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신체증상장애와 관련된 분노정서특질과 아동기 역경 경험

Anger-Related Characteristics and Childhood Adversity in Somatic Symptom Disorder

대한불안의학회지 2020년 16권 2호 p.49 ~ 56
강성혁, 박천일, 김혜원, 김세주, 강지인,
소속 상세정보
강성혁 ( Kang Sung-Hyuk ) - Yonsei University College of Medicine Department of Psychiatry
박천일 ( Park Chun-Il ) - CHA University CHA Bundang Medical Center Department of Psychiatry
김혜원 ( Kim Hae-Won ) - Yonsei University College of Medicine Department of Medical Education
김세주 ( Kim Se-Joo ) - Yonsei University College of Medicine Department of Psychiatry
강지인 ( Kang Jee-In ) - Yonsei University College of Medicine Department of Psychiatry

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.

키워드

감정; 분노 표현; 아동기 역경; 신체화; 신체증상장애
Emotion; Anger expression; Childhood adversity; Somatization; Somatic symptom disorder

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