2019 Fiscal Year Final Research Report

Development of Clustering of Neuroimage in Chronic Pain; Alexithymia vs. Neurosisi

Research Project

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Project/Area Number	16K15414
Research Category	Grant-in-Aid for Challenging Exploratory Research
Allocation Type	Multi-year Fund
Research Field	General internal medicine(including psychosomatic medicine)
Research Institution	Fukuoka International University of Health and Welfare (2019) International University of Health and Welfare (2016-2018)
Principal Investigator	Komaki Gen 福岡国際医療福祉大学, 医療学部, 教授 (70225564)
Co-Investigator(Kenkyū-buntansha)	馬場天信追手門学院大学, 心理学部, 教授 (00388216) 細井昌子九州大学, 大学病院, 講師 (80380400)
Project Period (FY)	2016-04-01 – 2020-03-31
Keywords	アレキシサイミア / 失感情症 / 神経症 / 慢性痛 / 線維筋痛症 / TAS / 構造化面接 / 心身症
Outline of Final Research Achievements	Appropriate assessment of alexithymia personality is required for proper understanding and treatment of psychosomatic disorders. Since the conventional self-reported questionnaire such as Toronto Alexithymia Scale-20 (TAS-20) has been difficult to distinguish from “neurotic” personality, we developed a structured interview for alexithymia, the 10-item version of the modified Beth Israel Hospital Psychosomatic Questionnaire (m-SIBIQ) and examined its reliability and validity. As a result, this method has a high internal consistency, can be distinguished from neurotic personality, and its validity has been proved. As a preliminary study, a small number of patients with fibromyalgia was examined by MRI study using VBM brain morphology analysis. We found a positive correlation with External Oriented Thinking Style of TAS-20 score and the right cerebellar volume. We are planning to proceed with verification by brain image analysis using the m-SIBIQ for patients with chronic pain.
Free Research Field	心身医学
Academic Significance and Societal Importance of the Research Achievements	Alexithymia(Alex)は心身症患者に特徴的な「感情への気づき・表出の困難さ」を指しており、心理療法的介入を困難にさせるパーソナリティの特徴の一つとして注目されてきた。一方、慢性疼痛を初め同症患者においてしばしば認められる“陰性感情への敏感さ”（＝神経症）傾向はAlexと対極をなすパーソナリティでありながら、従来汎用されてきた自記式Alex評価法では鑑別が困難であった。本研究により我々が開発したAlex構造化面接法の信頼性・妥当性が証明され、神経症傾向との鑑別を含め、Alexの正しい評価法の開発ができたことは、今後、難治化しやすい心身症の実施臨床において大変有意義なことと考えられる。