The perception of emotions in individuals with medically unexplained somatic symptoms

The current study aims to examine emotion recognition and the perception of
crying in individuals with Medically Unexplained Somatic Symptoms (MUSS).

Individuals with MUSS lack the ability to mentalize about their feelings, which
might be explained by negative childhood experiences and insecure attachment
relationships. However, it is unknown whether MUSS patients also show deficits
in understanding the emotions of others. The current study aims to examine the
relation between MUSS and emotion recognition and the moderating role of
attachment and childhood experiences.

In addition, it aims to examine the perception of crying and crying behaviour
in individuals with MUSS. Tearful crying has been suggested to promote social
bonding, prosocial helpful behaviour, elicit empathy and reduce tension and
negative mood in the crier (Vingerhoets & Bylsma, 2016). Consequently,
disturbances in crying behaviour and the perception of crying may reflect
emotional problems in individuals with psychopathology. Although, studies
examining the functions of crying may clarify emotional dysfunctioning in
individuals with psychopathology, little research on the role of crying in
clinical disorders has been conducted until now. In the current study, we aim
to examine the perception of crying and crying behaviour in individuals with
MUSS and the role of childhood experiences and attachment in this relation.

1) to examine emotion recognition in MUSS patients 2) To examine whether MUSS
patients show differences in crying behaviour and the perception of crying

Patients with chronic MUSS and control participants will be asked to
participate in a study examining emotion recognition and the perception of
tears. Participants will be asked to fill in questionnaires about childhood
experiences and attachment. They will be asked to perform an emotion
recognition task and evaluate pictures of adults and infants with tears on
their faces and pictures with tears digitally removed. Qualtrics will be used
to administer the questionnaires.

Participation in this study is without risks, total time for participation is 1
hour (2 sessions of 1/2 hour). There are no benefits for patients or control
when they participate in the current study. Participants will not receive money
or other rewards. There is no physical burden associated with participation.
Emotional burden consists of filling in questionnaire about negative childhood
experiences. Participants will be made clear that they can withdraw from
participation at any time they want. They will be given contact information of
a psychologist and an (independent) psychiatrist in case they experience
negative emotions after filling in the questionnaires.

There are no risk associated with participation. However, this study will
increase insight into symptoms of individuals with MUSS.
Patients in search of treatment for physical complaints without a clearly
defined somatic constitute a problem in primary care and comprise 15% to 30% of
all primary care consultations (Escobar, Waitzkin, Silver, Gara, & Holman,
1998; Selders et al., 2015). In addition, MUSS is a major problem for patients
because of the high level of experienced distress. Studies examining the
functions of crying may clarify emotional dysfunctioning in individuals with
MUSS, may provide more insight into the mechanism underlying their symptoms.
This knowledge is needed for the development of new therapies, such as the
mentalization-based Dynamic Interpersonal Therapy (DIT) (Selders et al., 2015).