Somatoform disorders as disorders of affect regulation: a study comparing the TAS-20 with non-self-report measures of alexithymia.
OBJECTIVE
To determine the role of undifferentiated and dysregulated affects in somatoform disorders by using a multimethod assessment approach of alexithymia.


METHODS
Forty patients with ICD-10 somatoform disorders (SoD) and 20 healthy controls, matched for age, education and sex, were included in the study. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20), the Affect Consciousness Interview (ACI), and the Levels of Emotional Awareness Scale (LEAS). All classifications were made blinded with regard to clinical status.


RESULTS
Scores of the ACI and the TAS-20 showed that alexithymia is higher in SoD than in healthy controls. No differences were found on the LEAS. In terms of the multidimensionality of the alexithymia construct, our results indicate a specific positive association between SoD and a proneness to experience undifferentiated affects. The three subfactors of the TAS-20 were differentially related to non-self-report measures of alexithymia and to negative affectivity (NA). Only the cognitive facet of the TAS-20 (externally oriented thinking [EOT]) was related to the LEAS and the ACI. In contrast, the affective facets of the TAS-20-difficulties identifying feelings (DIF) and difficulties describing feelings (DDF)-were substantially related to NA.


CONCLUSIONS
The findings highlight the important role of impaired affect regulation and NA in the process of somatization.
Waller
Elisabeth
E
Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital of Freiburg, Hauptstr. 8, D-79104, Freiburg, Germany. ew@psysom.ukl.uni-freiburg.de
Scheidt
Carl Eduard
CE
D000328:Adult; D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology*; D001364:Awareness; D005260:Female; D006801:Humans; D008297:Male; D020377:Self Efficacy; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires