Understanding the Physical-Symptom Experience

Abstract

Individuals tend to believe that the somatic sensations they are currently experiencing or have experienced accurately reflect their physical functioning; however, the experience of somatic symptoms is also affected by psychological and social factors. For two decades, the dominant perspective has been that the general tendency to experience negative emotions—negative affectivity (NA; also known as neuroticism or negative emotionality)—inflates physical-symptom reporting because persons high in NA are more likely to notice somatic changes and to label even minor or benign somatic changes as signs of illness. We review recent research suggesting that two components of NA—anxiety and depression, which are associated with distinctive cognitive-affective biases related to attention/encoding and recall, respectively—are more critical for the cognitive processing of somatic changes than is global NA per se. Specifically, anxiety is responsible for elevated reports of momentary symptoms, whereas depression is related to exaggerated recall of past symptoms. Understanding the distinctive roles of anxiety and depression in the experience of physical symptoms has implications for researchers and practitioners in the fields of personality, clinical science, health psychology, psychiatry, cognitive and affective neuroscience, and medicine.