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The vasovagal response during confrontation with blood-injury-injection stimuli: The role of perceived control.

Gilchrist PT1, McGovern GE2, Bekkouche N2, Bacon SL3, Ditto B2.

J Anxiety Disord. 2015 Feb 12;31C:43-48. doi: 10.1016/j.janxdis.2015.01.009. [Epub ahead of print]

Abstract
The vasovagal response (VVR) is a common medical problem, complicating and deterring people from various procedures. It is an unusual stress response given the widespread decreases in physiological activity. Nevertheless, VVR involves processes similar to those observed during episodes of strong emotions and pain. We hypothesized that heightened perceived control would reduce symptoms of VVR. Eighty-two young adults were randomly assigned to perceived control or no perceived control conditions during exposure to a stimulus video of a mitral valve surgery, known to trigger VVR in non-medical personnel. Perceived control was manipulated by allowing some participants to specify a break time, though all received equivalent breaks. Outcomes included subjective symptoms of VVR, anxiety, blood pressure, heart rate, and other measures derived from impedance cardiography. Compared to participants with perceived control, participants with no perceived control reported significantly more vasovagal symptoms and anxiety, and experienced lower stroke volume, cardiac output, and diastolic blood pressure. Participants who were more fearful of blood were more likely to benefit from perceived control in several measures. Perceived control appears to reduce vasovagal symptoms. Results are discussed in terms of cognition and emotion in VVR.

Copyright © 2015 Elsevier Ltd. All rights reserved. View on PubMed
KEYWORDS: Anxiety; Appraisal; Blood-injury-injection fears; Perceived control; Syncope; Vasovagal