Abstract
Subjective symptoms and experiences were explored within a group of 146 severe, chronic bronchitis and emphysema patients. Eighty-nine symptoms and experiences, derived from initial interviews with 29 patients, were rated according to the frequency of occurrence during breathing difficulties. Key cluster analyses were used to derive a Bronchitis-Emphysema Symptom Checklist (BESC) measuring 11 symptom categories: Helplessness-Hopelessness, Decathexis, Fatigue, Poor Memory, Peripheral-Sensory Complaints, Dyspnea, Congestion, Sleep Difficulties, Irritability, Anxiety, and Alienation. The BESC symptom categories are highly reliable and the relationships among categories are stable across two subgroups of patients. The BESC provides one way to describe how patients cope with and experience chronic bronchitis and emphysema.
Similar content being viewed by others
References
Agle, D. P., and Baum, G. L. (1977). Psychological aspects of chronic obstructive pulmonary disease.Med. Clin. N. Am. 61: 749–758.
American Lung Association (1975). Report of the Task Force on Comprehensive and Continuing Care for Patients with Chronic Obstructive Pulmonary Disease. American Lung Association, New York.
American Thoracic Society Committee on Diagnostic Standards for Nontuberculous Diseases (1962). Definitions and classification of chronic bronchitis, asthma, and pulmonary emphysema.Am. Rev. Respir. Dis. 85: 762–768.
Anastasi, A. (1968).Psychological Testing, Macmillan, New York.
Armstrong, J. S., and Soelberg, P. (1968). On the interpretation of factor analysis.Psychol. Bull. 70: 361–364.
Burns, B. H., and Howell, J. B. (1969). Disproportionately severe breathlessness in chronic bronchitis.Q. J. Med. (new series) 38: 277–294.
Comroe, J. H., Forster, R. F., DuBois, A. B., Brisco, W. A., and Carlson, E. (1962).The Lung: Clinical Physiology and Pulmonary Function Tests, 2nd ed., Year Book Medical, Chicago, pp. 257–263.
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests.Psychometrica 16: 297–334.
Dirks, J. F. (1982). Bayesian prediction of psychomaintenance in asthma: Rehospitalization and the Battery of Asthma Illness Behavior.J. Personal. Assess. 46: 159–163.
Dirks, J. F., and Kinsman, R. A. (1981). The clinical prediction of medical rehospitalization: Psychological assessment with the Battery of Asthma Illness Behavior.J. Personal. Assess. 45: 608–613.
Dirks, J. F., Kinsman, R. A., Staudenmayer, H., and Kleiger, J. H. (1979). Panic-Fear in asthma: Symptomatology as an index of signal anxiety and personality as an index of ego resources.J. Nerv. Ment. Dis. 167: 615–619.
Dudley, D. L., Martin, C. J., and Holmes, T. H. (1964). Psychophysiologic studies of pulmonary ventilation.Psychosom. Med. 26: 645–660.
Dudley, D. L., Martin, C. J., and Holmes, T. H. (1968). Dyspnea: Psychologic and physiologic observations.J. Psychosom. Res. 11: 325–339.
Dudley, D. L., Verhey, J. W., Masuda, M., Martin, C. J., and Holmes, T. H. (1969). Long term adjustment, prognosis, and death in irreversible diffuse obstructive pulmonary syndromes.Psychosom. Med. 31: 310–325.
Dudley, D. L., Glaser, E. M., Jorgenson, L. N., and Logan, D. L. (1980). Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. I. Psychosocial considerations.Chest 77: 413–420.
Engel, G. L. (1962).Psychological Development in Health and Disease, Saunders, Philadelphia.
Filley, G. F. (1967). Emphysema and chronic bronchitis: Clinical manifestations and their physiologic significance.Med. Clin. N. Am. 51: 283–292.
Fishman, A. P. (1980). The spectrum of chronic obstructive disease of the airways. In Fishman, A. P. (ed.),Pulmonary Diseases and Disorders, McGraw-Hill, New York.
Fishman, D. C., and Petty, T. L. (1971). Physical, symptomatic, and psychological improvement in patients receiving comprehensive care for chronic airways obstruction.J. Chronic Dis. 24: 775–785.
Grant, I., Heaton, R. K., McSweeney, A. J., Adams, K. M., and Tims, R. M. (1980). Brain dysfunction in COPD.Chest 77s: 308s-309s.
Heim, E., Blasser, A., and Waidelich, E. (1972). Dyspnea: Psychophysiologic relationships.Psychosom. Med. 34: 405–423.
Jones, N. F., Kinsman, R. A., Dirks, J. F., and Dahlem, N. W. (1979). Psychological contributions to chronicity in asthma: Patient response styles influencing medical treatment and its outcome.Med. Care. 17: 1103–1118.
Kinsman, R. A., O'Banion, K., Resnikoff, P., Luparello, T. J., and Spector, S. L. (1973a). Subjective symptoms of acute asthma within a heterogeneous sample of asthmatics.J. Allergy Clin. Immunol. 52: 284–296.
Kinsman, R. A., Luparello, T. J., O'Banion, K., and Spector, S. L. (1973b). Multidimensional analysis of the subjective symptomatology of asthma.Psychosom. Med. 35: 250–267.
Kinsman, R. A., Dahlem, N. W., Spector, S. L., and Staudenmayer, H. (1977). Observations on subjective symptomatology, coping behavior, and medical decisions in asthma.Psychosom. Med. 39: 102–119.
Kinsman, R. A., Dirks, J. F., and Jones, N. F. (1980). Levels of psychological experience in asthma: General and illness-specific concomitants of Panic-Fear personality.J. Clin. Psychol. 36: 552–561.
Kinsman, R. A., Dirks, J. F., Jones, N. F., and Dahlem, N. W. (1981). Anxiety reduction in asthma: Four catches to general application.Psychosom. Med. 42: 397–405.
Kinsman, R. A., Dirks, J. F., and Jones, N. F. (1982). Psychomaintenance of chronic physical illness: Clinical assessment of personal styles affecting medical management. In Millon, T., Green, C., and Meagher, R. (eds.),Handbook of Clinical Health Psychology, Plenum, New York.
Kinsman, R. A., Yaroush, R. A., Fernandez, E., Dirks, J. F., Schocket, M., and Fukuhara, J. (1983). Symptoms and experiences in chronic bronchitis and emphysema.Chest 83: 755–761.
Krop, H. D., Block, A. J., and Cohen, E. (1973). Neuropsychologic effects of continuous oxygen therapy in chronic obstructive pulmonary disease.Chest 64: 317–322.
Rowlett, D. B., and Dudley, D. L. (1980). COPD: Psychosocial and the psychophysiological issues.Psychosomatics 19: 277–279.
Schmale, A. H. (1964). A genetic view of affects: With special reference to the genesis of helplessness and hopelessness.Psychoanal. Study Child 19: 287–310.
Schmale, A. H. (1965). Object loss, “giving up” and disease onset: An overview of research in progress.Symposium on Medical Aspects of Stress in the Military Climate, U.S. Government Printing Office, Washington, D.C., pp. 433–443.
Schraa, J., Dirks, J. F., Jones, N. F., and Kinsman, R. A. (1981). Bender-Gestalt performance and recall in an asthmatic sample.J. Asthma 18: 7–9.
Suess, W. M., and Chai, H. (1981). Neuropsychological correlation of asthma: Brain damage or drug effects.J. Consult. Clin. Psychol. 49: 135–136.
Tryon, R. C., and Bailey, D. E. (1970).Cluster Analysis, New York, McGraw-Hill.
Author information
Authors and Affiliations
Additional information
This research was supported in part by Grants AI-15392 and HL-22065 from the National Institutes of Health.
Rights and permissions
About this article
Cite this article
Kinsman, R.A., Fernandez, E., Schocket, M. et al. Multidimensional analysis of the symptoms of chronic bronchitis and emphysema. J Behav Med 6, 339–357 (1983). https://doi.org/10.1007/BF00846323
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00846323