A test of delayed recovery following stressful stimulation in four psychosomatic disorders.

Sternbach proposed a three component model to account for the emergence of psychosomatic symptoms. He hypothesized that if an individual exhibited (1) marked response stereotypy, and (2) inadequate homeostatic restraints, then (3) exposure to activating situations would result in psychosomatic episodes. The main purpose of the present study was to examine the second component of the Sternbach model, homeostatic inadequacy, as indicated by impaired rate of recovery from stressful stimulation. In addition, the presence of response stereotypy was investigated in this study. Ten subjects from each of 5 diagnostic groups (rheumatoid arthritis, essential hypertension, migraine headache, tension headache, and healthy controls) were observed under conditions of unstructured relaxation, easement (exposure to stimuli intended to enhance relaxation), mild stress, and recovery from stress. Forearm and forehead muscle potential, peripheral temperature, electrodermal response, heart rate and systolic and diastolic blood pressure were monitored during these sessions. Although evidence of symptom specific response stereotypy was regularly observed, slowness of recovery did not emerge as a robust phenomenon in the four psychosomatic disorders investigated. The phenomenon was consistently observed in the arthritic subjects, absent in hypertensives and tension headache subjects, and ambiguous for migraine subjects.