The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

&NA; This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%‐40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short‐lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n's and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.

[1]  S. Hurd,et al.  National Asthma Education Program. , 1990, Chest.

[2]  D J Nutt,et al.  Lactate and hyperventilation substantially attenuate vagal tone in normal volunteers. A possible mechanism of panic provocation? , 1989, Archives of general psychiatry.

[3]  H. Kotses,et al.  The effects of suggestion on the total respiratory resistance of nonasthmatic female subjects. , 1988, Journal of psychosomatic research.

[4]  P. Gergen,et al.  National survey of prevalence of asthma among children in the United States, 1976 to 1980. , 1988, Pediatrics.

[5]  L. Boulet,et al.  Comparative bronchial responses to hyperosmolar saline and methacholine in asthma. , 1987, Thorax.

[6]  E. Pastorello,et al.  The role of suggestion in asthma. I. Effects of inactive solution on bronchial reactivity under bronchoconstrictor or bronchodilator suggestion. , 1987, Annals of allergy.

[7]  H. Kotses,et al.  Performing mental arithmetic increases total respiratory resistance in individuals with normal respiration. , 1987, Psychophysiology.

[8]  Respiratory airway changes in response to suggestion in normal individuals. , 1987, Psychosomatic medicine.

[9]  Jacob Cohen,et al.  Statistical Power Analysis For The Behavioral Sciences Revised Edition , 1987 .

[10]  A. Steptoe,et al.  Placebo responses: an experimental study of psychophysiological processes in asthmatic volunteers. , 1986, The British journal of clinical psychology.

[11]  A. M. Lindsey,et al.  Emotionally triggered asthma as a predictor of airway response to suggestion. , 1986, Research in nursing & health.

[12]  Stephen W. Porges,et al.  Respiratory Sinus Arrhythmia: Physiological Basis, Quantitative Methods, and Clinical Implications , 1986 .

[13]  P. Lehrer,et al.  Relaxation decreases large-airway but not small-airway asthma. , 1986, Journal of psychosomatic research.

[14]  I. Cameron,et al.  Bronchoconstriction in response to suggestion: its prevention by an inhaled anticholinergic agent. , 1985, British medical journal.

[15]  J. Bonner.  The epidemiology and natural history of asthma. , 1984, Clinics in chest medicine.

[16]  M. Starkman,et al.  Functional upper airway obstruction: a possible somatization disorder. , 1984, Psychosomatics.

[17]  P. Barnes,et al.  Autonomic regulation of the airways. , 1984, Annual review of medicine.

[18]  R. Maricle.  Vocal-cord dysfunction presenting as asthma. , 1983, The New England journal of medicine.

[19]  H. Kotses,et al.  Facial muscle tension influences lung airway resistance; limb muscle tension does not , 1983, Biological Psychology.

[20]  M. Kattan,et al.  Hypnosis for exercise-induced asthma. , 1982, The American review of respiratory disease.

[21]  J. F. Dirks,et al.  Clinical prediction of medical rehospitalization: psychological assessment with the Battery of Asthma Illness Behavior. , 1981, Journal of personality assessment.

[22]  S. Anderson,et al.  Bronchial hyperreactivity in response to inhalation of ultrasonically nebulised solutions of distilled water and saline. , 1981, British medical journal.

[23]  J. Dosman,et al.  Between-technician variation in the measurement of spirometry with air and helium. , 1981, The American review of respiratory disease.

[24]  A. B. Alexander.  20 – Behavioral Approaches in the Treatment of Bronchial Asthma , 1981 .

[25]  W. Kiely.  Psychobiology and human disease , 1980 .

[26]  K. Ashutosh,et al.  Density dependence of expiratory flow and bronchodilator response in asthma. , 1980, Chest.

[27]  R. Rosenthal.  The file drawer problem and tolerance for null results , 1979 .

[28]  J. Charpin,et al.  Mechanisms of the bronchoconstrictor effects of deep inspiration in asthmatic patients. , 1979, Thorax.

[29]  R. Levenson.  Effects of Thematically Relevant and General Stressors on Specificity of Responding in Asthmatic and Nonasthmatic Subjects , 1979, Psychosomatic medicine.

[30]  D. E. Thorne,et al.  Hypnotically suggested asthma. , 1978, The International journal of clinical and experimental hypnosis.

[31]  D. Miklich,et al.  Emotionally Induced Decreases in Pulmonary Flow Rates in Asthmatic Children , 1976, Psychosomatic medicine.

[32]  G. Klerman,et al.  Facial muscle patterning to affective imagery in depressed and nondepressed subjects , 1976, Science.

[33]  S. Spector,et al.  Response of asthmatics to methacholine and suggestion. , 1976, The American review of respiratory disease.

[34]  S. Spector,et al.  Standardization of bronchial inhalation challenge procedures. , 1975, The Journal of allergy and clinical immunology.

[35]  J. Charpin,et al.  Bronchoconstrictor effects of a deep inspiration in patients with asthma. , 1975, The American review of respiratory disease.

[36]  J. Charpin,et al.  Effect of maximal respiratory manoeuvres on bronchial sensitivity of asthmatic patients as compared to normal people. , 1975, British medical journal.

[37]  R. Levenson,et al.  Effects of suggestion on total respiratory resistance in mild asthmatics. , 1974, Journal of psychosomatic research.

[38]  A. U. Khan.  Hypnotic Suggestibility Compared with other Methods of Isolating Emotionally-Prone Asthmatic Children , 1974 .

[39]  A. Kahn,et al.  Role of counter-conditioning in the treatment of asthma. , 1973, Journal of psychosomatic research.

[40]  D. Miklich,et al.  A preliminary investigation of psychophysiological responses to stress among different subgroups of asthmatic children. , 1973, Journal of psychosomatic research.

[41]  P. Macklem,et al.  Site of airway obstruction in asthma as determined by measuring maximal expiratory flow breathing air and a helium-oxygen mixture. , 1972, The Journal of clinical investigation.

[42]  P. Knapp,et al.  Emotional and Adrenal Reactions to Stress in Bronchial Asthma , 1971, Psychosomatic medicine.

[43]  T. Luparello,et al.  The Interaction of Psychologic Stimuli and Pharmacologic Agents on Airway Reactivity in Asthmatic Subjects , 1970, Psychosomatic medicine.

[44]  H. Colebatch,et al.  Increase and decrease in pulmonary resistance with hypnotic suggestion in asthma. , 1970, The American review of respiratory disease.

[45]  J. H. Weiss,et al.  Effects of Suggestion on Respiration in Asthmatic Children , 1970, Psychosomatic medicine.

[46]  E. R. Mcfadden,et al.  The Mechanism of Action of Suggestion in the Induction of Acute Asthma Attacks , 1969, Psychosomatic medicine.

[47]  Z. Tomori,et al.  Muscular, bronchomotor and cardiovascular reflexes elicited by mechanical stimulation of the respiratory tract , 1969, The Journal of physiology.

[48]  E. R. Mcfadden,et al.  Influences of Suggestion on Airway Reactivity in Asthmatic Subjects , 1968, Psychosomatic medicine.

[49]  J. Wilder,et al.  THE LAW OF INITIAL VALUE IN NEUROLOGY AND PSYCHIATRY: Facts and Problems1 , 1957, The Journal of nervous and mental disease.

[50]  R. V. Sorol,et al.  [Psychosomatic medicine]. , 2020, El Dia medico.

[51]  G. Riva,et al.  [Death from bronchial asthma]. , 1950, Schweizerische medizinische Wochenschrift.

[52]  Psychogenic factors in bronchial asthma. , 1946, Canadian Medical Association journal.