1. SEMINAR PRESENTATION
Presented By : Amna Maqsood
Roll No : 16
Presented To : Ma’m Umm e Rubab

2. RESEARCH ARTICLE
EMOTIONS AND STRESS INCREASE
RESPIRATORY RESISTANCE IN ASTHMA
THOMAS RITZ , ANDREW STEPTOE ,STEPHEN DEWILDE
AND MARCO COSTA

3. Abstract
Objectives: Clinical reports suggest that
various emotions and types of stress can
precipitate asthmatic symptoms,but there
is little experimental evidence to
substantiate this claim.
We studied the impact of different emotional
states and stress on respiratory resistance
in asthmatic and nonasthmatic individuals.

4. T Abstract Cont…
Participants (24 asthmatic and 24 nonasthmatic)
viewed
short film sequences selected to
induce seven emotions
completed two stressful tasks
Methods
mental arithmetic
medical slides

5. Asthma
Asthma is a disease affecting
the airways that carry air to and
from your lungs.
Emotion
Respiratory resistance
Any strong feelings of
love, hate ,fear etc
It is also called airway resistance. accompanied by certai
It describes the resistance of the Key Words n physiological change
respiratory tract to airflow during s, as increased heartb
respiration and expiration. eat or respiration etc
Stress
We generally use the word "stress" when we feel
that everything seems to have become too much -
we are overloaded and wonder whether we really
can cope with the pressures placed upon us.

6. Literature Review
• The study of psychological influences on pulmonary function has been a
pervasive topic in asthma research throughout the years and a considerable
body of experimental work has been published on it.
• It has also been suggested that distinctive emotional states, such as
sadness or depression, are particularly linked to an aggravation of
symptoms in persons with asthma.
• Similarly, experimental studies have shown that different emotional
states, such as anxiety, anger, and joy, are equally capable of eliciting
increases in airway resistance in asthmatics.
• However, no systematic comparison of a broader range of emotional states
has yet been attempted, and comparisons between states of positive and
negative valence are rare.

7. Literature Review Cont..
Lehrer (1993) proposed that the active vs. passive coping demand of
the task could be a useful distinction in explaining airway
response to stress.
Active tasks
such as mental arithmetic or a reaction time task, should lead to
decreases in airway resistance whereas
Passive tasks
such as viewing distressing films or noise stimulation, should lead to
increases in airway resistance.
.

8. Literature Review Cont..
• Increases in airway resistance can more readily be explained in
stressful situations that are unavoidable or inescapable for the
individual, demanding a passive coping response.
• A number of studies have confirmed this idea, with stressful films
or noise stimulation leading to elevated airway resistance levels.
• Studies comparing nonasthmatic and asthmatic groups in their
response to aversive films are not fully consistent,with some
showing a stronger response in asthmatics and others showing no
differences.
Mathe´ and Knapp
reported evidence of a blunted
response of the hypothalamic-
medullary axis during stress in
asthmatics

9. Literature Review Cont..
Baroreftex stronger
Sensitivity BRS was
• BRS has With observed in
been studied
as an index of respect to a subgroup
vagal system asthma, of
functioning in asthmatics
. the cardiac
system patients
In addition,sympathetic effects
contribute to BRS to only a limited
degree ,particularly during the “up
sequences of the BR action,when
cardiac slowing is triggered by blood
pressure increases

10. Literature Review Cont..
Given these conflicting results and uncertainty
about the mechanisms of airway responses to stress,
additional investigation of active vs. passive coping
tasks is indicated. In this study, we investigated sympathetic
mechanisms and BR regulation as potential
mediators of airway response to stress, particularly
their contribution to a potentially stronger responsiveness
of asthmatics to stressful tasks.

11. Literature Review Cont..
Important abbreviations in Research

12. Participants
Methodology Asthmatic patients
Non Asthmatic participants
Each (N=24)

13. Mean Age Range
20-48 Years
.
Gender
16 Women
8 Men

14. All participants
were non -smokers
Non asthmatic group had Free of
no respiratory diseases psychiatric
illnesses
.
No family history of respiratory Free of Cardiovascular
diseases other than Asthma diseases
No family history of
CVD

15. In asthmatic patients degree of severity was Mild to
Moderate
Mean age of onset was 11.4 years (0-29 years) all but
three reported onset before the age of 18 years
Mean duration of Asthma was 16.9 years
Patients continued to take their prescribed asthma medication,
which consisted mainly of b-adrenergic bronchodilators or
inhalers
Asthmatic patients were tested during symptom free periods and were
instructed to take the last dose of their b-adrenergic bronchodilators (if
necessary) at least 8 hours before arriving at the laboratory.

16. Methods Cont…..
• Experimental Films and Tasks
Participants viewed seven film sequences that were pre evaluated
for eliciting certain emotional states, such as
Anxiety
Anger Sadness
Happiness
Elation
Contentment
Neutral
states

17. Experimental Films and Tasks Cont…..
After a pilot test was conducted, two
sketches of a British comedian were
chosen for induction of happiness and
elation to match cultural preferences
The duration of the film clips ranged
from 90 to 290 seconds
(mean = 224 seconds).
The order of the films was randomized
between participants
x2 tests revealed no significant order
effects for individual clips (p .>.68 –.99).

18. Experimental Films and Tasks Cont…..
A mental arithmetic task was presented to elicit active coping
behavior.
A colored slide with seven lines of 14 one- and two-digit numbers
was projected onto a screen. Participants were instructed to
add up as many numbers as possible in 3 minutes. They were
informed that the correctness of their results would be checked
Participants were instructed to add up as many numbers as
possible in 3 minutes. They were informed
that the correctness of their results would be checked.
Participants were instructed to calculate
“in their mind” and not to move their lips, whisper, or “speak
silently” during calculating.

19. Experimental Films and Tasks Cont…..
For passive coping behavior, nine medical slides depicting
injuries, mutilation, and corpses were presented
in a continuous series for 3 minutes (20 seconds per slide).
Participants were instructed to watch the
screen and keep their eyes open
during the whole presentation.

20. Equipment 1-Physiological
and Measures
Measures
Total respiratory resistance was
measured by forced oscillations using the
Siemens Siregnost
FD5 with a fixed oscillation frequency of
10 Hz.
.
Skin resistance level was measured with Ag-AgCl electrodes
Beat-to-beat HR, SBP, and DBP were monitored continuously
with a Finapres ( Biomedical Instrumentation.)
For each individual sequence, a correlation coefficient
was computed, and sensitivity was expressed as the
change in pulse interval per change in SBP

21. Equipment and Measures Cont . . .
2-Psychological Measures
Self-reports of shortness of breath and
emotion were given using visual analog scales
Self-reports were given for list of seven emotions
Nine-point Self Assessment Manikins of pleasure and
arousal were administered.
For ease 1 was assigned to” Displeasure”
And 9 was assigned to “Pleasure”
.
To compare both groups in terms of habitual affectivity and
defensiveness, the Toronto Alexithymia Scale
and Social Desirability Scale were administered before the
experiment

22. Procedure
 All laboratory sessions were scheduled individually in the afternoon
or early evening.
 Participants were then trained in the use
of the mouthpiece and nose clip for the respiration measurements..
.
 The lights were dimmed, and participants were
instructed to keep their eyes open during all stages of the experiment

23. Statistical Analysis Hypothesis
1) Increases in Ros would be
found in
asthmatics during negative
Statistical Methods emotional states compared with
the neutral
1-X2
state
2-Correlation
. 3-ANOVA 2) increases in Ros would be
found in both groups
during positive and negative
emotional states as compared with
the
neutral state.

24. Results
Film Baseline Task
Effects Differences Effects
Self- Physiological
reported
Measure Measures
s
Self- Physiological
reported
Measures
Measures

25. Results Cont..
1-Baseline Differences
No group differences in baseline physiological measures
or ratings were found
2-Film Effects
a) Self-Reported Measures b) Physiological Measures
Ros was increased during all emotional and
Each negative film reliably elicited negative films compared with neutral
the respective target emotion but films in asthmatics
positive (F(1,46)=39.66
films were not fully successful Non asthmatics F(1,46)=32.89

26. Results Cont..
3-Task Effects
a) Self-Reported Measures b) Physiological Measures
Task administration had a
strong impact on emotion and
shortness of breath ratings in asthmatics,
as revealed by Substantial increases were found in
MANOVA (F(20,21) 5 120.4, p , .001). Ros,HR, SBP, DBP, and SCL during
Post hoc test revealed higher ratings Tasks and films in asthmatics
of anxiety in asthmatics

27. Graphical Presentation
Graphic Representation

28. Line Chart

29. Line Chart

30. Research Research
Discussion
Effects of emotional films on Airways
All emotional conditions showed increases in Ros compared with the
neutral condition.
Effects of Stress Tasks on the Airways
We found significant increases
in Ros in both groups for the active coping task and in
asthmatic patients for the passive coping task.
SBP and DBP both increased in response to
mental arithmetic, and an even stronger response was
seen in asthmatics during viewing of the medical
slides.

31. Conclusion
Uniform increases in oscillatory resistance
were found in all emotional states compared with the neutral state and during
mental arithmetic in both groups.
Asthmatic patients showed stronger reactions to the medical slides than healthy control
subjects, with significant increases in oscillatory resistance, blood pressure,
skin conductance level, and minute volume, as well as higher
levels of self-reported depression, arousal, and shortness of breath.
Various emotional states and stress increase
oscillatory resistance largely independently of
concurrent increases in autonomic or ventilatory activity.

32. Suggestion
Additional research is needed to elucidate
the psychological importance and autonomic
dynamics associated with passive coping, particularly with
blood and injury-related stimuli, in asthma.

33. Critical Evaluation
Positive Evaluation Negative Evaluation
 In abstract ,every point is written in • In start ,no specific heading
headings of Abstract is given
 Abbreviations are explained • X2 and Correlation are also
precisely
used for statistical analysis
 Two-way ANOVA is clearly
explained but they are not clearly
 Measured emotion list is mentioned
mentioned • No study design is
 Results are graphically presented mentioned
very well in bar and line chart • Gender ratio is not equal
 Further research is suggested in
future
• Key words are not defined
 Researchers have published their • No reliability method is
thanks to advisors and supporters mentioned

34. Critical Evaluation
Negative Evaluation Positive Evaluation
• Sampling method is  Literature review is
different for both relevant
participants  Terms used in research
are written separately
with abbreviations
 Hypothesis is mentioned
 Result tables are
precisely explained

35. Thank You