Pavlovian conditioning of nausea and vomiting

Stockhorst, Ursula; Steingrueber, Hans-Joachim; Enck, Paul; Klosterhalfen, Sibylle

doi:10.1016/j.autneu.2006.07.012

Cited by 52 publications

(34 citation statements)

References 28 publications

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“…In our rotation experiments, we found gender differences in the unconditioned nausea response to rotation and in the hormonal and the immunological response patterns (see also [34] ). With regard to the unconditioned responses to motionsickness inducing treatment specified below, data from other groups agree that women report more symptoms than men [35] or report a greater incidence in their history of previous motion sickness [36,37] , but do not show differences from males in their symptoms after acute rotation [36,37] .…”

Section: Gender Differences In Rotationmentioning

confidence: 81%

“…As already outlined for animal studies, conditioning techniques that are well known to attenuate the CS-US contingency would be expected to reduce conditioned nausea in the rotation paradigm [34] . Two experiments were conducted in our group using latent inhibition [21] and overshadowing (Stockhorst et al, under revision).…”

Section: Experimental Intervention By Conditioning Techniques In the mentioning

confidence: 99%

“…In the chemotherapy situation, the emetogenity of the cytotoxic drug constitutes the US, the duration and intensity of post-treatment nausea and vomiting (PNV) indicate the duration and intensity of the UR, and the temporal distance between CS exposure and infusion onset (US) indicates the CS-US contiguity [34] .…”

Section: The Correlative and Quasi-experimental Approachmentioning

confidence: 99%

“…Validation of the rotation conditioning paradigm to induce an increase in cortisol and TNF-α, and conditioned taste aversion In pilot studies (25 female and 25 male university students), screening for rotation susceptible subjects, TNF-α and cortisol (in saliva) were measured prior to rotation (= conditioned anticipatory symptoms) and immediately, 15 min and 30 min after the end of the last of a series of maximally five rotations (unconditioned post-rotation symptoms) [34] . Rotation resulted in an immediate increase in post-rotation symptoms of nausea (P < 0.001), and a tendency for an increase in TNF-α (P < 0.10).…”

Section: Motion-sickness Model In Humansmentioning

confidence: 99%

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Role of classical conditioning in learning gastrointestinal symptoms

Stockhorst

Enck²,

Klosterhalfen³

2007

WJG

Self Cite

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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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Section: Gender Differences In Rotationmentioning

confidence: 81%

Section: Experimental Intervention By Conditioning Techniques In the mentioning

confidence: 99%

Section: The Correlative and Quasi-experimental Approachmentioning

confidence: 99%

Section: Motion-sickness Model In Humansmentioning

confidence: 99%

See 2 more Smart Citations

Role of classical conditioning in learning gastrointestinal symptoms

Stockhorst

Enck²,

Klosterhalfen³

2007

WJG

Self Cite

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“…The response is modifiable by experience and can be conditioned (Stockhorst, Steingrueber, Enck, & Klosterhalfen, 2006). Even in well-controlled animal studies, the timing of the emetic response is quite variable.…”

Section: Neurobiology Of Nausea and Vomitingmentioning

confidence: 99%

Why is the neurobiology of nausea and vomiting so important?

2008

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Nausea and vomiting are important as biological systems for drug side effects, disease co-morbidities, and defenses against food poisoning. Vomiting can serve the function of emptying a noxious chemical from the gut, and nausea appears to play a role in a conditioned response to avoid ingestion of offending substances. The sensory pathways for nausea and vomiting, such as gut and vestibular inputs, are generally defined but the problem of determining the brain's final common pathway and central pattern generator for nausea and vomiting is largely unsolved. A neurophysiological analysis of brain pathways provides an opportunity to more closely determine the neurobiology of nausea and vomiting and its prodromal signs (e.g., cold sweating, salivation).

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The Misdiagnosis of Hypertension

Ogedegbe¹,

Pickering²,

Clemow³

et al. 2008

Arch Intern Med

108

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Background-The white coat effect (defined as the difference between blood pressure [BP] measurements taken at the physician's office and those taken outside the office) is an important determinant of misdiagnosis of hypertension, but little is known about the mechanisms underlying this phenomenon. We tested the hypothesis that the white coat effect may be a conditioned response as opposed to a manifestation of general anxiety.Methods-A total of 238 patients in a hypertension clinic wore ambulatory blood pressure monitors on 3 separate days 1 month apart. At each clinic visit, BP readings were manually triggered in the waiting area and the examination room (in the presence and absence of the physician) and were compared with the mercury sphygmomanometer readings taken by the physician in the examination room. Patients completed trait and state anxiety measures before and after each BP assessment.Results-A total of 35% of the sample was normotensive, and 9%, 37%, and 19% had white coat, sustained, and masked hypertension, respectively. The diagnostic category was associated with the state anxiety measure (F 3,237 = 6.4, P < .001) but not with the trait anxiety measure. Patients with white coat hypertension had significantly higher state anxiety scores (t = 2.67, P < . 01), with the greatest difference reported during the physician measurement. The same pattern was observed for BP changes, which generally paralleled the changes in state anxiety (t = 4.86, P < . 002 for systolic BP; t = 3.51, P < .002 for diastolic BP).

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Pavlovian conditioning of nausea and vomiting

Cited by 52 publications

References 28 publications

Role of classical conditioning in learning gastrointestinal symptoms

Role of classical conditioning in learning gastrointestinal symptoms

Why is the neurobiology of nausea and vomiting so important?

The Misdiagnosis of Hypertension

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