Causal attributions about common somatic sensations among frequent general practice attenders

Psychol Med. 1996 May;26(3):641-6. doi: 10.1017/s0033291700035716.


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.

MeSH terms

  • Adult
  • Aged
  • Arousal
  • Defense Mechanisms
  • Family Practice
  • Female
  • Health Services Misuse
  • Humans
  • Internal-External Control*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Personality Assessment
  • Sick Role*
  • Social Environment
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / psychology*