The unbearable lightness of somatisation: A systematic review of the concept of somatisation in empirical studies of pain (2009) by Crombez et al.

[ME/CFS Skeptic]

This is from the same Belgian researchers who recently published a critical review of pain catastrophizing measures, discussed here.

Abstract
Somatisation is often invoked to explain pain and suffering in patients. Lipowski [34] defined somatisation as "a tendency to experience and communicate somatic distress and symptoms unaccounted for by pathological findings, to attribute them to physical illness, and to seek medical help for them" (p. 1359). His concept is widely accepted. This study investigated to what extent this conceptualisation is used in the empirical studies of pain. Studies were identified through searches from Web of Science, Pubmed and Psychinfo databases for the period from 1989 until 2007. Screening an initial set of 1020 articles resulted in 120 articles fulfilling inclusion criteria. One hundred and sixteen articles were retrieved and coded in terms of the conceptualisation of Lipowski [34]. All studies had a measure of somatic symptoms, most often questionnaires. Whether the symptoms were unaccounted for by pathological findings was rarely investigated. No study assessed whether the participants attributed the somatic complaints to physical illness. Most studies included patients seeking help in a clinical setting, but only one study investigated whether patients were seeking help for the somatisation complaints. In conclusion, no study fulfilled the construct criteria as defined by Lipowski [34]. Most studies focus upon the extent and diversity of somatic complaints. We recommend that researchers who use self-report instruments do not use the term "somatisation" (even if the instrument is labeled as a "somatisation" scale), but use the term "multiple physical symptoms" instead. The current operational use may unduly lead to a "psychologisation" of physical complaints.

https://insights.ovid.com/article/00006396-200909000-00011

 

[ME/CFS Skeptic]

Interesting quotes:

We recommend that researchers who use self-report instruments do not use the term ‘‘somatisation” (even if the instrument is labeled as a ‘‘somatisation” scale), but use the term ‘‘multiple physical symptoms” instead. The current operational use may unduly lead to a ‘‘psychologisation” of physical complaints.

only four studies (3.4%) explicitly investigated whether the assessed ‘‘somatisation” symptoms are unaccounted for by pathological findings. [...] None of the studies reported of having addressed the last criterion of somatisation, namely whether people attribute the complaint to a physical cause

The reported findings in the reviewed studies therefore cannot rule out other interpretations: (1) a physical cause may underlie (part of) the somatisation score; (2) somatic symptoms that are experienced during psychological distress and that are recognized as such by patients, may be included in the somatisation score

Some have argued that we should abandon the construct of somatisation because it is unnecessarily complicated to assess, is invalid, and because other more parsimonious accounts exist [9]. Indeed, the somatisation concept may easily be disentangled into three components: (1) symptom production, (2) causal attribution processes, and (3) help seeking behavior [23]. We argue that a psychology of physical symptoms might benefit from independent research programs into each of these three components

 

[Peter T]

Good that one team of researchers at least is attempting to apply scientific rigour to the idea of somatising conditions.

One wonders why the advocates of conversion syndromes almost universally eschew such intellectual rigour? It is not as if such analysis requires novel thinking or radical new ideas, it was basic undergraduate psychology forty years ago.

 

[Hoopoe]

One wonders why the advocates of conversion syndromes almost universally eschew such intellectual rigour?

I think there is process of self selection: those who are intellectually rigorous find the concept problematic and so never become advocates.

The question could also be phrased as "Why are there no smart people that believe in dumb ideas?"

 

[Hutan]

The sad thing about that abstract is that the paper was published in 2009 and it seems to have had very little impact on the BPS researchers who have continued to churn out studies with the same problems as were identified here.

Nevertheless, I feel an urge to hug Crombez et al. Perhaps some virtual flowers are safer in these times.

 

[Sean]

The sad thing about that abstract is that the paper was published in 2009 and it seems to have had very little impact on the BPS researchers who have continued to churn out studies with the same problems as were identified here.

True. But they cannot say they have not been warned by their own colleagues.

 

[spinoza577]

unbearable lightness -

a saying I heard from my grandmother comes to my mind: Den een sin brood is den annern sin dood.
Here it´s quite easy to translate into the English language: The one´s bread is the other one´s death.


I think bad researchers really should be thankful that they have such a resilient subject like us.

 

[Subtropical Island]

I’m taking this on here (instead of a new thread) partly because this abstract deserves bumping and partly because it seems on the same general subject (somatisation - what does it mean?).

I found this thread https://www.s4me.info/threads/alter...tom-levels-in-ibs-2021-grinsvall-et-al.24008/

which starts with “Somatization, defined as the presence of multiple somatic symptoms,” and wondered if that was a bit of a vague thing to define (if you have more than one symptom you have somatisation? Or do you just have someone taking a good history in the primary or secondary survey?). So I looked it up on Wikipedia https://en.wikipedia.org/wiki/Somatization

and I got a number of things …mostly more clearly how this is a dangerous and unproven idea but then of course any theory needs to be tested so how does treatment go? So far, not very useful. And when you see what the treatment is that’s not a surprise: “Based on multiple systematic reviews,[13][14] the initial suggested treatment for somatic disorder is regular, scheduled outpatient visits (every 4–8 weeks) that are not based on active symptoms. These visits should focus on establishing a therapeutic alliance, legitimizing the somatic symptoms, and limiting diagnostic tests and referral to specialists.”

They’re saying that the treatment is to meet the person regularly, irrespective of their symptoms, tell them you’re taking them seriously, and prevent them from getting any diagnostic tests nor referral to specialist. Gaslighting as a treatment?

 

[MSEsperanza]

This is from the same Belgian researchers who recently published a critical review of pain catastrophizing measures, discussed here.

Interesting that Christopher Eccleston (Cochrane) is a co-author -- on both papers.

Edited to add:
Thread on Eccleston's book 'Embodied: The psychology of physical sensation' (2015) here.