCLUSIONS: MBSR improved positive affect more than an active control arm in the 3 months following the start of the intervention. However, this difference was not maintained over the 12-month follow-up and there were no significant differences in immunologic outcomes between intervention groups. These results emphasize the need for further carefully designed research if we are to translate evidence linking psychological states to immunological outcomes into evidence-based clinical practices.


Assuntos
Infecções por HIV/psicologia , Atenção Plena/métodos , Estresse Psicológico/terapia , Adulto , Ansiedade/terapia , Contagem de Linfócito CD4/métodos , Linfócitos T CD4-Positivos/imunologia , Depressão/terapia , Feminino , Soropositividade para HIV , Humanos , Masculino , Meditação/métodos , Meditação/psicologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Resultado do Tratamento
3.
J Soc Pers Relat ; 34(8): 1168-1185, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36714796

RESUMO

Within the field of relationship science there is increasing interest in the connections between close relationships and physical health. In the present study, we examined whether adolescents' (~12 years old) and young adults' (~20 years old) perceptions of their parents as a secure base prospectively predict C-reactive protein (CRP), a commonly used marker of inflammatory activity, at age 32 in a well-characterized sample of African Americans. We utilized existing data collected as part of the Maryland Adolescent Development in Context Study (MADICS) to construct measures of perceptions of parental secure base support (SBS), general parental support, and peer support in early adolescence and early adulthood. In the present study, SBS was operationalized as the perceived ability to depend on parents in times of need. Fifty-nine African American MADICS participants who reported on perceived support in early adolescence and early adulthood participated in a follow-up home visit at age 32 during which serum CRP was measured via a blood draw. After controlling for inflammation-related confounds (e.g., tobacco use, body mass index), adolescents' perceptions of parental SBS, but not peer support or general parental support, predicted lower CRP values at age 32 (b = -.92, SE = .34, p < .05). None of the support variables in early adulthood predicted CRP at 32 years. This study adds to a growing literature on relationships and health-related outcomes and provides the first evidence for a link between parental SBS in adolescence and a marker of inflammatory activity in adulthood.

4.
Brain Behav Immun ; 26(7): 1047-56, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22687333

RESUMO

A dynamic systems model was used to generate parameters describing a phenotype of Hypothalamic-Pituitary-Adrenal (HPA) behavior in a sample of 36 patients with chronic fatigue syndrome (CFS) and/or fibromyalgia (FM) and 36 case-matched healthy controls. Altered neuroendocrine function, particularly in relation to somatic symptoms and poor sleep quality, may contribute to the pathophysiology of these disorders. Blood plasma was assayed for cortisol and ACTH every 10 min for 24h. The dynamic model was specified with an ordinary differential equation using three parameters: (1) ACTH-adrenal signaling, (2) inhibitory feedback, and (3) non-ACTH influences. The model was "personalized" by estimating an individualized set of parameters from each participant's data. Day and nighttime parameters were assessed separately. Two nocturnal parameters (ACTH-adrenal signaling and inhibitory feedback) significantly differentiated the two patient subgroups ("fatigue-predominant" patients with CFS only versus "pain-predominant" patients with FM and comorbid chronic fatigue) from controls (all p's<.05), whereas daytime parameters and diurnal/nocturnal slopes did not. The same nocturnal parameters were significantly associated with somatic symptoms among patients (p's<.05). There was a significantly different pattern of association between nocturnal non-ACTH influences and sleep quality among patients versus controls (p<.05). Although speculative, the finding that patient somatic symptoms decreased when more cortisol was produced per unit ACTH, is consistent with cortisol's anti-inflammatory and sleep-modulatory effects. Patients' HPA systems may compensate by promoting more rapid or sustained cortisol production. Mapping "behavioral phenotypes" of stress-arousal systems onto symptom clusters may help disentangle the pathophysiology of complex disorders with frequent comorbidity.


Assuntos
Doença/classificação , Fenótipo , Medicina de Precisão/métodos , Adolescente , Hormônio Adrenocorticotrópico/sangue , Adulto , Algoritmos , Ritmo Circadiano/fisiologia , Interpretação Estatística de Dados , Síndrome de Fadiga Crônica/fisiopatologia , Síndrome de Fadiga Crônica/psicologia , Feminino , Fibromialgia/fisiopatologia , Humanos , Hidrocortisona/sangue , Sistema Hipotálamo-Hipofisário/fisiopatologia , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Sistema Hipófise-Suprarrenal/fisiopatologia , Adulto Jovem
5.
Psychol Sci ; 20(10): 1237-44, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19754527

RESUMO

This study experimentally tested whether a stressor characterized by social-evaluative threat (SET), a context in which the self can be judged negatively by others, would elicit increases in proinflammatory cytokine activity and alter the regulation of this response. This hypothesis was derived in part from research on immunological responses to social threat in nonhuman animals. Healthy female participants were assigned to perform a speech and a math task in the presence or absence of an evaluative audience (SET or non-SET, respectively). As hypothesized, stimulated production of the proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) increased from baseline to poststressor in the SET condition, but was unchanged in the non-SET condition. Further, the increases in TNF-alpha production correlated with participants' cognitive appraisals of being evaluated. Additionally, the ability of glucocorticoids to shut down the inflammatory response was decreased in the SET condition. These findings underscore the importance of social evaluation as a threat capable of eliciting proinflammatory cytokine activity and altering its regulation.


Assuntos
Autoimagem , Comportamento Social , Estresse Psicológico/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto , Análise de Variância , Pressão Sanguínea , Citocinas/sangue , Emoções , Feminino , Glucocorticoides/administração & dosagem , Humanos , Matemática , Fala , Inquéritos e Questionários , Análise e Desempenho de Tarefas , Adulto Jovem
6.
Brain Behav Immun ; 23(1): 1-9, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18809488

RESUMO

There exists a bidirectional network of interactions between the central nervous system, the endocrine system and the immune system. The existence of these pathways allows stressful life experience to impact the immune system with important implications for health. One powerful elicitor of changes in the autonomic, endocrine and immune systems is threat to social status. This review describes the development of a human model of social status threat that specifies a set of contextual, psychological and biological pathways that may underlie the health consequences of threats to social status and regard. The role of cognitive processes in shaping the physiological response to the social world will be emphasized.


Assuntos
Adaptação Psicológica/fisiologia , Neuroimunomodulação/fisiologia , Meio Social , Estresse Psicológico/fisiopatologia , Humanos , Modelos Psicológicos , Neuroimunomodulação/imunologia , Psiconeuroimunologia , Estresse Psicológico/imunologia , Estresse Psicológico/psicologia
7.
Psychosom Med ; 69(3): 225-34, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17401058

RESUMO

OBJECTIVE: To examine the effect of unemployment on natural killer cell cytotoxicity (NKCC) and, in a subsample of persons who become re-employed, to determine if, after termination of the stressor, immune values recover to levels similar to matched controls. METHODS: One hundred unemployed and 100 matched employed healthy men and women, aged 29 to 45 years, were followed for 4 months with monthly blood samples taken to measure NKCC, the ability of NK cells to kill target cells. Twenty-five participants obtained employment before the end of the study, leaving 75 unemployed (and 75 employed) participants in the main sample. For unemployed participants who obtained employment before the end of the study, subsample analyses compared NKCC levels before and after obtaining a new job. RESULTS: The persistently unemployed sample had significantly lower NKCC levels for all three effector:target ratios (100:1, p = .0004; 50:1, p = .002; and 25:1, p = .02) when compared with the matched employed sample. There were no significant gender effects. In the subsample analyses, NKCC was significantly higher after the participants became employed, compared with their unemployed period, with substantial "recovery" of immune function (44%-72%) compared with values from the steadily employed group. CONCLUSIONS: Chronic stress is associated with persistent NKCC impairment. When the chronic stressor is terminated, however, the immune cell functional capacity quickly begins to recover. We believe this is the first study in humans to document immune function recovery after the definable end of a chronic stressor.


Assuntos
Citotoxicidade Imunológica , Emprego , Síndromes de Imunodeficiência/etiologia , Células Matadoras Naturais/imunologia , Estresse Psicológico/imunologia , Desemprego , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Casos e Controles , Doença Crônica , Testes Imunológicos de Citotoxicidade , Economia , Escolaridade , Emprego/psicologia , Etnicidade/estatística & dados numéricos , Exercício Físico , Feminino , Febre/epidemiologia , Seguimentos , Humanos , Síndromes de Imunodeficiência/imunologia , Síndromes de Imunodeficiência/psicologia , Renda/estatística & dados numéricos , Infecções/epidemiologia , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas , São Francisco , Privação do Sono/epidemiologia , Fumar/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Desemprego/psicologia
8.
Pers Soc Psychol Bull ; 33(8): 1088-99, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17578931

RESUMO

Research findings within posttraumatic growth (PTG) and terror management theory (TMT) currently appear contradictory. Following confrontations with mortality, PTG research demonstrates intrinsic goal shifts, whereas TMT suggests extrinsic shifts. The current studies examine factors contributing to these inconsistent results. Study 1 demonstrates that perceived death threat is associated with PTG effects. Study 2 illuminates the importance of duration of death processing. Study 3 demonstrates that existing goal values and duration and type of processing all interact in determining ultimate goal structure, with a match between level of goals and processing producing the most psychologically advantageous outcomes. Although previous research suggests that short-term confrontations with death may lead to defensiveness, the current studies suggest that encountering death over a longer period or in a manner consistent with goal structure may lead individuals to transcend defensiveness and maintain intrinsic goals or become more intrinsically oriented.


Assuntos
Desastres , Medo/psicologia , Objetivos , Mortalidade , Adulto , Idoso , California , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários
10.
Obesity (Silver Spring) ; 24(4): 794-804, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26955895

RESUMO

OBJECTIVE: To determine whether adding mindfulness-based eating and stress management practices to a diet-exercise program improves weight loss and metabolic syndrome components. METHODS: In this study 194 adults with obesity were randomized to a 5.5-month program with or without mindfulness training and identical diet-exercise guidelines. Intention-to-treat analyses with multiple imputation were used for missing data. The primary outcome was 18-month weight change. RESULTS: Estimated effects comparing the mindfulness to control arm favored the mindfulness arm in (a) weight loss at 12 months, -1.9 kg (95% CI: -4.5, 0.8; P = 0.17), and 18 months, -1.7 kg (95% CI: -4.7, 1.2; P = 0.24), though not statistically significant; (b) changes in fasting glucose at 12 months, -3.1 mg/dl (95% CI: -6.3, 0.1; P = 0.06), and 18 months, -4.1 mg/dl (95% CI: -7.3, -0.9; P = 0.01); and (c) changes in triglyceride/HDL ratio at 12 months, -0.57 (95% CI: -0.95, -0.18; P = 0.004), and 18 months, -0.36 (95% CI: -0.74, 0.03; P = 0.07). Estimates for other metabolic risk factors were not statistically significant, including waist circumference, blood pressure, and C-reactive protein. CONCLUSIONS: Mindfulness enhancements to a diet-exercise program did not show substantial weight loss benefit but may promote long-term improvement in some aspects of metabolic health in obesity that requires further study.


Assuntos
Atenção Plena , Obesidade/terapia , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redução de Peso
11.
Psychoneuroendocrinology ; 52: 229-38, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25497480

RESUMO

Anticipation may play a role in shaping biological reactions to repeated stressors-a common feature of modern life. We aimed to demonstrate that: (a) individuals who display a larger cortisol response to an initial stressor exhibit progressive anticipatory sensitization, showing progressively higher cortisol levels before subsequent exposures, and (b) attention/emotional skills training can reduce the magnitude of this effect on progressive anticipatory sensitization. Female school teachers (N=76) were randomly assigned to attention/emotion skills and meditation training or to a control group. Participants completed 3 separate Trier Social Stress Tests (TSST): at baseline (Session 1), post-training (Session 2), and five months post (Session 3). Each TSST session included preparing and delivering a speech and performing an arithmetic task in front of critical evaluators. In each session participants' salivary cortisol levels were determined before and after the stressor. Control participants with larger cortisol reactivity to the first stressor showed increasing anticipatory (pre-stressor) cortisol levels with each successive stressor exposure (TSST session)-suggesting progressive anticipatory sensitization. Yet this association was absent in the training group. Supplementary analyses indicated that these findings occurred in the absence of group differences in cortisol reactivity. Findings suggest that the stress response can undergo progressive anticipatory sensitization, which may be modulated by attention/emotion-related processes. An important implication of the construct of progressive anticipatory sensitization is a possible self-perpetuating effect of stress reactions, providing a candidate mechanism for the translation of short-to-long-term stress reactions.


Assuntos
Antecipação Psicológica/fisiologia , Terapia Cognitivo-Comportamental/métodos , Hidrocortisona/metabolismo , Meditação/métodos , Estresse Psicológico/metabolismo , Estresse Psicológico/terapia , Adulto , Sensibilização do Sistema Nervoso Central/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade
12.
Biol Psychiatry ; 54(12): 1444-56, 2003 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-14675810

RESUMO

BACKGROUND: Epidemiologic studies have identified psychological risk factors for specific physical diseases, but the biological mechanisms mediating these relationships remain poorly defined. METHODS: Social inhibition and autonomic nervous system (ANS) activity were assessed on multiple occasions in 54 gay men with asymptomatic human immunodeficiency virus (HIV) infection. Following baseline ANS assessment, plasma HIV-1 viral load and CD4+ T cell levels were monitored for 12-18 months to assess relationships between ANS activity and HIV pathogenesis. RESULTS: We confirmed the previously reported relationship between socially inhibited temperament and vulnerability to viral pathology. Plasma viral load set-point was elevated eight-fold in socially inhibited individuals, and these individuals showed poorer virologic and immunologic response to initiation of highly active antiretroviral therapy (HAART). Effects were independent of duration of infection, HAART regimen, demographic characteristics, and health-relevant behavior. Neurophysiologic assessments documented elevated ANS activity in socially inhibited individuals, and mediational analyses showed that such differences could account for 64%-92% of the covariance between social inhibition and virologic parameters. CONCLUSIONS: These data provide the first clinical evidence that differential neural activity mediates relationships between psychological risk factors and infectious disease pathogenesis. Such findings also suggest novel targets for adjunctive therapy in long-term control of HIV-1 disease.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Infecções por HIV/fisiopatologia , Infecções por HIV/psicologia , Negociação , Fatores de Risco , Adulto , Terapia Antirretroviral de Alta Atividade/métodos , Pressão Sanguínea , Contagem de Linfócito CD4 , Estudos de Coortes , Eletrocardiografia/métodos , Seguimentos , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Soropositividade para HIV , Humanos , Inibição Psicológica , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Pletismografia , Testes Psicológicos , Fatores de Tempo , Carga Viral/métodos
13.
Psychol Bull ; 130(3): 355-91, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15122924

RESUMO

This meta-analysis reviews 208 laboratory studies of acute psychological stressors and tests a theoretical model delineating conditions capable of eliciting cortisol responses. Psychological stressors increased cortisol levels; however, effects varied widely across tasks. Consistent with the theoretical model, motivated performance tasks elicited cortisol responses if they were uncontrollable or characterized by social-evaluative threat (task performance could be negatively judged by others), when methodological factors and other stressor characteristics were controlled for. Tasks containing both uncontrollable and social-evaluative elements were associated with the largest cortisol and adrenocorticotropin hormone changes and the longest times to recovery. These findings are consistent with the animal literature on the physiological effects of uncontrollable social threat and contradict the belief that cortisol is responsive to all types of stressors.


Assuntos
Hidrocortisona/fisiologia , Modelos Psicológicos , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Doença Aguda , Adolescente , Hormônio Adrenocorticotrópico/biossíntese , Adulto , Idoso , Feminino , Humanos , Hidrocortisona/biossíntese , Hidrocortisona/sangue , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Motivação , Valor Preditivo dos Testes , Saliva , Comportamento Social , Meio Social , Estresse Psicológico/sangue , Análise e Desempenho de Tarefas , Fatores de Tempo
14.
Psychosom Med ; 66(6): 915-24, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15564358

RESUMO

OBJECTIVE: Our Social Self Preservation Theory asserts that situations which threaten the "social self" (ie, one's social value or standing) elicit increased feelings of low social worth (eg, shame), decrements in social self-esteem, and increases in cortisol, a hormone released by the hypothalamic-pituitary-adrenal axis. To test our theoretical premise, cognitive, emotional, and physiological responses to the performance of laboratory stressor tasks were compared in participants who performed these tasks in the presence or absence of social-self threat. METHODS: Pre- and poststressor emotion, self-esteem, heart rate, blood pressure, and salivary cortisol were compared in 81 participants randomly assigned to complete speech and mental arithmetic stress tasks with social evaluation present (n = 41) or absent (n = 40). RESULTS: As hypothesized, participants in the social evaluation condition exhibited greater increases in shame and greater decrements in social self-esteem. Other psychological states (eg, anxiety, performance self-esteem) did not show differential changes as a function of the social context. Salivary cortisol increased in social evaluation condition participants but did not increase in participants who performed the same tasks in the absence of social evaluation. Cortisol increases were greater in participants who experienced greater increases in shame and greater decreases in social self-esteem under social-self threat. CONCLUSION: Threat to the social self is an important elicitor of shame experience, decreases in social self-esteem and cortisol increases under demanding performance conditions. Cortisol changes may be specifically tied to the experience of emotions and cognitions reflecting low self-worth in this context.


Assuntos
Ansiedade/fisiopatologia , Hidrocortisona/fisiologia , Autoimagem , Vergonha , Comportamento Social , Adolescente , Adulto , Ansiedade/psicologia , Pressão Sanguínea/fisiologia , Cognição/fisiologia , Emoções/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Hidrocortisona/análise , Masculino , Saliva/química , Ajustamento Social , Estresse Psicológico/diagnóstico
15.
Psychosom Med ; 66(1): 124-31, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-14747646

RESUMO

OBJECTIVE: To determine if inducing self-blame would lead to increases in shame and guilt as well as increases in proinflammatory cytokine activity and cortisol. Based on previous research and theory, it was hypothesized that induced shame would be specifically associated with elevations in proinflammatory cytokine activity. MATERIALS AND METHODS: Healthy participants were randomly assigned to write about traumatic experiences in which they blamed themselves (N = 31) or neutral experiences (N = 18) during three 20-minute experimental laboratory sessions over 1 week. Tumor necrosis factor-alpha receptor levels (sTNFalphaRII), an indicator of proinflammatory cytokine activity, beta2-microglobulin, cortisol (all obtained from oral fluids), and emotion were assessed prewriting and postwriting. RESULTS: Participants in the self-blame condition showed an increase in shame and guilt as well as an increase in sTNFalphaRII activity when compared with those in the control condition. Cortisol and beta2-microglobulin levels were unaffected by the procedures. Those individuals in the self-blame condition reporting the greatest increases in shame in response to the task showed the greatest elevations in proinflammatory cytokine activity, while levels of guilt and general negative emotion were unrelated to cytokine changes. CONCLUSION: These data suggest that inducing self-related emotions can cause changes in inflammatory products, and that shame may have specific immunological correlates.


Assuntos
Antígenos CD/sangue , Culpa , Hidrocortisona/fisiologia , Inflamação/psicologia , Receptores do Fator de Necrose Tumoral/sangue , Vergonha , Adulto , Emoções , Feminino , Humanos , Hidrocortisona/análise , Imunocompetência , Inflamação/fisiopatologia , Masculino , Plasma , Psiconeuroimunologia , Receptores Tipo II do Fator de Necrose Tumoral , Saliva/química , Fator de Necrose Tumoral alfa/análise , Redação , Microglobulina beta-2/análise
16.
Health Psychol ; 21(3): 219-28, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12027027

RESUMO

The research tested a model of treatment decision making in chronic illness that includes health beliefs, quality of life, and relationship with the physician (shared or not). Inflammatory bowel disease patients (N = 218) reported on their physician-patient relationship, general and disease-specific quality of life, and intentions to take a drug, for which perceived benefits and costs were manipulated. For more symptomatic patients, both costs and benefits predicted intentions; however, for less symptomatic patients, costs played a more important role. Physician recommendation predicted intention primarily among those who shared a decision-making relationship with their physician. Overall, the model accounted for 57.8% of the variance in medication-taking intention. Findings suggest that an integrative consideration of relationship factors, health beliefs, and health status may help explain treatment intentions among the chronically ill.


Assuntos
Tomada de Decisões , Doenças Inflamatórias Intestinais/terapia , Intenção , Cooperação do Paciente , Relações Médico-Paciente , Qualidade de Vida , Perfil de Impacto da Doença , Adulto , Idoso , Doença Crônica , Análise Custo-Benefício , Feminino , Humanos , Doenças Inflamatórias Intestinais/economia , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Inquéritos e Questionários
17.
J Psychosom Res ; 54(3): 213-24, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12614831

RESUMO

OBJECTIVE: This cross-sectional study examined the hypothesis that the capacity for emotional expression is a critical moderator of the emotional support-health relationship. METHODS: In a sample of 61 HIV-seropositive women without AIDS, coping interviews were conducted to assess HIV-specific emotional support and emotional expression and inhibition (percentage of positive/negative emotion words and inhibition words, respectively). RESULTS: Hierarchical regression analyses revealed no relationship between availability of HIV-specific emotional support and concurrent CD4 levels and no moderation of emotional expression or inhibition. However, a higher percentage of inhibition words was associated with lower CD4 T-cell levels controlling for health behaviors, demographics, and treatment regimen (DeltaR(2)=.08, P<.05). CONCLUSIONS: These findings are consistent with prior theory and research showing a relationship between psychological inhibition and deleterious health outcomes.


Assuntos
Emoções Manifestas , Infecções por HIV/imunologia , Infecções por HIV/psicologia , Inibição Psicológica , Adaptação Psicológica , Adulto , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Análise de Regressão , Apoio Social
18.
Health Psychol ; 33(8): 862-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25068456

RESUMO

OBJECTIVE: Weight discrimination is associated with increased risk of obesity. The mechanism of this relationship is unknown, but being overweight is a highly stigmatized condition and may be a source of chronic stress that contributes to the development and pathophysiology of obesity. The objective of this study was to test whether weight stigma is associated with physiological risk factors linked to stress and obesity, including hypercortisolism and oxidative stress, independent of adiposity. METHOD: We examined the frequency of experiencing situations involving weight stigma and consciousness of weight stigma in relation to hypothalamic--pituitary--adrenal axis activity and oxidative stress (F2-isoprostanes) in 45 healthy overweight to obese women. RESULTS: Independent of abdominal fat, weight stigma was significantly related to measures of cortisol (including salivary measures of cortisol awakening response and serum morning levels) as well as higher levels of oxidative stress. Perceived stress mediated the relationship between weight stigma consciousness and the cortisol awakening response. CONCLUSION: These preliminary findings show that weight stigma is associated with greater biochemical stress, independent of level of adiposity. It is possible that weight stigma may contribute to poor health underlying some forms of obesity.


Assuntos
Hidrocortisona/análise , Sobrepeso/psicologia , Estresse Oxidativo/fisiologia , Estereotipagem , Estresse Psicológico/fisiopatologia , Adiposidade , Adulto , Feminino , Humanos , Hidrocortisona/sangue , Sistema Hipotálamo-Hipofisário/fisiopatologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Obesidade/psicologia , Sobrepeso/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Saliva/química , Adulto Jovem
19.
Psychophysiology ; 50(8): 777-89, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23692525

RESUMO

Attention to internal bodily sensations is a core feature of mindfulness meditation. Previous studies have not detected differences in interoceptive accuracy between meditators and nonmeditators on heartbeat detection and perception tasks. We compared differences in respiratory interoceptive accuracy between meditators and nonmeditators in the ability to detect and discriminate respiratory resistive loads and sustain accurate perception of respiratory tidal volume during nondistracted and distracted conditions. Groups did not differ in overall performance on the detection and discrimination tasks; however, meditators were more accurate in discriminating the resistive load with the lowest ceiling effect. Meditators were also more accurate during the nondistracted tracking task at a lag time of 1 s following the breath. Results provide initial support for the notion that meditators have greater respiratory interoceptive accuracy compared to nonmeditators.


Assuntos
Meditação/psicologia , Mecânica Respiratória/fisiologia , Adulto , Resistência das Vias Respiratórias/fisiologia , Atenção/fisiologia , Discriminação Psicológica/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Plena , Desempenho Psicomotor/fisiologia , Autoimagem , Volume de Ventilação Pulmonar/fisiologia
20.
PLoS One ; 8(7): e63429, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23922644

RESUMO

OBJECTIVE: The level of T cell activation in untreated HIV disease is strongly and independently associated with risk of immunologic and clinical progression. The factors that influence the level of activation, however, are not fully defined. Since endogenous glucocorticoids are important in regulating inflammation, we sought to determine whether less optimal diurnal cortisol patterns are associated with greater T cell activation. METHODS: We studied 128 HIV-infected adults who were not on treatment and had a CD4(+) T cell count above 250 cells/µl. We assessed T cell activation by CD38 expression using flow cytometry, and diurnal cortisol was assessed with salivary measurements. RESULTS: Lower waking cortisol levels correlated with greater T cell immune activation, measured by CD38 mean fluorescent intensity, on CD4(+) T cells (r = -0.26, p = 0.006). Participants with lower waking cortisol also showed a trend toward greater activation on CD8(+) T cells (r = -0.17, p = 0.08). A greater diurnal decline in cortisol, usually considered a healthy pattern, correlated with less CD4(+) (r = 0.24, p = 0.018) and CD8(+) (r = 0.24, p = 0.017) activation. CONCLUSIONS: These data suggest that the hypothalamic-pituitary-adrenal (HPA) axis contributes to the regulation of T cell activation in HIV. This may represent an important pathway through which psychological states and the HPA axis influence progression of HIV.


Assuntos
Infecções por HIV/imunologia , Hidrocortisona/metabolismo , Ativação Linfocitária/imunologia , Linfócitos T/imunologia , Adulto , Ritmo Circadiano , Feminino , Citometria de Fluxo , Infecções por HIV/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
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