Asthma has not declined in morbidity and mortality despite significant advances in medical treatment. A literature review was conducted and a program of research was devised with the goal of improving understanding of why many appropriately treated and educated asthmatics are unable to gain adequate control of their asthma. A review of the literature found that psychological stress was a poorly understood trigger for asthmatic symptoms and a possible factor in poor asthma control. A clinic visit study of adult asthmatics found: (1) life event stress was associated with asthma quality of life but not ventilatory function, (2) asthma self-efficacy was strongly related to asthma quality of life and ventilatory function, (3) style of coping with stress appeared to buffer the effects of stress on asthma, and (4) evidence for a stress-responsive asthmatic subgroup. A subsequent longitudinal daily diary study found: (1) concurrent stress and daily asthma symptoms were strongly associated, (2) daily bronchodilator use appeared to be determined by pre-diary beliefs about disease severity and controllability, (3) stress could precede (within one day) increases in asthma symptoms and decreases in airflow, and (4) clinically significant decreases in peak flow were often preceded by large increases in perceived stress. A laboratory study found: (1) exposure of asthmatics to specific passive and asthma-related stressors resulted in decreased airflow and that these decreases are associated with a concurrent increase in vagal (parasympathetic) tone, (2) an active stressor that resulted in increased sympathetic arousal did not result in decreased airflow, (3) relaxation resulted in parasympathetic arousal and decreased airflow, and (4) asthma self-efficacy was associated with parasympathetic reactivity. In sum, the program of research has generated findings that help explain how stress, coping and self-efficacy contribute to asthma control led to concrete suggestions to improve c
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.35553 |
| Date | January 1999 |
| Creators | Aboussafy, David, 1969- |
| Contributors | Aboud, Frances E. (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Psychology.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001746514, proquestno: NQ64491, Theses scanned by UMI/ProQuest. |
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