| Summary: | Objectives: Medically Unexplained Symptoms are a heterogeneous group of conditions that cannot be accounted for by medical illness or injury. A fl:umber of variables have been deemed to be key factors in the development and maintenance of MUS. The first purpose of this study was to investigate three variables implicated in the development of MUS models in this area: childhood trauma, dissociation, and body-focused attention. The second aim of study was to evaluate the theoretical underpinnings of two models that have attempted to explain the observed link between childhood trauma and MUS. These models were Janet's dissociation model, which proposed that dissociation mechanisms explain the link between childhood trauma and MUS, and Brown's integrative conceptual model, which proposed that body-focused attention explains link. .Method: Participants who met the criteria for chronic widespread pain formed the I\1US group and participants who were pain free formed a healthy control group. These participants were compared on a measure of childhood trauma Chl1dll0Cld. Trauma Questionnaire [CTQ]; Bernstein & Fink, 1998), a measure of dissociation, (Somatoform Dissociation Questionnaire [SDQ-20] Nijenhuis et aI., 1996), and an experimental task measuring body-focused attention (Bro\-vn et aI.,2007). The experimental task consisted of a series of body-relevant or bodyirrelevant pictures, half of which were threatening and half were neutral, followed by a target stimuli in either the visual or the tactile modality. The participant's task was to judge the location of the target stimuli their performance was used to calculate their tendency to attend away from or toward the body. Results: In line with predictions, elevated levels of childhood trauma and dissociation were found in the MUS group. However, difference between the groups on the dissociation measure disappeared when general tendency to somatize was controlled for, raising doubts about the validity of the SDQ-20 as a measure of dissociative symptomatology. Furthermore, contrary to prediction, the MUS group demonstrated a tendency to direct attention away from (or toward the body, rather than increased body-focused attention. This bias was demonstrated when responding to targets occurring SOOms after the presentation of body pictures. Finally, body-focused attention was not found to mediate the link between childhood trauma and abuse. Conclusions: These findings support the importance of trauma as a predisposing factor for rvrus. The contradictions between the present study's finding of a body-avoidant tendency and the widely-held assumption of increased body-focus in MUS are discussed. It is proposed that a modified version ofBrown's (2004) integrative conceptual model is best placed to account for this finding. These findings have clear clinical implications for intervention in MUS further delineation of this attentional bias in MUS is required. Methodological limitations of the study are also discussed. Supplied by The British Library - 'The world's knowledge'
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