Physical symptom reporting is associated with a tendency to experience somatosensory distortion

Abstract

Objective: Theory suggests that a tendency to experience distortions in somatosensory awareness is associated with physical symptom reporting (i.e., somatization) but empirical evidence for this is lacking. This article describes research designed to test this hypothesis.

Methods: Somatosensory distortion was operationalized as the frequency of illusory touch experiences (i.e., false alarm rate) on the Somatic Signal Detection Task. Two studies correlated false alarms on this task with physical symptom reporting on the 15-item Patient Health Questionnaire, the first using a nonclinical sample (n = 35), the second using a clinical sample of endoscopy patients who were identified as having either medically explained (n = 25) or medically unexplained symptoms (n = 30).

Results: Scores on the 15-item Patient Health Questionnaire were positively correlated with false alarm rate in both studies (r = 0.288-0.506), even after controlling for trait anxiety, depression, anxiety (standardized β range = 0.793-0.932, all p < .0001) and (in Study 2) somatosensory amplification and hypochondriacal worry (standardized β range = 0.345-0.375, both p < .05). There was no difference in false alarm rate between patients with medically explained and medically unexplained symptoms (medically explained median range = 6.8 [3.7] to 6.8 [4.0] versus medically unexplained median range = 4.3 [3.9] to 5.6 [3.1], both p > .1).

Conclusions: There seems to be a robust link between physical symptom reporting and the tendency to experience somatosensory distortion, consistent with recent cognitive theories. It may be possible to reduce the impact of somatization by developing treatments that target this tendency.