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Defensiveness and Individual Response Stereotypy in Asthma

From the Department of Psychology (J.M.F.), Rutgers University, New Brunswick, New Jersey; Department of Psychiatry (P.M.L.) and Department of Pulmonary and Critical Care Medicine (S.M.H.), Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, NJ; and Department of Psychology (G.E.S.), University of Arizona, Tucson, Arizona.

Address reprint requests to: Paul M. Lehrer, PhD, Department of Psychiatry, Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ 08854-5635. Email: lehrer{at}umdnj.edu

OBJECTIVE: Previous literature has shown that the psychological trait of defensiveness is related to elevated sympathetic reactivity to stress and to several cardiac risk factors. The aim of this study was to examine whether these previous findings on defensiveness extend to an asthmatic population.

METHODS: Defensiveness was measured by the Marlowe-Crowne Social Desirability Scale using a quartile split: high (upper 25%) and low (bottom 75%). Twenty-two defensive and 66 nondefensive participants with asthma were exposed to laboratory tasks (initial baseline rest period, reaction time task, and a shop accident film).

RESULTS: During the tasks there was evidence of lower skin conductance levels and greater respiratory sinus arrhythmia amplitudes among defensive patients with asthma. After exposure to the tasks, defensive patients with asthma showed a decline on spirometry test measures compared with nondefensive asthmatic patients, who displayed an increase.

CONCLUSIONS: These data confirm individual response stereotypy and suggest that defensiveness may be characterized by sympathetic hypoarousal and parasympathetic hyperarousal among patients with asthma. Future studies are needed to determine whether defensiveness is a risk factor for stress-induced bronchoconstriction.

Key Words: defensiveness, • asthma, • stress, • pulmonary function, • respiratory sinus arrhythmia, • skin conductance level.

Abbreviations: ANOVA = analysis of variance; ECG = electrocardiogram; FEF_50% = forced expiratory flow at 50% of vital capacity; FEV₁ = forced expiratory volume at 1 second; FVC = forced vital capacity; HF = high frequency; LF = low frequency; MC = Marlowe-Crowne Social Desirability Scale; RSA = respiratory sinus arrhythmia; SCL = skin conductance level; TMAS = Taylor Manifest Anxiety Scale

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