Somatization of Emotional Conflict Scale (SECS)

Abstract

The Somatization of Emotional Conflict Scale (SECS) is a specialized self-report instrument developed to assess the degree to which individuals experience common physical symptoms, the impact of these symptoms on daily life, and the perceived connection between these physical difficulties and underlying negative emotional states. Developed by Borckardt et al. in 2000, the SECS moves beyond simply measuring the presence of somatization by investigating the subject’s attribution of physical distress to specific affective categories, such as stress, anxiety, depression, or anger. This focus allows researchers to better understand the mechanism through which emotional conflict is expressed physiologically.

Keywords

Somatization, emotional conflict, psychosomatic illness, affective attribution, psychological assessment, physical symptoms, psychopathology, Borckardt.

Authors

Jeffrey J. Borckardt, J.W. Younger, B.J. Adams, M.R. Nash, Leah Willis.

Purpose

The primary purpose of the SECS is to provide a detailed, multidimensional assessment of the phenomenon of somatization, specifically focusing on the perceived causality between psychological distress and physical manifestation. Unlike scales that only count symptoms, the SECS quantifies three crucial components for each of the 40 listed physical difficulties: frequency, impact, and emotional linkage. This detailed breakdown aims to differentiate between general physical illness and symptoms specifically related to emotional conflict or psychological factors.

The scale was initially utilized in research investigating the complex relationship between somatization, psychopathology, and individual differences in hypnotizability. By capturing the subjective link between moods (e.g., anxiety, anger, sadness) and physical symptoms (e.g., headaches, stomach aches), the instrument facilitates a deeper understanding of mind-body connections in clinical and non-clinical populations.

Construct

The core construct measured by the SECS is the subjective experience of Somatization of Emotional Conflict. This construct assumes that specific, commonly experienced physical symptoms are perceived by the individual as being triggered or exacerbated by identifiable negative affective states. The measurement relies on the participant’s self-attribution across three dimensions:

• Symptom Frequency (Column A): The rate at which the physical symptom occurs.
• Symptom Impact (Column B): The degree to which the symptom negatively affects the individual’s life.
• Emotional Attribution (Column C): The identification of specific emotional clusters (Anxiety/Worry, Depression/Sadness, Anger/Agitation) that the respondent believes precede or contribute to the physical symptom onset.

The scale thus yields a comprehensive score that reflects not just the burden of physical symptoms but the degree to which that burden is psychologically mediated, linking physical distress directly to measurable emotional distress and potential psychopathology.

Validity

Specific, published validity data (e.g., convergent, discriminant, or criterion validity coefficients) for the SECS are primarily detailed within the associated doctoral dissertation by Borckardt (2002) and related research papers. The scale’s face validity is high, as it lists 40 common physical complaints often associated with psychosomatic conditions, ranging from migraine headaches to generalized fatigue. Content validity is established by including a broad spectrum of symptoms across various bodily systems (gastrointestinal, neurological, musculoskeletal, and cardiovascular).

The use of the SECS in studies relating somatization to constructs like hypnotizability and general psychopathology suggests its utility in measuring the intended construct distinct from general physical health measures. For detailed empirical validation statistics, researchers must consult the original works cited, particularly the 2002 doctoral dissertation by Jeffrey J. Borckardt.

Reliability

While the explicit internal consistency (e.g., Cronbach’s alpha) or test-retest reliability figures are not present in the provided abstract, the rigorous academic context of its development (a doctoral dissertation) suggests that standard psychometric testing, including reliability assessments, was performed. Given the scale’s multi-column structure, reliability would likely be assessed across the three dimensions (Frequency, Impact, and Emotional Attribution) both individually and compositely. High reliability is crucial for instruments used to predict clinical outcomes or relationships with other psychological variables.

Factor Analysis

Detailed information regarding the factor structure of the 40 physical symptoms or the three emotional attribution clusters is not available in the source snippets. However, factor analysis is typically employed in the development of such scales to determine if the 40 symptoms cluster into meaningful subscales (e.g., gastrointestinal symptoms, pain symptoms, cardiovascular symptoms). Furthermore, factor analysis would be essential to confirm whether the three intended emotional categories (Stress/Anxiety, Depression/Sadness, Anger/Agitation) function as distinct factors in predicting symptom endorsement.

Instrument

Test Type: Self-report inventory; Multidimensional rating scale.

Format: Paper-and-pencil questionnaire requiring circling and check-marking responses across three columns (Frequency, Impact, Emotional Attribution).

Language Available: English (Original development language).

Population Group: Clinical and non-clinical adults.

Age Group: Typically 18+ years (Inferred from demographic questions regarding sexual health issues like Impotence and menstrual cycles).

Population Details: The scale includes preliminary questions regarding general health status, smoking habits, frequency of common illnesses, and specific diagnoses such as Chronic fatigue syndrome, Irritable bowel syndrome, and Fibromyalgia, suggesting its application in populations potentially presenting with medically unexplained symptoms.

Test Methodology: Participants rate 40 physical symptoms using a 0-4 frequency scale (Column A) and a 0-4 impact scale (Column B). They then check all applicable emotional states (stressed/anxious, depressed/sad, angry/agitated) that they believe precede or contribute to the physical problem (Column C).

Keywords

Somatoform disorder, stress response, Borckardt, emotional regulation, physical complaints, psychophysiology, psychosomatic medicine, self-efficacy, Fibromyalgia.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material; associated with the University of Tennessee (2002 dissertation).

Permissions & Fee and Test Year

The scale was first presented in 2000 (Borckardt et al.) and subsequently featured in academic theses in 2002. The instrument is available through the University of Tennessee’s institutional repository, suggesting it may be available for academic use without a formal fee, though permission from the primary author (Jeffrey J. Borckardt) should be sought for formal research applications.

The original instrument files and related academic papers can be accessed online via the University of Tennessee Trace repository. The original PDF or instrument text is linked here: http://trace.tennessee.edu/utk_interstp2/108 and trace.tennessee.edu/cgi/viewcontent.cgi?article=1107&context=utk_interstp2.

Reference’s

1. Borckardt, J.J., Younger, J.W., Adams, B.J., & Nash, M.R. (2000). Toward a better understanding of the relationship between somatization and hypnotizabilility. Paper presented at the meeting of the Society for Clinical and Experimental Hypnosis, Seattle, WA.

2. Borckardt, Jeffrey J. (2002). Physiological reactivity to mental imagery as a predictor of somatization and psychopathology. University of Tennessee. Doctoral Dissertation.

3. Willis, Leah. (2002). Self-efficacy, Psychosomatic Illness, and Psychopathology. Senior Thesis Projects, 1993-2002. http://trace.tennessee.edu/utk_interstp2/108.

Items of the Somatization of Emotional Conflict Scale (SECS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The SECS begins with demographic and medical history questions:

• Sex (circle): Male Female Age:____ Height:____ Weight: ____ Race:
• Do you smoke cigarettes? Yes No
• If yes, how many cigarettes per day? ____
• How often do you get sick with the cold, flu, or similar common illness? (circle the number of the most accurate response): 1 = less than once a year, 2 =once or twice a year, 3 = three or four times a year, 4 =more than four times a year
• Have you ever been diagnosed with the following (circle the appropriate response): Chronic fatigue syndrome Yes No, Severe allergies Yes No, Irritable bowel syndrome Yes No, Fibromyalgia Yes No, Asthma Yes No, Conversion Disorder Yes No, Arthritis Yes No, Seizure Disorder Yes No, High blood pressure Yes No, Arteriosclerosis Yes No
• Please list medications you are currently taking (including oral contraceptives):

Instructions for rating the 40 physical difficulties:

Column-A: How frequently do you have the following problems? “0 =I have never had this problem, 1= less than once month, 2= once or twice month, 3=three or four times a month, and 4=more than four times a month”

Column-B: How much does this problem affect you? “0=Never a problem at all, 1=Barely noticeable; not a problems, 2= A minor problem; small discomfort, 3= A problem; but can be dealt with, 4= Huge negative impact on my life”.

Column – C: I have these problems when I feel … (Check All That Apply) “Stressed, anxious, frightened, or worried,” “depressed, lonely, empty, or sad,” “angry, irritated, mad, or agitated.”

The 40 physical difficulties assessed are:

• Migraine headache
• Headache
• Nausea or upset stomach
• Numbness or tingling
• Trouble breathing or short of breath
• Stomach aches or pains
• Shakiness or trembling
• Difficulty sleeping
• Vomiting
• Heart pounding or racing
• Diarrhea
• Blackouts or fainting
• Cramps
• Backaches
• Appetite problems
• Leg or foot pain
• Dizziness
• Fatigue or weakness
• Indigestion
• Impotence (males)
• Chest pain
• Blurred vision
• Nose bleeds
• Diffuse body aches and pains
• Constipation
• Hot or cold spells
• Skin rash
• Pain or aches in arms or hands
• Genital/Sexual Pain
• Cold sores or fever blisters
• Twitching of eyelid
• Premature ejaculation (males)
• Heartburn
• Ulcer
• Ringing in ears
• Dry or red eyes
• Absence of menstruation (females)
• Acne
• Muscle tension
• Severe PMS (females)
• Inability to achieve orgasm
• Excessive energy