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Medically unexplained symptoms in women as related to physiological stress responses
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
2005 (English)In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 21, no 1, 45-52 p.Article in journal (Refereed) Published
Abstract [en]

The present, cross-sectional study explored whether self-reported symptoms are related to physiologicalstress indicators in a group of 43-year-old women representing the general populationin Sweden. Analyses were performed both on raw scores of physiological indicators and on a multisystemsummary index of allostatic load as a measure of cumulative biological burden. Participantsanswered a health questionnaire and underwent a medical examination including bloodpressure, heart rate measurements, determination of blood lipids and stress hormones. Urinaryepinephrine and norepinephrine were measured both on a working day and a work free day athome. In addition, salivary morning cortisol was measured on a non-work day. The physiologicalprofiles based on raw scores from 222 women showed that women with a high symptom loadhad significantly higher levels of cortisol (p < 0.05), and higher heart rate (p < 0.05) than didthose with a low symptom load. In contrast, women with a low symptom load had significantlyhigher levels of epinephrine on a work free day than did women with a high symptom load (p <0.05). No significant differences were found in norepinephrine responses. When analysing thesummary measure of allostatic load in relation to symptom prevalence no significant differencebetween the symptom groups emerged. One possible explanation for this result could be that amajority of the study population was healthy, reporting a low level of symptoms in general.However, the results support the notion that common, medically unexplained symptoms amongwomen are associated with certain biological parameters known to play a role in the developmentof ill health.

Place, publisher, year, edition, pages
2005. Vol. 21, no 1, 45-52 p.
Keyword [en]
unexplained symptoms, physiological stress, stress responses, self reported symptoms
National Category
URN: urn:nbn:se:su:diva-22884DOI: 10.1002/smi.1037OAI: diva2:189677
Available from: 2004-04-23 Created: 2004-04-23 Last updated: 2011-03-01Bibliographically approved
In thesis
1. Women's subjective and objective health over time: the role of psychosocial conditions and physiological stress responses
Open this publication in new window or tab >>Women's subjective and objective health over time: the role of psychosocial conditions and physiological stress responses
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.

Place, publisher, year, edition, pages
Stockholm: Psykologiska institutionen, 2004. 66 p.
health, medically unexplained symptoms, females, longitudinal, psychosocial, stress
National Category
urn:nbn:se:su:diva-124 (URN)91-7265-853-3 (ISBN)
Public defence
2004-05-07, David Magnussonsalen (U31), hus 8, Frescati hagväg 8, Stockholm, 14:00
Available from: 2004-04-23 Created: 2004-04-23Bibliographically approved

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Mellner, ChristinKrantz, GunillaLundberg, Ulf
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