Date of Degree
PhD (Doctor of Philosophy)
Psychological and Quantitative Foundations
William Ming Liu
Chronic back pain is a pervasive and debilitating phenomenon contributing to staggering health costs and a host of psychological, medical, vocational, and social consequences. The etiology of chronic back pain remains unclear and traditional biomedical, psychological, and interdisciplinary treatments have not been completely effective at eliminating pain or restoring long-term functionality. Psychodynamic models of chronic back pain have not been fully explored due to methodological difficulties. Explorations of psychodynamic-related constructs such as alexithymia (i.e., lack of emotional awareness) may offer vital clues to help increase the understanding of chronic back pain. The purpose of this study was to serve as a preliminary descriptive analysis of alexithymia among patients seeking interdisciplinary treatment for chronic back pain. First, the prevalence of alexithymia in an interdisciplinary treatment seeking sample of patients with chronic back pain and comparisons to other chronic pain and psychosomatic samples were addressed. Second, the relationship between alexithymia and somatic complaints, pain, anxiety, depression, and health-related quality of life was explored. Finally, a meditational analysis was conducted to examine if the relationship between alexithymia and somatic complaints was mediated by negative affect. Eighty-one patients seeking interdisciplinary treatment for chronic back pain participated in the study. Analyses revealed that 14.8% patients met criteria for alexithymia, which was similar to other chronic pain samples but not significantly different from general medical samples. Higher alexithymia scores were found to be associated with higher levels of somatic complaints, negative affect, and mental-health related quality of life. Unexpectedly, higher alexithymia scores were also associated with better physical-related quality of life. There were no significant relationships between alexithymia and pain. The relationship between alexithymia and somatic complaints was found to be mediated by negative affect, which was consistent with psychodynamic models of chronic back pain. Findings were discussed in relation to clinical implications and future research.
Copyright 2011 Derek Geoffrey Turesky