Physical activity decreases somatic symptom distress in the affect and symptom paradigm
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Abstract
Objective:
According to recent empirical taxonomies (eg, the Hierarchical Taxonomy of Psychopathology), somatic symptom distress represents a transdiagnostically relevant dimension of psychopathology. To better understand the mechanisms, somatic symptoms can be experimentally provoked by inducing negative affect (in the Affect and Symptom Paradigm, ASP, formerly known as the Affective Picture Paradigm). Potential moderators of this relation include cardiorespiratory activation and body-focused attention.
Methods:
In this preregistered, cross-sectional study (https://osf.io/sc57z/), we tested whether cardiorespiratory activation and body-focused attention modulate somatic symptoms in the ASP. Participants (N = 144) completed 3 ASPs, interlaced with cardiorespiratory activation (cycling) and rest. Participants were randomized to a body-attention or distraction condition. We measured heart rate, respiratory rate, and end-tidal CO2 during these tasks. The data were analyzed using AN(C)OVAs, t tests, and multilevel models.
Results:
Exercise significantly increased, and rest significantly decreased immediatesomatic symptoms (F (81.86, 262.68) = 53,80, p < .001, η2part = 0.28). High levels of somatic symptoms were significantly related to a sustained greater decrease in somatic symptoms in the ASP after cycling (vs. rest, F(1,136) = 8.061, p = .005, η2part = 0.056). No significant effect of the attention manipulation was observed (Fatt (1, 141) = 0.52, p = .47, η2part = 0.004).
Conclusions:
Rest and exercise temporarily modulate somatic symptom reports, and people with higher baseline somatic symptoms show the strongest beneficial effect of physical activity on symptom reports in the ASP. The findings are compatible with recent models of predictive processing and active inference.
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Psychosomatic medicine, 87, 8, American Psychosomatic Society, Philadelphia, Pa., 2025, https://doi.org/10.1097/PSY.0000000000001425