Hannah Mohun

Topic

Dual-Method Assessment of Emotion Facets in Adolescents Affected by Somatization: Differences From Psychiatric Controls and Variations After Treatment

Department of Psychology

Date & location

• Thursday, August 15, 2024

• 11:00 A.M.

• Virtual Defence

Reviewers

Supervisory Committee

• Dr. Ulrich Müeller, Department of Psychology, University of Victoria (Co-Supervisor)

• Dr. Colette Smart, Department of Psychology, UVic (Co-Supervisor)

• Dr. Amrit Dhariwal, Department of Psychology, UBC (Outside Member) 

External Examiner

• Dr. Koraly Pérez-Edgar, Department of Psychology, Penn State University 

Chair of Oral Examination

• Dr. Laura Cowen, Department of Mathematics and Statistics, UVic 

Abstract

Introduction: Clinically significant somatization in adolescents is prevalent and impairing yet understudied. There are many proposed contributors to the development of somatization, including emotion regulation and attachment. However, the ways in which emotion regulation and attachment strategies differ in somatization compared to other internalizing disorders is not well understood. Additionally, whether emotion regulation is modifiable within this population is unknown. To learn more about emotion regulation in adolescents affected by somatization, this dissertation presents two studies using dual-method approaches.

Study One: We compared the emotion regulation and attachment strategies of adolescents affected by somatization and adolescents affected by anxiety. Results indicated differences between groups on an objective, biobehavioural measure of emotion regulation, but not on a self-report measure of emotion regulation. There were also differences in self-reported attachment, with adolescents with anxiety reported the use of more anxious attachment strategies than adolescents with somatization.

Study Two: We next assessed whether there were time-related variations in two emotion facets over the course of a treatment targeting emotion regulation for adolescents affected by somatization. In a sample of adolescent outpatient hospital patients, we assessed emotion regulation (using a biobehavioural measure) and emotional self-awareness (using a self-report measure), pre and post treatment. Results indicated that there were some time-related differences in self-reported emotional awareness, with an increase in mentalization over time. While there were no significant time-related differences on the biobehavioural measure of emotion regulation, we found that differences from pre to post were dependent on whether participants perceived a positive working alliance during the treatment.

Conclusion: Taken together, these studies make important contributions to the field of pediatric somatization. The noted differences between adolescents affected by somatization versus anxiety may have meaningful clinical implications for tailoring treatment. Importantly, both studies suggest that adolescents with somatization show no significant bias toward or away from negative emotions. Finally, preliminary results demonstrate that emotional self-awareness is modifiable, which is an important step for patients being open to accessing mental health interventions.