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Research Database -
International Updates
Stress
Issue 50
ELLER, Rutgers, State University of New Jersey, Newark 07102-1897
USA. eller@nightingale.rutgers.edu.
explores the effects of cognitive-behavioural interventions upon
the quality of life in people with HIV.
Methods: The author conducted a randomised, 3 x 3
block design study, in which 69 participants were randomly assigned to either a guided
imagery, progressive muscle relaxation or a control group. Following a
brief instruction, the subjects practised their respective intervention over a period of 6
weeks.
Results: Following the 6 week intervention period, the
subjects’ perceived health status, but not quality of life, was significantly
different across the treatment groups. The results suggested differential effects for
guided imagery and progressive muscle relaxation, with larger effects observed for those
at mid-stage disease and for low frequency users of guided imagery.
Eller LS. Effects
of cognitive-behavioral interventions on quality of life in persons with
HIV. International
Journal of Nursing Studies 36(3): 223-33. Jun 1999.
VEDHARA and colleagues, Department of Experimental Psychology,
University of Bristol, Clifton UK. k.vedhara@bris.ac.uk
write that in recent years there has been a dramatic increase in research
devoted to the psycho-behavioural modulation of immune function in
the field of Psychoneuroimmunology (PNI). The authors review (85
references) the field regarding measuring stress-related immune dysfunction
in PNI.
Results and Discussion: The authors caution
that since PNI’s inception, considerable uncertainty has existed regarding the
significance of the immune outcomes detected, which has been compounded by the equivocal
nature of certain data. The authors feel that a great deal of the uncertainty could be
overcome if a clearer understanding was achieved regarding the advantages and limitations
of the many immune assays described in the literature, which would in turn encourage their
more appropriate use within PNI. In their review the authors describe the rationale
underlying and evaluate some of the more frequently used in vitro and in vivo
immunological and virological techniques.
Conclusions: The authors hope that a clearer
understanding of the rationale behind such assays and their inherent advantages and
limitations will inform the discussion of the significance of stress-related immune
impairment.
Vehara K et al.
The measurement of stress-related immune dysfunction in psychoneuroimmunology.
Neuroscience and Biobehavioral Reviews 23(5): 699-715. May 1999.
KHASKY and SMITH, Roosevelt University Stress Institute, Chicago,
Illinois 60605 USA studied the relationship between stress, relaxation and
creativity.
Methods: 114 participants, divided into 4 groups,
practised 25 minutes of progressive muscle relaxation, yoga stretching, imagery or
a control task. Prior to and following each training, subjects were given tests,
including the Smith Quick Stress Test (Somatic Stress, Negative Affect and Worry), and the
Smith R-State Inventory (relaxation-related states Disengagement, Physical Relaxation,
Mental Relaxation, Strength and Awareness, Joy, Love and Thankfulness and Prayerfulness).
Following the training, all subjects were given both the Verbal and Figural forms of the
Torrance Tests of Creative Thinking.
Results: The groups’ scores did not differ on
Creativity. However, compared with yoga stretching, subjects in the imagery group
had lower posttest scores on Negative Affect. Compared with the controls, both the yoga
stretching and imagery groups had higher scores on self-reported Physical
Relaxation. The Progressive muscle relaxation group had lower scores on Somatic
Stress than controls. For all relaxation subjects, Disengagement (feeling "distant,
far away, indifferent") correlated positively with Negative Affect and Physical
Relaxation. This suggests that disengagement in relaxation may not lead to
relaxation-induced anxiety but may help one cope with such anxiety.
Khasky Ad and Smith
JC. Stress, relaxation states, and creativity.
Perceptual and motor skills 88(2): 409-16. Apr 1999.
KELLY reviews (106 references) the effects of stress and suggests
various nutritional and herbal substances to counter stress.
Background: The author writes that prolonged stress,
whether resulting from mental/emotional upset or due to physical factors including
malnutrition, surgery, chemical exposure, exercise, sleep deprivation or other
environmental causes, results in a range of systemic effects. These include increased
levels of stress hormones including cortisol, decline in immune system functions and
disruption of gastrointestinal microflora balance. These changes may contribute
significantly to health problems.
Results and Discussion: The author suggests a
variety of nutritional and botanical substances which may enable individuals to sustain an
adaptive response and minimise some of the systemic effects of stress, including adaptogenic
herbs, specific vitamins including vitamins B1, B6, B5 and B12, vitamin C,
tyrosine and other nutrients including lipoic acid, phosphatidylserine and plant
sterol/sterolin .combinations.
Kelly GS. Nutritional
and botanical interventions to assist with the adaptation to stress.
Alternative Medicine Review. 4(4): 249-65. Aug 1999.
Issue 33
BELLAROSA and CHEN, Illinois
Institute of Technology, Chicago USA compared a variety of
widely used stress management methodologies.
Methods: Stress management (SM)
experts (SMEs) evaluated 6 widely used occupational SM interventions,
including relaxation, physical fitness, cognitive restructuring,
meditation, assertiveness training, and stress inoculation from
the basis of 10 practicality criteria and 7 effectiveness objectives.
Results: Relaxation
was evaluated overall as the most practical intervention,
while meditation and stress inoculation the least practical. Physical
fitness was judged to be the most effective intervention, with
meditation and assertiveness training
rated the least effective. The findings also revealed
that the SMEs considered the history of success and the duration of effect,
rather than “relevance to programme objectives” to be the most
important actors when selecting SM interventions. The authors also discuss
incongruence between effectiveness ratings and actual choices of interventions.
Bellarosa
C and Chen PY. The effectiveness and practicality of occupational stress
management interventions: a survey of subject matter expert opinions.
J Occup Health Psychol
2(3): 247-62 Jul 1997.
Comments: This is quite
an important finding, since so many experts suggest meditation for stress
management. However, from the point of view of practicality and effectiveness,
meditation was the least effective of the 6 techniques evaluated. Of course,
this in no way implies that meditation is not a superb practice, and one
which all of us ought to do.
AHMAD and colleagues, Department of Ilmul-Advia,
A.K. Tibbiya College, Aligarh Muslim University, India write that
drugs of mineral origin, especially gems, are widely
used in Unani Medicine, both as single drugs and compound
formulations. However, such drugs have not yet been adequately scientifically
studied.
Methods: The authors studied
Jawahir Mohra (JM), an anti-stress Unani preparation, containing a few
herbal and animal ingredients. A modified JM preparation was studied for
its anti-stress activity against physical, chemical and
metabolic stimuli. The non-gem complement (NGC) of JM was assessed, in
rats, for its action against physical stress. The albino rats were stressed
by swimming and subsequently tested for motor function by Rota rod (muscle
coordination), activity wheel (forced motor activity) and photoactometer
(spontaneous motor activity).
Results: Following JM treatment
for 7 days, there was a striking and significant increase in activity.
The NGC also significantly increased activity, but less than with JM.
JM also produced a marked increase in cold swimming endurance and latency
of post-anoxia convulsions, and a significant decrease in pentylentetrazol
(PTZ)-induced defecation and urination in an open field arena under stimulation
by intense light and sound.
Conclusions: These results
indicate that the gem-containing Unani compounds JM demonstrates
significant anti-stress activity of a non-specific type against
diverse stressors, possibly due to adaptogenic activity.
This study also demonstrated that the gems in JM contribute significantly
to its anti-stress activity.
Ahmad
G et al. The anti-stress activity of a gem-containing Unani formulation
against diverse stressors. J
Ethnopharmacol 59(3): 187-93. Jan 1998.
FISHEL, University of North Carolina,
Chapel Hill, USA writes about the many aspects of everyday life which
are anxiety-provoking, including visits to hospitals,
emergency departments, and outpatient clinics.
Background: Anxiety exists
on a continuum from normal, which alerts us and demands our attention,
to severely dysfunctional, as happens with anxiety disorders.
Results: Nursing interventions
may be helpful. The aetiology of anxiety disorders is multidimensional,
including genetic vulnerability, neurophysiological dysregulations, stressful
present and past life events. Due to the complex nature of anxiety, treatment
usually is a combination of medication, education, including self-management
techniques, sensory interventions, psychotherapy and cognitive-behavioural
interventions. The nurse’s role in assessment, intervention,
and referral is critical.
Fishel
AH Nursing management of anxiety and panic.
Nurs Clin North Am 33(1): 135-51. Mar 1998.
Issue 27
MA and colleagues, General Hospital of PLA, Beijing China
studied the effects of relaxation training upon surgical stress
response. METHODS: 51 abdominal surgery patients were randomly
assigned to 2 groups: 1) Experimental group (n=25) where patients received
preoperative instruction and training in relaxation 2) Control group with
patients receiving preoperative instruction alone. State anxiety and
physical symptoms of anxiety, blood pressure, heart rate, blood serum
levels of cortisone and postoperative pain of the 2 groups were evaluated
and compared on the third preoperative day, operation day, and on the
first and fourth postoperative days. RESULTS: 1) Significant differences
between the 2 groups were found regarding state anxiety scores on each
day, physical anxiety symptoms and pain severity on the first and fourth
postoperative days 2) Compared with the control group, systolic and diastolic
blood pressure and heart rate decreased in the experimental group 3) Compared
with the control group, blood serum cortisone level was significantly
decreased in the experimental group on the first postoperative day. CONCLUSIONS:
These results demonstrate that relaxation training exerts positive
effects upon stress responses to surgery, particularly in reducing
the psychological anxiety response. Relaxation training can be used as
an easy and effective method in nursing practice.
Ma YL et al.
Relaxation training on stress to abdominal surgery. Chung Hua Hu Li
Tasa Chih 31(7): 377-80. Jul 1996.
MCKINNEY
and colleagues, Department of Music Education/Music Therapy, University
of Miami, USA. mckinnych@appstate.edu.
studied the effect of guided imagery and music therapy on mood and
stress levels. METHODS: 28 healthy adults took part in a randomised
trial of Bonny Method of Guided Imagery and Music (GIM - a depth approach
to music psychotherapy) sessions to study effects upon mood and cortisol
levels. Recruits in the GIM and waiting list control groups completed
the Profile of Mood States (POMS) and gave 15 cc blood prior to and following
the 13-week intervention period and also at 6-week follow-up. RESULTS:
Following 6 bi-weekly sessions, GIM participants reported significant
decreases in depression, fatigue and total mood disturbance and cortisol
level by follow-up. The pretest to follow-up decrease in cortisol
was significantly associated with decreased mood disturbance. CONCLUSIONS:
A short series of GIM sessions can positively affect mood and reduce
cortisol levels in health adults. Such changes in hormonal regulation
may have health implications for people who suffer chronic stress.
McKinney CH
et al. Effects of guided imagery and music (GIM) therapy on mood and cortisol
in healthy adults. Health Psychol 16(4): 390-400. Jul 1997.
COMMENTS: Positive Health will be publishing another extended
feature about the therapeutic properties of music in the June issue
No. 29.
PIKE
and colleagues, Department of Psychiatry, Veteran’s Affairs Medical Center, San
Diego, CA 92161 USA write that life stress is hypothesised to change the dynamic
regulation of the autonomic, neuroendocrine and immune systems. The authors studied
the effects of chronic life stress upon psychological and physiological responses
following challenge with an acute psychological stressor. METHODS: Male
volunteers, 12 with and 11 without chronic life stress were administered a 12-minute
laboratory stressor of mental arithmetic vs a video control. RESULTS: Compared to
the video control condition, the effects of the acute psychological stress were:
subjective distress, increased concentration of circulating epinephrine, norepinephrine,
beta-endorphin, adrenocorticotropic hormone (ACTH) and cortisol, and the selective
redistribution of natural killer (NK) cells into peripheral blood. At baseline the two
groups were virtually identical regarding psychological, sympathetic, neuroendocrine and
immune parameters however, compared to the non stress group, the chronic stress group
showed greater subjective distress, higher peak levels of epinephrine, lower peak levels
of beta-endorphin and NK cell lysis and greater redistribution of NK cells in response to
the acute psychological challenge. Additionally, the acute stressor caused a
protracted decline in NK lysis per NK cell in the chronic stress group, but had no effect
in the controls. CONCLUSIONS: An exaggerated psychological and peak reactivity
occurs when people undergoing chronic life stress are confronted with an acute
psychological challenge. This reaction is associated with decrements in individual NK cell
function and is protracted beyond termination of the stressor and recovery.
Pike JL et al. Chronic life stress alters
sympathetic, neuroendocrine, and immune responsivity to an acute psychological stressor in
humans. Psychosom Med 59(4): 447-57. Jul-Aug 1997.
KIECOLT-GLASER
et al, Department of Psychiatry, Ohio State University, Columbus USA studied endocrine
and immune parameters associated with marital conflict and satisfaction. METHODS: 31
older couples with a mean age of 67 years who had been been married on average for 42
years were recruited to the study. A catheter was placed in each person’s arm and
blood was drawn on entry for immune, analyses. For hormone analyses, 5 blood samples were
drawn during a 30-minute conflict discussion and a 15-minute recovery session. Conflict
sessions were video-recorded and later coded for problem-solving behaviours using the
Marital Interaction Coding System (MICS). RESULTS: For wives, escalation of
negative behaviour during conflict, and marital satisfaction were strongly related to
endocrine changes accounting for 16-21% of rate of change for cortisol,
adrenocorticotropic hormone (ACTH) and norepinephrine. In husbands however, there were no
significant relationships between endocrine data and negative behaviour or marital
quality. Both men and women who showed poorer immunological responses to three functional
assays (blastogenic response to two T-cell mitogens and antibody titres to latent
Epstein-Barr virus (EBV)) displayed more negative behaviour during conflict and also
characterised their usual marital disagreements as more negative than individuals who
showed better immune responses to the assays. CONCLUSIONS: Abrasive marital
interactions may provoke physiological consequences even in older couples in long-term
marriages.
Kiecolt-Glaser JK et al. Marital conflict in older
adults: endocrinological and immunological correlates. Psychosom Med 59(4):
339-49. Jul-Aug 1997.
COMMENTS:
Kiecolt-Glaser are among the pioneers in the psycho-neuro-immunology field. We are
starting to learn a great deal about how our emotions affect our bodies, but most of us,
including this writer, still struggle to respond in more appropriate ways
Issue 19
FEHR, Clinisch Psychologische Praxis, Wesel Germany studied the effects of personality
upon the success of beginners in maintaining their practice of Transcendal
Meditation (TM). METHODS: The author conducted two longitudinal studies, administering
the Freiburger Personality Inventory to TM beginners. Participants were monitored at 8
weeks (study 1) and 14 months (study 2). RESULTS: Compared to dropout-controls with
7 of 12 FPI-factors, meditators in study 2 demonstrated significantly greater improvements
after 14 months. Compared to successful meditators, controls showed significantly greater
extraversion prior to starting TM. Compared to the norm, significantly reduced openness
was found at the time of the second testing in study 1 and in 47% of the participants in a
cross section study with 360 TM-practitioners (study 3). The uncritically reserved
TM-practitioners in study 3 described themselves as remarkably positive, but no effects
correlated with length of practice were distinguished in this group. Also in study 3,
several groups of participants, including open meditators and several selected subgroups
demonstrated different focal points of generally constructive hypothetical effects
resulting from long-term TM practice. CONCLUSIONS: According to these studies there
needs to be a sufficiently self-critical and open attitude in order to meditate
successfully. People scoring clearly above average in extraversion should be discouraged
from starting TM because they are likely to abondon the TM routine early.
Fehr TG. Therapeutically relevant effects by transcendental meditation? Psychother
Psychosom Med Psychol 46(50): 178-88 May 1996.
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