Suicidality in patients with somatoform disorder – the speechless expression of anger?

Kämpfer, Nora; Staufenbiel, Sabine M.; Wegener, Ingo; Rambau, Stefanie; Urbach, Anne Sarah; Mücke, Martin; Geiser, Franziska; Conrad, Rupert

doi:10.1016/j.psychres.2016.10.022

Cited by 32 publications

(26 citation statements)

References 67 publications

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“…Difficulties in identifying and communicating feelings thus seem to be a factor common to both somatization and selfharming. In both cases, the body is used to express psychological and emotional issues that an individual finds impossible to communicate verbally (16).…”

Section: Discussionmentioning

confidence: 99%

“…The Achenbach questionnaires are among the scales most often used internationally for juvenile rating behavior, in the clinical setting, and research. We used the version for adolescents (YSR [11][12][13][14][15][16][17][18], which yields two profiles: one concerning competences (activities, social functioning, school performance), then how well the adolescent performs in sports, hobbies, autonomy, and socialization, and at school; the other covers behavioral and emotional problems, which can be classified as "normal," "borderline," or "clinical" on eight specific syndrome scales. These syndrome scales relate to various psychopathological pictures: anxiety/depression; withdrawal; somatization; social problems; thought-related problems, attention problems; aggressive and rule-breaking behavior.…”

Section: Study Protocol and Materialsmentioning

confidence: 99%

“…While psychosomatic patients express their psychological distress in the shape of physical disorders (e.g., headache, stomachache, nausea, sleep problems, dizziness, rashes, or other skin problems), self-harming individuals hurt the surface of their body to contain their psychological pain. Neither psychosomatic nor self-harming individuals can mentalize and express their negative feelings in words, so they use their body to show their psychological pain (16).…”

Section: Introductionmentioning

confidence: 99%

“…Empirical studies found that alexithymia, i.e., difficulty in identifying and describing feelings and modulating states of emotional arousal (17,18), is associated with both selfharming (19)(20)(21) and psychosomatic behavior (16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

“…As mentioned earlier, difficulties with identifying and communicating feelings (i.e., alexithymia) could also be a factor common to both somatic symptoms and self-injury. In both clinical pictures, the body is used to express psychological and emotional aspects that are otherwise impossible to communicate (16). Besides, in the case of self-harming behavior in people with somatic symptoms, several authors found a strong association between their latter symptoms and signs of anxiety and depressed mood (26,27).…”

Section: Introductionmentioning

confidence: 99%

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Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents

et al. 2020

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The present case-control study aimed to investigate the relationship between alexithymia and somatic complaints in the psychopathological setting of non-suicidal self-injury (NSSI). A clinical sample of 134 adolescents (115 females; 85.5%) from 12 to 18 years old engaging in NSSI was compared with a control group of 243 high-school students (157 females; 64.6%) from 13 to 18 years old. Data were collected using two questionnaires: The Youth Self-Report 11-18 and the 20 Toronto Alexithymia Scale. In both cases and controls, the presence of somatization and alexithymia was associated with more severe psychopathological problems. Analyses were conducted to explore the association between somatic disorders and alexithymia. In the clinical group, somatic complaints were reported by 95.9% of alexithymic individuals, whereas only 44.3% of alexithymic adolescents reported somatic complaints. A one-way relationship emerged between somatization and alexithymia: while alexithymia would seem to be a factor associated with self-injury, somatic disorders were strongly associated with alexithymia, but not necessarily with self-injury. Among the self-harming adolescents, those with both alexithymia and somatization had a more severe psychopathological picture than the individuals with alexithymia but no somatization. This would suggest that, in the setting of NSSI, greater difficulty with identifying feelings is associated with somatization, and alexithymia would be an attribute common to self-harming behavior and somatization, both of which are characterized by the body being used to express psychological and emotional problems. Future research could further investigate alexithymia in self-harming individuals, in relation to any presence or absence of somatic disorders, with longitudinal assessments on any differences in their manifestation of self-injury and its psychopathological correlates.

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Section: Discussionmentioning

confidence: 99%

Section: Study Protocol and Materialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents

et al. 2020

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Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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Background: This report evaluates whether anger attacks (sudden uncharacteristic bouts of anger that are associated with autonomic arousal and/or aggression) in patients with major depressive disorder (MDD) are associated with elevated suicidal ideation (SI; active suicidal thoughts and plans). Methods: Participants of Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study who completed Massachusetts General Hospital Anger Attack Questionnaire (AAQ) at baseline were included (n = 293). Levels of SI (suicidal thoughts factor of Concise Health Risk Tracking) were compared at baseline with generalized linear models, and during Stage 1 (baseline-to-week-8) and Stage 2 (week-8-to-week-16) with repeated-measures mixed model analyses. Covariates included age, sex, race, ethnicity, site, and treatment arm. Results: At baseline, participants with (n = 109) versus without anger attacks (n = 184) had higher levels of SI (Cohen's d effect size [d] = 1.20). Those with ≥9 anger attacks in the past month had significantly higher SI than those with 1-2 (d = 1.21), 3-4 (d = 1.48), and 5-8 (d = 0.94) anger attacks in the past month. Furthermore, participants with anger attacks at baseline reported higher SI at each post-baseline visit (both Stages 1 and 2) of EMBARC study (d = 0.39-0.77; all p < .05). Associations between anger attacks and SI were significant even after controlling for irritability, hostility, anxious arousal, depression, suicide propensity, and self-reported pain at baseline and lifetime suicidal tendencies. Similar results were found in participants with aggressive behaviors. Conclusion: Anger attacks in outpatients with MDD may be associated with chronically elevated SI.

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Somatoforme Störungen

Kasten¹

2020

Handbuch Klinische Psychologie

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Suicidality in patients with somatoform disorder – the speechless expression of anger?

Cited by 32 publications

References 67 publications

Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents

Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Somatoforme Störungen

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