title: Somatosensory amplification mediates sex differences in psychological distress among cardioverter-defibrillator patients.
abstract: 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.
  
  
  METHODS
  Consecutive ICD patients (N = 241; 33% women) participating in the Living with an Implanted Cardioverter-Defibrillator Study, completed a set of psychological questionnaires.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center of Research on Psychology in Somatic Diseases, Tilburg University.
authors.forename: Henneke
authors.initials: H
authors.lastname: Versteeg
authors.forename: Jens
authors.initials: J
authors.lastname: Baumert
authors.forename: Christof
authors.initials: C
authors.lastname: Kolb
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Joram
authors.initials: J
authors.lastname: Ronel
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D001294:Attitude to Health; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*; D020886:Somatosensory Disorders / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013557:Switzerland