Psychosomatic Medicine 1:271-292 (1939)
© 1939 American Psychosomatic Society

Affective States and Skin Temperature: Experimental Study of Subjects with "Cold Hands" and Raynaud's Syndrome

¹ New York Hospital and Department of Medicine, Cornell University Medical College, New York City

In this study both the emotional and physiological manifestations of the individual were studied simultaneously. Various affective states were induced experimentally through specifically devised situations in a standardized physical environment, and the skin temperature recorded by radiometric methods. In another part of the study the affectively charged test situations were kept identical but the temperature of the environment was altered from one experiment to the next.

The magnitude of the fall in different individuals varied greatly, although the reaction in any one individual under comparable stress was approximately the same on repeated observation. The skin temperature of the fingers dropped as much as 13.5°C, the lowest level being 3°C below the environmental temperature.

The emotional changes that were accompanied by a fall in the skin temperature of the extremities were always complex, though one or two emotions prevailed. These affective states contained, in different subjects, various degrees of tension, anxiety, guilt, feelings of being pushed and of being thwarted, embarrassment, irritation, anger, rebellion, feelings of inadequacy and of being criticized or disapproved of, insecurity, humiliation, grief, feelings of helplessness, depression, despair and pleasurable excitement. Hence there was no specificity in the quality of the predominant emotion that was accompanied by a fall in the skin temperature of the extremities. Major drops occurred under emotional stress both with and without awareness on the part of the subject of his emotional state. The subject's reaction to a given situation was dependent upon his life experience, his values and his aims. Major drops occurred with a variety of emotional reactions interrelated with life situations that meant a threat to the subject's welfare or were charged for him with conflict.

Subjects who were under sustained emotional stress and who were not able to relax even in the control situation showed a low finger temperature both outside and within the control period. Subjects who could relax in the control situation maintained a high finger temperature during the observation (32°C to 35°C). In such subjects during an induced affect, the magnitude of the fall in finger temperature in response to the same test situation was influenced by the subjects' dominant mood. Thus the fall was greater during a period of apprehension sustained for several days than during periods of sustained contentment.

Patients with Raynaud's Syndrome differed in no essential from other subjects in regard to the nature, the magnitude, or the speed of the fall in the finger temperature with induced stress. They differed dramatically, however, in that major falls in finger temperature were associated with pain, cyanosis and pallor. It is significant that a low environmental temperature in itself was not sufficient to precipitate pain and cyanosis in a patient who was adequately clad and relaxed, whereas emotional stress under the same physical circumstances was followed by distressing symptoms. Also, when a patient with Raynaud's Syndrome began to cool off as a result either of low room temperature or inadequate clothing a more severe attack of cyanosis and pain was precipitated by induced emotional stress than when the environment was warmer and the patient adequately clad. Thus, there was a striking interplay of the physical factors of body warmth, as determined by the environmental temperature and the body covering, and the emotional state induced by the situation. The interplay of these factors determined the amount of incapacity or pain the patient suffered.

Major drops in the skin temperature of the extremities under induced stress do not occur if the sympathetic nerve supply to the extremities has been interrupted.

Although vasoconstriction in the extremities under circumstances of stress is usually a minor event in the reaction of the organism to life situations, it may acquire pathological significance in maladjusted subjects or in those reacting to life crises, and in patients with Raynaud's Syndrome.

Note:

Aided by a grant from the Josiah Macy, Jr. Foundation

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