title: Can agonistic striving lead to unexplained illness? Implicit goals, pain tolerance, and somatic symptoms in adolescents and adults.
abstract: OBJECTIVE
  We tested the social action theory hypotheses that (a) psychological stress induced by struggling to control others (agonistic striving) is associated with higher levels of subjective somatic symptoms than stress induced by struggling to control the self (transcendence striving); (b) the association between agonistic striving and symptoms is moderated by the ability to tolerate pain; and (c) associations among agonistic goals, pain tolerance, and subjective symptoms are not explained by personality and affective traits or negative emotional responses to personal stressors.
  
  
  METHODS
  Implicit motives and negative emotional reactivity to recurring personal stressors were assessed by Social Competence Interview in 333 adolescents and adults who participated in longitudinal research on functional abdominal pain at a university medical center. Pain tolerance was assessed by graduated thermal pain protocol; subjective somatic symptoms, and personality/affective traits assessed by questionnaires. The primary outcome measure was the self-reported severity of 35 somatic symptoms often experienced in the absence of diagnosable disease.
  
  
  RESULTS
  All hypotheses were supported.
  
  
  CONCLUSIONS
  Nonconscious agonistic strivings may increase the perceived frequency and severity of subjective somatic symptoms; this tendency is greatly magnified by difficulty in self-regulating responses to painful stimuli. Implicit agonistic motives and their associations with symptoms are not explained by individual differences in trait neuroticism, anxiety, depression, anger, or low self-esteem or by negative emotional reactivity to a personal stressor. These findings may afford fruitful insights into mechanisms by which stressful social environments undermine health and suggest promising directions for clinical intervention.
authors.affiliation: Department of Psychology.
authors.forename: Craig K
authors.initials: CK
authors.lastname: Ewart
authors.affiliation: Department of Psychology.
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Elder
authors.affiliation: Department of Psychology and Human Development, Vanderbilt University.
authors.forename: Kelsey T
authors.initials: KT
authors.lastname: Laird
authors.affiliation: Department of Psychology and Human Development, Vanderbilt University.
authors.forename: Grace D
authors.initials: GD
authors.lastname: Shelby
authors.affiliation: Vanderbilt University School of Medicine.
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
mesh_terms: D015746:Abdominal Pain / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000378:Agonistic Behavior; D000786:Anger; D001008:Anxiety Disorders / Q000523:psychology*; D002648:Child; D002908:Chronic Disease; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D000075384:Neuroticism; D017288:Pain Threshold / Q000523:psychology; D012649:Self Concept; D012931:Social Environment; D013001:Somatoform Disorders / Q000209:etiology / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
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