A sensitive body or a sensitive mind? Associations among somatic sensitization, cognitive sensitization, health worry, and subjective health complaints Bart Verkuil a, ⁎ , Jos F. Brosschot a , Julian F. Thayer b a Clinical, Health, and Neuropsychology Unit, Institute for Psychological Research, Leiden University, Leiden, The Netherlands b Department of Psychology, The Ohio State University, Columbus, OH, USA Received 21 March 2007; received in revised form 2 July 2007; accepted 9 August 2007 Abstract Objectives: Psychobiological sensitization and health worry appear to be involved in the etiology of clinical manifestations of subjective health complaints (SHCs) via amplified processing of health-related information. However, it is not clear whether sensitization and health worry are also associated with common SHCs, which are extremely prevalent and are responsible for a large part of both human suffering and health care costs. In this study, we investigated whether SHCs are associated with health worry and two types of sensitization: cognitive health-related sensitization and somatic sensitization. We also examined whether health worry mediates the relationship between cognitive sensitiza- tion and SHCs and whether both levels of sensitization interact. Methods: A nonclinical sample of 47 female students completed questionnaires about their recent subjective health as well as health worry and underwent tests for cognitive sensitization, operationa- lized as Stroop interference and free recall performance, and somatic sensitization, operationalized as pain tolerance and pain threshold in a cold pressor task. Results: Severity of health complaints was positively related with recall of health-related stimuli, but not with Stroop interference, and with worrying about health complaints. In addition, worry mediated the relationship between recall bias and severity of health complaints. Both the number and severity of recent health complaints were associated with pain tolerance. Pain threshold was associated with Stroop interference for health-related information. Conclusions: The results suggest that specific types of cognitive sensitization and somatic sensitization are associated with common health com- plaints and that worrying about one's complaints might play a role by enhancing biased memory of health-related information. © 2007 Elsevier Inc. All rights reserved. Keywords: Cognitive bias; Health worry; Sensitization; Pain tolerance; Subjective health complaints Introduction Subjective health complaints (SHCs) are extremely common and are responsible for a large part of both human suffering and health care costs [1–3]. Moreover, SHCs and self-rated health (SRH) significantly predict mortality over and above objective measurements of health [4,5]. Most SHCs concern difficult-to-diagnose vague symptoms, such as low back pain, headache, and fatigue, and they are responsible for the majority of visits to general and other medical practitioners [6]. Typically, physicians can only find an organic basis for 10–20% of the most common symptoms, while only a small number of symptoms receive a psychiatric diagnosis (e.g., somatoform disorder) [7]. Clearly, it is essential to elucidate the processes underlying the reporting of health complaints. Research concerned with clinical manifestations of SHCs—somatoform or functional syndromes—suggested that these syndromes are characterized by sensitization, operating at somatic, cognitive, and even behavioral as well Journal of Psychosomatic Research 63 (2007) 673 – 681 ⁎ Corresponding author. Clinical, Health, and Neuropsychology Unit, Institute for Psychological Research, Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands. E-mail address: bverkuil@fsw.leidenuniv.nl (B. Verkuil). 0022-3999/07/$ – see front matter © 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.jpsychores.2007.08.010