Psychophysiology of the Gastrointestinal Tract : Experimental and Clinical Applications

Over a quarter century ago, Flanders Dunbar, in her 1954 compendium on "Emotion and Bodily Changes," surveyed over 5,000 references on psychoso­ matic interrelationships, including a literature on psychic factors in gastrointesti­ nal disorders dating back to 1845. The title of the present volume suggests a line of descent from these early initiatives, but important changes are in the making. Indeed, the form and substance of long overdue reformulations are clearly re­ flected in the scholarly contributions which enhance this report of the 1980 Munich symposium proceedings. Traditional psychosomatic approaches to understanding the gastrointestinal system and its functional disorders have been based in large part on two virtually unchallenged assumptions. In the first instance, unobserved (indeed unobserva­ ble) "psychological processes" have been considered causally related to disease onset and/or to fluctuations in the course of the disease. And secondly, it has been assumed that "psychotherapeutic" interventions for disease management should be designed to alter these hypothesized "psychic" antecedents. More recently, however, a new paradigm for analyzing the relationships involving disordered physiological functions and behavioral interactions has been devel­ oped within the framework of what has been termed behavioral medicine. The conceptual boundaries of this relatively new approach to behavioral physiology have not yet been firmly established, but the major differences between the new "behavioral" model and the traditional "psychosomatic" model are brought into sharp relief by the experimental and clinical contributions to the present volume. Front Matter....Pages i-xxv Front Matter....Pages 1-4 Studies of Esophageal Function During Waking and Sleep....Pages 5-20 The Responsiveness of the Esophagus To Environmental Stimuli....Pages 21-31 Disorders of the Esophagus....Pages 33-42 Psychological Treatment Approaches To Psychogenic Vomiting and Rumination....Pages 43-63 Front Matter....Pages 65-68 Surface Gastrograms as Measures of Gastric Motility....Pages 69-121 Conjoint Gastrography....Pages 123-159 Measurement of Gastric Acid Secretion....Pages 161-172 Telemetric snd Isotope Methods of Measuring Gastric Acid Secretion, Motility, and Emptying....Pages 173-179 Responsiveness of the Stomach to Environmental Events....Pages 181-207 Treating Stomach Disorders....Pages 209-233 Front Matter....Pages 235-238 The Measurement of Colon Motility....Pages 239-250 Measurement of Electrical Activity of the Colon in Man....Pages 251-261 Colonic Psychophysiology....Pages 263-288 Irritable Bowel Syndrome....Pages 289-297 Front Matter....Pages 299-300 Fecal Incontinence and Encopresis....Pages 301-310 Manometric and Electromyographic Techniques for Assessment of the Anorectal Mechanism for Continence and Defecation....Pages 311-329 Front Matter....Pages 331-332 Interoception....Pages 333-350 Intestinal Afferent Influence on Behavior....Pages 351-360 Back Matter....Pages 361-363