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Predicting improvement in cognitive behavioral therapy for somatization disorder: the role of alexithymia
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Title
Predicting improvement in cognitive behavioral therapy for somatization disorder: the role of alexithymia
Name
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Reese
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Jennifer Barsky
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Jennifer Barsky Reese
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author
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Woolfolk
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Robert
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Advisory Committee
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Robert L. Woolfolk
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chair
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Rosen
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Raymond
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Advisory Committee
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Raymond C. Rosen
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internal member
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Karlin
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Robert
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Advisory Committee
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Robert Karlin
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internal member
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Allen
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Lesley
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Advisory Committee
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Lesley Allen
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outside member
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Rutgers University
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degree grantor
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Graduate School - New Brunswick
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school
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theses
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2008
DateOther
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2008-10
Language
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English
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electronic
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viii, 89 pages
Abstract
Alexithymia has been defined as difficulty identifying and expressing emotions and an externally oriented mode of thinking. Previous research has linked alexithymia with somatoform symptoms yet there is little prospective data examining the role of alexithymia in somatization disorder. Thus, changes in alexithymia were examined over the course of a 10-session controlled trial of cognitive behavioral therapy for somatization disorder. It was predicted that the treatment would lead to reductions in alexithymia not seen in the group whose physicians received only a psychiatric consultation letter (PCL) and that CBT participants would score significantly lower on alexithymia than PCL participants. It was also hypothesized that changes in alexithymia from pre- to post-test, assessed through the Toronto Alexithymia Scale (TAS-20), would predict improvement in somatization symptoms, as assessed through the Clinician's Global Impression Scale for Somatization Disorder (CGI-SD) at post-test and at 12-month follow-up. Daily symptom diaries and physical functioning, assessed through the MOS-PF, were also examined as outcomes. Participants were 84 individuals diagnosed with full somatization disorder according to the DSM-IV. Baseline severity and post-treatment mental health, defensiveness, and somatosensory amplification were controlled for in regression analyses. Results partially supported hypotheses. Participants in the CBT condition decreased more in the TAS-20 and the DIF domain and marginally more in the EOT domain over the course of the study than participants in the PCL condition. They differed significantly from PCL participants at post-treatment in the EOT domain but not in the full scale TAS-20 or in any other domains. There were no significant differences between groups in alexithymia at follow-up. Decreases in alexithymia were significantly correlated with improvement in somatization symptoms and greater physical functioning. Although decreases in alexithymia significantly predicted certain outcomes at post-treatment and follow-up over and above control variables, tests for mediation yielded non-significant results. Findings from the current study support emotional functioning as a factor in somatization but do not advance the notion of alexithymia as a mediator of improvement in treatment for somatization disorder. Implications and suggestions for future areas of research are discussed.
Note
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Ph.D.
Note
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Includes bibliographical references (p. 70-74).
Subject
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Topic
Psychology
Subject
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Topic
Somatization disorder
Subject
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Topic
Alexithymia
Subject
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Topic
Cognitive therapy
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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http://hdl.rutgers.edu/1782.2/rucore10001600001.ETD.17555
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ETD_816
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NjNbRU
Identifier
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doi:10.7282/T3J966NF
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ETD doctoral
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Rights
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The author owns the copyright to this work.
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Copyright protected
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Open
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Name
Jennifer Reese
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Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
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Non-exclusive ETD license
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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