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 very 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. The construction of an ambulatory monitoring device is proposed as a means of recording skin conductance, heart rate, respiration and activity levels while patients go about their daily life activities. In a past study we found that although correlations between self report and physiology are low, patients are able to perceive the direction of changes in physiologcial activity under stress. In another study we found that patients with high levels of autonomic arousal differ on several somatic ratings from patients with low levels. In still another study we have found that patients with high ratings of autonomic symptomatology require higher doses of alprazolam for treatment than do those with low ratings. In the proposed study, we wish to determine whether patients with high and low levels of autonomic symptomatology differ in underlying physiological activity. Two groups of patients, one with and one without high levels of sympathetic nervous system activity, will be compared by means of the ambulatory monitoring device. Specifically, 32 patients who do, and 32 who do not, present with heart palpitations and sweaty palms will wear the ambulatory monitoring device for 8 hours of recording. They will rate their symptoms throughout the day and comparisons will be made between the physiological recordings of the two groups and between the self reported symptoms and physiological recordings of two groups under different levels of perceived stress. Data from the study will allow us to determine whether patients who report different sets of symptoms differ in underlying physiological activity, and whether self reports of somatic symptoms correlate with actual physiologcial measures during patients' everyday activities.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH042579-02
Application #
3381783
Study Section
Psychopathology and Clinical Biology Research Review Committee (PCB)
Project Start
1987-03-01
Project End
1989-02-28
Budget Start
1988-03-01
Budget End
1989-02-28
Support Year
2
Fiscal Year
1988
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Type
Schools of Medicine
DUNS #
045911138
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Hoehn-Saric, Rudolf; McLeod, Daniel R; Funderburk, Frank et al. (2004) Somatic symptoms and physiologic responses in generalized anxiety disorder and panic disorder: an ambulatory monitor study. Arch Gen Psychiatry 61:913-21
Hoehn-Saric, R; McLeod, D R (2000) Anxiety and arousal: physiological changes and their perception. J Affect Disord 61:217-24
Hoehn-Saric, R; Hazlett, R L; Pourmotabbed, T et al. (1997) Does muscle tension reflect arousal? Relationship between electromyographic and electroencephalographic recordings. Psychiatry Res 71:49-55
Pourmotabbed, T; Mcleod, D R; Hoehn-Saric, R et al. (1996) Treatment, discontinuation, and psychomotor effects of diazepam in women with generalized anxiety disorder. J Clin Psychopharmacol 16:202-7
Hoehn-Saric, R; McLeod, D R; Hipsley, P (1995) Is hyperarousal essential to obsessive-compulsive disorder? Diminished physiologic flexibility, but not hyperarousal, characterizes patients with obsessive-compulsive disorder. Arch Gen Psychiatry 52:688-93
Hoehn-Saric, R; McLeod, D R; Zimmerli, W D et al. (1993) Symptoms and physiologic manifestations in obsessive compulsive patients before and after treatment with clomipramine. J Clin Psychiatry 54:272-6
McLeod, D R; Hoehn-Saric, R; Porges, S W et al. (1992) Effects of alprazolam and imipramine on parasympathetic cardiac control in patients with generalized anxiety disorder. Psychopharmacology (Berl) 107:535-40
Hoehn-Saric, R; McLeod, D R (1987) Cardiac symptoms and anxiety disorders: contributing factors and pharmacologic treatment. Am J Cardiol 60:68J-73J