Psychosomatic Medicine, Vol 50, Issue 4 402-417, Copyright © 1988 by American Psychosomatic Society

ORIGINAL ARTICLES

Emotional fainting and the psychophysiologic response to blood and injury: autonomic mechanisms and coping strategies

A Steptoe and J Wardle
Department of Psychology, St George's Hospital Medical School, University of London, England.

This experiment was designed to examine the psychophysiologic response pattern associated with emotional fainting. A survey was carried out among students, from which 30 volunteers who reported that they felt faint at the sight of blood or injury were recruited, together with 26 nonfainters. Blood pressure, heart rate, and respiration rate were monitored while subjects viewed a film depicting open-heart surgery and a neutral control film. Parasympathetic cardiac control was indexed by respiratory sinus arrhythmia (RSA), and coping was assessed by questionnaire. Responders (n = 17, group FPOS) were defined by a positive survey rating plus marked lightheadedness during the surgery film, and they were compared with nonresponders (group FNEG). Group FPOS showed a classic diphasic response with increases in heart rate and systolic blood pressure early in the surgery film followed by decreases in both variables, and the pattern was significantly different from that found in group FNEG. Data from three subjects who fainted corroborate these observations, although there were marked individual differences in response. The two groups did not differ in RSA, although RSA was smaller in both groups early in the surgery film than at other points. The positive fainting response group reported focusing their attention on bodily sensations, while those who showed little distress used intellectual coping strategies. The results are discussed in terms of the psychophysiologic mechanisms involved in fainting.

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