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Liang L, Zhu W, Yang J, Wang F. Anxiety and emotional-behavioral problems of adolescents in China: evidence for a serial mediation model of alexithymia and dependency. PSYCHOL HEALTH MED 2024; 29:1680-1691. [PMID: 34806499 DOI: 10.1080/13548506.2021.2005249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/17/2021] [Indexed: 10/19/2022]
Abstract
High prevalence of emotional and behavioral problems among Chinese adolescence has been reported. This study seeks to investigate the mediating effect of alexithymia and dependency on anxiety and emotional-behavioral problems among adolescents. The study population included 519 adolescents. The assessments included the completion of standardized scales such as the Multidimensional Anxiety Scale (MASC), the Toronto Alexithymia Scale (TAS-20), the Depressive Experiences Questionnaire (DEQ), the Strengths and Difficulties Questionnaire (SDQ). Independent-sample t-tests, bivariate correlation, and serial mediation analyses were performed using SPSS23.0. Bivariate analyses revealed that anxiety, emotional-behavioral problem, alexithymia, and dependency were positively correlated. Alexithymia and dependency play a significant role in mediating the effect of multidimensional anxiety on emotional-behavioral problems. The effects of the two mediating paths were 69.86% and 7.81% for indirect effect through alexithymia, dependency, and specific indirect effect by alexithymia and dependency was 12.33%. Anxiety and emotional-behavioral problems mediate the relationship between alexithymia and dependency.
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Affiliation(s)
- Lijuan Liang
- Department of Psychology, The First Affiliated Hospital, Hainan Medical University, Haikou, China
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Wei Zhu
- Department of Public Health, Hainan Medical University, Haikou, China
| | - Juan Yang
- Department of Psychology, The First Affiliated Hospital, Hainan Medical University, Haikou, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
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Ursoniu S, Bredicean AC, Serban CL, Rivis I, Bucur A, Papava I, Giurgi-Oncu C. The interconnection between social media addiction, alexithymia and empathy in medical students. Front Psychiatry 2024; 15:1467246. [PMID: 39364386 PMCID: PMC11446739 DOI: 10.3389/fpsyt.2024.1467246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 08/28/2024] [Indexed: 10/05/2024] Open
Abstract
Introduction This study explores whether high alexithymia values correlate with low levels of empathy, while also trying to identify potential connections with social media addiction. Methods We hypothesized that alexithymia mediates the relationship between social media addiction and empathy levels in a sample of undergraduate students. The study population consisted of 649 medical students in the 4th/5th/6th University year, recruited between March and May 2021. For this assessment, we employed three psychometric instruments: the Toronto Empathy Questionnaire (TEQ), the Social Media Addiction Scale-Student Form (SMAS-SF), and the Toronto Alexithymia Scale (TAS-20). A pathway analysis investigated alexithymia as a mediator between social media addiction and the degree of empathy in medical undergraduates. Sobel's test and the Baron and Kenny approach were used for testing mediation. Results The TEQ total mean score was 48.76 ± 5.65, while the TAS-20 total mean score was 47.71 ± 11.49. Further analysis of the TAS-20 scale scores showed that 21.42% of students had possible alexithymia, while 14.02% had clear alexithymia. The SMAS-SF total mean score was 73.20 ± 14.59. None of the students reported levels consistent with major social media addiction. The mediated effect of the TAS-20 is about 1.3 times larger than the direct effect of the SMAS-SF on TEQ. Discussion We found a significant negative correlation between empathy and alexithymia in medical students. Alexithymia was a mediator between social media addiction and empathy. Therefore, we recommend further efforts to identify potential levels of alexithymia in medical students, in order to successfully develop tailored interventions aimed at increasing their emotional awareness.
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Affiliation(s)
- Sorin Ursoniu
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ana-Cristina Bredicean
- Department of Neuroscience, Discipline of Psychiatry, Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Psychiatry Compartment, “Dr. Victor Popescu” Emergency Military Clinical Hospital, Timisoara, Romania
| | - Costela Lacrimioara Serban
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ioana Rivis
- Department of Neuroscience, Discipline of Psychiatry, Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Adina Bucur
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Catalina Giurgi-Oncu
- Department of Neuroscience, Discipline of Psychiatry, Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Kick L, Schleicher D, Ecker A, Kandsperger S, Brunner R, Jarvers I. Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis. Front Psychiatry 2024; 15:1412229. [PMID: 39011338 PMCID: PMC11246998 DOI: 10.3389/fpsyt.2024.1412229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/07/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction Victims of child abuse have an elevated risk of developing mental health issues later in life. Several variables have been suggested as mediators of this correlation, but little is known about the possible influence of alexithymia. Alexithymia is a sub-clinical personality trait that manifests as difficulties recognizing and verbalizing emotions. Methods In this study, two separate meta-analyses were conducted using questionnaire data, and Pearson correlations for overall effects were estimated. Results The correlation between child abuse and alexithymia showed to be significant (r = .26), as did the correlation between alexithymia and general psychopathology (r = .44). Further analyses revealed no indication for possible publication bias. When investigating differences between various subtypes of child maltreatment, each subtype significantly correlated with alexithymia. Emotional abuse, emotional neglect, and physical neglect had stronger correlations than physical and sexual abuse. Discussion These results suggest that alexithymia plays a mediating role, at least in part, in the relationship between experiences of child abuse and general psychopathology in adulthood. Therefore, alexithymia may be relevant to further research and deserves attention in the prevention of and therapy for mental health issues in victims of child abuse.
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Affiliation(s)
- Lorenz Kick
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Daniel Schleicher
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Angelika Ecker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Stephanie Kandsperger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Irina Jarvers
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Liu Y, Shen Q, Duan L, Xu L, Xiao Y, Zhang T. The relationship between childhood psychological abuse and depression in college students: a moderated mediation model. BMC Psychiatry 2024; 24:410. [PMID: 38816793 PMCID: PMC11141024 DOI: 10.1186/s12888-024-05809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Childhood psychological abuse (CPA) are highly correlated with depression among college students, but the underlying mechanisms between variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia as a moderating factor, in order to further elucidate the potential risk factors between CPA and depression among college students. METHODS A self-report survey was conducted among 1196 college students from four universities in three provinces in China. The survey included measures of CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed. RESULTS CPA was positively correlated with depression among college students, as well as internet addiction with alexithymia. Internet addiction partially mediated the relationship between CPA and depression among college students, while alexithymia strengthened the relationships among the paths in the moderated mediation model. CONCLUSION This study provides further insights into the psychological mechanisms underlying the relationship between CPA and depression among college students. Internet addiction serves as a mediating factor in this relationship, while alexithymia may enhance the strength of the relationships among the three variables.
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Affiliation(s)
- Yang Liu
- School of Sports Science, Jishou University, Jishou, China
| | - Qingxin Shen
- School of Sports Science, Jishou University, Jishou, China
| | - Liangfan Duan
- School of Sports Science, Jishou University, Jishou, China
| | - Lei Xu
- School of Sports Science, Jishou University, Jishou, China
- Institute of Physical Education, Shanxi University of Finance and Economics, Taiyuan, China
| | - Yongxiang Xiao
- School of Sports Science, Jishou University, Jishou, China
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Hamel C, Rodrigue C, Clermont C, Hébert M, Paquette L, Dion J. Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence. Sci Rep 2024; 14:6359. [PMID: 38493260 PMCID: PMC10944459 DOI: 10.1038/s41598-024-56909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.
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Affiliation(s)
- Catherine Hamel
- Département de Psychologie, Université de Montréal, Montréal, H2V 2S9, Canada.
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada.
| | - Christopher Rodrigue
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Camille Clermont
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Martine Hébert
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Sexologie, Université du Québec À Montréal, Montréal, H2L 4Y2, Canada
| | - Linda Paquette
- Département Des Sciences de La Santé, Université du Québec À Chicoutimi, Chicoutimi, G7H 2B1, Canada
| | - Jacinthe Dion
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Psychologie, Université du Québec À Trois-Rivières, Trois-Rivières, G9A 5H7, Canada
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Boni M, Violi S, Ciaramella A. Role of history of traumatic life experiences in current psychosomatic manifestations. Scand J Pain 2024; 24:sjpain-2023-0102. [PMID: 38661113 DOI: 10.1515/sjpain-2023-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Although the relationship between traumatic experiences (TEs) and psychosomatic manifestations (pain, somatization, somatosensory amplification [SSA], and alexithymia) has been widely described, very few studies have investigated how these variables correlate with each other and with a history of TEs. The aim of this study was to investigate whether and how current psychosomatic manifestations are correlated with major and minor adult- and childhood TEs. METHODS One hundred and forty-six patients (91 with pain) from the Pisa Gift Institute for Integrative Medicine Psychosomatics Lab., Italy, were assessed for pain, history of TEs (divided into major and minor based on whether or not they meet the DSM-5 Criterion A for post-traumatic stress disorder), alexithymia, somatization, and SSA. RESULTS TEs were positively correlated with age, the sensorial dimension and intensity of pain, somatization, psychopathology index, SSA, and alexithymia. Using the somatization score (controlled for age) as a covariate, the previous correlations between psychosomatic dimensions and TEs lost their statistical significance: SSA (total TEs: from r = 0.30, p = 0.000 to r = -0.04, p = 0.652); alexithymia (total TEs: from r = 0.28, p = 0.001 to r = 0.04, p = 0.663); sensorial dimension of pain (total TEs: from r = 0.30, p = 0.015 to r = 0.12, p = 0.373); and pain intensity (total TEs: from r = 0.38, p = 0.004 to r = -0.15, p = 0.317). Interestingly, the tendency to report more intense pain was mainly predicted by minor TEs in childhood (β = 0.28; p = 0.030). CONCLUSIONS The number of lifetime TEs is positively correlated with the sensorial dimension and intensity of pain but not its affective and cognitive dimensions. However, the former relationship depends on the presence of somatization. The intensity of pain is associated with minor rather than major TEs, especially when they occur in childhood.
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Affiliation(s)
- Melania Boni
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
| | - Simone Violi
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Pisa, Italy
| | - Antonella Ciaramella
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
- GIFT Institute of Integrative Medicine, Pisa, Italy
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van Sleeuwen C, van Zuiden M, Koch SBJ, Frijling JL, Veltman DJ, Olff M, Nawijn L. How does it feel? An exploration of neurobiological and clinical correlates of alexithymia in trauma-exposed police-officers with and without PTSD. Eur J Psychotraumatol 2023; 14:2281187. [PMID: 38154073 PMCID: PMC10990451 DOI: 10.1080/20008066.2023.2281187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/25/2023] [Indexed: 12/30/2023] Open
Abstract
Background: Alexithymia, an inability to recognise one's emotions, has been associated with trauma-exposure and posttraumatic stress disorder (PTSD). Previous research suggests involvement of the oxytocin system, and socio-emotional neural processes. However, the paucity of neurobiological research on alexithymia, particularly in trauma-exposed populations, warrants further investigation.Objective: Explore associations between alexithymia, endogenous oxytocin levels, and socio-emotional brain function and morphometry in a trauma-exposed sample.Method: Dutch trauma-exposed police officers with (n = 38; 18 females) and without PTSD (n = 40; 20 females) were included. Alexithymia was assessed with the Toronto Alexithymia Scale (TAS-20). Endogenous salivary oxytocin was assessed during rest, using radioimmunoassay. Amygdala and insula reactivity to socio-emotional stimuli were assessed with functional MRI, amygdala and insula grey matter volume were derived using Freesurfer.Results: Alexithymia was higher in PTSD patients compared to trauma-exposed controls (F(1,70) = 54.031, p < .001). Within PTSD patients, alexithymia was positively associated with PTSD severity (ρ(36) = 0.497, p = .002). Alexithymia was not associated with childhood trauma exposure (β = 0.076, p = .509), police work-related trauma exposure (β = -0.107, p = .355), oxytocin levels (β = -0.164, p = .161), insula (β = -0.170, p = .158) or amygdala (β = -0.175, p = .135) reactivity, or amygdala volume (β = 0.146, p = .209). Insula volume was positively associated with alexithymia (β = 0.222, p = .016), though not significant after multiple testing corrections. Bayesian analyses supported a lack of associations.Conclusions: No convincing neurobiological correlates of alexithymia were observed with any of the markers included in the current study. Yet, the current study confirmed high levels of alexithymia in PTSD patients, independent of trauma-exposure, substantiating alexithymia's relevance in the clinical phenotype of PTSD.
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Affiliation(s)
- Cindy van Sleeuwen
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia B. J. Koch
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
| | - Jessie L. Frijling
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry and Medical Psychology, OLVG Hospital, Amsterdam, the Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
- Arq National Psychotrauma Centre, Diemen, the Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Pei C, Fan C, Luo H, Bai A, Ni S, Luo M, Huang J, Zhou Y, Huo L. Sleep problems in adolescents with depression: Role of childhood trauma, alexithymia, rumination, and self-esteem. J Affect Disord 2023; 338:83-91. [PMID: 37269886 DOI: 10.1016/j.jad.2023.05.095] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND While sleep problems are common in adolescents with depression, the exact prevalence has not been reported. Although previous studies have shown that childhood trauma, alexithymia, rumination, and self-esteem are related to sleep problems, the interactions between these factors remain unclear. METHODS This study, conducted from March 1, 2021 to January 20, 2022, employed a cross-sectional design. The participants were 2192 adolescents with depression with a mean age of 15 years. The Chinese version of the Pittsburgh Sleep Quality Index, Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20, Ruminative Response Scale, and Rosenberg Self-Esteem Scale were used to measure sleep problems, childhood trauma, alexithymia, rumination, and self-esteem, respectively. We used PROCESS 3.3 for SPSS to determine the chain mediating effect of alexithymia and rumination and the moderating effect of self-esteem in the relationship between childhood trauma and sleep problems. RESULTS Up to 70.71 % of adolescents with depression had sleep problems. Furthermore, alexithymia and rumination played a chain mediation role in the relationship between childhood trauma and sleep problems. Finally, self-esteem moderated the relationships between alexithymia and sleep problems and rumination and sleep problems. LIMITATIONS Owing to the study design, we cannot derive causal relationships between variables. Further, the self-reported data may have been influenced by subjective participant factors. CONCLUSIONS This study reveals potential ways of how childhood trauma influences sleep problems in adolescents with depression. These findings suggest that interventions targeting alexithymia, rumination, and self-esteem in adolescents with depression may be effective in reducing their sleep problems.
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Affiliation(s)
- Chenran Pei
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Changhe Fan
- Department of Psychiatry, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Haocheng Luo
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ayu Bai
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shengmiao Ni
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Min Luo
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Junxuan Huang
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.
| | - Lijuan Huo
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
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Di Trani M, Metallo C, Renzi A, Mariani R, Rosabianca A, Tomasini A, Celano A. Childhood traumatic events, alexithymia and perceived stress in patients with rheumatoid arthritis during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:2169-2181. [PMID: 37386736 DOI: 10.1080/13548506.2023.2229243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease, causing joint-swelling and pain. International literature highlights that patients with RA are more likely to report high levels of alexithymia, adverse childhood events (ACEs) and stress, but studies investigating the association between these dimensions are lacking. The general aim of the present study is to investigate the association between alexithymia, ACEs, and stress in RA patients and to highlight possible predictors of greater perceived stress. One hundred and thirty-seven female patients with RA (mean age = 50.74; SD = 10.01) participated in an online survey between April and May 2021. Participants completed a questionnaire for the collection of sociodemographic and clinical information, the 20-item Toronto Alexithymia Scale, the Adverse Childhood Events questionnaire and the 10-item Perceived Stress Scale. The correlational analysis highlighted several significant associations between the dimensions evaluated. Regression analyses showed that alexithymia, ACEs and the perceived health status have a predictive effect on the perceived stress of RA patients. More specifically, the role of difficulty in identifying feelings, and the physical and emotional neglect, has been highlighted. ACEs and high levels of alexithymia are common in RA clinical populations and seem to affect the wellbeing of these patients. The use of a biopsychosocial approach to RA treatment appears essential in achieving a better quality of life and illness control in this specific clinical population.
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Affiliation(s)
- Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Carla Metallo
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Alessandra Rosabianca
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
| | - Andrea Tomasini
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
| | - Antonella Celano
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
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Liu Y, Li M, Gao Y, Zhang C, Wang Y, Liu X, Yang S, Li J. Specific correlation between childhood trauma and social cognition in Chinese Han first-episode, drug-naïve major depressive disorder. J Affect Disord 2023; 333:51-57. [PMID: 37084962 DOI: 10.1016/j.jad.2023.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Childhood trauma (CT) is a significant factor affecting social cognition in major depressive disorder (MDD). However, the relationship between CT, social cognition, and MDD is still not well-understood. METHODS A total of 251 Han Chinese participants, comprising 117 first-episode drug-naïve MDD patients and 134 healthy controls (HCs), were recruited. The Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS-20), Interpersonal Reactivity Index (IRI), and Facial Emotion Recognition Test were used to measure CT and social cognition. Partial correlations were conducted to analyze the association between CT and social cognition. RESULTS Our results showed that no significant correlation was observed between CTQ total score and social cognition in MDD (p > 0.05), while it was different in HCs (TAS-20 total score: r = 0.21, p = 0.016; difficulty identifying feelings (DIF): r = 0.219, p = 0.012; perspective-taking (PT): r = -0.214, p = 0.014; recognizing neutral facial emotions: r = -0.4, p < 0.001). CTQ subtyping analysis revealed that CTQ subscale scores in MDD were significantly correlated with PT, personal distress (PD), and recognizing angry facial emotions. Interestingly, physical abuse score was positively correlated with PT in MDD (r = 0.219, p = 0.019) but negatively with PT in HCs (r = -0.276, p = 0.001). LIMITATIONS Insufficient sample size and cross-sectional designs. CONCLUSION The correlation between CT and social cognition in MDD was weakened or reversed compared to HCs, highlighting the need for further investigation to determine the cause of this specific correlation.
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Affiliation(s)
- Yuan Liu
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Meijuan Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ying Gao
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Chuhao Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Yuting Wang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Xueying Liu
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Shu Yang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
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11
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Salles BM, Maturana de Souza W, Dos Santos VA, Mograbi DC. Effects of DBT-based interventions on alexithymia: a systematic review. Cogn Behav Ther 2023; 52:110-131. [PMID: 36426727 DOI: 10.1080/16506073.2022.2117734] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
While dialectical behavior therapy (DBT) appears effective for some psychiatric conditions commonly associated with alexithymia, it is unclear whether DBT improves difficulties experienced by alexithymic individuals. This review investigated the current evidence on the effectiveness of DBT-based interventions in improving alexithymia. A qualitative synthesis of studies that investigated the efficacy of DBT on self-reported alexithymia was performed, identifying eligible studies using EBSCO/Essentials, Google Scholar, PubMed, Web of Science, and PsychINFO databases. Eight studies were identified. Overall, the results were inconclusive due to the heterogeneity of the studies but suggest that DBT-based interventions may be associated with self-reported decreases in alexithymia and increases in the ability to identify emotional states. The literature is limited by significant methodological problems, such as the low number of controlled trials, small samples, and high variability between DBT programs, which increases the risk of bias across study outcomes. More research is needed to reach conclusions regarding the effectiveness of DBT in improving alexithymia. Future studies should conduct randomized controlled trial designs (primarily with active treatment control conditions), greater standardization of DBT-based interventions, and a more in-depth examination of the level of participant involvement in long-term DBT-based interventions may help to understand whether DBT improves alexithymia difficulties.
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Affiliation(s)
- Bruno M Salles
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Wayson Maturana de Souza
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Veruska Andrea Dos Santos
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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12
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Muacevic A, Adler JR, Khalayla M, Lazraq M, Miloudi Y, Bensaid A, El Harrar N. Moroccans' Views on Resuscitation According to Presumed Degree of Disability: A Cross-Sectional Study. Cureus 2023; 15:e33460. [PMID: 36628402 PMCID: PMC9822531 DOI: 10.7759/cureus.33460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION According to the World Health Organization (WHO), disability is a public health problem that can be difficult to manage medically and financially. Disability can either be innate or develop after resuscitation. Therefore, the decision regarding whether to resuscitate a patient or not raises certain ethical questions, especially in the context of a Muslim country such as Morocco. AIM The main aim of this study is to survey the public's opinions regarding their willingness to be resuscitated or have their relatives be resuscitated based on their foreseeable degree of disability. METHODS This cross-sectional study was conducted over a 10-month period and employed a self-administered questionnaire. The participants included were all adult (i.e., over 18 years of age) Moroccan nationals, and they were selected regardless of their religious identity. Moreover, the modified Rankin Scale (mRS) was used to measure the participants' foreseeable degree of handicap. The participants were divided into two groups: healthcare workers and non-healthcare workers. RESULTS In total, 1083 questionnaires were retained. The average age of the participants was 30 (± 8) years, with the male-to-female sex ratio being 0.78. Moreover, 39.6% of the participants were healthcare workers. It was found that compared to the non healthcare workers, the healthcare professionals were more willing to be resuscitated themselves and have resuscitation performed on their relatives, but only when the degree of foreseeable disability was estimated to be absent or insignificant, whereas they were less willing to be resuscitated and have resuscitation performed on their relatives when the degree of foreseeable disability was estimated to be mild or higher. CONCLUSION In conclusion, there should be a pre-established procedure, along with a legislative and multidisciplinary framework, within the hospital structures in order to help in the decision-making process regarding whether to resuscitate a patient or not.
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13
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Ekbäck E, Rådmark L, Granåsen G, Svärling R, Sörlin M, Schönbeck C, Henje E. Clinical effectiveness of training for awareness, resilience, and action for adolescents and young adults with depression: The pilot phase of a multicenter randomized controlled trial. Front Psychiatry 2023; 14:1130035. [PMID: 37065894 PMCID: PMC10102586 DOI: 10.3389/fpsyt.2023.1130035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 04/18/2023] Open
Abstract
Background Depression is a top-ranking global health concern increasing in magnitude. Available treatments for adolescents and young adults are not convincingly effective and relapse rates remain high. Training for Awareness, Resilience and Action (TARA) is a group treatment program targeting specific pathophysiological mechanisms of depression in young people. TARA is feasible, acceptable, preliminarily efficacious in depressed American adolescents, and it affects postulated brain-circuitry. Methods As an initial step of a multicenter randomized controlled trial (RCT) we performed a single-arm multicenter pilot-study on TARA. Thirty-five depressed individuals (15-21 years old, 28 females) received TARA for 12 weeks face-to-face or online. Data was collected before (T0), during, and after the intervention (T1). The trial was pre-registered at clinicaltrials.gov, NCT Registration: identifier [NCT04747340]. Feasibility outcomes included recruitment, attendance rates, and session ratings. Adverse events were recorded weekly and extracted from medical records at the end of the trial. Primary effectiveness outcome was self-rated depression severity on Reynolds Adolescent Depression scale 2nd ed. at T1. Secondary outcomes were Children's Depression Rating Scale-revised (CDRS-R) and Multidimensional Anxiety Scale for Children (MASC) at T1. Results TARA was feasible and safe in the present trial. No significant RADS-2-change was seen (adjusted mean difference -3.26, 95 % CI -8.35 to 1.83; p= 0.20), however a significant decrease in CDRS-R scores is reported (adjusted mean difference -9.99, 95% CI -14.76 to -5.22; p < 0.001). MASC-scores did not change significantly (adjusted mean difference 1.98, 95% CI -0.96 to 4.91; p=0.18). Additional feasibility aspects are presented and discussed. Discussion Limitations include substantial loss-to-follow-up, no randomization to control, and that some participants received concomitant treatment(s). The Coronavirus pandemic complicated both implementation and interpretation of the trial. In conclusion TARA was feasible and safe in depressed adolescents and young adults. Preliminary signs of effectiveness were seen. The initiated RCT will be important and worthwhile to conduct, and several improvements to the design are suggested based on the present results. Clinical Trial Registration clinicaltrials.gov, identifier NCT04747340.
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Affiliation(s)
- Erik Ekbäck
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
- *Correspondence: Erik Ekbäck,
| | - Lina Rådmark
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Gabriel Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rachel Svärling
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Matilda Sörlin
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Caspar Schönbeck
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Eva Henje
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
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14
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You JS, Lee CW, Park JY, Jang Y, Yu H, Yoon J, Kwon SS, Oh S, Park YS, Ryoo HA, Lee JH, Lee D, Lee J, Kim Y, Cho N, Ihm HK, Park CHK, Lee YC, Won HH, Kang HS, Beak JH, Ha TH, Myung W. Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma. Psychiatry Investig 2022; 19:909-918. [PMID: 36444154 PMCID: PMC9708861 DOI: 10.30773/pi.2022.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. METHODS A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory-Borderline Features Scale. RESULTS BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. CONCLUSION The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.
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Affiliation(s)
- Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Yoon Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sunghee Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Hun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yeoju Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Hyun Beak
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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15
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Khan AN, Jaffee SR. Alexithymia in individuals maltreated as children and adolescents: a meta-analysis. J Child Psychol Psychiatry 2022; 63:963-972. [PMID: 35438190 DOI: 10.1111/jcpp.13616] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children who are maltreated show deficits in emotion recognition, expression, and understanding. The goal of the current meta-analysis was to determine the degree to which maltreatment is associated with deficits in the ability to recognize one's own emotions - a phenomenon known as alexithymia. Alexithymia may be a mechanism explaining the association between childhood maltreatment and various psychological disorders. METHODS This meta-analytic review (88 studies, n = 43,076) examined the association between the experience of childhood maltreatment and alexithymia, mainly in adulthood. Additional meta-analyses were run to examine if the strength of the association between maltreatment as a child and alexithymia varied as a function of the type of maltreatment individuals reported and other moderators. RESULTS We found significant small effect sizes for all models, indicating higher levels of maltreatment in childhood or adolescence were associated with higher levels of alexithymia. Alexithymia was more strongly associated with forms of neglect than with physical or sexual abuse. The effect sizes also increased as the percentages of females in the sample increased. CONCLUSIONS Results suggest that researchers should examine whether alexithymia is a transdiagnostic mechanism in the association between childhood maltreatment and psychopathology and whether targeting alexithymia in treatment could reduce a wide range of symptoms.
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Affiliation(s)
- Anika N Khan
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sara R Jaffee
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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16
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Brown S, Fite PJ, Bortolato M. The mediating role of impulsivity in the associations between child maltreatment types and past month substance use. CHILD ABUSE & NEGLECT 2022; 128:105591. [PMID: 35306342 PMCID: PMC9119917 DOI: 10.1016/j.chiabu.2022.105591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Child maltreatment has emerged as an important risk factor for substance use. However, despite evidence consistently demonstrating that substance use peaks during emerging adulthood, less is known about the specificity of maltreatment effects on substance use during this critical developmental period. Further, the factors that might play a role in these associations are not well understood. OBJECTIVE The current study examined the associations between child maltreatment types (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) and past month marijuana, alcohol, and tobacco use among emerging adults, and tested whether impulsivity accounted for these associations. METHODS Participants were 500 emerging adults ranging in age between 18 and 25 years old (M = 18.96, SD = 1.22, 49.6% male) recruited from a large, public university in the Midwest United States. RESULTS Tests of indirect effects suggested that impulsivity accounted for associations between emotional abuse and past month marijuana, alcohol, and tobacco use. CONCLUSIONS Current findings provide support for impulsivity as a mechanism linking childhood emotional abuse to substance use among emerging adults, highlighting the need for targeted screening and intervention.
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Affiliation(s)
- Shaquanna Brown
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA; Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA.
| | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA; Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Marco Bortolato
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA; Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA
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17
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The mediating role of early maladaptive schemas in the relationship between early childhood trauma and alexithymia. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02988-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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18
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Bordalo F, Carvalho IP. The role of alexithymia as a risk factor for self-harm among adolescents in depression - A systematic review. J Affect Disord 2022; 297:130-144. [PMID: 34695502 DOI: 10.1016/j.jad.2021.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Considering the suggested role of alexithymia in increasing the risk of self-harm, especially when depression is also present, and that rates of self-harm tend to peak in adolescence, the aim of this systematic review was to synthetize the most relevant research studies on this topic and provide an understanding on whether alexithymia can be considered as an important risk factor for non-suicidal self-harm among adolescents with depression. METHODS Searches were conducted in PubMed, Web of Science, and PsycINFO, resulting in 290 records. After removal of duplicates, 273 records were left and after reading the titles and abstracts, 231 articles were excluded, leaving 42 articles that were read in full. Of these 42, nine articles were included in this review. RESULTS The sample of this review consists of eight case-control studies and one cross-sectional and longitudinal survey. All nine studies concluded that the most important variables associated with self-harming behavior were depression and alexithymia, among all other variables assessed. The self-harming groups showed significantly higher scores on alexithymia (overall and particularly Factor 1- difficulties identifying feelings and differentiating them from bodily sensations), when compared to the control (no self-harming) groups, and the mean depression scores for self-harming groups were significantly higher than those for non-harming groups. All nine studies included in this review shared the limitation of self-reported information. CONCLUSION These results indicate that alexithymia is a risk factor for non-suicidal self-harm among adolescents with depression, even when other variables were also inspected, and may be a prevention and therapeutic target in the future.
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Affiliation(s)
- Felícia Bordalo
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal.
| | - Irene P Carvalho
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; Medical Psychology Unit, Department of Clinical Neuroscience and Mental Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; CINTESIS, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal
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19
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Löffler-Stastka H, Dietrich D, Sauter T, Fittner M, Steinmair D. Simulating the mind and applications – a theory-based chance for understanding psychic transformations in somatic symptom disorders. World J Meta-Anal 2021; 9:474-487. [DOI: 10.13105/wjma.v9.i6.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/15/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
With the new category of somatic symptom disorder/bodily distress disorder in ICD-11, research into pathogenetic and therapeutic pathways is stimulated. By turning away from the definition of somatoform disorders as “the lack of something physical explaining everything”, this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom. Modelling and simulation have a long history in science to gain insight also into complex phenomena. Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research. Calculation models have to fit to the complexity of this disorder category. In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer, fine grained calculation model is elaborated. Starting from a clinical case history, within iterative discussion, by acknowledging the demand for interdisciplinary synergy and cooperation in science, psychoanalytic theory served as the basis for computer-scientific information technique. A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research. How psychic transformations can be understood properly in order to provide meaningful treatments, the respective training, and to conduct appropriate process- and outcome-research is established in simulating the mind and applications.
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Affiliation(s)
| | | | - Thilo Sauter
- Institute of Computer Technology, TU Wien, Vienna 1040, Austria
- Center for Integrated Sensor Systems, Danube University Krems, Wiener Neustadt 2700, Austria
| | - Martin Fittner
- Institute of Computer Technology, TU Wien, Vienna 1040, Austria
| | - Dagmar Steinmair
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna 1090, Austria
- University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten 3100, Austria
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20
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Karaca Dinç P, Oktay S, Durak Batıgün A. Mediation role of alexithymia, sensory processing sensitivity and emotional-mental processes between childhood trauma and adult psychopathology: a self-report study. BMC Psychiatry 2021; 21:508. [PMID: 34654396 PMCID: PMC8520293 DOI: 10.1186/s12888-021-03532-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is overwhelming evidence for a strong association between childhood trauma and adult psychopathology. This study aimed to investigate the mediation roles of alexithymia, sensory processing sensitivity, and emotional-mental processes in the relationship between childhood traumas and adult psychopathology. METHODS The sample consisted of 337 people (78.9% female, 21.1% male) aged between 20 and 64 years. Participants filled the scales online via a Google form. Reading Mind in the Eyes (EYES), Sensory Processing Sensitivity Scale (SPS), Toronto Alexithymia Scale (TAS-26), Childhood Trauma Questionnaire (CTQ), and the Brief Symptom Inventory (BSI) were used. PROCESS (Model 4) macro was used to examine the mediating role of sensory processing sensitivity, alexithymia, and the EYES test results in the relationship between childhood trauma and psychopathology. RESULTS The results of mediation analysis demonstrated that sensory processing sensitivity and alexithymia mediated the relationship between childhood trauma and adult psychopathology. However, the EYES test (mentalization) did not mediate in this relationship. CONCLUSION This study shows that childhood traumas may relate to more psychological symptoms in individuals with high sensory processing sensitivity and alexithymia. Our study may contribute to the understanding of what may lead to a person's vulnerability to experiencing psychological symptoms after childhood trauma. It may be crucial that future treatment and intervention programs should include sensory sensitivity and alexithymia. Sensory processing sensitivity and alexithymia can be examined in the treatment of psychological problems of individuals who have experienced childhood trauma.
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Affiliation(s)
- Pelin Karaca Dinç
- Ankara University, Ankara, Turkey
- Department of Psychology, Faculty of Languages History and Geography, University of Ankara University, No:45-45/A 06100, Sıhhiye, Ankara, Turkey
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21
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Ceruso A, Martínez-Cengotitabengoa M, Peters-Corbett A, Diaz-Gutierrez MJ, Martínez-Cengotitabengoa M. Alterations of the HPA Axis Observed in Patients with Major Depressive Disorder and Their Relation to Early Life Stress: A Systematic Review. Neuropsychobiology 2021; 79:417-427. [PMID: 32203965 DOI: 10.1159/000506484] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are common in patients diagnosed with major depressive disorder (MDD). Nevertheless, these alterations are not found in every patient. There is evidence to indicate a possible mediating role of early life stress (ELS) in the relation between dysfunction of the HPA axis and MDD. We conducted a systematic review to understand if the alterations of the HPA axis commonly found in patients with MDD are due to early life stress or are caused by the disorder itself. METHODS The review was conducted by following the PRISMA guidelines. Original articles were found in PubMed and via a manual search. Only studies whose design allowed comparison of the HPA functioning in the 4 groups no-MDD/no-ELS, MDD/no-ELS, no-MDD/ELS, and MDD/ELS were included. RESULTS Hyperactivity or hypoactivity of the HPA axis was found in 8 articles. A greater number of abnormalities and a higher rate of posttraumatic stress disorder comorbidity were found in the MDD/ELS group. Dysfunction of the HPA axis was also found in the no-MDD/ELS groups. CONCLUSION HPA dysfunction found in MDD seems to be more related to the presence of ELS rather than to the MDD itself. Future studies are needed to clarify the exact mechanisms involved.
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Affiliation(s)
- Angela Ceruso
- Pharmacy Faculty, University of the Basque Country, Vitoria, Spain
| | | | | | | | - Monica Martínez-Cengotitabengoa
- Pharmacy Faculty, University of the Basque Country, Vitoria, Spain, .,Psychology Clinic of East Anglia, Norwich, United Kingdom,
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22
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Lee S, Kim B. Cognitive and Emotional Processes and Life Satisfaction of Korean Adults With Childhood Abuse Experience According to the Level of Emotional Expressiveness. Psychol Rep 2021; 125:1957-1976. [PMID: 33940975 DOI: 10.1177/00332941211012622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluates a hypothesized model describing the cognitive and emotional processes of childhood abuse and its influence on life satisfaction and explores the moderating effect of emotional expressivity in Korean young adults. The mediating roles of early maladaptive schema and state anxiety are explored, and the level of life satisfaction is compared according to the emotional expressivity level. A total of 550 young adults completed self-reported questionnaires, including Childhood Trauma Questionnaire (CTQ-SF), Young Schema Questionnaire (YSQ-SF), State-Trait Anxiety Inventory (STAI-Y), Satisfaction With Life Scale (SWLS), and Emotional Expressivity Scale (EES). The mediating roles of early maladaptive schema and state anxiety between childhood abuse and life satisfaction are confirmed. In the low emotional expressivity group, the double-mediation effect of early maladaptive schema and state anxiety is confirmed, whereas for the high emotional expressivity group, the mediating roles of each early maladaptive schema and state anxiety are confirmed, as well as the double-mediation effect. Moreover, the high emotional expressivity group showed higher life satisfaction. The study results imply that even though expressing emotions does not result in immediate mood elevation, but eventually leads to higher life satisfaction. The implications, limitations, and suggestions are discussed.
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Affiliation(s)
- Sinhye Lee
- Department of Psychology, The Catholic University of Korea, Bucheon, South Korea
| | - Boyoung Kim
- Department of Psychology, The Catholic University of Korea, Bucheon, South Korea
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23
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Huh HJ, Lee SY, Lee SS, Chae JH. A Network Model of Positive Resources, Temperament, Childhood Trauma, and Comorbid Symptoms for Patient with Depressive Disorders. Psychiatry Investig 2021; 18:214-224. [PMID: 33685037 PMCID: PMC8016691 DOI: 10.30773/pi.2020.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/20/2020] [Accepted: 11/18/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Temperament, positive resources, childhood trauma, and other clinical comorbid symptoms are related to depressive symptom severity. Here, we used network analysis to examine the interrelations between these clinical factors in patients with depressive disorders. METHODS Patients with depressive disorders (n=454) completed self-report questionnaires evaluating clinical symptoms, childhood trauma, temperament, and positive resources. To identify network pattern and the most central aspect, we performed network analysis and centrality analyses. First, we analyzed the network pattern in total participants. Second, we established two groups of those with severe depressive symptoms and those with mild depressive symptoms and compared their network patterns. RESULTS Deficient optimism and depression were the central factors in the network of total participants. In the group with severe depressive symptoms, lack of social support and childhood emotional trauma showed high centrality. Deficient social support and other positive resources played central roles in the group with mild depressive symptoms. CONCLUSION Network pattern of psychological factors was different between those with mild or severe depression. Lack of positive resources is an important factor in psychological processes in both mild and severe depression. However, childhood emotional trauma may play a relatively important role in patients with severe depressive symptoms.
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Affiliation(s)
- Hyu Jung Huh
- Department of Psychiatry, Incheon St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Incheon, Republic of Korea
| | - Soon Young Lee
- Department of Library, Archives and Information Studies, Pusan National University, Busan, Republic of Korea
| | - Soo Sang Lee
- Department of Library, Archives and Information Studies, Pusan National University, Busan, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
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24
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Khosravani V, Berk M, Sharifi Bastan F, Samimi Ardestani SM, Wrobel A. The effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms and suicidal ideation in females with bipolar disorder: emotion dysregulation as a mediator. Int J Psychiatry Clin Pract 2021; 25:90-102. [PMID: 33559512 DOI: 10.1080/13651501.2021.1879867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The relations of childhood emotional maltreatment and alexithymia to the clinical course of bipolar disorder (BD) have been widely recognised. Difficulties in regulating emotions may explain these relationships. The current study evaluated the effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms as well as suicidal ideation in female patients with BD. Emotion dysregulation was evaluated as a mediating factor. METHODS Three hundred hospitalised female patients with a diagnosis of BD provided information regarding their history of childhood emotional maltreatment, alexithymia, difficulties in emotion regulation, depressive and manic symptoms, and suicidal ideation. A series of structural equation models (SEMs) were calculated to assess the associations between these variables. RESULTS Childhood emotional abuse and difficulty in identifying feelings were indirectly associated with depressive and manic symptoms as well as suicidal ideation. This association was mediated by emotion dysregulation. This association remained significant after depressive and manic symptoms were controlled in the model. CONCLUSIONS This study indicates that patients with BD who experienced emotional abuse during childhood and have difficulties identifying emotions report greater emotion dysregulation. These individuals, in turn, are more likely to experience more severe depressive and manic symptoms as well as suicidal ideation.Key pointsChildhood emotional maltreatment and emotional and clinical factors in bipolar disorder were assessed.Childhood emotional abuse indirectly affected clinical factors via emotion dysregulation.Difficulty in identifying feelings was linked to clinical factors via emotional dysregulation.Emotional dysregulation affected the links of childhood emotional maltreatment and difficulty in identifying feelings on suicidal ideation after controlling for clinical symptoms.Emotional dysregulation dimensions of impulse, strategies, and goals emerge in relation to suicidal ideation.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael Berk
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Australia
| | | | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anna Wrobel
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.,Orygen, Parkville, Australia
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25
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Edwards ER, Rose NLJ, Gromatsky M, Feinberg A, Kimhy D, Doucette JT, Goodman M, McClure MM, Perez-Rodriguez MM, New AS, Hazlett EA. Alexithymia, Affective Lability, Impulsivity, and Childhood Adversity in Borderline Personality Disorder. J Pers Disord 2021; 35:114-131. [PMID: 33650890 DOI: 10.1521/pedi_2021_35_513] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Long-standing theories of borderline personality disorder (BPD) suggest that symptoms develop at least in part from childhood adversity. Emotion dysregulation may meaningfully mediate these effects. The current study examined three factors related to emotion dysregulation-alexithymia, affective lability, and impulsivity-as potential mediators of the relation between childhood adversity and BPD diagnosis in 101 individuals with BPD and 95 healthy controls. Path analysis compared three distinct models informed by the literature. Results supported a complex mediation model wherein (a) alexithymia partially mediated the relation of childhood adversity to affective lability and impulsivity; (b) affective lability mediated the relation of childhood adversity to BPD diagnosis; and (c) affective lability and impulsivity mediated the relation of alexithymia to BPD diagnosis. Findings suggest that affective lability and alexithymia are key to understanding the relationship between childhood adversity and BPD. Interventions specifically targeting affective lability, impulsivity, and alexithymia may be particularly useful for this population.
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Affiliation(s)
- Emily R Edwards
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York
| | - Nina L J Rose
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Molly Gromatsky
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York
| | - Abigail Feinberg
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David Kimhy
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - John T Doucette
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai
| | - Marianne Goodman
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Margaret M McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Psychology, Fairfield University, Fairfield, Connecticut
| | | | - Antonia S New
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Erin A Hazlett
- Mental Health Research, Education, and Clinical Center (MIRECC VISN-2), James J. Peters VA Medical Center, Bronx, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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26
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Melin EO, Svensson R, Dereke J, Hillman M. Galectin-3 Binding Protein, Depression, and Younger Age Were Independently Associated With Alexithymia in Adult Patients With Type 1 Diabetes. Front Psychiatry 2021; 12:672931. [PMID: 34045984 PMCID: PMC8144300 DOI: 10.3389/fpsyt.2021.672931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022] Open
Abstract
Aims: Alexithymia has been linked to cardiovascular disease. The aim was to explore whether the immuno-inflammatory variables galectin-3 binding protein (Gal3BP), soluble (s)CD163 and galectin-3 were independently associated with alexithymia, while controlling for known risk factors for cardiovascular disease, such as depression, anxiety, impaired glycemic control, obesity, smoking, and physical inactivity in patients with type 1 diabetes (T1D). Methods: Cross-sectional design. The participants were consecutively recruited from one diabetes out-patient clinic. Alexithymia, depression and anxiety were assessed by self-report instruments. Blood samples, anthropometrics, and blood pressure were collected, supplemented with data from electronic health records. High Gal3BP was defined as ≥3.3 μg/ml, high sCD163 as ≥0.6 μg/ml, high galectin-3 as ≥2.6 ng/ml, impaired glycemic control as HbA1c >70 mmol/mol (>8.6%) and abdominal obesity as waist circumference ≥ 1.02 m for men and ≥ 0.88 m for women. Results: Two hundred and ninety two patients participated (men 56%, aged 18-59 years, alexithymia prevalence 15%). Patients with alexithymia had higher prevalence of depression (34 vs. 6%, p < 0.001), anxiety (61 vs. 30%, p < 0.001), high Gal3BP levels (39 vs. 17%, p = 0.004), high HbA1c levels (46 vs. 24%, p = 0.006), and abdominal obesity (29 vs. 15%, p = 0.045). Depression [adjusted odds ratio (AOR) 6.5, p < 0.001], high Gal3BP levels (AOR 2.4, p = 0.035), and age (AOR 0.96, p = 0.027) were independently associated with alexithymia. Abdominal obesity (AOR 4.0, p < 0.001), high Gal3BP levels (AOR 2.8, p = 0.002), and depression (AOR 2.9, p = 0.014) were associated with high HbA1c. Abdominal obesity and anxiety were associated [Crude odds ratio (COR) 2.4, p = 0.006]. Conclusions: T1D patients with alexithymia had higher prevalence of high Gal3BP levels, depression, impaired glycemic control, anxiety, and abdominal obesity, which are known risk factors for cardiovascular disease. Only high Gal3BP levels, depression, and younger age were independently associated with alexithymia in adult patients with T1D.
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Affiliation(s)
- Eva O Melin
- Diabetes Research Laboratory, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Region Kronoberg, Department of Research and Development, Växjö, Sweden
| | - Ralph Svensson
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Jonatan Dereke
- Diabetes Research Laboratory, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Magnus Hillman
- Diabetes Research Laboratory, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Zhang CH, Li G, Fan ZY, Tang XJ, Zhang F. Psychological Capital Mediating the Relationship Between Childhood Trauma and Alexithymia in Chinese Medical Students: A Cross-Sectional Study. Psychol Res Behav Manag 2020; 13:1343-1352. [PMID: 33408537 PMCID: PMC7781113 DOI: 10.2147/prbm.s288647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/12/2020] [Indexed: 01/20/2023] Open
Abstract
Purpose A much higher prevalence of alexithymia has been found in medical students compared with the general population. This study aimed to test the potential mediating effect of psychological capital on the relationship between childhood trauma and alexithymia in Chinese medical students, thereby providing clues for future interventions aimed at dealing with alexithymia in this population. Methods Convenience cluster sampling was used to recruit 1200 medical students in Chongqing, China. This cross-sectional study utilised the Childhood Trauma Questionnaire Short Form, the Toronto Alexithymia Scale, and the Psychological Capital Questionnaire. A structural equation model with maximum likelihood was used to study the mediating effect presented in the aim, and the significance of the mediating effect was examined by the bootstrap method. Multiple-group invariance analyses were also conducted to confirm the stability of the model. Results A total of 1018 were identified to have valid responses with a rate of 84.83%. 38.4% were males, 61.6% were females. The prevalence of alexithymia was 16.5%. Results of structural equation model showed that childhood trauma was positively related to alexithymia, with a standard path coefficient of 0.219 (C.R.=6.644, P<0.001). The partial mediating effect of psychological capital was 0.060 (P<0.001), accounting for 21.51% of the total effect of childhood trauma on alexithymia. Results of bootstrap method showed that the lower and upper bounds of the 95% confidence interval did not contain 0, and the multiple-group invariance analyses showed that the p values of the changes in the degrees of freedom and chi-square value were greater than 0.05, thus confirming the stability of the model. Conclusion Childhood trauma was a direct predictor of alexithymia among Chinese medical students, and the relationship between these two was partially mediated by psychological capital. Therefore, interventions aimed at enhancing psychological capital in this population may be effective at diminishing alexithymia.
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Affiliation(s)
- Chang-Hong Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Ge Li
- The Center of Experimental Teaching Management, Chongqing Medical University, Chongqing 401331, People's Republic of China
| | - Zhao-Ya Fan
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Xiao-Jun Tang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Fan Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
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28
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Wade-Bohleber LM, Boeker H, Grimm S, Gärtner M, Ernst J, Recher DA, Buergi N, Seifritz E, Richter A. Depression is associated with hyperconnectivity of an introspective socio-affective network during the recall of formative relationship episodes. J Affect Disord 2020; 274:522-534. [PMID: 32663985 DOI: 10.1016/j.jad.2020.05.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/27/2020] [Accepted: 05/16/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Depression and the experience of early adversity are associated with impairments in interpersonal and social cognitive functioning. The neural mechanisms involved in these impairments remain insufficiently understood. METHODS In a sample of 48 depressed and 50 healthy participants, we explored seed-to-voxel functional connectivity (FC) during the recall of formative relationship episodes using functional magnetic resonance imaging. RESULTS While depressive symptoms were associated with increased FC of brain regions that form an introspective socio-affective network, such as the precuneus, bilateral anterior insula, dorsal anterior cingulate cortex, left amygdala, and medial prefrontal cortex, early adversity linked to decreased FC of brain regions mediating emotion processing such as the bilateral anterior insula and increased FC of the bilateral parahippocampal gyrus. LIMITATIONS We report both results that are corrected for the number of seeds tested in FC analyses using strict Bonferroni adjustments and unadjusted results as part of an exploratory analysis. DISCUSSION Our findings suggest that depression and early adversity are associated with differential FC patterns in the brain during the recall of formative relationship episodes. Hyperconnectivity of an introspective socio-affective network associated with depressive symptoms may link to enhanced self-focus and emotional reactivity. Patterns of neural activation associated with early adversity may underpin numbed affective states or enhanced affective memory regulation. Overall, these findings inform about the neural underpinnings of a reflective ability that is predictive of the adaptation to depression and to early adversity and relevant for psychotherapy outcomes.
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Affiliation(s)
- L M Wade-Bohleber
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland; School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - H Boeker
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - S Grimm
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland; Medical School Berlin, Berlin, Germany; Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - M Gärtner
- Medical School Berlin, Berlin, Germany; Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - J Ernst
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - D A Recher
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - N Buergi
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - A Richter
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Switzerland
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29
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Kumar R, Jahan M. Multimodal psychotherapy in the management of somatization disorder. Ind Psychiatry J 2020; 29:205-212. [PMID: 34158703 PMCID: PMC8188936 DOI: 10.4103/ipj.ipj_11_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/08/2020] [Accepted: 11/26/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Somatization is the presentation of physical symptoms without an objective and identifiable cause, and the condition is among the most common and challenging problems in primary medical care. Several modal of psychotherapy modal is being practiced but effective treatment in rarely delivered. AIM The aim of this study is to evaluate the efficacy and durability of multimodal psychotherapy in the management of somatization disorder. MATERIALS AND METHODS This is a hospital-based study using the pre-post design with control group. Thirty outpatient department patients with somatization disorder were selected and divided into two groups, i.e., intervention group and control group using the purposive sampling method. Intervention group was given 12 sessions of management package, i.e., symptoms monitoring form, scheduling of daily activity, sleep hygiene, diaphragmatic breathing, psycho-social intervention, psychodynamic individual psychotherapy, and cognitive restructuring (approximately 3-4 months). Efficacy and durability were measured by the Bradford somatic inventory, general health questionnaire-28 (GHQ-28), defense mechanism inventory (DMI), and Sack's sentence completion test (SSCT). RESULTS The results reveal that there are significant differences found among intervention group in comparisons to the control group in the context of somatic complaints (BSI), general health functioning (GHQ-28), life conflict (SSCT), and in defense mechanism (DMI). Significant improvement also found between postintervention and follow-up of the intervention group on different study variables. CONCLUSION The present study findings indicate that multimodal psychotherapy program is effective in the Indian context in the management of somatization disorder.
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Affiliation(s)
- Ranjan Kumar
- Department of Psychology, RKD College, PPU, Patna, Bihar, India
| | - Masroor Jahan
- Department of Clinical Psychology, RINPAS, Ranchi, Jharkhand, India
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30
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Tang W, Hu T, Yang L, Xu J. The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 165:110131. [PMID: 32518435 PMCID: PMC7273169 DOI: 10.1016/j.paid.2020.110131] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023]
Abstract
Objective While it is well known that mental health problems are common consequences of deadly pandemics, the association with alexithymia is less clear. This study examined this association in an evaluation of home-quarantined university students during the 2019/2020 COVID-19 pandemic in China. Methods In total, 2501 home-quarantined students from six southwest Chinese universities completed the following questionnaires: the 20-item Toronto Alexithymia Scale (TAS-20), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL—C), and the Patients Health Questionnaire-9 (PHQ-9), after which structural equation modeling (SEM) and mediation analyses were employed to extract and evaluate the possible associations. Results It was found that participants with probable depression or PTSD also reported more severe alexithymia features, such as difficulties in identifying feelings (DIF) or describing feelings (DDF). Alexithymia was also found to partially mediate the effect of number of exposures on mental health problems. Conclusion These results suggested that implementing strategies to assist young people identify and deal with their own emotions and those of others could prevent or mitigate the mental health problems associated with deadly pandemic events. However, future longitudinal studies are needed to examine the specific involvement of DIF or DDF in people with mental health problems.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, No. 24, South Section 1, Yihuan Road Wuhou District, 610065 Chengdu, China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Le Yang
- West China College of Pharmacy, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, No. 24, South Section 1, Yihuan Road Wuhou District, 610065 Chengdu, China
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Tang W, Xu D, Xu J. The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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32
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Vergallito A, Mattavelli G, Gerfo EL, Anzani S, Rovagnati V, Speciale M, Vinai P, Vinai P, Vinai L, Lauro LJR. Explicit and Implicit Responses of Seeing Own vs. Others' Emotions: An Electromyographic Study on the Neurophysiological and Cognitive Basis of the Self-Mirroring Technique. Front Psychol 2020; 11:433. [PMID: 32296363 PMCID: PMC7136519 DOI: 10.3389/fpsyg.2020.00433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/25/2020] [Indexed: 01/29/2023] Open
Abstract
Facial mimicry is described by embodied cognition theories as a human mirror system-based neural mechanism underpinning emotion recognition. This could play a critical role in the Self-Mirroring Technique (SMT), a method used in psychotherapy to foster patients’ emotion recognition by showing them a video of their own face recorded during an emotionally salient moment. However, dissociation in facial mimicry during the perception of own and others’ emotions has not been investigated so far. In the present study, we measured electromyographic (EMG) activity from three facial muscles, namely, the zygomaticus major (ZM), the corrugator supercilii (CS), and the levator labii superioris (LLS) while participants were presented with video clips depicting their own face or other unknown faces expressing anger, happiness, sadness, disgust, fear, or a neutral emotion. The results showed that processing self vs. other expressions differently modulated emotion perception at the explicit and implicit muscular levels. Participants were significantly less accurate in recognizing their own vs. others’ neutral expressions and rated fearful, disgusted, and neutral expressions as more arousing in the self condition than in the other condition. Even facial EMG evidenced different activations for self vs. other facial expressions. Increased activation of the ZM muscle was found in the self condition compared to the other condition for anger and disgust. Activation of the CS muscle was lower for self than for others’ expressions during processing a happy, sad, fearful, or neutral emotion. Finally, the LLS muscle showed increased activation in the self condition compared to the other condition for sad and fearful expressions but increased activation in the other condition compared to the self condition for happy and neutral expressions. Taken together, our complex pattern of results suggests a dissociation at both the explicit and implicit levels in emotional processing of self vs. other emotions that, in the light of the Emotion in Context view, suggests that STM effectiveness is primarily due to a contextual–interpretative process that occurs before that facial mimicry takes place.
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Affiliation(s)
| | | | - Emanuele Lo Gerfo
- Clinical Psychology Service of Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCSS IsMeTT), Palermo, Italy
| | - Stefano Anzani
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Viola Rovagnati
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Milan, Italy
| | | | - Piergiuseppe Vinai
- "GNOSIS" Research and Psychotherapy Group, Mondovì, Italy.,Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy.,Psicologia Scientifica - Centro di Ricerca e Promozione Sociale, Milan, Italy
| | - Paolo Vinai
- "GNOSIS" Research and Psychotherapy Group, Mondovì, Italy
| | - Luisa Vinai
- Pôle de Psychiatrie et Psychothérapie du Centre Hospitalier du Valais Romand, Monthey, Switzerland
| | - Leonor J Romero Lauro
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Milan, Italy.,Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
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Humphreys KL, LeMoult J, Wear JG, Piersiak HA, Lee A, Gotlib IH. Child maltreatment and depression: A meta-analysis of studies using the Childhood Trauma Questionnaire. CHILD ABUSE & NEGLECT 2020; 102:104361. [PMID: 32062423 PMCID: PMC7081433 DOI: 10.1016/j.chiabu.2020.104361] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Researchers have documented that child maltreatment is associated with adverse long-term consequences for mental health, including increased risk for depression. Attempts to conduct meta-analyses of the association between different forms of child maltreatment and depressive symptomatology in adulthood, however, have been limited by the wide range of definitions of child maltreatment in the literature. OBJECTIVE We sought to meta-analyze a single, widely-used dimensional measure of child maltreatment, the Childhood Trauma Questionnaire, with respect to depression diagnosis and symptom scores. PARTICIPANTS AND SETTING 192 unique samples consisting of 68,830 individuals. METHODS We explored the association between total scores and scores from specific forms of child maltreatment (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and depression using a random-effects meta-analysis. RESULTS We found that higher child maltreatment scores were associated with a diagnosis of depression (g = 1.07; 95 % CI, 0.95-1.19) and with higher depression symptom scores (Z = .35; 95 % CI, .32-.38). Moreover, although each type of child maltreatment was positively associated with depression diagnosis and scores, there was variability in the size of the effects, with emotional abuse and emotional neglect demonstrating the strongest associations. CONCLUSIONS These analyses provide important evidence of the link between child maltreatment and depression, and highlight the particularly larger association with emotional maltreatment in childhood.
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Affiliation(s)
| | | | - John G Wear
- Western University of Health Sciences, United States
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Serafini G, Lamis DA, Aguglia A, Amerio A, Nebbia J, Geoffroy PA, Pompili M, Amore M. Hopelessness and its correlates with clinical outcomes in an outpatient setting. J Affect Disord 2020; 263:472-479. [PMID: 31969280 DOI: 10.1016/j.jad.2019.11.144] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/04/2019] [Accepted: 11/29/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This study examined whether patients with hopelessness and those without may significantly differ regarding their main presentations and clinical course in a large Italian population. METHODS The recruited sample included 583 currently euthymic outpatients with major affective disorders. The Beck Hopelessness Scale (BHS) assessed hopelessness using a cutoff score of 9 or higher. Participants were categorized based on the presence/absence of hopelessness. A binary logistic regression analysis -accounting for age and gender and considering history of psychotherapy, emotional/physical abuse, depressive symptoms, Toronto Alexithymia Scale (TAS) total score, difficulties identifying and communicating feelings as potential predictors- was carried out in order to detect the variables associated with hopelessness. RESULTS Individuals with hopelessness, compared to those without, were more likely to be older (p=0.005), females (p=0.01), to have a unipolar depressive disorder (p≤0.05), be prescribed antidepressants and psychotherapy in the past (p=0.001 and p≤0.05). Moreover, individuals with hopelessness scored higher on the Montgomery-Asberg Depression Rating Scale (p≤0.05) and on the emotional (p=<0.001), physical abuse (p≤0.01) and physical neglect (p≤0.05) subscales of the Childhood Trauma Questionnaire - Short form, and reported more difficulties identifying (p≤0.001) and communicating feelings (p≤0.001) than those without hopelessness. The multivariate analysis showed that having difficulties identifying feelings is independently associated with hopelessness. DISCUSSION These findings indicate that individuals with difficulties identifying feelings are at higher risk of hopelessness and of negative outcomes. Further studies need to explore the impact of alexithymia on hopelessness and clinical outcomes in the lifetime illness course.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufs Medical center, Boston, MA, USA
| | - Jacopo Nebbia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pierre Alexis Geoffroy
- Departement de psychiatrie et d'addictologie, AP-HP, Hopital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant Andrea Hospital, University of Rome, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Honkalampi K, Flink N, Lehto SM, Ruusunen A, Koivumaa-Honkanen H, Valkonen-Korhonen M, Viinamäki H. Adverse childhood experiences and alexithymia in patients with major depressive disorder. Nord J Psychiatry 2020; 74:45-50. [PMID: 31808358 DOI: 10.1080/08039488.2019.1667430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of the article: Adverse childhood experiences (ACEs) have been postulated to negatively affect the development of emotional regulation. However, little is known about specific associations between ACEs, depressive symptoms, and alexithymia or its components [i.e. difficulty in identifying feelings (DIF), difficulty in describing feelings to others (DDF) and externally-oriented thinking (EOT)] in patients with major depressive disorder (MDD). The aims of the present cross-sectional study were to (1) compare ACEs (emotional neglect, emotional abuse, physical neglect, physical abuse, sexual abuse) between alexithymic and non-alexithymic patients with MDD; (2) explore whether specific ACEs, depressive symptoms or the interaction between sex and depressive symptoms predicted TAS-20 or its components.Materials and Methods: The study sample consisted of 186 psychiatric outpatients with MDD (aged 21-61 years, mean 33.87 years, SD 10.88) recruited from the Department of Psychiatry, Kuopio University Hospital between 2016-2019. Alexithymia and its components were assessed using the 20-item Toronto Alexithymia Scale (TAS-20). ACEs were assessed with the Trauma and Distress Scale (TADS).Results: Almost all patients with alexithymia and 80% of non-alexithymic patients reported that they had experienced emotional abuse or neglect, at least sometimes. Approximately 60% of MDD patients reported having experienced physical neglect and 30% described physical abuse. Emotional and physical abuse and neglect predicted DDF score.Conclusions: These findings suggest that among MDD patients, early experiences of emotional and physical abuse and neglect is associated with difficulties in describing feelings in adulthood.
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Affiliation(s)
- Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Niko Flink
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu Ruusunen
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.,IMPACT Strategic Research Centre/Food and Mood Centre, School of Medicine, Deakin University, Geelong, Australia.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Minna Valkonen-Korhonen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Heimo Viinamäki
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
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The relationship between childhood trauma, dopamine release and dexamphetamine-induced positive psychotic symptoms: a [ 11C]-(+)-PHNO PET study. Transl Psychiatry 2019; 9:287. [PMID: 31712556 PMCID: PMC6848217 DOI: 10.1038/s41398-019-0627-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 09/17/2019] [Accepted: 10/20/2019] [Indexed: 02/08/2023] Open
Abstract
Childhood trauma is a risk factor for psychosis. Amphetamine increases synaptic striatal dopamine levels and can induce positive psychotic symptoms in healthy individuals and patients with schizophrenia. Socio-developmental hypotheses of psychosis propose that childhood trauma and other environmental risk factors sensitize the dopamine system to increase the risk of psychotic symptoms, but this remains to be tested in humans. We used [11C]-(+)-PHNO positron emission tomography to measure striatal dopamine-2/3 receptor (D2/3R) availability and ventral striatal dexamphetamine-induced dopamine release in healthy participants (n = 24). The relationships between dexamphetamine-induced dopamine release, dexamphetamine-induced positive psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), and childhood trauma using the Childhood Trauma Questionnaire (CTQ) were assessed using linear regression and mediation analyses, with childhood trauma as the independent variable, dexamphetamine-induced dopamine release as the mediator variable, and dexamphetamine-induced symptoms as the dependent variable. There was a significant interaction between childhood trauma and ventral striatal dopamine release in predicting dexamphetamine-induced positive psychotic symptoms (standardized β = 1.83, p = 0.003), but a mediation analysis was not significant (standardized β = -0.18, p = 0.158). There were no significant effects of dopamine release and childhood trauma on change in negative (p = 0.280) or general PANSS symptoms (p = 0.061), and there was no relationship between ventral striatal baseline D2/3R availability and positive symptoms (p = 0.368). This indicates childhood trauma and dopamine release interact to influence the induction of positive psychotic symptoms. This is not consistent with a simple sensitization hypothesis, but suggests that childhood trauma moderates the cognitive response to dopamine release to make psychotic experiences more likely.
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Dahoun T, Calcia MA, Veronese M, Bloomfield P, Reis Marques T, Turkheimer F, Howes OD. The association of psychosocial risk factors for mental health with a brain marker altered by inflammation: A translocator protein (TSPO) PET imaging study. Brain Behav Immun 2019; 80:742-750. [PMID: 31112791 DOI: 10.1016/j.bbi.2019.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 12/11/2022] Open
Abstract
Psychiatric disorders associated with psychosocial risk factors, including depression and psychosis, have been shown to demonstrate increased microglia activity. Whilst preclinical studies indicate that psychosocial stress leads to increased levels of microglia in the frontal cortex, no study has yet been performed in humans. This study aimed at investigating whether psychosocial risk factors for depression and/or psychosis would be associated with alterations in a brain marker expressed by microglia, the translocator specific protein (TSPO) in humans. We used [11C]-PBR28 Positron Emission Tomography on healthy subjects exposed to childhood and adulthood psychosocial risk factors (high-risk group, N = 12) and age- and sex-matched healthy controls not exposed to childhood and adulthood psychosocial risk factors (low-risk group, N = 12). The [11C]-PBR28 volume of distribution (VT) and Distribution Volume Ratio (DVR) were measured in the total gray matter, and frontal, parietal, temporal, occipital lobes. Levels of childhood trauma, anxiety and depression were measured using respectively the Childhood Trauma Questionnaire, State-anxiety questionnaire and Beck Depression Inventory. Compared to the low-risk group, the high-risk group did not exhibit significant differences in the mean [11C]-PBR28 VT (F(1,20) = 1.619, p = 0.218) or DVR (F(1,22) = 0.952, p = 0.340) on any region. There were no significant correlations between the [11C]-PBR28 VT and DVRs in total gray matter and frontal lobe and measures of childhood trauma, anxiety and depression. Psychosocial risk factors for depression and/or psychosis are unlikely to be associated with alterations in [11C]-PBR28 binding, indicating that alterations in TSPO expression reported in these disorders is unlikely to be caused by psychosocial risk factors alone.
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Affiliation(s)
- Tarik Dahoun
- Psychiatric Imaging Group MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College, Hammersmith Hospital, London W12 0NN, UK; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX37 JX, UK
| | - Marilia A Calcia
- Institute of Psychiatry, Neurology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Neurology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - Peter Bloomfield
- Psychiatric Imaging Group MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College, Hammersmith Hospital, London W12 0NN, UK
| | - Tiago Reis Marques
- Psychiatric Imaging Group MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College, Hammersmith Hospital, London W12 0NN, UK; Institute of Psychiatry, Neurology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - Federico Turkheimer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Neurology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - Oliver D Howes
- Psychiatric Imaging Group MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College, Hammersmith Hospital, London W12 0NN, UK; Institute of Psychiatry, Neurology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK.
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Ballespí S, Vives J, Alonso N, Sharp C, Ramírez MS, Fonagy P, Barrantes-Vidal N. To know or not to know? Mentalization as protection from somatic complaints. PLoS One 2019; 14:e0215308. [PMID: 31048857 PMCID: PMC6497236 DOI: 10.1371/journal.pone.0215308] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/29/2019] [Indexed: 01/29/2023] Open
Abstract
Somatization processes are usually associated with a lack of insight or with emotional unawareness, especially in adolescents where the ability for self-reflection is beginning to mature. However, the extent to which different levels of insight explain variations in somatization remains understudied. This study aimed to evaluate whether high-level emotional awareness (comprehension) but not low-level awareness (only attention) is needed to psychologically cope with suffering, thus leading to lower somatization. Specific predictions were: 1) High attention along with High comprehension will be associated with significantly lower frequency of somatic complaints than other combinations (Low attention and Low comprehension, or High attention but Low comprehension); 2) In absence of comprehension, no attention will be more optimal than attention only, because only-attention might work as an amplificatory of suffering without the possibility of processing it. Self-reports of meta-cognitive processes, somatization, and control variables were obtained from 264 adolescents from a non-clinical population (54.5% female; aged 12-18, M = 14.7, SD = 1.7). In line with expectations, results revealed significant differences in the effects of insight positions on somatization: Attention+Comprehension (M = 4.9, SE = 0.9) < Nothing (M = 7.1, SE = 0.3) < Only attention (M = 8.9, SE = 0.7). Compared to Nothing, Attention+comprehension was associated with significantly reduced somatic complaints (B = -2.2, p = 0.03, 95% CI -4,1 to 0.2). However, Only attention was associated with increased somatic complaints compared to the other two conditions (B = 1.8, p = 0.03, 95% CI 0.2 to 3.4; B = 4, CI 95% 1.6-6.3, p = 0.001, respectively). This highlights the role of higher-order awareness (i.e., comprehension or clarity) in the processing of suffering and stresses its value in the adaptive coping of emotional distress.
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Affiliation(s)
- Sergi Ballespí
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Jaume Vives
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Naida Alonso
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, United States of America
| | - María Salvadora Ramírez
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Peter Fonagy
- Department of Psychology & Lang Sciences, University College London, London, United Kingdom
| | - Neus Barrantes-Vidal
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Mental Health, Fundació Sanitària Sant Pere Claver, Barcelona, Catalonia, Spain
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Hoppen TH, Chalder T. Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clin Psychol Rev 2018; 65:81-151. [PMID: 30189342 DOI: 10.1016/j.cpr.2018.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 02/09/2023]
Affiliation(s)
| | - Trudie Chalder
- Academic Department of Psychological Medicine, King's College London, UK
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40
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Morina N, Schnyder U, Klaghofer R, Müller J, Martin-Soelch C. Trauma exposure and the mediating role of posttraumatic stress on somatic symptoms in civilian war victims. BMC Psychiatry 2018; 18:92. [PMID: 29631551 PMCID: PMC5891991 DOI: 10.1186/s12888-018-1680-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 03/27/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been well documented that the exposure to war has a negative effect on the psychological health of civilian. However, little is known on the impact of war exposure on the physical health of the civilian population. In addition, the link between trauma exposure and somatic symptoms remain poorly understood. This cross-sectional study examined levels of somatic symptoms in the aftermath of war, and the mediating role of posttraumatic stress symptoms in the relationship between trauma exposure and somatic symptoms. METHODS Civilian war survivors (N = 142) from Kosovo were assessed for potentially traumatic events, posttraumatic stress symptoms, and somatic symptoms. Data were analyzed using mediation analyses. Posttraumatic stress disorder (PTSD) symptoms were categorized based on King's four factor model (Psychol Assessment. 10: 90-96, 1998). RESULTS Participants reported on average more than 5 types of traumatic exposure. The cut-off indicative for PTSD was exceeded by 26.1% of participants. Symptom levels of PTSD were associated with somatic symptoms. The relationship between trauma exposure and somatic symptoms was partly mediated by the active avoidance and hyperarousal symptom clusters of PTSD. CONCLUSION Active avoidance and hyperarousal symptoms seem to play a key role in traumatized people suffering from somatic symptoms.
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Affiliation(s)
- Naser Morina
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Culmannstrasse 8, 8091, Zurich, Switzerland.
| | - Ulrich Schnyder
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland
| | - Richard Klaghofer
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland
| | - Julia Müller
- Psychiatric Services Thurgau, 8596 Münsterlingen, Switzerland ,0000 0004 0523 5263grid.21604.31Paracelsus Medical University, Salzburg, Austria
| | - Chantal Martin-Soelch
- 0000 0004 0478 1713grid.8534.aDivision of Clinical and Health Psychology, Department of Psychology, University of Fribourg, 1700 Fribourg, Switzerland
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Hébert M, Boisjoli C, Blais M, Oussaïd E. Alexithymia as a mediator of the relationship between child sexual abuse and psychological distress in adolescence: A short-term longitudinal study. Psychiatry Res 2018; 260:468-472. [PMID: 29274605 PMCID: PMC5770211 DOI: 10.1016/j.psychres.2017.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/08/2017] [Accepted: 12/09/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Understanding factors influencing mental health of sexually abused teenagers is essential to orient treatment with this vulnerable population. The purpose of this study was to explore alexithymia as a mediator of the relationship between child sexual abuse and psychological distress using a representative sample of teenagers, while considering gender as a potential moderator. METHODS Teenagers participating in the Quebec Youths' Romantic Relationships Survey completed measures evaluating a history of child sexual abuse and alexithymia at baseline while psychological distress was evaluated 6 months later. RESULTS A moderated mediated model revealed a partial mediation effect of alexithymia in the relationship between child sexual abuse and psychological distress. Gender acted as a moderator as the conditional indirect effects of child sexual abuse on mental health via alexithymia were stronger for boys. CONCLUSION Findings underscore the relevance of assessing and targeting sexually abused victims' capacity to identify and communicate emotions to promote well-being.
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Affiliation(s)
- Martine Hébert
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada.
| | - Cyndi Boisjoli
- Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Martin Blais
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Essaïd Oussaïd
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
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Childhood maltreatment is associated with attachment insecurities, dissociation and alexithymia in bipolar disorder. Psychiatry Res 2018; 260:391-399. [PMID: 29253803 DOI: 10.1016/j.psychres.2017.12.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/10/2017] [Accepted: 12/11/2017] [Indexed: 12/22/2022]
Abstract
Child maltreatment is a public health issue that is a well-established risk factor for many psychological conditions, including bipolar disorder. The current study is one of the first to investigate associations among child maltreatment, dissociative symptomatology, alexithymia, anxiety, depression, and attachment insecurities. 40 patients with bipolar disorder-I and 40 healthy subjects matched for age, gender, and education participated in the study. The Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), Childhood Trauma Questionnaire (CTQ-28), Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Experiences in Close Relationships-Revised (ECR-R) were completed by participants. In comparison to control participants, patients with bipolar disorder-I reported significantly more frequent abusive experiences in childhood, higher levels of attachment insecurities, more severe pathological and somatoform dissociation, as well as higher scores on measures of alexithymia, anxiety, depression and psychological stress. Reports of psychopathology among first-degree relatives (OR = 102.169, 95%IC = 4.596-2271.255; P < 0.01) and childhood emotional trauma (OR = 1.032; 95%CI = 0.782-1.363, P = 0.05) significantly contributed to bipolar disorder-I diagnosis. In contrast, absorption was negatively associated with bipolar illness (OR = 0.852; 95% CI = 0.747-0.973, P < 0.05). Our results showed significant associations between childhood trauma exposure and risk of bipolar disorder. Moreover, the results demonstrate that emotional abuse exposure predicts bipolar illness.
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Chen L, Xu L, You W, Zhang X, Ling N. Prevalence and associated factors of alexithymia among adult prisoners in China: a cross-sectional study. BMC Psychiatry 2017; 17:287. [PMID: 28768497 PMCID: PMC5541430 DOI: 10.1186/s12888-017-1443-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/24/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prison is an extremely stressful environment and prisoners have an increasing risk of suffering from alexithymia. Therefore, this study aims to investigate the prevalence and associated factors of alexithymia among prisoners in China. METHODS A cross-sectional study was conducted in five main jails of the district of Zhejiang province in China, and a total of 1705 adult prisoners ultimately took part in the study. Toronto Alexithymia Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale and several short demographic questions were applied. RESULTS Over 30% of prisoners were classified as alexithymics and as high as 96.2% of prisoners suffered from at least one traumatic experience in their childhood, meanwhile, 81.5%, 53.4% and 85.8% were found to be positive for depression, anxiety and hopelessness symptoms respectively. Education, childhood trauma, negative emotional symptoms including depression, anxiety and hopelessness of the respondents, were negatively or positively associated with alexithymia among prisoners. CONCLUSIONS The results indicated that high prevalence of alexithymia among prisoners is linked with their level of education, experience of childhood trauma and symptoms of negative emotions. Accordingly, the findings in our study can be used for prevention and intervention of alexithymia among prisoners.
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Affiliation(s)
- Li Chen
- Department of Applied Psychology, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Linna Xu
- 0000 0001 2151 7947grid.265850.cDepartment of Economics, University at Albany, State University of New York, Albany, NY USA
| | - Weimin You
- Public Security Sub-Bureau of Huangyan, Taizhou Public Security Bureau, Huangyan, China
| | - Xiaoyan Zhang
- 0000 0004 1764 2632grid.417384.dDepartment of Children’s Health Care, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Saariaho AS, Saariaho TH, Mattila AK, Ohtonen P, Joukamaa MI, Karukivi M. Alexithymia and depression in the recovery of chronic pain patients: a follow-up study. Nord J Psychiatry 2017; 71:262-269. [PMID: 28413937 DOI: 10.1080/08039488.2016.1275782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Childhood adversities and emotional dysregulation are connected with chronic pain, alexithymia, and depression. Longitudinal studies exploring the impact of their co-occurrence on the pain situation are rare. AIMS The influence of alexithymia, depression, baseline pain situation, and treatment options on the course of chronic pain in a clinical sample was studied. METHODS The baseline data was collected from chronic pain patients (n = 154) before their first pain clinic visit, and the follow-up data after 1 year by self-report questionnaires. Study variables consisted of pain intensity, pain disability, alexithymia (TAS-20), depression (BDI-II), and treatment interventions. Statistical analyses were performed to find out differences between baseline and follow-up, as well as between alexithymic and non-alexithymic patients, and to estimate the effect of the treatment provided. RESULTS At follow-up, the majority of the patients had pain intensity and disability severe enough to disrupt with their daily living. None of treatment interventions was related to better outcome. Alexithymic patients reported more pain disability and depression at both baseline and at follow-up. The effect of alexithymia on pain disability was mediated by depression. The use of opioids was connected to alexithymia and depressiveness. Alexithymia and depression made a substantial contribution to poorer outcome. CONCLUSIONS Severe pain intensity and disability with depression and alexithymia predicted difficulties in achieving improvement. Depression and alexithymia probably impair compliance with treatment and adherence to interventions. Their co-occurrence with a more severe pain situation and with the use of opioids indicates psychological problems underlying the pain experience.
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Affiliation(s)
| | - Tom H Saariaho
- b Pain Clinic , Oulu University Hospital , Oulu , Finland
| | - Aino K Mattila
- c Department of Psychiatry , Tampere University Hospital , Tampere , Finland
| | - Pasi Ohtonen
- d Department of Anesthesiology and Surgery , Oulu University Hospital , Oulu , Finland
| | - Matti I Joukamaa
- e School of Health Sciences, Tampere University , Tampere , Finland
| | - Max Karukivi
- f Department of Psychiatry , University of Turku and Turku University Hospital, Turku Unit of Adolescent Psychiatry, Satakunta Hospital District , Pori , Finland
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Brown S, Fite PJ, Stone K, Richey A, Bortolato M. Associations between emotional abuse and neglect and dimensions of alexithymia: The moderating role of sex. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2017; 10:300-308. [PMID: 28414491 DOI: 10.1037/tra0000279] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Child maltreatment, specifically emotional maltreatment (i.e., an act, such as belittling, blaming, or rejection, that is potentially harmful to a child's emotional development), has emerged as an important correlate of alexithymia. However, the evidence is mixed with regard to how emotional abuse and neglect might relate to dimensions of alexithymia (i.e., externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings). Furthermore, research is needed to identify individual factors that might influence these associations. The current study examined the links between emotional abuse and neglect and externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings and evaluated whether sex moderated these associations. METHOD Participants included 500 emerging adults (49.6% male) who completed an online battery of questionnaires assessing history of child maltreatment and dimensions of alexithymia. RESULTS Regression analyses revealed that emotional abuse was associated with difficulty describing feelings and externally oriented thinking, but not difficulty identifying feelings. Emotional neglect was associated with difficulty identifying feelings, but not difficulty describing feelings or externally oriented thinking. There were no sex differences associated with difficulty describing feelings or externally oriented thinking. However, sex moderated the associations between emotional abuse and neglect and difficulty identifying feelings such that emotional abuse and neglect were both more strongly associated with difficulty identifying feelings for females. CONCLUSION These results suggest that, in the aftermath of emotional maltreatment, sex may play an important role in the development of difficulty identifying feelings. (PsycINFO Database Record
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Affiliation(s)
| | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
| | - Katie Stone
- Clinical Child Psychology Program, University of Kansas
| | - Allora Richey
- Clinical Child Psychology Program, University of Kansas
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, University of Utah
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Zhu Y, Luo T, Liu J, Qu B. Influencing factors of alexithymia in Chinese medical students: a cross-sectional study. BMC MEDICAL EDUCATION 2017; 17:66. [PMID: 28372565 PMCID: PMC5379661 DOI: 10.1186/s12909-017-0901-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 03/14/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND A much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors. METHODS A cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach's α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student's t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0. RESULTS Of the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach's α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05). CONCLUSIONS Gender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.
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Affiliation(s)
- Yaxin Zhu
- School of Public Health, China Medical University, Shenyang, Liaoning Province People’s Republic of China
| | - Ting Luo
- Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province Postal Code: 110122 People’s Republic of China
| | - Jie Liu
- School of Public Health, China Medical University, Shenyang, Liaoning Province People’s Republic of China
| | - Bo Qu
- Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province Postal Code: 110122 People’s Republic of China
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Taycan O, Özdemir A, Erdoğan Taycan S. Alexithymia and Somatization in Depressed Patients: The Role of the Type of Somatic Symptom Attribution. Noro Psikiyatr Ars 2017; 54:99-104. [PMID: 28680305 DOI: 10.5152/npa.2016.12385] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/11/2015] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION This study aimed to establish the association between alexithymia and various factors, mainly somatization, and to determine the predictors of alexithymia in depressed patients. METHODS A total of 90 patients with major depressive disorder who met The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Symptom Checklist-90 (SCL-90), Somatosensory Amplification Scale, and Symptom Interpretation Questionnaire. The patients were classified into two groups as alexithymic and non-alexithymic with respect to the TAS cut-off points (≥59=alexithymic). Predictors of alexithymia were tested by multiple linear regression analysis. RESULTS Of all patients, 36 (40%) were in the alexithymic group. The percentage of women, depression severity, level of general psychopathology and distress, and somatic symptom reporting (SCL-90), as well as the tendency to somatosensory amplification and three forms of somatic symptom attributions, were significantly higher in alexithymic patients than in non-alexithymic patients. Furthermore, age, depression severity, somatic symptom reporting, and the tendency to attribute physical symptoms to somatic causes were predictors of alexithymia. CONCLUSION The results indicated an intimate association between alexithymia and somatization in depressed patients. Therefore, when evaluating depressed patients with alexithymia, their tendency for somatization should be considered, and alexithymic individuals should be assessed with particular attention, considering that somatization can mask the underlying depressive condition.
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Affiliation(s)
- Okan Taycan
- Clinic of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Armağan Özdemir
- Clinic of Psychiatry, Bakırköy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
| | - Serap Erdoğan Taycan
- Clinic of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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Zou Z, Huang Y, Wang J, He Y, Min W, Chen X, Wang J, Zhou B. Association of childhood trauma and panic symptom severity in panic disorder: Exploring the mediating role of alexithymia. J Affect Disord 2016; 206:133-139. [PMID: 27474959 DOI: 10.1016/j.jad.2016.07.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 05/26/2016] [Accepted: 07/18/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND The aim of the present study was to examine the association between childhood trauma (CT), alexithymia, and panic symptom severity in patients with panic disorder (PD). Moreover, the effect of specific subtypes of CT on alexithymia and panic symptom severity was also investigated. METHODS 142 patients with PD and 146 healthy age-matched and sex-matched controls were enrolled in the study. The Structured Clinical Interview for DSM-IV axis I (SCID-I), Childhood Trauma Questionnaire-28 item Short Form (CTQ-28), Toronto Alexithymia Scale (TAS-20), and Panic Disorder Severity Scale (PDSS) were administered to all subjects. The relationships among CT subtypes, alexithymia, and panic symptom severity were investigated using Pearson's correlation analysis. The types of CT that predict alexithymia and panic symptom severity were also investigated using Regression analyses. RESULTS PD patients showed higher scores on reporting all kinds of CT except sexual abuse. In addition, the TAS-20, DIF (difficulty identifying feelings) and DDF (difficulty describing feelings) scores were significantly higher in patients with PD than in controls. Significant positive correlations were noted among CT, alexithymia and panic symptoms severity. Results of regression analyses showed alexithymia as a mediator between the different types of CT and panic disorder severity, except sexual abuse. LIMITATIONS Although self-report questionnaires are reliable and widely used, the phenomenon of patients who underreport or overreport their symptoms cannot be ignored. CONCLUSION The present study showed that CT and alexithymia are more common in patients with PD and impact the severity of panic symptoms. Results suggest that alexithymia may be an important mediator between CT and panic disorder severity.
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Affiliation(s)
- Zhili Zou
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Yulan Huang
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Jinyu Wang
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Ying He
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Wenjiao Min
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Xu Chen
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Jing Wang
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China
| | - Bo Zhou
- Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, China.
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Serafini G, Gonda X, Pompili M, Rihmer Z, Amore M, Engel-Yeger B. The relationship between sensory processing patterns, alexithymia, traumatic childhood experiences, and quality of life among patients with unipolar and bipolar disorders. CHILD ABUSE & NEGLECT 2016; 62:39-50. [PMID: 27792883 DOI: 10.1016/j.chiabu.2016.09.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 06/06/2023]
Abstract
Several studies documented the involvement of sensory perception in emotional processes. The long-term consequences of traumatic experiences and alexithymia have been demonstrated as well. However, the role of extreme sensory processing patterns, traumatic childhood experiences, and alexithymia has not been thoroughly examined in major affective disorders. The present study aimed to: (1) compare unipolar/bipolar patients with regard to their sensory processing patterns, alexithymia, childhood traumatic experiences and quality of life; (2) examine the correlations between sensory processing patterns and childhood traumatic experiences; (3) investigate the relative contribution of diagnostic groups (unipolar/bipolar), sensory processing patterns, alexithymia, and childhood traumatic experiences in predicting quality of life. The sample included 336 participants, 197 with unipolar and 139 with bipolar disorder. All participants completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale, Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI)-II, and Short Form 12 Health Survey version 2 (SF-12). Bipolar patients showed significantly higher physical neglect, emotional abuse, and emotional neglect compared with unipolar patients. Both in unipolar and bipolar groups, lower registration of sensory input as well as hypersensitivity correlated with enhanced childhood trauma events. Reduced sensory sensitivity accounted for 11% of the variance in physical health composite score (PCS) of SF-12 whereas reduced depression accounted for 8% of the variance in mental health composite score (MCS). Furthermore, elevated MCS was predicted by depression, physical and emotional neglect. Sensory processing patterns and childhood traumatic experiences may specifically characterize individuals with major affective disorders and play a role in the prediction of their quality of life.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Semmelweis University, Hungary
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant'Andrea Hospital, University of Rome, Rome, Italy
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
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Aceto P, Lai C, Perilli V, Sacco T, Modesti C, Raffaelli M, Sollazzi L. Factors affecting acute pain perception and analgesics consumption in patients undergoing bariatric surgery. Physiol Behav 2016; 163:1-6. [DOI: 10.1016/j.physbeh.2016.04.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/15/2016] [Accepted: 04/16/2016] [Indexed: 01/25/2023]
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