How alexithymia impacts the association between interpersonal trauma and somatization

Exposure to traumatic events has many health-related sequalae, one of which is somatization. Somatization is the manifestation of psychological or emotional distress in bodily symptoms, often leading to distressing thoughts and behaviors related to the physical symptoms and unusual or persistent requests for medical assistance. Interpersonal trauma, which includes traumatic events that occur in the context of an interpersonal relationship (e.g., physical/emotional/sexual assault, intimate partner violence, childhood trauma) has been strongly linked to somatic symptoms. Another potential risk factor for somatization is alexithymia, such that individuals with alexithymia struggle to understand their emotional distress and thus confuse it with bodily distress. The current study utilized secondary data analysis to investigate these constructs using a subset of items from the Traumatic Life Events Questionnaire, the somatization subscale of the Symptom Checklist-90 Revised, and the Toronto Alexithymia Scale. It was hypothesized that higher ratings of interpersonal trauma would be associated with higher levels of somatization, and that this relationship would be moderated by levels of alexithymia. In a cross-sectional study of 531 young adults aged 18 to 29, interpersonal trauma and somatization demonstrated a small significant relationship (r = 0.178, p < 0.001), and the relationship between interpersonal trauma and somatization was moderated by alexithymia, β = 0.001, p = 0.027. The effect of interpersonal trauma on somatization was smaller when alexithymia was low (effect = 0.018) than the effect when alexithymia was high (effect = 0.043), showing that the relationship between trauma and somatization is stronger for individuals who have higher levels of alexithymia. Based on these findings, identification of alexithymia within trauma exposed individuals may be important in understanding one's risk for developing somatic symptoms. Further implications for understanding, identifying, and treating somatization in traumatized samples are discussed, such as considering alexithymia as a treatment target in psychosocial interventions.