Positive interventions cannot prevent the occurrence of symptoms triggered by negative pictures

The affect and symptom paradigm was developed to study the mechanisms behind somatic symptom perception. In this paradigm, the presentation of negative pictures, compared to neutral ones, typically increases symptom reporting, and this effect is stronger in participants with high levels of persistent somatic symptom distress. An open and clinically highly relevant question is, however, whether positive interventions can prevent this effect. Also, findings concerning the physiological changes accompanying somatic symptom reports are mixed.

In a preregistered laboratory experiment, young adults (n = 118) in two groups were administered three times with blocks of neutral or negative pictures, respectively. Before the presentation of a picture block, they received positive interventions (positive pictures, slow stroking of the skin) or no intervention (control) in a randomized order. Heart rate, respiration rate, and skin conductance level were recorded simultaneously. Certain psychological characteristics (somatic symptom distress, negative affectivity, somatosensory amplification, health anxiety) were also assessed.

The negative picture group consistently showed more somatic symptoms than the neutral picture group. Positive pictures could not prevent the increase of symptoms. Following slow stroking, symptom reports increased but did not elevate further after the presentation of negative pictures. No differences in physiology were found between the two groups. Psychological characteristics were positively related to symptom reports.

The appearance of physical symptoms could not be prevented by positive psychological and bodily interventions. Psychological characteristics related to symptom reporting might have contributed to the change; however, symptoms were not associated with physiological changes.