Alexithymia and 7.5-year incidence of compensated low back pain in 1207 urban public transit operators.
J Psychosom Res 2007 Jun; 62(6):667-674
Objective: alexithymia, a lack of emotional awareness, was positively associated with self-reported low back pain (LBP) in cross-sectional studies. We assessed the association of alexithymia with 7.5-year incidence of LBP prospectively in a cohort study of 1207 San Francisco transit operators. Methods: alexithymia was measured by the 20-item Toronto Alexithymia Scale (TAS-20). LBP was assessed by physician-confirmed diagnoses from administrative workers' compensation data. Cox proportional hazards analyses controlled for demographic, behavioral, and physical and psychosocial job factors measured by questionnaire and interview. Results: of all drivers, 27.7% (n=334) filed compensated claims for LBP injuries with workers' compensation insurance during the 7.5-year observation time. The hazard ratios from the fully adjusted model were 0.73 (0.56-0.96) for the TAS-20 scale and 0.82 (0.69-0.98) for the subscale "difficulty describing feelings." Alexithymia scores did not predict the duration of compensated work disability. Conclusion: in contrast to previous cross-sectional positive associations between alexithymia and LBP, alexithymia is negatively associated with compensated LBP claims. We hypothesize that shame and reporting behavior may explain these inconsistent results.
Back-injuries; Worker-health; Drivers; Questionnaires; Behavior-patterns; Job-analysis; Demographic-characteristics; Statistical-analysis; Psychological-factors; Psychological-effects; Physical-reactions; Physiological-factors; Quantitative-analysis; Work-environment; Worker-health
Wolf E. Mehling, Department of Family and Community Medicine, University of California-San Francisco, Campus Box 1726, 1701 Divisadero, #150, San Francisco, CA 94143-1726, USA
Journal of Psychosomatic Research
Department of Occupational and Environmental Medicine, San Francisco General Hospital, University of California - San Francisco, San Francisco, California