Symptoms and the body: Taking the inferential leap

•The experience of physical symptoms is related to physiological dysfunction in a highly variable way.•Using a predictive coding framework we propose a new model of the body-symptom relationship.•We describe critical conditions influencing the body-symptom correspondence.•Theoretical and clinical im...

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Veröffentlicht in:Neuroscience and biobehavioral reviews Jg. 74; H. Pt A; S. 185 - 203
Hauptverfasser: Van den Bergh, Omer, Witthöft, Michael, Petersen, Sibylle, Brown, Richard J.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Ltd 01.03.2017
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ISSN:0149-7634, 1873-7528
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Abstract •The experience of physical symptoms is related to physiological dysfunction in a highly variable way.•Using a predictive coding framework we propose a new model of the body-symptom relationship.•We describe critical conditions influencing the body-symptom correspondence.•Theoretical and clinical implications of this new account are explored. The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of “medically unexplained” or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates existing concepts within a unifying framework that addresses many of the shortcomings of current theory. We describe the conditions under which a close correspondence between the experience of symptoms and objective physiology might be expected, and when they are likely to diverge. We conclude by exploring some theoretical and clinical implications of this new account.
AbstractList The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of "medically unexplained" or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates existing concepts within a unifying framework that addresses many of the shortcomings of current theory. We describe the conditions under which a close correspondence between the experience of symptoms and objective physiology might be expected, and when they are likely to diverge. We conclude by exploring some theoretical and clinical implications of this new account.
•The experience of physical symptoms is related to physiological dysfunction in a highly variable way.•Using a predictive coding framework we propose a new model of the body-symptom relationship.•We describe critical conditions influencing the body-symptom correspondence.•Theoretical and clinical implications of this new account are explored. The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of “medically unexplained” or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates existing concepts within a unifying framework that addresses many of the shortcomings of current theory. We describe the conditions under which a close correspondence between the experience of symptoms and objective physiology might be expected, and when they are likely to diverge. We conclude by exploring some theoretical and clinical implications of this new account.
Author Brown, Richard J.
Petersen, Sibylle
Van den Bergh, Omer
Witthöft, Michael
Author_xml – sequence: 1
  givenname: Omer
  surname: Van den Bergh
  fullname: Van den Bergh, Omer
  email: omer.vandenbergh@kuleuven.be
  organization: Health Psychology, University of Leuven, Tiensestraat 102, Belgium
– sequence: 2
  givenname: Michael
  surname: Witthöft
  fullname: Witthöft, Michael
  organization: Clinical Psychology, Psychotherapy, and Experimental Psychopathology, University of Mainz, Germany
– sequence: 3
  givenname: Sibylle
  surname: Petersen
  fullname: Petersen, Sibylle
  organization: Health Psychology, University of Leuven, Tiensestraat 102, Belgium
– sequence: 4
  givenname: Richard J.
  surname: Brown
  fullname: Brown, Richard J.
  organization: Centre for New Treatments and Understanding in Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28108416$$D View this record in MEDLINE/PubMed
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Snippet •The experience of physical symptoms is related to physiological dysfunction in a highly variable way.•Using a predictive coding framework we propose a new...
The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on...
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SubjectTerms Consciousness
Humans
Medically unexplained symptoms
Predictive coding
Symptom perception
Title Symptoms and the body: Taking the inferential leap
URI https://dx.doi.org/10.1016/j.neubiorev.2017.01.015
https://www.ncbi.nlm.nih.gov/pubmed/28108416
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