An investigation of personality factors in somatization and hypochondriacal tendencies: A study of coping style, attachment, alexithymia and empathy

Hollifield et al. (1999) recommend that hypochondriacal and somatization tendencies be characterized as personality disorders and they recommend further study to differentiate them, as the diagnostic boundaries are unclear. This study was designed to compare and contrast these tendencies using four psychological and personality constructs, namely, coping style, attachment style, alexithymia and empathy. It was hypothesized that clear and distinct differences would emerge, providing evidence that they are manifest symptoms of underlying problematic defensive and personality structures.; Findings from this study indicated that significant differences existed in the predicted direction between healthy and non-healthy groups, specifically on measures of attachment, alexithymia and empathy. However, when findings for somatization and hypochondriasis were compared, they were similar, making differentiation difficult. This may suggest that somatization and hypochondriacal processes were not successfully measured. However, due to the validity of the WI (and the lack of validity of the IHS) it is more likely that hypochondriasis (not somatization) was successfully measured.; Findings for hypochondriasis are compelling. Reports of past abuse were significantly associated and degree of hypochondriasis increased significantly as the number of kinds of abuses increased, which has never been established. Degree of Preoccupied attachment style was also moderately associated with hypochondriasis and was evidenced significantly more than for non-hypochondriacals, indicating that hypochondriacals may have experienced unpredictable caretaking. Hypochondriacals also evidenced alexithymia significantly more than non-hypochondriacals and hypochondriasis was moderately associated with alexithymia. Furthermore, they evidenced significantly lower levels of empathy than non-hypochondriacals, all consistent with predictions, but never previously established. These findings may accurately reflect underlying psychological processes involved in the hypochondriacal process. Furthermore, they are consistent with Hollifield's et al's. (1999) notion that hypochondriasis is a personality disorder and should be characterized as such. Important and powerful clinical and treatment implications are clear and findings indicate that psychodynamically oriented psychotherapy would be most useful in treating this problem. Further study is necessary to differentiate somatization from hypochondriasis and the use of a clinical interview to tap into unconscious states, as well as different scales for the variables are recommended in order to confirm these findings.