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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.
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.
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.
A blushing questionnaire and the Self-Consciousness scale (SCS) were completed by 86 respondents. A measure of the tendency to blush correlated significantly with the Social Anxiety subscale of the SCS, but not with the public and private subscales. Self-rated tendency to blush was significantly correlated with rated likelihood of blushing in those situations where the individual had some responsibility for an embarrassing incident, but not in situations where others had instigated the incident.
Percutaneous transluminal coronary angioplasty (PTCA) was performed on 146 saphenous vein grafts in 116 patients. In 29 patients, 31 grafts were totally occluded. Myocardial staining lasting over 5 minutes--"the blush phenomenon"--followed the opening of the occluded grafts in 9 of these patients. In 5 of these 9, enzyme release suggested infarction. A sixth patient died within a few hours of PTCA, with suspected infarction. Autopsy demonstrated diffuse and extensive distal coronary arterial embolization of grumous material, including cholesterol crystals, platelets, and fibrin. The blush phenomenon was not seen following PTCA in the remaining 20 patients with total occlusions, nor in any of the 87 patients with stenosed grafts. We have not observed the blush phenomenon following PTCA of more than 3300 coronary arteries. Of the 9 patients demonstrating the blush phenomenon, 6 had a recent history of myocardial infarction or unstable angina pectoris, compared with 4 of the remaining 20 patients with occluded grafts. We now approach occluded grafts with injection of intragraft thrombolytic agents or with atherectomy prior to PTCA. Future approaches may include atherectomy or laser angioplasty.
Seven cases of ring blush following spontaneous and post-traumatic, subacute and chronic intracerebral hematoma are presented. As such a hematoma ages, a ring blush may be seen following contrast-agent enhancement. Serial CT demonstrates disappearance of the ring blush from two to six months after the first scan. The CT appearance of the ring blush is not specific for hematoma, but its peripheral location and lack of mass effect may be considered suggestive of hematoma with appropriate clinical findings. The characteristic serial changes permit correct diagnosis without surgical intervention in most cases.
In order to investigate factors associated with chronic blushing, 108 self-defined chronic blushers completed a series of self-report inventories. Severe chronic blushing was associated with social anxiety, state and trait anxiety and depression, but not with general physical sensations. Implications of the results for understanding chronic blushing are discussed.
Apart from physiological flushes represented by emotional or prudish blushing, post-prandial flushes and menopausal hot flushes, various pathologic flushes exist of various etiologies: endocrine, dysmetabolic, histaminic and iatrogenic. Their pathogenicity is based mainly on local metabolites secretion provoking vasodilatation of the intermediary microcirculation rather than of the terminal microcirculation. Treatment is a function of etiology and therefore of the patient's history and results of clinical examination, functional exploration and standard biologic tests.
Cranial sonography in neonates almost always reveals a hyperechoic "blush" just posterior and superior to the ventricular trigones on parasagittal views. This normal increased echogenicity resembles fine brush strokes. It is probably caused by the interface of numerous parallel fibers that are nearly perpendicular to the longitudinal axis of a sonographic beam passing through the anterior fontanelle. The same echogenicity is not seen on sonograms obtained through the posterior fontanelle because with that angulation the long axis of the sonographic beam and the fiber tracts are nearly parallel. Sonographic-pathologic correlation in 28 autopsy cases showed that abnormal, dense, globular, coarse, peritrigonal echogenicity was due to periventricular leukomalacia with hemorrhage. Cases with nonhemorrhagic periventricular leukomalacia or perinatal telencephalic leukoencephalopathy demonstrated the normal peritrigonal hyperechogenicity.
We show, through correlation of fetal, neonatal, and necropsy brain sonography, that the three-parallel-echogenic-line configuration classically thought to represent fetal lateral ventricular margins on high axial images are actually extraventricular, lying within cerebral white matter. Accurate sonographic identification of fetal hydrocephalus is essential for appropriate patient management. Both qualitative and quantitative methods of determining ventriculomegaly have been described. The latter require identification of lateral ventricular walls for subsequent ventricular mensuration and comparison with hemispheric width. The parallel-line configuration, thought to represent ventricular margins, has been used for such measurements. We have--through careful fetal, neonatal, and necropsy specimen scanning in several planes--determined that the presumed ventricular wall echoes are actually extraventricular, arising from fibers within the cerebral white matter aligned perpendicular to the sonographic beam. This is identical to the etiology of the normal echogenic periventricular "blush" described in the neonate. Since these parallel echogenic lines do not represent actual ventricular margins, they should not be relied upon for the diagnosis of ventriculomegaly.
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Two malignant intracranial tumors that originated in the paranasal sinuses are described. The patients in both cases were investigated for neurological disorders and had no relevant history of sinus disease. Cerebral angiography demonstrated tumor vascularity identical to meningioma.