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Köteles F, Nordin S. Do somatic symptom distress and attribution predict symptoms associated with environmental factors? J Psychosom Res 2024; 179:111637. [PMID: 38442536 DOI: 10.1016/j.jpsychores.2024.111637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Not much is known on the development of symptoms associated with environmental factors (SAEF), also known as (idiopathic) environmental intolerances. Findings from qualitative studies suggest that appearance of symptoms might be the first step, followed by the acquisition of a specific attribution. The current study investigated cross-sectional and longitudinal (three years) associations between attribution and symptoms with respect to symptoms associated with chemical substances, certain indoor environments (buildings), sounds, and electromagnetic fields (EMFs). METHODS We used data from the first two waves of the population-based Västerbotten Environmental Health Study (n = 2336). Participants completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Environmental Symptom-Attribution Scale, and answered single questions on the four aforementioned SAEFs. RESULTS Using binary logistic regression analyses, all four SAEFs showed significant cross-sectional associations with somatic symptom distress and the respective attribution. In the longitudinal analysis, development of SAEF-Sound and SAEF-Chemicals were predicted by both somatic symptom distress and attribution. SAEF-EMFs was predicted only by attribution, whereas neither somatic symptom distress nor attribution forecasted SAEF-Buildings. CONCLUSION Overall, these findings suggest that attribution (i.e., a specific expectation) plays a substantial role in the development and maintenance of many SAEFs.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Köteles F, Nordin S, Claeson AS. Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms. J Psychosom Res 2023; 173:111476. [PMID: 37643562 DOI: 10.1016/j.jpsychores.2023.111476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The objective of the present study was to investigate the associations between somatosensory amplification, modern health worries (MHWs), and symptoms among patients with building-related symptoms (BRS). METHODS Patients with self-reported and medically confirmed BRS (n = 83) were included in this cross-sectional study. The Somatosensory Amplification Scale (SSAS) was used to quantify the tendency to amplify somatic sensations and perceive them as unpleasant and dangerous. Concerns about harmful effects of modern technologies were assessed with the Modern Health Worries Scale (MHWS). Symptoms commonly found in different forms of environmental intolerance were assessed with the Environmental Hypersensitivity Symptom Inventory (EHSI). RESULTS Patients with BRS were characterized by more frequent and more severe environmental hypersensitivity symptoms compared to a reference population. Females and those with co-morbid self-reported chemical intolerance reported even more symptoms. MHWS and SSAS scores showed weak to moderate associations with symptoms, even after adjusting for socio-economic variables. However, neither the mean MHWS score or the SSAS score of our sample differed from normative scores. CONCLUSION Patients with BRS are not characterized by elevated levels of MHWs and somatosensory amplification, thus other, psychosocial and/or environmental, factors may have contributed to the development of the condition. However, the associations between severity of symptoms and MHWs and somatosensory amplification suggest that psychosocial characteristics may substantially influence symptom experience in this group.
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Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Köteles F, Szemerszky R, Petrie K, Nordin S. Modern health worries and annoyance from environmental factors are largely unrelated to smoking, alcohol consumption, and physical activity. J Psychosom Res 2023; 172:111417. [PMID: 37331267 DOI: 10.1016/j.jpsychores.2023.111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Modern health worries, as well as environmental annoyance from chemical agents, noise, and electromagnetic exposure are associated with symptom reporting and marked affective-behavioural changes. As promotion and protection of health is a primary characteristic of these conditions, it can be expected that they will be related to less risk behaviour (smoking and alcohol consumption) and more health behaviour (physical activity), both cross-sectionally and longitudinally. METHODS Hypotheses were tested in a sample of 2336 individuals participating in T1 and T2 data collection (3 years apart) of the Västerbotten Environmental Health Study, Sweden. Health-related behaviours were assessed using single self-report questions. Smoking was measured on a binary (yes-or-no) scale; frequency of alcohol consumption and physical activity was measured on a 5-point and a 4-point scale, respectively. RESULTS Modern health worries showed no cross-sectional association with the three behaviours, whereas annoyance was typically inversely, very weakly, related to smoking and alcohol consumption. Physical activity was significantly positively associated only with chemical annoyance. None of the variables significantly predicted change of behaviours at T2 after controlling for the respective T1 value and demographic variables. CONCLUSIONS Individuals with high levels of modern health worries and annoyance from various environmental agents are not clearly characterized by a healthier lifestyle. Perhaps they focus on the alleviation of their existing symptoms; alternatively, somatic symptom distress decreases their cognitive-affective resources necessary for a long-term life style change.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Renáta Szemerszky
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Keith Petrie
- Department of Psychological Medicine, University of Auckland, New Zealand.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Watrin L, Nordin S, Szemerszky R, Wilhelm O, Witthöft M, Köteles F. Psychological models of development of idiopathic environmental intolerances: Evidence from longitudinal population-based data. ENVIRONMENTAL RESEARCH 2022; 204:111774. [PMID: 34506786 DOI: 10.1016/j.envres.2021.111774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 06/13/2023]
Abstract
The origin of idiopathic environmental intolerances (IEIs) is an open question. According to the psychological approaches, various top-down factors play a dominant role in the development of IEIs. The general psychopathology model assumes a propensity towards mental ill-health (negative affectivity) increases the probability of developing IEIs. The attribution model emphasizes the importance of mistaken attribution of experienced somatic symptoms; thus, more symptoms should lead to more IEIs. Finally, the nocebo model highlights the role of expectations in the development of IEIs. In this case, worries about the harmful effects of environmental factors are assumed to evoke IEIs. We estimated cross-lagged panel models with latent variables based on longitudinal data obtained at two time points (six years apart) from a large near-representative community sample to test the hypothesized associations. Indicators of chemical intolerance, electromagnetic hypersensitivity, and sound sensitivity fit well under a common latent factor of IEIs. This factor, in turn, showed considerable temporal stability. However, whereas a positive association was found between IEIs and increased somatic symptoms and modern health worries six years later, the changes therein could not be predicted as hypothesized by the three psychological models. We discuss the implications of these results, as well as methodological aspects in the measurement and prediction of change in IEIs.
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Affiliation(s)
- Luc Watrin
- Institute for Psychology and Education, Ulm University, Germany.
| | | | - Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary
| | - Oliver Wilhelm
- Institute for Psychology and Education, Ulm University, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary
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Kocsel N, Köteles F, Galambos A, Kökönyei G. The interplay of self-critical rumination and resting heart rate variability on subjective well-being and somatic symptom distress: A prospective study. J Psychosom Res 2021; 152:110676. [PMID: 34823115 DOI: 10.1016/j.jpsychores.2021.110676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/25/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this prospective study was to investigate the association of self-critical rumination, autonomic function (indexed by a time domain metric of resting heart rate variability-RMSSD), subjective well-being and somatic symptom distress. METHOD 84 healthy participants (73 females; mean age = 23.56, SD = 3.35 years) completed the Somatic Symptom Severity Scale of the Patient Health Questionnaire and Mental Health Continuum Short Form at two timepoints (at baseline and six months later). Resting heart rate variability (HRV) was assessed at baseline, along with content specific rumination using the Self-Critical Rumination Scale. Four moderation analyses were performed to test these associations. RESULTS The interaction between resting HRV and self-critical rumination significantly explained somatic symptom distress at baseline. For those participants who had high resting HRV, somatic symptom distress was basically independent from the level of self-critical rumination. At the same time, lower resting HRV was associated with higher somatic symptom distress, especially in the presence of more ruminative thoughts. Prospectively, however, the interaction between rumination and resting HRV was not a significant predictor of somatic symptom distress. The association between resting HRV and self-critical rumination did not explain the variance on subjective well-being, but subjective well-being was negatively related to self-critical rumination. CONCLUSION Our findings potentially indicate that self-critical rumination could have a long-term negative impact on psychological functioning, even in a non-clinical sample, and highlight that a lower level of parasympathetic activation, assessed with RMSSD, might be an important factor in the relationship of self-critical rumination and somatic symptom distress.
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Affiliation(s)
- Natália Kocsel
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Ferenc Köteles
- Institution of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Attila Galambos
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.
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Selinheimo S, Lampi J, Pekkanen J. Parent's self-reported indoor environment-related symptoms and health worry increase symptom reports among their children at school-Study in two independent populations. INDOOR AIR 2021; 31:1298-1307. [PMID: 33955596 DOI: 10.1111/ina.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Little is known whether parent's indoor environment quality (IEQ)-related symptoms or health perceptions influence the risk of self- or parent-reported symptoms in their children. We assessed (i) the association of parents' IEQ-related symptoms with IEQ-related symptoms in their children at school and (ii) whether parental IEQ-related health worry increases the risk for children's symptoms. We used two Finnish studies: a national, population-based survey of indoor air and related health problems (n = 611 parents) and a subset of survey for all primary school pupils (grade 3-6) and their parents in Helsinki, which also included school IEQ-related symptoms reported by children (n = 1617 parent-child dyads). In the school survey, parent's own symptoms increased strongly their reporting of their children's symptoms at school (aOR 4.0, 95% CI 2.7-6.0 for parents experiencing a lot of symptoms) and also symptoms reported by the child itself (aOR 2.2, 95% CI 1.5-3.1). Similar, but slightly weaker associations were seen with parental IEQ-related health worries. Results remained unchanged when adjusted for the IEQ of school buildings or parental and children's allergic diseases. Similar associations were seen in the national survey between parent's symptoms at work and child's symptoms at school. The results suggest that parents' health perceptions may increase the reporting of children's IEQ-related symptoms even more than is typically seen for many indoor air contaminants.
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Affiliation(s)
| | - Jussi Lampi
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Juha Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Szemerszky R, Dömötör Z, Witthöft M, Köteles F. Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation. J Psychosom Res 2021; 146:110501. [PMID: 33930739 DOI: 10.1016/j.jpsychores.2021.110501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Paranoid ideation is assumed to characterize worries about possible harmful effects of modern technologies (MHWs) and idiopathic environmental intolerances (IEIs), such as IEI attributed to electromagnetic fields (IEI-EMF). Empirical evidence on these associations is scarce. METHODS In a cross-sectional on-line survey, participants of a community sample (n = 700; mean age: 28.4 ± 12.0; 434 females) completed the Somatosensory Amplification Scale, the Modern Health Worries Scale, and the Paranoid Ideation scale of the Symptom Checklist 90 Revised. They were considered IEI-EMF if (1) they categorized themselves so, (2) they had experienced symptoms that they attributed to the exposure to electromagnetic fields, and (3) the condition impacted their everyday functioning. RESULTS Paranoid ideation was significantly positively associated with MHWs (standardized β = 0.150, p < .001) even after controlling for socio-demographic variables and somatosensory amplification tendency, an indicator of somatic symptom distress. Also, paranoid ideation explained significant variability in IEI-EMF (OR = 1.090, 95% CI: 1.006-1.180, p = .035) even after statistically controlling for socio-demographic variables and somatosensory amplification. CONCLUSIONS Paranoid ideation was found to be associated with MHWs and IEI-EMF. This association appears independent of general somatic symptom distress in both cases. This might partly explain the temporal stability of these constructs.
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Affiliation(s)
- Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
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Furnham A. Modern Health Worries and the Personality Disorders: Two Studies Using Different Measures. Health (London) 2021. [DOI: 10.4236/health.2021.133019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Köteles F, Szemerszky R, Witthöft M, Nordin S. No evidence for interactions between modern health worries, negative affect, and somatic symptom distress in general populations. Psychol Health 2020; 36:1384-1396. [DOI: 10.1080/08870446.2020.1841761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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Barends H, Claassen-van Dessel N, van der Wouden JC, Twisk JWR, Terluin B, van der Horst HE, Dekker J. Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study. J Psychosom Res 2020; 135:110131. [PMID: 32473411 PMCID: PMC7614434 DOI: 10.1016/j.jpsychores.2020.110131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The somatosensory amplification theory considers symptom focusing and somatosensory amplification as important perpetuating factors of persistent physical symptoms. We investigated whether symptom focusing and somatosensory amplification were associated with symptom severity and mental and physical functioning over a three-year period in patients with persistent physical symptoms (PPS). METHODS Baseline, 6-, 12-, 24- and 36-months follow-up data from the PROSPECTS study, a prospective cohort consisting of 325 patients with PPS, were used. We applied longitudinal mixed model analyses to investigate if symptom focusing (CBRQ Symptom Focusing Subscale) and somatosensory amplification (Somatosensory Amplification Scale) at baseline were associated with symptom severity (PHQ-15), mental and physical functioning (RAND-36 MCS and PCS) over three years, using all measurements. RESULTS Symptom focusing was associated with increased symptom severity and lower mental and physical functioning over time. Somatosensory amplification at baseline was associated with increased symptom severity and lower mental and physical functioning over time. Effect sizes were small. Associations with baseline symptom focusing decreased over time, associations with baseline somatosensory amplification were more stable. There was no interaction effect of both constructs, but they partly overlapped. CONCLUSION This is the first study to show that over an extended period, symptom focusing and somatosensory amplification are associated with symptom severity and lower mental and physical functioning in patients with PPS. These results support the impact of both symptom focusing and somatosensory amplification on the perpetuation of symptoms and lowered mental and physical functioning in individuals with PPS.
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Affiliation(s)
- Hieke Barends
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, the Netherlands; Amsterdam Public Health research institute, the Netherlands.
| | - Nikki Claassen-van Dessel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, the Netherlands; Amsterdam Public Health research institute, the Netherlands.
| | - Johannes C van der Wouden
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, the Netherlands; Amsterdam Public Health research institute, the Netherlands.
| | - Jos W R Twisk
- Amsterdam Public Health research institute, the Netherlands; Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands.
| | - Berend Terluin
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, the Netherlands; Amsterdam Public Health research institute, the Netherlands.
| | - Henriëtte E van der Horst
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, the Netherlands; Amsterdam Public Health research institute, the Netherlands.
| | - Joost Dekker
- Amsterdam Public Health research institute, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine and Department of Psychiatry, the Netherlands.
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Association between somatic symptoms and modern health worries. J Psychosom Res 2020; 135:110163. [PMID: 32559520 DOI: 10.1016/j.jpsychores.2020.110163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/11/2020] [Accepted: 05/26/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Modern health worries (MHWs) refer to perceived risk to personal health from technological changes and features of modern life, and is associated with health outcomes. The present objective was to test the hypotheses of (i) associations between MHWs and a global measure of typical somatization symptoms, referred to as somatic symptom distress, and (ii) associations between MHWs and a broad range of specific typical somatization symptoms and eye/skin and airway symptoms. METHODS Cross-sectional population-based data were used. Validated instruments were used to assess MHWs (Modern Health Worries Scale), typical somatization symptoms (Patient Health Questionnaire 15-item Somatic Symptom Severity Scale, PHQ-15), eye/skin and airway symptoms (Environmental Hypersensitivity Symptom Inventory), depression and anxiety (Hospital Anxiety and Depression Scale). Multivariate linear regression analyses were conducted with MHWs as dependent variable, symptoms as independent variables, and background variables, anxiety and depression as confounding variables. RESULTS When controlled for background variables, MHWs were statistically significantly, but only very weakly, associated with global PHQ-15 score, most of the specific typical somatization symptoms, and eye/skin and airway symptoms. When controlled also for depression and anxiety, the associations were statistically significant, but even more weakly associated with global PHQ-15 score and most of the specific symptoms. CONCLUSIONS The results suggest a very small increased risk of somatic symptom distress and related specific symptoms in MHW, and that depression and anxiety are confounding variables in these associations.
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Dömötör Z, Nordin S, Witthöft M, Köteles F. Modern health worries: A systematic review. J Psychosom Res 2019; 124:109781. [PMID: 31443819 DOI: 10.1016/j.jpsychores.2019.109781] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Modern health worries (MHWs) refer to people's concerns about possible harmful effects of modern technologies, and are widespread in the developed countries. The aim of the present work was to provide comprehensive, yet integrated understanding for MHWs and associated factors. METHODS Following the PRISMA guideline, a systematic review was conducted based on 48 empirical articles published between 2001 and 2018 (Prospero registration number: CRD42018103756). All empirical studies were included that (1) were published between 2001 and 2018 in peer-reviewed scientific journals in English, German, or Hungarian, (2) used the Modern Health Worries Scale or any of its sub-scales, and (3) assessed associations between MHWs and other constructs and/or compared criterion groups (i.e. purely psychometric studies were excluded). RESULTS The results from the review suggest that female gender, age, somatic symptom distress and idiopathic environmental intolerances, holistic thinking, and paranoid beliefs are positively associated with MHWs, whereas educational qualification and the five major dimensions of personality appear not to be. CONCLUSION Scientific inquiry on the MHWs phenomenon is still in its descriptive-explorative phase; more rigorously designed studies are needed. The presented theoretical framework integrates illness-related and holistic thinking-related aspects of MHWs as a starting point to guide further research in this area.
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Affiliation(s)
- Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
| | | | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
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Modern health worries: Deriving two measurement invariant short scales for cross-cultural research with Ant Colony Optimization. PLoS One 2019; 14:e0211819. [PMID: 30730928 PMCID: PMC6366774 DOI: 10.1371/journal.pone.0211819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022] Open
Abstract
Worries about possible harmful effects of new technologies (modern health worries) have intensely been investigated in the last decade. However, the comparability of translated self-report measures across countries is often problematic. This study aimed to overcome this problem by developing psychometrically sound brief versions of the widely used 25-item Modern Health Worries Scale (MHWS) suitable for multi-country use. Based on data of overall 5,176 individuals from four European countries (England, Germany, Hungary, Sweden), Ant Colony Optimization was used to identify the indicators that optimize model fit and measurement invariance across countries. Two scales were developed. A short (12-item) version of the MHWS that represents the four-factor structure of the original version and an ultra-short (4-item) scale that only measures the general construct. Both scales show that overall levels of health worries were highest in England and Hungary, but that the main reason for concern (e.g. electromagnetic radiation or food related fears) differs considerably between these countries. This study also shows that even if measurement invariance of translated self-report instruments across countries is problematic, it can be optimized by using adequate item selection procedures. Differences of modern health worries across countries and recommendations for cross-cultural research are discussed.
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Martens AL, Reedijk M, Smid T, Huss A, Timmermans D, Strak M, Swart W, Lenters V, Kromhout H, Verheij R, Slottje P, Vermeulen RCH. Modeled and perceived RF-EMF, noise and air pollution and symptoms in a population cohort. Is perception key in predicting symptoms? THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:75-83. [PMID: 29778684 DOI: 10.1016/j.scitotenv.2018.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/23/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Psychosocial research has shown that perceived exposure can influence symptom reporting, regardless of actual exposure. The impact of this phenomenon on the interpretation of results from epidemiological research on environmental determinants of symptoms is unclear. OBJECTIVE Our aim was to compare associations between modeled exposures, the perceived level of these exposures and reported symptoms (non-specific symptoms, sleep disturbances, and respiratory symptoms) for three different environmental exposures (radiofrequency electromagnetic fields (RF-EMF), noise, and air pollution). These environmental exposures vary in the degree to which they can be sensorially observed. METHODS Participant characteristics, perceived exposures, and self-reported health were assessed with a baseline (n = 14,829, 2011/2012) and follow-up (n = 7905, 2015) questionnaire in the Dutch population-based Occupational and Environmental Health Cohort (AMIGO). Environmental exposures were estimated at the home address using spatial models. Cross-sectional and longitudinal regression models were used to examine the associations between modeled and perceived exposures, and reported symptoms. RESULTS The extent to which exposure sources could be observed by participants likely influenced correlations between modeled and perceived exposure as correlations were moderate for air pollution (rSp = 0.34) and noise (rSp = 0.40), but less so for RF-EMF (rSp = 0.11). Perceived exposures were consistently associated with increased symptom scores (respiratory, sleep, non-specific). Modeled exposures, except RF-EMF, were associated with increased symptom scores, but these associations disappeared or strongly diminished when accounted for perceived exposure in the analyses. DISCUSSION Perceived exposure has an important role in symptom reporting. When environmental determinants of symptoms are studied without acknowledging the potential role of both modeled and perceived exposures, there is a risk of bias in health risk assessment. However, the etiological role of exposure perceptions in relation to symptom reporting requires further research.
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Affiliation(s)
- Astrid L Martens
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Marije Reedijk
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Universiteitsweg 100, 3584CG Utrecht, The Netherlands.
| | - Tjabe Smid
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Anke Huss
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Danielle Timmermans
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands; National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721MA Bilthoven, The Netherlands.
| | - Maciej Strak
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Wim Swart
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721MA Bilthoven, The Netherlands.
| | - Virissa Lenters
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Robert Verheij
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513CR Utrecht, The Netherlands.
| | - Pauline Slottje
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Roel C H Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Universiteitsweg 100, 3584CG Utrecht, The Netherlands; Imperial College, Department of Epidemiology and Public Health, South Kensington Campus, SW7 2AZ London, United Kingdom.
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Longitudinal associations between risk appraisal of base stations for mobile phones, radio or television and non-specific symptoms. J Psychosom Res 2018; 112:81-89. [PMID: 30097140 DOI: 10.1016/j.jpsychores.2018.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/19/2018] [Accepted: 07/13/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Studies found that higher risk appraisal of radiofrequency electromagnetic fields is associated with reporting more non-specific symptoms such as headache and back pain. There is limited data available on the longitudinal nature of such associations and what aspects of risk appraisal and characteristics of subjects are relevant. OBJECTIVE To examine cross-sectional and longitudinal associations between risk appraisal measures and non-specific symptoms, and assess the role of subject characteristics (sex, age, education, trait negative affect) in a general population cohort. METHODS This study was nested in the Dutch general population AMIGO cohort that was established in 2011/2012, when participants were 31-65 years old. We studied a sample of participants (n = 1720) who filled in two follow-up questionnaires in 2013 and 2014, including questions about perceived exposure, perceived risk, and health concerns as indicators of risk appraisal of base stations, and non-specific symptoms. RESULTS Perceived exposure, perceived risk, and health concerns, respectively, were associated with higher symptom scores in cross-sectional and longitudinal analyses. Only health concerns (not perceived exposure and perceived risk) temporally preceded high symptom scores and vice versa. Female sex, younger age, higher education, and higher trait negative affect were associated with higher risk appraisal of mobile phone base stations. DISCUSSION The findings in this study strengthen the evidence base for cross-sectional and longitudinal associations between higher risk appraisal and non-specific symptoms in the general population. However, the directionality of potential causal relations in non-sensitive general population samples should be examined further in future studies, providing information to the benefit of risk communication strategies.
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Simor P, Harsányi A, Csigó K, Miklós G, Lázár AS, Demeter G. Eveningness is associated with poor sleep quality and negative affect in obsessive-compulsive disorder. J Behav Addict 2018; 7:10-20. [PMID: 29415552 PMCID: PMC6035014 DOI: 10.1556/2006.7.2018.07] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/18/2018] [Accepted: 01/21/2018] [Indexed: 11/19/2022] Open
Abstract
Background Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors that severely encumber daily functioning. OCD patients seem to exhibit sleep disturbances, especially delayed bedtimes that reflect disrupted circadian rhythmicity. Morningness-eveningness is a fundamental factor reflecting individual variations in diurnal preferences related to sleep and waking activities. Eveningness reflecting a delayed sleep-wake timing has repeatedly been associated with sleep problems and negative affect (NA). Therefore, the aim of this study was to examine the associations between morningness-eveningness, sleep complaints, and symptom severity in OCD patients and compared with a mixed psychiatric control group. Materials and methods The data of 49 OCD and 49 mixed psychiatric inpatients (with unipolar depression and anxiety disorders) were analyzed. Patients completed questionnaires regarding morningness-eveningness, sleep quality, nightmare frequency, depression, anxiety, and affective states. Obsessive and compulsive symptom severity was also assessed within the OCD group by clinician-rated scales. Results Eveningness preference was associated with impaired sleep quality and higher NA in OCD patients. In addition, impaired sleep quality showed a moderate correlation with anxiety and strong correlations with depressive symptoms and NA. Interestingly, in the mixed psychiatric group, eveningness was not linked to NA, and sleep quality also showed weaker associations with depressive symptoms and NA. Within the OCD group, eveningness preference was predictive of poorer sleep quality regardless the influence of depressive symptoms. Conclusion Our findings suggest that eveningness and sleep complaints are predictive of affective dysfunctions, and should be carefully considered in the evaluation and treatment of OCD patients.
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Affiliation(s)
- Péter Simor
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - András Harsányi
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Kata Csigó
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | | | - Alpár Sándor Lázár
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Gyula Demeter
- Department of Cognitive Sciences, Budapest University of Technology and Economics, Budapest, Hungary
- Rehabilitation Department of Brain Injuries, National Institute of Medical Rehabilitation, Budapest, Hungary
- Learning and Memory Disorders Research Group, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
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Köteles F, Witthöft M. Somatosensory amplification - An old construct from a new perspective. J Psychosom Res 2017; 101:1-9. [PMID: 28867412 DOI: 10.1016/j.jpsychores.2017.07.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
Abstract
The paper reviews and summarizes the history and the development of somatosensory amplification, a construct that plays a substantial role in symptom reports. Although the association with negative affect has been supported by empirical findings, another key elements of the original concept (i.e. body hypervigilance and the tendency of focusing on mild body sensations) have never been appropriately addressed. Recent findings indicate that somatosensory amplification is connected with phenomena that do not necessarily include symptoms (e.g. modern health worries, or expectations of symptoms and medication side effects), and also with the perception of external threats. In conclusion, somatosensory amplification appears to refer to the intensification of perceived external and internal threats to the integrity of the body ("somatic threat amplification") rather than amplification of perceived or actual bodily events only. Practical implications of this new approach are also discussed.
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Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Bogdánfy Ödön u. 10, H-1117 Budapest, Hungary.
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Bräscher AK, Raymaekers K, Van den Bergh O, Witthöft M. Are media reports able to cause somatic symptoms attributed to WiFi radiation? An experimental test of the negative expectation hypothesis. ENVIRONMENTAL RESEARCH 2017; 156:265-271. [PMID: 28371755 DOI: 10.1016/j.envres.2017.03.040] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/27/2017] [Accepted: 03/27/2017] [Indexed: 05/04/2023]
Abstract
People suffering from idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) experience numerous non-specific symptoms that they attribute to EMF. The cause of this condition remains vague and evidence shows that psychological rather than bioelectromagnetic mechanisms are at work. We hypothesized a role of media reports in the etiology of IEI-EMF and investigated how somatosensory perception is affected. 65 healthy participants were instructed that EMF exposure can lead to enhanced somatosensory perception. Participants were randomly assigned to watch either a television report on adverse health effects of EMF or a neutral report. During the following experiment, participants rated stimulus intensities of tactile (electric) stimuli while being exposed to a sham WiFi signal in 50% of the trials. Sham WiFi exposure led to increased intensity ratings of tactile stimuli in the WiFi film group, especially in participants with higher levels of somatosensory amplification. Participants of the WiFi group reported more anxiety concerning WiFi exposure than the Control group and tended to perceive themselves as being more sensitive to EMF after the experiment compared to before. Sensational media reports can facilitate enhanced perception of tactile stimuli in healthy participants. People tending to perceive bodily symptoms as intense, disturbing, and noxious seem most vulnerable. Receiving sensational media reports might sensitize people to develop a nocebo effect and thereby contribute to the development of IEI-EMF. By promoting catastrophizing thoughts and increasing symptom-focused attention, perception might more readily be enhanced and misattributed to EMF.
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Affiliation(s)
- Anne-Kathrin Bräscher
- Johannes Gutenberg University Mainz, Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Wallstraße 3, 55122 Mainz, Germany.
| | - Koen Raymaekers
- Johannes Gutenberg University Mainz, Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Wallstraße 3, 55122 Mainz, Germany; KU Leuven - University of Leuven, School Psychology and Development in Context, Belgium
| | | | - Michael Witthöft
- Johannes Gutenberg University Mainz, Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Wallstraße 3, 55122 Mainz, Germany
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What makes sense in our body? Personality and sensory correlates of body awareness and somatosensory amplification. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.07.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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20
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Szemerszky R, Dömötör Z, Berkes T, Köteles F. Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms. Int J Behav Med 2016; 23:204-13. [PMID: 26420517 DOI: 10.1007/s12529-015-9511-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution. PURPOSE The current study aimed to find empirical evidence supporting this theory. METHOD Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed. RESULTS No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables. CONCLUSIONS An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.
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Affiliation(s)
- Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary
| | - Zsuzsanna Dömötör
- Doctoral School of Psychology and Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Tímea Berkes
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary.
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Palmquist E, Petrie KJ, Nordin S. Psychometric Properties and Normative Data for a Swedish Version of the Modern Health Worries Scale. Int J Behav Med 2016; 24:54-65. [PMID: 27324490 DOI: 10.1007/s12529-016-9576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Simor P, Krietsch KN, Köteles F, McCrae CS. Day-to-Day Variation of Subjective Sleep Quality and Emotional States Among Healthy University Students--a 1-Week Prospective Study. Int J Behav Med 2016; 22:625-34. [PMID: 25622815 DOI: 10.1007/s12529-015-9464-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In spite of the apparently bidirectional relationship between daytime emotions and nocturnal sleep quality, relatively few studies have examined the day-to-day co-variation of daytime emotional states and sleep quality. PURPOSE In order to address this issue, we used a 7-day prospective design allowing for the simultaneous investigation of the bidirectional link between sleep quality and affective states. METHOD Seventy-five healthy university students completed a daily log during 7 days, reporting subjective sleep quality after their final morning awakenings. Eight hours later, they completed the Positive and Negative Affect Schedule measuring daytime affective states. Multilevel modeling was applied in order to examine level 1 (day-to-day co-variation of sleep quality and affective states within individuals) as well as level 2 (averaged between-subjects) effects. RESULTS Individuals reporting poor sleep quality (on average) were characterized by lower positive and higher negative affect during daytime. Similarly, higher positive and lower negative affect (on average) predicted better subjective sleep quality during the assessment period. Moreover, daily ratings of positive and negative affect were related to the subjective sleep quality of the preceding night: On occasions in which participants reported poor (below average) sleep quality, they also reported lower positive and higher negative affect during the day. Nevertheless, daytime positive and negative affective states did not predict subsequent sleep quality ratings. CONCLUSION These findings suggest daily dynamic associations between subjective sleep quality and next day's emotional states in a group of healthy individuals, while in the inverse, the co-variation between daytime affective states and subsequent sleep quality was not supported.
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Affiliation(s)
- Péter Simor
- Department of Cognitive Sciences, Budapest University of Technology and Economics, Egry József u. 1. Tépület./V.em., Budapest, 1111, Hungary. .,Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary.
| | - Kendra N Krietsch
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ferenc Köteles
- Institute for Health Promotion and Sport Sciences, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Christina S McCrae
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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Dömötör Z, Doering BK, Köteles F. Dispositional aspects of body focus and idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). Scand J Psychol 2016; 57:136-43. [DOI: 10.1111/sjop.12271] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/02/2015] [Indexed: 11/29/2022]
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Doering BK, Nestoriuc Y, Barsky AJ, Glaesmer H, Brähler E, Rief W. Is somatosensory amplification a risk factor for an increased report of side effects? Reference data from the German general population. J Psychosom Res 2015; 79:492-7. [PMID: 26553385 DOI: 10.1016/j.jpsychores.2015.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The study investigates the association between somatosensory amplification and the reporting of side effects. It establishes a German version of the Somatosensory Amplification Scale and examines its psychometric properties in a representative sample of the German population. METHODS Sample size was 2.469, with 51% taking any medication. Participants answered the Somatosensory Amplification Scale, Generic Assessment of Side Effects Scale, and indicated whether they were taking any medication and the type of medication. Correlational analysis and binary logistic regression were performed. RESULTS When examining a subsample reporting both medication intake and general bodily symptoms, participants higher in somatosensory amplification rated more of their general bodily symptoms as medication-attributed side effects. However, somatosensory amplification scores were not associated with the intake of any type of medication. In the overall sample, higher somatosensory amplification scores were associated with an increased report of bodily symptoms. Additionally, participants with higher somatosensory amplification reported intake of a greater number of different medications. The psychometric properties of the translated scale were good, and previously established associations of somatosensory amplification with demographic variables (age, sex) were replicated. CONCLUSION Results suggest a possible attributional bias concomitant to somatosensory amplification which in turn may increase the reporting of side effects after medication intake.
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Affiliation(s)
- B K Doering
- Department of Psychology, University of Marburg, Germany.
| | - Y Nestoriuc
- Institute of Psychology, University of Hamburg, Germany
| | - A J Barsky
- Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany; University Medical Center of the Johannes Gutenberg University Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - W Rief
- Department of Psychology, University of Marburg, Germany
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The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data. J Psychosom Res 2015; 79:355-61. [PMID: 26526308 DOI: 10.1016/j.jpsychores.2015.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The present study investigates the association of modern health worries (MHW) with self-reported as well as general practitioner (GP)-registered non-specific physical symptoms (NSPS), medication use, alternative therapy consultations, sleep quality and quality of life. The interrelation between MHW, general environmental sensitivity and the aforementioned outcomes is also explored. METHODS Self-reported questionnaires and data from electronic medical records from 21 general practices in The Netherlands were combined in a sample of 5933 adult participants. RESULTS The majority of the participants reported increased worries about potential health effects from environmental exposures. The highest worry scores were reported by people who perceived themselves as more vulnerable to environmental stressors. After adjustment for socio-demographic characteristics and diagnosed psychiatric morbidity, higher MHW were significantly associated with increased self-reported prevalence and duration of NSPS, symptom-related healthcare utilization, GP-registered NSPS, alternative therapy consultations and lower sleep quality and quality of life. These associations were statistically mediated by perceived environmental sensitivity. No association was observed between worries and GP-registered medication prescriptions. CONCLUSION Modern health worries are very common in the general population. They are associated with self-reported as well as clinically defined NSPS and as such might play a key role in the process of developing and maintaining environmental sensitivities and related symptoms. A large cross-cultural longitudinal study would help to determine important aspects such as temporal precedence and stability of MHW and the relevant psychosocial context within which symptomatic conditions occur.
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Köteles F, Doering BK. The many faces of somatosensory amplification: The relative contribution of body awareness, symptom labeling, and anxiety. J Health Psychol 2015; 21:2903-2911. [PMID: 26060240 DOI: 10.1177/1359105315588216] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The questionnaire study aimed to evaluate the relative contribution of body awareness, subjective symptoms, and anxiety to the construct of somatosensory amplification in both healthy controls (n = 475) and patients visiting their general practitioner (n = 236). Regression analysis explained 52.0 percent of total variance of the somatosensory amplification scale scores. Body awareness was the most influential predictor (β = 0.489, p < 0.001) when considering all predictors simultaneously. The results suggest that dispositional interoceptive focus, as indicated by body awareness, may be an important aspect of somatosensory amplification, over and above dispositional anxiety or subjective symptom report.
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Köteles F, Simor P. Somatic symptoms and holistic thinking as major dimensions behind modern health worries. Int J Behav Med 2015; 21:869-76. [PMID: 24136400 DOI: 10.1007/s12529-013-9363-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Modern health worries (MHWs) were related to somatic symptoms and to preference of holistic healing methods in previous studies. PURPOSE The study aimed to investigate the contribution of symptom-related and holism-related factors to MHWs. METHODS Participants (visitors of an Internet news portal; N = 16152; 64.1 % males) completed a questionnaire assessing MHWs, somatosensory amplification, somatic symptoms, positive and negative affect, spirituality, holistic health beliefs, and various aspects of health care utilization (both conventional and alternative). RESULTS Exploratory factor analysis with oblique rotation revealed two independent dimensions ("Somatic symptom distress" and "Holism") MHWs were involved with factor loadings of 0.294 and 0.417, respectively. The existence of two factors was supported by the results of confirmatory factor analysis. No practically significant interaction between the two factors was found in binary logistic regression analysis. Positive and negative affect, somatosensory amplification, spirituality, and holistic health beliefs were positively connected, while self-rated health status was negatively connected to MHWs even after controlling for socio-demographic and treatment-related variables. CONCLUSIONS Holistic thinking and symptom-related behavioral and psychological factors are independently associated with MHWs. Modern health worries can be conceptualized as symptom-related by-products of a holistic-spiritual worldview.
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Affiliation(s)
- Ferenc Köteles
- Faculty of Education and Psychology, Institute for Health Promotion and Sport Sciences, Eötvös Loránd University, Budapest, Bogdánfy Ödön u. 10., 1117, Hungary,
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Szemerszky R, Gubányi M, Árvai D, Dömötör Z, Köteles F. Is There a Connection Between Electrosensitivity and Electrosensibility? A Replication Study. Int J Behav Med 2015; 22:755-63. [DOI: 10.1007/s12529-015-9477-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fionda S, Furnham A. Hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine and modern health worries predict patient satisfaction. JRSM Open 2014; 5:2054270414551659. [PMID: 25408919 PMCID: PMC4229056 DOI: 10.1177/2054270414551659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate how hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine (CAM) and modern health worries (MHWs) related to patient satisfaction with their general practitioner. Design Participants completed a five-part questionnaire anonymously which measured satisfaction with one’s doctor, hypochondriacal beliefs, attitudes to CAM, MHWs and personality. Setting England Participants Included 215 adults from a variety of cultural backgrounds. Main outcome measure The Illness Attitudes Scales measuring the attitudes, fears and beliefs associated with hypochondriasis; Worry about Illness; Concerns about Pain, Health Habits, Hypochondriacal beliefs; Thanatophobia, Disease phobia, Bodily preoccupations; Treatment experience and Effects of symptoms. Results Correlations (around r = .10 to .25) and Regressions (R square from .06 to .09) showed demographic and personality variables only modestly related to patient satisfaction. Hypochondriasis, CAM and MHWs were associated with greater patient dissatisfaction as predicted with the former as the most powerful correlate. Conclusion The study indicates the different needs of potential patients in a typical medical consultation. It is important to ascertain patients’ health beliefs and practices with regard to medical history, attitudes to CAM and MHWs to increase consultation satisfaction.
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Affiliation(s)
- Sofia Fionda
- Research Department of Clinical, Educational and Health Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK
| | - Adrian Furnham
- Research Department of Clinical, Educational and Health Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK
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Creed FH, Tomenson B, Chew-Graham C, Macfarlane GJ, Davies I, Jackson J, Littlewood A, McBeth J. Multiple somatic symptoms predict impaired health status in functional somatic syndromes. Int J Behav Med 2014; 20:194-205. [PMID: 22932928 DOI: 10.1007/s12529-012-9257-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The relationship between functional somatic syndromes and multiple somatic symptoms is unclear. PURPOSE We assessed whether the number of somatic symptoms is a predictor of health status in three functional somatic syndromes (FSS). METHODS In a population-based study of 990 UK adults we assessed chronic widespread pain (CWP), chronic fatigue (CF) and irritable bowel syndrome (IBS) by questionnaire and medical record data. We assessed health status (Short Form 12 and EQ-5D), number of somatic symptoms (Somatic Symptom Inventory) and anxiety/depression (Hospital Anxiety and Depression Scale) both at baseline and at follow-up 1 year later. RESULTS The proportion of people with an FSS who also have multiple somatic symptoms (52-55 %) was similar in the three functional syndromes. The presence of multiple somatic symptoms was associated with more impaired health status both at baseline and at follow-up. This finding was not explained by severity of FSS. In the absence of multiple somatic symptoms, the health status of the FSS was fair or good. In multiple regression analysis, the number of somatic symptoms, the presence of a functional syndrome (CWP or CF) and anxiety/depression were predictors of EQ-5D thermometer at follow-up after adjustment for confounders. CONCLUSIONS Multiple somatic symptoms in people with an FSS are associated with impaired health status and this cannot be explained by more severe functional syndrome or the presence of anxiety and depression.
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Affiliation(s)
- F H Creed
- School of Community Based Medicine, University of Manchester, Oxford Road, Manchester, UK.
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Family background of modern health worries, somatosensory amplification, and health anxiety: A questionnaire study. J Health Psychol 2014; 20:1549-57. [DOI: 10.1177/1359105313516661] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In the development of somatosensory amplification, health anxiety, and modern health worries, environmental factors seem more important than genetic background. Parental attitudes might represent a major source of learning. In total, 186 adolescents and their parents completed a questionnaire assessing modern health worries, somatosensory amplification, health anxiety, and somatic symptoms. Adolescents’ modern health worries, somatosensory amplification, and health anxiety were positively related to respective parental characteristics in regression analyses even after controlling for sociodemographic variables and somatic symptoms. Parental beliefs may play a role in the development of these characteristics.
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THOMPSON TIFFANYS, BARKSDALE DEBRAJ, SEARS SAMUELF, MOUNSEY JOHNPAUL, PURSELL IRION, GEHI ANILK. The Effect of Anxiety and Depression on Symptoms Attributed to Atrial Fibrillation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 37:439-46. [DOI: 10.1111/pace.12292] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/08/2013] [Accepted: 09/13/2013] [Indexed: 11/26/2022]
Affiliation(s)
- TIFFANY S. THOMPSON
- School of Nursing; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - DEBRA J. BARKSDALE
- School of Nursing; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - SAMUEL F. SEARS
- Departments of Psychology and Cardiovascular Sciences; East Carolina University; Greenville North Carolina
| | - JOHN PAUL MOUNSEY
- Department of Medicine; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - IRION PURSELL
- Department of Medicine; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - ANIL K. GEHI
- Department of Medicine; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
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Freyler A, Kőhegyi Z, Köteles F, Kökönyei G, Bárdos G. Modern health worries, subjective somatic symptoms, somatosensory amplification, and health anxiety in adolescents. J Health Psychol 2013; 18:773-81. [DOI: 10.1177/1359105313479629] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The cross-sectional study aimed at the psychometric evaluation of the Modern Health Worries Scale in adolescents and the exploration of the relationship among modern health worries, somatosensory amplification, health anxiety, and somatic symptoms. A total of 480 secondary school students (aged between 14 and 19 years) completed a set of questionnaires. Four-factor structure of the scale was confirmed by confirmatory factor analysis. Modern health worries were connected to somatosensory amplification and health anxiety, and somatosensory amplification and health anxiety were partial mediators of the connection between modern health worries and somatic symptoms. Perceived vulnerability (conceptualized as somatosensory amplification and health anxiety) appears to build a “social-cognitive-emotional bridge” between symptoms and modern health worries.
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