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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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Blinka L, Faltýnková A, Rečka K. Alexithymia in gaming addiction and engagement. J Affect Disord 2024; 354:104-109. [PMID: 38479516 DOI: 10.1016/j.jad.2024.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND It has been suggested that alexithymia plays a significant role in substance and behavioral addictions. However, only a handful of studies investigated this construct in relation to gaming addiction, and no study analyzed its differential effect on gaming engagement and addiction. METHODS A total of u adult gamers (Mage = 26.04, SD = 5.78, 94 % male) completed a questionnaire that included the Toronto Alexithymia Scale (and its subscales of difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking), the Addiction-Engagement Questionnaire, and additional questions about gender, age, and time spent gaming. Structural equation modeling was used as the main analytical strategy. RESULTS Difficulty identifying feelings (β = 0.28) and externally oriented thinking (β = 0.19) showed a significant positive effect on gaming addiction. Contrary to addiction, externally oriented thinking showed a significant negative effect (β = -0.21) on gaming engagement. No other alexithymia subscales were significant. The model with alexithymia explained 32.7 % of the variance in gaming addiction while only 10.4 % of gaming engagement. CONCLUSIONS Alexithymia is a strong predictor of gaming addiction. Gaming engagement seems to be a qualitatively different phenomenon that shows an opposite association with alexithymia than gaming addiction. However, both are related to increased time spent gaming. This suggests a need to distinguish between problematic vs. non-problematic excessive gaming as they have different associations with affect dysregulation.
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Affiliation(s)
- Lukas Blinka
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic.
| | - Anna Faltýnková
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic
| | - Karel Rečka
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Czech Republic
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Schell C, Quilty LC, Cunningham JA. Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024:7067437241249412. [PMID: 38682315 DOI: 10.1177/07067437241249412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. METHOD As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. RESULTS The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). CONCLUSION These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. PLAIN LANGUAGE TITLE Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?
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Affiliation(s)
- Christina Schell
- Institute for Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - John A Cunningham
- Institute for Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Li R, Kajanoja J, Karlsson L, Karlsson H, Nolvi S, Karukivi M. Longitudinal patterns of alcohol use and psychological symptoms during COVID-19 pandemic and role of alexithymia: A latent transition analysis in the FinnBrain Birth Cohort Study. J Affect Disord 2023; 338:440-448. [PMID: 37385387 PMCID: PMC10299841 DOI: 10.1016/j.jad.2023.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has been posing widespread influence on mental well-being. However, research on the dynamic relations between alcohol use and psychological symptoms in the context of the pandemic and the role of alexithymic traits in predicting the development of mental health problems longitudinally remains scarce. METHODS Latent profile and transition analyses were conducted to model the longitudinal patterns of transitions in the profiles of alcohol use and psychological symptoms across 10 months during the pandemic (from May 2020 to March 2021) and to investigate the role of alexithymia and its dimensions Difficulty Identifying and Describing Feelings (DIF and DDF), and Externally Oriented Thinking (EOT) in 720 parents from the FinnBrain Birth Cohort Study. RESULTS Three profiles, Risky Drinking, Distressed Non-Risky Drinking, and Non-Distressed, Non-Risky Drinking, and their transitions were identified. The role of alexithymia appeared to be stronger in Risky Drinking than Non-Distressed, Non-Risky Drinking. DIF predicted the development of symptoms in Risky Drinking, whereas DDF predicted Risky Drinking remaining stable over time and showed a trend towards psychological distress in Risky Drinking and Non-Distressed, Non-Risky Drinking. EOT was more likely to be a risk factor for Risky Drinking remaining constant and Non-Distressed, Non-Risky Drinking becoming Risky Drinking. LIMITATIONS This study was mainly limited by the generalizability of the findings. CONCLUSIONS Our findings add deeper insights into the longitudinal development of alcohol use and psychological symptoms as well as evidence on the role of alexithymia in shaping mental health, providing implications for tailoring clinical preventive and therapeutic measures.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland.
| | - Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Finland
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Bottiroli S, Rosi A, Sances G, Allena M, De Icco R, Lecce S, Vecchi T, Tassorelli C, Cavallini E. Social cognition in chronic migraine with medication overuse: a cross-sectional study on different aspects of mentalization and social relationships. J Headache Pain 2023; 24:47. [PMID: 37106347 PMCID: PMC10139829 DOI: 10.1186/s10194-023-01578-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Social cognition refers to all mental operations to decipher information needed in social interactions. Here we aimed to outline the socio-cognitive profile of Chronic Migraine with Medication Overuse (CM + MO), given they are recognized to be at risk of socio-cognitive difficulties. Given the multidimensionality of this construct, we considered: (1) socio-cognitive abilities, (2) socio-cognitive beliefs, (3) alexithymia and autism traits, and (4) social relationships. METHODS Seventy-one patients suffering from CM + MO, 61 from episodic migraine (EM), and 80 healthy controls (HC) were assessed with a comprehensive battery: (1) the Faux Pas test (FP), the Strange Stories task (SS), the Reading Mind in the Eyes test (RMET), (2) the Tromsø Social Intelligence Scale, (3) the Toronto Alexithymia Scale, the Autism Spectrum Quotient, (4) the Lubben Social Network Scale, the Friendship Scale. RESULTS CM + MO: (1) performed similar to EM but worse than HC in the FP and SS, while they were worse than EM and HC in the RMET; (2) were similar to EM and HC in social intelligence; (3) had more alexithymic/autistic traits than EM and HC; (4) reported higher levels of contact with their family members but felt little support from the people around them than HC. CONCLUSIONS CM + MO results characterized by a profile of compromised socio-cognitive abilities that affects different dimensions. These findings may have a relevant role in multiple fields related to chronic headache: from the assessment to the management.
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Affiliation(s)
- Sara Bottiroli
- Giustino Fortunato University, Benevento, Italy.
- IRCCS Mondino Foundation, Pavia, Italy.
| | - Alessia Rosi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | | | - Roberto De Icco
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Serena Lecce
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Tomaso Vecchi
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Wang J, Deane FP, Kelly PJ, Robinson L. A narrative review of outcome measures used in drug and alcohol inpatient withdrawal treatment research. Drug Alcohol Rev 2023; 42:415-426. [PMID: 36633552 PMCID: PMC10108086 DOI: 10.1111/dar.13591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 01/13/2023]
Abstract
ISSUES Assessing drug and alcohol inpatient withdrawal treatment programs is important, as these represent a first step of treatment among people with alcohol and drug problems. However, there are many ways of measuring outcomes making it difficult for service providers to decide which domains and methods to use. This narrative review aims to clarify frequencies of the domains and methods used to assess withdrawal treatment outcomes. APPROACH We reviewed published studies that examined outcomes of inpatient drug and alcohol withdrawal treatment. The types of outcome measures used and the frequency of use were summarised. KEY FINDINGS The review showed that assessment of withdrawal treatment outcomes goes beyond traditional abstinence measures. Outcomes mainly focus on biological and psychological outcomes, with social outcomes rarely measured. Even within outcome domains (e.g., cravings), there were many assessment methods. IMPLICATIONS The review provides service providers with an outline of common outcome domains and measures. Given the importance of social functioning to recovery from alcohol and drug problems, greater emphasis on such measures is desirable. Future research could develop greater consensus on outcome measures for use in withdrawal management services to facilitate clarity around factors associated with treatment success. CONCLUSION Outcome assessment in withdrawal treatment goes beyond abstinence to include holistic measurement of biological, psychological and some social outcomes; but more work needs to be done to cohere the different assessment methods and broaden the scope to include social functioning.
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Affiliation(s)
- Jing Wang
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
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7
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Li J, Jiang W, Zhu R, Fan F, Fu F, Wei D, Tang S, Tian Y, Chen J, Li Y, Zhou H, Wang L, Wang D, Zhang XY. Depression in Chinese men with methamphetamine dependence: Prevalence, correlates and relationship with alexithymia. J Affect Disord 2022; 319:235-243. [PMID: 36162653 DOI: 10.1016/j.jad.2022.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/10/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The comorbidity between substance use disorder and major depressive disorder is a typical dual diagnosis in the field of substance addiction. However, the prevalence and correlates of depression in methamphetamine addicts and whether it is associated with drug craving and alexithymia have been rarely reported in the Chinese population. METHODS We recruited 585 methamphetamine-dependent males from a drug rehabilitation center in China and 203 healthy controls. Demographic and drug use data were collected. Depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N·I.). Methamphetamine cravings and alexithymia were assessed using the Desire for Drugs Questionnaire (DDQ) and the Toronto Alexithymia Scale (TAS). RESULTS The prevalence rate of depression in methamphetamine-dependent men was 16.58 % (97/585). The scores of DDQ desire and intention, DDQ negative reinforcement, total DDQ, difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and total TAS score of depressed patients were higher than those of non-depressed patients. However, only DDQ negative reinforcement score, DIF, DDF, and total TAS score remained significant after Bonferroni correction. Additionally, logistic regression analysis found that age, DIF score, and DDQ negative reinforcement score were significant factors contributing to depression in methamphetamine-dependent men. CONCLUSION Our findings suggest that the prevalence of depression is significantly higher in methamphetamine-dependent men than in the healthy Chinese population. Furthermore, age, components of alexithymia and drug craving are risk factors for depression in methamphetamine addicts.
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Affiliation(s)
- Jiaxin Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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8
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Honkalampi K, Jokela M, Lehto SM, Kivimäki M, Virtanen M. Association between alexithymia and substance use: A systematic review and meta-analysis. Scand J Psychol 2022; 63:427-438. [PMID: 35436351 PMCID: PMC9790486 DOI: 10.1111/sjop.12821] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/11/2021] [Accepted: 01/12/2022] [Indexed: 12/31/2022]
Abstract
Alexithymia has been associated with substance use, but the magnitude of the association has not been evaluated and sub-group differences, if any, are unknown. The aim of this meta-analysis is to systematically review the association between alexithymia and substance use (alcohol or illicit drugs). We identified studies through a systematic review of PubMed and Web of Science and obtained a total of 52 publications using the Toronto Alexithymia Scale-20 scale. Random effects meta-analysis was used to evaluate the overall and sub-group associations. Of the studies, 50 were cross-sectional and two longitudinal. Alexithymia was associated with any substance use (Cohen's d = 0.62, 95% confidence interval [CI] 0.49-0.76), with little difference between estimates for use of alcohol or illicit drugs. A stronger association was observed for the alexithymia dimension "Difficulty in Identifying Feelings" (d = 0.64, 95% CI = 0.47-0.81) and "Difficulty in Describing Feelings" (d = 0.44, 95% CI = 0.32-0.55) than for "Externally Oriented Thinking" (d = 0.19, 95% CI = 0.09-0.28). The association was stronger in studies with clinical patient populations (d = 0.83, 95% CI = 0.62-1.05) than in those investigating general or student populations, and in studies with a majority of male rather than female participants. These findings suggest a strong overall association between alexithymia and substance use and a very strong association among clinical patient populations. The association may be stronger with the emotion-related dimensions than with the cognition-related dimension of alexithymia. As nearly all the studies were cross-sectional, more longitudinal studies are needed.
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Affiliation(s)
- Kirsi Honkalampi
- School of Educational Sciences and PsychologyUniversity of Eastern FinlandJoensuuFinland
| | - Markus Jokela
- Department of Psychology and LogopedicsUniversity of HelsinkiHelsinkiFinland
| | - Soili M. Lehto
- Department of Psychology and LogopedicsUniversity of HelsinkiHelsinkiFinland,Institute of Clinical MedicineUniversity of OsloOsloNorway,R&D department, Division of Mental Health ServicesAkershus University HospitalLørenskogNorway,Department of PsychiatryUniversity of HelsinkiHelsinkiFinland
| | - Mika Kivimäki
- Clinicum, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland,Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Marianna Virtanen
- School of Educational Sciences and PsychologyUniversity of Eastern FinlandJoensuuFinland,Division of Insurance MedicineKarolinska InstitutetStockholmSweden
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9
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Pape M, Reichrath B, Bottel L, Herpertz S, Kessler H, Dieris-Hirche J. Alexithymia and internet gaming disorder in the light of depression: A cross-sectional clinical study. Acta Psychol (Amst) 2022; 229:103698. [PMID: 35939974 DOI: 10.1016/j.actpsy.2022.103698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 07/12/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Social and emotional deficits are assumed to be involved in the development and maintenance of internet gaming disorder (IGD). Alexithymia refers to a personality construct, which is characterized by deficits in emotional awareness and processing. The constructs of alexithymia and depression share similarities, and depression is a common comorbidity of IGD patients. The aim of this study was to analyze the relationship between alexithymia and IGD when controlling for depression symptom severity. Moreover, we compared alexithymia traits of IGD patients with those of non-pathological video gamers. METHODS In a cross-sectional study n = 38 male IGD patients (EG) were recruited at specialized healthcare services in Germany. In addition, n = 39 male non-pathological video gamers (CG) were recruited via social media and bulletin board announcement. Both groups completed questionnaires measuring alexithymia (TAS-20), depression symptom severity (BDI) and IGD severity (s-IAT). RESULTS Alexithymia and depression symptom severity both predicted IGD severity. Yet, when including both factors in multiple regression analysis, only alexithymia predicted IGD severity. The prevalence of alexithymia in the EG was 34.2 % (n = 13). None of the non-pathological video gamers scored above the cut-off indicating alexithymia. IGD patients showed higher traits of alexithymia in general and on each subscale, irrespective of whether or not they were currently consuming video games. As previously observed, depression symptom severity was significantly greater in IGD patients compared to healthy video gamers. Yet, group differences in alexithymia traits remained stable, with a ~29 % decrease of effectiveness in the relationship, when controlling for depression symptom severity and sociodemographic factors. CONCLUSION The results reveal that alexithymia is associated with and predicts IGD severity independently of depression symptom severity. Moreover, alexithymia is highly prevalent in IGD patients.
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Affiliation(s)
- Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany.
| | - Benedict Reichrath
- Heinrich Heine University, Department of Clinical Psychology, Düsseldorf, Germany
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany
| | - Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany
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10
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Morie KP, Crowley MJ, Mayes LC, Potenza MN. The process of emotion identification: Considerations for psychiatric disorders. J Psychiatr Res 2022; 148:264-274. [PMID: 35151218 PMCID: PMC8969204 DOI: 10.1016/j.jpsychires.2022.01.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/07/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
Emotional regulation is important for mental health and behavioral regulation. A relevant precursor to emotional regulation may involve identification of one's emotions. Here, we propose a model of seven components that may provide a foundation for emotion identification. These factors include baseline mood, monitoring, physiological responses, interoception, past personal experiences regarding emotions/metacognition, context, and labeling. We additionally examine how deficits in different components may contribute to the concept of alexithymia, which is defined by difficulty identifying and describing one's own emotions. Ultimately, we explore how the model may support a relationship between specific psychiatric disorders and alexithymia. The proposed model may help explain emotional identification impairment in multiple psychiatric disorders and guide future research and treatment development efforts.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Michael J Crowley
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Linda C Mayes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT, 06510, USA
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11
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DiPierro-Sutton M, Poquiz J, Brown S, Fite P, Bortolato M. Models predicting the role of emotion reactivity in the link between reasons for not using and lifetime substance use. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:527-535. [PMID: 32407218 DOI: 10.1080/07448481.2020.1756828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/16/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
Objective Substance use peaks in emerging adulthood, with evidence suggesting that college-attending emerging adults have a higher rate of substance use than their non-college attending peers. More insight into the factors that might contribute to substance use among college-attending emerging adults is needed. The current study examined the moderating role of emotion reactivity in the link between perceived importance of reasons for not using substances and lifetime marijuana and alcohol use. Participants: 440 undergraduate students under the age of 21 (M = 18.67, 47.7% Male) from a large Midwestern university participated in the study. Methods Participants responded survey items assessing reasons for not using, lifetime marijuana and alcohol use, and emotion reactivity. Results: Emotion reactivity only moderated the link between reasons for not using alcohol (i.e., reasons related to self-control) and lifetime alcohol use. Conclusions: Future research on reasons for not using is warranted. Implications for preventative interventions are discussed.
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Affiliation(s)
- Moneika DiPierro-Sutton
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, Kansas, USA
| | - Jonathan Poquiz
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, Kansas, USA
| | - Shaquanna Brown
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, Kansas, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Paula Fite
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, Kansas, USA
| | - Marco Bortolato
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, Kansas, USA
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake, Utah, USA
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12
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Mason D, Happé F. The role of alexithymia and autistic traits in predicting quality of life in an online sample. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 90:None. [PMID: 35116075 PMCID: PMC8763252 DOI: 10.1016/j.rasd.2021.101887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Autistic people tend to report poorer Quality of Life (QOL) than comparison groups, though some studies do report more optimistic findings. Higher autistic traits are also related to poorer QOL. However, the role of alexithymia in this relationship has not been explored. METHOD A total of 163 participants (N = 53 autistic and N = 111 comparison) consented to take part; however, 30 participants were excluded due to missing data (who did not differ from those who were retained on age, gender, education, employment, or living status), leaving a final sample of 133 (N = 42 Autistic and 91 Comparison participants). Demographic information (including age, gender) was collected, alongside self-report measures of autistic traits, mental health, alexithymia, and QOL. We estimated regression models based on pre-registered analysis, and we conducted exploratory network analyses. RESULTS Alexithymic traits did not predict QOL when controlling for covariates. Depression significantly predicted Physical, Psychological, and Social QOL. When examining the impact of just alexithymic traits and autistic traits, both were significantly associated with Physical and Psychological QOL. For participants with a low depression score, the correlation between alexithymia and QOL was strong; suggesting that depression occludes the association between alexithymia and QOL. Network analyses suggested that depression and anxiety exert direct effects on Physical and Psychological QOL, whereas alexithymia scores may influence Physical QOL via autistic traits. CONCLUSION In sum, depression is a pervasive negative predictor of multiple QOL domains. The role of alexithymia in predicting QOL dimensionally and categorically was not ruled out, given our exploratory analyses, we suggest that interventions which target alexithymia may positively impact QOL for those who score low on depressive symptoms.
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Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
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13
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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: 59] [Impact Index Per Article: 19.7] [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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14
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Palma-Álvarez RF, Ros-Cucurull E, Daigre C, Perea-Ortueta M, Serrano-Pérez P, Martínez-Luna N, Salas-Martínez A, Robles-Martínez M, Ramos-Quiroga JA, Roncero C, Grau-López L. Alexithymia in Patients With Substance Use Disorders and Its Relationship With Psychiatric Comorbidities and Health-Related Quality of Life. Front Psychiatry 2021; 12:659063. [PMID: 33897505 PMCID: PMC8062860 DOI: 10.3389/fpsyt.2021.659063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Alexithymia frequently correlates with several psychiatric disorders, including substance use disorder (SUD). However, most studies reporting the associations between alexithymia and psychiatric disorders have been performed in populations without SUD. This research, therefore, evaluates alexithymia in Spanish patients with SUD and the relationship among alexithymia, psychiatric comorbidities, psychological symptoms/traits, SUD variables, and health-related quality of life (HRQoL). Methodology: A cross-sectional study was conducted with 126 Spanish outpatients with SUD (75.4% males; mean age 43.72 ± 14.61 years), correlating their alexithymia levels (using the Toronto Alexithymia Scale 20 [TAS-20]) to their psychiatric comorbidities, psychological symptoms/traits, SUD variables, and HRQoL. Results: Alexithymia was significantly higher in patients who had cannabis use disorder. Higher alexithymia scores were also related to higher levels of depression, anxiety, impulsivity, and lower HRQoL. After multivariate analysis, trait anxiety, impulsivity, and the physical component summary of the HRQoL were found to be independently related to alexithymia. Conclusions: SUD patients with higher alexithymia levels have more frequently psychiatric comorbidities, present specific psychological features, and have worse HRQoL. Hence, it is important to evaluate these factors and offer more accurate psychotherapeutic approaches for this patient population.
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Affiliation(s)
- Raul F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Anna Salas-Martínez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María Robles-Martínez
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Institute for Biomedical Research (IMIM), Barcelona, Spain
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain.,Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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15
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Nunes da Silva A. Developing Emotional Skills and the Therapeutic Alliance in Clients with Alexithymia: Intervention Guidelines. Psychopathology 2021; 54:282-290. [PMID: 34749373 DOI: 10.1159/000519786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/17/2021] [Indexed: 11/19/2022]
Abstract
Despite being a longstanding and well-established concept, alexithymia is unfamiliar for many clinicians. This article aimed to address the alexithymia concept from a clinical perspective based on a review of the research on alexithymia intervention. Several strategies are proposed to help clinicians better work with alexithymic clients in psychotherapy. Alexithymia assessment, its impact on the therapeutic alliance, and the difficulties in emotional tasks are highlighted points. Considering alexithymia will inform clinicians' current diagnosis and conceptualization and provide specific targets and venues for intervention, increasing the effectiveness of psychotherapy.
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16
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Morie KP, Potenza MN, Beitel M, Oberleitner LM, Roos CR, Yip SW, Oberleitner DE, Gaeta M, Barry DT. Alexithymia and pain experience among patients using methadone-maintenance therapy. Drug Alcohol Depend 2021; 218:108387. [PMID: 33168339 PMCID: PMC8103623 DOI: 10.1016/j.drugalcdep.2020.108387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/09/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alexithymia, difficulty identifying and describing one's emotions coupled with a tendency to externalize, is a potentially important yet understudied treatment target for patients with opioid use disorder. The aim of this study was to examine the role of alexithymia in pain experience among individuals with opioid use disorder. METHODS One-hundred-and-sixty-four patients receiving methadone maintenance treatment completed a battery of self-report measures related to alexithymia, drug use, and pain experiences. Comparisons were performed on the full sample between those with or without clinically significant levels of alexithymia. For a subsample reporting pain (n = 138), intercorrelations were performed to test whether drug use history, pain catastrophizing, pain acceptance, and alexithymia were related to pain severity and pain interference. Regression analyses were performed to test for serial mediation of pain catastrophizing and pain acceptance on the relationship between alexithymia and pain interference in this subsample. RESULTS Individuals with alexithymia showed increased pain catastrophizing and interference, and intercorrelations indicated that increased alexithymia was associated with increased pain interference, more pain catastrophizing, and reduced pain acceptance. A serial regression model among a subset of patients with pain indicated that pain catastrophizing and pain acceptance mediated the effect of alexithymia on pain interference. CONCLUSIONS These findings suggest that alexithymia, as well as both pain catastrophizing and pain acceptance, contribute to interference associated with pain and are potentially important intervention targets among methadone-treated patients with pain.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
| | - Lindsay M Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychology, Western Connecticut State University, Danbury, CT, USA
| | - Corey R Roos
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | | | - Marina Gaeta
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Pain Treatment Services, APT Foundation, Inc, New Haven, CT, USA
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17
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Kashimura M, Ishizu K, Shimoda Y. Factor Structure and Psychometric Properties of a New Scale to Assess Alexithymia-Like Features in Japanese Youth. J NIPPON MED SCH 2020; 87:285-293. [PMID: 32074538 DOI: 10.1272/jnms.jnms.2020_87-507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies of alexithymia have primarily targeted adult populations. Although some recent studies of alexithymia have focused on children and young adolescents, the literature is not sufficient for development of an assessment tool. The aim of this study was to develop, and evaluate the psychometric properties of, a new scale to measure alexithymia-like features in young adolescents. METHODS A total of 1,444 Japanese junior high school students (701 males, 743 females; age range 12-15; mean [SD] age, 13.37 [0.98] years) participated in 2 surveys conducted at their own schools. RESULTS First, exploratory factor analysis of the first survey data (n=981) demonstrated that this new scale had a unifactor structure, as determined by minimum average partial analysis and parallel analysis. Second, confirmatory factor analysis of the second survey data (n=463) confirmed the unifactor structure of this new scale and acceptable goodness of model fit. The new scale had modest internal consistency. CONCLUSIONS The correlations of this new alexithymia scale with related variables were weak but significant, in accordance with our hypothesis. The scale had acceptable reliability and convergent validity and thus might be useful for measuring alexithymic tendency in young adolescents.
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Affiliation(s)
| | - Kenichiro Ishizu
- Graduate School of Teacher Training Development, University of Toyama
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18
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Lyvers M, Holloway N, Needham K, Thorberg FA. Resilience, alexithymia, and university stress in relation to anxiety and problematic alcohol use among female university students. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
| | - Natalie Holloway
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
| | - Katarina Needham
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
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19
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Hakvoort L, de Jong S, van de Ree M, Kok T, Macfarlane C, de Haan H. Music Therapy to Regulate Arousal and Attention in Patients With Substance Use Disorder and Posttraumatic Stress Disorder: A Feasibility Study. J Music Ther 2020; 57:353-378. [PMID: 32651585 DOI: 10.1093/jmt/thaa007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Patients diagnosed with both substance use disorder (SUD) and posttraumatic stress disorder (PTSD) often experience hypervigilance, increased fear, and difficulties regulating emotions. This dual diagnosis increases treatment complexity. Recently, a short-term music therapy intervention for arousal and attention regulation (the SMAART intervention) was designed based on neurobiological findings. Twelve patients with SUD and PTSD (50% females) in outpatient treatment participated in six weekly one-hour sessions of the SMAART intervention. Six patients completed the study. PTSD symptom severity was evaluated with the Posttraumatic Stress Disorder Symptom Scale Interview for DSM-5 (PSSI-5) pre- and post-intervention, and sustained attention was evaluated with the Bourdon-Wiersma (BW) test. A significant difference in measurements for the PSSI-5 overall symptom severity was found pre- and post-intervention. Furthermore, participants showed significant improvement on subscales of hyperarousal, mood and cognition, and attention. The BW test completion time decreased significantly. Two participants dropped out before the end of the intervention due to craving. Concerning future research, it is recommended to define the role of the music more explicitly and to change the design to a randomized controlled trial. A risk for future larger studies is a high dropout rate (50%). Several limitations of the study are discussed.
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Affiliation(s)
| | - Sirik de Jong
- ArtEZ University of the Artsm, Enschede, The Netherlands
| | - Maartje van de Ree
- ArtEZ University of the Artsm, Enschede, The Netherlands.,Tactus, Addiction Care Twente, Enschede, The Netherlands
| | - Tim Kok
- Tactus, Addiction Care Twente, Enschede, The Netherlands
| | - Clare Macfarlane
- Penitentiary Psychiatric Center Institution Vught & Vrije Universiteit, Amsterdam, The Netherlands
| | - Hein de Haan
- Tactus, Addiction Care Twente, Enschede, The Netherlands
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20
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De Berardis D, Fornaro M, Valchera A, Rapini G, Di Natale S, De Lauretis I, Serroni N, Orsolini L, Tomasetti C, Bustini M, Carano A, Vellante F, Perna G, Core L, Alessandrini M, Fraticelli S, Martinotti G, Di Giannantonio M. Alexithymia, resilience, somatic sensations and their relationships with suicide ideation in drug naïve patients with first-episode major depression: An exploratory study in the "real world" everyday clinical practice. Early Interv Psychiatry 2020; 14:336-342. [PMID: 31402575 DOI: 10.1111/eip.12863] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/20/2019] [Accepted: 07/14/2019] [Indexed: 12/15/2022]
Abstract
AIM The present study is aimed at revaluating alexithymia, somatic sensations, resilience and their relationships with suicide ideation in drug naïve adult outpatients suffering from first episode major depression (MD). METHODS Data of 103 adult outpatients (49 men, 56 women) with a diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) diagnosis of MD were analysed. Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20) and resilience with the 25 items Connor-Davidson Resilience Scale (CD-RISC) whereas depression was evaluated using the 17-item Hamilton Depression Rating Scale, somatic sensations with the Body Sensations Questionnaire and suicide ideation with Scale of Suicide Ideation (SSI). RESULTS Gender comparisons between all demographic and clinical variables showed no significant differences in all variables. Subjects who were found positive for alexithymia showed higher scores on all clinical variables controlling for age, gender and duration of the current episode. In a linear regression model, lower scores on CD-RISC and Difficulty in Identifying Feelings dimension of TAS-20 were significantly predictive of higher scores on SSI. CONCLUSIONS Alexithymia and low resilience were significant predictors of increased suicide ideation in a first MD episode. However, study limitations must be considered and future research needs are being discussed.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy.,Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine Federico II, Naples, Italy.,Polyedra Research Group, Teramo, Italy
| | - Alessandro Valchera
- Polyedra Research Group, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | - Serena Di Natale
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | - Ida De Lauretis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Nicola Serroni
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Laura Orsolini
- Polyedra Research Group, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | | | - Alessandro Carano
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", San Benedetto del Tronto, Italy
| | - Federica Vellante
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Italy.,Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, Florida
| | - Laura Core
- NHS, Department of Mental Health, Center of Mental Health, ASL 4, Giulianova, Italy
| | - Marco Alessandrini
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Silvia Fraticelli
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
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21
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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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22
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Linn BK, Stasiewicz PR, Fillo J, Bradizza CM. The Great Disrupter: Relationship of Alexithymia to Emotion Regulation Processes and Smoking among Pregnant Women. Subst Use Misuse 2020; 55:1113-1121. [PMID: 32153230 PMCID: PMC7401085 DOI: 10.1080/10826084.2020.1729198] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Many women continue to smoke during pregnancy, despite known risks, often in response to negative affect. Recent scholarship has begun to examine factors that decrease the success of behavioral treatments for smoking cessation in pregnancy, which are the preferred interventions. Alexithymia is one factor that may interfere with smoking cessation interventions. Alexithymia restricts access to emotional information and increases propensity toward maladaptive behaviors, including smoking. However, mechanisms underlying such effects are largely unknown. Objectives: Using data from a longitudinal treatment study, the present research examined difficulties with emotion regulation as a potential mechanism linking alexithymia and smoking. Pregnant smokers (n = 73; mean age = 24.78; SD = 4.50) completed measures related to alexithymia, smoking, emotion regulation, depression, anxiety, and anger at baseline and then again following eight sessions of Cognitive-Behavioral Smoking Cessation Treatment. Results: Nearly 40% of the sample met the criteria for alexithymia. The alexithymia group reported higher depression, anxiety, and anger. They also reported more difficulties with emotion regulation. In a path analysis, baseline alexithymia had a significant positive indirect effect on number of cigarettes smoked at the end of treatment through difficulties with emotion regulation. Conclusions/Importance: Similar to other studies, alexithymia limits the understanding of emotional information necessary for selection and implementation of adaptive coping responses. Our results extend the literature by suggesting that smoking may be an attempt to manage undifferentiated and unpleasant sensations created by alexithymia.
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Affiliation(s)
- Braden K Linn
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Paul R Stasiewicz
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Jennifer Fillo
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Clara M Bradizza
- School of Social Work, University at Buffalo, Buffalo, New York, USA
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Bakhla AK, Dayal M, Bala R, Toppo A. Auditory sensation with affective agnosia: A prevalence of alexithymia among tinnitus patients. Ind Psychiatry J 2020; 29:149-154. [PMID: 33776288 PMCID: PMC7989460 DOI: 10.4103/ipj.ipj_40_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 04/26/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of the present study was to determine the prevalence and association of alexithymia, depression, and anxiety in patients affected by tinnitus. METHODS The study was conducted among the patients referred for audiometric evaluation for tinnitus. They were further evaluated with the Hospital Anxiety and Depression Scale, the Tinnitus Handicap Inventory, and the Toronto Alexithymia Scale. Analysis was done for prevalence and the sample was categorized as high and low tinnitus handicap subgroups, and mean scores of alexithymia, anxiety, and depression were compared. RESULTS A total of 70 patients (55.7% - male and 44.3% - female) with a mean age of 33.17 ± 12.24 years were finally analyzed. The severity of tinnitus was most severe (34.3%), followed by moderate (20%), catastrophic (18.6%), mild (17.1%), and slight (10%). The prevalence of alexithymia, anxiety, and depression among patients of tinnitus was found to be 65.7%, 37.1%, and 20%, respectively. The high tinnitus handicap group showed higher scoring on total alexithymia score, anxiety, and depression and higher scoring with describing emotion and identification of emotion, but there was no difference for the subscale of externally oriented thinking. CONCLUSIONS The study found a prevalence of alexithymia, anxiety, and depression as 65.7%, 37.1%, and 20%, respectively, among patients of tinnitus, and problem of describing and identification of emotion are associated with higher tinnitus handicap.
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Affiliation(s)
- Ajay Kumar Bakhla
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Meenakshi Dayal
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Rajni Bala
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ashit Toppo
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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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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Riadh O, Naoufel O, Rejeb MRB, Le Gall D. Neuro-cognitive correlates of alexithymia in patients with circumscribed prefrontal cortex damage. Neuropsychologia 2019; 135:107228. [PMID: 31634488 DOI: 10.1016/j.neuropsychologia.2019.107228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/18/2019] [Accepted: 10/10/2019] [Indexed: 02/01/2023]
Abstract
Alexithymia has been extensively reported in studies of psychiatric patients. However, little attention has been paid regarding its occurrence in the context of patients with circumscribed prefrontal cortex lesions. Moreover, the neuro-cognitive impairments that lead to alexithymia remain unclear and limited numbers of studies have addressed these issues. The authors investigated the impact of prefrontal cortex lesions on alexithymia and its neuro-cognitive correlates in a population of 20 patients with focal frontal lesions, 10 patients with parietal lesions and 34 matched control participants. Alexithymia was screened using the Toronto Alexithymia Scale (TAS-20) and executive functions were assessed using a large battery of executive tasks that address inhibition, flexibility and the planning process. Results showed that patients with prefrontal cortex damage showed significantly increased difficulty in facets of identifying feelings (DIF) and externally oriented thinking (EOT) on TAS-20, compared to parietal patients and control participants. Moreover, both correlation and regression analysis revealed that higher alexithymia levels on the three facets of TAS-20 were consistently but differentially associated with impairment in inhibition, flexibility and planning tasks for frontal patients and both control groups. These findings provide clinical evidence of the implication of prefrontal cortex damage and executive control in alexithymia. Our results were also discussed in the light of the cognitive appraisal concept as a mechanism involved in emotion episode processing. This study suggests that increased neuropsychological attention should be directed to the relation between the neuro-cognitive model of executive functions and cognitive appraisal theory in processing emotion.
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Affiliation(s)
- Ouerchefani Riadh
- University of Tunis El Manar, High Institute of Human Sciences, 26 Boulevard Darghouth Pacha, Tunis, Tunisia; University of Angers, Laboratory of Psychology of Pays de La Loire (EA 4638), 5 Bis, Boulevard Lavoisier, 49045, Angers, Cedex 01, France.
| | - Ouerchefani Naoufel
- Department of Neurosurgery, Foch Hospital, 40 Rue Worth, 92151, Suresnes, France.
| | - Mohamed Riadh Ben Rejeb
- University of Tunis I, Faculty of Human and Social Science of Tunisia, Boulvard 9 Avril, C.P. 1007, Tunis, Tunisia.
| | - Didier Le Gall
- University of Angers, Laboratory of Psychology of Pays de La Loire (EA 4638), 5 Bis, Boulevard Lavoisier, 49045, Angers, Cedex 01, France.
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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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Bottiroli S, Galli F, Viana M, Sances G, Tassorelli C. Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse. Front Psychol 2018; 9:704. [PMID: 29867669 PMCID: PMC5960722 DOI: 10.3389/fpsyg.2018.00704] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/23/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Many factors are involved in the prognosis and outcome of Chronic Migraine and Medication Overuse Headache (CM+MOH), and their understanding is a topic of interest. It is well known that CM+MOH patients experience increased psychiatric comorbidity, such as anxiety, depression, or personality disorders. Other psychological factors still need to be explored. The present study is aimed to evaluate whether early life traumatic experiences, stressful life events, and alexithymia can be associated with CM+MOH. Methods: Three hundred and thirty-one individuals were recruited for this study. They belonged to one of the two following groups: CM+MOH (N = 179; 79% females, Age: 45.2 ± 9.8) and episodic migraine (EM) (N = 152; 81% females; Age: 40.7 ± 11.0). Diagnosis was operationally defined according to the International Classification of Headache Disorders 3rd edition (ICHD-IIIβ). Data on early life (physical and emotional) traumatic experiences, recent stressful events and alexithymia were collected by means of the Childhood Trauma Questionnaire, the Stressful life-events Questionnaire, and the Toronto Alexithymia Scale (TAS-20), respectively. Results: Data showed a higher prevalence of emotional (χ2 = 6.99; d.f. = 1; p = 0.006) and physical (χ2 = 6.18; d.f. = 1; p = 0.009) childhood trauma and of current stressful events of important impact (χ2 = 4.42; d.f. = 1; p = 0.025) in CM+MOH patients than in EM ones. CM+MOH patients were characterized by higher difficulties in a specific alexithymic trait (Factor 1 subscale of TAS-20) [F(1, 326) = 6.76, p = 0.01, ηp2 = 0.02] when compared to the EM group. The role of these factors was confirmed in a multivariate analysis, which showed an association of CM+MOH with emotional (OR 2.655; 95% CI 1.153–6.115, p = 0.022) or physical trauma (OR 2.763; 95% CI 1.322–5.771, p = 0.007), and a high score at the Factor 1 (OR 1.039; 95% CI 1.002–1.078, p = 0.040). Conclusions: Our findings demonstrated a clear relationship between CM+MOH and life traumas, stressful events, and alexithymia. These observations have a relevant role in multiple fields of related to chronic headache: from the management to the nosographic framing.
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Affiliation(s)
- Sara Bottiroli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Galli
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Viana
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Grazia Sances
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Mood Regulation, Alexithymia, and Personality Disorders in Adolescent Male Addicts. ADDICTIVE DISORDERS & THEIR TREATMENT 2017. [DOI: 10.1097/adt.0000000000000098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hiirola A, Pirkola S, Karukivi M, Markkula N, Bagby RM, Joukamaa M, Jula A, Kronholm E, Saarijärvi S, Salminen JK, Suvisaari J, Taylor G, Mattila AK. An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population. J Psychosom Res 2017; 95:81-87. [PMID: 28314554 DOI: 10.1016/j.jpsychores.2017.02.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/14/2017] [Accepted: 02/12/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population. METHODS Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders. RESULTS The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p<0.001), the effect size for the increase was medium. TAS-20 score in 2000 explained a significant proportion of variance in TAS-20 score in 2011. Controlling for all baseline confounders improved the model incrementally; the same applied to controlling for confounders at follow-up. Baseline depression or anxiety disorders were not associated with the TAS-20 scores in 2011, whereas current diagnoses were. CONCLUSIONS According to our large longitudinal study both the absolute and relative stability of alexithymia assessed with the TAS-20 are high in the adult general population.
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Affiliation(s)
- A Hiirola
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | - S Pirkola
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - M Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - N Markkula
- National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
| | - R M Bagby
- Department of Psychology, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - M Joukamaa
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - A Jula
- National Institute for Health and Welfare (THL), Turku, Finland
| | - E Kronholm
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Saarijärvi
- Department of Adolescent Psychiatry, University of Turku, Turku, Finland; Unit of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - J K Salminen
- Department of Psychiatry, University of Turku, Turku, Finland
| | - J Suvisaari
- National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland
| | - G Taylor
- Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Toronto, Canada
| | - A K Mattila
- Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland
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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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da Silva AN, Vasco AB, Watson JC. Alexithymia and Emotional Processing: A Mediation Model. J Clin Psychol 2016; 73:1196-1205. [DOI: 10.1002/jclp.22422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 09/18/2016] [Accepted: 10/31/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Jeanne C. Watson
- Ontario Institute for Studies in Education of the University of Toronto; Canada
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Brewer R, Cook R, Bird G. Alexithymia: a general deficit of interoception. ROYAL SOCIETY OPEN SCIENCE 2016; 3:150664. [PMID: 27853532 PMCID: PMC5098957 DOI: 10.1098/rsos.150664] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 09/09/2016] [Indexed: 05/22/2023]
Abstract
Alexithymia is a sub-clinical construct, traditionally characterized by difficulties identifying and describing one's own emotions. Despite the clear need for interoception (interpreting physical signals from the body) when identifying one's own emotions, little research has focused on the selectivity of this impairment. While it was originally assumed that the interoceptive deficit in alexithymia is specific to emotion, recent evidence suggests that alexithymia may also be associated with difficulties perceiving some non-affective interoceptive signals, such as one's heart rate. It is therefore possible that the impairment experienced by those with alexithymia is common to all aspects of interoception, such as interpreting signals of hunger, arousal, proprioception, tiredness and temperature. In order to determine whether alexithymia is associated with selectively impaired affective interoception, or general interoceptive impairment, we investigated the association between alexithymia and self-reported non-affective interoceptive ability, and the extent to which individuals perceive similarity between affective and non-affective states (both measured using questionnaires developed for the purpose of the current study), in both typical individuals (n = 105 (89 female), mean age = 27.5 years) and individuals reporting a diagnosis of a psychiatric condition (n = 103 (83 female), mean age = 31.3 years). Findings indicated that alexithymia was associated with poor non-affective interoception and increased perceived similarity between affective and non-affective states, in both the typical and clinical populations. We therefore suggest that rather than being specifically associated with affective impairment, alexithymia is better characterized by a general failure of interoception.
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Affiliation(s)
- Rebecca Brewer
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London SE5 8AF, UK
- School of Psychology, University of East London, University Way, London E16 2RD
- Author for correspondence: Rebecca Brewer e-mail:
| | - Richard Cook
- Department of Psychology, City University London, London EC1V OHB, UK
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London SE5 8AF, UK
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AR, UK
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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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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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Galli F, Caputi M, Sances G, Vegni E, Bottiroli S, Nappi G, Tassorelli C. Alexithymia in chronic and episodic migraine: a comparative study. J Ment Health 2016; 26:192-196. [DOI: 10.3109/09638237.2015.1124404] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Federica Galli
- Department of Health Sciences, University of Milan, Milan, Italy,
- Headache Science Center, National Neurological Institute C. Mondino, Pavia, Italy,
| | - Marcella Caputi
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy, and
| | - Grazia Sances
- Headache Science Center, National Neurological Institute C. Mondino, Pavia, Italy,
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy,
| | - Sara Bottiroli
- Headache Science Center, National Neurological Institute C. Mondino, Pavia, Italy,
| | - Giuseppe Nappi
- Headache Science Center, National Neurological Institute C. Mondino, Pavia, Italy,
| | - Cristina Tassorelli
- Headache Science Center, National Neurological Institute C. Mondino, Pavia, Italy,
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
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Okita K, Ghahremani DG, Payer DE, Robertson CL, Mandelkern MA, London ED. Relationship of Alexithymia Ratings to Dopamine D2-type Receptors in Anterior Cingulate and Insula of Healthy Control Subjects but Not Methamphetamine-Dependent Individuals. Int J Neuropsychopharmacol 2015; 19:pyv129. [PMID: 26657175 PMCID: PMC4886668 DOI: 10.1093/ijnp/pyv129] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/25/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Individuals with substance-use disorders exhibit emotional problems, including deficits in emotion recognition and processing, and this class of disorders also has been linked to deficits in dopaminergic markers in the brain. Because associations between these phenomena have not been explored, we compared a group of recently abstinent methamphetamine-dependent individuals (n=23) with a healthy-control group (n=17) on dopamine D2-type receptor availability, measured using positron emission tomography with [(18)F]fallypride. METHODS The anterior cingulate and anterior insular cortices were selected as the brain regions of interest, because they receive dopaminergic innervation and are thought to be involved in emotion awareness and processing. The Toronto Alexithymia Scale, which includes items that assess difficulty in identifying and describing feelings as well as externally oriented thinking, was administered, and the scores were tested for association with D2-type receptor availability. RESULTS Relative to controls, methamphetamine-dependent individuals showed higher alexithymia scores, reporting difficulty in identifying feelings. The groups did not differ in D2-type receptor availability in the anterior cingulate or anterior insular cortices, but a significant interaction between group and D2-type receptor availability in both regions, on self-report score, reflected significant positive correlations in the control group (higher receptor availability linked to higher alexithymia) but nonsignificant, negative correlations (lower receptor availability linked to higher alexithymia) in methamphetamine-dependent subjects. CONCLUSIONS The results suggest that neurotransmission through D2-type receptors in the anterior cingulate and anterior insular cortices influences capacity of emotion processing in healthy people but that this association is absent in individuals with methamphetamine dependence.
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Affiliation(s)
- Kyoji Okita
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Doris E Payer
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Chelsea L Robertson
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Mark A Mandelkern
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern).
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Morie KP, Nich C, Hunkele K, Potenza MN, Carroll KM. Alexithymia level and response to computer-based training in cognitive behavioral therapy among cocaine-dependent methadone maintained individuals. Drug Alcohol Depend 2015; 152:157-63. [PMID: 25982006 PMCID: PMC4458169 DOI: 10.1016/j.drugalcdep.2015.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Alexithymia, a characteristic marked by poor ability to identify, define and communicate emotions, has been associated with poorer treatment outcome, including traditional clinician delivered CBT. Computerized cognitive behavioral therapy (CBT4CBT), an effective adjunct to treatment, may provide a means of conveying skills without requiring interaction with a clinician. METHODS Seventy-three methadone maintained, cocaine dependent individuals participating in an 8-week randomized clinical trial comparing standard methadone maintenance to methadone maintenance plus CBT4CBT completed the Toronto Alexithymia Scale (TAS-20) at pretreatment, post-treatment, and follow-ups conducted one, two, and 6 months after treatment. RESULTS There were no statistically significant differences on baseline TAS-20 scores by multiple demographic and substance use variables including gender and substance use severity. Higher TAS-20 scores were associated with somewhat higher levels of distress as measured by the Beck Depression Inventory and multiple Brief Severity Index scales. TAS-20 scores remained relatively stable throughout the duration of treatment and follow-up. Indicators of treatment process, including treatment retention, adherence and therapeutic alliance, were not significantly correlated with TAS-20 scores. There was a significant interaction of alexithymia and treatment condition, such that individuals with higher baseline scores on the TAS-20 submitted significantly higher percentages of cocaine-negative urine toxicology specimens and reported a higher percentage of abstinence days, and longer periods of consecutive abstinence within treatment when assigned to CBT4CBT compared with treatment as usual. CONCLUSIONS These findings suggest that individuals with increased alexithymia may benefit from computerized CBT; possibly via reduced demands on interpersonal skills and interactions associated with computerized therapies.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Charla Nich
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Karen Hunkele
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Kathleen M Carroll
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, 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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