The impact of expectation and framing on the course of symptom severity in somatic symptom disorder - ecological momentary assessment from the SOMA.SSD study
Publication date
2025-05-08
Document type
Preprint
Author
Toussaint, Anne
Wittenbecher, Henrike
Löwe, Bernd
Blankenburg, Kristina
Organisational unit
Project
SOMA.SSD
Publisher
JMIR Publications Inc.
Part of the university bibliography
✅
Language
English
Abstract
Background:
Symptom-related expectations play a critical role for persistent somatic symptoms. Expectation framing has been suggested as a promising technique to modify expectations. However, the short-term interplay between symptom-related expectations, expectation framing, and symptom severity in patients with somatic symptom disorder remains mostly unexplored to this day.
Objective:
To clarify if the short-term course of symptom severity in patients with somatic symptom disorder is associated with the course of symptom-related expectations and weather expectation framing impacts these potential dynamics.
Methods:
Patients with somatic symptom disorder participated in a 10-day smartphone-based ecological momentary assessment. Participants were randomized to one of two expectation framing groups, either receiving prompts for the expected impairment due to somatic symptoms (standard framing) or the expected freedom from impairment (positive framing). Symptom-related expectations and symptom severity were measured three times per day and latent growth curve model analyses were conducted to investigate the short-term courses of both constructs.
Results:
Based on 217 patients (34.6% male, M = 43.62 years), the levels of symptom-related expectations and symptom severity slightly decreased over time (slope expectation = -0.084, z = -2.241, p < 0.050; slope severity = -0.081, z = -2.203, p < 0.050). Moreover, large associations were found between the growth trajectories for the 10-day courses of both constructs. The reduction in symptom severity was faster for participants with lower symptom-related expectations than in those with higher initial symptom-related expectations (β = -0.130, z = -2.691, p < 0.010). There were no significant effects of expectation framing.
Conclusions:
Growth trajectories for the short-term courses of symptom-related expectations and symptom severity were strongly associated. Thus, expectations constitute a potentially modifiable factor of somatic symptoms persistence. Their role for the clinical management of somatic symptoms and for longer timeframes should be further explored. The role of expectation framing as a method for modifying expectations in patients with somatic symptom disorder requires further research. Clinical Trial: https://www.isrctn.com/ISRCTN36251388?q=nestoriuc&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10
Symptom-related expectations play a critical role for persistent somatic symptoms. Expectation framing has been suggested as a promising technique to modify expectations. However, the short-term interplay between symptom-related expectations, expectation framing, and symptom severity in patients with somatic symptom disorder remains mostly unexplored to this day.
Objective:
To clarify if the short-term course of symptom severity in patients with somatic symptom disorder is associated with the course of symptom-related expectations and weather expectation framing impacts these potential dynamics.
Methods:
Patients with somatic symptom disorder participated in a 10-day smartphone-based ecological momentary assessment. Participants were randomized to one of two expectation framing groups, either receiving prompts for the expected impairment due to somatic symptoms (standard framing) or the expected freedom from impairment (positive framing). Symptom-related expectations and symptom severity were measured three times per day and latent growth curve model analyses were conducted to investigate the short-term courses of both constructs.
Results:
Based on 217 patients (34.6% male, M = 43.62 years), the levels of symptom-related expectations and symptom severity slightly decreased over time (slope expectation = -0.084, z = -2.241, p < 0.050; slope severity = -0.081, z = -2.203, p < 0.050). Moreover, large associations were found between the growth trajectories for the 10-day courses of both constructs. The reduction in symptom severity was faster for participants with lower symptom-related expectations than in those with higher initial symptom-related expectations (β = -0.130, z = -2.691, p < 0.010). There were no significant effects of expectation framing.
Conclusions:
Growth trajectories for the short-term courses of symptom-related expectations and symptom severity were strongly associated. Thus, expectations constitute a potentially modifiable factor of somatic symptoms persistence. Their role for the clinical management of somatic symptoms and for longer timeframes should be further explored. The role of expectation framing as a method for modifying expectations in patients with somatic symptom disorder requires further research. Clinical Trial: https://www.isrctn.com/ISRCTN36251388?q=nestoriuc&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10
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