title: Insecure attachment strategies are associated with cognitive alexithymia in patients with severe somatoform disorder.
abstract: OBJECTIVE
  In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperactivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology.
  
  
  METHODS
  In a cross-sectional study among patients with somatoform disorder, self-report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strategies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology.
  
  
  RESULTS
  Only cognitive alexithymia, i.e., the inability to analyze, identify, and verbalize emotions, was associated with personality dysfunction, in particular insecure attachment strategies. Affective alexithymia, i.e., the inability to fantasize and to experience emotions, was associated (negatively) with negative affectivity but not with the personality variables.
  
  
  CONCLUSIONS
  This study, therefore, indicates that both types of alexithymia are relevant for the assessment and treatment of severe somatoform disorder, yet each type may tap into different features of somatoform disorder.
authors.affiliation: Altrecht Psychosomatic Medicine, The Netherlands jurkoel@gmail.com.
authors.forename: Jurrijn A
authors.initials: JA
authors.lastname: Koelen
authors.affiliation: Department of Clinical and Health Psychology, Leiden University, The Netherlands.
authors.forename: Elisabeth H M
authors.initials: EH
authors.lastname: Eurelings-Bontekoe
authors.affiliation: Psychologische Hochschule Berlin, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Stuke
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Leuven, Belgium Research Department of Clinical, Educational and Health Psychology, University College London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Luyten
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D010554:Personality Disorders / Q000503:physiopathology; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000503:physiopathology*
keywords: Insecure attachment; affective alexithymia; attachment strategies; cognitive alexithymia; negative affectivity; personality pathology; somatoform disorders