Medically unexplained symptoms: do high symptom reporters show deficits in emotional awareness and theory of mind?

Golm, Dennis, Barke, Antonia, Tonassi, T., Dittko, N. and Kroener-Herwig, Birgit (2012) Medically unexplained symptoms: do high symptom reporters show deficits in emotional awareness and theory of mind? International Journal of Behavioral Medicine, 19 (Suppl 1), S52-S52, [P128].

Abstract

Background: the term “medically unexplained symptoms” refers to somatic symptoms, which are not caused by an organic illness or cannot be fully explained by one. Up to 50% of patients in primary care have unspecific somatic complaints. Among commonly reported symptoms are headache, palpitations and bloatedness. Up to 82% of patients fulfill partially or at least for a short time the diagnostic criteria of a somatoform disorder. A recently conducted study on patients with somatoform disorders suggested an etiological mechanism whereby deficits in emotional awareness result in patients misrepresenting emotional states as bodily symptoms. They also found that persons with somatoform disorders showed impaired performance in a theory of mind task. We hypothesized that if there was an association between emotional awareness, theory of mind and bodily symptoms, those associations should also be found in a sample of participants reporting a high level of medically unexplained symptoms.

Method: we examined 51 participants who were characterized as high (n = 28; mean age: 50.0; SD: 10.7) and low (n = 23; mean age: 42.7; SD: 12.0) symptom reporters by means of the Beschwerdeliste (BL), a questionnaire to assess unspecific bodily symptoms. The participants filled in the Emotionale Kompetenzfragebogen (EKF), a questionnaire which assesses – among other things –awareness of one’s own emotions and of the emotions of other persons. The participants also performed two theory of mind tasks: the Faux-pas Test and a computer-based paradigm to identify others’ emotions and intentions.

Results: high symptom reporters showed lower scores in the emotional awareness subscale of the EKF, but performed as well in the two theory of mind tasks as the low symptom reporters.

Conclusions: high rate of bodily symptoms seems to be associated with lower emotional awareness even in a non-clinical sample. However, in this population we failed to find any impairment in the theory of mind.

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Contributors

Author: Dennis Golm

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