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The Danish Center of Psychotraumatology


Somatisation is a term for bodily symptoms where somatic explanations cannot be identified or are not in proportion to the discomfort experienced.
The Danish Center for Psychotraumatology has researched the relationship between PTSD and the degree of somatisation in a number of contexts.

Our research shows, among other things, that post-traumatic stress symptoms are mediating factors in the explanation of persistent symptoms after accidents and contribute to an understanding of chronic pain and somatisation.

Similarly, we have found that negative affect and feelings of incompetence resulting from traumatic experiences are strong predictors of somatisation, while other psychological variables such as dissociation, depression and anxiety are not associated with the degree of somatisation.


Unexplained somatic symptoms are common among trauma survivors. The relationship between trauma and somatization appears to be mediated by posttraumatic stress disorder (PTSD). However, only few studies have focused on what other psychological risk factors may predispose a trauma victim towards developing somatoform symptoms. The present paper examines the predictive value of PTSD severity, dissociation, negative affectivity, depression, anxiety, and feeling incompetent on somatization in a Danish sample of 169 adult men and women who were affected by a series of explosions in a firework factory settled in a residential area. Negative affectivity and feelings of incompetence significantly predicted somatization, explaining 42% of the variance. PTSD was significant until negative affectivity was controlled for. Negative affectivity and feelings of incompetence significantly predicted somatization in the trauma sample whereas dissociation, depression, and anxiety were not associated with degree of somatization. PTSD as a risk factor was mediated by negative affectivity.


Elklit, A. & Christiansen, D. M. (2009). Predictive factors for somatisation in a trauma sample. Clinical Practice and Epidemiology in Mental Health, 5 (1), 1-8. Doi:10.1186./1745-0179-5-1.

The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.


Andersen, T. E., Elklit, A., & Brink O. (2013). PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash injury. Clinical Practice & Epidemiology in Mental Health, 9, 75-83. Doi: 10.2174/1745017901309010075



Last Updated 29.09.2023