Stress Research InstituteBe reminded of symptoms and reappraise your healthAnna Andreasson, Helena Schiller, Göran Kecklund, Mats Lekander Stress Research Institute, Stockholm University, Sweden

CONTACT Anna Andreasson, Stress Research Institute, Stockholm, Sweden

E-mail anna.andreasson@su.se

Stress Research Institute is a knowledge centre in the area of stress and health. The Institute is part of the Faculty of Social Science, Stockholm University, Sweden and conducts basic and applied research on multidisciplinary and interdisciplinary methodological approaches. E-mail info@stressforskning.su.se Website www.stressresearch.se

BackgroundBodily signals and how these are in-terpreted are important determinants of self-ratings of health. Likewise, at-tention increases and distraction de-creases pain ratings. In a related vein, disease primes are known to cause anxiety, decrease extraversion and stimulate avoidance and other nega-tive social behaviors. It is thus reaso-nable that even appraisals of general health are affected by imminent ex-posures and disease primes. We the-refore aimed to investigate whether self-ratings of health are affected by a symptom rating and if changes are substantiated in persons who report more symptoms.

MethodsIncluded in the analyses are 813 per-sons who rated completed a ques-tionnaire daily for 21 consecutive days. The questionnaire included a one-item self-rating of health (”pre-SRH”; 1=excellent, 7=very poor), a subsequent 26-item rating of physi-cal and mental symptoms and a se-cond (identical) self-rating of health just after the symptom rating (”post-SRH”). Paired t-tests were used to test for differences between pre-SRH and post-SRH. Mixed effect regres-sion models were used to calculate the interaction between pre-SRH and symptom score on post-SRH adju-sted for gender, age and if the person had been working that day.

ResultsSRH worsened significantly (p<.0001) after the symptom rating, from 2.72 (Pre-SRH. 95%CI: 2.70-2.74) to 2.75 (Post-SRH: 95%CI: 2.75-2.79). Both Pre-SRH and symp-tom score were associated with Post-SRH. There was a significant interac-tion between Pre-SRH and symptoms on post-SRH so that persons who re-ported more symptoms changed their Post-SRH rating to a higher degree than those who reported few symp-toms, irrespective of their subjective health status.

ConclusionTo consider and rate bodily symptoms affect self-rated health, and more so for persons reporting more symptoms. The results support the notion that attention on bodily signals influences subjective health perception, and sug-gests that the presence of more symptoms may cause a larger change in the rating. The study demonstrates that short-term variations can be shown also in ratings of general health. Health can thus be reappraised even if an identi-cal rating task has been performed only minutes before.

Table 1Prediction of Post-SRH adjusted for age, gender and working day

Pre-SRH 2 .83 (.80-.86)***(1 reference) 3 1.53 (1.47- 1.58)***

4 2.24 (2.07-2.41)***5 3.19 (2.86-3.51)***

Symptom (3 categories) 2 .17 (.11-.22)***(1 reference) 3 .25 (.07-.42)**Pre-SRH * symtom 2*2 -.01 (-.07-.05)(1 reference) 2*3 .19 (.01-.37)*

3*2 .05 (-.02-.13)3*3 .23 (.04-.41)*4*2 .15 (-.03*.33)4*3 .40 (.16-.65)**5*2 .15 (-.18-.49)5*3 .67 (.30-1.04)***