title: Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study.
abstract: Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r = 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative explanations for these findings are discussed.
authors.affiliation: a Department of Medical Psychology , Academic Medical Centre/University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Leonie N C
authors.initials: LN
authors.lastname: Visser
authors.affiliation: b Department of Clinical Psychology , Leiden University , Leiden , The Netherlands.
authors.forename: Marieke S
authors.initials: MS
authors.lastname: Tollenaar
authors.affiliation: c Department of Clinical Psychology , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bosch
authors.affiliation: d Department of Clinical and Health Psychology , Utrecht University , Utrecht , The Netherlands.
authors.forename: Lorenz J P
authors.initials: LJ
authors.lastname: van Doornen
authors.affiliation: a Department of Medical Psychology , Academic Medical Centre/University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
authors.affiliation: a Department of Medical Psychology , Academic Medical Centre/University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Ellen M A
authors.initials: EM
authors.lastname: Smets
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D011939:Mental Recall / Q000502:physiology; D009369:Neoplasms / Q000175:diagnosis / Q000503:physiopathology; D012017:Referral and Consultation; D057566:Self Report; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult
keywords: Recall; analog patients; cardiovascular activity; electrodermal activity; medical communication; oncology; recognition; video-vignettes design