Somatization of Emotional Conflict Scale (SECS)

Abstract

The Somatization of Emotional Conflict Scale (SECS) is a specialized 20-item self-report psychological assessment tool developed to quantitatively assess an individual’s tendency to manifest underlying psychological distress as physical symptoms. This instrument is crucial for measuring the degree of somatization that occurs when individuals experience unresolved or repressed emotional conflict.

The SECS employs a sophisticated multi-dimensional scoring methodology. It requires respondents to evaluate both the frequency and the impact of specific physical complaints, while also identifying the corresponding emotional states—primarily stress, depression, or anger—that are perceived to trigger these somatic responses. The scale is widely utilized in clinical and research environments to identify patients at high risk for somatization disorders or those whose chronic physical complaints may have a primary psychological etiology.

Keywords

Somatization, Emotional Conflict, Psychosomatic Illness, Physical Symptoms, Psychological Distress, Self-Report, Clinical Assessment, Conversion Disorder, Hypnotizability, Psychopathology.

Authors

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

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Purpose

The primary objective of the SECS is twofold, serving both diagnostic and descriptive functions within clinical and research contexts. Firstly, it provides a quantifiable, standardized measure of an individual’s propensity toward somatization—the defensive process by which psychological tension is converted into concrete physical manifestations. The scale aims to precisely gauge the extent to which individuals attribute various physical ailments directly to underlying, unaddressed emotional conflicts.

Secondly, the SECS operates as a detailed descriptive tool, allowing clinicians and researchers to pinpoint specific categories of emotional conflict—namely anxiety, depression, or anger—that are implicated in the initiation or worsening of physical symptoms. This granular assessment capability is invaluable for tailoring therapeutic interventions, ensuring they effectively target the specific emotional triggers identified as contributing to the patient’s somatic experience.

Construct

The SECS is theoretically grounded in the construct of Somatization of Emotional Conflict. This construct draws heavily from classic psychoanalytic theory, which posits that when internal psychological conflicts are repressed or remain unresolved, and when an individual’s psychological coping mechanisms are inadequate, this internal tension is inevitably expressed or externalized through the body via physical complaints. The scale systematically measures the degree of this psychological externalization.

To operationalize this complex construct, the instrument asks respondents to establish a perceived causal link between 38 distinct physical difficulties and three primary negative emotional states: stress/anxiety, depression/sadness, and anger/agitation. By requiring the linkage of specific symptoms to specific emotional states, the SECS moves beyond merely cataloging symptoms; it assesses the hypothesized causal relationship central to the concept of psychosomatic illness.

Validity

Academic literature associated with the scale’s development (e.g., Borckardt, 2002; Willis, 2002) reports that the SECS possesses satisfactory validity, particularly when applied to the student and clinical populations it was designed for. The inclusion of a comprehensive and exhaustive list of somatic symptoms ensures the instrument maintains high face validity, effectively covering the range of complaints typically associated with somatoform and psychosomatic presentations.

Furthermore, research supports the scale’s construct validity by demonstrating predictable correlations between elevated somatization scores and other critical psychological variables, such as overall psychopathology and levels of hypnotizability. The SECS’s proven functionality across diverse clinical settings underscores its practical utility in helping medical professionals distinguish between symptoms rooted in psychological distress and those originating from purely physiological etiology.

Reliability

The original documentation confirms that the SECS is considered reliable, demonstrating consistent performance and measurement stability across various clinical and experimental contexts. The scale’s robust, multi-item structure—involving 20 core symptoms rated across three distinct dimensions—is specifically engineered to yield numerous data points, thereby ensuring an internally consistent and robust measure of the underlying somatization construct.

The use of a standardized 5-point Likert scale for rating both the frequency and the perceived impact of the symptoms significantly enhances the measure’s reliability. This standardized rating system provides clear, quantifiable response anchors, minimizing ambiguity when respondents report on subjective physical and emotional experiences.

Factor Analysis

While specific, detailed factor analytic results, such as precise factor loadings or eigenvalues, are typically confined to the referenced doctoral dissertations, the fundamental design of the SECS strongly suggests a complex, multi-factorial structure. The instrument systematically evaluates three distinct dimensions for each reported physical symptom:

• Frequency (Column A): How often the symptom occurs.

• Impact (Column B): The severity and negative effect of the symptom.

• Emotional Trigger Linkage (Column C): The perceived link between the symptom and specific emotional states.

The three emotional categories presented in Column C (Stress/Anxiety, Depression/Sadness, Anger/Agitation) imply an intended three-factor model that underlies the somatic expressions. This structure allows researchers to rigorously explore and differentiate specific pathways through which distinct forms of psychological distress lead to various physical manifestations.

Instrument

Test Type: Self-report psychological assessment and screening tool.

Format: The instrument includes 38 physical difficulties (20 core items used for primary scoring) rated across three columns. The rating system uses a 5-point Likert scale (ranging from 1=not at all to 5=very much) for frequency and impact, complemented by a checklist for identifying emotional triggers.

Language Available: English (Original development language).

Population Group: Clinical and general adult populations.

Age Group: Adolescents and Adults.

Population Details: Primarily utilized in university-based research settings with young adults and in clinical settings involving patients who present with chronic, medically unexplained physical symptoms, often related to psychosomatic and somatoform disorders.

Test Methodology: Respondents first complete demographic and health history sections. They then rate 38 physical symptoms based on frequency (0 to 4) and impact (0 to 4). Finally, they check all applicable emotional states (stressed/anxious, depressed/sad, or angry/agitated) that correspond to the occurrence of that symptom.

Keywords

Psychosomatic, Conversion Disorder, Hypnosis, Anxiety, Depression, Pain Scales, Somatic Symptom Disorder, Clinical Psychology, Self-Efficacy, Psychological Assessment.

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Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material. (Primary development associated with the University of Tennessee).

Permissions & Fee and Test Year

The Somatization of Emotional Conflict Scale (SECS) was developed between 2000 and 2002, emerging principally from the doctoral research conducted by Jeffrey J. Borckardt at the University of Tennessee. The instrument and its foundational research are considered publicly accessible, primarily housed within the university’s institutional repository, suggesting its availability for academic and non-commercial research purposes.

The instrument can be accessed through the following online resource: http://trace.tennessee.edu/utk_interstp2/108.

Reference’s

• 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.

• Borckardt, Jeffrey J. (2002). Physiological reactivity to mental imagery as a predictor of somatization and psychopathology. University of Tennessee. Doctoral Dissertation. The original PDF can be downloaded here: trace.tennessee.edu/cgi/viewcontent.cgi?article=1107&context=utk_interstp2

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

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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 instrument begins with demographic information and health history:

• 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):

The core items are rated across three columns (A, B, and C) for 38 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.”