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Ditto B, Balegh S, Gilchrist PT, Holly CD. Relation between perceived blood loss and vasovagal symptoms in blood donors. Clin Auton Res 2011; 22:113-6. [PMID: 22045364 DOI: 10.1007/s10286-011-0147-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 05/25/2011] [Indexed: 11/28/2022]
Abstract
UNLABELLED INTRODUCTION/RESULTS: This study examined whether a belief of significant blood loss may be associated with vasovagal symptoms, irrespective of actual blood loss. Individual differences in vasovagal symptoms among blood donors who had an equivalent amount of blood withdrawn were significantly associated with their rating of perceived blood loss. CONCLUSION The anticipation or belief of blood loss, and perhaps more remotely associated ideas, may trigger processes similar to those induced by actual hemorrhage though further research is required to address other possibilities such as the inflation of ratings by vasovagal symptoms.
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Holly CD, Balegh S, Ditto B. Applied tension and blood donation symptoms: the importance of anxiety reduction. Health Psychol 2011; 30:320-5. [PMID: 21463037 DOI: 10.1037/a0022998] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Despite being a voluntary activity, many blood donors experience anxiety, and fainting (syncope) is not unusual. The muscle-tensing technique applied tension (AT) has been found to be effective in reducing vasovagal symptoms and syncope. A series of studies was developed to investigate the role of AT on anxiety and fainting. METHODS The mechanisms of AT were examined in the laboratory and the blood donor clinic. In Study 1, 70 participants were assigned randomly to either a control group or an experimental group who learned AT before watching a video depicting blood draws. In Study 2, 667 volunteer blood donors completed similar questionnaires. RESULTS In Study 1, a significant Condition × Sex × Needle Fear interaction, F(1, 59) = 4.97, p = .03, indicated that AT reduced vasovagal symptoms in higher-fear women. Study 2 also found a significant Condition × Sex × Needle Fear effect on vasovagal symptoms, F(2, 653) = 3.95, p = .02, indicating that AT reduced symptoms but primarily among women with more pronounced fear of needles. CONCLUSIONS Analysis of the physiological data and self-reported anxiety supports the conclusion that the reduction in vasovagal symptoms was due more to decreased anxiety rather than exercise-related cardiovascular change. These results suggest that AT may provide a useful means of coping with invasive medical procedures in part by reducing anxiety.
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Soliman A, O'Driscoll GA, Pruessner J, Joober R, Ditto B, Streicker E, Goldberg Y, Caro J, Rekkas PV, Dagher A. Limbic response to psychosocial stress in schizotypy: a functional magnetic resonance imaging study. Schizophr Res 2011; 131:184-91. [PMID: 21705195 DOI: 10.1016/j.schres.2011.05.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 05/11/2011] [Accepted: 05/17/2011] [Indexed: 11/27/2022]
Abstract
Psychological stress causes dopamine release in the striatum and is thought to play a role in susceptibility to psychotic illness. Previous work suggests that an elevated dopaminergic response to stress may index vulnerability to psychosis in certain individuals. With functional magnetic resonance imaging, we measured stress-induced changes in brain activity in healthy individuals at elevated risk of developing psychosis. Participants were 15 controls and 25 psychometric schizotypes: 12 with positive symptom schizotypy (perceptual aberrations) and 13 with negative symptom schizotypy (physical anhedonia), as determined by questionnaires (Chapman et al., 1976; Chapman and Chapman, 1978). In the scanner, participants performed the Montreal Imaging Stress Task and a matched sensory-motor control task. Measures of self-reported stress and salivary cortisol levels were taken throughout the experiment. All three groups showed significant increases in self-reported stress and significant fMRI signal change in the striatal, limbic and cortical regions. However, the Physical Anhedonia group showed greater stress-induced striatal and limbic deactivation than the other two groups. Deactivation in the striatum was significantly correlated with Physical Anhedonia score across all subjects. Our findings suggest the presence of abnormalities in striatal response to stress in negative symptom schizotypy.
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Gordon JL, Ditto B, Lavoie KL, Pelletier R, Campbell TS, Arsenault A, Bacon SL. The effect of major depression on postexercise cardiovascular recovery. Psychophysiology 2011; 48:1605-1610. [DOI: 10.1111/j.1469-8986.2011.01232.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ditto B, Gilchrist PT, Holly CD. Fear-related predictors of vasovagal symptoms during blood donation: it's in the blood. J Behav Med 2011; 35:393-9. [PMID: 21751041 DOI: 10.1007/s10865-011-9366-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 06/20/2011] [Indexed: 11/24/2022]
Abstract
A recent theory proposes that emotional fainting developed from an earlier adaptive characteristic, fainting in response to hemorrhage. Despite potential loss of consciousness, a dramatic decrease in blood pressure improves chances of survival in animals with severe wounds by reducing blood loss and facilitating clotting. Humans may have developed the characteristic of emotional fainting as a response to anticipated blood loss. This idea suggests that people with stronger fears of blood should be especially susceptible to fainting and milder vasovagal symptoms such as dizziness and lightheadedness. Two samples of young adult blood donors (N = 276 and 663) who completed the Medical Fears Survey (MFS) were studied. Items from the MFS related to fears of blood, needles, and mutilation were used to predict self-reported dizziness and nurse-initiated treatment for vasovagal reactions. In both samples, fears of experiencing or seeing blood loss were more closely associated with both subjective and objective measures of vasovagal reactions, despite the fact that other fears (e.g., fears related to needles) were more common overall. Better understanding of the mechanisms of vasovagal reactions has both theoretical and clinical implications, such as improving means of coping with invasive medical procedures.
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Ditto B, France CR, Holly C. Applied tension may help retain donors who are ambivalent about needles. Vox Sang 2010; 98:e225-30. [PMID: 20432513 DOI: 10.1111/j.1423-0410.2009.01273.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Vasovagal symptoms can discourage people who might otherwise give blood on many occasions. However, the effects of symptoms on donor retention as well as the effects of treatments to reduce vasovagal symptoms on donor retention are probably moderated by a person's confidence that they can tolerate the procedure. METHODS Data from a study on the effects of the muscle tensing technique applied tension (AT) on donor retention were examined to determine if (1) the degree of donor ambivalence about needles influenced the impact of vasovagal symptoms on subsequent return and (2) ambivalence about needles moderated the effect of learning AT on donor return. One-year follow-up data on 614 people who had previously given blood and were randomly assigned to either a no treatment, donation-as-usual condition or one of two conditions involving AT were obtained. Self-reported degree of needle ambivalence and vasovagal symptoms were assessed during the initial blood donation. RESULTS Among participants in the no treatment group, increases in vasovagal symptoms were associated with decreases in donor return but only among people who expressed some fear of blood draws. Similarly, among people who expressed no fear of needles, learning AT had no effect on post-donation estimate of the likelihood they would give blood again or return rate. However, among people with some fear of blood draws learning AT led to both a higher estimate that they would give blood again as well as actual return rate. CONCLUSIONS The experience of vasovagal symptoms may not deter people who are generally confident in their ability to tolerate blood donation. However, among people who are ambivalent about needles, symptoms may 'confirm' pre-existing doubts about their suitability for blood donation and lead to drop-out. Targeted interventions that give the uncertain volunteer a sense of confidence that they might be able to realize their goal and become a regular blood donor may be useful.
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France CR, Ditto B, Wissel ME, France JL, Dickert T, Rader A, Sinclair K, McGlone S, Trost Z, Matson E. Predonation hydration and applied muscle tension combine to reduce presyncopal reactions to blood donation. Transfusion 2010; 50:1257-64. [PMID: 20113455 PMCID: PMC2935324 DOI: 10.1111/j.1537-2995.2009.02574.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A randomized controlled trial was conducted to test the effects of hydration and applied muscle tensing on presyncopal reactions to blood donation. Both interventions are designed to prevent the decreases in blood pressure that can contribute to such reactions, but due to the distinct physiologic mechanisms underlying their pressor responses it was hypothesized that a combined intervention would yield the greatest benefit. STUDY DESIGN AND METHODS Before blood donation, first- and second-time blood donors (mean age, 20.2 years; SD, 4.9) were randomly assigned to 1) standard donation, 2) placebo (leg exercise before venipuncture), 3) predonation water, or 4) predonation water and leg exercise during donation. RESULTS Main effects of group were observed for phlebotomist classification of vasovagal reactions (chi(2)(3) = 8.38, p < 0.05) and donor reports of presyncopal reactions (chi(2)(3) = 13.16, p < 0.01). Follow-up analyses of phlebotomist classifications revealed fewer reactions in the predonation water and predonation water and leg exercise groups relative to placebo but not standard donation. Follow-up analyses of self-reported reactions revealed that women, but not men, had lower scores in both the predonation water and the predonation water and leg exercise groups relative to both placebo and standard donation. CONCLUSIONS Predonation hydration and a combination of hydration and leg exercise may help attenuate presyncopal reactions in relatively novice donors, although future studies with larger samples are required to confirm this effect.
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Ditto B, Byrne N, Holly C. Physiological Correlates of Applied Tension May Contribute to Reduced Fainting During Medical Procedures. Ann Behav Med 2009; 37:306-14. [DOI: 10.1007/s12160-009-9114-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ditto B, Lewkowski MD, Rainville P, Duncan GH. Effects of cardiopulmonary baroreceptor activation on pain may be moderated by risk for hypertension. Biol Psychol 2009; 82:195-197. [PMID: 19646503 DOI: 10.1016/j.biopsycho.2009.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 07/17/2009] [Accepted: 07/20/2009] [Indexed: 11/17/2022]
Abstract
Cardiopulmonary baroreceptor stimulation may modulate pain, though the literature is much smaller than research showing that sinoaortic baroreceptor stimulation can buffer pain. To examine the possibility that risk for established high blood pressure may moderate the effects of cardiopulmonary baroreceptor stimulation on pain, 22 borderline hypertensive and 18 normotensive men participated in a laboratory experiment. Group differences in blood pressure were documented by 24-h ambulatory blood pressure recording. Ratings of the intensity of acute heat pain were influenced by both group membership and leg position. Passive elevation of the legs, a technique that stimulates cardiopulmonary baroreceptors, reduced ratings of heat pain though only among borderline hypertensives. Alteration of pain sensitivity may reflect the development of the hypertensive process.
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Ditto B, France CR, Albert M, Byrne N, Smyth-Laporte J. Effects of applied muscle tension on the likelihood of blood donor return. Transfusion 2009; 49:858-62. [DOI: 10.1111/j.1537-2995.2008.02067.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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France CR, Ditto B, France JL, Himawan LK. Psychometric properties of the Blood Donation Reactions Inventory: a subjective measure of presyncopal reactions to blood donation. Transfusion 2008; 48:1820-6. [PMID: 18657080 DOI: 10.1111/j.1537-2995.2008.01831.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ditto B, France CR, Albert M, Byrne N. Dismantling applied tension: mechanisms of a treatment to reduce blood donation–related symptoms. Transfusion 2007; 47:2217-22. [PMID: 17714419 DOI: 10.1111/j.1537-2995.2007.01449.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Blood donation-related symptoms such as dizziness, nausea, and fainting are unpleasant for the donor and a significant disincentive for repeat donation. The muscle tensing technique of applied tension (AT) reduced symptoms in several studies. STUDY DESIGN AND METHODS This study was a randomized controlled trial of different components of AT. A total of 1209 donors were randomly assigned to one of six conditions involving tension of different muscle groups or donation as usual. Dependent measures included a symptom questionnaire and whether or not the donor's chair was reclined to treat a reaction. RESULTS Replicating previous findings, donors who practiced the "full" AT procedure reported significantly fewer symptoms, were less likely to require chair reclining, and rated their chances of giving blood again as greater than those in the donation-as-usual group. Of the component groups, donors who tensed only their lower body were most similar to the full-AT group. Upper-body tension in and of itself did not reduce symptoms though another condition involving upper body tension, which directed attention away from the arm with the needle in it had several significant effects. CONCLUSION The positive effects of AT on blood donation outcome appear to be mediated primarily by lower-body tension though distraction also probably contributes to its impact.
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Ferguson E, France CR, Abraham C, Ditto B, Sheeran P. Improving blood donor recruitment and retention: integrating theoretical advances from social and behavioral science research agendas. Transfusion 2007; 47:1999-2010. [DOI: 10.1111/j.1537-2995.2007.01423.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gordon JL, Lavoie KL, Arsenault A, Ditto B, Bacon SL. Health behaviors and endothelial function. J Behav Med 2007; 31:5-21. [PMID: 17906923 DOI: 10.1007/s10865-007-9129-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 08/17/2007] [Indexed: 01/17/2023]
Abstract
An unhealthy lifestyle, including excess caloric intake, lack of exercise, smoking, and excessive alcohol consumption, increases one's risk of developing cardiovascular disease (CVD). However, the exact mechanisms by which these behaviors influence the development and progression of CVD have yet to be determined. Endothelial function (EF) has been shown to be a potent predictor of CVD, yet the effects of health behaviors on EF are not clear. The literature assessing the role of four health behaviors, obesity (a proxy of excess caloric intake), smoking, physical inactivity, and alcohol consumption, on the development of endothelial dysfunction is reviewed. Potential mechanisms through which these behaviors may influence EF are discussed. Smoking, being overweight or obese, and physical inactivity are all associated with decreased EF. A direct causal relationship between these measures and EF is suggested by the fact that improvements in these behaviors leads to parallel improvements in EF. The influence of alcohol consumption is somewhat more contentious, with some studies indicating a dose-response relationship such that those with greater consumption have poor EF. However, other studies have shown that those who drink moderately have the best EF. Although there is a growing body of literature implicating poor health behaviors in the development of endothelial dysfunction, more work is needed to establish the exact mechanisms by which this occurs. To our knowledge, there are no studies that have assessed the impact of multiple health behaviors or the interaction of health behaviors on EF.
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Lewkowski MD, Young SN, Ghosh S, Ditto B. Effects of opioid blockade on the modulation of pain and mood by sweet taste and blood pressure in young adults. Pain 2007; 135:75-81. [PMID: 17560720 DOI: 10.1016/j.pain.2007.05.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 04/20/2007] [Accepted: 05/02/2007] [Indexed: 11/28/2022]
Abstract
Increased blood pressure and sweet taste are often associated with decreased pain sensitivity. Animal research suggests that endogenous opioids are involved in both these relationships. Fifty-eight healthy young adults (36 male, 22 female) participated in two sessions receiving a placebo tablet or 50mg of naltrexone on counterbalanced days. On each day, three cold-pressor tests were administered while the participant held a sweet solution, water, or nothing in their mouth when their hand was in the water. 2 Drug x 3 Solution x 2 Gender x Pre-Drug Resting Blood Pressure general linear models (GLM) were conducted separately for systolic (SBP) and diastolic (DBP) pressure. Consistent with previous research, significant main effects of SBP were observed in GLMs of pain tolerance and pain unpleasantness ratings. A main effect of solution on tolerance was seen in the GLM with DBP, which was qualified by an interaction of solution by blood pressure. Sweet taste increased pain tolerance among those with lower DBP across drug conditions. This suggests some overlap between mechanisms of sweet taste and blood pressure analgesia, without implicating opioid activity in sweet taste analgesia. However, the GLM of tolerance also produced a significant drug by DBP interaction suggesting that blood pressure-related analgesia is at least partially opioid-mediated. Also participants with higher DBP showed dampened mood reactivity to the experiment, which was partially reversible by naltrexone. These results are consistent with findings suggesting that endogenous opioid activity may contribute to generally reduced pain sensitivity, and perhaps mood reactivity, in those with higher BP.
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Ditto B, D'Antono B, Dupuis G, Burelle D. Chest pain is inversely associated with blood pressure during exercise among individuals being assessed for coronary heart disease. Psychophysiology 2007; 44:183-8. [PMID: 17343701 DOI: 10.1111/j.1469-8986.2007.00494.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Acute and chronic increases in blood pressure have been related to decreases in pain perception. This phenomenon has been studied primarily using acute experimental pain stimuli. To extend the literature to naturalistic pain and in particular the problem of silent cardiac ischemia, this study examined the relationship between blood pressure and chest pain during exercise stress testing. Nine hundred seven (425 men, 482 women) individuals undergoing exercise stress testing for diagnosis of possible myocardial ischemia completed the McGill Pain Questionnaire (MPQ) immediately afterward and other questionnaires before and after testing. Blood pressure was measured before, during, and after exercise. Systolic blood pressure at the end of exercise was inversely related to a number of measures of pain such as total score on the MPQ. The relationship could not be explained by individual differences in exercise duration, medication use, sex, or other measured variable. In sum, the inverse relationship between blood pressure and sensitivity to pain that has been observed in other populations in experimental and naturalistic conditions was observed for chest pain during exercise. Blood pressure may contribute to episodes of silent ischemia.
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Ditto B, Eclache M, Goldman N. Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Ann Behav Med 2006; 32:227-34. [PMID: 17107296 DOI: 10.1207/s15324796abm3203_9] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Recent research suggests that the Mindfulness-Based Stress Reduction program has positive effects on health, but little is known about the immediate physiological effects of different components of the program. PURPOSE To examine the short-term autonomic and cardiovascular effects of one of the techniques employed in mindfulness meditation training, a basic body scan meditation. METHODS In Study 1, 32 healthy young adults (23 women, 9 men) were assigned randomly to either a meditation, progressive muscular relaxation or wait-list control group. Each participated in two laboratory sessions 4 weeks apart in which they practiced their assigned technique. In Study 2, using a within-subjects design, 30 healthy young adults (15 women, 15 men) participated in two laboratory sessions in which they practiced meditation or listened to an audiotape of a popular novel in counterbalanced order. Heart rate, cardiac respiratory sinus arrhythmia (RSA), and blood pressure were measured in both studies. Additional measures derived from impedance cardiography were obtained in Study 2. RESULTS In both studies, participants displayed significantly greater increases in RSA while meditating than while engaging in other relaxing activities. A significant decrease in cardiac pre-ejection period was observed while participants meditated in Study 2. This suggests that simultaneous increases in cardiac parasympathetic and sympathetic activity may explain the lack of an effect on heart rate. Female participants in Study 2 exhibited a significantly larger decrease in diastolic blood pressure during meditation than the novel, whereas men had greater increases in cardiac output during meditation compared to the novel. CONCLUSIONS The results indicate both similarities and differences in the physiological responses to body scan meditation and other relaxing activities.
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Lavoie KL, Bacon SL, Barone S, Cartier A, Ditto B, Labrecque M. What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both? Chest 2006; 130:1039-47. [PMID: 17035436 DOI: 10.1378/chest.130.4.1039] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The high burden of asthma appears to be related to poor asthma control. Although previous studies have reported associations between depressive disorders (DDs) and anxiety disorders (ADs) and worse asthma control and quality of life, the relative impact of these disorders on asthma control and quality of life has not been explored. This study evaluated the relative impact of having a DD and/or AD on asthma control and quality of life. METHOD Five hundred four consecutive adults with confirmed, physician-diagnosed asthma underwent a brief, structured psychiatric interview using the Primary Care Evaluation of Mental Disorders. Asthma control and asthma-related quality of life were assessed using the Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ). All patients underwent standard spirometry. RESULTS Thirty-one percent of patients (n = 157) met the diagnostic criteria for one or more psychiatric disorders (8% had DD only, 12% had AD only, and 11% had both). Analyses revealed independent effects for DDs on total ACQ scores (p < 0.01), and for DDs and ADs on total AQLQ scores and all four AQLQ subscales (p < 0.05). There were no interaction effects. CONCLUSIONS Results suggest that DDs and ADs are associated with worse asthma-related quality of life, but only DDs are associated with worse asthma control. Interestingly, having both a DD and an AD did not confer additional risk for worse asthma control or quality of life. Physicians may want to consider the differential impact of negative mood states when assessing levels of asthma control and quality of life.
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Ditto B, France CR. The effects of applied tension on symptoms in French-speaking blood donors: a randomized trial. Health Psychol 2006; 25:433-7. [PMID: 16719616 DOI: 10.1037/0278-6133.25.3.433] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Blood-donation-related symptoms such as dizziness and weakness discourage people from participating in this important health-related activity. Four hundred sixty-seven young adult, French-speaking blood donors were randomly assigned to (a) a condition in which they learned a possible preventive technique called applied tension and were asked to practice it from the time they got on the donation chair until they were just about to get up, (b) a placebo condition in which they learned applied tension and were asked to practice it from the time they got on the chair until the insertion of the donation needle, or (c) a no-treatment control condition. Donors assigned to the treatment condition reported significantly fewer blood-donation-related symptoms than did donors assigned to the other conditions and rated their likelihood of returning to give blood again as greater than did those in the no treatment condition. Among donors whose chairs were not reclined, participants in the treatment condition had significantly smaller heart rate reactions to blood donation than did those in the other conditions.
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Ditto B, France CR. Vasovagal symptoms mediate the relationship between predonation anxiety and subsequent blood donation in female volunteers. Transfusion 2006; 46:1006-10. [PMID: 16734818 DOI: 10.1111/j.1537-2995.2006.00835.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although not universal, a certain amount of predonation anxiety is common and not surprising among inexperienced blood donors. Variations in predonation anxiety, however, may influence the donor's experience in several respects and might be related to the likelihood of subsequent donation even among those who do not report particularly high levels of anxiety. STUDY DESIGN AND METHODS A total of 671 inexperienced blood donors (zero or one prior donation) enrolled in a treatment study and completed questionnaires assessing anxiety before and after giving blood. Ratings of pain and blood donation-related symptoms were obtained after giving blood, as well as information from the nurses about the blood donation procedure. Follow-up information on number of additional visits to a blood collection clinic during the subsequent year was also obtained for most participants. RESULTS Predonation anxiety was positively related to ratings of blood donation-related symptoms and chair reclining by the nurses and negatively related to the donor's rating, obtained at the end of the procedure, of the likelihood that he or she would give blood again. Women, but not men, with higher predonation anxiety were significantly less likely to return to a blood clinic in the following year. The results of mediation analyses suggest that this was due to the association between anxiety and donation-related symptoms. CONCLUSION The results do not indicate whether or not it is feasible or useful to modify predonation anxiety, but highlight the relationships between the emotional state of inexperienced donors and several aspects of the donation experience, including subsequent donor return. Further study of the psychosocial aspects of blood donation and examination of related research (e.g., treatment of dental anxieties) may be worthwhile.
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Ditto B, Séguin JR, Tremblay RE. Neuropsychological characteristics of adolescent boys differing in risk for high blood pressure. Ann Behav Med 2006; 31:231-7. [PMID: 16700636 DOI: 10.1207/s15324796abm3103_4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Individuals with established hypertension have been found to display deficits in a number of neuropsychological abilities. In general, these are probably due to structural changes in the brain produced by sustained high blood pressure. However, a potentially important line of research suggests that some of these deficits may extend to younger individuals with less severe elevations of blood pressure, perhaps even children, and thus be related more to risk for hypertension than hypertension per se. PURPOSE The objective was to examine the relationships between neuropsychological function and risk for hypertension in children. METHODS Measurements of blood pressure and parental history of hypertension were obtained in 88 French-Canadian 14-year-old boys and used to predict performance on a neuropsychological battery. RESULTS Boys at greater risk of hypertension by virtue of having a parental history of high blood pressure and normatively elevated systolic blood pressure had significantly lower scores on a verbal learning factor score compared to boys at lower risk. Boys with normatively elevated systolic blood pressure also had significantly lower scores on a spatial learning and memory factor score compared to boys with lower blood pressure. The results could not be attributed to differences in family socioeconomic status. CONCLUSIONS Using a younger sample than typically employed in the area, the results support previous suggestions that some of the neuropsychological characteristics displayed by hypertensive individuals may predate the development of clinically elevated blood pressure and could be associated with risk for the disorder.
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Bacon SL, Lavoie KL, Campbell TS, Fleet R, Arsenault A, Ditto B. The role of ischaemia and pain in the blood pressure response to exercise stress testing in patients with coronary heart disease. J Hum Hypertens 2006; 20:672-8. [PMID: 16710292 DOI: 10.1038/sj.jhh.1002043] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Silent myocardial ischaemia is a common phenomenon in patients with coronary heart disease. However, very little is known about the underlying mechanisms of silent ischaemia. One potential pathway that may contribute to this absence of pain is increased blood pressure. The main aim of the current study was to assess the associations among blood pressure, pain and ischaemia in patients undergoing a standard exercise stress test. We hypothesized that patients who experienced chest pain during exercise would have lower baseline and peak blood pressures compared to those who did not experience chest pain. A total of 1,355 patients (418 women) who underwent a single-photon emission computed tomography treadmill exercise stress test and had not experienced a cardiac event in the past 2 weeks participated in the current study. Myocardial perfusion defects were assessed at rest and during the stress challenge. Systolic blood pressure (SBP), diastolic blood pressure, heart rate (HR) and rate pressure product (RPP) were assessed during rest and at peak exercise. There were no main effects of either pain or ischaemia on the baseline cardiovascular variables. Peak exercise data revealed main effects of pain on SBP, RPP and HR, and main effects of ischaemia on SBP and RPP, controlling for age, sex, baseline level, medication status and cardiac history. These findings suggest that acute rather than chronic increases in blood pressure may be one mechanism to explain the phenomena of silent myocardial ischaemia in cardiac patients, and may potentially provide a target for future treatment strategies.
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Campbell TS, Lavoie KL, Bacon SL, Scharf D, Aboussafy D, Ditto B. Asthma self-efficacy, high frequency heart rate variability, and airflow obstruction during negative affect in daily life. Int J Psychophysiol 2006; 62:109-14. [PMID: 16632007 DOI: 10.1016/j.ijpsycho.2006.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2005] [Revised: 01/13/2006] [Accepted: 02/27/2006] [Indexed: 12/01/2022]
Abstract
BACKGROUND Emotional stress has been considered an important asthma trigger for years, though the mechanisms by which stress may exacerbate asthma remain poorly understood. The stress-asthma morbidity association could occur through cognitive-behavioral pathways, such as decreased asthma self-efficacy and disorganized self-care, or through the more direct physiological effects of stress on autonomic (parasympathetic) nervous system activity. No study has examined how these two mechanisms may interact to contribute to greater airflow obstruction during emotional stress in daily life. This study investigated associations between peak expiratory flow rate (PEFR) and high frequency heart rate variability (HFHRV) during periods of negative affect and physical activity in daily life in patients with higher versus lower asthma self-efficacy scores. METHODS Fifty-three patients with mild to moderate asthma completed the Asthma Self-Efficacy Scale (ASES) and underwent a 15 h ambulatory assessment of daytime HFHRV and PEFR, while completing self-report diaries of their physical activities and affect. RESULTS In patients with lower asthma self-efficacy scores, increased levels of negative affect during daily life were associated with higher levels of HFHRV and decreased PEFR relative to patients with higher asthma self-efficacy scores. Increased levels of physical activity were associated with decreased levels of HFHRV irrespective of asthma self-efficacy scores. CONCLUSIONS Findings suggest that lower asthma self-efficacy may be associated with increased parasympathetic activity and airflow obstruction during periods of negative affect during daily life.
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Lavoie KL, Bacon SL, Labrecque M, Cartier A, Ditto B. Higher BMI is associated with worse asthma control and quality of life but not asthma severity. Respir Med 2006; 100:648-57. [PMID: 16159709 DOI: 10.1016/j.rmed.2005.08.001] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Revised: 07/20/2005] [Accepted: 08/02/2005] [Indexed: 01/02/2023]
Abstract
Asthma and obesity tend to co-occur, but relatively few studies have linked obesity, measured using body mass index (BMI), to clinically relevant measures of asthma morbidity. This study assessed BMI in a Canadian sample of asthma outpatients, and evaluated associations between BMI and levels of asthma severity, asthma control, and asthma-related quality of life. A total of 382 adult asthma patients underwent demographic and medical history interviews on the day of their clinic visit. Patients' self-reported height and weight were used to calculate BMI (kg/m(2)). Asthma severity was classified according the GINA (2002) guidelines. Patients completed the Asthma Control (ACQ) and Asthma Quality of Life (AQLQ) Questionnaires and underwent standard pulmonary testing (spirometry). A total of 139 (36%) patients had a normal BMI; 149 (39%) patients were overweight; and 94 (25%) patients were obese. There was no relationship between BMI and asthma severity when controlling for age and sex. Patients with higher BMI scores had higher ACQ and lower AQLQ scores, independent of age, sex and asthma severity. Results identify higher BMI and obesity as potential behavioral factors related to worse asthma control and quality of life, but not asthma severity, and suggest important avenues for asthma management and control initiatives.
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Aboussafy D, Campbell TS, Lavoie K, Aboud FE, Ditto B. Airflow and autonomic responses to stress and relaxation in asthma: the impact of stressor type. Int J Psychophysiol 2006; 57:195-201. [PMID: 15975675 DOI: 10.1016/j.ijpsycho.2005.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Accepted: 02/01/2005] [Indexed: 11/21/2022]
Abstract
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.
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