Stress reactivity of intraocular pressure after relaxation training in open-angle glaucoma patients

The present study was based on the hypothesis that stress may contribute to increased intraocular pressure (IOP) in open-angle glaucoma patients. It is investigated whether IOP reactivity to a mental stressor test (MST) can be influenced by relaxation training. Twenty three patients with open-angle glaucoma were randomly assigned either to a training group (TG) or to a waiting-list control group (CG). Prior to as well as after the completion of the training all patients were exposed to the MST. IOP and heart rate as well as self-ratings of psychological strain were assessed three times: (1) at baseline, (2) after exposition to the stressor, and (3) after a 10-min relaxation phase. Results provide evidence that the MST is a valid procedure to induce psychophysiological activation and that elevated IOP levels in open-angle glaucoma patients might be provoked by stressing situations. However, participation in the relaxation training did not influence IOP stress reactivity.     

Effectiveness of relaxation training in reducing adverse reactions to cancer chemotherapy

Cancer patients who had developed negative conditioned responses to their chemotherapy either did (relaxation training) or did not (no relaxation training) receive progressive muscle relaxation training and guided relaxation imagery instructions immediately before and during their chemotherapy treatments. Physiological (blood pressure and pulse rate) measures of arousal, frequency of vomiting, and patient-reported and nurse-reported indices of negative affect and nausea were collected during pretraining, training, and posttraining chemotherapy sessions. Results indicated that during both the training and the posttraining sessions, patients in the relaxation training condition reported feeling less emotionally distressed and nauseated, and showed less physiological arousal following the chemotherapy infusion, than patients in the no relaxation training condition. The attending nurses' observations confirmed the patients' self-reports. No differences were found in frequency of vomiting between conditions. These data clearly suggest that the use of relaxation procedures may be an effective means of reducing several of the adverse side effects of cancer chemotherapy.     

Biofeedback and Progressive Relaxation: Effects on Systolic and Diastolic Blood Pressure and Heart Rate

Two groups of subjects were pretrained in Jacobson's progressive relaxation, then instructed to lower their blood pressure while receiving contingent feedback or no feedback for two 1-hr sessions. A third group was pretrained in a control relaxation procedure, then instructed to lower blood pressure while receiving contingent feedback. All subjects returned for a Follow-up session in which they attempted to reduce blood pressure without feedback. The results indicated reliable decreases in systolic blood pressure for all three groups in the first two sessions. The group pretrained in progressive relaxation and given feedback achieved greater control than the other two groups which did not differ from each other. During the Follow-up session, blood pressure decreases were small but reliable in the two groups pretrained in progressive relaxation. Heart rate and diastolic blood pressure decreased in all groups, with the progressive relaxation groups achieving the lowest levels. It is concluded that progressive relaxation and blood pressure feedback in combination are highly compatible and that progressive relaxation allows for modest blood pressure control in the absence of feedback.     

Blood pressure reactivity can be reduced by a cognitive behavioral stress management program

Although enhanced cardiovascular reactivity is extensively discussed as a relevant negative factor in the alteration of vascular structure, only a few controlled studies have been published presenting approaches to alter reactivity. Therefore, we examined whether enhanced reactivity could be reduced by stress management training (SMT). To control for expectation effects, progressive muscular relaxation (PMR) was the control condition. Forty-four patients with a blood pressure response greater than 15 mm Hg to a mental stress test participated in this study. Participants who took part in SMT showed a significantly stronger reduction of diastolic blood pressure reactivity to a mental stress test from pretest to posttest than the controls. Furthermore, patients who took part in SMT showed significantly smaller systolic blood pressure reactions to mental arithmetic and 2 social stress tests than the controls after the trainings. This study indicates that enhanced blood pressure reactivity can be reduced by SMT.     

Effects of stress management on blood pressure and other cardiovascular variables.

Blood pressure and impedance cardiography derived measures of heart rate, stroke volume, cardiac output and total peripheral resistance were measured in 16 persons before and after participation in a comprehensive program of stress management that included home monitoring of blood pressure and feedback of finger skin temperature during relaxation. Ten of the subjects were hypertensive and six were normotensive. Baseline measures of systolic and diastolic blood pressure and heart rate decreased significantly after participation in the program. In addition, reactivity to a psychological stressor (oral quiz) was significantly lower as revealed in reduced systolic and diastolic pressure, heart rate and cardiac output at the second assessment. A reduction in sympathetic nervous system activity is postulated as a possible mechanism for the changes observed.     

Psychophysiological Reactivity in Cardiac Transplant Recipients

To assess the contribution of the heart's autonomic innervation to reactivity to psychological stressors, hemodynamic responsiveness of the denervated human heart was examined in two studies. In Study 1, cardiac output measured by thermodilution. heart rate, and systolic and diastolic blood pressure responses to a 4-min mental arithmetic task were studied in 7 cardiac transplant patients during routine post-transplant cardiac catheterization. In Study II, 6 cardiac transplant patients, 5 normal controls, and 5 renal transplant patients participated in a 78-min psychophysiological stress protocol during which heart rate, systolic and diastolic pressure, and cardiac output (measured noninvasively by impedance cardiography) as well as serum epinephrine and norepinephrine were measured at baseline and while subjects performed mental arithmetic and reaction time tasks. In Study I, transplant patients showed significant increases, relative to baseline, in heart rate, systolic blood pressure, and cardiac output in response to mental arithmetic. The diastolic blood pressure response was marginally significant. In Study II, mental arithmetic produced significant reactivity in systolic blood pressure and marginally significant increases in heart rate and diastolic blood pressure in cardiac transplant patients. Reaction time produced only marginally significant diastolic blood pressure reactivity. Hemodynamic reactivity of the cardiac transplant group generally was lower than that of the two innervated groups, which generally were similar to each other. Although the small number of subjects makes conclusions tentative, these data suggest that: 1) Cardiac transplant patients are capable of significant reactivity to psychological stressors despite the absence of innervation of the heart, and 2) reactivity to these stressors is diminished relative to innervated control subjects. In the absence of cardiac innervation, reactivity is due to the vascular system and cardiac effects mediated by humoral factors.     

Predicting treatment outcome to progressive relaxation training in essential hypertensive patients

Nineteen borderline essential hypertensive patients participated in (a) a pretreatment assessment of sympathetic nervous system activity (SNS), (b) a progressive muscle relaxation training program, and (c) a posttreatment assessment of SNS functioning. During both pre- and posttreatment assessments, each subject participated in a laboratory session during which cardiovascular responses to two behavioral challenges were measured, a 24-hr urine collection for catecholamine analysis and the completion of relevant self-report questionnaires. Results revealed that subjects who improved the most with relaxation training (showed the greatest reduction in blood pressure) were individuals who, at pretreatment, (a) were less reactive to laboratory challenges, (b) possessed lower levels of resting epinephrine, and (c) scored lower on measures of trait anger and higher on assertiveness. Posttreatment assessment results showed that relaxation training did not affect cardiovascular reactivity to laboratory tasks or self-report of anger and assertion.Funding for this study was made available through a West Virginia University Senate Research Grant (87-824).     

Airflow and autonomic responses to stress and relaxation in asthma: the impact of stressor type.

The impact of stress on respiratory airflow in asthmatics is unclear. Part of the uncertainty may spring from the different physiological effects of different stressors. Given their potential to elicit increases in parasympathetic vagal activity, stressful situations that present few opportunities for coping (passive coping stressors) may be particularly problematic for people with asthma. Thirty-one adult asthmatics participated in a protocol including a widely used passive coping stressor (the cold pressor test), an active coping stressor (mental arithmetic), an interview about an upsetting asthma-related incident (viewed as a potential passive coping stressor given the exposure to unpleasant memories), and progressive muscle relaxation. Repeated measurements of airflow (via peak expiratory flow), vagal tone (via heart rate variability), and other variables were obtained. The cold pressor test, asthma interview and progressive muscle relaxation produced significant decreases in airflow compared to the baseline period. The cold pressor test and progressive muscle relaxation produced significant, complementary increases in vagal tone. These results suggest that passive coping stressors and other stimuli (e.g., certain forms of relaxation) that elicit increased vagal tone may be associated with poorer asthma control, a view consistent with a significant negative correlation between the participant's mean vagal tone response to the tasks and score on a measure of asthma self-efficacy.     

Single- and successive-site EMG training in responding to anticipated pain

In a comparison among relaxation procedures, 32 college students were assigned to four groups of equal size. Electromyographic response training was given with biofeedback (EMG training) on the forehead (frontal area) alone, on the frontal area, neck (sternomastoid), and forearm areas in succession, or on these three sites in conjunction with recorded relaxation instructions used at home. Relative to a control group, which received no training, the three biofeedback-trained groups maintained lower EMG levels on the frontal and sternomastoid sites, and the group provided with the relaxation instructions plus EMG training showed lower skin conductance levels. These patterns were generally maintained during the presentation of a stimulus (stressor) that ostensibly signaled an impending electric shock. Other measures, including peripheral temperatures and self-reported anxiety, also showed effects consistent with the stressor presentations but did not differentiate the groups. The results are discussed in terms of common clinical relaxation procedures, an alternative procedure for training several sites simultaneously, and implications for models of EMG training and arousal.This paper summarizes a portion of the data originally presented in a masters thesis by the first author (Diaz, 1982).     

Aerobic Fitness Affects Cardiovascular and Catecholamine Responses to Stressors

Subjects of varying degrees of aerobic fitness were subjected to four laboratory stressors in a test of the hypothesis that aerobic fitness is associated with decreased responsiveness to stressors other than exercise. Blood pressure, heart rate, norepinephrine, epinephrine, and psychological responses to a film of industrial accidents (passive psychological stressor), the Stroop word color task (active psychological stressor), the cold pressor test (passive physical stressor), and running to exhaustion on a treadmill (active physical stressor) were measured. Baseline systolic blood pressure and relative diastolic responses to the film, Stroop task, and exercise were smaller in fit subjects over 40 than in less fit subjects of the same age group. Heart rates were lower in fit subjects at most times, except during and after maximal exercise. Norepinephrine was lower after 9 min of exercise in fit subjects, but was much higher at exhaustion, after these subjects had accomplished more work. Norepinephrine levels fell rapidly and were not different among groups 3 and 10 min after exercise. There was no preferential generalization of the “fitness effect” to the active psychological task.     

暴力袭击造成的创伤后应激障碍临床个案报告

目的分析暴力袭击造成的创伤后应激障碍形成的心理机制，探讨运用系统脱敏法，结合认知疗法与行为疗法中的放松训练，治疗暴力袭击造成的PTSD（创伤后应激障碍）的方法和步骤，为此类案例的临床治疗提供借鉴。方法采用访谈法、认知疗法，放松训练及系统脱敏法对一名暴力袭击造成的PTSD患者进行心理咨询与治疗。结果患者认识到PTSD发生的心理机制，在没有任何药物辅助的情况下，通过认知治疗、系统脱敏法及放松训练．患者社会功能与心理功能已经基本恢复。结论系统脱敏法结合认知疗法与放松训练，对暴力袭击造成的创伤后应激障碍的治疗有显著的临床疗效。     

Interactive effects of type A personality and psychological and physical stressors on human cardiovascular functions

The first part of this study examined the relationship(s) between Type A behavior scores and heart rate, blood pressure and impedance derived cardiovascular measures in response to discrete stressors during a standardized psychophysiological assessment. Expts. 2A and 2B considered cardiovascular responses to dynamic exercise stress alone and in combination with psychological and cold pressor tests. Gender and stroke volume changes during the psychological stress correlated 0.45 (P less than 0.02) with Type A score. Subscale scores of Job Involvement correlated 0.78 (P less than 0.02) with stroke volume, total systemic resistance and heart rate during the psychological stressor, and systolic blood pressure during the cold pressor task. The combined effects of psychological stress and dynamic exercise on systolic and diastolic blood pressure were significantly greater than the individual effects of these stressors. The use of impedance cardiography in measuring cardiovascular variables that correlate with Type A behavior, during psychophysiological assessments, may further elucidate our understanding of Type A behavior in addition to providing information about how stress interacts with aerobic exercise.     

The Availability of Social Support Reduces Cardiovascular Reactivity to Acute Psychological Stress

The influence of the availability of social support on cardiovascular reactivity to acute psychological stress was examined. Twenty-eight men and twenty-one women performed a speech task either in a support availability or no support availability condition while measures of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed. Consistent with past research, the speech stressor was associated with significant increases in SBP, DBP, and HR. More important, the availability of social support moderated cardiovascular reactivity to the acute stressor: individuals in the support availability condition were characterized by lower SBP and DBP reactivity to the acute stressor compared to individuals in the no support availability condition. These data suggest that simply having potential access to support is sufficient to foster adaptation to stress in the absence of enacted support.     

Differential hostility profiles accompany different hemodynamic response patterns

Cardiovascular reactivity has been proposed as a mechanism by which psychosocial variables may lead lo coronary heart disease. Although reactivity as a generalized response has been linked lo psychological factors, there are specific hemodynamic profiles that underlie blood pressure reactivity. This study characterized subsets of young adults as myocardial or vascular reactors, in response to three laboratory tasks: mental arithmetic, videogame, and anger recall interview. Vascular reactors had higher diastolic blood pressure increases to all tasks, whereas reactor groups were equivalent at rest and on systolic blood pressure responses. Correlational analyses were conducted to determine whether psychological dimensions are uniquely associated with myocardial or vascular reactors' cardiovascular responses, at rest and during acute stressors. For myocardial reactors, resting systolic blood pressure was higher in hostile and suspicious individuals, whereas reactivity was linked to impulsivity. For vascular reactors, low trust, low gregariousness, and high depression were associated with diastolic reactivity to tasks. The predictive validity of hostility, distrust, sociability, and depression for cardiovascular pathology may vary with reactor type.     

The Influence of Two Different Sets of Information and Suggestions on the Subjective Effects of Relaxation

Abstract

The study compared the subjective effects of different relaxation techniques and their susceptibility to influence by information and suggestions provided by the trainers. Two groups of twelve subjects each were trained in autogenic training and in progressive relaxation successively. On three occasions during their training, each group was given one of two contrasting sets of information and suggestions concerning the subjective effects to be expected. At the end of training, differences in the subjective effects accompanying the two relaxation techniques were found but no significant effect of the contrasting sets of information and suggestions emerged. These results suggest that the subjective effects of relaxation were resistant to simple suggestions and, being more robust and real than often thought, could constitute a basis for differential indications of various relaxation methods.     

Parental History of Essential Hypertension, Active Coping, and Cardiovascular Reactivity

Differences in cardiovascular reactivity to stress between individuals with and without a family history of essential hypertension (EH) may be affected by stimulus characteristics and/or individual differences in behavioral response. Twenty-four male students with a parental history of EH and 24 without a parental history of EH participated in two laboratory sessions during which two “active’ (mental arithmetic and the Stroop word-color interference test) stressors and one “non-active’ (isometric hand-grip) stressor were presented. Family history subjects exhibited greater systolic blood pressure responses than non-family history subjects only to the two active stressors in Session 2, despite the fact that, overall, isometric hand-grip elicited the largest responses. High-performing Stroop subjects with a parental history of EH displayed greater heart rate responses to the task than high-performing subjects without a parental history of EH in both sessions. No group differences appeared among poor performers. The degree to which a stressor encourages active coping behavior appears to be one determinant of differences in cardiovascular response between individuals with and without a family history of EH.     

Generalization of cardiovascular response: supportive evidence for the reactivity hypothesis.

Cardiovascular responses were monitored while 36 subjects completed a battery of laboratory stressors comprising mental arithmetic, a reaction time task, a speech task, and the forehead cold pressor. Inter-task consistency was assessed for each of 6 physiological parameters for all task pairings. Considerable inter-task consistency for reactivity scores was seen among the psychological stressors for all variables. The question of such consistency between the cold pressor and the psychological tasks was then addressed. The pattern of consistency was not as clear-cut in this case. For systolic blood pressure and pre-ejection period, reactivity scores to the cold pressor did not correlate with those to any of the psychological tasks. In contrast, cardiac output and total peripheral resistance responses showed considerable consistency. The importance of determining the nature of the relationship between psychological and physical stressors is discussed.     

习得性口吃患者的临床心理治疗个案报告

目的分析习得性口吃患者口吃形成的心理机制,探讨运用元认知干预技术治疗习得性口吃的方法和步骤,为口吃问题的临床治疗提供借鉴。方法采用观察法、访谈法、认知疗法及行为疗法中的放松训练,并结合元认知行为干预技术中情感组织者技术对一名习得性口吃患者进行心理咨询与治疗。结果习得性口吃患者认识到口吃发生的心理机制,在没有使用任何辅助药物的情况下,通过元认知干预技术和5次放松训练,患者口吃问题已经基本消除。结论元认知干预技术治疗习得性口吃临床效果显著,适合于普遍推广和使用。     

Evidence for a lack of phasic inhibitory properties of habituated stressors on HPA axis responses in rats

This experiment tested the hypothesis that habituation to repeated stressor exposures is produced by phasic inhibitory influence on the neural circuitry that normally drives the paraventricular nucleus of the hypothalamus and subsequently the adrenocortical hormone response to psychological stress. Such a process would be expected to lower the acute response to a novel stressor when experienced concurrently with a habituated stressor. Rats were exposed to restraint or no stress conditions for 14 consecutive days. On the 15th day, the rats were exposed to the control condition (no stress), acute restraint, loud noise, or restraint and loud noise concurrently. Blood was taken and assayed for ACTH and corticosterone and brains were collected to examine c-fos messenger RNA expression in several brain areas. As predicted, the rats that received the same (homotypic) stressor repeatedly and again on the test day displayed low levels of ACTH and corticosterone, similar to the control conditions (i.e., showed habituation). All rats that received a single novel stressor on the test day, regardless of prior stress history, exhibited high levels of ACTH and corticosterone. The rats that received two novel stressors also displayed high levels of ACTH and corticosterone, but little evidence of additivity was observed. Importantly, when a novel stressor was concurrently given with a habituated stressor on the test day, no reduction of HPA axis response was observed when compared to previously habituated rats given only the novel stressor on the test day. In general, c-fos mRNA induction in several stress responsive brain areas followed the same patterns as the ACTH and corticosterone data. These data suggest that habituation of the adrenocortical hormone response to psychological stressors is not mediated by phasic inhibition of the effector system.     

Psychophysiological correlates of individual differences in patterns of hemodynamic reactivity.

The present study delineates a method for the quantification of six hemodynamic reactivity patterns, in response to a laboratory stressor, and examines the psychophysiological correlates of individual differences in these patterns. One hundred and ninety-four young adult men and women participated in rest periods and two laboratory stressors, mental arithmetic and an anger recall interview. Measures were taken of blood pressure, heart rate, and cardiac output, from which total peripheral resistance was derived, as well as state reports of feelings during the tasks. Six hemodynamic reactor patterns were identified: Non-reactors, Mild Myocardials, Mild Vasculars, Myocardials, Vasculars, and Dual Reactors, each associated with a unique profile of cardiac output and total peripheral resistance change. Myocardial reactors to the interview had the highest resting levels of blood pressure and total peripheral resistance. Dual reactors had the largest increases in diastolic reactivity; Dual and Myocardial reactors had the largest increases in systolic reactivity. The extreme reactor groups (Dual, Myocardial, Vascular) all reported greater task invigoration than the Non-reactors, who reported greater efforts to relax. Reactor groups were similar on anger-related trait affect. Based on both resting blood pressure and magnitude of task-induced reactivity, Myocardial and Dual reactors may be at the greatest risk for subsequent hypertension.