Universität zu Köln

Wolters, Carolin ORCID: 0000-0002-6252-477X (2023). “I don’t want to miss a symptom” – The role of biased interoception in somatic symptoms and illness anxiety. PhD thesis, Universität zu Köln.

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Abstract

Somatic symptom disorder and illness anxiety disorder both involve preoccupation with signals from the body. According to predictive coding theory, the perception of somatic signals is guided by predictions from the brain. Pathological forms of somatic symptoms have been linked to a “better safe than sorry” decision strategy. This strategy is intended to avoid missing important signals at the cost of overreporting these signals. Predictions may thus lead to the assumption that a somatic signal is present, even when sensory evidence is sparse or missing altogether. In interoceptive tasks, the individual tendency to overreport signals (liberal response bias) can be distinguished from accuracy. In a systematic review and meta-analysis, results from 68 studies showed that interoceptive accuracy was reduced in functional syndromes, but not in somatic symptoms and illness anxiety. At the same time, a more liberal response bias was consistently associated with somatic symptoms and illness anxiety in the eight included studies. In a study with healthy participants, it was attempted to manipulate predictions to test whether tactile sensations are overreported under these circumstances. To this end, sham Wi-Fi exposure was used, given that many individuals belief that Wi-Fi exposure is able to induce physical symptoms. Indeed, participants tended to overreport sensations in the sham Wi-Fi as compared to a no-Wi-Fi condition, providing evidence for a predictive coding account of symptom perception. In a second study, individuals with pathological illness anxiety and healthy controls conducted a tactile detection task. It was expected that participants with pathological illness anxiety would show a more liberal response bias, and that this liberalization would be stronger in trials including illness words. Unexpectedly, response bias did not differ between groups in any of the conditions. Implications of the findings for clinical practice and future research are discussed.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Wolters, Carolin carolin.wolters@posteo.de orcid.org/0000-0002-6252-477X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-711136
Date:	25 September 2023
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Psychologie
Subjects:	Psychology
Uncontrolled Keywords:	Keywords Language Interoception English Predictive Coding English Illness anxiety English Somatic symptoms English
Date of oral exam:	6 September 2023
Referee:	Name Academic Title Gerlach, Alexander L. Prof. Ehrenthal, Johannes C. Jun.-Prof. Witthöft, Michael Prof.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/71113