Evidence mapPaperPMID 39920078Full record

Trial reportBMJ open2025

Time-dynamic associations between symptom-related expectations, self-management experiences and somatic symptom severity in everyday life: an ecological momentary assessment study with university students.

Stefanie Hahn, Yvonne Nestoriuc, Simon Kirchhof, Anne Toussaint, Bernd Löwe, Franz Pauls

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Stefanie HahnClinical Psychology and Psychotherapy, Helmut-Schmidt-University / University of the Armed Forces Hamburg, Hamburg, Germany hahns@hsu-hh.de.ORCID http://orcid.org/0000-0003-4175-248X
Yvonne NestoriucClinical Psychology and Psychotherapy, Helmut-Schmidt-University / University of the Armed Forces Hamburg, Hamburg, Germany.ORCID http://orcid.org/0000-0003-2191-0495
Simon KirchhofDepartment of Developmental and Educational Psychology, Helmut-Schmidt-University / University of the Armed Forces Hamburg, Hamburg, Germany.
Anne ToussaintDepartment of Psychosomatic Medicine and Psychotherapy, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0000-0002-5189-6615
Bernd LöweDepartment of Psychosomatic Medicine and Psychotherapy, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0000-0003-4220-3378
Franz PaulsClinical Psychology and Psychotherapy, Helmut-Schmidt-University / University of the Armed Forces Hamburg, Hamburg, Germany.ORCID http://orcid.org/0000-0001-6483-3456

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe present study investigated the associations between symptom-related expectations, self-management experiences and expectation framing on somatic symptom severity in university students in two conditions (positive or standard expectation framing). We hypothesised that symptom-related expectations are significantly associated with concurrent and subsequent levels of somatic symptom depending on expectation framing.

designA smartphone-based micro-longitudinal ecological momentary assessment study with randomisation to one of two expectation framing groups (positive vs negative) was carried out. Multilevel mixed-effects linear regression analyses were conducted for data analysis.

settingData was collected in real-time from university students via smartphones, with three predetermined assessments per day over seven consecutive days.

participantsA total of 104 students (63.5% male, 0% diverse) who were 18 years or older, possessing sufficient German language skills and had access to an Android-powered smartphone were included.

interventionsParticipants were randomised to one of two different expectation framing groups, either receiving questionnaires for the expected impairment due to somatic symptoms (negative framing) or for the expected freedom from impairment due to somatic symptoms (positive framing). PRIMARY OUTCOME MEASURES: Somatic symptom severity was assessed using an adapted version of the Patient Health Questionnaire, with 11-point instead of 3-point Likert-scales. Symptom-related expectations were assessed using 11-point Numerical Rating Scales and self-management experiences were assessed using binary variables.

resultsConcurrent analysis revealed a significant association between symptom-related expectations and symptom severity (β=0.934, p<0.001), but no significant associations between self-management experiences and symptom severity. Regarding expectation framing, participants in the negative group reported higher symptom severity levels than those in the positive group (β=-0.071, p<0.001). Results indicated a stronger association between symptom-related expectations and symptom severity in the negative framing group (β=-0.088, p<0.001). Time-lagged analysis showed higher levels of symptom-related expectations predicted higher subsequent symptom severity levels (β=0.502, p<0.001), whereas preceding symptom severity levels or self-management experiences did not predict subsequent symptom severity levels. Negative framing was associated with higher subsequent symptom severity levels (β=-0.158, p<0.001). The effect of symptom-related expectations on subsequent symptom severity levels was independent of expectation framing.

conclusionsOur findings highlight the impact of expectations and expectation framing on somatic symptom severity among university students and expand the knowledge needed for the development of expectation management techniques. TRIAL REGISTRATION NUMBER: ISRCTN36251388.

Indexed as

Ecological Momentary AssessmentMedically Unexplained SymptomsSelf-ManagementStudentsAdolescentAdultFemaleHumansLongitudinal StudiesMaleSeverity of Illness IndexSmartphoneSurveys and QuestionnairesUniversitiesYoung AdultMENTAL HEALTHPUBLIC HEALTHSomatoform Disorders

Identifiers

PMID39920078
PMCPMC11808919

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.