"And how did that make you feel?" : repeated symptom queries enhance symptom reports elicited by negative affect
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Abstract
Objective: Negative affect, alexithymia, and other predisposing traits (such as health anxiety) can influence an
individual's symptom perception. In this study, we used the affective picture paradigm (APP, Bogaerts et al.,
2010) to induce symptoms using affective picture stimuli. We aimed to cross-sectionally test the effect of high vs
low-frequency symptom queries and analyze the time course of the APP, including interactions with health
anxiety and somatic symptom distress.
Methods: Participants (N = 124) completed a modified APP and filled out various questionnaires. In the APP,
participants were randomized to either a highly-frequent-query condition (18 symptom checklists) or a lessfrequent-query condition (6 checklists). Data were analyzed using ANOVAs, cross-lagged panel models,
moderation models, and multilevel models.
Results: Both groups had comparable symptom baseline values, but people in the highly frequent as opposed to
less frequent condition reported significantly higher symptom levels once the experiment started (F (1,120) =
14.319, p < .001, η2 = .107). Symptom levels stayed stable over the course of the experiment and were best
predicted by symptom levels at earlier timepoints in the experiment (β = 0.43 and β = 0.68, both p < .001).
Health anxiety levels significantly predicted symptom levels (F(1,121) = 10.054, p = .002, η2 = .077) and
moderated the relation between condition and symptom levels (F(2,121) = 16.253, p < .001, η2 = .212).
Conclusion: In terms of the predictive processing model (e.g.,[1]), repeated symptom queries following negative
affective cues may activate prior beliefs about symptoms, resulting in elevated levels of symptom reports in
interaction with health anxiety.
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Published in
Journal of psychosomatic research, 181, Elsevier Science, Amsterdam u.a., 2024, https://doi.org/10.1016/j.jpsychores.2024.111634