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Zizzi A, Berri IM, Berri A, Occhipinti M, Escelsior A, Guglielmo R, Pereira Da Silva B, Amore M, Serafini G. Psychological dimensions in alcohol use disorder: comparing active drinkers and abstinent patients. Front Psychiatry 2024; 15:1420508. [PMID: 38993382 PMCID: PMC11236675 DOI: 10.3389/fpsyt.2024.1420508] [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: 04/20/2024] [Accepted: 06/03/2024] [Indexed: 07/13/2024] Open
Abstract
Background Alcohol use disorder (AUD) is a major public health concern due to its various physical, psychological, and social consequences. Despite regulatory differences, abstinence remains the primary treatment objective. Addressing the multifaceted nature of alcohol use disorder requires a comprehensive approach. Methods 150 AUD patients (66%male) with a mean age of 54.10 ± 11.3 years were recruited for the study. Depression, impulsivity, alexithymia, and hopelessness were assessed to determine if there were significant differences in these dimensions between abstinent (N=72) and active drinkers (N=78). Results The study found significant differences in the psychological dimensions scores, active drinkers exhibited higher levels of depression, impulsivity, alexithymia, and hopelessness compared to abstinent patients. Conclusion Treatment outcomes for patients with AUD vary between regulatory agencies, but abstinence remains the safest and most preferred objective in managing AUD. Prioritizing abstinence-oriented interventions is crucial for achieving long term recovery and minimizing relapse risk. These results emphasize the intricate relationship between AUD and mental health issues, highlighting the need for comprehensive interventions addressing both alcohol consumption and associated psychological distress. Promoting abstinence (or at least reducing alcohol consumption) not only preserves mental health but also prevents life-threatening consequences such as suicide.
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Affiliation(s)
- Alessio Zizzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
| | | | | | | | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
- San Martino Hospital (IRCCS), Genova, Italy
| | - Riccardo Guglielmo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
- San Martino Hospital (IRCCS), Genova, Italy
| | - Beatriz Pereira Da Silva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child, School of Medical and Pharmaceutical Sciences, University of Genoa, Genova, Italy
- San Martino Hospital (IRCCS), Genova, Italy
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2
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Do Individuals with Internet Gaming Disorder Share Personality Traits with Substance-Dependent Individuals? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159536. [PMID: 35954898 PMCID: PMC9368036 DOI: 10.3390/ijerph19159536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Internet gaming disorder (IGD) shares many similarities with substance use disorder (SUD), contributing to its recognition as an addictive disorder. Nevertheless, no study has compared IGD to other addictive disorders in terms of personality traits established as highly co-occurring with SUDs. (2) Methods: We recruited a sample of gamers (massively multiplayer online role-playing games) (MMORPGs) via online in-game forums. We compared 83 individuals with IGD (MMORPG-IGD group) to 47 former heroin addicts under methadone maintenance treatment (MMT; MMT group) with regard to alexithymia, impulsivity, sensation seeking and aggressiveness assessed through self-administered scales, being TAS-20, BIS-10, Z-SSS and BDHI, respectively. (3) Results: Our results draw a relatively similar personality profile between groups but indicate that the subject traits are generally more pronounced in the MMT cohort. The overall lesser intensity of these traits in the MMORPG-IGD group might reflect the greater variability in the severity of the IGD. (4) Conclusions: IGD shares personality traits with MMT, and intensity may be influenced by the severity of the addiction or by certain direct environmental factors, and might also influence the propensity towards one behavior rather than another.
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3
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Arunagiri V, Reilly EE. Revisiting alexithymia as an important construct in the treatment of anorexia nervosa: a proposal for future research. Eat Disord 2022; 30:267-278. [PMID: 32966162 DOI: 10.1080/10640266.2020.1814987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Consistent research supports altered emotional processing in adult patients with anorexia nervosa (AN), including elevations in alexithymia, or deficits in identifying and describing emotions and other internal experiences. Despite increasing interest in emotion-focused therapies for AN, alexithymia is often not directly addressed within many existing treatments, and little empirical work has moved beyond descriptive, cross-sectional research. In this paper, we propose that refining the field's understanding of alexithymia may provide insights into poor outcomes in existing psychological treatments for AN. First, we provide a brief overview of existing work exploring alexithymia in AN, and then describe several next steps in treatment-relevant research, including differentiating alexithymia from related constructs, considering neurobiological correlates of alexithymia, testing the link between alexithymia and outcome across treatment modalities, and piloting adjunctive treatment techniques focused on emotional identification and description. Altogether, exploring adjunctive treatment approaches targeting alexithymia may offer one promising possibility for improving long-term outcomes.
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Affiliation(s)
| | - Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, NY, USA
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4
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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5
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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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6
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Orsolini L. Unable to Describe My Feelings and Emotions Without an Addiction: The Interdependency Between Alexithymia and Addictions. Front Psychiatry 2020; 11:543346. [PMID: 33192657 PMCID: PMC7644516 DOI: 10.3389/fpsyt.2020.543346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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7
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de Bruin PMJ, de Haan HA, Kok T. The prediction of alexithymia as a state or trait characteristic in patients with substance use disorders and PTSD. Psychiatry Res 2019; 282:112634. [PMID: 31757640 DOI: 10.1016/j.psychres.2019.112634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022]
Abstract
Alexithymia is common in patients with a substance use disorder (SUD) and is possibly a negative prognostic factor in their treatment. The aim of this study was twofold. First, we explored whether SUD patients with posttraumatic stress disorder (PTSD) are more alexithymic than SUD patients without PTSD. Next, we explored whether trait and state-related parts of alexithymia could be differentiated in these patients. This phenomenon was studied in 197 SUD patients with the Toronto Alexithymia Scale-20 (TAS-20); Clinician Administered PTSD Scale; Self-Report Inventory for PTSD; Traumatic Experiences Checklist; European Addiction Severity Index; and the Depression, Anxiety and Stress Scale in a cross-sectional design. SUD patients with current PTSD showed more alexithymic characteristics than patients without PTSD or with previous lifetime/not current PTSD. The severity of PTSD complaints; alcohol addiction; and the combination of depression, anxiety and stress symptoms, all of which are more related to alexithymia as a state, explained 38.1% of the TAS-20. In conclusion, we advise that SUD patients be assessed for alexithymia and that its degree is taken into account. We also tentatively assume that a considerable part of alexithymia is more state- than trait-related in these patients.
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Affiliation(s)
- Peggy M J de Bruin
- Tactus Addiction Treatment, P.O. Box 154, 7400 AD Deventer, the Netherlands.
| | - Hein A de Haan
- Tactus Addiction Treatment, P.O. Box 154, 7400 AD Deventer, the Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, 6500 HE Nijmegen, the Netherlands
| | - Tim Kok
- Tactus Addiction Treatment, P.O. Box 154, 7400 AD Deventer, the Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, 6500 HE Nijmegen, the Netherlands
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8
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Leshem R, van Lieshout PHHM, Ben-David S, Ben-David BM. Does emotion matter? The role of alexithymia in violent recidivism: A systematic literature review. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:94-110. [PMID: 30916846 DOI: 10.1002/cbm.2110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/28/2019] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Several variables have been evidenced for their association with violent reoffending. Resultant interventions have been suggested, yet the rate of recidivism remains high. Alexithymia, characterised by deficits in emotion processing and verbal expression, might interact with these other risk factors to affect outcomes. AIM Our goal was to examine the role of alexithymia as a possible moderator of risk factors for violent offender recidivism. Our hypothesis was that, albeit with other risk factors, alexithymia increases the risk of violent reoffending. METHOD We conducted a systematic literature review, using terms for alexithymia and violent offending and their intersection. RESULTS (a) No study that directly tests the role of alexithymia in conjunction with other potential risk factors for recidivism and actual violent recidivism was uncovered. (b) Primarily alexithymia researchers and primarily researchers into violence have separately found several clinical features in common between aspects of alexithymia and violence, such as impulsivity (total n = 24 studies). (c) Other researchers have established a relationship between alexithymia and both dynamic and static risk factors for violent recidivism (n = 16 studies). CONCLUSION Alexithymia may be a possible moderator of risk of violent offence recidivism. Supplementing offenders' rehabilitation efforts with assessments of alexithymia may assist in designing individually tailored interventions to promote desistance among violent offenders.
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Affiliation(s)
- Rotem Leshem
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Pascal H H M van Lieshout
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Boaz M Ben-David
- Communication, Aging and Neuropsychology lab (CANlab), Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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9
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Hemming L, Haddock G, Shaw J, Pratt D. Alexithymia and Its Associations With Depression, Suicidality, and Aggression: An Overview of the Literature. Front Psychiatry 2019; 10:203. [PMID: 31031655 PMCID: PMC6470633 DOI: 10.3389/fpsyt.2019.00203] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 03/20/2019] [Indexed: 11/21/2022] Open
Abstract
Depression affects around 4-10% of the general population in England. Depression can often lead to behaviors and thoughts related to suicide and aggression, which have a social and economic burden to the United Kingdom. One construct that has been theorized as having an association with these behaviors is alexithymia. People with alexithymia have difficulties identifying and describing their emotional experiences. To date, there is no consensus on types or causes of alexithymia. Whilst the literature evidences a strong relationship between alexithymia and suicidality and aggression, little is known about the nature of this relationship. The present article will attempt to describe the extant literature on this relationship, drawing out some of the contentions and unanswered questions.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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10
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Sampogna F, Puig L, Spuls P, Girolomoni G, Radtke M, Kirby B, Brunori M, Bergmans P, Smirnov P, Rundle J, Castiglia A, Lavie F, Paul C. Reversibility of alexithymia with effective treatment of moderate‐to‐severe psoriasis: longitudinal data from
EPIDEPSO. Br J Dermatol 2018; 180:397-403. [DOI: 10.1111/bjd.17259] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- F. Sampogna
- Clinical Epidemiology Unit Dermatological Hospital IDI‐IRCCS FLMM Rome Italy
| | - L. Puig
- Universitat Autònoma de Barcelona Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - P. Spuls
- Department of Dermatology University of Amsterdam Amsterdam the Netherlands
| | | | - M.A. Radtke
- Universitätsklinikum Hamburg‐Eppendorf Hamburg Germany
| | - B. Kirby
- St Vincent's University Hospital Dublin Ireland
| | | | | | | | | | | | | | - C. Paul
- Toulouse University and CHU Hôpital Larrey Toulouse France
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11
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Kajanoja J, Scheinin NM, Karukivi M, Karlsson L, Karlsson H. Alcohol and tobacco use in men: the role of alexithymia and externally oriented thinking style. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:199-207. [DOI: 10.1080/00952990.2018.1528267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M. Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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12
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Ramzi NH, Yiorkas AM, Sebert S, Keinänen-Kiukaanniemi S, Ala-Mursula L, Svento R, Jokelainen J, Veijola J, Auvinen J, Miettunen J, Dovey TM, Järvelin MR, Blakemore AIF. Relationship between BMI and emotion-handling capacity in an adult Finnish population: The Northern Finland Birth Cohort 1966. PLoS One 2018; 13:e0203660. [PMID: 30256810 PMCID: PMC6157858 DOI: 10.1371/journal.pone.0203660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/26/2018] [Indexed: 12/02/2022] Open
Abstract
Background Alexithymia, a difficulty in identifying and expressing emotions, has been associated with obesity and eating disorders in small-scale cross-sectional studies. Here, we assess the relationship between body mass index (BMI) and alexithymia in a large cohort of free-living Finnish adults over a 15-year period. Methods Participants were drawn from the Northern Finnish Birth Cohort 1966 (NFBC1966). The 20-Item Toronto Alexithymia Scale (TAS-20) was used as a measure of alexithymia and was completed at the age of 31 years (31y: n = 4841), and 46 years (46y: n = 5404). BMI was recorded at both time points. Where data at both time points were available (n = 3274), the relationship between changes in BMI and TAS-20 over this time period was also investigated. Results BMI was significantly and positively associated with TAS-20 score (p<0.0001, both at 31 years and at 46 years of ages). The association remained statistically significant after adjustment for potential confounders (sex, marital status and several socio-economic indicators). In individuals who experienced the greatest change in BMI (in either direction) over the 15-year period, there was a modest mean increase in TAS-20 score. Conclusions Our data revealed that TAS-20 score was correlated with and co-varied with body mass status. We suggest that future clinical research should consider the role of alexithymia in obesity. Further investigation of this relationship is warranted to ensure that the needs of obese subjects with undiagnosed alexithymia are considered in the design of weight management programmes.
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Affiliation(s)
- Nurul Hanis Ramzi
- Section of Investigative Medicine, Division of Diabetes, Endocrinology, and Metabolism, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
- * E-mail:
| | - Andrianos M. Yiorkas
- Section of Investigative Medicine, Division of Diabetes, Endocrinology, and Metabolism, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
| | - Sylvain Sebert
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Leena Ala-Mursula
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Rauli Svento
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Terence M. Dovey
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
| | - Marjo-Riitta Järvelin
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Alexandra I. F. Blakemore
- Section of Investigative Medicine, Division of Diabetes, Endocrinology, and Metabolism, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
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13
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Bram AD, Gottschalk KA, Leeds WM. Emotional Regulation in Women with Chronic Fatigue Syndrome and Depression: Internal Representations and Adaptive Defenses. J Am Psychoanal Assoc 2018; 66:701-741. [PMID: 30249136 DOI: 10.1177/0003065118798043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic fatigue syndrome (CFS) presents challenges in differential diagnosis and treatment. Complicating diagnosis is that its symptoms overlap with those of depression. This study applies psychoanalytic concepts to understand emotional regulation (ER) in women with CFS and/or depression. One hundred eighty-six women were assigned to four groups and compared: (a) CFS plus high er depression (CFS-HD); (b) CFS plus lower depression (CFS-LD); (c) depressive disorder (DD); and (d) healthy controls (HC). ER was operationalized by measures of capacity to form internal representations and adaptive defenses. The study's premise was that difficulties metabolizing emotions psychologically would be associated with their greater somatic expression. Some support was found for the hypothesis that CFS participants would exhibit more impairment in representing emotions and in adaptive defenses compared to the DD and HC groups, but this held only for the CFS-HD group. Although CFS-LD participants were expected to be more purely somatizing than the CFS-HD group, they instead showed more sophisticated capacities for ER than that group and recalled less distressing early relationships, revealing more resilience. Still, however, we found support for somatization in some CFS sufferers: Within both the CFS-HD and the CFS-LD groups, weaknesses in representing emotions and in defensive functioning were associated with more severe physical symptoms. Clinically, the heterogeneity of CFS and those who suffer from it indicates the need for individual assessment and depression treatment.
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14
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Mahapatra A, Sharma P. Association of Internet addiction and alexithymia - A scoping review. Addict Behav 2018; 81:175-182. [PMID: 29429757 DOI: 10.1016/j.addbeh.2018.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Ananya Mahapatra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Pawan Sharma
- Department of Psychiatry, Patan Academy of Health Sciences, School of Medicine, Lalitpur, Nepal.
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15
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Parolin M, Miscioscia M, De Carli P, Cristofalo P, Gatta M, Simonelli A. Alexithymia in Young Adults With Substance Use Disorders: Critical Issues About Specificity and Treatment Predictivity. Front Psychol 2018; 9:645. [PMID: 29872408 PMCID: PMC5972315 DOI: 10.3389/fpsyg.2018.00645] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/16/2018] [Indexed: 11/18/2022] Open
Abstract
Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent. The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: (a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and (b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop-outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2. Study 1 involved 90 late adolescents, aged 17-21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale-20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R. Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the "Distant" OAS subscale predicted the number rate relapses only in males. The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population.
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Affiliation(s)
- Micol Parolin
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Pietro De Carli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Michela Gatta
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Childhood Adolescence Family Unit, Ulss6 Veneto, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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Sampogna F, Puig L, Spuls P, Girolomoni G, Radtke M, Kirby B, Brunori M, Bergmans P, Smirnov P, Rundle J, Lavie F, Paul C. Prevalence of alexithymia in patients with psoriasis and its association with disease burden: a multicentre observational study. Br J Dermatol 2017; 176:1195-1203. [DOI: 10.1111/bjd.15243] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
Affiliation(s)
- F. Sampogna
- Dermatological Hospital IDI-IRCCS; Rome Italy
| | - L. Puig
- Universitat Autònoma de Barcelona; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - P. Spuls
- Department of Dermatology; University of Amsterdam; Amsterdam the Netherlands
| | | | - M.A. Radtke
- Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - B. Kirby
- St Vincent's University Hospital; Dublin Ireland
| | | | | | | | - J. Rundle
- Janssen-Cilag Ltd; High Wycombe Buckinghamshire, U.K
| | | | - C. Paul
- Department of Dermatology; Toulouse University; Hôpital Larrey; 24 Chemin de Pouvourville 31059 Toulouse France
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Dorard G, Bungener C, Phan O, Edel Y, Corcos M, Berthoz S. Is alexithymia related to cannabis use disorder? Results from a case-control study in outpatient adolescent cannabis abusers. J Psychosom Res 2017; 95:74-80. [PMID: 28314553 DOI: 10.1016/j.jpsychores.2017.02.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In recent decades, alexithymia has been considered a risk factor for multiple somatic and psychiatric conditions. Yet, whereas alexithymia has been extensively studied in adults with a substance misuse, only one study has reported data on cannabis abusers from the general population. Hence, our main objective was to explore alexithymia in a clinical sample of treatment-seeking young outpatients with a DSM-IV cannabis dependence or abuse diagnosis compared to controls. METHODS 120 young patients (95 males - mean age 17.9years (SD=2.8; 14 to 25)) with a cannabis dependence or abuse (DSM-IV-TR criteria evaluated with the MINI), seeking treatment in an addiction unit, and 110 healthy control subjects (77 males - mean age 18.2years (SD=3.4; 14 to 25)) participated in the study. They completed a battery of self-reports measuring alexithymia (TAS-20; BVAQ-B), depression (BDI-13) and state and trait anxiety (STAI). RESULTS 35.3% of cannabis users were alexithymic, and logistic regression analysis showed that the alexithymic components of difficulties identifying and describing feelings combined with trait anxiety predicted group membership. CONCLUSION This first study on young cannabis abusers and dependent subjects further emphasizes the importance of considering the affective style, and particularly the anxious temperament and alexithymia features, as factors associated with substance misuse during late adolescence.
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Affiliation(s)
- Géraldine Dorard
- Laboratoire de Psychopathologie et Processus de Santé EA 4057, Institut Universitaire Paris Descartes de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, 71 avenue Édouard Vaillant, 92100 Boulogne-Billancourt, France.
| | - Catherine Bungener
- Laboratoire de Psychopathologie et Processus de Santé EA 4057, Institut Universitaire Paris Descartes de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, 71 avenue Édouard Vaillant, 92100 Boulogne-Billancourt, France.
| | - Olivier Phan
- Clinique Dupré, FSEF, 30 avenue Franklin Roosevelt, BP 101, 92333 Sceaux cedex, France; CJC Pierre Nicole, Croix-Rouge Française, 27 rue Pierre Nicole, 75005 Paris, France; CESP, Université Paris-Sud, Cochin-Maison des Adolescents, 97 Boulevard Port Royal, 75014 Paris, France..
| | - Yves Edel
- Equipe d'addictologie hospitalière de liaison et de soins (ELSA), Hôpital de la Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75013 Paris, France.
| | - Maurice Corcos
- Département de psychiatrie de l'adolescent et du jeune adulte, Institut Mutualiste Montsouris, 42 Bd Jourdan, 75014 Paris, France.
| | - Sylvie Berthoz
- CESP, Université Paris-Sud, Cochin-Maison des Adolescents, 97 Boulevard Port Royal, 75014 Paris, France.; Département de psychiatrie de l'adolescent et du jeune adulte, Institut Mutualiste Montsouris, 42 Bd Jourdan, 75014 Paris, France.
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Role of Alexithymia, Anxiety, and Depression in Predicting Self-Efficacy in Academic Students. ScientificWorldJournal 2017; 2017:5798372. [PMID: 28154839 PMCID: PMC5244027 DOI: 10.1155/2017/5798372] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/01/2016] [Accepted: 12/18/2016] [Indexed: 11/21/2022] Open
Abstract
Objective. Little research is available on the predictive factors of self-efficacy in college students. The aim of the present study is to examine the role of alexithymia, anxiety, and depression in predicting self-efficacy in academic students. Design. In a cross-sectional study, a total of 133 students at Babol University of Medical Sciences (Medicine, Dentistry, and Paramedicine) participated in the study between 2014 and 2015. All participants completed the Toronto Alexithymia Scale (TAS-20), College Academic Self-Efficacy Scale (CASES), and 14 items on anxiety and depression derived from the 28 items of the General Health Questionnaire (28-GHQ). Results. Pearson correlation coefficients revealed negative significant relationships between alexithymia and the three subscales with student self-efficacy. There was no significant correlation between anxiety/depression symptoms and student self-efficacy. A backward multiple regression analysis revealed that alexithymia was a negative significant predictor of self-efficacy in academic students (B = −0.512, P < 0.001). The prevalence of alexithymia was 21.8% in students. Multiple backward logistic analysis regression revealed that number of passed semesters, gender, mother's education, father's education, and doctoral level did not accurately predict alexithymia in college students. Conclusion. As alexithymia is prevalent in college students and affects self-efficacy and academic functioning, we suggest it should be routinely evaluated by mental physicians at universities.
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Bulai I, Enea V. Dissociation and alexithymia in a Romanian sample of substance abuse patients. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2015.1130183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McGillivray L, Becerra R, Harms C. Prevalence and Demographic Correlates of Alexithymia: A Comparison Between Australian Psychiatric and Community Samples. J Clin Psychol 2016; 73:76-87. [DOI: 10.1002/jclp.22314] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Rodrigo Becerra
- Edith Cowan University; Western Australia
- Fremantle Adult Mental Health Services
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21
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Alexithymia and Addiction: A Review and Preliminary Data Suggesting Neurobiological Links to Reward/Loss Processing. CURRENT ADDICTION REPORTS 2016; 3:239-248. [PMID: 27695665 DOI: 10.1007/s40429-016-0097-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alexithymia, characterized by impairments in emotional awareness, is common among individuals with substance use disorders. Research on alexithymia suggests that it is a trait that may contribute to substance dependence. This paper will review alexithymia as it relates to substance use and substance use disorders, considering its potential role in the maintenance and treatment of these disorders. We will then describe how neural correlates associated with alexithymia may shed light on how alexithymia relates to addiction. Finally, we present preliminary fMRI data that examines how alexithymia may relate to the neurobiological correlates of reward/loss processing in individuals with cocaine dependence. While preliminary, these findings suggest a role of alexithymia in reward anticipation in cocaine-dependent individuals.
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Ling Y, Zeng Y, Yuan H, Zhong M. Cross-cultural validation of the 20-item Toronto Alexithymia Scale in Chinese adolescents. J Psychiatr Ment Health Nurs 2016; 23:179-87. [PMID: 27028136 DOI: 10.1111/jpm.12298] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The TAS-20 is the most widely used self-reported questionnaire to assess the level of alexithymia in students and community and clinical samples. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The TAS-20-C exhibited high levels of reliability and validity, indicating that it is appropriate for the assessment of alexithymia in Chinese adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Screening adolescents who are at risk of alexithymia through the TAS-20 could help to perform necessary and effective precautions to decrease the adverse effects of alexithymia, such as the risks of developing depressive mood and behavioral problems. ABSTRACT Purpose The aim of this study was to examine the psychometric properties of the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) in a sample of Chinese adolescents. Method Adolescents (n = 1260) recruited from three schools in mainland China completed the TAS-20-C, the somatization subscale of the Symptom Checklist 90 (SCL-90) and Center for Epidemiological Studies Depression Scale (CES-D). Five different factorial models of the TAS-20 were tested using confirmatory factor analysis (CFA). Cronbach's α, mean inter-item correlations and predictive validity were also evaluated. Results Among those five different factorial models, the four-factor structure model was suitable and invariant across gender and age in this sample. The TAS-20-C demonstrated adequate internal reliability. Gender and age accounted for insignificant amounts of variability in total TAS-20-C and factor scores. TAS-20-C total and subscale scores were correlated significantly with SCL-90 somatization subscale and CES-D. Girls scored higher than boys on difficulty identifying feelings (DIF) and pragmatic thinking (PR) subscales. DIF and lack of subjective significance or importance of emotions (IMs) subscale scores were higher among younger than among middle and older adolescents. Implications for Practice Validating the TAS-20 in adolescents is quite important to use it in evaluating adolescents' alexithymia, and screen those at risk of alexithymia.
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Affiliation(s)
- Y Ling
- College of Education, Hunan Agriculture University, Changsha, Hunan, China
| | - Y Zeng
- College of Education, Hunan Agriculture University, Changsha, Hunan, China
| | - H Yuan
- Students Affairs Department, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - M Zhong
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Interactions between the salience and default-mode networks are disrupted in cocaine addiction. J Neurosci 2015; 35:8081-90. [PMID: 26019326 DOI: 10.1523/jneurosci.3188-14.2015] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cocaine dependence is a complex neuropsychiatric disorder manifested as dysregulation of multiple behavioral, emotional, and cognitive constructs. Neuroimaging studies have begun to identify specific neurobiological circuit impairments in cocaine-dependent (CD) individuals that may underlie these symptoms. However, whether, where, and how the interactions within and between these circuits are disrupted remain largely unknown. We used resting-state fMRI and modularity network analysis to identify brain modules of a priori interest (default-mode network [DMN], salience network [SN], executive control network [ECN], medial temporal lobe [MTL], and striatum) in 47 CD and 47 matched healthy control (HC) participants and explored alterations within and between these brain modules as a function of addiction. At the module level, intermodule connectivity decreased between DMN and SN in CD. At the nodal level, several regions showed decreased connections with multiple modules in CD: the rostral anterior cingulate connection strength was reduced with SN and MTL; the posterior cingulate had reduced connections with ECN; and the bilateral insula demonstrated decreased connections with DMN. Furthermore, alexithymia, a personality trait previously associated with addiction, correlated negatively with intramodule connectivity within SN only in cocaine users. Our results indicate that cocaine addiction is associated with disrupted interactions among DMN, MTL, and SN, which have been implicated, respectively, in self-referential functions, emotion and memory, and coordinating between internal and external stimuli, providing novel and important insights into the neurobiological mechanisms of cocaine addiction.
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Kopera M, Jakubczyk A, Suszek H, Glass JM, Klimkiewicz A, Wnorowska A, Brower KJ, Wojnar M. Relationship between emotional processing, drinking severity and relapse in adults treated for alcohol dependence in Poland. Alcohol Alcohol 2014; 50:173-9. [PMID: 25543129 DOI: 10.1093/alcalc/agu099] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
AIMS Growing data reveals deficits in perception, understanding and regulation of emotions in alcohol dependence (AD). The study objective was to explore the relationships between emotional processing, drinking history and relapse in a clinical sample of alcohol-dependent patients. METHODS A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland was recruited and assessed at baseline and follow-up after 12 months. Baseline information about demographics, psychopathological symptoms, personality and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence (EI) Test and Toronto Alexithymia Scale (TAS) were utilized for emotional processing assessment. Follow-up information contained data on drinking alcohol during the last month. RESULTS At baseline assessment, the duration of alcohol drinking was associated with lower ability to utilize emotions. Patients reporting more difficulties with describing feelings drank more during their last episode of heavy drinking, and had a longer duration of intensive alcohol use. A longer duration of the last episode of heavy drinking was associated with more problems identifying and regulating emotions. Poor utilization of emotions and high severity of depressive symptoms contributed to higher rates of drinking at follow-up. CONCLUSIONS These results underline the importance of systematic identification of discrete emotional problems and dynamics related to AD. This knowledge has implications for treatment. Psychotherapeutic interventions to improve emotional skills could be utilized in treatment of alcohol-dependent patients.
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Affiliation(s)
- Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St, Warsaw, Poland
| | - Hubert Suszek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Jennifer M Glass
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor MI, USA
| | - Anna Klimkiewicz
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St, Warsaw, Poland
| | - Anna Wnorowska
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St, Warsaw, Poland
| | - Kirk J Brower
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor MI, USA
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St, Warsaw, Poland Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor MI, USA
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Karukivi M, Saarijärvi S. Development of alexithymic personality features. World J Psychiatry 2014; 4:91-102. [PMID: 25540724 PMCID: PMC4274591 DOI: 10.5498/wjp.v4.i4.91] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/06/2014] [Accepted: 12/10/2014] [Indexed: 02/05/2023] Open
Abstract
The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymia with different aberrations in brain function related to emotion regulation; however, the development of these deviations is poorly understood. A notable amount of research covers the relation of alexithymia to different environmental factors. Many of these associations, for example, with low socio-economic status and general psychopathology in childhood, are well established. However, the retrospective and cross-sectional designs commonly used in these studies, as well as the use of self-report measures, hinder the ability to firmly establish causality. Certain individual developmental factors, such as lagging speech development and congenital cardiac malformations in childhood, have been associated with the development of alexithymia. Regarding the stability of alexithymia, a systematic review of the literature was conducted for this paper. In addition to being characterized as a personality feature in the general population, alexithymia also clearly has a state-like dimension that results in increases and decreases in alexithymic features in conjunction with mental disorder symptoms. An essential question is whether the alexithymic features in adulthood are, in fact, infantile features of a restricted ability to identify and describe emotions that simply persist in individuals through adolescence to adulthood. To firmly establish the roots of alexithymia development, longitudinal studies, particularly in younger populations, are needed. Furthermore, multifaceted study settings are encouraged.
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Stability of alexithymia in late adolescence: results of a 4-year follow-up study. Psychiatry Res 2014; 219:386-90. [PMID: 24953425 DOI: 10.1016/j.psychres.2014.05.058] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/26/2014] [Accepted: 05/30/2014] [Indexed: 01/12/2023]
Abstract
The aim of the present study was to assess the stability of alexithymia in adolescents and the effects of parental factors and social support thereon. The sample comprised 315 late adolescents, of whom 259 were female and 56 male. At baseline, the mean age of the subjects was 19 years (range 17-21 years). The follow-up period was 4 years (2008-2012). The 20-item Toronto Alexithymia Scale (TAS-20) was used for the assessment of alexithymia both at baseline and follow-up. The Multidimensional Scale of Perceived Social Support (MSPSS) and the Parental Bonding Instrument (PBI) were used as measures at baseline. Regarding absolute stability, the changes in the TAS-20 total scores and two subscales (DIF and EOT) were statistically significant but the effect sizes for the changes were small (Cohen׳s d 0.21-0.24). The test-retest correlations for the TAS-20 total and subscale scores were high (ρ=0.50-0.64, P<0.001), indicating relative stability. While several parental and social support variables were associated with alexithymia at baseline, low social support from friends was the only to predict higher alexithymia at follow-up. Alexithymia is a stable personality trait also in late adolescence. Low social support from friends is related to alexithymia in young adulthood.
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Marchesi C, Ossola P, Tonna M, De Panfilis C. The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression, panic disorder, eating disorders and substance use disorders. Compr Psychiatry 2014; 55:972-8. [PMID: 24439561 DOI: 10.1016/j.comppsych.2013.12.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/10/2013] [Accepted: 12/13/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study evaluates whether the difference in Toronto Alexithymia Scale-20 item (TAS-20) between patients with major depression (MD), panic disorder (PD), eating disorders (ED), and substance use disorders (SUD) and healthy controls persisted after controlling for the severity of anxiety and depression. METHODS Thirty-eight patients with MD, 58 with PD, 52 with ED, and 30 with SUD and 78 healthy controls (C) completed the TAS-20, the Hamilton Rating Scale for Anxiety (Ham-A), the Hamilton Rating Scale for Depression (Ham-D). RESULTS The differences in TAS-20 scores observed between patient groups, regardless of the type of their disorders, and controls disappeared after controlling for the effect of anxiety and depression severity. In contrast, the differences in severity of anxiety and depression between patients and controls were still present, after excluding the effect of alexithymic levels. CONCLUSIONS Our data suggest that alexithymic levels, as measured by the TAS-20, are modulated by the severity of symptoms, supporting the view that alexithymia can represent a state phenomenon in patients with MD, PD, ED and SUD, because the TAS-20 seems overly sensitive to a general distress syndrome, and it is more likely to measure negative affects rather than alexithymia itself.
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Affiliation(s)
- Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
| | - Paolo Ossola
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | | | - Chiara De Panfilis
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
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Abstract
Alexithymia, a deficit characterized by difficulties identifying, differentiating, and articulating emotions, is associated with significant physical and mental health impairment. It is generally accepted that alexithymia has a negative impact on a variety of physical and mental health treatments. Less clear is the extent to which alexithymia itself can be modified. In this article we review studies that have examined the effects of psychological interventions on alexithymia. Taken together, findings from investigations included in this review suggest that alexithymia is partly modifiable with therapeutic interventions. Studies that directly targeted alexithymic symptoms tended to report significant reductions in alexithymia scores following treatment, whereas studies that measured changes in alexithymia but did not employ any psychological interventions specifically intended to treat alexithymia had more inconsistent results. We close by considering the practical implications of the findings, and by offering suggestions for future research.
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de Haan HA, van der Palen J, Wijdeveld TGM, Buitelaar JK, De Jong CAJ. Alexithymia in patients with substance use disorders: state or trait? Psychiatry Res 2014; 216:137-45. [PMID: 24534122 DOI: 10.1016/j.psychres.2013.12.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/25/2013] [Accepted: 12/29/2013] [Indexed: 01/12/2023]
Abstract
Previous research on substance use disorders (SUD) has yielded conflicting results concerning whether alexithymia is a state or trait, raising the question of how alexithymia should be addressed in the treatment of SUD-patients. The absolute and relative stabilities of alexithymia were assessed using the Toronto Alexithymia Scale (TAS-20) and its subscales. In total, 101 patients with SUD were assessed twice during a 3-week inpatient detoxification period while controlling for withdrawal symptoms and personality disorder traits. The relative stability of the total TAS-20 and subscales was moderate to high but showed remarkable differences between baseline low, moderate, and high alexithymic patients. A small reduction in the mean levels of the total TAS-20 scores and those of one subscale revealed the absence of absolute stability. The levels of alexithymia were unrelated to changes in withdrawal symptoms, including anxiety- and depression-like symptoms. The differences between low, moderate, and high alexithymic patients in terms of the change in alexithymia scores between baseline and follow-up indicated a strong regression to the mean. The findings suggest that alexithymia in SUD patients as measured using the TAS-20 is both a state and trait phenomenon and does not appear to be related to changes in anxiety- and depression-like symptoms.
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Affiliation(s)
- Hein A de Haan
- Tactus Addiction Treatment, 7400 AD Deventer, The Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, 6500 HE Nijmegen, The Netherlands.
| | - Job van der Palen
- Department of Research Methodology, Measurement and Data Analysis, University of Twente, 7500 AE Enschede, The Netherlands; Medical School Twente, Medisch Spectrum Twente, 7513 ER Enschede, The Netherlands
| | - Toon G M Wijdeveld
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6500 HE Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Cor A J De Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6500 HE Nijmegen, The Netherlands
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Honkalampi K, Viinamäki H, Niskanen L, Koivumaa-Honkanen H, Valkonen-Korhonen M, Elomaa AP, Harvima I, Herzig KH, Lehto SM. Reduced serum adiponectin levels in alexithymia. Neuroimmunomodulation 2014; 21:234-9. [PMID: 24603661 DOI: 10.1159/000357051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/04/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Clinical studies have demonstrated that circulating cytokine profiles may differ between alexithymic and non-alexithymic subjects. We examined whether the levels of adiponectin (μg/ml) and resistin (ng/ml) are independently related to alexithymic features in a population-based sample. METHODS In 2005, clinical data including laboratory assessments were obtained from a sub-sample (n = 308) of the Kuopio Depression Study general population study including subjects aged 25-64 years. Based on the Toronto Alexithymia Scale score in 1998, 1999, 2001 and 2005, a group of subjects with high alexithymic features (n = 85) was formed and compared with non-alexithymic controls (n = 206). RESULTS Serum adiponectin levels were significantly lower in subjects with alexithymic features than in non-alexithymic control subjects. No difference was found in resistin levels. Similarly, in a logistic regression model adjusted for age, gender and body mass index (BMI), lowered levels of adiponectin, but not resistin, were associated with an increased likelihood of belonging to the group with alexithymic features. Further adjustments for cardiovascular risk factors (i.e. smoking, BMI, metabolic syndrome, alcohol use, and coronary heart disease), depressive symptoms (Hamilton Depression Rating Scale with 17 items) and the use of antidepressants in addition to age and gender did not change these patterns. CONCLUSIONS Our findings suggest that a disturbed anti-inflammatory balance may characterize alexithymia. In addition, our results widen the concept of alexithymia and highlight the role of immune system alterations and stress in alexithymic individuals.
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Affiliation(s)
- Kirsi Honkalampi
- Department of Education and Psychology, University of Eastern Finland, Joensuu, Finland
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Impact of 5-HTTLPR polymorphism on alexithymia in alcoholic patients after detoxification treatment. J Addict Med 2013; 7:372-3. [PMID: 24089041 DOI: 10.1097/adm.0b013e31829c3049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Dalbudak E, Evren C, Aldemir S, Coskun KS, Ugurlu H, Yildirim FG. Relationship of Internet Addiction Severity with Depression, Anxiety, and Alexithymia, Temperament and Character in University Students. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:272-8. [DOI: 10.1089/cyber.2012.0390] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ercan Dalbudak
- Department of Psychiatry, Fatih University, Ankara, Turkey
| | - Cuneyt Evren
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Alcohol and Drug Research, Treatment and Training Center (AMATEM), Istanbul, Turkey
| | - Secil Aldemir
- Department of Psychiatry, Fatih University, Ankara, Turkey
| | - Kerem Senol Coskun
- Department of Psychiatry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Hilal Ugurlu
- Fatih University School of Nursing, Ankara, Turkey
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