TY  - JOUR
A1  - Pollatos, Olga
A1  - Dietel, Anja
A1  - Herbert, Beate M.
A1  - Wankner, Sarah
A1  - Wachsmuth, Cornelia
A1  - Henningsen, Peter
A1  - Sack, Martin
T1  - Blunted autonomic reactivity and increased pain tolerance in somatoform patients
JF  - Pain : journal of the International Association for the Study of Pain
N2  - Somatoform disorders are characterized by the presence of multiple somatic symptoms. Patients often experience different pain syndromes, and recent research suggests that sympathovagal balance is disturbed in somatoform patients, which could be related to alteration in pain sensitivity. This study analyzed how proposed sympathovagal imbalance interacts with objective pain assessment and the imagination of pain in somatoform disorders. Twenty-one patients (4 men) with diagnosed multisomatoform disorder were included in the study and matched to healthy control subjects. Autonomic measures and heart rate variability were assessed during baseline; pain perception was assessed by means of a pressure algometer and pain imagination. We found evidence for a sympathovagal imbalance in somatoform disorders characterized by low parasympathetic activation and high sympathetic activation during all conditions. Additionally, somatoform patients had reduced pain tolerance. Vagal withdrawal during pain assessment was more pronounced for healthy control subjects and correlated positively with assessed pain tolerance. During imagination somatoform, patients reported higher pain unpleasantness and higher pain intensity as compared to control subjects. We conclude that our data demonstrate an imbalance in sympathovagal activation and a hyposensitivity to pain tolerance stimuli in somatoform disorders. Parasympathetic reactivity might form crucial information when judging pain-associated affective-motivational components. Our results might be attributable to a deficient detection of visceral signals and might be a pathogenetic mechanism for the development of emotional difficulties and increased everyday vulnerability in somatoform patients.
KW  - Autonomic
KW  - Heart rate variability
KW  - Pain threshold
KW  - Pain tolerance
KW  - Response
KW  - Somatoform disorder
KW  - Sympathovagal balance
Y1  - 2011
U6  - https://doi.org/10.1016/j.pain.2011.05.024
SN  - 0304-3959
VL  - 152
IS  - 9
SP  - 2157
EP  - 2164
PB  - Elsevier
CY  - Amsterdam
ER  - 
TY  - JOUR
A1  - Pollatos, Olga
A1  - Herbert, Beate M.
A1  - Wankner, Sarah
A1  - Dietel, Anja
A1  - Wachsmuth, Cornelia
A1  - Henningsen, Peter
A1  - Sack, Martin
T1  - Autonomic imbalance is associated with reduced facial recognition in somatoform disorders
JF  - Journal of psychosomatic research
N2  - Objectives: Somatoform disorders are characterized by the presence of multiple somatic symptoms. While the accuracy of perceiving bodily signal (interoceptive awareness) is only sparely investigated in somatoform disorders, recent research has associated autonomic imbalance with cognitive and emotional difficulties in stress-related diseases. This study aimed to investigate how sympathovagal reactivity interacts with performance in recognizing emotions in faces (facial recognition task).
 Methods: Using a facial recognition and appraisal task, skin conductance levels (SCLs), heart rate (HR) and heart rate variability (HRV) were assessed in 26 somatoform patients and compared to healthy controls. Interoceptive awareness was assessed by a heartbeat detection task.
 Results: We found evidence for a sympathovagal imbalance in somatoform disorders characterized by low parasympathetic reactivity during emotional tasks and increased sympathetic activation during baseline. Somatoform patients exhibited a reduced recognition performance for neutral and sad emotional expressions only. Possible confounding variables such as alexithymia, anxiety or depression were taken into account. Interoceptive awareness was reduced in somatoform patients.
 Conclusions: Our data demonstrate an imbalance in sympathovagal activation in somatoform disorders associated with decreased parasympathetic activation. This might account for difficulties in processing of sad and neutral facial expressions in somatoform patients which might be a pathogenic mechanism for increased everyday vulnerability.
KW  - Somatoform disorder
KW  - Interoceptive awareness
KW  - Facial recognition
KW  - Autonomic response
KW  - Heart rate variability
Y1  - 2011
U6  - https://doi.org/10.1016/j.jpsychores.2011.03.012
SN  - 0022-3999
VL  - 71
IS  - 4
SP  - 232
EP  - 239
PB  - Elsevier
CY  - Oxford
ER  -