Personality Variations in Bronchial Asthma

Abstract

Bronchial asthma is a dramatic syndromevisible, audible, and frequent. For years, clinicians, and later research workers, have suspected that emotional factors played a role in it. Search for these has paralleled, in ways recapitulated, work done with other so-called "psychosomatic states." Yet, like them, the disorder presents unsolved problems, which concern the personality of its sufferers, the precise sources of their emotional tension, and the ways by which such tension may lead to physiological derangement.We will defer our answer to the latter questions and deal in this paper with the first one, which is broad and deceptively simple: What sort of person develops asthma? The From the

Emotional and Adrenal Reactions to Stress in Bronchial Asthma

“…Furthermore, it suggested that stressful arousal occurred in both. We have already remarked on the striking inhibition in expression of hostility among asthmatic Ss, consistent with reports linking asthma with passive, dependent characterologic organization and inability to express aggressive impulses from fears of loss (66,67).…”

Personality Profiles and Breathlessness Perception in Outpatients with Different Gradings of Asthma

“…In the 36 enrolled patients, treatment at preliminary evaluation included: short-acting ␤ 2 -agonists (6), long-acting ␤ 2 -agonists (3), oral theophylline (5), antihistamines (2), and a combination of ␤ 2 -agonists and low dose inhaled steroids (beclomethasone dipropionate 50 g per puff) (10). Twenty-six of 36 enrolled patients were receiving antiasthmatic therapy on a regular basis or as needed.…”

“…Though previous studies suggested that emotional factors were important influences in asthma (1,2), later reports could not demonstrate any differences in the mental health between asthmatic and nonasthmatic subjects (3,4). Indeed, coping with a chronic disease such as asthma is greatly influenced not only by the features of the disease but also by the personality and behavioral characteristics of the patient (5).…”

Personality and Physical Health: An Introduction

“…A condensed history of early psychosomatic formulations is provided to illustrate the distance traveled between initial efforts and the current work on personality and health Psychiatrists, particularly of the Freudian dynamic tradition, were the first to consider the associations between disease and personalities-defined in terms of traits or predispositions (Dunbar, 1943) They adopted a "specificity approach" m which specific illnesses were believed to be associated with specific traits Alexander's approach is probably the best known ofthe early psychosomatic researchers He and his associates (Alexander, 1950, Alexander, French, & Pollack, 1968 proposed that there were seven psychosomatic diseases peptic ulcer, essential hypertension, bronchial asthma, thyroidtoxicosis, rheumatoid arthntis, ulcerative colitis, and neurodermatitis For Alexander, each illness had a different underlymg unconscious conflict which predisposed the individual to the disorder When situations arose that activated the conflict, specific emotions such as anger, anxiety, and depression were produced and these tnggered autonomic, neural, or hormonal outflow, bringing about the anatomical and physiological changes characteristic of the disease For example, Alexander maintained that a chronic conflict about the wish to be fed or cared for would increase secretion of stomach acid leading to the development of ulcers In actuality, Alexander's approach emphasized that these emotional states or conflicts may occur m a great number of very different personalities Nonetheless, Krantz and Glass (1983) observed that, " the tendency was to describe the constellations of underlying conflicts in language conducive to the interpretation of these constellations as personality traits or types" (p 42) Findings from research on the specificity notion have been inconsistent For example, Alexander thought that the conflict about dependency stimulates gastric secretion, yet only one-third to one-half of all duodenal ulcer patients are hypersecretors of gastric acid (Weiner, 1977) Even researchers who shared psychoanalytic techniques with Alexander found It difficult to determine which conflicts were specific to individual diseases (Engel, 1954, Knapp & Nemetz, 1957 Because much of the research was retrospective in design, in many cases it was also unclear whether the conflict or trait was a cause or consequent of the physical disorder Finally, Alexander was cnticized for placing too much emphasis on the psychogenic causes of illness, although he did explicitly acknowledge the importance of constitutional predispositions (see Weiner, 1977) The general conclusion in the 1950s and 1960s was that Alexander's approach had little explanatory or predictive power in understanding physical disease Such perceived failures encouraged the pursuit of more general explanations of psychological processes leading to illness In these approaches, processes were identified that increased susceptibility to illnesses of many kinds These approaches were also nonspecific on the psychological side, rather than examine dispositional variables, stress from more situationally induced factors was the focus For example. Engel (1968) and Engel and Schmale (1967) postulated that certain kinds of events, parti...…”