EFFECT OF DEPRESSIVE EMOTIONS ON AIRWAYS IN ASTHMA

描述(改编自申请人的摘要)： 建议的项目是应用独特的概念模型和实验室、方法、 由P.I.开发，以调查在什么情况下， 其中，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 情绪自主性调节障碍模型的检验与阐述 对哮喘的影响(Miller 1987，Miller&Wood，1997)提出 抑郁、绝望或绝望的情绪状态与ANS有关 胆碱能(PNS)偏向导致胆碱能增强的失调 三七总皂甙(PNS)介导的呼吸道收缩！在心理生理学上引发了 脆弱的哮喘状态。 电影《外星人E.T.》将被用来提供 对138名11-16岁男性青少年和138名女性青少年的情绪特异性挑战 (Tanner分期2-5)，患有哮喘，同时持续测量自主神经 神经系统(ANS)对心肺系统和呼吸道的调节 功能。唤起恐惧、悲伤/绝望、幸福/兴奋和 混合的悲伤/幸福将被相互比较，并被比作一个中性的场景 和基线。唾液皮质醇和呼吸道功能(FEV1)措施将 拍摄电影前后和每一场戏之后。血氧饱和度将达到 在整部电影中都进行了测量。受试者的哮喘和情绪状态将是 在电影上映前的侧写。用乙酰甲胆碱法测定呼吸道反应性 挑战测试(PC20)。绝望/抑郁状态将由 调整后的儿童无望量表和儿童抑郁量表 治疗焦虑症。自主神经(三叉神经节和三叉神经节)反应性由心率反映 对实验诱导的情绪挑战的反应，即“电影”。 他将使用两种收敛的方法来区分交感神经(SNS)和 副交感神经(PNS)对心肺系统的调制：1)阻抗 对SNS进行心动图(PEP)，对PNS进行呼吸性心律失常(RSA)；2)和 心率变异性(HRV)的功率谱分析(PSA) SNS和PNS指数。 PC20、绝望/抑郁状态、PNS和SNS之间的假设关系 将测试激活、皮质醇和呼吸道功能。多元回归 并采用重复测量的方差分析方法对其进行分析 数据。如有必要，将评估药物效果并进行不同的分析。

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.