Andrykowski M A
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington 40536-0086.
Psychosom Med. 1990 Jul-Aug;52(4):458-75. doi: 10.1097/00006842-199007000-00008.
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.
状态焦虑在癌症化疗所致预期性恶心和呕吐（ANV）发生过程中的作用，一直是大量实证研究和理论推测的焦点。然而，尽管假定状态焦虑与ANV之间存在某种关系，但事实证明，确定其确切性质却很困难。根据实证证据，对将状态焦虑与ANV联系起来的具体假设进行了描述和评估。这些假设包括：（a）ANV是状态焦虑的一种症状性伴随现象；（b）状态焦虑直接促进了ANV的经典条件作用；（c）状态焦虑加剧了治疗后恶心和呕吐的程度，从而增加了ANV的风险；（d）ANV导致与输液相关的状态焦虑；（e）观察到的ANV与状态焦虑之间的关系是方法学假象的结果。得出的结论是，状态焦虑在某些患者ANV的发生过程中可能起因果作用。特别是，状态焦虑会加剧治疗后恶心和呕吐并因此增加ANV风险这一假设似乎得到了数据的最佳支持。最后，讨论了ANV与状态焦虑之间的关系对ANV治疗和预防的临床意义。
