Associations between emotional awareness deficits and somatic symptoms in a community and clinical populations: a cross-sectional study 2025 Kang+

[Andy]

Abstract​

Background​

Deficits in emotional awareness may contribute to the development and maintenance of somatic symptoms. This study explored emotional awareness deficits and their association with somatic symptoms among individuals with a high somatic symptom burden from an online community sample, as well as among patients with somatic symptom disorders.

Methods​

Emotional awareness deficits were analyzed by comparing 77 individuals with a high somatic symptom burden and 129 individuals with a low somatic symptom burden from a community population (Study 1). The severity of somatic symptom burden was measured using the Somatic Symptom Scale-8, with scores of eight or higher classified as high. Deficits in emotional awareness in clinical somatic symptoms were examined by comparing 34 patients with somatic symptom disorders to 34 matched healthy controls (Study 2). Emotional awareness was assessed by evaluating alexithymia using the 20-Item Toronto Alexithymia Scale (TAS-20) and empathy using the Interpersonal Reactivity Index (IRI). Multivariate analysis of covariance (MANCOVA) was conducted to examine group differences in emotional awareness while controlling for potential covariates.

Results​

After adjusting for covariates, the MANCOVA results in Study 1 revealed significantly higher scores on the Difficulty Identifying Feelings subscale of the TAS-20 and the Personal Distress subscale of the IRI among participants with a high somatic symptom burden. These findings were replicated in Study 2, where patients with somatic symptom disorders exhibited deficits comparable to those of healthy controls.

Conclusions​

This study suggests that difficulties in emotional awareness are closely associated with somatic symptoms in both clinical and community populations. Interventions aimed at improving emotional awareness may alleviate the manifestations of somatic symptoms and prevent related functional impairments.

Open access

 

[Utsikt]

Interventions aimed at improving emotional awareness may alleviate the manifestations of somatic symptoms and prevent related functional impairments.

Once again jumping from correlation between answers on dodgy questionnaires, to possible causation (in just one direction).

 

[SNT Gatchaman]

Somatic symptom disorder is characterized by persistent somatic symptoms accompanied by significant psychological distress at the affective, cognitive, and behavioral levels, regardless of whether a medical explanation has been identified.

"Somatic" means "relating to the body, especially as distinct from the mind". So symptoms in the body accompanied by significant psychological distress (ie correlation not causation). Regardless of whether a medical explanation has been identified. So including when a medical explanation for the body symptoms is identified.

So by this definition someone who has a significant body injury, eg serious burns or major stroke or high level spinal cord injury, who would be expected to be in significant psychological distress would qualify for "somatic symptom disorder".

But they immediately continue with the claim that this proves psychological causation with that definition —

This highlights the central role of psychological mechanisms—particularly emotional dysregulation—in the development and maintenance of the disorder.

 

[Hoopoe]

Once again jumping from correlation between answers on dodgy questionnaires, to possible causation (in just one direction).

Yes, there are two incredibly obvious alternative explanations for the correlation.

The first is that the patients have an illness that affects the body and the brain. The affected brain cannot perform all of its usual function as well, and the result is things like deficits in emotional awareness, processing, etc. In other words, a brain fogged patient doesn't perform well on many cognitive tests...

The other is that the illness leads to reduced ability to do fun things and social activities, which then leads to a decline in various skills concerning emotions and social function due to lack of usage of the relevant brain areas.

It's so sad that people are still trying to prove psychosomatic illness instead of concentrating on figuring out what works with an open mind. I'm pretty sure most of them would agree that it's difficult to help the patients in question, which implies that current attitudes and approaches are not working well. But somehow the current attitudes and approaches must not be critically questioned.

 

[Jesse]

"Somatic" means "relating to the body, especially as distinct from the mind". So symptoms in the body accompanied by significant psychological distress (ie correlation not causation). Regardless of whether a medical explanation has been identified. So including when a medical explanation for the body symptoms is identified.

So by this definition someone who has a significant body injury, eg serious burns or major stroke or high level spinal cord injury, who would be expected to be in significant psychological distress would qualify for "somatic symptom disorder".

But they immediately continue with the claim that this proves psychological causation with that definition —

Based on my reading on somatic symptom disorder it's about the thoughts, feelings and behaviors related to the symptoms being excessive. Which mostly becomes a problem for illnesses doctors have a poor understanding of and thus don't know what constitutes a "normal" psychological reaction. And that's exactly the type of illnesses they will argue are SSD.

Like if you have a broken leg and you're extremely worried about your leg, afraid of walking and spending a lot of time figuring out what the hell is wrong with your leg that won't raise any eyebrows. But if you exhibit the same behaviour while you're leg is perfectly healthy they'll call it SSD. This becomes problematic real fast if they wouldn't have any tests or understanding about broken legs..

 

[Hoopoe]

Re. judging the appropriate level of concern/distress. Maybe they know some statistics about this category of patients and therefore know it's probably not life threatening. Even if an illness is not life threatening, the possibility of permanent disability and continued decline are horrifying. I wonder what the relation is between the level of empathy of the doctor and their propensity to give SSD diagnoses.

Also, the level of distress and concern will depend on other factors. A patient with good social support and good financial situation will have less reason to worry. One would think that proponents of the bio-psycho-social model would be well aware of this.

Healthcare professionals should be taught to never judge another person because they're not in their position, don't know the larger context and full history, and don't have access to the subjective experience.

 

[rvallee]

Deficits in emotional awareness may contribute to the development and maintenance of somatic symptoms

No, it may not. This is just ridiculous. You are in angels and fairies territory here.

Deficits in emotional awareness in clinical somatic symptoms were examined by comparing 34 patients with somatic symptom disorders to 34 matched healthy controls (Study 2). Emotional awareness was assessed by evaluating alexithymia using the 20-Item Toronto Alexithymia Scale (TAS-20) and empathy using the Interpersonal Reactivity Index (IRI)

This has nothing to do with some vague idea of whatever "deficits in emotional awareness" even mean. It's just random nonsense.

As is tradition, they take a correlation and make it a specific attribution, one-way only. The traditional way. None of this is serious. Being ill is terrible, but they decided that the illness can't exist so they talk nonsense instead. As is tradition. Decades of doing that, and they're still doing the exact same nonsense as whoever it, incapable of changing or learning anything.

I'm sorry, but these people have no idea what they are talking about or doing. This is complete sham expertise. They could go right back to some old ideas like putting smiley masks on people and pretending like it's science. They're not even trying.

But they immediately continue with the claim that this proves psychological causation with that definition —

Even though the literal title of the paper states that it's associations. Which make sense, being ill is awful.

Has any other idea been tried so hard for so long, failed anyway, and still some continue to try and prove it? This is beyond ridiculous, it's completely fanatical. Medieval alchemists were far more sensible and reasonable about their pseudoscience.

Re. judging the appropriate level of concern/distress. Maybe they know some statistics about this category of patients and therefore know it's probably not life threatening. Even if an illness is not life threatening, the possibility of permanent disability and continued decline are horrifying. I wonder what the relation is between the level of empathy of the doctor and their propensity to give SSD diagnoses.

What's absurd about this is that following this fallacious reasoning, life in prison, even in solitary confinement, would be no problem. If it won't kill you, why even care? Just live your life to the fullest extent that spending the rest of your life in solitary confinement affords you. But it makes no sense to them because in this scenario, they imagine they could just walk out of there, that the walls, the gates, the guards, the system that will track you and put you back in don't matter.

It's completely childish to believe this nonsense. It's the same thing as closing your eyes to make the danger go away. Except they're closing their minds.