Date of Award
2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Clinical Psychology
Department
Psychology
Committee Chair and Members
Sara Haden, Chair
Nicholas Papouchis
Matthew Morrison
Keywords
Attachment, Emotion regulation Identity, Personality, Somatic symptom disorder, Somatic symptoms
Abstract
Prior research has established strong associations between emotion regulation (ER) difficulties and somatic symptom distress. The mechanisms underlying this relationship however remain unclear. Attachment theory explains how early caregiving experiences shape emotional and physiological responses that contribute to individual differences in emotion regulation and somatic distress. Building on this framework, this study examined the relationship between insecure attachment, emotion regulation (ER) difficulties and somatic symptom distress. Recent findings also suggest that ER is influenced by contextual factors. The present study also explored the role of different emotions (sadness and anger) and emotion beliefs in the ER process. Two moderated mediation models were used to assess whether ER difficulties (sadness and anger) mediated the relationship between insecure attachment and somatic symptom distress. Beliefs about the controllability and acceptability of emotions was examined as a moderator between insecure attachment and emotion regulation difficulties. A sample of N = 254 participants aged, 30 – 65 and endorsing somatic complaints was recruited using the online research platform Prolific. As hypothesized, insecure attachment predicted greater somatic symptom distress. In both models, assessing sadness and anger, emotion regulation difficulties significantly mediated this relationship. However, beliefs about emotions did not moderate the relationship between insecure attachment and sadness/anger regulation difficulties. These findings support the relationship between attachment and somatic symptom distress. They also highlight emotion regulation as a key mechanism explaining the relationship between attachment insecurity and somatic symptom distress.
Recommended Citation
Livieratos, Mathylda, "Somatic symptom distress: Individual differences in attachment style, emotion regulation, and identity functioning" (2026). Selected Full-Text Dissertations 2020-. 80.
https://digitalcommons.liu.edu/brooklyn_fulltext_dis/80