Reference
Guide | Reference

43  Somatic Distress and Interoception

43.1 Summary

  • A dimensional construct describing heightened bodily symptom distress and sensitivity to internal cues.

43.2 Core Construct

  • Amplified attention to bodily sensations with distress or uncertainty about their meaning.

43.3 Subdimensions

  • Pain or fatigue burden.
  • Interoceptive sensitivity and scanning.
  • Health-related worry or uncertainty.

43.4 Severity Anchors (0-4)

  • 0: No clinically meaningful somatic distress.
  • 1: Mild, intermittent, manageable.
  • 2: Moderate, persistent, impacts function.
  • 3: Severe, frequent, with high distress or impairment.
  • 4: Extreme, disabling or unsafe.

43.5 Time-Course Patterns

  • Chronic persistence with flares.
  • Trigger-linked or stress-linked spikes.

43.6 Functional Impact

  • Work/school: reduced stamina or attendance.
  • Relationships: reassurance seeking or withdrawal.
  • Self-care: healthcare overuse or avoidance.

43.7 Developmental Expression

  • Childhood: somatic complaints, school avoidance.
  • Adolescence: fatigue or pain prominence.
  • Late life: symptom focus with medical overlap.

43.8 Cultural / Context Notes

  • Somatic framing may be culturally normative.
  • Medical access shapes symptom meaning.

43.9 Differential and Rule-Outs

  • Medical conditions with clear etiology.
  • Trauma-related hyperarousal.
  • Anxiety-driven bodily alarm.
  • Medication effects or withdrawal.

43.10 Measurement Prompts

  • Brief somatic symptom measure.
  • Pain/fatigue tracking.

43.11 Treatment-Relevant Correlates (non-prescriptive)

  • High interoceptive focus often predicts reassurance seeking.

43.13 Documentation Snippet (1-2 lines)

  • “Somatic distress elevated with persistent pain and fatigue; Somatic 3; chronic course.”