[Connection between disease progress and coping with stress in patients with retinopathy centralis serosa]. / Uber den Zusammenhang zwischen Krankheitsprogredienz und Stressverarbeitung bei Patienten mit Retinopathia centralis serosa.

To illuminate the disease progression in retinopathy centralis serosa, 50 patients were enrolled in a basic study. Evaluated data included medical and sociodemographic data as well as data regarding the patient's coping with everyday conflicts and the disease. Hence, the German multidimensional coping inventory (SVF, Janke, Erdmann u. Boucsein 1985), measuring the trait aspects of coping with everyday troubles, as well as the German coping questionnaire (EFK, Franke 1997), dealing with coping with retinopathy, were applied. We described three different clusters of patients according to active and passive coping strategies. These three clusters also differed in terms of coping with the disease as well as in ophthalmological parameters. To illuminate the individual situation of the members of the clusters, we discuss the specific situation of three patients.

["Filtered normality": psychological causes and sequelae of specific retinal diseases]. / "Die gefilterte Normalität": Psychologische Ursachen und Folgen von spezifischen Netzhauterkrankungen.

Until now there is a lack of investigation in psychological aspects of retinopathy in patients of the middle ages. The few studies have been found, focused on an old-fashioned psychopathology. Medical treatment, f.e. laser therapy is only partially available, constant visual loss to blindness is possible. Life events, coping strategies, social support, and symptomatic distress of patients with presumed ocular histoplasmosis (group 1) and patients with retinopathy centralis serosa (group 2) were compared with another and with a comparison group. Group 1 scored higher on the Schedule of Recent Experiences (Holmes and Rahe 1967) and showed better social support. Group 2 scored higher on the Brief Symptom Inventory (Derogatis and Melisaratos 1983) and showed low social support. Additionally gender differences were discussed.

[Between isolation and new hope: the psychosocial status of HIV-infected women]. / Zwischen Isolation und neuer Hoffnung: Die psychosoziale Situation HIV-infizierter Frauen.

HIV-infected women were an increasingly larger group among the risk groups in Germany. In order to illuminate the psychological situation of HIV-infected women in Germany, 100 women with HIV disease were enrolled in a basic study. 72% of the patients were intravenous drug addicted, 28% were infected through other means. The study population comprised patients of all stages of infection. We found 52% in the first stages, 28% in ARC and 20% with AIDS. Evaluated data included medical, socio-demographic, and data regarding the patients' history of drug abuse. The SCL-90-R, a psychological symptom inventory, was applied. Questions about differences between the two groups of HIV-infected women (iv drug addicted vs non-drug addicted) were answered first. Second, we described three clusters of HIV infected women with regard to different levels of psychological distress. Important factors to distinguish between these clusters are the subjective impact of physical distress (e.g. suffering from HIV-associated symptoms) and loss of joy and interest in sex. In order to illuminate the psychosocial situation, we discuss the specific situation of three patients.

The Lyapunov exponent of heart rate dynamics as a sensitive marker of central autonomic organization: an exemplary study of early multiple sclerosis.

In a study of central autonomic dynamics in early multiple sclerosis, we measured the temporal oscillations of the momentary heart rate (heart rate dynamics). 11 young patients suffering from relapsing remitting definite multiple sclerosis in relapse-free and early stages of illness and 11 healthy controls were examined under vagotonic and sympathicotonic conditions. The temporal structure of the heart rate dynamics was operationalized phase-space analytically through the estimation of the largest Lyapunov exponent. Positive Lyapunov exponents were found in all participants under all conditions indicating deterministically chaotic heart rate oscillations. The variance analysis of these exponents detected no significant effect of sympathetic or vagal activity (experimental condition) but a significant group difference (p < .02). The multiple sclerosis patients were characterized by significantly lower Lyapunov exponents than the healthy controls. This finding suggests a more stable and thus less adaptive central-autonomic organization in early multiple sclerosis.

Differential effects of acute mental stress on interdigestive secretion of gastric acid, pancreatic enzymes, and gastroduodenal motility.

To study the effects of acute mental stress on gastric and pancreatic secretion, 12 healthy fasting volunteers swallowed two multilumen tubes, which allowed continuous aspiration of gastric and duodenal juices and measurement of motility of the stomach and the duodenum. In each study at least three duodenal phase III complexes of the migrating motor complex were recorded. In randomized order after the first or second duodenal phase III, mental stress was induced for 60 min by means of solving anagrams and doing mental arithmetic. Mental stress significantly increased the duration of the migrating motor complex by 60% (137.9 +/- 16.3 vs 86.1 +/- 13.0). Gastric flow rate and gastric acid output were not significantly altered. Duodenal flow rate was not changed during the stress period but significantly decreased by more than 52% in the following 30-min resting period. Duodenal concentration and output of chymotrypsin were significantly increased during the second 30-min period of acute mental stress; chymotrypsin output was significantly reduced in the poststress period. We conclude that acute mental stress has different effects on the stomach, the pancreas, and the upper gastrointestinal motility. The mechanisms by which the central nervous activity induced by mental stress affects the motility and secretion of the upper gastrointestinal tract remain to be elucidated.

[Stimulus and response characteristics as determinants of the electrodermal orienting reaction in the Rorschach trial]. / Reiz- und Antwortcharakteristiken als Determinanten der elektrodermalen Orientierungsreaktion im Rorschach-Versuch.

The Rorschach test was used as an experiment of perception to analyze (external and internal) stimulus-response and individual response specificity of electrodermal orienting response OR (skin conductance response SCR) to presentations of unstructured material. On a sample of 84 subjects (medical students and colleagues of the medical department) the partial effects of "card" (external stimulus), "affective content of the signification" (internal stimulus), and "subject" on the (range-corrected) electrodermal OR were analyzed. The variance-analytic model was highly significant. The highly significant card effect with a physiological variance component of about 9% was interpreted as a "novelty" component of the electrodermal OR. The examined response characteristic also had a significant effect on the electrodermal OR with a physiological variance component of about 1%. Yet the determining variable was not the affective content of the signification, but rather the complexity of the (affective) signification. This result was discussed in terms of information processing and conflict theory. The important interindividual OR variance of nearly 40% supported the concept of the individual specificity of physiological response.

Associations of personality variables with smoking behavior and pulmonary function.

Interindividual variability of lung function responses to smoking is unexplained. The aim of the present study is to inquire about a possible role of personality factors for an explanation of interindividual differences of lung function responses in smokers of both sexes. The results of canonical correlation analyses showed that there are no substantial correlations of personality with smoking behavior and also no significant associations of smoking behavior with pulmonary function in a healthy sample of smokers. In males only, personality factors were related to breathing frequency, but not to static and dynamic lung volumes.