Alexithymia and Somatization in Chronic Pain Patients: A Sequential Mediation Model

Lanzara, Roberta; Conti, Chiara; Camelio, Martina; Cannizzaro, Paolo; Lalli, V.; Fulle, Stefania; Saggini, Raoul; Porcelli, Piero

doi:10.3389/fpsyg.2020.545881

Cited by 18 publications

(21 citation statements)

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“…Furthermore, depression mediated the relationship between alexithymia and several dimensions of illness perception in patients with systemic lupus erythematosus [ 32 ]. Moreover, the difficulty in identifying emotions affected somatization through distress and mental health impairment in patients with chronic pain, supporting the idea that alexithymia may increase somatic symptoms through emotional distress [ 33 ]. Finally, depression partially mediated the relationship between alexithymia scores and both physical and mental functioning in candidates for solid organ transplantation [ 24 ].…”

Section: Introductionmentioning

confidence: 96%

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

Quinto

Vincenzo

Graceffa

et al. 2022

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Background: Psoriasis is a common skin disease that affects quality of life, especially mental health. Alexithymia has been considered a relevant feature in psoriasis patients. Moreover, psoriasis was found to be associated with negative psychological health, including anxiety and depression. As the pathways linking alexithymia and mental health remain unclear among patients with psoriasis, we aimed to examine the mediating role of anxiety and depression in the relationship between alexithymia and mental health in these patients. Methods: To explore our variables of interest, we used the Toronto Alexithymia Scale (TAS-20), the 12-Item Short Form Health Survey (SF-12), and the Hospital Anxiety and Depression Scale (HADS). Results: Forty-four percent of patients were alexithymic and reported higher anxiety and depression, and lower quality of life compared to non-alexithymic patients. Alexithymic patients also had lower educational attainment. A correlation analysis showed positive associations between alexithymia and both anxiety and depression, whereas mental and physical health were negatively associated with alexithymia. Moreover, anxiety and depression fully mediated the relationship between alexithymia and mental health. Conclusions: Our findings highlight the importance of assessing alexithymia and psychological distress in clinical practice to identify vulnerable patients and to implement interventions aimed at improving negative emotional states.

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Section: Introductionmentioning

confidence: 96%

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

Quinto

Vincenzo

Graceffa

et al. 2022

IJERPH

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“…Various, generally nonclinical, studies identified an association between alexithymia and different somatization measures (Kumar et al, 2018; Lanzara et al, 2020). A correlation between alexithymia and varying somatization measures has been found in numerous, often nonclinical trials.…”

Section: Discussionmentioning

confidence: 99%

Does alexithymia, independent of depressive and anxiety disorders, correlate with the severity of somatic manifestations among patients with medically unexplained physical symptoms?

Rady

Alamrawy²,

Ramadan

et al. 2021

Journal of Experimental Psychopathology

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Background: Medically unexplained physical symptoms (MUPS) are highly prevalent, frequently co-occurring with psychiatric symptoms such as depression, alexithymia, and anxiety. Objective: To evaluate the relation between depression, anxiety, and alexithymia and severity of somatic symptoms in patients with MUPS. Method: This is a cross-sectional study conducted on 196 patients suffering from MUPS. The patients were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. The Patient Health Questionnaire (PHQ-15), (PHQ-9), Generalized Anxiety Disorder (GAD-7), Structured Clinical Interview for DSM-IV Axis I Disorders Clinician Version (SCID-I-CV), and Toronto Alexithymia Scale (TAS-20) were employed to assess somatic severity, depression, anxiety, major mental disorders, and alexithymia in the sample of patients. Results: The results of the study indicate that GAD-7 and PHQ-9 scores had a positive correlation with PHQ-15 ( p < 0.05) in multivariate regression. In contrast, TAS-20 was not independently correlated with PHQ-15. Adding TAS-20 to GAD-7 and PHQ-9 in the equation of the regression model enhances the predictive capacity of the model ( p < 001). Conclusion: The results of the study indicate that only anxiety and depressive symptoms, but not alexithymia, were associated independently with MUPS severity.

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“…The literature also reflects the possibility that individuals with early developmental trauma may process sensory input including psychological stress and pain, differently than others, due to a combination of factors that include sensory overload and somatic memory traces of abuse (42). An absence of feedback in the form of sensitive responsiveness and help with emotional regulation may similarly play an important role in validating painful emotional experiences within the attachment relationship (43)(44)(45). In one review of the literature, several familial risk factors for the development of somatoform disorders in youth were identified, including: somatization of parents, psychopathology of close family members, dysfunctional family climate, and traumatic experiences in childhood (46).…”

Section: Introductionmentioning

confidence: 99%

Families With Violence Exposure and the Intergenerational Transmission of Somatization

et al. 2022

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Introduction:Adults who have histories of childhood trauma have been noted to display greater somatization, dissociative symptoms and affect dysregulation. What happens in the parent-child relationship when those traumatized children become parents? A potential link to somatization in the child has been suggested by several prior studies. Children who have early attachment disturbances had more physical complaints if their mothers displayed less maternal sensitivity during observed parent-child interactions. Yet, the intergenerational link between maternal and child somatization has not been sufficiently explored in a longitudinal study in order to understand the potential impact of maternal trauma history and related psychopathology on subsequent child somatization and psychopathology.MethodsThis paper examined prospective, longitudinal data of 64 mother-toddler dyads (mean age = 2.4 years, SD = 0.7) who were later studied when children had a mean age of 7 years. Mothers with and without histories of interpersonal violence (IPV; physical/sexual abuse and/or family violence exposure) were included. Mothers with IPV histories were oversampled. Linear and Poisson regression models were used to test the associations between maternal IPV-related post-traumatic stress disorder (PTSD) with maternal somatization severity when children were toddlers, and between maternal somatization and maternal interactive behaviors with child somatization by maternal report and clinician-rated assessment at school-age.ResultsMaternal PTSD severity was significantly associated with increased maternal somatization severity (p = 0.031). Maternal somatization severity during the child's early childhood predicted both maternal report of child somatization (p = 0.011) as well as child thought problems (p = 0.007) when children were school-aged. No association was found between maternal somatization and child-reported psychopathology. The study did not find that maternal alexithymia, caregiving behaviors or child exposure to violence contributed significantly to the model examining the association between maternal and child somatization.ConclusionThe results are in line with the hypothesis of intergenerational transmission of somatization in the context of IPV and related maternal PTSD during formative early development. We interpret this as an expression of psychological distress from mother to child, as maternal trauma and pathology affect the caregiving environment and, thus, the parent–child relationship. The authors conclude with a discussion of implications for parent–infant and early childhood intervention.

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Alexithymia and Somatization in Chronic Pain Patients: A Sequential Mediation Model

Cited by 18 publications

References 85 publications

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

Does alexithymia, independent of depressive and anxiety disorders, correlate with the severity of somatic manifestations among patients with medically unexplained physical symptoms?

Families With Violence Exposure and the Intergenerational Transmission of Somatization

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