A Conditional Process Model to Explain Somatization During Coronavirus Disease 2019 Epidemic: The Interaction Among Resilience, Perceived Stress, and Sex.

Fangfang Shangguan,Chenhao Zhou,Zhengkui Liu,Xiang Yang Zhang,Chen Zhang,Wei Qian

doi:10.3389/fpsyg.2021.633433

Abstract

BackgroundMore than 15% of Chinese respondents reported somatic symptoms in the last week of January 2020. Promoting resilience is a possible target in crisis intervention that can alleviate somatization.ObjectivesThis study aims to investigate the relationship between resilience and somatization, as well as the underlying possible mediating and moderating mechanism, in a large sample of Chinese participants receiving a crisis intervention during the coronavirus disease 2019 epidemic.MethodsParticipants were invited online to complete demographic information and questionnaires. The Symptom Checklist-90 somatization subscale, 10-item Connor–Davidson resilience scale, and 10-item Perceived Stress Scale were measured.ResultsA total of 2,557 participants were included. Spearman correlation analysis revealed that lower resilience was associated with more somatic symptoms (p < 0.001). The conditional process model was proved (indirect effect = −0.01, 95% confidence interval = [−0.015, −0.002]). The interaction effects between perceived stress and sex predicted somatization (b = 0.05, p = 0.006).ConclusionResilience is a key predictor of somatization. The mediating effects of perceived stress between resilience and somatization work in the context of sex difference. Sex-specific intervention by enhancing resilience is of implication for alleviating somatization during the coronavirus disease 2019 epidemic.

Highlights

Somatization is common in primary care across cultures (Gureje et al, 1997)
Considering that some factors might influence the results of this study, 15 of the participants were excluded because their relatives or friends were infected with COVID-19, and 189 participants were excluded because they have a history of mental disorder or are taking medication
The results indicated significant sex differences in resilience (p < 0.001), perceived stress (p < 0.001), and somatic symptoms (p < 0.001), with the female having lower resilience and suffering more stress as well as more somatic symptoms

Summary

Introduction

Somatization is common in primary care across cultures (Gureje et al, 1997). Approximately 20% of primary care patients report “non-specific, functional, and somatoform bodily complaints” (Schaefert et al, 2012). People with somatic symptoms always tend to seek medical or nonmedical help for reassurance (Zantinge et al, 2005; Budtz-Lilly et al, 2015), but somatization is difficult to treat (Zantinge et al, 2005; Jones and de C Williams, 2019). It hinders the understanding of somatization in view of the heterogeneity of somatic symptoms and the difficulty of collecting data from a big sample size within a limited time. Promoting resilience is a possible target in crisis intervention that can alleviate somatization

Objectives

Methods

Results

Discussion

Conclusion