1,720,989 research outputs found
Underlying mechanisms of persistent physical symptoms: A focus on the role of interoception, proprioception and stress physiology
No full textnot availabl
Comparing autonomic nervous system function in patients with functional somatic syndromes, stress-related syndromes and healthy controls.
No full textAbstract
Background
The goal of this study was to examine autonomic nervous system function by measuring heart rate (HR), heart rate variability (HRV), skin conductance levels (SCL), and peripheral skin temperature (ST) in response to and during recovery from psychosocial stressors in patients with functional somatic syndromes (FSS; fibromyalgia and/or chronic fatigue syndrome), stress-related syndromes (SRS; overstrain or burn-out), and healthy controls (HC).
Methods
Patients with FSS (n = 26), patients with SRS (n = 59), and HC (n = 30) went through a standardized psychosocial stress test consisting of a resting phase (120 s), the STROOP color word task (120 s), a mental arithmetic task (120 s) and a stress talk (120 s), each followed by a 120 s recovery period. HR, HRV, SCL, and ST were monitored continuously.
Results
Average HR and SCL were higher, and HRV was lower, in both patient groups compared to HC during rest (0.50 < Cohen's d < 0.97). A larger SC response to psychosocial stress was found in FSS compared to HC (d = 0.71). However, HR increased less during psychosocial stress and showed a smaller reduction during recovery in both patient groups compared to HC (0.68 < d < 0.98). HRV was lower in both patient groups compared to HC during recovery (0.91 < d < 0.98). There were no differences in ST levels or responses between groups.
Conclusions
Our results indicate a dominance of the sympathetic nervous system in both patient groups compared to controls, suggesting that autonomic nervous system dysfunction is a transdiagnostic feature for stress-related and functional somatic syndromes.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Acknowledgements
The authors thank the therapists at Tumi Therapeutics for their help with the recruitment of patients, Dorien Groven and Claire De Decker for their help with data collection and data processing, and Els Gijsen, Melanie Hubrechts, Aline De Wit, and Amber Gielen for visual inspection of the data
End-tidal CO2 Levels in Rest, During and After Respiratory Challenges: A Comparison Between and Within Patients with Stress-Related Disorders versus Panic Disorder Patients and Healthy Controls
No full textBackground. Although a dysregulated autonomic stress physiology is hypothesized to play a crucial role in the etiology and perpetuation of Medically Unexplained Physical Symptoms (MUPS), the respiratory system tends to be overlooked in current available literature. Objectives. The aim of our study was 1) to examine end-tidal CO2 concentration (PetCO2) in patients experiencing MUPS in daily life, diagnosed with overstrain, burnout, and functional somatic syndromes (FSS), compared to patients with panic disorder (PD) and healthy controls (HC) and 2) to explore the triangular relationship between psychological variables (maladaptive perfectionism, experiential avoidance, and exposure to traumatic experiences), the stress response system, and MUPS. Methods. Three groups of MUPS patients (overstrain [n=35], burnout [n=44] and fibromyalgia/chronic fatigue syndrome (CFS) [n=36]), PD patients (n=36) and HC (n=30) filled out trait questionnaires and went through a baseline measurement of PetCO2 and two respiratory challenges with recovery whilst PetCO2 was continuously monitored by a capnograph. Results. Our data showed respiratory abnormalities in MUPS and PD patients compared to HC, suggesting a transdiagnostic mechanism for both stress and anxiety related disorders. This dysfunction was found to be partially mediated by maladaptive perfectionism, experiential avoidance, and exposure to traumatic experiences. Furthermore, we found preliminary evidence for a chronicity and severity-based MUPS-continuum underlying 1) overstrain, 2) burnout, and 3) fibromyalgia/CFS in ascending order, characterized by an increasing depletion of the stress-response system. Conclusion. Our results are indicative for dysfunctional activity of the autonomic nervous system, including the respiratory system, to be an underlying working mechanism of MUPS
Interoception and proprioception as an underlying working mechanism of Medically Unexplained Symptoms
No full textAt least 40-49% of primary health care patients present with symptoms that cannot be (sufficiently) medically explained. It is hypothesized that inadequate interoceptive processes play a crucial role in the development and perpetuation of these Medically Unexplained Symptoms (MUS). In this proposed research project, three different factors of interoceptive abilities in MUS will be investigated: accuracy, sensibility, and awareness. With this research, we aim to investigate the interoceptive abilities of individuals located across the stress continuum (overstrain, burnout, and functional somatic syndromes (FSS)) by asking participants to perform the Respiratory Occlusion Discrimination (ROD) task (=accuracy), to fill out the Interoceptive Sensitivity and Attention Questionnaire (ISAQ) and THree-domain Interoceptive Sensations Questionnaire (THISQ) (=sensibility) and to give confidence ratings on their performance on the ROD task (=awareness). For another study, the effect of a brief interoceptive training procedure on interoceptive accuracy in an FSS population will be investigated. Furthermore, a new broader definition of interoception includes the afferent information that arises from anywhere and everywhere within the body, including proprioceptive functions. That's why we also aim to translate the interoceptive theoretical framework into a proprioceptive framework. This will be done by developing a new measure for proprioceptive accuracy as similar as possible to the ROD task and by validating a proprioceptive sensibility questionnaire. In a final study, we will measure both interoceptive and proprioceptive abilities within healthy participants and FSS patients
The need for controllability and predictability questionnaire: Psychometric properties and first findings in a clinical sample
No full textIn a large cohort from a cancer registry, we assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method A registry-based sample of N = 633 adult long-term CCS underwent medical and psychologcal assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. Findings of a heightened vulnerability in this group of cancer survivors are consistent with an additional representative survey in the general population (N = 2500) during the ongoing pandemic in which we found an increased risk for anxiety, suicidal ideation and loneliness among cancer survivors. Affective responses to both climbing and nordic walking exercise are associated with intermediate-term increases in physical activity in patients with anxiety and posttraumatic stress disorder-a randomized longitudinal controlled clinical pilot trial Objective Exercise programs have shown anxiolytic effects in psychiatric patients. Adherence to exercise programs and subsequent long-term lifestyle change is influenced by acute affective responses of the exercise programs. This research aimed to assess acute affective responses of two different exercise modalities compared to a non-exercise control program and its effects on persisting physical activity behavior change. Methods Sixty-six outpatients diagnosed with an anxiety disorder or posttraumatic stress disorder were randomly allocated to one of three groups in a randomized longitudinal controlled clinical pilot trial: climbing, nordic walking, social contact control. Affective responses were assessed pre, during, and post activity. General physical activity was recorded prior to participation, post, and at follow-ups three and six months after the program. Results Multilevel modelling analyzes of 1066 individual data points revealed increases in affective valence in the exercise sessions compared to the social contact sessions. State anxiety decreased in the climbing group compared to the social contact group. Physical activity was increased immediately following the program as well as at six months follow up in both exercise groups. A larger increase in affective valence during and after the sessions was associated with higher physical activity post program. Conclusion Climbing and conventional nordic walking exercise sessions revealed positive affective changes in outpatients indicating therapeutic potential of both modalities for acute emotion regulation. In accordance with theoretical models of human behavior change the experience of a more pleasant affective state after exercising induced more persisting effects on physical activity behavior after the exercise programs. Objective To validate the 'Need for Controllability and Predictability questionnaire' (NCP-q), a 15-item self-report measure assessing a person's need for control and predictability, building upon the clinical need for high quality assessment of these constructs. Methods In study 1, exploratory and confirmatory factor analysis was performed in a student convenience sample (n = 768). In study 2, NCP-q data of various patient groups experiencing stress-related (overstrain, n = 33; burnout, n = 40; panic disorder, n = 34) and/or persistent somatic symptoms in daily life (fibromyalgia and/or chronic fatigue syndrome, n = 34) were compared with healthy controls (n = 30). The associations between the NCP-q and other questionnaires were tested. Results In study 1, results suggest that the NCP-q should be used as a one-dimensional instrument. The NCP-q has good to excellent internal consistency and a good four-week test-retest reliability. Convergent validity was demonstrated by finding moderate to high correlations between the NCP-q and the Intolerance of Uncertainty Scale (IUS), Penn-State Worry Questionnaire (PSWQ), State-Trait Anxiety Inventory-trait (STAI-T), and the Beck Depression Inventory-II (BDI-II). Study 2 revealed significantly higher NCP-q scores for all patient groups compared with healthy controls, but no differences between patient groups. Abstracts
Dominance of the Sympathetic Nervous System in Patients with Fibromyalgia/Chronic Fatigue Syndrome Compared to Healthy Controls
No full textBackground. A dominance of the sympathetic nervous system (SNS) is hypothesized to play a crucial role in the etiology and perpetuation of functional somatic syndromes. However, literature on this topic is still inconsistent. Objectives. The aim of our study was to examine physiology of the autonomic nervous system (ANS) by measuring heart rate (HR), skin conductance (SC), and peripheral skin temperature (ST) in response to psychosocial stressors in patients with fibromyalgia/chronic fatigue syndrome (CFS) and healthy controls (HC). Methods. Patients with fibromyalgia/CFS (n=26) and HC (n=30) went through a stress test consisting of a baseline phase (120s), a Stroop Color and Word Test (120s), a mental arithmetic task (120s) and a stress talk (120s). Each stressor was followed by a 120s recovery period. HR, SC, and ST were monitored continuously. Random intercept random slope linear mixed model analyses were performed on the different phases. Results. Our main findings were that fibromyalgia/CFS patients had a significantly higher HR during all phases compared to HC. Fibromyalgia/CFS patients also had significantly higher SC compared to HC during all phases. No significant difference was found between fibromyalgia/CFS patients compared to HC regarding ST. Conclusion. Our results showed a dominance of the SNS regarding HR and SC in fibromyalgia/CFS patients compared to HC, suggesting the presence of ANS dysfunctionalities as an underlying working mechanism of fibromyalgia/CFS
End-tidal CO2 Levels in Rest, During and After Respiratory Challenges: A Comparison Between and Within Patients with Stress-Related Disorders versus Panic Disorder Patients and Healthy Controls
No full textBackground. Although a dysregulated autonomic stress physiology is hypothesized to play a crucial role in the etiology and perpetuation of Medically Unexplained Physical Symptoms (MUPS), the respiratory system tends to be overlooked in current available literature. Objectives. The aim of our study was 1) to examine end-tidal CO2 concentration (PetCO2) in patients experiencing MUPS in daily life, diagnosed with overstrain, burnout, and functional somatic syndromes (FSS), compared to patients with panic disorder (PD) and healthy controls (HC) and 2) to explore the triangular relationship between psychological variables (maladaptive perfectionism, experiential avoidance, and exposure to traumatic experiences), the stress response system, and MUPS. Methods. Three groups of MUPS patients (overstrain [n=35], burnout [n=44] and fibromyalgia/chronic fatigue syndrome (CFS) [n=36]), PD patients (n=36) and HC (n=30) filled out trait questionnaires and went through a baseline measurement of PetCO2 and two respiratory challenges with recovery whilst PetCO2 was continuously monitored by a capnograph. Results. Our data showed respiratory abnormalities in MUPS and PD patients compared to HC, suggesting a transdiagnostic mechanism for both stress and anxiety related disorders. This dysfunction was found to be partially mediated by maladaptive perfectionism, experiential avoidance, and exposure to traumatic experiences. Furthermore, we found preliminary evidence for a chronicity and severity-based MUPS-continuum underlying 1) overstrain, 2) burnout, and 3) fibromyalgia/CFS in ascending order, characterized by an increasing depletion of the stress-response system. Conclusion. Our results are indicative for dysfunctional activity of the autonomic nervous system, including the respiratory system, to be an underlying working mechanism of MUPS
Physiological overreactivity and low end-tidal CO2 as a transdiagnostic stress response: Comparing between and within patients with stress-related bodily complaints versus healthy controls.
No full textBackground: Although a dysregulated autonomic stress physiology is hypothesized to play a crucial role in the etiology and perpetuation of stress-related disorders, the respiratory system tends to be overlooked in the current literature.
Methods: The aim of our study was (1) to examine end-tidal CO2 concentration (PetCO2) in various patient groups experiencing stress-related bodily complaints in daily life [overstrain; n=35, burnout; n=44; and functional somatic syndrome (FSS); n=36], panic disorder (PD, n=36) and healthy controls (HC, n=30), and (2) to explore the triangular relationships between psychological variables (maladaptive perfectionism, experiential avoidance, and exposure to traumatic experiences), end-tidal CO2, and patient status. Participants filled out trait questionnaires and went through a baseline measurement of PetCO2 and two respiratory challenges with recovery whilst PetCO2 was continuously monitored by a capnograph.
Results: Our data showed lower PetCO2 in patients with stress-related disorders and PD compared to HC, suggesting physiological overreactivity as a transdiagnostic mechanism for both stress- and anxiety related disorders. This overreactivity was found to be partially mediated by exposure to traumatic experiences. Interestingly, a more passive action tendency was observed in the most chronic and severe stress-related disorders (FSS) compared to the more acute ones (overstrain).
Discussion: Taken together, our results are indicative for behavioral regulation to overrule metabolic regulation of the respiratory system in stress-related disorders
Psychophysiological correlates of glucose monitoring frequency in diabetes mellitus
No full textAims: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by heightened blood glucose levels.
Prevention of DM complications relies heavily on self-management, including frequent monitoring of blood glucose
levels. The goal of this study was to investigate psychological and physiological correlates of blood glucose monitoring
frequency (BGM frequency) in DM patients using a continuous blood glucose monitoring sensor connected to a
electronic reading system.
Methods: Fifty-nine DM patients (26 women; 49 DM type 1) wearing a continuous blood glucose monitoring sensor
filled out the Hospital Anxiety and Depression Scale, the Need for Controllability and Predictability Questionnaire, and
the Action and Acceptance in Diabetes Questionnaire. The number of glucose sensor readings was recorded daily from
the monitoring system for three months.
Results: Sixty-three percent of patients had an HbA1c value over 7. Anxiety, depression, and traumatic experiences
levels were overall low in our sample (10% had a HADS depression score > 12, and 12% had a HADS anxiety score > 12).
On average, patients read out their blood glucose levels 7.83 times per day (SD = 3.60). BGM frequency was negatively
correlated with HbA1c levels (r = -0.355, p = 0.018). No associations between (BGM frequency) on the one hand and
depression, anxiety, need for control, or experiential avoidance on the other hand, were found.
Conclusion: Patients who measured their glucose levels more frequently had lower HbA1c values, and thus better long-
term glucose control. Frequency of blood glucose measuring was unrelated to the psychological variables included in
this study
- …
