From sensations to symptoms: The social shaping of functional illness experience

功能性神经障碍（FND）是一种广泛存在的，但医学上无法解释的疾病，与高水平的痛苦和残疾有关。由于目前缺乏客观的生物学标记FND，其病理学有时被描述为潜在的心理疾病的身体表现。科学家现在了解到，心灵和身体对彼此产生强烈的影响，因此FND和相关疾病的症状受到身心相互作用的影响。然而，目前的医学研究主要集中在心灵上，而没有考虑塑造心理体验的社会和文化背景。这项研究增强了人们对社会习得的期望和意义的理解，这些期望和意义与他们的身体感觉相关联，塑造了他们的疾病经历，并影响了他们感知症状的方式。通过分析FND的客观标志物以及感知的症状和疾病经历，并与临床医生和人群分享结果，该研究将提供与临床实践相关的见解，并支持被诊断患有FND的个人。 研究人员测试了一个假设，即社会环境塑造了个人如何体验和理解他们的症状，有助于文化人类学的科学，质疑共享文化对健康和福祉的影响。这与专注于个人心理属性如何影响心理学的假设形成对比，而不是专注于社会关系如何加强或改变FND的体验。该研究使用了一套创新的研究方法来收集有关FND患者生活经历的数据。研究人员使用混合方法测试他们的假设，包括密集访谈，问卷调查，日志移动的应用程序和心率监测任务。研究结果将阐明心态，社会背景和症状感知之间的关系，为测试人类学的体现理论提供实证证据，并增强对影响FND的多个层面的理解。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Functional Neurological Disorder (FND) is a widespread, yet medically unexplained illness that is associated with high levels of distress and disability. Given the current lack of objective biological markers of FND, its symptomology is sometimes characterized as bodily manifestations of underlying psychological illness. Scientists now understand that the mind and body exert strong influences on one another, such that the symptoms of FND and related disorders are affected by mind-body interactions. Yet current medical research focuses on the mind largely without consideration of the social and cultural contexts that shape psychological experiences. This research enhances an understanding of how socially learned expectations and meanings that people associate with their bodily sensations shape their illness experience and influence the way they perceive their symptoms. By analyzing objective markers of FND alongside perceived symptoms and experiences of the disease, and sharing results with clinical practitioners and populations, the research will provide insights that are relevant to clinical practice and support of individuals diagnosed with FND. The investigators test the hypothesis that social contexts shape how individuals experience and understand their symptoms, contributing to science in cultural anthropology that queries the effects of shared culture on health and well-being. This contrasts with hypotheses focused on how individual psychological attributes affect symptomology, instead focusing on how social relationships can reinforce or alter experiences of FND. The research uses an innovative set of research methods to gather data about the lived experiences of people with FND. The researchers test their hypothesis using mixed methods, involving intensive interviewing, questionnaires, a journaling mobile app, and a heart rate monitoring task. Findings from the research will elucidate the relationships between mindsets, social contexts, and symptom perceptions, contributing empirical evidence to test anthropological theories of embodiment and enhancing understandings of the multiple levels affecting FND. Findings will thereby contribute to scientific knowledge about how culture and biology interact to shape health.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.