Tactile and interpersonal sound symbolic associations in patients with multiple somatic symptoms 2025 Jiang et al

Andy

Retired committee member
Abstract

Patients with functional somatic symptoms (FSS) have distorted exteroception and interoception. It is unclear whether they also process and associate sounds and tactile/interpersonal factors differently. This study investigates the differences in how patients with multiple somatic symptoms (SS-high) and those without functional somatic disorders (SS-low) associate features of Mandarin rimes with tactile and interpersonal properties.

Two groups of participants listened to rime chains consisting of two identical Mandarin rimes. They rated sound stimuli on five-point scales for smooth-rough, light-heavy, polite-rude, and friendly-hostile. Linear mixed-effects models and representational similarity analyses showed that both groups relied on duration and F0 for all four dimensions, and on alveolar nasal rimes and ΔF1 for the smooth-rough dimension.

Beyond commonalities, the study also found that the two groups of participants weighed F1–F3 and nasality differently when associating rimes with tactile and interpersonal dimensions. Mediation analyses revealed differing mechanisms for sound symbolism between the groups. In the SS-high group, the smooth-rough dimension mediated the association between duration and the polite-rude dimension, which aligned with the Transitivity Proposal. In the SS-low group, the relationship between duration and smoothness was mediated by politeness, supporting the Emotion Mediation Hypothesis.

This study highlights the importance of considering both tactile and interpersonal dimensions in sound symbolism research, especially in clinical populations with FSS.

Open access
 
Shanghai study
For example, Erkic et al. found that compared with healthy controls, patients with somatic disorders had difficulties in identifying and describing their own feelings, but were more sensitive to recognize negative emotions such as anger27. These patients invested less in a trust game compared to healthy controls, which potentially pointed to the relationship between heightened emotional sensitivity and less trust in others. Moreover, evidence showed that patients with FSS were associated with maladaptive personality traits, which could result in disrupted interpersonal behaviors29.
Umm, perhaps if researchers weren't suggesting that a person has maladaptive personality traits, the person might be less inclined to anger, and more inclined to invest more in playing 'trust games' with them?

Mandarin rime?
The study uses compound Mandarin rimes as the experimental stimuli, consisting of diphthongs and possible nasal codas (alveolar nasal/n/or velar nasal/ŋ/). The Mandarin syllables contain initials (consonants) and rimes (vowels and nasal codas). Rimes are fundamental phonological units in the language, which are taught as an entirety (vowel and nasal coda) in formal education, forming an essential part of formal language learning54. Using rimes as stimuli provides meaningful contribution to investigating sound symbolism within the language context of Mandarin and its native speakers.

Selection
Two participant groups were recruited at the Department of Psychosomatic Medicine of Shanghai East Hospital. One group of participants self-reported to have negative emotional and/or physical experiences. They voluntarily sought treatment for their problems. Most participants were self-referred and some were referred by the Departments of Neurology, Cardiology and Gastroenterology. According to the inclusion criteria, the patients had somatic symptoms without medical explanation. The other group of participants who were recruited as the control group were also patients but did not report physical discomfort.

75 participants took part in the experiment. Six participants were excluded for using the same response throughout a block of trials, indicating lack of seriousness.

After exclusion, 69 participants (45 female, mean age = 32.43 years, SD = 7.57, range = 17–48 years) were considered for subsequent analyses. Participants were regrouped according to the 15-symptom Patient Health Questionnaire (PHQ-15)58. Those who obtained a score above or equal to 10 were classified as the somatic symptom high (SS-high) group and those who achieved a score below 10 were treated as the somatic symptom low (SS-low) group1,59. As a result, the SS-high group included 37 participants (26 female, mean age = 31.00 years, SD = 6.87, range = 17–47 years) and the SS-low group included 32 participants (19 female, mean age = 34.09 years, SD = 7.99, range = 20–48 years).
 
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As I started skimming this study, I was wishing the authors had decided to not bother with work and had instead chosen to stay home to play with their children or something, rather than produce this time-wasting study. Getting towards the end, I can see that the authors probably wished that they had stayed home too. It was a bust.

Then, the study conducted four linear mixed-effect models (LMEMs) to examine how demographic and psychometric measures predict sound symbolic ratings in all participants. In this analysis, original PHQ-15 scores were included instead of the two-level grouping factor. The function lmer() from the lmerTest package was used to construct LMEMs73. Random effects included participant and/or by item intercepts. Because many of the demographic and psychometric measures are highly correlated, leading to high VIFs (Variance Inflation Factors), the study first manually deleted the variables that had high VIFs from the models with a complete set of variables. After this, these models were simplified using the step() function from the lmerTest package. The study validated such simplification by comparing the AIC values of these models. The simplified models all achieved lower AICs.
As PHQ-15 was not found to be significant in any of the simplified models, results of this analysis are described in Supplementary Materials.

The aim of the study was to assess somaticism against perception of sounds. It looks as though they started with two groups - people wanting therapy for psychological ailments reporting no physical problems and people wanting therapy for psychological ailments who did report physical problems that were not attributed to a physical cause. I suspect they didn't get a result from that, so they regrouped the participants according to results from the PHQ15 measure of psychosomaticism.

They found that dividing the group into two on the basis of the PHQ15 - psychosomatic and not psychosomatic - didn't give them a useful result. They found that using the actual scores from the PHQ15 survey didn't work either.

The study also reported how demographic and psychometric measures predicted sound symbolic ratings in Supplementary Materials. PHQ-15 scores were excluded as a result of model simplification in all four dimensions, showing that somatic symptoms did not have statistically significant relationships with sound symbolic ratings.

So, they parked the analysis in a Supplementary table and, I suspect, tried to find some other way to feel superior to their patients
Therefore, the study was motivated to explore further and compare the underlying mechanisms of sound symbolism with the help of acoustic features.
 
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The current study has clinical implications for the treatment of FSS. Because of the different mechanisms underlying sound symbolic associations in patients with multiple somatic symptoms, future research could incorporate cross-modal testing and training to provide more effective diagnosis and intervention for the symptoms.

Additionally, intervention studies can be conducted by using brain stimulation on regions responsible for cross-modal mappings, such as the primary sensory cortex, superior temporal gyrus, inferior parietal lobule, and insula89,90, to examine modulatory effects on altered multisensory perception in these patients.
In my opinion, these researchers are treating patients of this clinic, the Department of Psychosomatic Medicine of Shanghai East Hospital, as nothing more than lab rats.

I think they should feel ashamed of themselves, I think the ethics committee that approved this work should feel ashamed. That this was published in a Nature journal is a travesty - the editors and peer reviewers should feel ashamed.

Six participants were excluded for using the same response throughout a block of trials, indicating lack of seriousness.
I salute those six participants, who probably felt compelled to take part in this study while they tried to get help at this clinic, for treating the study with the seriousness it deserved.
 
Mandarin rime
Probably a typo:
mandarin-peel-isolated-peeled-tangerine-fresh-citrus-rind-mandarins-skin-tangerines-shell-isolated-mandarin-peel-isolated-peeled-271760298.jpg
Just as relevant.
 
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