The Psychophysiology of Nausea

Abstract

Nausea is an unpleasant sensation usually referred to the stomach and sometimes followed by vomiting. Little is known about the subjective aspects of nausea because like pain and fatigue, it is a private sensation. We conceive of nausea as a complex control mechanism that signals us when not to eat. Our research in the areas of motion sickness and chemotherapy has led us to propose that we each have a dynamic threshold for nausea, which depends on the interaction of inherent factors and more changeable psychological factors, and that this threshold effects the individual’s cognitive appraisal of both the nauseogenic stimulus and his/her bodily change in response to the nauseogenic stimulus. Inherent factors that are described are age, gender and race; psychological factors that are included are anxiety, expectation, anticipation and adaptation. The physiological responses that have been found to accompany nausea include an increase in sympathetic nervous system activity, a decrease in parasympathetic activity, an increase of abnormal dysrhythmic gastric activity, and an increase in plasma vasopressin. It is concluded that beneficial selective reduction of nausea will depend on a greater knowledge of the interaction of the psychological and physiological variables.

References

  1. 1.

    Andrykowski, M. A. (1990) The role of anxiety in the development of anticipatory nausea in cancer chemotherapy: A review and synthesis. Psychosom. Med. 52, 458–475.

    CAS  Article  Google Scholar 

  2. 2.

    Edwards, C., Carmichael, J., Baylis, P., Harris, A. (1989) Arginine vasopressin–a mediator of chemotherapy induced emesis. Brit. J. Cancer 59, 467.

    CAS  Article  Google Scholar 

  3. 3.

    Eversmann, T., Gottsmann, M., Uhlich, E., Ulbrecht, G., von Werder, K., Scriba, P. C. (1978) Increased secretion of growth hormone, prolactin, antidiuretic hormone, and cortisol induced by the stress of motion sickness. Aviation, Space and Environmental Medicine 49, 53–57.

    CAS  Google Scholar 

  4. 4.

    Feldman, M., Samson, W. K., O’Dorisio, T. M. (1988) Apomorphine-induced nausea in humans: Release of vasopressin and pancreatic polypeptide. Gastroenterology 95, 721–726.

    CAS  Article  Google Scholar 

  5. 5.

    Gianaros, P. J., Stern, R. M., Morrow, C. R., Hickok, J. T. (2001) Relationship of gastric myoelectrical and cardiac parasympathetic activity to chemotherapy-induced nausea. J. Psychosom. Res. 50, 263–266.

    CAS  Article  Google Scholar 

  6. 6.

    Gianaros, P. J., Quigley, K. S., Mordkoff, J. T., Stern, R. M. (2001) Gastricmyoelectrical and autonomic cardiac reactivity to laboratory stressors. Psychophysiology 38, 1–11.

    Article  Google Scholar 

  7. 7.

    Grant, P. J., Hughes, J. R., Dean, H. G., Davies, J. A., Prentice, C. R. M. (1986) Vasopressin and catecholamine secretion during apomorphine-induced nausea mediate acute changes in hemostatic function in man. Clin. Sci. 71, 621–624.

    CAS  Article  Google Scholar 

  8. 8.

    Hawthorn, J., Andrews, P. L. R., Ang, V. T. Y., Jenkins, J. S. (1988) Differential release of vasopressin and oxytocin in response to abdominal vagal afferent stimulation of apomorphine in the ferret. Brain Res. 438, 193–198.

    CAS  Article  Google Scholar 

  9. 9.

    Jacobsen, P. B., Andrykowski, M. A., Redd, W. H., Die- Trill, M., Hakes, T. B., Kaufman, R. J., Currie, V. E., Holland, J. C. (1988) Nonpharmacologic factors in the development of post treatment nausea with adjuvant chemotherapy for breast cancer. Cancer 61, 379–385.

    CAS  Article  Google Scholar 

  10. 10.

    Jokerst, M. D., Gatto, M., Fazio, R., Gianaros, P. J., Stern, R. M., Koch, K. L. (1999) Effects of gender of subjects and experimenter on susceptibility to motion sickness. Aviation, Space and Environmental Medicine 70, 962–965.

    CAS  Google Scholar 

  11. 11.

    Kelly, K. (1993) A neural control of gastric electrical and motor activity. In: Brooks, F. P., Evers, P. W. (eds). Nerves and the Gut. Slack, Thorofare, New Jersey.

    Google Scholar 

  12. 12.

    Kirsch, I. (1999). How Expectancies Shape Experience. American Psychological Association, Washington, D.C. pp. 5–8.

    Book  Google Scholar 

  13. 13.

    Koch, K. L., Stern, R. M., Vasey, M. W., Seaton, J. F., Demers, L. M., Harrison, T. S. (1990) Neuroendocrine and gastric myoelectric responses to illusory self-motion in men. Am. J. Physiol. 258, E304–E310.

    CAS  PubMed  Google Scholar 

  14. 14.

    Levine, M. E., Stern, R. M. (2002) The effect of placebo-induced expectations on gastric tachyarrhythmia and vection-induced nausea. Neurogastroenterology and Motility. 14, 319.

    Google Scholar 

  15. 15.

    Marten, P. A., Brown, T. A., Barlow, D. H., Borkovec, T. D., Shear, K. M., Lydiard, R. B. (1993) Evaluation of the ratings comprising the associated symptom criterion of DSM-III-R Generalized Anxiety Disorder. J. Nervous & Mental Disorders 181, 676–682.

    CAS  Article  Google Scholar 

  16. 16.

    Morrow, G. R. (1989) Chemotherapy-related nausea and vomiting: Etiology and management. Cancer 39, 89–104.

    CAS  Google Scholar 

  17. 17.

    Reason, J. T., Brand, J. J. (1975). Motion Sickness. Academic Press, London.

    Google Scholar 

  18. 18.

    Robertson, G. L. (1977) The regulation of vasopressin function in health and disease. Recent Progr. Hormonal Res. 33, 333–385.

    Google Scholar 

  19. 19.

    Stern, R. M., Koch, K. L., Muth, E. R. (2000) Gastrointestinal System. In: Cacioppo, J. T., Tassinary, L. G., Berntson, G. G. (eds). Handbook of Psychophysiology, 2nd ed. Cambridge University Press, Cambridge, pp.

    Google Scholar 

  20. 20.

    Stern, R. M., Koch, K. L. (1996) Motion sickness and differential susceptibility. Curr. Directions Psycholog. Sci. 5, 115–120.

    Article  Google Scholar 

  21. 21.

    Stern, R. M., Hu, S., LeBlanc, R., Koch, K. L. (1993) Chinese hyper-susceptibility to vection-induced motion sickness. Aviation, Space and Environmental Medicine 64, 827–830.

    CAS  Google Scholar 

  22. 22.

    Stern, R. M., Hu, S., Uijtdehaage, S. H. J., Muth, E. R., Xu, L. H., Koch, K. L. (1996) Asian hypersusceptibility to motion sickness. Human Heredity 46, 7–14.

    CAS  Article  Google Scholar 

  23. 23.

    Stern, R. M., Hu, S., Vasey, M. W., Koch, K. L. (1989) Adaptation to vection-induced symptoms of motion sickness. Aviation, Space, and Environmental Medicine 60, 566–571.

    CAS  PubMed  Google Scholar 

  24. 24.

    Verbalis, J. G., Richardson, D. W., Stricker, E. M. (1987) Vasopressin release in response to nauseaproducing agents and cholecystokinin in monkeys. Am. J. Physiol. 252, 749–753.

    Google Scholar 

  25. 25.

    Xu, L. H., Koch, K. L., Summy- Long, J., Stern, R. M., Seaton, J. F., Harrison, T. S., Demers, L. M., Bingaman, S. (1993) Hypothalamic and gastric myoelectric responses during vection-induced nausea in healthy Chinese subjects. Am. J. Physiol. 265, E578–E584.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to R. M. Stern.

Additional information

Dedicated to Professor György Ádám on the occasion of his 80th birthday.

Rights and permissions

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Cite this article

Stern, R.M. The Psychophysiology of Nausea. BIOLOGIA FUTURA 53, 589–599 (2002). https://doi.org/10.1556/ABiol.53.2002.4.17

Download citation

Keywords

  • Nausea
  • chemotherapy
  • motion sickness
  • gastric dysrhythmia
  • autonomic nervous system