Relationship between alexithymia and coping strategies in patients with somatoform disorder

Figures & data

Table 1 Demographics in patients with somatoform disorder (N=196)

Patient characteristics	N	%
Sex
Female	131	66.8
Male	65	33.2
Mean (SD) age, years	41.27 (15.4)
Educational level
Junior high school, <10 years	3	1.5
Senior high school, <13 years	56	28.6
College, <15 years	52	26.5
University, ≥15 years	85	38.8
Marital status
Single	93	47.4
Married	71	36.2
Separated	4	2.0
Divorced	25	12.8
Widowed	3	1.5
Employment
In school	8	4.1
Housewife	47	24.0
Retired	5	2.6
Worker (employed)	136	69.4
Living situation
Living with partner or parents	144	73.5
Living alone	50	25.5
ICD10
45.0 Somatization disorder	3	1.5
45.1 Undifferentiated somatoform disorder	47	24.0
45.3 Somatoform autonomic dysfunction	46	23.5
45.4 Persistent somatoform pain disorder	20	10.2
45.8 Other somatoform disorders	43	21.9
45.9 Somatoform disorder, unspecified	37	18.9

Abbreviations: ICD10, International Classification of Diseases, Tenth Revision; SD, standard deviation.

Table 2 Mean scores on the 20-item Toronto Alexithymia Scale, Screener for Somatoform Disorders, Somatosensory Amplification Scale, Zung Self-Rating Depression Scale, Spielberger State–Trait Anxiety Inventory, and Stress Coping Inventory

	Mean	SD
Prior visits to clinical departments	3.64	2.33
Duration of somatic symptoms, months	14.30	21.07
Number of somatic symptoms (SSD)	4.93	1.93
SSAS	30.78	5.92
SDS	51.28	9.27
STAI-trait (II)	57.73	11.06
STAI-state (I)	55.91	10.31
TAS-20	56.21	10.57
DIF	20.76	6.12
DDF	15.95	4.33
EOT	19.55	3.94
Stress Coping Scale
Planful problem solving	6.57	3.77
Confrontive coping	6.06	3.33
Seeking social support	6.42	4.07
Accepting responsibility	7.35	4.10
Self-control	6.88	3.21
Escape–avoidance	5.91	2.83
Distancing	5.42	3.18
Positive reappraisal	6.44	3.97

Note: Visits to prior clinical departments included those to internal medicine, family medicine, the emergency room, and specialists.

Abbreviations: DDF, difficulty in describing feelings; DIF, difficulty in identifying feelings; EOT, externally oriented thinking; SDS, Zung Self-Rating Depression Scale; SSAS, Somatosensory Amplification Scale; SSD, Screener for Somatoform Disorders; STAI, Spielberger State–Trait Anxiety Inventory; TAS-20, 20-item Toronto Alexithymia Scale.

Table 3 Associations between the 20-item Toronto Alexithymia Scale, demographic variables, psychological variables, and the Stress Coping Scale

	TAS-20	DIF	DDF	EOT
Age	−0.27***	−0.24***	−0.41***	0.09
Sex	0.10	0.18*	0.09	−0.12
Duration of somatic symptoms, months	0.06	0.01	0.05	0.11
Number of previous clinic visits	−0.08	0.03	−0.03	−0.05
Number of somatic symptoms (SSD)	−0.35***	0.31***	0.27***	0.15*
Psychological variables
SDS	0.49***	0.45***	0.47***	0.11
STAI-state (I)	0.61***	0.42***	0.27***	0.18*
STAI-trait (II)	0.61***	0.54***	0.53***	0.20**
SSAS	0.43***	0.44***	0.37***	0.08
Stress Coping Scale
Planful problem solving	−0.25***	−0.10	−0.23**	−0.26***
Confrontive coping	−0.18*	0.03	−0.18*	−0.34***
Seeking social support	−0.25***	−0.07	−0.28***	−0.25***
Accepting responsibility	0.07	0.13	0.07	−0.08
Self-control	0.00	0.12	0.00	−0.20**
Escape–avoidance	0.09	0.21*	0.02	−0.09
Distancing	−0.01	0.10	−0.05	−0.12
Positive reappraisal	−0.29***	−0.13	−0.25***	−0.30***

Note:

* P<0.05

** P<0.01

*** P<0.001.

Abbreviations: DDF, difficulty in describing feelings; DIF, difficulty in identifying feelings; EOT, externally oriented thinking; SDS, Zung Self-Rating Depression Scale; SSAS, Somatosensory Amplification Scale; SSD, Screener for Somatoform Disorders; STAI, Spielberger State–Trait Anxiety Inventory; TAS-20, 20-item Toronto Alexithymia Scale.

Table 4 Results from the multiple regression analyses on the 20-item Toronto Alexithymia Scale total score with the three subscales as dependent variables

	Unstandardized coefficients		Standardized coefficients	t	P
	β	SE	β
TAS-20
STAI-trait (II)	0.47	0.06	0.49	8.14	***
SSAS	0.38	0.11	0.21	3.47	***
Seeking social support	−0.47	0.14	−0.18	−3.34	***
DIF
STAI-trait (II)	0.24	0.04	0.43	6.74	***
SSAS	0.22	0.07	0.21	3.30	**
Escape–avoidance	0.33	0.13	0.15	2.60	*
DDF
Age	−0.08	0.02	−0.27	−4.63	***
STAI-trait (II)	0.17	0.02	0.44	7.50	***
Seeking social support	−0.22	0.06	−0.20	−3.62	***
EOT
STAI-state (I)	0.07	0.03	0.19	2.82	**
Confrontive coping	−0.41	0.08	−0.35	−5.25	***

Notes:

* P<0.05

** P<0.01

*** P<0.001; TAS-20: R²=0.434, adjusted R²=0.425, F=49.34; DIF: R²=0.366, adjusted R²=0.356, F=37.15; DDF: R²=0.63, adjusted R²=0.40, F=42.4; EOT: R²=0.152, adjusted R²=0.143, F=17.32.

Abbreviations: DDF, difficulty in describing feelings; DIF, difficulty in identifying feelings; EOT, externally oriented thinking; SE, standard error; STAI, Spielberger State–Trait Anxiety Inventory; TAS-20, 20-item Toronto Alexithymia Scale; SSAS, Somatosensory Amplification Scale.