1
|
Yang X, Liu L, Tian Y, Yang C, Ling C, Liu H. Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations. Psychol Res Behav Manag 2024; 17:615-625. [PMID: 38404923 PMCID: PMC10893783 DOI: 10.2147/prbm.s446788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose Insomnia is related to alexithymia in adults, but the relationship between insomnia and alexithymia in adolescents with major depressive disorder remains unclear. This study aimed to investigate the sex differences and the association between insomnia and alexithymia in adolescents with major depressive disorder. Patients and Methods From October 2020 to April 2022, adolescent patients with major depressive disorder were recruited from psychiatric departments of seven hospitals in Anhui Province, China. Their general demographic and clinical information were collected. The 20-item Toronto Alexithymia Scale, the Center for Epidemiologic Studies of Depression Scale, and the Insomnia Severity Index Scale were used to assess their alexithymia, depression, and insomnia symptoms, respectively. The analysis of variance (ANOVA), Student's t-test and Mann-Whitney U-test were used for continuous variables and chi-square tests for categorical variables. Pearson's correlation analysis and Spearman correlation analysis were used to examine the correlation between ISI and demographic and clinical variables. Multiple binary logistic regression analyses with the "Enter" method were carried out to explore the correlations of insomnia. Results The prevalence of insomnia in female adolescent patients was similar to that of male patients (χ2=1.84, p = 0.175). Compared with those without insomnia, patients with insomnia had worse family relationships (F = 7.71, p = 0.021), perceived heavier academic stress (F = 6.32, p = 0.012), more likely to take sedative-hypnotics (F = 5.51, p = 0.019), had higher levels of depression (F = 81.57, p < 0.001) and alexithymia (F = 28.57, p < 0.001). Correlation analysis showed that alexithymia was significantly associated with insomnia in adolescent patients (r = 0.360, p < 0.01). Binary logistic regression analyses showed that, alexithymia was significantly associated with insomnia in female patients (OR = 1.050, p < 0.05) but not male patients. Conclusion In female adolescent patients, alexithymia is a risk factor of insomnia, which is of great importance in the understanding of the psychopathological mechanisms, treatments and psychological interventions of insomnia in adolescents with major depressive disorder.
Collapse
Affiliation(s)
- Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Chen Ling
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| |
Collapse
|
2
|
Vicario CM, Scavone V, Lucifora C, Falzone A, Pioggia G, Gangemi S, Craparo G, Martino G. Evidence of abnormal scalar timing property in alexithymia. PLoS One 2023; 18:e0278881. [PMID: 36689490 PMCID: PMC9870170 DOI: 10.1371/journal.pone.0278881] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/26/2022] [Indexed: 01/24/2023] Open
Abstract
Evidence suggests that incidental modulation of affective states affects the ability to keep track of time. Alexithymia represents an ideal condition to further address the emotion-time processing link, as it refers to a trait characterized by a deficit of affective processing. 31 healthy participants completed an online version of the TAS-20 scale, which measures alexithymia, and a time reproduction task of visual stimuli related to positive (i.e., happiness) and negative (i.e., anger) facial expressions. Results documented a positive correlation between TAS-20 score and the variability in reproducing sub-second durations of the anger expression stimuli We also found an overestimation of sub-second durations of non-affective expressions in borderline/alexithymic participants. Finally, in line with the literature, we confirmed the overall tendency to overestimate the duration of anger expression stimuli. These findings, which can be interpreted in terms of abnormal scalar timing property in alexithymia, expand previous investigations linking this personality trait with abnormal processing of negative emotions. The evidence that alexithymia predicts the reproduction variability of sub-second durations of negative affective stimuli corroborates previous neuroimaging studies documenting cerebellar deficits in these individuals.
Collapse
Affiliation(s)
- Carmelo Mario Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Vito Scavone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | | | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Sebastiano Gangemi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna, Italy
| | - Gabriella Martino
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| |
Collapse
|
3
|
Wei XY, Jiang YZ, Zhou HL, Jiang HB. Neuroticism and problematic smartphone use symptom types: Roles of anxiety and alexithymia. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
4
|
Psychophysiology of positive and negative emotions, dataset of 1157 cases and 8 biosignals. Sci Data 2022; 9:10. [PMID: 35058476 PMCID: PMC8776805 DOI: 10.1038/s41597-021-01117-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/09/2021] [Indexed: 11/09/2022] Open
Abstract
AbstractSubjective experience and physiological activity are fundamental components of emotion. There is an increasing interest in the link between experiential and physiological processes across different disciplines, e.g., psychology, economics, or computer science. However, the findings largely rely on sample sizes that have been modest at best (limiting the statistical power) and capture only some concurrent biosignals. We present a novel publicly available dataset of psychophysiological responses to positive and negative emotions that offers some improvement over other databases. This database involves recordings of 1157 cases from healthy individuals (895 individuals participated in a single session and 122 individuals in several sessions), collected across seven studies, a continuous record of self-reported affect along with several biosignals (electrocardiogram, impedance cardiogram, electrodermal activity, hemodynamic measures, e.g., blood pressure, respiration trace, and skin temperature). We experimentally elicited a wide range of positive and negative emotions, including amusement, anger, disgust, excitement, fear, gratitude, sadness, tenderness, and threat. Psychophysiology of positive and negative emotions (POPANE) database is a large and comprehensive psychophysiological dataset on elicited emotions.
Collapse
|
5
|
Melfsen S, Romanos M, Jans T, Walitza S. Betrayed by the nervous system: a comparison group study to investigate the 'unsafe world' model of selective mutism. J Neural Transm (Vienna) 2021; 128:1433-1443. [PMID: 34390394 PMCID: PMC8423629 DOI: 10.1007/s00702-021-02404-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
The study presented in the following verifies some assumptions of the novel 'unsafe world' model of selective mutism (SM). According to this model, SM is a stress reaction to situations erroneously experienced via cognition without awareness as 'unsafe'. It assumes a high sensitivity to unsafety, whereby the nervous system triggers dissociation or freeze mode at relatively low thresholds. We examine whether there is a correlation between SM, sensory-processing sensitivity and dissociation. We compared a sample of 28 children and adolescents with SM (mean age 12.66 years; 18 females) to 33 controls without SM (mean age 12.45 years; 21 females). Both groups were compared using a medical history sheet, the 'Selective Mutism Questionnaire' (SMQ), a 'Checklist for Speaking Behaviour' (CheckS), the 'Highly Sensitive Person Scale' (HSPS), the 'Child Dissociative Checklist' (CDC), the 'Adolescent Dissociative Experience Scale' (A-DES) and the 'Social Phobia and Anxiety Inventory for Children' (SPAIK). Appropriate parametric and non-parametric tests were conducted to examine differences between groups. The results indicate that sensory-processing sensitivity was significantly higher in the group of children and adolescents with SM [X2(1) = 7.224, p = 0.0007; d = 1.092]. Furthermore, dissociative symptoms were more common in children and adolescents with SM than in controls [F(1, 33) = 13.004, p = 0.001; d = 0.986]. The results indicate that sensory-processing sensitivity and dissociation are important factors of SM that may hold important implications for the treatment. TRIAL REGISTRATION: This study is registered with the ClinicalTrials.gov number NCT04233905.
Collapse
Affiliation(s)
- Siebke Melfsen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University Zurich, Neumunsterallee 3, P.O. Box 233, 8032 Zurich, Switzerland
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Würzburg, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Würzburg, Germany
| | - Thomas Jans
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Würzburg, Germany
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University Zurich, Neumunsterallee 3, P.O. Box 233, 8032 Zurich, Switzerland
| |
Collapse
|
6
|
Terock J, Klinger-König J, Janowitz D, Nauck M, Völzke H, Grabe HJ. Alexithymia is associated with increased all-cause mortality risk in men, but not in women: A 10-year follow-up study. J Psychosom Res 2021; 143:110372. [PMID: 33540301 DOI: 10.1016/j.jpsychores.2021.110372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Alexithymia is associated with various mental as well as physical disorders. Some evidence also suggested high alexithymia to increase mortality risk, but these results are few and based on specific sample compositions. We aimed to investigate the impact of alexithymia on mortality risk in a large population based cohort. In addition, we sought to elucidate the effects of the subfactors of alexithymia and sex differences. METHODS In a sample of N = 1380 individuals from the Study of Health in Pomerania (SHIP), we investigated the hazard-ratio (HR) of alexithymia as obtained by the Toronto Alexithymia Scale-20 (TAS-20) on all-cause mortality over an average observation time of 10 years. Sex-by-TAS-20-interactions as well as sex-stratified analyses were performed. RESULTS Alexithymia was significantly associated with enhanced mortality risk (HR = 1.033; 95%-CI = 1.008-1.058); p = 0.009). While sex-by-TAS-20 interactions remained insignificant, sex-stratified analyses showed that this effect was only significant in men (HR = 1.050; 95%-CI = 1.022-1.079; p ≤ 0.001), but not in women (HR: 1.008; 95%-CI = 0.960-1.057; p = 0.76). The effect was validated for the "difficulties identifying feelings" (DIF) and "difficulties describing feelings" (DDF) subfactors of the TAS-20. CONCLUSION Our study supports and extents previous findings by indicating that mortality risk enhancing effects of alexithymia are specific to male subjects and validated for the DIF and DDF facets. Socioeconomic, clinical and metabolic factors were associated with this relationship. Finding that the impact of alexithymia remains stable in the fully adjusted models suggests that yet unidentified additional factors must be considered.
Collapse
Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany.
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany; German Center for Neurodegenerative Diseases DZNE, Site Rostock/Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| |
Collapse
|
7
|
Casagrande M, Favieri F, Langher V, Guarino A, Di Pace E, Germanò G, Forte G. The Night Side of Blood Pressure: Nocturnal Blood Pressure Dipping and Emotional (dys)Regulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238892. [PMID: 33265925 PMCID: PMC7729863 DOI: 10.3390/ijerph17238892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
Introduction: The dipping phenomenon is a physiological drop in blood pressure (around 10-20%) during sleep and represents an event related to the circadian blood pressure trend. This phenomenon, in some cases, is characterized by some alterations that can be expressed by an increase (extreme dipping), a decrease (non-dipping), or a reverse (i.e., higher blood pressure during sleep compared to awake state; reverse-dipping) physiological decline of blood pressure. Few studies focused on the association between the circadian variation of blood pressure and psychological variables, although this information could help understanding how psychological characteristics (e.g., emotional regulation or dysregulation) interact with individuals' physiological processes. Given the association between emotional dysregulation and essential hypertension, this study aimed to investigate the relationship between alexithymia and dipping status in a sample of healthy and hypertensive adults in the absence of other medical conditions. Methods: Two hundred and ten adults took part in the study and were classified, according to ambulatorial blood pressure measure (ABPM), into three groups: dippers (n = 70), non-dippers (n = 70), and extreme dippers (n = 70). The participants completed a socio-demographic and anamnestic interview and the Toronto Alexithymia Scale-20 (TAS-20). Results: The ANOVAs on the TAS-20 subscales showed that the groups differed in the difficulty identifying feelings and difficulty describing feelings. In both the subscales, dippers showed lower scores than non-dippers and extreme dippers. The ANOVA on the global score of TAS-20 confirmed that dippers were less alexithymic than both extreme dippers and non-dippers. Conclusions: This study confirms that some psychological factors, like alexithymia, could represent a characteristic of patients who fail to exhibit an adaptive dipping phenomenon. Moreover, an association between an excessive reduction of BP (extreme dipping) or a lack of the decrease of BP during sleep (non-dipping) and a worse emotional regulation, considering alexithymia construct, was highlighted for the first time, confirming the relevant role of the emotional process in the modulation of an essential psychophysiological process such as the circadian variation of BP.
Collapse
Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma “Sapienza”, 00185 Roma, Italy;
- Correspondence:
| | - Francesca Favieri
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Viviana Langher
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma “Sapienza”, 00185 Roma, Italy;
| | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Enrico Di Pace
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Giuseppe Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma “Sapienza”, 00815 Roma, Italy;
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| |
Collapse
|
8
|
Rab SL, Admon R. Parsing inter- and intra-individual variability in key nervous system mechanisms of stress responsivity and across functional domains. Neurosci Biobehav Rev 2020; 120:550-564. [PMID: 32941963 DOI: 10.1016/j.neubiorev.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 08/21/2020] [Accepted: 09/03/2020] [Indexed: 12/16/2022]
Abstract
Exposure to stressful events is omnipresent in modern human life, yet people show considerable heterogeneity in the impact of stress exposure(s) on their functionality and overall health. Encounter with stressor(s) is counteracted by an intricate repertoire of nervous-system responses. This narrative review starts with a brief summary of the vast evidence that supports heart rate variability, cortisol secretion, and large-scale cortical network interactions as kay physiological, endocrinological, and neural mechanisms of stress responsivity, respectively. The second section highlights potential sources for inter-individual variability in these mechanisms, by focusing on biological, environmental, social, habitual, and psychological factors that may influence stress responsivity patterns and thus contribute to heterogeneity in the impact of stress exposure on functionality and health. The third section introduces intra-individually variability in stress responsivity across functional domains as a novel putative source for heterogeneity in the impact of stress exposure. Challenges and future directions are further discussed. Parsing inter- and intra-individual variability in nervous-system mechanisms of stress responsivity and across functional domains is critical towards potential clinical translation.
Collapse
Affiliation(s)
- Sharona L Rab
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
| |
Collapse
|
9
|
Rosenberg N, Ihme K, Lichev V, Sacher J, Rufer M, Grabe HJ, Kugel H, Pampel A, Lepsien J, Kersting A, Villringer A, Suslow T. Alexithymia and automatic processing of facial emotions: behavioral and neural findings. BMC Neurosci 2020; 21:23. [PMID: 32471365 PMCID: PMC7257227 DOI: 10.1186/s12868-020-00572-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Alexithymia is a personality trait characterized by difficulties identifying and describing feelings, an externally oriented style of thinking, and a reduced inclination to imagination. Previous research has shown deficits in the recognition of emotional facial expressions in alexithymia and reductions of brain responsivity to emotional stimuli. Using an affective priming paradigm, we investigated automatic perception of facial emotions as a function of alexithymia at the behavioral and neural level. In addition to self-report scales, we applied an interview to assess alexithymic tendencies. RESULTS During 3 T fMRI scanning, 49 healthy individuals judged valence of neutral faces preceded by briefly shown happy, angry, fearful, and neutral facial expressions. Alexithymia was assessed using the 20-Item Toronto Alexithymia Scale (TAS-20), the Bermond-Vorst Alexithymia Questionnaire (BVAQ) and the Toronto Structured Interview for Alexithymia (TSIA). As expected, only negative correlations were found between alexithymic features and affective priming. The global level of self-reported alexithymia (as assessed by the TAS-20 and the BVAQ) was found to be related to less affective priming owing to angry faces. At the facet level, difficulties identifying feelings, difficulties analyzing feelings, and impoverished fantasy (as measured by the BVAQ) were correlated with reduced affective priming due to angry faces. Difficulties identifying feelings (BVAQ) correlated also with reduced affective priming due to fearful faces and reduced imagination (TSIA) was related to decreased affective priming due to happy faces. There was only one significant correlation between alexithymia dimensions and automatic brain response to masked facial emotions: TAS-20 alexithymia correlated with heightened brain response to masked happy faces in superior and medial frontal areas. CONCLUSIONS Our behavioral results provide evidence that alexithymic features are related in particular to less sensitivity for covert facial expressions of anger. The perceptual alterations could reflect impaired automatic recognition or integration of social anger signals into judgemental processes and might contribute to the problems in interpersonal relationships associated with alexithymia. Our findings suggest that self-report measures of alexithymia may have an advantage over interview-based tests as research tools in the field of emotion perception at least in samples of healthy individuals characterized by rather low levels of alexithymia.
Collapse
Affiliation(s)
- Nicole Rosenberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Klas Ihme
- Institute of Transportation Systems, German Aerospace Center, Lilienthalplatz 7, 38108 Brunswick, Germany
| | - Vladimir Lichev
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Julia Sacher
- Department of Neurology, Max-Planck-Institute of Human Cognitive and Brain Sciences, Stephanstraße 1, 04103 Leipzig, Germany
- Clinic of Cognitive Neurology, University of Leipzig, Liebigstrasse 18, 04103 Leipzig, Germany
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Zurich, University of Zurich, Militärstrasse 8, 8021 Zurich, Switzerland
| | - Hans Jörgen Grabe
- Department of Psychiatry, University Medicine of Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - André Pampel
- Nuclear Magnetic Resonance Unit, Max-Planck-Institute of Human Cognitive and Brain Sciences, Stephanstraße 1, 04103 Leipzig, Germany
| | - Jöran Lepsien
- Nuclear Magnetic Resonance Unit, Max-Planck-Institute of Human Cognitive and Brain Sciences, Stephanstraße 1, 04103 Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck-Institute of Human Cognitive and Brain Sciences, Stephanstraße 1, 04103 Leipzig, Germany
- Clinic of Cognitive Neurology, University of Leipzig, Liebigstrasse 18, 04103 Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| |
Collapse
|
10
|
Starita F, Pietrelli M, Bertini C, di Pellegrino G. Aberrant reward prediction error during Pavlovian appetitive learning in alexithymia. Soc Cogn Affect Neurosci 2020; 14:1119-1129. [PMID: 31820808 PMCID: PMC6970149 DOI: 10.1093/scan/nsz089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 09/02/2019] [Accepted: 09/30/2019] [Indexed: 12/31/2022] Open
Abstract
Extensive literature shows that alexithymia, a subclinical trait defined by difficulties in identifying and describing feelings, is characterized by multifaceted impairments in processing emotional stimuli. Nevertheless, its underlying mechanisms remain elusive. Here, we hypothesize that alexithymia may be characterized by an alteration in learning the emotional value of encountered stimuli and test this by assessing differences between individuals with low (LA) and high (HA) levels of alexithymia in the computation of reward prediction errors (RPEs) during Pavlovian appetitive conditioning. As a marker of RPE, the amplitude of the feedback-related negativity (FRN) event-related potential was assessed while participants were presented with two conditioned stimuli (CS) associated with expected or unexpected feedback, indicating delivery of reward or no-reward. No-reward (vs reward) feedback elicited the FRN both in LA and HA. However, unexpected (vs expected) feedback enhanced the FRN in LA but not in HA, indicating impaired computation of RPE in HA. Thus, although HA show preserved sensitivity to rewards, they cannot use this response to update the value of CS that predict them. This impairment may hinder the construction of internal representations of emotional stimuli, leaving individuals with alexithymia unable to effectively recognize, respond and regulate their response to emotional stimuli.
Collapse
Affiliation(s)
| | | | | | - Giuseppe di Pellegrino
- Department of Psychology, Center for Studies and Research in Cognitive Neuroscience, University of Bologna, 40126 Bologna (BO), Italy
| |
Collapse
|
11
|
Orsolini L. Unable to Describe My Feelings and Emotions Without an Addiction: The Interdependency Between Alexithymia and Addictions. Front Psychiatry 2020; 11:543346. [PMID: 33192657 PMCID: PMC7644516 DOI: 10.3389/fpsyt.2020.543346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| |
Collapse
|
12
|
Casagrande M, Mingarelli A, Guarino A, Favieri F, Boncompagni I, Germanò R, Germanò G, Forte G. Alexithymia: A facet of uncontrolled hypertension. Int J Psychophysiol 2019; 146:180-189. [PMID: 31639379 DOI: 10.1016/j.ijpsycho.2019.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Proper control of blood pressure reduces the risk of developing cardiovascular and cerebrovascular complications in hypertensive people. However, this control remains mostly unsatisfactory. Although alexithymia has been associated with essential hypertension, no study has analysed the relationship between alexithymia and blood pressure control in drug-treated hypertension. This research aimed to analyse the presence and the characteristics of this relationship, considering both the pharmacological treatment and the achievement of adequate maintenance of blood pressure in a physiological range. METHOD One thousand two hundred and forty-one people participated in the study. Eight hundred and ten were hypertensive patients, and four hundred and thirty-one were normotensive people. The Toronto Alexithymia Scale-20 was used to assess alexithymia. RESULTS Results show that hypertensive people are more alexithymic than normotensive people. According to the presence of pharmacological treatment, treated hypertensive patients are more alexithymic than normotensive and not treated hypertensive patients. Considering the blood pressure control associated with the drug-therapy, people with uncontrolled hypertension are more alexithymic than normotensive and untreated hypertensive people. CONCLUSIONS These findings confirm a relationship between alexithymia and essential arterial hypertension, but they also highlight that alexithymia appears to be associated with higher severity of hypertension. Alexithymia could be a facet of uncontrolled hypertension.
Collapse
Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma "Sapienza", Italy.
| | | | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma "Sapienza", Italy
| | | | | | - Rosanna Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma "Sapienza", Italy
| | - Giuseppe Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma "Sapienza", Italy
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma "Sapienza", Italy
| |
Collapse
|
13
|
Zucchelli MM, Starita F, Bertini C, Giusberti F, Ciaramelli E. Intentionality attribution and emotion: The Knobe Effect in alexithymia. Cognition 2019; 191:103978. [DOI: 10.1016/j.cognition.2019.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/12/2019] [Accepted: 05/17/2019] [Indexed: 12/14/2022]
|
14
|
Dijkhuis RR, Ziermans T, van Rijn S, Staal W, Swaab H. Emotional Arousal During Social Stress in Young Adults With Autism: Insights From Heart Rate, Heart Rate Variability and Self-Report. J Autism Dev Disord 2019; 49:2524-2535. [PMID: 30945093 PMCID: PMC6546666 DOI: 10.1007/s10803-019-04000-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In order to better understand which factors play a role in non-adaptive social behavior in autism spectrum disorder (ASD) we looked into physiological arousal and awareness of one’s own emotions. Heart rate (HR) and heart rate variability (HRV) were measured during a public speaking task in 51 young adults with ASD and 28 typically developing (TD) controls. The results showed no significant group differences in baseline HR/HRV, HR reactivity (change from baseline to the speaking task) or self-reported emotional awareness. However, adults with ASD showed significantly lower HRV reactivity (p = .023, d = 0.6) compared to TD adults. These results suggest a mismatch between arousal regulation and emotional awareness, which may be related to problems in social adaptation in ASD.
Collapse
Affiliation(s)
- Renee R Dijkhuis
- Department of Clinical Child and Adolescent Studies, Neuropedagogics and Developmental Disorders, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Tim Ziermans
- Department of Clinical Child and Adolescent Studies, Neuropedagogics and Developmental Disorders, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Sophie van Rijn
- Department of Clinical Child and Adolescent Studies, Neuropedagogics and Developmental Disorders, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Wouter Staal
- Department of Clinical Child and Adolescent Studies, Neuropedagogics and Developmental Disorders, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Karakter Universitair Centrum, Nijmegen, The Netherlands.,Radboud Universitair Medisch Centrum, Nijmegen, The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Neuropedagogics and Developmental Disorders, Leiden University, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| |
Collapse
|
15
|
Crawford DA, Heinrich KM, Drake NB, DeBlauw J, Carper MJ. Heart rate variability mediates motivation and fatigue throughout a high-intensity exercise program. Appl Physiol Nutr Metab 2019; 45:193-202. [PMID: 31287963 DOI: 10.1139/apnm-2019-0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-intensity exercise interventions are often promoted as a time-efficient public health intervention to combat chronic disease. However, increased physical effort and subsequent fatigue can be barriers to long-term maintenance of high-intensity exercise programs. The purpose of the present study was to determine if heart rate variability (HRV) mediated state traits related to exercise program adherence. Fifty-five healthy men and women (ages 19-35 years) used a commercially available smartphone application to monitor daily HRV status throughout a 6-week high-intensity exercise intervention. Participants reported state motivation to exercise and global physical fatigue immediately prior to each exercise session. Temporary shifts toward increased parasympathetic reactivation (p = 0.030) resulted in significant increases in daily fatigue (p < 0.001) and decreases in motivation to exercise (p = 0.028). Through modulation of exercise volume, in response to these temporary shifts in HRV, these effects were reversed (p < 0.001) via increased parasympathetic withdrawal (p = 0.018). For the first time, these data demonstrate a mediating effect of HRV on adherence-related trait states throughout a high-intensity exercise program. Applied strategies, such as appropriately timed exercise volume moderation, may be able to leverage this effect and help facilitate long-term exercise program maintenance. Novelty These data establish a link between expected shifts in HRV throughout high-intensity exercise programs with motivation to participate and physical fatigue. Modulation of training volume, in response to these shifts, can optimize adherence-related behavioral responses during high-exercise programs.
Collapse
Affiliation(s)
- Derek A Crawford
- School of Nutrition, Kinesiology and Psychological Science, University of Central Missouri, Warrensburg, MO 64093, USA
| | - Katie M Heinrich
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - Nicholas B Drake
- Applied Physiology Laboratory, Department of Health, Human Performance, & Recreation, Pittsburg State University, Pittsburg, KS 66762, USA
| | - Justin DeBlauw
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - Michael J Carper
- Applied Physiology Laboratory, Department of Health, Human Performance, & Recreation, Pittsburg State University, Pittsburg, KS 66762, USA
| |
Collapse
|
16
|
Kaczmarek LD, Behnke M, Kosakowski M, Enko J, Dziekan M, Piskorski J, Hughes BM, Guzik P. High-approach and low-approach positive affect influence physiological responses to threat and anger. Int J Psychophysiol 2019; 138:27-37. [DOI: 10.1016/j.ijpsycho.2019.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 01/15/2019] [Accepted: 01/23/2019] [Indexed: 11/12/2022]
|
17
|
Smith R, Kaszniak AW, Katsanis J, Lane RD, Nielsen L. The importance of identifying underlying process abnormalities in alexithymia: Implications of the three-process model and a single case study illustration. Conscious Cogn 2019; 68:33-46. [DOI: 10.1016/j.concog.2018.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/14/2018] [Accepted: 12/19/2018] [Indexed: 11/28/2022]
|
18
|
Thorberg FA, Young RM, Hasking P, Lyvers M, Connor JP, London ED, Huang YL, Feeney GFX. Alexithymia and Alcohol Dependence: The Roles of Negative Mood and Alcohol Craving. Subst Use Misuse 2019; 54:2380-2386. [PMID: 31429362 DOI: 10.1080/10826084.2019.1650773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18-71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02-0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07-0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.
Collapse
Affiliation(s)
- Fred Arne Thorberg
- National Centre for Dual Diagnosis, Innlandet Hospital Trust, Brumunddal, Norway.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Psychology and Counseling, Queensland University of Technology, Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.,School of Psychology, University of Queensland, Brisbane, QLD, Australia.,Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Michael Lyvers
- Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| |
Collapse
|
19
|
Starita F, di Pellegrino G. Alexithymia and the Reduced Ability to Represent the Value of Aversively Motivated Actions. Front Psychol 2018; 9:2587. [PMID: 30631295 PMCID: PMC6315179 DOI: 10.3389/fpsyg.2018.02587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/03/2018] [Indexed: 01/26/2023] Open
Abstract
Alexithymia is a subclinical trait defined by difficulties in identifying and describing feelings and a cognitive style avoidant of introspection. Extensive literature shows that alexithymia is characterized by multifaceted impairments in processing emotional stimuli. Nevertheless, the mechanisms that may account for such impairments remain elusive. Here, we hypothesize that alexithymia may be understood as impairment in learning the emotional value of one’s own actions and test this comparing performance of participants with high (HA) and low (LA) levels of alexithymia on a probabilistic selection task. Results show that, compared to LA, HA need more time to learn the value of individual stimuli and associated actions as difference in reinforcement rate between stimuli decreases. In addition, HA appear less able to generalize the value of previously learned actions that lead to a negative outcome, to make adaptive choices in a new context, requiring more time to avoid the most negative stimulus between two negative stimuli. Together, the results indicate that individuals with alexithymia show impaired learning of the value of aversively motivated actions. We argue that this impairment may hinder the construction of internal representations of emotional stimuli and actions and represent a mechanism that may account for the difficulties of alexithymia in processing emotional stimuli.
Collapse
Affiliation(s)
- Francesca Starita
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Cesena, Italy
| | - Giuseppe di Pellegrino
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Cesena, Italy
| |
Collapse
|
20
|
Söder E, Clamor A, Kempkensteffen J, Moritz S, Lincoln TM. Stress levels in psychosis: Do body and mind diverge? Biol Psychol 2018; 138:156-164. [DOI: 10.1016/j.biopsycho.2018.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 12/15/2022]
|
21
|
Poquérusse J, Pastore L, Dellantonio S, Esposito G. Alexithymia and Autism Spectrum Disorder: A Complex Relationship. Front Psychol 2018; 9:1196. [PMID: 30065681 PMCID: PMC6056680 DOI: 10.3389/fpsyg.2018.01196] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/20/2018] [Indexed: 02/05/2023] Open
Abstract
Alexithymia is a personality construct characterized by altered emotional awareness which has been gaining diagnostic prevalence in a range of neuropsychiatric disorders, with notably high rates of overlap with autism spectrum disorder (ASD). However, the nature of its role in ASD symptomatology remains elusive. Here, we distill research at the intersection of alexithymia and ASD. After a brief synopsis of the studies that plaid a pioneering role in the identification of the overlapping fields between alexithymia and ASD, we comb the literature for evidence of its overlap with ASD in terms of prevalence, etiology, and behaviors. Through a formalized framework of the process of emotional interpretation and expression, we explore evidence for where and how deficits arise in this complex network of events. We portray how these relate to the dynamic interplay between alexithymic and autistic traits and find emerging evidence that alexithymia is both a cause and consequence of autistic behaviors. We end with a strategic proposal for future research and interventions to dampen the impacts of alexithymia in ASD.
Collapse
Affiliation(s)
- Jessie Poquérusse
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Sara Dellantonio
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
22
|
Aaron RV, Snodgress MA, Blain SD, Park S. Affect labeling and other aspects of emotional experiences in relation to alexithymia following standardized emotion inductions. Psychiatry Res 2018; 262:115-123. [PMID: 29428774 PMCID: PMC5866771 DOI: 10.1016/j.psychres.2018.02.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/29/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
Alexithymia is associated with increased risk for mental and physical health disorders but available assessments rely exclusively on self-report. The major aim of the current study was to develop and implement a performance-based task designed to characterize and quantify the relationship between one's description of emotional experience and self-reported alexithymia. Specifically, we examined performance-based measures of affect labeling of one's own emotions, emotional granularity and dialecticism. Healthy participants (N = 108) completed the Toronto Alexithymia Scale-20 Item Questionnaire. Participants viewed a series of film clips standardized to elicit discrete emotional states. After each clip, they indicated the emotion they experienced "the most" and rated a list of non-primary emotions, which formed indices of emotional granularity and dialecticism. Alexithymia was associated with increased tendency to report experiencing "no emotion" following evocative film clips, reduced negative emotional granularity and dialecticism of experienced emotions. TAS-20 subscales were each associated with a unique set of emotional correlates. In a healthy population, alexithymia is associated with reduced awareness of emotional states, and reduced dialecticism and granularity of negative (but not positive) emotions. Our performance-based assessment enriches understanding of the mechanisms underlying alexithymia by underscoring the central importance of emotion awareness, negative emotional granularity and dialecticism.
Collapse
Affiliation(s)
- Rachel V Aaron
- Department of Anesthesiology and Pain Medicine, University of Washington and Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Matthew A Snodgress
- University of Minnesota Twin Cities, Department of Psychology, Minneapolis, MN, USA.
| | - Scott D Blain
- University of Minnesota Twin Cities, Department of Psychology, Minneapolis, MN, USA.
| | - Sohee Park
- Vanderbilt University Department of Psychology, Nashville, TN, USA.
| |
Collapse
|
23
|
Cecchetto C, Rumiati RI, Aiello M. Alexithymia and emotional reactions to odors. Sci Rep 2017; 7:14097. [PMID: 29074970 PMCID: PMC5658372 DOI: 10.1038/s41598-017-14404-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/02/2017] [Indexed: 12/29/2022] Open
Abstract
Alexithymia is a psychological construct characterized by deficits in processing emotional stimuli. However, little is known about the processing of odours in alexithymia, even though there is extensive proof that emotion and olfaction are closely linked. The present study is aimed at investigating how alexithymic individuals process emotions conveyed by odors. Emotional responses to unpleasant, neutral odors and clean air were collected through self-report ratings and psychophysiological measures in a sample of 62 healthy participants with high (HA), medium (MA) and low (LA) levels of alexithymia. Moreover, participants performed tests on odors identification and threshold and completed questionnaires assessing olfactory imagery and awareness. Two main results have been found: first, HA and MA groups showed altered physiological responses to odors, compared to LA, while no differences among the groups were observed in odor ratings; and second, affective and cognitive alexithymia components were differently associated with the performance on olfactory tests, skin conductance response to odors, reaction times in the rating task, and scores on olfactory questionnaires. We conclude that alexithymia is characterized by altered physiological reactions to olfactory stimuli; moreover, we stress the importance of evaluating the different alexithymia components since they affect emotional stimuli processing in different ways.
Collapse
Affiliation(s)
- Cinzia Cecchetto
- SISSA - International School for Advanced Studies, Neuroscience Area, Via Bonomea, 265, 34136, Trieste, Italy.
- Institute of Psychology, University of Graz, Graz, Austria.
- BioTechMed, Graz, Austria.
| | - Raffaella Ida Rumiati
- SISSA - International School for Advanced Studies, Neuroscience Area, Via Bonomea, 265, 34136, Trieste, Italy
- ANVUR - Agenzia Nazionale della Valutazione del Sistema Universitario e della Ricerca, Via Ippolito Nievo, 35 - 00153, Roma, Italy
| | - Marilena Aiello
- SISSA - International School for Advanced Studies, Neuroscience Area, Via Bonomea, 265, 34136, Trieste, Italy
| |
Collapse
|
24
|
Panayiotou G, Constantinou E. Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability. Psychophysiology 2017; 54:1323-1334. [PMID: 28480975 DOI: 10.1111/psyp.12887] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/14/2022]
Abstract
Alexithymia is associated with deficiencies in recognizing and expressing emotions and impaired emotion regulation, though few studies have verified the latter assertion using objective measures. This study examined startle reflex modulation by fearful imagery and its associations with heart rate variability in alexithymia. Fifty-four adults (27 alexithymic) imagined previously normed fear scripts. Startle responses were assessed during baseline, first exposure, and reexposure. During first exposure, participants, in separate trials, engaged in either shallow or deep emotion processing, giving emphasis on descriptive or affective aspects of imagery, respectively. Resting heart rate variability was assessed during 2 min of rest prior to the experiment, with high alexithymic participants demonstrating significantly higher LF/HF (low frequency/high frequency) ratio than controls. Deep processing was associated with nonsignificantly larger and faster startle responses at first exposure for alexithymic participants. Lower LF/HF ratio, reflecting higher parasympathetic cardiac activity, predicted greater startle amplitude habituation for alexithymia but lower habituation for controls. Results suggest that, when exposed to prolonged threat, alexithymics may adjust poorly, showing a smaller initial defensive response but slower habituation. This pattern seems related to their low emotion regulation ability as indexed by heart rate variability.
Collapse
Affiliation(s)
- Georgia Panayiotou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.,Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | | |
Collapse
|
25
|
|
26
|
Donges US, Suslow T. Alexithymia and automatic processing of emotional stimuli: a systematic review. Rev Neurosci 2017; 28:247-264. [DOI: 10.1515/revneuro-2016-0049] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/19/2016] [Indexed: 11/15/2022]
Abstract
AbstractAlexithymia is a personality trait characterized by difficulties in recognizing and verbalizing emotions and the utilization of a cognitive style that is oriented toward external events, rather than intrapsychic experiences. Alexithymia is considered a vulnerability factor influencing onset and course of many psychiatric disorders. Even though emotions are, in general, elicited involuntarily and emerge without conscious effort, it is surprising that little attention in etiological considerations concerning alexithymia has been given to deficits in automatic emotion processing and their neurobiological bases. In this article, results from studies using behavioral or neurobiological research methods were systematically reviewed in which automatic processing of external emotional information was investigated as a function of alexithymia in healthy individuals. Twenty-two studies were identified through a literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2016. The review reveals deficits in the automatic processing of emotional stimuli in alexithymia at a behavioral and neurobiological level. The vast majority of the reviewed studies examined visual processing. The alexithymia facets externally oriented thinking and difficulties identifying feelings were found to be related to impairments in the automatic processing of threat-related facial expressions. Alexithymic individuals manifest low reactivity to barely visible negative emotional stimuli in brain regions responsible for appraisal, encoding, and affective response, e.g. amygdala, occipitotemporal areas, and insula. Against this background, it appears plausible to assume that deficits in automatic emotion processing could be factors contributing to alexithymic personality characteristics. Directions for future research on alexithymia and automatic emotion perception are suggested.
Collapse
Affiliation(s)
- Uta-Susan Donges
- 1Department of Psychosomatic Medicine, University of Leipzig, Semmelweisstr 10, D-04103 Leipzig, Germany
- 2Department of Psychiatry, Psychotherapy, Psychosomatics and Addiction Medicine, Martin Gropius Krankenhaus, Oderberger Straße 8, D-16225 Eberswalde, Germany
| | - Thomas Suslow
- 3Department of Psychosomatic Medicine, University of Leipzig, D-04103 Leipzig, Germany
| |
Collapse
|
27
|
Martínez-Velázquez ES, Honoré J, de Zorzi L, Ramos-Loyo J, Sequeira H. Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia. Front Psychol 2017; 8:361. [PMID: 28348539 PMCID: PMC5346581 DOI: 10.3389/fpsyg.2017.00361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
Emotional difficulties in alexithymia and their social consequences have been linked to alterations in autonomic nervous system. However, most of previous studies did not take into account the distinction between the affective and the cognitive dimensions of the alexithymia, leading to inconsistent results. Aim: In this study, we compared the effects of both dimensions of alexithymia on the autonomic arousal to emotional and social visual stimulations. Methods: Skin conductance responses (SCRs) to items of the International Affective Pictures System characterized by emotional (unpleasant, neutral, and pleasant), social (with humans) or non-social (without humans) content were recorded in non-alexithymic (NA), affective (AA) and cognitive alexithymic (CA) participants, selected on the basis of the Toronto Alexithymia Scale and the Bermond-Vorst Alexithymia Questionnaire. All participants responded to questionnaires of empathy, social phobia, depression, and anxiety before the experiment and evaluated the arousal of the pictures after it. Results: Cognitive alexithymic group showed lower amplitudes of SCRs to pictures with social than without social relevance whereas the opposite pattern was observed for the NA group. Arousal emotional effects of the pictures on SCRs did not differ among groups. In addition, CA participants showed lower scores than NA in the Personal Taking sub-scale of the empathy questionnaire, while AA showed lower scores than NA in the fantasy sub-scale. The CA group showed higher social phobia, depression and anxiety scores, than the other two groups. Conclusion: This work has two original outcomes: first, affective alexithymics expressed lower empathic affective scores than other groups; second, alexithymia modulated the impact of the social relevance of the stimuli on the autonomic reactivity, this impact vanishing in affective alexithymics and reversing in cognitive alexithymics. Thus, though the groups could not be distinguished on the basis of emotional effect on SCRs, they clearly differed when the empathic characteristics and the autonomic impact of social relevance were considered. Finally, the described autonomic signature to social relevant information could contribute to elucidate the difficulty of alexithymics to deal with emotions during social transactions.
Collapse
Affiliation(s)
- Eduardo S. Martínez-Velázquez
- Laboratorio de Psicofisiologia, Institute of Neuroscience, University of GuadalajaraGuadalajara, Mexico
- Facultad de Psicología, Meritorious Autonomous University of PueblaPuebla, Mexico
| | - Jacques Honoré
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
| | - Lucas de Zorzi
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
| | - Julieta Ramos-Loyo
- Laboratorio de Psicofisiologia, Institute of Neuroscience, University of GuadalajaraGuadalajara, Mexico
| | - Henrique Sequeira
- DEEP Team, SCALab, UMR 9193, CNRS & University of LilleLille, France
| |
Collapse
|
28
|
Laborde S, Mosley E, Thayer JF. Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research - Recommendations for Experiment Planning, Data Analysis, and Data Reporting. Front Psychol 2017; 8:213. [PMID: 28265249 PMCID: PMC5316555 DOI: 10.3389/fpsyg.2017.00213] [Citation(s) in RCA: 952] [Impact Index Per Article: 136.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/03/2017] [Indexed: 01/25/2023] Open
Abstract
Psychophysiological research integrating heart rate variability (HRV) has increased during the last two decades, particularly given the fact that HRV is able to index cardiac vagal tone. Cardiac vagal tone, which represents the contribution of the parasympathetic nervous system to cardiac regulation, is acknowledged to be linked with many phenomena relevant for psychophysiological research, including self-regulation at the cognitive, emotional, social, and health levels. The ease of HRV collection and measurement coupled with the fact it is relatively affordable, non-invasive and pain free makes it widely accessible to many researchers. This ease of access should not obscure the difficulty of interpretation of HRV findings that can be easily misconstrued, however, this can be controlled to some extent through correct methodological processes. Standards of measurement were developed two decades ago by a Task Force within HRV research, and recent reviews updated several aspects of the Task Force paper. However, many methodological aspects related to HRV in psychophysiological research have to be considered if one aims to be able to draw sound conclusions, which makes it difficult to interpret findings and to compare results across laboratories. Those methodological issues have mainly been discussed in separate outlets, making difficult to get a grasp on them, and thus this paper aims to address this issue. It will help to provide psychophysiological researchers with recommendations and practical advice concerning experimental designs, data analysis, and data reporting. This will ensure that researchers starting a project with HRV and cardiac vagal tone are well informed regarding methodological considerations in order for their findings to contribute to knowledge advancement in their field.
Collapse
Affiliation(s)
- Sylvain Laborde
- Institute of Psychology, Department of Performance Psychology, German Sport University CologneCologne, Germany; Normandie Université Caen, UFR STAPS, EA 4260Caen, France
| | - Emma Mosley
- Southampton Solent UniversitySouthampton, UK; Bournemouth UniversityBournemouth, UK
| | | |
Collapse
|
29
|
Cecchetto C, Korb S, Rumiati RI, Aiello M. Emotional reactions in moral decision-making are influenced by empathy and alexithymia. Soc Neurosci 2017; 13:226-240. [DOI: 10.1080/17470919.2017.1288656] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Sebastian Korb
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
| | | | | |
Collapse
|
30
|
Social support and networks: cardiovascular responses following recall on immigration stress among Chinese Americans. J Immigr Minor Health 2016; 17:543-52. [PMID: 24288021 DOI: 10.1007/s10903-013-9955-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Social support has been shown to act as a buffer for cardiovascular responses to stress. However, little is known about how social support and networks are related to cardiovascular responses to immigration stress recall. The current study evaluated the impact of structural and functional support on cardiovascular reaction following immigrant stress recall provocation as well as the moderation effect of interdependent self-construal among first-generation Chinese immigrants. One hundred fifty Chinese immigrants were recruited in the New York Chinatown area. Participants completed questionnaires assessing their levels of social support and networks, and interdependent self-construal. Following adaptation, participants recalled a recent post-immigration stress-provoking situation. Cardiovascular measures were taken during adaptation, stressor task, and recovery period. Hierarchical multiple regression analysis was performed. Social network size and type, as well as perceived emotional support were positively predictive of systolic blood pressure (SBP) reactivity changes. Instrumental support seeking was a positive predictor of SBP and diastolic blood pressure (DBP) reactivity. The moderation effect between instrumental support seeking and interdependent self-construal were significantly predictive of DBP reactivity and recovery, suggesting that perceptions about themselves in relation to others is a crucial factor for determining whether support seeking is beneficial or not. Social support was not a direct buffer on cardiovascular responses to stress among Chinese immigrants. Chinese values of interdependence and collectivism may partly explain the disconfirming results. Still, when interdependent self-construal was taken into account, Chinese immigrants who had less interdependent self-construal, but solicited more instrumental support, had faster adaptation to stress over the long term.
Collapse
|
31
|
Alexithymia in Adolescents with Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition. J Autism Dev Disord 2016; 46:1354-67. [PMID: 26659552 DOI: 10.1007/s10803-015-2670-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Alexithymia is a personality trait frequently found in adults with autism spectrum disorder (ASD), and has been linked to impairments in emotion recognition and empathy. The presentation of alexithymia within ASD at younger ages remains unexplored, and was examined in the present study. Alexithymia rates were significantly elevated in ASD (55%; 31/56 scoring above cut-off) versus non-ASD adolescents (16%; 5/32 scoring above cut-off). Within individuals with ASD, alexithymia was associated with increased self-reported anxiety, parent-reported emotional difficulties, self-reported sensory processing atypicalities, and poorer emotion recognition, but was not associated with theory of mind ability. Overall, our results suggest that alexithymia is highly prevalent, and has selective cognitive correlates in young people with ASD.
Collapse
|
32
|
Starita F, Làdavas E, di Pellegrino G. Reduced anticipation of negative emotional events in alexithymia. Sci Rep 2016; 6:27664. [PMID: 27278856 PMCID: PMC4899736 DOI: 10.1038/srep27664] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/13/2016] [Indexed: 02/07/2023] Open
Abstract
Alexithymia is characterized by difficulties in different domains of emotion processing, especially in relation to negative emotions. Nevertheless, its causal mechanisms remain elusive. Reduced anticipation of negative emotional events might be one such mechanism because it enables the individual to prepare to respond effectively to coming events. To test this, changes in skin conductance response (SCR) were recorded during classical fear conditioning in sixty participants with high (HA), medium (MA) and low (LA) levels of alexithymia. Two coloured squares were presented, one was reinforced with a mild electrical stimulation (CS+) while the other was never reinforced (CS−). Critically, despite all groups showing higher SCR to CS+ compared to CS−, SCR to CS+ was lower and extinguished earlier in HA compared to MA and LA. These differences appeared to be attributable neither to differences in the intensity of stimulation received, nor to SCR to the stimulation itself. Groups showed comparable SCR to CS− as well. Therefore, HA exhibited decreased anticipation of the occurrence of a negative emotional event. Disruption of this mechanism may then compromise effective emotion recognition, emotional response and response regulation, which characterise HA, and represent a unifying causal mechanism underlying the difficulties in emotion processing of this group.
Collapse
Affiliation(s)
- Francesca Starita
- Department of Psychology, University of Bologna, Italy.,CSRNC, Center for Studies and Research in Cognitive Neuroscience, University of Bologna, Italy
| | - Elisabetta Làdavas
- Department of Psychology, University of Bologna, Italy.,CSRNC, Center for Studies and Research in Cognitive Neuroscience, University of Bologna, Italy
| | - Giuseppe di Pellegrino
- Department of Psychology, University of Bologna, Italy.,CSRNC, Center for Studies and Research in Cognitive Neuroscience, University of Bologna, Italy
| |
Collapse
|
33
|
Kanbara K, Fukunaga M. Links among emotional awareness, somatic awareness and autonomic homeostatic processing. Biopsychosoc Med 2016; 10:16. [PMID: 27175214 PMCID: PMC4863353 DOI: 10.1186/s13030-016-0059-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 02/11/2016] [Indexed: 11/10/2022] Open
Abstract
Emotional awareness and somatic interoceptive awareness are essential processes for human psychosomatic health. A typical trait of lacking emotional awareness related to psychosomatic symptoms is alexithymia. In contrast, alexisomia refers to the trait of lacking somatic awareness. Links between emotional and somatic awareness and homeostatic processing are also significant for the psychosomatic health. The purpose of the present paper is to review the links among emotional awareness, somatic interoceptive awareness and autonomic homeostatic processing. On the basis of the collected evidence, the following arguments were presented1: (1) The main subcortical neural substrates for these processes are limbic-related systems, which are also responsible for autonomic functions for optimization of homeostatic efficiency. (2) Considerable studies have shown that autonomic activity and/or reactivity to stress correlate with both emotional and interoceptive awareness. A hypothesis was advocated about the links between the two types of awareness and autonomic function: Autonomic dysfunction, especially high sympathetic tone at baseline and/or attenuated reactivity or variability to stress, appears to be involved in disturbance of emotional and interoceptive awareness. (3) Several studies suggest that a link or a cooperative relationship exists between emotional and somatic awareness, and that somatic awareness is the more fundamental of the two types of awareness. Emotional awareness, somatic awareness and autonomic homeostatic processing generally occur in parallel or concurrently. However, some complex features of pathologies include coexistence of reduced interoceptive awareness and somatosensory amplification. The autonomic homeostatic process is fundamentally involved in emotional and somatic awareness. Investigation of these types of awareness with both neuroimaging evaluations and estimation of peripheral autonomic function are required as next steps for exploration of the relationship between awareness and human somatic states including somatic symptoms as well as general psychosomatic health.
Collapse
Affiliation(s)
- Kenji Kanbara
- Department of Psychosomatic Medicine, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, Osaka 573-1010 Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, Osaka 573-1010 Japan
| |
Collapse
|
34
|
Lin Y, Lin C, Sun IW, Hsu CC, Fang CK, Lo MT, Huang HC, Liu SI. Resting respiratory sinus arrhythmia is related to longer hospitalization in mood-disordered repetitive suicide attempters. World J Biol Psychiatry 2016; 16:323-33. [PMID: 25839729 DOI: 10.3109/15622975.2015.1017603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Our aims were (1) to measure respiratory sinus arrhythmia (RSA), a high-frequency spectrum component of heart rate variability (HRV) in mood-disordered suicide attempters and (2) to investigate the relationship of RSA to symptoms and length of hospitalization. METHODS Forty-nine female repetitive-suicide attempters with depressive disorder or bipolar disorder were recruited in a general hospital setting. Manic or psychotic patients were excluded. Resting RSA values were calculated from electrocardiogram data, and severity of clinical presentation shortly after admission and length of hospital stay were assessed. RESULTS RSA was positively associated with a higher Beck Scale for Suicidal Ideation score (r = 0.33 P = 0.019). Stepwise multiple regression analysis showed a significant correlation between RSA and hospitalization length after adjusting other variables (beta coefficient = 3.00; P = 0.030). Patients with a higher resting RSA had more prolonged hospitalizations (hospitalization beyond 30 days) after controlling for other variables (odds ratio = 5.08, P = 0.017). CONCLUSIONS Interaction between the environment and the autonomic nervous system is complex. Further and more comprehensive research is needed.
Collapse
Affiliation(s)
- Ying Lin
- Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Gaher RM, Arens AM, Shishido H. Alexithymia as a Mediator Between Childhood Maltreatment and Impulsivity. Stress Health 2015; 31:274-80. [PMID: 26468625 DOI: 10.1002/smi.2552] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 10/10/2013] [Accepted: 10/16/2013] [Indexed: 11/06/2022]
Abstract
Impulsivity, specifically negative urgency, is associated with diverse health risk behaviours, yet relatively little research has examined factors contributing to negative urgency. The purpose of this study was to examine the relationship between childhood maltreatment, alexithymia and negative urgency. The sample was comprised of 410 undergraduate students who completed measures online. A series of regression analyses tested whether alexithymia mediated the association between childhood maltreatment and negative urgency. Results supported the hypothesized mediation model. Subsequent analyses examined effects of specific subtypes of maltreatment and alexithymia subscales. These analyses indicated that growing up in a punishing environment (e.g. being hit or beat; expected to follow a strict code of behaviour) was indirectly associated with negative urgency via difficulty identifying feelings, suggesting that excessive use of punishment during childhood may reduce the development of the ability to identify and label feeling states. This difficulty in emotional processing may in turn lead to acting rashly when emotionally aroused.
Collapse
Affiliation(s)
- Raluca M Gaher
- Department of Psychology, The University of South Dakota, Vermillion, SD, USA
| | - Ashley M Arens
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Hanako Shishido
- Department of Psychology, The University of South Dakota, Vermillion, SD, USA
| |
Collapse
|
36
|
Dysphoria is associated with reduced cardiac vagal withdrawal during the imagery of pleasant scripts: Evidence for the positive attenuation hypothesis. Biol Psychol 2015; 106:28-38. [DOI: 10.1016/j.biopsycho.2014.11.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/10/2014] [Accepted: 11/30/2014] [Indexed: 11/22/2022]
|
37
|
Emotion processing deficits in alexithymia and response to a depth of processing intervention. Biol Psychol 2014; 103:212-22. [DOI: 10.1016/j.biopsycho.2014.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/20/2022]
|
38
|
Lyvers M, Duric N, Thorberg FA. Caffeine Use and Alexithymia in University Students. J Psychoactive Drugs 2014; 46:340-6. [DOI: 10.1080/02791072.2014.942043] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
39
|
Lemche AV, Chaban OS, Lemche E. Alexithymia as a risk factor for type 2 diabetes mellitus in the metabolic syndrome: a cross-sectional study. Psychiatry Res 2014; 215:438-43. [PMID: 24388726 DOI: 10.1016/j.psychres.2013.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 08/13/2013] [Accepted: 12/04/2013] [Indexed: 01/01/2023]
Abstract
Alexithymia is a clinical trait consisting of diminished introspective and interoceptive capacities that has been shown to implicate elevated autonomic outflow and to bias for hypertension. To estimate relative risk associated with alexithymia in the metabolic syndrome (MetS), we conducted a cross-sectional analysis of patients with manifest type 2 diabetes mellitus (T2DM) or familial diabetes risk (N=101; 67 females; age 45.6±13.96) in a nationwide sampled treatment cohort for MetS in the Ukrainian governmental health care system. Laboratory data of single components of the MetS according to International Diabetes Federation Consensus were dependent measures in multivariable regression models with self-reported alexithymia severity (TAS-20) and socio-demographic data. TAS-20 as the sole surviving psychometric predictor for T2DM in the simplest regression equation provided the best model fit: OR 1.073, Z=19.04, (95%CIs 1.065-1.081). For microalbuminuria, the best fitting model was OR 1.030, Z=3.49 (95%CIs 1.013-1.048). TAS-20 predicted also triglyceride level at Wald-χ(2)=1299.27, Z=36.05 (95%CIs 0.052-0.058) and blood pressure maximum at Wald-χ(2)=2309.05, Z=48.05 (95%CIs 2.402-2.606). Our results show that alexithymia severity contributes to MetS by covarying with several of its single components, and that it may be a substantial concurrent indicator of T2DM and cardiovascular risks in MetS.
Collapse
Affiliation(s)
- Alexandra V Lemche
- Department of Psychosomatic Medicine, Charité University Medicine Berlin, Germany
| | - Oleg S Chaban
- Section of Neuroses and Somatoform Disorders, Bogolomets National Medical University, Kiev, Ukraine
| | - Erwin Lemche
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, UK.
| |
Collapse
|
40
|
Emotional distress, alexithymia, and coping as predictors of cardiac rehabilitation outcomes and attendance. J Cardiopulm Rehabil Prev 2013; 33:26-32. [PMID: 23221810 DOI: 10.1097/hcr.0b013e318276864c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to examine emotional distress, alexithymia, and coping styles as predictors of cardiac rehabilitation (CR) outcomes and attendance. METHODS Participants included 56 patients in an outpatient CR program (65% male, 59% white, M = 61.1 years) who completed self-report measures of emotional distress (ie, depressive and anxiety symptoms), alexithymia, and coping styles (ie, approach and avoidance coping). CR outcomes recorded at entry and completion of the program included blood cholesterol, oxygen uptake ((Equation is included in full-text article.)VO(2max)), knowledge about cardiac disease, and self-reported lipid consumption. Attendance was also recorded as a measure of adherence. RESULTS Significant improvements were observed in oxygen uptake, high-density lipoprotein levels, disease knowledge, and self-reported lipid consumption. Older age was associated with less distress, and anxiety and higher education were associated with better attendance. Higher alexithymia (ie, greater difficulty processing emotion) was associated with increased low-density lipoprotein cholesterol, and alexithymia predicted increased self-reported lipid consumption in the context of higher approach coping. CONCLUSIONS CR is associated with physical and quality-of-life benefits, as well as increased knowledge about cardiac disease management. However, coping strategies that are generally beneficial (approach coping) may be associated with negative health behavior among individuals who have difficulty processing emotion. Anxiety and lower education were associated with poorer attendance, perhaps indicating the need for intervention to prevent dropout.
Collapse
|
41
|
Davydov DM, Luminet O, Zech E. An externally oriented style of thinking as a moderator of responses to affective films in women. Int J Psychophysiol 2013; 87:152-64. [DOI: 10.1016/j.ijpsycho.2012.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 12/06/2012] [Accepted: 12/07/2012] [Indexed: 01/21/2023]
|
42
|
GRYNBERG DELPHINE, DAVYDOV DMITRYM, VERMEULEN NICOLAS, LUMINET OLIVIER. Alexithymia is associated with an augmenter profile, but not only: Evidence for anticipation to arousing music. Scand J Psychol 2012; 53:375-81. [DOI: 10.1111/j.1467-9450.2012.00962.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
43
|
Musser ED, Ablow JC, Measelle JR. Predicting maternal sensitivity: The roles of postnatal depressive symptoms and parasympathetic dysregulation. Infant Ment Health J 2012; 33:350-359. [PMID: 28520177 DOI: 10.1002/imhj.21310] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Previous research has established that maternal depression is a risk factor for a variety of negative developmental outcomes among infants and children. Although low levels of maternal sensitivity have been hypothesized to explain this risk, the biological mechanisms underlying the association between maternal depressive symptoms and low levels of maternal sensitivity have been largely underexplored. This study examined the roles of postnatal depressive symptoms and parasympathetic nervous system functioning as predictors of low levels of maternal sensitivity, during a stressful mother-infant interaction-the reunion phase of the Still-Face Paradigm. Depressive symptoms and traitlike predispositions toward parasympathetic dysregulation, as indexed by low resting levels of respiratory sinus arrhythmia, were associated independently with less sensitive parenting. Discussion considers that during stressful mother-infant interactions, both mothers with depressive symptoms and mothers predisposed to parasympathetic dysregulation may have fewer emotional, physiological, and psychological resources with which to respond sensitively to their infants' cues.
Collapse
Affiliation(s)
- Erica D Musser
- University of Oregon and Oregon Health and Science University
| | | | | |
Collapse
|
44
|
Herbert BM, Herbert C, Pollatos O. On the Relationship Between Interoceptive Awareness and Alexithymia: Is Interoceptive Awareness Related to Emotional Awareness? J Pers 2011; 79:1149-75. [DOI: 10.1111/j.1467-6494.2011.00717.x] [Citation(s) in RCA: 262] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
45
|
Thorberg FA, Young RM, Sullivan KA, Lyvers M, Hurst CP, Connor JP, Feeney GFX. Alexithymia in alcohol dependent patients is partially mediated by alcohol expectancy. Drug Alcohol Depend 2011; 116:238-41. [PMID: 21185660 DOI: 10.1016/j.drugalcdep.2010.11.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 11/09/2010] [Accepted: 11/14/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND Up to fifty percent of alcohol dependent individuals have alexithymia, a personality trait characterised by difficulties identifying and describing feelings, a lack of imagination and an externalised cognitive style. Although studies have examined alexithymia in relation to alcohol dependence, no research exists on mechanisms underlying this relationship. The present study examined the mediational effect of alcohol expectancies on alexithymia and alcohol dependence. METHODS 230 outpatients completed the Toronto Alexithymia Scale (TAS-20), the Drinking Expectancy Questionnaire (DEQ) and the Alcohol Use Disorder Identification Test (AUDIT). RESULTS Regression analysis showed that alexithymia and alcohol dependence was, in two of three cases, partially mediated through alcohol expectancy. CONCLUSIONS Alcohol expectancies of assertion and affective change show promise as mediators of alcohol dependence in individuals with alexithymia.
Collapse
Affiliation(s)
- Fred Arne Thorberg
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | | | | | | | | | | | | |
Collapse
|
46
|
Pollatos O, Werner NS, Duschek S, Schandry R, Matthias E, Traut-Mattausch E, Herbert BM. Differential effects of alexithymia subscales on autonomic reactivity and anxiety during social stress. J Psychosom Res 2011; 70:525-33. [PMID: 21624575 DOI: 10.1016/j.jpsychores.2010.12.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 11/03/2010] [Accepted: 12/09/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Alexithymia is characterized by a difficulty in identifying and describing one's emotions. Recent research has associated differential effects of the alexithymia facets to hypothalamic-pituitary-adrenal (HPA) axis markers during stress. This study aimed to analyze how the facets of alexithymia interact with autonomic reactivity as well as self- and observer-rated anxiety during a social stress task. METHODS With the use of a public-speaking paradigm, skin conductance levels (SCLs) and heart rate (HR) during the defined periods of baseline, preparation, stress, and recovery were assessed in 60 volunteers (42 females, mean age 22.8) categorized as having either high (HDA) or low (LDA) degrees of alexithymia. RESULTS We found smaller SCLs during preparation and speech in the HDA group. Regression analyses indicated that only the alexithymia facet "difficulty in describing feelings" (DDF) was associated with smaller electrodermal responses. In the HDA group, self- and observer-rated anxiety was higher in the HDA than in the LDA group, which was attributable to higher scores in the subscales "difficulty in identifying feelings" (DIF) and "externally oriented thinking" (EOT). CONCLUSIONS Our data support and specify the decoupling hypothesis of alexithymia by showing that the facets of alexithymia are differentially related to autonomic reactivity as well as self- and observer-rated anxiety during social stress.
Collapse
Affiliation(s)
- Olga Pollatos
- Department of Psychology, University of Potsdam, Potsdam, Germany.
| | | | | | | | | | | | | |
Collapse
|
47
|
Diamond LM, Hicks AM, Otter-Henderson KD. Individual Differences in Vagal Regulation Moderate Associations Between Daily Affect and Daily Couple Interactions. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2011; 37:731-44. [DOI: 10.1177/0146167211400620] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research suggests that cardiac vagal regulation (indexed by respiratory sinus arrhythmia, or RSA) provides a physiological substrate for affect regulation, which presumably underlies adaptive interpersonal functioning.The authors tested these associations in the context of daily interactions between 68 cohabiting couples. Participants underwent a laboratory assessment of RSA during rest and also during a series of psychological stressors. Subsequently, they kept daily measures of affect and interaction quality for 21 days. Individual differences in baseline and stress levels of RSA moderated within-person associations between daily affect and the quality of couple interactions. The pattern of results differed for women versus men. Men with lower vagal tone or higher vagal reactivity had stronger associations between daily negative affect and daily negative interactions, and men with higher vagal tone had more positive daily interactions overall. Women with higher vagal tone had stronger associations between daily positive affect and daily positive interactions.
Collapse
|
48
|
Baslet G. Psychogenic non-epileptic seizures: a model of their pathogenic mechanism. Seizure 2010; 20:1-13. [PMID: 21106406 DOI: 10.1016/j.seizure.2010.10.032] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 09/22/2010] [Accepted: 10/25/2010] [Indexed: 10/18/2022] Open
Abstract
Psychogenic non-epileptic seizures (PNES) consist of paroxystic events facilitated by a dysfunction in emotion processing. Models explaining the pathogenic mechanisms leading to these seizure-like episodes are limited. In this article, evidence that supports dysfunction at the level of arousal tolerance, cognitive-emotional information processing and volitional control is reviewed. A hypothetical pathophysiological mechanism is discussed based on functional neuroimaging evidence from PNES-related conditions and traits. This pathophysiological model suggests an alteration in the influence and connection of brain areas involved in emotion processing onto other brain areas responsible for sensorimotor and cognitive processes. Integrating this information, PNES are conceptualized as brief episodes facilitated by an unstable cognitive-emotional attention system. During the episodes, sensorimotor and cognitive processes are modified or not properly integrated, allowing the deployment of autonomous prewired behavioral tendencies. Finally, I elaborate on how therapeutic applications could be modified based on the proposed hypothetical model, potentially improving clinical outcomes.
Collapse
Affiliation(s)
- Gaston Baslet
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, M/C 913, Chicago, IL 60612, USA.
| |
Collapse
|
49
|
Abstract
OBJECTIVE To explore the associations between alexithymia and increased somatic morbidity. The mechanisms underlying these associations, however, are still unclear. Furthermore, data on the association between alexithymia and mortality are scarce. METHODS A total of 2321 Finnish men, aged 46 to 61 years, were followed up for an average of 20 years. Mortality rates were obtained from the national register. The associations between baseline alexithymia and cardiovascular disease (CVD), all-cause, injury, and cancer deaths were examined with adjustments for age and several behavioral (smoking, alcohol consumption, physical activity), physiological (low- and high-density lipoprotein cholesterol, body mass index, systolic blood pressure, history of CVD), and psychosocial (marital status, education, depression) factors. RESULTS After all adjustments, the risk of CVD death was increased by 1.2% for each 1-point increase in Toronto Alexithymia Scale-26 scores. CONCLUSIONS Alexithymia is associated with increased cardiovascular mortality.
Collapse
|
50
|
Bermond B, Bierman DJ, Cladder MA, Moormann PP, Vorst HCM. The cognitive and affective alexithymia dimensions in the regulation of sympathetic responses. Int J Psychophysiol 2009; 75:227-33. [PMID: 19951721 DOI: 10.1016/j.ijpsycho.2009.11.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 11/18/2009] [Accepted: 11/20/2009] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The literature regarding research into alexithymia and sympathetic responses is far from consistent. An explanation might be on the way subjects are classified. Generally, subjects are diagnosed as either alexithymic or non-alexithymic on the basis of questionnaires focusing on the cognitive aspects of alexithymia. However, alexithymia, as originally defined, concerns both emotion-affective and emotion-cognitive deficits. The aim of the present paper is to study the importance of the affective and cognitive alexithymia components in the regulation of sympathetic responses. METHODS Subjects, who scored extremely (either high or low) on both the cognitive and the affective components of alexithymia, were shown neutral and emotional pictures, while their GSR was measured. RESULTS The affective alexithymia component, not the cognitive component, turned out to be an important factor in the regulation of GSR peak amplitude. The results further indicate a significant interaction of type of emotional deficit (cognitive by affective) on GSR latency times. Finally, suggestive evidence indicated that baselines values, defined by the levels during the second preceding the stimulus, are related to the cognitive component of alexithymia, in the sense that higher emotion-cognitive capacities result in higher baseline values. CONCLUSIONS We cautiously conclude that the classification of alexithymics on the basis of both the affective and cognitive components, rather than on the basis of the cognitive component only, might provide more consistent research results, and thus lead to a better understanding of emotional physiological responses in alexithymic subjects.
Collapse
Affiliation(s)
- Bob Bermond
- Department of Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The Netherlands.
| | | | | | | | | |
Collapse
|