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- Arnetz, Bengt B, et al.
(författare)
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Obstructive sleep apnea, posttraumatic stress disorder, and health in immigrants
- 2012
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Ingår i: Psychosomatic Medicine. - 0033-3174 .- 1534-7796. ; 74:8, s. 824-831
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States.METHODS: A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health.RESULTS: The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH.CONCLUSIONS: Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.
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- Coyne, James C, et al.
(författare)
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Lack of Prognostic Value of Type D Personality for Mortality in a Large Sample of Heart Failure Patients
- 2011
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Ingår i: Psychosomatic Medicine. - : Lippincott, Williams and Wilkins. - 0033-3174 .- 1534-7796. ; 73:7, s. 557-562
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Tidskriftsartikel (refereegranskat)abstract
- Background: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms. Methods: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression. Results: At 18 months, there were 192 deaths (27.2%). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95% confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95% CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95% CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95% CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144). Conclusions: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.
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- Ivarsson, Malena, et al.
(författare)
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The effect of violent and nonviolent video games on heart rate variability, sleep, and emotions in adolescents with different violent gaming habits
- 2013
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Ingår i: Psychosomatic Medicine. - : Lippincott Williams & Wilkins. - 0033-3174 .- 1534-7796. ; 75:4, s. 390-396
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study cardiac, sleep-related, and emotional reactions to playing violent (VG) versus nonviolent video games (NVG) in adolescents with different gaming habits.Methods Thirty boys (aged 13-16 years, standard deviation = 0.9), half of them low-exposed (≤1 h/d) and half high-exposed (≥3 h/d) to violent games, played a VG/NVG for 2 hours during two different evenings in their homes. Heart rate (HR) and HR variability were registered from before start until next morning. A questionnaire about emotional reactions was administered after gaming sessions and a sleep diary on the following mornings.Results During sleep, there were significant interaction effects between group and gaming condition for HR (means [standard errors] for low-exposed: NVG 63.8 [2.2] and VG 67.7 [2.4]; for high-exposed: NVG 65.5 [1.9] and VG 62.7 [1.9]; F(1,28) = 9.22, p = .005). There was also a significant interaction for sleep quality (low-exposed: NVG 4.3 [0.2] and VG 3.7 [0.3]); high-exposed: NVG 4.4 [0.2] and VG 4.4 [0.2]; F(1,28) = 3.51, p = .036, one sided), and sadness after playing (low-exposed: NVG 1.0 [0.0] and VG 1.4 [0.2]; high-exposed: NVG 1.2 [0.1] and VG 1.1 [0.1]; (F(1,27) = 6.29, p = .009, one sided).Conclusions Different combinations of the extent of (low versus high) previous VG and experimental exposure to a VG or an NVG are associated with different reaction patterns-physiologically, emotionally, and sleep related. Desensitizing effects or selection bias stand out as possible explanations.
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- Johansson, Gunn, et al.
(författare)
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The Effects of Urban Bus Driving on Blood Pressure and Musculoskeletal Problems : A Quasi-Experimental Study
- 2012
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Ingår i: Psychosomatic Medicine. - 0033-3174 .- 1534-7796. ; 74:1, s. 89-92
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Work settings with high levels of stress are consistently associated with poor health outcomes. This study examines the longitudinal relationships between the number of hours of driving a bus in a city and blood pressure and musculoskeletal problems. Methods: A prospective longitudinal design coupled with multilevel random coefficient modeling was used to examine the relationship among exposure to a job with high level of stress, urban bus driving, blood pressure, and musculoskeletal problems. Baseline blood pressure and musculoskeletal symptoms of men and women (n = 88) were assessed before they began driving a bus in central Stockholm. The number of hours of driving per week, blood pressure, and musculoskeletal symptoms were tracked for a period of 5 years. Multilevel random coefficient modeling techniques were used to model how individual trajectories of health effects were affected by the number of hours of driving, after statistically controlling for baseline preworking health measures. Results: Controlling for sex and baseline health outcomes, the average number of hours of bus driving per week predicted higher diastolic blood pressure (B = 0.069, standard error = 0.034, p =.042) and more frequent musculoskeletal symptoms (B = 0.013, standard error = 0.003, p < .001). Conclusions: The findings provide evidence for a positive association between the number of hours of bus driving and blood pressure and musculoskeletal problems. These findings are discussed in exposures to potentially toxic physical and psychosocial work-related factors.
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- Lumley, Mark A., et al.
(författare)
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The Relationship of Chronic and Momentary Work Stress to Cardiac Reactivity in Female Managers : Feasibility of a Smart Phone-Assisted Assessment System
- 2014
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Ingår i: Psychosomatic Medicine. - : Lippincott Williams & Wilkins. - 0033-3174 .- 1534-7796. ; 76:7, s. 512-518
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate a wireless smart phone-assisted (SPA) system that assesses ongoing heart rate (HR) and HR-triggered participant reports of momentary stress when HR is elevated during daily life. This SPA system was used to determine the independent and interactive roles of chronic and momentary work stress on HR reactivity among female managers. Methods: A sample of 40 female managers reported their chronic work stress and wore the SPA system during a regular workday. They provided multiple reports of their momentary stress, both when triggered by increased HR and at random times. Relationships among chronic stress, momentary stress, and HR were analyzed with hierarchical linear modeling. Results: Both chronic work stress (b = 0.08, standard error [SE] = 0.03, p = .003) and momentary work stress (b = 1.25, SE = 0.62, p = .052) independently predicted greater HR reactivity, adjusting for baseline HR, age, smoking, caffeine, alcohol use, and momentary physical activity levels. More importantly, chronic and momentary stress significantly interacted (b = 1.00, SE = 0.04, p = .036); high momentary stress predicted elevated HR only in the context of high chronic stress. Conclusions: Female managers who experience chronic work stress displayed elevated cardiac reactivity during momentary stress at work. The joint assessment of chronic stress and momentary stress and their relationship to physiological functioning during work clarifies the potential health risks associated with work stress. Moreover, this wireless SPA system captures the immediate subjective context of individuals when physiological arousal occurs, which may lead to tailored stress management programs in the workplace.
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- Alex, Christian, et al.
(författare)
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Aerobic Exercise and Strength Training Effects on Cardiovascular Sympathetic Function in Healthy Adults: A Randomized Controlled Trial
- 2013
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Ingår i: Psychosomatic Medicine. - 0033-3174. ; 75:4, s. 375-381
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Exercise has widely documented cardioprotective effects, but the mechanisms underlying these effects are not entirely known. Previously, we demonstrated that aerobic but not strength training lowered resting heart rate and increased cardiac vagal regulation, changes that were reversed by sedentary deconditioning. Here, we focus on the sympathetic nervous system and test whether aerobic training lowers levels of cardiovascular sympathetic activity in rest and that deconditioning would reverse this effect. Methods: We conducted a randomized controlled trial contrasting the effects of aerobic (A) versus strength (S) training on indices of cardiac (preejection period, or PEP) and vascular (low-frequency blood pressure variability, or LF BPV) sympathetic regulation in 149 young, healthy, and sedentary adults. Participants were studied before and after conditioning, as well as after 4 weeks of sedentary deconditioning. Results: As previously reported, aerobic capacity increased in response to conditioning and decreased after deconditioning in the aerobic, but not the strength, training group. Contrary to prediction, there was no differential effect of training on either PEP (A: mean [SD] -0.83 [7.8] milliseconds versus S: 1.47 [6.69] milliseconds) or LF BPV (A: mean [SD] -0.09 [0.93] lnmm Hg-2 versus S: 0.06 [0.79] lnmm Hg-2) (both p values >.05). Conclusions: These findings, from a large randomized controlled trial using an intent-to-treat design, show that moderate aerobic exercise training has no effect on resting state cardiovascular indices of PEP and LF BPV. These results indicate that in healthy, young adults, the cardioprotective effects of exercise training are unlikely to be mediated by changes in resting sympathetic activity.
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