Relations entre dimensions émotionnelles et symptômes somatiques : effets médiateurs de la dépression et de l’alexithymie

Objectives

The aim of the present study was first to complete previous research on negative affectivity, alexithymia, depression and somatic symptoms by testing a theoretical model of their relations. It was second to investigate potential mediating effect on the relations between negative emotionality (i.e. neuroticism) and somatic symptoms.

Patients and method

A sample of 309 subjects (77% F et 23% M; mean age = 20, 61 ± 1.55) completed the following questionnaires: the Positive and Negative Emotion questionnaire-31 items (EPN-31), the Toronto Alexithymia Scale 20 items (TAS-20), the Center for Epidemiological Studies Depression scale (CES-D), and the Symptom Check List Revised, 90 items (SCL-90 R). Theoretical model and mediating effects were tested using structural equation modeling, and bootstrapping method.

Results

Three measurement models were tested: First, a direct effect model did not fit the data. Second, a partially mediated model fit partially the data for some indices, but not for others, and was rejected for lack of parsimony. Finally, a full mediation model showed the best adjustment with results confirming the good fit of this structural model including (Chi² = 10.245, P = 0.069, ns; CFI = 0.989 > 0.95, RMSEA = 0.058 < 0.07 [90% IC = 0.000–0.100], SRMR = 0.026 < 0.08). So as, our results show that alexithymia and depression are full mediators of the negative affectivity–somatic symptoms relation. In other words, when depression and alexithymia are introduced in the relation between negative affectivity and somatic symptoms, the direct effect of negative affectivity becomes non-significant, and turns to an indirect effect. Moreover, depression as a stronger effect on somatic symptoms than alexithymia, which seems to confirm previous research on the distinction between both constructs. These results are compatible with that of previous works on somatic symptoms and negative affectivity, and on somatic symptoms and alexithymia.

Conclusion

The propensity to experiment negative emotional states may contribute to develop negative emotion regulation strategies such as alexithymia, which as a direct effect on somatic symptoms. But more precisely, we can hypothesize that alexithymia is not fully efficient as a defense against negative emotions, and that depression remains a strong characteristic of subjective emotional experience for some subjects, constituting a strong contributor to declarative somatic symptoms. Implications for psychotherapy are discussed, supporting the enhancement of negative emotions regulations strategies for subjects showing somatic complaints.