Psychological Variables Mediate Symptoms in Persistent Postural-Perceptual Dizziness (PPPD): A Cross-Sectional...

Area of Science:

• Neuroscience
• Otolaryngology
• Psychology

Background:

• Persistent Postural-Perceptual Dizziness (PPPD) is a common functional neuro-otologic disorder.
• Current diagnostic criteria focus on physical symptoms, yet psychological factors are linked to PPPD onset and maintenance.
• This study explores psychological factors in vestibular disorders, comparing PPPD patients with healthy controls and Bilateral Vestibulopathy (BVP) patients.

Purpose of the Study:

• To investigate psychological factors differentiating PPPD patients from healthy controls and BVP patients.
• To identify potential psychological treatment targets for PPPD.
• To explore the role of cognitive appraisals in PPPD symptomatology.

Main Methods:

• A cross-sectional study involving 164 participants (59 PPPD, 16 BVP, 89 healthy controls).
• Participants completed questionnaires assessing illness perception, anxiety, cognitive fusion, perceived injustice, balance vigilance, visually induced dizziness (VIMSSQ), and dizziness severity (NPQ).
• Logistic regression and mediation analyses were used to assess psychological variables mediating dizziness symptoms and differentiating patient groups.

Main Results:

• Perceived injustice (IEQ) was the strongest differentiator between PPPD patients and healthy controls, outperforming measures of dizziness severity and other psychological constructs.
• Visually induced dizziness (VIMSSQ) most effectively distinguished PPPD from BVP, surpassing the PPPD-specific Niigata PPPD Questionnaire (NPQ).
• Mediation analyses revealed that the predictive power of VIMSSQ was significantly influenced by anxiety and perceived injustice.

Conclusions:

• Cognitive appraisals, particularly perceived injustice, are crucial in PPPD.
• There is a need for psychometric tools that specifically assess psychological dimensions in PPPD beyond general anxiety.
• Developing such assessments is essential for creating evidence-based, holistic interventions for PPPD.