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Shared Genetic Etiology of Hwabyung (Anger Syndrome) and Somatization Symptoms in South Korean Adolescent and Young Adult Twins

  • Yoon-Mi Hur (a1), Hee-Jeong Jin (a2), Siwoo Lee (a2) and Jong-Woo Kim (a3)

Abstract

Somatization is known to be more prevalent in Asian than in Western populations. Using a South Korean adolescent and young adult twin sample (N = 1754; 367 monozygotic male, 173 dizygotic male, 681 monozygotic female, 274 dizygotic female and 259 opposite-sex dizygotic twins), the present study aimed to estimate heritability of somatization and to determine common genetic and environmental influences on somatization and hwabyung (HB: anger syndrome). Twins completed self-report questionnaires of the HB symptoms scale and the somatization scale via a telephone interview. The results of the general sex-limitation model showed that 43% (95% CI [36, 50]) of the total variance of somatization was attributable to additive genetic factors, with the remaining variance, 57% (95% CI [50, 64]), being due to individual-specific environmental influences, including measurement error. These estimates were not significantly different between the two sexes. The phenotypic correlation between HB and somatization was .53 (p < .001). The bivariate model-fitting analyses revealed that the genetic correlation between the two symptoms was .68 (95% CI [.59, .77]), while the individual-specific environmental correlation, including correlated measurement error, was .41 (95% CI [.34, .48]). Of the additive genetic factors of 43% that influence somatization, approximately half (20%) were associated with those related to HB, with the remainder being due to genes unique to somatization. A substantial part (48%) of individual environmental variance in somatization was unrelated to HB; only 9% of the environmental variance was shared with HB. Our findings suggest that HB and somatization have shared genetic etiology, but environmental factors that precipitate the development of HB and somatization may be largely independent from each other.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work

Corresponding author

Author for correspondence: Hee-Jeong Jin, Email: hjjin@kiom.re.kr

References

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Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Department of Psychiatry.
Akaike, H. (1987). Factor analysis and AIC. Psychometrica, 52, 317332.
American Psychiatric Association (APA). (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Bartels, M., van de Aa, N., van Beijsterveldt, C. E., Middeldorp, C. M., & Boomsma, D. I. (2011). Adolescent self-report of emotional and behavioral problems: Interactions of genetic factors with sex and age. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 20, 3552.
Bornstein, R. F., & Gold, S. H. (2008). Comorbidity of personality disorders and somatization disorder: A meta-analytic review. Journal of Psychopathology and Behavioral Assessment, 30, 154161.
Brown, R. J., Schrag, A., & Trimble, M. R. (2005), Dissociation, childhood interpersonal trauma, and family functioning in patients with somatization disorder. The American Journal of Psychiatry, 162, 899905.
Choi, E., Chentsova-Dutton, Y. & Parrott, W. G. (2016). The effectiveness of somatization in communicating distress in Korean and American cultural contexts. Frontiers in Psychology, 7, 383. doi: 10.3389/fpsyg.2016.00383
Ciechanowski, P. S., Walker, E. A., Katon, W. J, & Russo, J. E. (2002) Attachment theory: A model for health care utilization and somatization. Psychosomatic Medicine, 64, 660667.
Demirkan, A. J., Lahti, J., Direk, N., Viktorin, A., Lunetta, K. L., Terracciano, A., … Räikkönen, K. (2016). Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: A meta-analysis of genome-wide association studies. Psychological Medicine, 46, 16131623.
Dere, J., Sun, J., Zhao, Y., Persson, T. J., Zhu, X., Yao, S., … Ryder, A.G. (2013). Beyond ‘somatization’ and ‘psychologization’: Symptom-level variation in depressed Han Chinese and Euro-Canadian outpatients. Frontiers in Psychology, 4, 377390.
Gillespie, N. A., Zhu, G., Heath, A. C., Hickie, I. B., & Martin, N. G. (2000). The genetic aetiology of somatic distress. Psychological Medicine, 30, 10511061.
Hansell, N. K., Wright, M. J., Medland, S. E., Davenport, T. A., Wray, N. R., Martin, N. G., & Hickie, I. B. (2012). Genetic co-morbidity between neuroticism, anxiety/depression and somatic distress in a population sample of adolescent and young adult twins. Psychological Medicine, 42, 12491260.
Horwitz, B. N., Marceau, K., Narusyte, J., Ganiban, J., Spotts, E. L., Reiss, D., … Neiderhiser, J. M. (2015). Parental criticism is an environmental influence on adolescent somatic symptoms. Journal of Family Psychology, 29, 283289.
Hsu, L. K., & Folstein, M. F. (1997). Somatoform disorders in Caucasian and Chinese Americans. The Journal of Nervous and Mental Disease, 185, 382387.
Hur, Y.-M., Choi, E.- J., Kim, J.-W., Jin, H.-J., & Lee, S. (2018). Heritability of hwabyung symptoms in South Korean adolescent and young adult twins. Twin Research and Human Genetics, 21, 378383.
Hur, Y.-M., Jeong, H.-U., Chung, K. W., Shin, J. S., & Song, T.-B. (2013). The South Korean Twin Registry: An update. Twin Research and Human Genetics, 16, 237240.
Hur, Y.-M., & Kwon, J. S. (2005). Changes in twinning rates in South Korea; 1981–2002. Twin Research and Human Genetics, 8, 7679.
Hur, Y.-M., MacGregor, A. J., Cherkas, L., Williams, F. M. K., & Spector, T. D. (2012). Age differences in genetic and environmental variations to stress coping during adulthood: A study of female twins. Behavior Genetics, 42, 541548.
Imbierowicz, K., & Egle, U. T. (2003). Childhood adversities in patients with fibromyalgia and somatoform pain disorder. European Journal of Pain, 7, 113119.
Kämpfer, N., Staufenbiel, S., Wegener, I., Rambau, S., Urbach, A. S., Mücke, M., … Conrad, R. (2016). Suicidality in patients with somatoform disorder — The speechless expression of anger? Psychiatry Research, 246, 485491.
Kendler, K. S., Walters, E. E., Truett, K. R., Heath, A. C., Neale, M. C., Martin, N. G., & Eaves, L. J. (1995). A twin-family study of self-report symptoms of panic-phobia and somatization. Behavior Genetics, 25, 499515.
Kim, J.-W., Chung, S.-Y., Suh, H.-U., Jung, I.-C., Lee, S.-G., Kim, B.-K., & Kim, S.-H. (2010). The characteristics of Hwa-Byung patients based on Hwa-Byung epidemiologic data. Journal of Oriental Neuropsychiatry, 21(2), 157169.
Kim, Y-H., Kim, J-H., Oh, S-W., Im, Y-R., & Hong, S-H. (2001). Standardization study of Personality Assessment Inventory (PAI): Reliability and validity. Korean Journal of Clinical Psychology, 5, 311329.
Klengel, T., Heck, A., Pfister, H., Bruckl, T., Hennings, J. M., Menke, A., … Ising, M. (2011). Somatization in major depression — Clinical features and genetic associations. Acta Psychiatrica Scandinavica, 124, 317328.
Kwon, J. H., Kim, J. W., Park, D. G., Lee, M. S., Min, S. G., & Kwon, H. I. (2008). Development and validation of the Hwa-Byung Scale. Korean Journal of Clinical Psychology, 27, 237252.
Lee, J.-K., & Lee, J.-H. (2008). Study on the prevalence of hwabyung diagnosed by HBDIS in the general population in Kang-won province. Journal of Oriental Neuropsychiatry, 19, 133139.
Lieb, R., Meinlschmidt, G., & Araya, R. (2007). Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: an update. Psychosomatic Medicine, 69, 860863.
Lipowski, Z. J. (1988). Somatization: The concept and its clinical application. The American Journal of Psychiatry, 145, 13581368.
McGue, M., & Bouchard, T. J. Jr., (1984). Adjustment of twin data for the effects of age and sex. Behavior Genetics, 14, 325343.
Min, S. K. (2013). Culture and somatic symptoms: Hwa-byung, a culture-related anger syndrome. In Koh, K. (Ed.), Somatization and psychosomatic symptoms (pp. 5160). New York, NY: Springer.
Min, S. K., & Suh, S. Y. (2010). The anger syndrome hwa-byung and its comorbidity. Journal of Affective Disorders, 124, 211214.
Morey, L. C. (2007). The Personality Assessment Inventory professional manual. Odessa, FL: Psychological Assessment Resources.
Neale, M., Boker, S. M., Xie, G., & Maes, H. (2003). Mx: Statistical modeling. Richmond, VA: Virginia Commonwealth University Medical School, Department of Psychiatry.
Neale, M. C., & Cardon, L. R. (1992). Methodology for genetic studies of twins and families. London: Kluwer.
Ooki, S., Yamada, K., & Asaka, A. (1993). Zygosity diagnosis of twins by questionnaire for twins’ mothers. Acta Geneticae Medicae et Gemellologicae (Roma), 42, 1722.
Oyama, L., Patoo, C., Greengold, J., & Plant, M. (2007). Somatoform disorders. American Family Physician, 76, 13331338.
Rao, D., Young, M., & Raguram, R. (2007). Culture, somatization, and psychological distress: symptom presentation in South Indian patients from a public psychiatric hospital. Psychopathology, 40, 349355.
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128, 330366.
Ryder, A. G., & Chentsova-Dutton, Y. E. (2012). Depression in cultural context: ‘Chinese somatization’, revisited. The Psychiatric Clinics of North America, 35, 1536.
Schulte, I. E., & Petermann, F. (2011) Somatoform disorders: Thirty years debate about criteria. What about children and adolescents? Journal of Psychosomatic Research, 70, 218228.
Vassend, O., Roysamb, E., & Nielsen, C. S. (2012). Neuroticism and self-reported somatic health: A twin study. Psychology & Health, 27, 112.
Yu, W., Gwinn, M., Clyne, M., Yesupriya, A., & Khoury, M. J. (2008). A navigator for human genome epidemiology. Nature Genetics, 40, 124125.
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Twin Research and Human Genetics
  • ISSN: 1832-4274
  • EISSN: 1839-2628
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