The impact of emotions on the sensory and affective dimension of perceived dyspnea

Abstract

Dyspnea is an impairing symptom in various diseases. Recent research has shown that the perception of dyspnea, like pain, consists of a sensory (intensity) and an affective (unpleasantness) dimension, but little is known about the specific impact of different emotions on these distinct dimensions. We therefore examined the impact of viewing affective picture series of positive, neutral, and negative valence on perceived dyspnea during resistive load breathing in healthy volunteers. Inspiratory time (Ti), breathing frequency (f), and oscillatory resistance (Ros) remained unchanged across conditions. Ratings for unpleasantness of dyspnea increased from positive to neutral to negative series, but ratings for intensity of dyspnea showed no changes. The results suggest that the affective dimension of the perception of dyspnea is particularly vulnerable to emotional influences, irrespective of objective lung function.

Accuracy and bias in retrospective symptom reporting

“…A question prompting a symptom report from the individual requires an intuitive integration of both components into one global symptom report. This process is influenced by emotional states [76]. So, it is no surprise that symptom reports tend to be more elevated with higher state anxiety, distress, as well as in individuals scoring high for trait negative affectivity, a personality trait characterized by an overreactive evaluative system, elevated threat sensitivity, and vulnerability to negative emotions (see Table 1).…”

“…The experience of a symptom entails a sensory-perceptual component referring to intensity, location, and other qualities, and an affective-motivational component providing the drive for action to preserve the integrity of the body [73][74][75][76][77]. A question prompting a symptom report from the individual requires an intuitive integration of both components into one global symptom report.…”

The Affective Dimension of Laboratory Dyspnea

“…We calculated an A/SI ratio using published mean data; statistical testing was not possible without paired individual data. More recent studies have measured SI and unpleasantness (A 1 ) while attempting to alter their relationship by acutely altering psychological state (33,34). These studies were performed on healthy subjects in whom moderate respiratory discomfort was produced with inspiratory resistive loads.…”

Validation of a Swedish Version of the Cancer Dyspnea Scale

“…Findings from another study of patients with COPD indicated that patients could distinguish their dyspnea from the distress and anxiety associated with dyspnea (CarrieriKohlman et al 1996a), such that distress and anxiety were considered as responses to dyspnea. In another study that divided the dyspnea experience into a sensory and an affective dimension, it was found that the affective dimension was more vulnerable to emotional influences (von Leupoldt et al 2006). In the present thesis, anxiety and depression were regarded as responses, while distress as measured by discomfort was considered an evaluation.…”