[not in handout, see intranet]

Stockhorst, U., Steingrueber, H. J., Enck, P., & Klosterhalfen, S. (2006). Pavlovian conditioning of nausea and vomiting. Autonomic Neuroscience-Basic & Clinical, 129(1-2), 50-57.

Cancer patients undergoing cytotoxic drug treatment often experience side-effects, the most distressing being nausea and vomiting. Despite antiernetic drugs, 25-30% of the chemotherapy patients report these side-effects when being re-exposed to the stimuli that usually signal the chemotherapy session ...

The present paper summarizes the evidence that anticipatory vomiting is acquired by Pavlovian conditioning, and, consequently, may be alleviated by conditioning techniques.

To explore the mechanisms that induce and alleviate conditioned nausea and vomiting further, a conditioned nausea model was established in healthy humans using body rotation as the nausea-inducing treatment.

The validity of this motion sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea was demonstrated. ....endocrine and immunological correlates of nausea were elevated after the experience of rotations. The paper concludes with a review of applications of the demonstrated conditioning principles as interventions to ameliorate distressing anticipatory nausea or anticipatory vomiting in cancer patients undergoing chemotherapy

[ i. overshadowing by giving distinctively flavoured drinks just prior to chemotherapy, then switching to water. ii. "Latent inhibition" exposing patients several times to the chemotherapy envirement several times before chemotherapy is actually given. (see Lieberman, pp. 157-8.)]