Self-reported stressors, symptom complaints and psychobiological functioning I: Cardiovascular stress reactivity.

Taking into account neuroticism and lifestyle variables (smoking and alcohol consumption), cardiovascular and psychological reactions to stressful films were studied in four groups of subjects selected on self-reported levels of recent stressor load and symptom complaints (low-load/low-symptoms: low-load/high-symptoms; high-load/low-symptoms; high-load/high-symptoms). The films were known either to stimulate or to depress cardiovascular activity. The results showed that psychological reactions (distress; deactivation; openness/involvement) were associated with group membership and condition. In addition, high-symptom subjects were characterized by faster resting heart rates and smaller ECG T-wave amplitudes (TWAs), reflective of greater sympathetic tone on the myocard. Further, low-symptom subjects, in particular those labeled as stress-resistant (high-load/low-symptoms), exhibited larger myocardial responses to the cardiovascular-stimulating films than did high-symptom subjects. Low-symptom subjects showed predicted variations in physiological responses to the different films, whereas the responses by the high-symptom subjects showed lesser variation across films. It is concluded that the cardiovascular responses of low-symptom subjects more accurately followed the energetic demands of the body, whereas the high-symptom subjects were in a comparatively enduring state of arousal.

Self-reported stressors, symptom complaints and psychobiological functioning-II: Psychoneuroendocrine variables.

The present study examined resting endocrinological functioning and endocrine responsivity to new challenges as a function of self-reported stress load and symptomatology. Following a baseline period, four groups of male subjects (low-load/low-symptoms; low-load/high-symptoms; high-load/low-symptoms; high-load/high-symptoms) were exposed to stressful films, followed by a rest period. Blood samples were drawn after each film and after the rest condition, and urinary samples were collected during two nights preceding the experimental session. Neuroendocrine variables measured in plasma included adrenaline, noradrenaline, ACTH, cortisol, growth hormone, prolactin, and testosterone. The urinary samples were assayed for noradrenaline and adrenaline (in relation to creatinin). High-symptom subjects had significantly higher plasma levels of noradrenaline and overnight urinary adrenaline levels, whereas their cortisol levels tended to be lower as compared to the low-symptom group. The plasma noradrenaline/cortisol ratio was higher among the high-symptom subjects. However, upon controlling for neuroticism and life style factors (smoking and alcohol consumption), all but the effects on cortisol failed to meet significance criteria. Higher stress load was associated with higher plasma adrenaline responses during the laboratory session, irrespective of neuroticism or life-style measures. These results therefore suggest that in addition to measuring exposure to real-life stressors, it is also necessary to measure outcomes, such as symptoms, and to be aware of the effects of neuroticism and life-style when attempting to understand which specific psychosocial factors effect psychoendocrinological functioning.

Migraine patients cognitively impaired?

In order to investigate the hypothesis that migraine has a detrimental effect on cognitive functioning, 37 female migraine patients and 34 nonheadache female controls underwent a battery of neuropsychologic tests. No significant difference in test performance between groups was found. There was no relation between the length of migraine history or medication use and the level of impairment of cognitive abilities. The patient and control groups differed significantly on several self-report measures known to interfere with performance. Patients reported higher trait and state anxiety levels, higher debilitating anxiety and state depression, and less vigor. Statistical correction for these variables, however, did not result in significant group differences of cognitive performance. The results suggest that the general population of female migraine patients show no indication of cognitive impairment.

Chronic low back pain: a medical-psychological report.

This paper begins with general discussion of chronic pain, in which the complex nature of this symptom is pointed out and the incorrect application of the widespread distinction between 'organic' and 'psychogenic' pain is criticized. A different classification which has proved clinically valuable is then briefly discussed. Subsequently, there is a discussion of the symptom of low back pain, a frequent disorder as demonstrated by the epidemiologic investigation reported. Then, reference is made to chronic low back pain which is often treated by surgical intervention such as operation for prolapsed intervertebral disc (PID). To conclude, a detailed report is presented of a study of 55 patients all of whom had been subjected at least once to a PID operation without success and who subsequently applied for partial percutaneous rhizotomy (PPR). Every patient was interviewed in depth and the results of these interviews are presented, classified by the main topics discussed. In addition, 6 months after PPR, a follow-up interview was conducted concerning the therapeutic results in the 31 patients who underwent this procedure.