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At least 19 recordsLinked to original sources
PubMed2006

Blushing during social interactions in people with a fear of blushing.

Changes in facial blood flow were investigated during an introductory conversation, delivering a speech, and listening to the speech afterwards in 16 people with a fear of blushing and 16 controls. It was hypothesized that fear of blushing would be associated with high ratings of self-reported blushing intensity and embarrassment during the tasks, and with persistence of the blushing reaction between tasks. Embarrassment and self-reported blushing intensity were greater in the fear-of-blushing group than in controls throughout the experiment. Increases in facial blood flow were similar in the two groups during each of the tasks. However, blushing dissipated more slowly after each task in the fear-of-blushing group than in controls, resulting in an incremental increase in facial blood flow over the course of the experiment. The slow recovery after an episode of blushing might result in physiological or social cues that help to maintain a fear of blushing.

Adult↗
PubMed2005

Do blushing phobics overestimate the undesirable communicative effects of their blushing?

Previous research indicated that blushing has socially threatening revealing effects in ambiguous situations. To explain blushing phobics' fearful preoccupation with blushing, we tested the hypothesis that blushing fearful individuals overestimate its revealing effects. High (n = 20) and low (n = 20) blushing fearful individuals read vignettes describing prototypical mishaps and ambiguous social events. Participants were prompted in the perspective of the actor, and were asked to indicate their expectations of the observers' judgments (meta-perceptions). Blushing fearful individuals overestimated the probability and the costs of undesirable outcomes. However, this judgmental bias was not inflated by displaying a blush. Thus, the results provide no evidence to support the idea that fear of blushing is fuelled by a biased conception of its communicative effects.

Adolescent↗
PubMed2003

The impact of verbal feedback about blushing on social discomfort and facial blood flow during embarrassing tasks.

To investigate whether verbal feedback about blushing influences subsequent social discomfort or blushing itself, changes in facial blood flow and ratings of blushing and embarrassment were investigated in high (N=28) and low scorers (N=28) on the Blushing Propensity scale while singing and reading aloud, and while listening to audiotapes of their performance. After each task half of the participants were told that they had blushed, and the rest were told that they had not blushed. Blood flow increased progressively in participants with high blushing propensity scores who were given "blushing" feedback, but not in the other participants. This finding suggests that expecting to blush may become a self-fulfilling prophecy. Verbal feedback about blushing strongly influenced subsequent social discomfort, and mimicked the effects of blushing propensity on ratings of embarrassment and blushing intensity. In sum, the findings support the view that preconceptions about blushing propensity are shaped by past learning experiences, that concern about blushing is a major source of discomfort in embarrassing situations, and that these concerns are often unrelated to the actual intensity of blushing.

Adolescent↗
PubMed2003

Relation of coronary flow pattern to myocardial blush grade in patients with first acute myocardial infarction.

BACKGROUND: Analysis of myocardial blush grade (MBG) and coronary flow velocity pattern has been used to obtain direct or indirect information about microvascular damage and reperfusion injury after percutaneous transluminal coronary angiography for acute myocardial infarction. OBJECTIVE: To evaluate the relation between coronary blood flow velocity pattern and MBG immediately after angioplasty plus stenting for acute myocardial infarction. DESIGN: The coronary blood flow velocity pattern in the infarct related artery was determined immediately after angioplasty in 35 patients with their first acute myocardial infarct using a Doppler guide wire. Measurements were related to MBG as a direct index of microvascular function in the infarct zone. RESULTS: Coronary flow velocity patterns were different between patients with absent myocardial blush (n = 14), reduced blush (n = 7), or normal blush (n = 14). The following variables (mean (SD)) differed significantly between the three groups: systolic peak flow velocity (cm/s): absent blush 10.9 (4.2), reduced blush 14.2 (6.4), normal blush 19.2 (11.2); p = 0.036; diastolic deceleration rate (ms): absent blush 103 (58), reduced blush 80 (65), normal blush 50 (19); p = 0.025; and diastolic-systolic velocity ratio: absent blush 4.06 (2.18), reduced blush 2.02 (0.55), normal blush 1.88 (1.03); p = 0.002. In a multivariate analysis MBG was the only variable with a significant impact on the diastolic deceleration rate (p = 0.034,) while age, infarct location, time to revascularisation, infarct vessel diameter, and maximum creatine kinase had no significant impact. CONCLUSIONS: The coronary flow velocity pattern in the infarct related epicardial artery is primarily determined by the microvascular function of the dependent myocardium, as reflected by MBG.

Aged↗
PubMed1998

Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Zwolle Myocardial Infarction Study Group.

BACKGROUND: The primary objective of reperfusion therapies for acute myocardial infarction is not only restoration of blood flow in the epicardial coronary artery but also complete and sustained reperfusion of the infarcted part of the myocardium. METHODS AND RESULTS: We studied 777 patients who underwent primary coronary angioplasty during a 6-year period and investigated the value of angiographic evidence of myocardial reperfusion (myocardial blush grade) in relation to the extent of ST-segment elevation resolution, enzymatic infarct size, left ventricular function, and long-term mortality. The myocardial blush immediately after the angioplasty procedure was graded by two experienced investigators, who were otherwise blinded to all clinical data: 0, no myocardial blush; 1, minimal myocardial blush; 2, moderate myocardial blush; and 3, normal myocardial blush. The myocardial blush was related to the extent of the early ST-segment elevation resolution on the 12-lead ECG. Patients with blush grades 3, 2, and 0/1 had enzymatic infarct sizes of 757, 1143, and 1623 (P<0.0001), respectively, and ejection fractions of 50%, 46%, and 39%, respectively (P<0.0001). After a mean+/-SD follow-up of 1.9+/-1.7 years, mortality rates of patients with myocardial blush grades 3, 2, and 0/1 were 3%, 6%, and 23% (P<0.0001), respectively. Multivariate analysis showed that the myocardial blush grade was a predictor of long-term mortality, independent of Killip class, Thrombolysis In Myocardial Infarction grade flow, left ventricular ejection fraction (LVEF), and other clinical variables. CONCLUSIONS: In patients after reperfusion therapy, the myocardial blush grade as seen on the coronary angiogram can be used to describe the effectiveness of myocardial reperfusion and is an independent predictor of long-term mortality.

Aged↗
PubMed2001

Blushing and physiological arousability in social phobia.

Blushing is the most prominent symptom of social phobia, and fear perception of visible anxiety symptoms is an important component of cognitive behavioral models of social phobia. However, it is not clear how physiological and psychological aspects of blushing and other somatic symptoms are linked in this disorder. The authors tested whether social situations trigger different facial blood volume changes (blushing) between social phobic persons with and without primary complaint of blushing and control participants. Thirty social phobic persons. 15 of whom were especially concerned about blushing, and 14 control participants were assessed while watching an embarrassing videotape, holding a conversation, and giving a talk. Only when watching the video did the social phobic persons blush more than controls blushed. Social phobic persons who complained of blushing did not blush more intensely than did social phobic persons without blushing complaints but had higher heart rates, possibly reflecting higher arousability of this subgroup.

Adult↗
PubMed2003

The incidence of flushing on induction of anaesthesia in patients who blush easily.

Flushing (reddening and blotching of the skin) is seen frequently at induction of anaesthesia, is associated with anaesthetic agents such as thiopental and muscle relaxants, and is attributed to histamine release. The changes are generally confined to the neck and upper chest (the blush area). In conscious subjects, the mechanisms responsible for blushing in the same skin distribution are well defined and neurally mediated. We investigated the relationship between a history of blushing easily and flushing after intravenous induction o f anaesthesia. We interviewed 898 patients about to undergo general anaesthesia and asked them if they blushed easily. Anaesthesia was induced with thiopental followed by suxamethonium and/or alcuronium. We noted skin colour and the presence of a flush every 5 min for 20 min. Women reported blushing more than men (47% of women, compared with 33% of men, p < 0.001), and blushing was more common in young people (p < 0.001). In those women with a history of blushing, 32% flushed on induction of anaesthesia, compared with 6% of those who did not blush. In men, a flush was seen in 22% of those who blushed, and in 0.2% of those who did not. These differences in the frequency of flushing were significant (p < 0.001). In conclusion, flushing after induction of anaesthesia appears to be related to individual predisposition and may be neurally mediated.

Adolescent↗
PubMed2005

Endoscopic sympathectomy in the treatment of facial blushing.

INTRODUCTION: Bilateral endoscopic thoracic sympathectomy (BETS) has been shown to be an effective, permanent, and safe treatment for severe upper limb hyperhydrosis. More recently, the possibility of using BETS to treat facial blushing, a redness of the face bought on by emotional or social stress, has been raised. This followed incidental reports from patients of relief from their blushing following this procedure for hyperhydrosis. At King's College Hospital, 120 patients underwent BETS over a 3-year period for both upper limb hyperhydrosis and facial blushing. In this study we report our results in relation to facial blushing. PATIENTS AND METHODS: The outcome was evaluated by questionnaire and symptoms assessed using the visual analogue scale. Questions on postoperative complications and overall quality of life were included. RESULTS: A total of 80 patients responded to our questionnaire of whom 59 (74%) experienced facial blushing. In 12 patients, this was their only symptom. Severity of facial blushing was reduced from a mean score of 78 before operation to 26 after BETS (P < 0.001); 29% reported complete resolution of their facial blushing. There was no mortality or conversion to open surgery. Quality of life was reported to be much better in 63% of facial blushers following the procedure. CONCLUSIONS: This study demonstrates both a statistically significant reduction in severity of facial blushing as well as a clear improvement in quality of life following a safe procedure with few complication rates. Facial blushing can, therefore, be considered as an indication for BETS on its own merit when not associated with hyperhydrosis.

Adolescent↗
PubMedDate not supplied

Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology.

Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change. Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared. The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.

Adult↗
PubMed2004

The significance of contrast blush on computed tomography in children with splenic injuries.

PURPOSE: Most children and adults with blunt splenic injuries are treated nonoperatively by well-established management protocols. The "blush sign" is an active pooling of contrast material within or around the spleen seen during intravenous enhanced computed tomography (CT) scan. Adult treatment algorithms often include the "blush sign" as an indication for embolization or surgical intervention. This study was designed to evaluate the implications of the "blush sign" in children with blunt splenic injuries. METHODS: A review was performed of all children with blunt splenic injuries treated between January 1996 and December 2001 at a level I pediatric trauma center using an established solid organ injury protocol. The demographic, CT imaging, and outcome data were recorded. Treatment was categorized as operative or nonoperative. A single pediatric radiologist retrospectively reviewed all available CT scans to confirm injury grade and the presence or absence of a "blush sign." RESULTS: There were 133 eligible children admitted with blunt splenic trauma, with a mean age of 9.1 years (range, 1 to 15), including 86 children with an abdominal CT available for review. A "blush sign" on initial CT scan was noted in 6 children, all with grade 3 or above splenic injuries, 5 of who were treated nonoperatively. In this series, the single child with a "blush sign" who did not respond to nonoperative treatment had a severe polytrauma requiring urgent splenectomy and left nephrectomy. None of the children died of their splenic injury. CONCLUSIONS: Although associated with higher grades of injury, the blush sign did not mandate embolization or surgical intervention in children with blunt splenic trauma in this series. Severe splenic injuries with a blush sign on the initial CT scan may be successfully treated nonoperatively when using an established treatment protocol. Management should be based primarily on physiological response to injury rather than the radiologic features of the injury.

Abdominal Injuries↗
PubMed2003

Significance of 'blush' on computed tomography scan in children with liver injury.

BACKGROUND/PURPOSE: The aim of this study was to determine if the presence of "blush" (an indication of active bleeding) on abdominal CT in children with blunt liver injury adversely affected their clinical outcome as has been reported in adults. METHODS: The authors reviewed the records of 105 children ages 1 to 16 years with blunt liver injury seen on admission IV contrast CT seen over a 6-year period. Demographic characteristics measured were age, mechanism of injury, and injury severity score (ISS). Clinical outcomes included ICU stay, hospital length of stay (LOS), transfusion requirement (milliliters per kilogram), operations performed, and mortality rate. CT scans were evaluated retrospectively by a radiologist blinded to prior reports, for a "blush" and grade of liver injury. No patient underwent arterial embolization. The authors eliminated children with grade I-II injuries (30 patients), because only one had a blush, and analyzed the 75 patients with severe liver injuries (grades III-V). Those patients without a blush (n = 53) seen on CT were the control group, whereas patients with a blush (n = 22) were the study group. Data were analyzed using the Fisher's Exact and Mann-Whitney U test. The level of significance was set at.05. RESULTS: Patients with a blush had a significantly larger transfusion requirement (17.3 +/- 30.5 mL/kg v 5.0 +/- 10.9 mL/kg; P =.02) and mortality rate (23% v 4%; P =.02), but the ISS also was significantly greater (25.8 +/- 14.5 v 17.5 +/- 12.2; P =.019). All other data were similar between the 2 groups. CONCLUSIONS: Children with a blush seen on abdominal CT after blunt liver injury have higher transfusion requirements and greater risk of mortality than those without blush. Mortality is primarily related to the severity of their other injuries.

Adolescent↗
PubMed2006

[Limitations of myocardial blush grade in the evaluation of myocardial perfusion in patients with acute myocardial infarction and TIMI grade 3 flow].

INTRODUCTION AND OBJECTIVES: An analysis was made of variability in the measurement of the angiographic index blush between a university hospital and an independent core laboratory, as well as its correlation with perfusion analyzed by intracoronary myocardial contrast echocardiography (MCE) and the ventricular function at the sixth month. METHODS: The study comprised 40 patients with a first ST-segment elevation myocardial infarction, single-vessel disease and open infarct-related artery. Perfusion was quantified by angiography (median fifth day, range 3-7) with blush in our laboratory and in an independent core laboratory. MCE was performed. Ejection fraction at the sixth month was determined with magnetic resonance imaging. RESULTS: We found a weak correlation (r=0.38) between both laboratories. In the comparison of blush measurements concordance was 80%, kappa=0.43 if normality was defined by blush 2-3; and concordance 55%, kappa=0.1 for blush 3. Neither perfusion analyzed by MCE (r= 0.23, P=.2) nor ejection fraction by resonance (r=0.20, P=.3) did correlate to blush. CONCLUSIONS: After infarction in patients with TIMI 3, variability is observed in blush measurements between a university hospital and an independent core laboratory, therefore it seems advisable to centralize blush measures in highly specialized core laboratories. A weak correlation was detected with perfusion analyzed by MCE and with late systolic function.

Aged↗
PubMed1992

Social blushing.

This article reviews theory and research regarding the physiology, situational and dispositional antecedents, behavioral concomitants, and interpersonal consequences of social blushing and offers a new theoretical account of blushing. This model posits that people blush when they experience undesired social attention. Puzzling questions involving blushing in solitude, the phenomenology of blushing, types of blushing, and blushing in dark-skinned people are discussed.

Arousal↗
PubMed1992

Blushing as a function of audience size.

Almost no experimental analysis of blushing has been done since Darwin's observations in 1872. Forty-eight college women watched a videotape intended to elicit blushing, and a videotape not intended to elicit blushing, but elicit physiological responses. A subject was alone, or with one or four persons present. Blushing, which was measured directly with a photoplethysmograph probe on the cheek, was greater during the blushing than nonblushing stimulation. Blushing increased as audience size increased from one to four, but not from zero to one. Audience size and kind of stimulation interacted statistically. Similar results were obtained with ear coloration, cheek temperature, and skin conductance responses, although confidence levels were lower. Cheek coloration and temperature were significantly correlated during nonblushing stimulation, and the zero and one audience conditions, but not during the four audience condition, when blushing was greatest. These results may be placed within the context of emotional effects of audience size generally, including stuttering and speech disturbance, disruption of learning, and self-reported tension.

Adult↗
PubMed2006

Final myocardial blush grade predicts troponin I elevation in unstable angina patients undergoing percutaneous intervention.

BACKGROUND: Improved myocardial blush grade is associated with better MACE outcomes in acute myocardial infarction patients but there are no data on myocardial blush grade (MBG) assessment in unstable angina (UA) patients treated with coronary intervention. We sought to evaluate the use of angiographic MBG assessment in a cohort of UA patients treated with angioplasty. METHODS: Three hundred and seventy-two consecutive UA patients (mean age 68+/-1 years) treated with PCI were included. No patients had a pre-procedural troponin I (TnI) elevation. Final MBG was recorded for the territory subserving the PCI treated culprit lesion in each patient and graded 0 (no blush), 1 (minimal blush), 2 (moderate blush) and 3 (normal blush). TnI (normal range <0.1 microg/L) was measured 24h post-procedure. Patients who did not have a TnI elevation (i.e. <0.1 microg/L) were ascribed a value of 0.1 microg/L. Patients were followed up (mean 962+/-83 days) by postal questionnaire. RESULTS: Baseline risk factors were comparable between final MBG groups. There was no significant difference in mortality rate between groups. Post-procedural troponin I elevations were 0.34+/-0.12, 0.68+/-0.26, 0.14+/-0.01 and 0.11+/-0.01 for MBG groups 0, 1, 2 and 3 (p<0.001). Patients with minimal MBG underwent proportionately more target vessel revascularisation (p<0.05). CONCLUSIONS: Improved blush grade in UA patients undergoing PCI is associated with lower post-procedural TnI elevation. Identification of UA patients with poor final MBG may allow a window of opportunity for the administration of adjuvant therapies to improve microvascular perfusion in the future.

Aged↗
PubMed1990

Facial coloration and temperature responses in blushing.

Little work on the psychophysiology of blushing has been done since Darwin's 1872 observations. Facial vascular and temperature changes have been largely ignored in psychophysiology. We had 16 female and 16 male undergraduate volunteers watch a videotape intended to produce blushing (the individual's singing recorded the previous day), and a videotape not intended to produce blushing, but elicit physiological responses for comparison (a segment from Hitchcock's movie Psycho). Four people were present as a subject watched these video segments. Cheek and ear coloration, measured photoplethysmographically, cheek temperature, and finger skin conductance responses were significantly greater during stimulation intended to elicit blushing than during comparison stimulation. Gender interacted statistically with kind of stimulation only in cheek temperature. Only video segments of the subject's face that coincided with maximal cheek coloration during stimulation intended to produce blushing were judged reliably as blushing, and then more often in females than in males.

Adolescent↗
PubMed2006

Thoracoscopic sympathectomy for isolated facial blushing.

BACKGROUND: Facial blushing is one of the most peculiar of human expressions and has become a cardinal symptom of social phobia. The pathophysiology is unclear and the prevalence is unknown. Thoracoscopic sympathectomy may cure the symptom, but very few surgeons treat patients with isolated facial blushing. The literature is limited, and there are few long-term follow-up studies. METHODS: A follow-up study by questionnaire in 180 consecutive patients who underwent thoracoscopic sympathectomy for isolated facial blushing at two Danish university hospitals during a 6-year period. Patients routinely underwent T2 sympathectomy at the university hospital in Aarhus (n = 101) and T2-T3 sympathectomy at the university hospital in Odense (n = 79). RESULTS: The questionnaire was returned by 96% of the patients after a median follow-up time of 20 months. Overall, 90% of the patients had some effect from the operation, and the result was excellent or satisfactory in 75%. There was no significant difference between the two extents of sympathectomy. Compensatory sweating occurred in 88% of all patients and was significantly more frequent after T2-T3 sympathectomy (p = 0.02) Ten percent of our patients regretted the operation because of side effects or no effect of the operation. CONCLUSIONS: This study demonstrates that thoracoscopic sympathectomy is an effective treatment for isolated facial blushing. The majority of patients achieve an excellent or satisfactory long-term result. Our results suggest that a T2 sympathectomy is superior for patients with isolated facial blushing because side effects are lower compared with a T2-T3 sympathectomy.

Adolescent↗