Biološke, psihološke i socijalne odrednice zaduhe

Basara, Latinka. (2017). Biološke, psihološke i socijalne odrednice zaduhe. Specialist Thesis. Filozofski fakultet u Zagrebu, Department of Psychology.
(Poslijediplomski specijalistički studij kliničke psihologije) [mentor Jokić-Begić, Nataša].

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Abstract

Dyspnea, also known as unpleasant breathing awareness, breathlessness or “air hunger” primarily represents a respiratory medicine symptom. On the other hand, interest to study dyspnea as biopsychosocial phenomenon is relatively “young” and it reflects the connection between different areas of medicine, psychophysiology, biological and health psychology. Taking into consideration the unique breathing characteristic – being the unconscious process that can become conscious as well as the possibility that,changes in breathing can simultaneously be a form of reaction and a cause of dyspnea - we found it very important to bring together all current findings regarding this interdisciplinary field and decompound the complex nature of dyspnea. Inspite of the first ideas about dyspnea being unidimensional construct, today we are witnessing a larger number of studies implying two or three dyspnea dimensions (affective and sensory component, and the impact on daily activities). Using recent literature from the year 2000 to 2016, we explained some mechanisms underlying dyspnea and its moderating variables. Except data that demonstrate protective nature of dyspnea (maintaining homeostasis) we showed all its complexty by critically presenting recent findings regarding the relation of dyspnea to psychosocial factors. Intensity and quality of dyspnea sensation depend on the presence/absence of pulmonary disease, age, gender and physiologic mechanisms, but also on personality, emotional status, mood, affect, stress levels and duration, family support, race and/or ethnical/cultural background. Research shows that in some cases, psychosocial variables can serve as better predictors of dyspnea compared to objective obstruction of the airways. We also presented the central nervous system structures involved in dyspnea sensation as well as the circumstances in which dyspnea can be altered; manipulating emotions, context, thought distraction and induction of empathy. Possibility to alter dyspnea sensation is very interesting because it suggests that besides medication therapy to reduce it, there is a need for routine interventions regarding emotions, personality and social support.

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