Individual variation in temporal relationships between stress and functional somatic symptoms

Anne van Gils; Christopher Burton; Elisabeth H Bos; Karin A M Janssens; Robert A Schoevers; Judith G M Rosmalen

doi:10.1016/j.jpsychores.2014.04.006

Individual variation in temporal relationships between stress and functional somatic symptoms

Anne van Gils, Christopher Burton, Elisabeth H Bos, Karin A M Janssens, Robert A Schoevers, Judith G M Rosmalen

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

Abstract

OBJECTIVE: Medically unexplained or functional somatic symptoms (FSSs) constitute a major health problem because of their high prevalence and the suffering and disability they cause. Psychosocial stress is widely believed to be a precipitating or perpetuating factor, yet there is little empirical evidence to support this notion. Prior studies mainly focused on comparing groups, which has resulted in the obscuring of temporal complexity and individual differences. The aim of this study is to elucidate the relationship between stress and FSSs over time within individual patients.

METHODS: Twenty patients (17 females, ages 29-59) with multiple, persistent FSSs were included in the study. They used electronic diaries to report stress and FSSs twice daily over the course of 12 weeks. For each individual data set, Vector autoregressive (VAR) modelling was used to investigate possible associations between daily average stress and FSSs scores.

RESULTS: In six subjects (30%), an increase in stress was followed by an increase in one or more FSSs. In three subjects (15%), an increase in FSSs was followed by an increase in stress. Additionally, negative and mixed associations were found. Only two subjects (10%) showed no cross-lagged association between stress and FSSs in either direction. We did not find specific types of symptoms to be more stress-related than others.

CONCLUSION: Although stress does not seem to be a universal predictor of FSSs, an increase in stress precedes an increase in symptoms in some individuals. Identifying these individuals using time-series analysis might contribute to a more patient-tailored treatment.

Original language	English
Pages (from-to)	34-39
Number of pages	6
Journal	Journal of Psychosomatic Research
Volume	77
Issue number	1
Early online date	30 Apr 2014
DOIs	https://doi.org/10.1016/j.jpsychores.2014.04.006
Publication status	Published - Jul 2014

Bibliographical note

Copyright © 2014 Elsevier Inc. All rights reserved.
Acknowledgments
We would like to thank the participants for their dedication and efforts in completing the diaries.

This study received no direct financial support. The original data was collected as part of a Research Training Fellowship funded by the Chief Scientist Office of National Health Service (NHS) Scotland (C.B., grant number CZF/1/22).

Keywords

electronic diaries
functional somatic symptoms
idiographic
medically unexplained symptoms
stress
time-series analysis

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10.1016/j.jpsychores.2014.04.006

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title = "Individual variation in temporal relationships between stress and functional somatic symptoms",

abstract = "OBJECTIVE: Medically unexplained or functional somatic symptoms (FSSs) constitute a major health problem because of their high prevalence and the suffering and disability they cause. Psychosocial stress is widely believed to be a precipitating or perpetuating factor, yet there is little empirical evidence to support this notion. Prior studies mainly focused on comparing groups, which has resulted in the obscuring of temporal complexity and individual differences. The aim of this study is to elucidate the relationship between stress and FSSs over time within individual patients.METHODS: Twenty patients (17 females, ages 29-59) with multiple, persistent FSSs were included in the study. They used electronic diaries to report stress and FSSs twice daily over the course of 12 weeks. For each individual data set, Vector autoregressive (VAR) modelling was used to investigate possible associations between daily average stress and FSSs scores.RESULTS: In six subjects (30%), an increase in stress was followed by an increase in one or more FSSs. In three subjects (15%), an increase in FSSs was followed by an increase in stress. Additionally, negative and mixed associations were found. Only two subjects (10%) showed no cross-lagged association between stress and FSSs in either direction. We did not find specific types of symptoms to be more stress-related than others.CONCLUSION: Although stress does not seem to be a universal predictor of FSSs, an increase in stress precedes an increase in symptoms in some individuals. Identifying these individuals using time-series analysis might contribute to a more patient-tailored treatment.",

keywords = "electronic diaries, functional somatic symptoms, idiographic, medically unexplained symptoms, stress, time-series analysis",

author = "{van Gils}, Anne and Christopher Burton and Bos, {Elisabeth H} and Janssens, {Karin A M} and Schoevers, {Robert A} and Rosmalen, {Judith G M}",

note = "Copyright {\textcopyright} 2014 Elsevier Inc. All rights reserved. Acknowledgments We would like to thank the participants for their dedication and efforts in completing the diaries. This study received no direct financial support. The original data was collected as part of a Research Training Fellowship funded by the Chief Scientist Office of National Health Service (NHS) Scotland (C.B., grant number CZF/1/22).",

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AU - Bos, Elisabeth H

AU - Janssens, Karin A M

AU - Schoevers, Robert A

AU - Rosmalen, Judith G M

N1 - Copyright © 2014 Elsevier Inc. All rights reserved. Acknowledgments We would like to thank the participants for their dedication and efforts in completing the diaries. This study received no direct financial support. The original data was collected as part of a Research Training Fellowship funded by the Chief Scientist Office of National Health Service (NHS) Scotland (C.B., grant number CZF/1/22).

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N2 - OBJECTIVE: Medically unexplained or functional somatic symptoms (FSSs) constitute a major health problem because of their high prevalence and the suffering and disability they cause. Psychosocial stress is widely believed to be a precipitating or perpetuating factor, yet there is little empirical evidence to support this notion. Prior studies mainly focused on comparing groups, which has resulted in the obscuring of temporal complexity and individual differences. The aim of this study is to elucidate the relationship between stress and FSSs over time within individual patients.METHODS: Twenty patients (17 females, ages 29-59) with multiple, persistent FSSs were included in the study. They used electronic diaries to report stress and FSSs twice daily over the course of 12 weeks. For each individual data set, Vector autoregressive (VAR) modelling was used to investigate possible associations between daily average stress and FSSs scores.RESULTS: In six subjects (30%), an increase in stress was followed by an increase in one or more FSSs. In three subjects (15%), an increase in FSSs was followed by an increase in stress. Additionally, negative and mixed associations were found. Only two subjects (10%) showed no cross-lagged association between stress and FSSs in either direction. We did not find specific types of symptoms to be more stress-related than others.CONCLUSION: Although stress does not seem to be a universal predictor of FSSs, an increase in stress precedes an increase in symptoms in some individuals. Identifying these individuals using time-series analysis might contribute to a more patient-tailored treatment.

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ER -

Individual variation in temporal relationships between stress and functional somatic symptoms

Abstract

Bibliographical note

Keywords

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