Waller Elisabeth, Scheidt Carl Eduard
Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital of Freiburg, D-79104 Freiburg, Germany.
Int Rev Psychiatry. 2006 Feb;18(1):13-24. doi: 10.1080/09540260500466774.
This paper considers the role of disturbances in affect regulation in the development and course of somatoform disorders. We first give an overview of contemporary theories in the field of psychosomatic medicine that links deficits in emotion regulation to the process of somatization, and then review recent empirical research that focuses on the association between affect regulation and somatoform disorders, with an emphasis on studies investigating the alexithymia construct. Overall, the findings suggest that somatoform disorders are linked to a diminished capacity to consciously experience and differentiate affects and express them in an adequate or healthy way. It must be noted, however, that this result has not been obtained exclusively for somatoform disorders. A promising approach to further our understanding of the developmental roots of impaired affect regulation in somatoform disorders is attachment research. The attachment research reviewed in this paper indicates that a dismissing status of attachment is linked to defensive forms of processing and expressing emotions. We present some new data that not only provide empirical support of a high proportion of dismissing attachment in somatoform disorders but also suggest that the degree to which somatoform disorder patients employ dismissing attachment strategies is strongly related to affect dysregulation. Finally, some implications for psychotherapeutic interventions in patients with somatoform disorders are considered.
本文探讨了情绪困扰在躯体形式障碍的发展和病程中对情感调节的作用。我们首先概述了心身医学领域的当代理论，这些理论将情绪调节缺陷与躯体化过程联系起来，然后回顾了最近的实证研究，这些研究聚焦于情感调节与躯体形式障碍之间的关联，尤其着重于对述情障碍这一概念的研究。总体而言，研究结果表明，躯体形式障碍与有意识地体验、区分情感并以适当或健康方式表达情感的能力减弱有关。然而，必须指出的是，这一结果并非仅在躯体形式障碍中出现。依恋研究是进一步理解躯体形式障碍中情感调节受损的发展根源的一个有前景的方法。本文所回顾的依恋研究表明，疏离型依恋状态与处理和表达情感的防御形式有关。我们展示了一些新数据，这些数据不仅为躯体形式障碍中高比例的疏离型依恋提供了实证支持，还表明躯体形式障碍患者采用疏离型依恋策略的程度与情感失调密切相关。最后，我们考虑了对躯体形式障碍患者心理治疗干预的一些启示。
