Linking Reflective Functioning to Somatic Symptoms in Daily Life: A Smartphone-Based Digital Health Study

Somatic symptoms, such as bodily pain, fatigue, or signs of bodily dissociation, are frequent in the general population, impair mental wellbeing, and form early signs of developing mental disorders, such as depression. Managing somatic symptoms effectively in daily life is a crucial step towards establishing early intervention strategies that prevent the occurrence of mental disorders. Yet, somatic symptoms that occur in daily life have received little scientific attention so far. Here, we ask if mentalizing abilities, specifically the ability to reflect on ones own or others emotion, cognitive, or bodily states, explain somatic symptom burden in daily life. Reflective functioning was assessed in N = 96 healthy individuals via a standardized questionnaire, RFQ-8, in addition to a novel questionnaire focusing on the ability to understand ones own and others bodily reactions, BRFQ-9. Subsequently, over the period of 8 weeks, somatic symptoms were sampled in daily life via a novel Mobile Application that combines standardized questionnaire items of the FFSS, SCL-90, SDQ and SSD-12 with an interactive 3D avatar. 91.7% of participants reported somatic symptoms in the assessment period, and BRFQ scores show a significant negative relationship to overall somatic symptom burden. Such a relationship could not be evidenced for RFQ scores. Body reflective functioning abilities are also a significantly stronger predictor of somatic symptoms and explain more variance than standard reflective functioning abilities. This study introduces a new mobile Application that monitors somatic symptoms in daily life and suggests that body reflective functioning is a novel target for prevention and early intervention techniques with the aim to reduce the negative influence of aberrant bodily feelings on daily life.