Abstract
Alexithymia was found to be associated with a variety of somatic complaints, including somatoform pain symptoms. This study addressed the question of whether the different facets of alexithymia are related to responses in heat pain stimulation and its interrelations with levels of everyday pain as assessed by self-report. In the study, sensitivity to heat pain was assessed in 50 healthy female participants. Alexithymia facets were assessed by the Toronto Alexithymia Scale. Pain threshold and tolerance were determined using a testing the limits procedure. Participants, furthermore, rated subjective intensities and unpleasantness of tonic heat stimuli (45.5-47.5°C) on visual analog scales and on a questionnaire. Possible confounding with temperature sensitivity and mood was controlled. Everyday pain was assessed by self-report addressing everyday pain frequency, intensity, and impairment experienced over the last 2 months. Main results were that the facets of alexithymia were differentially associated with pain perception. The affective scale "difficulties in describing feelings" was associated with hyposensitivity to pain as indicated by higher pain tolerance scores. Furthermore, everyday pain frequency was related to increased alexithymia values on the affective scale "difficulties in identifying feelings," whereas higher values on the cognitive alexithymia scale "externally oriented thinking" were related to lower pain impairment and intensity. We conclude that the different facets of alexithymia are related to alternations in pain processing. Further research on clinical samples is necessary to elucidate whether different aspects of alexithymia act as a vulnerability factor for the development of pain symptoms.
Highlights
Alexithymia is characterized by a marked difficulty to identify, describe, and express one’s emotions [1, 2] and has been related to a broad range of somatic and psychiatric disorders {e.g., alcoholism, drug addiction, somatoform disorders [see Ref. [3, 4]]}
Different studies could demonstrate that healthy participants scoring high on alexithymia report more somatic complaints [11], leading to the assumption that alexithymia is associated with over-reporting of physical symptoms, including pain
Recent data [15, 16] support this notion, as, e.g., in the general population, higher levels of alexithymia are associated with higher risk of having chronic pain
Summary
Alexithymia is characterized by a marked difficulty to identify, describe, and express one’s emotions [1, 2] and has been related to a broad range of somatic and psychiatric disorders {e.g., alcoholism, drug addiction, somatoform disorders [see Ref. [3, 4]]}. Different studies could demonstrate that healthy participants scoring high on alexithymia report more somatic complaints [11], leading to the assumption that alexithymia is associated with over-reporting of physical symptoms, including pain. Previous studies support this view: a meta-analytic review of 18 studies [12] found significant positive correlations between alexithymia (facet DIF) and measures of somatic symptoms. This study addressed the question of whether the different facets of alexithymia are related to responses in heat pain stimulation and its interrelations with levels of everyday pain as assessed by self-report
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