Somatic Distress Research Articles

Correlates of jaw functional limitation, somatization and psychological distress among different temporomandibular disorder diagnostic subtypes.

This study investigated the jaw functional status and severity of somatic/psychological symptoms in different Diagnostic Criteria for temporomandibular disorders (DC/TMD) diagnostic subtypes and established the correlates between jaw functional limitation, somatization, depression and anxiety. Data were accrued from consecutive 'first-visit' patients seeking TMD treatment at a university-based oral medicine/diagnosis clinic. Axis I physical TMD diagnoses were derived using the DC/TMD methodology and patients were categorized into pain-related (PT), intra-articular (IT) and combined (CT) TMD groups. Axis II measures were also administered and included the Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-15 and 9 (PHQ-15 and PHQ-9) and General Anxiety Disorder Scale-7 (GAD-7). Chi-square/Kruskal-Wallis tests and Spearman's correlation were employed for statistical evaluations (α = .05). The final dataset consisted of 772 TMD patients (mean age of 37.7 ± 15.9 years; 70.2% females). The prevalence of PT, IT and CT was 11.9%, 15.7% and 72.4%, respectively. Significant differences in functional jaw limitations, somatization, depression (CT, PT > IT) and anxiety (CT > PT, IT) were observed. Moderate-to-severe somatization, depression and anxiety were detected in 12.6%-15.7% of patients. For all three TMD groups, JFLS global scale/subscale scores were weakly associated with somatization, depression and anxiety scores (rs < 0.4). Moderate-to-strong correlations were noted between somatization, depression and anxiety (rs = 0.50-0.74). Functional jaw limitations were associated with painful TMDs but appear to be unrelated to somatization and psychological distress. Somatization and depression/anxiety were moderately correlated, underscoring the importance of somatic symptom screening when managing TMD patients.

Examining the Longitudinal Relationship Between Metacognitive Beliefs and Psychological Distress in an Adolescent Population: A Preliminary Analysis.

Adolescence is a period marked by significant vulnerability to the onset of mental health concerns. Within adults, the metacognitive model of psychological disorders advocates for the involvement of metacognitive beliefs in the onset, and maintenance, of psychopathology. The current study aimed to assess the applicability of the metacognitive model in adolescence by exploring the relationship, as well as the trajectory, between metacognitive beliefs and psychological distress. The longitudinal prospective cohort study investigated data from a community-based sample of participants aged 12 to 13. Self-report assessment measures of metacognitive beliefs, psychological distress, and somatic distress are reported across four time-points. Baseline assessments are reported for 70 participants, which reduced to 53 participants at time-point four. Correlational analyses demonstrated a significant relationship between overall metacognition, as well as negative metacognitive beliefs, and psychological distress at each of the four time-points. Generalised Estimating Equations found a significant association between metacognitive predictors and psychological distress over the four time-points. These results indicate that negative metacognitive beliefs, positive metacognitive beliefs, metacognitive beliefs related to superstition, punishment, and responsibility, low perceived levels of cognitive confidence and cognitive self-consciousness predict psychological distress over 12months in adolescents aged 12 to 13. The strongest longitudinal correlational structure was found for the model of negative metacognitive beliefs and psychological distress. These findings provide preliminary evidence for the positive linear relationship between metacognitive beliefs and psychological distress in adolescence. The study provides an important contribution to understanding the role of metacognitive beliefs in the aetiology and perpetuation of psychological distress in adolescence.

Psychological factors in Temporomandibular disorders and somatization: A multidimensional analysis of personality, coping, and distress among young adults.

The association of Temporomandibular disorder (TMD) and somatic symptoms with the psychological variables of personality, coping, and distress were analyzed in young adults. Physical and psychological correlates were also explored along with the risk factors for TMDs/somatization. Participants were enlisted from a local university and the presence of TMDs and somatic symptoms was determined with the Short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. The psychological variables of personality, coping, and distress was assessed with the Big-Five Personality Inventory-10, brief-COPE Inventory, and Depression, Anxiety, Stress Scales-21 accordingly. Statistical evaluations were performed with the Mann-Whitney U test, Spearman's correlation, and logistic regression analyses (α = 0.05). Among the 455 participants (mean age 22.7 ± 1.2 years), 18.2% and 5.7% had TMDs and medium-to-high somatization respectively. Participants with TMDs exhibited substantially higher somatization and psychological distress scores than those with no TMDs. Significant differences in TMD, conscientiousness, extraversion, and psychological distress scores were observed between participants with no-to-mild and medium-to-high somatization. The association between TMD and somatization scores, albeit significant, was weak. Neuroticism and dysfunctional coping style were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.62). Findings suggest that anxiety is the main risk factor for the presence of TMDs and medium-to-high somatization in non-clinical young adults while conscientiousness is a protective factor for somatization.

Somatic symptom distress and ICD-11 prolonged grief in a large intercultural sample

ABSTRACT Background: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant. Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD. Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD. Results: ‘High’ or ‘very high’ levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (β = 0.08, p < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance. Conclusions: High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.

Book Review: Dance/Movement Therapy for Infants and Young Children with Medical Illness: Treating Somatic and Psychic Distress, DMT with Infants, Children, Teens, and Families, by Suzi Tortora and Miri Keren, New York: Routledge, 2023, 218 pages

Book Review: Dance/Movement Therapy for Infants and Young Children with Medical Illness: Treating Somatic and Psychic Distress, DMT with Infants, Children, Teens, and Families, by Suzi Tortora and Miri Keren, New York: Routledge, 2023, 218 pages

Soreness Reminds Me of Grief: Patients With Chronic Pain Show Less Differentiated Representations of Emotional Feelings and Bodily States

People experience similarities between emotional feelings and bodily states on a daily basis, but both the magnitude and pervasiveness of this experiential similarity vary across individuals. Inspired by previous findings that chronic pain (CP) is characterized by strengthened pain-affect coupling and reduced interoceptive accuracy, we conducted 2 cross-sectional studies to examine whether patients with CP would exhibit less differentiated perception and mental representation of emotional feelings and bodily states. In study 1 (N = 500), patients with CP and healthy controls (HCs) completed a self-report questionnaire that asked explicitly about the perceived similarity between 5 basic emotion categories and a series of bodily states. In study 2 (N = 73), a specially designed false memory test was administered to examine whether patients with CP would have reduced differentiation of concepts of negative emotion and somatic distress. We found that patients with CP perceived greater and more pervasive similarities between emotional feelings and bodily states, as indicated by higher questionnaire scores and denser, less specialized bipartite emotion-body networks, both associated with lower subjective interoceptive accuracy. Furthermore, patients with CP formed false memories of negative emotion words (eg, grief) more readily than HCs after memorizing somatic distress words (eg, soreness), as if they represented negative emotion and somatic distress as a single, enmeshed semantic category. Our findings extend previous literature by demonstrating reduced discrimination between emotional and bodily experiences in CP that is not restricted to pain-related emotional and sensory experiences and may be related to a fundamentally less differentiated interoception. PerspectivesThis study shows that patients with chronic pain have a profoundly less differentiated perception and implicit conceptualization of emotional feelings and bodily states, which appears to be associated with altered interoception. These findings may provide new perspectives on why they often experience a stronger pain-affect coupling.

Treatment-associated network dynamics in patients with globus sensations: a proof-of-concept study

In this proof-of-concept study, we used a systems perspective to conceptualize and investigate treatment-related dynamics (temporal and cross-sectional associations) of symptoms and elements related to the manifestation of a common functional somatic syndrome (FSS), Globus Sensations (GS). We analyzed data from 100 patients (M = 47.1 years, SD = 14.4 years; 64% female) with GS who received eight sessions of group psychotherapy in the context of a randomized controlled trial (RCT). Symptoms and elements were assessed after each treatment session. We applied a multilevel graphical vector-autoregression (ml GVAR) model approach resulting in three separate, complementary networks (temporal, contemporaneous, and between-subject) for an affective, cognitive, and behavioral dimension, respectively. GS were not temporally associated with any affective, cognitive, and behavioral elements. Temporally, catastrophizing cognitions predicted bodily weakness (r = 0.14, p < 0.01, 95% confidence interval (CI) [0.04–0.23]) and GS predicted somatic distress (r = 0.18, p < 0.05, 95% CI [0.04–0.33]). Potential causal pathways between catastrophizing cognitions and bodily weakness as well as GS and somatic distress may reflect treatment-related temporal change processes in patients with GS. Our study illustrates how dynamic NA can be used in the context of outcome research.

Psychological Distress in Young Chilean Adults Exposed to Parental Alienating Behaviors during Childhood/Adolescence.

The aim of this study was to analyze the psychological distress of young adults exposed to alienating behaviors during childhood/adolescence. Four hundred and sixteen adults responded to the online survey. A brief sociodemographic questionnaire, the Brief Symptom Scale, and a questionnaire on adverse childhood experiences were included. The analyses revealed that individuals who experienced one or more alienating behaviors exhibited higher levels of anxiety, depression, somatization, and overall psychological distress. Furthermore, even after controlling for the effect of other adverse childhood experiences, alienating behaviors had a significant impact on psychological distress in adulthood. This highlights an understudied aspect of alienating behaviors, i.e., their conjunction or parallelism with other adverse childhood experiences.

Psychophysiological Assessment of Individual Personality in Two Patients with Severe Local Radiation Injuries (LRI) of Hand and Acute Radiation Sickness (ARS) I Degree (30 Years of Follow-up)

Psychophysiological examination was carried out on two patients, former border guards, who suffered on October 05, 1982 as a result of accidental contact with a source of gamma radiation (137Cs) while on duty while serving on the Iranian-Azerbaijani border in the ranks of the Soviet army. They suffered ARS of the 1st degree with extremely uneven gamma irradiation in the form of local radiation injuries of the hands of varying severity. The assessment of the aver -age dose for the whole body according to the frequency of dicentrics in cultures of peripheral blood lymphocytes in patient No. 1 and patient No. 2 is the same and is 0,26 Gy. Psychophysiological research was carried out in dynamics in 2001-2013 using the automated software and methodological complex «Expert». According to the MMPI data, both victims have a hyperthymic type of psychophysiological adaptation with varying degrees of severity. Patient No. 2 is a chronically hyperthymic personality with a significant increase in the profile on the 9th scale and with its gradual increase in dynamics, which reflects the persistence of hyperthymic personality traits and causes an overstrain of mental adaptation, with an increase in the dynamics of the tendency to explain their difficulties and problems by somatic distress (1Hs). Patient No. 1 has a hyperthymic personality type with a moderate increase in profile dynamics on the ninth scale. A personality trait is indicated by a high, growing in dynamics, indicator on the K scale, which determines behavior depending on social approval and concern for one’s social status. The appearance in dynamics (2013) of a peak on scales 1 (preoccupation with the state of health) and 4 (emotional tension in direct behavior) determines the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of one’s own settings (a combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and the scales of the neurotic triad reflect the tendency to various options for the implementation of antisocial attitudes in a socially acceptable way, the desire to appear in a favorable light (scale L). Sufficiently high intelligence and demonstrative behavior determine good adaptation to the environment with self-confidence, high social adaptability, and resilience in overcoming difficulties.

The prevalence and dynamics of the test anxiety in foreign students before and within COVID-19 pandemic in Ukraine

Test anxiety (TA) is a psychological condition of a person’s distress before, during, or after a test or other assessment. The prevalence and dynamics of TA before and after COVID-19 pandemic in foreign graduate medical students in Bukovinian State Medical University (Ukraine) was investigated. After receiving informed consent 6 year foreign students: 234 on the eve of COVID-19 pandemic and 74 students in spring 2023 anonymously filled in the TA questionnaire (Sarason I.G., 1980), total points ≥ 12 signified presence of TA. The average level of TA before COVID-19 pandemic was 6,3±2,8 points, while later in 2023 it increased significantly to 8,0±3,8 points, p&lt;0,01. In 2023 more than 70% of students answered that they “feel very panicky when they have to take a surprise exam” and more than 30% of graduates when taking tests, find that “their emotional feelings interfere with their performance”. More than 48% of students answered, that they “find themselves thinking of the consequences of failing during test”. Physical manifestations of TA included positive answer for the question “I sometimes feel my heart beating very fast during important examinations” in 74% of students and in 38% of cases students struggle with excessive perspiration. Around 30% of students “usually get depressed” or deal with any gastrointestinal problems after important tests. Totally in 2023 34% of examined students demonstrated borderline or present TA as compared to 15% before (p&lt;0,02). Thus, TA causing somatic and/or psychological distress is present in every third medical foreign student and has significantly increased within COVID-19 pandemic period in Ukraine, that’s why it deserves more attention.

Features of the Social Situation of a Child's Development with an Allergic Disease

With all the variety of approaches to the study of the social situation of a child's development in the presence of somatic distress, currently insufficient attention is paid to the problems of the occurrence and course of allergies of unclear genesis. Consideration of an allergy of unclear genesis through the prism of a psychosomatic reaction is im-possible without taking into account the social situation of the child's development. In our study, we consider the pe-culiarities of the social situation of a child's development by studying various psychological characteristics, ranging from the characteristics of intra-family conflicts, the type of upbringing, the quality of contact between mother and child, and ending with the past experience of the child's mother interacting with her own mother. The aim of the study is to study the peculiarities of the social situation of a child's development in the manifestation of allergies of both clear and unclear genesis.The article presents the results of a study of 63 mothers with children, who were further divided into three groups, depending on the presence of a diagnosis of allergy of clear/unclear genesis or its absence. Taking into ac-count the set goals, our study used groups of methods focused on studying the peculiarities of the social situation of child development: clinical conversation, analysis of medical documentation, developed questionnaire aimed at diag-nostic examination of mothers and their children with allergies of unclear genesis, as well as children without allergies of unclear genesis, in order to identify risk factors disorders of mental and psychosomatic health, psychodiagnostic methods.According to the results of the study, the article presents a differentiated identification of factors of violation of the social situation of the child's development, by studying the quality of contact between mother and child, determin-ing the significance of the influence of past negative experiences of interaction with one's own mother; disturbed in-tra-family relations, which in the future may act as a trigger for the manifestation of allergies of unclear genesis in children.

Sensory and affective aspects of the perception of respiratory resistance

Perception of airway resistance has a sensory and an affective aspect, i.e., perceived resistance and unpleasantness, respectively. The current study aimed to shed more light on the relationship of these aspects, as well as their malleability to trait-like aspects of body awareness. In a laboratory study, 71 young participants completed two respiratory resistive load discrimination tasks relying on sensory and affective evaluation, respectively, and filled out questionnaires assessing somatosensory amplification, anxiety sensitivity, somatic symptoms distress, and breath awareness. Frequentist and Bayesian statistical analysis revealed no differences in discrimination accuracy with respect to the sensory and affective aspect of perceived resistance. Psychological traits were not associated with accuracy scores. In conclusion, affective evaluation of respiratory load is as accurate as sensory evaluation. Neither sensory not affective accuracy is influenced by various aspects of body awareness.

Is the rubber hand illusion associated with somatic symptom reporting?

Current approaches to somatic symptom perception conceptualize somatic symptoms partly as somato-visceral or body illusions evoked by an interaction between bottom-up (sensory) and top-down (expectations, attention) processes. Similar processes of multisensory integration are assumed to contribute to the rubber hand illusion (RHI). Findings concerning the strength and direction of associations between these two phenomena, symptom perception and the RHI, are equivocal. Individuals of a non-clinical sample (N = 63; 56% females; Mage = 20.4; SD = 1.6) completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15) and participated in an experiment that evoked the RHI. In repeated measures analyses of variance with the PHQ-15 score as covariate, no significant interaction effects between the PHQ-15 score and indicators of the RHI, i.e., proprioceptive drift (F(1,61) < 0.001 p = 0.993, partial η2 < 0.001; BF10 = 0.307), felt body ownership(F(1,59) = 0.043, p = 0.836, partial η2 = 0,001; BF10 = 0.501), and felt body disownership (F(1,59) = 0.148, p = 0.702, partial η2 = 0.002; BF10 = 1.972) were found. Overall, frequentist and Bayesian analysis indicated that the support for a possible association between the PHQ-15 and indicators of the RHI remains inconclusive, i.e., neither the null nor the alternative hypotheses were sufficiently supported. At least in this non-clinical sample, the association between somatic symptom distress and the strength of the RHI appears so weak (perhaps non-existing), that both phenomena (somatic symptom distress and the RHI) appear distinct and largely unrelated.

Do we need to accurately perceive our heartbeats? Cardioceptive accuracy and sensibility are independent from indicators of negative affectivity, body awareness, body image dissatisfaction, and alexithymia.

Assessment of the acuity of heartbeat perception, dubbed cardioceptive accuracy, as well as its association with various psychological characteristics are hot topics of interoception research. In this study, we aimed (1) to replicate previously reported findings on the association between the mental tracking task and a novel motor tracking task that eliminates disturbing tactile sensations; and (2) to explore associations between performance in the latter task and indicators of negative affectivity (anxiety, depression, anxiety sensitivity, somatic symptom distress), alexithymia, body focus, and dissatisfaction with body image. 102 young people (age = 20.8±5.08 yrs) participated in the study. Mental tracking score was significantly higher than motor tracking scores, although they were strongly associated. Frequentist correlation analysis showed no significant associations between indicators of cardioceptive accuracy and questionnaire scores; Bayesian analysis indicated the lack of association for the majority of the cases. Similarly, detectors and non-detectors showed no differences in any of the assessed characteristics and Bayesian results typically supported the lack of associations. In conclusion, cardioceptive accuracy, as assessed with different tracking methods, is not associated with the aforementioned self-reported characteristics in young individuals.

Personal identity, somatic symptoms, and symptom-related thoughts, feelings, and behaviors in adolescence: Examining between- and within-person associations and the role of depressive symptoms.

Recent literature highlights the complex relationship between personal identity and body-related pathology, yet there is a lack of integrative longitudinal research on the relationship between identity and somatic symptoms. The present study investigated the longitudinal associations between identity functioning and (psychological characteristics of) somatic symptoms, and examined the role of depressive symptoms in this relationship. A total of 599 community adolescents (Time 1: 41.3% female; Mage = 14.93, SD = 1.77, range = 12-18 years) participated in three annual assessments. Using cross-lagged panel models, a bidirectional relationship between identity and (psychological characteristics of) somatic symptoms, mediated by depressive symptoms, emerged at the between-person level; whereas only a unidirectional relationship from psychological characteristics of somatic symptoms to identity functioning, mediated by depressive symptoms, emerged at the within-person level. Identity and depressive symptoms were bidirectionally related at both levels. The present study suggests that adolescent identity development is closely related to somatic and emotional distress.

Modern health worries and annoyance from environmental factors are largely unrelated to smoking, alcohol consumption, and physical activity

ObjectiveModern health worries, as well as environmental annoyance from chemical agents, noise, and electromagnetic exposure are associated with symptom reporting and marked affective-behavioural changes. As promotion and protection of health is a primary characteristic of these conditions, it can be expected that they will be related to less risk behaviour (smoking and alcohol consumption) and more health behaviour (physical activity), both cross-sectionally and longitudinally. MethodsHypotheses were tested in a sample of 2336 individuals participating in T1 and T2 data collection (3 years apart) of the Västerbotten Environmental Health Study, Sweden. Health-related behaviours were assessed using single self-report questions. Smoking was measured on a binary (yes-or-no) scale; frequency of alcohol consumption and physical activity was measured on a 5-point and a 4-point scale, respectively. ResultsModern health worries showed no cross-sectional association with the three behaviours, whereas annoyance was typically inversely, very weakly, related to smoking and alcohol consumption. Physical activity was significantly positively associated only with chemical annoyance. None of the variables significantly predicted change of behaviours at T2 after controlling for the respective T1 value and demographic variables. Conclusions: Individuals with high levels of modern health worries and annoyance from various environmental agents are not clearly characterized by a healthier lifestyle. Perhaps they focus on the alleviation of their existing symptoms; alternatively, somatic symptom distress decreases their cognitive-affective resources necessary for a long-term life style change.

Somatic symptoms, perceived stress, and preventive behavior during the COVID-19 pandemic

Numerous studies of the COVID-19 effects on mental health have documented increases in anxiety and depressive symptoms, panic and adjustment disorders, suicidal ideation and suicide attempts, somatic and psychological distress, feelings of loneliness, and alcohol use problems [21]. These findings suggest the need for further examination of the COVID-19 effects on mental health and adherence to preventive behavior regarding the risks of SARS-CoV-2 infection.Objective. The aim of this study was to examine the prevalence and relationship between somatic symptoms, perceived stress, and preventive behavior during the COVID-19 pandemic in Russia.Material and Methods. The participants were 1,987 volunteers who were recruited with the help of Anketolog, an empirical data collection company in Russia. All respondents completed a questionnaire with a sociodemographic form and Russian versions of the Somatic Symptom Scale-8, Perceived Stress Scale-10, and COVID-19 Preventive Behavior Index.Results. Results showed that 39.1% of Russians had clinically significant somatic symptoms, 81% of Russians experienced moderate to high perceived stress, and from 46.5% to 84.4% of Russians were willing to follow some form of COVID-19 pandemic preventive behavior. Russians with somatic symptoms experienced more perceived stress than Russians without somatic symptoms, while Russians with higher perceived stress did not differ from Russians with lower perceived stress in frequency and severity of somatic symptoms.Conclusion. Preventive and psychoeducational interventions can be useful in reducing somatization and perceived stress, maintaining and increasing the adherence of Russians to preventive behavior during the COVID-19 pandemic.

Composition and implications of foreign‐language anxiety among American study‐abroad students in Morocco

AbstractIn this study, the foreign‐language anxiety (FLA) of American students of Arabic on three study‐abroad programs in Morocco was examined. Exploratory factor analyses (EFAs) of the students’ data based on items from the Foreign Language Classroom Anxiety Scale yielded four distinct factors, or domains, of FLA: Somatic Distress, Self‐Doubt, Nonengagement, and Apprehension. Although the students had a moderate level of self‐doubt concerning their studies as well as a moderate level of apprehension about being with Arabic L1 users, they tended to report engagement and absence of somatic distress in relation to Arabic. Scores among all four factors differed significantly from each other, apart from the comparison between Self‐Doubt and Apprehension. In addition to having implications for pedagogical practice and study‐abroad programs, this research is an attempt to demonstrate best practice in EFA.

Heart rate variability behavior in athletes after a sports concussion: A systematic review.

This systematic review aims to investigate the adaptations of the autonomic nervous system (ANS) after a concussion by measuring HRV in athletes over the age of 16 after injury. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using predefined search terms to identify relevant original cross-sectional, longitudinal, and cohort epidemiological studies published before December 2021. After screening 1737 potential articles, four studies met the inclusion criteria. Studies included participants with concussion (n = 63) and healthy control athletes (n = 140) who practised different sports. Two studies describe a decrease in HRV following a sports concussion, and one proposed that the resolution of symptoms does not necessarily reflect ANS recovery. Lastly, one study concluded that submaximal exercise induces alteration in ANS, not seen in rest after an injury. In the frequency domain, a decrease in high frequency power and an increase of low frequency/high frequency ratio is expected, as the activity of the sympathetic nervous system increases, and the parasympathetic nervous system decreases after injury. In the frequency domain, heart rate variability (HRV) may help monitor the activity of ANS evaluating signals of somatic tissue distress and early identification of other types of musculoskeletal injuries. Further research should investigate the relationship between HRV and other musculoskeletal injuries.

Interrelationship of psychological and sociological factors after a first percutaneous coronary intervention (PCI) : Implications for secondary prevention

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): This study is supported with a young investigator grant from Vísindaráð Landspítala [the science committee of Landspitali-University Hospital] awarded to dr. Erla Svansdóttir. Background Coronary artery disease (CAD) is a leading cause of death, disability, and health-care burden worldwide. Advances in medical technology combined with identification of CAD risk factors has resulted in lower CAD mortality rates in western countries in the past decades. Secondary prevention constitutes a crucial factor for hindering further CAD development by helping patients with risk factor modification. Psychological and sociological factors have been identified as risk factors for progression of CAD and adverse well-being following adverse CAD events, and should be given consideration in secondary prevention. Purpose The aim of this study was to assess the prevalence of psycho- and sociological factors in patients undergoing a first Percutaneous Coronary Intervention (PCI) and to explore how the interrelationship of these factors affect patients’ well-being. This study is a part of a larger study investigating the psychological well-being and rehabilitation success of patients after an initial PCI procedure up to six months post-PCI. Methods Participants were 97 patients (mean age 60±7.6 years) who underwent a PCI in Iceland from December 2021 to May 2022. Questionnaires assessing somatic symptoms, anxiety, depression, perceived stress, cardiac anxiety, and distress personality were administered during hospitalization. Results Majority of participants were male (79%), in a relationship (79%), had secondary/higher education (83%), worked full time (72%) and lived in the capital area (69%). Overall, nearly half of PCI patients showed some depression symptoms (47%) and 38% some anxiety symptoms. Of these, 15% and 10% had moderate or severe symptoms of depression and anxiety, respectively. Women scored higher than men on cardiac anxiety and cardiac-related avoidance (p’s&amp;lt;0.05). Age had a negative correlation with somatic symptom scores (r=-0.26, p&amp;lt;0.05), anxiety (r=-0.32, p&amp;lt;0.01), cardiac anxiety (r=-0.24, p&amp;lt;0.01), cardiac fear and worry (r=-0.39, p&amp;lt;0.01) and social inhibition (r=-0.26, p&amp;lt;0.01). Higher education level was linked with lower anxiety, depression, perceived stress, negative affectivity and social inhibition (table 1). Not being in a relationship was associated with more somatic symptoms (ß=0.27), perceived stress (ß=0.24) and cardiac-related avoidance (ß=0.25), independent of age, gender, and education status (see table 2, all p’s&amp;lt;0.05). In secondary analyses patients not in a relationship had higher odds of current smoking (OR 5.4, 95% CI:1.7-17.6) and of having some depression symptoms (OR 2.7, 95% CI:1.0-7.4). Conclusion Nearly half of PCI patients in Iceland had some depression or anxiety symptoms, and psychological distress was higher among patients of younger age or lower education levels. Single patients may pose a group in need of specific support in secondary prevention given their elevated somatic symptoms, cardiac-related avoidance and perceived stress which may hinder rehabilitation efforts.