Review articleSomatosensory amplification – An old construct from a new perspective☆
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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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.