Sources of somatization: Exploring the roles of insecurity in relationships and styles of anger experience and expression

Research in the U.S. has shown strong connections between insecure attachment in close relationships and somatization. In addition, studies have demonstrated connections between somatic symptoms and anger experience and expression. In this study, we integrate perspectives from these two literatures by testing the hypothesis that proneness to anger and suppression of anger mediate the link between insecurity in relationships and somatization. Between 2000 and 2003, a community-based sample of 101 couples in a large U.S. city completed self-report measures, including the Somatic Symptom Inventory, the Relationship Scales Questionnaire, the Multidimensional Anger Inventory, the Revised Conflict Tactics Scale, and the Beck Depression Inventory. Controlling for age, income, and recent intimate partner violence, analyses showed that the link between insecure attachment and somatization was partially mediated by anger proneness for men and by anger suppression for women. Findings are consistent with the hypothesis that men who are insecurely attached are more prone to experience anger that in turn fosters somatization. For women, findings suggest that insecure attachment may influence adult levels of somatization by fostering suppression of anger expression. Specific clinical interventions that help patients manage and express angry feelings more adaptively may reduce insecurely attached individuals’ vulnerability to medically unexplained somatic symptoms.

► This study sheds new light on ways that insecurity in close relationships amongst US couples may be linked with somatization. ► Styles of experiencing and regulating anger mediated this link, and men and women differed in the way that anger mattered. ► For men, proneness to anger mediated the link between fearful attachment and somatization. ► For women, the tendency to suppress anger mediated the link between fearful attachment and somatization.