International Journal of Behavioral Medicine

, Volume 21, Issue 5, pp 861–868 | Cite as

Modifying the Implicit Illness-Related Self-Concept in Patients with Somatoform Disorders May Reduce Somatic Symptoms

  • Kathrin RiebelEmail author
  • Boris Egloff
  • Michael Witthöft



According to dual process theories, not only do explicit but also implicit cognitive processes play a major role in the development and maintenance of somatoform disorders (SFDs). Recent evidence [1] suggests that patients with SFDs have a stronger implicit illness-related self-concept, which is related to the experience of medically unexplained symptoms.


The current study was designed to investigate a possible causal link between biased implicit associations and symptoms in SFD patients by experimentally modifying the implicit illness-related self-concept.


Twenty-nine patients with SFDs (according to the DSM-IV) initially completed an Implicit Association Test (IAT) for assessing the implicit illness-related self-concept. Two weeks later, they underwent an evaluative conditioning task to modify the implicit self-concept.


After this procedure, a change toward a healthier implicit self-concept was apparent in the follow-up IAT. A reduction in symptom severity and changes in health- and body-related cognitions were observed 13 days after the training in the follow-up questionnaires.


The findings suggest that a biased implicit self-concept may be causally relevant for symptom experiences in patients with SFDs. Existing cognitive behavioral treatments for SFDs might benefit from targeting implicit cognitive processes more directly.


Somatoform disorders Cognitive bias modification Implicit self-concept Evaluative conditioning Implicit Association Test 



This study was supported by a scholarship awarded to Kathrin Riebel by the Johannes Gutenberg-University Mainz.


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Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Kathrin Riebel
    • 1
    Email author
  • Boris Egloff
    • 1
  • Michael Witthöft
    • 1
  1. 1.Department of PsychologyJohannes Gutenberg-University MainzMainzGermany

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