Skip to main content
Log in

Multidimensional analysis of the symptoms of chronic bronchitis and emphysema

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Anastasi, A. (1968).Psychological Testing, Macmillan, New York.

    Google Scholar 

  • Armstrong, J. S., and Soelberg, P. (1968). On the interpretation of factor analysis.Psychol. Bull. 70: 361–364.

    Google Scholar 

  • Burns, B. H., and Howell, J. B. (1969). Disproportionately severe breathlessness in chronic bronchitis.Q. J. Med. (new series) 38: 277–294.

    Google Scholar 

  • 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.

    Google Scholar 

  • Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests.Psychometrica 16: 297–334.

    Google Scholar 

  • Dirks, J. F. (1982). Bayesian prediction of psychomaintenance in asthma: Rehospitalization and the Battery of Asthma Illness Behavior.J. Personal. Assess. 46: 159–163.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Dudley, D. L., Martin, C. J., and Holmes, T. H. (1964). Psychophysiologic studies of pulmonary ventilation.Psychosom. Med. 26: 645–660.

    Google Scholar 

  • Dudley, D. L., Martin, C. J., and Holmes, T. H. (1968). Dyspnea: Psychologic and physiologic observations.J. Psychosom. Res. 11: 325–339.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Engel, G. L. (1962).Psychological Development in Health and Disease, Saunders, Philadelphia.

    Google Scholar 

  • Filley, G. F. (1967). Emphysema and chronic bronchitis: Clinical manifestations and their physiologic significance.Med. Clin. N. Am. 51: 283–292.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Grant, I., Heaton, R. K., McSweeney, A. J., Adams, K. M., and Tims, R. M. (1980). Brain dysfunction in COPD.Chest 77s: 308s-309s.

    Google Scholar 

  • Heim, E., Blasser, A., and Waidelich, E. (1972). Dyspnea: Psychophysiologic relationships.Psychosom. Med. 34: 405–423.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Rowlett, D. B., and Dudley, D. L. (1980). COPD: Psychosocial and the psychophysiological issues.Psychosomatics 19: 277–279.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • Suess, W. M., and Chai, H. (1981). Neuropsychological correlation of asthma: Brain damage or drug effects.J. Consult. Clin. Psychol. 49: 135–136.

    Google Scholar 

  • Tryon, R. C., and Bailey, D. E. (1970).Cluster Analysis, New York, McGraw-Hill.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This research was supported in part by Grants AI-15392 and HL-22065 from the National Institutes of Health.

Rights and permissions

Reprints 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

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00846323

Key words

Navigation