Somatic Reactions Research Articles

The psychodynamic of panic attacks: A useful integration of psychoanalysis and neuroscience

This article tries to explain, in the light of some neuroscientific and psychoanalytical considerations, the repetitive pattern of panic attacks. Freud considered the panic attack as an ‘actual neurosis’ not involving any conflictual process. Recent neuroscientific findings indicate that psychosomatic reactions, set off by a danger situation, depend on the primitive circuit of fear (including the amygdala) characterised by its speed, but lack accurate responses and may also be activated by harmless stimuli perceived erroneously as dangerous. The traumatic terror is stored in implicit memory and may be set off by a conditioned stimulus linked to a previous danger situation. In the panic attack, the traumatic event is created by the imagination and this construction (a micro‐delusion), built in loneliness and anxiety, has the same power as the real trauma. A mutual psychosomatic short‐circuit between body and psyche, in which terror reinforces the somatic reactions and the psychic construction, is established. Therefore, it is important to highlight these constructions in order to analyse and transform them. In the second part of the article the author reviews the main psychoanalytical theories about panic attacks, stressing how, in his opinion, panic attack is a consequence of the breakdown of the defence organisation at various levels and may appear during periods of life crisis. Two patients suffering from a deficit of personal identity are presented. The various organisations and the different levels (biological, neuroscientific, associative, traumatic) of the panic attack determine different kinds of therapeutic approaches (pharmacological, cognitive and psychoanalytical). While the psychopharmacological treatment is aimed at reducing the neurovegetative reaction and the cognitive method is attempting to correct the associative and perceptive processes of fear signals, psychoanalytical therapy represents both a specific means to free patients from panic attacks as well as an indispensable route for their emotional growth.

A Social-Psychological Theory of Collective Anxiety Attacks: The “Mad Gasser” Reexamined

This article presents a social-psychological theory to explain collective behavior involving unusual somatic reactions. The authors term this social phenomenon a “collective anxiety attack,” to distinguish it from the psychiatric label of “mass psychogenic illness.” First, the article contrasts fundamental assumptions of a psychiatric-medical interpretation with a social-psychological interpretation. Next, the article illustrates the difference using a reinterpretation of and new data about the classic case of the “mad gasser of Mattoon.” Then, the authors present a social-psychological theory which suggests that collective anxiety is induced by a shared belief in a threat rumor. Once a belief in an imminent threat spreads widely enough to create a consensual definition of the situation, the belief intensifies fear and distorts individual perception. Belief in the threat rumor creates psychological stress and expectancy effects that shape an individual's somatic reactions, so that expectations of feeling sick result in symptoms of sickness. In conclusion, the article suggests a program for research and ways of managing collective anxiety attacks.

Estímulos emocionais: processamento sensorial e respostas motoras

Emotion can be functionally considered as action dispositions preparing the organism for either avoidance- or approach- related behaviors. In order to prepare an appropriate behavioral output, the organism has to be efficient in the encoding of relevant stimuli. We herein present evidence from neuroimaging studies that seeing emotional and arousing pictures leads to greater activation in visual cortex than seeing neutral ones. In addition to this facilitation of sensory processing, emotional stimuli prompt somatic and vegetative reactions. Recordings of postural oscillations and heart rate while participants visualized a block of unpleasant pictures, revealed a significant reduction of body sway and bradycardia. A parallel investigation showed that reaction time also slows down after the visualization of negative pictures. Taken together, immobility, bradycardia and slower reaction time in the laboratory experimental set may reflect the engagement of the defensive system, resembling the defensive reactions to distant threatening stimuli in natural contexts. In summary, the affective system operates at an early level of sensory encoding and at the motor output favoring dispositions for appropriate actions.

Automatic mimicry reactions as related to differences in emotional empathy.

The hypotheses of this investigation were derived by conceiving of automatic mimicking as a component of emotional empathy. Differences between subjects high and low in emotional empathy were investigated. The parameters compared were facial mimicry reactions, as represented by electromyographic (EMG) activity when subjects were exposed to pictures of angry or happy faces, and the degree of correspondence between subjects' facial EMG reactions and their self-reported feelings. The comparisons were made at different stimulus exposure times in order to elicit reactions at different levels of information processing. The high-empathy subjects were found to have a higher degree of mimicking behavior than the low-empathy subjects, a difference that emerged at short exposure times (17-40 ms) that represented automatic reactions. The low-empathy subjects tended already at short exposure times (17-40 ms) to show inverse zygomaticus muscle reactions, namely "smiling" when exposed to an angry face. The high-empathy group was characterized by a significantly higher correspondence between facial expressions and self-reported feelings. No differences were found between the high- and low-empathy subjects in their verbally reported feelings when presented a happy or an angry face. Thus, the differences between the groups in emotional empathy appeared to be related to differences in automatic somatic reactions to facial stimuli rather than to differences in their conscious interpretation of the emotional situation.

Ibogaine interferes with motivational and somatic effects of naloxone-precipitated withdrawal from acutely administered morphine

It has been reported that ibogaine interferes with somatic withdrawal reactions in rats chronically treated with morphine. The present experiments demonstrated that ibogaine also interferes with motivational withdrawal reactions and somatic withdrawal reactions in rats treated with morphine on only two occasions. On each of two conditioning trials, naloxone was administered 24 h following an injection of morphine. Four hours prior to each naloxone administration, rats were injected with either ibogaine or saline. In two experiments, ibogaine interfered with naloxone-precipitated withdrawal. In Experiment 1, ibogaine-treated rats displayed a weaker aversion to the withdrawal-paired chamber, and in Experiment 2, ibogaine-treated rats displayed fewer somatic withdrawal reactions than did saline treated rats.

Aggressive Behavior in Combat Veterans with Post-Traumatic Stress Disorder

The incidence of aggression and violent behavior in combat veterans varies and can be observed with regard to the presence or absence of post-traumatic stress disorder (PTSD). Significantly greater occurrence of aggression was observed in combat veterans with PTSD compared with those without PTSD. There are various types of aggressive behavior that frequently are combined. Autoaggressive (suicidal) and heteroaggressive (interpersonal violence) behaviors predominate, with dominating verbal aggression and impulsive somatic reactions. Impulsive reactions are more frequently directed toward unknown persons, whereas verbal aggression is mostly aimed at known people. In the occurrence of aggressive behavior in combat veterans with PTSD, important roles are played by education level, low socioeconomic status, maltreatment in childhood, and previous types of violent behavior (before participation in war events).

Gender Differences in Acute Somatic and Psychological Reactions to Moderate Orthopedic Injuries

It has been shown that the risk of posttraumatic stress disorder (PTSD) in patients with severe trauma is higher among females than among males. However, it is less well known whether there is a gender difference in acute psychological reactions after trauma among patients with less severe injuries. The aim of this study was to investigate whether female and male patients experience somatic and psychological symptoms differently following moderate orthopedic injury.

Tratamiento preventivo de las cefaleas

Headache continues to be the commonest neurological disorder of childhood. There are few studies of prophylactic treatment for headache at this age, perhaps because of the difficulty in measuring intensity of pain and response to treatment in children. Before headache can be treated prophylactically, it is necessary to know its exact site and main trigger mechanisms. Therefore, treatment has to be adapted to the individual, bearing in mind the age of the patient, frequency of headaches, presence or absence of aura, intensity of pain and attitude of the family. Behavior therapy, psychological support and relaxation exercises may be necessary to reduce the frequency and intensity of the headache.The first prophylactic treatment for chronic headache should be identification of any underlying trigger factor. Tension type headache may be a simple somatic reaction to stress. Prophylactic drugs should be given according to the frequency of headaches, their duration and intensity whenever drug treatment for the acute phase has not eased the pain completely. The tricyclic antidepressants are the initial drug of choice for use in tension headache. It should be remembered that in children drugs should only be used when other measures of pain control have proved useless. In general prophylactic treatment of migraine should be started as monotherapy, maintained for at least one month (approximately between 3 and 6 months) before gradually stopping the drug. The drugs usually used in children are adrenergic beta blockers, calcium antagonists, seretoninergenic antagonists, antidepressants, non steroid anti inflammatory drugs, and the anti convulsant drugs currently being developed.

Specific dimensions of anxiety in surgical patients. Development of a questionnaire and empirical results

This article reports on the construction and empirical evaluation of an instrument for the measurement of different components of surgery-related state anxiety. The anxiety inventory KASA identifies three components: cognitive, autonomic, and somatic anxiety reactions. Internal consistencies of the three scales related to these components were highly satisfactory (Cronbach's alpha between 0.80 and 0.91). An analysis of scores of these three components across the perioperative period demonstrates that the KASA is a sensitive indicator of state anxiety changes. Further analyses concerning external relationships of this new instrument with indicators of coping, trait anxiety, perioperative mood states and postoperative adjustment are reported. Results of these analyses indicate that the KASA is a reliable and valid measure of different components of surgery-related anxiety.

Preliminary investigation of computer stress and the big five personality factors.

This study investigated correlates of personality factors, measured with the Big Five Inventory, with computer users' stress, measured with the Computer Hassles Scale. Based on an analysis of the responses of 95 college students using computers, there was a significant correlation between the computer users' stress and Openness, one of the Big Five personality factors. There was a significant correlation between the Computer Hassles Scale and the somatic complaints and anxiety reactions, typical responses to stress. Hierarchical regression analyses indicated that Neuroticism and Extraversion had a "buffering effect" between computer stressors and typical stress responses. The significant correlation between scores on the Computer Hassles Scale and on Openness was a surprising finding and suggested that additional research was needed to clarify the nature of this relationship.

Changing psychobiological stress reactions by manipulating cognitive processes

This study aimed at manipulating psychobiological reactions to public speaking stress by means of verbal comments during the anticipation period. Sixty male students were instructed to give a public talk in 10 min. Twenty subjects each were randomly assigned to one of three experimental conditions: During anticipation of the speech the experimenter remained silent in the control condition, gave feedback that the subject was physiologically aroused and nervous in the second (arousing manipulation), or that he was physiologically calm and relaxed in the third condition (reassuring manipulation). Within the three stress conditions heart rate, systolic blood pressure, cortisol, and electrodermal responses were highest in the condition with reassuring manipulation and lowest in the condition without manipulation. Emotional stress reactions were highest in the condition with arousing manipulation and lowest in the condition with reassuring manipulation. Compared to the group without manipulation clear intraindividual discrepancies between emotional and somatic stress reactions could be observed in the group with reassuring manipulation (emotional<somatic arousal) and the group with arousing manipulation (emotional>somatic arousal). The two groups were significantly different in their discrepancy scores. It was concluded that the arousing manipulation seemed to have induced a sensitive, the reassuring manipulation a defensive coping style.

An integrated study of individualism in Lentinula edodes in nature and its implication for cultivation strategy

A field study was carried out in a remote broadleaved Fagus longipetiolata forest in Shaanxi province, China to study the natural local distribution of Lentinula edodes. Following spatial mapping, 24 fruit bodies were collected for tissue isolation into axenic culture. 24 genets distributed on fallen tree trunks within a distance of 120 m were identified and clustered into 7 groups using the unweighted pair-group method algorithm using data based on colony morphologies, abilities to degrade aromatic poly-R478 dye, somatic incompatibility reaction patterns and DNA fingerprints. Among the parameters used, the somatic incompatibility reaction, a polygenic phenotype, was the most differentiating, identifying 22 incompatible classes. Two sets of fruit bodies of different genets were so close together that they would otherwise have been described as aggregate fruits of presumed identical origin. Eighteen genets found on the same 5.6 m long tree trunk divided roughly into two clusters, matching their spatial distribution, and a nearby branch bore another distinct cluster. More heterogeneity was encountered between isolates the greater the distance separating them on the original site. Genets on the same tree trunk showed more compatible somatic reactions among themselves, and their DNA fingerprints showed higher similarity. Nevertheless, considering the totality of phenotypic characters, each fruit body is a genet in L. edodes. Such features are concluded to result from a reproductive strategy which depends on basidiospore dispersal. Within each cluster of isolates from the collection site genets seemed to have arisen from multiple sib-mating events. Thus, a cluster may represent a lineage of L. edodes. Individualism in L. edodes is based on a strong somatic incompatibility system. Strong competition from contaminating individuals arriving as air-borne basidiospores could explain decreased and fluctuating crop yields which are now frequently observed in later flushes from the outdoor wood log cultivation system. Further, it would also explain why multispore spawn is not favoured in artificial cultivation of this economically important edible mushroom.

On discriminating and not discriminating between affect and representation.

The topic involves two issues. They can be related either to different clinical pictures or to divergent opinions about the same clinical facts. But the above mentioned opposition can be found in Freud's work. Listening in analysis differentiates between situations where the distinction of affect and representation is blurred within the general frame of communication and others where this distinction imposes itself because of the critical or chronic character of the predominance of affect. Problems about the discrimination between affect and representation in the unconscious are elucidated in the light of their structural differences. The notion of the psychical representative of the drive announces the reference to the further notion of instinctual impulse. Later on, in Freud's theory, the notion of instinctual impulse has encompassed the distinction between affects and representation. Contemporary authors have, in their vast majority, chosen to refer preferably to object relationships. Nevertheless, the problems raised by Freud remain unanswered. It is with the clinical picture of borderline personality disorders that the lack of discrimination between affect and representation becomes evident. A detailed description is presented of the forms of transference where the irrepresentable prevails, accompanied by feelings of being overwhelmed, repetition compulsion, acting out and somatic reactions. In the countertransference, the affects of helplessness, despair and even the impossibility of grasping the meaning of the patient's communication are frequently met in the analyst. In these clinical pictures, intermediary formations, i.e. psychic organisations where primary processes structures the unconscious, are impaired. One is struck by the limitation of the capacities of representation and by the importance of phenomena related to negative hallucinations specially focused on thought processes, The communication is frequently self-contradictory, the transference oscillating between disembodiment and primitive fusion. The object has a paradoxical status; it is at the same time everything and nothing, the transference being incomprehensible and unanalysable. Different hypotheses are presented to explain the importance of destruction. Finally, the author presents a hypothesis for the deficiency of these intermediary formations because of the absence of continuing cathexis from the primary object at certain important moments of the relationship. It is the establishment of theses intermediary formations that will permit the acceptance of the separation from the object, the child now being able to rely on his own internal creations. However important the influences of the relationship to the other in the genesis of affects, the internal orientation towards the body of the psychic processes is what constitutes the core of the primordial psychic world.

Sleep and stress in man: an approach through exercise and exposure to extreme environments

In this paper, the effects of exercise on human sleep (in temperate, cold, and hot climates) are compared with those of exposure to extreme environments (tropical, polar climates). Exercise has two effects: (i) when the exercise load is too heavy or if the subject is not trained to the exercise conditions, the hypothalamo-pituitary-adrenocortical axis (HPA) is strongly activated (somatic stress reaction), and a diachronic (delayed) decrease in total sleep time and slow-wave sleep (SWS) occurs with a synchronic (concomitant) sleep disruption (such as a decrease in REM sleep); (ii) a diachronic enhancement of SWS and (or) REM sleep occurs during moderate training and in athletes, with a moderate HPA activation (neurogenic stress reaction). Heat acclimatization (neurogenic stress response) results in a diachronic increase in SWS, contrary to acute heat exposure (somatic stress) which leads to a diachronic decrease in SWS. Nocturnal cold exposure (somatic and (or) neurogenic stress) provokes a synchronic decrease in REM sleep with an activation of stress hormones, which are reduced by previous acclimation (neurogenic pathway); SWS remains undisturbed in the cold, as it occurs at the beginning of the night before body cooling. In conclusion, when the brain can deal with the stressor (neurogenic stress), diachronic increases in SWS and (or) REM sleep occur. When these "central" mechanisms are overloaded, the classical "somatic" stress reaction occurs with diachronic and synchronic disruptions of the sleep structure.Key words: sleep, exercise, extreme environments, stress.

Anxiety and autonomic flexibility: a cardiovascular approach

Autonomic characteristics of panickers, blood phobics, and nonanxious controls were compared with a variety of cardiovascular measures, including spectral analysis of the cardiac inter-beat interval time series (derived from the electrocardiogram). Responses to laboratory stressors (shock avoidance and cold face stress) of 16 participants who reported recent occurrences of frequent severe panic attacks, 15 participants who reported strong somatic reactions and fainting to the sight of blood, and 15 controls, were recorded. Results suggested distinct autonomic patterns among the three groups. Across conditions, panickers displayed the highest heart rates (HR) coupled with the least HR variability, which indicates low levels of cardiac vagal tone. Blood phobics showed more vagally mediated HR variability than panickers, with a significant association between cardiac rate and mean arterial pressure. Controls generally showed the most HR variability and `spectral reserve' (a quality that indicates flexible responsivity). Results are discussed in the context of traditional models of anxiety and autonomic activity in contrast to contemporary notions of stability and change in biological systems.

Somatic incompatibility among African Armillaria isolates

SummaryTwenty‐five African Armillaria isolates paired on malt‐agar were divided into four groups on the basis of somatic incompatibility reactions. One of the groups is similar to the European species Armillaria mellea, while another group is provisionally designated as Armillaria heimii.

Reduction by fentanyl of the Cp50 values of propofol and hemodynamic responses to various noxious stimuli.

Propofol and fentanyl infusion rates should be varied according to the patient's responsiveness to stimulation to maintain satisfactory anesthetic and operative conditions. However, somatic and autonomic responses to various noxious stimuli have not been investigated systematically for intravenous propofol and fentanyl anesthesia. Propofol and fentanyl were administered via computer-assisted continuous infusion to provide stable concentrations and to allow equilibration between plasma-blood and effect-site concentrations. The propofol concentrations needed to suppress eye opening to verbal command and motor responses after 50-Hz electric tetanic stimulation, laryngoscopy, tracheal intubation, and skin incision in 50% or 95% of patients (Cp50 and Cp95) were determined at fentanyl concentrations of 0.0, 1.0, 2.0, 3.0, and 4.0 ng/ml in 133 patients undergoing lower abdominal surgery. The ability of propofol with fentanyl to suppress hemodynamic reactions in response to various noxious stimuli also was evaluated by measuring arterial blood pressure and heart rate before and after stimulation. The various Cp50 values for propofol alone (no fentanyl) for the various stimuli increased in the following order: Cp50loss of consciousness, 4.4 microg/ml (range, 3.8-5.0); Cp50tetanus, 9.3 microg/ml (range, 8.3-10.4); Cp50laryngoscopy, 9.8 microg/ml (range, 8.9-10.8); Cp50skin incision, 10.0 microg/ml (range, 8.1-12.2); and Cp50intubation, 17.4 microg/ml (range, 15.1-20.1; 95% confidence interval). The reduction of Cp50loss of consciousness, with fentanyl was minimal; 11% at 1 ng/ml of fentanyl and 17% at 3 ng/ml of fentanyl. A plasma fentanyl concentration of 1 ng/ml (3 ng/ml) resulted in a 31-34% (50-55%) reduction of the propofol Cp50s for tetanus, laryngoscopy, intubation, and skin incision. Propofol alone depresses prestimulation blood pressure but had no influence on the magnitude blood pressure or heart rate increase to stimulation. Propofol used with fentanyl attenuated the systolic blood pressure increases to various noxious stimuli in a dose-dependent fashion. The authors successfully defined the propofol concentration required for various stimuli. Tracheal intubation was the strongest stimulus. The absence of somatic reactions for propofol does not guarantee hemodynamic stability without fentanyl. Propofol with fentanyl was able to suppress motor and hemodynamic reactions to various noxious stimuli.

Intraspecific variation in 137Cs activity concentration in sporocarps of Suillus variegatus in seven Swedish populations

Following the Chernobyl accident in 1986, sporocarps of Suillus variegatus in Sweden showed a large amount of individual variation in concentration of 137 Cs activity. Our aim was to determine the degrees to which this variability in sporocarp 137 Cs levels could be explained by differences between (i) local populations, (ii) fungal genets and (iii) locations within genets. Five populations in a 100-yr-old Scots pine forest, located within a 1 km 2 area, and two populations in Scots pine/Norway spruce forest, located 40 km northwest of Uppsala, were investigated. In total, 154 sporocarps were analysed to determine their 137 Cs content. Of these, the genetic affiliations of 86 were successfully characterized using somatic incompatibility reactions. Twenty-six genets were found which, on average, consisted of 6·5 sporocarps. The genets averaged 7·5 m in size, measured as the length between the most distant sporocarps. The mean sporocarp 137 Cs level was 67·1 ± 2·8 kBq kg -1 D.W. (range between 13·6 and 182). According to analyses of variance, within-population variation accounted for 60% of the total variation in 137 Cs levels, while 40% was ascribed to variation among populations. Within a population, 137 Cs levels did not generally differ significantly between genets. Plausible reasons for intraspecific variation in radiocaesium content in sporocarps are discussed.

Population ecology of Suillus variegatus in old Swedish Scots pine forests

Spatial characteristics of Suillus variegatus populations, including the size, distribution and number of genets, were measured in four naturally regenerated stands of Scots pine, Pinus sylvestris in Sweden that were more than 100 years old. In the oldest forest, a continuous tree-layer had been present at least since the last forest fire in 1647. Genets were identified based on somatic incompatibility reactions performed on mycelial cultures from sporocarps. In total, 38 genets were identified from 120 tested sporocarps. The maximal extension of a genet, as reflected by its outermost sporocarps, was 27 m in the oldest stand and ranged between 10 and 17 m in the other stands. On average, genet size was 20 m in the oldest stand and 10 m in the other stands. Other genets were not found within the domains of established genets. The closest detected distance between genets was 1–5 m, and the average distance was 4 m. The number of genets ranged between 56 and 74 ha − at the studied sites. Possible reasons for the high degree of resemblance in characteristics in old forests between S. variegatus, the dominant bolete in mature forests, and S. bovinus when present, more a characteristic for younger forests and only scarcely occurring in older forests, are discussed.

Randomized comparison of sitting and prone positions for stereotactic fine-needle aspiration breast biopsy

In a prospective randomized study, 103 women had stereotactic biopsies performed either in the prone (n = 51) or sitting (n = 52) position. Questionnaires were administered before and after biopsy, to measure anxiety, pain and subjective experience in all patients. Vasovagal reactions were scored from 0 to 2 according to severity. There was no significant difference between biopsies performed in the sitting or the prone position with regard to overall tolerance. Significantly more patients biopsied in the prone position (15 of 51, 29 per cent) than in the sitting position (seven of 52, 13 per cent) would prefer premedication before a repeat biopsy (P = 0.04). Of the total patient group, three women fainted, one in the prone position and two others in the sitting position. Breast biopsies performed in the prone or sitting position are equally well tolerated. Somatic reactions such as fainting are not a major problem during breast biopsy; however, attention should be focused on patient care, including information given before the procedure.