Abstract
Objective: Rejection sensitivity (RS) is often associated with mental disorders but as yet has not been investigated in patients with somatoform pain disorder (SPD). The aim of the study was to explore the degree of RS in patients with SPD compared to healthy controls. In addition, we examined factors associated with RS and the moderator effect of SPD.Methods: A total of 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) and 65 age- and gender-matched healthy controls participated. Rejection Sensitivity Questionnaire (RSQ), Patient Health Questionnaire (PHQ-9, PHQ-15), Relationship Scale (ReSQ), Essen Trauma Inventory (ETI) and the Childhood Trauma Questionnaire (CTQ) were applied. Multiple linear regression analysis was performed.Results: The level of RS was significantly higher in patients with SPD compared to healthy controls (M = 10.30, SD = 5.64; M = 6.13, SD = 2.50; p < 0.001; d = 0.95). Higher levels of depressive symptoms (p < 0.001), childhood adversities (p < 0.001) and the insecure attachment style (p = 0.007) were related to higher levels of RS. No significant moderation effect was detected.Conclusions: Patients with SPD are highly sensitive to social rejection. In addition, insecure attachment styles as well as depressive symptoms and childhood adversities are strongly associated with RS. Further studies are needed to figure out how RS is connected to SPD over lifetime.
Highlights
Somatoform pain disorder (SPD) is defined by the presence of pain that either persists in the absence of a physical condition or is not fully explained by a medical condition
Inclusion criteria for the patient groups consisted of the diagnosis of “pain disorder associated with psychological factors” according to Code 307.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV) [1], which is consistent with the International Classification of Diseases criteria (ICD-10) [31]
We investigated the association between attachment style, number of traumatic events, childhood adversities, depressive symptoms, presence of SPD, sociodemographic characteristics age, gender, education and Rejection Sensitivity (RS)
Summary
Somatoform pain disorder (SPD) is defined by the presence of pain that either persists in the absence of a physical condition or is not fully explained by a medical condition. Psychological factors are central in the onset, severity, exacerbation and maintenance of SPD, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [1]. The recent edition (DSM-5) introduced somatic symptom disorder (SSD) as a single diagnostic entity that replaces. SPD and other somatoform disorders and no longer differentiates between medically unexplained or explained symptoms. Current models assume somatoform pain results from a complex interaction between bio- and psychosocial factors [4, 5] but the associated etiology and maintenance are still poorly understood. It is necessary to identify associated factors for better understanding and future interventions
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