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Lozza-Fiacco S, Gordon JL, Andersen EH, Kozik RG, Neely O, Schiller C, Munoz M, Rubinow DR, Girdler SS. Baseline anxiety-sensitivity to estradiol fluctuations predicts anxiety symptom response to transdermal estradiol treatment in perimenopausal women - A randomized clinical trial. Psychoneuroendocrinology 2022; 143:105851. [PMID: 35809362 PMCID: PMC9716440 DOI: 10.1016/j.psyneuen.2022.105851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/10/2022] [Accepted: 06/22/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND The menopausal transition (perimenopause) is associated with an increased risk of major depression, characterized by anxiety and anhedonia phenotypes. Greater estradiol (E2) variability predicts the development of perimenopausal depression, especially within the context of stressful life events (SLEs). While transdermal E2 (TE2) reduces perimenopausal depressive symptoms, the mechanisms underlying TE2 efficacy and predictors of TE2 treatment response remain unknown. This study aimed at determining relationships between E2 fluctuations, mood symptoms, and physiologic stress-reactivity (cortisol and interleukin-6) and whether differences in mood-sensitivity to E2 fluctuations predict mood responses to TE2 treatment. METHODS This randomized, double-blind, placebo-controlled trial investigated medically healthy women (46-60 years) in the early or late menopause transition. Baseline E2-sensitivity strength was calculated from eight weekly individual correlations between week-to-week E2 change and index week anxiety (State-Trait Anxiety Inventory) and anhedonia (Snaith-Hamilton Pleasure Scale). Women then received eight weeks of TE2 or transdermal placebo. RESULTS Analyses included 73 women (active TE2 n = 35). Greater baseline E2 fluctuations predicted greater anhedonia (p = .002), particularly in women with more SLEs. Greater E2 fluctuations also predicted higher cortisol (p = .012) and blunted interleukin-6 (p = .02) stress-responses. Controlling for baseline symptoms, TE2 was associated with lower post-treatment anxiety (p < .001) and anhedonia (p < .001) versus placebo. However, the efficacy of TE2 for anxiety (p = .007) and also for somatic complaints (p = .05) was strongest in women with greater baseline E2 sensitivity strength. CONCLUSIONS TE2 treatment reduced perimenopausal anxiety and anhedonia. The ability of baseline mood-sensitivity to E2 fluctuations to predict greater TE2 efficacy has implications for individualized treatment of perimenopausal anxiety disorders.
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Affiliation(s)
- Serena Lozza-Fiacco
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Department of Psychology, University of Zurich, 8052 Zurich, Switzerland.
| | - Jennifer Lee Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, S4S 0A2 Canada
| | - Elizabeth Helen Andersen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Rachel Grace Kozik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Olivia Neely
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Crystal Schiller
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Maria Munoz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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Logan TK, Lynch KR. Dangerous Liaisons: Examining the Connection of Stalking and Gun Threats Among Partner Abuse Victims. VIOLENCE AND VICTIMS 2018; 33:399-416. [PMID: 30567855 DOI: 10.1891/0886-6708.v33.i3.399] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Little is known about the scope and nature of how guns are used to threaten (ex)partners particularly during periods of stalking, which often occurs after victims leave their abusers. This study examines survey results from over 500 women from across the United States who contacted the National Domestic Violence Hotline. Specifically, this study (a) describes the prevalence and characteristics of partner abuse victims who were and were not stalked and who were and were not threatened with guns, (b) compares types of gun threats experienced by partner abuse victims who were and were not stalked, (c) examines worries about gun threats for those who were and were not stalked among partner abuse victims not threatened with a gun, and (d) assesses factors associated with advice to obtain a gun for personal safety. This article also provides open-ended comments selected to highlight themes from the quantitative information around participant fears and worries about gun threats and stalking. Findings from this study show one-third of the participants had experienced threats with guns, and one-fifth of those without gun threats worried their (ex)partner would harm them with a gun. Furthermore, there was a significant association between stalking and gun threats, as three-fourth of those who were threatened with a gun reported being stalked. Victims who experienced stalking were also more likely to report their (ex)partner threatened others with guns and were more likely to carry a firearm on their body or in their car, which suggests stalkers who threatened with guns may pose a significant risk to public safety. Implications for future research are discussed.
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Affiliation(s)
- T K Logan
- University of Kentucky, Lexington, Kentucky
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Logan TK, Walker R. Stalking: A Multidimensional Framework for Assessment and Safety Planning. TRAUMA, VIOLENCE & ABUSE 2017; 18:200-222. [PMID: 26337574 DOI: 10.1177/1524838015603210] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Despite the high prevalence of stalking and the risk of harm it poses to victims, arrest rates, prosecutions, and convictions for stalking continue to be low in the United States. The overall goal of this article is to introduce a multidimensional framework of stalking that adds to the current literature by (1) providing a conceptual framework consistent with legal elements of many stalking statutes to facilitate assessment, communication, documentation, and safety planning for stalking several victims; (2) introducing a more systematic way of assessing course of conduct and the context of fear in stalking situations in order to increase the understanding of cumulative fear for stalking victims; (3) emphasizing the aspects of stalking harm that go beyond violence and that show how harm from stalking accumulates over time including life sabotage; and (4) discussing 12 risk factors derived from the overall multidimensional framework that can be used to describe the big picture of stalking and to facilitate safety planning for victims. Implications for future research are discussed.
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Affiliation(s)
- T K Logan
- 1 University of Kentucky, Lexington, KY, USA
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Logan TK. "If I Can't Have You Nobody Will": Explicit Threats in the Context of Coercive Control. VIOLENCE AND VICTIMS 2017; 32:126-140. [PMID: 28234202 DOI: 10.1891/0886-6708.vv-d-14-00187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Physical assault is only one tool in partner abuse characterized by coercive control. Coercive control creates an ongoing state of fear and chronic stress. Explicit threats are an important component of coercive control yet have received limited research attention. This study examined 210 women with protective orders (POs) against abusive (ex)partners and their experiences of explicit threats including threats of harm and death, threats about harming friends and family, and actual threats to friends and family. There are 4 main findings from this study: (a) explicit threats of harm and death, threats about harming others, and actual threats to others are common both in the history of the abusive relationship as well as within 6 months prior to obtaining a PO but are only moderately correlated with each other; (b) the high-frequency threats of harm group had the highest rates of concurrent abuse, violence, distress, and fear; (c) the prevalence and frequency of threats changed over time for all 3 types of threats examined in this study; and (d) understanding the variety of threats partner abuse victims experience, especially threats of third-party harm, may be important in understanding the larger context and consequences of partner abuse. This study is an interim step toward a better understanding of the role of explicit threats in abusive relationships. Future research is needed to examine the prevalence, frequency, trajectory, features, context, and types of explicit threats that victims of partner abuse experience. This information may be especially key to understanding more about future risk of harm, risk of harm to others, victim distress and fear, and safety planning.
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Abstract
Counseling psychologists generally agree that science-practice integration is a good thing. However, most discussions of this topic are less clear about how to actually apply scientific findings to an individual client case. In this article, the author attempts to describe a philosophy for applying research to practice in counseling psychology that requires using theory as the bridge between science and practice.
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Bruk-Lee V, Nixon AE, Spector PE. An expanded typology of conflict at work: Task, relationship and non-task organizational conflict as social stressors. WORK AND STRESS 2013. [DOI: 10.1080/02678373.2013.841303] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Burns JW, Quartana PJ, Gilliam W, Matsuura J, Nappi C, Wolfe B. Suppression of anger and subsequent pain intensity and behavior among chronic low back pain patients: the role of symptom-specific physiological reactivity. J Behav Med 2012; 35:103-14. [PMID: 21597981 PMCID: PMC4170675 DOI: 10.1007/s10865-011-9347-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 04/11/2011] [Indexed: 11/26/2022]
Abstract
Suppression of anger may be linked to heightened pain report and pain behavior during a subsequent painful event among chronic low back patients, but it is not clear whether these effects are partly accounted for by increased physiological reactivity during suppression. Chronic low back pain patients (N = 58) were assigned to Suppression or No Suppression conditions for a "cooperative" computer maze task during which a confederate harassed them. During baseline and maze task, patients' lower paraspinal and trapezius muscle tension, blood pressure and heart rate were recorded. After the maze task, patients underwent a structured pain behavior task (behaviors were videotaped and coded). Results showed that: (a) Suppression condition patients revealed greater lower paraspinal muscle tension and systolic blood pressure (SBP) increases during maze task than No Suppression patients (previously published results showed that Suppression condition patients exhibited more pain behaviors than No Suppression patients); (b) residualized lower paraspinal and SBP change scores were related significantly to pain behaviors; (c) both lower paraspinal and SBP reactivity significantly mediated the relationship between Condition and frequency of pain behaviors. Results suggest that suppression-induced lower paraspinal muscle tension and SBP increases may link the actual suppression of anger during provocation to signs of clinically relevant pain among chronic low back pain patients.
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Affiliation(s)
- John W Burns
- Department of Behavioral Science, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL, 60612, USA.
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Lee YM, Kim GM. Patterns of Anger Expression among Middle-aged Korean Women: Q methodology. J Korean Acad Nurs 2012; 42:1001-8. [DOI: 10.4040/jkan.2012.42.7.1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yong Mi Lee
- Department of Nursing, Kangwon National University, Chuncheon, Korea
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Kreibig SD. Autonomic nervous system activity in emotion: a review. Biol Psychol 2010; 84:394-421. [PMID: 20371374 DOI: 10.1016/j.biopsycho.2010.03.010] [Citation(s) in RCA: 1191] [Impact Index Per Article: 85.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 03/10/2010] [Accepted: 03/10/2010] [Indexed: 11/26/2022]
Abstract
Autonomic nervous system (ANS) activity is viewed as a major component of the emotion response in many recent theories of emotion. Positions on the degree of specificity of ANS activation in emotion, however, greatly diverge, ranging from undifferentiated arousal, over acknowledgment of strong response idiosyncrasies, to highly specific predictions of autonomic response patterns for certain emotions. A review of 134 publications that report experimental investigations of emotional effects on peripheral physiological responding in healthy individuals suggests considerable ANS response specificity in emotion when considering subtypes of distinct emotions. The importance of sound terminology of investigated affective states as well as of choice of physiological measures in assessing ANS reactivity is discussed.
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Affiliation(s)
- Sylvia D Kreibig
- Department of Psychology, University of Geneva and Swiss Center for Affective Sciences, Geneva, Switzerland.
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Lipp MEN, Pinho C, Casteli AC, Santos MGD, Fujita AT. O controle da raiva: eficácia do treino cognitivo na doença arterial coronariana. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2009. [DOI: 10.1590/s0103-166x2009000400011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo teve por objetivos averiguar se o treino cognitivo de controle da raiva é eficaz na redução da reatividade cardiovascular de pacientes diagnosticados com doença arterial coronariana, avaliar seu impacto na redução da raiva e no nível de stress e analisar se há correlação significativa entre a raiva e a magnitude na reatividade cardiovascular em momentos de stress experimental. Vinte e nove adultos com doença arterial coronariana participaram da pesquisa. A reatividade cardiovascular foi aferida, antes e após o tratamento em grupo para a raiva, em sessões de role-play representando situações de stress interpessoal. Resultados mostraram que o tratamento reduziu significativamente os índices de raiva para dentro, raiva estado, raiva traço, expressão, reação e controle da raiva e sintomatologia do stress. A magnitude da reatividade da pressão arterial sistólica correlacionou-se com os índices de raiva temperamento. Verificou-se uma redução significativa na reatividade da pressão arterial sistólica na terceira avaliação, realizada seis meses após o treino cognitivo de controle da raiva.
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Affiliation(s)
| | - Cláudio Pinho
- Pontifícia Universidade Católica de Campinas, Brasil
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Bonomo AMS, Araujo TCCFD. Psicologia aplicada à cardiologia: um estudo sobre emoções relatadas em exame de holter. PSICOLOGIA: TEORIA E PESQUISA 2009. [DOI: 10.1590/s0102-37722009000100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Estudos sobre fatores de risco associados a doenças do coração dão ênfase às emoções negativas e não esclarecem quanto aos efeitos cardíacos de vivências de alegria ou segurança. Realizou-se uma investigação com 30 pessoas submetidas ao exame de Holter 24 horas, visando identificar emoções e episódios de vida diária que ocorrem simultaneamente a arritmias cardíacas. Reuniram-se registros de arritmias, atividades e emoções, complementados por entrevistas semiestruturadas. Verificaram-se diferenças acentuadas entre gêneros: mulheres apresentaram mais arritmias que homens. Nas mulheres, arritmias ventriculares ocorreram mais simultaneamente à preocupação do que à ansiedade e não se mostraram relacionadas à raiva. A tristeza não foi associada a arritmias ventriculares por nenhum dos gêneros.
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Trait anger management style moderates effects of actual ("state") anger regulation on symptom-specific reactivity and recovery among chronic low back pain patients. Psychosom Med 2008; 70:898-905. [PMID: 18725429 PMCID: PMC4170676 DOI: 10.1097/psy.0b013e3181835cb7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We examined whether "state" anger regulation-inhibition or expression-among chronic low back pain (CLBP) patients would affect lower paraspinal (LP) muscle tension following anger-induction, and whether these effects were moderated by trait anger management style. METHOD Eighty-four CLBP patients underwent harassment, then they regulated anger under one of two conditions: half expressed anger by telling stories about people depicted in pictures, whereas half inhibited anger by only describing objects appearing in the same pictures. They completed the anger-out and anger-in subscales (AOS; AIS) of the anger expression inventory. RESULTS General Linear Model procedures were used to test anger regulation condition by AOS/AIS by period interactions for physiological indexes. Significant three-way interactions were found such that: a) high trait anger-out patients in the inhibition condition appeared to show the greatest LP reactivity during the inhibition period followed by the slowest recovery; b) high trait anger-out patients in the expression condition appeared to show the greatest systolic blood pressure (SBP) reactivity during the expression period followed by rapid recovery. CONCLUSIONS Results implicate LP muscle tension as a potential physiological mechanism that links the actual inhibition of anger following provocation to chronic pain severity among CLBP patients. Results also highlight the importance of mismatch situations for patients who typically regulate anger by expressing it. These CLBP patients may be at particular risk for elevated pain severity if circumstances at work or home regularly dictate that they should inhibit anger expression.
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Glynn LM, Christenfeld N, Gerin W. Recreating cardiovascular responses with rumination: the effects of a delay between harassment and its recall. Int J Psychophysiol 2007; 66:135-40. [PMID: 17570551 DOI: 10.1016/j.ijpsycho.2007.03.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 03/10/2007] [Accepted: 03/29/2007] [Indexed: 11/23/2022]
Abstract
Cardiovascular responses occur not only in the immediate presence of stressors, but also while later thinking about those experiences. Evidence suggests that these delayed responses, such as those produced by ruminating about prior angering experiences, may play an important role in the development of cardiovascular disease. We examine whether physiological consequences of rumination depend on the delay between a stressor and its recall, and whether the magnitude of physiological responses decreases with repetition. Twenty-two participants experienced a three-minute harassment stressor, and later spent 3 min vividly recalling the task. Half the subjects returned for the first time after a week, and half returned after half an hour, and then also after a week. Blood pressure and heart rate were monitored during a baseline period, and during each session's stressor or rumination period. Results indicated that rumination was sufficient to elevate blood pressure (systolic and diastolic) above baseline, that the delay made no difference to the magnitude of the elevation, but that the second rumination seemed to be associated with a smaller response than the first. Response to the stressor was not associated with rumination responses, but the first rumination response was significantly correlated with the second. The effects of stress may be experienced long after the actual stressor is passed, and people who experience large delayed responses may not be the same as those with high initial responses. The "hot" affective portion of rumination may not be diminished by the passage of time, but by prior recreation of the experience.
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Affiliation(s)
- Laura M Glynn
- Department of Psychiatry and Human Behavior, University of California, Irvine, 333 City Blvd. W, Suite 1200, Orange, CA 92868, USA.
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Burns JW. Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. ACTA ACUST UNITED AC 2006; 6:309-19. [PMID: 16768562 DOI: 10.1037/1528-3542.6.2.309] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anger may have greater effects on chronic pain severity than other negative emotions and may do so by increasing muscle tension near the site of injury (symptom-specific reactivity). For patients with chronic low back pain (CLBP), relevant muscles are lower paraspinals (LP). Ninety-four CLBP patients and 79 controls underwent anger and sadness recall interviews. EMG and cardiovascular activity were recorded. Patients exhibited greater LP tension increases during anger and slower recovery than controls. Only patients showed greater LP reactivity during anger than sadness. For both groups, trapezius reactivity during anger and sadness did not differ. LP reactivity to anger correlated with everyday pain severity for patients. Anger-induced symptom-specific LP reactivity may be linked to chronic pain aggravation among CLBP patients.
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Affiliation(s)
- John W Burns
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
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Burns JW, Bruehl S, Quartana PJ. Anger management style and hostility among patients with chronic pain: effects on symptom-specific physiological reactivity during anger- and sadness-recall interviews. Psychosom Med 2006; 68:786-93. [PMID: 17012534 DOI: 10.1097/01.psy.0000238211.89198.e4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We examined whether anger-in, anger-out, and hostility predicted symptom-specific muscle tension reactivity during anger induction (but not sadness induction) among patients with chronic low back pain (CLBP). For patients with CLBP, relevant muscles are the lower paraspinals (LPs). Anger-in x hostility and anger-out x hostility interactions were tested to determine whether particularly reactive groups of patients could be identified with a multivariable profile approach. METHODS Ninety-four patients with CLBP underwent anger recall (ARI) and sadness recall (SRI) interviews, whereas LP and trapezius electromyography and systolic blood pressure, diastolic blood pressure, and heart rate were recorded. They completed anger-in, anger-out, hostility, and trait anger measures. RESULTS Hierarchical regressions were used to test anger-in x hostility and anger-out x hostility interactions for physiological changes during the ARI and SRI. A significant anger-in x hostility interaction was found for LP change during the ARI (but not SRI) such that high anger-in/high hostility patients evinced the greatest reactivity. Effects for trapezius reactivity were nonsignificant. Significant anger-in x hostility interactions were also found for systolic blood pressure and diastolic blood pressure changes during the ARI such that high anger-in/low hostility patients showed the smallest changes. The anger-out x hostility interaction for diastolic blood pressure change during ARI was also significant such that high anger-out/low hostility patients showed the smallest changes. All effects remained significant with trait anger controlled. CONCLUSIONS A multivariable profile approach may help identify especially vulnerable patient groups. Patients with CLBP who tend to suppress anger and are cynically hostile may be more likely to experience high levels of muscle tension near the site of pain and injury during anger, but not during sadness, than other groups.
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Affiliation(s)
- John W Burns
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL 60064, USA.
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Fassino S, Leombruni P, Pierò A, Abbate-Daga G, Giacomo Rovera G. Mood, eating attitudes, and anger in obese women with and without Binge Eating Disorder. J Psychosom Res 2003; 54:559-66. [PMID: 12781310 DOI: 10.1016/s0022-3999(02)00462-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the anger levels and their management in obese patients. METHODS A total of 103 obese women [51 with Binge Eating Disorder (BED) and 52 without BED] were included in the study and compared to 93 healthy controls. They were assessed with the State-Trait Anger Expression Inventory (STAXI), Beck Depression Inventory (BDI), and Eating Disorder Inventory-2 (EDI-2). RESULTS The BDI score is higher in obese subjects than in controls and obese binge eaters have higher levels of depression than obese patients without BED. Differences among the three groups can be found in almost all subscales of the EDI-2, even after controlling for the variable depression (BDI). For STAXI, the only difference among the three groups, which remains significant after controlling for depression, is the tendency to express anger outside (AX-OUT), which is higher in obese binge eaters. The correlation study highlights the importance of impulsivity in the group of obese binge eaters, whereas in obese patients without BED, the tendency toward anger suppression (AX-IN) is seen. DISCUSSION Obese patients with BED might be considered a subgroup deserving greater psychiatric interest, both for the greater severity of the eating disorder and for the comorbidity with subthreshold depressive symptoms and with borderline personality traits. In obese patients without BED, eating behavior seems more correlated to the psychological functioning typical of psychosomatic disorders. Implications for treatment are discussed.
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Affiliation(s)
- Secondo Fassino
- Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Psychiatry Institute, University of Turin, Via Cherasco 11, 10126 Turin, Italy.
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Fassino S, Pierò A, Boggio S, Piccioni V, Garzaro L. Anxiety, depression and anger suppression in infertile couples: a controlled study. Hum Reprod 2002; 17:2986-94. [PMID: 12407062 DOI: 10.1093/humrep/17.11.2986] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State-Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility ('organic', 'functional' or 'undetermined'). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS Differences emerged in the degree of psychopathology between 'organic' and 'functional' infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS The 'functional' infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.
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Affiliation(s)
- S Fassino
- Department of Neurosciences, Psychiatric Institute and Clinic, University School of Medicine, via Cherasco 15, CAP 10126, Turin, 'S Anna' Hospital of Turin, Italy.
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