Attentional bias and physical symptom reporting

• Main Author: Scott, Sarah
• Other Authors: Poliakoff, Ellen; Brown, Richard
• Published: University of Manchester 2015
• Subjects: 616.89
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.668572

Attentional bias to health-threat information in the sphere of medically unexplained symptoms (MUS) is the focus of this thesis. Confusion and debate regarding the classification of MUS exists, and medical and psychiatric classifications of MUS have resulted in separate literatures in the two areas. In addition to “medical” and “psychiatric” diagnoses, there are habitual symptom reporters who are frequently seen in the general population. Contemporary psychological theories of MUS postulate attentional bias towards health-threat information as central in their development and maintenance, although a causal relationship has yet to be established. Paper 1 provides an overview of the experimental paradigms used to examine attentional bias to health-threat information in “medical” MUS (functional somatic syndromes). This is provided within the theoretical context of attention. Eighteen studies satisfied inclusion criteria, and it was concluded that the evidence for an attentional bias in individuals with functional somatic syndromes is equivocal. The strengths and limitations of the individual studies are provided, together with recommendations for future research. The review has been prepared for submission to ‘Clinical Psychology Review’.Paper 2 employed an attentional bias modification (ABM) paradigm to explore whether it is possible to generate an attentional bias towards health-threat information in a low symptom reporting population. Fifty-six non-clinical low symptom reports were randomly assigned to a ‘training’ or ‘no training’ version of the ABM paradigm. ABM increased the degree to which low symptom reporters were distracted by threat but this did not lead to increased physical symptoms or anxiety. The empirical paper has been prepared for submission to the ‘Journal of Abnormal Psychology’.Paper 3 is a critical appraisal of the previous papers. Methodological considerations are discussed, together with theoretical and clinical implications.