ArticleFrontiers in psychiatry2025
Alexithymia mediates the pathway from negative life events to somatic symptoms: a cross-sectional study in a psychosomatic outpatient sample.
Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Somatic Symptom Disorder (SSD), characterized by distressing and functionally impairing physical symptoms without adequate medical explanation, imposes substantial personal and socioeconomic burdens. While negative life events (NLEs) and alexithymia (difficulty identifying/describing emotions) are established risk factors for somatic symptoms, their interrelationships and underlying mechanisms remain inadequately explored. This study investigated whether alexithymia mediates the pathway between NLEs and somatic symptoms in a clinical sample. Methods: A cross-sectional analysis was conducted with 523 psychosomatic outpatients (65.2% female, mean age 41.45 ± 12.36 years) from Peking Union Medical College Hospital (2020-2025). Participants completed: 1) the Results: NLEs and alexithymia were significantly correlated with somatic symptoms (r = 0.330 and r = 0.369, respectively, p<0.01). Linear regression confirmed both as significant predictors, explaining 11% and 13.6% of somatic symptom variance, respectively. Alexithymia subscales DIF (β = 0.220, p<0.001) and DDF (β = 0.141, p = 0.014) contributed significantly, while externally oriented thinking (EOT) did not. Crucially, mediation analysis revealed alexithymia partially mediated the NLEs-somatic symptoms pathway (indirect effect: B = 0.0028, 95% CI[0.001, 0.005]), accounting for 16.25% of the total effect. A bidirectional mediation effect was also observed, with NLEs mediating 11.9% of the alexithymia-somatic symptoms relationship. Conclusion: Alexithymia significantly mediates the relationship between NLEs and somatic symptoms in psychosomatic outpatients, though its effect size (16.25%) suggests additional multifactorial pathways. Conversely, NLEs also partially mediate the alexithymia-symptom relationship, indicating complex bidirectional dynamics. Clinically, interventions targeting both alexithymia and NLE exposure may alleviate somatic symptom burden.
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