Does childhood trauma impact daily psychobiological stress in somatic symptom disorder? An ambulatory assessment study

Autor(en)

Susanne Fischer, Nida Ali, Anja C. Feneberg, Ricarda Mewes, Urs M. Nater

Abstrakt

Objectives: Somatic symptom disorder is characterized by excessive thoughts, feelings, and behaviors dedicated to bodily symptoms, which are often medically unexplained. Although 13% of the population are affected by this disorder, its aetiopathogenesis is not fully understood. Research in medically unexplained conditions (e.g., fibromyalgia) points to increased psychosocial stress and alterations in stress-responsive bodily systems as a potential contributing factor. This pattern has often been hypothesized to originate from early life stress, such as childhood trauma. The aim of this study was to examine, for the first time, whether individuals with somatic symptom disorder exhibit elevated levels of self-reported daily stress and alterations in the autonomic nervous system and hypothalamic-pituitary-adrenal axis, both in comparison to healthy controls and individuals with depressive disorders, and whether reports of childhood trauma influence these alterations. Methods: A total of N = 78 individuals were recruited into this study. Of these, n = 27 had a somatic symptom disorder, n = 23 were healthy controls, and n = 28 had a depressive disorder. All individuals underwent a 14-day measurement period at home, with five assessments of self-reported stress, salivary alpha-amylase, and cortisol per day. Childhood trauma was assessed by the Childhood Trauma Questionnaire. Results: Individuals with somatic symptom disorder exhibited higher daily stress levels (p = 0.063) as well as a less pronounced alpha-amylase awakening response (p = 0.050), compared to healthy controls (statistical trends). Moreover, they were characterized by significantly attenuated diurnal cortisol concentrations (p < 0.001). A nearly identical pattern was observed in individuals with depression. In individuals with somatic symptom disorder and depressive disorders, childhood trauma was, by trend, associated with a more pronounced alpha-amylase awakening response (b = −0.27, p = 0.077). Conclusions: This study provides preliminary evidence for elevated daily stress and blunted sympathetic and hypothalamic-pituitary-adrenal axis activity in individuals with somatic symptom disorder and depressive disorders. Further studies will help to uncover the conditions under which these dysregulations develop into medically unexplained vs. depressive symptoms.

Organisation(en)

Institut für Klinische und Gesundheitspsychologie, Forschungsplattform The Stress of Life - Processes and Mechanisms underlying Everyday Life Stress, Forschungs-, Lehr- und Praxisambulanz

Externe Organisation(en)

Universität Zürich (UZH)

Journal

Frontiers in Psychiatry

Band

13

ISSN

1664-0640

DOI

https://doi.org/10.3389/fpsyt.2022.954051

Publikationsdatum

09-2022

Peer-reviewed

Ja

ÖFOS 2012

501010 Klinische Psychologie

Schlagwörter

ASJC Scopus Sachgebiete

Psychiatry and Mental health

Sustainable Development Goals

SDG 3 – Gesundheit und Wohlergehen

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/4d55f7a3-b7ee-4c09-932d-a0456bc31c9a