Journal of psychosomatic research
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Randomized Controlled Trial Clinical Trial
Labor room and laboratory: clinical validation of the cold pressor as a means of testing preparation for childbirth strategies.
Annually, numerous couples prepare for childbirth through Lamaze childbirth education classes. Research on various portions of the Lamaze method has used the cold pressor as an analogue for labor. In this experiment, pregnant women who had attended either (a) Lamaze classes which taught pain control methods (n = 22), or (b) Red Cross parenting classes which did not teach pain control methods (n = 7), and students who received either (c) brief Lamaze training (n = 10), or (d) no training (n = 10), were tested on the cold pressor. ⋯ Post hoc analyses showed that women who managed labor pain well performed better on the cold pressor task than women who did not manage labor pain well. This experiment established some limits for applying analogue results to childbirth. Moreover, it showed that women who attended Lamaze classes received less medication during labor than women who attended Red Cross classes; however, it was not clear whether this difference was due to the Lamaze classes per se, or to other uncontrolled variables.
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This study investigated the effects of three types of laboratory stressors (stressful imagery, mental arithmetic, pain) on temporal artery, skeletal muscle, general autonomic [digital blood volume pulse (DBVP), spontaneous resistance responses (SRR's)] and self-report measures of distress in chronic migraine, mixed, muscle contraction and non-headache controls. All subjects were female, free of medication at time of testing and equated for age. Headache subjects reported a 19 year history of headache. ⋯ The results do not support the general autonomic dysfunction theory of migraine or the specificity hypothesis implicating an overreactive temporal artery or skeletal muscle response to stress in migraine and muscle contraction headache, respectively. Despite epidemiological research supporting the stress-headache relationship, the present results indicate that the psychophysiological mechanism underlying this relationship does not appear to involve abnormal tonic levels or phasic response to stress. It is argued that the temporal artery dilation response to pain questions the role of stress in triggering the two stage vasoconstriction-dilation mechanism of migraine and suggests the need to evaluate a four stage model as a potential psychophysiological mechanism underlying the stress-headache relationship.