Background: Between 22% and 58% of patients in primary care settings complain of somatic symptoms. Previous research has found that somatization was associated with anger traits and family functions. However, studies that specifically assess the moderating effect of family function in how anger traits become somatic complaints are lacking.
Aim: This study was designed to examine whether the variances in family cohesion and family adaptability moderated the strength of the relationship between anger traits and somatization.
Methods: A cross-section design was conducted and 2008 college students were recruited from a comprehensive university in Shanghai. All participants finished questionnaires including Symptom Check List- 90 (SCL-90), State-Trait Anger Expression Inventory 2 (STAXI-2, Chinese version) and Family Adaptability and Cohesion Scale, second edition (FACES II, Chinese Version) to assess their degree of current somatization, anger trait and family function. Hierarchical linear regression analysis (Enter) was conducted respectively for men and women to examine the moderation effect of family cohesion and family adaptability in the association between anger and somatization.
Results: Somatic symptoms were significantly linked in the expected directions with depression and anger trait for both genders. Family cohesion and family adaptability were negatively associated with somatic symptoms. For female college students family cohesion was found to moderate the link between anger trait and somatization, but for male college students the moderation effect of family cohesion was marginally significant. The moderating role of family adaptability was significant for neither male nor female after current depressive symptoms were accounted for.
Conclusion: Proneness to anger is an independent predictor of somatization. For women, a high level of family cohesion was a protective factor which could reduce the influence of anger trait on somatic symptoms. Without comorbidity of current depression, family adaptability to some degree exempted individuals with anger proneness from developing somatic complaints. Interventions that integrate family cohesion cultivation, family flexibility fostering and depression treatment might be more effective for somatic patients high in anger trait.
背景: 22% 至58% 的患者在初级保健机构主诉躯体症 状。既往研究发现躯体化与愤怒特质和家庭功能相关。 然而，有关研究却非常缺乏，特别是评估家庭功能在 愤怒特质如何成为躯体主诉中的调节作用。.
目的: 本研究的目的是验证家庭亲密度和适应性的变 化是否调节愤怒特质和躯体化之间的关系强度。.
方法: 采用横断面研究设计并从上海一所综合性大学 招募2008 名大学生。所有参加者完成问卷，包括采用 症状自评量表（SCL-90）、状态- 特质愤怒表达量表2 （STAXI-2 中文版）、家庭亲密度和适应性量表第二版 （FACES II 中文版）来评估其当前的躯体化程度、愤怒 特质与家庭功能。采用分层线性回归分析（进入）分 别对男性和女性验证家庭亲密度和适应性对愤怒和躯 体化之间的关联性的调节作用。.
结果: 躯体症状在男性女性中均与抑郁和愤怒特质以 预期的方向显著相关。家庭亲密度和家庭适应性与躯 体症状呈负相关。女大学生家庭亲密度对愤怒特质和 躯体化之间的联系起到调节作用，而男大学生家庭亲 密度的调节作用是轻微的。变量目前抑郁症状矫正后， 家庭适应能力的调节作用在男性和女性中均没有显著 性。.
结论: 容易愤怒是躯体化的一个独立预测因素。对于 女性来说，较高的家庭凝聚力是一种保护因素，可以 减少愤怒特质对躯体症状的影响。没有当前抑郁的共 病的话，家庭适应性在一定程度上可以避免有愤怒倾 向的个体发展为躯体化。家庭凝聚力培养、家庭灵活 性培养和抑郁治疗相结合的干预措施可能对有愤怒特 质的躯体化患者更有效。.
Keywords: anger proneness; anger trait; family adaptability; family cohesion; family conflict; moderation; somatization.