bluuebunny/crossref_metadata_2025 huggingface dataset:
Beta‐blockers in anxiety
Authors: Kelly Desmond
Published: May 2007

The physiological correlates of anxiety include a number of cardiovascular and adrenergic effects that are indicated by an increased blood level of adrenaline and noradrenaline. Anxiety can also be induced by injection of isoprenaline. Pharmacological beta‐blockade is therefore a logical procedure in the treatment of anxiety.

A number of clinical trials have shown the effectiveness of beta‐blockers such as propranolol, sotalol and oxprenolol, in the relief of anxiety symptoms both in comparison to placebo and benzodiazepines. There is evidence suggesting that beta‐blocking drugs produce their benefit by a peripheral action and may therefore be most useful when somatic anxiety symptoms predominate. These drugs have also been used for treating stress‐induced anxiety in normal subjects, such as may occur when speaking in public.

Beta‐blockers have also been used in the treatment of anxiety tremor, alcoholism and migraine. Unwanted effects are relatively uncommon, although headache, insomnia and unpleasant dreams may occur. Absolute contra‐indications to their use are heart block and failure, and bronchospasm of whatever cause.
Urinary peptides in schizophrenia and depression
Authors: Reichelt Karl L. , Edminson Paul D. , Toft Kim G.
Published: May 2007

Increased levels of benzoic acid‐precipitable aromatic compounds and glycoprotein‐associated peptide material are found in the urines of patients with schizophrenic psychoses and endogenous depressions. Factors with regulatory effects on aminergic transmission have been found. A working hypothesis is proposed whereby genetically determined peptidase insufficiency interacts with increased peptide levels of either endogenous and/or exogenous origin to cause the psychotic state. These disorders are probably multifactorial syndromes, displaying changes in several factors with bioactive effects.
Slimnastics
Authors: Lampluch Diana
Published: May 2007

Although Slimnastics appears on the surface to tackle only the straightforward subjects of exercise, healthy eating, relaxation and tension control, as well as lifestyle (as it relates directly to health), and to deal with them through classes which are fun and uncomplicated, in fact all the aspects are scientifically based. The whole concept is built on Maslow's hierarchy of motivation (or human needs). This article hopes to show the arguments and illustrations that prove the success of this idea in practice. Slimnastics is a concept which not only works extremely well but is also simple to put into operation.
Fear avoidance and chronic musculoskeletal pain
Authors: Troup J. D. G. , Slade P. D.
Published: May 2007

Confrontation and avoidance are the two extreme responses to the fear of pain. Life‐events, personality, previous experience of and coping strategies for pain, together with iatrogenic factors and parental attitudes, comprise the psychosocial context in which fear of pain may persist. This leads to avoidance of anything which might conceivably provoke it. Pain avoidance, if unrecognized and untreated, may then become a pathological factor itself, independent of any concomitant organic changes and causing progressive stiffness, weakness and reinforcement of the invalid status.
Chemotherapy and psychological side‐effects in breast cancer patients
Authors: Schwarz Reinhold , Michel Ute
Published: May 2007

To find out the significance of psychosocial compared to physical reactions we interviewed 56 breast cancer patients who had finished intravenous adjuvant chemotherapy. In general, psychological distress was rated to be less tolerable than physical side‐effects. Active coping proved to be relevant, especially for the incidence of anticipatory reactions.
Alterations in stress‐induced responses in the rat produced by amino acids
Authors: Quirce C. M. , Vargas G. , Coto F. , Maickel R. P.
Published: May 2007

The effects of repetitive exposure of rats to immobilization stress were examined in terms of alterations in body weight gain, adrenal size and plasma levels of corticosterone, fatty acids and glucose. Prestress administrations of small doses of L‐alanine, L‐tryptophan and L‐tyrosine were tested for ability to modulate the stress‐induced effects. In general, L‐alanine had no characteristic actions, L‐tryptophan exacerbated and L‐tyrosine modulated the stress effects.
Stress and life event methodology
Authors: Cooper Cary L. , Cooper Rachel , Faragher Brian
Published: May 2007

Life event scales that include generic weightings may bias or distort research results in the field of stress. The authors have devised a new scale based upon the subject's individual perceptions of life events. There is a need for life event scales designed on a sample of the population on which a larger study is to be undertaken.
Inferring causality in life event research
Authors: Cooke David J.
Published: May 2007

In evaluating the validity of causal propositions, there are four considerations: statistical, internal, construct and external. The reliability of published instruments, in the sense of internal reliability, can be maximized by the principal component analysis of obtained responses. Once it has been demonstrated that two variables covary to a significant degree, the next step is to assess the internal validity of the relationship. Next, the investigator must attempt to determine which higher order constructs are involved in these relationships. Finally, the level of generality of the relationship should be determined. In the last two decades, a shift has occurred in that the hypothesis that life events cause illness is based less on faith and more on scientific evidence.
Refractory depression
Authors: Zetin Mark , Warren Stacey , Pangan Editha A. , Stasiek Chris
Published: May 2007

Refractory depression is a poorly defined illness involving the persistence of symptoms of major depression or dysthymia over a prolonged period of time despite attempts at medical and psychotherapeutic intervention. The authors present a review of literature relevant to defining, evaluating and treating refractory depression. Medical illnesses, medications and substances of abuse may cause refractory depressions that fail to respond to conventional or extra‐ordinary treatments. Numerous medication strategies including the use of tricyclic and monoamine oxidase inhibitors, lithium, bright artificial light and electroconvulsive therapy constitute the major medical interventions available. Psychotherapies include cognitive, interpersonal, marital, psychoanalytic and group approaches. The clinician dealing with chronically depressed patients must be familiar with most of these diagnostic and treatment approaches in order to plan an effective long‐term intervention strategy for helping the patient to deal with the demoralization and seemingly overwhelming life stresses that frequently occur in refractory depression.
Taking the waters at Tunbridge Wells
Authors: Ford John M. T.
Published: May 2007

The medical indications for drinking the waters at Tunbridge Wells and the regimens prescribed from the early seventeenth century are reviewed. It is suggested that iron‐deficient patients would have benefited pharmacologically and that other patients would have been helped by the way of life and relaxation offered. Treatment would have been particularly efficacious in stress‐related syndromes which are described in all the texts.
Serenics and aggression
Authors: Olivier Berend , Mos Jan
Published: May 2007

This paper describes the behavioural effects of a new class of psychotropic drugs, the serenics, which exert specific antiaggressive effects in animal paradigms of (offensive) agonistic behaviour. Serenics specifically inhibit offensive aggression, leaving defensive behaviour intact. Ethological profiling of serenics and reference drugs from different drug classes shows the unique profile of the serenics: antiaggressive action without impairment of sensoric or motoric functions and without sedation or muscle relaxation. This contrasts sharply with drugs from other drug classes, eg neuroleptics, psychostimulants or anxiolytics, which all have non‐specific antiaggressive or even proaggressive actions.

The behavioural profile of serenics is illustrated in this paper in a male aggression paradigm (resident‐intruder in rats) and a female aggression paradigm (maternal aggression of lactating rats). For comparative reasons, drugs from several different classes have also been tested in these paradigms to compare the profiles of action.

The use and possible future applications of specific antiaggressive drugs are discussed.
Stress from a psychiatric epidemiological perspective
Authors: Schwab John J.
Published: May 2007

From voodoo deaths to life events, stress produces many psychophysiological responses. Social changes constitute an important stress factor and there is a correlation between stress scores and mental health risk. In personal studies, a three‐way relationship among life events, socioeconomic status and health impairment scores has been demonstrated. Furthermore, there was a reciprocal influence between life events and impairment scores that has previously been somewhat overlooked. Recently, an emphasis has developed on current stressors rather than on previous life events, such stressors being tied to social role. There are powerful associations between social stressors and psychiatric symptomatology. especially symptoms of anxiety and/or depression. The individual's responses to stress depend little on attitudes and values but almost entirely upon the individual's ‘definition of the situation’. Whether or not the character of life in western society is more stressful than in the past is debatable, and even the most fortunate of persons may live lives that have their full share of difficulty and private despair.
Environmental factors as a risk for future hypertension
Authors: Schmieder Roland E. , Messerli Franz H.
Published: May 2007

A review of the literature indicates that several factors have been purported to increase the risk for the development of arterial hypertension: family history, age, sex, race, nutritional factors, salt intake, obesity, various chemical agents, traffic noise, occupational stress, socioeconomic status and social stress. However, it is not known whether these are really independent risk factors for hypertension. We point out that these factors are related to each other and that they differ with regard to their impact on the pathogenesis of essential hypertension. In particular, a hyper‐responsiveness of blood pressure to different stimuli, reflecting an overreactivity of the sympathetic nervous system, appears to play a central role in the pathogenesis of hypertension. Thus, the haemodynamic response to provocative stress tests may enable us to identify individuals at high risk for future hypertension.
Delirium, a study of 100 cases
Authors: Newton Norris L. , Janati Abdorasool
Published: May 2007

A retrospective study has been made on 100 consecutive cases of delirium admitted to the John L. McClellan Veterans Hospital, Little Rock, Arkansas, during the past 7½ years. The cases were statistically grouped according to the classification recommended by the American Psychiatric Association. They were further grouped as to predominant medical or precipitating conditions. Observations were drawn as to pertinent laboratory and neurosensory findings. Emergency and general treatment recommendations are discussed.
Psychological sequelae in the rape victim
Authors: Torem Moshe S.
Published: May 2007

The psychological consequences of rape are described. Many rape victims develop a syndrome that meets the DSM III diagnostic criteria for post‐traumatic stress disorder. The patient's coping mechanisms of dissociation and amnesia are described and the implications for the delayed post‐traumatic stress disorder are discussed. Principles of therapeutic management are delineated with special emphasis on therapeutic abreaction and alleviation of guilt by reframing and restructuring the patient's perception of the rape.
Stress‐induced stress in the psychiatrist: A naval psychiatrist's personal view of the Falklands conflict
Authors: O'Connell Morgan R.
Published: May 2007

The views of the author are his own and do not purport to reflect the position of the Medical Director General (Navy) or the Ministry of Defence. The Falklands War happened over 3 years ago and much has been written about it from many angles. A search of the literature indicates that this may be the first occasion in which psychiatrists were specifically deployed with a seaborne task force. The war itself was unusual in many features. This report tends to communicate in the first instance to fellow psychiatrists, and not least to the medical profession in general, the more personal aspects of a unique life event.
Psychological problems arising from disaster work
Authors: Duckworth Douglas H.
Published: May 2007

A case study is presented of a problem‐solving exercise with UK police officers who experienced psychological problems after their duties in connection with the Bradford fire disaster of May 11 1985. It is argued that they typify the ‘forgotten victims’ of disasters: official helpers of one kind or another whose experiences may lead to significant psychological disturbance. Out of the 399 officers who had been involved with the fire, 234 (59 per cent) completed a screening questionnaire and 34 attended a series of confidential counselling sessions. Their specific problems included performance guilt, reconstruction anxiety, generalized irritability, focused resentment and motivational changes. Treatment interventions were tailored to these problems. A second administration of the screening questionnaire three weeks after counselling, and a follow‐up approximately nine months after the disaster, indicated a satisfactory level of recovery in the officers.
The stress‐resolving component in primary medical care
Authors: Ben‐Sira Zeev
Published: May 2007

A study among Israeli primary care practitioners was aimed at elucidating the factors underlying a doctor's reluctance to demonstrate affective (humane, emotional, supportive) behaviour. Although there is awareness of the eventual aetiological role of psychosocial stress, such awareness does not imply recognition of the necessity for affective behaviour. Oblivion of such behaviour is justified by its insignificance for coping with stress and its alleged contradiction with the necessity for compliance with the doctor's regimen–compliance being identified as the most important factor in recovery. The importance of the data should be understood in the light of the accumulating evidence on the aetiological role of stress and its implications for incorporating stress‐alleviating behaviour as an inherent component of the medical intervention.
Executive stress in the Netherlands. A survey of managers
Authors: van der Ploeg Henk M. , Vis Jan , Cooper Cary L. , Spielberger Charles D.
Published: May 2007

This article reports the results of a survey of Dutch managers using an adaptation of the Cooper Executive Stress Questionnaire and the Spielberger Job Stress Survey. Dutch managers (N=366) are compared with executives from 10 countries studied by Cooper.1 Dutch managers reported less job dissatisfaction and lower degrees of depression, anxiety and psychosomatic tendencies than managers from other countries. Higher levels of job stress were associated with greater job dissatisfaction, depression and anxiety and with more psychosomatic tendencies for the Dutch managers. Although the number of different sources of job stress having impact on performance remained relatively constant with increasing age, job dissatisfaction decreased as a function of the manager's age.
Frequency of relaxation practice, blood pressure reduction and the general effects of relaxation following a controlled trial of behaviour modification for reducing coronary risk
Authors: Steptoe Andrew , Patel Chandra , Marmot Michael , Hunt Barbara
Published: May 2007

A questionnaire concerning frequency of relaxation practice, the general effects of relaxation and other factors was completed at four‐year follow‐up by participants in a controlled trial of relaxation‐based behaviour modification for reducing coronary risk. Data were available from 81 (82 per cent) of the original treatment group and 72 (77 per cent) of controls. Only 17 per cent of subjects in the treatment group reported that they still practised relaxation regularly. Blood pressure reductions in these people were significantly greater than in those who had never relaxed, or had stopped relaxing within two and a half years of the end of the trial. Suggestive links between blood pressure reductions and attempts to use relaxation as a coping skill in everyday life were also observed. The treatment group reported greater improvements in several aspects of their lives (including relationships at work, enjoyment of life and personal and family relationships) than controls. Treatment subjects who continued to practise found relaxation less disruptive and easier to fit into their schedules than did others. These data are discussed in relation to factors determining long‐term positive outcome following relaxation‐based behaviour modification.
The stress of unexpected bereavement
Authors: Lundin Tom
Published: May 2007

In a prospective interview study 28 relatives of sudden and unexpected deceased persons were approached for an initial interview. The investigation took the form of a process study with recurring interviews during the first two years after bereavement. Fifty per cent of the interviewees developed an anxiety grief with either pronounced symptoms or life‐restricting effects. Using the interview material the mourning process and grief reactions are discussed in relation to the following variables: guilt feelings, the separation process, defence mechanisms, seeing the dead body, visiting the grave, anniversary reactions, coping process and dreams.
Amedicus: A new iatrogenic syndrome
Authors: Torem Moshe S. , Allen Arnold
Published: May 2007

This iatrogenic syndrome is found in patients in general hospitals and in a variety of medical clinics, to a degree assuming almost epidemic proportions. It is characterized by one or all of these clinical manifestations: confusion, anxiety, insomnia, hostility, depression, suspiciousness, hopelessness, indecisiveness. distrust, withdrawal and the feeling of abandonment. The patient's organic pathology is not sufficient to account for these manifestations and they often appear in patients with no previous psychiatric history. The common denominator in this condition is the patient's communication that he feels he is operating without a physician who is directly responsible for his care. This comes about as a direct consequence of the proliferation of group medical practices and the increasing mechanization and specialization in medical practice over the last one or two decades. The result is often a lack of communication between the many different physicians by whom the patient is seen. Consequent to this, the patient is faced with contradictory information from a variety of physicians who fail to coordinate the diagnostic workup and treatment approach. The direct cause is the absence of a single physician who would coordinate the patient's care and orchestrate the harmonious functioning of the health care team. The clinical manifestations of this syndrome rapidly clear when the liaison psychiatrist or some other member of the health care team can fulfill this function.

This article on the ‘amedicus syndrome’ addresses itself to the clinical picture of this syndrome, possible etiology, dynamics and treatment. Supportive case vignettes are presented.
Type a behaviour and vulnerability to diseases: A Spanish retrospective study
Authors: Valdés Manuel , De Flores Tomas
Published: May 2007

The authors present a Spanish retrospective study in which type A behaviour is related to the prevalence of different disorders and diseases in a white‐collar sample of both sexes (n = 963). This survey was aimed to ascertain if type A behaviour is a general risk factor, able to initiate different pathophysiological mechanisms. Data about general health were collected through the Blackburn Health Questionnaire and type A behaviour was assessed by the Bortner questionnaire. Results showed that among A people there was a significantly higher prevalence of disorders and diseases related to the respiratory and circulatory systems.
Affect and angina
Authors: Channer Kevin S. , Rees J. Russell
Published: May 2007

The influence of mood on exercise tolerance was studied in 186 patients with chest pain presenting to a cardiology clinic for diagnostic exercise stress testing. Mood was measured using the Hospital Anxiety and Depression Scale and patients were exercised using a standard protocol. One hundred and fourteen patients had positive exercise tests indicating the presence of coronary artery disease and 72 patients had negative or inconclusive tests. Patients with negative exercise tests were younger, more commonly female, had atypical chest pain, and significantly higher anxiety and depression scores compared with those with positive exercise tests. In patients with positive exercise tests there was a significant negative correlation between the exercise duration and both anxiety and depression scores.

Thus, mood influences the symptomatology of ischaemic heart disease. Many patients with atypical chest pain have significant abnormalities of mood which may be causally related to their pain.
Personality correlates of chronic, unstable epilepsy
Authors: Souheaver Gary T. , Janati Abdorasool
Published: May 2007

The present study included 60 males with unstable epilepsy despite therapeutic levels of anticopulsants. They were middle age or older (x = 45.6 years; s.d. = 11.1), with chronic documented seizures (X = 17.1 years; s.d. = 13.2). When type of EEG abnormality was considered, significant differences were found on two individual MMPI scales. Scale L was significantly higher in patients with right temporal lobe abnormalities compared to left temporal foci. The group with generalized EEG findings also scored higher on L compared to those with left temporal, extratemporal and normal EEG patterns. In addition, those with right temporal lobe EEG abnormalities and the group with extratemporal foci scored significantly higher on scale Pd than those with generalized, left temporal or normal EEGs. No differences were found on the MMPI when chronicity, trauma or age at onset were considered. Thus, subtle personality differences as measured by the MMPI were found only when type and laterality of the EEG abnormalities were controlled.
Relationship between life events and personality in psychiatric disorder
Authors: Seivewright N.
Published: May 2007

In order to investigate any relationship between personality and the occurence of stressful life events. 7.5 outpatients with depressive and anxiety disorders had life events rated for a nine‐month period and assessments made of premorbid personality using a recently devised instrument.

In comparisons made of events occurring beofre the onset of illness, subjects with personality disorders had significantly more undesirable life events than subjects with non‐disordered personality. After the development of illness subjects with personality disorders had a significant excess of events which were classed as primarily self‐generated rather than chance occurrences. Analysis by personality type revealed the presence of sociopathic traits to be the most important determinant of life events, these traits significantly correlating with both the total rate of life events and the rate of undesirable events in both studied periods.

The findings have implications for clinicians and also for research workers who have not usually considered the confounding effect of personality when making life‐events comparisons.
Post‐traumatic stress disorder
Authors: Duckworth Douglas H.
Published: May 2007

Developments in the study of psychological trauma are briefly charted, prior to the inclusion of the stressor‐generic diagnostic category of ‘post‐traumatic stress disorder’ (PTSD) in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM‐III). Against the context of the assumptions underlying the DSM‐III classification system, evidence relating to the general validity of the PTSD diagnostic criteria is examined. Progress in the development of assessment techniques and psychotherapeutic procedures is reviewed. and proposals for refinement and revision of the diagnostic category are considered.
Stress in retirement and its management
Authors: Watts Arthur
Published: May 2007

Changes in family life that have taken place over the past 200 years have profoundly altered the social circumstances of elderly people in the community. This leads to more independence in planning for retirement, which should be done well ahead. This will include rearranging daily activities and starting new recreational pursuits as well as new social contacts. New opportunities for travel and the adequate time now available to undertake this should be exploited to the full. Mental and physical routines should be developed, and the younger generation still have a vital role to play in the welfare of their elders. Diet is important in ensuring normal daily functions and adequate sleep. The final rule is to try and retain a sense of humour.
The neuroendocrinology of stress
Authors: Wuttke W. , Duker E. , Vaupel R. , Jarry H.
Published: May 2007

An attempt was made to demonstrate that stress activates extrahypothalamic and hypothalamic neuronal systems. Substance P and CCK‐ergic neurons in many parts of the brain are affected by stress. Within the hypothalamus catecholaminergic as well as peptidergic neurons are involved in regulating anterior‐pituitary ACTH and prolactin secretion in response to stress. Within the adrenal medulla catecholamine and peptide containing cells are affected specifically by different stressors. Substance P and met‐enkephalin containing cells are activated by exogenous stressors whereas CCK containing cells secrete catecholamines and the peptide in response to severe hypoglycemia.
Stress as a diagnostic challenge for psychiatric disorders
Authors: Wheatley David , Wheatley Susana , Lader Malcolm
Published: May 2007

At the Stress Clinic we are investigating nine areas in which stress factors may play an important part: social habits, social relationships, life events, psychiatric, sexual, sleep, geriatric, menstrual and stress and the heart. The degree of stress in each area is quantified and a stress profile constructed for each patient. Thus, the relationships between the different stresses can be assessed and appropriate treatment advised. Inter‐rater reliability in assessing the different items comprising the stress profile has shown a high degree of correlation for all items (P<O.Ol). On analysis of the records of the first 45 patients, the commonest principal diagnosis was depression (47 per cent), followed by anxiety (27 per cent), whilst in 17 per cent the main stress was insomnia and in three patients an organic illness (7 per cent) was the cause of the stress problems. The stress profile is also used to assess improvement and analysis of the first 18 cases demonstrated a significant reduction in many stress areas which was coincident with response to treatment.
Life events and psychiatric disorders
Authors: Gyllenhammar Carl , Wistedt Börje
Published: May 2007

During a 28‐day period, 469 patients attending a psychiatric emergency clinic were studied. The diagnoses made were compared to the severity of psychosocial stressors according to the DSM III axis IV. The largest diagnostic subgroup comprised alcohol problems (29.8 per cent), followed by psychosis (18.6 per cent), depression (12.9 per cent), neurotic (10.1 per cent) and acute breakdown due to external crisis (9.9 per cent). It was found that the more ‘endogenous’ the psychiatric illness, the lower were the ratings of stressful life events. DSM III does not contain sufficiently detailed information concerning axis IV to enable it to be used for research purposes and for clinical use it gives the clinician very little new information.
New longitudinal insights into relationships between unemployment and mortality
Authors: Fox A. J. , Shewry M.
Published: May 2007

The rise in unemployment during the 1970s and early 1980s has affected more and more 'ordinary' members of society. Nevertheless, longitudinal comparisons between people's characteristics in 1971 and 198I confirm that the unemployed in 1981 were drawn disproportionately from disadvantaged sections of the community such as men who had previously been unemployed, men who had least skills, resided in local authority housing, or in deprived areas particularly in the North and West and Central regions of the country. Recent entrants to the labour market from socio‐economically disadvantaged backgrounds found particular difficulty in obtaining jobs.

While the least skilled and most disadvantaged were at greatest risk of becoming unemployed, ill‐health, marriage breakdown, movement into local authority housing and downward occupational mobility can be shown to have followed unemployment in the early 1970s. These constitute some of the consequences of unemployment for the affected individuals.

In this article we described how a study of the antecedents and consequences of unemployment helps explain relationships between unemployment and mortality and also suggests what might be expected at a time of high unemployment.
Premenstrual stress
Authors: Vellacott I. D. , O'Brien P. M. S.
Published: May 2007

Stress is frequently associated with the prementrual syndrome. In many women there is an underlying increased stress level so that the physiological premenstrual symptoms with which they could normally cope considerably affect their life styles; this is secondary premenstrual syndrome. In others, stress is part of the symptomatology of their primary premenstrual syndrome; they are free from stress at other times. Appropriate management for these two groups of women differs and is discussed.
Stress, anxiety, and cascades in clinical decision‐making
Authors: Stein Howard F. , Mold James W.
Published: May 2007

Biomedical decision‐making and patient care are not altogether based on rational, scientific, objective factors. Physicians' experience of stress, both as aspects of the current situation and as symbols of personal, often unconscious issues, frequently leads to the use of assessment, diagnosis and treatment as primarily anxiety‐alleviating processes. A not uncommon consequence of these stress‐reduction efforts, by both individual physicians and health care groups, is the 'cascade effect', which the authors define as a sequence of clinical events that proceed inexorably and feel out of the control of those who participate in them.
Siesta and risk of coronary heart disease
Authors: Trichopoulos Dimitrios , Tzonou Anastasia , Christopoulos Costas , Havatzoglou Stavros , Trichopoulou Antonia
Published: May 2007

A case‐control study exploring the long‐term effects of night and afternoon sleep on the occurrence of acute coronary heart disease (CHD) episodes was undertaken in Athens, Greece. The case series consisted of 97 consecutive male patients with an electro cardiographically confirmed CHD episode, admitted during a six‐month period in either of the two cardiologic clinics of the largest Greek teaching hospital. The control series consisted of 90 male orthopaedic, opthalmologic or urologic patients, free from clinical or electrocardiographic evidence of overt CHD, admitted to the same hospital at the same dates as the corresponding cases. All patients were interviewed and examined in the hospital wards during the first week of their hospitalization; the statistical analysis was done by multiple logistic regression, controlling for the confounding influences of socioeconomic variables and several established CHD risk factors. Four of the CHD cases, but none of the controls, reported occupations involving shift work; these patients were not included in subsequent sleep‐focused analyses. The duration of night sleep was shorter among CHD patients than among controls, but the regression‐adjusted difference was slight and statistically non‐significant. However, there was a strong, duration‐dependent and statistically significant association of afternoon sleep with the occurrence of (at least) non‐fatal CHD episodes, indicating that a 30‐minute siesta may be related with an almost 30 per cent reduction of the corresponding incidence rate. Although the study is relatively small and residual confounding cannot be excluded, the results are not biologically implausible and appear remarkably consistent with the geocultural pattern of CHD occurrence (low incidence of CHD in siesta countries and population groups).
The motor vehicle, stress and circulatory system
Authors: Robinson A. A.
Published: May 2007

In our western society today, there are a number of diseases that are generally stated to have no known cause; these diseases are rare, or non‐existent, in the undeveloped nations. It has been found that the greater the number of vehicles in the various countries, the greater the number of deaths from cancer and circulatory complaints.

This article is a brief review of work carried out over the last 20 years involving driving stress tests and statistical analyses of disease in relation to motor vehicle usage.
The changing concept of cardiovascular reactivity
Authors: Rosenman Ray H. , Ward Marcia M.
Published: May 2007

Cardiovascular reactivity has long been measured in laboratory responses to a wide variety of cognitive and physical stressors, with the hypothesis that exaggerated reactivity plays a pathogenetic role in the development of essential hypertension. However there are few data to support the belief that behavioural differences of cognitive perception of stressors account for observed differences of reactivity. Cardiovascular reactivity in the laboratory does not predict hypertension or account for differences of blood pressure variability in the natural environment. Hypertensives do not exhibit increased blood pressure variability. Antihypertensive therapy consistently fails to lower cardiovascular reactivity in either the laboratory or natural milieu, supporting the dual and largely independent regulation of the basal and reactive blood pressures. It is concluded that there is little support for the use of laboratory stress testing to delineate either the pathogenesis of hypertension, the evaluation of hypertensive subjects, or the efficacy of antihypertensive therapy.
Genes, stress and the heart
Authors: Rose Richard J.
Published: May 2007

Effects of stress and its relationship to coronary morbidity and mortality are modified by genetic variation between people. We do not uniformly react to stress, nor do we create equally stressful living environments. The underlying causes of such individual variation are, in part, heritable. Two possible mechanisms through which genetic variation modulates the link between stress and coronary disease are cardiovascular stress reactivity and coronary‐prone personality. Both possess characteristics of genetic markers: they are stable, familial, and heritable; they associate with the disease and are prospectively predictive of it. Twin‐family data on cardiovascular stress reactivity and coronary‐prone personality provide instructive illustrations of the interrelationship of genes, stress, and the heart.
Efficacy versus effectiveness of relaxation therapy in hypertension
Authors: Patel Chandra , Marmot M. G.
Published: May 2007

Non‐pharmacological measures are gaining popularity in the reduction of mildly elevated blood pressure. Their efficacy has been reported in a number of controlled trials. However, efficacy does not automatically ensure effectiveness in everyday clinical practice. Three main factors are likely to determine the effectiveness of relaxation or stress reduction therapy (relaxation techniques plus stress management strategies): 1) the efficacy of the treatment, 2) the characteristics of the therapists and 3) the characteristics of the patients to whom the treatment is applied. Reviewing the literature, and our own studies, we conclude that therapy is more likely to be effective if it includes relaxation techniques as well as behavioural and cognitive strategies, taught by an experienced and committed therapist to highly motivated patients living in favourable family and social surroundings.
Changes in hormonal, immunological and autonomic measures during the performance of a laboratory ‘stress’ task
Authors: Pettingale K. W. , Watson M. , Bhakri H. L. , Jones H. , Tee D. E. H.
Published: May 2007

Plasma cortisol, growth hormone and prolactin were measured together with lymphocyte subpopulation numbers in nine volunteers in good health during the performance of a laboratory task, and five of these subjects were tested during an otherwise identical control period where the task was not performed. Psychological and autonomic measures indicated that the task was found to be moderately arousing and stressful by the subjects. Although homonal changes were not statistically significant because of the variability of individual responses, consistent patterns in the responses were observed. Plasma cortisol decreased progressively on the task day whereas on the non‐task day cortisol levels rose during the post‐task period. On both days growth hormone levels rose prior to the task and fell progressively afterwards. Prolactin levels fell throughout the procedure on both days. There were significant falls in all lymphocyte subpopulations between the initial and basal sample (p < 0.02) and the counts rose again subsequently on both task and non‐task days. It is suggested that the effect of an initial anticipatory reaction confounded the effects of the task on plasma hormone and lymphocyte dynamics. The possible implications of the results of immune function are discussed.
The stress‐prone personality: A review of the research in the context of occupational stress
Authors: Taylor Helen , Cooper Cary L.
Published: May 2007

This article reviews the recent research into personality predisposition in terms of stress, with particular reference to occupational contexts. We explore the work on type A behaviour, locus of control, the ‘hardy’ personality, extra‐version/neuroticism/psychoticism and tension discharge rate. We attempt to highlight how these findings might be of use in understanding occupational stress.
Micturition disorders
Authors: Macaulay Andrew
Published: May 2007

This article reviews the psychological factors associated with micturition disorders and suggests that they may be causally linked to detrusor instability and sencory urgency. Patients with genuine stress incontinence have psychological profiles in keeping with a population who have a chronic physical disability. The treatment of patients with micturition disorders is reviewed and proposals are made for clinical management. The overall conclusion is that, in general, surgery and medication have little to offer whilst psychological treatments appear to be effective.
Aerobic and non‐aerobic forms of exercise in the treatment of anxiety disorders
Authors: Martinsen Egil. W. , Hoffart Asle , Solberg Ø Yvind
Published: May 2007

We compared aerobic and non‐aerobic forms of exercise in the treatment of anxiety disorders. Seventy‐nine inpatients took part in the study. All met the DSM‐III‐R criteria for anxiety disorders, 71 per cent had the diagnosis panic disorder with agorphobia. Patients were randomly assigned to the two physical training conditions, aerobic and non‐aerobic, by block randomization with respect to sex. Seventy patients completed the trial, and exercised for one hour three times a week for eight weeks. There was a significant increase in aerobic capacity in the aerobic group, but no change in the non‐aerobic group. Both groups achieved similar and significant reductions in anxiety scores, but the differences between the groups were small and not statistically significant. There were four exercise‐related dropouts in the aerobic group, none in the non‐aerobic. All dropouts had the diagnosis panic disorder with agoraphobia. The study indicates that intensive aerobic exercise, with resulting increase in aerobic capacity, has no specific effect on the anxiety level in patients with anxiety disorders. The reductions in anxiety scores which in previous studies have been shown to be associated with physical fitness training are most probably mediated via psychological mechanisms, like distraction and mastering.
Stress and schizophrenia: A review of research models and findings
Authors: Teague Gregory B. , Drake Robert E. , Bartels Stephen J.
Published: May 2007

Current thinking on schizophrenia suggests that patients are particularly vulnerable to stress, which may contribute significantly to triggering acute episodes of the illness. Previous investigation of the relationship of stress to schizophrenia has emphasized two themes. There is weak evidence that significantly stressful events may precipitate relapse. There are stronger indications that family communication styles characterized by criticism and hostility directed towards the patient may contribute to relapse. Working along both lines has provoked discussion and criticism on both conceptual and methodological grounds. The literature on stress models exhibits a diversity of approaches on several issues critical to the development of an effective stress‐schizophrenia model: the locus of stress in the person‐environment system; the elements to be included; the nature and direction of causal effect; and the methodology to be applied in the investigation of stress. Previous investigations have attempted but failed satisfactorily to isolate the person from the environment to obtain a clear measure of relationship between stress and schizophrenic episodes. The nature of the illness and of the identified psychosocial stress domain suggests that a more effective model would incorporate a systems‐theoretical approach, focusing on coping processes used in achieving various forms of equilibrium with the environment.
Psychological outcome of treatment for early breast cancer: A review
Authors: Hall Angela , Fallowfield Lesley
Published: May 2007

This paper critically reviews 10 studies which compare the psychological outcome of treatment for early breast cancer by either mastectomy or breast‐conserving procedures. There are few methodologically sound data supporting the assumption that less mutilating techniques protect women from psychological and sexual dysfunction.
Electrosleep and stress relief
Authors: Haslam M. T.
Published: May 2007

Interrupted galvanic current via bitemporal electrodes on the brain induces a state of immobility and torpor with retention of consciousness. The procedure has been mainly developed in the USSR, where it has principally been used for anxiety states, insomnia, psychosomatic conditions and withdrawal from alcohol and drug dependence. Electrosleep would seem to have proved its value at least as an adjunct to other methods of therapy and has an advantage over drug therapies in the present climate of opinion, in a wide variety of studies. Results of a personal research study are reviewed.
Nurses under stress: A reliability and validity study of the NSI
Authors: Cooper Cary L. , Mitchell Simon
Published: May 2007

The Nurse Stress Index (NSI) and other measures were instrumented with 117 nurses in seven hospitals and four hospices who were dealing with high‐risk aspects of the profession. The NSI would seem to be a reliable and reasonably construct‐valid measure for this purpose, but the findings of factor analysis suggested that for different groups of nurses, slightly different factor structures or subscales would be more appropriate.
Stress and marital discord: Some sex differences
Authors: Rust John , Golombok Susan
Published: May 2007

The general importance of stress reduction techniques in sexual and marital therapy is examined in the light of findings that sexual dysfunction is an important factor in marital discord for men, but not for women. The implications of this finding for treatment are examined, and it is concluded that, while stress reduction may have a role to play in the treatment of specific sexual dysfunctions in men, a more global approach to change is needed for sex therapy in women.
Dementia: A study of 104 cases
Authors: Janati Abdorasool , Nowack William J. , Newton Norris , Raval Jugalkishor , Floyd Rebecca
Published: May 2007

A prospective study has been made in 104 consecutive cases with dementia admitted to the McClellan Memorial Veterans Hospital in Little Rock and Parkland Medical Center in Dallas. Utilizing a standard dementia battery, we identified a specific cause for dementia, other than Alzheimer's disease and cerebrovascular disease, in 25 per cent of the cases. Alzheimer's disease was diagnosed in approximately 28 per cent of the cases. Senile dementia of the Alzheimer's type and vascular dementias were the most common etiologies encountered. A potentially treatable cause of dementia was found in 21 per cent of the patients. The importance of early detection of dementia, the diagnostic value of various ancillary procedures, and the value of a diligent search for treatable causes of dementia were emphasized by our data.
Premonition of foetal death
Authors: Chapman Kenneth , Chapman Rokhsareh
Published: May 2007

Five patients who had a presentiment that their unborn child would die are described and their treatment and foetal outcome are discussed.
Stress‐protective functions of positive experiences during the premenstrual period
Authors: Chaturvedi S. K. , Chandra Prabha S.
Published: May 2007

The present study aimed at studying the presence of positive emotions during the premenstruum. A positive premenstrual assessment form was constructed and administered to 48 female nursing students in the reproductive age group. Ratings were done using numerical and visual analogue scales. Forty‐six women reported experiencing at least some positive symptoms and two had none. Extremes of positive emotions were seen in 12–37 per cent of the women. The commonest emotions were a sense of well‐being in 75 per cent and feelings of excitement and relief in 62 per cent. Increased sexual desire was reported by 42 per cent. The implications of these positive perimenstrual changes are described in terms of a stress‐protective function regarding premenstrual distress and the premenstrual syndrome. It is likely that cultural factors may be involved in the stress‐protective functions of these positive experiences.
Measurement problems in estimating theoretically informed models of stress: A sociological perspective
Authors: Kaplan Howard B.
Published: May 2007

The estimation of theoretically informed models of stress require valid and unconfounded measures of the explanatory constructs that comprise the models. Psychosocial theoretical perspectives draw analytic distinctions between life circumstances, subjective evaluation of threat, adaptive/defensive/coping responses, and dysfunctional personal and social consequences. The theoretical considerations surrounding these constructs and the implications of these considerations for measurements decisions are reviewed. Further progress in understanding the stress process depends on increasingly sophisticated theoretical statements that permit finer delineation of explanatory constructs. Progress depends also on analytic techniques that permit the estimation of structural relations among latent constructs independent of the correlated errors between the observed variables.