title: Alexithymia and chronic pain: the role of negative affectivity.
abstract: OBJECTIVE
  Alexithymia has been shown to be associated with key pain-related variables in persons with chronic pain from western countries, but the generalizability of these findings across cultures has not been examined adequately. Also, there remain questions regarding the importance of alexithymia to patient functioning over and above the effects of the general negative affectivity.
  
  
  METHODS
  Alexithymia, pain intensity, pain interference, depression, anxiety, and pain catastrophizing were measured in 128 Japanese patients with chronic pain. Because of the low internal consistency coefficients for 2 of the alexithymia scales (measuring difficulty describing feelings and externally oriented feelings) in our sample, we limited our analyses to a scale assessing difficulty identifying feelings and the total alexithymia scale score.
  
  
  RESULTS
  Although the 20-item Toronto Alexithymia Scale total and the Difficulty Identifying Feelings scale scores were not significantly associated with pain intensity, these scales were associated with pain interference, catastrophizing, and negative affectivity in our sample. However, these associations became nonsignificant when measures of negative affectivity were controlled.
  
  
  CONCLUSIONS
  The findings support the cross-cultural generalizability of significant associations between alexithymia and both pain interference and catastrophizing. However, whether (1) alexithymia influences patient functioning indirectly by its effects on negative affect or (2) the univariate associations found between alexithymia and measures of patient functioning are a byproduct of both being influenced by negative affect needs to be tested using longitudinal and experimental research.
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Makino
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Arimura
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Obata
authors.forename: Kozo
authors.initials: K
authors.lastname: Anno
authors.forename: Rie
authors.initials: R
authors.lastname: Iwaki
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kubo
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo
authors.forename: Masako
authors.initials: M
authors.lastname: Hosoi
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D058443:Catastrophization / Q000523:psychology*; D059350:Chronic Pain / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index