The relationship of expectancies to outcome in stress management treatment of essential hypertension: results from the Joint USSR-USA Behavioral Hypertension Project.

Outcome expectancy and efficacy expectancy measures were made during the course of a cross-cultural comparison of thermal biofeedback and autogenic training as treatments for mild essential hypertension. There were no differences between groups at either pre- or posttreatment, and expectancy measures were not related to initial success or failure at the completion of treatment. However, both outcome and efficacy expectations were related to relapse over the three months immediately following the completion of treatment.

A preliminary investigation of prediction of mean arterial pressure after self-regulatory treatments.

This study investigated the ability of pretreatment variables from three different domains (social-demographic, psychological, and psychophysiological) to predict posttreatment mean arterial pressure (MAP) for 59 unmedicated males with mild hypertension who were participating in a cross-cultural (USA-USSR) comparison of autogenic training and thermal biofeedback to a self-relaxation control. The overall multiple regression equation consisted of two variables and indicated that higher diastolic blood pressures during a cold pressor task were predictive of greater MAP reductions while higher scores on the Irritability subscale of the Buss-Durkee Hostility Scale were predictive of less MAP reductions. Suggestions for future research in this area are provided.

[A method of rapid psychological diagnosis of patients with a history of myocardial infarction].

The aim of the study was to develop a compact questionnaire for analysis of the psychological status of patients who had survived a myocardial infarction (MI) meant for physicians with no special psychology or psychiatry training. For this purpose of 185 questions selected by expert method on the data of 236 cases of MI using the program of stepped discriminant analysis, 37 most informative questions were chosen. These questions allowed determination of the general response to MI (adequate or neurotic) as well as of the degree of overestimation or negation of the disease and the degree of anxious-depressive syndrome.

[Psychophysiological correlations and reactivity of patients with hypertension].

A clinical psychophysiologic and psychologic assessment was made twice, at 12 months' interval, in 203 patients with essential hypertension (EH). In addition to aggravated heredity, EH patients showing more marked BP increment under emotional stress had higher level of anxiety, rigidity and interpersonal conflicts. Different cardiovascular response to various emotive stressors was dependent on psychological characteristics of EH patients.

The effects of thermal biofeedback and autogenic training of cardiovascular reactivity: the joint USSR-USA Behavioral Hypertension Treatment Project.

Cardiovascular reactivity (heart rate, systolic, and diastolic BP) to mental arithmetic and cold pressor were measured before and after treatment as part of the cross-cultural (USSR and USA) evaluation of thermal biofeedback and autogenic training (in comparison with self-relaxation) as treatments for mild hypertension in unmedicated males. There were no statistically reliable decreases in cardiovascular reactivity from before to after treatment. However, downward shifts in basal levels of systolic and diastolic BP at post-treatment led treated patients to have lower stress-induced levels of BP.

Psychophysiological interrelations and reactivity characteristics in hypertensives.

Two hundred three patients with essential hypertension (20- to 55-year-old men) were examined initially and at the end of a 1-year follow-up. Clinical, psychological, and psychophysiological methods were used. In the psychophysiological assessment, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, and respiratory rate were recorded at rest and during various emotional stressors.

The USA-USSR collaborative cross-cultural comparison of autogenic training and thermal biofeedback in the treatment of mild hypertension.

We have conducted a cross-cultural (USA and USSR) comparison of thermal biofeedback (TBF) and autogenic training (AT) to a self-relaxation control condition in 59 unmedicated males with mild hypertension. Identical assessment and treatment protocols were carried out in both settings (Albany, New York, and Moscow). Treatments were delivered in small groups on an outpatient basis twice per week for 10 weeks.

[Use of a psychoemotional test for detecting heart rhythm disorders in patients with various cardiovascular diseases].

Emotional stress was simulated by consecutive exposure to 3 tests in patients with a variety of heart rhythm disorders based on different forms of underlying disease. Arrhythmias were detected in 16.4%, and extrasystoles in 2.

[Sensitivity to the psycho-emotional test and the characteristics of the psychological status of ischemic heart disease patients].

Sixty-three coronary patients were subjected to mental testing, using the SMALL test and Kettell's 16 PF test. Positive test results were significantly more frequent in patients of the second and third functional classes with neurotic anxiety-depressive disturbances. In patients of the fourth functional class, the results of the tests were not dependent on their psychological status.

[Effect of a short course of physical training on the mental status of post-myocardial infarct patients].

The psychological effect of short exercise on a bicycle trainer (30 sessions over 10 weeks) was assessed in 20 postmyocardial infarction patients, while spontaneous mental changes were assessed in 21 untrained controls. Exercise was started 2 to 2.5 months after the attack.

[Psychological and psychophysiological characteristics of arterial hypertension patients].

A total of 120 essentially-hypertensive patients and 30 coronary patients were investigated clinically and by means of psychophysiologic and psychological tests. Different patterns of physiological response to psychoemotional stress were demonstrated in hypertensive and coronary patients. The markedness and duration of stress-induced hypertensive response was found to be related to psychosocial status of essentially-hypertensive patients.

[Psychological nondrug treatment of hypertension and the criteria of its effectiveness].

Eighty patients with essential hypertension, stages IIA-IIB, were examined three times: on admission to hospital, and 1 and 12 months later. All patients were subjected to clinical, psychological (brief multifactorial questionnaire for examination of a personality and the interpersonal relationships test) and psychophysiological investigation. The patients were allocated to 3 groups by random selection: 30 patients practicing autogenic training (group 1), 30 patients on relaxation therapy making use of biological feedback (BFB) (group 2), and 20 patients exposed to no psychological influences (group 3, or the controls).

[A school for patients with a history of myocardial infarct and their families: a method of group psychosocial intervention and an assessment of its effectiveness].

A group method of psychosocial intervention (a "school") has been developed for post-myocardial infarction patients and their families in order to build up positive attitudes to medical recommendations. The efficiency of the school as well as the social and psychologic factors involved were assessed using the multifactorial scale of psychosocial changes, and 16PF, and "polar profiles" tests, and Leary's method, in 27 post-myocardial infarction patients (mean age 49.8 years) and their 12 wives.

[Multifactorial rating scale of psychosocial changes in patients with a history of myocardial infarct].

The developed multifactorial assessment schedule is sufficiently valid and can be successfully applied to dynamic studying the psychosocial factors, which are connected with the rehabilitation of the patients who have survived myocardial infarction. Owing to its simplicity and universality the schedule can be easily introduced into health care practice and applied according to the study tasks.

[Effect of somatic factors on the mental state of patients who have had an acute myocardial infarct].

Patients who have survived 3 and more myocardial infarctions (MI) were found to exhibit psychopathologic symptoms twice as frequently as compared to patients with a history of 1-2 MIs. It is the duration (over 5 years) of angina pectoris or arterial hypertension, rather than mere presence of these diseases that appears to be essential for the development of anxiety and depression. Psychopathologic manifestations were about twice as frequent following life-threatening complications (shock, cardiac arrest, repeat MI) during the acute stage of infarction, as compared to uncomplicated clinical course of the disease.