Sensory and affective aspects of the perception of respiratory resistance

Perception of airway resistance has a sensory and an affective aspect, i.e., perceived resistance and unpleasantness, respectively. The current study aimed to shed more light on the relationship of these aspects, as well as their malleability to trait-like aspects of body awareness. In a laboratory study, 71 young participants completed two respiratory resistive load discrimination tasks relying on sensory and affective evaluation, respectively, and filled out questionnaires assessing somatosensory amplification, anxiety sensitivity, somatic symptoms distress, and breath awareness. Frequentist and Bayesian statistical analysis revealed no differences in discrimination accuracy with respect to the sensory and affective aspect of perceived resistance. Psychological traits were not associated with accuracy scores. In conclusion, affective evaluation of respiratory load is as accurate as sensory evaluation. Neither sensory not affective accuracy is influenced by various aspects of body awareness.

Self-reported interoception, worries and protective behaviors during the COVID-19 pandemic: a longitudinal study

BACKGROUND

Protective behaviors were essential for minimizing the spread of the virus during the coronavirus disease 2019 (COVID-19) pandemic. It is often assumed that awareness of bodily sensations (interoception) can improve decision-making and facilitate adaptive behavior.

OBJECTIVE

This paper investigates cross-sectional and longitudinal relationships between different aspects of self-reported interoception, trait anxiety, COVID-related worry, and health protective behaviors.

METHODS

The study was conducted on a community sample of 265 adults. The two data collection phases took place online, before (baseline) and during the second wave of the COVID-19 pandemic in Hungary.

RESULTS

Contrary to our expectations, neither cross-sectional nor longitudinal associations were found between protective behaviors and indicators of self-reported interoception. However, worry at baseline predicted protective behaviors during the second wave, even after controlling for socio-economical characteristics and protective behaviors at baseline.

CONCLUSION

Our results highlight the adaptivity of health-related worry when behavioral steps to avoid threats are known and available. Also, higher level of perceived interoception did not appear to be health protective under these circumstances.

An idiographic approach to idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) part I. Environmental, psychosocial and clinical assessment of three individuals with severe IEI-EMF

IEI-EMF refers to an environmental illness whose primary feature is the occurrence of symptoms that are attributed to exposure to weak electromagnetic fields (EMFs). There is a growing evidence that this condition is characterized by marked individual differences thus a within-subject approach might add important information beyond the widely used nomothetic method. A mixed qualitative/quantitative idiographic protocol with a threefold diagnostic approach was tested with the participation of three individuals with severe IEI-EMF. In this qualitative paper, the environmental, psychosocial, and clinical aspects are presented and discussed (results of ecological momentary assessment are discussed in Part II of this study). For two participants, psychopathological factors appeared to be strongly related to the condition. Psychological assessment indicated a severe pre-psychotic state with paranoid tendencies, supplemented with a strong attentional focus on bodily sensations and health status. The psychological profile of the third individual showed no obvious pathology. Overall, the findings suggest that the condition might have uniformly been triggered by serious psychosocial stress for all participants. Substantial aetiological differences among participants with severe IEI-EMF were revealed. The substantial heterogeneity in the psychological and psychopathological profiles associated with IEI-EMF warrants the use of idiographic multimodal assessments in order to better understand the different ways of aetiology and to facilitate person-taylored treatments.

Sustained attention is related to heartbeat counting task performance but not to self-reported aspects of interoception and mindfulness

Although association between sustained attention and various aspects of interoception (i.e. the perception of the body state) seems plausible, research on this subject is scarce. In the present study, 74 undergraduate students (41 females; age: 22.3 ± 4.04 yrs) filled out the Body Awareness Questionnaire, the Mindful Attention Awareness Scale, and the Somatosensory Amplification Scale and completed the Heartbeat Counting Task (HCT), a sensory-perceptual measure of cardiac interoception and the PEBL Continuous Performance Test (CPT) assessing sustained attention. The HCT score showed a weak to moderate negative correlation with the number of commission errors shown in CPT, indicating a lack of response inhibition (frequentist analysis: r_s = -0.313, p = 0.008; Bayesian analysis: τ_b = -0.216, BF₁₀ = 5.865). Questionnaire measures did not show any connection with CPT-performance. These findings suggest that the subjective representation of attentiveness to bodily processes is unrelated to the objectively measured sustained attention. Response inhibition, however, is moderately related to HCT performance.

Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation

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.

Examining the Factor Structure and Validity of the Multidimensional Assessment of Interoceptive Awareness

The goal of this study was to psychometrically evaluate the Multidimensional Assessment of Interoceptive Awareness (MAIA), a popular self-report questionnaire claimed to assess the most important subjective aspects of interoception. We collected data in two samples (N = 644 and N = 1,516) and focused on the factor structure and validity of MAIA, as well as its associations with personality traits. Confirmatory Factor Analysis suggested that six of the eight subscales measure a common general factor of self-reported interoception; two MAIA subscales, Not-Worrying and Not-Distracting were only weakly related to this factor. Whereas the general factor correlated strongly with a measure of perceived attentiveness to normal nonemotive body processes, and moderately with Extraversion, Openness and Conscientiousness, the Not-Worrying factor showed moderate to strong negative correlations with Emotionality, pain catastrophization, and anxiety-related aspects of body focus. Not-Distracting was only weakly associated with the validating scales. Overall, these findings do not support the claimed eight-factor structure of the MAIA but indicate the existence of an overarching general factor. Additionally, this study provides evidence that interoceptive awareness, as measured by the MAIA, is related to, but distinct from personality.

Somatosensory amplification - An old construct from a new perspective

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.

Nature relatedness is connected with modern health worries and electromagnetic hypersensitivity

Although nature relatedness is considered a positive characteristic, its relationship to constructs involving worries about the negative effects of artificial environmental factors is also feasible. A questionnaire assessing modern health worries, electrosensitivity, somatosensory amplification, spirituality, and nature relatedness was completed by 510 individuals. Nature relatedness was related to electrosensitivity, modern health worries, and spirituality. In a binary logistic regression analysis, somatosensory amplification, modern health worries, and nature relatedness were associated with electrosensitivity, and nature relatedness moderated the connection between modern health worries and electrosensitivity. In naive representations, “natural” might be associated with health, whereas “modern” and “artificial” evoke negative associations.

Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms

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.

Somatosensory Amplification Is a Predictor of Self-Reported Side Effects in the Treatment of Primary Hypertension: a Pilot Study

PURPOSE

Side effects consist of drug-specific and non-specific symptoms. Both components are based on bodily sensations that a person perceives after taking a drug and subsequently attributes to the drug. We suggest that somatosensory amplification (SSA) may explain a proportion of inter-individual differences in reports of side effects that cannot be accounted for by drug-specific safety profiles. This hypothesis was investigated in hypertensive patients starting a new pharmacotherapy.

METHOD

This longitudinal study included 50 patients (66 % women, aged 55 ± 14 years) with a diagnosis of primary hypertension. Patients completed the Somatosensory Amplification Scale (SSAS), started to take their new medication, and recorded side effects on a daily basis for 4 weeks.

RESULTS

After controlling for age, gender, number of pills taken, and previous personal and family experiences with medication side effects in the regression analyses, SSAS scores remained a significant predictor of reported side effects over the entire study period (weeks 1 and 2: β = .621, p < .001; weeks 3 and 4: β = .493, p = .003). In a subsample comprising patients taking the four most commonly used drug regimes, SSAS was a significant predictor of side effects, even when controlling for type of medication.

CONCLUSION

In this sample of patients undergoing anti-hypertensive pharmacotherapy, higher SSA scores predicted increased reports of medication side effects. To account for this tendency and to improve compliance with medication regimes, this group may require special education about the nocebo phenomenon.

Is somatosensory amplification a risk factor for an increased report of side effects? Reference data from the German general population

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.

The many faces of somatosensory amplification: The relative contribution of body awareness, symptom labeling, and anxiety

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.

Somatic symptoms and holistic thinking as major dimensions behind modern health worries

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.

Modern health worries, somatosensory amplification and subjective symptoms: a longitudinal study : a longitudinal study

BACKGROUND

Modern health worries (MHWs; i.e., concerns about possibly harmful features of modern life) have been associated with somatic symptoms and somatosensory amplification in previous cross-sectional studies. Causal relationship among these variables is yet to be discovered.

PURPOSE

The study investigates the temporal association among subjective symptoms, somatosensory amplification (SSA), and modern health worries (MHWs).

METHOD

Baseline and follow-up questionnaires (somatic symptoms--PHQ-15, somatosensory amplification scale--SSAS, modern health worries scale--MHW, PANAS negative affect scale-NA) were completed by 366 undergraduate students in a 2-month longitudinal study.

RESULTS

MHWs were predicted by baseline MHWs (β = 0.721, p < 0.001) and by somatic symptoms (β = 0.084, p < 0.05). Somatic symptoms were predicted by baseline symptoms (β = 0.610, p < 0.001), NA (β = 0.104, p < 0.05), and SSAS scores (β = 0.089, p < 0.05). The only predictor of SSA was baseline SSAS score (β = 0.628, p < 0.001).

CONCLUSION

Based on the results, a linear model (proneness to somatosensory amplification leads to subjective symptoms which lead to MHWs) was proposed, where MHWs serve as explanations of physical symptoms or as possible environmental threats to avoid.

Family background of modern health worries, somatosensory amplification, and health anxiety: A questionnaire study

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.

Modern health worries, subjective somatic symptoms, somatosensory amplification, and health anxiety in adolescents

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.

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) and electrosensibility (ES) - are they connected?

INTRODUCTION

The tendency of experiencing unpleasant symptoms in the proximity of working electric devices is called idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). Evidence about psychophysiological backgrounds of the phenomenon (i.e., detection ability and mechanisms of symptom generation) is not yet conclusive.

METHODS

Participants of the provocation experiment were 29 individuals with self-reported IEI-EMF and 42 control persons. Participants completed questionnaires (symptom expectations, somatosensory amplification - SSAS, modern health worries radiation subscale - MHW-R), and attempted to detect the presence of 50 Hz 0.5 mT magnetic field (MF) directed to their right arm in 20 subsequent 1-min sessions. Heart rate was also recorded and various indices of heart rate variability (HF, LF/HF, SDNN) were calculated.

RESULTS

Using the methodology of the signal detection theory, individuals with IEI-EMF as opposed to the control group showed a higher than random detection performance (d' differed slightly but statistically significantly from zero), and they used a significantly lower criterion (β value) when deciding about the presence of the MF. Detection sessions followed by correct decisions (hits or correct rejections) were characterized by higher HRV (SDNN and HF indices) than periods followed by errors (misses or false alarms). Previous expectations and affiliation to the IEI-EMF group were significant predictors of symptoms reported following exposure. IEI-EMF was closely related to MHW-R and SSAS scores.

CONCLUSION

Detection of MF might be possible for people with IEI-EMF to some extent. Although heightened sensibility to MFs may play a role in the development and/or in the perpetuance of the IEI-EMF phenomenon, symptoms attributed to the MF seem to be mainly of psychogenic origin.