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Survivors of motor vehicle accidents with acute stress disorder (ASD) or with no ASD participated in a study on autobiographical memory within a week of their trauma. In Experiment 1, participants were provided cue words to elicit autobiographical memories of both an unconstrained time period and their trauma. Participants with ASD reported fewer specific memories to positive cue words than did non-ASD participants, even when the influence of depression was controlled. In Experiment 2, the same participants were assessed for posttraumatic stress disorder (PTSD) 6 months posttrauma. Poor recall of specific memories of the trauma in Experiment 1 accounted for 25% of the variance of PTSD severity. Accessibility of trauma memories in the acute posttrauma phase may have significant implications for longer term adjustment.
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PMID:Autobiographical memory in acute stress disorder. 964 88

This study investigates whether in stress-prone subjects, carbohydrate-rich, protein-poor food (CR/PP) prevents a deterioration of mood and performance under uncontrollable laboratory stress conditions. The assumption was that in stress-prone subjects there is a higher risk of serotonin deficiency in the brain and that carbohydrates may prevent a functional shortage of central serotonin during acute stress, due to their potentiating effect on brain tryptophan. Twenty-four subjects with a high stress-proneness (HS) and 24 subjects with a low stress-proneness (LS) participated in an uncontrollable stress situation under both a CR/PP and a protein-rich, carbohydrate-poor (PR/CP) diet condition. The plasma ratio of tryptophan to the other large neutral amino acids (LNAA) (ratio Tryptophan/ summation operatorLNAA) was determined as a measure indicating the dietary effect on brain tryptophan and serotonin levels. Significant increases were found in the ratio tryptophan/ summation operatorLNAA during the CR/PP diet compared with the PR/CP diet. Experimental stress had significant effects on pulse rate, skin conductance, cortisol and mood in all subjects. During the CR/PP diet only the HS subjects did not show the stress-induced rise in depression, decline in vigour and cortisol elevation that they showed after the PR/CP diet. With respect to cognitive performance, significant dietary effects were found on reaction time. It is suggested that CR/PP food in HS subjects may increase personal control, probably under the influence of higher levels of brain tryptophan and serotonin.
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PMID:Does carbohydrate-rich, protein-poor food prevent a deterioration of mood and cognitive performance of stress-prone subjects when subjected to a stressful task? 971 35

The objective of this research was to identify the psychological and physiological variables that differentiate persons reporting masticatory muscle pain (MMP) from normal controls (NC). This study examined the characteristics of 35 MMP patients in comparison to 35 age-, sex-, and weight-matched NCs. All subjects completed a series of standardized questionnaires prior to undergoing a laboratory evaluation consisting of a psychosocial stressor and pressure pain stimulation at multiple body sites. During the evaluation, subjects' emotional and physiological responses (heart rate, blood pressure, respiration, skin temperature, and muscle activity) were monitored. Results indicated that persons with MMP reported greater fatigue, disturbed sleep, depression, anxiety, menstrual symptoms, and less self-deception (P's < 0.05) than matched controls. At rest, MMPs had lower end tidal carbon dioxide levels (P < 0.04) and lower diastolic blood pressures than the NCs (P < 0.02). During laboratory challenge, both groups responded to the standard stressor with significant physiological activity and emotional responding consistent with an acute stress response (P < 0.01), but there were no differences between the MMPs and NCs. Muscle pain patients reported lower pressure pain thresholds than did NCs at the right/left masseter and right temporalis sites (P's < 0.05); there were no differences in pressure pain thresholds between MMPs and NCs for the left temporalis (P < 0.07) and right/left middle finger sites (P's > 0.93). These results are discussed in terms of the psychological and physiological processes that may account for the development of muscle pain in the masticatory system.
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PMID:Psychological and physiological parameters of masticatory muscle pain. 971 48

Cancer patients frequently have symptoms of anxiety and depression after diagnosis. Often these symptoms are apparent to the physician. We report the case of a cancer patient who appeared to her physician to be coping relatively well but was actually having psychologic symptoms that met criteria for acute stress disorder (ASD). Cancer patients who have psychologic trauma at diagnosis and meet criteria for ASD may appear to be coping better than they are. Mental health interventions for cancer patients are recommended.
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PMID:Evidence of acute stress disorder after diagnosis of cancer. 974 61

Intrusive trauma-related thoughts and the means to manage them are a central dynamic in posttraumatic stress. Thought control strategies were investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n = 20) or no ASD (n = 20). Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale, and the Thought Control Questionnaire (TCQ) within four weeks of their accident. Although distraction, social control, and reappraisal were the most common strategies in both groups, ASD participants engaged in punishment and worry more than non-ASD participants. Worry and punishment were also strongly associated with severity of intrusive, avoidance, arousal, and depressive symptoms. Findings are discussed in terms of the role of cognitive strategies in resolving posttraumatic stress.
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PMID:Thought control strategies in acute stress disorder. 974 1

Cognitive bias was investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n = 17) or no ASD (n = 17). Participants completed the acute stress disorder interview, the Beck depression inventory, the Beck anxiety inventory, the impact of event scale, and a probability questionnaire (PQ) and a cost questionnaire (CQ) within four weeks of their accident. ASD participants exaggerated both the probability of negative events occurring, and the adverse cost of those events more than non-ASD participants. IES-Avoidance scores were the only significant predictors of both PQ and CQ scores. Findings are discussed in terms of the role of cognitive errors in posttraumatic adjustment.
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PMID:Cognitive bias in acute stress disorder. 974 2

We are often faced with patients with increased psychosocial stress, anxiety and depression and various cardiovascular symptoms such as hypertension, tachycardia, arrhythmia and chest pain. Psychological factors are important in particular in ischaemic heart disease and in arterial hypertension. In this respect chronic as well as acute stress plays a part. The problem of stress as a risk factor of these diseases of civilization is investigated. Some psychopathological signs may lead first to cardiological examination but their origin is within the psychic sphere of the patient. In the diagnostic sphere of some diseases which belong primarily into the cardiological or psychiatric sphere collaboration at a scientific as well as practical level is necessary.
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PMID:[Psychological factors and heart diseases]. 1037

Recent studies provide clear and convincing evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary artery disease (CAD). This evidence is composed largely of data relating CAD risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation, and (5) chronic life stress. Pathophysiological mechanisms underlying the relationship between these entities and CAD can be divided into behavioral mechanisms, whereby psychosocial conditions contribute to a higher frequency of adverse health behaviors, such as poor diet and smoking, and direct pathophysiological mechanisms, such as neuroendocrine and platelet activation. An extensive body of evidence from animal models (especially the cynomolgus monkey, Macaca fascicularis) reveals that chronic psychosocial stress can lead, probably via a mechanism involving excessive sympathetic nervous system activation, to exacerbation of coronary artery atherosclerosis as well as to transient endothelial dysfunction and even necrosis. Evidence from monkeys also indicates that psychosocial stress reliably induces ovarian dysfunction, hypercortisolemia, and excessive adrenergic activation in premenopausal females, leading to accelerated atherosclerosis. Also reviewed are data relating CAD to acute stress and individual differences in sympathetic nervous system responsivity. New technologies and research from animal models demonstrate that acute stress triggers myocardial ischemia, promotes arrhythmogenesis, stimulates platelet function, and increases blood viscosity through hemoconcentration. In the presence of underlying atherosclerosis (eg, in CAD patients), acute stress also causes coronary vasoconstriction. Recent data indicate that the foregoing effects result, at least in part, from the endothelial dysfunction and injury induced by acute stress. Hyperresponsivity of the sympathetic nervous system, manifested by exaggerated heart rate and blood pressure responses to psychological stimuli, is an intrinsic characteristic among some individuals. Current data link sympathetic nervous system hyperresponsivity to accelerated development of carotid atherosclerosis in human subjects and to exacerbated coronary and carotid atherosclerosis in monkeys. Thus far, intervention trials designed to reduce psychosocial stress have been limited in size and number. Specific suggestions to improve the assessment of behavioral interventions include more complete delineation of the physiological mechanisms by which such interventions might work; increased use of new, more convenient "alternative" end points for behavioral intervention trials; development of specifically targeted behavioral interventions (based on profiling of patient factors); and evaluation of previously developed models of predicting behavioral change. The importance of maximizing the efficacy of behavioral interventions is underscored by the recognition that psychosocial stresses tend to cluster together. When they do so, the resultant risk for cardiac events is often substantially elevated, equaling that associated with previously established risk factors for CAD, such as hypertension and hypercholesterolemia.
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PMID:Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. 1077 77

OBJECTIVES: To determine relationships among ethnicity, reactivity to acute stress and psychologic characteristics. DESIGN: We measured cardiovascular parameters and catecholamine levels at rest and after stress in a group of black and white men and women (45 blacks and 40 whites). METHODS: Blood pressure, heart rate, stroke volume, total peripheral resistance and catgecholamine measures of reactivity to a speaking stressor task were recorded. Multiple regression analysis was used to examine relationships between stress responsivity and psychologic characteristics in black and white subjects. RESULTS: Repeated-measures analysis of variance indicated that systolic and diastolic blood pressure reactivity was lower in blacks than in whites (P < 0.01). A multiple regression model that treated reactivity as a function of psychologic attributes and ethnicity suggested that psychologic attributes differentially affect racial physiologic reactivity. For example, expression of anger was related to lower blood pressure changes in whites but higher blood pressure changes in blacks. Conversely, hostility was related to increased blood pressure reactivity in whites but lower blood pressure reactivity in blacks. Greater task-induced changes in heart rate and stroke volume were related to higher depression scores in blacks but lower depression scores in whites. In addition, the relationship between coping style, anger, anxiety, and stress and catecholamine reactivity in blacks and whites. CONCLUSION: Our findings support those of previous studies; we identified racial differences in stress reactivity and psychologic characteristics that affect reactivity differently in blacks and whites.
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PMID:Acute psychologic stress reactivity in blacks versus whites:relationship to psychologic characteristics. 1022 98

The aim of this study was to investigate the predictors of acute stress following motor vehicle accidents (MVA). Sixty-two consecutive adult admissions to a hospital were assessed between two days and four weeks following a MVA. Participants were assessed for acute stress disorder (ASD) with a structured clinical interview and administered the Beck Depression Inventory (BDI), Coping Style Questionnaire, Dissociative Experiences Scale, and the Eysenck Personality Inventory. The prevalences of full and sub-syndromal ASD were 16.1% and 14.5%, respectively. BDI, history of psychiatric treatment, history of posttraumatic stress disorder (PTSD), and history of previous MVA accounted for 61% of the variance of acute stress severity. The findings indicate that predictors of acute stress severity are comparable to the predictors of PTSD and highlight the possibility of identifying those who may benefit from early treatment.
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PMID:Predictors of acute stress following motor vehicle accidents. 1046 59


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