title: Relationships among alexithymia and pain intensity, pain interference, and vitality in persons with neuromuscular disease: Considering the effect of negative affectivity.
abstract: Alexithymia, the inability to identify or label emotions, has been shown to be associated with pain in patients with a number of chronic pain conditions. We sought to: (1) replicate this association in samples of persons with chronic pain secondary to neuromuscular disease, (2) extend this finding to other important pain-related measures, and (3) to determine whether relationships among alexithymia and study variables existed after controlling for negative affect. One hundred and twenty-nine individuals with muscular dystrophy and chronic pain were administered measures of alexithymia (Toronto Alexithymia Scale, TAS-20), pain intensity (0-10 NRS), pain interference (Brief Pain Inventory Interference scale), mental health (SF-36 Mental Health scale; as a proxy measure of negative affect) and vitality (SF-36 Vitality scale). Higher TAS scores were associated significantly with higher pain intensity and interference, and less vitality. Although the strengths of these associations were reduced when mental health was used as a control, the associations between the Difficulty Identifying Feelings scale and vitality, and the Externally Oriented Thinking and Total TAS scales and pain intensity remained statistically significant. The findings replicate and extend previous findings concerning the associations between alexithymia and important pain-related variables in a sample of persons with chronic pain and neuromuscular disease. Future research is needed to determine the extent to which the associations are due to (1) a possible causal effect of alexithymia on patient functioning that is mediated via its effects on negative affect or (2) the possibility that alexithymia/outcome relationships reflect response bias caused by general negative affectivity.
authors.affiliation: Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan Department of Rehabilitation Medicine, University of Washington School of Medicine, Box 356490, Seattle, WA, USA Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Hosoi
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Molton
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.forename: Silvia
authors.initials: S
authors.lastname: Amtmann
authors.forename: Sarah
authors.initials: S
authors.lastname: O'Brien
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Arimura
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kubo
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D000339:Affect / Q000502:physiology; D000342:Affective Symptoms / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D002908:Chronic Disease / Q000523:psychology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests; D010147:Pain Measurement / Q000379:methods; D010148:Intractable Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D055815:Young Adult