Posttraumatic Stress Disorder and Persistent Somatic Symptoms During the COVID-19 Pandemic: The Role of Sense of Threat

Abstract

Objective: Persistent somatic symptoms, such as pain and fatigue, have been referred to as somatization. Somatization is commonly associated with histories of trauma and posttraumatic stress disorder (PTSD). Although previous research has demonstrated that PTSD can predict somatic problems, there has been no examination of this at the level of PTSD symptom clusters and multidimensional assessment of somatic symptoms. We examined the association between the three International Classification of Disease (11th Edition) PTSD symptom clusters (reexperiencing in the here and now, avoidance, and sense of threat), measured in relation to the COVID-19 pandemic as the stressor, and somatic symptoms while statistically adjusting for confounding variables. Methods: Participants were a nationally representative sample of 1041 adults from the general population of the Republic of Ireland. Physical health problems across the domains of pain, gastrointestinal, cardiopulmonary, and fatigue were assessed by the Patient Health Questionnaire, and PTSD symptoms were assessed using the International Trauma Questionnaire. Results: Sense of threat was associated with the presence of pain (β = 0.254), fatigue (β = 0.332), gastrointestinal (β = 0.234), and cardiovascular symptoms (β = 0.239). Avoidance was associated with pain (β = 0.347). Reexperiencing was not associated with any physical health variable. Conclusions: In the context of COVID-19, the sense of threat symptoms in PTSD is most strongly related to somatic problems. Findings suggest that interventions addressing sense of threat symptoms might provide relief from somatization.

Predictors of Psychosomatic Health during the first COVID-19 Outbreak in Greece. A Multiple Linear Regression Analysis in an Epidemiological Sample of 1,156 Individuals

“…[56,57] Various studies also highlight that stressrelated symptoms that may be included in the diagnostic criteria for PTSD are strongly related to somatic symptoms in the COVID-19 era. [58][59][60] On the other hand, the second most significant predictor in the model of this study was found to be the level of PR, which worked as a protective factor for psychosomatic health. In Greece, little evidence supported the link between psychosomatic health and resilience before the COVID-19 outbreak.…”

Maternal Prenatal Somatization, Postnatal Depression, and Offspring Temperament During the COVID-19 Pandemic

“…Notably, participants' ratings of distress about COVID-19 symptoms and illness in themselves and friends and family were associated with increased symptoms of somatization. Consistent with Motivated Cue-Integration theory (Shalev, 2021) in the context of COVID-19, a lack of certainty about the facts of the disease in the spring of 2020, especially concerning its effects on pregnancy, known variability in symptom presentation, and a heightened sense of threat (Jowett et al, 2021) may have contributed to hypervigilant monitoring of physical symptoms.…”

“…Fewer studies have examined maternal somatization in relation to offspring functioning. Nevertheless, given the increase in somatization documented during the pandemic (Jowett et al, 2021;Ran et al, 2020), we hypothesized that maternal somatization would affect infant temperament. Although we did not collect biological specimens in our study to elucidate mechanisms that might underlie the relations between maternal mental health and infant temperament, prior research testing the Developmental Origins of Health and Disease hypothesis (Gluckman et al, 2007) implicates epigenetic, neuroendocrine, and/or inflammatory pathways in this association.…”

“…Both depression and anxiety often have comorbid symptoms of somatization, that is, the perception of physical symptoms without an organic cause (De Gucht & Fischler, 2002;Löwe et al, 2008). It is not surprising, therefore, that somatization symptoms have also risen globally during the pandemic (Jowett et al, 2021;Ran et al, 2020). Few studies, however, have examined somatization symptoms in pregnant women in the context of the pandemic.…”

A systematic review of persistent symptoms and residual abnormal functioning following acute COVID-19: Ongoing symptomatic phase vs. post-COVID-19 syndrome

“…The suggested higher relative importance of psychosocial drivers in the PCS phase may inform more holistic assessment and treatment strategies, including psychological and psychosocial supports. Additionally, the frequent presence of psychological distress may be linked to several reported symptoms, with a range of psychological disorders often associated with hair loss (61), sleep disorders (62), gastrointestinal issues (63), pain (64), and cardiovascular symptoms (64).…”