The relationship of ego development to somatization tendencies and symptom interpretation
Abstract
Inappropriate consultations directed at primary caregivers by individuals complaining of somatic symptoms are a matter of timely concern to health care providers. Studies investigating subjects prone to somaticize have not delineated clearly the factors contributing to somatization behavior. The present study investigated the relative contribution of perceptual, cognitive, emotional, and ego functions to somatization. Loevinger's construct of ego development (1976) was selected as the personality variable of interest in this study of health beliefs. Subjects included 122 people recruited from three groups at a Midwestern state hospital: psychiatric and addictions treatment inpatients and staff members. Somatization tendencies and illness interpretive strategies (perceived psychological versus somatic causal factors) were assessed by self-report (Illness Behaviour Questionnaire and the SCL-90-R), behavioral (rates of physician consultation and medication use), and observational (physician ratings) indices. Information on demographic variables, estimated level of intelligence, health status, and level of psychopathology also was obtained. Hierarchical stepwise multiple regression analyses showed ego development and a summary score of psychopathology from the SCL-90-R to be significant predictors of scores on an IBQ scale assessing psychological/somatic interpretive strategies to symptoms as well as on scales assessing self-reported degree of hypochondriacal beliefs. Canonical correlation analyses and discriminant analyses revealed similar trends. Results indicated that ego development and level of perceived psychopathology are highly important in influencing self-report somatization tendencies. Somatization apparently is one symptom of many involved in psychopathology, supporting the commonality of somatization in psychiatric disorder. Somatization is a sick role behavior favored by persons of less complex levels of ego development. These people cannot cognitively appreciate other explanations for their symptoms and are limited in selecting coping strategies, favoring those strategies of a behavioral sort (e.g., medication requests). Intervention with subjects presenting somatic complaints must be geared toward subjects' level of cognitive appreciation for symptoms, best assessed by level of ego development.
Degree
Ph.D.
Advisors
Swensen, Purdue University.
Subject Area
Psychotherapy
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