title: Asthma self-efficacy, high frequency heart rate variability, and airflow obstruction during negative affect in daily life.
abstract: BACKGROUND
  Emotional stress has been considered an important asthma trigger for years, though the mechanisms by which stress may exacerbate asthma remain poorly understood. The stress-asthma morbidity association could occur through cognitive-behavioral pathways, such as decreased asthma self-efficacy and disorganized self-care, or through the more direct physiological effects of stress on autonomic (parasympathetic) nervous system activity. No study has examined how these two mechanisms may interact to contribute to greater airflow obstruction during emotional stress in daily life. This study investigated associations between peak expiratory flow rate (PEFR) and high frequency heart rate variability (HFHRV) during periods of negative affect and physical activity in daily life in patients with higher versus lower asthma self-efficacy scores.
  
  
  METHODS
  Fifty-three patients with mild to moderate asthma completed the Asthma Self-Efficacy Scale (ASES) and underwent a 15 h ambulatory assessment of daytime HFHRV and PEFR, while completing self-report diaries of their physical activities and affect.
  
  
  RESULTS
  In patients with lower asthma self-efficacy scores, increased levels of negative affect during daily life were associated with higher levels of HFHRV and decreased PEFR relative to patients with higher asthma self-efficacy scores. Increased levels of physical activity were associated with decreased levels of HFHRV irrespective of asthma self-efficacy scores.
  
  
  CONCLUSIONS
  Findings suggest that lower asthma self-efficacy may be associated with increased parasympathetic activity and airflow obstruction during periods of negative affect during daily life.
authors.affiliation: Department of Psychology, University of Calgary, Calgary, Canada T2N 1N4. t.s.campbell@ucalgary.ca
authors.forename: Tavis S
authors.initials: TS
authors.lastname: Campbell
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.forename: Deborah
authors.initials: D
authors.lastname: Scharf
authors.forename: David
authors.initials: D
authors.lastname: Aboussafy
authors.forename: Blaine
authors.initials: B
authors.lastname: Ditto
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000402:Airway Obstruction / Q000503:physiopathology* / Q000523:psychology; D001249:Asthma / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D020377:Self Efficacy; D012720:Severity of Illness Index