Proprioception in somatoform disorders

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Abstract

20 patients with somatoform disorders as defined by DSM-IV and 20 healthy controls were examined for their proprioception. Several psychophysiological theories of somatoform disorders suggest biased proprioceptive abilities. The primary question is, whether we may find an inaccurate myogen perception in somatization as suggested by the approach of Bischoff [Wahrnehmung der Muskelspannung (Perception of muscle tension) Gottingen: Hogrefe (1989)] or a more precise proprioception as may be derived from concepts of a higher awareness of body reactions [e.g. Barksky, A. J. (1992) Amplification, somatization, and the somatoform disorders. Psychosomatics, 39, 28–34; Salkovskis, P. M., & Clark, D. M. (1993) Panic disorder and hypochondiasis. Adv. Res. Ther. 15, 23–48]. Furthermore it is expected, that somatoform patients perceive their muscle tension more intensely than do healthy subjects. Proprioceptive abilities were tested using a visual EMG biofeedback task. Resulting objective data and subjective ratings were analyzed within a psychophysiological regression approach which allows one to estimate the reliability, precision and intensity of proprioception. Results revealed that somatoform subjects demonstrated a more precise but not a more intense perception of muscle tension than did healthy controls.

Section snippets

Subjects

Participants were 20 in-patients with somatoform disorders and the mean age of 46.00 years (SD=7.93) and 20 healthy controls with the mean age of 41.78 (SD=8.29). The groups did not differ in age [t(38)=1.58, n.s.]. Both groups consisted of 13 men and 7 women.

Subjects participated voluntarily and free of charge. The clinical sample was recruited in a psycho-somatic clinic with a cognitive-behavioural therapeutic background. The control subjects were asked personally to take part in the

Results

A two-tailed MANOVA (P<0.01) was calculated across the five proprioceptive parameters in order to establish whether differences occurred between somatoform patients and healthy subjects. This analysis showed no significant overall effect, F(5,34)=1.87, n.s.. Nevertheless, the corresponding univariate analysis showed some significant differences (s. Table 2). Somatoform patients exhibited higher precision than healthy subjects. Furthermore, the group difference for intensity were just short of

Discussion

The results of this study reveal three important aspects of proprioception: (1) within a univariat comparision patients with somatoform disorders show a tendency to a more intense and a more precise myogen proprioception (see Table 2). (2) The variables precision and intensity show a high sample dependent correlation within the population (see Table 3). Correlation coefficient is statistically significant for healthy people, but only by chance for somatoform patients. Although there seems to be

Acknowledgements

The authors wish to thank Mrs Sally Hallet, Reading, England, for her effort, to make the manuscript a fluent English and Dipl.-Psych. Erika Blitz for doing some experiments. This research was supported by grant Scho-327/5-1 from Deutsche Forschungsgemeinschaft.

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