Modifying the Implicit Illness-Related Self-Concept in Patients with Somatoform Disorders May Reduce Somatic Symptoms

Abstract

Background: According to dual process theories, not only do explicit but also implicit cognitive processes play a major role in the development and maintenance of somatoform disorders (SFDs). Recent evidence [1] suggests that patients with SFDs have a stronger implicit illness-related self-concept, which is related to the experience of medically unexplained symptoms. Purpose: The current study was designed to investigate a possible causal link between biased implicit associations and symptoms in SFD patients by experimentally modifying the implicit illness-related self-concept. Methods: Twenty-nine patients with SFDs (according to the DSM-IV) initially completed an Implicit Association Test (IAT) for assessing the implicit illness-related self-concept. Two weeks later, they underwent an evaluative conditioning task to modify the implicit self-concept. Results: After this procedure, a change toward a healthier implicit self-concept was apparent in the follow-up IAT. A reduction in symptom severity and changes in health- and body-related cognitions were observed 13 days after the training in the follow-up questionnaires. Conclusions: The findings suggest that a biased implicit self-concept may be causally relevant for symptom experiences in patients with SFDs. Existing cognitive behavioral treatments for SFDs might benefit from targeting implicit cognitive processes more directly.