Does symptom perception after negative affect induction differ between physically ill and healthy individuals? An experimental study within SOMA.CK

IntroductionSymptom perception is highly subjective and influenced by the complex interplay of biopsychosocial factors. This study aimed to explore whether negative affect induction using the Affect and Symptoms Paradigm (ASP) influences symptom perception in patients with non-dialysis chronic kidney disease (ND-CKD) and healthy controls. MethodsParticipants watched three picture series with varying affective content (positive, negative, neutral) from the International Affective Picture System (IAPS). After each picture set, participants rated symptom levels (10-item symptom checklist), affective state (Positive and Negative Affect Schedule) and arousal levels (Self-Assessment-Manikin-System). ResultsIn N = 115 individuals with ND-CKD from the SOMA.CK study (mean age = 62.95, SD = 12.60) and 100 age- and gender-matched healthy controls (mean age = 60.00, SD = 12.80) negative pictures significantly increased negative affectivity and arousal. All participants reported significantly higher symptom levels after negative versus positive and neutral pictures. No significant group differences in overall symptom levels emerged. Habitual symptoms did not moderate symptom levels after negative affect induction, although high habitual symptom reporters showed higher symptom levels across all picture categories. In the CKD group symptom levels were moderated by difficulties in identifying feelings and in controls by suppression as emotion regulation strategy. ConclusionNegative affect induction increases symptom levels, even in a chronic illness such as CKD. These results are in line with the predictive processing model which suggests that symptom perception develops from a complex inferential process of somatosensory input in light of pre-existing symptom representations in memory (priors). HighlightsO_LIPatients with ND-CKD and healthy controls reported higher symptom levels after negative pictures C_LIO_LIHabitual symptoms did not moderate symptom levels after negative pictures C_LIO_LIDifficulties in identifying feelings moderated symptom levels in the CKD group C_LIO_LISuppression moderated symptom levels in the HC group C_LIO_LISymptoms after negative pictures predicted CKD-specific symptom burden at 6 months C_LI