Alexithymia is associated with higher pain ratings and greater pressure pain tolerance in adolescents with major depressive disorder: Evidence consistent with sensory-affective dissociation

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI:10.1016/j.jpsychores.2026.112538

Qing Zhang , Jingwen Shang , Jinyue Xue , Qingqing Shen , Yudong Shi , Zhichun Liu , Zhiwei Liu , Liang Sun , Kai Zhang , Huanzhong Liu

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引用次数: 0

Abstract

Objective

To examine associations of alexithymia with subjective pain intensity and pressure pain tolerance in adolescents with major depressive disorder (MDD), and to test whether alexithymia shows indirect effects linking depressive severity with these pain outcomes in cross-sectional models.

Methods

193 adolescents with MDD completed the Hamilton Depression Rating Scale (HAMD) and Toronto Alexithymia Scale-20 (TAS-20). Subjective pain intensity was rated with the NRS-11. Experimental pain indicators included pressure pain threshold (PPT) and pressure pain tolerance (PTO).

Results

Pain intensity was associated with HAMD (OR = 1.054, P = 0.010) and TAS-20 (OR = 1.045, P = 0.008). TAS-20 was associated with higher pain tolerance (PTO-1: B = 0.003, P = 0.014; PTO-2: B = 0.004, P = 0.021). Depressive severity was associated with alexithymia (P < 0.001). Indirect effects via alexithymia were significant for tolerance with nonsignificant direct effects (both P < 0.05). For pain intensity, both the direct effect (0.247, P = 0.001) and the indirect effect (0.064, P < 0.05) were significant, with the indirect effect accounting for 20.7% of the total effect.

Conclusion

Alexithymia is associated with altered pain perception in adolescents with MDD and may statistically account for part of the association between depressive severity and pain outcomes. The pattern is consistent with sensory-affective dissociation and supports considering emotional processing difficulties when assessing and managing pain complaints in depressed adolescents.

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患有重度抑郁症的青少年述情障碍与更高的疼痛评分和更大的压力疼痛耐受性有关：与感觉-情感分离一致的证据

目的研究重度抑郁症（MDD）青少年述情障碍与主观疼痛强度和压力疼痛耐受性的关系，并在横截面模型中检验述情障碍是否表现出抑郁严重程度与这些疼痛结果之间的间接影响。方法对193例MDD青少年进行汉密尔顿抑郁评定量表（HAMD）和多伦多述情障碍量表-20 （TAS-20）的测试。主观疼痛强度用NRS-11评分。实验疼痛指标包括压痛阈值（PPT）和压痛耐受性（PTO）。结果西班牙强度与HAMD （OR = 1.054, P = 0.010）、TAS-20 （OR = 1.045, P = 0.008）相关。TAS-20与较高的疼痛耐受性相关（PTO-1: B = 0.003, P = 0.014; PTO-2: B = 0.004, P = 0.021）。抑郁严重程度与述情障碍相关（P < 0.001）。通过述情障碍产生的间接影响对耐受性显著，直接影响不显著（P < 0.05）。对于疼痛强度，直接效应（0.247,P = 0.001）和间接效应（0.064,P < 0.05）均显著，间接效应占总效应的20.7%。结论青少年重度抑郁症患者的述情障碍与痛觉改变有关，可能是抑郁严重程度与疼痛结局之间部分关联的统计学原因。该模式与感觉-情感分离一致，并支持在评估和管理抑郁青少年的疼痛主诉时考虑情绪处理困难。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.