Talking and body complaints in group therapy patients.
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Sternbach proposed a three component model to account for the emergence of psychosomatic symptoms. He hypothesized that if an individual exhibited (1) marked response stereotypy, and (2) inadequate homeostatic restraints, then (3) exposure to activating situations would result in psychosomatic episodes. The main purpose of the present study was to examine the second component of the Sternbach model, homeostatic inadequacy, as indicated by impaired rate of recovery from stressful stimulation. In addition, the presence of response stereotypy was investigated in this study. Ten subjects from each of 5 diagnostic groups (rheumatoid arthritis, essential hypertension, migraine headache, tension headache, and healthy controls) were observed under conditions of unstructured relaxation, easement (exposure to stimuli intended to enhance relaxation), mild stress, and recovery from stress. Forearm and forehead muscle potential, peripheral temperature, electrodermal response, heart rate and systolic and diastolic blood pressure were monitored during these sessions. Although evidence of symptom specific response stereotypy was regularly observed, slowness of recovery did not emerge as a robust phenomenon in the four psychosomatic disorders investigated. The phenomenon was consistently observed in the arthritic subjects, absent in hypertensives and tension headache subjects, and ambiguous for migraine subjects.
The study compared the presence of somatic illnesses in manic-depressive (n = 100) and schizophrenic patients (n = 156) in the out-patient psychiatric clinics of three general hospitals. The average age of manic-depressive and schizophrenic patients was 40.7 yr and 39.8 yr respectively and did not differ significantly. The sample consisted of both sexes. Among the manic-depressive patients there were 46 males and 54 females. The schizophrenic sample consisted of 84 (54%) males and 72 (46%) females. The result showed that there was a greater rate of the occurrence of physical illnesses in manic-depressive patients as compared to the schizophrenic patients in respect to all the surveyed systemic disorders except for the gastrointestinal diseases. The cardiovascular, neurological and endocrinological diseases were more frequent in the manic-depressives than in the schizophrenic patients.
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Thirty-three asthmatic subjects were told they were receiving, alternately, an inhaled bronchoconstrictor and inhaled bronchodilator, although they actually were only breathing room air. No subjects showed suggestion-produced effects on FEV1, although two (of the 19 on whom FEF50 was measured) showed effects of greater than 20% on measures of maximal midexpiratory flow. The incidence of the effect is smaller than reported previously, possibly because some subjects in previous studies inhaled saline, a mild bronchoconstrictor, and reversal of effect was not required for classification as a reactor. Higher percentages of subjects in this study showed decreased MMEF in response to the 'bronchoconstrictor', but this appeared to reflect fatigue rather than suggestion effects. However, the fact that the effect occurred in a relatively non-effort-dependent measure suggests that real changes occurred in bronchial caliber, not just in test effort. Suggestion had a significant effect on perception of bronchial changes, but the correlation between actual and perceived changes was minimal. There was an increase in FVC prior to administration of the 'bronchoconstrictor', possibly reflecting a preparatory response to the expected drug. Correlations among self-report variables suggested the existence of three personality dimensions among our population related to suggestion and asthma: cognitive susceptibility to suggestion of bronchial change; feeling of physical vulnerability; and anxiety. However, there was no significant relationship between airway response to suggested changes and hypnotic susceptibility, as measured by the Harvard Group Scale of Hypnotic Susceptibility.
The topic of a single vs multiple premenstrual syndromes has generated much discussion. In this study, multivariate profile analysis was used to determine whether or not physical and affective symptoms associated with the premenstrual syndrome (PMS) could be explained as the manifestation of one underlying pathophysiologic process. The premenstrual symptom profiles of 820 undergraduate students and 485 graduate students were evaluated. It was not possible to reject the null hypothesis of parallel profiles in most comparisons, suggesting that variability in the severity of premenstrual symptoms may be the result of individual differences in the expression of one underlying pathophysiologic process.
Temporal and digital pulse amplitudes, forehead temperature, heart rate, respiration rate and electrodermal activity of 37 migraine patients and 37 matched controls from a population of psychology students were recorded during three experimental sessions: adaptation, real-life stress (an examination) and experimental stress (an IQ test). Migraine sufferers showed significantly smaller pulse amplitudes of the temporal artery during the examination than the control group. No group differences were present in the other physiological measures. The findings are interpreted as indirect evidence for the symptom specificity hypothesis, which states that individuals with specific psychosomatic complaints display abnormal responses to stress in the relevant physiological system.
Duodenal ulcer (DU) is a common medical disorder which frequently becomes chronic. The factors involved in the aetiology of DU are poorly understood. Evidence for the contribution of psychosocial factors to the onset of DU is reviewed in the context of evidence of organic factors, genetic and environmental, with special reference to new evidence of infectious agents in the aetiology of DU. Recent progress in understanding of biological forces of duodenal ulcer disease has lead to a substantially revised view of psychosomatic factors. Although these may be of significance, their relative contribution to aetiology is likely to be modest.
Serotonin is a ubiquitous neurotransmitter with widespread projections that provide for the involvement of serotonin in the regulation of many biological and psychological functions. A variety of serotonin receptor subtypes exist that mediate overlapping psychobiological functions and that are targets for a new generation of medications. Although these new generation medications appear to possess great biochemical specificity, their actions extend to many psychiatric disorders, reflecting the many interactions of serotonergic subsystems.
In order to determine the occurrence of psychological disturbances the authors studied 47 women who fulfilled the American College of Rheumatology Criteria for the classification of fibromyalgia and 25 random selected control patients without chronic muscle pain, all of whom live in Sorocaba, SP, Brazil. Personality disturbances were observable in 63.8% of the patients and 8.0% of the control group (p < 0.05); depression in 80.0% of the fibromyalgia group and 12.0% of the controls (p < 0.05) and anxiety in 63.8% of the patients and 16.0% of the controls (p < 0.05). The Hamilton test mean scores showed higher values for depression and anxiety among the fibromyalgia patients when compared to the control group. A significant association between fibromyalgia and depression, anxiety and personality disturbances was studied and recorded.