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I feel terrible! Can you measure that?: Exploring psychophysiological stress responses and their interactions with performance, subjective reports and health status
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine .ORCID iD: 0000-0003-2530-4126
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite recent research advances, there are still several common medical conditions whose underlying mechanisms are poorly understood. In conditions with few or diffuse physical findings, it can be difficult to diagnose and determine the state of the condition and its effects on working ability or performance, and the health care practitioners have to rely on the patient’s self-reports. Identification of objective measurements that are sensitive enough to aid in diagnosis or determination of the state of these conditions would thus be valuable. Psychophysiological measurements are generally non-invasive and have the potential to serve as such diagnostic or prognostic tools. In this thesis, psychophysiological reactions to different stressors were recorded in two selected medical conditions; namely motion sickness and chronic trapezius myalgia (musculoskeletal pain). These subjective conditions are unpleasant, unwanted and apparently serve no survival purpose. It is therefore important to elucidate any physical findings associated with them to, eventually, find new means to prevent the development of these conditions or to ameliorate symptoms.

The overall aim of the thesis was to explore the development of psychophysiological responses to stressors in relation to performance and subjective reports in healthy individuals and in women with chronic trapezius myalgia. More in detail, the purpose was to identify psychophysiological responses that could provide information about the mechanisms behind, or serve as candidates for characterization of motion sickness and chronic trapezius myalgia, respectively.

Responses to motion sickness, triggered by optokinetic stimulation, were studied in healthy individuals, whereas responses to repetitive low-force work and psychosocial stress were studied in women with chronic trapezius myalgia and in pain-free controls. In both medical conditions, the psychophysiological responses were accompanied by subjective reports. The effects of motion sickness on two different aspects of memory performance were tested during exposure to optokinetic stimulation. In the studies of chronic trapezius myalgia, psychophysiological responses were also related to health status, i.e., being a patient or a pain-free control and measurements of pain intensity, psychological symptoms, sleep-related problems and quality of life.

The psychophysiological responses to optokinetic stimulation were inconclusive. Moderate levels of motion sickness did not affect memory performance, whereas decreased short term memory performance was seen in subjects reporting high levels of motion sickness. The autonomic responses and stress hormone secretion in response to low-force repetitive work and psychosocial stress in the chronic trapezius myalgia group were similar to those of the pain-free controls. However, muscle activity in the trapezius muscle was generally higher in the chronic trapezius myalgia group. There were indications of negative psychological states being related to a slower response and lower circadian variations of stress hormone secretion.

With the present methods, it was possible to measure general stress responses but none of the measurements showed sufficient specificity to serve as predictors or indicators of motion sickness and chronic musculoskeletal pain, respectively. Summarizing, I cannot objectively measure how you feel; I still have to rely on your description of your condition.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2010. , 67 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1164
Keyword [en]
psychophysiology, motion sickness, chronic pain, stressor, performance, autonomic responses, HPA axis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-54345ISBN: 978-91-7393-457-2 (print)OAI: oai:DiVA.org:liu-54345DiVA: diva2:302949
Public defence
2010-04-09, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-03-15 Created: 2010-03-10 Last updated: 2013-09-10Bibliographically approved
List of papers
1. Performance and Autonomic Responses during Motion Sickness
Open this publication in new window or tab >>Performance and Autonomic Responses during Motion Sickness
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2009 (English)In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 51, no 1, 56-66 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the study was to investigate how motion sickness, triggered by an optokinetic drum, affects short term memory performance and to explore autonomic responses to perceived motion sickness.

Background: Previous research has found motion sickness to decrease performance, but it is not known how short term memory in particular is affected.

Method: Thirty-eight healthy participants performed a listening span test while seated in a rotating optokinetic drum. Measurements of motion sickness, performance, heart rate, skin conductance, blood volume pulse, and pupil size were performed simultaneously throughout the experiment.

Results: A total of 16 participants terminated the trial due to severe nausea, while the other 22 endured the full 25 minutes. Perceived motion sickness increased over time in both groups, but less among those who endured the trial. Short term memory performance decreased towards the end for those who terminated, while it increased for the other group. Results from the measured autonomic responses were ambiguous.

Conclusion: The present study concludes that performance, measured as short term memory, declines as perceived motion sickness progresses.

Application: This research has potential implications for command and control personnel in risk of developing motion sickness.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15916 (URN)10.1177/0018720809332848 (DOI)
Available from: 2008-12-16 Created: 2008-12-16 Last updated: 2017-12-14Bibliographically approved
2. Effects of motion sickness on encoding and retrieval performance and on psychophysiological responses
Open this publication in new window or tab >>Effects of motion sickness on encoding and retrieval performance and on psychophysiological responses
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2010 (English)Article in journal (Refereed) Submitted
Abstract [en]

Motion sickness has previously been found to deteriorate performance, e.g., regarding psychomotor functions and short term memory. Sustained ability to perform, despite motion sickness, is crucial in complex working environments. This study focuses on effects of motion sickness on encoding and retrieval of words through the use of long term memory. In addition, the temporal development of different psychophysiological responses and their relationship with perceived motion sickness were investigated. Forty healthy participants performed an encoding and retrieval task during exposure to an optokinetic drum. The results were compared with data from 20 controls that performed the task without motion sickness exposure. Measurements of heart rate, heart rate variability, skin conductance, blood volume pulse, respiration rate, and skin temperature were made throughout optokinetic drum exposure. Data analyses revealed no significant effects of moderate levels of motion sickness on the ability to encode or retrieve words. We found positive relationships between subjective motion sickness ratings and heart rate, blood volume pulse and skin temperature whereas respiration rate was negatively related to perceived motion sickness. The psychophysiological measurements did not show consistent patterns of sympathetic activation and parasympathetic withdrawal, as could be expected. Hence, they are not recommended as predictors of motion sickness.

Keyword
Motion sickness, memory, autonomic responses, performance, optokinetic drum
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54332 (URN)
Available from: 2010-03-10 Created: 2010-03-10 Last updated: 2014-02-27
3. Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia
Open this publication in new window or tab >>Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia
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2009 (English)In: BMC MUSCULOSKELETAL DISORDERS, ISSN 1471-2474, Vol. 10, no 63Article in journal (Refereed) Published
Abstract [en]

Background: Repetitive and stressful work tasks have been linked to the development of pain in the trapezius muscle, although the underlying mechanisms still remain unclear. In earlier studies, it has been hypothesized that chronic muscle pain conditions are associated with imbalance in the autonomic nervous system, predominantly expressed as an increased sympathetic activity. This study investigates whether women with chronic trapezius myalgia show higher muscle activity and increased sympathetic tone at baseline and during repetitive low-force work and psychosocial stress, compared with pain-free controls. Methods: Eighteen women with chronic trapezius myalgia (MYA) and 30 healthy female controls (CON) were studied during baseline rest, 100 min of repetitive low-force work, 20 min of psychosocial stress (Trier Social Stress Test, TSST), and 80 min recovery. The subjects rated their pain intensity, stress and energy level every 20 min throughout the experiment. Muscle activity was measured by surface electromyography in the trapezius muscle (EMGtrap) and deltoid muscle (EMGdelt). Autonomic reactivity was measured through heart rate (HR), skin conductance (SCL), blood pressure (MAP) and respiration rate (Resp). Results: At baseline, EMGtrap, stress ratings, and HR were higher in MYA than in CON. Energy ratings, EMGdelt, SCL, MAP and Resp were, however, similar in the two groups. Significant main group effects were found for pain intensity, stress ratings and EMGtrap. Deltoid muscle activity and autonomic responses were almost identical in MYA and CON during work, stress and recovery. In MYA only, pain intensity and stress ratings increased towards the end of the repetitive work. Conclusion: We found increased muscle activity during uninstructed rest in the painful muscle of a group of women with trapezius myalgia. The present study could not confirm the hypothesis that chronic trapezius myalgia is associated with increased sympathetic activity. The suggestion of autonomic imbalance in patients with chronic local or regional musculoskeletal pain needs to be further investigated.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20186 (URN)10.1186/1471-2474-10-63 (DOI)
Note
Original Publication: Anna Sjors, Britt Larsson, Joakim Dahlman, Torbjorn Falkmer and Bjorn Gerdle, Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia, 2009, BMC MUSCULOSKELETAL DISORDERS, (10), 63, . http://dx.doi.org/10.1186/1471-2474-10-63 Licencee: BioMed Central http://www.biomedcentral.com/ Available from: 2009-09-02 Created: 2009-08-31 Last updated: 2013-09-10
4. Salivary cortisol response to acute stress and its relation to psychological factors in women with chronic trapezius myalgia – a pilot study
Open this publication in new window or tab >>Salivary cortisol response to acute stress and its relation to psychological factors in women with chronic trapezius myalgia – a pilot study
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2010 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 35, no 5, 674-685 p.Article in journal (Refereed) Published
Abstract [en]

This study investigated differences in HPA axis function, measured as salivary cortisol concentrations, between 18 women with chronic trapezius myalgia (MYA) and 30 healthy female controls. In addition, the interactions between HPA axis reactions to psychosocial stress and aspects of pain, health and psychological symptoms were analyzed. Salivary cortisol was measured both in daily life, to assess the circadian profile, and in the laboratory during light repetitive work and standardized psychosocial stress (Trier Social Stress Test, TSST). MYA and CON exhibited similar circadian rhythms and comparable salivary cortisol response magnitudes after TSST. In subjects defined as responders to the TSST, the mean peak time point of the cortisol response after TSST differed significantly between MYA and CON. Furthermore, negative psychological states and higher pain intensity were related to a slower HPA axis response to TSST. Low circadian variations in cortisol and smaller cortisol responses to TSST were found among subjects scoring high on anxiety sensitivity. Thus, a relatively favorable sample of female chronic trapezius myalgia patients exhibited normal circadian rhythm and normal salivary cortisol response magnitudes after a psychosocial stress test. In the subgroup of responders, the MYA group showed indications of a slower salivary cortisol response to psychosocial stress. Further studies are needed to elucidate the possibility of altered HPA axis activity in terms of a slower salivary cortisol response.

Keyword
salivary cortisol; HPA axis; chronic pain; musculoskeletal disorders; stress; Trier Social Stress Test (TSST)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54334 (URN)10.1016/j.psyneuen.2009.10.007 (DOI)000278431500005 ()19900762 (PubMedID)
Available from: 2010-03-10 Created: 2010-03-10 Last updated: 2017-12-12

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