ABSTRACT
Using microelectrode recordings of postganglionic sympatheticaction potentials, the authors studied the effects of hypnotic suggestion on sympathetic outflow targeted to skin during static handgrip exercise. All subjects performed sustained handgrip at 33% maximal voluntary contraction (MVC) for 2 minutes during 3 consecutive trials. Two subjects randomly assigned to a hypnosis condition received suggestions that the 2nd trial was more difficult and the last trial was less difficult than the first trial. Two subjects randomly assigned to the control condition received no hypnosis or suggestions about task difficulty. In the nonhypnosis condition, skin sympathetic nerve activity (SNA) increased by 6% from baseline during the 2nd trial and 13% from baseline during the 3rd trial. In the hypnosis condition, skin SNA increased by 25% during the 2nd trial (suggestion of increased difficulty) and returned to baseline during the 3rd condition (suggestion of decreased difficulty). Therefore, the impact of central command on skin SNA is suggested by these results.
Subject(s)
Brain/physiology , Hypnosis , Pressoreceptors/physiology , Sympathetic Fibers, Postganglionic/physiology , Humans , Reflex/physiology , SuggestionABSTRACT
OBJECTIVE: To improve the accuracy of the Beck Depression Inventory (BDI) in assessing depression in chronic back pain (CBP) patients, the pattern of depression symptomatology was evaluated. DESIGN: Analyses of BDI data obtained from nondepressed and depressed CBP patients were conducted to identify the major factors that differentiated among the patient groups. SETTING: CBP patients were recruited from a tertiary rehabilitation center. PATIENTS: One hundred one nondepressed and 99 depressed CBP patients from the tertiary treatment center. OUTCOME MEASURES AND RESULTS: Analyses of the BDI data revealed a general factor of depression severity that excluded items reflecting weight loss, sleep disturbance, and work inhibition. In addition, these analyses yielded a second factor reflecting somatic concerns and disability. Weight loss, sleep disturbance, and work inhibition failed to differentiate the depressed from the nondepressed CBP subjects, suggesting that these symptoms have poor diagnostic potential for CBP patients. CONCLUSIONS: This study demonstrated that the BDI can be used to generate important information about the severity of interference posed by pain on the functioning of an individual, while allowing for an independent evaluation of subjective indices of depression and somatic disturbances that need to be attended to by clinicians.
Subject(s)
Depressive Disorder/psychology , Low Back Pain/psychology , Adult , Depressive Disorder/complications , Female , Humans , Low Back Pain/complications , Male , Psychiatric Status Rating ScalesABSTRACT
Socioeconomic status (SES) is an important predictor of a range of health and illness outcomes. Research seeking to identify the extent to which this often-reported effect is due to protective benefits of higher SES or to toxic elements of lower social status has not yielded consistent or conclusive findings. A relatively novel hypothesis is that these effects are due to chronic stress that is associated with SES; lower SES is reliably associated with a number of important social and environmental conditions that contribute to chronic stress burden, including crowding, crime, noise pollution, discrimination, and other hazards or stressors. In other words, chronic stress may capture much of the variance in health and social outcomes associated with harmful aspects of lower social status. Low SES is generally associated with distress, prevalence of mental health problems, and with health-impairing behaviors that are also related to stress. Research targeting this hypothesis is needed to determine the extent to which stress is a pathway linking SES and health.
Subject(s)
Health Status , Social Class , Stress, Psychological/physiopathology , Stress, Psychological/psychology , Chronic Disease , Crime/psychology , Environmental Pollution , Health Behavior , Humans , Mental Health , Models, Psychological , Prejudice , Prevalence , Risk Factors , Social Environment , Stress, Psychological/complicationsABSTRACT
The authors describe a prospective study designed to examine the clinical utility of the Research Diagnostic Criteria for Temporomandibular Disorders, or RDC/TMD, in evaluating physical and psychological differences between patients with acute TMD that does not become chronic and patients with chronic TMD. A total of 153 patients with acute TMD participated in the study; the researchers deemed the condition of 87 of these patients to be chronic after a six-month follow-up period, and that of 66 patients to be nonchronic. Using a multiple logistic regression model, the authors found that a number of physical and psychological variables differed significantly between the two groups. These results highlight the importance of the physical-psychosocial interface that affects the development of chronic TMD.
Subject(s)
Temporomandibular Joint Disorders/classification , Temporomandibular Joint Disorders/psychology , Acute Disease , Chi-Square Distribution , Chronic Disease , Facial Pain/etiology , Facial Pain/psychology , Female , Humans , Logistic Models , Male , Middle Aged , Pain Measurement , Personality Assessment , Predictive Value of Tests , Prospective Studies , Psychometrics , Risk Factors , Severity of Illness IndexABSTRACT
This study assessed psychological disorders in 50 patients with chronic temporomandibular disorders and 51 patients with acute TMD. The results revealed a significant psychological comorbidity in both groups of patients. Both groups had high rates of psychopathology that exceeded the base rates of the general population. Such findings are in keeping with an integrated biopsychosocial model of TMD, and have significant implications for treatment of these patients.
