Can subjective asthma symptoms be learned?
Abstract
Objective: We investigated whether perception of subjective asthma symptoms can be brought under control of biomedically irrelevant cues in the environment, i.e., whether subjective asthma symptoms can be learned in response to harmless stimuli. Methods: Twenty patients with asthma and 20 healthy participants were presented with two placebo-inhalers presented as new chemicals for diagnosing asthma. One inhaler was coupled three times with rebreathing 5% CO2 in oxygen, the other inhaler was coupled three times with rebreathing oxygen. In the subsequent test phase, both inhalers were coupled once with oxygen. We assessed airway resistance and subjective symptoms throughout the study. Results: Both groups expected and reported more symptoms with the inhaler that was previously associated with the CO2 trials compared with trials with the inhaler that was used on trials without CO2 without concomitant effects on respiratory resistance. The learning effects were most pronounced in a subgroup of patients reporting symptoms of hyperventilation during asthma exacerbations in daily life. Conclusions: Subjective respiratory symptoms can be learned in response to harmless stimuli and a substantial proportion of patients with asthma might be especially vulnerable to this phenomenon. Because asthma patients rely mainly on perceived symptoms for their medication use, it is likely that they will take reliever medication based on expected symptoms instead of real exacerbations of respiratory dysfunction. ASC = Asthma Symptom Checklist; ANX = ASC anxiety subscale; DYS = ASC dyspnea subscale; FAT = ASC fatigue subscale; FOT = forced oscillation technique; HYP = ASC hyperventilation subscale; IRR = ASC irritability subscale; NA = negative affectivity; OBS = ASC obstruction subscale; VAS = visual analog scale.
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Recent experimental studies have demonstrated that subclinical anxiety might be enough to complicate the perception of asthma symptoms.
“recent experimental studies have demonstrated that sub-clinical anxiety might be enough to complicate the perception of asthma symptoms (De Peuter et al., 2005; Janssens et al., 2015).”
From Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online (2021) · cites this paper as De Peuter et al., 2005
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Song, Y. (2014) · Nottingham ePrints (University of Nottingham) · Cited by 7 · see citing works
Le fardeau psychologique de l’asthme
Rolland‐Debord, C., Goriounov, I., & Pitron, V. (2021) · Revue des Maladies Respiratoires · doi:10.1016/j.rmr.2021.01.018 · Cited by 6 · see citing works
Respondent and operant behavior
Sturmey, P., Ward‐Horner, J. C., & Doran, E. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-805469-7.00002-4 · Cited by 6 · see citing works
Interoceptive cues predicting exteroceptive events
Zaman, J., Peuter, S. D., Diest, I. V., den Bergh, O. V., & Vlaeyen, J. W. S. (2016) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2016.09.003 · Cited by 6 · see citing works
The effect of unpredictability on the perception of breathlessness: a narrative review
Pavy, F., Torta, D. M. E., & von Leupoldt, A. (2024) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2023.1339072 · Cited by 5 · see citing works
Interoception and Physical Health
Harrison, O. K., & Pink, A. E. (2024) · Springer eBooks · doi:10.1007/978-3-031-68521-7_8 · Cited by 3 · see citing works
Severe Health Anxiety in the Somatic Symptom and Related Disorders
Hedman‐Lagerlöf, E., & Axelsson, E. (2017) · Wiley eBooks · doi:10.1002/9781118877142.ch23 · Cited by 3 · see citing works
990 PAIN‐RELATED FEAR AND CHRONIC PAIN: INTEROCEPTIVE FEAR CONDITIONING AS A NOVEL APPROACH
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Acquisition and generalization of cough trigger beliefs in allergic rhinitis
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Interoception. Stable characteristic, or person-by-situation interaction?
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Home Monitoring of Asthma: Symptoms and Peak Flow
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Asthma and self-management : feasibility and efficacy
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- Authors
- De Peuter, S., Van Diest, I., Lemaigre, V., Li, W., Verleden, G., Demedts, M., & Van den Bergh, O.
- Affiliations
- KU Leuven (BE)
- ORCID
- Verleden, Geert
- Venue
- Psychosomatic Medicine
- Published
- 2005-05
- Volume
- 67
- Issue
- 3
- Pages
- 454-461
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2083704758
- Cited by
- 64
- References
- 50
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 1 · 2013: 5 · 2012: 3
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- asthma, subjective symptoms, rebreathing, hyperventilation, airway resistance, asthma exacerbations, medication use, psychosomatic factors
- MeSH terms
- Adolescent, Adult, Airway Obstruction, Anxiety, Association Learning, Asthma, Carbon Dioxide, Dyspnea, Fatigue, Female, Gases, Humans, Hyperventilation, Male, Nebulizers and Vaporizers, Perception, Respiratory Function Tests, Anti-Asthmatic Agents
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