Articles
Psychophysiologic Reactivity in Asthmatic Children: A Cholinergically Mediated Confluence of Pathways

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ABSTRACT

Objective

The purpose of this study was to determine the suitability of a newly developed experimental paradigm, designed to assess relationships among emotional responsivity, physiologic (autonomic) reactivity, airway reactivity, and pulmonary function in asthmatic children under controlled conditions of ecologically valid emotional stimulation.

Method

Twenty-four children, aged 8 through 17, with moderate to severe asthma viewed the movie, E.T., the Extra-Terrestrial, while having their heart and respiration rate and oxygen saturation continuously measured and recorded. Airway reactivity was assessed by the methacholine challenge test, and pre- and postmovie pulmonary function by spirometry. Self-report of emotion was recorded for targeted scenes.

Results

Findings indicated that emotional responsivity and physiologic reactivity to the movie were associated with increased airway reactivity and with decreased pulmonary function.

Conclusions

The pattern of results suggests cholinergically mediated psychophysiologic pathways of emotional influence in the asthmatic process for some asthmatic children. A heuristic biopsychosocial model of these pathways is presented.

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    This work was supported in part by a Clinical Research Center Grant to Dr. Miller from the National Jewish Center for Immunology and Respiratory Medicine, and in part by funding from the Department of Psychiatry at the University of Rochester School of Medicine and Dentistry. The authors thank Drs. David Mrazek and Bruce Bender for their professional contributions to this effort, William Orr and Isaac George for their technical assistance, and their patients for participation in this study.

    Dr. Miller dedicates this paper to the memory of Haroutun M. Babigian, M.D., who as Chairman, mentor, and friend at the University of Rochester provided support and encouragement for this work.

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