Symptoms In Daily Life Research Articles

Symptoms in Daily Life and Activity Level of Women with and without Hypermobility

Objective: Generalized Joint Hypermobility (GJH) is defined as a condition in which several joints move beyond their normal limits. It seems to be associated with musculoskeletal disorders, pain, reduced activity level in sports and reduced strength. The aim of the current study was to record specific problems and disorders of hypermobile women and to build subgroups based on these results. As a second objective, the study aimed to identify differences in activity level between these subgroups. Methods: A total of 195 women were included in this exploratory study: 67 normomobile (NM) and 128 hypermobile. Of these, 56 were classified as hypermobile with symptoms and 47 as hypermobile without symptoms. Symptoms were first recorded with the Canadian Occupational Performance Measure (COPM) and then monthly over a period of 6 months with a face validated questionnaire including general impairment, localization, type, intensity and frequency of problems. Activity level was determined by the International Physical Activity Questionnaire. Results: On the COPM there was no significant difference between patients in the NM and HM groups. The face validated questionnaire identified the most important problem to be pain in different localizations after remaining in one position for too long. The highest activity level was found in the HM group (p=0.021). Conclusion: Hypermobile women are active for longer during the day than women with normal mobility, but the type and degree of activity needs further evaluation. More detailed recording of symptoms in women with GJH is required to identify the discrete differences between the groups. To build subgroups in GJH the procedure of screening has to be more comprehensive. Widespread pain and level of activity are aspects that have to be included in the holistic approach to the management of patients with GJH.

Stress is associated with exercise differently among individuals with higher and lower eating disorder symptoms: An ecological momentary assessment study.

Stress is associated with the maintenance of eating disorders and exercise behaviors. However, it is unclear how stress is associated with exercise and vice-versa among individuals with higher levels of eating disorder symptoms in daily life. The current study tested the moderating effect of eating disorder symptoms on the relationships between (1) daily stress and later exercise behavior and (2) daily exercise behavior and later stress. Female college students [N = 129, mean age = 19.19 (SD = 1.40)] completed the Eating Disorder Inventory-2. Participants then completed measures of stress and exercise four times daily across seven days using an automated telephone ecological momentary assessment system. Data were analyzed using multilevel models. Drive for thinness, bulimic symptoms, and body dissatisfaction significantly moderated the relationship between daily stress and later exercise (ps = .01-.05), such that higher daily stress predicted higher later exercise only in individuals who were low (but not average or high) in drive for thinness, bulimic symptoms, and body dissatisfaction symptoms. Stress is associated with exercise differentially depending on individuals' eating disorder symptoms. Our findings suggest that only individuals with lower levels of eating disorder symptoms exercise when stressed.

Second look arthroscopic evaluation of repaired radial/oblique tears of the midbody of the lateral meniscus in stable knees.

Radial/oblique tears of the midbody of the lateral meniscus significantly impair the ability of the meniscus to withstand the tibiofemoral load, requiring meniscal repair. However, healing status after meniscal repair has not been fully elucidated. This study aimed to evaluate arthroscopic findings after inside-out suture repair for isolated radial/oblique tears of the midbody of the lateral meniscus. From 2011 to 2015, 18 consecutive patients with isolated radial/oblique tears of the midbody of the lateral meniscus underwent arthroscopic inside-out repair with the tie-grip suture technique. All knees were stable with no previous surgery. All patients were evaluated by second-look arthroscopy at six months postoperatively. Activities including jogging were not allowed until meniscal status was evaluated arthroscopically. To analyze factors associated with healing rates, age, time from injury to initial surgery, and tear zone were compared. Second-look arthroscopy revealed complete healing in four (22%) patients, partial healing in seven (39%), and failure to heal in seven (39%). Significant differences were observed for tear zone (p<0.0001), but not for age and timing of repair. Arthroscopic evaluation revealed that inside-out repair with the tie-grip suture technique for isolated radial/oblique tears of the midbody of the lateral meniscus achieved complete or partial healing only in 61% of patients. Satisfactory results were observed particularly in patients with tears extending to the vascular zone, whereas those with tears in the avascular zone failed to achieve healing. Therefore, the operative indication of inside-out repair for radial/oblique tears of the midbody of the lateral meniscus might be limited to tears extending into the vascular zone. Given that 39% of cases were arthroscopically considered a failure even if patients complained of no symptoms in daily life, decisions should be made carefully to allow patients to return to sports activities.

Perceiving social pressure not to feel negative predicts depressive symptoms in daily life.

Western societies often overemphasize the pursuit of happiness, and regard negative feelings such as sadness or anxiety as maladaptive and unwanted. Despite this emphasis on happiness, the amount of people suffering from depressive complaints is remarkably high. To explain this apparent paradox, we examined whether experiencing social pressure not to feel sad or anxious could in fact contribute to depressive symptoms. A sample of individuals (n = 112) with elevated depression scores (Patient Health Questionnaire [PHQ-9] ≥ 10) took part in an online daily diary study in which they rated their depressive symptoms and perceived social pressure not to feel depressed or anxious for 30 consecutive days. Using multilevel VAR models, we investigated the temporal relation between this perceived social pressure and depressive symptoms to determine directionality. Primary analyses consistently indicated that experiencing social pressure predicts increases in both overall severity scores and most individual symptoms of depression, but not vice versa. A set of secondary analyses, in which we adopted a network perspective on depression, confirmed these findings. Using this approach, centrality analysis revealed that perceived social pressure not to feel negative plays an instigating role in depression, reflected by the high out- and low instrength centrality of this pressure in the various depression networks. Together, these findings indicate how perceived societal norms may contribute to depression, hinting at a possible malignant consequence of society's denouncement of negative emotions. Clinical implications are discussed.

Categorizing and assessing negative symptoms.

To provide a review on studies published in the last year relevant to the categorization and assessment of negative symptoms. Recent research supported the validity of the 'deficit/non-deficit schizophrenia' categorization. Few studies confirmed the validity of the category 'persistent negative symptoms', whereas no recent study explored the validity of the category 'predominant negative symptoms'. The two-factor structure of the negative dimension is supported by studies reporting different correlates for the two subdomains: diminished expression and avolition/apathy. The need to further split avolition/apathy in two distinct components, that is anhedonia and amotivation, is confirmed in recent papers. Additional approaches to the assessment of negative symptoms have been proposed, including the self-assessment of negative symptoms, and the evaluation of negative symptoms in daily life and their assessment by means of computerized analyses. Negative symptoms represent an unmet need in the care of schizophrenia, as they are associated to poor response to available treatments and to poor functional outcome. Their accurate categorization and assessment represent a major challenge for research on neurobiological substrates and new treatment strategies.

When Feelings Lack Precision: Low Positive and Negative Emotion Differentiation and Depressive Symptoms in Daily Life

Research suggests the ability to differentiate discrete emotions protects against psychopathology. Little is known about daily processes through which negative and positive emotion differentiation (NED, PED) influence depressive symptomatology. We examined NED and PED as moderators of associations between daily processes (negative/positive experiences, brooding, and savoring) and daily depressive symptoms. Hypotheses were tested using intensive longitudinal techniques in two samples oversampled for depression: 157 young adults (Study 1) and 50 veterans recruited from VA primary care (Study 2). In Study 1, low NED predicted stronger associations between daily brooding and depressive symptoms. In Study 2, low NED predicted stronger reactivity to daily negative events. In both studies, low PED strengthened salutary effects of positive experiences and savoring on symptoms. Largely consistent across demographically divergent samples, results suggest both low NED and PED enhance effects of daily events and perseverative self-focus on fluctuations in depressive symptoms.

Long-term outcome of anterior cruciate ligament tear without reconstruction: a longitudinal prospective study.

To analyse subjective and objective long-term outcomes of patients with anterior cruciate ligament (ACL)-deficient knees and limited demands regarding sportive activities. This subgroup of patients might be well-treated without ligament reconstruction. We included 303 patients with unilateral tears of the ACL and conservative treatment into a prospective study. Mean age at injury was 33.8 (min. 18, max. 66) years. Follow-up was 27.1 (min. 21.3, max. 31.5) years. Follow-up examinations were conducted 12 and 27years after injury. At the last follow-up we analysed 50 patients completely. To evaluate clinical and radiological outcomes we used the Lysholm score, Tegner activity scale, visual analogue scale for pain (VAS-pain), KOOS and Sherman score. Subjective outcome (Lysholm score and VAS-pain scale) improved between the 12th and 27th year after anterior cruciate ligament tear. At the same time activity level (Tegner activity scale) decreased. Also, arthritis (Sherman score) worsened over time. Twenty-sevenyears after injury, 90% of the patients rated their ACL-deficient knee as normal or almost normal; 10% of the patients rated it as abnormal. The findings of this study show that there is a subgroup of patients with ACL tears who are well treated with physiotherapy alone, not reconstructing the ligament. Also, other authors found this correlation between activity level reduction and better subjective outcome. Conservative treatment of an ACL tear is a good treatment option for patients with limited demands regarding activity. Patient age, sportive activities and foremost subjective instability symptoms in daily life should be considered when deciding for or against ACL reconstruction.

Orthostatic Hypotension in Parkinson's Disease: The Relation of Blood Pressure Tests and Symptoms in Daily Life.

Orthostatic hypotension (OH) is common in Parkinson's disease (PD), but the relation between the results of orthostatic blood pressure tests and orthostatic symptoms in daily life is not clear. We performed a cross-sectional study in an incident nontertiary care cohort of PD patients with additional recruitment of PD patients from our own outpatient clinic. We recruited sex- and age-matched controls. All participants underwent orthostatic blood pressure tests using continuous blood pressure measurements. Orthostatic symptoms experienced in daily life were assessed using autonomic symptom questionnaires (SCOPA-AUT and COMPASS-31). A total of 83 PD patients and 35 controls were included. Mean patient age was 69.2 years (standard deviation [SD]: 10.0). Mean disease duration was 6.6 years (SD, 0.8). The estimated prevalence of OH in PD was 24.1% (95% confidence interval: 16.2-34.3). There was no significant difference between PD patients with and without OH regarding reported daily orthostatic symptoms. Alternative OH criteria did not substantially improve this. Perceived orthostatic symptoms in daily life have no clear association with the results of a single orthostatic blood pressure test. Better diagnostic strategies are needed.

A Qualitative Study on Experiences After Vulvar Surgery in Women With Lichen Sclerosus and Sexual Pain

IntroductionLichen sclerosus (LS) of the vulva can profoundly affect sexual interaction because of painful fissures and narrowing of the vaginal introitus. Successful surgical treatment is usually defined as restoration of (pain-free) penetrative sexual activity. AimsTo evaluate the impact of surgery on (dyadic) sexual functioning and pleasure and psychological well-being. MethodsNineteen women with anogenital LS participated in audiotaped, qualitative, individual interviews after surgery to re-enable sexual intercourse. Main Outcome MeasuresPhysical, sexual, and psychological experiences were analyzed using the constant comparative method. ResultsVulvar surgery resulted in a decrease of sexual pain in 13 of 19 patients (68%). Of these 13 patients, 4 were completely free of pain and the other 9 patients expressed a shift from preoperative sexual pain to postoperative sexual discomfort. These women reported improved sexual functioning, increased sexual activity and intimacy with the partner, and reinstated feelings of being an adequate woman and sexual partner. In 1 of the 19 patients (5%), surgery did not result in decreased sexual pain, yet she continued to have intercourse. Five of the 19 patients (26%) stopped having intercourse because of pain; one woman had secondary vaginismus and another woman, in retrospect, had premorbid generalized unprovoked vulvodynia. Four of these women were unable to communicate with their partner about sexual matters and to change their sexual repertoire (satisfactorily) once they had ceased intercourse (attempts). Eighteen women (95%) reported a decrease of LS symptoms in daily life. ConclusionVulvar surgery seems an effective treatment for most women with LS who experience sexual pain owing to anatomic or epithelial changes and who wish to resume intercourse. To assess whether women might benefit from such surgery and/or whether (additional) sexual counseling is indicated, preoperative sexological couple-based consultation is needed. This consultation should exclude comorbid vaginismus and generalized unprovoked vulvodynia and index the couple's pre-existing sex life, including sexual communication skills, and the ability to incorporate non-coital pain-free sexual activities.

The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies

This review examined the assessment of posttraumatic stress symptoms (PTSS) in daily life using experience sampling methodology (ESM)/ecological momentary assessment (EMA) and daily diary studies in adult samples. Fifteen peer-reviewed studies were identified and categorized into areas of total PTSD/multiple PTSS (studies including three or more symptom clusters), intrusive memories, and mood and anxiety symptoms. Overall, ESM and the daily diary method proved feasible for assessing the real-world expression of PTSS, resulted in minimal reactivity, and offered a number of advantages over classical assessment. Even within the two measurement types of ESM and daily diary, there was great variability in study design and analysis. The benefits and limitations of the different approaches are discussed. Different themes in content emerged as well, such as coping strategies and affective instability throughout the course of a day. Gaps in our current understanding are highlighted and suggestions for methodology and future areas of research are proposed.

Motives for Vulvar Surgery of Women with Lichen Sclerosus.

Women with lichen sclerosus (LS) may experience (superficial) dyspareunia or the inability to have vaginal intercourse due to painful fissures and narrowing of the vaginal introitus. A surgical procedure may contribute to the relief of these sexual pain problems. It is unknown what motives women have to undergo surgery in order to regain the ability to have sexual intercourse. Such knowledge can offer important insights that are indispensable when discussing the option of vulvar surgery with patients with LS and might prevent potential patient dissatisfaction. This study's purpose is to examine why women with LS decide to undergo vulvar surgery in order to restore intercourse. Nineteen women with anogenital LS participated in audiotaped qualitative individual interviews, in which their motives for undergoing vulvar surgery to restore intercourse were explored retrospectively. Interview data were analyzed using the constant comparative method. Three main motives for wanting to undergo surgery in order to restore intercourse were found. These were the desire to be a "normal" woman, the desire to sexually satisfy the male partner, and the desire to regain the experience of intimacy and sexual enjoyment. Another reason for surgery was to reduce daily life LS symptoms. The sexual pain complaints prevented the women from living up to their norms about heterosexuality and gender roles. Being unable to have intercourse led women to feel inadequate as a woman and as a sexual partner. Women with LS may opt for surgery to restore their identity as a "normal" woman and sexual partner, to regain the experience of coital intimacy, and to be less bothered by LS symptoms in daily life. The present findings point to the importance of a thorough couple-based sexual history in which women's motives for and expectations of vulvar surgery will be explored in order to facilitate a good decision and to increase treatment satisfaction.

Anger Expression, Momentary Anger, and Symptom Severity in Patients with Chronic Disease.

Anger expression styles are associated with physical health, and may affect health by modulating anger experience in daily life. Research examining this process in the daily lives of clinically relevant populations, such as patients with chronic disease, is needed. Community adults with asthma (N = 97) or rheumatoid arthritis (RA; N = 31) completed measures of trait-level anger expression styles (anger-in and anger-out), followed by ecological momentary assessments of anger and physical health five times daily for 7days. High anger-in predicted greater momentary anger, physical limitations, and greater asthma symptoms. High anger-out predicted reduced RA symptoms. Momentary anger was robustly associated with more severe symptoms in daily life. Three-way interactions showed that anger-in moderated these momentary anger-symptom associations more consistently in men. Anger expression styles, particularly anger-in, may affect the day-to-day adjustment of patients with chronic disease in part by altering the dimensions of everyday anger experience, in ways that appear to differ by gender.

Unraveling the relationship between trait negative affectivity and habitual symptom reporting.

ObjectiveIn two studies, we aimed at further elucidating the relationship between trait negative affectivity (NA) and habitual symptom reporting (HSR) by relating these variables to measures of executive function, trait questionnaires, and effects of emotion induction.MethodsHealthy female participants (N = 75) were selected on their scores for trait NA and for the Checklist for Symptoms in Daily Life. Three groups were compared: (1) low NA-low HSR; (2) high NA-low HSR; and (3) high NA-high HSR (low NA-high HSR did not occur). In study 1, participants underwent a Parametric Go/No-go Task and a Stroop Color-Word test, and trait questionnaires measured alexithymia and absorption. Forty-five participants (N = 15 in each group) were further engaged in study 2 to induce state NA using an affective picture paradigm.ResultsImpaired inhibition on the Stroop and Go/No go Task characterized high trait NA, but not high HSR, whereas alexithymia and absorption were elevated in HSR, regardless of trait NA. Negative picture viewing induced elevated state NA in all groups, but only high HSR also reported more bodily symptoms. This effect was moderated, but not mediated by state NA.ConclusionHigh trait NA is a vulnerability factor but not a sufficient condition to develop HSR. Deficient inhibition is related to the broad trait of NA, whereas the moderating effect of state NA on symptom reporting is specific for high HSR. Understanding processes related to alexithymia and absorption may specifically help to explain elevated HSR.

Financial capability: Standardizing assessment for adult beneficiaries with co-occurring disorders

s / Drug and Alcohol Dependence 140 (2014) e2–e85 e15 14–15, respectively, had used marijuana prior to opioids. Regardless of age of opioid initiation, alcohol and tobacco use tended to precede opioids and cocaine and heroin to come after opioids. Conclusions: By early adulthood (20–21 yo), most who started NMP opioid use had already started use of marijuana, but opioid use tended to precede marijuana use in early adolescence (12-15 years). These findings point to changing patterns of onset across developmental stages that should be addressed in prevention and intervention strategies. Financial support: Funded by Purdue Pharma, L.P. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.061 Financial capability: Standardizing assessment for adult beneficiaries with co-occurring disorders Anne C. Black1,2, T.J. McMahon1, R.A. Rosenheck1,2, M.I. Rosen1,2 1 Psychiatry, Yale University, New Haven, CT, United States 2 Psychiatry, VA Connecticut Healthcare System, West Haven, CT, United States Aims: In 2011, 6.5 million adults with psychiatric disorders received Social Security benefits to provide for basic needs. Payments typicallymade directly to the beneficiarymay be assigned to a representative payee if the beneficiary is determined not capable to manage funds. SSA assesses capability as “the ability to understand and act on the ordinary affairs of life, such as providing for own adequate food, housing, clothing, etc., and the ability, in spite of physical impairments, to manage funds or direct others how to manage them” (SSA, 2010). The breadth of the current definition poses the risk that bias and subjectivity may influence conclusions on this high-stakes assessment. The aim of this study was to develop an instrument to further standardize clinician assessment of financial capability for adults with co-occurring disorders. Methods: A 58-item questionnaire was pilot-tested with clinicians of 122 adult beneficiaries with substance abuse/dependence receiving intensive psychiatric care. Items were based on expert consensus about manifestations, correlates, and consequences of financial incapability. Data analyses explored response distributions, tested factorial validity, item reliability, and compared assessment-based capabilitydeterminations togold-standardfindings. Items were trimmed based on a priori item function criteria. Results: Clinicians lacked specific information about patients’ financial management; “don’t know” responses created high rates of missing data. Items involving gambling problems generally were not endorsed. One-week test-retest reliability ranged from r= .18–.98; item-total correlations were r= .06–.85. CFA-confirmed subscalesof spendingonnon-essentials, failing tomeetbasicneeds, spending on harmful things, and future likelihood of misspending led to capability determinations thatmatched the gold standard for 75% of cases. Conclusions: The questionnaire was reduced to 27most salient and reliable items. The next phase will validate the reduced questionnaire. Financial support: NIDA; 1R01DA025613 (M.I. Rosen). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.062 Chronic methamphetamine use heightens concurrent risk of functional dependence in persons living with HIV infection Kaitlin Blackstone1, J.E. Iudicello2, E.E. Morgan2, E. Weber1, D.J. Moore2, R.J. Ellis2, I. Grant2, S.P. Woods2 1 SDSU/UCSD Joint Doctoral Program, San Diego, CA, United States 2 Psychiatry, UCSD, San Diego, CA, United States Aims: Disability among chronic methamphetamine (MA) users is multifactorial. We examined the additive adverse impact of HIV infection, a common comorbidity in MA users, on functional dependence. Methods: Participants (N=798) were stratified by lifetime MA dependence diagnoses (i.e., MA+ or MA−) and HIV serostatus (i.e., HIV+ or HIV−) and underwent comprehensive neuromedical, neuropsychiatric, and functional research evaluations, including assessment of neurocognitive symptoms in daily life, instrumental and basic activities of daily living, and employment status. Results: A logistic regression revealed additive effects of HIV and MA across all measures of functional dependence, independent of other demographic, psychiatric, and substance use factors. The prevalence of global functional dependence increased in the expected stepwise fashion, with the lowest rates in the HIV/MA-group (29%) and the highest rates in the HIV+/MA+ sample (69%). Post-hoc ANOVAs indicated that the impact of HIV on MAassociated functional dependence was moderated by nadir CD4 (i.e., historic immunosuppression), such that MA use was associated with greater disability among HIV+ persons with higher, but not lower nadir CD4. A logistic regression within the HIV+/MA+ cohort illustrated that functional dependence was reliably associated with neurocognitive impairment, lower cognitive reserve, polysubstance use, and major depressive disorder. Conclusions: HIV infection confers an increased risk of MA-associated disability, particularly among HIV+ persons without histories of immune compromise. Standard MA treatment approaches may benefit from compensatory strategies aimed at counteracting the effects of low cognitive reserve, neurocognitive impairment, and psychiatric comorbidities for functional dependence in the context of HIV. Financial support: The authors report no conflicts of interest. This researchwas supported byNational Institutes of Health grants T32-DA31098, P01-DA12065, P50-DA026306, L30-DA032120, L30DA034362, F31-DA034510, and P30-MH62512. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.063 Factors associated with time to injection initiation among drug injectors Ricky Bluthenthal1, L. Wenger2, J. Thing1, S. Arreola2, D. Chu1, Martin Y. Iguchi3, P. Bourgois4, A. Kral2 1 University of Southern California, Los Angeles, CA, United States 2 RTI International, San Francisco, CA, United States 3 Georgetown University, Washington, DC, United States 4 University of Pennsylvania, Philadelphia, PA,

Psychometric schizotypy predicts psychotic-like, paranoid, and negative symptoms in real life

The present study employed experience sampling methodology (ESM) to assess positive and negative schizotypy in daily life in a non-clinical sample of 206 young adults. Participants were prompted eight-times daily for one week to complete assessments of their current symptoms and experiences. Positive schizotypy was associated with psychotic-like and paranoid symptoms in daily life. Negative schizotypy was associated with a subset of these symptoms and with negative symptoms in daily life. Momentary stress was associated with psychotic-like and paranoid symptoms, but only for those high in positive schizotypy. Likewise, time-lagged analyses indicated that stress at the preceding signal predicted psychotic-like symptoms at the current assessment, but only for individuals high in positive schizotypy. The results are consistent with models linking stress-sensitivity with the experience of psychotic symptoms. The findings demonstrate that ESM is an effective method for predicting the experience of psychotic-like symptoms in daily life.

Real-world impact of neurocognitive deficits in acute and early HIV infection

The acute and early period of HIV-1 infection (AEH) is characterized by neuroinflammatory and immunopathogenic processes that can alter the integrity of neural systems and neurocognitive functions. However, the extent to which central nervous system changes in AEH confer increased risk of real-world functioning (RWF) problems is not known. In the present study, 34 individuals with AEH and 39 seronegative comparison participants completed standardized neuromedical, psychiatric, and neurocognitive research evaluations, alongside a comprehensive assessment of RWF that included cognitive symptoms in daily life, basic and instrumental activities of daily living, clinician-rated global functioning, and employment. Results showed that AEH was associated with a significantly increased risk of dependence in RWF, which was particularly elevated among AEH persons with global neurocognitive impairment (NCI). Among those with AEH, NCI (i.e., deficits in learning and information processing speed), mood disorders (i.e., Bipolar Disorder), and substance dependence (e.g., methamphetamine dependence) were all independently predictive of RWF dependence. Findings suggest that neurocognitively impaired individuals with AEH are at notably elevated risk of clinically significant challenges in normal daily functioning. Screening for neurocognitive, mood, and substance use disorders in AEH may facilitate identification of individuals at high risk of functional dependence who may benefit from psychological and medical strategies to manage their neuropsychiatric conditions.

Psychometric schizotypy predicts psychotic-like, paranoid, and negative symptoms in daily life.

Positive and negative schizotypy exhibit differential patterns of impairment in social relations, affect, and functioning in daily life. However, studies have not examined the association of schizotypy with real-world expression of psychotic-like, paranoid, and negative symptoms. The present study employed experience-sampling methodology (ESM) to assess positive and negative schizotypy in daily life in a nonclinical sample of 206 Spanish young adults. Participants were prompted randomly 8 times daily for 1 week to complete assessments of their current symptoms and experiences. Positive schizotypy was associated with psychotic-like and paranoid symptoms in daily life. Negative schizotypy was associated with a subset of these symptoms and with negative symptoms in daily life. Momentary stress was associated with psychotic-like and paranoid symptoms, but only for those high in positive schizotypy. Social stress predicted momentary psychotic-like symptoms in both positive and negative schizotypy. Time-lagged analyses indicated that stress at the preceding signal predicted psychotic-like symptoms at the current assessment, but only for individuals high in positive schizotypy. The results are consistent with models linking stress sensitivity with the experience of psychotic symptoms. The findings provide cross-cultural support for the multidimensional model of schizotypy and schizophrenia. Furthermore, the findings demonstrate that ESM is an effective method for predicting the experience of psychotic-like symptoms, as well as their precursors, in daily life.

Less small airway dysfunction in asymptomatic bronchial hyperresponsiveness than in asthma

Bronchial hyperresponsiveness (BHR) can be present in subjects without any respiratory symptoms. Little is known about the role of the small airways in asymptomatic subjects with BHR. We investigated small airway function assessed by spirometry and impulse oscillometry, as well as Borg dyspnea scores at baseline and during a methacholine provocation test in 15 subjects with asymptomatic BHR, 15 asthma patients, and 15 healthy controls. At baseline, small airway function (R5 -R20 and X5 ) was comparable between subjects with asymptomatic BHR and healthy controls, whereas asthma patients showed small airway dysfunction as reflected by higher R5 -R20 and lower X5 values. During methacholine provocation, small airway dysfunction was more severe in asthma patients than in subjects with asymptomatic BHR. Interestingly, a higher increase in small airway dysfunction during methacholine provocation was associated with a higher increase in Borg dyspnea scores in subjects with asymptomatic BHR, but not in asthma patients. Subjects with asymptomatic BHR may experience fewer symptoms in daily life because they have less small airway dysfunction.

Biological and psychological predictors of visceral pain sensitivity in healthy premenopausal women

Factors that are associated with pain perception remain incompletely understood, especially in the visceral pain field. Therefore, the current study aimed to investigate possible psychological and biological predictors of visceral pain sensitivity in healthy subjects. In a sample of 59 healthy premenopausal female subjects on hormonal contraceptives, measures of gastrointestinal (GI) symptoms in daily life, trait and state anxiety, depression, serum cortisol concentrations and serum levels of interleukin-6 (IL-6) were obtained, followed by assessment of rectal distension pain sensitivity measures (i.e., rectal distension sensory threshold, pain threshold and pain ratings for discrete rectal distension stimuli). Regression analyses showed that more GI symptoms in daily life predicted a lower pain threshold. Higher levels of state anxiety predicted a lower pain threshold. Higher cortisol concentrations predicted lower pain ratings. IL-6 was positively related to GI symptoms but was a non-significant predictor of pain threshold in the multiple regression analysis. Similar to findings in patients with functional GI symptoms, we showed that subclinical GI symptoms predict visceral pain sensitivity. In line with somatic pain findings, state but not trait anxiety was found to predict visceral pain sensitivity. Our finding on serum cortisol as positive predictor of pain sensitivity might be interpreted in light of immunosuppressive effects of cortisol. Our finding on the role of IL-6 in GI symptoms is promising for understanding GI complaints in patients and needs further investigation.

154. Can we predict visceral pain sensitivity? An experimental study in healthy women

Patients and healthy subjects show large inter-individual differences in visceral pain sensitivity, which may have pathophysiological relevance. However, the factors contributing to differences in pain sensitivity remain poorly understood. Thus, this study aimed to investigate psychological and biological predictors of visceral pain sensitivity in healthy subjects. Methods : In N = 59 healthy young females, psychological (i.e., state and trait anxiety, depression) and biological (i.e., gastrointestinal (GI) symptoms in daily life, serum cortisol, and serum levels of interleukin (IL)-6) were collected, followed by assessment of rectal distension pain sensitivity. To do so, rectal distension sensory and pain thresholds, and pain ratings for discrete rectal distension stimuli at pain threshold level were assessed. Results : Regression analyses revealed that lower pain thresholds were predicted by higher state anxiety and more GI symptoms in daily life (both p < .05). Increased pain ratings were predicted by lower cortisol levels ( p < .05). Additional correlation analyses showed that lower sensory thresholds were associated with GI symptoms ( p < .05). Conclusions : We observed that psychological (state anxiety) and biological (cortisol levels, subclinical GI symptoms) variables predict different aspects of visceral pain sensitivity, which is in line with results from studies in somatic pain. Our findings may help to refine our understanding of predictors and/ or risk factors for visceral pain hypersensitivity, which may contribute to the pathophysiology of visceral pain syndromes such as Irritable Bowel Syndrome.