The relationships of antisocial behavior with attachment styles, autonomy-connectedness, and alexithymia

Improving the Objective Measurement of Alexithymia Using a Computer-Scored Alexithymia Provoked Response Questionnaire with an Online Sample

The study and measurement of alexithymia - a trait marked by difficulty identifying and describing feelings - can be improved by incorporating objective measures to supplement self-report scales. The Alexithymia Provoked Response Questionnaire (APRQ) is an observer-rated alexithymia tool that shows promise yet can be time-consuming to administer. The present study aimed to assess the feasibility of computer administration and scoring of the APRQ. Further, the APRQ's association with verbal IQ and emotional vocabulary use was examined, as was the relationship between the APRQ and the self-report Bermond-Vorst Alexithymia Questionnaire-B (BVAQ-B). Adult participants (n = 366), including a proportion gathered through purposive sampling, participated in an online study. Inter-rater reliability measures indicated that computerized scoring of the APRQ is as reliable as human scoring, making the measure scalable for use with large samples. Alexithymia levels were independent of two measures of verbal IQ. Correlational analyses indicated overlap in alexithymia as measured by the APRQ and most of the subscales of the BVAQ-B. The APRQ, as an objective measure, may capture deficits in emotional awareness independent of self-insight.

A cross-modal component of alexithymia and its relationship with performance in a social cognition task battery

BACKGROUND

The personality trait alexithymia describes an altered emotional awareness that is associated with a range of social impairments and constitutes a transdiagnostic risk factor for various psychopathologies. Despite the characteristic interoceptive deficits in alexithymia, it is predominantly assessed via self-reports. This can result in unreliable measurements and arguably contributes to the prevailing uncertainty regarding its components, including constricted imaginal processes and emotional reactivity.

METHODS

The current study employed an interview and two validated questionnaires to derive a shared component of multi-modally assessed alexithymia in a German non-clinical sample (n = 78) via prinicipal component analysis. This component was used as a predictor for performance in four behavioural social cognition tasks. The relative importance of this predictor against related variables was assessed via dominance analysis.

RESULTS

The identified component reflected cognitive alexithymia. Higher cognitive alexithymia scores were associated with less affective distress in an ostracizing task. Dominance analysis revealed the dominance of competing autism traits relative to cognitive alexithymia and competing predictors empathy, depression, and anxiety, in predicting affective distress.

LIMITATIONS

Emotional reactivity was only assessed via self-report and no implicit measures of alexithymia were employed. Due to the low reliability of the self-report measure, no measure of emotional reactivity could be included in the principal component analysis.

CONCLUSIONS

Our results provide compelling evidence that cognitive interoceptive deficits are at the core of alexithymia across assessment modalities. Behavioural data suggest that these deficits result in diminished emotional sensitivity to high-pressure social situations, which may cause a lack of behavioural adaptation.

Alexithymia and Self Differentiation: The Role of Fear of Intimacy and Insecure Adult Attachment

It is suggested in literature that there is a link between Alexithymia and Self-Differentiation; however, little is known about possible mediation factors. The goal of this work is to test in a non-clinical population of adults the mediation role of Fear of Intimacy and Adult Attachment in the relationship between Alexithymia and Self-Differentiation. A sample of 258 participants self identified as gay or lesbian, aged 20–50 years (M: 30.29; SD: 7.27), 45% of whom were males, completed self-reported measures of Alexithymia (TAS-20), Self-Differentiation (SDI), Fear of Intimacy (FIS); and Insecure Adult Attachment (RAAS). Our results show that Alexithymia predicts Self-Differentiation both directly and indirectly, through Fear of Intimacy and Insecure adult attachment. In addition, Fear of Intimacy directly influences Self-Differentiation, and also mediates the relationship between Alexithymia and Adult Attachment which, in turn, negatively predicts Self-Differentiation. In conclusion, Alexithymia predicts Self-Differentiation while Fear of Intimacy and adult attachment may act as mediators of the report. Limitations of the study and directions of future research are described.

Factor Structure and Psychometric Properties of a New Scale to Assess Alexithymia-Like Features in Japanese Youth

BACKGROUND

Studies of alexithymia have primarily targeted adult populations. Although some recent studies of alexithymia have focused on children and young adolescents, the literature is not sufficient for development of an assessment tool. The aim of this study was to develop, and evaluate the psychometric properties of, a new scale to measure alexithymia-like features in young adolescents.

METHODS

A total of 1,444 Japanese junior high school students (701 males, 743 females; age range 12-15; mean [SD] age, 13.37 [0.98] years) participated in 2 surveys conducted at their own schools.

RESULTS

First, exploratory factor analysis of the first survey data (n=981) demonstrated that this new scale had a unifactor structure, as determined by minimum average partial analysis and parallel analysis. Second, confirmatory factor analysis of the second survey data (n=463) confirmed the unifactor structure of this new scale and acceptable goodness of model fit. The new scale had modest internal consistency.

CONCLUSIONS

The correlations of this new alexithymia scale with related variables were weak but significant, in accordance with our hypothesis. The scale had acceptable reliability and convergent validity and thus might be useful for measuring alexithymic tendency in young adolescents.

What is alexithymia? Using factor analysis to establish its latent structure and relationship with fantasizing and emotional reactivity

OBJECTIVE

There is ongoing uncertainty about the structure and definition of alexithymia. Conceptually, alexithymia has traditionally been defined as a multidimensional trait with four components: difficulty identifying feelings, difficulty describing feelings, externally orientated thinking, and difficulty fantasizing. However, some authors suggest that difficulty fantasizing might not be a component, and others suggest low emotional reactivity is a fifth component. In this study, we sought to clarify this issue using factor analysis.

METHOD

In a sample of adults (N = 508), we administered a comprehensive battery of psychometric measures and analyzed their latent structure using exploratory factor analysis.

RESULTS

Subscales assessing difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking all loaded well together on the alexithymia factor. However, none of the subscales assessing aspects of difficulty fantasizing (i.e., daydreaming frequency, vividness, content, or use of daydreams to regulate emotions) loaded on the alexithymia factor. Similarly, no emotional reactivity subscales loaded on the alexithymia factor, and alexithymia was associated with higher (not lower) levels of emotional reactivity for negative emotions.

CONCLUSIONS

Difficulty fantasizing and low emotional reactivity are not components of the latent alexithymia construct. The traditional four-component definition of alexithymia likely warrants refinement to a more parsimonious three-component solution.

Attachment Style, Early Childhood Trauma, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Structural Equation Model of Dependencies

AIM

Attachment theory is a broadly used paradigm for understanding human affective development. It is recognized that alexithymia is a key factor responsible for the non-adaptive strategies of regulating emotions in people addicted to alcohol. In addition, an important role is attributed to early childhood trauma and dissociation. The theoretical model was examined, in which connections between attachment styles, trauma, and alexithymia and dissociation were investigated in persons addicted to alcohol.

METHODS

The total number of study participants amounted to 268 persons, including 116 women (43% of all subjects) and 152 men (57% of all subjects) at the age of 18-73 (M = 39.19; SD = 13.45). In order to measure the analyzed variables, the following questionnaires were applied: Michigan alcoholism screening test (MAST), attachment styles questionnaire (ASQ), 20-item Toronto Alexithymia Scale (TAS-20), traumatic experiences checklist (TEC), and curious experiences survey (CES).

RESULTS

A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to attachment style, intensity of trauma, alexithymia, and dissociation. With structural equation models (i.e., AMOS and GLS), the adjustment of theoretical model to data was examined, which allowed the description of dependency paths. As a result of the conducted analysis of paths, it was found out that the model was accurately fitted to data, but only when an impact path related to a direct connection between an attachment style and an addiction was deleted. This impact is indirect, and from one side, it results from affective and cognitive deficits, i.e., alexithymia, and on the other side, from the intensity of traumatic experiences. No direct impact of dissociation on the development of an inclination to addiction was found, if contextual variables, i.e., alexithymia and trauma, are taken into account. The strongest direct relation was proven in the case of the anxious-ambivalent attachment style and alexithymia (β = 0.389; p < 0.01) and avoidant attachment style and alexithymia (β = 0.497; p < 0.01), which turned out a strong predictor fostering the development of alexithymia and the occurrence of traumas related to emotional negligence and mental violence and finally addiction.

CONCLUSION

Our studies revealed how important it is to investigate the role of individual variables in the context of developmental models. An extremely important element of the scientific achievement presented here is showing pillars of trauma, alexithymia, and dissociation in their cumulative impact on the development of emotional disorders resulting in addiction.

Enhancing Autonomy-Connectedness in Patients With Anxiety Disorders: A Pilot Randomized Controlled Trial

Autonomy-enhancing treatment (AET) is a person-centered, gender-sensitive treatment, targeting transdiagnostic personal autonomy deficits. The current study was set up as a first pilot randomized controlled trial (RCT) to investigate the preliminary efficacy of AET. Earlier small non-controlled plots showed AET to be feasible and acceptable. In the current study (Trial Code 3513), patients receiving 15-session group-based AET (N = 43) were compared with those in a waitlist control condition (N = 40). Both the intention-to-treat and completers analyses suggested a larger decrease in agoraphobic symptoms in the experimental treatment than in the waitlist condition. In both analyses, effect sizes were small. The completers analyses showed additional beneficial effects in two of three autonomy-connectedness components, as well as psychoneuroticism, anxiety, and depression, which disappeared after correcting for multiple testing. AET may alleviate agoraphobic symptoms in a patient sample with severe anxiety. Future research, including more stringent inclusion criteria and follow-up assessment, is needed to further evaluate whether AET may serve as a promising alternative or addition to existing approaches. Clinical Trial Registration: www.trialregister.nl, identifier NTR3513.

The Strong, Silent Type(ology): Examining Intersections of Alexithymia and the Drive for Muscularity

This study used latent profile analysis to explore the interrelations of drive for muscularity (DM) and alexithymia among 505 men. Four unique classes of men emerged: (1) low endorsement of DM and alexithymia, (2) moderate endorsement of alexithymia and DM, (3) moderate endorsement of alexithymia and high endorsement of attitudinal and behavioral DM, and (4) high endorsement of DM attitudes and alexithymia, and low endorsement of DM behaviors. We explored relations between class membership and avoidant attachment, social pressure to be muscular, help-seeking attitudes, and body appreciation, using Class 1 as the reference group. Alexithymia and attitudinal DM, in the absence of behavioral DM, appear to be a particularly unhealthful constellation of alexithymia and DM.

Autonomy deficits as vulnerability for anxiety: evidence from two laboratory-based studies

BACKGROUND

Autonomous individuals are characterized by self-governance; awareness of and capacity to realize one's wishes and needs, while being connected with and sensitive towards others. In line with earlier research showing consistent associations between autonomy-connectedness deficits and anxiety, we tested in two studies whether autonomy deficits predict anxious responses to acute stressors.

METHODS

In Study 1, participants (N = 177) viewed an anxiety-inducing film fragment and reported anxiety before and after viewing the clip. In experimental Study 2, participants (N = 100) were randomly allocated to one of two conditions: giving a short presentation to an audience (impromptu speech task) or watching another person's presentation (control condition). Anxiety was measured at baseline, after a preparation period and directly after the presentation.

RESULTS

In Study 1, individuals' anxiety in reaction to watching the movie was positively associated with the autonomy-connectedness component sensitivity to others. In Study 2, individuals' anxiety in reaction to preparing the presentation was negatively associated with the autonomy-connectedness component self-awareness.

CONCLUSIONS

Specific autonomy components may be related to experiencing anxiety in differing situations (i.e., related to others' distress or presenting one's personal views). Collectively these results indicate that autonomy-connectedness deficits may form a vulnerability factor for experiencing anxiety.

Alexithymia and Its Associations With Depression, Suicidality, and Aggression: An Overview of the Literature

Depression affects around 4-10% of the general population in England. Depression can often lead to behaviors and thoughts related to suicide and aggression, which have a social and economic burden to the United Kingdom. One construct that has been theorized as having an association with these behaviors is alexithymia. People with alexithymia have difficulties identifying and describing their emotional experiences. To date, there is no consensus on types or causes of alexithymia. Whilst the literature evidences a strong relationship between alexithymia and suicidality and aggression, little is known about the nature of this relationship. The present article will attempt to describe the extant literature on this relationship, drawing out some of the contentions and unanswered questions.

Perceptions of Close Relationship Through the Machiavellians´ Dark Glasses: Negativity, Distrust, Self-Protection Against Risk and Dissatisfaction

It is commonly known from the literature that Machiavellian individuals have negative attitudes towards people and in general towards the world´s affairs. They are distrustful of the intentions of others, and they get cautiously involved into interpersonal interactions and take risks only if that may not have any severe negative consequence. It is also a fact that there are few ventures in life that potentially involve as much insecurity and personal vulnerability as the establishment and maintenance of close relationships. In our study, we were seeking the answer to the question: do people with high levels of Machiavellianism show a generally negative, distrustful and cautious attitude in their intimate relationships, as well? What effect their pessimistic approaches have on the other consequences of the relationship (satisfaction, commitment, investment, quality of alternatives)? This question was investigated on a dyadic sample of heterosexual couples (N = 101 pairs) with Actor-Partner Interdependence Model (APIM). The results of the correlations and actor effects show that men with high levels of Machiavellianism perceive in a negative way not just people in general, but their romantic partners and relationships as well and they experience an increased level of distrust, risk, and dissatisfaction into their close relationships. Women with high levels of Machiavellianism are less negativistic and feel less discontent towards their intimate partner and relationship, but even they are unable to put their distrust and precaution aside. The results of partner effects have revealed that women's Machiavellianism undermines men's trust, while men's Machiavellianism has the effect of minimizing women's investment into their relationship.

Relationship Between Attachment Style in Adulthood, Alexithymia, and Dissociation in Alcohol Use Disorder Inpatients. Mediational Model

Background: Attachment theory is a widely used framework for understanding emotion regulation as well as alexithymia, and dissociation and this perspective has also been applied to understand alcohol use disorders. Apart from these theoretical suggestions, there has been scarce empirical research on this subject-matter. Therefore, the objective of the present study was to investigate potential associations between attachment style in adulthood, alexithymia, and dissociation in alcohol use disorder inpatients. Methods: The Revised Adult Attachment Scale (RAAS), the Toronto Alexithymia Scale-20 (TAS-20), the Michigan Alcoholism Screening Test (MAST), and the Curious Experiences Survey (CES) were administered to a sample of 97 alcohol use disorder inpatients recruited from drug and alcohol treatment centers in Warsaw, and 104 persons in control groups, Poland. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: alexithymia, dissociation, and attachment styles. The analysis of models related to the impact of attachment styles on the level of alcohol addiction with regard to a mediatory role of alexithymia and dissociation showed that all models are well fitted to data and statistically significant: intimacy F(3.197) = 34.41; p < 0.001 and explains 34% (R ² = 0.3438); depend F(3.197) = 36.55; p < 0.001, and explains 36% (R ² = 0.3576); anxiety F(3.197) = 34.71; p < 0.001, and explains 35% (R ² = 0.3458) of the variability of alcohol addiction scores. Mediation analysis found that alexithymia and dissociation enhance the fear of intimacy and rejection in a romantic relationship. Conclusion: These findings support the broad attachment theory suggesting that attachment is associated with and predicts alexithymia and dissociation in the sample of substance use disorder inpatients. Alexithymia and dissociation, by inhibiting the processes of emotions' identification and verbalization, cause that language does not serve for the purpose of changing self or others, as the communication is distorted. Absent are common meanings and accurate mutual understanding in a relationship.

Trauma, Temperament, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Mediation Model of Dependencies

Objective: The attachment theory has been conceptualized as an affect regulation theory, proposing that attachment is associated with the expression and recognition of emotions as well as interpersonal functioning. The purpose of the study was to examine a model, in which a relation was analyzed between childhood trauma, temperament, alexithymia, and dissociation in a group of individuals addicted to alcohol. Method: The total number of 201 persons were examined, comprising 67 women (33.3% of participants) and 134 men (66.7% of participants). The participants aged from 18 to 68 (M = 32.81; SD = 12.12). In order to measure the analyzed variables, the following questionnaires were applied: MAST, SSSV, TAS20, TEC, and CES. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: the intensity of trauma, temperament, alexithymia, and dissociation. The study of models related to the impact of traumatic experience intensity on the level of alcohol addiction with regard to a mediatory role of alexithymia, dissociation, and temperament showed the existence of several important indirect effects, and the model, which takes into account all three mediators, is statistically significant F(4,196) = 35.1964; p < 0.001. Conclusion: Childhood trauma, as well as alexithymia and dissociation block dealing with stress based on self-reflection and self-control, and contribute to affective disorders and their regulation with alcohol. Limitations: The selection of participants to homogeneous groups with regard to age and gender constituted the most important difficulty and limitation. A perfect age criterion for investigating the interaction between the temperament and the consequences of traumatic development would be early adulthood.

Attachment styles and secure base priming in relation to emotional reactivity after frustration induction

In two experimental studies, we explored the role of attachment in predicting emotional reactivity after frustration induction. In the first study, using a cognitive frustration task, we examined in a college sample (N = 134) how attachment styles related to the experience and expression of emotions after frustration induction. In the second study, we investigated in college students (N = 198) the effect of conscious priming of the secure base schema on mood disturbance after the performance of a cognitive frustration task. Results showed that individuals experienced and expressed emotions after frustration induction independent of their attachment styles. Conscious priming of the secure base script attenuated self-reported emotional reactivity after frustration induction independent of individuals' attachment styles. These findings suggest that the mechanism of attachment-related emotional reactivity might not pertain to frustration during an unsolvable cognitive task, but that the activation of the sense of having a secure base is useful in reducing mood disturbance in the context of a frustrating performance task.

Psychometric Properties of the Bermond-Vorst Alexithymia Questionnaire (BVAQ) in the General Population and a Clinical Population

INTRODUCTION

The Bermond-Vorst Alexithymia Questionnaire (BVAQ) has been validated in student samples and small clinical samples, but not in the general population; thus, representative general-population norms are lacking.

AIM

We examined the factor structure of the BVAQ in Longitudinal Internet Studies for the Social Sciences panel data from the Dutch general population (N = 974).

RESULTS

Factor analyses revealed a first-order five-factor model and a second-order two-factor model. However, in the second-order model, the factor interpreted as analyzing ability loaded on both the affective factor and the cognitive factor. Further analyses showed that the first-order test scores are more reliable than the second-order test scores. External and construct validity were addressed by comparing BVAQ scores with a clinical sample of patients suffering from somatic symptom and related disorder (SSRD) (N = 235). BVAQ scores differed significantly between the general population and patients suffering from SSRD, suggesting acceptable construct validity. Age was positively associated with alexithymia. Males showed higher levels of alexithymia.

DISCUSSION

The BVAQ is a reliable alternative measure for measuring alexithymia.

Autonomy-connectedness mediates sex differences in symptoms of psychopathology

OBJECTIVES

This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder).

METHOD

Participants (N = 5,525) from a representative community sample in the Netherlands filled out questionnaires regarding the variables under study.

RESULTS

Autonomy-connectedness (self-awareness, SA; sensitivity to others, SO; capacity for managing new situations, CMNS) fully mediated the sex differences in depression and anxiety, and partly in eating disorder -(drive for thinness, bulimia, and body dissatisfaction) and anti-social personality disorder characteristics. The mediations followed the expected sex-specific patterns. SO related positively to the internalizing disorder indices, and negatively to the anti-social personality disorder. SA related negatively to all disorder indices; and CMNS to all internalizing disorder indices, but positively to the anti-social personality disorder.

CONCLUSION

Treatment of depression, anxiety, but also eating disorders and the antisocial personality disorder may benefit from a stronger focus on autonomy strengthening.

The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology: among psychiatric and healthy elderly

OBJECTIVES

In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age.

METHOD

A path model was tested which was based on neo-analytical object relation, attachment- and primary-personality theory, among 100 clinical and 106 non-clinical elderly.

RESULTS

In line with our model, autonomy-connectedness (self-awareness and capacity of managing new situations) was strongly associated to internalizing PDS in both groups. In both groups, neither sex nor autonomy-connectedness predicted externalizing PDS. Sex, internalizing as well as externalizing PDS and reactive defensive coping were associated to axis-I psychopathology.

CONCLUSIONS

We conclude that sex and autonomy-connectedness were, similarly as in adult populations, associated to internalizing PDS and axis-I pathology. Treatment of elderly with internalizing PDS and axis-I psychopathology should therefore focus on enhancing autonomy-connectedness.

Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness

OBJECTIVE

Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression.

METHOD

Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design.

RESULTS

The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect.

CONCLUSIONS

The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression.

PRACTITIONER POINTS

The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness.

The role of sex, attachment and autonomy-connectedness in personality functioning

Previous studies have found significant relationships among sex, attachment and autonomy-connectedness and DSM-IV personality characteristics. In the present study, we aimed to add to the current knowledge about attachment-related aspects of personality pathology, by examining the relationships of these same variables with dimensions of pathological personality structure as conceptualized by Kernberg. The study was performed among 106 ambulatory patients from a Dutch mental healthcare institute. A path model based upon neo-analytical object relation theory and attachment theory was tested. We expected significant associations among sex, attachment, autonomy and aspects of personality functioning. Both insecure attachment styles as well as the autonomy-connectedness components of sensitivity to others (SO) and capacity of managing new situations predicted general personality dysfunctioning significantly. More specifically, reality testing was negatively predicted by the autonomy component of capacity of managing new situations, and aggression was significantly predicted by sex as well as both insecure attachment styles. We advise scientists as well as clinicians to be alert on sex differences in autonomy-connectedness and aspects of personality dysfunctioning. Taking sex-specific variations in attachment and autonomy into account next to a more explicit focus on insecure attachment styles and autonomy problems may enhance, the current relatively low, treatment effectiveness for personality pathology.

Attachment dimensions’ capacity to predict problem behaviors in an African context

Considerable research links aspects of attachment to internalizing and externalizing problem behaviors. The association is yet to be established in an African context. Canonical correlation analysis was conducted on the data of 135 primary school learners and their parents and guardians in Mankweng, a township in Polokwane, South Africa, to evaluate the avoidance and anxiety attachment dimensions’ capacity to predict problem behaviors. There was a relationship between learner-reported internalizing problem behaviors and the attachment dimensions avoidance, and to some extent anxiety. Conversely, externalizing could not be predicted from the attachment patterns of the learners. The results are discussed within existing attachment and the problem behavior literature.

When parenting fails: alexithymia and attachment states of mind in mothers of female patients with eating disorders

INTRODUCTION

In recent years alexithymia and attachment theory have been recognized as two parallel research lines trying to improve the information on the development and maintenance of eating disorders (EDs). However, no research has analyzed these constructs among patients' families. In this study we compared alexithymia and attachment in mothers of patients with EDs and a control group. Further, we hypothesized that mothers of daughters with EDs with insecure and unresolved states of mind will reported high levels of alexithymia. Lastly, we explored the daughters' evaluations of maternal alexithymia.

METHODS

45 mothers of ED women and 48 mothers of healthy controls (N = 93) matched for age and socio-demographic variables were administered by the Toronto Alexithymia Scale-20 (TAS-20) (S), while two sub-groups of "ED" mothers (n = 20) and "non-ED" ones (n = 22) were assessed by the Adult Attachment Interview (AAI). Moreover, the Observer Alexithymia Scale (OAS) was administered to the daughters for evaluating maternal alexithymia.

RESULTS

Regarding alexithymia, no differences were found between ED and non-ED mothers according to the TAS-20, while ED mothers showed more unresolved AAI classifications than non-ED mothers. No correlations were found between the TAS-20 and the AAI. Lastly, ED mothers were evaluated more alexithymic by their daughters with the OAS than those in the control group, and their alexithymic traits were significantly correlated with dismissing states of mind (idealization and lack of memory) in the AAIs.

DISCUSSION

Our results highlighted an interesting discrepancy among mothers with ED daughters between the low level of alexithymia provided by their self-reports and the high level of alexithymia observed by their daughters, although the OAS showed severe methodological limitations. Maternal attachment states of mind characterized by the lack of resolution of past losses could be connected to a confusing and incoherent quality of parenting.

Neuroanatomical profiles of alexithymia dimensions and subtypes

Alexithymia, a major risk factor for a range of psychiatric and neurological disorders, has been recognized to comprise two dimensions, a cognitive dimension (difficulties identifying, analyzing, and verbalizing feelings) and an affective one (difficulties emotionalizing and fantasizing). Based on these dimensions, the existence of four distinct alexithymia subtypes has been proposed, but never empirically tested. In this study, 125 participants were assigned to four groups corresponding to the proposed alexithymia subtypes: Type I (impairment on both dimensions), Type II (impairment on the cognitive, but not the affective dimension), Type III (impairment on the affective, but not the cognitive dimension), and Lexithymics (no impairment on either dimension). By means of voxel-based morphometry, associations of the alexithymia dimensions and subtypes with gray and white matter volumes were analyzed. Type I and Type II alexithymia were characterized by gray matter volume reductions in the left amygdala and the thalamus. The cognitive dimension was further linked to volume reductions in the right amygdala, left posterior insula, precuneus, caudate, hippocampus, and parahippocampus. Type III alexithymia was marked by volume reduction in the MCC only, and the affective dimension was further characterized by larger sgACC volume. Moreover, individuals with the intermediate alexithymia Types II and III showed gray matter volume reductions in distinct regions, and had larger corpus callosum volumes compared to Lexithymics. These results substantiate the notion of a differential impact of the cognitive and affective alexithymia dimensions on brain morphology and provide evidence for separable neuroanatomical representations of the different alexithymia subtypes.

Cognitive alexithymia is associated with the degree of risk for psychosis

Alexithymia is a personality construct denoting emotion processing problems. It has been suggested to encompass two dimensions: a cognitive and affective dimension. The cognitive dimension is characterized by difficulties in identifying, verbalizing and analyzing emotions, while the affective dimension reflects the level of emotional arousal and imagination. Alexithymia has been previously proposed as a risk factor for developing psychosis. More specifically, the two alexithymia dimensions might be differentially related to the vulnerability for psychosis. Therefore, we examined the two dimensions of alexithymia, measured with the BVAQ in 94 siblings of patients with schizophrenia, 52 subjects at ultra-high risk (UHR) for developing psychosis, 38 patients with schizophrenia and 109 healthy controls. The results revealed that siblings and patients had higher levels of cognitive alexithymia compared to controls. In addition, subjects at UHR for psychosis had even higher levels of cognitive alexithymia compared to the siblings. The levels of affective alexithymia in siblings and patients were equal to controls. However, UHR individuals had significantly lower levels of affective alexithymia (i.e. higher levels of emotional arousal and fantasizing) compared to controls. Alexithymia was further related to subclinical levels of negative and depressive symptoms. These findings indicate that alexithymia varies parametrically with the degree of risk for psychosis. More specifically, a type-II alexithymia pattern, with high levels of cognitive alexithymia and normal or low levels of affective alexithymia, might be a vulnerability factor for psychosis.

Machiavellianism and Adult Attachment in General Interpersonal Relationships and Close Relationships

Up to the present, the relationship between Machiavellianism and adult attachment has remained a question to be answered in the psychological literature. That is why this study focused on the relationship between Machiavellianism and attachment towards significant others in general interpersonal relationships and in intimate-close relationships. Two attachment tests (Relationship Questionnaire and long-form of Experiences in Close Relationship) and the Mach-IV test were conducted on a sample consisting of 185 subjects. Results have revealed that Machiavellian subjects show a dismissing-avoidant attachment style in their general interpersonal relationships, while avoidance is further accompanied by some characteristics of attachment anxiety in their intimate-close relationships. Our findings further refine the relationship between Machiavellianism and dismissing-avoidant attachment. Machiavellian individuals not only have a negative representation of significant others, but they also tend to seek symbiotic closeness in order to exploit their partners. This ambitendency in distance regulation might be particularly important in understanding the vulnerability of Machiavellian individuals.

Alexithymia and adult attachment representations: associations with the five-factor model of personality and perceived relationship adjustment

Several studies have demonstrated associations between alexithymia, adult attachment styles, personality traits, and relationship adjustment. Only two studies, however, have explored associations between alexithymia and attachment representations. As part of a larger investigation of maternal and infant attachment, the current study explored this association in a sample of 97 pregnant women; in addition, measures of alexithymia and domains of the five-factor model (FFM) of personality were compared in predicting attachment security, assessed with the Adult Attachment Interview Coherence of Mind mind scale, and perceived relationship adjustment. Alexithymia negatively predicted coherence of mind; the domains of the FFM did not add significantly to the prediction. The Openness-to-Experience domain predicted relationship adjustment better than alexithymia. Contrary to findings from studies that assessed adult attachment styles, coherence of mind was unrelated to relationship adjustment and the FFM. The results suggest that alexithymia does not uniquely predict relationship adjustment beyond the domains of the FFM.

Alexithymia influences brain activation during emotion perception but not regulation

Alexithymia is a psychological construct that can be divided into a cognitive and affective dimension. The cognitive dimension is characterized by difficulties in identifying, verbalizing and analysing feelings. The affective dimension comprises reduced levels of emotional experience and imagination. Alexithymia is widely regarded to arise from an impairment of emotion regulation. This is the first functional magnetic resonance imaging (fMRI) study to critically evaluate this by investigating the neural correlates of emotion regulation as a function of alexithymia levels. The aim of the current study was to investigate the neural correlates underlying the two alexithymia dimensions during emotion perception and emotion regulation. Using fMRI, we scanned 51 healthy subjects while viewing, reappraising or suppressing negative emotional pictures. The results support the idea that cognitive alexithymia, but not affective alexithymia, is associated with lower activation in emotional attention and recognition networks during emotion perception. However, in contrast with several theories, no alexithymia-related differences were found during emotion regulation (neither reappraisal nor suppression). These findings suggest that alexithymia may result from an early emotion processing deficit rather than compromised frontal circuits subserving higher-order emotion regulation processes.

The sound of feelings: electrophysiological responses to emotional speech in alexithymia

BACKGROUND

Alexithymia is a personality trait characterized by difficulties in the cognitive processing of emotions (cognitive dimension) and in the experience of emotions (affective dimension). Previous research focused mainly on visual emotional processing in the cognitive alexithymia dimension. We investigated the impact of both alexithymia dimensions on electrophysiological responses to emotional speech in 60 female subjects.

METHODOLOGY

During unattended processing, subjects watched a movie while an emotional prosody oddball paradigm was presented in the background. During attended processing, subjects detected deviants in emotional prosody. The cognitive alexithymia dimension was associated with a left-hemisphere bias during early stages of unattended emotional speech processing, and with generally reduced amplitudes of the late P3 component during attended processing. In contrast, the affective dimension did not modulate unattended emotional prosody perception, but was associated with reduced P3 amplitudes during attended processing particularly to emotional prosody spoken in high intensity.

CONCLUSIONS

Our results provide evidence for a dissociable impact of the two alexithymia dimensions on electrophysiological responses during the attended and unattended processing of emotional prosody. The observed electrophysiological modulations are indicative of a reduced sensitivity to the emotional qualities of speech, which may be a contributing factor to problems in interpersonal communication associated with alexithymia.

Adult attachment and emotional awareness impairment: a multimethod assessment

Our objective was to explore the relationships between adult attachment and various aspects of emotional awareness, including alexithymia and level of emotional awareness. Participants were 112 university students who completed the Attachment Style Questionnaire, the Bermond-Vorst Alexithymia Questionnaire (BVAQ), and the Level of Emotional Awareness Scale. We found that alexithymia was positively related to the avoidant attachment style and negatively with the anxious attachment style. Anxious style-but not avoidance-was also related to the level of emotional awareness. An analysis of the four attachment categories revealed subtle differences regarding the subscales of the BVAQ. Findings are discussed with reference to internal working models of self and others, highlighting the relationship between emotional awareness impairment and interpersonal behaviour.

Feeling angry and acting angry: different effects of autonomy-connectedness in boys and girls

This study examined effects of the autonomy-connectedness components sensitivity to others, self-awareness and capacity for managing new situations on anger experience versus anger expression in adolescent boys and girls. One hundred thirty-one high school students were randomly assigned to an anger-inducing or neutral condition using the Dictator Game. Whereas after anger induction boys experienced and expressed anger independent of autonomy-connectedness, girls' anger experience depended on the level of sensitivity to others: girls experienced increased anger only when they scored high on sensitivity to others. However, girls' expression of anger did not depend on the level of sensitivity to others. Effects of self-awareness and capacity for managing new situations were found when anger was not induced. This study contributed to emotion regulation research by showing differences in anger experience and anger expression as a function of autonomy-connectedness in boys and girls.

Predicting individual differences in autonomy-connectedness: the role of body awareness, alexithymia, and assertiveness

Autonomy-connectedness is the capacity for being on one's own as well as for satisfactorily engaging in interpersonal relationships. Associations have been shown between autonomy-connectedness components (self-awareness, sensitivity to others, and the capacity for managing new situations) and various indices of psychopathology. Both in a theoretical sense as well as for enhancing treatment and prevention, it is relevant to identify which factors most powerfully predict individual differences in autonomy-connectedness: body awareness, alexithymia, or assertiveness. The present study examined this question in a clinical sample of women who were diagnosed as having autonomy problems (N=52) and in a female nonclinical community sample (N=59). In line with expectations, assertiveness was a strong predictor of (all three components of) autonomy-connectedness, as was emotionalizing, one of the alexithymia-components, but the latter in an opposite direction than we had expected: the higher an individual's ability to emotionalize was, the less self-aware and capable to manage new situations that person was, and the more sensitive to others. Cognitive alexithymia contributed to self-awareness as well as to the capacity for managing new situations, and one of the components of body awareness appeared to predict capacity for managing new situations. Our results indicate that assertiveness training and the enhancement of emotion regulation are important elements of autonomy-connectedness targeted interventions.