SOMATIC SYMPTOMS AND THE PSYCHOBIOLOGY OF ANXIETY

在焦虑症中，治疗的选择和评估取决于 很大程度上取决于患者对躯体症状的报告。它是 因此，重要的是要更好地理解这些关系 患者报告和实际潜在的生理活动之间的差异。在……里面 一般情况下，自我报告和生理指标之间没有很好的相关性。 这一发现的可能原因之一是生理上的 这些措施是在实验室环境中而不是在 患者的日常活动。一种动态监测设备已经被 构建记录皮肤电导、心率、呼吸和 在患者进行日常活动时的活动水平。过去的事 研究发现，广泛性焦虑症(CAD)患者 有类似水平的精神测量和阿普唑仑的需求。我们 也显示惊恐障碍(PD)患者表现出高度的自主神经 即使在休息时也能唤醒(皮肤电导，心率)，而GAD患者 作为一个整体，他们与非焦虑的对照组相当。试点研究与 Monitor发现广泛性AD患者心率增加，但矛盾的是 当感到焦虑时皮肤传导性下降。帕金森病患者表现出 恐慌症发作期间的自主神经变化，但它们并不总是一致的 带着主观体验。我们建议：1)将广泛性AD患者与 心脏症状的高低，以及，2)比较GAD患者 与帕金森病患者和正常对照组比较。具体地说，32个GAD 有和没有心悸的患者将穿上 动态监测装置，用于8小时的记录。他们会评价 他们的症状将在一天中进行比较 治疗期间的生理记录和自我报告的症状 压力和感知到的压力。类似的录音将在PD获得 患者和正常对照组。研究的数据将使我们能够研究 焦虑患者在日常活动中的生理状态 确定报告不同症状组的患者在 潜在的生理活动和是否自我报告的躯体 症状与患者日常生活中的生理指标有关 活动。

In anxiety disorders, the selection and assessment of treatment depend to a large extent on patient reports of somatic symptomatology. It is important, therefore, to obtain a better understanding of the relationships between patient reports and actual underlying physiological activity. In general, self reports and physiological measures do not correlate well. Among the possible reasons for this finding is that the physiological measures have been taken in laboratory settings rather than during patients' usual daily activities. An ambulatory monitoring device has been constructed which records skin conductance, heart rate, respiration, and activity levels while patients go about their daily activities. The past studies we have found that generalized anxiety disorder (CAD) patients who had comparable levels of psychic measures and the need for alprazolam. We also showed that panic disorder (PD) patients showed heightened autonomic arousal (skin conductance, heart rate) even during rest, while GAD patients as a group were comparable to nonanxious controls. Pilot studies with the monitor found GAD patients to have increased heart rate, but, paradoxically a decrease in skin conductance when feeling anxious. PD patients showed autonomic changes during panic attacks, but they were not always consistent with subjective experiences. We propose to: 1) compare GAD patients with high and low levels of cardiac symptoms and, 2) to compare GAD patients with PD patients and normal controls. Specifically, thirty-two GAD patients with and thirty-two without heart palpitations will wear the ambulatory monitoring device for eight hours of recording. They will rate their symptoms throughout the day and comparisons will be made between the physiological recordings and self reported symptoms during periods of stress and perceived stress. Similar recordings will be obtained in PD patients and normal controls. The data of the study will allow us to study physiological states of anxiety patients during everyday activities and, to determine whether patients who report different sets of symptoms differ in underlying physiological activity and whether self reports of somatic symptoms correlate with physiological measures during patients' everyday activities.