Reply to Dr. P. Slade

118 6. 7.

Letters

to the Editor

VILA J, BEECH HR. Premensrrual symptomatology: an interaction hypothesis. Br J Social Clinical Psycho1 1980; 19: 73-80. MAY RR. Mood shifts and the menstrual cycle. J Psychosam Res 1976: 20: 125-130.

Reply to Dr P. Slade WE AGREE with the bulk of Slade’s views on the importance of prospective recording of symptoms for valid research and thank her for drawing attention to the limitations of our study. However, the findings of our research do more than highlight and document the issue of inter-cycle variability. As Slade states, the gathering of prospective data, even under clinical laboratory conditions, is time consuming and difficult, both for the researchers and more importantly for the subjects or clients. Thus in clinical practice retrospective self-report remains overwhelmingly the commonest method of assessment. In that context documentation of the relationships between recall and prospective records, in the light of test-retest reliability of measures, is important and interesting. That a sample of women (no doubt well motivated, as any who complete a three month daily prospective non-intervention study must be) can recall the severity of the specifically premenstrual symptom excacerbations experienced in the preceding cycle so accurately (the correlation was 0.85), is important information to a clinician. W. G. HART, G. J. COLEMAN and J. W. RUSSELL Health Psychology Centre, Lincoln Institute of Health Sciences, Victoria 3053, Australia.

CHIARI G, FOSCHINO-BARBARO GM, Nuzzo ML, PECCI L, ROSSI R. Individual emotions in asthmatic children. J Psychosom Res 1987; 31: 341-350.

knowledge

of

IN THE introduction to this paper the authors cite references (e.g. [2]) that in asthmatic children there may be an inverse relation between asthmatic symptoms and expression of aggressive emotions. The authors themselves then give details that children with bronchial asthma regard their emotions in a more cognitive manner than normal children, by whom a behaviouristic description of emotions is more commonly adopted. On these issues I offer two suggestions of how some of the complexities of asthmatic psychology may parsimoniously be understood. Firstly, the inverse relation between aggressive emotions and asthmatic symptoms may arise because asthmatics have acquired the ability to clear their lungs by generating aggressive emotional states. The mediator between these two events would be the release of hormones from the adrenal medulla, which are known to dilate the bronchioles [3], and whose release is known to be under central control, though not usually under voluntary control. If this were the case, asthmatics would be able to use their aggressive emotions for two quite different purposes - the normal social functions, and the clearing of the airways. This would inevitably create a major area of conflict concerning the control and appropriate use of aggressive emotional responses. In comparison with normal subjects there would be an additional factor propelling the asthmatic subjects towards free expression, and even exaggeration, of his or her aggressive emotions, regardless of whether this was appropriate to the social context. The literature on this subject shows that such difficulties are in fact very common amongst asthmatics [I, 21. The second point concerns the specific topic of the paper by Chiari et al., and introduces the process of biofeedback. In a number of so-called autonomic functions it has been shown that conscious control can be acquired, especially if the subject has good sensory feedback from the variable he/she is attempting to control [4]. In asthma therefore, the respiratory symptoms may be providing a sensory feedback signal which allows conscious control over adrenal medulla secretion to develop. As an extension of the same process the control of aggressive emotions would come to have some of the characteristics of normal voluntary control. Aggressive emotions would then become available for’much more detailed cognitive analysis than in normal persons, where there is no direct and explicit sensory signal of the prevailing emotional state. In effect ‘aggression’ would have come to have some of the attributes of a ‘concept’ rather than of an ‘emotion’.

Department

ROBERT MILLER of Anatomy and Neuroscience Centre, University of Otago Medical School, P.O. Box 913, Dunedin, New Zealand.