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The Psychophysiology of Nausea

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Nausea and Vomiting

Abstract

Nausea is a debilitating and decidedly aversive subjective condition that is experienced by millions of people on a regular basis, yet nowhere near enough is known about its underlying physiological mechanisms or the manner in which it is influenced by behavioral and psychosocial factors to consistently or effectively manage the suffering with which it coincides. The intensity of nausea appears to be a function of the complex interaction of physiological states, individuals’ perceptions or interpretations of those states, and psychological variables such as expectation, control, predictability, stress, distraction, and adaptation. Studies involving the assessment of physiological aspects of nausea have revealed a distinct pattern of reactivity that accompanies reports of symptoms, and is sensitive to the effects of manipulation of psychological variables that affect nausea ratings. Gastric dysrhythmias, parasympathetic nervous system withdrawal, sympathetic nervous system activation, and increases in plasma vasopressin have each been repeatedly demonstrated to relate significantly to reports of nausea. Brain imaging studies are also beginning to explicate central nervous system patterns of activation associated with nausea. The extent to which behavioral and psychosocial factors affect the subjective experience of nausea and its corresponding physiological response profile remains to be adequately understood. If nausea is indeed the result of a complex psychophysiological mechanism, then the satisfactory elucidation of its nature will undoubtedly help inform and promote the development of successful intervention and prevention strategies.

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References

  1. Peyrot des Gachons C, Beauchamp GK, Stern RM, Koch KL, Breslin PA. Bitter taste induces nausea. Curr Biol. 2011;21:R247–8.

    Article  CAS  PubMed  Google Scholar 

  2. Koch KL. Dyspepsia of unknown origin: pathophysiology, diagnosis, and treatment. Dig Dis. 1996;15:316–29.

    Article  Google Scholar 

  3. Zhou M, Popovic M, Pasetka M, Pulenzas N, Ahrari S, Chow E, DeAngelis C. Update on the management of chemotherapy-induced nausea and vomiting – focus on palonosetron. Ther Clin Risk Manag. 2015;11:713–29.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Einarson TR, Piwko C, Koren G. Prevalence of nausea and vomiting of pregnancy in the USA: a meta-analysis. J Popul Ther Clin Pharmacol. 2013;20:e163–70.

    PubMed  Google Scholar 

  5. de Graaf B, Bles W, Bos JE. Roll motion stimuli: sensory conflict, perceptual weighting, and motion sickness. Brain Res Bull. 1998;47:489–95.

    Article  PubMed  Google Scholar 

  6. Stern RM, Koch KL. Motion sickness and differential susceptibility. Curr Dir Psychol Sci. 1996;4:115–20.

    Article  Google Scholar 

  7. Leventhal H, Easterling DV, Nerenz DR, Love RR. The role of motion sickness in predicting anticipatory nausea. J Behav Med. 1998;11:117–30.

    Article  Google Scholar 

  8. Stern RM. The psychophysiology of nausea. Acta Biol Hung. 2002;53:589–99.

    Article  CAS  PubMed  Google Scholar 

  9. Stern RM, Koch KL, Levine ME, Muth ER. Gastrointestinal response. In: Cacioppo JT, Tassinary LG, Berntson GG, editors. Handbook of psychophysiology. 3rd ed. New York: Cambridge University Press; 2007. p. 211–30.

    Chapter  Google Scholar 

  10. Gianaros PJ, Quigley KS, Mordkoff JT, Stern RM. Gastric myoelectrical and autonomic cardiac reactivity to laboratory stressors. Psychophysiology. 2001;38:642–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Gianaros PJ, Stern RM, Morrow GR, Hickok JT. Relationship of gastric myoelectrical and cardiac parasympathetic activity to chemotherapy-induced nausea. J Psychosom Res. 2001;50:263–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Koch KL, Stern RM, Vasey MW, Botti JJ, Creasy GW, Dwyer A. Gastric dysrhythmias and nausea of pregnancy. Dig Dis Sci. 1990;35:961–8.

    Article  CAS  PubMed  Google Scholar 

  13. Levine ME. Sickness and satiety: physiological mechanisms underlying perceptions of nausea and stomach fullness. Curr Gastroenterol Rep. 2005;7:280–8.

    Article  PubMed  Google Scholar 

  14. Koch KL. Diagnosis and treatment of neuromuscular disorders of the stomach. Curr Gastroenterol Rep. 2003;5:323–30.

    Article  PubMed  Google Scholar 

  15. Koch KL, Summy-Long J, Bingaman S, Sperry N, Stern RM. Vasopressin and oxytocin responses to illusory self-motion and nausea in man. J Clin Endocrinol Metabol. 1990;71:1269–75.

    Article  CAS  Google Scholar 

  16. Napadow V, Sheehan JD, Kim J, LaCount LT, Park K, Kaptchuk TJ, Rosen BR, Kuo B. The brain circuitry underlying the temporal evolution of nausea in humans. Cereb Cortex. 2013;23:806–13.

    Article  PubMed  Google Scholar 

  17. Cowings PS, Suter S, Toscano WB, Kamiya J, Naifeh K. General autonomic components of motion sickness. Psychophysiology. 1986;23:542–51.

    Article  CAS  PubMed  Google Scholar 

  18. Hu S, Grant WF, Stern RM, Koch KL. Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum. Aviat Space Environ Med. 1991;62:308–14.

    CAS  PubMed  Google Scholar 

  19. Koch KL, Stern RM, Vasey MW, Seaton JF, Demers LM, Harrison TS. Neuroendocrine and gastric myoelectrical responses to illusory self-motion in humans. Am J Physiol. 1990;258:E304–10.

    CAS  PubMed  Google Scholar 

  20. Hu S, Stern RM, Vasey MW, Koch KL. Motion sickness and gastric myoelectric activity as a function of speed of rotation of a circular vection drum. Aviat Space Environ Med. 1989;60:411–4.

    CAS  PubMed  Google Scholar 

  21. Koch KL, Stern RM. Handbook of electrogastrography. New York: Oxford University Press; 2004.

    Google Scholar 

  22. Levine ME, Muth ER, Gianaros PJ, Stern RM. Electrogastrographic correlates of nausea. Dig Dis Sci. 2000;45:1248.

    Google Scholar 

  23. Hu S, Stern RM, Koch KL. Electrical acustimulation relieves vection-induced motion sickness. Gastroenterology. 1992;102:1854–8.

    Article  CAS  PubMed  Google Scholar 

  24. Stern RM, Hu S, Anderson RB, Leibowitz HW, Koch KL. The effects of fixation and restricted visual field on vection-induced motion sickness. Aviat Space Environ Med. 1990;61:712–5.

    CAS  PubMed  Google Scholar 

  25. Stern RM, Hu S, LeBlanc R, Koch KL. Chinese hypersusceptibility to vection-induced motion sickness. Aviat Space Environ Med. 1993;64:827–30.

    CAS  PubMed  Google Scholar 

  26. Stern RM, Koch KL, Leibowitz HW, Lindblad IM, Shupert CL, Stewart WR. Tachygastria and motion sickness. Aviat Space Environ Med. 1985;56:1074–7.

    CAS  PubMed  Google Scholar 

  27. Geldof H, van der Schee EJ, van Blankenstein M, Grashuis JL. Gastric dysrhythmia: an electrogastrographic study. Gastroenterology. 1983;84:1163.

    Google Scholar 

  28. Uijtdehaage SHJ, Stern RM, Koch KL. Effects of scopolamine on autonomic profiles underlying motion sickness susceptibility. Aviat Space Environ Med. 1993;64:1–8.

    CAS  PubMed  Google Scholar 

  29. Weinstein SE, Stern RM. Comparison of marezine and dramamine in preventing symptoms of motion sickness. Aviat Space Environ Med. 1997;68:890–4.

    CAS  PubMed  Google Scholar 

  30. Levine ME, Chillas JC, Stern RM, Knox GW. Effects of serotonin (5-HT3) receptor antagonists on gastric tachyarrhythmia and the symptoms of motion sickness. Aviat Space Environ Med. 2000;71:1111–4.

    CAS  PubMed  Google Scholar 

  31. Stern RM, Uijtdehaage SHJ, Muth ER, Koch KL. Effects of phenytoin on vection-induced motion sickness and gastric myoelectric activity. Aviat Space Environ Med. 1994;65:518–21.

    CAS  PubMed  Google Scholar 

  32. Koch KL, Stern RM. Functional disorders of the stomach. Semin Gastrointest Dis. 1990;1:23–36.

    CAS  PubMed  Google Scholar 

  33. Koch KL. Gastrointestinal factors in nausea and vomiting of pregnancy. Am J Obstet Gynecol. 2002;186:S198–203.

    Article  PubMed  Google Scholar 

  34. Jednak MA, Shadigian EM, Kim MS, Woods ML, Hooper FG, Owyang C, Hasler WL. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol. 1999;277:G855–61.

    CAS  PubMed  Google Scholar 

  35. DiBaise JK, Brand RE, Lyden E, Tarantolo SR, Quigley EM. Gastric myoelectrical activity and its relationship to the development of nausea and vomiting after intensive chemotherapy and autologous stem cell transplantation. Am J Gastroenterol. 2001;96:2873–81.

    Article  CAS  PubMed  Google Scholar 

  36. Berntson GG, Cacioppo JT, Binkley PF, Uchino BN, Quigley KS, Fieldstone A. Autonomic cardiac control. III Psychological stress and cardiac response in autonomic space as revealed by pharmacological blockades. Psychophysiology. 1994;31:599–608.

    Article  CAS  PubMed  Google Scholar 

  37. Vybiral T, Byrg RJ, Maddens ME, Boden WE. Effect of passive tilt on sympathetic and parasympathetic components of heart rate variability in normal subjects. Am J Cardiol. 1989;63:1117–20.

    Article  CAS  PubMed  Google Scholar 

  38. Dawson ME, Schell A, Filion DL. The electrodermal system. In: Cacioppo JT, Tassinary LG, Berntson GG, editors. Handbook of psychophysiology. 2nd ed. New York: Cambridge University Press; 2000. p. 200–23.

    Google Scholar 

  39. Uijtdehaage SHJ, Stern RM, Koch KL. Effects of eating on vection-induced motion sickness, cardiac vagal tone, and gastric myoelectric activity. Psychophysiology. 1992;29:193–201.

    Article  CAS  PubMed  Google Scholar 

  40. Berntson GG, Cacioppo JT, Quigley KS. Respiratory sinus arrhythmia: autonomic origins, physiological mechanisms, and psychophysiological implications. Psychophysiology. 1993;30:183–96.

    Article  CAS  PubMed  Google Scholar 

  41. Levine ME, Muth ER, Williamson MJ, Stern RM. Protein-predominant meals inhibit the development of gastric tachyarrhythmia, nausea, and the symptoms of motion sickness. Aliment Pharmacol Ther. 2004;19:583–90.

    Article  CAS  PubMed  Google Scholar 

  42. Hasler WL, Kim MS, Chey WD, Stevenson V, Stein B, Owyang C. Central cholinergic and α-adrenergic mediation of gastric slow wave dysrhythmias evoked during motion sickness. Am J Physiol. 1995;268:G539–47.

    CAS  PubMed  Google Scholar 

  43. Levine ME, Stern RM. The use of facial cooling for the management of motion-induced nausea and gastric dysrhythmia. Psychosom Med. 2015;77:A112.

    Google Scholar 

  44. Morrow GR, Andrews PL, Hickok JT, Stern RM. Vagal changes following cancer chemotherapy: implications for the development of nausea. Psychophysiology. 2000;37:378–84.

    Article  CAS  PubMed  Google Scholar 

  45. Koch KL. A noxious trio: nausea, gastric dysrhythmias, and vasopressin. Neurogastroenterol Motil. 1997;9:141–2.

    Article  CAS  PubMed  Google Scholar 

  46. Caras SD, Soykan I, Beverly V, Lin Z, McCalum RW. The effect of intravenous vasopressin on gastric myoelectrical activity in humans. Neurogastroenterol Motil. 1997;9:151–6.

    Article  CAS  PubMed  Google Scholar 

  47. Kim J, Napadow V, Kuo B, Barbieri R. A combined HRV-fMRI approach to assess cortical control of cardiovagal modulation by motion sickness. Conference proceedings of the IEEE engineering in medicine and biological society, 2011. p. 2825–8.

    Google Scholar 

  48. Napadow V, Sheehan J, Kim J, Dassatti A, Thurler AH, Surjanhata B, Vangel M, Makris N, Schaechter JD, Kuo B. Brain white matter microstructure is associated with susceptibility to motion-induced nausea. Neurogastroenterol Motil. 2013;25:448–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Stern RM, Koch KL. Motion sickness. Motil. 1991;16:11–4.

    Google Scholar 

  50. Roscoe JA, Morrow GR, Hickok JT, Stern RM. Nausea and vomiting remain a significant clinical problem: trends over time in controlling chemotherapy-induced nausea and vomiting in 1413 patients treated in community clinical practices. J Pain Symptom Manage. 2000;20:113–21.

    Article  CAS  PubMed  Google Scholar 

  51. Kirsch I. How expectancies shape experience. New York: American Psychological Association; 1999.

    Book  Google Scholar 

  52. Kirsch I. Response expectancy as a determinant of experience and behavior. Am Psychol. 1985;40:1189–202.

    Article  Google Scholar 

  53. Montgomery GH, Tomoyasu N, Bovbjerg DH, Andrykowski MA, Currie VF, Jacobsen PB, Redd WH. Patients’ pretreatment expectations of chemotherapy-related nausea are independent predictor of anticipatory nausea. Ann Behav Med. 1998;20:104–9.

    Article  CAS  PubMed  Google Scholar 

  54. Roscoe MA, Hickok JT, Morrow GA. Patient expectations as a predictor of chemotherapy induced nausea. Ann Behav Med. 2000;22:121–6.

    Article  CAS  PubMed  Google Scholar 

  55. Eden D, Zuk B. Seasickness as a self-fulfilling prophecy: raising self-efficacy to boost performance at sea. J Appl Psychol. 1995;9:628–35.

    Article  Google Scholar 

  56. Mearin F, Balboa A, Zarate N, Cucala M, Malagelada JR. Placebo in functional dyspepsia: symptomatic, gastrointestinal, motor, and gastric sensorial responses. Am J Gastroenterol. 1999;94:116–25.

    Article  CAS  PubMed  Google Scholar 

  57. Stern RM, Jokerst MD, Muth ER, Hollis C. Acupressure relieves the symptoms of motion sickness and reduces abnormal gastric activity. Altern Ther Health Med. 2001;7:91–4.

    CAS  PubMed  Google Scholar 

  58. Fields HL, Price DD. Toward a neurobiology of placebo analgesia. In: Harrington A, editor. The placebo effect: an interdisciplinary exploration. Cambridge: Harvard University Press; 1997. p. 93–116.

    Google Scholar 

  59. Price DD, Fields HL. The contribution of desire and expectation to placebo analgesia: implications for new research strategies. In: Harrington A, editor. The placebo effect: an interdisciplinary exploration. Cambridge: Harvard University Press; 1997. p. 117–37.

    Google Scholar 

  60. Ross M, Olson JM. An expectancy-attribution model of the effects of placebos. Psychol Rev. 1981;88:408–37.

    Article  CAS  PubMed  Google Scholar 

  61. Levine ME, Stern RM, Koch KL. The effects of manipulating expectations through placebo and nocebo administration on gastric tachyarrhythmia and motion-induced nausea. Psychosom Med. 2006;68:478–86.

    Article  PubMed  Google Scholar 

  62. Williamson MJ, Thomas MJ, Stern RM. The contribution of expectations to motion sickness symptoms and gastric activity. J Psychosom Res. 2004;56:721–6.

    Article  PubMed  Google Scholar 

  63. Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, Burke TA, Gu A, Rolia F. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manage. 2014;47:839–48.

    Article  PubMed  Google Scholar 

  64. Morrow GR, Lindke J, Black PM. Anticipatory nausea development in cancer patients; replication and extension of a learning model. Br J Psychol. 1991;82:61–72.

    Article  PubMed  Google Scholar 

  65. Levine ME, Puzino KM, Koch KL. Anticipatory nausea in cancer chemotherapy: predicting its incidence and severity to facilitate the development of effective interventions. Psychosom Med. 2011;73:A56.

    Google Scholar 

  66. Abelson JL, Khan S, Liberzon I, Erickson TM, Young EA. Effects of perceived control and cognitive coping on endocrine stress responses to pharmacological activation. Biol Psychiatry. 2008;64:701–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Gerin W, Pieper C, Marchese L, Pickering TG. The multi-dimensional nature of active coping: differential effects of effort and enhanced control on cardiovascular reactivity. Psychosom Med. 1992;54:707–19.

    Article  CAS  PubMed  Google Scholar 

  68. Peters ML, Godaert GLR, Ballieux RE, van Vliet M, Willemsen JJ, Sweep FCGJ, Heijnen CJ. Cardiovascular and endocrine responses to environmental stress: effects of mental effort and controllability. Psychoneuroendocrinology. 1998;23:1–17.

    Article  CAS  PubMed  Google Scholar 

  69. Abbott BB, Schoen LS, Badia P. Predictable and unpredictable shock: behavioral measures of aversion and physiological measures of stress. Psychol Bull. 1984;96:45–71.

    Article  CAS  PubMed  Google Scholar 

  70. Oka S, Chapman CR, Kim B, Shimizu O, Noma N, Takeichi O, Imamura Y, Oi Y. Predictability of painful stimulation modulates subjective and physiological responses. J Pain. 2010;11:239–46.

    Article  PubMed  Google Scholar 

  71. Sapolsky RM. Why zebras don’t get ulcers: an updated guide to stress, stress-related diseases, and coping. New York: W.H. Freeman and Company; 1998.

    Google Scholar 

  72. Levine ME, Stern RM, Koch KL. Enhanced perceptions of control and predictability reduce motion-induced nausea and gastric dysrhythmia. Exp Brain Res. 2014;232:2675–84.

    Article  PubMed  Google Scholar 

  73. Marten PA, Brown TA, Barlow DH, Borkovec TD, Shear MK, Lydiard RB. Evaluation of the ratings comprising the associated symptom criterion of DSM-III-R generalized anxiety disorder. J Nerv Ment Dis. 1993;181:676–82.

    Article  CAS  PubMed  Google Scholar 

  74. Jacobsen PB, Andrykowski MA, Redd WH, Die-Trill M, Hakes TB, Kaufman RJ, Currie VE, Holland JC. Nonpharmacologic factors in the development of posttreatment nausea with adjuvant chemotherapy for breast cancer. Cancer. 1988;61:379–85.

    Article  CAS  PubMed  Google Scholar 

  75. Andrykowski MA. The role of anxiety in the development of anticipatory nausea in cancer chemotherapy: a review and synthesis. Psychosom Med. 1990;52:458–75.

    Article  CAS  PubMed  Google Scholar 

  76. Chellew W, Evans P, Fornes-Vives J, Perez G, Garcia-Banda G. The effect of progressive muscle relaxation on daily cortisol secretion. Stress. 2015;18:538–44.

    Article  PubMed  Google Scholar 

  77. Unger CA, Busse D, Yim IS. The effect of guided relaxation on cortisol and affect; stress reactivity as a moderator. J Health Psychol. 2015;20:1–10.

    Article  Google Scholar 

  78. Levine ME, Puzino KM, Crovello NJ. Sit back and relax: the effects of progressive muscle relaxation on motion-induced nausea and gastric dysrhythmia. Poster presented at the annual meeting of the association for psychological science, New York; 2015.

    Google Scholar 

  79. Cohen LL, Cohen RJ, Blount RL, Schaen ER, Zaff JF. Comparative study of distraction versus topical anesthesia for pediatric pain management during immunizations. Health Psychol. 1999;18:591–8.

    Article  CAS  PubMed  Google Scholar 

  80. McCaul KD, Monson N, Maki RH. Does distraction reduce pain-produced distress among college students? Health Psychol. 1992;11:210–7.

    Article  CAS  PubMed  Google Scholar 

  81. Levine ME, Puzino KM. Music helps but shadowing doesn’t: the effects of emotional and cognitive distraction on motion-induced nausea and gastric dysrhythmia. Psychosom Med. 2013;75:A87.

    Article  Google Scholar 

  82. Stern RM, Hu S, Vasey MW, Koch KL. Adaptation to vection-induced symptoms of motion sickness. Aviat Space Environ Med. 1989;60:566–72.

    CAS  PubMed  Google Scholar 

  83. Williamson MJ. Visual-vestibular adaptation for motion sickness rehabilitation. Unpublished doctoral dissertation, The Pennsylvania State University/University Park, 2003.

    Google Scholar 

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  1. Department of Psychology, Siena College, 515 Loudon Road, Loudonville, NY, 12211, USA

    Max E. Levine PhD

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  1. Section on Gastroenterology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA

    Kenneth L. Koch

  2. Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA

    William L. Hasler

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Levine, M.E. (2017). The Psychophysiology of Nausea. In: Koch, K., Hasler, W. (eds) Nausea and Vomiting. Springer, Cham. https://doi.org/10.1007/978-3-319-34076-0_14

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  • DOI: https://doi.org/10.1007/978-3-319-34076-0_14

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