The distinctiveness and utility of a brief measure of alexithymia for adolescents

The mediating effect of internet addiction and the moderating effect of physical activity on the relationship between alexithymia and depression

There is a certain relationship between alexithymia and depression, but further investigation is needed to explore their underlying mechanisms. The aims of this study was to explore the mediating role of internet addiction between alexithymia and depression and the moderating role of physical activity. A total of 594 valid responses were included in the analysis, with a mean age of 18.72 years (SD = 1.09). The sample comprised 250 males (42.09%) and 344 females (57.91%). These responses were utilized for descriptive analysis, correlation analysis, regression analysis, and the development of mediation and moderation models. Alexithymia showed positive correlations with depression and internet addiction, and physical activity was negatively correlated with internet addiction and depression. Internet addiction partially mediated the relationship between alexithymia and depression, while physical activity weakened the association between internet addiction and depression, acting as a moderator. Our findings suggest that excessive Internet engagement may mediate the relationship between alexithymia and depression as an emotional regulatory coping strategy, and that physical activity attenuates the predictive effect of Internet addiction on depression.

Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence

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.

Serial Mediation Roles of Alexithymia and Loneliness in the Association Between Family Function and Internet Addiction Among Chinese College Students

A lot of previous research has highlighted the negative consequences of Internet addiction. However, relatively few is known about the underlying mechanism for Internet addiction among college students in relation to family function. The present study explored the relationship between family function and Internet addiction among college students, as well as the mediating effects of alexithymia and loneliness. A sample of 783 Chinese college students were administered a number of psychometric scales including the “General Function” subscale of the Chinese version of the Family Assessment Device, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Revised Chinese Internet Addiction Scale. The results showed that family function was negatively associated with Internet addiction; the association was significantly mediated by alexithymia; the association was significantly mediated by loneliness; and alexithymia and loneliness sequentially mediated the association. The total mediating effect was 63.96%. The results of the present study are of great significance to the prevention and intervention of Internet addiction among college students.

Disentangling the diversity of profiles of adaptation in youth during COVID-19

Background: The COVID-19 outbreak has major psychosocial consequences on the global population and specialists report that youth may be significantly impacted. Adolescents and young adults, for whom social life is an important protective factor, had to face a new isolation caused by social distancing and home schooling. This study aims to explore youth's profiles of adaptation to COVID-19 pandemic in the province of Quebec, Canada, and the risk factors and strengths associated with each profile.

Methods: A sample of 4936 youth living in Quebec were recruited on social media and filled out an online survey during the lockdown of the first wave of COVID-19. They completed measures of psychological distress, positive adaptation (well-being, resilience), risk factors (alexithymia and emotional dysregulation), COVID-related worries and fear of contamination and COVID-related post-traumatic stress disorder (PTSD).

Results: The results of the latent class analysis showed four patterns of adjustment. The Resilient group (36.6% of the sample) showed the highest probability of a positive adaptation. The High distress class (29.5%) reported clinical distress, low to moderate symptoms of PTSD and fear of contamination and no significant well-being. The Moderate symptoms class (17.55%) showed moderate levels of distress and COVID-related symptoms, with half of the group still showing significant well-being. The Traumatized class (16.35%) reported the worst adaptation. Correlates significantly differentiated profiles.

Limitations: The study relied on a convenience sample and a cross-sectional design.

Conclusion: Disentangling the diversity of adaptation profiles may orient more adapted resources for youth in need during this unprecedented crisis.

The Relationship of Smartphone Addiction and Alexithymia

OBJECTIVE

This study aims to evaluate whether smartphone addiction (SA) is associated with social media use and alexithymia levels in university students.

METHODS

A group of 935 students aged between 18 and 45 years (509 females and 426 males) was recruited from different universities in Istanbul. SAs, alexithymia and social media use were assessed using the Smartphone Addiction Scale Short Version (SAS-SV), Toronto Alexithymia Scale-20 (TAS-20), and ad-hoc questions regarding social media use.

RESULTS

The mean age of participants was 21.89±3.27 years and 509 of participants were female (54.4%). 455 (48.6%) participants were placed in the "SA" and 198 (21.2%) in the "alexithymia" categories. The study found a high level of positive correlation (p<0.001) between both subscale and total TAS-20 scores and SAS-SV scores. Gender (OR=1.496, 95% CI 1.117-2.002, p=0.007) and number of social media by participants (OR=1.221, 95% CI 1.134-1.315, p<0.001) and TAS (OR=1.074, 95% CI 1.059-1.090, p<0.001) were found to be an independent predictors for SA.

CONCLUSION

The study revealed a positive correlation between alexithymia and smartphone use severity, and alexithymia was a significant predictor of SA. Future studies focusing on the causal aspect of this relationship will be useful in planning strategies for treatment.

Low Emotional Awareness as a Transdiagnostic Mechanism Underlying Psychopathology in Adolescence

The ability to identify and label one's emotions is associated with effective emotion regulation, rendering emotional awareness important for mental health. We evaluated how emotional awareness was related to psychopathology and whether low emotional awareness was a transdiagnostic mechanism explaining the increase in psychopathology during the transition to adolescence and as a function of childhood trauma-specifically violence exposure. In Study 1, children and adolescents (N=120, aged 7-19 years) reported on emotional awareness and psychopathology. Emotional awareness was negatively associated with psychopathology (p-factor) and worsened across age in females but not males. In Study 2 (N=262, aged 8-16 years), we replicated these findings and demonstrated longitudinally that low emotional awareness mediated increases in p-factor as a function of age in females and violence exposure. These findings indicate that low emotional awareness may be a transdiagnostic mechanism linking adolescent development, sex, and trauma with the emergence of psychopathology.

Cross-National Associations Among Cyberbullying Victimization, Self-Esteem, and Internet Addiction: Direct and Indirect Effects of Alexithymia

The relationship among cyberbullying victimization, lower self-esteem, and internet addiction has been well-established. Yet, little research exists that explains the nature of these associations, and no previous work has considered the inability to identify or describe one’s emotions, namely, alexithymia, as a potential mediator of these links. The present study sought to investigate the indirect effects of cyberbullying victimization on self-esteem and internet addiction, mediated by alexithymia. The sample consisted of 1,442 participants between 12 and 17 years (M_age = 14.17, SD = 1.38, 51.5% male) from Germany, the Netherlands, and the United States. Results showed a direct relationship between cyberbullying victimization and self-esteem and an indirect association mediated by alexithymia in the Dutch sample. However, in the German and U.S. samples, only an indirect relationship via alexithymia, but not a direct effect of cyberbullying victimization on self-esteem, was found. Consistent across the three country samples, cyberbullying victimization and internet addiction were directly and also indirectly associated via alexithymia. In sum, findings indicate that alexithymia might help better understand which detrimental effects cyberbullying victimization has on adolescent psychological health. Thus, cyberbullying prevention programs should consider implementing elements that educate adolescents on the ability to identify and describe their own emotions.

The Relationship Between Parental Attachment and Mobile Phone Dependence Among Chinese Rural Adolescents: The Role of Alexithymia and Mindfulness

Mobile phone has experienced a significant increase in popularity among adolescents in recent years. Findings indicate dependence on mobile phone is related to poor parent-child relationship. However, previous research on mobile phone dependence (MPD) is scant and mainly focus on adult samples. In this view, the present study investigated the association between parental attachment and MPD as well as its influence mechanism, in sample of adolescents in rural China. Data were collected from three middle schools in rural areas of Jiangxi and Hubei Province (N = 693, 46.46% female, M age = 14.88, SD = 1.77). Participants completed the Inventory of Parent and Peer Attachment (IPPA), the twenty-item Toronto alexithymia scale (TAS-20), the Mindful Attention Awareness Scale (MAAS) and the Mobile Phone Addiction Index Scale (MPAI). Among the results, parental attachment negatively predicted MPD and alexithymia were exerting partial mediation effect between parental attachment and MPD. Further, mindfulness acted as moderator of the relationship between alexithymia and MPD: The negative impact of alexithymia on MPD was weakened under the condition of high level of mindfulness. Knowledge of this mechanism could be useful for understanding adolescents' MPD in terms of the interaction of multiple factors.

Compulsive internet use and the development of self-esteem and hope: A four-year longitudinal study

OBJECTIVE

Compulsive internet use (CIU) has been linked to decrements in mental health and well-being. However, relatively little is known about how CIU relates to evaluations of the self, and in particular, whether CIU is antecedent to or is a consequence of negative evaluations of one's social worth (self-esteem) and general efficacy (hope). To examine this, we explored the longitudinal relations between CIU and the development of self-esteem and hope among adolescents over a four-year period.

METHOD

Two thousand eight hundred and nine adolescents completed measures yearly from Grade 8 (M_Age = 13.7) to Grade 11. Autoregressive cross-lagged structural equation models were used to test whether CIU influenced or was influenced by self-esteem and hope.

RESULTS

We found consistent support for a CIU-as-antecedent model. CIU preceded reductions in trait hope, and small reductions in self-esteem. In contrast, we did not find evidence for a CIU-as-consequence model: low self-esteem and hope did not predict increases in CIU over time.

CONCLUSIONS

Our findings suggest that CIU has negative consequences for young people's feelings of goal-efficacy, and that interventions that address the compulsive use of the internet are likely to strengthen hope and self-esteem among young people.

Association of Internet addiction and alexithymia - A scoping review

It has been hypothesized that individuals with alexithymia who have difficulty in identifying, expressing, and communicating emotions may overuse Internet as a tool of social interaction to better regulate their emotions and to fulfill their unmet social needs. Similarly, an increasing body of evidence suggests that alexithymia may also play an essential role in the etiopathogenesis of addictive disorders. We conducted a scoping review of questionnaire-based studies of problematic Internet use/Internet addiction and alexithymia. From initial 51 studies, all of the final 12 included studies demonstrated a significant positive association between scores of alexithymia and severity of Internet addiction. However, the causal direction of the association is not clear because the interplay of numerous other variables that could affect the relation has not been studied. There are limitations in the methodology of the studies conducted. Hence, we emphasise the need for longitudinal studies with stronger methodologies.

Self-Esteem Trajectories and Their Social Determinants in Adolescents With Different Levels of Cognitive Ability

This study examines the development of self-esteem in a sample of 138 Australian adolescents (90 males; 48 females) with cognitive abilities in the lowest 15% (L-CA) and a matched sample of 556 Australian adolescents (312 males; 244 females) with average to high levels of cognitive abilities (A/H-CA). These participants were measured annually (Grade 7 to 12). The findings showed that adolescents with L-CA and A/H-CA experience similar high and stable self-esteem trajectories that present similar relations with key predictors (sex, school usefulness and dislike, parenting, and peer integration). Both groups revealed substantial gender differences showing higher levels of self-esteem for adolescent males remaining relatively stable over time, compared to lower levels among adolescent females which decreased until midadolescence before increasing back.

A worthy self is a caring self: Examining the developmental relations between self-esteem and self-compassion in adolescents

OBJECTIVE

Self-compassion has been framed as a healthy alternative to self-esteem, as it is nonevaluative. However, rather than being alternatives, it may be that the two constructs develop in a mutually reinforcing way. The present study tested this possibility among adolescents.

METHOD

A large adolescent sample (N = 2,809; 49.8% female) reported levels of trait self-esteem and self-compassion annually for 4 years. Autoregressive cross-lagged structural equation models were used to estimate the reciprocal longitudinal relations between the two constructs.

RESULTS

Self-esteem consistently predicted changes in self-compassion across the 4 years of the study, but not vice versa.

CONCLUSIONS

Self-esteem appears to be an important antecedent of the development of self-compassion, perhaps because the capacity to extend compassion toward the self depends on one's appraisals of worthiness. These findings add important insights to our theoretical understanding of the development of self-compassion.

The measurement of alexithymia in children and adolescents: Psychometric properties of the Alexithymia Questionnaire for Children and the twenty-item Toronto Alexithymia Scale in different non-clinical and clinical samples of children and adolescents

This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18–0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.

[The alexithymia questionnaire for children (AQC): Psychometric properties in a sample of 105 adolescents hospitalized in an adolescent psychiatric department]

OBJECTIVE

The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used measure of alexithymia in non-clinical or clinical populations. The TAS-20 evaluates three dimensions of the alexithymia construct: the difficulty identifying feelings (DIF), the difficulty describing feelings (DDF) and externally oriented thinking (EOT). The TAS-20 is also used in adolescents or children, and the psychometric properties of the scale have not been systematically evaluated in these populations. Recently several studies have shown systematic age differences in the factor structure and a decrease of the quality of the measurement with age. Notably, low reliability measured by the Cronbach α coefficient has been found for the EOT factor. Taking into account the limitations of the TAS-20 in pre-adult populations the Alexithymia Questionnaire for Children (AQC), an adaptation of the TAS-20, has been proposed by a reformulation of the TAS-20 items (Rieffe et al., 2006). Two studies in healthy children found satisfactory psychometric properties with the three-factor structure demonstrating adequate parameters in the confirmatory factorial analyses (CFA). In the two studies low reliabilities of the EOT factor were reported, and recent studies in adolescents using the TAS-20 found that a two-factor model (DDF, DIF) had a better fit than the original three-factor model. Thus, the aim of the present study was firstly to verify the psychometric properties of the AQC in a sample of adolescents presenting various psychiatric disorders and secondly to test the adequacy of the bi- or tridimensional model of the scale.

METHOD

One hundred and five adolescents (27 males, 78 females) with a mean age of 15.06 years (sd=1.55, range: 12-18 years) were hospitalized in the adolescent psychiatric department of the Erasme Hospital (Bruxelles, Belgium) for various psychiatric disorders. The main diagnoses were: adjustment disorder (n=56, 53.5%), mood or anxiety disorders (n=17, 16.2%), impulse control disorder (n=11, 10.5%). The subjects completed the French version of the AQC. CFA were done testing the adequacy of the three or two-factor structure of the scale. Two indices were considered: the normed χ² (ratio of χ² and degrees of freedom) and the root mean square error of approximation (RMSEA). The values for acceptable fit were normed χ²<3 and RMSEA<0.05. Cronbach α were also calculated.

RESULTS

Fit indices for the three-factor model were respectively 1.165 and 0.0303 for the normed χ² and RMSEA. For the two-factor model, the values were respectively 0.819 and 0. Thus, these two well-fitting models were compared using the χ²-difference test, which indicated a significantly better fit for the two-factor model over the three-factor model (χ²-difference=151.447, delta df=114, P<0.05). The values of the Cronbach α coefficients were respectively 0.72, 0.75, 0.18 for DIF, DDF and EOT subscales. Moreover, the values of the Cronbach α coefficients were respectively 0.71 and 0.83 for the full scale and the scale without the EOT items.

CONCLUSION

The Alexithymia Questionnaire for Children had satisfactory psychometric properties found in a sample of adolescent psychiatric inpatients. Taking into account firstly the superiority of the two-factor model over the classical three-factor model and secondly the low value of the Cronbach α for the EOT factor, it is proposed to use only the twelve-item scale by excluding the EOT items.

The relationship between alexithymia, anxiety, depression, and internet addiction severity in a sample of Italian high school students

We aimed to assess whether Internet addiction (IA) severity was related to alexithymia scores among high school students, taking into account the role of gender differences and the possible effect of anxiety, depression, and age. Participants in the study were 600 students (ages ranging from 13 to 22; 48.16% girls) recruited from three high schools in two cities from Southern Italy. Participants completed a sociodemographic questionnaire, the Toronto Alexithymia Scale, the Internet Addiction Test, the Hamilton Anxiety Scale, and the Hamilton Depression Scale. The findings of the study showed that IA scores were associated with alexithymia scores, over and above the effect of negative emotions and age. Students with pathological levels of alexithymia reported higher scores on IA severity. In particular, results showed that difficulty in identifying feelings was significantly associated with higher scores on IA severity. No effect of gender was found. Implications for clinicians were discussed.

The role of emotion identification skill in the formation of male and female friendships: a longitudinal study

The present study explored the relationship between emotion identification skill (EIS) and friendships in adolescence. Students from five Australian high schools completed questionnaires annually from Grade 8 to Grade 12 including subjective measures of EIS and a peer-based objective measure of social functioning (e.g., friendship nominations). The total sample of participants was 795 (406 males; 389 females) with 468 (225 males; 243 females) completing questionnaires in Grade 12. EIS in early adolescence was predictive of friendships for females in late adolescence. Specifically, girls starting out with low EIS in Grade 8 tended to have fewer female friendships and more male friendships in Grade 12. There were no effects for males. Lower initial EIS was associated with significant improvements in awareness over time, but these improvements had no effect on friendships in Grade 12. The EIS that girls enter high school with may influence their friendship composition into late adolescence.

Is self-esteem a cause or consequence of social support? A 4-year longitudinal study

Considerable research has been devoted to examining the relations between self-esteem and social support. However, the exact nature and direction of these relations are not well understood. Measures of self-esteem, and social support quantity and quality were administered to 961 adolescents across five yearly time points (M(age) = 13.41 years). Structural equation modeling (SEM) was utilized to test between a self-esteem antecedent model (self-esteem precedes changes in social support), self-esteem consequence model (social support precedes change in self-esteem), and a reciprocal influence model. Self-esteem reliably predicted increasing levels of social support quality and network size across time. In contrast, the consequence model was not supported. The implications of this for helping adolescents to develop higher quality social support structures are discussed.