Psychophysiological Influences on Peripheral
Venous Tone
SANFORD I. COHEN, M.D., STUART BONDURANT, M.D.,
and ALBERT J. SILVERMAN, M.D.
T. HE TONE of superficial veins is known to
be altered following both physical and psy-
chological stimulation. Venous constriction
has been demonstrated following tilt from
the horizontal to the upright position, a
deep breath, chilling of an extremity, and
headward acceleration. Venous constric-
tion has also been observed following an
unexpected noise, a threatened venipunc-
ture, during anger, and during anxi-
etv .3,4.5.11, i2,22,23,25,27,29 The consistency
and magnitude of psychogenic changes in
venomotor tone have not been investigated
systematically.
This study was designed to extend the
observations of psychogenic changes in
venomotor tone by measuring these changes
in subjects who were exposed to auditory
stimuli, etc. (words, phrases) which were
psychologically arousing. The magnitude
of changes in pressure in the vein segment
in response to arousing stimuli would then
be compared to any alterations in pressure
which occurred when the subjects were
exposed to "bland" word stimuli or equiva-
This work was completed while the authors were
on active duty with the United States Air Force at
the Aeromedical Laboratory, Wright Air Develop-
ment Center, WPAFB, Dayton, Ohio.
Present address: S.I.C. and A.J.S., Psychophysi-
ology Laboratory, Department of Psychiatry, Duke
University Medical Center; S.B., Department of
Medicine, Indiana University School of Medicine.
Received for publication July 23, 1959.
lent period in which no auditory stimuli
were presented (silent periods).
It was recognized that the choice of
"charged" and "bland" expressions was a
value judgment by the experimenters. The
charged words were chosen on the basis of
expressions which are generally associated
in our culture with some shock or startle
value.
The bland words were felt to be the type
to which persons in our culture would be
indifferent (and, it, the). A postexperi-
mental interview was held with the sub-
jects in an effort to evaluate the meaning
of the various aspects of the experiment,
particularly the word stimuli and the sub-
jects' responses. The evaluation utilized
the subject's conscious and voluntarily re-
ported feelings and reactions and the ex-
perimenter's inferences based on observa-
tion of the subject's behavior, verbaliza-
tions, and associations. In an attempt to
define further the subject's response to the
experimental periods, various indices of
"arousal" were used before, during, and
after the presentation of the stimulus
(heart rate, EEG, and skin resistance).
Method
Measures of Vein Activity
To measure changes in venous tone,
pressure was recorded continuously from a
hemodynamically isolated forearm vein
PSYCHOSOMATIC MEDICINE
COHEN ET AL. 107
segment by a modification of the technique psychologic stimuli, the amplitude of spe-
of Duggan et a/.11 The tip of a polyethy- cific GSR increases; however, with further
lene (PE20) catheter was introduced stimulation the amplitude diminishes. The
through a distal venipuncture to lie within nonspecific GSR measured in number per
a tributary-fill vein segment of 5 to 7-cm. minute progressively increases as a person
length. Both ends of the segment were oc- is stimulated.
cluded during periods of measurement by The amplitude (or magnitude) of de-
the application of pneumatic arterial tour- crease in skin resistance following the ex-
niquets (320 mm. Hg). The external end posure to an external stimulus (specific
of the catheter was attached to a Statham GSR) is felt to reflect the level of reactivity
strain gauge, and pressure within the seg- to external events. The reactivity to an
ment was recorded along with the galvanic external stimulus may be a function of sev-
skin resistance on a direct writing recorder. eral factors; for example, perception of the
The tourniquets were inflated at 5-minute stimulus, meaning and reaction to the
intervals. After allowing 1 minute for seg- stimulus, level of central excitation pro-
ment pressure to stabilize, the stimulus was duced by the stimulus, and the degree of
introduced. Maximum response occurred sympathetic nervous system discharge asso-
within 30 seconds, and the tourniquets were ciated with central excitation (the sym-
released after 1 minute. An increase in pathetic nervous system has been demon-
pressure in the isolated segment is due to strated to be the final common 8 24
path of de-
venous constriction mediated by the sym- creases in skin resistance) . '
pathetic nervous system. The number per unit time of spontane-
ous fluctuations in skin resistance is felt
Measures of Central Nervous to reflect the level of central excitability
(possibly the reflection of reticular system
System Activity
activity).
Skin Resistance The GSR was recorded from thin lead
plates on the soles of both feet as a tran-
Recent work with an improved, highly sient change in resistance to an impressed
sensitive skin resistance meter* has indi- constant current.
cated that various aspects of alterations in A direct reading of the basal skin resist-
skin resistance can be used meaningfully ance level was also obtained, as well as the
to assess changes in the level of arousal or magnitude (specific GSR) and number
alertness of individuals.7-1S- u-18 (nonspecific GSR) of the transient resist-
Two aspects of skin resistance changes ance changes.
will be reported here: (1) rapid and tran- The improved skin resistance meter pro-
sient decreases in skin resistance following vides an accurate and sensitive measure
the exposure to specific, external events or of very minute resistance fluctuations, as
stimuli, called "specific" galvanic skin re- well as changes in base resistance which
sponses (GSR); (2) decreases in skin re- may be shifting very slowly over a wide
sistance identical in all respects to specific range. It employs a sensitive electronic
GSR except that they do not appear to be amplifier in conjunction with an auto-
associated with external stimuli—that is, matic self-balancing resistance bridge. It is
they appear to be spontaneous. These are stable and operates over a long period of
referred to as "nonspecific" GSR. If a per- time with minimum attention.
son is stimulated by drugs, physical, or The amplitude of the GSR to specific
experimental word stimuli was recorded, as
•Developed at the Aerometlical Laboratory, well as the specific GSR to all other "in-
Wright Air Development Center, Wright-Patterson puts"—e.g., inflation of the cuffs, clicking
Air Force Base, Dayton, Ohio. of the microphone, etc. The number of
VOL. XXII, NO. 2, 1960
106 PSYCHOPHYSIOLOGY AND VENOUS TONE
nonspecific GSR was available for tabula-
tion in (he pre- and poststimulus periods.
The amplitude of the specific GSR (sym-
pathetic discharge to the stimulus) could
then be compared directly to the magni-
tude of venous pressure change and the de-
gree of EEG activation. The difference in
the number of nonspecific GSR pre- and
poststimulus was felt to reflect alterations
in arousal level in the pre- and poststimu-
lus period and could be compared to
changes in the level of skin resistance, the
pulse, the EEG record, and the change in
venous pressure.
EEG
The EEG was recorded on a Grass III-C
machine and was used primarily to monitor
the state of consciousness of the subjects
and to correlate it grossly with other
parameters. Bilateral fronto-occipital and
anterior-posterior temporal leads were used.
The vertex was used as reference and the
ear as ground. EEG findings, which will
not be reported in this paper, in general
reflected the same changes recorded by skin
resistance variations.
Experimental Procedure
Ten volunteer subjects were tested. All
were male research personnel between 18
and 38 years of age. The subjects were
unaware of the nature and purpose of the
experiment. Initially they were asked to
participate in an experiment which would
necessitate placing a small tube in a fore-
arm vein.
When they reported to the experimental
room, they were told that this was a test
to evaluate the reactions of their veins to
sound. Since it was necessary to control the
noise level, they would be placed in an iso-
lated, electrically shielded room where they
would wear earphones. Occasionally they
would hear a word, but they were not ex-
pected to do anything. It was pointed out
that this was not a test of personal feelings
or reactions. However, after the test they
would be interviewed so that any reactions
they had could be evaluated, since a re-
sponse of any type could influence physio-
logical processes. (Since the experimenter
did not wish to disturb the course of the
experiment, any instructions or comments
they wished to make would be done over
the earphones.)
Following the instructions, electrodes for
skin resistance, EEG, and EK.G were
placed. The subjects then were asked to
lie on a comfortable bed in the shielded,
sound-attenuated room. A polyethylene
catheter was inserted in a forearm vein.
The recordings were stabilized, earphones,
placed, and the door closed.
The EEG, skin resistance, and EKG were
recorded continuously. Stimulus periods-
occurred every 5 minutes. These periods,
were divided as follows: 1 minute before
inflation of the tourniquets was used to-
evaluate the level of arousal of the subject
immediately preceding the introduction of
experimental stimuli. The tourniquets were
then inflated* and the venous pressure
reading allowed to stabilize. The cuffs were
kept inflated for 1 minute so that any
change in the subject's skin resistance due
to the cuffs would be noted. The micro-
phone into which the experimenter spoke
was turned on, the verbal stimulus pre-
sented, and the microphone then turned!
off. The cuffs were kept inflated for 1 min-
ute to obtain a 1-minute poststimulus con-
trol. The cuffs were deflated, and the re-
cording over the next minute was used as a-
poststimulus, postinflation control. There
were 12 stimulus periods which included a-
randomized series of 4 charged words (col-
loquial expression for intercourse, defeca-
tion, and urination, etc.), 4 bland words.,
(and, the, it, etc.), and 4 equivalent pe-
riods of silence. (The microphone was-
turned on and off, but no verbal stimulus-
was presented. Hence, the experimental"
profile was completely duplicated except
for the absence of a word.) After the last
period the subject was interviewed, with-
the major focus on evaluating the mean-
ing of and conscious subjective response to-
the various experimental stimuli.
PSYCHOSOMATIC MEDICINE
COHEN ET AL.
Results
Venomotor Tone
In most instances, following each of the
3 stimuli pressure in the isolated venous
segment began to increase within 2 or 3
seconds, increased to a maximum between
30 and 60 seconds, and then returned slow-
ly toward the prestimulus level (Fig. 1).
This pattern of venomotor response is simi-
lar to that which has been previously ob-
served following various physical stimuli.
•It might be thought that occluding the cuffs at
320 mm. Hg could lead to the subject's experiencing
pain which might account for some of the re-
sponses. This particular subject population was
composed persons or who had been volunteers for
many previous experiments at the laboratory in-
volving similar types of procedures. They did not
report the cuffs as painful, although experienced
as a firm pressure. If the cuffs were left on longer
than 5 minutes pain might be experienced. It
should also be noted that the cuffs were inflated
during the silent, bland word and charged word
periods. Hence, if the cuff pressure was responsible
for some of the responses, it should have been an
equivalent influence in the 3 (randomly distributed)
experimental periods.
ISOLATED
SEGMENT
PRESSURE
(Cm HgO)
Fig. 1. Effect of psychic stimulation on venous pressure in one subject. (Paper speed of 25 cm./sec.)
VOL. xxii, NO. 2, 1960
109
Table 1 presents, for each subject, the
median of 4 determinations of the maxi-
mum pressure change following each of
the stimuli. The range of pressure changes
of the group also is indicated. It is appar-
ent that there is considerable interindivid-
ual variation in the magnitude of the re-
sponse (see discussion). In 8 of the 10 sub-
jects, an increase in pressure was observed
during the silent period. In 9 of the 10,
the increase following the bland word was
greater than that which followed the silent
period. Seven of the 10 subjects manifested
a greater increase in pressure following the
charged word than that after the bland
word. A nonparametric analysis of this
data indicates that for the group the dif-
ference in response of venous segments un-
der the 3 conditions is significant at the
level of P<.002.
Table 2 shows the mean pressure change
during the silent, bland word, and charged
word periods in the total subject popula-
tion. The range also is indicated. These
values are of interest since they indicate the
110 PSYCHOPHYSIOLOGY AND VENOUS TONE
TABLE 1. MEDIAN PRESSURE CHANGES IN ISOLATED TABLE 2. PRESSURE CHANGE IN ISOLATED VFNOUS
VENOUS SEGMENT (CM. HSO) SEGMENTS FOLLOWING PSYCHIC STIMULATION
(10 SUBJECTS)
Subject Stimulus
Silence Bland word Charged word Stimulus
Bland Charged
1 3.0 3.5 7.0 Silence word word
2 1.0 on 3.5
3 2.0 2.5 2.5 Mean maximal 2.7 6.9" 11.6"
4 0 3.0 4.0 pressure
5 3.5 4.0 6.0 change in iso-
6 4.0 6.0 10.0 lated venous
7 0 -1.0 -2.0 segment (cm
8 2.0 3.0 7.0 H2O)
9 1.5 14.0 10.0 Range (cm _3to+17 —1 t o + 2 4 + 1 to+32
10 5.0 13.0 18.5 H2O)
nl i 1 m i 9 i
range — 3 to + 17 — 1to + 24 + 1 to + 34
P < .002 P<.002 "Change significant P<.002.

sponse characteristics of the various sub-

general magnitude of the responses. How- jects. Because of this, autocorrelative tech-
ever, the interindividual variability in niques are used, and the degree and direc-
venous diameter precludes the mean re- tion of change in the amplitude of response
sponses of the group being a valid indica- to the control stimulus and a stressful
tor of the experimental results.* stimulus are utilized. The bland word is
used as the control, and if the charged word
Specific GSR to Bland and does not represent a significant and con-
Charged Words sistently more arousing stimulus, the am-
One limitation of skin resistance meas- plitude of specific GSRs to the charged
ures is that interindividual comparisons stimulus in the subject population should
of absolute amplitude changes are not feasi- vary in a chance manner from the ampli-
ble due to the marked variability between tude of specific GSRs to the bland word.
various subject's basal skin resistance levels Table 3 demonstrates the median of 9 of
and the marked variation in amplitude re- the subjects' specific GSRs which occurred
after the introduction of 4 bland and 4
•The median rather than the mean values of the charged expressions (the median would, of
venous pressure changes were used in statistical course, tend to obscure or decrease any
evaluation because interindividual variation and
the diameter of the venous segments make direct
TABLE 3. SPECIFIC GSR TO BLAND AND CHARRED
interindividual comparison of the absolute pressure
WORDS
change invalid. A comparison of the mean and
median pressure changes following both bland and
Subject Bland Charged
charged words revealed that the mean change was
(Median response (Median response
greater. This reflects the fact that individual re-
in centimeters) in centimenters)
sponses varied widely, possibly because some sup-
posedly charged words were not in fact charged for 1.0
1 0.2
some individuals; this was borne out in the postrun
2 4.2 3.2
interview. 1.6 8.0
3
For these reasons an average of pressure changes 4 6.4 16.6
of the group has no significance. Accordingly, a 5 0.1 2.4
nonparametric analysis was used to evaluate the 6 0.7 3.0
significance of the change in pressure in the isolated 7 2.8 12.0
venous segment under the 3 experimental condi- 8 9.0 10.0
tions (silent period, bland word stimulus, and 9 0.16 1.6
charged word stimulus). The difference in response Range 0.1 to 9.0 1 to 16
to these S periods was significant at the P < .002 P<.01
level.

PSYCHOSOMATIC MEDICINE
COHEN ET AL. 111
differences in contrast to the mean, but ittionship to the various phases of the ex-
was used because nonparametric techniques periment was then noted.
had to be utilized with this type of data). Once again, the expected interindividual
(One subject had no GSR record because variability ot absolute numbers of non-
of mechanical problems.) specific fluctuations was obtained; however,
Except for subject 2, all showed an in- when intraindividual comparisons were
crease in the amplitude of response to made of the median number of responses
charged words. The group mean of the am- prior to and after each stimulus phase, dis-
plitude of specific GSRs in response bland tinct differences were obtained.
words was 2.9 cm. and in response to All subjects except 1 (who showed no
charged words was 7.0 cm. change) revealed a drop in the number of
The specific GSRs are not reported for nonspecific fluctuations after the silent pe-
the silent periods since there was no inputriod, indicating a decrease in arousal. A
equivalent to the word stimuli of the othersimilar decrease in nonspecific GSR was
periods. Of course, there were occasional seen after bland words in all but 1 subject.
However, the amount of decrease after
responses to the clicking of the microphone,
but these were not noted consistently and bland words was less than after silent pe-
were seldom marked. Occasionally a sub- riods (P = <.01).
ject would show a response during this After charged words the number of non-
period, and many of these the subjects re- specific GSR increased in all of these sub-
ported that they had been expecting a word jects. Nonparametric analysis revealed that
to be presented. However, except for the the increase after charged words was signifi-
occasional anticipatory response there werecantly different from the decrease after
few GSRs noted in this period. bland words (P = .01).
Figure 2 demonstrates the difference in
Nonspecific GSR Before and After Silent numbers of nonspecific GSR, before and
Periods, Bland Words, and Charged after the 3 experimental periods, in 8 of
Words the subjects. (One subject had no GSR
The number of spontaneous oscillations record at all because of instrument diffi-
of skin resistance which occurred in rela- culties, and 1 subject's nonspecific GSR was

CHANGE IN NUMBER OF "NON-SPECIFIC" GSR BEFORE

AND AFTER SILENT, BLAND WORD. AND "CHARGED"WORD PERIODS
Difference in
"Non-specific" GSR Silent Bland Word "Charged" Word
(Post-Pre Stimulus] Periods Periods Periods

(p<JOD
Amount of +8-
Increosein +6
Number In
Post Stimulus + 4
Period
J
Amount of
Decrease in
Number in
-2
.
"q
•••
Post Stimulus -6 ABCOEFGH AB CDEFGH ABCOEF GH
Period 8 (Subject)

Fig. 2. Median number of "nonspecific" GSR.

VOL. XXII, NO. 2, 1960

112 PSYCHOPHYSIOLOGY AND VENOUS TONE
CONTROL
(SILENCE)
MICROPHONE ONf—lOFF
SKIN RESISTANCE
"SPECIFIC' GSR
'NON i!fj£" 4.3/min. 2.6/min. 3.8Aniit
pi. .01
VENOUS PRESSURE
( In Centimeters
Pi.OO2
Fig. 3. Mean skin resistance and venous pressure changes with verbal stimuli.
not utilizable because the record was ob-
scurred by movement and mechanical arti-
fact.)
Figure 3 shows the mean skin resistance
changes and venous pressure changes for
the subject population.
Discussion
It is recognized that the charged words
were charged to variable degrees for the
different subjects. To avoid having to rely
entirely on psychologic techniques for eval-
uating the effect of individual words on
each individual subject, it was elected to
group the responses to all preselected
charged words rather than attempt to se-
lect post facto those words which had spe-
cific meanings for the individual subject.
Since the words were equated in numbers
of syllables and delivered in random se-
quence at equal volumes, it would seem
any difference in venomotor response must
be related to the connotation of the word.
The magnitude of the decrease in skin
resistance to a specific external stimulus is
felt to be ultimately a function of the degree
of sympathetic nervous system activation
BLAND
STATEMENTS STATEMENTS
ON I—I OFF ON I—lOFF
2:9 cm
11.6
pt.002
caused by the stimulus. It appears plausible
to assume that if a change in 1 physiologic
measure (skin resistance) which reflects
peripheral sympathetic activity occurs, then
physiologic changes in other systems in-
nervated by peripheral sympathetic fibers
might be expected. However, Lacey20-21
has indicated that the magnitude of change
in different autonomic measures to the
same stimulus may be considerably differ-
ent. Recent work has indicated that veno-
constriction is a function of sympathetic
impulses; hence an increase in pressure in
an isolated forearm vein segment might be
assumed to be a result of sympathetic nerv-
ous system discharge causing a constriction
of the vein wall.5'2T The skin resistance re-
sults strongly suggested that a charged word
caused a higher level of arousal and more
intense sympathetic activity than bland
words (indicated by the greater magnitude
of the specific GSR to the charged word
and increase in number of poststimulus
nonspecific GSRs from the prestimulus
state following the charged word as com-
pared with the pre- and poststimulus non-
specific GSR difference after the silent and
bland word periods). Work by Wang has
PSYCHOSOMATIC MEDICINE
COHEN ET AL.
indicated that the number of spontaneous
GSRs can be correlated with the level of
reticular system stimulation.32 It is hy-
pothesized, then, that words which are emo-
tionally charged cause a higher level of
reticular-activating system stimulation and
that this leads to an increase in posterior
hypothalamic excitability. This, in turn,
causes an increase in sympathetic discharge
with charged words, which then leads to
specific GSRs of greater magnitude and
more intense venoconstriction (although
the magnitude of change in skin resistance
and venoconstriction may not be directly
parallel).
The only exception to the above formu-
lation was noted in 1 subject. This subject
showed no increase in venous pressure to
any of the experimental periods. However,
his skin resistance record indicated he was
highly aroused and the interview evalua-
tion suggested that he was in a state of
acute anxiety. The amplitude of specific
GSR to charged words was greater than
that to bland words (4.7 cm. versus 1.7
cm.). The assumed failure of his vein to
constrict may be a function of the fact that
SUBJECT A
PRE-
EXPERI MENTAL
REST PERIOD
NON-SPECIFIC
9
PER MINUTE /MINUTE
"BLAND" WORD
STIMULUS Il7c(n
MEAN GSR
RESPONSE
MEAN
VENOUS
PRESSURE
iCHARGED WORD
STIMULUS
MEAN GSR 4.6 em
RESPONSE
MEAN
VENOUS
PRESSURE
Fig. 4. Venous pressure and skin resistance change in subjects at different levels
of arousal.
VOL. XXII, NO. 2, 1960
113
his vein had reached a level of maximal
constriction because of the high level of
arousal before the introduction of the
stimulus, and an increase in sympathetic
activity was no longer capable of causing
further constriction. This may be related
to Lacey's finding that persons in a state of
high autonomic excitement preceding
stimulation show very low autonomic re-
activity with stimulation.20-21
This hyperaroused subject's mean skin
resistance responses during the pre-experi-
mental rest period (nonspecific GSR), as
well as during the bland and charged word
stimulus periods (specific and nonspecific
GSR), is charted in Fig. 4, together with
the mean venous pressure during these
stimulus periods (subject A). Subject B is
presented for comparison. This subject
demonstrated a low level of arousal on his
skin resistance record (as well as in his
EEG). He showed a rather marked in-
crease in venous pressure when a bland or
charged stimulus was presented. His skin
resistance record suggests he was more
aroused by the charged words; however, he
had only a slight increase in his venous
SUBJECT B
'MINUTE
6/MINl/TE
^/MINUTE
114 PSYCHOPHYSIOLOGY AND VENOUS TONE
pressure response to the charged word as
compared with bland word. It was felt that
subject B was, in a sense, in an opposite
psychophysiological state from subject A.
That is, he was quite relaxed psychological-
ly and physiologically; hence a stimulus
which was perceived and reacted to with a
sympathetic discharge (regardless of its
exact intensity) could result in a rather
large change in venous pressure since the
peripheral veins were in a "relaxed" state
and might respond to an autonomic stimu-
lus with a greater degree of change in pres-
sure than might occur if the vessel was al-
ready constricted. (This is not meant to
imply that the absolute pressure in the
stimulated "relaxed" vessel would be high-
er, but that the magnitude of a response
may depend on the "set" of the vessel be-
fore it is stimulated.)
The response of the hyperaroused sub-
ject who manifested a slight decrease in
venous pressure when exposed to bland
and charged word stimuli might be ex-
plained on a basis different from that of
his peripheral veins being maximally con-
stricted. Burch 4 ' 5 reported a similar effect
to that noted in this subject—i.e., a de-
crease in venous pressure in some subjects
exposed to various stimuli. He suggested
that a vagal discharge might account for
this and presented this as a possible mecha-
nism of vasovagal syncope. The evidence is
not definitive enough to support either
contention. However, the skin resistance
changes tend to favor marked sympathetic
vasoconstrictive state as the major deter-
minant.
The magnitude of the venomotor re-
sponse to psychogenic stimulation is inter-
esting. Although the average pressure
change of a group of subjects has no real
significance unless the diameter of the ves-
sels be known, previous investigators using
a similar technique have averaged the pres-
sure change of groups of subjects following
such physical stimuli as deep breath, val-
salva maneuvers, cold pressor test, and tilt-
ing from supine to erect.4-B-19-27> 29 If one
compares the average pressure change of
the subjects in the present study to the
pressure changes in subjects exposed to
physical stimuli, the change in venomotor
tone is of the same general order of magni-
tude following physical stimuli. If the vein
segment used in these studies was of com-
parable diameter, it would appear that
psychogenic stimuli are as effective as physi-
cal stimuli in producing constriction of
superficial veins.
The physiological and clinical impor-
tance of a change in peripheral venous tone
is not well established. It is generally ac-
cepted that right auricular pressure does in-
crease with peripheral venous constriction.
For this reason it is assumed that periph-
eral venous constriction causes a decrease
in peripheral venous blood volume, with
an increase in central blood volume and
possibly of cardiac output. The matter is
confused by a lack of techniques for meas-
uring venous blood volumes.
In a recent study by Martin, Vernon, and
White, 2526 evidence was presented which
tended to support the hypotheses that:
". . . there is an association between specific
emotional stimuli and elevation of central
venous pressure and that the magnitude of the
response is a function of both the degree of
cardiac failure and the significance of the emo-
tional stimulus. Mechanisms involved in the
central venous pressure increases have not been
elucidated completely. Such increases may be
associated with changes in cardiac rate, arterial
blood pressure, respiratory rate or intrathoracic
pressure change, rapid increases in blood vol-
ume or changes in the tone of central and/or
peripheral vessels or any combination of these
factors."
Further studies indicate that peripheral
venous constriction may be one of the more
important mechanisms involved.22 The
authors point out that peripheral venous
constriction may lead to the shift of large
amounts of blood from the periphery to the
central veins, since about 66 to 75 per cent
of the blood volume is contained within
the peripheral venous vascular system. It
was pointed out by the authors that if the
heart was unable to increase its output
PSYCHOSOMATIC MEDICINE
COHEN ET AL.
sufficiently to reduce the increased amount
of blood flowing into the central veins, the
result might be an increase in central
venous pressure, the intensity of which
would depend upon the degree of cardiac
decompensation which might be pres-
ent. 2 2 2 3 3 4 Several previous studies have
suggested the relationship of the emotional
stress and congestive heart failure, as well
as the relationship of emotional factors and
peripheral arterial vasospasm or peripheral
plethysmographic changes.1- 2- '• *• 10> 15> 16>
19, 28, so, 3i, S3 The work reported in this
paper complements the work reported in
previous papers in that the specific changes
in a peripheral venous segment were shown
to be related to the presentation of an emo-
tionally charged stimulus which led to an
increase in central nervous system arousal
as assessed by changes in skin resistance and
the electroencephalogram.
It seems apparent that emotional factors
may effect both the arteriolar and venous
side of the vascular tree through autonomic
and, probably, through humoral mecha-
nisms (adrenal cortical hormones, catechol
amines) .17 Although the relationships sug-
gested between emotional factors and vas-
cular factors by the results of this study are
not new, it is hoped that the findings sug-
gest more specifically the mechanisms in-
volved in psychophysiological vascular re-
lationships. The clearer the identification
of the specific factors involved in the medi-
ation of vascular changes precipitated by
emotional "stress," the more likely it is
that specific psycho- and pharmacothera-
peutic regimes can be established to amelio-
rate vascular disorders which have psycho-
physiological components.
Summary
Ten volunteer subjects were exposed to
a series of words and phrases while they
were resting in an isolated sound-attenu-
ated area. The verbal stimuli presented
were bland or neutral expressions and
charged words or expressions. In addition
to periods ni which words were presented,
4 silent periods were introduced in which
VOL. xxii, NO. 2, 1960
115
all experimental procedures were carried
out.
Venous pressure was measured through a
polyethylene catheter in a forearm vein seg-
ment. The vein segment was isolated from
all other vessels by the inflation of cuffs
above and below the segment selected.
Hence, any change in venous pressure
would be a function of alterations in the
degree of venoconstriction mediated by
autonomic fibers.
Pulse rate, skin resistance and EEG were
carried out to evaluate changes in the level
of arousal of the subjects. Pre- and post-
stimulus recordings were done so that the
psychophysiological state before and after
the stimulus period, as well as the reaction
to the stimulus, would be obtained. Post-
run psychiatric interviews evaluated the
specific meaning of the experimental pro-
cedures and stimuli to the subject and their
psychological response to them. Venous
pressure changes were significantly greater
following the introduction of charged
words and phrases than following bland
expressions. Furthermore, the change fol-
lowing bland expressions was considerably
higher than during silent control periods.
The skin resistance decreases specifically
associated with the presentation of words
was significantly greater after charged than
neutral expressions. Pre- and poststimulus
skin resistance records indicated a more in-
tense level of arousal in the poststimulus
periods following charged words, an equiva-
lent level after bland words, and a de-
creased level of arousal after silent periods.
The reactions of individual subjects were
not merely a function of the type of stimu-
lus but were closely related to the personal
meaning the stimulus had for each subject.
Venous pressure changes probably are
due to sympathetic impulses which cause
an increase in venoconstriction. Emotional-
ly arousing stimuli are able to produce
changes in venous tone. This change prob-
ably is due to the central nervous system
arousal caused by the provoking psycho-
logic stimuli. The increased levels of
116 PSYCHOPHYSIOLOGY AND VENOUS TONE
arousal, in turn, lead to an increase in sym-
pathetic nervous system excitation.
Vascular changes associated with psychic
factors may be a function of alterations in
the venous system, as well as the arterial
system or cardiac functions.
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Psychosomatic Aspects of Cancer

A society of those interested in research into the psychosomatic aspects of

cancer is being formed. The first meeting will be in Amsterdam, Aug. 11 to 13,
1960. Those interested are invited to communicate with Dr. Lawrence LeShan,
144 East 90 St., New York 28, N. Y.

voi« xxii, NO. 2, 1960