Toward a biobehavioral model of visceral hypersensitivity in irritable bowel syndrome

A review of records at a large urban methadone clinic revealed a substantial group of patients with treatment tenures of at least 6 months whose urinalysis results indicated continued regular use of opiates. In an attempt to characterize these "nonresponsive" patients and to identify their specific treatment needs, we compared them to a group of patients with comparable treatment tenures but whose urinalysis results indicated little or no recent illicit opiate use. Contrary to expectations, opiate use itself was virtually the only feature that clearly distinguished the two groups. "Responders" and "nonresponders" did not differ significantly on measures of psychosocial problem severity in any other area, nor did they differ in their treatment service utilization. Moreover, examination of admission data indicated that the two groups showed similar rates of improvement in the severity of their psychosocial problems in all seven measured areas. The implications of these results for treatment and clinic administration are discussed.     

Signal detection and threshold measures for chronic back pain patients, chronic illness patients, and cohort controls to radiant heat stimuli.

15 chronic low back pain patients, 11 chronic respiratory patients, and 11 nonpatient controls (mean ages 47–56 yrs) were studied using a standard radiant heat signal detection methodology. Following determination by ascending limits of each S's stimulus detection and faint pain thresholds, 26 randomized trials at each of 5 stimulus levels were administered. Ss rated each stimulus on a 6-point subjective rating scale ranging from no pain to severe pain. Results indicate that the back pain Ss and respiratory Ss had higher radiant heat pain thresholds than the controls, and the back pain Ss had a discrimination deficit for mildly painful stimuli. Results fit the predictions of an adaptation model of pain perception in chronic pain patients as opposed to a hypochondriasis model. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial precursors and correlates of migraine headache.

Tested the interactions of migraine headache cycles and sufferers' daily experiences of stressful events, emotional arousal, and physical activity. Hypotheses were that patterns of these variables would be associated with the episodic onset of migraine headache and that frequency of attacks could be predicted by combinations of personality and behavioral variables. 33 23–63 yr old migraine sufferers were interviewed; administered the Minnesota Multiphasic Personality Inventory (MMPI); and given a 4-wk diary for recording daily headache activity, physical activity, stressful events, and emotional states. Repeated-measures analyses found significant elevations of stressful events over the 4 days leading up to and including a migraine day. Physical activity declined over the same period. Emotional arousal tended to significance. Regression analyses identified sets of personality and behavioral predictors accounting for substantial variance in the reported numbers of migraine and headache-free days. Results support a model of migraine characterized by parallel physiological and psychosocial instability during a 4-day cycle and by an interaction of personality and behavioral (self-reported stress) functions. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental and physical stress as moderators of the postural response in insulin-dependent diabetic patients.

In 14 insulin-dependent diabetic patients (mean age 31.3 yrs) and in 15 normal controls (mean age 30.9 yrs), continuous measures were taken of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and skin conductance (SC) during postural change under baseline and stressor conditions. Diabetic Ss without symptoms of neuropathy and healthy controls showed generally similar responses to postural change and to stressor conditions (mental arithmetic and isometric handgrip). SBP and DBP were more responsive to mental and physical stressors than were HR or SC, especially after standing. Two diabetics with postural hypotension showed significant increases in overall BP levels and less of a fall in BP during postural change under the stressor conditions, despite minimal HR or SC responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)