Table 3 Final themes (n = 11) with definitions and participants who were coded as demonstrating the theme

Experiences

1. Impact of childhood trauma

Expressions of traumatic experiences at a young age

3, 4, 6, 7, 8, 9, 13, 14, 15, 19

2. Impact of adult abuse

Explicitly described physical, verbal or sexual abuse during Adult

6, 12, 14, 15, 17, 19

3. Family patterns of distress and/or dysfunction

Expressions of illnesses, behaviours, or conditions that were repeated among different family members; also includes expressed negative emotions about the actions and intentions of family members and other personal relationships

1, 3, 4, 5, 6, 8, 9, 10, 11, 13, 14, 15, 16, 17, 18, 19

Perceptions

4. Entitlement

Inferred lack of participant's sense of accountability for his or her actions or inactions, usually from statements that offer symptoms as excuses for not being able to fulfil societal roles

1, 3, 4, 6, 10, 14, 16, 17, 18

5. Health anxiety

Expressed or inferred participant concern about serious undiagnosed disease. Neither normal tests nor doctors' benign assessments of their symptoms reassured patients who expressed health anxiety. Either they had personally experienced a medical error, or they knew someone who had

3, 5, 7, 12, 19

6. Psychological explanations and insights

Expressed or inferred awareness of the relationship between personal psychological stress and physical symptoms

5, 7, 8, 11, 12, 15 - "high" insight

2 - "neutral"

1, 4, 6 - "very low" insight

All others - "low" or "moderate" insight

Behaviours

7. Symptom focus

A pervasive emphasis on symptoms

1, 4, 6, 9, 10, 13, 14, 18, 16, 19

8. Expressing dissatisfaction with healthcare

Expressed and inferred dissatisfaction with healthcare system or providers.

3, 7, 9, 11, 12, 13, 14, 16, 19

9. Achievement

Expressions of higher education, supervisory role, professional status, entrepreneurship, and/or creative activities

2, 3, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

10. Action

Expressed or inferred ability to cope effectively or change behaviour for the better

2, 3, 5, 7, 8, 9, 11, 12, 13, 15, 16, 19

11. Altruism

Spontaneous descriptions of volunteer activity, significant care-taking or meaningful work

3, 5, 7, 8, 9, 11, 12, 15, 19