Effects of overshadowing on conditioned nausea in cancer patients: an experimental study

Stockhorst, Ursula; Wiener, J.Andreas; Klosterhalfen, Sibylle; Klosterhalfen, Wolfgang; Aul, Carlo; Steingrüber, Hans-Joachim

doi:10.1016/s0031-9384(98)00135-8

Cited by 64 publications

(66 citation statements)

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“…One of the interesting strategies developed as a result of the study of food aversions in humans is the 'scapegoat' technique (Broberg and Bernstein, 1987;Mattes et al, 1987;Stockhorst et al, 1998). This technique is based on the overshadowing principle underlying the principles of the classical conditioning technique (Pavlov, 1960).…”

Section: Obesity and Eating Disordersmentioning

confidence: 99%

“…It consists of the presentation of a compound of two stimuli as a potential CS, which is paired with the US. The more salient of the stimuli is assumed to override the effects of the less salient one and the conditioned response elicited by the less salient element is weaker than if it alone had been paired with the US (Miller et al, 1990;Stockhorst et al, 1998). Broberg and Bernstein (1987) found that using strongly flavoured candies as scapegoats reduces food aversions during chemotherapy and, thereby, increases food consumption among paediatric patients.…”

Section: Obesity and Eating Disordersmentioning

confidence: 99%

“…entry of the nurse or the doctor, sight of the syringe and of the infusion apparatus, hospital odours) can be associated with the symptoms and acts like a CS in itself. Thereby, after some pairings of CS) and US, some anticipatory symptoms may occur before the onset of the infusion, which clearly indicates conditioning (Stockhorst et al, 1998;Stockhorst et al, 2007). Holmes (1993) reported that 82% of patients under chemotherapy developed food avoidance, whereas, according to Mattes et al (1987), over 50% of patients developed a food aversion after chemotherapy.…”

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confidence: 99%

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Food preferences and aversions in human health and nutrition: how can pigs help the biomedical research?

Clouard

Meunier-Salaün

Val‐Laillet

2012

Animal

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The establishment of food preferences and aversions determines the modulation of eating behaviour and the optimization of food intake. These phenomena rely on the learning and memory abilities of the organism and depend on different psychobiological mechanisms such as associative conditionings and sociocultural influences. After summarizing the various behavioural and environmental determinants of the establishment of food preferences and aversions, this paper describes several issues encountered in human nutrition when preferences and aversions become detrimental to health: development of eating disorders and obesity, aversions and anorexia in chemotherapy-treated or elderly patients and poor palatability of medical substances and drugs. Most of the relevant biomedical research has been performed in rodent models, although this approach has severe limitations, especially in the nutritional field. Consequently, the final aim of this paper is to discuss the use of the pig model to investigate the behavioural and neurophysiological mechanisms underlying the establishment of food preferences and aversions by reviewing the literature supporting analogies at multiple levels (general physiology and anatomy, sensory sensitivity, digestive function, cognitive abilities, brain features) between pigs and humans.Keywords: pig, conditioned learning, eating behaviour, animal model, biomedical applications ImplicationsInvestigation of the behavioural and neurophysiological mechanisms of the establishment of food preferences and aversions can lead to important developments in the context of human nutrition and health. Because the rodent models are not always adequate in this field, there is a need to develop alternative experimental models. Pigs have numerous similarities with humans in terms of the physiology, anatomy, sensory sensitivity, cognitive abilities and brain functions. The aim of this paper is to promote the use of pigs for biomedical research in human nutrition. IntroductionFeeding is a complex behaviour, which can be described as 'the research and consumption of food and drink to maintain vital functions ' (Bellisle, 1999) and to 'fulfil the metabolic needs of the organism ' (Ferreira, 2004). Today, it is also well acknowledged that a high proportion of human food consumption in developed countries appears to be driven by pleasure (for a review, see Lowe and Butryn, 2007) and sociocultural influences. Food consumption is also involved in fundamental metabolic homeostasis regulation, as it controls the supply of energy and nutrients in the organism (Bellisle, 1999). According to Ferreira (2004), feeding behaviour implies that animals learn to consume high-energy foods and to avoid toxic foods. Establishment of food selection implies that, during its first experience with food, the organism memorizes the sensorial characteristics of the food (e.g. taste, odour, texture and visual cues) and the postingestive consequences of its ingestion, and associates these food characteristics with these consequences (Garcia et ...

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Section: Obesity and Eating Disordersmentioning

confidence: 99%

Section: Obesity and Eating Disordersmentioning

confidence: 99%

mentioning

confidence: 99%

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Food preferences and aversions in human health and nutrition: how can pigs help the biomedical research?

Clouard

Meunier-Salaün

Val‐Laillet

2012

Animal

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“…In addition, we studied how conditioning techniques might be used to alleviate AN and ANV responses in healthy subjects that are exposed to an experimental nausea model with rotation as the nausea-inducing stimulus and we considered how to extend the effective methods to patients receiving chemotherapy. An aspect of the conditioning model for chemotherapy that has been considered recently is whether post-chemotherapy nausea is augmented by learning processes, which then add to the unconditioned nausea response [3,7] . This question is also addressed in the present paper.…”

Section: Introductionmentioning

confidence: 99%

Role of classical conditioning in learning gastrointestinal symptoms

Stockhorst

Enck²,

Klosterhalfen³

2007

WJG

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Nausea and/or vomiting are aversive gastrointestinal ( G I ) s y m p t o m s . N a u s e a a n d v o m i t i n g m a n i fe s t unconditionally after a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evidence that nausea and vomiting can also be learned via classical (Pavlovian) conditioning and might occur in anticipation of the nauseogenic event. Classical conditioning of nausea can develop with chemotherapy in cancer patients. Initially, nausea and vomiting occur during and after the administration of cytotoxic drugs (post-treatment nausea and vomiting) as unconditioned responses (UR). In addition, 20%-30% of cancer patients receiving chemotherapy report these side effects, despite antiemetic medication, when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea (AN) and/or anticipatory vomiting (ANV) and are explained by classical conditioning. Moreover, there is recent evidence for the assumption that postchemotherapy nausea is at least partly influenced by learning. After summarizing the relevant assumptions of the conditioning model, revealing that a context can become a conditioned stimulus (CS), the present paper summarizes data that nausea and/or vomiting is acquired by classical conditioning and, consequently, may be alleviated by conditioning techniques. Our own research has focussed on two aspects and is emphasized here. First, a conditioned nausea model was established in healthy humans using body rotation as the nauseainducing treatment. The validity of this motion-sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea and associated endocrine and immunological responses is summarized. Results from the rotation-induced motion sickness model showed that gender is an important moderator variable to be considered in further studies. This paper concludes with a review of the application of the demonstrated conditioning principles as interventions to ameliorate distressing AN/ANV in cancer patients undergoing chemotherapy, which is the second focus of our work.

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“…Pavlovian conditioning and learning have been shown to be in effect with nausea-associated symptoms, such as occur with cancer chemotherapy [27] , and with behavioral treatment modalities, such as latent inhibition and overshadowing, which have been shown to be effective in the prevention and reduction of anticipatory nausea and vomiting (ANV) [28] . Experimental nausea research, e.g.…”

Section: Learning Of Gi Symptoms: the Example Of Nauseamentioning

confidence: 99%