The process of symptom perception represents a bridge between physiological activity and psychological appraisal. The Cognitive-Perceptual model of symptom perception emphasizes the role of perception and attentional processing on symptom assessment (Cioffi, 1991). Females have been found to report a greater number of somatic symptoms compared to males (Gijsbers van Wijk et al., 1999;
Gijsbers van Wijk & Kolk, 1997). This thesis examined whether gender differences in symptom perception were explained by the following hypotheses: 1) Females are more susceptible to a retrospective reporting bias, 2) Females report a greater number of psychological symptoms (Macintyre et al., 1996), 3) Negative Affect
(NA) increases symptom reporting in females, 4) Females are more vulnerable to the influence of external factors and state mood, i.e. the ‘Competition of Cues’ hypothesis (Roberts & Pennebaker, 1995) and 5) Health beliefs and cognitions have a greater influence on symptom perception in females.
Methods: Gender differences in a physiological measure of body awareness
(interoception) were investigated in Study 1. Study 1 additionally examined whether interoceptive accuracy (IA) in females was more vulnerable to the influence of mood change, e.g. stress, in regards to performance on the heartbeat detection and respiratory resistance tasks. Study 2 utilised the newly developed symptom report questionnaire in an undergraduate sample. This study examined gender differences in frequency of symptoms, in addition to the symptom constructs: duration severity and worry. Study 3 addressed symptom attribution in an undergraduate sample, using participants’ responses to distinguish between physically and psychologically attributed symptoms and to develop male and female models of symptom perception. Study 4 involved a longitudinal analysis of symptom perception in the same undergraduate sample. Study 5 developed the symptom perception models from study 3 in an occupational sample.
Results: The findings suggested that females reported a higher frequency of psychological symptoms on a retrospective basis compared to males (Hypotheses 1
& 2), however, the gender difference did not remain when current symptoms were assessed. Additionally, females reported their psychological symptoms to be of increased severity, and to result in greater worry. NA had a stronger association with retrospective symptom reports, particularly in females (Hypothesis 3). NA ii

had an additional indirect effect mediated by body attention in females, supporting the ‘Joint Impact Hypothesis’ (Gendolla et al., 2005). There was no support for
Hypothesis 4, that females are more vulnerable to the influence of external cues
(e.g. stress and mood) than males, from study 1 or the symptom report studies
(studies 5, 6 and 7). There was some evidence that chronic stressors (i.e. life events) had a greater impact on symptom perception in males. Hypothesis 5 was partially supported, but this effect was not unique to females. Health beliefs were associated with physical symptom frequency in males and with the impact of psychologically attributed symptoms in females.
Conclusions: This research can be used to inform primary care professionals of the psychological issues associated with symptom perception in men and women.
There is strong evidence for the role of body attention and health beliefs in symptom perception. iii