愤怒的身体、愤怒的心灵——愤怒压抑、精神病理与身体痛苦生活质量的中介分析

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-09-17 DOI:10.1016/j.jpsychores.2025.112381

Stefan M. Kahnert , Nora Kämpfer , Markus Ramm , Franziska Geiser , Rupert Conrad

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引用次数: 0

摘要

身体痛苦在成年人中非常普遍，受影响的人表现出生活质量下降（QoL）。导致生活质量下降的原因尚不完全清楚。由于身体痛苦与合并症和情绪调节的改变有关，特别是愤怒抑制，因此研究了抑制愤怒、精神病理学和生活质量之间的关系。方法采用横断面研究方法，对以躯体形式障碍为表现躯体痛苦的成人心身门诊患者进行愤怒抑制（状态-特质愤怒表达量表中的愤怒- in量表）、精神病理（症状检查表90-R）和生活质量问卷（世界卫生组织生活质量问卷简版）评估。首先，研究了愤怒抑制与生活质量不同领域的关系。其次，采用中介分析检验愤怒抑制与生活质量的关系是否受精神病理症状水平的中介作用。结果分析539例患者资料，其中女性63.1%，平均年龄41.3岁（SD: 15）岁。较高的Anger-In与所有四个领域的生活质量下降相关（p < 0.001）。中介分析显示愤怒抑制对心理和社会生活质量的降低有直接影响。然而，对于生活质量的物理和环境领域，这种关系完全由精神病理（抑郁、躯体化）介导。结论愤怒抑制与躯体痛苦患者生活质量下降密切相关。虽然这可以通过基本的精神病理学部分解释，但愤怒抑制有一些直接影响，特别是在社会和心理生活质量方面。因此，愤怒管理可能会被整合到身体痛苦的治疗中。

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Angry body, angry mind – mediation analysis of anger suppression, psychopathology and quality of life in bodily distress

Background

Bodily distress is highly prevalent in the adult population and those affected exhibit a decreased quality of life (QoL). What contributes to this decreased QoL is incompletely understood. As bodily distress has been associated both with comorbidities and alterations in emotion regulation, in particular anger suppression, the relation between suppressed anger, psychopathology and QoL was studied.

Methods

In a cross-sectional study of adult psychosomatic outpatients presenting with bodily distress classified as somatoform disorders, anger suppression (Anger-In scale from the State-Trait Anger Expression Inventory), psychopathology (Symptom Checklist 90-R) and QoL (short version of the World Health Organization's Quality of Life Questionnaire) were assessed. Firstly, the association between anger suppression and different domains of QoL was examined. Secondly, mediation analyses were employed to test whether the relationship between anger suppression and QoL was mediated by the level of psychopathological symptoms.

Results

Data from 539 patients (63.1 % female, mean age 41.3 (SD: 15) years) were analysed. Higher Anger-In was associated with decreased QoL in all four domains (p < 0.001). Mediation analysis showed a direct effect of anger suppression on decreased psychological and social QoL. For the physical and environmental domains of QoL, however, this relationship was fully mediated by psychopathology (depression, somatisation).

Conclusion

Anger suppression was strongly associated with decreased QoL in patients with bodily distress. While this was partly explained through basic psychopathology, there were some direct effects of anger suppression, in particular on social and psychological QoL. Anger management might hence be integrated in the treatment of bodily distress.

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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.