The relevance of Gilbert’s three affect regulation systems, in particular the soother system, among immigrants with persistent physical symptoms in the Netherlands

Abstract

This study investigated the relevance of Gilbert’s three affect regulation systems and tried to uncover relevant soothers for the immigrant (non-Dutch) patients with persistent physical symptoms in the Netherlands. The affect regulation systems are the (1) threat - may include emotions such anger and anxiety, (2) drive - is the successful seeking of resources that might incite excitement, for example, and the (3) soother – which, for instance, aids rest or the process of contentment. The soother system balances the arousal from threats and drives. Nevertheless, when one of the systems is off balance, it can lead to stress and mental health issues. Patients with physical symptoms feel chronic symptoms, such as pain, fatigue, dizziness and so on, and over utilize medical health care. In total, 722 Dutch and 54 non-Dutch (36 Western immigrants and 18 non-Western) completed this questionnaire on threats, drives, soothers and the PHQ-15, which measures the severity of physical symptoms. Data were analyzed with repeated measures analysis of variance (Anova), the post-hoc-test with Bonferroni correction, principal axis factoring with oblimin rotation, multiple regression analysis and Pearson’s correlation coefficient. The PHQ-15 indicated more severe physical symptoms for the non-Dutch in comparison to the Dutch. The soother questionnaire uncovered five dimensions: comforting environment, self-care, enjoying activity and condition, support measures and positivity in life. Perceived as the most important was the support measure and least the positivity in life dimension. No association could be found between the severity of physical symptoms, the soother dimensions, age and education. Likewise, there was no significant difference between the perceived strengths of threats, drives and soothers among the Dutch and non-Dutch. Furthermore, both the Western and non-Western immigrants with physical symptoms showed an association between the perceived threats and the severity of physical symptoms. This first study of the topic did not yield evidence that integrating the three affect regulation systems, in particular the soother system, into clinical treatment of persistent physical symptoms for minority populations in the Netherlands can make treatment easier and lead to better outcomes..