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Current perspectives on symptom perception in asthma: A biomedical and psychological review

International Journal of Behavioral Medicine volume 6, pages 120–134 (1999)Cite this article

Abstract

Symptom perception in patients with asthma is often inadequate. Patients may fail to perceive serious airway obstruction or suffer from breathlessness without objective cause. These extremes are associated with fatal asthma and excessive use of medicines, respectively. This article covers symptom perception in a multidisciplinary perspective. A presentation of current definitions and methods for studying symptom perception in asthma is followed by a summary of theories on the origin of breathlessness. Next, biomedical and psychological factors influencing symptom perception are exmined. Preliminary biomedical research emphasizes neural pathway impairment, but causal factors remain inconclusive, particularly regarding the overperception of symptoms. Psychological studies suggest that the accuracy of symptom perception is influenced by (a) competition between asthmatic and nonasthmatic sensory information, (b) negative emotions, and (c) acquired response tendencies (e.g. habituation to symptoms, repression of symptoms, selective perception, and false interpretation of symptoms). These factors may favor either blunted perception or overperception. Empirical data in support of psychological factors are still insufficient. Methodological problems and procedures to improve symptom perception are discussed.

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  1. Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, 1018, Amsterdam, WB, The Netherlands

    Simon Rietveld

  2. Department of Psychology, Leiden University, The Netherlands

    Jos F. Brosschot

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  1. Simon Rietveld
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  2. Jos F. Brosschot
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Correspondence to Simon Rietveld.

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The authors thank James Boutos, David Vaghi, and Cedric Sands for commenting on the original manuscript.

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Rietveld, S., Brosschot, J.F. Current perspectives on symptom perception in asthma: A biomedical and psychological review. Int. J. Behav. Med. 6, 120–134 (1999). https://doi.org/10.1207/s15327558ijbm0602_2

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Key words

  • airway obstruction
  • asthma
  • breathlessness
  • symptom perception