신체증상장애와 관련된 분노정서특질과 아동기 역경 경험

Abstract

Objective : The present study aims to investigate differences in anger-related features in patients withsomatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and angerregulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examinedthe relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessedwith State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed usingthe somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory AmplificationScale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis ofcovariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725,F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they hada high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, adirected inward style of anger expression was significantly associated with somatization symptom severity(p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSDgroup than the control group (p=0.012). Within the SSD group, childhood extreme illness was associatedwith higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversityof extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-relatedfeatures and its relationship with childhood adversity in the pathophysiology of SSD.