Psychological aspects of disproportionate breathlessness
Psychological aspects of disproportionate breathlessness
This thesis is primarily
concerned with a group of individuals who experience symptoms of breathlessness
which doctors can not attribute to organic causes. These patients have been
classified as Disproportionately Breathless (DB).
Research has shown that
psychological and emotional factors can affect patterns of breathing and
symptoms of breathlessness. It is argued in this thesis that in order to
understand these phenomena it is necessary to broaden our conception of
respiratory sensations to take account of perceptual as opposed to purely
sensory events. The first experimental study which collected reports of
symptoms from patients with chronic breathlessness supported this argument.
This survey led to larger questionnaire studies which evaluated the frequency
of occurrence and level of distress occassioned by symptoms of breathlessness
and factors associated with them. Results suggested that more DBs experience
symptoms of hyperventilation and emotional or affective aspects of
breathlessness than do patients considered to be appropriately breathless. DBs
also rated all symptoms as more distressing especially those relating to their
reaction to symptoms.
A psychophysiological experiment
was designed to explore the possibilities that (a) DB is due to an increased
sensitivity to peripheral stimulation or (b) that DBs are more emotional
individuals and react to stress by changing their breathing. Results showed
that DBs were no more sensitive to increased levels of CO2 and although several
DBs showed irregularities in breathing and dramatic changes in breathing with
stress, they did not as a group, differ from normals or patients with asthma.
However, DBs differed from controls in that they were more depressed and
anxious and experienced more stressful life events (eg. bereavement,
unemployment). Furthermore, more DBs associated the onset, exacerbation and
relief of symptoms with psychological or emotional factors.
The behavioural control of
breathing proposed by Howell (1983) and theories about the cause of chronic
hyperventilation are discussed. Finally, a model which implies that DB is best
conceptualized as a vicious cycle is described in an attempt to understand the
heterogeneous and multi-dimensional nature of DB. This model takes account of
the interrelationship between faulty breathing habits, emotional stress and
personality, factors which are shown to be most relevant to DBs.
University of Southampton
McEvoy, Teresa Maureen
445c9832-00a1-4f20-8669-e5e9d9ea1ee4
1984
McEvoy, Teresa Maureen
445c9832-00a1-4f20-8669-e5e9d9ea1ee4
Marcer, Don
1b86412e-2c75-46ee-bc7d-9a5b2cf783be
McEvoy, Teresa Maureen
(1984)
Psychological aspects of disproportionate breathlessness.
University of Southampton, Doctoral Thesis, 308pp.
Record type:
Thesis
(Doctoral)
Abstract
This thesis is primarily
concerned with a group of individuals who experience symptoms of breathlessness
which doctors can not attribute to organic causes. These patients have been
classified as Disproportionately Breathless (DB).
Research has shown that
psychological and emotional factors can affect patterns of breathing and
symptoms of breathlessness. It is argued in this thesis that in order to
understand these phenomena it is necessary to broaden our conception of
respiratory sensations to take account of perceptual as opposed to purely
sensory events. The first experimental study which collected reports of
symptoms from patients with chronic breathlessness supported this argument.
This survey led to larger questionnaire studies which evaluated the frequency
of occurrence and level of distress occassioned by symptoms of breathlessness
and factors associated with them. Results suggested that more DBs experience
symptoms of hyperventilation and emotional or affective aspects of
breathlessness than do patients considered to be appropriately breathless. DBs
also rated all symptoms as more distressing especially those relating to their
reaction to symptoms.
A psychophysiological experiment
was designed to explore the possibilities that (a) DB is due to an increased
sensitivity to peripheral stimulation or (b) that DBs are more emotional
individuals and react to stress by changing their breathing. Results showed
that DBs were no more sensitive to increased levels of CO2 and although several
DBs showed irregularities in breathing and dramatic changes in breathing with
stress, they did not as a group, differ from normals or patients with asthma.
However, DBs differed from controls in that they were more depressed and
anxious and experienced more stressful life events (eg. bereavement,
unemployment). Furthermore, more DBs associated the onset, exacerbation and
relief of symptoms with psychological or emotional factors.
The behavioural control of
breathing proposed by Howell (1983) and theories about the cause of chronic
hyperventilation are discussed. Finally, a model which implies that DB is best
conceptualized as a vicious cycle is described in an attempt to understand the
heterogeneous and multi-dimensional nature of DB. This model takes account of
the interrelationship between faulty breathing habits, emotional stress and
personality, factors which are shown to be most relevant to DBs.
Text
McEvoy 1984 Thesis
- Version of Record
More information
Published date: 1984
Identifiers
Local EPrints ID: 459656
URI: http://eprints.soton.ac.uk/id/eprint/459656
PURE UUID: 93efadd7-43c1-4387-bbdf-ed313be92f45
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Date deposited: 04 Jul 2022 17:15
Last modified: 16 Mar 2024 18:32
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Contributors
Author:
Teresa Maureen McEvoy
Thesis advisor:
Don Marcer
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