Perceived Health and Somatic Complaints in Somatic Symptom Disorder: The Mediating Role of Health Anxiety and Psychological Attribution

Impaired Perceived Health (PH) is frequently encountered in Somatic Symptom Disorder (SSD). Health Anxiety (HA) and Psychological Attribution (PA) of symptoms are influential factors in the conversion of poor PH into Somatic Complaints (SC). This study explores the mediating roles of HA and PA in the relationship between PH and SC in SSD while controlling for family history of chronic disease and various demographic factors such as gender, age, education level, income level, and marital status. To better reflect the current DSM-5 SSD diagnosis, participants were recruited from seven different clinics across five health institutions in three major provinces of Turkey (Istanbul, Ankara, and Mersin), rather than only from psychiatric clinics. The cross-sectional study included a total of 314 SSD outpatients: 212 women (67.5%) and 102 men (32.5%), with ages ranging from 18 to 84 years (<i>M</i> = 39; <i>SD</i> = 14). The Whiteley Index and Symptom Interpretation Questionnaire, along with a semi-structured form questioning PH, SC, and demographics, were administered to all participants under the supervision of clinicians. Additionally, the Clinician Assessment Form was used as evidence of whether the patients had SSD or not. To check the indirect effect of PH on SC through HA and PA, mediation model 4 (parallel mediation) of the SPSS PROCESS macro was used. There was a significant total indirect effect of PH through HA and PA, <i>b</i> = -.12% CI [-.09,-.18], from which an indirect effect of PH on SC through HA was <i>b</i> = -.08, CI [-.05,-.12], and through PA it equaled <i>b</i> = -.04, CI [-.02,-.07]. The indirect to total effect ratio was .49.