The World Health Organization (WHO)contends that violence against women is a serious health issue and a public health concern globally especially inthe Philippines (Zuniga, Marks, & Gostin, 2013; Antai, Oke, Braithwaite,& Lopez, 2014; Jaymalin, 2016). According to a multicountry study conductedby the WHO (Hibbard, Barlow, & MacMillan, 2012), women who had experiencedpsychological abuse from their intimate partners were more commonly reported.
Psychological abuse has been known to be anantecedent of somatic symptoms (Hibbard, Barlow, & MacMillan, 2012).Hurwitz (2004) asserts that somatization is the tendency of individuals tocommunicate psychological distress in the form of somatic symptoms. The failure to adaptively express one’s distressingexperiences may have had caused negative emotions to be somatized (Gross , 1993; Petrova, 2008; McHugh & Vallis, 2012). Although thereare numerous studies supporting the abuse-distress-somatization link, to theauthor’s knowledge, none so far have studied the moderating role ofpsychological capital and individual’s inhibition. We contend that therelationship between psychological abuse and psychological distress isconditional to the psychological capital of the individuals and therelationship between psychological distress and somatic symptoms is conditionalto the inhibitional attitude of an individual. To meet the criteria of somatic symptomdisorder, the Diagnostic and Statistical Manual of Mental Disorders (5thed.; DSM-5; American Psychiatric Association, 2013) requires patients tohave one or more chronic somatic symptoms about which they are excessivelyconcerned, preoccupied or fearful.
These fears and behaviors cause significantdistress and dysfunction, and although patients may make frequent use of healthcare services, they are rarely reassured and often feel their medical care hasbeen inadequate (Moran, Gross, & Stern, 2010; Maclean, Palsson, , 2012; Staab, 2015). Some of the numerous symptoms that can occur withsomatic symptom disorder include: cardiac (e.g., shortness of breath,palpitations, chest pain); gastrointestinal (e.g.
, vomiting, abdominal pain,difficulty swallowing, nausea, bloating, diarrhea); musculoskeletal (e.g., painin the legs or arms, back pain, joint pain); neurological (e.g.
, headaches,dizziness, amnesia, vision changes, paralysis or muscle weakness); urogenital(e.g., pain during urination, low libido, dyspareunia, impotence, dysmenorrhea,irregular menstruation and menorrhagia) (Shaw, Bernard, & DeMaso, 2011;Dimsdale et al., 2013; Vishal, Brahmbhatt, & Vankar, 2014). Heim et al.,(2013) assert that psychological abuse can leave its victims prone todepression, moodiness and extreme or dulled emotional responsiveness, dependingon the person and the particular circumstances. Thus, adults have difficultyreflecting on themselves and finding the right way to deal with emotions anddistress leading sustained levels of arousal and increased somatic symptoms(Literacy, 2011; Heim, Mayberg, Mietzko, Nemeroff & Pruessner, 2013). Abusedwomen who had difficulty expressing their discomfort or fear and silently experiencedistress, were more likely to experience somatic symptoms (Stone, 2014; Castle & Abel, 2016).
Somatic symptoms brought about by failure toexpress psychological distress among abused women has been theoretically andempirically supported. However, it should be noted that not all who aresuffering from undisclosed distress will increase the severity of somaticsymptoms. This study speculates that this may be caused by psychologicalcapital and individual’s inhibition attitude.PsychologicalCapital have been known to lower psychological distress (Riolli, Savicki, &Richards, 2012; Aslund, Starrin, & Nilsson, 2014).
While, inhibition ofemotion is a critical component in the development and maintenance ofdepression and anxiety disorder (Barlow et al., 2004; Sills et al., 2006;Kashdan et al., 2006; Mennin, 2006; Compare et al., 2014) which then results tosomatic symptoms (Liu et al., 2013; Krasikova, Lester, & Harm, 2015; Kan& Yu, 2015).
Thus, it is plausible that psychological distress’ effect onthe development of somatic symptoms is a function of psychological capital andemotional inhibition. To the author’s knowledge, there have been few studies onthe moderating roles of psychological capital and inhibition in therelationship between psychological abuse and somatic symptoms withpsychological distress as the mediating factor. Additionally, most of thestudies conducted with intimate partner violence (IPV) is coming frominstitutions or residential care center (Roelens, Verstraelen, & Temmerman,2009; Bauer, Rodriquez, & Perez-Stable, 2000). Only few studies haveactually tried to locate IPV to the community sample, particularly amongFilipinos or in rural areas In this study, we assert that psychological capitalis a moderating variable in abuse-distress link, as well as the inhibition indistress-somatization link with psychological distress as the mediating factor.