Journals / KADEM Kadın Araştırmaları Dergisi / 2026 / Cilt: 9 Sayı: 1

Somatization in Women: An Evaluation from the Biopsychosocial Perspective

Kadınlarda Somatizasyon: Biyopsikososyal Yaklaşım Perspektifinden Bir Değerlendirme

Selin Karaköse(Florida State University)0000-0001-8629-4422
Özlem Sertel Berk(İSTANBUL ÜNİVERSİTESİ)0000-0002-3045-3903
Pages
93–117
Publication Date
2023-06-27
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

While the multi-dimensional nature of somatization emphasizes the necessity of a multidisciplinary approach for an effective treatment, it also underlines the significance of including psychological and social factors in prevention studies.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Somatization, defined as the expression of psychological and emotional factors through physical symptoms, is a complex psychological syndrome with its predisposing causes, perpetuating factors and treatment.
📊
Key Findings & Data:The biomedical model, which explains the causes of diseases via cellular and chemical processes, has been replaced by the biopsychosocial model, which emphasizes that diseases are related to biological, social and psychological factors.
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Conclusion & Impact:While the multi-dimensional nature of somatization emphasizes the necessity of a multidisciplinary approach for an effective treatment, it also underlines the significance of including psychological and social factors in prevention studies.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Biyopsikososyal model · Kadınlarda somatizasyon · Biyolojik faktörler ve somatizasyon

Abstract

Somatization, defined as the expression of psychological and emotional factors through physical symptoms, is a complex psychological syndrome with its predisposing causes, perpetuating factors and treatment. The biomedical model, which explains the causes of diseases via cellular and chemical processes, has been replaced by the biopsychosocial model, which emphasizes that diseases are related to biological, social and psychological factors. This study aims to examine somatization, in which being a woman is considered a risk factor, from the biopsychosocial perspective. The fact that it is more common to observe somatization in women is linked with biological differences in the brain system, hormones and reproductive system. Compared to men, women suffer from mental health issues more, particularly depression and anxiety, and having a high tendency on the neuroticism dimension are physiological factors associated with somatization. In addition to the fact that somatization is more common in non-western societies, it is noteworthy that in male-dominated societies, women have more responsibilities regarding marriage and family, and women’s disadvantaged positions both in society and marriage are recognized as social factors for somatization. While the multi-dimensional nature of somatization emphasizes the necessity of a multidisciplinary approach for an effective treatment, it also underlines the significance of including psychological and social factors in prevention studies.

Özet

Somatizasyon, psikolojik ve duygusal faktörlerin bedensel belirtilerle ifade edilmesi olarak tanımlanan, ortaya çıkış nedenleri, sürdürücü faktörleri ve tedavisiyle çok yönlü karmaşık bir yapıya sahip psikolojik bir sendromdur. Hastalıkların kaynağını hücresel ve kimyasal süreçlerle açıklayan biyomedikal model günümüzde yerini, hastalıkların biyolojik, sosyal ve psikolojik faktörlerle ilişkili olduğunu vurgulayan biyopsikososyal modele bırakmıştır. Bu çalışmanın amacı kadın olmanın bir risk faktörü olarak görüldüğü somatizasyonu biyopsikososyal model bakış açısından incelemektir. Kadınlarda somatizasyonun daha yaygın olarak görülmesi biyolojik faktörler kapsamında beyin sistemi,hormonlar ve üreme sistemindeki farklarla ilişkilendirilmektedir. Kadınların erkeklere kıyasla depresyon ve anksiyete başta olmak üzere diğer ruh sağlığı problemlerini daha çok yaşamaları ve daha yüksek nörotisizm kişilik boyutu eğilimine sahip olmaları ise somatizasyonla ilişkili görülen psikolojik faktörlerdir. Somatizasyonun Batılı olmayan toplumlarda daha sık görülmesine ek olarak, özellikle erkek egemen toplumlarda kadınların dezavantajlı konumda yer almaları ve evlilik-aileyle ilgili konularda daha çok sorumlu olmaları somatizasyonla ilgili sosyal faktörler olarak görülmektedir. Somatizasyonun çok boyutlu yapısı etkin bir tedavide multidisipliner yaklaşım gerekliliğini ortaya koyarken, önleyici çalışmalar içerisinde psikolojik ve sosyal etmenlerin yer almasının önemini vurgulamaktadır.

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Cite This Article

Karaköse, S., Berk, Ö. S. (2023). Somatization in Women: An Evaluation from the Biopsychosocial Perspective. KADEM Kadın Araştırmaları Dergisi, Cilt: 9 Sayı: 1, 93–117. https://ajindex.com/articles/951387

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References (103)

  1. Akyunus, M., Gençöz, T. & Aka, B.T. (2021). Age and sex differences in basic per- sonality traits and interpersonal problems across young adulthood. Current Psychology, 40, 2518–2527. https://doi.org/10.1007/s12144-019-0165-z
  2. Alkın, T. (1999). Somatizasyonda Biyolojik Etmenler. Türkiye Klinikleri Psikiyatri Dergisi, 1(1), 18-26.
  3. APA (1980). DSM-3 Tanı Ölçütleri Başvuru El Kitabı. Ankara: Hekimler Yayın Bir- liği Yayıncılık.
  4. APA (2010). DSM-4-TR Tanı Ölçütleri Başvuru El Kitabı. Ankara: Hekimler Yayın Birliği Yayıncılık.
  5. APA (2013). DSM-5 Tanı Ölçütleri Başvuru El Kitabı. Ankara: Hekimler Yayın Bir- liği Yayıncılık.
  6. American Psychiatric Association. (2022). Somatic symptoms and related disorders Disorder içinde. Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787.x09_Soma- tic_Symptom_and_Related_Disorders
  7. Babacan, S. (2003). Hastalıkta Ruh ve Baden Etkileşimi. Gazi Üniversitesi Kastamo- nu Eğitim Dergisi, 11(2), 519-524.
  8. Babu, A. R., Sreedevi, A., John, A. & Krishnapillai, V. (2019). Prevalence and deter- minants of somatization and anxiety among adult women in an urban popu- lation in Kerala. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 44(Suppl 1), 66-69. https://doi.org/10.4103/ijcm.IJCM_55_19
  9. Barsky, A.J., Peekna, H.M. & Borus, J.F. (2001). Somatic symptom reporting in wo- men and men. Journal of General Internal Medicine, 16(4), 266-275. https:// doi:10.1046/j.1525-1497.2001.00229.x
  10. Beam, C. R., Dinescu, D., Emery, R. & Turkheimer, E. (2017). A Twin Study on Per- ceived Stress, Depressive Symptoms, and Marriage. Journal of Health and Social Behavior, 58(1), 37–53. https://doi.org/10.1177/0022146516688242
  11. Bener, A., Ghuloum, S. & Burgut, F. T. (2010). Gender differences in prevalen- ce of somatoform disorders in patients visiting primary care centers. Journal of Primary Care & Community Health, 1(1), 37-42. https://doi. org/10.1177/2150131909353333
  12. Bonomi, A. E., Thompson, R. S., Anderson, M., Reid, R. J., Carrell, D., Dimer, J. A. & Rivara, F. P. (2006). Intimate partner violence and women’s physical, mental, and social functioning. American Journal of Preventive Medicine, 30(6), 458- 466. https://doi.org/10.1016/j.amepre.2006.01.015
  13. Bragazzi, N. L., Puente, G. D. & Natta, W. M. (2014). Somatic perception, cultural differences and immigration: results from administration of the Modified So- matic Perception Questionnaire (MSPQ) to a sample of immigrants. Psycho- logy Research and Behavior Management, 7, 161–166. https://doi.org/10.2147/ PRBM.S55393
  14. Brambila-Tapia, A. J. L., Saldaña-Cruz, A. M., Meléndez-Monreal, K. C., Esparza-Gu- errero, Y., Martínez-Hernández, A., Rosales-Torres, B. G. & Ríos-González, B. E. (2021). Association of personal, behavioral and positive psychological variables with somatization and number of diseases in Mexican general po- pulation: the influence of gender. Psychology, Health & Medicine, 1-9. https:// doi.org/10.1080/13548506.2021.1985150
  15. Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative conceptual model. Psychological Bulletin, 130 (5), 793-812.
  16. Ciciolla, L. & Luthar, S. S. (2019). Invisible household labor and ramifications for adjustment: Mothers as captains of households. Sex Roles, 81(7), 467-486. ht- tps://doi.org/10.1007/s11199-018-1001-x
  17. Costa, P. X., Sr. & McCrae, R. R. (1985). NEO Personality Inventory (NEO-PI). Odes- sa, FL: Psychological Assessment Resources.
  18. Davila, G. W., Bernier, F., Franco, J. & Kopka, S. L. (2003). Bladder dysfunction insexual abuse survivors. The Journal of Urology, 170(2 Pt 1), 476–479. https://doi.org/10.1097/01.ju.0000070439.49457.d9
  19. Dhindsa, D. S., Khambhati, J., Schultz, W. M., Tahhan, A. S. & Quyyumi, A. A. (2020). Marital status and outcomes in patients with cardiovascular disease. Tren- ds in Cardiovascular Medicine, 30(4), 215-220. https://doi.org/10.1016/j. tcm.2019.05.012
  20. Dickinson, W.P., Dickinson, L.M., deGruy, F.V., Candib, L.M., Main, D.S., Libby, A.M. & Rost, K. (2003). The somatization in primary care study: a tale of three di- agnoses. General Hospital Psychiatry, 25(1), 1-7. https://doi.org/10.1016/s0163
  21. Durak, M., Senol-Durak, E. & Karaköse, S. (2022). Psychological distress and anxiety among housewives: The mediational role of perceived stress, loneliness, and housewife burnout. Current Psychology. https://doi.org/10.1007/s12144-021- 02636-0
  22. Duruk, B. & Sertel Berk, Ö. (2019). Fonksiyonel somatik sendromlar ve DSM-5: Zihin beden yaklaşımı açısından bir değerlendirme. Klinik Psikoloji Dergisi, 3(2), 116-128. https://doi.org/ 10.5455/kpd.26024438m000013
  23. Eagly, A. H. (2013). Sex differences in social behavior: A social-role interpretation. Psychology Press.
  24. Engel, G. (1977). The need for a new medical model: a challenge for biomedical scien- ce. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460
  25. Enna, S. J. & McCarson, K. E. (2006). The role of GABA in the mediation and per- ception of pain. Advances in Pharmacology, 54, 1-27. https://doi.org/10.1016/ S1054-3589(06)54001-3
  26. Feinauer, L. L. & Steele, W. R. (1992). Caretaker marriages: The impact of chronic pain syndrome on marital adjustment. American Journal of Family Therapy, 20(3), 218–226. https://doi.org/10.1080/01926189208250891
  27. Fillingim, R. B. & Maixner, W. (1995, December). Gender differences in the respon- ses to noxious stimuli. In Pain forum (Vol. 4, No. 4, pp. 209-221). Churchill Livingstone.
  28. Gabriel, B., Beach, S. R.H. & Bodenmann, G. (2010). Depression, marital satisfacti- on and communication in couples: Investigating gender differences. Behavior Therapy, 41(3), 306–316. https://doi.org/10.1016/j.beth.2009.09.001
  29. Garrusi, B., Danaei, M. & Aboosaeidi, R. (2019). The prevalence and predictive fac- tors of somatization and its relationship with anxiety and depression in Ira- nian population. Journal of Preventive Medicine and Hygiene, 60(4), 400-406. https://doi.org/10.15167/2421-4248/jpmh2019.60.4.1006
  30. Ghaemi S. N. (2009). The rise and fall of the biopsychosocial model. The British Journal of Psychiatry: The Journal of Mental Science, 195(1), 3–4. https://doi. org/10.1192/bjp.bp.109.063859
  31. Glise, K., Ahlborg, G. & Jonsdottir, I. H. (2014). Prevalence and course of somatic symptoms in patients with stress-related exhaustion: does sex or age mat- ter. BMC Psychiatry, 14(1), 1-13. https://doi.org/10.1186/1471-244X-14-118
  32. Gupta, S., Taneja, N., Kapoor, S. K. & Kumar, A. (2020). Comparison of mental health status of married and unmarried girls of late adolescent age in an urban slum of Delhi. Indian Journal of Community Medicine, 45(2), 145–148. https://doi.org/10.4103/ijcm.IJCM_204_19
  33. Gureje, O., Simon, G.E., Ustun, T.B. & Goldberg, D.P. (1997). Somatization in cross-cultural perspective: a World Health Organization study in primary care. American Journal of Psychiatry, 154(7), 989-995. https://doi.org/10.1176/ ajp.154.7.989
  34. Gülec, M. Y., Hocaoglu, C., Gökce, M. & Sayar, K. (2007). Kalple ilişkili olmayan gö- güs ağrısında aleksitimi, öfke ve bedensel duyumlari büyütme*/Alexithymia, anger and somatosensory amplification with chest pain without cardiac etio- logy. Anadolu Psikiyatri Dergisi, 8(1), 14.
  35. Heinrich, T. W. (2004). Medically unexplained symptoms and the concept of somatiza- tion. WMJ-MADISON-, 103, 83-87.
  36. Hinz, A., Ernst, J., Glaesmer, H., Brähler, E., Rauscher, F. G., Petrowski, K. & Kocale- vent, R. D. (2017). Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15). Jour- nal of Psychosomatic Research, 96, 27-31. https://doi.org/10.1016/j.jpsycho- res.2016.12.017
  37. Hsu, L. K. G. & Folstein, M. F. (1997). Somatoform disorders in Caucasian and Chi- nese Americans. Journal of Nervous and Mental Disease, 185(6), 382–387. ht- tps://doi.org/10.1097/00005053-199706000-00004
  38. Jasmin, L., Wu, M. V. & Ohara, P. T. (2004). GABA puts a stop to pain. Current Drug Targets-CNS & Neurological Disorders, 3(6), 487-505. https://doi. org/10.2174/1568007043336716
  39. Jellesma, F. C. (2008). Health in young people: social inhibition and negative affect and their relationship with self-reported somatic complaints. Journal of De- velopmental & Behavioral Pediatrics, 29(2), 94-100. https://doi.org/10.1097/ DBP.0b013e31815f24e1
  40. Karaköse, S. (2018). Yeni evli çiftlerde evlilik uyumu ve somatizasyon arasndaki kar- şılıklı ilişkinin boylamsal açıdan incelenmesi. Yayınlanmamış Doktora Tezi, İstanbul Üniversitesi, Sosyal Bilimler Enstitüsü, İstanbul.
  41. Karaköse, S., & Ulusoy, A. (2022). Ev kadınlarında tükenmişlik ve somatizasyon: Depresyonun yordayıcıları. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 4(1), 94-102. https://doi.org/10.35365/ctjpp.22.1.10
  42. Karaköse, S., & Ledermann, T. (2023). Let’s talk, honey: An analysis of associ- ations between communication patterns and dyadic adjustment in mar- ried couples. Journal of Social and Personal Relationships, https://doi. org/10.1177/02654075231153668
  43. Karaköse, S., Urs, M., Marshall, J. E. & Ledermann, T. (2023). Depression, anxiety, stress, and sexual satisfaction in couples. Journal of Sex & Marital Therapy, 1-14. https://doi.org/10.1080/0092623X.2023.2166637
  44. Kırpınar, İ., Deveci, E., Kılıç, A. & Çamur, D. Z. (2016). Somatization disorder and hypochondriasis: As like as two peas? Anadolu Psikiyatri Dergisi, 17(3), 165– 173. https://doi.org/10.5455/apd.201002
  45. Kiecolt-Glaser, J. K. & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127(4), 472–503. https://doi.org/10.1037/0033-2909.127.4.472
  46. Kiecolt-Glaser, J. K. & Wilson, S. J. (2017). Lovesick: How Couples’ Relationship Inf- luence Health. Annual review of clinical psychology, 8(13), 421–443. https:// doi.org/10.1146/annurev-clinpsy-032816-045111
  47. Kirmayer, L. J., Groleau, D., Looper, K. J. & Dao, M. D. (2004). Explaining medically unexplained symptoms. Canadian Journal of Psychiatry. Revue canadienne de psychiatrie, 49(10), 663–672. https://doi.org/10.1177/070674370404901003
  48. Kirmayer, L. J. & Young, A. (1998). Culture and somatization: clinical, epidemiologi- cal, and ethnographic perspectives. Psychosomatic Medicine, 60(4), 420–430. https://doi.org/10.1097/00006842-199807000-00006
  49. Klimowicz, A. (2003). Comparison of the personality of anxiety disorder patients and somatization disorder patients before and after psychotherapy. Psychiatria Polska, 37(2), 235-246.
  50. Kocalevent, RD., Hinz, A. & Brähler, E. (2013). Standardization of a screening instru- ment (PHQ-15) for somatization syndromes in the general population. BMC Psychiatry, 13(91), 1-8 https://doi.org/10.1186/1471-244X-13-91
  51. Koh, K. B. (2018). Biological Mechanisms of Somatization. In Stress and Somatic Symptoms (pp. 95-103). Springer, Cham.
  52. Güleç, M. Y., Hocaoglu, C., Gökce, M. & Sayar, K. (2007). Kalple ilişkili olmayan göğüs agrısında aleksitimi, öfke ve bedensel duyumları büyütme. Anadolu Psikiyatri Dergisi, 8(1), 14.
  53. Larson, J. H. & Holman, T. B. (1994). Premarital predictors of marital quality and stability. Family Relations, 43(2), 228-237. https://doi.org/10.2307/585327
  54. Lavner, J. A. & Bradbury, T. N. (2010). Patterns of change in marital satisfaction over the newlywed years. Journal of Marriage and Family, 72(5), 1171-1187. https://doi.org/10.1111/j.1741-3737.2010.00757.x
  55. Le, B. & Agnew, C. R. (2003). Commitment and its theorized determinants: A meta– analysis of the Investment Model. Personal Relationships, 10(1), 37-57. htt- ps://doi.org/10.1111/1475-6811.00035
  56. Levenson, R. W., Carstensen, L. L. & Gottman, J. M. (1993). Long-term marriage: Age, gender, and satisfaction. Psychology and Aging, 8(2), 301–313. https:// doi.org/10.1037/0882-7974.8.2.301
  57. Lewis, R. & Spanier, G. (1979). Theorizing about the quality and stability of marri- age. In: Burr, W.R, Hill, R., Nye, F.I, Reiss I, editors. Contemporary Theories about the Family: Research-based theories. 2 ed. New York: Free Press.
  58. Lipowski, Z.J (1988). Somatization: the concept and its clinical application. Ame- rican Journal of Psychiatry, 145(11), 1358-1368. https://doi.org/10.1176/ ajp.145.11.1358
  59. Lim, B. K. H. (2000). Conflict resolution styles, somatization, and marital satisfaction in Chinese couples: The moderating effect of forgiveness and willingness to seek professional help. Texas Tech University.
  60. Malatyalı, M. K. & Sunal, A. B. (2020). Evli çiftlerde bağlanma boyutları ile evlilik doyumu arasındaki ilişkide evlilik gücünün aracı rolü. Türk Psikoloji Dergisi, 35(85), 65-78. https://doi.org/10.31828/tpd1300443320181219m000016
  61. Macina, C., Bendel, R., Walter, M. & Wrege, J. S. (2021). Somatization and somatic symptom disorder and its overlap with dimensionally measured personality pathology: A systematic review. Journal of Psychosomatic Research, 151, 110646. https://doi.org/10.1016/j.jpsychores.2021.110646
  62. Ma-Kellams, C. (2016). Addendum: Cross-cultural differences in somatic awareness and interoceptive accuracy: A review of the literature and directions for fu- ture research. Frontiers in Psychology, 5, 1379-1487. https://doi.org/10.3389/ fpsyg.2014.01379
  63. McLean, C. P., Asnaani, A., Litz, B. T. & Hofmann, S. G. (2011). Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035. https://doi.or- g/10.1016/j.jpsychires.2011.03.006
  64. Mourad, G., Jaarsma, T., Strömberg, A. & Johansson, P. (2022). Somatization in wo- men and men with non-cardiac chest pain compared to the general Swedish population. Psychiatry Research Communications, 2(2), 100047. https://doi. org/10.1016/j.psycom.2022.100047
  65. Okyayuz, H. Ü. (1999). Sağlık Psikolojisi, Sağlık Psikolojisi Giriş, Türk Psikologlar Derneği Yayınları.
  66. Orathinkal, J., Vansteenwegen, A. & Burggraeve, R. (2008). Are demographics important for forgiveness? The Family Journal, 16(1), 20–27. https://doi. org/10.1177/1066480707309542
  67. Özel, E. P. & Karaköse, S. (2023). Bağlanma stilleri ile ilişki merkezli ve partner odaklı obsesif kompulsif belirtiler arasındaki ilişkide evlilik uyumunun aracı rolü. Klinik Psikoloji Dergisi, 7 (1), 11-25. https://doi.org/10.57127/ kpd.26024438m000077X
  68. Parlak, Ü. & Karaköse, S. (2022). COVİD-19 sürecinde evden çalışan annelerde dep- resyonu yordayan faktörler: İş-aile çatışması, evlilik uyumu ve ebeveyn tü- kenmişliği. KADEM Kadın Araştırmaları Dergisi,7(2), 149-189. https://doi. org/ 10.21798/kadem.2022.56
  69. Peleg, O. (2008). The relation between differentiation of self and marital sa- tisfaction: What can be learned from married people over the course of life?. The American Journal of Family Therapy, 36(5), 388-401. https://doi. org/10.1080/01926180701804634
  70. Piccinelli, M. & Simon, G. (1997). Gender and cross-cultural differences in soma- tic symptoms associated with emotional distress. An international study in primary care. Psychological Medicine, 27(2), 433–444. https://doi.org/10.1017/ s0033291796004539
  71. Real, M., Rodrı ́guez-Arias, J., Cagigas, J., Aparicio, M. & Real, M. (2000). Terapia Familiar Breve: Ahorro enel gasto sanitario de la patologı ́a somatomorfa [Brief Family Therapy: Cost reduction in the treatment of somatoform patho- logy. Cuadernos de terapia familiar, 14, 167–173.
  72. Regitz-Zagrosek, V. (2012). Sex and gender differences in health: Science & So- ciety Series on Sex and Science. EMBO Reports, 13(7), 596-603. https://doi. org/10.1038/embor.2012.87
  73. Riecher-Rössler, A. (2010). Prospects for the classification of mental disorders in women. European Psychiatry, 25(4), 189-196. https://doi.org/10.1016/j. eurpsy.2009.03.002
  74. Rief, W., Hennings, A., Riemer, S. & Euteneuer, F. (2010). Psychobiological differen- ces between depression and somatization. Journal of Psychosomatic Resear- ch, 68(5), 495-502. https://doi.org/10.1016/j.jpsychores.2010.02.001
  75. Robles, T. F. (2014). Marital quality and health: Implications for marriage in the 21st century. Current Directions in Psychological Science, 23(6), 427–432. ht- tps://doi.org/10.1177/0963721414549043
  76. Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J. & Bagby, R. M. (2008). The cultural shaping of depression: somatic symptoms in China, psychological sy- mptoms in North America? Journal of Abnormal Psychology, 117(2), 300-313. https://doi/10.1037/0021-843X.117.2.300
  77. Schmeling-Kludas, C., Fröschlin, R. & Boll-Klatt, A. (2003). Stationäre psychosoma- tische Rehabilitation für türkische Migranten: Was ist realisierbar, was ist erreichbar? [Inpatient psychosomatic rehabilitation for Turkish migrants: what can be realized, what are the effects?]. Die Rehabilitation, 42(6), 363– 370. https://doi.org/10.1055/s-2003-45460
  78. Schmitt, D. P., Realo, A., Voracek, M. & Allik, J. (2008). Why can’t a man be more like a woman? Sex differences in Big Five personality traits across 55 cultu- res. Journal of Personality and Social Psychology, 94(1), 168–182. https://doi. org/10.1037/0022-3514.94.1.168
  79. Scott, K. M., Wells, J. E., Angermeyer, M., Brugha, T. S., Bromet, E., Demyttenaere, K., de Girolamo, G., Gureje, O., Haro, J. M., Jin, R., Karam, A. N., Kovess, V., Lara, C., Levinson, D., Ormel, J., Posada-Villa, J., Sampson, N., Takes- hima, T., Zhang, M. & Kessler, R. C. (2010). Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders. Psychological Medicine, 40(9), 1495–1505. https://doi.org/10.1017/ S0033291709991942
  80. Sharpe, M., Peveler, R. & Mayou, R. (1992). The psychological treatment of patients with functional somatic symptoms: a practical guide. Journal of Psychoso- matic Research, 36(6), 515-529. https://doi.org/10.1016/0022-3999(92)90037-3
  81. Skapinakis, P. & Araya, R. (2011). Common somatic symptoms, causal attributions of somatic symptoms and psychiatric morbidity in a cross-sectional commu- nity study in Santiago, Chile. BMC Research Notes, 4(1), 1-5. https://doi. org/10.1186/1756-0500-4-155
  82. Spanier, G.B. (1976). Measuring dyadic adjustment: New scales for assessing the qu- ality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15-28. https://doi/10.2307/350547
  83. Stoudemire A. (1991). Somatothymia. Psychosomatics, 32(4), 365–381. https://doi. org/10.1016/s0033-3182(91)72037-9
  84. Şahin, E. M. Ö., Türkcan, A. S., Belene, A., Yeşlilbursa, D. & Yurt, E. (2009). Soma- tizasyonda kültürel ve sosyolojik faktörler [Somatization: Cultural and so- ciologic factors]. Yeni Symposium: Psikiyatri, Nöroloji ve Davraniş Bilimleri Dergisi, 47(4), 187–193.
  85. Taycan, O., Şar, V., Çelik, C. & Erdogan-Taycan, S. (2014). Trauma-related psychi- atric comorbidity of somatization disorder among women in eastern Turkey. Comprehensive Psychiatry, 55(8), 1837–1846. https://doi.org/10.1016/j.comp- psych.2014.08.052
  86. Taylor, E.S. (2009)ç Health Psychology, McGraw-Hill International Edition, 7th edi- tion, NY.
  87. Trofimova, I., Sulis, W. (2018). There is more to mental illness than negative affect: comprehensive temperament profiles in depression and generalized anxiety. BMC Psychiatry 18, 125- 142. https://doi.org/10.1186/s12888-018-1695-x
  88. Tunçer, Ö. (1999). Somatizasyon-Bir Klinik Yaklaşım. Türkiye Klinikleri Psikiyatri Dergisi, 1(1). 90-91.
  89. Twenge, J. M., Campbell, W. K. & Foster, C. A. (2003). Parenthood and marital satis- faction: a meta-analytic review. Journal of Marriage and Family, 65(3), 574- 583. https://doi.org/10.1111/j.1741-3737.2003.00574.x
  90. Vlassoff, C. (2007). Gender differences in determinants and consequences of health and illness. Journal of Health, Population, and Nutrition, 25(1), 47-61.
  91. Wade, T. J. & Pevalin, D. J. (2004). Marital Transitions and Mental He- alth. Journal of Health and Social Behavior, 45(2),155-170. https://doi. org/10.1177/002214650404500203
  92. Walker, E. A., Gelfand, A. N., Gelfand, M. D., Koss, M. P. & Katon, W. J. (1995). Medical and psychiatric symptoms in female gastroenterology clinic patients with histories of sexual victimization. General Hospital Psychiatry, 17(2), 85–92. https://doi.org/10.1016/0163-8343(94)00058-L
  93. Wanic, R. & Kulik, J. (2011). Toward an understanding of gender differences in the impact of marital conflict on health. Sex Roles: A Journal of Research, 65(5-6), 297–312. https://doi.org/10.1007/s11199-011-9968-6
  94. Warner, C. D. (1995). Somatic awareness and coronary artery disease in women with chest pain. Heart & Lung, 24(6), 436-443. https://doi.org/10.1016/s0147- 9563(95)80021-2
  95. Weisberg, Y. J., Deyoung, C. G. & Hirsh, J. B. (2011). Gender Differences in Perso- nality across the Ten Aspects of the Big Five. Frontiers in Psychology, 2, 178- 189. https://doi.org/10.3389/fpsyg.2011.00178
  96. Weiss, G.L. & Lonnquist, L.E (2016). The Sociology of Health, Healing and Illness, New York: Routledge. https://doi.org/10.4324/9781315662749
  97. Whitson, S. & El-Sheikh, M. (2003). Marital conflict and health: Processes and pro- tective factors. Aggression and Violent Behavior, 8(3), 283 312. https://doi. org/10.1016/S1359-1789(01)00067-2
  98. Whisman, M. A., Weinstock, L. M. & Tolejko, N. (2006). Marriage and Depression. In C. L. M. Keyes & S. H. Goodman (Eds.), Women and depression: A handbook for the social, behavioral, and biomedical sciences (pp. 219–240). Cambridge University Press. https://doi.org/10.1017/CBO9780511841262.012
  99. World Health Organization. (2005).Constitution of the World Health Organization: World Health Organization: Basic documents. 45th ed. Geneva: World Health Organization; 2005.
  100. Williams, K. & Umberson, D. (2004). Marital status, marital transitions, and health: A gendered life course perspective. Journal of Health and Social Behavior, 45(1), 81–98. https://doi.org/10.1177/002214650404500106
  101. Wongpakaran, T. & Wongpakaran, N. (2014). Personality traits influencing somati- zation symptoms and social inhibition in the elderly. Clinical Interventions in Aging, 9, 157–164. https://doi.org/10.2147/CIA.S56246
  102. Zhou, X., Min, S., Sun, J., Kim, S. J., Ahn, J. S., Peng, Y., Nohn, S. & Ryder, A. G. (2015). Extending a structural model of somatization to South Koreans: Cul- tural values, somatization tendency, and the presentation of depressive symp- toms. Journal of Affective Disorders, 176, 151-154. https://doi.org/10.1016/j. jad.2015.01.040
  103. Yavuz, F. (2012). Fibromyalji ve Somatoform Bozukluk Hastalarında Kişilik Özel- liklerinin Karşılaştırılması, Uzmanlık Tezi, Düzce Üniversitesi, Psikiyatri Anabilim Dalı, Düzce.