The role of anxiety in the development of anticipatory nausea in cancer chemotherapy: a review and synthesis.

Abstract

The role of state anxiety in the development of anticipatory nausea and vomiting (ANV) in cancer chemotherapy has been the focus of considerable empirical investigation and theoretical speculation. However, while some relationship between state anxiety and ANV is presumed to exist, determination of its precise nature has proven elusive. Specific hypotheses linking state anxiety to ANV are described and evaluated in light of the empirical evidence. These hypotheses include (a) ANV is a symptomatic concomitant of state anxiety; (b) state anxiety directly facilitates the classical conditioning of ANV; (c) state anxiety exacerbates the magnitude of post-treatment nausea and vomiting experienced, thus increasing the risk of ANV; (d) ANV causes infusion-related state anxiety; and (e) the observed relationship between ANV and state anxiety is a result of methodological artifact. It is concluded that state anxiety can play a causal role in the development of ANV in some patients. In particular, the hypothesis that state anxiety exacerbates post-treatment nausea and vomiting and thus increases the risk for ANV appears best supported by the data. Finally, the clinical implications of the relationship between ANV and state anxiety for the treatment and prevention of ANV are discussed.

Chemotherapy-induced Nausea and Vomiting

“…7,[24][25][26] Anxiety is known to affect the development of NV at least in part through negative expectancies, 24,[27][28][29] and, reciprocally, negative expectancies are instrumental in the development of anxiety. 16,30 Expectancies affect the generation of conditioning effects, [31][32][33] and, conversely, conditioning influences response expectancies.…”

Autonomic changes induced by provocative motion in rats bred for high (HAB) and low (LAB) anxiety-related behavior: Paradoxical responses in LAB animals

“…However, it should be noted that the relationship between anxiety and nausea is based primarily on the higher probability of occurrence of nausea in subjects with higher anxiety levels [2,21,23,37,42], and correlations between degree of anxiety and magnitude of nausea are weak [27,44]; the present A C C E P T E D M A N U S C R I P T study only models the latter situation. Taking the results at face value, motion clearly produced hypothermia in all three lines, and this is consistent with previous studies of hypothermia induced by a number of emetic stimuli in both rats (lacking an emetic reflex [19]) and Suncus murinus (with an emetic reflex) [9,17,35].…”

“…Nausea and vomiting are among the key symptoms of generalized anxiety disorder and of panic attacks [31]. Anxious subjects are more susceptible to anticipatory and therapeutic-induced nausea and vomiting resulting from chemotherapy [2,21], and the level of nausea and vomiting following surgery is positively correlated with preoperative anxiety magnitude [28,44]. Anxiety is considered to be a sensitising factor for air and motion sickness [23,37,42], and subjects with a better ability to handle stress have a lower risk of being motion sick [20].…”

Les Effets Indésirables Digestifs De La Chimiothérapie : Cas Des Patients De L’institut National D’oncologie De Rabat (Maroc)

“…Les chimiothérapies anticancéreuses induisent indirectement des crises émétiques qualifiées d'anticipées. Ces accès émétiques anticipés, présentés dès la seconde cure chimiothérapique, s'observent chez 25 % à 60 % des patients selon la nature du traitement prescrit (Andrykowski MA, 1990). …”