Basic emotions [in pw/] persistent physical symptoms receiving exposure therapy versus healthy lifestyle promotion in primary care 2026 Hybelius et al

[Andy]

Full title: Basic emotions reported by individuals with persistent physical symptoms receiving exposure therapy versus healthy lifestyle promotion in primary care

Abstract​

The importance of fear has been emphasized in research and treatment focusing on persistent physical symptoms (PPS). Recognizing a broader range of emotions may inform theory and personalized care. This study aimed to examine what basic emotions individuals with PPS experience related to their physical symptoms, the correlations between such emotions and overall somatic symptom burden and disability, and whether emotions change with treatment.

Analyses drew on data from a randomized controlled trial that compared internet-delivered exposure therapy with healthy lifestyle promotion for patients with PPS (n = 159), supplemented by data from age- and gender-matched healthy volunteers (n = 160). Participants self-reported emotions related to their physical symptoms. Mean differences were evaluated within a linear regression modeling framework.

Compared with the healthy volunteers, PPS participants scored significantly higher on anger, disgust, fear, sadness, and shame, and lower on joy. Disgust, fear, sadness, and shame correlated significantly with somatic symptom burden; anger, fear, sadness, and shame with disability. All negatively valenced emotions reduced significantly in both interventions, without significant between-group effects. Joy increased significantly in exposure. These results highlight the potential relevance of diverse emotions in PPS. To facilitate personalized care, future work could evaluate the unique contribution of specific emotions to clinical outcomes.

Open access

 

[Andy]

"Participants could endorse any symptom domain, including cardiopulmonary symptoms, fatigue, gastrointestinal complaints, or pain. Symptoms could be of any origin, including somatic diseases such as asthma or inflammatory bowel disease, be related to a functional somatic syndrome such as fibromyalgia or irritable bowel syndrome, or lack a medical attribution. For inclusion, participants had to be either “much bothered” by at least one physical symptom (item of the Patient Health Questionnaire 15 [PHQ-15]) or report a moderate somatic symptom burden (PHQ-15 ≥ 10), with somatic symptoms having been present for a minimum of 4 months. Similar to the bodily distress disorder diagnosis of the International Classification of Diseases 11, the dominant clinical problem was required not to be best explained as primary pathological health anxiety or a non-somatoform psychiatric disorder."

 

[Spartacus]

Full title: Basic emotions reported by individuals with persistent physical symptoms receiving exposure therapy versus healthy lifestyle promotion in primary care

Abstract​

The importance of fear has been emphasized in research and treatment focusing on persistent physical symptoms (PPS). Recognizing a broader range of emotions may inform theory and personalized care. This study aimed to examine what basic emotions individuals with PPS experience related to their physical symptoms, the correlations between such emotions and overall somatic symptom burden and disability, and whether emotions change with treatment.

Analyses drew on data from a randomized controlled trial that compared internet-delivered exposure therapy with healthy lifestyle promotion for patients with PPS (n = 159), supplemented by data from age- and gender-matched healthy volunteers (n = 160). Participants self-reported emotions related to their physical symptoms. Mean differences were evaluated within a linear regression modeling framework.

Compared with the healthy volunteers, PPS participants scored significantly higher on anger, disgust, fear, sadness, and shame, and lower on joy. Disgust, fear, sadness, and shame correlated significantly with somatic symptom burden; anger, fear, sadness, and shame with disability. All negatively valenced emotions reduced significantly in both interventions, without significant between-group effects. Joy increased significantly in exposure. These results highlight the potential relevance of diverse emotions in PPS. To facilitate personalized care, future work could evaluate the unique contribution of specific emotions to clinical outcomes.

Open access

I have no idea what this is about, but "exposure therapy" sounds like something the Dr might get arrested for.

 

[Amw66]

still waiting for the penny drop moment - why is so much of this seen arse over elbow ?


PPS participants scored significantly higher on anger, disgust, fear, sadness, and shame, and lower on joy. Disgust, fear, sadness, and shame correlated significantly with somatic symptom burden; anger, fear, sadness, and shame with disability.-

With DSM5 being reviewed this looks like potential capture under BDD or similar?

And dataset is not available

The datasets analyzed during the current study are not publicly available at present. This is because individual participant data (IPD) cannot currently be shared due to restrictions under Swedish and EU data protection legislation, as the dataset contains personal data that could potentially, using the existing study database, be linked to an identifiable living natural person.

 

[rvallee]

I have no idea what this is about, but "exposure therapy" sounds like something the Dr might get arrested for.

Genuinely not sure which version is worse. For sure they would produce identical outcomes.

You could plug a computer to an LLM producing Vorgon poetry with a printer whose output feed is connected to a shredder and it would be more useful than whatever the hell this is. Hell, you could even add a loop that fully recycles the paper and feeds it back to the printer, and it would amount to a more meaningful contribution. This general area of health care might be the only professional work that is actually less useful than a Rube Goldberg machine, which at least has some entertainment value.

I will never understand people who choose to do useless things. It's one thing to be in a pointless job involving pointless busywork, but to choose this? It's so hard to understand.

 

[Trish]

I got as far as the heading and gave up,

Can anyone enlighten me on what the difference is between a "basic emotion" and some other sort of emotion?

 

[Utsikt]

The paper is based on this trial:

Effect of internet-delivered exposure therapy versus healthy lifestyle promotion for patients with persistent physical symptoms (SOMEX1): a randomized controlled trial with planned moderator analysis - PMC

The management of persistent physical symptoms poses a challenge in many healthcare settings, including primary care. Psychological treatments that involve exposure have shown promise for several conditions where patients suffer from persistent ...

pmc.ncbi.nlm.nih.gov

In the primary analysis, exposure therapy was not superior to healthy lifestyle promotion in its average effect on somatic symptom burden (b = −0.7 [−1.8 to 0.4]; p = 0.220; d = 0.14; Table 3).

As is shown in Table 3, exposure therapy was superior to healthy lifestyle promotion in its average effect on symptom preoccupation (b = −2.7 [−5.3 to 0.2]; p = 0.033; d = 0.31) but not in its effect on general anxiety, depression, or functional impairment.

They managed to get patients to think less about symptoms by repeatedly telling them to do things and not think of the symptoms. It doesn’t seem like it did much else.

 

[Andy]

The paper is based on this trial:

Effect of internet-delivered exposure therapy versus healthy lifestyle promotion for patients with persistent physical symptoms (SOMEX1): a randomized controlled trial with planned moderator analysis - PMC

The management of persistent physical symptoms poses a challenge in many healthcare settings, including primary care. Psychological treatments that involve exposure have shown promise for several conditions where patients suffer from persistent ...

pmc.ncbi.nlm.nih.gov

They managed to get patients to think less about symptoms by repeatedly telling them to do things and not think of the symptoms. It doesn’t seem like it did much else.

Thread here,

Trial Report Thread 'Effect of internet-delivered exposure therapy versus healthy lifestyle promotion for [...] persistent physical symptoms (SOMEX1): 2025 Hybelius et al'

Aug 9, 2025

Full title: Effect of internet-delivered exposure therapy versus healthy lifestyle promotion for patients with persistent physical symptoms (SOMEX1): a randomized controlled trial with planned moderator analysis

Abstract

Background
The management of persistent physical symptoms poses a challenge in many healthcare settings, including primary care. Psychological treatments that involve exposure have shown promise for several conditions where patients suffer from persistent physical symptoms and unwanted responses to these. It is unclear, however, to what extent exposure therapy has...

• Andy
• Replies: 3
• Forum: Psychosomatic research - ME/CFS and Long Covid

• 

 

[rvallee]

They managed to get patients to think less about symptoms by repeatedly telling them to do things and not think of the symptoms. It doesn’t seem like it did much else.

It allowed them to publish this awful paper, padding their resume, which, as far as I understand how medical research works, is the only goal 99% of the time, or something like that, at least outside of real, serious, biomedical lab research.

This is not about us. It has nothing to do with us. Everything they do is all about them.