Harm avoidance and persistence are associated with somatoform disorder psychopathology: A study in Taiwan

Wei-Lieh Huang; Tzu-Ting Chen; I-Ming Chen; Li-Ren Chang; Yu-Hsuan Lin; Shih-Cheng Liao; Susan Shur-Fen Gau

doi:10.1016/j.jad.2016.02.009

Harm avoidance and persistence are associated with somatoform disorder psychopathology: A study in Taiwan

J Affect Disord. 2016 May 15:196:83-6. doi: 10.1016/j.jad.2016.02.009. Epub 2016 Feb 10.

Authors

Wei-Lieh Huang¹, Tzu-Ting Chen², I-Ming Chen³, Li-Ren Chang⁴, Yu-Hsuan Lin⁵, Shih-Cheng Liao⁶, Susan Shur-Fen Gau⁷

Affiliations

¹ Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan.
³ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
⁶ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: scliao@ntu.edu.tw.
⁷ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.

PMID: 26919056
DOI: 10.1016/j.jad.2016.02.009

Abstract

Background: Whether personality features affect the development of somatoform disorders and their psychopathologies is an important issue. Aim of this study was to resolve this issue by comparing indicators of psychopathology and personality features in subjects with somatoform disorders and healthy controls.

Methods: This study recruited 148 subjects with somatoform disorders and 146 healthy controls. The severity of psychopathology was measured with the Patient Health Questionnaire-15 (PHQ-15), Health Anxiety Questionnaire (HAQ), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). The Tridimensional Personality Questionnaire (TPQ) was used to assess personality features. Demographic data, psychopathology indicators, and TPQ scores were compared between groups. Correlation and multivariate linear regression analysis were used to identify the personality dimensions or demographic variables associated with psychopathology.

Results: The somatoform group had lower novelty seeking (NS) and reward dependence (RD) and higher harm avoidance (HA) and severity of psychopathologies. Multiple regression analysis revealed that fatigability, persistence, gender, and education level were predictive of PHQ-15; HA, educational level, persistence, and dependence were predictive of HAQ; HA, persistence, education level, and NS were predictive of BDII-II; and fatigability, education level, persistence, and anticipatory worry were predictive of BAI. The development of somatoform disorders was associated with fatigability, age, residence location, education level, and attachment.

Limitations: The limitations include heterogeneity of the diagnosis, the high proportion of undifferentiated somatoform disorder, and the cross-sectional study design.

Conclusion: HA/fatigability, persistence, and education level are associated with each type of psychopathology. Fatigability is a powerful predictor of somatoform disorder development.

Keywords: Fatigability; Harm avoidance; Persistence; Psychopathologies; Somatoform disorders; Tridimensional personality questionnaire.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / psychology
Avoidance Learning*
Case-Control Studies
Cross-Sectional Studies
Fatigue / psychology
Female
Harm Reduction*
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Personality
Personality Inventory
Psychiatric Status Rating Scales
Psychopathology
Reward
Somatoform Disorders / psychology*
Surveys and Questionnaires
Taiwan