Andrew
Harver, Ph.D.
Chair and Professor
Department of Health Behavior and Administration
College of Health and Human Services
UNC Charlotte
9201 University City Blvd.
Charlotte, NC 28212
Biographical Sketch
Personal:
Born, Youngstown, Ohio
Wife, Nancy Hall Harver, M.A., C.C.C. (Speech Pathology)
Children, Philip and Emma
Education:
B.S., 1979, University of Washington, Psychology
M.S., 1982, Ohio University, Experimental psychology
Ph.D., 1984, Ohio University, Experimental psychology
Postdoctoral Fellow, 1984-1987, Dartmouth Medical School, Respiratory
physiology
Positions:
1979-1984 Graduate
Teaching and Research Associate, Department of Psychology,
1984-1987 Postdoctoral
Research Fellow, Department of Physiology,
1987-1991 Research
Assistant Professor, Department of Psychology, SUNY Stony Brook
1991-1994 Adjunct
Assistant Professor, Department of Psychology, SUNY Stony Brook
1991-1995 Assistant
Professor, Department of Psychology, UNC
1995-2001 Associate
Professor, Department of Psychology, UNC
2000-2001 Faculty
Associate, Office of the Provost, UNC Charlotte
2001-2002 Professor,
Department of Psychology, UNC
2001-2002 Interim
Associate Dean of the Graduate School, UNC
2002- Chair
and Professor, Department of Health Behavior and Administration, UNC
Research Interests:
Asthma; COPD; Dyspnea; Psychophysiology; Respiration
Recent Publications:
Mahler, D. A., Harver, A., Lentine, T.,
Scott, J. A., Beck, K., & Schwartzstein, R. M. (1996). Descriptors of
breathlessness in cardiorespiratory diseases. American Journal of Respiratory
and Critical Care Medicine, 154, 1357-1363.
Bloch-Salisbury, E., Harver, A., & Squires, N. K. (1998). Event-related
potentials to inspiratory flow-resistive loads in young adults: Stimulus
magnitude effects [Special Issue: Respiratory Psychophysiology]. Biological
Psychology, 49, 165-186.
Moy, M. L., Lantin, M. L., Harver, A., & Schwartzstein, R. M. (1998).
Language of dyspnea in assessment of patients with acute asthma treated with
nebulized albuterol. American Journal of Respiratory and Critical Care
Medicine, 158, 749-753.
Kotses, H., & Harver, A. (Eds.) (1998). Self-management of asthma. New
York: Marcel Dekker, Inc.
Harver, A., & Mahler, D. A. (1998). Dyspnea:
Sensation, symptom, and illness. In D.
A. Mahler (Ed.), Dyspnea (pp. 1-34). New York: Marcel Dekker, Inc.
Harver, A., & Mahler, D. A. (1998). Perception of
increased resistance to breathing. In H. Kotses and A. Harver (Eds.), Self-management
of asthma (pp. 147-193). New York: Marcel Dekker, Inc.
Harver, A., & Katkin, E. S. (1998). Modification
of respiratory perceptions: A self-management perspective. In H. Kotses and A. Harver (Eds.), Self-management
of asthma (pp. 407-433). New York: Marcel Dekker, Inc.
Meek, P. M., Schwartzstein, R. M., Adams, L., et al. (1999).
Dyspnea - Mechanisms, assessment, and management: A consensus statement. American
Journal of Respiratory and Critical Care Medicine, 159, 321-340.
Harver, A., & Lorig, T. (2000). Respiration. In J.
T. Cacioppo, L. G. Tassinary, and G. Berntson (Eds.), Handbook of
psychophysiology (2nd ed., pp. 265-293). Cambridge: Cambridge
University Press.
Mahler, D. A., & Harver, A. (2000). Are you speaking the language of
dyspnea? [Editorial]. Chest, 117, 929-928.
Harver, A., Mahler, D. A., Schwartzstein, R. M., &
Baird, J. C. (2000). Descriptors of breathlessness in healthy individuals:
Distinct and separable constructs. Chest, 118, 679-690.
Harver, A. (2002). Defining dyspnoea [Special issue:
Key outcomes in COPD: exacerbations and dyspnoea]. European Respiratory
Review, 12 (review no.82), 26-27.
Ritz, T., Dahme, B., DuBois, A. B., Folgering, H.,
Fritz, G. K., Harver, A., Kotses, H., Lehrer, P. M., Ring, C. M., Steptoe, A.,
& Van de Woestijne, K. P. (2002). Guidelines for mechanical lung function
measurements in psychophysiology. Psychophysiology, 39, 546-567.
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The respiratory system is unique among the organ systems responsible for
maintenance of vital bodily functions in that it is regulated both by an
"automatic" or reflex controller within the brainstem and by
instructions emanating from higher centers within the cortex. It is, therefore,
fitting that as attention to the relevance of mind-body interactions grows
within medicine, we have a volume that elucidates what it known about the role
of psychological and emotional factors in the pathobiology of asthma, one of
the most common and costly respiratory diseases afflicting both children and
adults, and the impact of these factors on the management of the disease.
To some degree the title of the volume does not do justice to its contents; the
most intriguing chapters deal with the ways in which physiological events are
transformed into symptoms. This process is not a simple neurological
transmission. Rather it is dependent upon central processing that is affected
by the emotional and behavioral context of the individual and that determines
whether the stimulation of a receptor leads to a perception, a perception which
may or may not be translated into a symptom.
The book is divided into three sections: The Psychology of Asthma, Asthma
Symptoms, and Asthma Self-Management. The first section contains several
chapters which offer an excellent discussion of the interplay between emotional
factors and physiological changes in the respiratory system. I found the
material describing research on the role of familial problems in the genesis of
poorly controlled asthma particularly interesting. One glaring omission,
however, from this section was a review of the entity of laryngospasm and
asthma. Laryngospasm is increasingly recognized as a problem that may mimic moderate
to severe asthma, often leads to excessive use of corticosteroids in an effort
to control symptoms, and is felt to be exacerbated by emotional stress.
The chapters on assessment of asthma symptoms are comprehensive and
informative. The discussion of the potential pitfalls associated with measuring
peak flow at home, an accepted standard of care in all asthma practice
guidelines today, is must reading for all health care professionals who
supervise these patients. Quality of life, in addition to physiologic measures,
is increasingly recognized as a critical "outcome measure" when
assessing therapeutic interventions. Identifying and using a reliable tool to
assess quality of life, however, is often not easy and the material provided
here should assist clinicians determined to incorporate these techniques into
their practice. For the researcher interested in more focused physiological and
psychophysical measurements in asthma patients, two excellent chapters provide
detailed background material on the science of these assessments.
Finally, while the section on asthma self-management too often reproduces
material provided in previous sections, it is extremely comprehensive and
should be quite helpful to clinicians. Perhaps the most intriguing and ultimately
important chapter, however, is the final one on "Modifications of
Respiratory Perceptions" by Andrew Harver and Edward Katkin. The authors
explore possible explanations for the differences between "good" and
"poor" perceivers of changes in lung function and examine scenarios
by which perceptual ability may be altered. Given the difficulties associated
with the use of peak flow meters, a better understanding of the factors that
may impact perception of changes in the physiological state and, ultimately, possible
interventions to improve the "accuracy" of perception could be the
key to improved management of asthma.
Richard M. Schwartzstein, MD
Clinical Director, Division of Pulmonary and Critical Care Medicine
Beth Israel Deaconess Medical Center
Harvard Medical School, Boston, MA 02215
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Correspondence:Andrew Harver