Alexithymia

Attitudes Toward Dating Violence, Social Impact, and Alexithymia in University Students: A Structural Equation Modeling

This research was conducted to determine the effects of social impact and alexithymia on attitudes toward dating violence. Additionally, the interaction between them was examined. In this context, the effect of social impact on alexithymia was also examined. In addition, this research tried to determine whether alexithymia has a mediating role between social impact and attitudes toward dating violence. The study was descriptive and cross-sectional. There was a total of 582 participants in the study. The study used the Sociodemographic Questionnaire Form, Social Impact Scale (SIS), 20-Item Toronto Alexithymia Scale (TAS-20), and Dating Violence Scale (DVS) for data collection. The study used the descriptive statistics, spearman correlation analysis and structural equation modeling in the evaluation of the data. Participants' SIS scores had a statistically significant and positive correlation with their TAS-20 scores (p < .01), while they had a statistically significant and negative correlation with their DVS scores (p < .01). In addition, a statistically significant and negative correlation was found between TAS-20 scores and DVS scores (p < .01). SIS scores directly affected the TAS-20 (effect value = 0.481; p = .001) and DVS scores (effect value = -0.405; p = .001). Similarly, the TAS-20 scores had a direct effect on the DVS scores (effect value = -0.261; p = .008). In addition to this direct effect of TAS-20 scores, there was a significant mediator effect between the SIS scores and DVS scores (effect value = -0.126; p = .008). In this study, it was established that social impact effects both alexithymia and attitudes toward dating violence, and moreover, alexithymia influences attitudes toward dating violence. Additionally, it was identified that alexithymia serves as a mediator in the relationship between social impact and attitudes toward dating violence.

Studying the social mind: An updated summary of findings from the Vietnam Head Injury Study

Lesion mapping studies allow us to evaluate the potential causal contribution of specific brain areas to human cognition and complement other cognitive neuroscience methods, as several authors have recently pointed out. Here, we present an updated summary of the findings from the Vietnam Head Injury Study (VHIS) focusing on the studies conducted over the last decade, that examined the social mind and its intricate neural and cognitive underpinnings. The VHIS is a prospective, long-term follow-up study of Vietnam veterans with penetrating traumatic brain injury (pTBI) and healthy controls (HC). The scope of the work is to present the studies from the latest phases (3 and 4) of the VHIS, 70 studies since 2011, when the Raymont et al. paper was published (Raymont et al., 2011). These studies have contributed to our understanding of human social cognition, including political and religious beliefs, theory of mind, but also executive functions, intelligence, and personality. This work finally discusses the usefulness of lesion mapping as an approach to understanding the functions of the human brain from basic science and clinical perspectives.

Alexithymia and Quality of Life in Saudi Women with Polycystic Ovary Syndrome: A Community-Based Study

BACKGROUND The endocrine metabolic disorder polycystic ovary syndrome (PCOS) is quite common among women. Women with PCOS show a compromised health-related quality of life (HRQoL), impaired emotional well-being, and alexithymia, a neuropsychological phenomenon conceptualized as difficulty in recognizing and expressing one's emotions. However, the relationship between alexithymia and HRQoL in women with PCOS is unclear. This study aimed to investigate the impact of alexithymia on HRQoL in women with PCOS in Saudi Arabia. MATERIAL AND METHODS This descriptive cross-sectional, community-based study enrolled 518 female patients with a diagnosis of PCOS from all age groups. The patients were surveyed via a self-administered questionnaire from December 2022 to January 2023. The survey encompassed sociodemographic data, the 20-item Toronto Alexithymia Scale (TAS-20), and HRQoL 15-dimensional scale (15D). RESULTS This study included 320 participants (61.8%) with alexithymia. A significant association was found between alexithymia and low HRQoL 15D scores in patients with PCOS. Specifically, scores on the TAS-20 subscales related to difficulty in identifying feelings and describing feelings were positively correlated with HRQoL (P=0.000). However, externally oriented thinking subscale scores were not positively correlated with HRQoL (P=0.44). CONCLUSIONS The presence of alexithymia is associated with poor HRQoL in women with PCOS, which is more pronounced among those who received a diagnosis ≥4 years ago. Alexithymia must be considered when assessing the HRQoL of patients with PCOS, considering the relatively high prevalence of alexithymia in these patients.

Assessing alexithymia: the proposal of a psychometric tool based on spheric videos

The present perspective introduces a novel psychometric tool designed to enhance the evaluation of alexithymia. Alexithymia, a condition marked by difficulties in recognizing and expressing emotions, along with a propensity to direct attention outside rather than toward one's own interior experiences, is commonly investigated through self-report questionnaires. These instruments assume that individuals have sufficient self-awareness and abstraction capabilities, which restricts the understanding of the underlying mechanisms of emotional recognition in individuals who do not possess these capacities. To address this lack, emerging technologies like virtual reality (VR) and 360° videos facilitate the recreation of immersive contexts, enabling subjects to engage with scenarios even remotely. Our innovative tool employs spherical video technology to recreate social and non-social scenarios that elicit emotions. Psychophysiological measures are collected during video observation; then, questions are asked to investigate how the subject consciously processes the emotions they experienced. This multimodal approach aims to capture both implicit and explicit emotion processing, providing a comprehensive assessment. Overall, the proposed psychometric tool offers the potential for a more nuanced understanding of alexithymic traits and their real-life impact, empowering clinicians to tailor treatment processes to individual needs based on a richer set of information.

Trauma, early life stress, and mindfulness in adulthood

This article is a review that was inspired by recent studies investigating the effects of childhood trauma or early life stress (ELS) and mindfulness in adulthood. One recent study found that some forms of abuse and neglect led to higher scores in several subscales of a self-report measure of mindfulness. The authors concluded that some forms of ELS can help cultivate certain aspects of mindfulness in adulthood. However, and in contrast to this recent finding, much of the extant literature investigating ELS and trauma are linked to emotional dysregulation, alexithymia, and a host of psychopathologies in adulthood which makes the results of this study surprising. Central to the mindfulness literature is cultivating an open, non-reactive, or non-judgment awareness of inner experiences which are important for emotional regulation. In this paper, I review some of the effects of trauma or ELS on critical neural circuits linked to mindfulness, interoception, attachment, and alexithymia which I hope may clarify some of the conflicting findings from this study and throughout the literature and provide additional context and a framework that may inform research investigating these two constructs going forward.

Gender difference in association between clinical symptoms and alexithymia in chronic schizophrenia: A large sample study based on Chinese Han population

BACKGROUND

Alexithymia, a prevalent social cognitive impairment in schizophrenia, remains insufficiently studied. Though some studies propose a link between alexithymia and clinical symptoms of schizophrenia, this connection lacks consistent confirmation. Additionally, there is limited research on gender difference in alexithymia among schizophrenia patients. To fill this gap, our study aimed to conduct a large-sample survey of Chinese Han patients with chronic schizophrenia to explore whether there are gender differences between clinical symptoms and alexithymia.

METHODS

We obtained sociodemographic characteristics of 987 schizophrenia patients, measured their clinical symptoms using the Positive and Negative Syndrome Scale (PANSS), and assessed their self-reported alexithymia using the Toronto Alexithymia Scale (TAS-20).

RESULTS

In patients with chronic schizophrenia, the prevalence of alexithymia did not differ between genders (male: 35.51 % vs. female: 26.91 %, P = 0.018). Correlation and linear regression analyses revealed that PANSS scores and TAS-20 scores were widely correlated in both male and female patients. In particular, multiple linear regression analysis showed that the TAS total score was positively correlated with negative symptoms and cognitive symptoms in male patients, while it was positively correlated with negative symptoms and depressive symptoms in female patients.

CONCLUSION

Our study suggests that the prevalence of alexithymia in patients with chronic schizophrenia does not differ between genders. Negative symptoms are related to the TAS-20 total score in both male and female patients, while cognitive symptoms are only related to the TAS-20 total score in male patients, and depressive symptoms are only related to the TAS-20 total score in female patients.

Journeying to the past: time travel and mental time travel, how far apart?

Spatial models dominated memory research throughout much of the twentieth century, but in recent decades, the concept of memory as a form of mental time travel (MTT) to the past has gained prominence. Initially introduced as a metaphor, the MTT perspective shifted the focus from internal memory processes to the subjective conscious experience of remembering. Despite its significant impact on empirical and theoretical memory research, there has been limited discussion regarding the meaning and adequacy of the MTT metaphor in accounting for memory. While in previous work I have addressed the general limitations of the MTT metaphor in explaining memory, the objective of this article is more focused and modest: to gain a better understanding of what constitutes MTT to the past. To achieve this objective, a detailed analysis of the characteristics of MTT to the past is presented through a comparison with time travel (TT) to the past. Although acknowledging that TT does not refer to an existing physical phenomenon, it is an older concept extensively discussed in the philosophical literature and provides commonly accepted grounds, particularly within orthodox theories of time, that can offer insights into the nature of MTT. Six specific characteristics serve as points of comparison: (1) a destination distinct from the present, (2) the distinction between subjective time and objective time, (3) the subjective experience of the time traveler, (4) their differentiation from the past self, (5) the existence of the past, and (6) its unchangeability. Through this research, a detailed exploration of the phenomenal and metaphysical aspects of MTT to the past is undertaken, shedding light on the distinct features that mental time travel to the past acquires when it occurs within the realm of the mind rather than as a physical phenomenon. By examining these characteristics, a deeper understanding of the nature of mental time travel is achieved, offering insights into how it operates in relation to memory and the past.

The associations of parental attitudes and peer bullying with alexithymia in adolescents: A structural equality model

AIM

The aim of this study is to investigate the relationship between parental attitude and peer bullying and alexithymia in adolescents.

METHODS

This cross-sectional descriptive study was conducted with adolescents aged 13-18 years within high schools in eastern Turkey. Cluster sampling method was applied, and the study was completed within four high schools determined by random selection method. Sociodemographic characteristics questionnaire form, Peer Bullying Scale Adolescent Form, and Twenty-item Toronto Alexithymia Scale (TAS-20) were used to collect the data.

RESULTS

Among the adolescents, 52% were female, 60% had a medium income level, 25.3% were in the 11th grade, 83% were living with their parents, 7.4% had chronic illnesses, 9.2% had psychiatric illnesses, 25.3% had suicidal thoughts, 10.1% engaged in suicidal behavior, and 25.3% used TV, smartphones, or tablets for 3-4 h a day. Rejecting and indifferent parental attitudes were found to be a possible risk factor for alexithymia, bullying and victimization.

CONCLUSIONS

This study highlights the connections between parental attitudes, peer bullying, and alexithymia in adolescents. By targeting positive parental attitudes and addressing peer interactions, nurses can effectively contribute to reducing the risk of alexithymia.

PRACTICE IMPLICATIONS

Through collaboration with parents, nurses can establish supportive environments that nurture emotional understanding. Remaining attentive to risk factors, such as chronic illnesses and mental health issues in adolescents, empowers nurses to offer timely support or referrals. Partnerships with educators further enhance emotional awareness and encourage positive peer relationships.

Childhood trauma and social support affect symptom profiles through cortical thickness abnormalities in major depressive disorder: A structural equation modeling analysis

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.

The relevance of the socio-emotional deficits in cerebral small vessels disease (CSVD): An exploratory study with sporadic CSVD and CADASIL patients

Background

Cerebral Small Vessels Disease (CSVD) is categorized in different forms, the most common being the sporadic form and a genetic variant - Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Amongst the most frequent clinical manifestations are the neuropsychological changes of cognitive, behavioral, and emotional nature, whose features are still under debate.

Objective

This exploratory study aimed to compare the neuropsychological profile of a sporadic CSVD sample and a CADASIL sample with an age, education, and gender matched control group, between the ages of 30-65 YO (total sample mean age=51.16; SD=4.31).

Methods

20 patients with sporadic CSVD, 20 patients with CADASIL and 20 matched controls completed a neuropsychological assessment battery. Global cognitive state, processing speed, working memory, attention, executive dysfunction, episodic memory, social cognition, impulsivity, apathy, alexithymia, depression, and anxiety were measured. White matter hyperintensities (WMH) volume were quantified and measured as lesion burden.

Results

The cognitive differences found between the clinical groups combined (after confirming no differences between the two clinical groups) and matched controls were restricted to speed processing scores (d = 0.32 95 % CI [.12-.47]). The socio-emotional and behavioral profile revealed significantly higher levels of depression (d = 0.21, 95 % CI [.16-.33]). and anxiety (d = 0.25 95 % CI [.19-.32]) in CADASIL and sporadic CSVD groups, and the same for the alexithymia score (d = 0.533 95 % CI [.32-.65]) were the clinical groups revealed impoverished emotional processing compared to controls. WMH only significantly correlated with the cognitive changes and age.

Conclusions

In our study, CADASIL and sporadic cSVD patients combined, present multiple emotional-behavioral symptoms - alexithymia, anxiety, depression, and in a lower extent apathy and impulsivity - suggesting for the presence of emotion dysregulation behaviors, present independently of age and of the presence of cognitive deficits. Despite of the small sample size that could underpower some findings, this exploratory research supported that these symptoms may have a significant impact in disease monitoring, progression, and prognosis, requiring further investigation regarding their neurophysiological substrates.

Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study

BACKGROUND

Alexithymia, a subclinical cognitive-affective impairment, is prevalent in older people and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of older people in nursing homes lacking access to adequate mental health care. The study aimed to evaluate the effects of rational emotive behavior therapy (REBT) on alexithymia, anxiety, depression and sleep quality of older people in nursing homes.

METHODS

This quasi-experimental study was conducted with two groups (the control group and intervention) from March to November 2021. This study enrolled 86 participants, two of whom were lost to follow-up; 42 received usual care (control group) and 42 received REBT based on usual care (intervention group) in nursing homes. The older people in both groups were evaluated at baseline (T0), within one-week post-intervention (T1), and at 3-month follow-up (T3). Generalized estimating equations were used by SPSS version 26 to assess the differential change in the outcomes between the two groups.

RESULTS

The intervention group shows significantly greater improvement in alexithymia than the control group at both T1 (β = -8.167, 95%CI= -10.965, -5.368, P < 0.001) and T2 (β=-4.119, 95%CI= -7.171, -1.067, P = 0.008). The two groups showed significant differences at both T1 and T2 in both difficulty identifying feelings and difficulty describing feelings. Compared to the control group, the intervention group shows a significant improvement in sleep quality at T2 (β = -2.048, 95%CI=-4.004, -0.091, P = 0.040). The two groups showed significant differences at both T1 and T2 in both sleep disturbance and daytime dysfunction. For depression and anxiety, no significant differences were found between the intervention and control groups.

CONCLUSIONS

REBT showed to be an effective method for improving alexithymia and sleep quality of older people in nursing homes. However, it failed to significantly alleviate anxiety and depression at least in a short-term trial. Refining this intervention may have a broader, more substantial impact on future research.

Alexithymia and asthma: a systematic review

Growing evidence from scientific research elucidates the important role of alexithymia in chronic immune diseases. This Review aims to explore the presence of alexithymia in patients affected by asthma and clarify its associations with other involved psychological and physical factors. In January 2023, according to PRISMA guidelines, a systematic search using PubMed and Scopus was conducted. Twenty-six studies were eligible based on inclusion criteria. Alexithymia was significantly present in asthma patients, with most studies reporting a higher prevalence (from 9 to 62.8%) than in control groups (approximately 10%). The coexistence of asthma and alexithymia was associated with a worse quality of life, psychiatric comorbidity, poor symptom control, and difficulty in recognizing exacerbations of the disease. These results suggest that alexithymia can negatively impact the management of asthma. For this reason, we recommend an accuracy assessment in clinical settings and the implementation of psychological interventions to promote the emotional and physical wellbeing of asthmatic patients.

Daring to Feel: Emotion-Focused Psychotherapy Increases Amygdala Activation and Connectivity in Euthymic Bipolar Disorder-A Randomized Controlled Trial

BACKGROUND

In bipolar disorder (BD), the alternation of extreme mood states indicates deficits in emotion processing, accompanied by aberrant neural function of the emotion network. The present study investigated the effects of an emotion-centered psychotherapeutic intervention on amygdala responsivity and connectivity during emotional face processing in BD.

METHODS

In a randomized controlled trial within the multicentric BipoLife project, euthymic patients with BD received one of two interventions over 6 months: an unstructured, emotion-focused intervention (FEST), where patients were guided to adequately perceive and label their emotions (n = 28), or a specific, structured, cognitive behavioral intervention (SEKT) (n = 31). Before and after interventions, functional magnetic resonance imaging was conducted while patients completed an emotional face-matching paradigm (final functional magnetic resonance imaging sample of patients completing both measurements: SEKT, n = 17; FEST, n = 17). Healthy control subjects (n = 32) were scanned twice after the same interval without receiving any intervention. Given the focus of FEST on emotion processing, we expected FEST to strengthen amygdala activation and connectivity.

RESULTS

Clinically, both interventions stabilized patients' euthymic states in terms of affective symptoms. At the neural level, FEST versus SEKT increased amygdala activation and amygdala-insula connectivity at postintervention relative to preintervention time point. In FEST, the increase in amygdala activation was associated with fewer depressive symptoms (r = 0.72) 6 months after intervention.

CONCLUSIONS

Enhanced activation and functional connectivity of the amygdala after FEST versus SEKT may represent a neural marker of improved emotion processing, supporting the FEST intervention as an effective tool in relapse prevention in patients with BD.

Suicidal ideation in Chinese patients with chronic schizophrenia: prevalence, clinical correlates, and relationship with alexithymia

Suicidal ideation (SI) is common among people with schizophrenia. However, it has received less attention than suicide attempts (SA), especially in the Chinese population. Alexithymia is a well-established risk factor for SI across different populations. Nevertheless, very few studies evaluated their relationship in schizophrenia patients. We aimed to determine the prevalence and clinical correlates of SI and its relationship with alexithymia in 812 Chinese chronic schizophrenia inpatients. We assessed SI, clinical symptoms, and alexithymia by the Beck Scale for Suicidal Ideation, the Positive and Negative Syndrome Scale (PANSS), and the Toronto Alexithymia Scale, respectively. A multiple logistic regression model was conducted to identify independent correlates of SI. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were performed to determine the ability of our model to distinguish between patients with and without SI. 10% (n = 84) reported current SI. Lifetime SA (OR, 4.68; 95% CI 2.76-7.94, p < 0.001), PANSS depressive factor (OR, 1.24; 95% CI 1.12-1.38, p < 0.001), PANSS positive subscale (OR, 1.055; 95% CI 1.004-1.108, p = 0.035), and difficulty identifying emotions (OR, 1.07; 95% CI 1.03-1.12, p = 0.002) were associated with SI. The AUC value was 0.80, indicating excellent distinguishing capabilities. Timely assessments of these factors may help identify schizophrenia patients who are at risk for SI.

Predicting depression and anxiety of Chinese population during COVID-19 in psychological evaluation data by XGBoost

BACKGROUND

Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety.

METHODS

The eXtreme Gradient Boosting (XGBoost¹) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE²), anxiety (AN³), comorbid depression and anxiety (DA⁴), and healthy controls (HC⁵), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination.

RESULTS

The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86).

CONCLUSIONS

Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.

Alexithymia in a Chinese Patient with Chronic Pain and Associated Factors: A Cross-Sectional Study

BACKGROUND

Alexithymia is more prevalent among those with patients living with chronic pain. Information on the prevalence of alexithymia in Chinese patients with chronic pain and associated factors is limited.

AIM

The primary objective of this study was to determine the prevalence of alexithymia, as defined by a score of 61 or greater in the 20-item Toronto Alexithymia Scale (TAS-20), in a Chinese patient with chronic pain. The secondary objective was to investigate the relationship between alexithymia and the clinical and psychological aspects of chronic pain.

METHODS

A cross-sectional observational study used the TAS-20 to assess alexithymia of Chinese patients with chronic pain. Sociodemographic and clinical information were obtained and participants filled in the Fear Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and General Self-efficacy Scale.

RESULTS

Of the 346 patients screened, 321 patients living with chronic pain were enrolled into the study. The prevalence of alexithymia among the study population (TAS-20 score ≥61) was 19.6% (95% confidence interval [CI]: 15.3-24.0). The findings showed anxiety (odds ratio [OR] = 2.474; 95% CI, 1.241-4.935), pain catastrophizing (2.649; 1.014-6.921), and self-efficacy (0.952; 0.908-0.988) as independent predictors of alexithymia in patients living with chronic pain.

CONCLUSIONS

Patients with chronic pain exhibiting alexithymia were at higher risk of pain catastrophizing, anxiety, and lower self-efficacy, compared with patients without alexithymia. It is important to identify and pay a special attention in clinical practice to patients with chronic pain exhibiting alexithymia, as these individuals are unable to properly express their emotions.

Alexithymia and Coping With Stress in Patients With Multiple Sclerosis: A Comparative Study

ABSTRACT

BACKGROUND: Multiple sclerosis (MS), which is frequently seen in young adults, affects mental health because of disease symptoms and cognitive disorders. This study was conducted to evaluate the presence of alexithymia and problem- or emotion-focused coping strategies with stress in MS patients, determine the relationship between these variables, and compare the results of MS patients with those of healthy individuals. METHODS: This descriptive, cross-sectional, and comparative study was carried out with the participation of 120 MS patients presenting to a neurology clinic and outpatient clinic of a university hospital and 120 healthy individuals. Data were collected using a personal information form, the Toronto Alexithymia Scale, and the Ways of Coping Scale. RESULTS: The 40.8% rate of alexithymia in the MS patients was higher than that in the healthy individuals (21.7%). Compared with healthy individuals, MS patients use emotion-focused coping methods, such as a lack of self-confidence approach and a submissive approach, more frequently ( P < .05). A significant negative correlation was found between the alexithymia and problem-focused coping strategies of MS patients ( P < .01). CONCLUSION: Alexithymia is more common in MS patients than in healthy individuals. Alexithymia negatively affects the methods patients use to cope with stress. In the treatment and care of MS patients, nurses should plan interventions for the ability of these patients to recognize and express their emotions and develop positive coping methods.

Alexithymia in systemic lupus erythematosus: A cross sectional study in a Brazilian sample

BACKGROUND

Alexithymia is considered as a reduced capacity to be aware of, to clearly recognize, and to define one's feelings with a limited fantasy and a concrete, externally oriented cognitive style. Some studies have stated that alexithymia is more common in systemic lupus erythematosus patients (SLE) than in general population but there is a paucity of studies in such context.

AIM

To study the prevalence of alexithymia in a sample of SLE patients looking for associated epidemiological and clinical findings and its relationship to quality of life.

METHODS

Cross-sectional study in 93 SLE patients collecting clinical, epidemiological, and serological data, data on quality of life by 12 item short health survey (SF-12), and alexithymia by Toronto scale (TAS-26). Disease's cumulative damage was measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage index.

RESULTS

In this sample (90.3% females and median age of 46 years), 55.9% had alexithymia; 22/92 (23.9%) did not and 19/93 (20.4%) had inconclusive results. Alexithymia presence had a positive association with age (p = 0.01) and a negative association with presence of glomerulonephritis (25% vs 59%; p = 0.005) and glucocorticoid use (19.2% vs 59.0%; p = 0.0007). A negative correlation of TAS-26 was observed with mental domain of (r = -0.46; p < 0.0001) and physical domain (r = -0.32; p = 0.004) of SF-12, but not with cumulative damage index.

CONCLUSION

We found a high prevalence of alexithymia in this sample of SLE patients that negatively associated with quality of life, but not with cumulative damage index.

The prevalence of alexithymia in psoriasis: A systematic review and meta-analysis

OBJECTIVES

Alexithymia is characterized by an inability to identify and describe feelings, which may increase the psychological burden of patients with psoriasis. The prevalence of alexithymia in psoriasis has been investigated with variable results. This study aimed to estimate the overall alexithymia prevalence in psoriasis.

METHODS

The PubMed, PsycInfo, Web of Science, The Cochrane Library, EMBASE, China Knowledge Resource in Integrated Database (CNKI), WanFang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) electronic databases were searched from inception to March 28, 2022, for cross-sectional studies, that reported prevalence of alexithymia. The included studies were evaluated for quality, data synthesis, subgroup analysis, sensitivity analysis, and publication bias.

RESULTS

This systematic review and meta-analysis included 16 articles involving 3752 patients with psoriasis from eight countries. The pooled prevalence of alexithymia was 28% (95% CI: 25-32%), with heterogeneity between studies (I² = 80.03%, p < .001). There was a higher prevalence of alexithymia in women with psoriasis, patients with a Psoriasis Area Severity Index (PASI) score >10, patients with psoriatic arthritis, and patients with psoriasis with visible skin lesions had a higher prevalence of alexithymia.

CONCLUSION

More than a quarter of people with psoriasis have alexithymia., But due to the small sample size of the included studies, the results of the subgroup analysis should be interpreted with caution. More research is needed to elucidate the mechanism of alexithymia development in psoriasis. These findings may provide a theoretical basis for the screening and intervention of alexithymia in patients with psoriasis.

Neurobiological Features of Posttraumatic Stress Disorder (PTSD) and Their Role in Understanding Adaptive Behavior and Stress Resilience

Posttraumatic stress disorder (PTSD) has been impacting the functioning of a large number of people in military activities and victims of violence for many generations. However, investments in research aiming to understand the neurobiological aspects of the disorder started relatively late, around the last third of the 20th century. The development of neuroimaging methods has greatly supported further understanding of the structural and functional changes in the re-organization processes of brains with PTSD. This helps to better explain the severity and evolution of behavioral symptoms, and opens the possibilities for identifying individual preexisting structural characteristics that could increase symptom severity and the risk of development. Here, we review the advances in neuroanatomical research on these adaptations in PTSD and discuss how those modifications in prefrontal and anterior cingulate circuitry impact the severity and development of the disorder, detaching the research from an amygdalocentric perspective. In addition, we investigate existing and contradictory evidence regarding the preexisting neurobiological features found mostly in twin studies and voxel-based morphometry (VBM) reports.

Effects of comprehensive nursing intervention based on self-disclosure on improving alexithymia in elder patients with coronary heart disease

OBJECTIVES

Patients with coronary heart disease (CHD) experience stress and suffer from the risk of recurrence and death. Comprehensive nursing intervention based on self-disclosure (CNISD) is an interdisciplinary service and an effective approach to care that improves quality of life and alleviates suffering for patients with CHD. The purpose of this study was to analyze the effects of CNISD on alexithymia in patients with CHD.

METHODS

A total of 1088 patients with CHD were recruited and received CNISD (n = 540) and usual care (n = 548). The quality of life, alexithymia, four statutory health insurance funds, recurrence, mortality, and satisfaction was compared in patients with CHD between CNISD and usual care group.

RESULTS

Outcomes showed that CNISD improved sleep quality and quality of life, increased physical activity, reduced the hospital anxiety and depression scale in patients with CHD compared to usual care. Recurrence and mortality of patients with CHD were markedly improved by CNISD compared to patients with CHD in usual care group.

CONCLUSIONS

In conclusion, data in this study indicate that CNISD presents benefits in improving quality of life, physical activity, anxiety, depression, recurrence, and mortality for patients with CHD.

The influence of alexithymia on problematic mobile phone use among Chinese adolescent students: Multiple mediating roles of social interaction anxiousness and core self-evaluations

BACKGROUND

Alexithymia can lead to problematic mobile phone use (PMPU). However, the underlying mechanisms remain unclear.

METHODS

Drawing on the Interaction of Person-Affect-Cognition-Execution model, the present study tests the mediating effects (parallel and serial) of social interaction anxiety (SIA) and core self-evaluations (CSE) on the relationship between alexithymia and PMPU. We obtained 1267 valid responses from adolescent students (mean age, 20.36, standard deviation, 0.97) from southeast China who completed the Mobile Phone Addiction Index, Toronto Alexithymia-20 Scale, Social Interaction Anxiousness Scale, and Core Self-Evaluation Inventory.

RESULTS

After controlling for demographic variables (i.e., gender) as covariates, the results revealed that: (1) alexithymia had a positive predictive effect on PMPU in adolescent students; (2) SIA and CSE mediated the association between alexithymia and PMPU; and (3) a series of indirect pathways (i.e., from alexithymia to PMPU via SIA and CSE) were detected. Thus, alexithymia can directly affect (parallel mediation) PMPU by increasing SIA and lowering CSE simultaneously. However, alexithymia can also indirectly affect (serial mediation) PMPU by increasing the level of SIA by decreasing CSE.

LIMITATIONS

Data were collected by participant self-report. This method may lead to recall bias. Further, we adopted a cross-sectional rather than an experimental design, thus precluding causal conclusions. Lastly, it would be useful to validate our findings with other age groups outside southeast China.

CONCLUSIONS

The current study findings are conducive to understanding the relationship between alexithymia and PMPU and inspire the prevention and intervention of PMPU.

Plasma circulating micro-RNAs associated with alexithymia reflect a high overlap on neuropsychiatric outcomes

BACKGROUND

Alexithymia ("no word for feelings") is a personality feature that is common in patients with psychiatric disorders. However, little is known about biological causes and mechanism behind. Research so far focusses on genetic risk variants primary associated with depression, but analyses on epigenetic mechanisms are still missing.

METHODS

In a sample of n = 813 subjects from the "Study of Health in Pomerania" we analyzed the association between alexithymia and plasma circulating micro RNAs (miRNA). Significant miRNAs were compared to associations regarding depression and pathway analyses were performed.

RESULTS

Two miRNAs were significantly associated with at least one of the alexithymia scores (hsa-miR-324-3p, hsa-miR-33a-5p) and three miRNAs additionally revealed a strong association pattern to alexithymia (hsa-miR-106b-5p, hsa-miR-484, hsa-miR-25-3p). None of these miRNAs was significantly associated with depressive symptoms in our sample. Literature research showed that all of the miRNAs have been found in association with several neuropsychiatric phenotypes.

LIMITATIONS

Main limitations are the lack of a replication sample as well as the limited number of miRNAs analyzed.

CONCLUSIONS

This is the first analysis investigating the association between miRNAs and alexithymia. Results indicate that miRNAs are not specific for one psychiatric disorder but may influence biological mechanisms that are involved in various psychiatric conditions which might be relevant for future treatment options and improve the biological understanding of psychiatric conditions.

Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances

Background

Posttraumatic stress disorder (PTSD) is a debilitating mental disorder that develops in the aftermath of traumatic life experiences, especially those that occurred in childhood. PTSD is associated with intrusive memories, distressing dreams, dissociative reactions, avoidance of trauma-related stimuli, negative mood and sense of well-being, increased arousal and irritability, and clinically significant distress and impaired functioning. Case Presentation. The following case report presents a 42-year-old male displaying symptoms of PTSD, alexithymia, and depression.

Conclusion

Untreated alexithymia may aggravate the trauma and cause the development of PTSD and depression.

The moderating effect of alexithymia on the relationship between stress and cyberchondria

OBJECTIVES

The pandemic has increased the level of perceived stress and provided a fertile soil for Cyberchondria. This study aims to investigate the relationship between stress, cyberchondria, and alexithymia.

METHODS

This cross-sectional study used convenience sampling to carried out on a total 1,117 college students (female/male:536/581; mean age: 19.95 ± 1.32). Cyberchondria Severity Scale (CSS), Toronto Alexithymia Scale (TAS) and Short Depression Anxiety Stress Scales (DASS-21) were used to assessed the present study variables.

RESULTS

Significant differences emerged for CSS scores by gender (t = 3.74, p < 0.01) and had any comorbid disease (t = 2.47, p < 0.05), The Pearson correlation showed Cyberchondria has a significant positive correlation with stress and alexithymia (r = 0.50, p < 0.01, r = 0.36, p < 0.01). Furthermore, the regression analysis described that stress (β = 0.50, p < 0.01) and alexithymia (β = 0.36, p < 0.01) were the significant positive predictors of cyberchondria. Moreover, moderation analysis showed that alexithymia significantly strengthened the association between stress and cyberchondria (F = 107.20, p < 0.01).

CONCLUSION

The study will help medical practitioners to understand how stress and alexithymia can cause an increase in cyberchondria. This will help them to elaborate operational indications for prevention and psychological support.

Emotional and Neuropsychiatric Disorders Associated with Alzheimer's Disease

Alzheimer's disease is associated with impairments in emotional communication including comprehension and production of facial emotional expressions, comprehension of affective prosody, and alexithymia. It is also associated with disorders of emotional experience including mood disorders (depression and anxiety), agitation/aggression, and psychosis. Agitation/aggression and psychosis are particularly disruptive, are associated with earlier institutionalization, and pose a major challenge to institutional management. Treatment of disorders of emotional experience has been primarily pharmacologic (reviewed here in detail) and has relied heavily on antipsychotic medications despite the small effect sizes demonstrated in a large number of randomized controlled trials and the prevalence of serious side effects associated with these drugs. Recent studies suggest that treatment with pimavanserin, an antipsychotic without activity at dopamine receptors, may represent an important advance for treatment of psychotic manifestations, even as the drug appears to pose significant risk. Dextromethorphan/quinidine may represent an important advance in the treatment of agitation/aggression. There is also compelling evidence that sleep disorders, which are common among patients with Alzheimer's disease and are readily treatable, may potentiate psychotic manifestations and agitation/aggression, but further studies are needed.