Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-06-04T11:26:27.162Z Has data issue: false hasContentIssue false
  • English
  • Français

Causal attributions about common somatic sensations among frequent general practice attenders

Published online by Cambridge University Press:  09 July 2009

T. Sensky ,
A. K. MacLeod  and
M. F. Rigby
T. Sensky*
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School, Department of Psychology, Royal Holloway, University of London
A. K. MacLeod
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School, Department of Psychology, Royal Holloway, University of London
M. F. Rigby
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School, Department of Psychology, Royal Holloway, University of London
*
1Address for correspondence. Dr Tom Sensky, Department of Psychiatry, Charing Cross and Westminster Medical School, West Middlesex Hospital, Isleworth, Middlesex TW7 6AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The causal attributions that people make about bodily symptoms or sensations are likely to influence their decisions whether or not to consult a doctor. Previous research has supported the model that people tend initially to look for external or environmental explanations for bodily sensations (normalizing attributions) and only if this process fails do they search for attributions internal to themselves (somatic or psychological attributions). This study tested two hypotheses about frequent general practice attenders: (1) compared with others, they are more likely to make somatic attributions and less likely to make normalizing ones; and (2) given a bodily symptom together with a somatic explanation, frequent attenders will have greater difficulty than others in finding reasons why the given (pathological) explanation is untrue. The frequent attenders' group had themselves initiated an average of 12 general practice visits in the 12 months before assessment, while a control group of infrequent attenders had not made appointments to see their general practitioner for an average of 24 months. The results provide partial support for the hypotheses. Frequent attenders generated significantly fewer normalizing explanations for a series of common bodily sensations than the comparison group, although the two groups did not differ in their somatic attributions. Given a common bodily sensation and an accompanying pathological explanation, the frequent attenders were less able than the control group to generate reasons why the given explanation might be untrue. Some associations were found between these measures and anxiety.

Type
Brief communication
Information
Psychological Medicine , Volume 26 , Issue 3 , May 1996 , pp. 641 - 646
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Cameron, L., Leventhal, E. & Leventhal, H. (1993). Symptom representations and affect as determinants of care seeking in a community-dwelling, adult sample population. Health Psychology 12, 171–179.CrossRefGoogle Scholar
Collyer, J. (1979). Psychosomatic illness in a solo general practice. Psychosomatics 20, 762–767.CrossRefGoogle Scholar
Connelly, J. E., Smith, G. R., Philbrick, J. T. & Kaiser, D. L. (1991). Healthy patients who perceive poor health and their use of primary care services. Journal of General Internal Medicine 6, 47–51.CrossRefGoogle ScholarPubMed
Ingham, J. G. & Miller, P. M. (1976). The determinants of illness declaration. Journal of Psychosomatic Research 20, 309–316.CrossRefGoogle ScholarPubMed
Katon, W., Von Korff, M., Lin, E., Lipscomb, P., Russo, J., Wagner, E. & Polk, E. (1990). Distressed high utilizers of medical care. DSM-III-R diagnoses and treatment needs. General Hospital Psychiatry 12, 355–362.CrossRefGoogle ScholarPubMed
Kirmayer, L. J. (1989). Cultural variations in the response to psychiatric disorders and emotional distress. Social Science and Medicine 29, 327–339.CrossRefGoogle ScholarPubMed
Lin, E. H., Katon, W., Von Korff, M., Bush, T., Lipscomb, P., Russo, J. & Wagner, E. (1991). Frustrating patients: physician and patient perspectives among distressed high users of medical services. Journal of General Internal Medicine 6, 241–246.CrossRefGoogle ScholarPubMed
MacLeod, A. K., Williams, J. M. G. & Bekerian, D. A. (1991). Worry is reasonable: the role of explanations in pessimism about future personal events. Journal of Abnormal Psychology 100, 478–486.CrossRefGoogle ScholarPubMed
Office of Health Economics (1992). Compendium of Health Statistics. Office of Health Economics: London.Google Scholar
Robbins, J. M. & Kirmayer, L. J. (1986). Illness cognition, symptom reporting and somatization in primary care. In Illness Behaviour: a Multidisciplinary Approach (ed. McHugh, S. and Vallis, T. M.) (pp. 283–302). Plenum: New York.CrossRefGoogle Scholar
Robbins, J. M. & Kirmayer, L. J. (1991). Attributions of common somatic symptoms. Psychological Medicine 21, 1029–1045.CrossRefGoogle ScholarPubMed
Shaver, K. G. (1975). An Introduction to Attribution Processes. Winthrop: Cambridge, Mass.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed