Behavioral and psychological approaches to breathing disorders

목차 (Table of Contents)

• CONTENTS
• Introduction / Beverly H. Timmons = 1
• Ⅰ. Anatomy, Physiology, Physiopathology, and Psychology of the Respiratory System
• 1. Basic Anatomy and Physiology of the Respiratory System and the Autonomic Nervous System / Karen H. Naifeh = 17
• 1. The Respiratory System = 17
• 1.1. Basic Anatomy = 18
• 1.2. Mechanics of Breathing = 22
• 1.3. Gas Exchange = 26
• 1.4. Regulation of Respiration = 31
• 1.5. Influence of Respiration on Cardiac Function = 35
• 2. The Autonomic Nervous System = 36
• 2.1. Anatomy = 36
• 2.2. Neurotransmitters = 40
• 2.3. Functions of the Autonomic Nervous System = 42
• 3. Stress = 44
• 4. Further Reading = 45
• 2. Nasopulmonary Physiology / Pat A. Barelli = 47
• 1. The Role of the Nose in Breathing and Respiration = 47
• 1.1. Preperation of Air for the Lungs = 49
• 1.2. Control of Air Stream = 49
• 1.3. Olfaction = 49
• 1.4. Nasal Resistances = 49
• 1.5. Body Temperature = 50
• 1.6. Nasal Reflexes = 50
• 1.7. Nasal Reflexes and the Cardiovascular System = 50
• 1.8. Sleep and Postural Adjustment = 51
• 1.9. Nose versus Mouth Breathing = 52
• 2. The Role of the Rhinologist = 52
• 2.1. Nasal Examination = 52
• 2.2. Nasal Pressure Tests (Rhinomanometry) = 53
• 2.3. Sinus (Nasoantral) Pressure Tests = 54
• 2.4. Nasocardiovascular Relationships = 54
• 2.5. Nasopulmonary Tests = 54
• 2.6. Middle Turbinate Syndrome = 55
• 2.7. Nasal Surgery = 55
• 3. Psychological Aspects = 55
• 4. Conclusion = 56
• 5. References = 56
• 3. Behavioral Perspective on Abnormalities of Breathing during Sleep / Christian Guilleminault ; Donald L. Bliwise = 59
• 1. Sleep and Respiratory Physiology = 59
• 2. Sleep Apnea Syndrome = 61
• 3. Treatments for Sleep Apnea Syndrome = 62
• 4. Guidelings for Therapists = 64
• 5. References = 65
• 6. Further Reading = 66
• 4. Control of Breathing and Its Disorders / Sheila Jennett = 67
• 1. Components of Normal Automatic Control = 67
• 1.1. Brain Stem Neurons and Their Interconnections = 67
• 1.2. Motor Pathways from Brain to Respiratory Muscles = 68
• 1.3. Inputs to the Normal Behavioral Control = 70
• 2. Components of Normal Behavioral Control = 72
• 2.1. Use of the Respiratory System for Purposes Other Than Breathing = 72
• 3. Goals of Normal Automatic Regulation and Effects of Failure = 73
• 3.1. Maintaining Correct Volume of Ventilation for Gas Exchange Requirement (Metabolic Control) = 73
• 3.2. Correction of Acid-Base State = 74
• 3.3. Pattern of Breathing for Minimal Work = 74
• 3.4. Correction following Reflex and Voluntary Interferences = 75
• 3.5. Summary = 75
• 4. Disorders of Control = 76
• 4.1. Disorders of the Pattern of Breathing = 76
• 4.2. Breathing Too Little or Too Much = 78
• 4.3. Inability to Exert Voluntary Control over Breathing = 80
• 5. Summary = 80
• 5. Breathing and the Psychology of Emotion, Congnition, and Behavior / Ronald Ley = 81
• 1. Conditioning, Behavior, Emotions, and Breathing = 81
• 1.1. Conditional Emotional Responses = 81
• 2. The Effects of Breathing on Emotion and Behavior = 82
• 3. Breathing and Cognition = 84
• 3.1. The Effects of Thoughts on Breathing = 84
• 3.2. The Effects of the Expectation of Noxious Events on Cognition = 85
• 3.3. The Effects of Breathing on Thought: Hyperventilation and Cognition = 86
• 3.4. Hyperventilation and Cognitive Deficit = 87
• 3.5. Test Anxiety and Hyperventilation = 88
• 4. Hyperventilation, Cognition, and Conditioned Emotions = 89
• 4.1. Frustration, Stress, and Hyperventilation = 89
• 5. Concluding Remarks = 90
• 5.1. Clinicians, Research, and the Progress of Science = 91
• 6. References = 91
• Ⅱ. Hyperventilation: Diagnosis and Therapy
• 6. Diagnosis and Organic Causes of Symptomatic Hyperventilation / William N. Gardner = 99
• 1. Introduction = 99
• 2. Physiology and Definitions = 99
• 2.1. Introduction = 99
• 2.2. Alveolar and Dead-Space Volumes = 100
• 2.3. End-Tidal Pco$$_{2}$$ = 100
• 2.4. Control of Breathing and CO$$_{2}$$ = 101
• 2.5. Definition of Hyperventilation = 101
• 2.6. Symptoms of Hyperventilation = 101
• 3. Short Historical Survey = 102
• 4. Diagnosis = 103
• 4.1. Symptoms = 103
• 4.2. Signs = 104
• 4.3. Voluntary Overbreathing and Other Tests = 104
• 4.4. Measurement of Pco$$_{2}$$ = 104
• 5. Etiology of Hyperventilation = 105
• 5.1. Introduction = 105
• 5.2. Organic Causes of Hyperventilation = 106
• 6. Investigative Sequence = 108
• 6.1. Investigation of Presenting Symptoms = 108
• 6.2. Diagnosis of Hyperventilation = 109
• 6.3. Search for Organic Causes of Hyperventilation = 110
• 7. Treatment = 110
• 8. Conclusion = 111
• 9. References = 111
• 7. Hyperventilation Syndromes: Physiological Considerations in Clinical Management / L. C. Lum = 113
• 1. Introduction = 113
• 2. Etiology = 115
• 3. Factors Affecting Symptom Threshold = 116
• 3.1. Climate, Weather, and Barometric Pressure = 116
• 3.2. Exacerbation of Symptoms at Rest = 116
• 3.3. Menstruation = 116
• 3.4. The Voice = 117
• 3.5. Blood Glucose = 117
• 4. Perception of Internal and External Environment = 117
• 4.1. Hallucinations = 117
• 4.2. Depersonalization and Unreality = 117
• 5. Physiological Mechanisms = 118
• 5.1. Blood Glucose = 118
• 5.2. Respiratory Alkalosis = 119
• 5.3. Hypoxia = 119
• 5.4. Loss of CO$$_{2}$$ Ions from Neurons = 120
• 5.5. Tetany = 120
• 5.6. Sympathetic Dominance = 120
• 5.7. Allergies = 120
• 6. Pseudoallergy = 121
• 7. Panic and Phobic States = 121
• 7.1. Sex Distribution = 121
• 8. Implications for Treatment = 121
• 8.1. Breathing Restraining = 121
• 8.2. Diet = 121
• 8.3. Education = 122
• 8.4. Relaxation = 122
• 8.5. Hypnotherapy = 122
• 8.6. Self-Understanding = 122
• 9. Summary = 122
• 10. References = 123
• 8. Psychiatric and Respiratory Aspects of Functional Cardiovascular Syndromes / Chrstopher Bass ; William N. Gardner ; Graham Jackson = 125
• 1. Introduction = 125
• 2. Psychiatric Aspects = 126
• 3. Respiratory Aspects = 128
• 3.1. Breathlessness in FCSs = 128
• 3.2. Hyperventilation as an Etiological Factor in FCSs = 129
• 3.3. The Etiology of Chest Pain in Functional Heart Disorders = 130
• 3.4. Effects of Hyperventilation on Cardiolvascular Function = 131
• 4. Assessment = 132
• 4.1. Cardiac Assessment = 132
• 4.2. Assessment for Evidence of Hyperventilation = 133
• 4.3. Psychiatric Assessment = 134
• 5. Management = 134
• 5.1. Excluding Organic Disease = 134
• 5.2. Explanation and Reassurance = 134
• 5.3. Cognitive-Behavioral Treatment = 134
• 5.4. Psychotropic Drugs = 135
• 6. Conclusions = 135
• 7. References = 136
• 9. Hyperventilation and Psychopathology: A Clinical Perspective / Herbert Fensterheim = 139
• 1. Introduction = 139
• 2. Diagnostic Criteria = 139
• 3. The Secondary Reactions = 140
• 4. Problems in Formulation and Treatment = 144
• 5. Summary = 146
• 6. References = 146
• 10. Management of Patients with Hyperventilation-Related Disorders / Christopher Bass = 149
• 1. Introduction = 149
• 2. Disorders Associated with Hyperventilation = 149
• 3. Treatments = 150
• 3.1. Physical Treatments = 150
• 3.2. Breathing Retraining (Physiotherapy or Controlled Breathing) = 151
• 3.3. Psychological Treatments = 152
• 3.4. Breathing Control without the Cognitive Element May Be Ineffective = 152
• 4. Concluding Remarks = 153
• 5. References = 154
• 11. The Role of the Physiotherapist in the Treatment of Hyperventilation / Elizabeth A. Holloway = 157
• 1. Introduction = 157
• 1.1. Normal Breathing = 158
• 1.2. Hyperventilators' Breathing Patterns = 158
• 2. Initial Assessment = 159
• 2.1. Source of Referral = 159
• 2.2. Observation = 159
• 2.3. History = 160
• 2.4. Symptoms = 160
• 2.5. Identification of Trigger Factors = 161
• 2.6. Allergies = 161
• 2.7. Other Types of Breathing Training = 162
• 2.8. Voluntary Hyperventilation = 162
• 2.9. Panic Attacks = 162
• 3. Reeducation of Breathing Patterns = 163
• 3.1. Explanation and Demonstration = 163
• 3.2. Preparation = 164
• 3.3. Retraining Method = 165
• 3.4. Frequency of Sessions = 166
• 3.5. Group Instruction = 167
• 3.6. Hospitalization = 167
• 3.7. Medication = 167
• 3.8. Progress = 168
• 3.9. Exacerbation of Symptoms = 168
• 3.10. Posture = 169
• 3.11. Matching Breathing Patterns to Activities = 169
• 3.12. Speech = 169
• 3.13. Clothing = 170
• 3.14. Practice = 170
• 3.15. Emergency or Coping Measures (when Pco$$_{2}$$ Is Likely to Fall) = 170
• 3.16. Challenge = 171
• 4. Relaxation = 171
• 4.1. General Physical Relaxation = 171
• 4.2. Mental Relaxation = 172
• 4.3. Tape-Recorded Instruction = 173
• 4.4. Specific Tensions = 173
• 5. Guidelines for Therapists = 173
• 6. Conclusion = 174
• 7. References = 174
• 8. Further Reading = 175
• Ⅲ. Other Therapeutic Approaches to Breathing Disorders
• 12. Breathing and Vocal Dysfunction / Daphne J. Pearce = 179
• 1. Introduction = 179
• 2. Larynx = 179
• 3. Resonators = 181
• 4. Breathing = 181
• 5. Singing = 182
• 6. Influences on Breathing and Phonation = 182
• 7. Smoking = 183
• 8. Posture = 184
• 9. Vocal Use and Abuse = 184
• 10. Observation = 186
• 11. Vocal Dysfunction = 186
• 12. Therapy = 187
• 12.1. Relaxation = 188
• 12.2. Breathing = 188
• 12.3. Voice Exercises = 188
• 13. Conclusion and Guidelines for Therapists = 189
• 14. References = 190
• 15. Further Reading = 190
• 13. Respiratory System Involvement in Western Relaxation and Self-Regulation / Paul M. Lehrer ; Robert L. Woolfolk = 191
• 1. Introduction = 191
• 2. Progressive Relaxation = 191
• 3. Hypnosis = 193
• 4. Autogenic Training = 193
• 5. The Alexander Method = 194
• 6. Meditation = 195
• 7. Paced Slow Respiration = 196
• 8. Abdominal Breathing = 197
• 9. Biofeedback = 198
• 10. Relaxation and Hyperventilation = 199
• 11. Conclusion = 200
• 12. References = 200
• 14. Behavioral Management of Asthma / Jonathan H. Weiss = 205
• 1. Introduction = 205
• 2. Description of Asthma = 205
• 3. The Role of Psychological Factors in Asthma = 207
• 3.1. Cognitive Variables = 208
• 3.2. Emotional Variables = 208
• 3.3. Behavioral Variables = 210
• 3.4. Background Variables = 210
• 4. Assessing Psychological Variable in Asthma = 210
• 4.1. Asthma Interview = 211
• 4.2. Asthma Problems Checklist (APCL) = 212
• 4.3. Asthma Attitude Survey (AAS) = 212
• 4.4. Asthma Diary = 213
• 5. Treating the Psychological Contributors to Asthma = 213
• 5.1. Knowing the Facts and Fallacies about Asthma and Its Management = 215
• 5.2. Knowing One's Symptom Precipitants and Aggravants = 216
• 5.3. Knowing and Attending to Early Warning Signs and Knowing What to Do in Response to Them = 216
• 5.4. Relaxing and Doing Abdominal Breathing = 217
• 5.5. Talking to the Doctor and Other Members of the Treatment Team = 218
• 6. Conclusions = 218
• 7. References = 219
• 15. Respiratory Practices in Yoga / Frank A. Chandra = 221
• 1. Introduction = 221
• 2. Pranayama = 221
• 3. Prolonged Expiration = 222
• 4. Abdominal Diaphragmatic Breathing = 222
• 5. Increased Resistance = 222
• 6. Alternate Nostril Breathing = 222
• 7. Nasal Passages and Nasal Cycles = 223
• 8. Asthma = 223
• 9. Effects of Pranayama on Carbon Dioxide Levels = 224
• 10. Underbreathing, Normal, and Overbreathing = 225
• 11. Respiratory Muscles = 226
• 12. Valsalva Mneuver = 226
• 13. Comparison of Pranayama and Mechanically Assisted Ventilation = 227
• 14. Abdominal Pressures = 227
• 15. Hormonal Effects = 228
• 16. Meditation = 229
• 17. Conclusions = 229
• 18. Guidelines for Therapists = 230
• 19. References = 230
• 20. Further Reading = 232
• 16. Styles of Breathing in Reichian Therapy / David Boadella = 233
• 1. Introduction = 233
• 2. Breathing Patterns = 235
• 3. Muscle-Bound Breathing = 235
• 4. Intestinal Breathing = 236
• 5. Breathing as Sucking = 238
• 6. Schizoid and Hysterical Breathing = 238
• 7. Words of Caution for Therapists = 241
• 8. References = 242
• 9. Further Reading = 242
• 17. Breathing and Feeling / Ashley V. Conway = 243
• 1. Introduction = 243
• 2. Life Events, Hyperventilation, and Anxiety: An Integrative Model = 244
• 3. Implications for Therapy = 248
• 4. References = 250
• 18. Breathing Therapy / Magda Proskaucr = 253
• 1. Stress and Breathing = 261
• 2. Emotion and Breathing = 263
• 3. Placebo Responses and Breathing = 265
• 4. Panic Attacks and Breathing = 266
• 4.1. Models of Panic = 266
• 4.2. Assessing Treatment Outcome Studies = 267
• 5. Breathing Pattern: Their Signficance for Therapists = 270
• 5.1. Psychophysiological Studies of Breathing Patterns = 270
• 5.2. Physiological and Clinical Evidence = 271
• 5.3. Performance and Breathing Patterns = 273
• 6. Breathing Retraining = 274
• 6.1. Problems in Retraining Breathing = 276
• 7. Breathing Measurements in Therapy = 281
• 7.1. Measurement of Breathing Patterns = 281
• 7.2. Biofeedback of Respiratory Measurements = 282
• 7.3. Measurement of Other Parameters of Breathing = 282
• 7.4. Measuring the Effects of Hyperventilation = 282
• 8. Future Directions = 286
• 9. References = 288
• Appendix: Publications of the Symposia on Respiratory Psychophysiology = 293
• Author Index = 295
• Subject Index = 301