Posttraumatic Stress Disorder and Persistent Somatic Symptoms During the COVID-19 Epidemic: The role of Sense of Threat

Sally Jowett Jowett, M Shevlin, Philip Hyland, Thanos Karatzias

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Persistent somatic symptoms, such as pain and fatigue, have been referred to as somatisation. Somatisation is commonly associated with histories of trauma and PTSD. Although previous research has demonstrated that PTSD can predict somatic problems, there has been no examination of this at the level of PTSD symptom clusters and multi-dimensional assessment of somatic symptoms. We examined the association between the three ICD-11 PTSD symptom clusters (re-experiencing in the here and now, avoidance, and sense of threat), measured in relation to the COVID-19 pandemic as the stressor, and somatic symptoms while statistically adjusting for confounding variables.


Participants were a nationally representative sample of 1,041 adults from the general population of the Republic of Ireland. Physical health problems across the domains of pain, gastrointestinal, cardiopulmonary, and fatigue were assessed by the Patient Health Questionnaire, and PTSD symptoms were assessed using the International Trauma Questionnaire.


Sense of threat was associated with the presence of pain (β=.254), fatigue (β=.332), gastro-intestinal (β=0.234), and cardiovascular symptoms (β=.239). Avoidance was associated with pain (β=.347). Re-experiencing was not associated with any physical health variable.


In the context of COVID-19, the sense of threat symptoms in PTSD are most strongly related to somatic problems. Findings suggest that interventions addressing sense of threat symptoms might provide relief from somatisation.
Original languageEnglish
JournalPsychosomatic Medicine
Early online date18 Dec 2020
Publication statusPublished online - 18 Dec 2020


  • PTSD
  • Somatisation
  • Hyperarousal
  • Pandemic
  • Trauma
  • Physical health


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