日常生活中的情绪动态和躯体症状：躯体症状障碍和健康对照组的生态瞬时评估。

Emotion dynamics and somatic symptoms in everyday life: Ecological momentary assessment in somatic symptom disorder and healthy controls.

机构信息

Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany.

Department of Health Psychology, University of Mainz, Germany.

出版信息

J Psychosom Res. 2023 Sep;172:111429. doi: 10.1016/j.jpsychores.2023.111429. Epub 2023 Jun 26.

DOI:10.1016/j.jpsychores.2023.111429

PMID:37406416

Abstract

OBJECTIVE

Negative affectivity (NA) is associated with the emergence and persistence of physical symptoms with unclear organic pathology. This study investigated the temporal dynamics of NA and somatic symptom burden using ecological momentary assessment (EMA) in adults with somatic symptom disorder (SSD) and healthy control participants (HC).

METHODS

Participants underwent a seven-day, smartphone-based EMA, with 6 randomly-stratified time points per day. NA was assessed using a five-item short form of the Positive and Negative Affectivity Scale (PANAS) and somatic symptom burden with two self-constructed items. 22 persons with SSD and 20 HCs were included in multilevel analyses.

RESULTS

Within-person analyses showed a significantly stronger (positive) association of concurrent NA with somatic symptom burden in participants with SSD than in HCs, β = 0.15, SE = 0.04, p = .001. Time-lagged analyses demonstrated that, across groups, NA at a previous time point t-1 significantly predicted somatic symptom burden at the subsequent timepoint t, β = 0.09, SE = 0.03, p = .005, but not in the other direction (somatic symptom burden→ NA, β = 0.01, SE = 0.04, p = .79). Between-person analyses showed that both inertia (i.e., persistence of negative affective states), d = 0.74, and instability (i.e., magnitude of moment-to-moment fluctuations), d = 0.76 of NA were significantly higher in participants with SSD than in HCs.

CONCLUSIONS

Our findings sustain the idea of (negative) affect-driven modulation in somatic signal processing and suggest that interoceptive and emotional differentiation training can advance the psychotherapeutic treatment of SSD.

摘要

目的

消极情感（NA）与具有不明确器质性病理学的身体症状的出现和持续有关。本研究使用生态瞬时评估（EMA）调查了躯体症状障碍（SSD）患者和健康对照参与者（HC）的 NA 和躯体症状负担的时间动态。

方法

参与者接受了为期七天的基于智能手机的 EMA，每天有 6 个随机分层时间点。使用正性和负性情感量表（PANAS）的五分量表评估 NA，并用两个自我构建的项目评估躯体症状负担。共有 22 名 SSD 患者和 20 名 HC 纳入了多级分析。

结果

个体内分析显示，与 HC 相比，SSD 患者中当前的 NA 与躯体症状负担之间存在更强的（正）关联，β=0.15，SE=0.04，p=0.001。时滞分析表明，在两组中，前一时间点 t-1 的 NA 显著预测了随后时间点 t 的躯体症状负担，β=0.09，SE=0.03，p=0.005，但不能朝相反的方向预测（躯体症状负担→NA，β=0.01，SE=0.04，p=0.79）。个体间分析表明，SSD 患者的 NA 惯性（即消极情感状态的持续性），d=0.74，和不稳定性（即瞬间波动的幅度），d=0.76，均明显高于 HC。