Schroeder H E, Schroeder U, Santibánez-H G
Pavlov J Biol Sci. 1986 Jan-Mar;21(1):16-24. doi: 10.1007/BF02995037.
This study analyzes so-called hopeless gaggers, i.e., patients in whom dental treatment and wearing of a prosthesis produced a retching or vomiting reaction, in order to investigate the sources and properties of this pathologic reaction. In 35 patients, an anamnestic inquiry, a determination of the reflexogenic zone, a recording of the peripheral pattern of the pathologic reflex, and extinction training were performed. A group of six normal persons served as a comparison group. It was shown that patients, in comparison with normals, had an enlarged receptive field, were sensitive to a broader population of stimuli, and showed precursors and aftereffects of the retching-vomiting not found in normals. This pathologic reaction was the symptom of different psychopathologic processes, such as specific fear, repugnance-fear-based disturbances, diffuse anxiety, goal-directed behavior, depressive states and, at least in one case, visceral pathology. The various patients differed with respect to properties of the reaction as well as in the sensitivity to the extinction procedure. It is discussed that different integrative nervous processes play a role in the origin and development of the syndrome: activation of unconditional reflexes, activation of classic and instrumental conditional reflexes, activation of such reflexes by an increase of the reactivity level of specific and unspecific structures of the brain, generalization of stimuli, etc.
本研究分析了所谓的顽固性作呕者，即牙科治疗和佩戴假牙会引发干呕或呕吐反应的患者，以探究这种病理反应的根源和特性。对35例患者进行了问诊、反射源区测定、病理反射外周模式记录及消退训练。选取6名正常人作为对照组。结果显示，与正常人相比，患者的感受野扩大，对更多种类的刺激敏感，且出现了正常人未有的干呕-呕吐先兆和后效应。这种病理反应是不同心理病理过程的症状，如特定恐惧、基于厌恶-恐惧的障碍、弥漫性焦虑、目标导向行为、抑郁状态，至少在1例中还伴有内脏病变。不同患者在反应特性以及对消退程序的敏感性方面存在差异。文中讨论了不同的整合神经过程在该综合征的发生和发展中起作用：无条件反射的激活、经典和工具性条件反射的激活、大脑特定和非特定结构反应性水平增加对这些反射的激活、刺激的泛化等。
