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Cognitive Dysfunction, Psychophysiological Regulation, and Psychosocial Factors in Psychosomatic Disorders: A Narrative Review

*Dela Riadi orcid scopus  -  Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
Open Access Copyright (c) 2026 Authors
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Psychosomatic disorders result from complex interactions among biological, psychological, cognitive, and social factors. Growing evidence suggests that cognitive dysfunction, particularly in attention, executive functioning, and working memory, contributes to the development and persistence of psychosomatic symptoms. This review aimed to synthesize current evidence on cognitive dysfunction, psychophysiological regulation, self-regulation mechanisms, and psychosocial factors associated with psychosomatic disorders..

Method: A narrative review was conducted using articles published between 2016 and 2026 and retrieved from Scopus, PubMed, ScienceDirect, and ProQuest through a literature search conducted on April 24, 2026. The search strategy was based on the PICOS framework and included terms related to psychosomatic disorders, somatic symptom disorder, executive functions, attention, working memory, self-regulation, and psychosocial factors. Following the screening and eligibility assessment, 14 articles were included in the review.

Result: The findings indicate that impairments in attention, executive functioning, and working memory are consistently associated with psychosomatic disorders and may influence symptom severity and treatment response. Psychophysiological regulation, particularly autonomic nervous system functioning, plays an important role in self-regulation and symptom management. Furthermore, psychosocial factors, including depression, illness beliefs, maladaptive coping, chronic pain, and childhood trauma, contribute to psychosomatic vulnerability and disease progression. Psychosomatic disorders are influenced by interactions among cognitive, psychophysiological, and psychosocial factors, highlighting the importance of integrated, patient-centered approaches to assessment and treatment.

Keywords: Attention, Executive function ,Psychosomatic disorders, Psychosocial factors ,Working memory

Article Metrics:

  1. Witthöft M, Jasper F. Somatic symptom disorder. In: Friedman HS, editor. Encyclopedia of mental health. 2nd ed. Oxford: Elsevier; 2016. p. 211–4
  2. Henningsen P, Zipfel S, Sattel H, Creed F. Management of functional somatic syndromes and bodily distress. Psychother Psychosom. 2018;87(1):12–31
  3. Trivedi JK, Sharma S, Singh AP, et al. Neurocognition in somatisation disorder. Ind Psychiatry J. 2005;15(1):35–40
  4. de Vroege L, Koppenol I, Kop WJ, et al. Neurocognitive functioning in patients with conversion disorder/functional neurological disorder. J Neuropsychol. 2021;15(1):69–87
  5. Eren-Kocak E, Kilic C. Cognitive dysfunctions in posttraumatic stress disorder. Turk Psikiyatri Derg. 2017;28(4):266–73
  6. Crivelli D, Balconi M. Psychopathology of executive functions. In: Balconi M, editor. Executive functions in health and disease. Academic Press; 2021. p. 41–59
  7. Wernberg CW, Grønkjær LL, Gade B, et al. P47 Cognitive impairment in obesity and NAFLD: a cross-sectional study of 180 patients with multi-domaine cognitive testing and liver biopsy. Am J Gastroenterol. 2023;118(10S):S31
  8. Liu C, Carvalho A, McIntyre R. Towards a "metabolic" subtype of major depressive disorder: shared pathophysiological mechanisms may contribute to cognitive dysfunction. CNS Neurol Disord Drug Targets. 2014;13(10):1693–707
  9. Sargénius HL, Lydersen S, Hestad K. Neuropsychological function in individuals with morbid obesity: a cross-sectional study. BMC Obes. 2017;4:6
  10. Mulhauser K, Reynolds EL, Callaghan BC, et al. Executive functioning in extreme obesity: contributions from metabolic status, medical comorbidities, and psychiatric factors. Obes Surg. 2021;31(6):2669–81
  11. Critchley HD, Eccles J, Garfinkel SN. Interaction between cognition, emotion, and the autonomic nervous system. Handb Clin Neurol. 2013;117:59–77
  12. Desai KM, Kale AD, Shah PU, et al. Psychosomatic disorders: a clinical perspective and proposed classification system. Arch Iran Med. 2018;21(10):480–8
  13. Fountoulakis KN. Psychophysiology and psychosomatics. In: Fountoulakis KN, editor. Psychobiology of behaviour. Cham: Springer International Publishing; 2019. p. 325–44
  14. Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 2018;87(Pt B):168–82
  15. Riadi D, Trihandini I, Sari DN. The effectiveness of remote patient monitoring in reducing the risk of rehospitalizations in COVID-19 patients: a meta-analysis. Kesmas J Kesehat Masy Nas. 2025;20(1):45–52
  16. Rahmadina N, Linawati SW, Khairunnisa SHH, et al. A systematic literature review of husband’s support for the incidence of postpartum depression in Indonesia. Open Public Health J. 2026;19:e18749445424980
  17. Wong KMF, Mak ADP, Yuen SY, et al. Nature and specificity of altered cognitive functioning in IBS. Neurogastroenterol Motil. 2019;31(11):e13696
  18. Inamura K, Tsuno N, Shinagawa S, et al. Correlation between cognition and symptomatic severity in patients with late-life somatoform disorders. Aging Ment Health. 2015;19(11):1018–25
  19. Jang YE, Jang Y, Choi HY, et al. The relationships between cognitive control and psychological
  20. symptoms in patients with somatic symptom disorder: a pilot longitudinal study. Cogn Neuropsychiatry. 2021;26(4):255–69
  21. Kim HJ, Kim HR, Jin JC, et al. Body mass index and somatic symptom severity in patients with somatic symptom disorder: the mediating role of working memory. Clin Psychopharmacol Neurosci. 2021;19(2):361–8
  22. Inamura K, Shinagawa S, Nagata T, et al. Executive dysfunction correlated with 2-year treatment response in patients with late-life undifferentiated somatoform disorders. Psychosomatics. 2016;57(5):502–9
  23. Krempel L, Martin A. Efficacy of heart rate variability biofeedback for somatic symptom disorder: a pilot randomized controlled trial. Psychosom Med. 2023;85(1):61–70
  24. Huang WL, Liao SC, Wu CS, et al. Clarifying the link between psychopathologies and heart rate variability, and the sex differences: can neuropsychological features serve as mediators? J Affect Disord. 2023;340:354–62
  25. Warth R Von Der, Rudolph M, Bengel J, et al. Contextual factors of patient self-regulation in psychosomatic rehabilitation a cross-sectional analysis before the start of rehabilitation. Rehabilitation (Stuttg). 2022;61(5):342–51
  26. Telesca A, Montisano DA, Usai S, et al. Exploring cognitive, behavioral, and psychological dimensions in persistent idiopathic facial pain and other chronic orofacial pain conditions. Brain Behav. 2026;16(2):e71283
  27. Tjoelker FM, Jeuring HW, Aprahamian I, et al. The impact of a history of child abuse on cognitive performance: a cross-sectional study in older patients with a depressive, anxiety, or somatic symptom disorder. BMC Geriatr. 2022;22(1):312
  28. Banker H, Goel A, Kumawat S, et al. Cognitive impairment in IBS: a narrative overview. J Gastrointestin Liver Dis. 2025;34(1):105–12
  29. Gelonch O, Garolera Freixa M, Rosselló Aubach L, et al. Disfunción cognitiva en la fibromialgia. Rev Neurol. 2013;56(11):573–85
  30. Lamberty GJ. Somatoform disorders and neuropsychological assessment. In: Lamberty GJ, editor. Understanding somatization in the practice of clinical neuropsychology. New York: Oxford University Press; 2023. p. 185–210
  31. Blaser BL, Weymar M, Wendt J. Smartphone-based heart rate variability biofeedback training improves premenstrual and depressive symptoms as well as anxiety/stress symptoms and attentional executive control: a pilot study. Authorea Preprints. 2023. DOI: 10.22541/au.170000973.36600989/v1
  32. Krempel L, Martin A. Efficacy of heart rate variability biofeedback for somatic symptom disorder: a pilot randomized controlled trial. Psychosom Med. 2023;85(1):61–70
  33. Schmidt J, Martin A. Herzratenvariabilitäts-Biofeedback in der klinischen Praxis. Psychotherapeut (Berl). 2017;62(6):498–506
  34. Al-Tamimi SM. Biofeedback of heart rate variability in the treatment of chronic diseases: a systematic review. J Contemp Med Sci. 2022;8(5):280–7

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