A Metacognitive Perspective on Somatic Symptom Reporting

  • Philip Milner

Student thesis: Doctor of Clinical Psychology


ABSTRACT OF THESISA metacognitive perspective on somatic symptom reporting.Philip Benedict MilnerDoctor of Clinical Psychology, The University of ManchesterJune 2012 The first part of this thesis explores the potential role of metacognitive beliefs and strategies in functional somatic symptoms. Current models (for example, Brown, 2004; Deary, Chalder and Sharpe, 2007) and treatments of functional somatic symptoms focus on cognitive models and cognitive behavioural treatments which show modest treatment effects. A metacognitive account is discussed based upon supervisory regulatory executive function theory (SREF; Wells and Matthews, 1994) and research is systematically reviewed which may support such an account. Current research offers limited indirect support for metacognitive factors playing a role in the difficulties of people suffering from functional somatic symptoms. This paper concludes that further research is needed in this promising area. The second part of the thesis describes a cross-sectional correlational study which examines the relationship of somatic symptom reporting in primary care with metacognitive beliefs, finding a significant association for the first time. Fifty patients were recruited from general practice surgeries took part in the study. Support for the novel Metacognitive Health Questionnaire measure was also found. This measure showed significant associations between health specific metacognitive beliefs and body focussed attention, health preoccupation and distress. This measure also showed significant associations with illness behaviours and thought control strategies. Each of these findings is in line with SREF theory. This study provides preliminary support for the role of metacognition in symptom reporting. The third part of the thesis critically evaluated issues salient to the study including methodologically, supervisory, ethical and clinical issues. The interpretations of the literature review and findings of the research paper are limited by the lack of direct findings to support a metacognitive account, and the cross sectional nature of this study. It is hoped that the prospective study which the research study reported forms part, will offer more robust insights into the role of metacognition in symptom reporting, and that future studies will examine this area further.
Date of Award31 Dec 2012
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorRichard Brown (Supervisor)


  • Metacognitive Therapy
  • Metacognitive Beliefs
  • Functional Somatic Syndromes
  • Somatic Symptom Reporting
  • Worry
  • Rumination
  • Threat Monitoring

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