Ferenc Köteles

Polluted places or polluted minds? An experimental sham-exposure study on background psychological factors of symptom formation in 'Idiophatic Environmental Intolerance attributed to electromagnetic fields'

INTRODUCTIONnIdiophatic Environmental Intolerance attributed to electromagnetic fields (IEI-EMF) refers to the perception of subjective symptoms during or following EMF exposure. IEI-EMF has become disproved to be a mostly biologic entity by now, and evidences accumulate to support the role of nocebo effect in the phenomenon. The two aims of this study were to demonstrate the significant role of the nocebo effect in physical symptoms reported at 50Hz frequency of EMF exposure, as well as to explore some psychological factors which may predispose to IEI-EMF.nnnMETHODSnA total of 40 volunteer university students have completed a battery of psychological questionnaires (expectations; IEI-EMF; state anxiety - STAI-S; dispositional optimism - LOT-R; somatisation - PHQ-15; somatosensory amplification - SSAS) before, and checklists of physical symptoms during sham exposure to weak and strong EMFs, respectively. Participants were also asked about the extent to which they had perceived the presence of the presumed EMF.nnnRESULTSnParticipants with higher IEI-EMF scores expected and experienced more symptoms. Suggestion of stronger EMF exposure resulted in larger symptom scores and enhanced EMF-perception as compared to the presumed weaker exposure. Experienced symptom scores were predicted primarily by somatisation scores, whereas self-rating of IEI-EMF was predicted by somatosensory amplification scores.nnnCONCLUSIONnThe results confirm that there is considerable nocebo effect in symptom reports related to 50Hz frequency EMFs. IEI-EMF seems to be formed through a vicious circle of psychosocial factors, such as enhanced perception of risk and expectations, self-monitoring, somatisation and somatosensory amplification, causalization and misattribution.

The influence of sleep complaints on the association between chronotype and negative emotionality in young adults

A great body of research indicates that eveningness is associated with negative psychological outcomes, including depressive and anxiety symptoms, behavioral dyscontrol and different health impairing behaviors. Impaired subjective sleep quality, increased circadian misalignment and daytime sleepiness were also reported in evening-type individuals in comparison with morning-types. Although sleep problems were consistently reported to be associated with poor psychological functioning, the effects of sleep disruption on the relationship between eveningness preference and negative emotionality have scarcely been investigated. Here, based on questionnaire data of 756 individuals (25.5% males, age rangeu2009=u200918–43 years, meanu2009=u200925.3u2009±u20095.8 years), as well as of the evening-type (Nu2009=u2009211) and morning-type (Nu2009=u2009189) subgroups, we examined the relationship among sleep problems, eveningness and negative emotionality. Subjects completed the Hungarian Version of the Horne and Östberg Morningness–Eveningness Questionnaire (MEQ-14), The Athen Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS). Moreover, a composite score of Negative Emotionality (NE) was computed based on the scores of the Short Beck Depression Inventory (BDI-9), the Perceived Stress Scale (PSS-4) and the General Health Questionnaire (GHQ-12). Morning and evening circadian misalignment was calculated based on the difference between preferred and real wake- and bedtimes. Two possible models were tested, hypothesizing that sleep problems (circadian misalignment, insomniac symptoms and daytime sleepiness) moderate or mediate the association between eveningness and negative emotionality. Eveningness preference was correlated with increased NE and increased AIS, ESS and circadian misalignment scores. Our results indicate that eveningness-preference is an independent risk factor for higher negative emotionality regardless of the effects of age, gender, circadian misalignment and sleep complaints. Nevertheless, while chronotype explained ∼6%, sleep problems (AIS and ESS) accounted for a much larger proportion (∼28%) of the variance of NE. We did not find a significant effect of interaction (moderation) between chronotype and sleep problems. In contrast, insomniac symptoms (AIS) emerged as a partial mediator between chronotype and NE. These findings argue against the assumption that indicators of mental health problems in evening-type individuals can be explained exclusively on the basis of disturbed sleep. Nevertheless, negative psychological outcomes seem to be partially attributable to increased severity of insomniac complaints in evening-types.

Somatosensory amplification as a possible source of subjective symptoms behind modern health worries

The theoretically hypothesized connection between modern health worries (MHWs) and somatosensory amplification (SSA), as well as the factor structure of the Hungarian version of the MHW scale were investigated in a cross-sectional questionnaire study. A total of 163 university students (mean age = 21.3± 2.70 yrs; 44.2% male) and 145 patients (mean age = 49.4±17.51 yrs; 31.7% male) visiting their general practitioners (GPs) completed questionnaires assessing MHWs, SSA, subjective somatic symptoms (PHQ-15), and trait anxiety (STAI-T). The previously described four-factor structure of the MHW scale was confirmed using confirmatory factor analysis (CFA). In the linear regression analysis, participants age and SSA scores were positively related to MHWs even after controlling for gender, anxiety, and subjective somatic symptom scores. The conclusions are that: MHWs are indicators of cognitive, behavioral and social level of sensitization for health-related concerns; SSA can provide the somatic background process for generation and/or misattribution of subjective somatic symptoms; better understanding of the cognitive-emotional background of MHWs could help to determine possible interventions.

Placebo Effects in Sport and Exercise: A Meta-Analysis

The empirical foundation of the ‘placebo effect’ is presented briefly, which is followed by the meta-analysis of the relatively few published reports that have investigated placebo effects in sports performance. Based on the analysis of the fourteen studies included in the meta-analysis, an overall medium effect size (0.4, 95% CI ranged from 0.24 to 0.56) was found. Homogeneity of effect sizes (χ2 (13, N = 196) = 9.35, p = 0.75) and the feasibility of possible explanation models were also tested. In various sports (e.g. cycling, running, weightlifting) the investigation of the placebo effect on various physiological or performance measures (e.g. muscle power, heart rate, running speed) and psychological attributes (e.g. perceived exertion, post-experiment interviews) yielded significant results. Indeed, the common finding of the reviewed studies was that from the point of view of the athletes there is substantial performance enhancement as a result of different forms of placebos. However, the interpretation of some of the results may be limited by methodological shortcomings. Based on the reviewed articles and further questions emerging from them, methodological recommendations as well as possible research ideas are suggested for further inquiries in the area.

Modern Health Worries, Somatosensory Amplification and Subjective Symptoms: A Longitudinal Study

BackgroundModern health worries (MHWs; i.e., concerns about possibly harmful features of modern life) have been associated with somatic symptoms and somatosensory amplification in previous cross-sectional studies. Causal relationship among these variables is yet to be discovered.PurposeThe study investigates the temporal association among subjective symptoms, somatosensory amplification (SSA), and modern health worries (MHWs).MethodBaseline and follow-up questionnaires (somatic symptoms—PHQ-15, somatosensory amplification scale—SSAS, modern health worries scale—MHW, PANAS negative affect scale—NA) were completed by 366 undergraduate students in a 2-month longitudinal study.ResultsMHWs were predicted by baseline MHWs (βu2009=u20090.721, pu2009<u20090.001) and by somatic symptoms (βu2009=u20090.084, pu2009<u20090.05). Somatic symptoms were predicted by baseline symptoms (βu2009=u20090.610, pu2009<u20090.001), NA (βu2009=u20090.104, pu2009<u20090.05), and SSAS scores (βu2009=u20090.089, pu2009<u20090.05). The only predictor of SSA was baseline SSAS score (βu2009=u20090.628, pu2009<u20090.001).ConclusionBased on the results, a linear model (proneness to somatosensory amplification leads to subjective symptoms which lead to MHWs) was proposed, where MHWs serve as explanations of physical symptoms or as possible environmental threats to avoid.

Interoceptive sensitivity, body image dissatisfaction, and body awareness in healthy individuals

Relationships among interoceptive sensitivity (IS), body image dissatisfaction, body mass index (BMI), and self-reported body awareness were investigated in a cross-sectional study. Eighty-two Norwegian high school students and 70 Hungarian undergraduate university students participated in the study. Subjects completed two questionnaires (Body Image Ideals Questionnaire - BIQ; Body Awareness Questionnaire - BAQ) followed by the assessment of interoceptive sensitivity using the Mental Tracking Method (MTM). An inverse, medium-level relationship between body image dissatisfaction and IS was found in both the Norwegian and the Hungarian samples. The relationships between IS and self-reported body awareness, and between body image dissatisfaction and BMI were uniformly non-significant in both samples. Predictors of body image dissatisfaction were resting heart rate, gender, and IS in the regression analysis after controlling for BMI, age, and nationality. The negative relationship between IS and body image dissatisfaction described in patients with anorexia nervosa also exists in healthy individuals. There is no direct connection between IS and self-reported body awareness.

Modern health worries, subjective somatic symptoms, somatosensory amplification, and health anxiety in adolescents

The cross-sectional study aimed at the psychometric evaluation of the Modern Health Worries Scale in adolescents and the exploration of the relationship among modern health worries, somatosensory amplification, health anxiety, and somatic symptoms. A total of 480 secondary school students (aged between 14 and 19 years) completed a set of questionnaires. Four-factor structure of the scale was confirmed by confirmatory factor analysis. Modern health worries were connected to somatosensory amplification and health anxiety, and somatosensory amplification and health anxiety were partial mediators of the connection between modern health worries and somatic symptoms. Perceived vulnerability (conceptualized as somatosensory amplification and health anxiety) appears to build a “social-cognitive-emotional bridge” between symptoms and modern health worries.

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) and electrosensibility (ES) - are they connected?

INTRODUCTIONnThe tendency of experiencing unpleasant symptoms in the proximity of working electric devices is called idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). Evidence about psychophysiological backgrounds of the phenomenon (i.e., detection ability and mechanisms of symptom generation) is not yet conclusive.nnnMETHODSnParticipants of the provocation experiment were 29 individuals with self-reported IEI-EMF and 42 control persons. Participants completed questionnaires (symptom expectations, somatosensory amplification - SSAS, modern health worries radiation subscale - MHW-R), and attempted to detect the presence of 50 Hz 0.5 mT magnetic field (MF) directed to their right arm in 20 subsequent 1-min sessions. Heart rate was also recorded and various indices of heart rate variability (HF, LF/HF, SDNN) were calculated.nnnRESULTSnUsing the methodology of the signal detection theory, individuals with IEI-EMF as opposed to the control group showed a higher than random detection performance (d differed slightly but statistically significantly from zero), and they used a significantly lower criterion (β value) when deciding about the presence of the MF. Detection sessions followed by correct decisions (hits or correct rejections) were characterized by higher HRV (SDNN and HF indices) than periods followed by errors (misses or false alarms). Previous expectations and affiliation to the IEI-EMF group were significant predictors of symptoms reported following exposure. IEI-EMF was closely related to MHW-R and SSAS scores.nnnCONCLUSIONnDetection of MF might be possible for people with IEI-EMF to some extent. Although heightened sensibility to MFs may play a role in the development and/or in the perpetuance of the IEI-EMF phenomenon, symptoms attributed to the MF seem to be mainly of psychogenic origin.

Are modern health worries associated with somatosensory amplification, environmental attribution style, and commitment to complementary and alternative medicine?

Relationship among modern health worries (MHWs), somatosensory amplification (SSA), and attributional styles was investigated in a cross-sectional questionnaire study. A total of 99 university students, 104 patients visiting their General Practitioners, and 102 future alternative therapists completed questionnaires assessing MHWs, SSA, negative affect (NA), and psychological, somatic and normalizing (environmental) attribution styles. Significant correlation between SSA and MHWs was found in all three samples. MHWs and psychological attribution style were significantly associated with Complementary and Alternative Medicine (CAM)-orientation in the regression equation even after controlling for SSA, NA, and sociodemographic variables. MHWs were independent from any attribution styles in the student and patient samples, while significant correlations with all three styles were found in the CAM group. Previously described association between MHWs and SSA was replicated in three different samples. The connection between MHWs and CAM preference seems to be independent from SSA, NA or any particular attribution style.

Mindfulness and dream quality: The inverse relationship between mindfulness and negative dream affect

The aim of the study was to examine the relationship of mindfulness to the emotional quality of dreaming. In our questionnaire-based study, comprising the data of 587 undergraduate students we examined the association between trait anxiety, perceived stress, trait mindfulness, negative dream affect and dream anxiety. Our results indicate that mindfulness is inversely related to disturbed dreaming and predicts less severe dream disturbances after controlling for trait anxiety. Moreover, the results of the applied hierarchical regression analysis suggest that mindfulness is associated with reduced dream anxiety by moderating the extent of waking anxiety. Our findings extend previous research relating mindfulness, emotional regulation and sleep quality to the domain of dream research. We suggest that mindfulness is a possible protective factor against dream disturbances.