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Li X, Peng C, Qin F, Luo Q, Ren Z, Wang X, Feng Q, Liu C, Li Y, Wei D, Qiu J. Basolateral Amygdala Functional Connectivity in Alexithymia: Linking Interoceptive Sensibility and Cognitive Empathy. Neuroscience 2024; 539:12-20. [PMID: 38176608 DOI: 10.1016/j.neuroscience.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
Emotions rely on bodily states, and perceiving the emotions of others depends on awareness of one's own emotional state. However, the intercorrelations among interoception, alexithymia, and empathy are not well understood, and the neural mechanisms behind this connection are also largely unknown. To address these issues, 297 college students participated in this study, completing measures of interoceptive sensibility (IS), empathy and alexithymia and undergoing resting-state fMRI scans. The functional connectivity of the amygdala was analysed to identify the neural substrates of alexithymia, and mediation analyses were conducted to examine the mediation effect of alexithymia and alexithymia-specific amygdala functional connectivity on the relationship between IS and empathy. The results showed that higher levels of IS were associated with increased cognitive empathy through weakened alexithymia. Functional connectivity analysis indicated that right basolateral amygdala (BLA)-left precuneus connectivity was negatively related to alexithymia, while right BLA-left precentral gyrus connectivity was positively related to alexithymia. Furthermore, right BLA-left precuneus connectivity was found to mediate the impact of interoception on cognitive empathy. In conclusion, this study provides valuable insights into the relationships among IS, alexithymia, and empathy. The right BLA-left precuneus connectivity may serve as a shared neural substrate between interoception and cognitive empathy.
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Affiliation(s)
- Xianrui Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Chuyao Peng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Facai Qin
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Qian Luo
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Zhiting Ren
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Xueyang Wang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Qiuyang Feng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Cheng Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Yang Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China; Southwest University Branch, Collaborative Innovation Center of Assessment, Toward Basic Education Quality at Beijing Normal University, China.
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de Vroege L, van Dijl TL, Woudstra-de Jong JE, Videler AC, Kop WJ. Personality traits related to cognitive functioning in patients with functional neurological disorder. J Clin Exp Neuropsychol 2023; 45:1014-1023. [PMID: 38623749 DOI: 10.1080/13803395.2024.2335599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/04/2024] [Indexed: 04/17/2024]
Abstract
Cognitive symptoms are prevalent in patients with functional neurological disorder (FND). Several studies have suggested that personality traits such as neuroticism may play a pivotal role in the development of FND. FND has also been associated with alexithymia: patients with FND report difficulties in identifying, analyzing, and verbalizing emotions. Whether or not alexithymia and other personality traits are associated with cognitive symptomatology in patients with FND is unknown. In the current study, we explored whether the Big Five personality model factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and alexithymia were associated with cognitive functioning in FND. Twenty-three patients with FND were assessed using a neuropsychological assessment and questionnaire assessment to explore personality traits (Neuroticism-Extraversion-Openness Five-Factor Inventory) and alexithymia (Bermond-Vorst Alexithymia Questionnaire). The results indicated that high conscientiousness was associated with lower planning scores (ρ = -0.52, p = .012) and high scores on alexithymia were associated with lower scores on verbal memory scores (ρ = -0.46, p = .032) and lower sustained attention scores (ρ = -0.45, p = .046). The results did not remain significant after controlling for multiple testing. The preliminary results of our study suggest that personality and cognitive symptomatology in patients with FND are topics that should be further explored in future studies, as cognitive symptomology can affect treatment results.
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Affiliation(s)
- Lars de Vroege
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, The Netherlands
- Tranzo department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Timothy L van Dijl
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, The Netherlands
- Tranzo department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | | | - Arjan C Videler
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, The Netherlands
- Tranzo department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Personacura, Clinical Centre of Excellence for Personality and Developmental Disorders in Older Adults, GGz Breburg, Tilburg, The Netherlands
| | - Willem J Kop
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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Liu Y, Du Q, Jiang Y. Prevalence of alexithymia in cancer patients: a systematic review and meta-analysis. Support Care Cancer 2023; 31:675. [PMID: 37932546 DOI: 10.1007/s00520-023-08106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/06/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE To systematically evaluate the prevalence of alexithymia in cancer patients and to compare the prevalence of alexithymia in different countries, genders, and cancer types. METHODS We thoroughly searched PubMed, EMBASE, Web of Science, The Cochrane Library, CINAHL, PsychINFO, China Integrated Knowledge Resource Database, Wanfang Database, Weipu Database, and Chinese Biomedical Database for studies on the prevalence of alexithymia in cancer patients from the inception to April 2, 2023. Based on the Stata 15.0 software package, the prevalence of alexithymia in cancer patients was estimated using a random-effects model in this meta-analysis. RESULTS Eighteen studies with a total of 3,196 participants met the eligibility criteria for the meta-analysis. In 18 studies, 37.0% (95% CI: 28.0% - 46.0%) of cancer patients had alexithymia. 13 studies identified that the pooled mean score of alexithymia in cancer patients was 56.91 (95% CI: 54.44% to 59.37%). The prevalence of alexithymia was higher in cancer patients in developing countries (39.7%, 95% CI: 28.7% to 50.7%), males (40.0%, 95% CI: 24.0% to 55.9%), and colorectal cancer patients (47.3%, 95% CI: 21.3% to 93.3%). CONCLUSIONS Our study found that the pooled prevalence of alexithymia in cancer patients was 37.0%, and higher in developing countries, males, and patients with colorectal cancer. Understanding the current status of alexithymia in cancer patients, timely identification and treatment by medical practitioners can improve the prognosis of cancer patients. CLINICAL TRIAL REGISTRATION The protocol was registered in PROSPERO [CRD42023414665].
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Affiliation(s)
- Yaxin Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Qiufeng Du
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Yunlan Jiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
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Li W, Liu Y, Qiu J, Li Y. Bidirectional relationship between insular grey matter volume and alexithymia: Evidence from a longitudinal study. J Affect Disord 2023; 339:799-806. [PMID: 37442449 DOI: 10.1016/j.jad.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/17/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND The insula is considered to be involved in emotional cognitive processes, and may be structurally altered in people with alexithymia. However, it remains unclear how the relationship between the insula and alexithymia changes over time. This study aimed to investigate whether alexithymia has longitudinal relationship with the insular structure. METHODS Having processed structural MRI data via FreeSurfer, the insula was divided into five sub-regions, and the Toronto Alexithymia Scale was administered to assess alexithymia in the general population. Subsequently, we established the latent change score models between insular sub-regions and the alexithymia (N = 252). RESULTS The TAS-20 mean value of the sample at Time 1 was not significantly different by sex (t = -0.993, df = 250, p = 0.321), while the TAS-20 mean value at Time 2 was slightly different by sex (t = 2.025, df = 250, p = 0.044). Most insular grey matter volumes at Time 1 and Time 2 were significantly associated with TAS-20 at Time 2. The baseline alexithymia and insular grey matter volume positively predicted the other's rate of change between Time 1 and Time 2 in a bidirectional way. LIMITATIONS This study had a limited number of measurement time points, potential bias due to smaller sample sizes and gender imbalance, as well as the potential for inaccuracy in the self-report measure of alexithymia. CONCLUSIONS Time-lagged alexithymia changes and insular grey matter volume changes occur in coupled manner over time, which might improve our understanding of the neurological underpinnings of alexithymia, and shed light on clinical and psychological treatment for alexithymia.
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Affiliation(s)
- Wenjing Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Yuan Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Yu Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China; Faculty of Education, Southwest University, Chongqing, China.
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Jiang C, Jiang W, Chen G, Xu W, Sun T, You L, Chen S, Yin Y, Liu X, Hou Z, Qing Z, Xie C, Zhang Z, Turner JA, Yuan Y. Childhood trauma and social support affect symptom profiles through cortical thickness abnormalities in major depressive disorder: A structural equation modeling analysis. Asian J Psychiatr 2023; 88:103744. [PMID: 37619416 DOI: 10.1016/j.ajp.2023.103744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Childhood trauma, low social support, and alexithymia are recognized as risk factors for major depressive disorder (MDD). However, the mechanisms of risk factors, symptoms, and corresponding structural brain abnormalities in MDD are not fully understood. Structural equation modeling (SEM) has advantages in studying multivariate interrelationships. We aim to illustrate their relationships using SEM. METHODS 313 MDD patients (213 female; mean age 42.49 years) underwent magnetic resonance imaging and completed assessments. We integrated childhood trauma, alexithymia, social support, anhedonia, depression, anxiety, suicidal ideation and cortical thickness into a multivariate SEM. RESULTS We first established the risk factors-clinical phenotype SEM with an adequate fit. Cortical thickness results show a negative correlation of childhood trauma with the left middle temporal gyrus (MTG) (p = 0.012), and social support was negatively correlated with the left posterior cingulate cortex (PCC) (p < 0.001). The final good fit SEM (χ2 = 32.92, df = 21, χ2/df = 1.57, CFI = 0.962, GFI = 0.978, RMSEA = 0.043) suggested two pathways, with left PCC thickness mediating the relationship between social support and suicidal ideation, and left MTG thickness mediating between childhood trauma and anhedonia/anxiety. CONCLUSION Our findings provide evidence for the impact of risk factor variables on the brain structure and clinical phenotype of MDD patients. Insufficient social support and childhood trauma might lead to corresponding cortical abnormalities in PCC and MTG, affecting the patient's mood and suicidal ideation. Future interventions should aim at these nodes.
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Affiliation(s)
- Chenguang Jiang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Gang Chen
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University; Department of Medical Psychology, Huai'an No.3 People's Hospital, Huaian, China
| | - Wei Xu
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University; Department of Clinical Psychology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Taipeng Sun
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University; Department of Medical Psychology, Huai'an No.3 People's Hospital, Huaian, China
| | - Linlin You
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Suzhen Chen
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiaoyun Liu
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhao Qing
- Shing-Tung Yau Center; School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, OH, United States.
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.
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Mo D, Guo P, Hu S, Tao R, Zhong H, Liu H. Characteristics and correlation of gray matter volume and somatic symptoms in adolescent patients with depressive disorder. Front Psychiatry 2023; 14:1197854. [PMID: 37559918 PMCID: PMC10407247 DOI: 10.3389/fpsyt.2023.1197854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Background Adolescent patients with depressive disorders commonly exhibit somatic symptoms, which have a significant negative impact on their treatment and prognosis. Despite this, specific brain imaging characteristics of these symptoms have been poorly studied. Methods The Hamilton Depression Rating scale (HAMD-17), Children's Functional Somatization scale (CSI), and Toronto Alexithymia scale (TAS) were used to evaluate the clinical symptoms of adolescent depression. We analyzed the correlation between brain gray matter volume (GMV) and clinical symptoms in adolescent patients with depression and somatic symptoms. Results The depression subgroups with and without functional somatic symptoms (FSS) had higher scores on the HAMD-17, CSI, and TAS than the normal control group. The group with FSS had higher HAMD-17, CSI, and TAS scores than the depression group without FSS (p < 0.05). CSI and TAS scores were positively correlated (r = 0.378, p < 0.05). The GMV of the right supplementary motor area was higher in the depression groups with and without FSSs than in the normal control group, and the GMV was higher in the group without FSS than in the group with FSS (F = 29.394, p < 0.05). The GMV of the right supplementary motor area was negatively correlated with CSI in the depressed group with FSS (r = -0.376, p < 0.05). In the group with depression exhibiting FSS, CSI scores were positively correlated with GMV of the middle occipital gyrus (pr = 0.665, p = 0.0001), and TAS scores were positively correlated with GMV of the caudate nucleus (pr = 0.551, p = 0.001). Conclusion Somatic symptoms of adolescent depressive disorder are associated with alexithymia; moreover, somatic symptoms and alexithymia in adolescent patients with depressive disorders are correlated with GMV changes in different brain regions.
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Affiliation(s)
- Daming Mo
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Mental Health Center, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Pengfei Guo
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
| | - Shuwen Hu
- Clinical Psychological Science, Anhui Provincial Children’s Hospital, Hefei, China
| | - Rui Tao
- Department of Psychiatry, Anhui Mental Health Center, Hefei, China
| | - Hui Zhong
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Mental Health Center, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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Butera C, Kaplan J, Kilroy E, Harrison L, Jayashankar A, Loureiro F, Aziz-Zadeh L. The relationship between alexithymia, interoception, and neural functional connectivity during facial expression processing in autism spectrum disorder. Neuropsychologia 2023; 180:108469. [PMID: 36610493 PMCID: PMC9898240 DOI: 10.1016/j.neuropsychologia.2023.108469] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/05/2023]
Abstract
Neural processing differences of emotional facial expressions, while common in autism spectrum disorder (ASD), may be related to co-occurring alexithymia and interoceptive processing differences rather than autism per se. Here, we investigate relationships between alexithymia, interoceptive awareness of emotions, and functional connectivity during observation of facial expressions in youth (aged 8-17) with ASD (n = 28) compared to typically developing peers (TD; n = 37). Behaviorally, we found no significant differences between ASD and TD groups in interoceptive awareness of emotions, though alexithymia severity was significantly higher in the ASD group. In the ASD group, increased alexithymia was significantly correlated with lower interoceptive sensation felt during emotion. Using psycho-physiological interaction (PPI) analysis, the ASD group showed higher functional connectivity between the left ventral anterior insula and the left lateral prefrontal cortex than the TD group when viewing facial expressions. Further, alexithymia was associated with reduced left anterior insula-right precuneus connectivity and reduced right dorsal anterior insula-left ventral anterior insula connectivity when viewing facial expressions. In the ASD group, the degree of interoceptive sensation felt during emotion was positively correlated with left ventral anterior insula-right IFG connectivity when viewing facial expressions. However, across all participants, neither alexithymia nor interoceptive awareness of emotions predicted connectivity between emotion-related brain regions when viewing emotional facial expressions. To summarize, we found that in ASD compared to TD: 1) there is stronger connectivity between the insula and lateral prefrontal cortex; and 2) differences in interhemispheric and within left hemisphere connectivity between the insula and other emotion-related brain regions are related to individual differences in interoceptive processing and alexithymia. These results highlight complex relationships between alexithymia, interoception, and brain processing in ASD.
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Affiliation(s)
- Christiana Butera
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA
| | - Jonas Kaplan
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA
| | - Emily Kilroy
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA
| | - Laura Harrison
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA
| | - Aditya Jayashankar
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA
| | - Fernanda Loureiro
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA
| | - Lisa Aziz-Zadeh
- Brain & Creativity Institute, University of Southern California, Los Angeles, CA, 90089, USA; Division of Occupational Science, University of Southern California, Los Angeles, CA, 90089, USA.
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Kenangil G, Demir M, Tur E, Domac F. Alexithymia, depression, and cognition in patients with Parkinson's disease. Acta Neurol Belg 2023; 123:85-91. [PMID: 33453039 DOI: 10.1007/s13760-020-01581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Basal ganglia are connected to dorsal prefrontal and orbitofrontal structures, which have an important role in emotional experience. Alexithymia is defined as the inability to recognize and verbalize emotions. There is little known about alexithymia and cognitive dysfunction and its relationship with depression. In this study, we examined the relation of alexithymia with cognition and depression in non-demented patients with Parkinson's disease (PD). MATERIALS AND METHODS Fort-two consecutive non-demented patients PD and 40 healthy controls were enrolled in the study. The Turkish version of the Montreal Cognitive Assessment scale (MOCA-TR), 20-item Toronto Alexithymia Scale (TAS-20) (F1, F2, F3 subgroups), and Beck Depression Inventory (BDI-I) were used to evaluate cognitive functions, alexithymia, and depression, respectively, in both groups. RESULTS The total TAS-20 score was 55.71 ± 19 in the PD group and 46.33 ± 8.21 in the control group. There was a statistically significant difference in the total TAS-20 scores between the groups (p < 0.001). In subgroups of alexithymia, all mean scores of F1, F2, and F3 were higher in the PD group (p = 0.019, p < 0.001, and p = 0.005, respectively). In the MOCA-TR test, the mean scores in visuospatial and delayed recall of patients with PD were statistically lower than in the control group (p = 0.044 and p = 0.04, respectively). The MOCA-TR and BDI total scores were significantly correlated with TAS-20 total scores. In subgroup analysis, we only found an association between the visuospatial domain of MOCA-TR and the F3 subgroup of TAS-20 (r = - 0.22, p = 0.03). There was no relation between alexithymia and disease duration or total levodopa dose (p < 0.05). CONCLUSION Alexithymia is not a rare symptom in PD. It should be accepted as an independent non-motor symptom, and patients should be interrogated accordingly.
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Affiliation(s)
- Gulay Kenangil
- Department of Neurology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
| | - Mehmet Demir
- Department of Neurology, Agri Dr. Yasar Eryılmaz Dogubeyazıt State Hospital, Agri, Turkey
| | - Esma Tur
- Department of Neurology, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Fusun Domac
- Department of Neurology, Istanbul Erenkoy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey
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Wen J, Wu Y, Peng L, Chen S, Yuan J, Wang W, Cong L. Constructing and Verifying an Alexithymia Risk-Prediction Model for Older Adults with Chronic Diseases Living in Nursing Homes: A Cross-Sectional Study in China. Geriatrics (Basel) 2022; 7:geriatrics7060139. [PMID: 36547275 PMCID: PMC9777669 DOI: 10.3390/geriatrics7060139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022] Open
Abstract
Alexithymia is a critical global public health concern. This questionnaire-based cross-sectional study explored the risk factors of alexithymia in older adults living in nursing homes with chronic diseases. It also developed and evaluated an alexithymia risk-prediction model. A total of 203 older adults with chronic diseases were selected from seven nursing homes in Changsha, China, using simple random and cluster sampling. The participants were surveyed using the Toronto Alexithymia Scale (TAS-20), Geriatric Depression Scale-15 (GDS-15), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and a socio-demographic characteristics questionnaire. The alexithymia total score was 43.85 ± 9.570, with an incidence rate of 8.9%. Alexithymia had a partial mediating effect on the relationship between social support and psychological resilience (the effect value was 0.12), accounting for 19.04% of the total effect. Gender, depression, and psychological resilience were the main independent influencing factors of alexithymia (p < 0.05). The area under the receiver operating characteristic (AUC-ROC) curve of the risk-prediction model was 0.770. The participants, especially those who were male and depressed, exhibited a certain degree of alexithymia. Additionally, it partially mediated the association between social support and psychological resilience, which is a protective factor against alexithymia. The risk-prediction model showed good accuracy and discrimination. Hence, it can be used for preliminary screening of alexithymia in older adults with chronic diseases living in nursing homes.
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Affiliation(s)
- Jing Wen
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Ying Wu
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Lixia Peng
- Shuda College, Hunan Normal University, Changsha 410000, China
| | - Siyi Chen
- Shuda College, Hunan Normal University, Changsha 410000, China
| | - Jiayang Yuan
- Shuda College, Hunan Normal University, Changsha 410000, China
| | - Weihong Wang
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Li Cong
- School of Medicine, Hunan Normal University, Changsha 410013, China
- Shuda College, Hunan Normal University, Changsha 410000, China
- Correspondence:
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10
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Kang Y, Kim A, Kang W, Han KM, Ham B. The Association of White Matter Tracts with Alexithymia among Individuals with Major Depressive Disorder. Exp Neurobiol 2022; 31:343-352. [PMID: 36351844 PMCID: PMC9659491 DOI: 10.5607/en22030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/09/2022] [Indexed: 04/20/2024] Open
Abstract
Alexithymia is characterized by impairments in the processing of emotions. Although the disruptions in the white matter (WM) integrity in Major depressive disorder (MDD) has frequently been reported, the underlying relationship with alexithymia remains unclear. In the present study, we investigated WM tracts with Tracts Constrained by UnderLying Anatomy approach to discover potential associations between alexithymia and WM integrity to identify the neural basis of impaired emotional self-awareness in MDD. 101 patients with MDD and 99 healthy sex- and age-matched individuals underwent diffusion-weighted imaging. All participants were assessed with the 20-item Toronto Alexithymia Scale (TAS). TAS scores were significantly higher in MDD patients than in controls. Patients with MDD exhibited significantly lower FA values in the left inferior longitudinal fasciculus and it also showed negative associations with TAS. These results contribute to the neurobiological evidence on the association between MDD and alexithymia. Additionally, they suggest that reduced white matter integrity in the regions constitutes a principal pathophysiology underlying impaired emotional recognition and description in MDD.
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Affiliation(s)
- Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea
| | - Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea
| | - Byoungjoo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea
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11
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Seyedmirzaei H, Shafie M, Kargar A, Golbahari A, Bijarchian M, Ahmadi S, Shahmohammadi A, Sadeghi M, Aarabi MH, Mayeli M. White matter tracts associated with alexithymia and emotion regulation: A diffusion MRI study. J Affect Disord 2022; 314:271-280. [PMID: 35878842 DOI: 10.1016/j.jad.2022.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/27/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alexithymia is a cognitive-affective impairment, suggested to be associated with emotion regulation. Herein, we investigated white matter (WM) tracts with Diffusion Magnetic Resonance Imaging (DMRI) connectometry approach using quantitative anisotropy (QA) tractography to discover possible associations between the emotion identification and regulation patterns and WM tracts. METHODS DMRI data were acquired from 218 healthy subjects aging 39.15 ± 20.19 who filled the Toronto Alexithymia Scale (TAS) and emotion regulation questionnaire (ERQ) from the LEMON dataset. Connectometry analysis was applied on WM tracts in DMRI images. RESULTS DMRI connectometry analysis revealed a significant correlation between TAS identification score and increased microstructural connectivity in WM pathways, including the body of corpus callosum (CC), bilateral fornix, and left arcuate fasciculus (AF) in males (FDR = 0.028), and corticospinal and cingulum tracts in females (FDR = 0.026). Furthermore, we found a significant positive correlation between overall TAS score and fornix properties in men (FDR = 0.026) and corticospinal tracts in women (FDR = 0.028). Middle cerebellar peduncle negatively correlated with describing emotion (FDR = 0.025) and the splenium of the CC and corticospinal tracts negatively correlated with this subscale (FDR = 0.049) in male group. However, the splenium of the CC, corticospinal tracts, and left AF positively associated with this subscale (FDR = 0.029). The splenium of the CC was negatively related to externally-oriented thinking among men (FDR = 0.038). Our results showed marginally associations between ERQ and similar WM tracts. CONCLUSION Certain WM microstructures significantly correlate with emotion identification and regulation. These tracts are associated with specific somatosensory areas, language processing areas, and limbic area.
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Affiliation(s)
- Homa Seyedmirzaei
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahan Shafie
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhosein Kargar
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Golbahari
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahareh Bijarchian
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepide Ahmadi
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shahmohammadi
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadeghi
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Department of Neuroscience (DNS), Padova Neuroscience Center, University of Padova, Padua, Italy.
| | - Mahsa Mayeli
- NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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12
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Affiliation(s)
- Heike Künzel
- Psychosomatische Beratungsstelle / Ambulanz, Klinikum Innenstadt d. LMU München, Pettenkoferstraße 8 a, 80336, München, Deutschland.
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13
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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14
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Wang Z, S Goerlich K, Luo Y, Xu P, Aleman A. Social-Specific Impairment of Negative Emotion Perception in Alexithymia. Soc Cogn Affect Neurosci 2021; 17:387-397. [PMID: 34406408 PMCID: PMC8972281 DOI: 10.1093/scan/nsab099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/25/2022] Open
Abstract
Alexithymia has been characterized as an impaired ability of emotion processing and regulation. The definition of alexithymia does not include a social component. However, there is some evidence that social cognition may be compromised in individuals with alexithymia. Hence, emotional impairments associated with alexithymia may extend to socially relevant information. Here, we recorded electrophysiological responses of individuals meeting the clinically relevant cutoff for alexithymia (ALEX; n = 24) and individuals without alexithymia (NonALEX; n = 23) while they viewed affective scenes that varied on the dimensions of sociality and emotional valence during a rapid serial visual presentation task. We found that ALEX exhibited lower accuracy and larger N2 than NonALEX in the perception of social negative scenes. Source reconstruction revealed that the group difference in N2 was localized at the dorsal anterior cingulate cortex. Irrespective of emotional valence, ALEX showed stronger alpha power than NonALEX in social but not non-social conditions. Our findings support the hypothesis of social processing being selectively affected by alexithymia, especially for stimuli with negative valence. Electrophysiological evidence suggests altered deployment of attentional resources in the perception of social-specific emotional information in alexithymia. This work sheds light on the neuropsychopathology of alexithymia and alexithymia-related disorders.
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Affiliation(s)
- Zhihao Wang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Katharina S Goerlich
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Yuejia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Faculty of Psychology, Beijing Normal University, Beijing, China.,Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Pengfei Xu
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China.,Great Bay Neuroscience and Technology Research Institute (Hong Kong), Kwun Tong, Hong Kong
| | - André Aleman
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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15
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Barchetta S, Martino G, Craparo G, Salehinejad MA, Nitsche MA, Vicario CM. Alexithymia Is Linked with a Negative Bias for Past and Current Events in Healthy Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6696. [PMID: 34206284 PMCID: PMC8296935 DOI: 10.3390/ijerph18136696] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 11/24/2022]
Abstract
Although research provides a rich literature about the influence of emotional states on temporal cognition, evidence about the influence of the style of emotion processing, as a personality trait, on temporal cognition is extremely limited. We provide a novel contribution to the field by exploring the relationship between difficulties of identifying and describing feelings and emotions (alexithymia) and time perspective. One hundred and forty-two healthy participants completed an online version of the TAS-20 scale, which measures alexithymia, and the Zimbardo Time Perspective Inventory, which monitors individual differences in time-orientation regarding the past, present, and future. The results show greater attention to past negative aspects in participants whose TAS-20 score was indicating borderline or manifest alexithymia, as compared to non-alexithymic individuals. Moreover, the higher the TAS-20 score, the higher the tendency was to focus on negative aspects of the past and interpret the present fatalistically. These results suggest that difficulties in identifying and describing feelings and emotions are associated with a negative bias for past and present events. Theoretical and clinical implications of this finding are discussed.
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Affiliation(s)
- Silvia Barchetta
- Department of Cognitive Sciences, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, 98122 Messina, Italy;
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy;
| | - Mohammad A. Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139 Dortmund, Germany; (M.A.S.); (M.A.N.)
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139 Dortmund, Germany; (M.A.S.); (M.A.N.)
- Department of Neurology, University Medical Hospital Bergmannsheil, Bürkle de La Camp-Platz 1, 44789 Bochum, Germany
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, 98122 Messina, Italy;
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16
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Paul LK, Pazienza SR, Brown WS. Alexithymia and Somatization in Agenesis of the Corpus Callosum. Soc Cogn Affect Neurosci 2021; 16:1071-1078. [PMID: 33973635 PMCID: PMC8483281 DOI: 10.1093/scan/nsab056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/02/2021] [Accepted: 05/11/2021] [Indexed: 12/20/2022] Open
Abstract
Deficient communication between the cerebral hemispheres is one of several prevailing neurobiological explanations for alexithymia and has been strongly supported by research on patients with commissurotomy. We examined self-reported symptoms of alexithymia in adults with agenesis of the corpus callosum (AgCC), a condition characterized by more subtle reductions in interhemispheric transfer than in commissurotomy. 16 adults with AgCC and FSIQ > 80 were compared with 15 age- and IQ-matched neurotypical controls. The AgCC group endorsed greater difficulty identifying and describing feelings and more vague physical symptoms than controls, but similar levels of emotional experience and emotional coping. This finding of impaired emotional interpretation with intact emotional experience is consistent with findings in callosotomy patients, implicating the critical role of the corpus callosum in cognitive dimensions of emotion processing. Further study of alexithymia in AgCC using task-based measures may help clarify the nature of this relationship.
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Affiliation(s)
- Lynn K Paul
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA.,Fuller Graduate School of Psychology, Travis Research Institute, Pasadena, CA, USA.,International Research Consortium for the Corpus Callosum and Cerebral Connectivity (IRC5), Pasadena, CA, USA
| | | | - Warren S Brown
- Fuller Graduate School of Psychology, Travis Research Institute, Pasadena, CA, USA.,International Research Consortium for the Corpus Callosum and Cerebral Connectivity (IRC5), Pasadena, CA, USA
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17
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Bagby RM, Sanches M, Carnovale M, Taylor GJ. An evaluation of alexithymia subtypes using latent profile analysis. Psychiatry Res 2021; 299:113840. [PMID: 33667948 DOI: 10.1016/j.psychres.2021.113840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 02/23/2021] [Indexed: 11/17/2022]
Abstract
Four subtypes of the alexithymia construct have been proposed based on different response patterns to the Cognitive and Affective dimensions of the Bermond-Vorst Alexithymia Questionnaire (BVAQ). Previous studies investigating whether alexithymia subtypes can be statistically estimated have not found complete support for these specific subtypes. These previous studies, however, contained several methodological limitations such as relatively small sample sizes, and considerations of only a limited number of proposed subtypes. In the current investigation, we examined whether the four proposed subtypes could be statistically detected in a large sample of undergraduate students (N = 612) who completed the BVAQ, using latent profile analysis (LPA). Based on observed responses to the five BVAQ subscales, consistent with previous studies, our results did not find support for the four proposed alexithymia subtypes. Rather, our results suggested LPA solutions that correspond to individuals with various degrees of alexithymia 'severity'. Although further studies are needed, especially with clinical samples, these results question the idea of four alexithymia subtypes and suggest that the implementation of these subtypes into various research studies may be a premature endeavour.
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Affiliation(s)
- R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada.
| | - Marcos Sanches
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Carnovale
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Graeme J Taylor
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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18
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Williams IA, Reuber M, Levita L. Interoception and stress in patients with Functional Neurological Symptom Disorder. Cogn Neuropsychiatry 2021; 26:75-94. [PMID: 33372576 DOI: 10.1080/13546805.2020.1865895] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Research suggests that patients with Functional Neurological Symptom Disorder (pwFND) struggle to identify their own emotions and associated physiological cues (interoceptive sensitivity, IS). However, it is not known how this deficit interacts with stress. This study aimed to assess IS in pwFND at baseline and following stress induction, and relate the findings to self-reported emotion processing difficulties. METHODS Twenty-six pwFND and 27 healthy controls performed the Heart Beat Detection Task pre- and post-stress induction with the Cold Pressor Test. Participants also completed questionnaires assessing anxiety (GAD-7) and depressive symptomology (PHQ-9), as well as emotion processing (EPS-25). RESULTS Patients reported deficits in emotion processing (p < . 001) and had lower IS (p = .032) than healthy controls. IS improved following stress induction across both groups (p = .003) but patients' IS was lower than that of healthy controls' pre-and post-stress induction. Exploratory analyses revealed that patients reporting sensory symptoms had lower IS at baseline than patients who did not. CONCLUSION Our findings suggest that pwFND are relatively impaired in the identification of their emotions at baseline and following stress induction. This may be related to the experience of functional sensory symptoms and has implications for the psychological treatment of emotion dysregulation in this population.
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Affiliation(s)
| | - Markus Reuber
- Academic Neurology, The University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, The University of Sheffield, Sheffield, UK
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19
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Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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20
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Abstract
Humans are highly adept at differentiating, regulating, and responding to their emotions. At the core of all these functions is emotional awareness: the conscious feeling states that are central to human mental life. Disrupted emotional awareness-a subclinical construct commonly referred to as alexithymia-is present in a range of psychiatric and neurological disorders and can have a deleterious impact on functional outcomes and treatment response. This chapter is a selective review of the current state of the science on alexithymia. We focus on two separate but related issues: (i) the functional deficits associated with alexithymia and what they reveal about the importance of emotional awareness for shaping normative human functioning, and (ii) the neural correlates of alexithymia and what they can inform us about the biological bases of emotional awareness. Lastly, we outline challenges and opportunities for alexithymia research, focusing on measurement issues and the potential utility of formal computational models of emotional awareness for advancing the fields of clinical and affective science.
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Affiliation(s)
- Jeremy Hogeveen
- Department of Psychology and Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM, United States.
| | - Jordan Grafman
- Cognitive Neuroscience Laboratory, Brain Injury Research, Shirley Ryan AbilityLab, Chicago, IL, United States; Departments of Physical Medicine and Rehabilitation, Neurology, and Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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21
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Alvarado-Bolaños A, Cervantes-Arriaga A, Zuazua-Vidal L, Esquivel-Zapata Ó, Alcocer-Salas Á, Rodríguez-Violante M. Determinants and impact of alexithymia on quality of life in Parkinson's disease. Neurologia 2020; 38:S0213-4853(20)30338-8. [PMID: 33317969 DOI: 10.1016/j.nrl.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.
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Affiliation(s)
- A Alvarado-Bolaños
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - A Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - L Zuazua-Vidal
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ó Esquivel-Zapata
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Á Alcocer-Salas
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - M Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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22
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Tantik Pak A, Otcu H, Sengul HS, Corakci Z, Sengul Y, Alkan A. Cognitive and brain micro-structural correlates of alexithymia in essential tremor patients. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:536-545. [PMID: 32657147 DOI: 10.1080/23279095.2020.1786693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Essential tremor (ET) is the most common movement disorder which has both motor and non-motor findings such as neuropsychiatic symptoms. Alexithymia is defined as inability to identify and describe emotions experienced by one's self or others. In our study, we aimed to evaluate the neurocognitive and brain micro-structural correlates of alexithymia in ET. 40 ET patients (mean age = 53.05 ± 19.74 years), were included. Fahn-Tolosa-Marin Tremor Rating Scale, Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Beck Anxiety Inventory and detailed neurocognitive evaluation were applied to all patients. The patients were divided into three groups based on their TAS scores: no alexithymia, probable alexithymia, definite alexithymia. Diffusion Tensor Imaging (DTI) was performed in all patients. The mean TAS score was 50.05 ± 10.06. Depressive symptoms and anxiety levels were higher in definite alexithymia (p < 0.001, p < 0.01). Partial correlation controlling for age, gender and educational level between alexithymia scores and each cognitive test showed significant association between similarities (p < 0.001) and phonemic verbal fluency (p = 0.04). Left orbitofrontal cortex average diffusion coefficient (ADC) value (p = 0.05), left anterior cingulate cortex fractional anisotropy (FA) value (p = 0.04), right cuneus FA value (p = 0.04), left amygdala ADC value (p = 0.01) and left insula ADC value (p = 0.02) were differed between groups. TAS and DTImetrics were not found to be independently associated with the level of anxiety (p < 0.001) and depressive symptoms (p < 0.01). As a conclusion, impairments in executive function and complex attention were correlated with higher levels of alexithymia in ET. Many micro-structural alterations were determined to be correlated with alexithymia levels.
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Affiliation(s)
- Aygul Tantik Pak
- Department of Neurology, Ministry of Health University, Gaziosmanpasa Research and Training Hospital, Istanbul, Turkey
| | - Hafize Otcu
- Department of Radiology, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Hakan Serdar Sengul
- Department of Psychiatry, Ministry of Health University, Gaziosmanpasa Research and Training Hospital, Istanbul, Turkey
| | - Zeynep Corakci
- Department of Occupational Therapy, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Yildizhan Sengul
- Department of Neurology, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Alpay Alkan
- Department of Radiology, Bezmialem Foundation University Hospital, Istanbul, Turkey
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Samur D, Tops M, Slapšinskaitė R, Koole SL. Getting lost in a story: how narrative engagement emerges from narrative perspective and individual differences in alexithymia. Cogn Emot 2020; 35:576-588. [PMID: 32151217 DOI: 10.1080/02699931.2020.1732876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present research examines how narrative engagement, or the extent to which people immerse themselves into the world of a story, varies as a function of narrative perspective and individual differences in alexithymia. The authors hypothesised that narrative engagement would be higher when people assume a first-person (rather than third-person) perspective and for people lower (rather than higher) on alexithymia. In an online study (N = 541) and a lab study (N = 55), participants with varying levels of alexithymia read first- and/or third-person narrated texts and then rated their narrative engagement. As expected, first-person stories evoked more narrative engagement than third-person stories, and global alexithymia was negatively correlated with narrative engagement. Narrative perspective did not interact with cognitive facets of alexithymia (i.e. difficulties identifying, verbalising, and understanding feelings). However, narrative perspective did interact with affective facets of alexithymia (i.e. emotionalising and fantasising): First-person (rather than third-person) stories elicited more narrative engagement at lower levels of affective alexithymia, but not at higher levels of affective alexithymia. The interaction effect was significant in Study 1; the interaction was significant in Study 2 after controlling for trait absorption. Together, these findings suggest that alexithymia is linked to difficulties in mentally simulating narrative worlds.
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Affiliation(s)
- Dalya Samur
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Mattie Tops
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | | | - Sander L Koole
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands
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Chalah MA, Kauv P, Palm U, Lefaucheur JP, Hodel J, Créange A, Ayache SS. Deciphering the neural underpinnings of alexithymia in multiple sclerosis. Neurosci Lett 2020; 725:134894. [PMID: 32147502 DOI: 10.1016/j.neulet.2020.134894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/01/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Alexithymia is a personality construct that could occur in up to 53 % of patients with multiple sclerosis (MS). It entails difficulties in identifying and describing one's feelings and an externally oriented thinking. The current work aims to assess the neural underpinnings of alexithymia in this population. METHODS Forty-five patients with MS filled in the Toronto Alexithymia Scale (n = 17 with high alexithymia and n = 28 with low alexithymia). Brain magnetic resonance imaging was obtained for each patient and a morphometry algorithm (MorphoBox) was applied to calculate regional brain volumes. All patients underwent a clinical and neuropsychological evaluation which included measures for anxiety, depression, fatigue, daytime sleepiness, and basic and social cognition. RESULTS Compared to patients with low alexithymia, patients with high alexithymia had significantly higher fatigue and depression ratings, and lower empathy scores. In addition, they had lower volumes of corpus callosum, deep white matter, pallidum bilaterally, and left thalamus. In the whole cohort, alexithymia scores were inversely correlated with gray matter (thalamus and pallidum bilaterally) and white matter volumes (corpus callosum and bilateral deep white matter) after controlling for covariates (ps<0.05). CONCLUSION This study offers insights on the neuropsychological and neural substrates of alexithymia in MS. The current findings are consistent with alexithymia reports in other clinical populations, and suggest an association between alexithymia and atrophy of thalami, pallidum, corpus callosum and deep white matter in MS. Further research is needed to enhance the understanding of alexithymia mechanisms in this clinical context.
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Affiliation(s)
- Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Paul Kauv
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neuroradiologie, Hôpital Henri-Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau, Germany
| | - Jean-Pascal Lefaucheur
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Jérôme Hodel
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neuroradiologie, Hôpital Henri-Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Alain Créange
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neurologie, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Samar S Ayache
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France.
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Jakobson LS, Pearson PM. Alexithymic traits predict the speed of classifying non-literal statements using nonverbal cues. Cogn Emot 2020; 35:569-575. [PMID: 31941409 DOI: 10.1080/02699931.2020.1715346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is increasing interest in exploring the impact of alexithymia on interpersonal interactions. This study explored relationships between alexithymia and the complex mentalising skills needed to infer how a speaker intended a non-literal statement to be understood. A sample of university students (N = 70) viewed videotaped exchanges and attempted to classify remarks as literal, sarcastic, jocular, or white lies. Alexithymia was not associated with less consistent labelling of statement types. However, after accounting for variance due to verbal intelligence and sex, we found that those who reported more difficulties identifying their own feelings needed more time to distinguish between different statement types on the basis of the speaker's nonverbal cues. These findings highlight the value of examining response times, and of accounting for individual differences in specific alexithymic traits, when assessing social perception and cognition.
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Affiliation(s)
- Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, Canada
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26
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Larwood JL, Vanman EJ, Dingle GA. Negative valence specific deficits in judgements of musical affective quality in alexithymia. Cogn Emot 2020; 35:500-509. [PMID: 31906793 DOI: 10.1080/02699931.2019.1707514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Alexithymia is characterised by a lack of words for emotional experiences and it has been implicated in deficits in emotion processing. Research in this area has typically focused on judgements of discrete emotions rather than of affect, which is a precursor to emotion construction. In the current study, higher alexithymia was predicted to be related to more neutral judgements of valence and arousal of music representing a range of emotions. Participants (N = 162) listened to ten 15-second musical pieces that represented five target emotions (happy, sad, tender, angry, and fearful) and rated the valence and arousal of each. Participants also listed emotion words they knew to be expressed in music. Analyses revealed that alexithymia was not related to the number of emotion words generated but was related to valence-specific affect judgements of music. Participants higher in alexithymia rated sad, angry, and fearful pieces as more neutral in valence and arousal. Alexithymia was not related to ratings of valence or arousal for happy and tender pieces. These findings suggest that perceptual deficits in alexithymia may be specific to negative emotions. Our results are consistent with the idea that alexithymia is related to the direction of attention away from negative stimuli.
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Affiliation(s)
- Joel L Larwood
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Eric J Vanman
- School of Psychology, The University of Queensland, St Lucia, Australia
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Delvecchio G, Rossetti MG, Caletti E, Arighi A, Galimberti D, Basilico P, Mercurio M, Paoli R, Cinnante C, Triulzi F, Altamura AC, Scarpini E, Brambilla P. The Neuroanatomy of Somatoform Disorders: A Magnetic Resonance Imaging Study. PSYCHOSOMATICS 2019; 60:278-288. [DOI: 10.1016/j.psym.2018.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022]
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Farah T, Ling S, Raine A, Yang Y, Schug R. Alexithymia and reactive aggression: The role of the amygdala. Psychiatry Res Neuroimaging 2018; 281:85-91. [PMID: 30273792 PMCID: PMC6226305 DOI: 10.1016/j.pscychresns.2018.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/23/2018] [Accepted: 09/14/2018] [Indexed: 11/20/2022]
Abstract
Past research suggests an association between reactive aggression and alexithymia, but neural mechanisms underlying this association remain unknown. Furthermore, the relationship between proactive aggression and alexithymia remains untested. This study aimed to: (1) test whether alexithymia is more related to reactive than proactive aggression; and (2) determine whether amygdala, insula, and/or anterior cingulate cortical (ACC) volume could be neurobiological mechanisms for this association. One hundred and fifty-six community males completed the Reactive-Proactive Aggression Questionnaire and the Toronto Alexithymia Scale. Amygdala, insula, and ACC volumes were assessed using MRI. Alexithymia was positively associated with reactive but not proactive aggression. Alexithymia was positively and bilaterally associated with amygdala and anterior cingulate volumes. Reactive aggression was positively associated with right amygdala volume. Controlling for right amygdala volume rendered the alexithymia-reactive aggression relationship non-significant. Results suggest that increased right amygdala volume is a common neurobiological denominator for both alexithymia and reactive aggression. Findings suggest that greater right hemisphere activation may reflect a vulnerability to negative affect, which in turn predisposes to experiencing negative emotions leading to increased aggression. Findings are among the first to explicate the nature of the alexithymia-aggression relationship, with potential clinical implications.
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Affiliation(s)
- Theodora Farah
- Department of Psychology, University of Pennsylvania, 425 S. University Ave, Philadelphia, PA 19104, USA.
| | - Shichun Ling
- Department of Criminology, University of Pennsylvania, 3809 Walnut St., Suite 201, Philadelphia, PA 19104, USA
| | - Adrian Raine
- Departments of Criminology, Psychology, and Psychiatry, University of Pennsylvania, 3809 Walnut St., Suite 204, Philadelphia, PA 19104, USA
| | - Yaling Yang
- Department of Pediatrics Children's Hospital Los Angeles, University of Southern California, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Robert Schug
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA
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Costa RM, Oliveira G, Pestana J, Costa D, Oliveira RF. Do Psychosocial Factors Moderate the Relation between Testosterone and Female Sexual Desire? The Role of Interoception, Alexithymia, Defense Mechanisms, and Relationship Status. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2018. [DOI: 10.1007/s40750-018-0102-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Williams IA, Levita L, Reuber M. Emotion dysregulation in patients with psychogenic nonepileptic seizures: A systematic review based on the extended process model. Epilepsy Behav 2018; 86:37-48. [PMID: 30075361 DOI: 10.1016/j.yebeh.2018.06.049] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/21/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Abstract
UNLABELLED Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal alterations in motor and sensory functions resembling epileptic seizures, but are not caused by epileptiform activity. In recent years, there has been increasing scientific interest in emotion dysregulation in patients with PNES (pwPNES), but the literature has not yet been interpreted within a broader model of emotion dysregulation. The aim of this review was therefore to synthesize the existing literature on emotion dysregulation in pwPNES within the extended process model (EPM) of emotion regulation. METHODS PubMed and Web of Science were searched for studies relevant to emotion dysregulation as defined by the EPM. These studies were subjected to a bespoke quality appraisal tool. Studies of acceptable quality were categorized to the different stages of the EPM and critically appraised. RESULTS Studies of emotion regulation in pwPNES were generally of low quality - a finding largely driven by small sample sizes. However, there was evidence of emotion dysregulation characterized by deficits in the identification of patients' own emotional states, as well as the selection and implementation of maladaptive regulatory strategies, and altered exteroceptive emotional processing. However, heterogeneity in findings suggests that emotion dysregulation is likely linked to other psychological factors and not common to all pwPNES. SIGNIFICANCE This review suggests that while pwPNES are likely to experience emotion dysregulation as defined by the EPM, there is variability in the distribution of regulatory deficits in this patient population, and a person-centered approach should be taken when working with these patients. There is a need for more high quality and better-powered studies in this area.
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Affiliation(s)
- Isobel Anne Williams
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Liat Levita
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, United Kingdom.
| | - Markus Reuber
- Academic Neurology Unit, The University of Sheffield, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom.
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Goerlich KS. The Multifaceted Nature of Alexithymia - A Neuroscientific Perspective. Front Psychol 2018; 9:1614. [PMID: 30210420 PMCID: PMC6124373 DOI: 10.3389/fpsyg.2018.01614] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 08/13/2018] [Indexed: 12/11/2022] Open
Abstract
Neuroscientific studies have mostly employed the 20-item Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994a) for the assessment of alexithymia, a self-report scale that assesses the alexithymia facets difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. These facets can be considered to capture difficulties in the cognitive processing of emotions associated with alexithymia. However, Nemiah and Sifneos' original conceptualization of alexithymia included also an affective component, a lack of imaginative capacities, which cannot be assessed using the TAS-20. Aiming to capture the entire alexithymia construct, the Bermond-Vorst Alexithymia Questionnaire (BVAQ; Vorst and Bermond, 2001) was developed, a self-report scale which assesses two affective facets (difficulty fantasizing and difficulty emotionalizing) in addition to three cognitive facets. Based on these facets, an affective and a cognitive dimension of alexithymia can be distinguished. By now, several neuroscientific studies have investigated the neural signatures of the different facets and dimensions of alexithymia. Here, I provide an overview of the history of the alexithymia facets and dimensions and review findings provided by functional and structural magnetic resonance imaging (MRI) studies that differentiated between the alexithymia facets and/or its affective and cognitive dimensions. I then provide a synopsis of the current neuroscientific evidence for dissociable substrates of alexithymia facets and dimensions. Finally, the scientific value and clinical implications of these findings are discussed.
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Affiliation(s)
- Katharina S Goerlich
- Department of Biomedical Sciences, Behavioural and Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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32
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Structure of the alexithymic brain: A parametric coordinate-based meta-analysis. Neurosci Biobehav Rev 2018; 87:50-55. [DOI: 10.1016/j.neubiorev.2018.01.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/10/2017] [Accepted: 01/17/2018] [Indexed: 11/23/2022]
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Valdespino A, Antezana L, Ghane M, Richey JA. Alexithymia as a Transdiagnostic Precursor to Empathy Abnormalities: The Functional Role of the Insula. Front Psychol 2017; 8:2234. [PMID: 29312079 PMCID: PMC5742870 DOI: 10.3389/fpsyg.2017.02234] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/08/2017] [Indexed: 12/22/2022] Open
Abstract
Distorted empathic processing has been observed across multiple psychiatric disorders. Simulation theory provides a theoretical framework that proposes a mechanism through which empathy difficulties may arise. Specifically, introspection-centric simulation theory (IST) predicts that an inability to accurately interpret and describe internal affective states may lead to empathy difficulties. The purpose of this review is to synthesize and summarize an empirical literature suggesting that simulation theory provides insights into a cognitive and neurobiological mechanism (i.e., alexithymia and insula pathology) that negatively impacts empathic processing, in addition to how disruptions in these processes manifest across psychiatric disorders. Specifically, we review an emerging non-clinical literature suggesting that consistent with IST, alexithymia and associated insula pathology leads to empathy deficits. Subsequently, we highlight clinical research suggesting that a large number of disorders characterized by empathy pathology also feature alexithymia. Collectively, these findings motivate the importance for future work to establish the role of alexithymia in contributing to empathy deficits across clinical symptoms and disorders. The current review suggests that simulation theory provides a tractable conceptual platform for identifying a potential common cognitive and neural marker that is associated with empathy deficits across a wide array of diagnostic classes.
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Affiliation(s)
- Andrew Valdespino
- Social Clinical Affective Neuroscience Laboratory, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Ligia Antezana
- Social Clinical Affective Neuroscience Laboratory, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Merage Ghane
- Social Clinical Affective Neuroscience Laboratory, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A Richey
- Social Clinical Affective Neuroscience Laboratory, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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Li X, Lu J, Li B, Li H, Jin L, Qiu J. The role of ventromedial prefrontal cortex volume in the association of expressive suppression and externally oriented thinking. J Affect Disord 2017; 222:112-119. [PMID: 28688264 DOI: 10.1016/j.jad.2017.06.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 06/04/2017] [Accepted: 06/26/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Studies have suggested that expressive suppression (ES) is linked to externally oriented thinking (EOT) through the ventromedial prefrontal cortex (vmPFC), and there are gender differences in their association. The present structural magnetic resonance imaging study was to investigate the neural bases of ES and EOT and their association in females versus males in a Chinese college sample. METHODS A total of 142 participants (83 females) were enrolled, and they completed the ES subscale of the Emotion Regulation Questionnaire, 20-item Toronto Alexithymia Scale, and anatomical scanning. Voxel-based morphometry, region of interest, and whole brain analyses with peak-level significance (family-wise error corrected at p < .05) were conducted to investigate the association of gray matter volume (GMV) variations with ES and EOT. A bootstrapping analysis was conducted to examine the role of vmPFC volume in the ES-EOT association. RESULTS The ES scores were positively linked to the GMV of the vmPFC in females and negatively related to right dorsolateral PFC volume in males. The EOT scores were positively correlated with the GMV of the vmPFC in females and supplementary motor area in males. Furthermore, vmPFC volume mediated the relationship between ES and EOT LIMITATIONS: The cross-sectional design limited causal conclusions. CONCLUSIONS The vmPFC may be the only neural base of ES and EOT and their association. In addition, these results were sex-specific.
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Affiliation(s)
- Xu Li
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Jiamei Lu
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China.
| | - Bingbing Li
- School of Psychology, Southwest University, Chongqing 400715,China; Center for Mental Health Education, Southwest University, Chongqing 400715,China
| | - Haijiang Li
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Li Jin
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing 400715,China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
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Alexithymia and anesthetic bladder capacity in interstitial cystitis/bladder pain syndrome. J Psychosom Res 2017; 100:15-21. [PMID: 28789788 DOI: 10.1016/j.jpsychores.2017.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE In contrast to the inconsistent results of organic causes, it has been found that psychological risk factors are reliably related to functional somatic syndromes (FSSs), including interstitial cystitis/bladder pain syndrome (IC/BPS). Compared to patients with acute cystitis, a subgroup of IC/BPS patients with a history of childhood relational trauma reported intensified unregulated affective states (i.e., anxiety and depression) and trauma-related psychopathology (i.e., dissociation). Nevertheless, it remains unknown whether psychosocial risk factors can be separated from bladder-centric factors. This study aimed to verify whether psychosocial factors such as alexithymia, which is a key psychological factor of FSSs, are less likely to be linked to a low bladder capacity in patients with IC/BPS. METHODS Ninety-four female IC/BPS patients were recruited from the outpatient departments of urology, obstetrics, and gynecology. Anxiety, depression, dissociation, childhood relational trauma, and alexithymia were assessed using standardized scales, and anesthetic bladder capacity was examined by cystoscopic hydrodistention. RESULTS Positive correlations were found between anesthetic bladder capacity and the psychosocial variables, including alexithymia. An increased bladder capacity was associated with anxiety, dissociation, and childhood relational trauma, and a combination of high cognitive and low affective alexithymia mediated the correlations between bladder capacity and the psychosocial variables. CONCLUSIONS Psychosocial variables that are associated with an aversive childhood relational environment and affect dysregulation may constitute a pathogenic trajectory that differs from bladder-centric defects such as a lower bladder capacity. The findings of this study support the notion that IC/BPS in some patients may be due to an FSS.
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36
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Chalah MA, Ayache SS. Alexithymia in multiple sclerosis: A systematic review of literature. Neuropsychologia 2017; 104:31-47. [DOI: 10.1016/j.neuropsychologia.2017.07.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/28/2017] [Accepted: 07/29/2017] [Indexed: 02/07/2023]
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Kajanoja J, Scheinin NM, Karlsson L, Karlsson H, Karukivi M. Illuminating the clinical significance of alexithymia subtypes: A cluster analysis of alexithymic traits and psychiatric symptoms. J Psychosom Res 2017; 97:111-117. [PMID: 28606490 DOI: 10.1016/j.jpsychores.2017.04.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/05/2017] [Accepted: 04/08/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alexithymia is a personality construct involving difficulties identifying and verbalizing feelings, and an externally oriented thinking style. There is preliminary evidence for alexithymia subtypes that may carry different risk profiles for psychiatric illness. The aim of this study was to gain support for the existence of alexithymia subtypes and further characterize their clinical relevance. METHODS To identify possible subtypes, a cluster analysis was conducted for individuals with high alexithymic traits (N=113). Current depressive and anxiety symptoms, self-reported psychiatric medical history, and self-reported early life adversity were compared between subtypes. The cluster analysis was replicated with the low (N=2471) and moderate (N=290) alexithymia groups. RESULTS We identified two alexithymia subtypes. Compared to type A, type B alexithymia was associated with higher levels of difficulties in identifying feelings, and was more strongly associated with current depressive (Cohen's d=0.77, p<0.001) and anxiety symptoms (Cohen's d=0.82, p<0.001), and self-reported early life adversity (Cohen's d 0.42, p=0.048). Compared to type A, type B alexithymia was also associated with a higher prevalence of self-reported diagnosis of major depressive- (30.2% vs. 8.3%) and anxiety disorder (18.9% vs. 3.3%). CONCLUSIONS The results of this study support the hypothesis of alexithymia subtypes, and add support to the growing evidence showing that alexithymia is likely a heterogeneous and dimensional phenomenon. The subtype (type B) with most pronounced difficulties in identifying feelings may be associated with a higher risk for psychiatric illness compared to type A alexithymia, and may exhibit a more severe history of early life adversity.
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Affiliation(s)
- J Kajanoja
- University of Turku, FinnBrain birth cohort study, Finland.
| | - N M Scheinin
- University of Turku, FinnBrain birth cohort study, Finland
| | - L Karlsson
- University of Turku, FinnBrain birth cohort study, Finland
| | - H Karlsson
- University of Turku, FinnBrain birth cohort study, Finland
| | - M Karukivi
- University of Turku, FinnBrain birth cohort study, Finland
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Martínez-Velázquez ES, Honoré J, de Zorzi L, Ramos-Loyo J, Sequeira H. Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia. Front Psychol 2017; 8:361. [PMID: 28348539 PMCID: PMC5346581 DOI: 10.3389/fpsyg.2017.00361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
Emotional difficulties in alexithymia and their social consequences have been linked to alterations in autonomic nervous system. However, most of previous studies did not take into account the distinction between the affective and the cognitive dimensions of the alexithymia, leading to inconsistent results. Aim: In this study, we compared the effects of both dimensions of alexithymia on the autonomic arousal to emotional and social visual stimulations. Methods: Skin conductance responses (SCRs) to items of the International Affective Pictures System characterized by emotional (unpleasant, neutral, and pleasant), social (with humans) or non-social (without humans) content were recorded in non-alexithymic (NA), affective (AA) and cognitive alexithymic (CA) participants, selected on the basis of the Toronto Alexithymia Scale and the Bermond-Vorst Alexithymia Questionnaire. All participants responded to questionnaires of empathy, social phobia, depression, and anxiety before the experiment and evaluated the arousal of the pictures after it. Results: Cognitive alexithymic group showed lower amplitudes of SCRs to pictures with social than without social relevance whereas the opposite pattern was observed for the NA group. Arousal emotional effects of the pictures on SCRs did not differ among groups. In addition, CA participants showed lower scores than NA in the Personal Taking sub-scale of the empathy questionnaire, while AA showed lower scores than NA in the fantasy sub-scale. The CA group showed higher social phobia, depression and anxiety scores, than the other two groups. Conclusion: This work has two original outcomes: first, affective alexithymics expressed lower empathic affective scores than other groups; second, alexithymia modulated the impact of the social relevance of the stimuli on the autonomic reactivity, this impact vanishing in affective alexithymics and reversing in cognitive alexithymics. Thus, though the groups could not be distinguished on the basis of emotional effect on SCRs, they clearly differed when the empathic characteristics and the autonomic impact of social relevance were considered. Finally, the described autonomic signature to social relevant information could contribute to elucidate the difficulty of alexithymics to deal with emotions during social transactions.
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Affiliation(s)
- Eduardo S. Martínez-Velázquez
- Laboratorio de Psicofisiologia, Institute of Neuroscience, University of GuadalajaraGuadalajara, Mexico
- Facultad de Psicología, Meritorious Autonomous University of PueblaPuebla, Mexico
| | - Jacques Honoré
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
| | - Lucas de Zorzi
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
| | - Julieta Ramos-Loyo
- Laboratorio de Psicofisiologia, Institute of Neuroscience, University of GuadalajaraGuadalajara, Mexico
| | - Henrique Sequeira
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
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Cecchetto C, Korb S, Rumiati RI, Aiello M. Emotional reactions in moral decision-making are influenced by empathy and alexithymia. Soc Neurosci 2017; 13:226-240. [DOI: 10.1080/17470919.2017.1288656] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Sebastian Korb
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
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Goerlich KS, Votinov M, Lammertz SE, Winkler L, Spreckelmeyer KN, Habel U, Gründer G, Gossen A. Effects of alexithymia and empathy on the neural processing of social and monetary rewards. Brain Struct Funct 2016; 222:2235-2250. [DOI: 10.1007/s00429-016-1339-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
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41
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Matsudaira I, Yokota S, Hashimoto T, Takeuchi H, Asano K, Asano M, Sassa Y, Taki Y, Kawashima R. Parental Praise Correlates with Posterior Insular Cortex Gray Matter Volume in Children and Adolescents. PLoS One 2016; 11:e0154220. [PMID: 27101139 PMCID: PMC4839741 DOI: 10.1371/journal.pone.0154220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 04/11/2016] [Indexed: 01/21/2023] Open
Abstract
A positive parenting style affects psychological and cognitive development in children. Neuroimaging studies revealed that a positive parenting style influenced brain structure in children. Parental praise is a concrete behavior observed in positive parenting. Although previous psychological studies revealed a positive effect of parental praise on children, little is known about the relationship between parental praise and brain structure in children. Thus, the purpose of the present study was to determine whether there was a correlation between the parental attitude towards praising their child and gray matter volume in the children (116 boys and 109 girls; mean age, 10.6 years old). We examined the correlation between regional gray matter volume and parental praise using voxel-based morphometry (VBM) following magnetic resonance imaging (MRI). In addition, to confirm the positive effects of parental praise, we analyzed the correlation between the frequency of parental praise and personality traits in children. We showed that the parental attitude towards praising their child was significantly and positively correlated with the gray matter volume of the left posterior insular cortex in children. Moreover, we found a significant positive correlation between parental attitude towards praising their child and the personality traits of conscientiousness and openness to experience in the children. Prior studies said that gray matter volume in the posterior insula was correlated with empathy, and the functional connectivity between this area and the amygdala was associated with emotional regulation. Furthermore, the posterior insula relates to auditory function, and therefore, was likely involved in the processing of parental praise. Considering the possibility of experience-dependent plasticity, frequent parental praise would lead to increased posterior insular gray matter volume in children. Our study is the first to elucidate the relationship between a specific positive parenting behavior and brain structure in children.
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Affiliation(s)
- Izumi Matsudaira
- Department of Nuclear Medicine & Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Susumu Yokota
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- * E-mail:
| | - Teruo Hashimoto
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Kohei Asano
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Michiko Asano
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yuko Sassa
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine & Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Functional Brain Imaging, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
- Smart Aging International Research Center, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
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Goerlich-Dobre KS, Lamm C, Pripfl J, Habel U, Votinov M. The left amygdala: A shared substrate of alexithymia and empathy. Neuroimage 2015; 122:20-32. [DOI: 10.1016/j.neuroimage.2015.08.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/21/2015] [Accepted: 08/05/2015] [Indexed: 12/30/2022] Open
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