Symptom Perception, Awareness and Interpretation

Abstract

Self-reported health complaints result from a complex integration of interoceptive (bottom-up) information emerging from peripheral physiological activity with (top-down) perceptual-cognitive and affective processes. Interoceptive signals have to be sensed, perceived, attended to, appreciated and interpreted, put into language and expressed, mostly in a social context. In this article, we will discuss the role of perceptual and attentional processes, anticipation, symptom schemata and illness beliefs, emotion and personality, and memory processes. Their role may importantly influence the relationship between indicators of peripheral physiological activity and self-reported health complaints. Interoception and Symptom PerceptionAlthough all self-reported health complaints are the result of processes in the brain, a general assumption is that they accurately reflect dysfunctional processes in the peripheral body. The afferent or sensory processes transmitting information from the body to the brain can be called interoception. However, although interoception and symptom perception are related processes, they are not the same.

Idiopathic Environmental Intolerance: A Comprehensive Model

“…These behavioral characteristics result from an overreactive evaluative system and poor inhibitory capacity (Costa & McCrae, 1987; Hariri, 2009). NA is a risk factor for developing MUS in general (Van den Bergh, Bogaerts, & Van Diest, 2015), and high NA persons with MUS show a poor correspondence between experimentally induced somatic episodes and self-reported symptoms (Bogaerts et al, 2005; Bogaerts, Janssens, De Peuter, Van Diest, & Van den Bergh, 2010; Van den Bergh et al, 2004). Several brain imaging studies in groups with MUS show greater activation of affective networks when processing somatic information, coupled with a failure to counterregulate unpleasantness (Kwan et al, 2005; Van Oudenhove & Aziz, 2013).…”

Perception of induced dyspnea in fibromyalgia and chronic fatigue syndrome

“…It has been proposed that FSS are at least partly a disorder of symptom perception (2,3). Symptom perception is influenced by (bottom-up) somatic sensations and (top-down) attentional, affective and memory processes (4). Because the relative contribution of these processes to the actual symptoms varies between and within persons, so does the correspondence between afferent input and reported symptoms.…”

Inducing Somatic Symptoms in Functional Syndrome Patients: Effects of Manipulating State Negative Affect

“…Depending on their relative precision (statistical confidence), the eventual percept may be more determined by priors or by prediction errors related to somatosensory input (7). Contextual cues (such as affective state), characteristics of the person (such as personality traits or past experiences) and their interactions may influence the relative contribution of priors and prediction errors in the symptom experience (8,9), see Figure 1. Consequently, the relationship between physiological dysfunction and the conscious experience of symptoms may vary between and within persons.…”