Somatic symptoms evoked by exam stress in university students: The role of alexithymia, neuroticism, anxiety and depression

PLoS ONE

Volumn 8, Issue 12, 2013, Pages

  Zunhammer, Matthias ^a   Eberle, Hanna ^a   Eichhammer, Peter ^a   Busch, Volker ^a  

^a UNIVERSITY OF REGENSBURG   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ALEXITHYMIA; ANXIETY; ARTICLE; BECK DEPRESSION INVENTORY; BIG FIVE PERSONALITY INTERVIEW; CONTROLLED STUDY; DEPRESSION; EXAM STRESS; FEMALE; HEALTH STATUS; HUMAN; LONGITUDINAL STUDY; MALE; MENTAL STRESS; NEUROSIS; PREDICTIVE VALUE; PSYCHOLOGIC TEST; QUASI EXPERIMENTAL STUDY; SCREENING FOR SOMATOFORM SYMPTOMS 7 DAY; SELF REPORT; SOMATIZATION; STATE TRAIT ANXIETY INVENTORY; TORONTO ALEXITHYMIA SCALE; UNIVERSITY STUDENT;

AFFECTIVE SYMPTOMS; ANXIETY; ANXIETY DISORDERS; DEPRESSION; GERMANY; HUMANS; LONGITUDINAL STUDIES; MODELS, PSYCHOLOGICAL; MODELS, STATISTICAL; PERSONALITY INVENTORY; QUESTIONNAIRES; SOMATOFORM DISORDERS; STRESS, PSYCHOLOGICAL; STUDENTS; YOUNG ADULT;

EID: 84893179786     PISSN: None     EISSN: 19326203     Source Type: Journal    
DOI: 10.1371/journal.pone.0084911     Document Type: Article

References (54)

1. Lipowski ZJ (1988) Somatization: the concept and its clinical application. Am J Psychiatry 145: 1358-1368. PubMed: 3056044.
2. Dimsdale J, Creed F (2009) The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV - a preliminary report. J Psychosom Res 66: 473-476. doi:10.1016/j.jpsychores.2009.03.005. PubMed: 19446706.
3. Kellner R (1990) Somatization. Theories and research. J Nerv Ment Dis 178: 150-160. doi:10.1097/00005053-199003000-00002. PubMed: 2407806.
4. Rief W, Broadbent E (2007) Explaining medically unexplained symptoms-models and mechanisms. Clin Psychol Rev 27: 821-841. doi:10.1016/j.cpr.2007.07.005. PubMed: 17716793. (Pubitemid 47410330)
5. De Gucht V, Fischler B, Heiser W (2004) Personality and affect as determinants of medically unexplained symptoms in primary care; A follow-up study. J Psychosom Res 56: 279-285. doi:10.1016/S0022-3999(03)00127-2. PubMed: 15046963. (Pubitemid 38445076)
6. Costa PT, McCrae RR (1980) Somatic complaints in males as a function of age and neuroticism: a longitudinal analysis. J Behav Med 3: 245-257. doi:10.1007/BF00845050. PubMed: 7441726.
7. Wise TN, Mann LS (1994) The relationship between somatosensory amplification, alexithymia, and neuroticism. J Psychosom Res 38: 515-521. doi:10.1016/0022-3999(94)90048-5. PubMed: 7990059. (Pubitemid 24256709)
8. Mattila AK, Kronholm E, Jula A, Salminen JK, Koivisto A-M et al. (2008) Alexithymia and somatization in general population. Psychosom Med 70: 716-722. doi:10.1097/PSY.0b013e31816ffc39. PubMed: 18596251.
9. De Gucht V (2003) Alexithymia and somatisation A quantitative review of the literature. J Psychosom Res 54: 425-434. doi:10.1016/S0022-3999(02)00467-1. PubMed: 12726898.
10. Bailey PE, Henry JD (2007) Alexithymia, somatization and negative affect in a community sample. Psychiatry Res 150: 13-20. doi:10.1016/j.psychres.2006. 05.024. PubMed: 17258817. (Pubitemid 46281339)
11. Martin JB, Pihl RO (1985) The stress-alexithymia hypothesis: theorectical and empirical considerations. Psychother Psychosom 43: 169-176. doi:10.1159/000287876. PubMed: 4034888. (Pubitemid 15000924)
12. De Timary P, Roy E, Luminet O, Fillée C, Mikolajczak M (2008) Relationship between alexithymia, alexithymia factors and salivary cortisol in men exposed to a social stress test. Psychoneuroendocrinology 33: 1160-1164. doi:10.1016/j.psyneuen.2008.06.005. PubMed: 18674866.
13. Connelly M, Denney DR (2007) Regulation of emotions during experimental stress in alexithymia. J Psychosom Res 62: 649-656. doi:10.1016/j.jpsychores. 2006.12.008. PubMed: 17540222. (Pubitemid 46809913)
14. Borella P, Bargellini a, Rovesti S, Pinelli M, Vivoli R, et al. (1999) Emotional stability, anxiety, and natural killer activity under examination stress. Psychoneuroendocrinology 24: 613-627
15. Johannsen a, Bjurshammar N, Gustafsson a (2010) The influence of academic stress on gingival inflammation. Int J Dent Hyg 8: 22-27. doi:10.1111/j.1601- 5037.2009.00397.x. PubMed: 20096078.
16. Weik U, Deinzer R (2010) Alterations of postawakening cortisol parameters during a prolonged stress period: Results of a prospective controlled study. Horm Behav 58: 405-409. doi:10.1016/j.yhbeh.2010.06.001. PubMed: 20638949.
17. Sherman DK, Bunyan DP, Creswell JD, Jaremka LM (2009) Psychological vulnerability and stress: the effects of self-affirmation on sympathetic nervous system responses to naturalistic stressors. Health Psychol 28: 554-562. doi:10.1037/a0014663. PubMed: 19751081.
18. Šimić N, Manenica I (2012) Exam experience and some reactions to exam stress. Hum Physiol 38: 67-72. doi:10.1134/S0362119712010161.
19. Loft P, Thomas MG, Petrie KJ, Booth RJ, Miles J et al. (2007) Examination stress results in altered cardiovascular responses to acute challenge and lower cortisol. Psychoneuroendocrinology 32: 367-375. doi:10.1016/j.psyneuen.2007.02. 004. PubMed: 17395393. (Pubitemid 46621208)
20. Spangler G (1997) Psychological and physiological responses during an exam and their relation to personality characteristics. Psychoneuroendocrinology 22: 423-441. doi:10.1016/S0306-4530(97)00040-1. PubMed: 9364621.
21. Koh KB, Choe E, Song JE, Lee EH (2006) Effect of coping on endocrinoimmune functions in different stress situations. Psychiatry Res 143: 223-234. doi:10.1016/j.psychres.2005.04.008. PubMed: 16831469. (Pubitemid 44301513)
22. Pitts FN, Winokur G, Stewart MA (1961) Psychiatric syndromes, anxiety symptoms and responses to stress in medical students. Am J Psychiatry 118: 333-340. PubMed: 14487002.
23. Ree MJ, French D, MacLeod C, Locke V (2008) Distinguishing Cognitive and Somatic Dimensions of State and Trait Anxiety: Development and Validation of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). Behav Cogn Psychother 36: 313-332. doi:10.1017/S1352465808004232. (Pubitemid 351862008)
24. Rief W, Hiller W (2003) A new approach to the assessment of the treatment effects of somatoform disorders. Psychosomatics 44: 492-498. doi:10.1176/appi.psy.44.6.492. PubMed: 14597684. (Pubitemid 37352227)
25. Hiller W, Rief W, Brähler E (2006) Somatization in the population: from mild bodily misperceptions to disabling symptoms. Soc Psychiatry Psychiatr Epidemiol 41: 704-712. doi:10.1007/s00127-006-0082-y. PubMed: 16794766. (Pubitemid 44363759)
26. Rief W, Hiller W (2008) SOMS - Screening für Somatoforme Störungen Manual. 2nd ed. Bern: Verlag Hans Huber, Hogrefe AG.
27. Fliege H, Rose M, Arck P, Walter OB, Kocalevent R-D et al. (2005) The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples. Psychosom Med 67: 78-88. doi:10.1097/01.psy.0000151491.80178.78. PubMed: 15673628.
28. Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E et al. (1993) Development of the Perceived Stress Questionnaire: a new tool for psychosomatic research. J Psychosom Res 37: 19-32. doi:10.1016/0022-3999(93)90024-A. PubMed: 8421257. (Pubitemid 23040175)
29. Laux L., Glanzmann P., Schaffner P. & Spielberger CD (1981) Das State-Trait-Angstinventar. Theoretische Grundlagen und Handanweisung. [Manual for the State-Trait-Anxiety- Inventory]. Weinheim: Beltz Test GmbH.
30. Beck AT, Steer RA, Ball R, Ranieri W (1996) Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess 67: 588-597. doi:10.1207/s15327752jpa6703-13. PubMed: 8991972. (Pubitemid 26382973)
31. Bagby RM, Parker JD, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale - I. Item selection and cross-validation of the factor structure. J Psychosom Res 38: 23-32. doi:10.1016/0022-3999(94)90005-1. PubMed: 8126686.
32. Bagby RM, Taylor GJ, Parker JD (1994) The Twenty-item Toronto Alexithymia Scale - II. Convergent, discriminant, and concurrent validity. J Psychosom Res 38: 33-40. doi:10.1016/0022-3999(94)90006-X. PubMed: 8126688.
33. Franz M, Popp K, Schaefer R, Sitte W, Schneider C et al. (2008) Alexithymia in the German general population. Soc Psychiatry Psychiatr Epidemiol 43: 54-62. doi:10.1007/s00127-007-0265-1. PubMed: 17934682.
34. Kooiman CG, Spinhoven P, Trijsburg RW (2002) The assessment of alexithymia: a critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. J Psychosom Res 53: 1083-1090. doi:10.1016/S0022-3999(02)00348-3. PubMed: 12479990. (Pubitemid 36040657)
35. Rief W, Heuser J, Fichter MM (1996) What does the Toronto Alexithymia Scale TAS?R measure? J Clin Psychol 52: 423-429. Available online at: doi:10.1002/(SICI)1097-4679(199607)52:4〈423:AID-JCLP6〉3.3.CO;2-C
36. Suslow T, Donges US, Kersting A, Arolt V (2000) 20-Item Toronto Alexithymia Scale: do difficulties describing feelings assess proneness to shame instead of difficulties symbolizing emotions? Scand J Psychol 41: 329-334.
37. De Gucht V, Fontaine J, Fischler B (2004) Temporal stability and differential relationships with neuroticism and extraversion of the three subscales of the 20-item Toronto Alexithymia Scale in clinical and nonclinical samples. J Psychosom Res 57: 25-33. doi:10.1016/S0022-3999(03)00577-4. PubMed: 15256292. (Pubitemid 38901092)
38. Körner A, Drapeau M, Albani C, Geyer M, Schmutzer G et al. (2008) Deutsche Normierung des NEO-Fünf-Faktoren-Inventars [German Norms for the Neo-Five Factor Inventory]. Zeitschrift für Medizinische Psychol 17: 133-144.
39. Spielberger CD, Brunner TM, Ritterband LM, Reheiser EC (2003) The nature and measurement of depression. Rev Int Psicol clínica y la salud= Int J Clin Heal Psychol 3: 209-234
40. Arndt S, Turvey C, Andreasen NC (1999) Correlating and predicting psychiatric symptom ratings: Spearman's r versus Kendall's tau correlation. J Psychiatr Res 33: 97-104. doi:10.1016/S0022-3956(98)90046-2. PubMed: 10221741. (Pubitemid 29134737)
41. Barr DJ, Levy R, Scheepers C, Tily HJ (2013) Random effects structure for confirmatory hypothesis testing: Keep it maximal. J Mem Lang 68: 255-278. doi:10.1016/j.jml.2012.11.001.
42. Wagenmakers E-J, Farrell S (2004) AIC model selection using Akaike weights. Psychon Bull Rev 11: 192-196. doi:10.3758/BF03206482. PubMed: 15117008. (Pubitemid 38652053)
43. Storch Ea, Roberti JW, Roth D a (2004) Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory-Second Edition in a sample of college students. Depress Anxiety 19: 187-189. doi:10.1002/da.20002. PubMed: 15129421.
44. Klaus K, Rief W, Brähler E, Martin A, Glaesmer H et al. (2013) The distinction between "medically unexplained" and "medically explained" in the context of somatoform disorders. Int J Behav Med 20: 161-171. doi:10.1007/s12529-012-9245-2. PubMed: 22678925.
45. Dhabhar FS (2009) Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation 16: 300-317. doi:10.1159/000216188. PubMed: 19571591.
46. Noyes R, Langbehn DR, Happel RL, Stout LR, Muller BA et al. (2001) Personality dysfunction among somatizing patients. Psychosomatics 42: 320-329. doi:10.1176/appi.psy.42.4.320. PubMed: 11496021. (Pubitemid 32692105)
47. Lane RD, Carmichael C, Reis HT (2011) Differentiation in the momentary rating of somatic symptoms covaries with trait emotional awareness in patients at risk for sudden cardiac death. Psychosom Med 73: 185-192. doi:10.1097/PSY.0b013e318203b86a. PubMed: 21257980.
48. Bolger N, Zuckerman A (1995) A framework for studying personality in the stress process. J Pers Soc Psychol 69: 890-902. doi:10.1037/0022-3514.69.5.890. PubMed: 7473036.
49. Gunthert KC, Cohen LH, Armeli S (1999) The role of neuroticism in daily stress and coping. J Pers Soc Psychol 77: 1087-1100. doi:10.1037/0022-3514.77.5. 1087. PubMed: 10573882.
50. Pedrosa Gil F, Bidlingmaier M, Ridout N, Scheidt CE, Caton S et al. (2008) The relationship between alexithymia and salivary cortisol levels in somatoform disorders. Nord J Psychiatry 62: 366-373. doi:10.1080/ 08039480801983554. PubMed: 18752108.
51. Kooiman CG (2004) Alexithymia Does Not Predict the Persistence of Medically Unexplained Physical Symptoms. Psychosom Med 66: 224-232. doi:10.1097/01.psy.0000116714.38868.06. PubMed: 15039507.
52. Lumley MA, Stettner L, Wehmer F (1996) How are alexithymia and physical illness linked? A review and critique of pathways. J Psychosom Res 41: 505-518. doi:10.1016/S0022-3999(96)00222-X. PubMed: 9032714. (Pubitemid 27032924)
53. Fukunishi I, Kikuchi M, Wogan J, Takubo M (1997) Secondary alexithymia as a state reaction in panic disorder and social phobia. Compr Psychiatry 38: 166-170. doi:10.1016/S0010-440X(97)90070-5. PubMed: 9154373.
54. Dewhurst Sa, Marlborough Ma (2003) Memory bias in the recall of pre-exam anxiety: the influence of self-enhancement. Appl Cogn Psychol 17: 695-702. doi:10.1002/acp.903.