Somatoform disorders as disorders of affect regulation

Waller, Elisabeth; Scheidt, Carl Eduard

doi:10.1016/s0022-3999(03)00613-5

Cited by 162 publications

(51 citation statements)

References 34 publications

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“…On the other hand, high levels of total cognitive features of alexithymia and low levels of the affective dimension of alexithymia were least characteristic of patients diagnosed with SoD alone. These results are not precisely in line with study hypotheses and are not consistent with the results of prior studies that reported a specific association between SoD and alexithymia [7,28]. Rather, combined with the low overall prevalence levels noted above, they suggest that the presence of all five features comprising the cognitive and affective dimensions of alexithymia is rare among adult patients with SoD.…”

Section: Discussioncontrasting

confidence: 99%

“…This study, therefore, aims to describe the different dimensions associated with difficulties in emotional functioning in a contemporary sample of psychiatric patients consisting of patients diagnosed with mixed mental disorders (psychiatric comparison sample, PC), SoD, BPD, and comorbid BPD and SoD (BPD+SoD), as these disorders have been associated with difficulties in identifying and modulating emotions [5,6,7,28]. Moreover, differentiating between these dimensions may further help our understanding of the inconsistencies found in alexithymia research [19] and of difficulties in emotional functioning in BPD, SoD and other psychiatric patients.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive and Affective Dimensions of Difficulties in Emotional Functioning in Somatoform Disorders and Borderline Personality Disorder

Dijke¹,

Hart

Son³

et al. 2012

Psychopathology

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Background: To study difficulties in emotional functioning in two mental disorders that have been associated with difficulties in identifying and modulating emotions: borderline personality disorder (BPD) and somatoform disorder (SoD). Sampling and Methods: In 472 psychiatric inpatients, difficulties in emotional functioning were measured using the Bermond-Vorst Alexithymia Questionnaire. Results: Profiles of difficulties in emotional functioning were identified, suggesting that patients diagnosed with BPD with or without SoD were more likely to report difficulty identifying emotions and less likely to report reduced ability to fantasize or ‘pensée opératoire' (externally oriented thinking) than patients diagnosed with SoD only and patients with mixed anxiety and affective disorders. SoD patients were more likely to report reduced ability to phantasize or pensée opératoire than difficulty identifying emotions. Patients with mixed anxiety and affective disorders were more likely to report reduced ability to experience emotions than patients diagnosed with BPD and/or SoD. Conclusions: By using a finer-grained perspective on difficulties in emotional functioning some evidence was found for the existence of cognitive-emotional profiles that may provide more clinically relevant information than alexithymia as just a unitary construct. Further research on cognitive-emotional profiles of difficulties in emotional functioning is needed to advance the understanding, diagnosis and treatment of mental disorders.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognitive and Affective Dimensions of Difficulties in Emotional Functioning in Somatoform Disorders and Borderline Personality Disorder

Dijke¹,

Hart

Son³

et al. 2012

Psychopathology

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“…Over-regulation of affect was in all participants assessed with the Bermond Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond, 2001), a Dutch forty-item questionnaire with demonstrated psychometric qualities (Vorst & Bermond, 2001). The Cognitive (inhibited verbalizing, identifying, and analysing emotions) over-regulation sub-scale was used to enable comparisons with previous studies (Waller & Scheidt, 2004, 2006) and based on its strong correlation with the Toronto Alexithymia Scale (TAS-20; Bagby, Parker, & Taylor, 1994; r = .80). The BVAQ cognitive scale had good internal consistency reliability in the present sample (Cronbach’s alpha = .88).…”

Section: Methodsmentioning

confidence: 99%

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Dijke

Hopman

Ford

2018

European Journal of Psychotraumatology

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Objective: Complex posttraumatic stress disorder (CPTSD) as defined by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) formulation is associated with childhood relational trauma and involves relational impairment, affect dysregulation, and identity alterations. However, the distinct contributions of relational impairment (operationalized in the form fears of closeness or abandonment), affect dysregulation (operationalized in the form of overregulation and under-regulation of affect), and identity alterations (operationalized in the form of positive or negative psychoform or somatoform dissociation) to the relationship between childhood trauma and CPTSD/DESNOS have not been systematically tested. Method and Results: In a clinical sample of adults diagnosed with severe and chronic psychiatric and personality disorders (n = 472; M = 34.7 years, SD = 10.1), structural equation modelling with bootstrap 95% confidence intervals demonstrated that the association between childhood trauma and CPTSD/DESNOS symptoms in adulthood was partially mediated by under-regulation of affect, negative psychoform dissociation, and adult relational fears of closeness and of abandonment. These results also were independent of the effects of borderline personality disorder (BPD) symptoms. Conclusions: Some, but not all, hypothesized components of the DESNOS formulation of CPTSD statistically mediate the relationship between childhood trauma and adult CPTSD/DESNOS. These relationships appear specific to CPTSD/DESNOS and not to the effects of another potential sequelae of childhood trauma BPD. Replication with prospective longitudinal studies is needed.

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“…Research suggests that alexithymia might play a role in the onset or development of several psychiatric and physical health problems such as substance abuse or pathological gambling [3,4,5], eating [6,7] and somatoform disorders [8,9], chronic pain [10], low back pain [11] or kidney failure [12], posttraumatic stress disorders [13,14] and stress-related disorders in general [15], asthma [16], myocardial infarction [17], inflammatory bowel disease [18], and also cancer [19]. Furthermore alexithymia is suspected to have an impact on treatment compliance and treatment outcome [20].…”

Section: Introductionmentioning

confidence: 99%

Alexithymia in Cancer Patients: Review of the Literature

Vries

Forni

Voellinger

et al. 2012

Psychother Psychosom

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Objective: To summarize the literature on alexithymia in cancer patients. Methods: The empirical literature published between 1972 and January 2010 was searched through MEDLINE, PSYINFO, EMBASE and the Cochrane Library. Key words were: alexithymia, affective symptoms, cancer, neoplasms. Results: The search identified 16 relevant studies which are methodologically problematic and show conflicting results. However, several interesting hypotheses emerge such as a possible link between alexithymia and the immune system, between alexithymia and quality of life, or between alexithymia, anxiety and depression. The question to what degree alexithymia in cancer patients is a trait or a state cannot be answered by these studies. Conclusions: A lack of methodologically sound studies and the large variations of results among studies suggest that the role of alexithymia in patients with cancer deserves more systematic research. Consequently, studies are needed which investigate the nature (state or trait) of alexithymia, its impact on cancer development and progression, as well as its influence on compliance and on the underestimation of psychological distress and psychiatric outcome in cancer patients.

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Somatoform disorders as disorders of affect regulation

Cited by 162 publications

References 34 publications

Cognitive and Affective Dimensions of Difficulties in Emotional Functioning in Somatoform Disorders and Borderline Personality Disorder

Cognitive and Affective Dimensions of Difficulties in Emotional Functioning in Somatoform Disorders and Borderline Personality Disorder

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Alexithymia in Cancer Patients: Review of the Literature

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