Refine
Document Type
- Doctoral Thesis (2)
Has Fulltext
- yes (2) (remove)
Is part of the Bibliography
- no (2)
Keywords
- Symptom (2) (remove)
Institute
Das weltweit verbreitete HHV 7 erreicht bis ins Jugendalter Durchseuchungsraten um 80 %. Ein Teil der Bevölkerung kann sich noch im Erwachsenenalter infizieren. Der Primoinfektion folgt eine lebenslange latente Infektion mit der Möglichkeit einer Reaktivierung. Das HHV 7- Krankheitsspektrum ist bis auf eine Exanthema subitum-ähnliche Erkrankung unbekannt. Patienten und Methoden: 551 Patienten (Alter 0-22 Jahre) mit einer akuten meist fieberhaften Erkrankung wurden auf eine HHV 7-Infektion hin untersucht (PCR, indirekter Immunfluoreszenztest). In 22 Fällen wurde eine aktive HHV 7-Infektion (14 Primoinfektion, 6 Reaktivierung, 2 nicht definierbare) nachgewiesen. Ergebnisse: Bei der HHV 7-Erkrankung wurden am häufigsten Fieber, Lymphknotenschwellungen und akute Entzündungen der oberen Atemwege beobachtet. Ein Exanthem trat bei knapp der Hälfte der Patienten auf. Seltener waren neurologische oder gastrointestinale Symptome. Das Krankheitsbild der Primoinfektion und der Reaktivierung unterschied sich nicht. Schlussfolgerung: 4 Verlaufsformen ließen sich differenzieren, dabei bestand ein Zusammenhang zwischen Alter bei HHV 7-Erkrankung und Krankheitsbild: 1.Exanthema subitum-ähnliche Erkrankung (bei Kleinkindern), 2.Mononukleose-ähnliches Krankheitsbild (bei älteren Kindern), 3.neurologische Manifestation, 4.katarrhalischer Verlauf. Kombinationen zwischen den einzelnen Verlaufsformen sind möglich.
Body sensations play a crucial role in the etiology and maintenance of diverse anxiety and health problems (e.g., in panic disorder or respiratory diseases) as they may be perceived as threatening and consequently elicit anxious responses. The factors that may affect the perception of bodily sensations as a threat and thus modulate the anxious response to body sensations have so far rarely been studied. Therefore, the present thesis targeted at elucidating the effect of contextual (i.e., the predictability, expectation, and proximity of a threat) and dispositional factors (i.e., tendency to fear arousal sensations or trait fear of suffocation) on the defensive response to body sensations.
In study 1, it was investigated how a personality factor, that is, fear of suffocation, affects the acquisition of fear to body sensations (i.e., mild dyspnea induced by inspiratory resistive loads) and contexts when faced with a predictable and unpredictable respiratory threat (i.e., severe dyspnea). Study 2 aimed at examining the main and interactive effects of the tendency to fear arousal sensations, again a personality trait factor, and current arousal expectations as varied by situational variables on anxious responding to arousal sensations. In this study, expected and unexpected arousal sensations were induced by administering caffeine in coffee or bitter lemon soda, respectively. Moreover, in study 3, it was explored how subjective anxiety, bodily symptoms, and defensive respiratory responses change and might culminate into active defense behavior (i.e., escape/active avoidance) during increasing dyspnea that was evoked by inspiratory resistive loads increasing in intensity. For a detailed analysis of the factors that contribute to the initiation and maintenance of avoidance of or escape from increasing dyspnea, in study 4 changes in subjective, autonomic, somatic reflex and brain responses were analyzed during repeated avoidance of increasing dyspnea.
In study 1, it was demonstrated that only individuals who fear suffocation learned to fear mild dyspnea preceding the onset of severe dyspnea and developed anxiety during a context of unpredictable respiratory threat. Moreover, the data from study 2 indicate that individuals who fear arousal sensations show an increased attention allocation towards unexpected arousal sensations and higher threat appraisal when expecting arousal sensations. Increasing intensity of dyspnea as provoked in study 3 led to increased defensive respiratory responses that were associated with increased symptom reports in individuals with high compared to low fear of suffocation. Moreover, culminating dyspnea elicited repeated avoidance behavior preceded by increases in defensive respiratory mobilization. The analysis of repeated avoidance of increasing dyspnea in study 4 revealed that physiological fear responses might be involved in the initial initiation of this avoidance behavior while no indication of response preparation and physiological arousal was related to persistent avoidance.
Taken together, the present data suggest that the fear of suffocation, as well as the tendency to fear arousal sensations along with the predictability, expectation, or proximity of interoceptive threat, may increase the perceived threat and thus the anxious response to body sensations. Therefore, contextual and dispositional factors may set the stage for the culmination of body sensations into defensive action and might contribute to the development of pathological anxiety and fear of body sensations. The present findings are integrated into the current literature and discussed in relation to the development and maintenance of pathological anxiety and fear of body sensations.