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ABSTRACT: Objective: We examined the mechanisms that underlie the observed relationships between loneliness and depressed mood and poor sleep quality in college students. This study was the first to investigate whether rumination and trait anxiety are psychological mechanisms that mediate this relationship. Methods: In Study 1 (n = 1,244), using factor analysis with cross-sectional data, we established that loneliness and rumination are distinct constructs. We then collected survey data in two cross-sectional samples (ns = 300 and 218) and one prospective (n = 334) sample to test whether rumination and anxiety were mediators of the relationship between loneliness and depressed mood and poor sleep quality. Structural equation modeling was used to test the proposed relationships. Participants completed self-report measures of loneliness, rumination, trait anxiety, depressed mood, and sleep quality. In addition, measures of hostility, neuroticism, negative affect, and tobacco use were also assessed and tested as mediators, while social support was assessed and tested as a moderator. Results: Consistent across the three studies, we found that rumination and trait anxiety fully mediated the associations between loneliness and depressed mood as well as poor sleep quality; these relationships held after testing all other factors. Conclusion: This study helps explain how loneliness dynamics relate to poor health and suggests specific points of departure for the development of interventions. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Health Psychology 07/2012; · 3.87 Impact Factor
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ABSTRACT: To discern whether gender was a unique predictor of the white coat effect (WCE) in a population of normotensives and patients diagnosed with hypertension.
Participants (n=252) underwent a doctor's office visit to have their blood pressure measured. Multiple blood pressure readings were taken by both a research assistant and by the attending physician. In addition, measures of anxiety variables were collected during the visit. Participants then underwent a 36-h ambulatory blood pressure monitoring.
Gender was a significant predictor of the systolic WCE, but, as expected, the effect size was small and was no longer significant when age and BMI were included in the regression model. State anxiety emerged as a significant independent predictor of systolic WCE; however, when household income was included in the model it became the only significant independent predictor (β=0.203, P<0.05), in addition to gender, age, and BMI.
This study suggests that the association between gender and the systolic WCE is small, and likely accounted for by other variables including age, BMI, state anxiety, and household income. Thus, gender may be of limited use in helping identify patients who may be more likely to have WCE or white coat hypertension. Gender differences in this area should be interpreted with great caution.
Blood pressure monitoring 02/2011; 16(1):1-6. · 1.62 Impact Factor
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ABSTRACT: Adequate sleep is essential for health across the lifespan and is likely to be influenced by different factors among those with chronic pain than among others. Questionnaires were administered to 362 college students, some of whom reported chronic pain from varied sources. Among chronic pain sufferers (n = 108), pain severity was uniquely associated with sleep quality after controlling for gender, BMI, perceived health, health behaviors, depressed mood, perceived stress, and scholastic/interpersonal self-esteem. For these participants, perceived health, alcohol use, pain medication use, and depressed mood were also associated with sleep quality, whereas for participants with non-chronic recent pain (n = 129) only perceived health and depressed mood predicted sleep. Individuals with both chronic pain and high stress had the worst sleep. Stress, alcohol use, pain, and mood may contribute to poor sleep among young adults with pain, which could lead to a cycle of long-term health problems.
Journal of Behavioral Medicine 05/2010; 33(5):335-45. · 3.10 Impact Factor
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10/2009; , ISBN: 9780470478509
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ABSTRACT: To examine whether greater cognitive engagement during a marital conflict discussion, as evidenced by use of words that suggest thinking and meaning-making, results in attenuated proinflammatory cytokine increases to stress and wounding.
Husbands and wives (N = 84 individuals) were observed during two separate 24-hr visits: each visit included a wounding procedure, which was followed by a nonconflictive marital discussion (first visit) and a conflictive marital discussion (second visit).
Serum proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha).
Individuals who used more cognitive processing words during the conflict discussion (but not the nonconflictive discussion) showed smaller increases in serum IL-6 and TNF-alpha over 24 hours; they also had lower levels of both cytokines 24 hours after baseline controlling for demographics, hostility, depressed mood, positive and negative interactions, and marital quality. Effects of word use were not mediated by ruminative thoughts after conflict. Although both men and women benefited from their own cognitive engagement, only husbands' IL-6 patterns were affected by spouses' engagement.
In accord with research demonstrating the value of cognitive processing in emotional disclosure, this research suggests that productive communication patterns may help mitigate the adverse effects of relationship conflict on inflammatory dysregulation.
Health Psychology 09/2009; 28(5):621-30. · 3.87 Impact Factor
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ABSTRACT: Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association.
Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors.
Gestational age at delivery, birth weight, preterm delivery (<37 weeks), and low birth weight (<2,500 g).
A latent pregnancy-specific stress factor predicted birth outcomes better than latent factors representing state anxiety, perceived stress, or life event stress, and than a latent factor constructed from all stress measures. Controlling for obstetric risk, pregnancy-specific stress was associated with smoking, caffeine consumption, and unhealthy eating, and inversely associated with healthy eating, vitamin use, exercise, and gestational age at delivery. Cigarette smoking predicted lower birth weight. Clinically-defined birth outcomes were predicted by cigarette smoking and pregnancy-specific stress.
Pregnancy-specific stress contributed directly to preterm delivery and indirectly to low birth weight through its association with smoking. Pregnancy-specific stress may be a more powerful contributor to birth outcomes than general stress.
Health Psychology 10/2008; 27(5):604-15. · 3.87 Impact Factor
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Psychoneuroendocrinology 10/2008; 33(9):1303. · 5.81 Impact Factor
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ABSTRACT: Objective: Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association. Design: Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors. Main Outcome Measures: Gestational age at delivery, birth weight, preterm delivery (
Health Psychology 08/2008; 27(5):604-615. · 3.87 Impact Factor
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ABSTRACT: Based on prior research demonstrating benefits of emotional disclosure for chronically ill individuals and evidence that anger is particularly problematic in chronic pain sufferers, outpatients from a chronic pain center (N=102) were randomly assigned to express their anger constructively or to write about their goals non-emotionally in a letter-writing format on two occasions. Letters were coded for degree of expressed anger and meaning-making (speculation and insight into conditions that precipitated anger). Over a 9 week period, participants in the anger-expression group (n=51) experienced greater improvement in control over pain and depressed mood, and marginally greater improvement in pain severity than the control group (n=51). Degree of expressed anger uniquely accounted for intervention effects and meaning-making mediated effects on depressed mood. These findings suggest that expressing anger may be helpful for chronic pain sufferers, particularly if it leads to meaning-making.
Journal of Behavioral Medicine 07/2008; 31(3):201-12. · 3.10 Impact Factor
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ABSTRACT: Despite aromatherapy's popularity, efficacy data are scant, and potential mechanisms are controversial. This randomized controlled trial examined the psychological, autonomic, endocrine, and immune consequences of one purported relaxant odor (lavender), one stimulant odor (lemon), and a no-odor control (water), before and after a stressor (cold pressor); 56 healthy men and women were exposed to each of the odors during three separate visits. To assess the effects of expectancies, participants randomized to the "blind" condition were given no information about the odors they would smell; "primed" individuals were told what odors they would smell during the session, and what changes to expect. Experimenters were blind. Self-report and unobtrusive mood measures provided robust evidence that lemon oil reliably enhances positive mood compared to water and lavender regardless of expectancies or previous use of aromatherapy. Moreover, norepinephrine levels following the cold pressor remained elevated when subjects smelled lemon, compared to water or lavender. DTH responses to Candida were larger following inhalation of water than lemon or lavender. Odors did not reliably alter IL-6 and IL-10 production, salivary cortisol, heart rate or blood pressure, skin barrier repair following tape stripping, or pain ratings following the cold pressor.
Psychoneuroendocrinology 05/2008; 33(3):328-39. · 5.81 Impact Factor
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ABSTRACT: Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.
Veterinary Clinics of North America Exotic Animal Practice 06/2007; 10(2):395-418.
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ABSTRACT: Rodents may be presented on an emergency basis with various conditions causing debilitation and disease. Common causes of emergent presentations include trauma, respiratory disease, dental disease, gastrointestinal disease, reproductive disorders, and urinary tract obstruction. Emergency treatment should always include immediate stabilization of the patient until the patient is able to tolerate diagnostic testing and additional therapeutics. Rodent patients benefit from supportive care, including thermal, fluid, and nutritional support. Administration of cardiopulmonary resuscitation, antibiotics, and analgesics through various routes is also appropriate. This article presents an overview of emergency medicine in rodents, including emergency procedures, handling and restraint, triage and patient assessment, sample collection, and supportive care procedures. The most common emergency presentations for rodents are also discussed.
Veterinary Clinics of North America Exotic Animal Practice 06/2007; 10(2):501-31.
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ABSTRACT: The purpose of this study was to examine processes through which chronic pain can result in depressed mood and to determine whether intrapersonal coping resources, namely high self-esteem and optimism, affect these processes. We hypothesized that pain severity contributes to depressed mood largely because pain interferes with involvement in important pursuits. We then examined whether intrapersonal resources are directly associated with pain severity, interference, and depressed mood and whether resources moderate associations between pain and interference or between interference and depressed mood. Structured interviews containing psychometrically robust measures were conducted with 141 outpatients of a university hospital-affiliated chronic pain center. As predicted, interference mediated much of the association between pain severity and depressed mood, and high resources were associated with less severe pain, less interference, and lower depressed mood. The association between pain severity and interference was stronger for people with high than people with low intrapersonal resources. The pattern of results that emerged from this study illustrates that intrapersonal coping resources may affect chronic pain patients through a variety of differentiated mechanisms. Pain severity appears to have greater adverse impact on the activity of people who possess highly positive self-views and outlook, but these resources are also associated with better emotional status. PERSPECTIVE: Pain had greater adverse impact on the activity of people with highly positive self-views and outlook, but these coping resources were also associated with better emotional status. Chronic pain sufferers with few resources may require different interventions than those with more positive views of themselves and the world around them.
Journal of Pain 04/2007; 8(3):256-62. · 4.93 Impact Factor
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ABSTRACT: Both aging processes and psychological stress affect the immune system: Each can dysregulate immune function with a potentially substantial impact on physical health. Worse, the effects of stress and age are interactive. Psychological stress can both mimic and exacerbate the effects of aging, with older adults often showing greater immunological impairment to stress than younger adults. In addition, stressful experiences very early in life can alter the responsiveness of the nervous system and immune system. We review the unique impact of aging and stress on immune function, followed by evidence of interactions between age and stress. Further, we suggest that prenatal or early life stress may increase the likelihood of maladaptive immune responses to stress in late life. An understanding of the interactive effects of stress and age is critical to efforts to determine underlying mechanisms, clarify the directionality of effects, and develop effective interventions in early and late life.
Journal of Behavioral Medicine 09/2006; 29(4):389-400. · 3.10 Impact Factor
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ABSTRACT: Chronically elevated systemic inflammation has a dramatic impact on health for older individuals. As stress-related responses, both hostility and pain perception may contribute to inflammation which in turn may maintain negative emotion and pain over time. We used structural equation modeling to examine the degree to which trait hostility and pain were uniquely associated with C-reactive protein (CRP) and serum IL-6 levels over a 6-year span in a sample of older adults. The sample included 113 present or former caregivers of a spouse with dementia and 101 non-caregivers. After accounting for depression, health behaviours, and other risk factors, which were also assessed longitudinally, pain and, to a lesser extent, hostility were uniquely associated with plasma levels of CRP but not IL-6. When examined separately, the association between pain and CRP was significant only for caregivers, while the association between hostility and CRP was comparable for the two groups. These findings suggest that hostility may play a role in a cycle of inflammation among older adults, and that pain may be particularly problematic for those under chronic stress. Our results also shed light on inflammation as a mechanism underlying the effects of hostility on cardiovascular disease morbidity and mortality.
Brain Behavior and Immunity 08/2006; 20(4):389-400. · 4.72 Impact Factor
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ABSTRACT: Over the past decade it has become clear that stress can significantly slow wound healing: stressors ranging in magnitude and duration impair healing in humans and animals. For example, in humans, the chronic stress of caregiving as well as the relatively brief stress of academic examinations impedes healing. Similarly, restraint stress slows healing in mice. The interactive effects of glucocorticoids (e.g. cortisol and corticosterone) and proinflammatory cytokines [e.g. interleukin-1beta (IL-1beta), IL-1alpha, IL-6, IL-8, and tumor necrosis factor-alpha] are primary physiological mechanisms underlying the stress and healing connection. The effects of stress on healing have important implications in the context of surgery and naturally occurring wounds, particularly among at-risk and chronically ill populations. In research with clinical populations, greater attention to measurement of health behaviors is needed to better separate behavioral versus direct physiological effects of stress on healing. Recent evidence suggests that interventions designed to reduce stress and its concomitants (e.g., exercise, social support) can prevent stress-induced impairments in healing. Moreover, specific physiological mechanisms are associated with certain types of interventions. In future research, an increased focus on mechanisms will help to more clearly elucidate pathways linking stress and healing processes.
NeuroImmunoModulation 02/2006; 13(5-6):337-46. · 2.38 Impact Factor
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ABSTRACT: The majority of information on oncology therapies has been reported in humans, canine, and feline patients, and laboratory animals with experimentally induced tumors. A variety of treatments,including radiation therapy, chemotherapy, photodynamic therapy, and others have been used with exotic animals. There are many species of exotic pets, and anatomic differences, as well as husbandry and nutritional requirements, must be taken into account to provide optimal care. By providing a broad overview of therapies and considerations for treatment, this article is intended to provide the practitioner with an overview of approach and options when addressing oncology cases in exotic animals.
Veterinary Clinics of North America Exotic Animal Practice 10/2004; 7(3):757-81, vii.
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ABSTRACT: To assess the use of a caudal external thoracic artery axial pattern flap to treat sternal cutaneous wounds in birds.
16 adult Japanese quail.
A cutaneous defect in the region of the mid-sternum was surgically created in all quail. In 6 quail (group I), an axial pattern flap was created from the skin of the lateral aspect of the thorax and advanced over the sternal defect. In 8 quail (group II), a flap was similarly created and advanced but the flap vasculature was ligated. All quail were euthanatized at 14 days after surgery and had necropsies performed. Sections of the flap and the surrounding tissue were examined histologically to assess flap viability.
All axial pattern flaps in group-I quail had 100% survival. In group II, mean percentage area of flap survival was 62.5%; mean area of necrosis and dermal fibrosis of flaps were significantly greater than that detected in group I. In flaps of group-II quail, neovascularization in the deep dermis and profound necrosis of the vascular plexus in the superficial dermis were observed.
Results indicated that the caudal external thoracic artery axial pattern flap could be used successfully in the treatment of surgically created sternal cutaneous defects in quail with no signs of tissue necrosis or adverse effects overall. Use of this technique to treat self-mutilation syndromes or application after surgical debulking of tumors or other masses might be beneficial in many avian species.
American Journal of Veterinary Research 05/2004; 65(4):497-502. · 1.27 Impact Factor
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Jennifer E Graham
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ABSTRACT: In conclusion, rabbits have a variety of common disease presentations that require wound management. Anatomic and physiologic characteristics should be kept in mind, as they may have influences upon the management of wounds. Many new topical medications and dressings have been designed that are routinely used in mammalian wound management cases and are potentially useful for rabbits. When topical medications are used in rabbits, care must be taken to ensure the medications are not ingested. In addition to topical therapies, surgical options such as flaps and skin grafts have been researched in rabbits. Many of the wound management concepts that are useful for dogs and cats should be considered when addressing rabbit wounds.
Veterinary Clinics of North America Exotic Animal Practice 02/2004; 7(1):37-55.
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ABSTRACT: Other than postpartum depression, little is known about women’s emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed the Beck Depression Inventory and the anger subset of the Affect Balance Scale. A number of childbirth–relevant variables were examined as predictors of postpartum emotional response, controlling for prepartum levels and for the association between anger and depressed mood. As expected, a substantial group of women reported high levels of anger irrespective of depressed mood. Although the majority of variables predicted depressed mood, childcare stress, age, and religious self–identification were independently predictive of postpartum anger (all p values > .05). Implications for research and clinical intervention are discussed.
Psychology of Women Quarterly 08/2002; 26(3):222 - 233. · 2.12 Impact Factor
