Learning to have psychosomatic complaints: Conditioning of respiratory behavior and somatic complaints in psychosomatic patients |
Author(s):
,Journal/Book: Psychosom Med. 1997; 59: 351 West Camden St, Baltimore, MD 21201-2436. Williams & Wilkins. 13-23.
Abstract: Objective: Assuming a subjective similarity between the experience of a hyperventilation episode and inhaling CO2-enriched air, we tested whether a respiratory challenge in association with a particular stimulus could result in altered respiratory behavior and associated somatic complaints upon presenting the stimulus only. Method: Psychosomatic patients (N = 28) reporting hyperventilation complaints participated in a differential conditioning paradigm using odors with a positive or negative valence as conditioned stimuli (CS+ or CS-) and 7.4% CO2-enriched air as the unconditioned stimulus (US). Three CS+ and three CS- acquisition trials were run. During the test phase, two CS+ -and two CS- -only trials were run, followed by two new test odors (with a positive or negative valence). Respiratory frequency, tidal volume, end-tidal fractional concentration of CO2, and heart rate were measured throughout the experiment. Somatic complaints were registered after each trial. Results: We observed a) increased respiratory frequency and an elevated level of somatic complaints upon presenting the CS+ only; b) a selective association effect: conditioning was only apparent with the negatively valenced CS+ odor; (c) no generalization of respiratory responses and complaints to the new odors; (d) no conditioning effect on dummy complaints that are usually not reported when inhaling CO2; (e) in exploratory comparisons with normal subjects, stronger conditioning effects on typical hyperventilation complaints in patients, and, in female subjects, on respiratory frequency. Conclusion: Respiratory responses and psychosomatic complaints can be elicited by conditioned stimuli in a highly specific way. The findings are relevant for disorders in which respiratory abnormalities and/or psychosomatic complaints may play a role and for multiple chemical sensitivity.
Note: Article VandenBergh O, Catholic Univ Leuven, Dept Psychol, Tiensestr 102, B-3000 Louvain, BELGIUM
Keyword(s): conditioning; hyperventilation; panic; odors; psychosomatic complaints; multiple chemical sensitivity; MULTIPLE CHEMICAL SENSITIVITIES; DIOXIDE-ENRICHED AIR; PANIC DISORDER; CARBON-DIOXIDE; HYPERVENTILATION SYNDROME; INFORMATION SEEKING; ANXIETY; INHALATION; SYMPTOMS; STRESS
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