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Objective Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers to understand the relationship of increasing physical symptom burden to healthcare utilization. Methods Data was examined from a prospective study of OEF/OIF soldiers assessed before and one year after deployment (n = 336). Physical symptom burden was measured with the Patient Health Questionnaire (PHQ-15). Analyses were conducted with polynomial regression and response surface analysis (RSA). Results Increases in physical symptom burden predicted greater healthcare utilization one year after deployment: primary care practitioner (slope = − 0.26, F = 4.07, p = 0.04), specialist (slope = − 0.43, F = 8.67, p = 0.003), allied health therapy (e.g., physical therapy) (slope = − 0.41, F = 5.71, p = 0.02) and mental health (slope = − 0.32, F = 4.04, p = 0.05). There were no significant difference in utilization between those with consistently high levels and those with increases in physical symptom burden. Conclusion This is the first prospective study to examine, and show, a relationship between onset of clinically significant physical symptoms and greater healthcare utilization. Our data suggest that patients with increasing physical symptom burden have the same level of healthcare as patients with chronic physical symptom burden. Needed next steps are to better understand the quality of care at inception and determine how to intervene so that recommended approaches to care are provided from the onset.

Objective The purpose of this study is to examine the role of emotional reactivity (ER) in symptom reporting and conceptualize somatizing processes as a signal detection task. Emotional reactivity has been theorized to influence symptom reporting through somatic sensitivity as well as via a negative reporting style. We assess the degree to which these two competing theories about the role of ER are accurate within the signal detection framework. Methods We used a multimethod approach that included using both static and prospective self-reports as well as a signal detection task. Results Results suggest that ER exerts its influence on somatization tendencies via a negatively biased reporting style and is not mediated by somatic sensitivity as suggested by the somatosensory amplification and the symptom perception hypothesis. Conclusion Emotional reactivity has yet to be associated with objective measures of somatic sensitivity. Until such an association is found, it is likely that ER influences symptom reports via negatively biased reporting.

Objective: The Somatosensory Amplification Scale (SSAS) purports to measure the extent to which individuals are sensitive to their bodies. The present study examined the psychometric properties of the SSAS in two studies with university students. Methods: Participants completed the SSAS, various cross-sectional measures of somatic and psychological distress, longitudinal measures of somatic symptoms, daily hassles and mood, and participated in a heartbeat detection task (Study 2 only). Results: The SSAS was correlated with cross-sectional measures of somatic symptom reporting, but not with somatic symptoms reported on a daily basis nor with an index of interoceptive sensitivity. The SSAS was also correlated with several indices of general distress including anxious and depressive symptoms, daily hassles, and negative emotionality. Conclusions: Taken together, the results suggest that the SSAS is more likely an index of negative emotionality and general distress than a valid measure of somatic sensitivity per se.