Article Insecure attachment strategies are asso- ciated with cognitive alexithymia in patients with severe somato- form disorder Jurrijn A Koelen 1 , Elisabeth HM Eurelings-Bontekoe 2 , Frauke Stuke 3 , and Patrick Luyten 4,5 Abstract Objective: In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperac- tivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology. Method: In a cross-sectional study among patients with somatoform disorder, self- report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strate- gies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology. Results: Only cognitive alexithymia, i.e., the inability to analyze, identify, and verbal- ize emotions, was associated with personality dysfunction, in particular insecure 1 Altrecht Psychosomatic Medicine, The Netherlands 2 Department of Clinical and Health Psychology, Leiden University, The Netherlands 3 Psychologische Hochschule Berlin, Germany 4 Faculty of Psychology and Educational Sciences, University of Leuven, Belgium 5 Research Department of Clinical, Educational and Health Psychology, University College London, UK Corresponding author: Jurrijn A Koelen, Altrecht Psychosomatic Medicine, Voortgang 6, Zeist 3705WD, The Netherlands. Email: jurkoel@gmail.com The International Journal of Psychiatry in Medicine 0(0) 1–15 ß The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0091217415589303 ijp.sagepub.com