A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome.

Ten of thirteen original participants with Irritable Bowel Syndrome (IBS) participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term. From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain (p = 0.017), diarrhea (p = 0.045), flatulence (p = 0.030), and bloating (p = 0.018). When we examined changes from the original three month follow-up point to the one year follow-up, we noted significant additional reductions in pain (p = 0.03) and bloating (p = 0.04), which tended to be the most distressing symptoms of IBS. It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and (2) RRM is a beneficial treatment for IBS in the both short- and the long-term.

Psychophysiological reactivity of aggressive drivers: an exploratory study.

In the United States, motor vehicle accidents are the leading cause of accidental death and injury. Aggressive driving, which has been identified as a major risk factor for motor vehicle accidents by transportation authorities, is thus an important topic of study. This study compared the physiological reactivity of self-referred aggressive and nonaggressive drivers. Heart rate, blood pressure, facial muscle activity, and skin resistance were monitored as participants listened to idiosyncratic vignettes of driving and fear-provoking scenarios, as well as during a standard stressor task (mental arithmetic). The results were that aggressive drivers exhibited significant increases in muscle tension and blood pressure during the driving vignettes, relative to controls. They also responded to the fear vignette and mental arithmetic in a qualitatively different fashion from that of controls. The aggressive drivers responded to these stimuli with less overall heart rate and electrodermal reactivity, but increased blood pressure and muscle tension. In contrast, the controls responded to the fear vignette and mental arithmetic primarily with increased heart rates and decreased skin resistance. The findings suggest that both physiological hyperarousal as well as differential responses to stressful stimuli may contribute to aggressive driving. Implications for interventions with this population are discussed.

The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: results of a controlled treatment study.

In this study, Herbert Benson's (1975) Relaxation Response Meditation program was tested as a possible treatment for Irritable Bowel Syndrome (IBS). Participants were 16 adults who were matched into pairs based on presence of Axis I disorder, primary IBS symptoms and demographic features and randomized to either a six week meditation condition or a six week wait list symptom monitoring condition. Thirteen participants completed treatment and follow-up. All subjects assigned to the Wait List were subsequently treated. Patients in the treatment condition were taught the meditation technique and asked to practice it twice a day for 15 minutes. Composite Primary IBS Symptom Reduction (CPSR) scores were calculated for each patient from end of baseline to two weeks post-treatment (or to post wait list). One tailed independent sample t-tests revealed that Meditation was superior to the control (P=0.04). Significant within-subject improvements were noted for flatulence (P=0.03) and belching (P=0.02) by post-treatment. By three month follow-up, significant improvements in flatulence (P<0.01), belching (P=0.02), bloating (P=0.05), and diarrhea (P=0.03) were shown by symptom diary. Constipation approached significance (P=0.07). Benson's Relaxation Response Meditation appears to be a viable treatment for IBS.

Gender differences in psychological distress among patients with irritable bowel syndrome.

OBJECTIVE: We examined possible gender differences in psychological distress in a sample of treatment-seeking Irritable Bowel Syndrome (IBS) patients. METHODS: A total of 341 IBS patients (238 females, 83 males) were studied. Structured psychiatric interviews were available on 250 participants. RESULTS: We found significantly higher scores for females than males on the Beck Depression Inventory (BDI), Trait Anxiety of the State-Trait Anxiety Inventory (STAI), and Scales 2 and 3 of the MMPI. However, there were no differences in the percentages of the two samples meeting criteria for one or more Axis I psychiatric disorders, with 65.6% of the total sample meeting these criteria. CONCLUSION: Gender differences in psychological distress appear to be a function of method of measurement.

[Intervention by nitric oxide, NO, and its oxide derivatives particularly in mammals]. / Intervention du monoxyde d'azote, NO, et de ses dérivés oxydés, particulièrement chez les mammifères.

Nitric oxide (NO) is a natural and stable free radical produced in soil and water by the bacteriological reduction of nitrites and nitrates and in animals by the enzyme oxidation of L-arginine. NO is biosynthesised by finely regulated enzymatic systems called NO-synthases and readily diffuses through tissues. It reacts rapidly with hemoproteins and iron-sulphur centers to form nitrosylated compounds. It oxidises more slowly to form nitrogen oxides that nitrosate thiols into thionitrite. NO is transported in these various forms and released spontaneously or through yet unclear mechanisms into most cells; it also regulates oxygen consumption at the mitochondrial respiratory chain level through interaction with cytochrome oxidase. In the cardiovascular system, NO lowers blood pressure by activating a hemoprotein, the guanylate cyclase present in muscle cells; through such interaction it acts also as a neuromediator and neuromodulator in the nervous system. However, many of NO's roles result from rapid coupling to other radicals; for example, it reacts with the superoxide anion (O2-) to form oxoperoxinitrate (ONOO-, also known as peroxynitrite). This strong oxidant of metallic centers, thiols, and antioxidants is also able to convert tyrosine to 3-nitrotyrosine and to act upon tyrosine residues contained in proteins. The biological aspects of the roles of NO are presented with particular respect to the rapid interactions of NO with hemoproteins' iron and other radicals. Concurrently, NO oxidation enables nitrosation reactions primarily of thiols but ultimately of nucleic bases. The thionitrite function (R-S-NO) thus formed and the dimerisation and nitration of tyrosine residues are protein post-translational modifications that are being investigated in animals.

The failure of intensive self-regulatory treatment with chronic daily headache: a prospective study.

Sixteen patients with chronic daily headache (HA) of moderate to severe intensity received 20 sessions of self-regulatory treatment including progressive muscle relaxation, thermal biofeedback, and cognitive stress coping therapy. Four stopped treatment after 12 visits (but had received all 3 treatment components). Only 2 of 12 completers (17%) showed more than 50% reduction in HA Index based on daily diaries. Chronic daily HA continues to be relatively refractory to self-regulatory treatment.

Information processing and PTSD: a review of the empirical literature.

This article reviews a series of studies that have utilized information-processing paradigms with posttraumatic stress disorder (PTSD) populations. The review suggests that pretrauma measures of intelligence (IQ) are predictive of the development of PTSD symptoms following trauma. There is also evidence of impaired performance on standardized tests of memory (independent of IQ) in PTSD populations. PTSD populations are found to exhibit deficits in memory function that may be due to hippocampus damage secondary to excessive neuroendocrine responses to conditioned stimuli. In addition, individuals with PTSD evince an attentional bias towards trauma-related stimuli at postrecognition stages of information processing. The review also includes that there is insufficient evidence to either support, or reject, the theoretical proposition that PTSD patients are sensitive to global valence effects at the earliest stages of information processing relative to traumatized non-PTSD populations. Finally, there is some evidence to suggest that the processes associated with autobiographical memory in PTSD populations are similar to those seen in depression. The implications of these findings for the behavioral and cognitive treatment of PTSD are discussed. Directions for future research with such paradigms are also discussed in light of contemporary information processing theories of PTSD.

Posttraumatic stress disorder in breast cancer patients following autologous bone marrow transplantation or conventional cancer treatments.

We assessed 17 women who had undergone autologous bone marrow transplants (BMT) for their breast cancer and 20 other women who had been treated for breast cancer (but not with BMT) by structured clinical interviews examining each stage of the breast cancer experience (e.g. initial diagnosis, initial treatment, recurrence of cancer (if applicable) and BMT (if applicable)) and at follow-up points; 3, 6 and 12 months (if applicable) posttreatment. The two groups did not differ on incidence of posttraumatic stress disorder (PTSD), major depressive disorder (MDD) or generalized anxiety disorder at any stage. We found a high rate of PTSD over the cancer experience, 35% for the combined sample, with cancer diagnosis being the most likely point for developing PTSD, 27% for the combined sample. None of the 17 women who had undergone BMT developed PTSD as a result of the treatment.

Psychophysiological assessment of compulsive gamblers' arousal to gambling cues: a pilot study.

Psychophysiological assessments measuring heart rate, systolic and diastolic blood pressure, and skin resistance level were conducted on 7 male compulsive gamblers and on 7 age and gender matched controls while both groups performed mental arithmetic and listened to individualized tapes of the gamblers' preferred form of gambling and an individualized fear tape. Heart rate responses of the gamblers to the 2 gambling audiotapes were significantly greater than those found for the controls whereas the groups did not differ on mental arithmetic or the fear provoking scene, confirming some degree of cue-specific arousal in gamblers. The other physical responses did not yield such strong results. If physiological arousal provides the motivational basis for gambling and is maintained on an intermittent schedule of reinforcement, the findings may have implications for the treatment of compulsive gambling.

Psychometric properties of a measure of aggressive driving: the Larson Driver's Stress Profile.

This paper presents three studies on Larson's 1996 Driver's Stress Profile, a measure of aggressive driving tendencies. In Study 1, utilizing 33 individuals (15 men, 18 women) who took the test twice with one week between tests, we found the test to have good test-retest reliability (r = .93). In Study 2, utilizing 176 individuals (77 men, 99 women), we found different preliminary norms for men and women and good internal consistency (.93). We also found significant correlation between the total test scores and age (r = -.27) and a significant correlation (age corrected) between total test scores and number of self-reported MVAs (r = .28). An exploratory factor analysis indicated that three factors, including 28 of the 40 items, accounted for 43.4% of the variance. In study 3, utilizing the same subjects as in Study 2 (84 individuals from the community of average age 35.3 yr.; 92 college students of average age 18.9 yr.), we found the full scale scores correlated significantly with scores on Trait Anger and Anger Out and Type A Behavior, especially speed and impatience. Finally, scores correlated significantly with the Deffenbacher Driving Anger Scale (r = .57) but clearly tapped processes different, in part, from those measured by the Deffenbacher, et al. scale (1994). Overall, the Driver's Stress Profile appears to be a sound, reliable, and valid scale for use with aggressive driving.

The definition of "applied psychophysiology": a dangerous exercise in exclusivity.

Dr. Schwartz's (1999) definition of "applied psychophysiology" and his attempt to limit what can be presented at the society's meeting, published in its journal, and by extension, used by members of AAPB, are discussed. The exclusivity is seen as repressive and even dangerous. Examples from irritable bowel syndrome and chronic headache are provided.

Effects of attribution of responsibility for motor vehicle accidents on severity of PTSD symptoms, ways of coping, and recovery over six months.

In light of Delahanty et al.'s (1997) identification of attribution of responsibility for a motor vehicle accident (MVA) as a powerful determinant of initial level of distress from the trauma and of early remission of PTSD, we reexamined data from Blanchard and Hickling's (1997) prospective follow-up of 158 MVA survivors. Despite differences between the two samples (Delahanty sample recruited from hospitals 2-3 weeks post-MVA and predominantly male; our sample recruited from outpatient care 1-4 months post-MVA and predominantly female) we replicated Delahanty's findings: those with PTSD who blame themselves for the MVA are less symptomatic initially and recover more rapidly in the first 6 months than those with PTSD who blame another party for the accident.

The psychosocial effects of rheumatoid arthritis on the patient and the well partner.

Rheumatoid arthritis (RA) is a chronic disorder that can have a severe impact on patient's lives. This present study investigated four questions regarding the psychosocial effects on patients and their well partners. First we found that depression for both patients and partners were slightly elevated and 35.7% of patients and 23.3% of well partners had scores above the cut-off for possible clinical depression on the Center for Epidemiological Studies Depression Scale. Second, there was no significant difference between the patients' level of distress and that of the partners. Third, there were moderate positive correlations between patients' and partners' scores on measure of psychological functioning. Fourth, there were no differences in either the patients' or partners' well-being based on the gender of the patient. Finally, an exploratory analysis was conducted to examine the factors which influence the patients' and partners' depression and their view of the relationship.

A confirmatory factor analysis of posttraumatic stress symptoms.

Investigators have recently identified a two-factor structure underlying posttraumatic stress symptoms through the use of exploratory factor analysis. [Taylor et al. (1988). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154-160]. These two factors, which were labeled as Intrusion and Avoidance, and Hyperarousal and Numbing, are consistent with current theoretical models of posttraumatic stress disorder--PTSD [e.g. Foa et al. (1992). Uncontrollability and unpredictability in post-traumatic stress disorder: An animal model. Psychological Bulletin, 112, 218-238]. However, the authors of the Taylor et al. study issued caution in interpreting their findings because there has yet to be a systematic replication of their results. This paper presents a confirmatory factor analysis of the two-factor structure of posttraumatic stress symptoms in 217 survivors of serious motor vehicle accidents with varying degrees of PTSD symptoms. A hierarchical, confirmatory-factor analysis conducted with a structural equation modeling statistics package confirmed that the model proposed by Taylor et al. can adequately account for the presentation of PTSD symptoms in this sample of motor vehicle accident survivors. The implications for the assessment and diagnosis of PTSD are discussed.

Responses to civilian war experiences: predictors of psychological functioning and coping.

This study investigated civilian war trauma in Central American refugees, focusing on the diagnosis of posttraumatic stress disorder (PTSD) as related to war experience and demographic characteristics. Sixty eight percent of the refugees met the diagnostic criteria for PTSD. Diagnosis was best predicted by number of war experiences, severity of war trauma and level of anxiety/depression. Higher numbers of war experiences predicted PTSD severity, as did involvement in the legalization process, parenthood, and being a citizen of El Salvador. In examining the PTSD symptom cluster scores, it was found that number of war experiences was a significant predictor in all clusters. These results are helpful in increasing our knowledge about the role of war experiences in civilian PTSD and the unique situation of the Central American refugees.

Effects of litigation settlements on posttraumatic stress symptoms in motor vehicle accident victims.

In order to investigate the effects of the initiation of litigation and its settlement on victims of motor vehicle accidents (MVAs), we followed up 132 MVA victims from an initial assessment 1 to 4 months post-MVA for 1 year. Of the 67 who had initiated litigation, 18 (27%) settled within the 12 months, while 49 still had litigation pending; 65 never initiated litigation. Those who initiated litigation had more severe injuries and higher initial levels of posttraumatic stress (PTS) symptoms. All three groups improved in major role function and had reduced PTS symptoms over the 1 year follow-up. Those whose suits were still pending, as well as those whose suits had been settled, showed no reduction in measures of anxiety or depression, whereas the nonlitigants did show improvement on these measures.

Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents.

This study investigated the effect of traumatic brain injury on the development of posttraumatic stress disorder (PTSD). Subjects were 107 motor vehicle accident survivors including 38 individuals who were diagnosed with posttraumatic stress disorder (PTSD). Neuropsychological testing was administered to all subjects during an initial diagnostic evaluation. Results showed that subjects who had lost consciousness during their MVA had greater impairment on speed dependent tests and delayed recall of verbal material. Subjects who suffered traumatic brain injury (TBI) were also found to have developed PTSD as often as those who had not reported TBI. Implications for future research and clinical utility are discussed.

Posttraumatic stress disorder and comorbid major depression: is the correlation an illusion?

We have examined data from 107 motor-vehicle accident (MVA) victims with regard to whether the presence of comorbid depression is important clinically, and with regard to whether the threshold for diagnosing the comorbid depression should be raised because of symptom overlap between posttraumatic stress disorder (PTSD) and major depression. Of the 62 MVA victims who met the criteria for PTSD 1 to 4 months post-MVA, 33 also met the criteria for major depression, with 27 cases for which the depression occurred post-MVA. A LISREL 8.12a analysis indicates that PTSD and major depression are correlated, but independent, responses to trauma. Those with PTSD and depression are more subjectively distressed, suffer more major role impairment, and remit less readily over the first 6 months of prospective follow-up than those with PTSD alone. The threshold for diagnosing comorbid depression (5 or 6 depressive symptoms versus 7 to 9 depressive symptoms) has no important effects on any of the indicators of "caseness."

Psychophysiological reactivity in pediatric migraine patients and healthy controls.

The hypothesis that physiological responses of migraine patients are symptom-specific was evaluated in 29 children (age range 8-16 years) suffering from migraine and 10 healthy control children. The assessment included two major stress phases and a relaxation period. A standard laboratory stressor (a subtraction task) and parent-child conflict served as stressors. A total of six physiological parameters were measured: pulse amplitude at two extracranial (A. temporalis, A. supraorbitalis) and one peripheral (index finger) sites; finger temperature; heart rate; and skin-conductance level. There were no significant group differences in autonomic arousal. Moreover, extracranial and peripheral vasomotor activity was not different between groups, a finding which might be partially due to the considerable interindividual variability. The implications of the results are discussed taking into account that studying pediatric rather than adult migraine patients allows to minimize the potentially confounding impact of factors such as headache chronicity, medication, and additional nonmigraine headaches.

Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: results from a Department of Veterans Affairs Cooperative Study.

This multisite study tested the ability of psychophysiological responding to predict posttraumatic stress disorder (PTSD) diagnosis (current, lifetime, or never) in a large sample of male Vietnam veterans. Predictor variables for a logistic regression equation were drawn from a challenge task involving scenes of combat. The equation was tested and cross-validated demonstrating correct classification of approximately 2/3 of the current and never PTSD participants. Results replicate the finding of heightened psychophysiological responding to trauma-related cues by individuals with current PTSD, as well as differences in a variety of other domains between groups with and without the disorder. Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt. Discussion addresses the value of psychophysiological measures for assessment of PTSD.