Anticipatory nausea: the role of individual differences related to sensory perception and autonomic reactivity.
BACKGROUND
Anticipatory nausea (AN) during chemotherapy has been difficult to control with conventional antiemetics. AN can lead cancer patients to delay or discontinue chemotherapy, possibly compromising the treatment.


OBJECTIVE
The aim is to investigate the possible influence on the development of AN of individual differences in absorption, somato-sensory amplification, and autonomic perception-measures theorized to be related to sensory perception and autonomic reactivity.


METHODS
Prior to treatment, 125 women (M age = 48.5 years) undergoing adjuvant chemotherapy for breast cancer rated their expected severity of side effects and completed the Tellegen Absorption Scale, the Somato-Sensory Amplification Scale, and the Autonomic Perception Questionnaire. AN, as well as anticipatory vomiting (AV), distress, and worry/anxiety, were measured prior to the fourth, sixth, and last cycle of chemotherapy. Posttreatment nausea (PN), vomiting, and fatigue were measured after the first, fourth, sixth, and last cycle.


RESULTS
34% of the women reported AN before 1 or more cycles. When controlling for treatment characteristics and other known predictors, AN was significantly associated with high absorption in addition to severity of PN, pretreatment worry/anxiety, and not receiving radiotherapy between chemotherapy sessions. AV was not associated with any of the variables investigated. Our data suggest that the association is strongest in the early phases of treatment.


CONCLUSIONS
Our results partly confirm the results of a previous study showing absorption and autonomic perception as predictors of anticipatory side effects in cancer patients receiving chemotherapy. Individuals high in absorption may be more autonomically reactive to aversive stimuli and, subsequently, more conditionable. Additional radiotherapy could be a competing stimulus, reducing the conditioning of chemotherapy-related nausea. Further studies investigating possible psycho-physiological mechanisms in the development of AN are needed.
Zachariae
R
R
Psychooncology Research Unit, Department of Oncology, Aarhus University Hospital, and Institute of Psychology, University of Aarhus, Denmark. bzach@as.aaa.dk
Paulsen
K
K
Mehlsen
M
M
Jensen
A B
AB
Johansson
A
A
von der Maase
H
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000523:psychology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007206:Individuality; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D010465:Perception / Q000502:physiology; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D012803:Sick Role; D013223:Statistics as Topic; D014840:Vomiting, Anticipatory / Q000503:physiopathology / Q000523:psychology*
D003561:Cytarabine; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate