Abstract
ObjectiveThe etiology of somatization is incompletely understood, but could be elucidated by models of psychosocial stress. Academic exam stress has effectively been applied as a naturalistic stress model, however its effect on somatization symptoms according to ICD-10 and DSM-IV criteria has not been reported so far. Baseline associations between somatization and personality traits, such as alexithymia, have been studied exhaustively. Nevertheless, it is largely unknown if personality traits have an explanatory value for stress induced somatization.MethodsThis longitudinal, quasi-experimental study assessed the effects of university exams on somatization — and the reversal of effects after an exam-free period. Repeated-observations were obtained within 150 students, measuring symptom intensity before, during and after an exam period, according to the Screening for Somatoform Symptoms 7-day (SOMS-7d). Additionally, self-reports on health status were used to differentiate between medically explained and medically unexplained symptoms. Alexithymia, neuroticism, trait-anxiety and baseline depression were surveyed using the Toronto-Alexithymia Scale (TAS-20), the Big-Five Personality Interview (NEO-FFI), the State Trait Anxiety Inventory (STAI) and Beck’s Depression Inventory (BDI-II). These traits were competitively tested for their ability to explain somatization increases under exam stress.ResultsSomatization significantly increased across a wide range of symptoms under exam stress, while health reports pointed towards a reduction in acute infections and injuries. Neuroticism, alexithymia, trait anxiety and depression explained variance in somatization at baseline, but only neuroticism was associated with symptom increases under exam stress.ConclusionExam stress is an effective psychosocial stress model inducing somatization. A comprehensive quantitative description of bodily symptoms under exam stress is supplied. The results do not support the stress-alexithymia hypothesis, but favor neuroticism as a personality trait of importance for somatization.
Highlights
Somatization has been defined as the “tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it” [1]
The present study investigated somatization by exploring increases in medically unexplained symptoms (MUS) as a reaction to naturalistic psychosocial stress and by competitively testing the explanatory value of several personality traits including alexithymia
We could show that somatization significantly increased under exam stress across a range of symptom dimensions in healthy university students
Summary
Somatization has been defined as the “tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it” [1]. The causes of somatization have been hypothesized to be multifactorial, involving several mechanisms (for review see: [1,3,4]). The belief that alexithymia causes or contributes to somatization is mainly based on cross-sectional studies, which do not allow causal inferences [8,9]. Alexithymia has been hypothesized to affect somatization by modulating physiological responses to stress [11]. This “stress-alexithymia hypothesis” has been experimentally tested on measures of autonomic reactivity [12,13], its relevance for somatization induced by a naturalistic psychosocial stressor has, to our knowledge, not been tested to date
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
