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Heniquez A, Lahaye H, Boissel L, Guilé JM, Benarous X. [Interoceptive difficulties in children and adolescents with severe form of somatic symptom disorder: A pilot study with nineteen participants]. L'ENCEPHALE 2023; 49:510-515. [PMID: 36244837 DOI: 10.1016/j.encep.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Despite the high rate of somatic symptom disorder (TSS) in the pediatric population, etiological mechanisms remain poorly understood. Previous studies conducted in youths with anxiety, eating disorder, or autistic disorder support a relation between difficulties in the perception of sensory signals (i.e., interoception) and difficulties in identifying emotions. METHOD A cross-sectional study was carried out at the University Hospital of Amiens-Picardie in 19 young people aged 9 to 17 hospitalized in the pediatric ward for TSS. A mental heartbeat tracking task was used to assess interoceptive accuracy, awareness and sensibility. The Porges Body Perception Questionnaire (PBPQ) was used to assess interoceptive attention. Other questionnaires were used to assess associated clinical dimensions such as depression, anxiety, emotional dysregulation and alexithymia. RESULTS The mean interoceptive accuracy score was lower in TSS subjects compared to expected scores in the general population (33% error vs. 20%). A statistically significant correlation was found between, on the one hand, interoceptive sensibility and the "avoidance" subscore of the ECAP (r=0.51) and, on the other hand, between interoceptive awareness and the total score of the Child Depression Inventory (r=0.51). A significant relationship was found between the PBPQ scale total score and the Children-Toronto Alexithymia Scale total score (r=0.42), in particular with the "difficulty expressing emotions" subscore (r=0.62). CONCLUSION This study confirms that interoceptive difficulties occur in young patients with severe TSS. Our finding adds empirical evidence supporting the relations between interoceptive difficulties, alexithymia and somatic symptoms in children and adolescents.
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Affiliation(s)
- A Heniquez
- Unité de périnatalité, service de psychopathologie de l'enfant et de l'adolescent, CHU Amiens-Picardie, Amiens, France
| | - H Lahaye
- Unité de périnatalité, service de psychopathologie de l'enfant et de l'adolescent, CHU Amiens-Picardie, Amiens, France; Inserm, Unit U1105, GRAMFC, université Picardie Jules-Verne, Amiens, France
| | - L Boissel
- Unité de périnatalité, service de psychopathologie de l'enfant et de l'adolescent, CHU Amiens-Picardie, Amiens, France; Inserm, Unit U1105, GRAMFC, université Picardie Jules-Verne, Amiens, France
| | - J-M Guilé
- Unité de périnatalité, service de psychopathologie de l'enfant et de l'adolescent, CHU Amiens-Picardie, Amiens, France; Inserm, Unit U1105, GRAMFC, université Picardie Jules-Verne, Amiens, France
| | - X Benarous
- Unité de périnatalité, service de psychopathologie de l'enfant et de l'adolescent, CHU Amiens-Picardie, Amiens, France; Inserm, Unit U1105, GRAMFC, université Picardie Jules-Verne, Amiens, France.
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Bagby RM, Parker JDA, Taylor GJ. Twenty-five years with the 20-item Toronto Alexithymia Scale. J Psychosom Res 2020; 131:109940. [PMID: 32007790 DOI: 10.1016/j.jpsychores.2020.109940] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Twenty-five years ago, this journal published two articles reporting the development and initial validation of the 20-Item Toronto Alexithymia Scale (TAS-20). Since then the literature on alexithymia has burgeoned with the vast majority of this research using the TAS-20, including multiple language translations of the scale. METHOD In this article we review the psychometric literature evaluating various aspects of the reliability and validity of the TAS-20 and examine some of the controversies surrounding the scale and the construct it assesses. We reflect on the ways in which the TAS-20 has advanced the measurement of the construct and theory of alexithymia. We also discuss recent developments and some future directions for the measurement of alexithymia. RESULTS Although not without some controversy, the preponderance of the accumulated evidence over a 25-year period supports various aspects of the reliability and validity of the TAS-20, including findings from confirmatory factor analytic and convergent and discriminant validity studies which are consistent with Nemiah et al.'s (Nemiah et al., 1976 [3]) and Taylor and colleagues (Taylor et al., 1997 [9]) theoretical formulations and definition of the alexithymia construct. CONCLUSIONS Based on the accumulated empirical evidence of 25 years, we conclude that the TAS-20 is a reliable and valid instrument and accurately reflects and measures the construct as it was originally defined by Nemiah et al. Nemiah et al. (1976) [3] as composed of deficits in affect awareness and expression and pensée opératoire (operational thinking). Clinicians and researchers can use the TAS-20 to confidently measure alexithymia, the roots of which have foundations in psychosomatic medicine.
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Affiliation(s)
- R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - James D A Parker
- Department of Psychology, Trent University, Peterborough, Ontario, Canada
| | - Graeme J Taylor
- Department of Psychiatry (Emeritus), University of Toronto, Toronto, Ontario, Canada
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Shank LM, Tanofsky-Kraff M, Kelly NR, Jaramillo M, Rubin SG, Altman DR, Byrne ME, LeMay-Russell S, Schvey NA, Broadney MM, Brady SM, Yang SB, Courville AB, Ramirez S, Crist AC, Yanovski SZ, Yanovski JA. The association between alexithymia and eating behavior in children and adolescents. Appetite 2019; 142:104381. [PMID: 31344421 DOI: 10.1016/j.appet.2019.104381] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/21/2019] [Accepted: 07/21/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Alexithymia, or the difficulty identifying or describing one's own emotions, may be a risk factor for dysregulated eating and excess weight gain. However, the relationships between alexithymia and eating behaviors in community samples of non-clinical youth have not been well-characterized. We hypothesized that alexithymia would be positively associated with disordered and disinhibited eating in a community-based sample of boys and girls without an eating disorder. METHOD Two hundred children (8-17 years old) across the weight spectrum completed an interview to assess loss of control (LOC) eating and eating-related psychopathology, a laboratory test meal designed to induce disinhibited eating, and questionnaires to assess alexithymia, eating in the absence of hunger, and emotional eating. Linear and logistic regressions were conducted to examine the relationship between alexithymia and eating variables, with age, sex, race, and fat mass as covariates. Test meal analyses also adjusted for lean mass. Given the overlap between alexithymia and depression, all models were repeated with depressive symptoms as an additional covariate. RESULTS Alexithymia was associated with an increased likelihood of reporting LOC eating (p < .05). Moreover, alexithymia was positively associated with disordered eating attitudes, emotional eating, and eating in the absence of hunger (ps < .05). Greater alexithymia was associated with more carbohydrate and less fat intake at the test meal (ps < .05). After adjusting for depressive symptoms, alexithymia remained associated with eating in the absence of hunger and carbohydrate and fat intake (ps < .05). DISCUSSION In healthy children, alexithymia is associated with some facets of eating behavior and food intake. If supported prospectively, these preliminary findings suggest alexithymia may be a modifiable risk factor to reduce disordered eating and excess weight gain in youth.
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Affiliation(s)
- Lisa M Shank
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA; Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA
| | - Marian Tanofsky-Kraff
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, and Prevention Science, College of Education, 5207 University of Oregon, Eugene, OR, 97403-5207, USA
| | - Manuela Jaramillo
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sarah G Rubin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Deborah R Altman
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Meghan E Byrne
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sarah LeMay-Russell
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Natasha A Schvey
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Miranda M Broadney
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Shanna B Yang
- Nutrition Department, Clinical Research Center, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Amber B Courville
- Nutrition Department, Clinical Research Center, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sophie Ramirez
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Alexa C Crist
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Susan Z Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA; Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
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Silvestri PR, Chiarotti F, Giustini S, Cardona F. Alexithymia and tic disorders: a study on a sample of children and their mothers. Eur Child Adolesc Psychiatry 2019; 28:461-470. [PMID: 30056587 DOI: 10.1007/s00787-018-1209-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 07/24/2018] [Indexed: 12/01/2022]
Abstract
Tic disorders are neurodevelopmental disorders characterised by the presence of motor or phonic tics, or both. Patients with tic disorders commonly report premonitory urges of tics. Alexithymia is a psychological trait characterised by a difficulty in identifying and expressing one's own feelings and by an externally oriented thinking. We aimed to explore alexithymia in children with tic disorders and in their mothers. Global alexithymia scores of both children with tic disorders and of their mothers did not differ from those of the participants from the control group. In the tic disorder group, however, both children and their mothers showed a cognitive style characterised by operational thinking and a lack of imaginative abilities. The mothers of children with tic disorder reported significantly higher parental stress. Alexithymia was not predictive of tic severity but was predictive of the severity of the premonitory urges. The implications of these findings are discussed.
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Affiliation(s)
- Paola R Silvestri
- Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108, 00185, Rome, Italy
| | - Flavia Chiarotti
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Sandra Giustini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Cardona
- Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108, 00185, Rome, Italy.
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Loas G, Braun S, Delhaye M, Linkowski P. The measurement of alexithymia in children and adolescents: Psychometric properties of the Alexithymia Questionnaire for Children and the twenty-item Toronto Alexithymia Scale in different non-clinical and clinical samples of children and adolescents. PLoS One 2017; 12:e0177982. [PMID: 28542508 PMCID: PMC5444663 DOI: 10.1371/journal.pone.0177982] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 05/05/2017] [Indexed: 01/17/2023] Open
Abstract
This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18–0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.
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Affiliation(s)
- Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
- * E-mail:
| | - Stéphanie Braun
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Marie Delhaye
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Paul Linkowski
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Delhaye M, Orts F, Bury F, Loas G. [The alexithymia questionnaire for children (AQC): Psychometric properties in a sample of 105 adolescents hospitalized in an adolescent psychiatric department]. Encephale 2016; 44:148-151. [PMID: 27745718 DOI: 10.1016/j.encep.2016.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 08/12/2016] [Accepted: 08/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used measure of alexithymia in non-clinical or clinical populations. The TAS-20 evaluates three dimensions of the alexithymia construct: the difficulty identifying feelings (DIF), the difficulty describing feelings (DDF) and externally oriented thinking (EOT). The TAS-20 is also used in adolescents or children, and the psychometric properties of the scale have not been systematically evaluated in these populations. Recently several studies have shown systematic age differences in the factor structure and a decrease of the quality of the measurement with age. Notably, low reliability measured by the Cronbach α coefficient has been found for the EOT factor. Taking into account the limitations of the TAS-20 in pre-adult populations the Alexithymia Questionnaire for Children (AQC), an adaptation of the TAS-20, has been proposed by a reformulation of the TAS-20 items (Rieffe et al., 2006). Two studies in healthy children found satisfactory psychometric properties with the three-factor structure demonstrating adequate parameters in the confirmatory factorial analyses (CFA). In the two studies low reliabilities of the EOT factor were reported, and recent studies in adolescents using the TAS-20 found that a two-factor model (DDF, DIF) had a better fit than the original three-factor model. Thus, the aim of the present study was firstly to verify the psychometric properties of the AQC in a sample of adolescents presenting various psychiatric disorders and secondly to test the adequacy of the bi- or tridimensional model of the scale. METHOD One hundred and five adolescents (27 males, 78 females) with a mean age of 15.06 years (sd=1.55, range: 12-18 years) were hospitalized in the adolescent psychiatric department of the Erasme Hospital (Bruxelles, Belgium) for various psychiatric disorders. The main diagnoses were: adjustment disorder (n=56, 53.5%), mood or anxiety disorders (n=17, 16.2%), impulse control disorder (n=11, 10.5%). The subjects completed the French version of the AQC. CFA were done testing the adequacy of the three or two-factor structure of the scale. Two indices were considered: the normed χ2 (ratio of χ2 and degrees of freedom) and the root mean square error of approximation (RMSEA). The values for acceptable fit were normed χ2<3 and RMSEA<0.05. Cronbach α were also calculated. RESULTS Fit indices for the three-factor model were respectively 1.165 and 0.0303 for the normed χ2 and RMSEA. For the two-factor model, the values were respectively 0.819 and 0. Thus, these two well-fitting models were compared using the χ2-difference test, which indicated a significantly better fit for the two-factor model over the three-factor model (χ2-difference=151.447, delta df=114, P<0.05). The values of the Cronbach α coefficients were respectively 0.72, 0.75, 0.18 for DIF, DDF and EOT subscales. Moreover, the values of the Cronbach α coefficients were respectively 0.71 and 0.83 for the full scale and the scale without the EOT items. CONCLUSION The Alexithymia Questionnaire for Children had satisfactory psychometric properties found in a sample of adolescent psychiatric inpatients. Taking into account firstly the superiority of the two-factor model over the classical three-factor model and secondly the low value of the Cronbach α for the EOT factor, it is proposed to use only the twelve-item scale by excluding the EOT items.
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Affiliation(s)
- M Delhaye
- Department of adolescent psychiatry, laboratory of psychiatry research (ULB 266), hôpital Erasme, université libre de Bruxelles, Bruxelles, Belgique
| | - F Orts
- Department of adolescent psychiatry, laboratory of psychiatry research (ULB 266), hôpital Erasme, université libre de Bruxelles, Bruxelles, Belgique
| | - F Bury
- Department of adolescent psychiatry, laboratory of psychiatry research (ULB 266), hôpital Erasme, université libre de Bruxelles, Bruxelles, Belgique
| | - G Loas
- Department of adolescent psychiatry, laboratory of psychiatry research (ULB 266), hôpital Erasme, université libre de Bruxelles, Bruxelles, Belgique.
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Deborde AS, Vanwalleghem Maury S, Aitel S. [Emotion regulation in adolescents with conduct disorder and controls]. Encephale 2014; 41:62-9. [PMID: 24703786 DOI: 10.1016/j.encep.2014.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Although many authors have highlighted similarities between conduct disorder (CD) and alexithymia, little empirical research has actually investigated the contribution of emotion processing to CD. The purpose of this study was to explore the relationships between CD and scores on affect regulation scales among 75 adolescents: a group of 30 adolescents with CD and a group of 45 controls, ranging in age from 13 to 18. METHOD All participants filled in a socio-demographic questionnaire. CD diagnosis was assessed in regard to DSM-IV criteria using the specific CD section of the Kiddie-Sads. Affect regulation was measured with two self-reports: TAS-20 (Toronto Alexithymia Scale), known as the gold standard for alexithymia measurement, and DERS (Difficulties in Emotion Regulation Scale), a recently validated scale. In addition, since depression may influence the correlations between CD and alexithymia, it was also measured with the BDI. In order to have more information on the CD group, the CTQ was also used. One way analyses of variance adjusting for age were used for mean score comparisons. Partial correlations adjusting for age were used to investigate the link between the CD severity (the severity index was calculated from the Kiddie-Sads) and affect regulation scores. Finally, discriminant analyses were conducted to explore whether affect regulation could correctly categorize controls and adolescents with CD. RESULTS These results provided some additional data in order to understand the relationship between affect regulation and CD. Controls and adolescents with CD had significantly different emotion regulation scales scores at both scales (TAS-20 and DERS) and in most of their dimensions. Moreover, they also point out the positive correlation between difficulties in affect regulation and CD severity. To our knowledge, this is the first study to have investigated relationships between CD and alexithymia using a severity index of CD. Finally, discriminant analyses showed that the two emotion regulation scales permitted the significant discrimination of both groups. These results are consistent with previous works highlighting the theoretical relationship between deficit in mental elaboration and acting-out. They point to the need to develop therapeutic programs in order to improve emotion regulation of teenagers with CD. Finally, an additional analysis showed a relationship between emotional neglect in childhood (measured with CTQ) and the CD severity. A task for future research would be to study the relationships between attachment, emotional regulation and CD in adolescence.
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Affiliation(s)
- A-S Deborde
- Laboratoire paragraphe EA 349, équipe de recherche CRAC-compréhension raisonnement et acquisition de connaissances, UFR psychologie de l'enfant et du développement, université Paris 8, 2, rue de la Liberté, 93200 Saint-Denis, France.
| | | | - S Aitel
- UFR psychologie de l'enfant et du développement, Université Paris 8, 93200 Saint-Denis, France
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