SOMATIC SYMPTOMS AND THE PSYCHOBIOLOGY OF ANXIETY

在焦虑症中，治疗的选择和评估取决于 在很大程度上依赖于患者报告的体细胞学。 是 因此，更好地理解这些关系是很重要的。 病人报告和实际潜在的生理活动之间的联系 在 一般来说，自我报告和生理测量并不相关。 这一发现的可能原因之一是， 在实验室环境中采取的措施， 患者的日常活动。 一种流动监测装置已经被 它可以记录皮肤电导、心率、呼吸， 活动水平，而病人去他们的日常活动。 过去 我们的研究发现，广泛性焦虑症（CAD）患者， 精神指标和阿普唑仑的需求水平相当。 我们 还表明，惊恐障碍（PD）患者表现出较高的自主神经功能， 唤醒（皮肤电导，心率），即使在休息，而广泛性焦虑症患者 作为一个组，与非焦虑的对照组相当。 试点研究， 监测发现GAD患者心率增加，但矛盾的是， 当感到焦虑时皮肤传导性下降。 PD患者显示 在惊恐发作期间，自主神经发生变化，但它们并不总是一致的。 主观经验。 我们建议：1）将GAD患者与 高和低水平的心脏症状和，2）比较广泛性焦虑症患者 PD患者和正常对照组。 具体来说，32个GAD 32名无心悸的患者将佩戴 动态监测装置，可记录8小时。 他们将评级 他们的症状整天和比较将作出之间的 生理记录和自我报告的症状期间， 压力和感知压力。 将在PD中获得类似的记录 患者和正常对照。 这项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， 确定报告不同症状的患者是否在 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相关 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.