Differentiation in the Momentary Rating of Somatic Symptoms Covaries With Trait Emotional Awareness in Patients at Risk for Sudden Cardiac Death

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Somatic symptom ratings covary with neuroticism. Yet, people vary from one another in their ability to report their own emotions and differentiate them from bodily sensations. We hypothesized that stressed individuals with greater emotional awareness would experience somatic symptoms in a more differentiated way independent of neuroticism.


Over 3 days, ecological momentary assessments were completed in 161 patients (72.6% female; mean age, 35 years) with Long QT Syndrome, a genetic disorder associated with increased risk for sudden cardiac death. Patients were paged randomly ten times per day to report their momentary experience of nine somatic symptoms (e.g., headache, sore throat, tiredness) as well as other variables. We examined the intercorrelation between somatic symptom ratings, reasoning that greater intercorrelation among ratings indicated less differentiation. Subjects completed measures of neuroticism, depression, and the Levels of Emotional Awareness Scale, a trait measure of the tendency to experience emotions in a complex and differentiated way.


Higher Levels of Emotional Awareness Scale-Self scores were associated with greater differentiation in the momentary rating of somatic symptoms (p < .001) in men and women independently. This association did not change after removing variance due to neuroticism, depression, or symptom intensity.


Among individuals stressed by having a life-threatening condition, those who are more emotionally aware report somatic symptoms in a more differentiated way. These findings regarding symptoms largely unrelated to the disorder are consistent with other evidence that medically unexplained physical symptoms, which tend to be nonspecific, may be accompanied by relatively undifferentiated negative affect.

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