Ambivalence over emotional expression and symptom attribution are associated with self-reported somatic symptoms in Singaporean school adolescents

Although somatization is common across cultures, its meanings may differ as culture shapes emotional experience. Thus, instead of treating somatization as a form of psychopathology, it is more useful to conceptualize it as an idiom of distress, and how complaints of somatic symptoms are related to social relationships, patterns of emotional expression and symptom attribution in a cultural context. This study seeks to explore whether ambivalence over emotional expression and causal attribution would shed light on the meanings of somatization among Asian adolescents. Three hundred secondary school adolescents in Singapore participated in this study. The main results show that emotional ambivalence, biomedical and Traditional Chinese Medicinal causal beliefs, and magical attribution contributed to additional variance in somatic symptoms over and above the variance explained by emotional distress. These findings are discussed from both psychological and cultural perspectives.