Psychological Functioning in Patients with Chronic Obstructive Pulmonary Disease: A Preliminary Study of Relations with Smoking Status and Disease Impact.

Nicotine Tob Res. 2018 May 17;:

Authors: Mathew AR, Yount SE, Kalhan R, Hitsman B

Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a tobacco-related disease associated with several comorbid conditions, including elevated rates of depression and anxiety. Psychological factors that commonly underlie nicotine dependence, depression, and anxiety may represent novel treatment targets, but have not yet been examined among COPD patients. We assessed three psychological factors - anxiety sensitivity (AS; fear of anxiety-related sensations), distress intolerance (DI; inability to withstand distressing states), and anhedonia (Anh; diminished sense of pleasure or interest) - in relation to smoking status, COPD symptom impact, and negative response to COPD symptoms.
Methods: We conducted a single-session laboratory assessment with 37 COPD patients (17 current daily smokers and 20 former smokers). All participants completed self-report measures of psychological factors, COPD symptom impact, response to COPD symptoms, and anxiety and depression symptoms.
Results: Current vs. former smokers with COPD reported higher levels of AS, DI, and Anh. In univariate regression models, AS, DI, and Anh were each associated with greater COPD symptom impact and breathlessness catastrophizing. Only AS remained a significant predictor of COPD symptom impact and breathlessness catastrophizing after adjusting for general depression and anxiety symptoms.
Conclusions: Our preliminary study is the first to assess AS, DI, and Anh among COPD patients. These psychological factors were elevated among current smokers and associated with more negative disease impact, suggesting their potential utility as treatment targets within this clinical population.
Implications: While elevated rates of anxiety and depression among COPD patients have been well-characterized, few studies have specifically addressed the causal, modifiable psychological factors that may underlie these disorders. Our preliminary findings demonstrate associations of three psychological factors - anxiety sensitivity, distress intolerance, and anhedonia - with smoking status, COPD symptom impact, and negative reaction to symptoms. Cognitive-behavioral interventions targeted to these psychological factors may improve smoking cessation outcomes and disease adjustment among COPD patients.

PMID: 29788395 [PubMed - as supplied by publisher]

Strained Bedfellows: An Actor-Partner Analysis of Spousal Attachment Insecurity and Sleep Quality.

Ann Behav Med. 2018 May 17;:

Authors: Kent de Grey RG, Uchino BN, Pietromonaco PR, Hogan JN, Smith TW, Cronan S, Trettevik R

Abstract
Background: The quality of interpersonal ties-especially closer relationships-appears to be associated with physical health outcomes. Sleep is one pathway through which relationships and health appear to be linked, but this has been inadequately investigated in the context of dyadic attachment.
Purpose: The present study examined links between relationship-specific attachment anxiety (which can involve preoccupation with one's partner, negative relationship cognitions, and fear of abandonment) and avoidance (e.g., low emotional investment or intimacy) and sleep quality.
Methods: Attachment, assessed using the Experience in Close Relationship (ECR), was used to predict Pittsburgh Sleep Quality Inventory (PSQI)-assessed sleep quality in 92 married heterosexual couples via actor-partner interdependence models. Depression was examined as a potential mediator of this association.
Results: Consistent with hypotheses, actors' anxious attachment predicted diminished quality of their own sleep, whereas actors' avoidant attachment was unrelated to their own sleep quality. Results further suggested that couples in which both spouses were higher in attachment anxiety experience better sleep quality (b = -0.74, SE = 0.28, p = .0082, 95% CI [-1.287, -0.196]). Conversely, couples in which both spouses were higher in attachment avoidance showed poorer sleep quality (b = 0.56, SE = 0.23, p = .0188, 95% CI [0.095, 1.016]). These effects were found to be independent of marital satisfaction and depression. Some evidence was also consistent with mediation of links between attachment and sleep quality via depression.
Conclusions: Results suggest adult romantic attachment and sleep are associated in complex ways, highlighting the importance of dyadic approaches to the study of relationships, sleep, and health.

PMID: 29788062 [PubMed - as supplied by publisher]

The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis.

Seizure. 2018 May 19;59:108-115

Authors: Indranada AM, Mullen SA, Duncan R, Berlowitz DJ, Kanaan RAA

Abstract
INTRODUCTION: Psychogenic Non-Epileptic Seizures (PNES) are events that appear epileptic but are instead thought to have a psychological origin. Increased rates of several psychiatric disorders have been reported in PNES, including anxiety and panic disorders. Some theories suggest panic and/or hyperventilation have aetiological roles in PNES, though these remain unproven.
METHODS: We conducted a systematic review of associations of panic and hyperventilation with PNES using Ovid Medline and PubMed, and a meta-analysis where appropriate.
RESULTS: We found eighteen studies reporting rates of panic in PNES and eight studies reporting hyperventilation. The reported rate of panic attacks in PNES ranged from 17% to 83%, with physical symptoms more commonly reported, and affective symptoms less so. 'Dizziness or light-headedness' was found to be more prevalent than 'fear of dying' by random-effects meta-analysis (68% vs. 23%). A proportion meta-analysis found a weighted occurrence of 20% of panic disorder in PNES. A pooled meta-analytic rate of PNES events following voluntary hyperventilation induction was 30%, while the clinically observed rates of peri-ictal hyperventilation in PNES without induction varied from 15 to 46%.
CONCLUSIONS: Previous studies have reported moderate rates of association of panic in PNES, though the proportions varied considerably across the literature, with physical symptoms more commonly reported than affective. Hyperventilation is an effective inducer of PNES events in a minority, and can be observed occurring in a minority of patients without induction. These results support an important, albeit not essential, role for panic and hyperventilation in the pathogenesis of PNES events.

PMID: 29787922 [PubMed - as supplied by publisher]

Osteopathic manipulative treatment including specific diaphragm techniques improves pain and disability in chronic non-specific low back pain: a randomized trial.

Arch Phys Med Rehabil. 2018 May 19;:

Authors: Martí-Salvador M, Hidalgo-Moreno L, Doménech-Fernández J, Lisón JF, Arguisuelas MD

Abstract
OBJECTIVE: To investigate the effects of an osteopathic manipulative treatment (OMT) which includes a diaphragm intervention compared to the same OMT with a sham-diaphragm intervention in chronic non-specific low back pain (NS-CLBP).
DESIGN: Parallel group randomized controlled trial SETTING: private and institutional health centers.
PARTICIPANTS: Sixty-six subjects (18-60 yrs.) with a diagnosis of NS-CLBP lasting at least 3 months.
INTERVENTIONS: Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham-diaphragm intervention (n=33), conducted in five sessions provided during 4 weeks.
MAIN OUTCOME MEASURE: The primary outcomes were pain [evaluated with the Short-Form McGill Pain Questionnaire (SF-MPQ) and the Visual Analogue Scale (VAS)] and disability [assessed with the Roland Morris Questionnaire (RMQ) and the Oswestry Disability Index (ODI)]. Secondary outcomes were fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization. All outcome measures were evaluated at baseline, at week 4, and at week 12.
RESULTS: A statistically significant reduction was observed in the experimental group compared to the sham group, in all variables assessed at week 4 and at week 12 [SF-MPQ (MD -6.2;95%CI: -8.6 to -3.8); VAS (MD -2.7;95%CI: -3.6 to -1.8); RMQ (MD -3.8;95%CI: -5.4 to -2.2); ODI (MD -10.6;95%CI: -14.9 to 6.3]. Moreover, improvements in pain and disability were clinically relevant.
CONCLUSION: An OMT protocol that includes diaphragm techniques produces significant and clinically relevant improvements in pain and disability in patients with NS-CLBP compared to the same OMT protocol using sham diaphragm-techniques.

PMID: 29787734 [PubMed - as supplied by publisher]

Repeated social defeat-induced neuroinflammation, anxiety-like behavior and resistance to fear extinction were attenuated by the cannabinoid receptor agonist WIN55,212-2.

Neuropsychopharmacology. 2018 Apr 17;:

Authors: Lisboa SF, Niraula A, Resstel LB, Guimaraes FS, Godbout JP, Sheridan JF

Abstract
Psychosocial stress contributes to the development of psychiatric disorders. Repeated social defeat (RSD) is a murine stressor that causes a release of inflammatory monocytes into circulation. Moreover, RSD-induced anxiety-like behavior is dependent on the recruitment of these monocytes to the brain. Activation of the endocannabinoid (ECB) system may modulate both neuroendocrine and inflammatory responses mediated by stress. Therefore, we hypothesized that a cannabinoid receptor agonist would attenuate RSD-induced inflammation, anxiety, and stress sensitization. To test this hypothesis, mice received an injection of the synthetic cannabinoid1/2 receptor agonist, WIN55,212-2 (WIN; 1 mg/kg, intraperitoneally) daily for six consecutive days, 30 min before each exposure to RSD. Anxiety-like behavior, immune activation, neuroinflammation, and microglial reactivity were determined 14 h after RSD. RSD-induced anxiety-like behavior in the open field and in the EPM was reversed by WIN55,212-2. Moreover, WIN55,212-2 reduced the accumulation of inflammatory monocytes in circulation and brain after RSD and attenuated RSD-induced interleukin-1β (IL-1β) messenger RNA (mRNA) expression in microglia/macrophages. Increased ex vivo reactivity of microglia/monocytes to lipopolysaccharides (LPS) after RSD was also attenuated by WIN55,212-2. Next, fear expression, extinction, and recall were evaluated 24 and 48 h, respectively, after contextual fear conditioning, which took place 7 days after RSD. Here, RSD caused prolonged fear expression and impaired fear extinction recall, which was associated with increased IL-1β mRNA in the brain. Moreover, these stress-induced effects were reversed by WIN55,212-2. In conclusion, activation of cannabinoid receptors limited the immune and neuroinflammatory responses to RSD and reversed the short-term and long-term behavioral deficits associated with RSD.

PMID: 29786066 [PubMed - as supplied by publisher]