To feel or not to feel: How social interactions shape symptom proneness


Early experiences related to the body and illness influence how we cope with symptoms throughout our lives. Recent insights suggest that early experiences might also directly influence what we do and do not feel. This is due to predictive processing, a strategy in which the brain uses previous experiences to process new sensory input.

We recently published how predictive processing can explain medically unexplained symptoms (MUS): somatic symptoms that cannot be attributed to a clear organic cause. MUS arise if previous experiences with symptoms have caused strong symptom expectations. Knowledge about how such expectations develop in the life course is highly needed.

I introduce the concept of a symptomatogenic family environment. I hypothesize that a symptomatogenic family environment is characterized by social interactions that strengthen implicit symptom expectations, that such interactions are rooted in parents' own childhood experiences, and that they predict proneness to somatic symptoms in general and MUS in particular throughout the life course.

I will enrich two large longitudinal three-generation-cohorts with observational, experimental and qualitative data on family interactions in response to somatic symptoms. These allow me to study parental cognitions, emotions and behavior in response to infants’ symptoms, their transgenerational roots, and their consequences for symptom proneness throughout the life course.

Insight into how symptom expectations are shaped in early life will open new avenues for prevention and treatment of symptom proneness. This will reduce individual suffering and societal costs related to MUS, which is the second most expensive health problem in the Netherlands, and to somatic symptoms caused by chronic diseases.





Prof. dr. J.G.M. Rosmalen

Verbonden aan

Universitair Medisch Centrum Groningen, Psychiatrie


01/05/2020 tot 01/05/2025