Somatoform disorders as disorders of affect regulation: A development perspective

Abstract

This paper considers the role of disturbances in affect regulation in the development and course of somatoform disorders. We first give an overview of contemporary theories in the field of psychosomatic medicine that links deficits in emotion regulation to the process of somatization, and then review recent empirical research that focuses on the association between affect regulation and somatoform disorders, with an emphasis on studies investigating the alexithymia construct. Overall, the findings suggest that somatoform disorders are linked to a diminished capacity to consciously experience and differentiate affects and express them in an adequate or healthy way. It must be noted, however, that this result has not been obtained exclusively for somatoform disorders. A promising approach to further our understanding of the developmental roots of impaired affect regulation in somatoform disorders is attachment research. The attachment research reviewed in this paper indicates that a dismissing status of attachment is linked to defensive forms of processing and expressing emotions. We present some new data that not only provide empirical support of a high proportion of dismissing attachment in somatoform disorders but also suggest that the degree to which somatoform disorder patients employ dismissing attachment strategies is strongly related to affect dysregulation. Finally, some implications for psychotherapeutic interventions in patients with somatoform disorders are considered.

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

“…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).…”

Alexithymia and Health-Related Quality of Life in Patients with Dizziness

“…medically unexplained somatic symptoms or psychosomatic diseases [11]. In earlier studies, difficulties in identifying and/or describing feelings have been particularly associated with somatization independently of somatic diseases, somatoform disorders [43,44,45], depression, anxiety [46] as well as the increased utilization of health care [47]. Furthermore, high scores in difficulties in identifying feelings emerged as an important predictor for somatization, as measured by the SCL-90-R [44].…”

Do Patients with Somatoform Disorders Present with Illusory Mental Health?

“…The low self-reported levels of depressive symptoms and anger may be related to high levels of alexithymia [50,51], overregulation of affect [52], and inhibitory self-regulation [53] that were found among SFD-patients and also to negative symptoms of dissociation, and in line with diminished psychological mindedness [7,54,55].…”