Hemodynamic profile of stress-induced anticipation and recovery.

Systolic and diastolic blood pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were measured in 100 healthy men and women with the aim of investigating hemodynamic profile during anticipation of, and recovery from, exposure to active and passive laboratory stressors. A 5-min anticipatory period preceded two tasks, both of which lasted 2.5 min. The tasks were mental arithmetic ('beta-adrenergic' stress) and the cold pressor test ('alpha-adrenergic' stress). Each task was followed by a 5-min recovery period. Blood pressure and heart rate were measured with a FinaPres 2300e, and stroke volume, cardiac output, and total peripheral resistance were computed from these parameters. Salivary cortisol was measured in relation to both tasks, and participants completed tests of state and trait anxiety, locus of control, and hostility. As expected, mental arithmetic and the cold pressor test elicited myocardial and vascular patterns of reactivity, respectively. However, contrary to expectations, anticipatory and recovery hemodynamic profile involved essentially vascular responding for both stressors. Salivary cortisol increased in response to both tasks but only weakly correlated with hemodynamic changes. None of the subjective measurements was a strong predictor of physiological reactivity. The findings suggest that stress-induced anticipatory and recovery reactivity may be generally vascular rather than myocardial. This could have important implications in light of suggestions that anticipatory and recovery responses may be better predictors of subsequent cardiovascular disease than direct stress-induced reactivity.

Effects of video-relayed social support on hemodynamic reactivity and salivary cortisol during laboratory-based behavioral challenge.

The authors tested the effects of a laboratory analogue of social support on reactivity to laboratory-based behavioral challenge. Video-relayed supportive commentary was provided by a same-sex confederate while participants (40 healthy men and women assigned to support and no-support groups) performed a demanding computer task, and their heart rate, systolic and diastolic blood pressure, and salivary cortisol were measured. The authors found that heart rate and cortisol level (but not blood pressure) were attenuated in the support condition for both genders. Objective performance on the task was similar in both groups, but the social support group reported higher levels of perceived support and rated the task as easier than did participants in the no-support condition. Video presentation offers new opportunities for systematically examining social support and its effects.

Neuropsychologic impairment in adult bone marrow transplant candidates.

BACKGROUND: Long-term cognitive impairment has been reported in adult bone marrow transplant (BMT) recipients. However, the degree to which such impairment is attributable to the procedure or is a condition existing before BMT is not known. METHODS: The presence, nature, and correlates of neuropsychologic impairment were investigated in 55 adult BMT candidates, all of whom had a malignant condition. Impairment was assessed using a screening battery of standardized neuropsychologic tests. RESULTS: Results indicated that: (1) neuropsychologic performance was associated with specific disease and treatment risk factors, in particular a history of cranial radiation or central nervous system disease treated with intrathecal chemotherapy; (2) performance on tests reflecting memory or higher cognitive processing was more likely to be impaired; and (3) the risk of impairment increased as the number of disease and treatment risk factors for cognitive impairment in the patient increased. CONCLUSIONS: It was concluded that neuropsychologic impairment occurs in a significant minority of adult patients before BMT. Research is necessary to determine the extent to which such impairment significantly compromises patients' abilities to: (1) make decisions regarding undergoing BMT or participating in research protocols and (2) understand and execute self-care behaviors after BMT. More broadly, greater attention should be devoted to investigating the presence of long-term neuropsychologic impairment in adult patients with cancer.

The role of psychological variables in post-chemotherapy nausea: anxiety and expectation.

Post-treatment nausea (PN) is a common side effect following cancer chemotherapy. Wide variability in PN is often evidenced among patients even within a specific drug regimen and dosage combination. Such variability might reflect the influence of psychological factors, such as anxiety and expectations for nausea, on the experience of PN. Sixty-five chemotherapy patients were studied across their initial two to four infusions. Ratings of state anxiety and PN were obtained for each infusion. Expectations for chemotherapy-related nausea were assessed prior to the initial infusion. Hierarchical regression analyses indicated that state anxiety was significantly related to the experience of PN while expectations for nausea were unrelated to PN. Subanalyses indicated that the strength of the anxiety-PN relationship was inversely related to the emetic potential of the chemotherapy regimen a patient received. It was concluded that understanding of the factors that contribute to the experience of PN necessitates consideration of not only pharmacological, but psychological and physiological, factors as well.