Author ORCID Identifier
https://orcid.org/0009-0000-1255-7461
Defense Date
2026
Document Type
Thesis
Degree Name
Master of Arts
Department
Psychology
First Advisor
Taylor Crouch
Second Advisor
Dace Svikis
Abstract
Persistent Sympathetic Activation (PSA) has emerged as a potential unifying mechanism underlying a range of complex chronic health conditions yet remains poorly characterized within biomedical and psychosocial research. Limited research has delineated how PSA manifests across diverse populations or how diagnostic and sociocultural factors shape lived experiences of this phenomenon; thus, the objective of the present study was to examine whether diagnostic certainty – operationalized as provider-confirmed versus self-suspected PSA-related diagnoses – is associated with symptom catastrophizing, and whether this relationship varies as a function of sociocultural factors. Drawing on data from a larger study aimed at characterizing the lived experience of individuals with PSA-informed disorders, the present research involved a cross-sectional secondary data analysis among a community sample of adults (N = 302, Mage = 37.5).
The present study found that diagnostic certainty in individuals with PSA was not related to symptom catastrophizing as hypothesized. However, racial and gender marginalization were significant positive predictors of catastrophizing, such that individuals from marginalized groups reported higher levels of symptom catastrophizing. Stratified analyses indicated that these associations were observed among participants assigned female at birth, whereas corresponding effects among participants assigned male at birth were not significant. The relationship between diagnostic certainty and symptom catastrophizing was not moderated by perceived relationship to healthcare provider, although greater diagnostic certainty was associated with more positive perceptions of healthcare providers. Additionally, racial marginalization was associated with greater diagnostic certainty.
Although the primary hypotheses were not supported, these findings suggest that symptom catastrophizing among individuals with PSA is more strongly associated with sociocultural factors than with diagnostic confirmation. This study contributes to the emerging literature by highlighting the role of marginalization in shaping the diagnostic and psychological experiences of individuals with PSA-related conditions and invites further research on systemic factors influencing chronic disease experience.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-20-2026