Accuracy of respiratory symptom perception in different affective contexts

Bogaerts, Katleen; Notebaert, Karolien; Diest, Ilse Van; Devriese, Stephan; Peuter, Steven De; Bergh, Omer Van den

doi:10.1016/j.jpsychores.2004.12.005

Cited by 108 publications

(91 citation statements)

References 53 publications

(46 reference statements)

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“…In the following presentation of the labelled aerosols, which were then completely free of CO 2 , healthy and asthmatic participants reported more respiratory symptoms than during presentation of aerosols which have not been coupled with CO 2 inhalation during the preceding training trials. The same research group further showed that a distressing context (i.e., foul smelling odor) leads to less accurate perception of CO 2 -induced dyspnea when compared to a pleasant context, particularly in participants with high negative emotionality [26]. However, both studies used symptom check lists to assess respiratory symptoms instead of the Borg scale or VAS, which makes it difficult to compare the results.…”

Section: Discussionmentioning

confidence: 99%

“…First, it is well known that beside many physiological pathways psychological processes also play an important role in the perception of respiratory sensations [43]. Particularly the influence of negative emotionality has been shown to be associated with inaccurate perception of dyspnea regardless of lung function [24,25,26]. These results might be due to the fact that individuals with high negative affectivity perceive the affective or unpleasant aspects of dyspnea to be much more pronounced than the sensory or intensity aspects.…”

Section: Discussionmentioning

confidence: 99%

“…This dimension itself might be highly impacted upon by negative affectivity of patients (e.g., depression and anxiety), which is frequent in obstructive pulmonary disorders [21,22,23] and might be associated with inaccurate perception of dyspnea [24,25,26], inadequate use of medication [27, 28], frequent visits to the physician [29] and high rehospitalization rates [30]. However, it is entirely unknown how sensory and affective aspects of dyspnea influence the Borg scale’s measurement of dyspnea, which does not differentiate between these distinct aspects.…”

Section: Introductionmentioning

confidence: 99%

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Sensory and Affective Aspects of Dyspnea Contribute Differentially to the Borg Scale’s Measurement of Dyspnea

Leupoldt¹,

Ambruzsova²,

Nordmeyer³

et al. 2006

Respiration

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Background:Recent research has shown that distinct dimensions in the perception of dyspnea can be differentiated; however, most studies to date have only used a global rating scale for the measurement of this sensation. Objectives: This study examined the different influence of sensory and affective aspects of perceived dyspnea on the commonly used Borg scale, which measures the global perception of dyspnea. Methods: Dyspnea was induced in 16 healthy volunteers (mean age 26.2 ± 6.3 years) by breathing through an inspiratory resistive load (3.57 kPa/l/s) in two experimental conditions (attention and distraction). After each of the two conditions the experienced intensity (i.e., sensory dimension) and unpleasantness (i.e., affective dimension) of dyspnea were rated on separate visual analog scales (VAS), followed by a global rating of dyspnea on the Borg scale. Hierarchical multiple linear regression models were calculated to analyze the predictive validity of VAS ratings of intensity and unpleasantness on the Borg scale ratings. Results: When subjects attended to their breathing, only VAS intensity scores showed a significant influence on Borg scale ratings (p < 0.05). In contrast, only the VAS unpleasantness scores showed a significant influence on Borg scale ratings (p < 0.05) when subjects were distracted. Conclusions: These findings show that sensory and affective aspects of perceived dyspnea differentially influence the global measure of dyspnea as determined by the Borg scale. A differentiation between these aspects in future studies through the use of separate rating scales could yield more detailed information on the perception and report of dyspnea.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sensory and Affective Aspects of Dyspnea Contribute Differentially to the Borg Scale’s Measurement of Dyspnea

Leupoldt¹,

Ambruzsova²,

Nordmeyer³

et al. 2006

Respiration

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“…This effect only appeared when participants were asked to rate "symptoms" (e.g., dyspnea/breathlessness) and not when rating neutrally labelled "sensations" (e.g., breathing intensity), showing that a reduction in sensory-perceptual detail is only applied when contextual cues advance symptom-related priors (Bogaerts et al, 2005(Bogaerts et al, , 2008(Bogaerts et al, , 2010b. Less detailed sensoryperceptual processing of somatic episodes in SSD patients may also underlie the absence of a peak-end bias when evaluating previous somatic episodes (Bogaerts et al, 2012) and less specific healthrelated autobiographical memories (Walentynowicz et al, 2016).…”

Section: Threat and Negative Affect (Na)mentioning

confidence: 94%

Symptoms and the body: Taking the inferential leap

Bergh

Witthöft

Petersen

et al. 2017

Neuroscience & Biobehavioral Reviews

Self Cite

388

354

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a b s t r a c tThe relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of "medically unexplained" or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates existing concepts within a unifying framework that addresses many of the shortcomings of current theory. We describe the conditions under which a close correspondence between the experience of symptoms and objective physiology might be expected, and when they are likely to diverge. We conclude by exploring some theoretical and clinical implications of this new account.

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“…For example, if climbing a flight of stairs triggers severe breathlessness, an individual will "expect" to experience severe breathlessness during subsequent stair climbing. Negative affect is thought to act as a moderator within the brain's perceptual system (8)(9)(10)(11), altering the balance between priors and sensory inputs to influence our perceptions of internal sensations such as breathlessness.…”

Section: Introductionmentioning

confidence: 99%

Opioids for breathlessness: Psychological and neural factors influencing response variability

Abdallah

Faull

Wanigasekera

et al. 2018

Preprint

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Effective management of distressing bodily symptoms (such as pain and breathlessness) is an important clinical goal. However, extensive variability exists in both symptom perception and treatment response. One theory for understanding variability in bodily perception is the ‘Bayesian Brian Hypothesis’, whereby symptoms may result from the combination of sensory inputs and prior expectations. In light of this theory, we explored the relationships between opioid responsiveness, behavioural/physiological symptom modulators and brain activity during anticipation of breathlessness.MethodsWe utilised two existing opioid datasets to investigate the relationship between opioid efficacy and physiological/behavioural qualities, employing hierarchical cluster analyses in: 1) a clinical study in chronic obstructive pulmonary disease, and 2) a functional magnetic resonance brain imaging study of breathlessness in healthy volunteers. We also investigated how opioid efficacy relates to anticipatory brain activity using linear regression in the healthy volunteers.ResultsConsistent across both datasets, diminished opioid efficacy was more closely associated with negative affect than with other physiological and behavioural properties. Furthermore, in healthy individuals, brain activity in the anterior cingulate and ventromedial prefrontal cortices during anticipation of breathlessness were inversely correlated with opioid effectiveness.ConclusionDiminished opioid efficacy for relief of breathlessness may be associated with high negative affective qualities, and was correlated with the magnitude of brain activity during anticipation of breathlessness.Clinical implicationsNegative affect and symptom expectations may influence perceptual systems to become less responsive to opioid therapy.

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Accuracy of respiratory symptom perception in different affective contexts

Cited by 108 publications

References 53 publications

Sensory and Affective Aspects of Dyspnea Contribute Differentially to the Borg Scale’s Measurement of Dyspnea

Sensory and Affective Aspects of Dyspnea Contribute Differentially to the Borg Scale’s Measurement of Dyspnea

Symptoms and the body: Taking the inferential leap

Opioids for breathlessness: Psychological and neural factors influencing response variability

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