Psychosomatic MedicinePub Date : 2024-10-01Epub Date: 2024-08-10DOI: 10.1097/PSY.0000000000001340
J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower
{"title":"Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms.","authors":"J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower","doi":"10.1097/PSY.0000000000001340","DOIUrl":"10.1097/PSY.0000000000001340","url":null,"abstract":"<p><strong>Objective: </strong>Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE).</p><p><strong>Methods: </strong>Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace.</p><p><strong>Results: </strong>MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively.</p><p><strong>Conclusions: </strong>Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03025139 .</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"700-709"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-10-01Epub Date: 2024-07-15DOI: 10.1097/PSY.0000000000001334
Elli L Cole, Alessandra R Grillo, Suzanne Vrshek-Schallhorn
{"title":"Habitual Caffeine Use Is Associated With Heightened Cortisol Reactivity to Lab-Based Stress in Two Samples.","authors":"Elli L Cole, Alessandra R Grillo, Suzanne Vrshek-Schallhorn","doi":"10.1097/PSY.0000000000001334","DOIUrl":"10.1097/PSY.0000000000001334","url":null,"abstract":"<p><strong>Objective: </strong>Habitual caffeine consumption protects against depression but through unclear mechanisms. Although habitual caffeine use predicts cortisol release in response to other acute stressors (e.g., exercise), this is less examined with lab-based psychosocial stress in healthy adults. Furthermore, caffeine-induced cortisol increases may mask theory-predicted cortisol blunting to robust stress in people with elevated depression risk. In two samples, we tested whether acute (same-day) and habitual caffeine use would predict greater cortisol reactivity to lab-based stress, and whether caffeine would \"mask\" the effect of a depression risk factor, trait rumination, on blunted cortisol reactivity.</p><p><strong>Method: </strong>In sample 1, N = 128 emerging adults completed one of three Trier Social Stress Test conditions: nonevaluative control, ambiguously evaluative intermediate, or explicit negative evaluative. In sample 2, N = 148 emerging adults completed either a control or negative evaluative condition.</p><p><strong>Results: </strong>In both samples, multilevel growth curve modeling indicated that habitual caffeine use ( t = -1.99, p = .048; t = -2.73, p = .007, samples 1 and 2, respectively) but not acute caffeine use predicted heightened cortisol reactivity as a function of condition. In sample 1, the relationship between condition, rumination, and blunted cortisol was evident only in caffeine nonusers, which differed from users ( t = 2.82, p = .005), but in sample 2, the predicted blunting pattern was evident regardless of caffeine use.</p><p><strong>Conclusion: </strong>The results provide evidence that habitual caffeine use is associated with greater cortisol release under psychosocial lab-based stress and may mask the influence of psychosocial variables; future research should examine whether habitual caffeine-induced cortisol release has behaviorally activating effects that protect against depression.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"730-737"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-10-01Epub Date: 2024-08-01DOI: 10.1097/PSY.0000000000001336
Megan G Strickland, Nils Myszkowski, Emily D Hooker, Peggy M Zoccola, Sally S Dickerson
{"title":"Depressive and Anxious Symptoms, Experimentally Manipulated Acute Social-Evaluative Threat, and Cortisol Reactivity.","authors":"Megan G Strickland, Nils Myszkowski, Emily D Hooker, Peggy M Zoccola, Sally S Dickerson","doi":"10.1097/PSY.0000000000001336","DOIUrl":"10.1097/PSY.0000000000001336","url":null,"abstract":"<p><strong>Objective: </strong>Exposure to social-evaluative threat (SET) can elicit greater physiological responses, including cortisol, compared to non-SET stressors. An individual's level of depressive and anxious symptoms predicts variability in cortisol responses to stressors, and other research suggests that these individual differences may predict vulnerability to social evaluation. The current study integrates both lines of research, testing if there are different relationships between depressive and/or anxious symptoms and cortisol reactivity in the presence or absence of SET.</p><p><strong>Methods: </strong>Healthy undergraduate students ( N = 158, 65% female) were randomly assigned to deliver a speech in the presence (SET) or absence (non-SET) of two evaluators. Salivary cortisol was collected throughout, and self-reported depressive and anxious symptoms were assessed. We hypothesized that in the SET condition, higher levels of depressive and/or anxious symptoms would predict dysregulated cortisol responses compared to lower levels of symptoms and/or assignment to the non-SET group.</p><p><strong>Results: </strong>In spite of inconclusive p values (which might be attributed to low statistical power), individuals with high depressive or high anxious symptoms appeared to have exaggerated cortisol responses in the SET condition, as indicated by more concave trajectories.</p><p><strong>Conclusions: </strong>This study suggests that both depression and anxiety could be associated with increased cortisol reactivity to SET.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"710-719"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iris Knoop,Annie S K Jones,Nicholas Gall,Sam Norton,William Pascoe,Rona Moss-Morris
{"title":"Correlates and predictors of symptom severity over time in people under investigation for postural orthostatic tachycardia syndrome (POTS).","authors":"Iris Knoop,Annie S K Jones,Nicholas Gall,Sam Norton,William Pascoe,Rona Moss-Morris","doi":"10.1097/psy.0000000000001346","DOIUrl":"https://doi.org/10.1097/psy.0000000000001346","url":null,"abstract":"OBJECTIVEPostural Orthostatic Tachycardia Syndrome (POTS) is a poorly understood chronic disorder characterised by an unexplained excessive increase in heartbeat upon standing. The aim of this study was to investigate psychosocial and physiological correlates and predictors of symptom severity over time in patients presenting with POTS-like symptoms.METHODSLongitudinal cohort study of patients under investigation for POTS (n = 149). Patients completed questionnaires at one month pre-clinic appointment and 6 months later. Diagnosis, blood pressure (BP) and heart rate (HR) measures were collected from medical records. Data were analysed using hierarchical linear multiple regression.RESULTSOrthostatic and small fibre neuropathy (SFN) symptoms remained stable over time and were significantly correlated with distress, cardiac anxiety, threatening views of the illness, and cognitive-behavioural responses to symptoms, but not with emotional reactivity or social support. Baseline psychosocial factors collectively explained 48% (F = 5.37, p < .001) of the variance in orthostatic symptoms, and 35% (F = 3.49, p < .001) of the variance of SFN symptoms at baseline, but a non-significant amount of variance in symptoms at 6 months when controlling for baseline symptoms. Haemodynamic measures explained a significant 4% (F = 3.37, p = .026) of variance of orthostatic symptoms at 6 months.CONCLUSIONSymptom burden in patients with suspected POTS remained high over 6 months. Psychosocial factors explained a large amount of the variance in symptoms at baseline. As symptoms did not change/improve over time, baseline symptoms accounted for most of the variance in symptoms at 6 months. An integrated approach addressing psychosocial factors alongside medical treatments may promote adjustment to the condition and lessen symptom burden for this group.","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":"33 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Andrew Ward,Genevieve Forget,Nanna Lindekilde,Sonya S Deschênes,François Pouwer,Norbert Schmitz,Miranda Schram,Rachel J Burns
{"title":"Anger Expression Styles, Cynical Hostility, and the Risk for the Development of Type 2 Diabetes or Diabetes-Related Heart Complications: Secondary Analysis of the Health and Retirement Study.","authors":"Richard Andrew Ward,Genevieve Forget,Nanna Lindekilde,Sonya S Deschênes,François Pouwer,Norbert Schmitz,Miranda Schram,Rachel J Burns","doi":"10.1097/psy.0000000000001344","DOIUrl":"https://doi.org/10.1097/psy.0000000000001344","url":null,"abstract":"OBJECTIVELimited research has examined associations between trait anger and hostility and incident type 2 diabetes (T2D) and diabetes-related heart complications. However, anger expression styles (i.e., anger-in, anger-out) have not been examined. The present study used secondary data to examine the associations between anger expression styles, cynical hostility, and the risk of developing T2D (objective 1) or diabetes-related heart complications (objective 2).METHODSSelf-report data came from participants aged 50-75 in the Health and Retirement Study. Anger-in (anger that is suppressed and directed toward oneself), anger-out (anger directed towards other people or the environment), and cynical hostility were measured at baseline (i.e., 2006 or 2008). Follow-up data (i.e., diabetes status or diabetes-related heart complications status) were collected every two years thereafter until 2020. The objective 1 sample included 7,898 participants without T2D at baseline, whereas the objective 2 sample included 1,340 participants with T2D but without heart complications at baseline.RESULTSOnly anger-in was significantly associated with incident T2D after controlling for sociodemographic characteristics, HR = 1.08, 95% CI [1.01, 1.16], but the association did not hold after further adjustment for depressive symptoms. Only anger-out was significantly associated with incident diabetes-related heart complications after adjusting for sociodemographic characteristics, health-related covariates, and depressive symptoms, HR = 1.21, 95% CI [1.02, 1.39].CONCLUSIONSAnger expression styles were differentially related to diabetes outcomes. These findings demonstrate the value of expanding the operationalization of anger beyond trait anger in this literature and encourage further investigation of anger expression styles.","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":"48 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-06-10DOI: 10.1097/PSY.0000000000001327
Stuart W G Derbyshire
{"title":"The Hope and Reality of Pain Relief Using Psychological Manipulations.","authors":"Stuart W G Derbyshire","doi":"10.1097/PSY.0000000000001327","DOIUrl":"10.1097/PSY.0000000000001327","url":null,"abstract":"<p><strong>Abstract: </strong>Many patients suffer from chronic pain despite the absence of injury or sufficient biomedical disease to explain their pain. These pains are highly resistant to treatment. Psychological therapies designed to help patients undermine the negative thought and behavioral patterns that maintain pain provide only modest pain relief, leading to suspicion that such pain might be maintained by unconscious processes. An article in this issue of Psychosomatic Medicine provides the first experimental evidence that unconscious negative memories can increase pain unpleasantness. These findings are exciting, but the effect sizes are small, which is consistent with the small effects of psychological therapy. It seems that pain stubbornly resists psychological manipulation, but this work provides some hope that psychological therapy for pain can be improved to provide more effective pain relief.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"578-579"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-05-01DOI: 10.1097/PSY.0000000000001316
Jaap Wijnen, Marciano Wilhelmina Henricus Geijselaers, Marc Lucas Pont, Geert Van't Hullenaar, Jessica Van Oosterwijck, Jeroen de Jong
{"title":"An Interdisciplinary Multimodal Integrative Healthcare Program for Chronic Spinal Pain and Comorbid Mental Disorders.","authors":"Jaap Wijnen, Marciano Wilhelmina Henricus Geijselaers, Marc Lucas Pont, Geert Van't Hullenaar, Jessica Van Oosterwijck, Jeroen de Jong","doi":"10.1097/PSY.0000000000001316","DOIUrl":"10.1097/PSY.0000000000001316","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies evaluating interdisciplinary multimodal interventions for chronic spinal pain often excluded patients with comorbid mental disorders. This study aims to assess the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for individuals experiencing co-occurring chronic spinal pain and mental disorders.</p><p><strong>Methods: </strong>Participants were 944 patients with chronic spinal pain and comorbid mental disorders. Primary outcomes were health-related quality of life, assessed using the Research and Development-36 (RAND-36), and pain-related disability, assessed using the Quebec Back Pain Disability Scale (QBPDS). Secondary outcomes included pain intensity, pain catastrophizing, kinesiophobia, fatigue, lumbar mobility, and isometric strength. Data were collected during the healthcare program at four time points: pretreatment (T0), midway through 20-week treatment (T1), end of 20-week treatment (T2), and at completion of 12-month relapse prevention program (T3). Multilevel regression analyses were conducted to examine the effects of the healthcare program on primary outcomes over time.</p><p><strong>Results: </strong>The 20-week treatment period yielded significant improvements in both mental ( B = 0.44, t (943) = 19.42, p < .001) and physical component summary scores ( B = 0.45, t (943) = 18.24, p < .001) of the RAND-36, as well as in QBPDS total score ( B = -0.77, t (943) = -26.16 p < .001). Pretreatment scores indicated the presence of problematic fatigue, kinesiophobia, and clinical levels of pain catastrophizing, all of which resolved by the end of the 12-month relapse prevention program.</p><p><strong>Conclusions: </strong>An interdisciplinary multimodal integrative healthcare program seems effective for patients with chronic spinal pain and comorbid mental disorders.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"603-614"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-07-03DOI: 10.1097/PSY.0000000000001328
Desirée Domacassé, Susanne R de Rooij, Tanja Vrijkotte, Ank de Jonge, Jens Henrichs
{"title":"Associations Between Early-Pregnancy Vitamin D Status and Postpartum Depressive and Anxiety Symptoms.","authors":"Desirée Domacassé, Susanne R de Rooij, Tanja Vrijkotte, Ank de Jonge, Jens Henrichs","doi":"10.1097/PSY.0000000000001328","DOIUrl":"10.1097/PSY.0000000000001328","url":null,"abstract":"<p><strong>Objective: </strong>Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.</p><p><strong>Methods: </strong>In 2483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks' gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.</p><p><strong>Results: </strong>After adjustments for confounders, vitamin D deficiency was only associated with increased postpartum anxiety symptoms ( B = 0.17, 95% confidence interval [CI] = 0.03-0.30, p = .017) compared to normal vitamin D levels (≥80 nM). In women not taking vitamin D supplementation ( n = 2303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms ( B = 0.14, 95% CI = 0.03-0.28, p = .045; and B = 0.17, 95% CI = 0.03-0.32, p = .015). Antepartum CRP did not mediate these links.</p><p><strong>Conclusions: </strong>We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"648-657"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-05-13DOI: 10.1097/PSY.0000000000001323
Chenyue Ma, Xiaoqin Wang, Scott D Blain, Yafei Tan
{"title":"The Adaptiveness of Emotion Regulation Variability and Interoceptive Attention in Daily Life.","authors":"Chenyue Ma, Xiaoqin Wang, Scott D Blain, Yafei Tan","doi":"10.1097/PSY.0000000000001323","DOIUrl":"10.1097/PSY.0000000000001323","url":null,"abstract":"<p><strong>Objective: </strong>In daily life, we must dynamically and flexibly deploy strategies to regulate our emotions, which depends on awareness of emotions and internal bodily signals. Variability in emotion-regulation strategy use may predict fewer negative emotions, especially when people pay more attention to their bodily states-or have greater \"interoceptive attention\" (IA). Using experience sampling, this study aimed to test whether IA predicts variability in strategy use and whether this variability and IA together predict negative affect.</p><p><strong>Methods: </strong>University student participants ( n = 203; 165 females; Mage = 20.68, SD age = 1.84) completed trait questionnaires and reported state levels of IA, emotional awareness, negative affect, and emotion-regulation strategies, seven times daily for 1 week.</p><p><strong>Results: </strong>State IA significantly predicted between-strategy variability, which was mediated by emotional awareness (indirect effect = 0.002, 95% confidence interval = <0.001-0.003). Between-strategy variability was associated with lower negative affect, particularly when individuals had higher state IA (simple slope = -0.83, t = -5.87, p < .001) versus lower IA (simple slope = -0.31, t = -2.62, p = .009).</p><p><strong>Conclusions: </strong>IA appears to facilitate adaptative emotion regulation and help alleviate negative affect. Findings underscore the key roles of IA and emotion-regulation flexibility in mental health.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"640-647"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-07-03DOI: 10.1097/PSY.0000000000001333
Sigrid Juhl Lunde, Sophie Rosenkjær, Susan Tomczak Matthiesen, Irving Kirsch, Lene Vase
{"title":"Conclusions Regarding the Role of Expectations in Placebo Analgesia Studies May Depend on How We Investigate It: A Meta-Analysis, Systematic Review, and Proposal for Methodological Discussions.","authors":"Sigrid Juhl Lunde, Sophie Rosenkjær, Susan Tomczak Matthiesen, Irving Kirsch, Lene Vase","doi":"10.1097/PSY.0000000000001333","DOIUrl":"10.1097/PSY.0000000000001333","url":null,"abstract":"<p><strong>Objective: </strong>Expectations are highlighted as a key component in placebo effects. However, there are different approaches to whether and how placebo studies should account for expectations, and the direct contribution has yet to be estimated in meta-analyses. Using different methodological approaches, this meta-analysis and systematic review examines the extent to which expectations contribute to pain in placebo studies.</p><p><strong>Methods: </strong>The databases PubMed, PsycINFO, Embase, and Web of Science were searched for placebo analgesia mechanism studies with numerical measures of both expectations and pain. Thirty-one studies, comprising 34 independent study populations (1566 subjects: patients and healthy participants) were included. Two meta-analyses were conducted: meta-analysis 1, using study-level data, estimated the effect of expectation interventions without taking measures of expectations into account (expectations assumed); and meta-analysis 2, using individual-level data, estimated the direct impact of participants' expectations on pain (expectations assessed). Risk of bias was assessed using the Cochrane risk-of-bias tool.</p><p><strong>Results: </strong>Meta-analysis 1 showed a moderate effect of expectation interventions over no expectation intervention on pain intensity (Hedges g = 0.45, I2 = 54.19). Based on 10 studies providing individual-level data, meta-analysis 2 showed that expectations predicted pain intensity in placebo and control groups ( b = 0.36, SE = 0.05), although inconsistently across study methodologies.</p><p><strong>Conclusions: </strong>Participants' expectations contributed moderately to pain in placebo analgesia studies. However, this may largely be influenced by how we measure expectations and how their contribution is conceptualized and analyzed-both within and across studies.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"591-602"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}