A laboratory medical anamnesis interview elicits psychological and physiological arousal

Abstract

Since medical communication can be perceived as stressful, the assessment of patients’ physiological arousal and behavior during anamnesis interviews may lead to a better understanding of doctor-patient interactions. Therefore, the aim of this study was to test physiological arousal and word use in a laboratory anamnesis interview. In total, sixty-five participants with a mean age of 25.0 years were randomly assigned either to an experimental group (n = 35, 65.7% women) in which they underwent an anamnesis interview or to a control group (n = 30, 73.3% women). Physiological arousal was assessed by salivary cortisol, salivary alpha-amylase (sAA), heart rate (HR) and heart rate variability (HRV). Psychological arousal was assessed using the Positive and Negative Affect Schedule (PANAS). Anamnesis interviews were analyzed using the Linguistic Inquiry and Word Count text analysis tool (LIWC). Participants of the experimental group showed an increase of sAA, HR and negative affect (p’s ≤.0.05). Moreover, higher cortisol area under the curve with respect to ground (AUCg) was associated with lesser use of positive emotion words during the interview and subsequent higher negative affect (p’s <.05). These results indicate that talking about one’s own and family’s medical history in anamnesis interview induces physiological arousal. Our findings suggest that anamnesis interviews could not only induce higher negative affect, but also induce physiological arousal, underscoring the importance of good doctor-patient communication.

Keywords:

• Anamnesis
• health
• risk
• doctor-patient relationship
• cortisol
• heart rate

Acknowledgements

We thank the study team members for contributing: Jana Dörr, Anette Malapally, Carsten Jakob, Rebecca Koller, Alexander Maßen, Sabrina Mellerowic, Irene Schießler, Maike Stumpf, Jana Welling.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, Sarah Sturmbauer, upon reasonable request.

Additional information

Notes on contributors

Sarah C. Sturmbauer

Sarah Sturmbauer, MSc graduated from University of Graz in Austria, in 2016. She is a psychologist currently working on her PhD supervised by Nicolas Rohleder at the Friedrich-Alexander University of Erlangen-Nürnberg on the assessment of stress in medical settings.

Andreas R. Schwerdtfeger

Andreas R. Schwerdtfeger is professor and head of the health psychology unit at the University of Graz, Austria. He received his Diploma in 1996 at the University of Freiburg, Germany, and his Ph.D. at the University of Wuppertal, Germany. His research activities focus on cardiovascular psychophysiology, stress and emotion, psychosocial resources and resilience, and psychophysiological ambulatory assessment.

Simon Schmelzle

Simon Schmelzle, BSc, a trained paramedic, studies psychology at Friedrich-Alexander University Erlangen-Nürnberg. Currently he is working on his master thesis in clinical psychology.

Nicolas Rohleder

Nicolas Rohleder, Ph.D. graduated from University of Trier in Germany, in 2003. He is a psychologist with a focus on biological and health psychology. His main research interest is on the pathways between Central Nervous System (CNS) states such as stress, depression, and trauma and pathophysiological changes in the organism. He currently directs the chair of Health Psychology at Friedrich-Alexander University Erlangen-Nürnberg.