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Approximately 75% of the 181,000 breast cancer patients newly diagnosed in 1992 will survive for at least 5 yr, but survival often depends on receiving adjuvant chemotherapy. We determined that mood variables and attitude toward cancer could predict compliance with IV-administered chemotherapy. The participants were seventy-four women diagnosed with primary breast cancer receiving treatment at a state-supported medical center in one of three southeastern metropolitan areas in the U.S. Most patients were members of minority and lower socioeconomic groups. The design was prospective in the sense that mood and attitude variables were assessed before determination of compliance. Two psychological instruments were used in this study, the Mental Adjustment to Cancer (MAC) Scale and the Affects Balance Scale (ABS). Patients who kept fewer than 85% of their appointments were classified as noncompliant; those keeping 85% or more were classified as compliant. Sixty-three percent of the patients for whom the compliance information was complete were classified as compliant; 37% were noncompliant; and four patients were not included in the analysis because their records were incomplete. The discriminant function was able to correctly classify 86% of the patients according to chemotherapy compliance, a 36% improvement over the chance level. High scores on MAC Fighting Spirit and ABS Anxiety, Depression, and Vigor scales were associated with greater adherence to a chemotherapy regimen. High scores on ABS Guilt and Hostility scales predicted lower levels of compliance.

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To develop a model of how stress and other psychosocial constructs may interact to explain recurrences of genital herpes, assessments of major and minor life stress, locus of control, arousal or stimulation seeking, and social support were given to 153 university students (33% male; 67% female) who were seropositive for genital herpes. Retrospective and concurrent indices of illness vulnerability were evaluated. Serum levels of thymosin-alpha-1, a peptide sensitive to psychosocial stress, were measured at the beginning of the study. A causal model suggested by previous research was not supported by the data. An alternate model showed that psychosocial stress did not affect herpes recurrence directly, but instead predisposed subjects to more generalized illnesses, which in turn mediated recurrences. Social support increased rather than decreased the likelihood of illness vulnerability, thus increasing the risk of recurrence. Higher levels of both arousal seeking and external locus of control increased illness vulnerability but moderated the likelihood of herpes recurrence. Higher levels of thymosin-alpha-1 were related to greater illness vulnerability but this peptide was not associated with psychosocial stress as originally predicted. Additional construct validation of the role of illness vulnerability in increasing the risk of herpes recurrence is recommended.

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Previous headache studies have been unable to verify the presumed presence of headache. Attempting to correct this design fault, the present study assessed four psychophysiological measures (frontalis EMG, temporal BVP, temporal and finger skin temperature) and salient subjective measures in 13 migraineurs, eight muscle-contraction headache sufferers, and 13 age-matched normals. All subjects submitted to two 30-minute sessions of quiet monitoring, and for the headache subjects, one of the sessions was headache active. A bogus, but convincing preliminary "assessment" revealed insufficient headache activity in the headache active session, forcing subjects to reschedule that session in the future when a strong headache was present. A parallel manipulation was employed with the normal subjects. A MANOVA failed to discriminate within- or between-group differences on the psychophysiological measures. Self-reported pain was uncorrelated with the psychophysiological indices. These results cast further doubt on the validity of the psychophysiological measures employed in this study, the same ones routinely endorsed by headache researchers and therapists. We discuss problems of recruitment, compliance, and attrition in basic headache research.

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Seventeen women masturbated to orgasm several times in succession while being measured intravaginally by a device that allows continuous oxygen and blood flow readings. Analysis of covariance showed significant differences between fantasy and orgasm and between orgasm and interorgasm relaxation periods. The data do not provide physiological evidence that successive orgasms are either physiologically or subjectively stronger but do provide physiological evidence of a plateau phase of sexual response in women.

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With the exception of work by Semmens (1979), the clinical value of physiologic measures of female sexual response has not been demonstrated; it almost seems that controlled attempts to apply measures of vaginal muscular tone or blood flow to clinical settings has been jinxed. Hence, this author takes issue with Hatch (1980), who gives the impression that physiologic measures can now be used in clinical applications. The reasons for failure in sex therapy or biofeedback are uncertain, but it may be useful to speculate briefly. Sexual arousal in women is too personal a phenomenon to be objectively assessed during waking states in an "artificial" laboratory context. Orgasmic response is not related to genital muscle tone, but to other unknown anatomic, learning-history, and psychological components. The circumstances under which there is agreement between physiologic and either psychometric or self-reports of arousal or pleasure are complex and interactive. Therefore, physiologic measures of female sexual response may not reflect the subjective experience of women and, taken alone, may be misleading. This conclusion should not surprise anyone, for human beings are truly a "cognitive" species with representational imagery and language. Sexuality is very much "in the frontal lobes," and what we perceive eroticism to mean in a given context is probably much more important than the physiologic and behavioral aspects of actual sexual expression. Despite these problems of employing physiologic measures of female response in clinical settings, research into more basic issues has been quite profitable and heuristic. For example, several common assumptions about female sexuality are now open to question: women are more arousable just prior to menses; Kegel exercises improve orgasm consistency; sex therapy for inhibited arousal and desire is efficacious; there is usually agreement between the physiologic intensity of sexual response and a patient's subjective estimate of that intensity. On the other hand, there is evidence that vaginal engorgement in women remains at a high level after an initial orgasm, thus setting the physiologic stage for consecutive orgasmic responses; sexual arousal can be measured physiologically with acceptable degrees of reliability and specificity; muscle contractions in women during orgasm can be measured with high levels of precision; women respond to direct representations of erotic activity much the way men do; there are cortical "physiologic" signatures of orgasmic response in men and women. Obviously, a number of clinical research issues in female sexuality can now be investigated with physiologic measures.(ABSTRACT TRUNCATED AT 400 WORDS)

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A blood volume pulse (BVP) biofeedback system is described that integrates BVP amplitude to provide a signal appropriate for auditory feedback. In comparison to binary BVP feedback methods, this integrated system offers the advantages of continuous feedback and increased scoring ease. The validity of this system was established by correlating the integrated BVP output with trough-to-peak measurements of the raw BVP signal during unassisted relaxation and temporal BVP biofeedback with eight migraine headache patients. Within-subject correlations of the integrated and raw BVP outputs ranged from .82 to .98 (means = .95). Although the integrated method admits unwanted BVP changes in rate, correlation analyses showed this confound factor to be small. Increments in biofeedback training effects were observed during the treatment course. Substantive migraine relief was achieved by the end of treatment and therapeutic gains were maintained at 1-year follow-up. In conclusion, it appears that this method successfully presents continuous auditory feedback from an integrated BVP signal resulting in therapeutic benefits to migraineurs.

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Two different multivariate techniques were applied to self-reported trait and behavioral data concerning sexual behavior from a sample of North American women. Canonical correlation delineated three styles in which certain demographic attributes and cognitive indices of sexual arousal were related to forms of sexual expression. The first style was characterized by respondents who experienced high rates of intercourse and orgasm in a cohabitation arrangement but who did not necessarily report satisfaction with their sexual responsivity. A second style was characterized by older women currently without partners who expressed a liking for erotic literature and media, direct genital stimulation, and frequent masturbation but who were dissatisfied with their sexual responsivity. The third style, which included respondents most satisfied with their sexual responsivity, was characterized by women who were more aware of physiological changes during sexual arousal and who enjoyed gently seductive erotic activities, breast stimulation, and genital stimulation. A discriminant analysis showed that those women who were most highly satisfied with their sexual responsivity experienced frequent intercourse and orgasm consistency, enjoyed gently seductive erotic activities and breast stimulation, but were unresponsive to erotic literature and media. A second discriminant analysis showed that women who achieved orgasm most consistently were older, were more aware of physiological changes during sexual arousal, reported higher frequencies of masturbation and intercourse, and were less likely to be aroused by erotic preliminaries. These results are discussed within the context of the literature on the treatment and prevention of sexual dysfunction.

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