Somatic Symptom Distress, Health Anxiety, Alexithymia, and Emotion Generation: Results of an Evidence Accumulation Model

Objective: High levels of somatic symptom distress and health anxiety have been linked to difficulties in emotion generation, identification, and regulation. However, these findings stem largely from correlational studies using questionnaires. Mechanistic experimental evidence is scarce and inconclusive. Methods: The present study investigated associations between somatic symptom distress (SSS-8), health anxiety (MK-HAI), alexithymia (TAS-20), and experimental indicators of emotion generation in N =78 participants (Age: M =23.12, SD =3.50; Gender: 80.8% female, 19.2% male). An innovative experimental paradigm of emotion generation by Givon et al (2023) was used, which assesses emotional responses to normed negative or positive pictures. It allows the calculation of evidence accumulation parameters, that reflect emotion processing efficiency (drift-rate) and response bias in emotion reporting (threshold), based on a linear ballistic accumulator model. Results: Somatic symptom distress was not associated with emotion processing efficiency (drift-rate) for negative emotions (BF inclusion =0.49). There was anecdotal evidence for an effect of health anxiety (BF inclusion =2.53), but the effect was small and inconclusive ( b =−0.01, SD =0.004, 95% CI −0.01, <0.001), thus failing to support a strong association. Experimental indicators of emotion generation were also unrelated to self-reported alexithymia (0.14 <BF 10 <0.18). Conclusions: The study did not provide evidence that somatic symptom distress or health anxiety are linked to a markedly reduced efficiency in processing of negative emotions. As this was a convenience sample with predominantly non-clinical symptom levels, future studies should test the generalizability of these findings to clinical samples.