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Neuroticism, alexithymia, negative affect and positive affect as predictors of medically unexplained symptoms in primary care1

Published online by Cambridge University Press:  24 June 2014

V. De Gucht*
Affiliation:
Leiden University, Department of Clinical and Health Psychology, Leiden, the Netherlands

Abstract

Background:

Somatization has been defined in a number of ways. Despite their differences, these definitions have one element in common, namely the presence of somatic symptoms that cannot be explained (adequately) by organic findings.

Objective:

The primary objectives of the dissertation were to gain a better insight into the concept of somatization, and to study (prospectively) the relationship between neuroticism and alexithymia, two personality traits that have been shown to be related to somatization, the affective state dimensions positive and negative affect (or psychological distress) and medically unexplained symptoms.

Method:

A selective review was conducted regarding conceptual and methodological issues related to somatization. A total number of 318 patients, presenting to their primary care physician with medically unexplained symptoms, participated in the prospective study. Both at baseline and at 6-month follow-up a number of measures were filled out with respect to somatization, neuroticism, alexithymia, negative and positive affect, anxiety and depression.

Results:

The concept of somatization was clarified, thereby making use of the distinction between presenting and functional somatization. The personality traits neuroticism and alexithymia were found to have an indirect influence on symptom reports. Both the cross-sectional and follow-up data pointed to the importance of positive and negative affect as determinants of (changes in) number of symptoms (over time). Negative affect, together with the alexithymia dimension measuring difficulty identifying feelings, predicted symptom persistence.

Conclusions:

The theoretical as well as therapeutic implications of the present paper may give an impetus to new research in the domain of somatization.

Type
Original Article
Copyright
Copyright © Blackwell Munksgaard 2002

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References

De Gucht, V, Fischler, B. Conceptual and clinical developments in somatization and its disorders. Acta Psychiatr Belg 2000;100: 1522. Google Scholar
Kellner, R. Somatization. Theories and research. J Nerv Ment Dis 1990;178: 150160.CrossRefGoogle ScholarPubMed
Kroenke, K, Price, RK. Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Int Med 1993;153: 24742480. CrossRefGoogle ScholarPubMed
Escobar, J I, Waitzkin, H, Silver, C R, Gara, M, Holman, A. Abridged somatization: a study in primary care. Psychosom Med 1998;60: 466472.CrossRefGoogle ScholarPubMed
Fink, P. The use of hospitalizations by persistent somatizing patients. Psychol Med 1992;22: 173180.CrossRefGoogle Scholar
Fink, P, Sörensen, L, Engberg, M, Holm, M, Munk-Jorgensen, P. Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Psychosomatics 1999;40: 330338.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Degruy, FVet al. Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Arch General Psychiatry 1997;54: 352358. CrossRefGoogle ScholarPubMed
Smith, GR. The course of somatization and its effects on utilization of health care resources. Psychosomatics 1994;35: 263267.CrossRefGoogle ScholarPubMed
Kellner, R. Somatization and Hypochondriasis. New York: Praeger Publishers, 1986. Google Scholar
Bass, C. Somatization. Physical symptoms and psychological illness. Oxford: Blackwell Scientific Publications, 1990. Google Scholar
Kirmayer, LJ, Robbins, JM. Current concepts of somatization: research and clinical perspectives. Washington, DC: American Psychiatric Press, 1991. Google Scholar
Mayou, R, Bass, C, Sharpe, M. Treatment of functional somatic symptoms. Oxford: Oxford University Press, 1995. Google ScholarPubMed
Craig, TKJ, Drake, H, Mills, K, Boardman, AP. The South London somatisation study. II. Influence of stressful life events, and secondary gain. Br J Psychiatry 1994;165: 248258.CrossRefGoogle ScholarPubMed
Jorgensen, LS, Christiansen, PM, Raundahl, U, Ostgaard, SE. Long-lasting functional abdominal pain and duodenal ulcer are associated with stress, vulnerability and symptoms of psychological stress. A controlled study including healthy and patient controls. Dan Med Bull 1996;43: 359363.Google ScholarPubMed
Scaloubaca, D, Slade, P, Creed, F. Life events and somatisation among students. J Psychosom Res 1988;32: 221229.CrossRefGoogle ScholarPubMed
Whitehead, WE. Psychosocial aspects of functional gastrointestinal disorders. Gastroenterol Clin North Am 1996;25: 2134.CrossRefGoogle ScholarPubMed
Drossman, DA, Talley, NJ, Leserman, J, Olden, KW, Barreiro, MA. Sexual and physical abuse and gastrointestinal illness. Rev Recommend Arch Int Med 1995;123: 782794. Google ScholarPubMed
McCauley, J, Kern, DE, Kolodner, Ket al. Clinical characteristics of women with a history of childhood abuse. JAMA 1997;277: 13621368.CrossRefGoogle ScholarPubMed
Reilly, J, Baker, GA, Rhodes, J, Salmon, P. The association of sexual and physical abuse with somatization: characteristics of patients presenting with irritable bowel syndrome and non-epileptic attack disorder. Psychol Med 1999;29: 399406.CrossRefGoogle ScholarPubMed
Whitehead, WE, Crowell, MD, Heller, BR, Robinson, JC, Schuster, MM, Horn, S. Modeling and reinforcement of the sick role during childhood predicts adult illness behavior. Psychosom Med 1994;56: 541550.CrossRefGoogle ScholarPubMed
Barsky, AJ. Amplification, somatization, and the somatoform disorders. Psychosomatics 1992;33: 2834.CrossRefGoogle ScholarPubMed
Pennebaker, JW, Watson, D. The psychology of somatic symptoms. In: Kirmayer, LJ, Robbins, JM, eds. Current concepts of somatization. Washington, DC: American Psychiatric Press, 1991: 2135. Google Scholar
Bridges, KW, Goldberg, DP. Somatic presentation of DSM-III psychiatric disorders in primary care. J Psychosom Res 1985;29: 563569.CrossRefGoogle ScholarPubMed
Katon, W, Ries, RK, Kleinman, A. Part II: a prospective DSM-III study of 100 consecutive somatization patients. Compr Psychiatry 1984;25: 305314.CrossRefGoogle Scholar
Lipowski, ZJ. Somatization: medicine's unsolved problem. Psychosomatics 1987;28: 294297.CrossRefGoogle ScholarPubMed
Costa, PT, McCrae, RR. Neuroticism, somatic complaints and disease: Is the bark worse than the bite? J Pers 1987;55: 299316.CrossRefGoogle Scholar
Sifneos, PE. The prevalence of ‘’alexithymic characteristics in psychosomatic patients. Psychother Psychosom 1973;22: 255262.CrossRefGoogle ScholarPubMed
Taylor, GJ. Somatoform disorders. In: Taylor, GJ, Bagby, RM, Parker, JDA, eds. disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press, 1997: 114137. CrossRefGoogle Scholar
Bagby, RM, Taylor, GJ, Parker, JDA. The twenty-item Toronto Alexithymia Scale-II. Convergent, discriminant and concurrent validity. J Psychosom Res 1994;38: 3340.CrossRefGoogle Scholar
Hendryx, MS, Haviland, MG, Shaw, DG. Dimensions of alexithymia and their relationships to anxiety and depression. J Pers Assess 1991;56: 227237.CrossRefGoogle ScholarPubMed
Honkalampi, K, Hintikka, J, Tanskanen, A, Lehtonen, J, Viinamäki, H. Depression is strongly associated with alexithymia in the general population. J Psychosom Res 2000;48: 99104.CrossRefGoogle ScholarPubMed
Luminet, O, Bagby, RM, Wagner, H, Taylor, GJ, Parker, JDA. Relation between alexithymia and the five-factor model of personality: a facet-level analysis. J Pers Assess 1999;73: 345358.CrossRefGoogle ScholarPubMed
Kirmayer, LJ, Robbins, JM. Three forms of somatization in primary care: prevalence, co-occurence, and sociodemographic characteristics. J Nerv Ment Dis 1991;179: 647655.CrossRefGoogle Scholar
Simon, G, Gater, R, Kisely, S, Piccinelli, M. Somatic symptoms of distress: an international primary care study. Psychosom Med 1996;58: 481488.CrossRefGoogle ScholarPubMed
Simon, GE, Von Korff, M. Somatization and psychiatric disorder in the NIMH Epidemiological Catchment Area study. Am J Psychiatry 1991;148: 14941500.Google Scholar
De Gucht, V, Fischler, B. Somatization. A critical review of conceptual and methodological issues. Psychosomatics 2002;43: 19.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd edn. Washington, DC; American Psychiatric Association, 1980. Google ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd rev. edn. Washington, DC: American Psychiatric Association, 1987. Google ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC: American Psychiatric Association, 1994. Google ScholarPubMed
Manu, P. Functional somatic syndromes. Cambridge: Cambridge University Press, 1998. CrossRefGoogle Scholar
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