The 'multiplex model' of somatic symptoms: application to tinnitus among traumatized Cambodian refugees

Somatic symptoms are a common clinical presentation of distress among ethnic populations in the USA, particularly traumatized refugees. In this article, we apply a 'multiplex model' of bodily experience to explain how a somatic symptom is evoked, amplified, and generates distress, particularly distress related to post-traumatic stress disorder. We illustrate the multiplex model's applicability to acute episodes of tinnitus (i.e., a buzzing-like sound in the ear) among Cambodian refugees, a common symptom in that group. The article demonstrates the importance of carefully examining somatic symptoms and associated meanings in distressed ethnic populations, especially traumatized refugees, and aims to contribute to a medical anthropology of somatic symptoms.