PERCEIVED SYMPTOMS AND DISCOMFORT DURING INDUCED BRONCHOSPASM - THE ROLE OF TEMPORAL ADAPTATION AND ANXIETY

Using a mixed within-between design, this study was designed to evalua te the sensorial and cognitive/evaluative aspects of bronchoconstricti on induced by progressive methacholine inhalation. 25 asthmatic patien ts and 15 normal controls were given two consecutive bronchoconstricti on tests, inducing a fall of > 30% of the forced expiratory volume in 1 sec (FEV1), which was measured after each inhalation of methacholine . Immediately before each FEV1 measurement, Ss rated perceived bronchi al closing, discomfort of breathing and anxiety, as well as the need t o use a bronchodilator. In addition to state-anxiety, after each broch oconstriction test asthma symptoms were evaluated by means of a Free S ymptom Report and the Asthma Symptom Checklist. The results show that during the first test, asthmatic patients perceived their symptoms mor e accurately than non-asthmatic controls. However, during the second t est, asthmatic patients became less accurate, while normal controls in creased their accuracy of symptom report. These changes were not paral lelled for the Free Symptom Report or the Asthma Symptom Checklist. Th ese results suggest that, depending on situational circumstances, pati ents rely on their cognitive schemata to report asthma symptoms. Need for bronchodilator use was related to perceived discomfort but not to actual or perceived bronchial closing. Clinical implications of this s tudy are discussed.