Psychosomatic Medicine 19:267-274 (1957)
© 1957 American Psychosomatic Society

Autonomic Nervous System Responses Related to the Funkenstein Test

I. To Epinephrine

¹ Department of Psychology, University of California at Los Angeles

A number of autonomic measures during rest and following subcutaneous injection with epinephrine were obtained on 45 patients with malignant neoplasm. The purpose of the study was to test the hypothesis stated by Kuntz⁹ that the "response to [epinephrine], as indicated particularly by the magnitude of the rise in [systolic] blood pressure ... provides a fairly reliable index of sympathetic reactivity" (p. 460).

The major findings of this investigation were:

Following subcutaneous injection with USP epinephrine (0.3 cc. in 1/1000 saline) the total group showed increases in systolic blood pressure, pulse pressure, forehead temperature, skin conductance, and initial respiration period. Decreases were found in diastolic blood pressure, heart period (faster heart rate), finger and hand temperatures, salivary output and pH, pupillary diameter, sublingual temperature, scores of autonomic balance, and respiration period during later time intervals.

When patients were classified according to systolic blood pressure response to epinephrine, those whose reaction was above the mean (Group A) and those who were below the mean (Group B), it was found that Group A deviated significantly in a sympathetic direction relative to Group B in six of thirteen other autonomic variables measured after stimulation. The groups also differed significantly in changes in respiration period following epinephrine, but did not differ significantly for the remaining six variables.

Resting levels for six of fourteen autonomic variables were significantly correlated with response to epinephrine. The trends were consistent; e.g., with higher resting levels there was less increase or greater decrease in a given variable following stimulation.

Groups A and B did not differ significantly in resting levels on any measure except diastolic blood pressure. Since this variable was not correlated with magnitude of response to epinephrine, correction of reactivity data for resting level effects was not necessary in this study.

Of 42 subjects given epinephrine and reporting subjective reactions, 29 reported increased nervousness and/or somatic symptoms, and 13 stated that they noticed no reaction whatever. A chi-square comparison between Groups A and B on the basis of verbal reports of increased nervousness after stimulation yielded a value at the 6 per cent level of confidence. It was concluded that individuals who show greater response to epinephrine also tend to report associated feelings of nervousness more often than those who show lesser autonomic response.

These results support the hypothesis that magnitude of systolic blood pressure rise to epinephrine is a fairly reliable index of sympathetic reactivity. They have special bearing on the work of Funkenstein and his co-workers who followed only systolic blood pressure changes and from these data made inferences regarding autonomic function. However, studying stress only in terms of blood pressure changes is not recommended. Autonomic measures other than blood pressure may prove more useful in specific applications; and, furthermore, if there are a number of measures all of which are correlated with a criterion, such as response to shock treatment, but are not perfectly intercorrelated, then the predictive validity of these measures taken together will be greater than any one of them taken alone. If a single function is studied, it can only increase, decrease, or show no change. When a number of functions are studied, the changes in level in each variable, as well as the important aspects of interaction and pattern, can be investigated.