Medically Unexplained Symptoms (MUS): What Do Current Trainee Psychologists, Neurologists and Psychiatrists Believe?

Abstract

Objectives: Medically unexplained symptoms (MUS) are common in all medical settings. These conditions remain controversial, aetiology remains poorly understood and treatments have been slow to develop. This study aimed to examine the beliefs held by psychologists and other professionals about MUS, which may impact upon clinical practice. Design: 375 clinical psychology trainees from 23 UK training courses, 12 neurologists and 19 psychiatrists in training completed a weblink survey designed to elicit a range of beliefs about MUS cause and treatment. Results: All three groups viewed MUS as a common clinical problem. Use of terminology differed between groups. All three groups held a view that sexual abuse was a medium to high risk factor for developing MUS. Only a minority of psychologists and psychiatrists doubted that the human mind is capable of massive repression for past distressing events; and few psychologists, and no psychiatrists, doubted the traditional psychodynamic causal model of MUS. Neurologists were generally more skeptical. Only a minority of all three groups disagreed that hypnosis was a helpful way to uncover memories that people can not access. Around one third of each group believed that traumatic memories recovered in therapy were reliable. Dualistic thinking was prevalent among all three groups, but more so among psychiatrists. Conclusions: The data show that many professsionals hold beliefs about MUS for which, empirical support is lacking. These beliefs may impact on clinical practice. Whether such beliefs are deemed to be correct or incorrect, they should be acknowledged.

The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma

“…Despite these critical articles, many psychologists, especially clinical and counseling psychologists, continue to harbor the idea that traumatic memories can be buried for years or decades in the unconscious and later recovered. Magnussen and Melinder (2012) surveyed licensed psychologists and found that 63% ( n = 540) believed recovered memories to be “real.” Kemp, Spilling, Hughes, and de Pauw (2013) demonstrated that 89% ( n = 333) of surveyed clinical psychologists believed that memories for childhood trauma (such as sexual abuse) can be “blocked out” for many years. Patihis et al (2014) found that 60.3% ( n = 35) of clinical practitioners and 69.1% ( n = 56) of psychoanalysts agreed that traumatic memories are often repressed.…”

Beliefs in repressed memory and dissociative amnesia from a cross-cultural lens

“…For example, Kemp et al (2013) showed that 89% (n ¼ 333) of surveyed clinical psychologists endorsed the belief that traumatic memories of childhood abuse could be blocked for many years. Also, Patihis et al (2014) showed that 60.3% (n ¼ 35) of clinical practitioners and 69.1% (n ¼ 56) of psychoanalysts believed that traumatic memories are frequently repressed.…”

The resource utilisation of medically unexplained physical symptoms

“…MUPS are commonly encountered across all healthcare settings. 2 , 3 Analyses from the United Kingdom have estimated that MUPS is the presenting problem for around 22% of primary care attendances and 8% of inpatient bed days. 4 , 5…”