Class 4

Symptoms

“A physical symptom or sensation is a perception, feeling, or even belief about the state of our body. (It)… is often—but not always—based on physiological activity. Above all, a physical symptom or sensation represents information about internal state.”

Pennebaker, 1983, p.1.

Symptom Defined

Functions of Symptoms

Sign that problem exists

Provide clues to nature of problem

Locate problem

Provide means to inform others of problem

Provide clues how to treat/respond

to problem

Why do we have symptoms?

1. How do we first notice symptoms? How do we know that a symptom is “happening”?

2. How do our beliefs about illness and our own bodies affect the way we interpret symptoms?

3. How well do perceived symptoms match up with actual physical states?

4. How do people categorize symptoms?

5. How do people differ in the ways that they report on symptoms?

The Psychology of Symptoms: Main Questions

Labeling Symptoms

Shortness of breath means?

Tense muscles makes you think of?

"Dr., I have shortness of breath and muscle tension" could mean:

Slow, labored breathing Rapid/shallow breathing

Tense back, chest Tense shoulders, legs

Slow, labored breathing Rapid/shallow breathing

Tense shoulders, legs Tense back, chest

____slow/labored ____rapid/shallow

___Back ___Shoulders ___Chest ____Legs

Ways that People Differ in Symptom ReportingPsychological

Emotionality

Coping style

Demographics

Age

Sex

Marital status

Residential status

Occupational status

SES

Race and culture

Symptom Reporting: Number of, Attention to Symptoms

Rates of symptom reporting could be due to:

____ Numbers of actual symptoms

____ Differential attention to symptoms

____ Number & AttentionX

X

X

Conditions of Perception

Limited capacity to process information

Info exists inside and outside person.

Perception can be both passive and active

Elements of Perception 1. Orienting: Does cue (event/sensation) get our attention

Unique? Complex? Mobile? 2. Schemas: Expectations, pre-set ways of understanding events.

3. Inference: Drawing conclusions from available information

Schemas and SymptomsSchema: Concept or framework that helps interpret or organize information.

House tour as a: RealtorBurglar Recall?

PMS and expectations of PMS symptoms (Ruble, 1972)

Women know about PMS and associated symptoms

Women told period due in 2 days or in 10 days – in fact, all due in 7 days.

All women asked “To what extent are you currently experiencing PMS?”

Result? Women told period starts in 2 days report more current PMS symptoms

Inference and Symptoms: Combining Orientation and Schemas

Inference: Drawing conclusion from symptoms, as guided by schemas.

I have a slight headache =

Got new glasses; told might induce headache =

I probably have a headache b/c of new glasses =

Orientation

Schema

Inference

Key terms: Inference, Orientation, Schema

Schema? Orientation? Inference?

Symptom Reporting and Competition of CuesPennebaker

Symptom perception = perception in general. Same processes.

Orienting, Schemas, Inferences

Limited information processing capacity.

Perception is both passive and active.

Info exists inside and outside organism; all info (internal and external) used to understand events.

http://www.youtube.com/watch?v=vJG698U2Mvo

Person's Plans, Expectations

(D. Simons)

Cue Salience

(A. Triesman)

Person's Physical State

(D. Proffitt)

Perception is Driven By:

Pennebaker Symptom and Exercise Studies

How does attending to internal cues or external cues affect feelings of exertion during exercise?

Prediction: Exercise with fewer external distracters will lead to more attention to internal cues.

Symptom reporting is a function of (Internal Cues) ÷ (External Cues)

Procedure Subjects all run same distance: oval track OR cross-country

Predictions All Ss run same speed, but those on oval / x-country report more symptoms, OR

All Ss report same symptoms, but oval / x-country run faster.

Result? x-country run faster (9.2 min v. 10.1 min) no symptom diff

Phase I No Sound No Sound No Sound

Phase 2 Breathing Street No Sound

Pennebaker Treadmill Study DesignProblem with running study: did pace really differ b/c of attention to internal v. external cues?

Treadmill study done to address this problem

Ss run on treadmill, which keeps time and effort: constant

Ss wear headphone, playing either:

a. Themselves breathing b. Street sounds c. Nothing at all

Pennebaker Treadmill Study Results

15

20

25

30

35

40

Day 1:Baserate

Day 2:Conditions

Mea

n S

ymp

tom

Rep

ort

ing

Breathing

Control

Sounds

Conclusion: when exertion is held constant, Ss become more / less aware of their own physiological state.

Key Take Home Points from Running and Treadmill Studies

No diffs. in NUMBER of symptoms reported, only in how much symptoms were noticed. This supports / doesn't support Pennebaker?

Relevance of Pennebaker to health/physical symptoms. Who has more health complaints?

___ Depressed ___ Non-Depressed

___ Work/live alone ___ Work/live with few others

Do professional athletes distract from / attend to internal states?

___ Distract ___ Attend

X

X

X

Purpose: Can external cues distract people from internal reflex?

Ss see movie. Portions of movie pre-rated for interestingness.

Researchers count number of coughs at each 30 sec. portion.

Coughing Study

Predict? Fewer coughs at more interesting moments.

Correlation of coughs to interestingness = -.57.Result

Purpose: Do we need time to register threatening events as upsetting?

Ss watch 5 min. shop safety film, finger chopped off by machine.Version 1. 0 sec. time gap between gory scene and next sceneVersion 2. 3 sec gap, time to reflectVersion 3. 8 sec gap, even more time to reflect

Warning vs. no warning conditionsHalf subs warned that about gory sceneHalf subs not warned.

Emotion Dead-time Study

No Warning 0 second gap 3 second gap 8 second gap

Warning 0 second gap 3 second gap 8 second gap

Emotion Dead-time Study

0

1

2

3

4

5

6

7

0 secdelay

3 secdelay

8 secdelay

Up

sett

ing

nes

s o

f M

ovi

e

No Warning

Warning

Can we have symptoms that we feel, but subconsciously?

Small balloon inserted into small intestine.

Balloon inflated, EEG (cortex) is monitored

Ss asked if they feel anything. Say "Nope", butEEG rises and falls with balloon inflation

People can be trained to detect balloon inflation

Unconscious Awareness of Symptoms(Adams, 1980)

EEG: Electroencephalogram

Ss work on treadmill, get physically worked-up.

Ss rate how much they favor/disfavor politicians.

Ss rate either:Group 1. Immediately after treadmillGroup 2. 10 min. after treadmillGroup 3. 20 min. after treadmill

Which Group rates politicians most extremely?

Do Symptoms Affect Opinions?Dolf Zillman

Group 2: still aroused, but not conscious of own arousal.

Time of Rating After Exertion

Immediate 5-10 minutes 15 minutes

Arousal Level

Much Higher, Evident

Higher, but not Evident

Low (baseline)

Nature of Rating

Moderate Extreme Moderate

Group 1 Group 2 Group 3

Do Symptoms Affect Opinions?Dolf Zillman

Symptoms, Misattribution, and Attraction

Which is the better movie to

induce romantic attraction?

____ Love Conquers All

____ The Rollercoaster From Hell

____ Harvey the Happy Hamster

X

Swinging bridge study (Dutton & Aron,1974)

1. Male Ss cross / don't cross scary bridge

2. Ss then complete TAT cards with pretty experimenter.

3. Ss rate cards as more sexual if cross bridge. Why?

4. Ss more likely to phone experimenter for debriefing if crossed bridge.