Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study

Sickness behavior is a coordinated set of psychological changes mediated by immune system activity, e.g., during infection and wounding. It is an adaptive response to conserve energy and resources in support of immune activity and to protect the community by signaling others that one is ill. In this...

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Main Authors: Christian Schubert, Lennart Seizer, Nina Camille Sophia Lauby, Dietmar Fuchs
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Comprehensive Psychoneuroendocrinology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666497625000207
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author Christian Schubert
Lennart Seizer
Nina Camille Sophia Lauby
Dietmar Fuchs
author_facet Christian Schubert
Lennart Seizer
Nina Camille Sophia Lauby
Dietmar Fuchs
author_sort Christian Schubert
collection DOAJ
description Sickness behavior is a coordinated set of psychological changes mediated by immune system activity, e.g., during infection and wounding. It is an adaptive response to conserve energy and resources in support of immune activity and to protect the community by signaling others that one is ill. In this integrative single-case study, a 27-year-old healthy woman collected her entire urine over a period of 63 days in continuous 12-h intervals (126 measurements in total). In addition, among other regular psychological assessments, she completed an emotional state questionnaire (EWL) each morning and evening, and had an in-depth psychological interview once a week. In the urine samples, neopterin, cortisol, and creatinine were measured. Coincidentally, the subject experienced a period of sickness during the study period, lasting two days (from 12-h interval 21 to 24), accompanied by fatigue, vomiting, diarrhea, low-grade fever, and increases in urinary neopterin and cortisol concentrations. During this sickness period, structural breaks occurred in the time-series of two positive emotional states, i.e., performance-related activity and general feeling of comfort, with significant drops in their mean levels lasting for over 50 days until the end of the study. The intensive longitudinal data set collected in this integrative single-case study makes it possible to adopt a biopsychosocial meta-perspective (bottom-up, top-down) when interpreting the results.
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spelling doaj-art-6cdfdbe3d8c949a98ab96b85e1b30d522025-08-20T03:23:34ZengElsevierComprehensive Psychoneuroendocrinology2666-49762025-08-012310030110.1016/j.cpnec.2025.100301Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case studyChristian Schubert0Lennart Seizer1Nina Camille Sophia Lauby2Dietmar Fuchs3Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Austria; Corresponding author.Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Tübingen, Germany; Department of Clinical Psychology and Psychotherapy for Children and Adolescents, Friedrich-Alexander-University Erlangen-Nürnberg, GermanyDepartment of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, AustriaInstitute of Biological Chemistry, Biocenter, Medical University Innsbruck, AustriaSickness behavior is a coordinated set of psychological changes mediated by immune system activity, e.g., during infection and wounding. It is an adaptive response to conserve energy and resources in support of immune activity and to protect the community by signaling others that one is ill. In this integrative single-case study, a 27-year-old healthy woman collected her entire urine over a period of 63 days in continuous 12-h intervals (126 measurements in total). In addition, among other regular psychological assessments, she completed an emotional state questionnaire (EWL) each morning and evening, and had an in-depth psychological interview once a week. In the urine samples, neopterin, cortisol, and creatinine were measured. Coincidentally, the subject experienced a period of sickness during the study period, lasting two days (from 12-h interval 21 to 24), accompanied by fatigue, vomiting, diarrhea, low-grade fever, and increases in urinary neopterin and cortisol concentrations. During this sickness period, structural breaks occurred in the time-series of two positive emotional states, i.e., performance-related activity and general feeling of comfort, with significant drops in their mean levels lasting for over 50 days until the end of the study. The intensive longitudinal data set collected in this integrative single-case study makes it possible to adopt a biopsychosocial meta-perspective (bottom-up, top-down) when interpreting the results.http://www.sciencedirect.com/science/article/pii/S2666497625000207Sickness behaviorPsychoneuroimmunologyIntegrative single-case studyCortisolNeopterinTime series
spellingShingle Christian Schubert
Lennart Seizer
Nina Camille Sophia Lauby
Dietmar Fuchs
Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
Comprehensive Psychoneuroendocrinology
Sickness behavior
Psychoneuroimmunology
Integrative single-case study
Cortisol
Neopterin
Time series
title Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
title_full Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
title_fullStr Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
title_full_unstemmed Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
title_short Mixed-methods analysis of sickness behavior during a natural experiment: An integrative single-case study
title_sort mixed methods analysis of sickness behavior during a natural experiment an integrative single case study
topic Sickness behavior
Psychoneuroimmunology
Integrative single-case study
Cortisol
Neopterin
Time series
url http://www.sciencedirect.com/science/article/pii/S2666497625000207
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AT ninacamillesophialauby mixedmethodsanalysisofsicknessbehaviorduringanaturalexperimentanintegrativesinglecasestudy
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