Ecological momentary assessment of the relation between affect and functional dizziness symptoms: a pilot study

Associations between dizziness symptoms and psychological factors have been reported, but evaluating this through questionnaires alone risks recall bias. In this study we used ecological momentary assessment to clarify the associations between positive affect (PA), negative affect (NA), and dizziness symptom severity in sample of patients with Chronic vestibular syndrome. Participants included 30 patients with CVS (16 with persistent postural perceptual dizziness (PPPD) and 14 with Chronic vestibular syndrome, unspecified (CVS-U)) aged 20–74 years with functional dizziness symptoms. Participants were sent survey forms at random times over 10 days, with 890 returned and available for analysis. Generalized linear mixed models were applied to examine the associations between PA, NA, and momentary dizziness severity, considering both within-person and between-person variance. Higher PA was significantly associated with lower dizziness severity, while higher NA was associated with greater dizziness severity. The negative association between PA and dizziness severity was consistently stronger in the PPPD group than in the CVS-U group. A significant interaction between PA and NA was observed; simple slope analyses indicated that the protective effect of PA remained significant across all levels of NA, though the association was stronger when NA was high. These findings suggest that enhancing PA may be beneficial for managing dizziness symptoms in patients with functional dizziness, regardless of the presence of NA.