Styles of verbal expression of emotional and physical experiences: A study of depressed patients and normal controls in China

Sixty depressed patients and 52 normal controls completed three selfreport inventories: the Symptom Checklist-90 (SCL-90), the Beck Depression Inventory (BDI) and a new Verbal Style Investigation Schedule (VESIS) developed by the first author. The VESIS uses 16 key emotional and physical terms from Western inventories and identified the words and phrases most commonly used by Chinese patients to express these feeling states. Chinese subjects commonly used the key term itself for only 3 or the 16 key terms; they usually preferred to use other words or phrases to express the feeling state. We categorized these Chinese expressions into four styles of verbal expression: Psychological, Somatic, Neutral (i.e., a mixture of psychological and somatic) and Deficient (i.e., lack of expression because of denial or suppression). Three of the 12 key emotional terms of the VESIS (depressed, fearful, and anxiousness) were more commonly expressed in a somatic or neutral mode than the other key emotional terms. The key terms suicidal interest and being punished were more commonly expressed in a deficient style than other key emotional terms. The somatic factor score of the SCL-90 was not correlated with increased somatic expression of emotional states; thus patients who have multiple somatic complaints are not more likely to express emotions somatically. The hypothesis of somatization is discussed in light of this study.