Behavioural and Cognitive Psychotherapy, 2003, 31, 13–31 Printed in the United Kingdom DOI: 10.1017/S1352465803001036 COGNITION AND THE BODY: SOMATIC ATTRIBUTIONS IN IRRITABLE BOWEL SYNDROME Maryanne Martin and Catherine Crane University of Oxford, UK Abstract. How do somatic causal attributions for symptoms relate to treatment seeking behaviour in Irritable Bowel Syndrome (IBS)? How might a tendency to make somatic attributions influence an individual’s cognitive representation of their illness once a dia- gnosis of IBS is established? In Study 1 attributions about symptoms were investigated in treatment-seekers and non treatment-seekers with IBS. Treatment-seekers had an increased tendency to make somatic attributions for both gastrointestinal symptoms and physiological symptoms characteristic of anxiety and depression, although they did not differ from non treatment-seekers in the severity of these symptoms or in their reports of psychological distress. Treatment-seekers also perceived themselves to be significantly less resistant to illness and to be significantly more likely to have poor health in the future than non treat- ment-seekers. In Study 2, 20 treatment seekers with chronic symptoms of IBS completed measures of mood and of the degree to which they viewed a range of symptoms as a part of their IBS. Physiological symptoms of anxiety and depression were seen as a part of IBS by a considerable proportion of the sample. Higher levels of depression were associated with an increased tendency to see physiological symptoms of anxiety and depression and even symptoms of colds as ‘‘a part of’’ IBS. It is concluded that a somatic attributional style may contribute both to initial treatment seeking for symptoms of IBS and the sub- sequent maintenance and exacerbation of the disorder once a diagnosis is established. Keywords: IBS, attributions, symptoms, cognition, illness representation, depression, (mis)interpretation. Introduction IrritableBowelSyndrome(IBS)isthemostcommonfunctionalboweldisorderandaccounts for between 20% and 50% of all referrals to gastroenterologists in the UK (Farthing, 1995). The symptoms of IBS (abdominal pain associated with changes in stool form or frequency) are benign and biological markers for the disorder have not been identified. Whilst up to 20%ofthegeneralpopulationinwesterncountriesreportsymptomsofIBSwhenquestioned only a proportion of these individuals, approximately one third, seek medical help (Jones & Lydeard, 1992). Further, although the majority of individuals who seek treatment for IBS respond to established medical treatments, some individuals remain distressed and disabled by their bowel symptoms (Corney & Stanton, 1990). Those individuals who are referred to Reprint requests to Maryanne Martin, Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK. E-mail: catherine.crane@psy.ox.ac.uk  2003 British Association for Behavioural and Cognitive Psychotherapies