van Vliet K P, Everaerd W, van Zuuren F J, Lammes F B, Briët M, Kleiverda G, Schutte M
Department of Psychiatry, Leiden University, The Netherlands.
J Psychosom Obstet Gynaecol. 1994 Sep;15(3):171-81. doi: 10.3109/01674829409025643.
Medically unexplained (gynecological) symptoms can be viewed as an indication of the somatization of negative emotions. Most studies regarding psychological correlates of medically unexplained gynecological symptoms have paid attention only to certain personality characteristics of women with these symptoms. In this study the reporting of physical symptoms and the resulting illness behavior is explained in terms of information processing or a perception process, i.e. the process by which people detect and interpret physical sensations as symptoms of illness (symptom perception). Symptom perception is in part determined by environmental characteristics and cognitive and emotional processes, such as variation in daily life, (coping with) emotional threat and the use of cognitive illness schemes. Differences in symptom perception and illness behavior of women with medically unexplained and explained gynecological symptoms, compared to women with medically explained gynecological symptoms and a control group, were established with the help of a questionnaire, containing a number of scales. As expected, women with medically unexplained gynecological symptoms had higher reports of common symptoms and sensations and showed also more other illness behavior than the other two groups. They reported less variation and more threat in daily life than the other two groups. These variables together with the use of illness schemes contributed most to symptom reporting of women with medically unexplained symptoms. It is concluded that defence against threat is probably an important determinant. Suggestions for further research and some practical implications are discussed.
医学上无法解释的（妇科）症状可被视为负面情绪躯体化的一种表现。大多数关于医学上无法解释的妇科症状的心理关联研究仅关注有这些症状的女性的某些人格特征。在本研究中，身体症状的报告及由此产生的疾病行为是根据信息处理或感知过程来解释的，即人们将身体感觉检测并解释为疾病症状的过程（症状感知）。症状感知部分由环境特征以及认知和情感过程决定，如日常生活中的变化、（应对）情感威胁以及认知疾病模式的运用。借助包含多个量表的问卷，确定了患有医学上无法解释的妇科症状的女性与患有医学上可解释的妇科症状的女性及一个对照组相比，在症状感知和疾病行为方面的差异。正如预期的那样，患有医学上无法解释的妇科症状的女性对常见症状和感觉的报告更多，并且比其他两组表现出更多的其他疾病行为。她们报告的日常生活中的变化比其他两组少，威胁比其他两组多。这些变量以及疾病模式的运用对患有医学上无法解释的症状的女性的症状报告贡献最大。得出的结论是，抵御威胁可能是一个重要的决定因素。讨论了进一步研究的建议和一些实际意义。
