Exploring temporal relationships among worrying, anxiety, and somatic symptoms.

OBJECTIVES: The role of anxiety symptoms in the development of functional somatic symptoms (FSS) is unknown. Somatic symptoms may be triggered by or give rise to anxiety symptoms. This study aimed to 1) explore interrelationships among within-day worrying, feeling anxious, and somatic symptoms, and 2) investigate the association between these interrelationships and overall level of FSS. METHODS: This study included 767 participants (83% females, mean age 39 years), who were recruited through an online crowdsourcing study in the Dutch general population. Somatic, and anxiety symptoms were reported thrice daily (6-h intervals) for 30 days using electronic diaries. FSS were assessed at baseline (PHQ-15). Temporal relationships among worrying, feeling anxious, and somatic symptoms were modeled using a multilevel vector autoregressive model. RESULTS: We observed large heterogeneity in the within-person interrelationships among worrying, feeling anxious and somatic symptoms. Averaged over participants, higher-than-usual somatic symptoms were associated with increases in levels of worrying six hours later (B = 0.017, 95% CI [0.006, 0.027]). At the between-person level, FSS levels predicted the persistence of feeling anxious (B = 0.230 95% CI [0.105, 0.350]) and the carry-over of worrying to feeling anxious over six-hours (B = 0.159, 95% CI [0.031, 0.283]). CONCLUSIONS: In contrast to what we expected, higher levels of somatic symptoms over multiple weeks were associated with the persistence and carry-over of within-day anxiety-related symptoms. One within-person association between psychological and somatic symptoms during the day was observed, suggesting that, over a time span of 6-h, anxiety symptoms relate to somatic symptoms only in a minority of people from the general population.

Let's get Physiqual - An intuitive and generic method to combine sensor technology with ecological momentary assessments.

The emergence of wearables and smartwatches is making sensors a ubiquitous technology to measure daily rhythms in physiological measures, such as movement and heart rate. An integration of sensor data from wearables and self-report questionnaire data about cognition, behaviors, and emotions can provide new insights into the interaction of mental and physiological processes in daily life. Hitherto no method existed that enables an easy-to-use integration of sensor and self-report data. To fill this gap, we present 'Physiqual', a platform for researchers that gathers and integrates data from commercially available sensors and service providers into one unified format for use in Ecological Momentary Assessments (EMA) or Experience Sampling Methods (ESM), and Quantified Self (QS). Physiqual currently supports sensor data provided by two well-known service providers and therewith a wide range of smartwatches and wearables. To demonstrate the features of Physiqual, we conducted a case study in which we assessed two subjects by means of data from an EMA study combined with sensor data as aggregated and exported by Physiqual. To the best of our knowledge, the Physiqual platform is the first platform that allows researchers to conveniently aggregate and integrate physiological sensor data with EMA studies.