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Using multilevel path analysis in analyzing 24-h ambulatory physiological recordings applied to medically unexplained
Jan H Houtveen1, Ellen L Hamaker, Lorenz J P Van Doornen
1Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, 3508 TC Utrecht, The Netherlands. j.h.houtveen@uu.nl
Psychophysiology
|December 25, 2009
Summary
Individuals with medically unexplained symptoms (MUS) show bodily symptoms linked to mood changes, not significantly to physiological measures. This study highlights the minor role of cardiac autonomic and respiratory functions in MUS.
Area of Science:
- Psychophysiology
- Behavioral Medicine
Background:
- Medically unexplained symptoms (MUS) represent a significant clinical challenge.
- Understanding the interplay between psychological, physiological, and somatic experiences in MUS is crucial.
Purpose of the Study:
- To investigate the within-subject relationships between somatic complaints, mood, and physiological measures in individuals with high MUS.
- To examine the role of cardiac autonomic activity and respiration in the psychophysiology of MUS.
Main Methods:
- Multilevel path analysis was employed to compare a non-clinical group high on MUS (n=97) with healthy controls (n=66).
- Ambulatory monitoring over 24 hours captured momentary somatic complaints, mood, cardiac autonomic activity (inter-beat intervals, pre-ejection period, respiratory sinus arrhythmia), and respiration (rate, end-tidal CO2).
- Analyses controlled for diurnal variation and individual means.
Main Results:
- Subtle group differences were observed in diurnal rhythms and within-subject physiological relationships.
- In the MUS group, changes in bodily symptoms were associated with changes in mood.
- These somatic-mood associations were only marginally related to physiological measures, including cardiac autonomic and respiratory parameters.
Conclusions:
- The findings suggest that mood, rather than specific cardiac autonomic or respiratory measures, is more closely linked to somatic symptoms within individuals experiencing high levels of MUS.
- Cardiac autonomic and respiratory parameters appear to play a subordinate role in the psychophysiology of medically unexplained symptoms.
