Morton F. Reiser

psychophysiologic Studies of the Neonate: An Approach Toward the Methodological and Theoretical Problems Involved

&NA; The heart rate and behavioral responses to a repetitive series of air‐stream stimulations were measured in 40 3–5 day old babies and their heart rate responses were correlated with their pre‐stimulus heart rate levels. These correlations were plotted as a series of individual statistical regression lines that reflect the apparent lawful inverse relationship between the size of the heart rate response and the heart rate of the babies at the time of stimulation. As the pre‐stimulus heart rate level increases, the reactivity decreases and at a certain value becomes negative‐‐the same stimulus now produces a decrease in heart rate. The babies differ as to the level at which a stimulus starts to produce this negative response (cross‐over point). In the 15 babies who were tested on 2 successive days the individual values of these cross‐over point levels show a test‐retest agreement constancy, p < .001. Since these cross‐over points are independent of the state of the baby, they can be useful in comparing different modalities of stimulation and different organ systems in individual babies. In addition, each babys individual regression line differed from every other in 2 qualities. They have different slopes as measured by their regression coefficients and different amounts of scatter or deviation about their regression line as measured by their estimates of standard error. These 2 qualities that have a test‐retest agreement, p < .05, may be used as indices of differences in aspects of homeostatic functioning that have been hypothesized as possible precursors of some ego functions. When the babies were either very quiet or very excited, they did not show any behavioral responses to a certain proportion of stimuli, and this phenomenon may be related to the functioning of a hypothetical neonatal stimulus barrier. In the comparative evaluation of differences in the autonomic responses of individuals the concept of reactivity or lability is meaningless without first defining its parameters which are: (1) the initial state as related to the individuals own regression equation and also, (2) what might be called the individuals receptivity to stimulation at the time of stimulation. Comparing an individual to the total population, may lead, at least in neonates, to spurious conclusions. It was determined that the change‐initial level regression was statistically equivalent to the stress‐initial level regression.

The development of cardiac rate regulation in preweanling rats.

&NA; Cardiac rate was recorded by lightweight leads from unrestrained pups under 4 conditions: in the home cage litter situation, while being picked up by the experimenter, during 6 min alone in a novel environment, and in response to a startle stimulus. Resting heart rates in the litter showed evidence of high sympathetic activity during the second week of life; cardiac responses to stimulation were consistently deceleratory. By 20 days, the adult pattern of low resting rates and tachycardia upon stimulation had become established. Patterned changes in cardiac rate accompanied behavioral rapid eye movement sleep in younger pups and self‐grooming in older pups. These distinct stages in the development of autonomic cardiac control may indicate critical periods within which early experience can differentially shape the pattern of adult cardiac responses.

Similarities in mental content of psychotic states, spontaneous seizures, dreams, and responses to electrical brain stimulation in patients with temporal lobe epilepsy.

&NA; The present study was guided by the hypothesis that temporal lobe epilepsy psychosis is associated with a definable syndrome of deficits in the higher cortical functions. Comparison was made of the mental content and mechanisms observed during psychotic episodes, seizures, dreams, and responses to electrical brain stimulation occurring in diverse combinations in 5 patients with drug‐refractory temporal lobe epilepsy referred for neurosurgical treatment. Neurological, neuroradiological, EEG, and neuropsychiatric base lines were available before onset of the psychosis. Psychiatric manifestations were related to the interaction of disturbances in specific higher cortical functions and individual dynamic configurations. Interpatient variation in psychotic symptomatology arose from significant elements in the patients past and current emotional life which provided the psychosis with form and content.

Life situations, emotions, and the course of patients with arterial hypertension.

THERE is a good deal of evidence to suggest that there is a close relationship between emotional tension and the diffuse arteriolar spasm of hypertension. This evidence has been garnered from several different types of clinical and laboratory research. In laboratory animals Selye has produced evidence which indicates that hypertension may be one of the diseases of adaptation, and suggests that hypertensive disease may be a manifestation of reaction to emotional stress (8). Psychoanalytic studies have revealed evidence of severe and early psychological trauma in patients with hypertension, and the findings strongly suggest that the elevated blood pressure of hypertensive patients may be an expression of suppressed and repressed hostility and rage ( i , 2, 7). Clinical studies of the parallel medical and psychological histories of patients with hypertension have suggested a close relationship in time between specific emotional events and significant occurrences in the natural history of the disease (1, 2, 7, 9). Weiss has reported several interesting and provocative studies of patients in whom the onset of benign hypertension, or the precipitation of the malignant phase, could be correlated with highly significant life events (9). We obtained similar findings in a study

Psychologic mechanisms in malignant hypertension.

HYPERTENSIVE cardiovascular disease is essentially a nonepisodic condition in which there is no clear-cut relationship between symptoms and structural change. For this reason, it is often quite difficult to establish, with any degree of certainty, the exact date of onset or to reconstruct satisfactorily the previous course. The transition from the benign to the malignant phase, however, represents a relatively well delineated episode and thus provides the clinical investigator with an excellent opportunity for the study of psychosomatic relationships and mechanisms in hypertension. As part of a comprehensive study of this disease, we have investigated 12 patients who were in various stages of the transition from benign to malignant hypertension. In each of these patients, examination of the relationship between the life history and the medical course of the disease revealed that the precipitation of the malignant phase could be chronologically correlated with emotionally significant life situations or events. In 8, where the time of onset of benign hypertension seemed reasonably clear, similar correlations could be made. The primary emphasis of this project was centered upon a simultaneous study of the medical, psychiatric, and physiologic aspects of the transition from the benign to the malignant phase of hypertension in each patient. This report then represents an exploratory effort to arrive at some understanding of the interrelationships involved in this basic phase of the hypertensive problem. This group of patients represented routine hospital admissions and were selected only on the basis of their ability to communicate adequately.

Implications of a Biopsychosocial Model for Research in Psychiatry

&NA; Developments in general and living systems theory, in computer science, and in research instrumentation and technology have led to new perspectives on the patient as a person. The biopsychosocial model forces realization that states of health and illness can be understood fully only in terms of their biological, psychological, and social parameters. Research implications of this model, particularly the appreciation it engenders for the brains role in mediating and regulating transactions along the society‐mind‐brain‐body continuum, are discussed. Objective data generated by skilled clinical psychiatric methods will be needed in addition to data generated in the basic science area for the full range of research challenges in psychiatry to be met.