To know or not to know? Mentalization as protection from somatic complaints

PLoS One. 2019 May 2;14(5):e0215308. doi: 10.1371/journal.pone.0215308. eCollection 2019.

Abstract

Somatization processes are usually associated with a lack of insight or with emotional unawareness, especially in adolescents where the ability for self-reflection is beginning to mature. However, the extent to which different levels of insight explain variations in somatization remains understudied. This study aimed to evaluate whether high-level emotional awareness (comprehension) but not low-level awareness (only attention) is needed to psychologically cope with suffering, thus leading to lower somatization. Specific predictions were: 1) High attention along with High comprehension will be associated with significantly lower frequency of somatic complaints than other combinations (Low attention and Low comprehension, or High attention but Low comprehension); 2) In absence of comprehension, no attention will be more optimal than attention only, because only-attention might work as an amplificatory of suffering without the possibility of processing it. Self-reports of meta-cognitive processes, somatization, and control variables were obtained from 264 adolescents from a non-clinical population (54.5% female; aged 12-18, M = 14.7, SD = 1.7). In line with expectations, results revealed significant differences in the effects of insight positions on somatization: Attention+Comprehension (M = 4.9, SE = 0.9) < Nothing (M = 7.1, SE = 0.3) < Only attention (M = 8.9, SE = 0.7). Compared to Nothing, Attention+comprehension was associated with significantly reduced somatic complaints (B = -2.2, p = 0.03, 95% CI -4,1 to 0.2). However, Only attention was associated with increased somatic complaints compared to the other two conditions (B = 1.8, p = 0.03, 95% CI 0.2 to 3.4; B = 4, CI 95% 1.6-6.3, p = 0.001, respectively). This highlights the role of higher-order awareness (i.e., comprehension or clarity) in the processing of suffering and stresses its value in the adaptive coping of emotional distress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Attention
  • Awareness*
  • Child
  • Comprehension
  • Female
  • Humans
  • Male
  • Mentalization*
  • Psychological Distress
  • Surveys and Questionnaires

Grants and funding

NB and SB are supported by the Catalan Government (AGAUR; Agència de Gestió d’Ajuts Universitaris i de Recerca; grant number 2014SGR1070) (http://agaur.gencat.cat/ca/beques-i-ajuts/convocatories-per-temes/Ajuts-per-donar-suport-a-les-activitats-dels-grups-de-recerca-SGR), by the Spanish National R&D&I Plan (PSI2014-54009-R) (http://www.ciencia.gob.es/portal/site/MICINN/menuitem.7eeac5cd345b4f34f09dfd1001432ea0/?vgnextoid=83b192b9036c2210VgnVCM1000001d04140aRCRD&lang_choosen=gl), and belong to the Red de Excelencia Investigación en Procesos, Mecanismos y Tratamientos Psicológicos para la Promoción de la Salud Mental (PROMOSAM; PSI2014-56303-REDT) (http://www.ciencia.gob.es/portal/site/MICINN/menuitem.7eeac5cd345b4f34f09dfd1001432ea0/?vgnextoid=83b192b9036c2210VgnVCM1000001d04140aRCRD&lang_choosen=gl) funded by the Spanish Ministry of Economy and Competitiveness. Neus Barrantes-Vidal is supported by the ICREA Academia Research Award (Institució Catalana de Recerca i Estudis Avançats) (https://www.icrea.cat/en/icrea-academia-awardees) from the Catalan Government. JV is supported by the grant PSI2014-52962-P, Spanish Ministry of Economy and Competitiveness (http://www.ciencia.gob.es/portal/site/MICINN/menuitem.7eeac5cd345b4f34f09dfd1001432ea0/?vgnextoid=83b192b9036c2210VgnVCM1000001d04140aRCRD&lang_choosen=gl). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.