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Personality Trait of Somatization Disorder

Personality Trait of Somatization Disorder

Personality characteristics, like the tendency to amplify bodily sensations, to focus excessively on physical symptoms, and to misinterpret physical symptoms may predispose individuals to somatization. Somatization may also reflect a form of ‘‘neuroticism’’. Somatizers score high on measures of neuroticism such as self-consciousness, vulnerability to stress, low self-esteem, anxiety, depression, and hostility. Somatization has also been associated with negative affectivity. The tendency to misinterpret bodily sensations or to overreact to minor bodily sensations as disabling has been interpreted as an enduring personality trait.
The term alexithymia also describes a personality trait that is apparently common among individuals with psychosomatic disorders. Patients with alexithymia have difficulties expressing affect, their fantasies tend to be devoid of feelings and emotions, and their thinking is characterized primarily by concrete operations rather than abstract operations. Although Shipko reported a positive relationship between somatization and alexithymia, it is unclear whether alexithymia is really a manifestation of an emotional state, a cognitive style, or a form of repression and denial. More recent data suggests that somatization and alexithymia are independent of each other. Developmental Learning.Childhood experiences that involve exposure to models with frequent complaints of pain play an instrumental role in childhood somatization. Children who learn early that being ill or complaining of symptoms is likely to be rewarded with attention and sympathy or to lead to avoidance of conflict and responsibilities will be predisposed toward somatization as a coping style. Later, as adults, these individuals maintain their behavior because of secondary gain and social reinforcement. The relationship between pain behavior and role models has received support in children with recurrent abdominal pain, headache, and low back pain. Family environment has also been implicated in the development of somatization. Sherry, McGuire, Mellins, Salmonson, Wallace, and Nepom found two predominant abnormal family milieus present in 100 children with musculoskeletal pain. One family environment could best be described as cohesive, stable, organized but intolerant of separation and individuation. The second predominant family milieu was characterized as chaotic, emotionally unsupportive, and highly conflictual. In a healthy sample of 933 subjects, ages ranging from 6–16, an examination of the relationship between family environment and physical health complaints indicated that disorganized and less cohesive family environments were associated with more health complaints. In a two-year longitudinal study, parental lack of care was the best predictor of adult somatization. Finally, Livingston, Witt, and Smith found that parental somatization, substance abuse, and antisocial symptoms predicted children’s somatization. In addition, children of adults with DSM-III-R somatization disorder had 11.7 times more emergency room visits and missed 8.8 times more school than children of adults with few unexplained somatic symptoms.

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