Idiopathic Environmental Intolerance: A comprehensive model

Idiopathic environmental intolerance refers to a group of poorly understood health conditions characterized by heterogeneous somatic symptoms that occur in response to environmental triggers, but for which no physiological causes can be found. We focus on three varieties, namely symptoms attributed to (a) chemical substances, (b) electromagnetic fields, and (c) infrasound and vibroacoustic sources. As no clear link with organ pathology or dysfunction has been established so far, we review critical evidence about alternative causal mechanisms as a platform for a novel unifying model of these conditions. There is consistent evidence that expectancy and nocebo mechanisms are critically involved. Using recent predictive coding models of brain functioning, we describe a comprehensive new model to explain how symptoms come about and become linked to specific environmental cues. This new model integrates phenomenally different pathologies, suggests testable new hypotheses, and specifies implications for treatment.</jats:p

Disentangling Fear and Anxiety in Self–reported Responses to Situational Scripts

With decreasing threat ambiguity and increasing threat imminence, human psychophysiological responses can be mapped onto a defensive continuum that distinguishes between the states of general anxiety, cued anxiety, and fear. The present study aimed to investigate whether self–reported physiological, cognitive, behavioral and attentional responses can also distinguish between cued anxiety and fear. Healthy participants (N=141) received 9 situational scripts (3 prototypical scripts per phase of the defensive continuum) each followed by 22 responses. They indicated how likely they would display each response in the described situation. The results of an INDCLAS–analysis indicated that the distinction between "cued anxiety" and "fear" can be made on the basis of self–reported responses. Responses typical for fear situations were "fear of dying", "breathing faster", and "feeling of choking". Cued anxiety situations evoked "accelerated heart rate", "to startle", "sharpened senses", "tense muscles" and "sweating". This finding may contribute to constructing an easy tool to distinguish cued anxiety and fear in both clinical and experimental contexts

Effects of long-acting bronchodilators and placebo on histamine-induced asthma symptoms and mild bronchusobstruction

SummaryStudy objectiveAccurate perception of airway caliber remains an important issue in asthma management. The way bronchodilation is perceived is partly related to the perception of the efficacy of bronchodilators in relieving complaints. In the present study, we compared the effects of salmeterol, formoterol and placebo on relief of histamine-induced asthma symptoms and mild bronchusobstruction.MethodsIn this randomized controlled, double blind study, 30 asthmatics were challenged with histamine until forced expiratory volume in 1s (FEV1) fell with ⩾20%. Subjects received salmeterol, formoterol or placebo after the histamine provocation. Pulmonary function (FEV1) and asthma symptoms (Asthma Symptom Checklist, Borg Dyspnea Scale) were assessed 5 and 20min later.ResultsFEV1 improved significantly more in the salmeterol and formoterol group than in the placebo group (P<0.001, P<0.001 and P<0.05, respectively). Salmeterol and formoterol were not different with regard to the pulmonary function recovery. No significant differences were found between the effects of salmeterol, formoterol and placebo on any of the symptom responses at the different time points.ConclusionsWe conclude that after a histamine-induced mild bronchusobstruction, a similar asthma symptom recovery occurred when inhaling salmeterol, formoterol or placebo, despite better recovery of pulmonary function in the active drug conditions

The Effects of Repeated Dyspnea Exposure on Response Inhibition

In order to treat dyspnea (=breathlessness) successfully, response inhibition (RI) as a major form of self-regulation is a premise. This is supported by research showing that self-regulation is associated with beneficial behavioral changes supporting treatment success in patients. Recent research showed that dyspnea has an impairing effect on RI, but the effects of repeated dyspnea exposure on RI remain unknown. Therefore, the present study tested the effects of repeated resistive load-induced dyspnea on RI over a 5-day period. Healthy volunteers (n = 34) performed the standard version of the Stroop task during baseline and dyspnea conditions on the first and fifth testing day and underwent an additional dyspnea exposure phase on each testing day. Variables of interest to investigate RI were reaction time, accuracy as well as the event-related potentials late positive complex (LPC) and N400 in the electroencephalogram. Reduced accuracy for incongruent compared to congruent stimuli during the dyspnea condition on the first testing day were found (p &lt; 0.001). This was paralleled by a reduced LPC and an increased N400 for incongruent stimuli during the induction of dyspnea (p &lt; 0.05). After undergoing dyspnea exposure, habituation of dyspnea intensity was evident. Importantly, on the fifth testing day, no differences between baseline, and dyspnea conditions were found for behavioral and electrophysiological measures of RI. These findings demonstrate that the impairing effect of dyspnea on RI disappeared after repeated dyspnea exposure in healthy participants. Translated to a clinical sample, it might cautiously be suggested that dyspnea exposure such as dyspnea perceived during physical exercise could reduce the impairing effect of dyspnea on RI which might have the potential to help increase self-regulation abilities and subsequent treatment efforts in dyspneic patients

Делистинг как инструмент управления ценностью для акционеров

Цель: выделить драйверы, влияющие на решение о делистинге, с целью построения инвестиционной стратегии для потенциальных бенефициаров сделок ухода публичных компаний с биржи Задачи: 1) Провести теоретический обзор проблемы исследования с идентификацией природы и принципов феномена делистинга; 2) Проанализировать главные причины для добровольного делистинга; 3) Провести обзор процедур ухода с биржи; 4) Провести эмпирическое исследование относительно оценки влияния независимы переменных на решение о делистинге; 5) Предложить рекомендации для менеджеров и индивидуальных инвесторов; 6) Сделать общее заключение, суммируя результаты и подтверждая достижение цели. Основные результаты: Рекомендации сформированы в таблицы для распространения между определенными целевыми группами. Данные материалы считаются удобными в использовании и не требуют глубокого профессионального погружения в вопросы феномена делистинга. Предложена инвестиционная стратегия для бенефициаров сделок ухода публичных компаний с биржи.Goal: to identify drivers of delisting process in order to build investment strategy for potential beneficiaries of the going private transactions Objectives: 7) To make the theoretical overview of the research problem with identification of nature and principles related to delisting phenomena; 8) To analyze the main reasons for voluntary delisting; 9) To overview procedures for going private transactions; 10) To conduct an empirical study regarding evaluation of variables influenced the decision to delist; 11) To provide the recommendations applicable for managers and individuals; 12) To make a general conclusion on the research paper summing up all the results and confirming of achievement the stated goal. Main results: The recommendations are formed in tables for distribution among particular target groups and considered to be user-friendly and adopted for different level of diving into voluntary delisting topic. The managerial implications suggest built investment strategy for those who are interested in obtaining benefits from public-to-private transactions

The Impact of Unpredictability on Dyspnea Perception, Anxiety and Interoceptive Error Processing

Dyspnea is a prevalent interoceptive sensation and the aversive cardinal symptom in many cardiorespiratory diseases as well as in mental disorders. Especially the unpredictability of the occurrence of dyspnea episodes has been suggested to be highly anxiety provoking for affected patients. Moreover, previous studies demonstrated that unpredictable exteroceptive stimuli increased self-reports and electrophysiological responses of anxiety such as the startle probe N100 as well as amplified the processing of errors as reflected by greater error-related negativity (ERN). However, studies directly examining the role of unpredictability on dyspnea perception, anxiety, and error processing are widely absent. Using high-density electroencephalography, the present study investigated whether unpredictable compared to predictable dyspnea would increase the perception of dyspnea, anxiety and interoceptive error processing. Thirty-two healthy participants performed a respiratory forced choice reaction time task to elicit an interoceptive ERN during two conditions: an unpredictable and a predictable resistive load-induced dyspnea condition. Predictability was manipulated by pairing (predictable condition) or not pairing (unpredictable condition) dyspnea with a startle tone probe. Self-reports of dyspnea and affective state as well as the startle probe N100 and interoceptive ERN were measured. The results demonstrated greater dyspnea unpleasantness in the unpredictable compared to the predictable condition. Post hoc analyses revealed that this was paralleled by greater anxiety, and greater amplitudes for the startle probe N100 and the interoceptive ERN during the unpredictable relative to the predictable condition, but only when the unpredictable condition was experienced in the first experimental block. Furthermore, higher trait-like anxiety sensitivity was associated with higher ratings for dyspnea unpleasantness and experimental state anxiety ratings. The present findings suggest that unpredictability increases the perception of dyspnea unpleasantness. This effect seems related to increased state and trait anxiety and interoceptive error processing, especially when upcoming dyspnea is particularly unpredictable, such as in early experimental phases. Future studies are required to further substantiate these findings in patients suffering from dyspnea

Affective Instability in Daily Life Is Predicted by Resting Heart Rate Variability

Previous research has shown that being affectively unstable is an indicator of several forms of psychological maladjustment. However, little is known about the mechanisms underlying affective instability. Our research aims to examine the possibility that being prone to extreme fluctuations in one’s feelings is related to maladaptive emotion regulation. We investigated this hypothesis by relating affective instability, assessed in daily life using the experience sampling method, to self-reported emotion regulation strategies and to parasympathetically mediated heart rate variability (HRV), a physiological indicator of emotion regulation capacity. Results showed that HRV was negatively related to instability of positive affect (as measured by mean square successive differences), indicating that individuals with lower parasympathetic tone are emotionally less stable, particularly for positive affect

Paul Eelen : reflections on life and work

This manuscript is part of a special issue to commemorate professor Paul Eelen, who passed away on August 21, 2016. Paul was a clinically oriented scientist, for whom learning principles (Pavlovian or operant) were more than salivary responses and lever presses. His expertise in learning psychology and his enthusiasm to translate this knowledge to clinical practice inspired many inside and outside academia. Several of his original writings were in the Dutch language. Instead of editing a special issue with contributions of colleagues and friends, we decided to translate a selection of his manuscripts to English to allow wide access to his original insights and opinions. Even though the manuscripts were written more than two decades ago, their content is surprisingly contemporary. This introductory article presents a reflection on Paul’s career and legacy and introduces the selected manuscripts that are part of this special issue