The relationship between chronic pain, mentalizing and alexithymic traits

Problem. Impaired mentalizing abilities are found among persons with chronic pain, yet it is still unknown how this deficit is associated with different aspects of pain and alexithymic traits, which are elevated in this population. Therefore, the aim of this study was to explore the relationship between chronic pain, mentalizing abilities and alexithymic traits. Methods. The present study consisted of two parts: persons with chronic pain, aged 32–86 (n = 120), participated in the first part (completion of the questionnaire), from whom 59.2 % (n = 71) continued participation in the second part (performance of the tasks). In the first part, participants completed questionnaire which consisted of SF-MPQ-2 scale (to evaluate affective and sensory pain), TAS-20 scale (to evaluate alexithymic traits), PHQ depression and anxiety subscales, CAGE questionnaire (to evaluate problematic alcohol use), as well as other well-being, chronic pain and sociodemographic factors. In the second part, Frith-Happé Animations Task (to evaluate mentalizing abilities) and digital correction tables (to evaluate attention) were administered. The data were analysed using univariate and bivariate methods as well as linear regression analysis. Results. The assessment of chronic pain characteristics revealed that in this study sample median of pain duration was 6.5 years, 83.3 % of participants experienced chronic pain in lower body, 53.3 % of participants were experiencing severe pain on the study day. Alexithymia levels in this sample were average (m = 53), 28.3 % of participants showed the presence of alexithymia. Higher alexithymia levels were correlated to greater depression and anxiety (p 0.05). Lower total mentalizing task score was significantly correlated to greater momentary pain intensity (r = –0.24; p = 0.045). However, regression analysis demonstrated that pain intensity lost its significance, when alexithymia and attention variables are controlled. Indeed, attention was found to be statistically significant predictor of total mentalizing task score (βs = 0.274), after controlling for alexithymia levels, pain intensity, depression, anxiety, age and education. Conclusions. Alexithymic traits showed no systematic associations with different variables of chronic pain intensity, however depression and anxiety might play mediating role between these factors. In addition, in persons with chronic pain, lower mentalizing abilities were mostly associated to lower attentional functions, rather than alexithymic traits or pain intensity