Volume 13 - Articles-1402                   MEJDS (2023) 13: 9 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Mohammad Bigi M, Taheri A, Abol-Maali K, Gargozli K. Structural Model of Predicting Physical Symptoms Based on Alexithymia, Childhood Trauma, and Perceived Social Support with the Mediation of Depression, Anxiety, and Stress in Patients with Epilepsy. MEJDS 2023; 13 :9-9
URL: http://jdisabilstud.org/article-1-3077-en.html
Structural Model of Predicting Physical Symptoms Based on Alexithymia, Childhood Trauma, and Perceived Social Support with the Mediation of Depression, Anxiety, and Stress in Patients with Epilepsy
Masomeh Mohammad Bigi1 , Afsaneh Taheri *2 , Khadijeh Abol-Maali3 , Korosh Gargozli4
1- PhD Student in Clinical Psychology, Roudhen Branch, Islamic Azad University, Roudhen, Iran
2- Assistant Professor of Psychology, Rudehen Unit, Islamic Azad University, Rudehen, Iran
3- Associate Professor Faculty of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran University, Tehran, Iran
4- Professor of Brain and Nervous Diseases, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
Abstract:   (1035 Views)

Abstract
Background & Objectives: Epilepsy is a common neurological disorder characterized by frequent and spontaneous seizures that are poorly controlled with current medications. This disease can occur in any age, race, and social class. One of the psychosomatic diseases that can occur in patients with epilepsy is somatization symptom disorder. The factors affecting somatization symptoms in these patients may include alexithymia, childhood trauma, and perceived social support. In psychology, the occurrence of any phenomenon is associated with several factors; perhaps anxiety, depression, and stress are among the factors that can directly or indirectly affect the relationship between physical symptoms and alexithymia, childhood trauma, and perceived social support. So, this study aimed to provide a structural model of physical symptoms based on alexithymia, childhood trauma, and perceived social support with the mediation of depression, anxiety, and stress in patients with epilepsy.
Methods: This study was descriptive in terms of its application and correlational in terms of method. A total of 260 required subjects were estimated for this study. In this research, there were 7 paths, 3 covariance errors, 11 indicator errors, 2 endogenous errors of mediating variables, and 3 subscales of mediating variables. Thus, there are 26 parameters, and 10 subjects were needed for each parameter. We used simple random sampling; the samples were selected by lottery from the list of patients who are members of the Iranian Epilepsy Association. The inclusion criteria were as follows: informed consent, the right to withdraw from the continuation of the research, and the ability to read and write. The exclusion criterion was not completing the questions of the research questionnaires. The research tools included the Patient Health Questionnaire (Kroenke et al., 2002), the Toronto Alexithymia Scale-20 (Bagby et al., 1994), the Childhood Trauma Questionnaire (Bernstein et al., 2003), the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), and the Depression Anxiety Stress Scale- Short Form (Lovibond & Lovibond, 1995). Data analysis was done by descriptive and inferential statistics. In the descriptive statistics section, the lowest and highest scores, mean, and standard deviation were calculated. In the inferential statistics section, the Pearson correlation coefficient, tolerance coefficient, variance inflation, and structural equation modeling were performed. SPSS version 23 and AMOS version 26 software were used in this research. The significance level for all tests was set at 0.05.
Results: Results showed that the sum of squared multiple correlations (R2) for the variable of physical symptoms was equal to 0.69. This value indicates that emotional dyslexia, childhood trauma, perceived social support, depression, anxiety, and stress explain 69% of the variance of physical symptoms in people with epilepsy. The total path coefficient between alexithymia and physical symptoms was positive and significant (p=0.001, β=0.381), and the total path coefficient between childhood trauma and physical symptoms was also positive and significant (p=0.001, β=0.269). The path coefficient between perceived social support and physical symptoms was negative and significant (p=0.001, β=-0.276). The direct path coefficient between depression, anxiety, and stress with physical symptoms was positive and significant (p=0.002, β=0.356). The indirect path coefficient between alexithymia and physical symptoms was positive and significant (p=0.001, β=0.174), and the indirect path coefficient between childhood trauma and physical symptoms was positive and significant (p=0.004, β=0.103). The indirect path coefficient between perceived social support and physical symptoms was negative and significant (p=0.043, β=-0.078). The fit indices were all acceptable (χ2/df =2.31, CFI=0.956, GFI=0.919, AGFI=0.877, RMSEA=0.071).
Conclusion: According to the results, alexithymia, childhood trauma, and perceived social support have a significant relationship with physical symptoms. On the other hand, the mediating role of depression, anxiety, and stress in the relationship between alexithymia, childhood trauma, and perceived social support with physical symptoms is confirmed.

Keywords: Depression, Anxiety and stress, Childhood trauma, Perceived social support, Physical symptoms, Alexithymia
Full-Text [PDF 732 kb]   (671 Downloads)    
Type of Study: Original Research Article | Subject: Psychology
References
1. Kedare JS, Baliga SP. Management of psychiatric disorders in patients of epilepsy. Indian J Psychiatry. 2022;64(Suppl 2):S319–29. [DOI]
2. Royer J, Bernhardt BC, Larivière S, Gleichgerrcht E, Vorderwülbecke BJ, Vulliémoz S, et al. Epilepsy and brain network hubs. Epilepsia. 2022;63(3):537–50. [DOI]
3. Yang L, Wang Y, Chen Z. Central histaminergic signalling, neural excitability and epilepsy. Br J Pharmacol. 2022;179(1):3–22. [DOI]
4. Jiang Y, Wei J, Fritzsche K, Toussaint AC, Li T, Cao J, et al. Assessment of the structured clinical interview (SCID) for DSM–5 for somatic symptom disorder in general hospital outpatient clinics in China. BMC Psychiatry. 2021;21(1):144. [DOI]
5. Pezeshki P, Aslzaker M, Nasiry S. The role of hostility and ambivalence in expressing emotion in predicting somatization symptoms among students of University of Tehran. Zanko Journal of Medical Sciences. 2021;22(72):5–14. [Persian] [Article]
6. Glaus J, Moser DA, Rusconi Serpa S, Jouabli S, Turri F, Plessen KJ, et al. Families with violence exposure and the intergenerational transmission of somatization. Front Psychiatry. 2022;13:820652. [DOI]
7. Fynn DM, Preece DA, Gignac GE, Pestell CF, Allan A, Kraats C vander, et al. Assessing alexithymia in adults with acquired brain injury: psychometric properties of the Perth Alexithymia Questionnaire. Journal of Affective Disorders. 2022;302:224–33. [DOI]
8. Xu P, Opmeer EM, van Tol MJ, Goerlich KS, Aleman A. Structure of the alexithymic brain: A parametric coordinate–based meta–analysis. Neurosci Biobehav Rev. 2018;87:50–5. [DOI]
9. Basharpoor S, Taghizadeh Hir S, Fattah Zadeh Ardalani G. Comparison of anxiety sensitivity, alexithymia and sleep quality in patients with migraine and normal people. Anesthesiology and Pain. 2022;12(4):87–97. [Persian] [Article]
10. Dvir Y. Childhood trauma and psychosis: a brief updated review and case study. Child Adolesc Psychiatr Clin N Am. 2022;31(1):91–8. [DOI]
11. Soleimani A, Lashkari A, Torabi Y. The relationship between trauma and psychological well–being: the mediating role of fear of happiness and alexithymia. Journal of Research in Behavioural Sciences. 2021;19(1):116–27. [Persian] [DOI]
12. Landvatter JD, Uchino BN, Smith TW, Bosch JA. Partner’s perceived social support influences their spouse’s inflammation: an actor–partner analysis. Int J Environ Res Public Health. 2022;19(2):799. [DOI]
13. Xie CS, Kim Y. Post–traumatic growth during COVID–19: the role of perceived social support, personality, and coping strategies. Healthcare (Basel). 2022;10(2):224. [DOI]
14. Abdi Zarrin S, Nikkhah Siruei Z. Psychological well–being: the role of self-differentiation, alexithymia and ego–strength. Shenakht Journal of Psychology and Psychiatry. 2021;8(3):13–24. [Persian] [DOI]
15. Saffari Nia M, Eisazadeh F, Hamzehei Z. Life expectancy predictions based on perceived social support and mental health among those recovering from Covid–19 disease. Journal of Sabzevar University of Medical Sciences. 2021;28(1):2–9. [Persian] [Article]
16. Weiss A, Canetti L, David SB, Reuveni I, Ekstein D. Seizure phobia: a distinct psychiatric disorder among people with epilepsy. Seizure. 2022;95:26–32. [DOI]
17. Xu ZYR, Shen CH, Cai MT, Zhang GF, Ding MP, Guo Y. Managing depression and anxiety in patients with epilepsy in eastern china: a survey of epilepsy health professionals in Zhejiang Province. Epilepsy & Behavior. 2022;127:108516. [DOI]
18. Kroenke K, Spitzer RL, Wiiliams JBW. The PHQ–15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64(2):258–66. [DOI]
19. Abdolmohammadi K, Ghadiri Sourman Abadi F, Sadat Seyed Pourmand N, Falsafinejad MR. The validation of somatization inventory in the students of Tabriz universities (Iran). Qom University of Medical Sciences Journal. 2018;11(12):61–7. [Persian] [Article]
20. Bagby RM, Taylor GJ, Parker JD. The Twenty–Item Toronto Alexithymia Scale-II. convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33–40. [DOI]
21. Besharat MA. Reliability and factorial validity of a Farsi version of the 20–item Toronto Alexithymia Scale with a sample of Iranian students. Psychol Rep. 2007;101(1):209–20. [DOI]
22. Besharat MA. Assessing reliability and validity of the Farsi version of the Toronto Alexithymia Scale in a sample of substance–using patients. Psychol Rep. 2008;102(1):259–70. [DOI]
23. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169–90. [DOI]
24. Garrusi B, Nakhaee N. Validity and reliability of a Persian version of the Childhood Trauma Questionnaire. Psychol Rep. 2009;104(2):509–16. [DOI]
25. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment. 1988;52(1):30–41. [DOI]
26. Basharat MA. Multidimensional Scale of Perceived Social Support: questionnaire, instruction and scoring. Journal of Developmental Psychology. 2018;15(60):447-9. [Article]
27. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–43. [DOI]
28. Samani S, Jokar B. Investigating the validity and reliability of the Short Form of Depression, Anxiety and Psychological Stress Scale. Journal of Social Sciences and Humanities, Shiraz University. 2007;26(3):65–77. [Persian]
29. Hooman HA. Structural equation modeling with LISREL application. Tehran: SAMT Pub; 2006. [Persian]
30. Meyers LS, Gamst GC, Guarino AJ. Applied multivariate research: design and interpretation. 3rd ed. Los Angeles: SAGE Publications, Inc; 2006.
31. Einy S, Nazar S, Ebadi M, Zeynalzadeh M. Development of structural equations of social adjustment of students with specific learning disorder based on alexithymia and metacognition beliefs and mediated by perceived social support. Journal of Learning Disabilities. 2022;11(4):62–77. [Persian] [Article]
32. Spensieri V, Valastro C, Cerutti R. Technology addition and alexithymia features in a sample of Italian adolescents. In: 3rd International Conference on Behavioral Addictions [Internet]. Switzerland, Geneva: Akadémiai Kiadó. 2016. p:58.
33. Öksüz E, Mersi̇n S, Tangül Özcan C. Childhood traumatic experiences, alexithymia, and resilience in patients with adjustment disorder. Gülhane Tıp Dergisi. 2018;60(3):97–102. [DOI]
34. Lang J, Jeschke S, Herziger B, Müller RM, Bertsche T, Neininger MP, et al. Prejudices against people with epilepsy as perceived by affected people and their families. Epilepsy Behav. 2022;127:108535. [DOI]
35. Li L, Lu J, Xu Y, Zhao Y. Changes in pre–and postsurgery for drug resistant epilepsy: cognition and sleep. BioMed Research International. 2022;2022:e9971780. [DOI]
36. Zamanloo K, Asgari Mobarakeh K, Kazemi R. An investigation and comparison of the effect of sodium valproate on electrophysiological specificities of the epileptic and bipolar patients. Alborz University Medical Journal. 2022;11(2):161–9. [Persian] [Article]
37. Şar V, Türk-Kurtça T. The vicious cycle of traumatic narcissism and dissociative depression among young adults: a trans–diagnostic approach. J Trauma Dissociation. 2021;22(5):502–21. [DOI]
38. Bertele N, Talmon A, Gross JJ. Childhood maltreatment and narcissism: the mediating role of dissociation. J Interpers Violence. 2022;37(11–12):NP9525–47. [DOI]
39. Şahin DS, Özer Ö, Yanardağ MZ. Perceived social support, quality of life and satisfaction with life in elderly people. Educational Gerontology. 2019;45(1):69–77. [DOI]
40. Brunsting NC, Zachry C, Liu J, Bryant R, Fang X, Wu S, et al. Sources of perceived social support, social–emotional experiences, and psychological well–being of international students. The Journal of Experimental Education. 2021;89(1):95–111. [DOI]
41. Narimani M, Rashidi J, Zardi B. The role of children’s self-concept, family’s social support, and parenting styles in predicting academic vitality among students with specific learning disability. Journal of Learning Disabilities. 2019;8(3):112–33. [Persian] [Article]
42. Rodríguez MS, Tinajero C, Páramo MF. Pre–entry characteristics, perceived social support, adjustment and academic achievement in first–year Spanish university students: A path model. J Psychol. 2017;151(8):722–38. [DOI]
43. Murugan PV. Mental health and adjustment of higher secondary school students. Journal on Educational Psychology. 2017;11(2):29–35. [Article]
44. Moazaz R, Narimani M, Hajloo N, Abolghasemi A, Savadi Osjoei D. The effect of cognitive-behavioral stress management in the frequency of epileptic seizures in adolescents with epilepsy. Nursing and Midwifery Journal. 2016;14(9):767-74. [Persian] [Article]
45. Mehrparvar M, Karimi SB. The effectiveness of cognitive–behavioral group therapy on stigma and death anxiety in epileptic patients in Bukan. Health Psychology. 2022;11(42):67–84. [Persian] [DOI]
46. Humphreys KL, LeMoult J, Wear JG, Piersiak HA, Lee A, Gotlib IH. Child maltreatment and depression: a meta–analysis of studies using the Childhood Trauma Questionnaire. Child Abuse & Neglect. 2020;102:104361. [DOI]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Middle Eastern Journal of Disability Studies

Designed & Developed by : Yektaweb