AUTHOR=Lanzara Roberta , Conti Chiara , Camelio Martina , Cannizzaro Paolo , Lalli Vittorio , Bellomo Rosa Grazia , Saggini Raoul , Porcelli Piero TITLE=Alexithymia and Somatization in Chronic Pain Patients: A Sequential Mediation Model JOURNAL=Frontiers in Psychology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.545881 DOI=10.3389/fpsyg.2020.545881 ISSN=1664-1078 ABSTRACT=Objective

To investigate whether chronic pain (CP) patients with somatization reported higher alexithymic traits than those without somatization and to study the different relationships between psychological characteristics, pain, health-related quality of life (HRQL), and somatization.

Method

A consecutive sample of 134 CP treatment-seeking outpatients were evaluated for alexithymia (TAS-20), somatization (PHQ-15), distress (HADS), HRQL (SF-12), and pain (BPI).

Results

Patients with somatization (37.04%) reported significantly higher TAS-20 total scores (p < 0.001) and difficulty in identifying feelings (DIF) (p < 0.001) than those without somatization. The somatizer group had also a significantly higher disease duration, severity and interference of pain, distress, and lower HRQL than the non-somatizer group. Hierarchical regression analysis showed that although distress, pain interference and the mental HRQL component are closely related to somatization (R2 = 0.55), DIF was the strongest predictor of severity of somatization (β = 0.31). A sequential indirect effect from DIF to somatization via distress symptoms and pain interference turned out to be significant [95% CI (0.01, 0.09)]. Support was also found for sequential mediation paths from DIF to somatization via distress and mental HRQL [95% CI (0.01, 0.11)].

Conclusions

Our results pointed-out that alexithymia, particularly DIF, may be major factor for somatization risk in CP patients. Longitudinal observations are needed for evaluating the role of alexithymia in clinical outcomes.