EFFECT OF DEPRESSIVE EMOTIONS ON AIRWAYS IN ASTHMA

描述（改编自申请人的摘要）： 拟议的项目是应用一个独特的概念模型和实验室，方法， 由私家侦探开发调查的条件下，和机制， 抑郁的情绪状态会影响自主神经过程 呼吸道在哮喘中起作用。这一目标将通过进一步 测试和阐述情绪自主神经（ANS）失调模型 对哮喘的影响（米勒1987，米勒和伍德，1997），其中提出， 抑郁、绝望或无望的情绪状态与ANS有关 调节异常，使得胆碱能（PNS）偏向增强胆碱能 (PNS)介导的气道收缩！在心理和生理上 易患哮喘 电影《外星人》，外星人”将被用来提供 对138名男性和138名女性青少年（年龄11-16岁）进行特定情绪挑战 （坦纳阶段2-5），哮喘，同时持续测量自主神经 心肺系统和气道的神经系统（ANS）调节 功能唤起恐惧、悲伤/绝望、快乐/兴奋和 混合的悲伤/快乐将相互比较，并与中性场景进行比较 基线。将测量唾液皮质醇和气道功能（FEV 1）。 在电影前后和每个场景之后拍摄。氧饱和度将是 在整个电影中测量。受试者的哮喘和情绪状态将 在电影之前的侧写。将通过乙酰甲胆碱测量气道反应性 挑战试验（PC 20）。绝望/抑郁状态将由 儿童绝望量表和儿童抑郁量表，调整后 治疗焦虑症自主神经（SNS和PNS）反应性通过心率反映 对实验诱导的情绪挑战的反应，i.例如，的“电影”。 两个收敛的方法将他使用区分交感神经（SNS）从 心肺系统的副交感神经（PNS）调节：1）阻抗 SNS的心电图（PEP），PNS的呼吸性窦性心律失常（RSA）; 2）和 心率变异性（HRV）的功率谱分析（PSA）， SNS和PNS指数。 PC 20、绝望/抑郁状态、PNS和SNS之间的假设关系 将测试激活、皮质醇和气道功能。多元回归 重复测量方差分析方法将用于分析 数据如有必要，将评估药物效应并进行协变分析。

DESCRIPTION (Adapted from the Applicant's Abstract): The objective of the proposed project is to apply a unique conceptual model and laboratory, method, developed by the P.I., to investigate conditions under which, and mechanisms by which, depressive emotional states affect autonomic processes associated with airways function in asthma. This objective will be accomplished by further testing and elaborating the Autonomic (ANS) Dysregulation Model of Emotional Influence on Asthma (Miller 1987, Miller & Wood, 1997) which proposes that depressed, despairing or hopeless emotional states are associated with ANS dysregulation such that a cholinergic (PNS) bias potentiates cholinergically (PNS) mediated airways constriction! giving rise to a psychophysiologically vulnerable asthmatic state. The movie "E.T., the Extra-Terrestrial" will be used to provide emotion-specific challenges to 138 male and 138 female adolescents, ages 11-16 (Tanner stages 2-5), with asthma, while continuously measuring autonomic nervous system (ANS) modulation of the cardio-respiratory system and airway function. Scenes evoking fear, sadness/hopelessness, happiness/excitement and mixed sadness/happiness will be compared to each other and to a neutral scene and baseline. Salivary cortisol and airway function (FEV1) measures will be taken pre and post movie and after each scene. Oxygen saturation will be measured throughout the movie. Subjects' asthma and emotional state will be profiled before the movie. Airway reactivity will be measured by methacholine challenge test (PC20). Hopeless/depressed states will be assessed by the Hopelessness Scale for Children and the Child Depression Inventory, adjusted for anxiety. Autonomic (SNS and PNS) reactivity is reflected by heart rate responses to experimentally induced emotional challenge, i. e., the "movie". Two convergent methods Will he used differentiate sympathetic (SNS) from parasympathetic (PNS) modulation of the cardio-respiratory system: 1) impedance cardiography (PEP) for SNS, respiratory sin us arrhythmia (RSA) for PNS; 2) and Power Spectral Analysis (PSA) of heart rate variability (HRV), which yields indices of SNS and PNS. Hypothesized relationships between PC20, hopeless/depressed states, PNS and SNS activation, cortisol and airways function will be tested. Multiple regression and repeated measures analysis of variance methods will be used to analyze the data. Medication effects will be assessed and analyses covaried if necessary.