I feel terrible! Can you measure that? : Exploring psychophysiological stress responses and their interactions with performance, subjective reports and health status

• Despite recent research advances, there are still several common medical conditions whose underlying mechanisms are poorly understood. In conditions with few or diffuse physical findings, it can be difficult to diagnose and determine the state of the condition and its effects on working ability or performance, and the health care practitioners have to rely on the patient’s self-reports. Identification of objective measurements that are sensitive enough to aid in diagnosis or determination of the state of these conditions would thus be valuable. Psychophysiological measurements are generally non-invasive and have the potential to serve as such diagnostic or prognostic tools. In this thesis, psychophysiological reactions to different stressors were recorded in two selected medical conditions; namely motion sickness and chronic trapezius myalgia (musculoskeletal pain). These subjective conditions are unpleasant, unwanted and apparently serve no survival purpose. It is therefore important to elucidate any physical findings associated with them to, eventually, find new means to prevent the development of these conditions or to ameliorate symptoms.The overall aim of the thesis was to explore the development of psychophysiological responses to stressors in relation to performance and subjective reports in healthy individuals and in women with chronic trapezius myalgia. More in detail, the purpose was to identify psychophysiological responses that could provide information about the mechanisms behind, or serve as candidates for characterization of motion sickness and chronic trapezius myalgia, respectively.Responses to motion sickness, triggered by optokinetic stimulation, were studied in healthy individuals, whereas responses to repetitive low-force work and psychosocial stress were studied in women with chronic trapezius myalgia and in pain-free controls. In both medical conditions, the psychophysiological responses were accompanied by subjective reports. The effects of motion sickness on two different aspects of memory performance were tested during exposure to optokinetic stimulation. In the studies of chronic trapezius myalgia, psychophysiological responses were also related to health status, i.e., being a patient or a pain-free control and measurements of pain intensity, psychological symptoms, sleep-related problems and quality of life.The psychophysiological responses to optokinetic stimulation were inconclusive. Moderate levels of motion sickness did not affect memory performance, whereas decreased short term memory performance was seen in subjects reporting high levels of motion sickness. The autonomic responses and stress hormone secretion in response to low-force repetitive work and psychosocial stress in the chronic trapezius myalgia group were similar to those of the pain-free controls. However, muscle activity in the trapezius muscle was generally higher in the chronic trapezius myalgia group. There were indications of negative psychological states being related to a slower response and lower circadian variations of stress hormone secretion.With the present methods, it was possible to measure general stress responses but none of the measurements showed sufficient specificity to serve as predictors or indicators of motion sickness and chronic musculoskeletal pain, respectively. Summarizing, I cannot objectively measure how you feel; I still have to rely on your description of your condition.

Nyckelord

psychophysiology

motion sickness

chronic pain

stressor

performance

autonomic responses

HPA axis

MEDICINE

MEDICIN

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