Review article
Somatosensory amplification – An old construct from a new perspective

https://doi.org/10.1016/j.jpsychores.2017.07.011Get rights and content

Highlights

  • Somatosensory amplification plays a role in symptom reporting.

  • The intensification of perceived symptoms is assumed.

  • It is also associated with health worries and expectations of symptoms.

  • It may refer to the sensitivity to any threats to the integrity of the body.

Summary

The paper reviews and summarizes the history and the development of somatosensory amplification, a construct that plays a substantial role in symptom reports. Although the association with negative affect has been supported by empirical findings, another key elements of the original concept (i.e. body hypervigilance and the tendency of focusing on mild body sensations) have never been appropriately addressed. Recent findings indicate that somatosensory amplification is connected with phenomena that do not necessarily include symptoms (e.g. modern health worries, or expectations of symptoms and medication side effects), and also with the perception of external threats. In conclusion, somatosensory amplification appears to refer to the intensification of perceived external and internal threats to the integrity of the body (“somatic threat amplification”) rather than amplification of perceived or actual bodily events only. Practical implications of this new approach are also discussed.

Section snippets

The development of the construct

In a seminal article published almost 40 years ago, Arthur J. Barsky made an attempt to reconsider the phenomenon of subjective somatic symptoms from a bio-psychosocial perspective [1]. It was already well known at that time that there are marked individual differences in the phenomenology of body symptoms, which can heavily impact patients' everyday functioning and well-being [2], [3], [4]. The proneness to amplification, which was not without predecessors (e.g. sensitization [5], [6],

A new approach

The above reported findings do not fit very well the original concept of SSA. Particularly in the case of negative health-related expectations and modern health worries, expected or feared symptoms might not be present thus no actual somatic amplification process can be at work.

These conditions do have a shared element - heightened levels of perceived threat and vulnerability [141], [142]. In empirical studies, both hypochondriacal concerns and SSA were connected with the perceived threat

Characteristics of SSA

As it was shown in the experiments mentioned above [147], [148], SSA (like other processes of primary appraisal) represents an automatic and emotional way of evaluation [156]. If the evaluation process concludes that a threat is posed on the integrity of the body, it will give rise to higher level processes (e.g. attribution, expectations, symptom perception, worry). In other words, SSA provides the motivational-emotional background for health and illness related cognitions (Fig. 1). Those with

Similar constructs

Catastrophizing refers to a cognitive distortion where the assumed negative consequences and outcomes of an event or condition are overestimated [165]. As the construct involves an exaggerated negative orientation toward noxious stimuli (particularly pain) [166], it appears to be quite close to the SSA. However, pain catastrophizing, involving worry [167] and the perceived inability to cope effectively with pain [168], belongs to the secondary appraisal domain, which clearly differentiates it

Future perspectives

Recently, as the critical amount of people is easily accessible via the Internet and the mass media, the likelihood and the severity of various health related social contagions increases. This fact was clearly shown by several recent reports [188], [189], [190], [191]. Generally, the importance of complete health is strongly stressed by the mass media, which leads to a heightened consciousness of health issues, and also to an increased feeling of vulnerability [142], [192]. Moreover, a new

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  • Cited by (0)

    Conflicts of interest and source of funding: This research was supported by the Hungarian National Scientific Research Fund (OTKA K 109549 and K 124132). The authors wish to say thank Keith Petrie for the Wanaka meeting that substantially catalyzed the preparation of this paper.

    No conflicts of interest are declared.

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