Introduction

Experiencing physical symptoms is very common. General population surveys show most people experience some form of symptom like headaches, aching joints and muscles or upper respiratory complaints two to three times a week (Dunnell & Cartwright, 1972; Hannay, 1978; Kroenke & Spitzer, 1998). Studies also show that rates of symptom reporting differ across various demographic groups. For instance, females generally report more symptoms than males, unemployed people more than employed, people living alone more than people living with a few others (Pennebaker & Epstein, 1983). These findings suggest that there is more to the reporting of symptoms than just underlying changes in physiology.

Understanding the factors that influence the perception of symptoms is important because symptom reporting forms such a central part of most medical encounters and diagnosis. The (mis)perception of symptoms typically forms the basis of delay in seeking treatment, the overuse of medical services and the inappropriate use of medication. Symptom perception is also important in determining responses in chronic illnesses. People with diabetes or asthma, for example, must regularly manage their illness by monitoring their symptoms and responding with self-medication and behavioural responses. This chapter explores the psychological processes involved in the perception and reporting of physical symptoms.

How accurately do people perceive symptoms?

People are generally accurate when perceiving extreme symptoms or bodily states that need attention immediately. For example, individuals can almost always tell when they need sleep, need to eat or to urinate.