Impaired memory retrieval correlates with individual differences in cortisol response but not autonomic response

Stress can enhance or impair memory performance. Both cortisol release and sympathetic nervous system responses have been implicated in these differential effects. Here we investigated how memory retrieval might be affected by stress-induced cortisol release, independently of sympathetic nervous system stress responses. Thirty-two healthy participants (16 women) learned emotionally arousing and neutral words. One hour later, half of the participants underwent a stressor (cold pressor test) and the other half, a control warm water exposure, both followed by a delayed free recall task. The stressed participants were split into those who did (responders, N = 8) and those who did not (nonresponders, N = 6) show a cortisol response. Both responders and nonresponders showed comparable sympathetic nervous system activity (skin conductance level) during the cold pressor. The cortisol responders recalled significantly fewer words compared to nonresponders, and compared to control participants; this effect was most pronounced for moderately arousing words (compared to highly arousing and neutral words). These results suggest that individual differences in cortisol reactivity affect memory retrieval performance, and help to explain the differential effects of stress on memory.     

Pain perception to the cold pressor test during the menstrual cycle in relation to estrogen levels and a comparison with men.

Animal and human research has shown that pain sensitivity changes during the menstrual cycle. This has sometimes been ascribed to hormonal variations. The aim of the present study was to examine how perception of pain, induced by the cold pressor test to the dominant hand, was related to gender and phases of the menstrual cycle. A repeated-measures design was used, where twenty-two female students participated at two different phases of the menstrual cycle (days 2-4 and days 20-24). A control group of nineteen male students participated on two occasions, separated by a three week period. The cycle phase during which each woman began her participation was randomized. Pain was induced using the cold pressor test. Pain threshold was determined as the duration of time between when the subject first reported pain and exposure to the painful stimulus. Pain tolerance was determined as the duration of time until the subject withdraw her/his hand from the test water because the pain was too intensive. The results showed that men tolerated significantly greater pain than women. Women's pain threshold was significantly higher during the second phase of the menstrual cycle. Systolic pressure was higher in men than women, increasing more in men in response to cold pressor testing than women. Further research, including measurements of plasma hormone levels during the menstrual cycle, is needed to clarify the role played by estrogens in pain perception.     

Sex differences in pain indices, exercise, and use of analgesics

To understand better reported sex differences in sensitivity to pain, this study examined daily pain frequency and intensity, use of analgesics, physical activity, and both subjective and physiological response to acute pain in 18 men and 24 women, healthy people who provided information about their daily pain symptoms and physical activity before completing a cold pressor task. Compared to men, women reported more frequent and intense pain symptoms, as well as more frequent use of analgesics and lower physical activity. Women evinced higher physiological arousal during the cold pressor task but similar subjective pain. The findings highlight the different ways men and women cope with pain and the effect on their responses to acute pain.     

Pain perception to the cold pressor test during the menstrual cycle in relation to estrogen levels and a comparison with men

Animal and human research has shown that pain sensitivity changes during the menstrual cycle. This has sometimes been ascribed to hormonal variations. The aim of the present study was to examine how perception of pain, induced by the cold pressor test to the dominant hand, was related to gender and phases of the menstrual cycle. A repeated-meausres design was used, where twenty-two female students participated at two different phases of the menstrual cycle (days 2–4 and days 20–24). A control group of nineteen male students participated on two occasions, separated by a three week period. The cycle phase during which each woman began her participation was randomized. Pain was induced using the cold pressor test. Pain threshold was determined as the duration of time between when the subject first reported pain and exposure to the painful stimulus. Pain tolerance was determined as the duration of time until the subject withdraw her/his hand from the test water because the pain was too intensive. The results showed that men tolerated significantly greater pain than women. Women’s pain threshold was significantly higher during the second phase of the menstrual cycle. Systolic pressure was higher in men than women, increasing more in men in response to cold pressor testing than women. Further research, including measurments of plasma hormone levels during the menstrual cycle, is needed to clarify the role played by estrogens in pain perception.     

Differences in high and low anxiety sensitive women's responses to a laboratory-based cold pressor task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain-related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16-item measure of AS. Participants were tested individually on a lab-based cold pressor task using a variety of self-report and observer-measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire-Short Form (SF-MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF-MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain-related fear as a mediating variable between AS and increased perceived pain intensity.     

Differences in High and Low Anxiety Sensitive Women's Responses to a Laboratory‐Based Cold Pressor Task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain‐related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16‐item measure of AS. Participants were tested individually on a lab‐based cold pressor task using a variety of self‐report and observer‐measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire – Short Form (SF‐MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF‐MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain‐related fear as a mediating variable between AS and increased perceived pain intensity.     

Active and passive distraction using a head-mounted display helmet: effects on cold pressor pain in children.

OBJECTIVE: The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. DESIGN: Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. MAIN OUTCOME MEASURES: Pain threshold and pain tolerance. RESULTS: Children who experienced either passive or interactive distraction demonstrated significant improvements in both pain tolerance and pain threshold relative to their baseline scores. In contrast, children who underwent a second cold pressor trial without distraction showed no significant improvements in pain tolerance or threshold. CONCLUSION: Although both distraction conditions were effective, the interactive distraction condition was significantly more effective. Implications for the treatment of children's distress during painful medical procedures are discussed.     

Pain sensitivity and individual differences in self-reported sexual behavior

The relationship between sexual behavior and pain sensitivity was assessed in 27 heterosexual men and 20 heterosexual women. Sexual behavior measures included sexual motivation and ratings of subjective sexual arousal to and enjoyment of an auditory stimulus. Pain sensitivity measures were pain threshold and pain tolerance in a cold pressor task. Participants were tested after exposure to a neutral or a sexual audio stimulus. Exposure to the sexual stimulus increased pain sensitivity in women but not in men. However, sexual behavior measures were correlated with pain threshold for both men and women. Specifically, higher pain thresholds were associated with weaker sexual motivation, lower enjoyment potential for sexual interaction, and increased inhibition during intercourse. These results are consistent with findings in laboratory animals, suggesting that differences in sexual behavior may reflect differences in responsiveness to a variety of stimuli.     

Associations of blood pressure with self-report measures of anger and hostility among black and white men and women

This study examined associations between blood pressure (BP) and dispositional variables pertaining to anger and hostility. Black and White 25- to 44-year old male and female normotensives and unmedicated mild to moderate hypertensives completed four reliable self-report scales--the Cook-Medley Hostility (Ho) Scale, the Trait Anger subscale of the State-Trait Anger Scale (STAS-T), and the Cognitive Anger and Somatic Anger subscales of the Cognitive-Somatic Anger Scale--plus the Framingham Anger Scale and the Harburg Anger Scale. They also engaged in three laboratory tasks--Type A Structured Interview (SI), a video game, and a cold pressor task--that elicit cardiovascular reactivity. Ambulatory BP readings at home and at work were also obtained from most subjects. Blacks had significantly higher Ho and lower STAS-T scores than did Whites. Women reported higher levels of somatic anger than did men. White women showed significant positive correlations between STAS-T and systolic BP (SBP) and diastolic BP (DBP) both at rest in the laboratory and during the SI. Black women revealed significant positive relationships between STAS-T and SBP and DBP at rest in the laboratory and at work as well as with DBP during the cold pressor test. For Black men, cognitive anger and DBP at rest were positively related. In contrast, White men revealed significant negative correlations between Ho scores and SBP at rest and during the video game; these men also showed significant negative relationships between somatic anger and SBP and DBP reactivity during the cold pressor test. Women, but not men, showed significant positive relationships between all four anger measures and ambulatory BP at work. Whereas main effects relating anger and cardiovascular measures were not apparent as a function of race, Blacks demonstrated significantly greater SBP and DBP reactivity than Whites during the cold pressor test, with the converse occurring during the SI. Men demonstrated significantly greater DBP reactivity than women during the video game. The present findings indicate that self-reports on anger/hostility measures and cardiovascular responses to behavioral tasks differ as a function of race but that relationships between anger and BP regulation need to take into account possible race-sex interactions and selection of anger/hostility measures.     

Clinical application of medical resonance therapy music in high-risk pregnancies

Music is an ancient method for healing. In the year 550 B.C., Pythagoras from Greece developed a concept for the use of music in medicine, esteeming music higher than many other medical treatments. The Medical Resonance Therapy Music (MRT-Music) of the German classical composer and musicologist Peter Huebner is built on this concept of Pythagorean music medicine. Its therapeutic effect may be best explained by the natural phenomenon of resonance between the harmony laws of the microcosm of music and the biological laws of the body. Results received after application of MRT-Music indicate multiple positive effects on the organism of pregnant women both with a healthy pregnancy as with a pathologic one, reducing the rate of premature births very effectively. Furthermore, MRT-Music came out to be an effective method in the complex therapy of late gestoses and a nearly irreplaceable method for preoperative preparation of pregnant woman for caesarean section. It demonstrated a powerful anti-stress effect and allowd to reduce the amount of administered pain-killers to pregnant women by the factor 1.5 to 2.0 thus reducing the negative pharmacological load to the foetus. It furthermore reduced labour time and shortened hospital stay. It helped to create optimal conditions for the course of pregnancy and heightened pain sensitivity threshold by means of improving the functional, hormonal, and psycho-emotional conditions of pregnant and lying-in women. Thus, the labour process became more natural, the delivery non-traumatic, and motherhood more happy and safe.     

Clinical application of Medical Resonance Therapy Music in high-risk pregnancies.

Music is an ancient method for healing. In the year 550 B.C., Pythagoras from Greece developed a concept for the use of music in medicine, esteeming music higher than many other medical treatments. The Medical Resonance Therapy Music (MRT-Music) of the German classical composer and musicologist Peter Huebner is built on this concept of Pythagorean music medicine. Its therapeutic effect may be best explained by the natural phenomenon of resonance between the harmony laws of the microcosm of music and the biological laws of the body. Results received after application of MRT-Music indicate multiple positive effects on the organism of pregnant women both with a healthy pregnancy as with a pathologic one, reducing the rate of premature births very effectively. Furthermore, MRT-Music came out to be an effective method in the complex therapy of late gestoses and a nearly irreplaceable method for preoperative preparation of pregnant woman for caesarean section. It demonstrated a powerful anti-stress effect and allowed to reduce the amount of administered pain-killers to pregnant women by the factor 1.5 to 2.0, thus reducing the negative pharmacological load to the foetus. It furthermore reduced labour time and shortened hospital stay. It helped to create optimal conditions for the course of pregnancy and heightened pain sensitivity threshold by means of improving the functional, hormonal, and psycho-emotional conditions of pregnant and lying-in women. Thus, the labour process became more natural, the delivery non-traumatic, and motherhood more happy and safe.     

Amygdala functional connectivity is reduced after the cold pressor task

The amygdala forms a crucial link between central pain and stress systems. Previous research indicates that psychological stress affects amygdala activity, but it is less clear how painful stressors influence subsequent amygdala functional connectivity. In the present study, we used pulsed arterial spin labeling (PASL) to investigate differences in healthy male adults’ resting-state amygdala functional connectivity following a cold pressor versus a control task, with the stressor and control conditions being conducted on different days. During the period of peak cortisol response to acute stress (approximately 15–30 min after stressor onset), participants were asked to rest for 6 min with their eyes closed during a PASL scanning sequence. The cold pressor task led to reduced resting-state functional connectivity between the amygdalae and orbitofrontal cortex (OFC) and ventromedial prefrontal cortex, and this occurred irrespective of cortisol release. The stressor also induced greater inverse connectivity between the left amygdala and dorsal anterior cingulate cortex (ACC), a brain region implicated in the down-regulation of amygdala responsivity. Furthermore, the degree of poststressor left amygdala decoupling with the lateral OFC varied according to self-reported pain intensity during the cold pressor task. These findings indicate that the cold pressor task alters amygdala interactions with prefrontal and ACC regions 15–30 min after the stressor, and that these altered functional connectivity patterns are related to pain perception rather than cortisol feedback.     

Cardiovascular and neurohumoral responses to behavioral challenge as a function of race and sex

Cardiovascular and hormonal responses to a structured interview, an electronic video game, a cold pressor test, and exercise on a bicycle ergometer were assessed in eighty-three 25- to 44-year-old normotensive Black and White men and women. Blacks showed significantly greater diastolic blood pressure (DBP) responses than Whites during the cold pressor test, which were not accounted for by an increase in plasma catecholamines. Exercise produced reliably greater systolic blood pressure (SBP) increases in Black women than in Black men or White women. Men showed significantly greater SBP and DBP changes than women during the video game. These findings suggest that the pattern of physiological reactivity elicited by challenge is related to the race and sex of the subjects.     

Hope against the cold: individual differences in trait hope and acute pain tolerance on the cold pressor task

Hope theory (see Snyder, 1994) is presented as a useful framework for understanding reactions to pain. In Study 1, persons scoring higher on the trait Hope Scale (Snyder, Harris et al., 1991) kept their hands in the freezing water (of a cold pressor task) for significantly longer. In Study 2, the higher-hope males, and not females, as measured by both trait and state hope (Snyder, Sympson et al., 1996), recognized the onset of the pain threshold significantly later. Moreover, in Study 2, results showed that individual differences measures of optimism, self-efficacy, depression, and positive and negative affects did not relate to the pain onset and tolerance variables. The implications of hope as related to the pain process and related research are discussed.     

Placental corticotrophin-releasing hormone, local effects and fetomaternal endocrinology

The human placenta produces corticotrophin-releasing hormone (CRH) in exponentially increasing amounts during pregnancy with peak levels during labour. CRH in human pregnancy appears to be involved in many aspects of pregnancy including placental bloodflow, placental prostaglandin production, myornetrial function, fetal pituitary and adrenal function and the maternal stress axis. Since fetal cortisol levels are associated with pulmonary development and maturity, placental CRH may have an indirect role in fetal development.Although the precise role of placental CRH in the regulation of gestational length and timing of parturition is unclear it appears to be involved in a placental clock. While glucocorticoids inhibit hypothalamic CRH production they stimulate CRH gene expression in the placenta.This difference may allow the fetal and maternal stress axes to influence this placental clock.Maternal CRH levels are elevated in many pathological conditions of pregnancy where fetal well-being is compromised, and in these situations it may act to maintain a stable intrauterine environment. Therefore, CRH appears to link placental function, maternal well-being, fetal well-being and fetal development to the duration of gestation and the timing of parturition.     

Pain anxiety among chronic pain patients: specific phobia or manifestation of anxiety sensitivity?

Rather than viewing anxiety among chronic pain patients as simply a component of negative affectivity, investigators have developed a model of "pain anxiety" in which patients develop fear and avoidance of activity linked to pain. We examined whether pain anxiety can be conceptualized as a specific phobia, or whether evidence supported the notion that pain anxiety is better understood as a manifestation of anxiety sensitivity in the context of chronic pain. Chronic musculoskeletal pain patients (N=70) underwent cold pressor and mental arithmetic tasks while cardiovascular, self-report, and behavior indexes were recorded. They completed measures of pain anxiety, anxiety sensitivity, fear of negative evaluation, depression and trait anxiety. Correlation analyses showed pain anxiety was related to pain-relevant responses during cold pressor, but it was also related to evaluation-relevant responses during cold pressor, and to pain- and evaluation-relevant responses (including subtraction accuracy) during mental arithmetic. Regression analyses showed that almost all effects of pain anxiety on task responses were accounted for by anxiety sensitivity. Fear of negative evaluation, in contrast, correlated only with evaluation-relevant responses, and mostly during mental arithmetic. These effects remained significant when depression, trait anxiety, or anxiety sensitivity were statistically controlled. Pain anxiety may be an expression of anxiety sensitivity rather than a circumscribed phobia; a distinction that could profitably guide treatment strategies.     

Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men

This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.     

Sensory information,fear level,and reactions to pain1

An experiment was conducted to investigate the conditions under which sensory information has beneficial versus detrimental value as preparatory information to assist individuals in coping with stress. Fourteen high fear and twelve low fear college women underwent exposure to the cold pressor test. Half of each fear group was provided with sensory information about the sensations produced by the cold pressor and half received a control message. Distress judgments made during the cold pressor showed (a) that sensory information effectively reduced distress for low fear women, but (b) sensory information exacerbated the distress of high fear women—at least during early portions of the cold pressor test. The data generally support Leventhal's (1979) perceptual-motor theory of emotion and have pragmatic implications for those persons who provide preparatory information to individuals anticipating a stressful encounter.     

The role of attentional strategies in moderating links between acute pain induction and subsequent psychological stress: evidence for symptom-specific reactivity among patients with chronic pain versus healthy nonpatients

Vulnerability to stressors after pain may depend on the degree to which the strategy used to process information about pain perpetuates thoughts of suffering and distress. Patients with chronic low back pain (CLBP) may show susceptibility to stress after pain through symptom-specific (lower paraspinal [LP]) muscle reactivity. Patients with CLBP (n = 100) and healthy nonpatients (n = 105) underwent a cold pressor, under sensory focus, distraction, suppression, or control conditions, and then performed mental arithmetic. Only patients under the suppression condition revealed increased LP tension during pain that was sustained during mental arithmetic and sustained systolic blood pressure after mental arithmetic. Patients with CLBP who suppress pain may detrimentally affect responses to the next noxious event, particularly through prolonged LP muscle tension, that may contribute to a cycle of pain-stress-pain.     

The effect of situation-evoked anxiety and gender on pain report using the cold pressor test

The aims of the present study were to investigate the influence of anxiety on pain perception and to test whether gender differences in pain perception are anxiety dependent. Sixty male and female university students exposed to situation-evoked anxiety or a control procedure were measured for their pain threshold, tolerance, and perceived intensity during a cold pressor test. Both subjective and autonomic responses indicated that anxiety was successfully induced in participants exposed to the anxiety condition. Increased situational anxiety had no significant effect on pain threshold or pain tolerance. Significant increases in pain intensity were found for the anxiety group. Levels of anxiety, however, did not correlate with this increased intensity, raising doubt as to the role of anxiety in producing this effect. No gender differences were found for pain tolerance or pain intensity. Gender differences were found for pain threshold in the anxiety group with, contrary to past findings, females showing significantly higher pain thresholds than males. The results are discussed in the light of related studies.