Somatosensory amplification mediates sex differences in psychological distress among cardioverter-defibrillator patients.

OBJECTIVE

The present study examined whether female patients with an implantable cardioverter defibrillator (ICD) report more psychological distress than male patients, and whether somatosensory amplification mediates this relationship.

DESIGN

Consecutive ICD patients (N = 241; 33% women) participating in the Living with an Implanted Cardioverter-Defibrillator Study, completed a set of psychological questionnaires.

MAIN OUTCOME MEASURES: Symptom Checklist-90 and Somatosensory Amplification Scale.

RESULTS

Univariable linear regression analyses showed that female ICD patients reported more symptoms of anxiety (β = .13, p = .04), phobic anxiety (β = .13, p = .05), and somatic health complaints (β = .15, p = .02), and scored higher on somatosensory amplification (β = .24, p < .001) than men. Multivariable regression analyses, adjusted for demographic and clinical risk factors, revealed that somatosensory amplification was associated with more anxiety (β = .48, p < .001), phobic anxiety (β = .34, p < .001), and somatic health complaints (β = .49, p < .001). Sobel tests indicated that somatosensory amplification mediated the association between sex and these three domains of psychological distress (p = .0005, .002, and .0006, respectively).

CONCLUSION

Somatosensory amplification mediated the relationship between female sex and heightened anxiety, phobic anxiety, and somatic health complaints in ICD patients. Women may be more likely to misinterpret bodily sensations as indicative of deterioration in their condition. Interventions focusing on modifying these dysfunctional beliefs may reduce their psychological distress.