درباره ناشنوایی برگشت پذیر، اختلال اضطراب فراگیر و مغز حرکتی: چشم انداز فیزیولوژیکی روانی

Electromyographic (EMG) recording during presentation of loud sounds revealed central motor inhibition in a rare case of conversion disorder with deafness. Two subjects in whom hypnotic deafness was induced resembled the patient. In contrast, patients with generalized anxiety disorder (GAD) showed a significantly delayed return of EMG to baseline, compared with normals and schizophrenics following administration of auditory startle stimuli. Blood pressure (BP) of GAD patients was also slower to return to baseline than that of normals and schizophrenics. BP recorded continuously during seven consecutive tests revealed a striking difference between GAD patients and controls. While the controls’ BP generally decreased during the session, pressure of the GAD patients remained at their initial levels. These data are interpreted in relation to allodynamic autonomic regulation as affected by vagal blockade, which appeared to decrease in controls while remaining undiminished in GAD patients. It is suggested that intrusions of uncontrollable worry in GAD patients, and their consequent overuse of certain rostral neural pathways involved in preparation for action prolonged their vagal blockade. A GAD case with typically high frontalis EMG is presented. Frontalis EMGs may provide an exceptionally sensitive indication of neural activity of relevance to GAD. EMG gradients in normal subjects draw attention to Sperry's motoric brain concept, whose influence is strong throughout the paper. Sperry's principle states that the main function of the brain is that of moving the animal in ways that are advantageous for satisfying basic needs and avoiding dangers. Also, with a focus on the motoric brain, some discoveries resulting from brain-recording experiments in freely moving rats are described.

From its inception as a scientific specialty, perhaps the most exciting aspect of psychophysiology has been its ability to blend not only human and animal research, but basic and clinical research, sometimes allowing a distinct perspective on the development of a particular illness. An interesting example is provided by a psychophysiological assessment conducted a number of years ago on a young woman suffering a conversion disorder with deafness (Malmo et al., 1952). At the time of the study, Anne (pseudonym) was a 19-year-old single woman of middle-class Scottish parentage, the youngest of three daughters. She attended school until the age of 16, completing the 10th grade, and subsequently was employed as an office worker. Approximately 6 weeks prior to admission, Anne awoke one morning to find herself totally deaf. Two weeks earlier she had left home following an altercation with her mother, an altercation related to long-standing and pronounced family conflict, and stayed with a girl friend. However, she returned home 2 days prior to the onset of deafness, complaining of spells of faintness and dizziness. She consulted the family physician, who prescribed some medication, but after taking it for 2 days she perceived a buzzing in her ears and the next morning became deaf. There was no reason to believe that her tinnitus (or her deafness) was due to medication. When she became deaf, all the other symptoms of faintness, dizziness and tinnitus disappeared. The deafness lasted for several weeks and forced her to give up her job. However, she did acquire considerable proficiency in lip reading, which made it possible for her to communicate with others. She was examined by a specialist who could detect no organic basis for the deafness, and referred her for psychiatric treatment.