Aims and background: Chronic pain, is one of the psychosomatic disease that a lot of people meet throughout their life. The aim of this study was to determine the mediation role of alexithymia between ego defense styles and the intensity of pain that percipience by the patients with chronic pain. Materials and methods: The method of the study was the correlation, and the statistical universe was the 20-60 age patients with chronic pain who had referred to the Mahan clinic and the physical medicine and rehabilitation clinic of Arman in Tehran from spring to autumn of 1396. 520 patients who had musculoskeletal pain at least for 3 months, were chosen purposefully and answered the Toronto Alexithymia Scale (TAS-20), defense styles questionnaire(DSQ), and Numeric Rating Scale (NRS). Findings: The intensity of pain had the positive relation with alexithymia, neurotic defense style, and immature defense style (p< 0.001). Alexithymia had negative relation with mature defense style (p< 0.001), and a positive relation with immature defense style (p< 0.001). Alexithymia (t=4.31, β= 0.19), and immature defense style (t=6.06, β= 0.26) could clarify the variance of the pain intensity. Alexithymia could also clarify the mature defense style (t= 8.75, β= -0.35), and the immature defense style (t= 6.17, β= 0.27). Conclusion: Based on the findings, the relation between immature defense style and the intensity of pain, was not a simple linear relationship, but alexithymia could affect this relation. Also, the alexithymia could be in a total mediator role for the mature defense style and the intensity of pain

Keywords: Alexithymia, Ego defense styles, chronic pain

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