Habituation of the Cold Shock Response May Include a Significant Perceptual Component

Introduction: Accidental immersion in cold water is a risk factor for many occupations. Habituation to cold-water immersion (CWI) is one practical means of reducing the cold shock response (CSR) on immersion. We investigated whether repeated thermoneutral water immersion (TWI) induced a perceptual habituation (i.e., could lessen perceived threat and anxiety) and consequently reduce the CSR on subsequent CWI. Methods: There were 12 subjects who completed seven 7-min head-out immersions. Immersions one and seven were CWIs [15.0 (0.1)°C], and immersions two to six were TWI [34.9 (0.10)°C]. Anxiety (20-cm visual analogue scale) and the cardiorespiratory responses [heart rate (fc), respiratory frequency (fR), tidal volume (VT), and minute ventilation (E)] to immersion were measured throughout. Data were compared within subject between conditions using ANOVA to an alpha level of 0.05. Results: Acute anxiety was significantly reduced after repeated exposure to the immersion scenario (i.e., TWI): CWI-1: 6.3 (4.4) cm; and CWI-2: 4.5 (4.0) cm [condition mean (SD)]. These differences did not influence the peak in the CSR. The fc, fR, and E responses were similar between CWI-1 and CWI-2. VT response was significantly lower in CWI-2; mean (SD) across the immersion: CWI-1 1.27 (0.17) vs. CWI-2 1.11 (0.2) L. Discussion: Repeated TWI lessened the anxiety associated with CWI (perceptual habituation). This had a negligible effect on the primary components of the CSR, but did lower VT, which may reduce the volume of any aspirated water in an emergency situation. Reducing the threat appraisal of an environmental stressor may be a useful biproduct of survival training, thereby minimizing psychophysiological strain.