1
|
Exploring alexithymia profiles and their associations with childhood adversity and COVID-19 burnout among Chinese college students: A person-centered approach. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
2
|
Pourová M, Řiháček T, Chvála L, Vybíral Z, Boehnke JR. Negative effects during multicomponent group-based treatment: A multisite study. Psychother Res 2022; 33:282-297. [PMID: 35776667 DOI: 10.1080/10503307.2022.2095237] [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] [Indexed: 10/17/2022] Open
Abstract
Objective Negative effects (NEs) in group treatments remain an under-researched area. This study aimed to explore the prevalence of various types of NEs in a multicomponent group-based treatment and to determine their predictors. Method: A total of 330 patients participating in a multicomponent group-based treatment were recruited across seven clinical sites. At the end of treatment, the Negative Effects Questionnaire (NEQ) was used to measure NEs. Item-level descriptive analysis was conducted to explore the prevalence of various types of NEs, and structural equation modeling was used to determine predictors of these NEs. Results: The most frequently reported type of NEs was the worsening of symptoms, and the single most frequently reported item was the resurfacing of unpleasant memories. Predictors of NEs included the overall distress level, alexithymia, attachment avoidance, low working alliance, problem actuation, and worse outcomes; psychological mindedness was a protective factor. Conclusion: Patients who experience higher levels of distress at the beginning of treatment, who perceive the group working alliance as problematic, and who experience high in-session emotional arousal related to their problem seem to be especially prone to reporting NEs. Furthermore, the findings do not support the assumption that NEs are a prerequisite for therapeutic change.Trial registration: ISRCTN.org identifier: ISRCTN13532466.
Collapse
Affiliation(s)
- Martina Pourová
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Tomáš Řiháček
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Luboš Chvála
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Zbyněk Vybíral
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, Scotland
| |
Collapse
|
3
|
Proença Lopes C, Allado E, Essadek A, Poussel M, Henry A, Albuisson E, Hamroun A, Chenuel B. Occurrence of Alexithymia and Its Association with Sports Practice from a Sample of University Students: Results from a French Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10050788. [PMID: 35627924 PMCID: PMC9141175 DOI: 10.3390/healthcare10050788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: This study aimed to assess the prevalence of alexithymia in a sample of university students and to determine its association with specific sports practice characteristics (competition and training). Methods: In this cross-sectional study, anthropometric data and characteristics of sport practice were collected, as well as level of alexithymia (Toronto Alexithymia Scale, (TAS-20)). Results: The study included 253 French university students who completed a questionnaire specifying their regular sports practice and level of alexithymia (TAS-20). We found 76 subjects (30%) who had proven alexithymia and 92 (36.4%) who were borderline alexithymic. A significant positive relationship between alexithymia and the weekly amount of training practice was observed. It should be noted that students who engage in more than 5 h of physical activity are more prone to be borderline or alexithymic (respectively, 19.6 and 19.7% versus 7.1% for non-alexithymics; p = 0.03). Conclusion: With a 30% frequency, alexithymia is more prevalent in this context than in the general population. Furthermore, alexithymia and borderline alexithymia are most favorably associated with higher physical activity (over 5 h per week).
Collapse
Affiliation(s)
- Catarina Proença Lopes
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Correspondence: ; Tel.: +33-6-12-21-87-42
| | - Edem Allado
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Aziz Essadek
- INTERPSY (EA 4432), University of Lorraine, 54000 Nancy, France;
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Audrey Henry
- Cognition, Health and Society Laboratory, University of Reims Champagne-Ardenne, 51571 Reims, France;
| | - Eliane Albuisson
- Institut Elie-Cartan de Lorraine, CNRS, Université de Lorraine, 54000 Nancy, France;
| | - Aghilès Hamroun
- Department of Public Health, Epidemiology, Health Economics and Prevention, Regional and University Hospital Center of Lille, Lille University, 59000 Lille, France;
| | - Bruno Chenuel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| |
Collapse
|
4
|
Leonidou C, Constantinou E, Panteli M, Panayiotou G. Attentional processing of unpleasant stimuli in alexithymia: Early avoidance followed by attention maintenance bias. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2054531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Elena Constantinou
- Department of Psychology, University of Cyprus; Kios Research & Innovation Center of Excellence, University of Cyprus
| | - Maria Panteli
- Department of Psychology, University of Cyprus; Center of Applied Neuroscience, University of Cyprus
| | | |
Collapse
|
5
|
Proença Lopes C, Allado E, Poussel M, Essadek A, Hamroun A, Chenuel B. Alexithymia and Athletic Performance: Beneficial or Deleterious, Both Sides of the Medal? A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10030511. [PMID: 35326989 PMCID: PMC8955528 DOI: 10.3390/healthcare10030511] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Numerous studies have been published on alexithymia among athletes in the last decades. The objective, here, is to provide a critical review on alexithymia in sport and identify elements demonstrating that alexithymic athletes can attain a competitive advantage. Methods: The Center for Reviews and Dissemination guidelines were used. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines served as the template for reporting the present systematic review. We searched PubMed, Embase, Science Direct, and PsycINFO, without language or date restrictions. Results: Within 72 eligible studies, 23 articles fulfilling the selection criteria were included in the review. Alexithymia is associated with various pathologies and considered to be counter-performing. However, despite considerable suspicion of an advantageous performance effect of alexithymia, there is a lack of data to quantify this effect. Studies identified are heterogeneous (different scales of measurement of alexithymia used or outcomes, different sports), that do not allow us to conclude on an observed causal relationship, because the studies are mostly observational. Conclusion: This systematic review opens a new search field on alexithymia, as possibly promoting performance.
Collapse
Affiliation(s)
- Catarina Proença Lopes
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Correspondence: ; Tel.: +33-6-12-21-87-42
| | - Edem Allado
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Aziz Essadek
- INTERPSY (EA 4432), University of Lorraine, 54000 Nancy, France;
| | - Aghilès Hamroun
- Department of Public Health, Epidemiology, Health Economics and Prevention, Regional and University Hospital Center of Lille, Lille University, 59000 Lille, France;
| | - Bruno Chenuel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| |
Collapse
|
6
|
Zimmermann KM, Schmidt KD, Gronow F, Sommer J, Leweke F, Jansen A. Seeing things differently: Gaze shapes neural signal during mentalizing according to emotional awareness. Neuroimage 2021; 238:118223. [PMID: 34098065 DOI: 10.1016/j.neuroimage.2021.118223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/19/2022] Open
Abstract
Studies on social cognition often use complex visual stimuli to asses neural processes attributed to abilities like "mentalizing" or "Theory of Mind" (ToM). During the processing of these stimuli, eye gaze, however, shapes neural signal patterns. Individual differences in neural operations on social cognition may therefore be obscured if individuals' gaze behavior differs systematically. These obstacles can be overcome by the combined analysis of neural signal and natural viewing behavior. Here, we combined functional magnetic resonance imaging (fMRI) with eye-tracking to examine effects of unconstrained gaze on neural ToM processes in healthy individuals with differing levels of emotional awareness, i.e. alexithymia. First, as previously described for emotional tasks, people with higher alexithymia levels look less at eyes in both ToM and task-free viewing contexts. Further, we find that neural ToM processes are not affected by individual differences in alexithymia per se. Instead, depending on alexithymia levels, gaze on critical stimulus aspects reversely shapes the signal in medial prefrontal cortex (MPFC) and anterior temporoparietal junction (TPJ) as distinct nodes of the ToM system. These results emphasize that natural selective attention affects fMRI patterns well beyond the visual system. Our study implies that, whenever using a task with multiple degrees of freedom in scan paths, ignoring the latter might obscure important conclusions.
Collapse
Affiliation(s)
- Kristin Marie Zimmermann
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Department of Neurology and Neurorehabilitation, Hospital zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen.
| | - Kirsten Daniela Schmidt
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Franziska Gronow
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen
| | - Jens Sommer
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen; Core-Unit Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Frank Leweke
- Clinic for Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Jansen
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen; Core-Unit Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| |
Collapse
|
7
|
Terock J, Klinger-König J, Janowitz D, Nauck M, Völzke H, Grabe HJ. Alexithymia is associated with increased all-cause mortality risk in men, but not in women: A 10-year follow-up study. J Psychosom Res 2021; 143:110372. [PMID: 33540301 DOI: 10.1016/j.jpsychores.2021.110372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Alexithymia is associated with various mental as well as physical disorders. Some evidence also suggested high alexithymia to increase mortality risk, but these results are few and based on specific sample compositions. We aimed to investigate the impact of alexithymia on mortality risk in a large population based cohort. In addition, we sought to elucidate the effects of the subfactors of alexithymia and sex differences. METHODS In a sample of N = 1380 individuals from the Study of Health in Pomerania (SHIP), we investigated the hazard-ratio (HR) of alexithymia as obtained by the Toronto Alexithymia Scale-20 (TAS-20) on all-cause mortality over an average observation time of 10 years. Sex-by-TAS-20-interactions as well as sex-stratified analyses were performed. RESULTS Alexithymia was significantly associated with enhanced mortality risk (HR = 1.033; 95%-CI = 1.008-1.058); p = 0.009). While sex-by-TAS-20 interactions remained insignificant, sex-stratified analyses showed that this effect was only significant in men (HR = 1.050; 95%-CI = 1.022-1.079; p ≤ 0.001), but not in women (HR: 1.008; 95%-CI = 0.960-1.057; p = 0.76). The effect was validated for the "difficulties identifying feelings" (DIF) and "difficulties describing feelings" (DDF) subfactors of the TAS-20. CONCLUSION Our study supports and extents previous findings by indicating that mortality risk enhancing effects of alexithymia are specific to male subjects and validated for the DIF and DDF facets. Socioeconomic, clinical and metabolic factors were associated with this relationship. Finding that the impact of alexithymia remains stable in the fully adjusted models suggests that yet unidentified additional factors must be considered.
Collapse
Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany.
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany; German Center for Neurodegenerative Diseases DZNE, Site Rostock/Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| |
Collapse
|
8
|
Luminet O, Nielson KA, Ridout N. Cognitive-emotional processing in alexithymia: an integrative review. Cogn Emot 2021; 35:449-487. [PMID: 33787442 DOI: 10.1080/02699931.2021.1908231] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Alexithymia is a multifaceted personality construct characterised by difficulties identifying one's feelings and distinguishing them from bodily sensations, difficulties describing one's feelings to others, and an externally oriented cognitive style. Over the past 25 years, a burgeoning body of research has examined how alexithymia moderates processing at the cognition-emotion interface. We review the findings in five domains: attention, appraisals, memory, language, and behaviours. The preponderance of studies linked alexithymia with deficits in emotion processing, which was apparent across all domains, except behaviours. All studies on behaviours and a proportion of studies in other domains demonstrated emotional over-responding. Analysis at the facet level revealed deficits in memory and language that are primarily associated with externally oriented thinking, while over-responding was most often linked to difficulty identifying feelings and difficulty describing feelings. The review also found evidence for contextual modulation: The pattern of deficits and over-responding was not restricted to emotional contexts but also occurred in neutral contexts, and in some circumstances, emotional over-responding in alexithymia was beneficial. Taken together, this review highlights alexithymia as a central personality dimension in the interplay between cognition and emotion.
Collapse
Affiliation(s)
- Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain, Louvain-la-Neuve, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| | - Kristy A Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, USA.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| |
Collapse
|
9
|
Vermeulen N, Toussaint J, Luminet O. The influence of Alexithymia and music on the Incidental Memory for Emotion Words. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.758] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Alexithymia is a multifaceted personality construct which encompasses difficulties in identifying and expressing feelings along with an externally oriented cognitive style. We investigated whether congruent vs. incongruent emotional musical priming (happy and angry music) during encoding would moderate the effects of alexithymia on recognition rates. We found that high alexithymia scorers recognized fewer joy and anger words than low scorers. Angry music decreased recognition rates in high alexithymia scorers compared to low alexithymia scorers. The congruency and incongruency effects between music and words depended on alexithymia level. The anger deficit in high alexithymia scorers and the possible support provided by happiness cues are discussed. Copyright © 2010 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Nicolas Vermeulen
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
- Belgian National Fund for Scientific Research, Belgium
| | - Julie Toussaint
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
| | - Olivier Luminet
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
- Belgian National Fund for Scientific Research, Belgium
| |
Collapse
|
10
|
Casagrande M, Boncompagni I, Forte G, Guarino A, Favieri F. Emotion and overeating behavior: effects of alexithymia and emotional regulation on overweight and obesity. Eat Weight Disord 2020; 25:1333-1345. [PMID: 31473988 DOI: 10.1007/s40519-019-00767-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Obesity and overweight are significant risk factors for many serious diseases. Several studies have investigated the relationship between emotional regulation and overweight or obesity in people with eating disorders. Although a few studies have explored alexithymia in individuals with severe obesity without eating disorders, no attention has been paid to individuals with overweight and preclinical form of obesity. This study aims to assess whether overweight and obesity are related to emotional dysregulation and alexithymia. METHODS The study involved 111 undergraduate students who had not been diagnosed with an eating disorder. The sample was divided into two groups according to their body mass index (BMI): normal weight (N = 55) and overweight (N = 56). All of them completed the Toronto Alexithymia Scale (TAS-20), the Emotional Regulation Questionnaire (ERQ), and the Eating Disorder Inventory-2 (EDI-2). RESULTS Results showed higher levels of alexithymia, and specifically higher difficulty in identifying feelings and an externally oriented thought, in participants with overweight. Multiple correlation analysis highlighted the positive relations between some EDI-2 subscales and both alexithymia and emotional regulation scores. Linear regressions revealed a significant relationship between body BMI and both alexithymia and emotional regulation strategies. CONCLUSIONS The condition of overweight/obesity seems to be associated with higher emotional dysregulation compared to normal weight condition. It is essential to study this relationship because it could represent a risk factor for the worsening of problems related to overeating and excessive body weight. These findings suggest that an integrated approach aimed at considering the promotion of emotional regulation could contribute to the effectiveness of a program designed to reduce overweight and obesity. LEVEL OF EVIDENCE Level III: case-control analytic study.
Collapse
Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma "Sapienza", Via degli Apuli, 1, 00185, Rome, Italy.
| | - Ilaria Boncompagni
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Francesca Favieri
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| |
Collapse
|
11
|
Lane RD, Solms M, Weihs KL, Hishaw A, Smith R. Affective agnosia: a core affective processing deficit in the alexithymia spectrum. Biopsychosoc Med 2020. [DOI: 10.1186/s13030-020-00184-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AbstractAffective agnosia, an impairment in knowing how one feels emotionally, has been described as an extreme deficit in the experience and expression of emotion that may confer heightened risk for adverse medical outcomes. Alexithymia, by contrast, has been proposed as an over-arching construct that includes a spectrum of deficits of varying severity, including affective agnosia at the more severe end. This perspective has been challenged by Taylor and colleagues, who argue that the concept of affective agnosia is unnecessary. We compare these two perspectives by highlighting areas of agreement, reasons for asserting the importance of the affective agnosia concept, errors in Taylor and colleagues’ critique, and measurement issues. The need for performance-based measures of the ability to mentally represent emotional states in addition to metacognitive measures is emphasized. We then draw on a previously proposed three-process model of emotional awareness that distinguishes affective response generation, conceptualization and cognitive control processes which interact to produce a variety of emotional awareness and alexithymia phenotypes - including affective agnosia. The tools for measuring these three processes, their neural substrates, the mechanisms of brain-body interactions that confer heightened risk for adverse medical outcomes, and the differential treatment implications for different kinds of deficits are described. By conceptualizing alexithymia as a spectrum of deficits, the opportunity to match specific deficit mechanisms with personalized treatment for patients will be enhanced.
Collapse
|
12
|
Triffaux JM, Nasello J, Luminet O, Servais C, Close M, Quertemont E, Blavier A. Relative stability of alexithymia and openness to emotions in one psychiatric day hospital setting. Clin Psychol Psychother 2020; 27:714-726. [PMID: 32285578 DOI: 10.1002/cpp.2456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 11/11/2022]
Abstract
Alexithymia (literally, difficulty finding words for emotions) and openness to emotions (OE: referring to the cognitive representation, communication, regulation, perception of internal and external bodily sensations, and social restriction of emotions) are strongly linked to psychopathology. The absolute and relative stability hypotheses were tested in order to determine whether significant changes occurred on these constructs after therapy, a condition where changes were expected for both constructs. Negative attitudes toward treatment (NTI) and perceived social support (PSS) were expected to significantly predict alexithymia and OE. Patients (N = 179) who participated in this longitudinal study filled in the Toronto Alexithymia Scale, the Dimensions of Openness to Emotions Scale, the NTI subscale, the Multidimensional Scale of Perceived Social Support, and the Social Desirability Scale. After treatment, we observed significant decrease of all alexithymia scores and significant increases of three OE scores, that is, cognitive representation, communication, and regulation of emotions. Regression analyses revealed that gender, age, NTI, and PSS were significant predictors of alexithymia and OE. NTI strongly predicted lower OE levels and higher alexithymia levels, whereas PSS had opposite predicting effects on these constructs. In conclusion, the significant changes, and the moderate to high correlational levels observed between before and after alexithymia and OE scores, strengthen the relative stability hypothesis for both constructs. In addition, PSS represents a protective factor and NTI a vulnerability indicator for therapists. Our aim is to optimize treatment by providing therapists treating emotion difficulties a more concrete array of variables that potentially either promote or subvert recovery.
Collapse
Affiliation(s)
- Jean-Marc Triffaux
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy.,Department of Medical Psychology, University of Liège, CHU of Liège, Liège, Belgium
| | - Julian Nasello
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy.,Department of Psychology, University of Liège, Liège, Belgium
| | - Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain and Belgian Fund for Scientific Research (FRS-FNRS)
| | - Catherine Servais
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy
| | - Mireille Close
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy
| | | | | |
Collapse
|
13
|
Elise B, Eynde SV, Egée N, Lamotte M, Van de Borne P, Carole FH. Are Trait Emotional Competencies and Heart Rate Variability Linked to Mental Health of Coronary Heart Disease Patients? Psychol Rep 2020; 124:23-38. [PMID: 31910715 DOI: 10.1177/0033294119898116] [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: 11/16/2022]
Abstract
PURPOSE Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. METHODS Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. RESULTS Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. CONCLUSIONS This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.
Collapse
Affiliation(s)
- Batselé Elise
- Université libre de Bruxelles, Belgium; National Fund for Scientific Research, Belgium.,Université libre de Bruxelles, Belgium
| | | | | | | | | | | |
Collapse
|
14
|
Vadini F, Sozio F, Madeddu G, De Socio G, Maggi P, Nunnari G, Vichi F, Di Stefano P, Tracanna E, Polilli E, Sciacca A, Zizi B, Lai V, Bartolozzi C, Flacco ME, Bonfanti P, Santilli F, Manzoli L, Parruti G. Alexithymia Predicts Carotid Atherosclerosis, Vascular Events, and All-Cause Mortality in Human Immunodeficiency Virus-Infected Patients: An Italian Multisite Prospective Cohort Study. Open Forum Infect Dis 2019; 6:ofz331. [PMID: 31660407 PMCID: PMC6761942 DOI: 10.1093/ofid/ofz331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/18/2019] [Indexed: 01/08/2023] Open
Abstract
Background Psychological factors (PFs) are known predictors of cardiovascular disease (CVD) in many clinical settings, but data are lacking for human immunodeficiency virus (HIV) infection. We carried out a prospective study to evaluate (1) psychological predictors of preclinical and clinical vascular disease and (2) all-cause mortality (ACM) in HIV patients. Methods We conducted a cross-sectional analysis of baseline data to evaluate the predictors of carotid plaques (CPs) and a prospective analysis to explore predictors of vascular events (VEs) and ACM over 10 years. Human immunodeficiency virus patients monitored at the Infectious Disease Units of 6 Italian regions were consecutively enrolled. Traditional CVD risk factors, PFs (depressive symptoms, alexithymia, distress personality), and CPs were investigated. Vascular events and ACM after enrollment were censored at March 2018. Results A multicenter cohort of 712 HIV-positive patients (75.3% males, aged 46.1 ± 10.1 years) was recruited. One hundred seventy-five (31.6%) patients had CPs at baseline. At the cross-sectional analysis, alexithymia was independently associated with CPs (odds ratio, 4.93; 95% confidence interval [CI], 2.90–8.50; P < .001), after adjustment for sociodemographic, clinical, and psychological variables. After an average follow-up of 4.4 ± 2.4 years, 54 (7.6%) patients developed a VE, whereas 41 (5.68%) died. Age, current smoking, hypertension, and alexithymia (hazard ratio [HR], 3.66; 95% CI, 1.80–7.44; P < .001) were independent predictors of VE. Likewise, alexithymia was an independent predictor of ACM (HR, 3.93; 95% CI, 1.65–9.0; P = .002), regardless of other clinical predictors. Conclusions The present results validate our previous monocentric finding. Alexithymia may be an additional tool for the multifactorial assessment of cardiovascular risk in HIV.
Collapse
Affiliation(s)
| | - Federica Sozio
- Infectious Disease Unit, Pescara General Hospital, Italy
| | - Giordano Madeddu
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | | | - Paolo Maggi
- Infectious Diseases Clinic, Policlinico Hospital, Bari, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Francesca Vichi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy
| | | | - Elisa Tracanna
- Infectious Disease Unit, Pescara General Hospital, Italy
| | - Ennio Polilli
- Clinical Pathology Laboratory, Pescara General Hospital, Italy
| | | | - Bernardetta Zizi
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | - Vincenzo Lai
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | - Claudio Bartolozzi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy
| | | | - Paolo Bonfanti
- Infectious Diseases Unit, A. Manzoni Hospital, Lecco, Italy
| | - Francesca Santilli
- Department of Medicine and Aging and Center of Aging Science and Translational Medicine, University of Chieti, Italy
| | | | | |
Collapse
|
15
|
Rice SM, Kealy D, Oliffe JL, Treeby MS, Ogrodniczuk JS. Shame and guilt mediate the effects of alexithymia on distress and suicide-related behaviours among men. PSYCHOL HEALTH MED 2019; 25:17-24. [DOI: 10.1080/13548506.2019.1601747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Simon M. Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Matt S. Treeby
- School of Psychology, La Trobe University, Bundoora, Australia
| | - John S. Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
16
|
Brosschot JF, Verkuil B, Thayer JF. Generalized Unsafety Theory of Stress: Unsafe Environments and Conditions, and the Default Stress Response. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E464. [PMID: 29518937 PMCID: PMC5877009 DOI: 10.3390/ijerph15030464] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/13/2018] [Accepted: 02/27/2018] [Indexed: 12/14/2022]
Abstract
Prolonged physiological stress responses form an important risk factor for disease. According to neurobiological and evolution-theoretical insights the stress response is a default response that is always "on" but inhibited by the prefrontal cortex when safety is perceived. Based on these insights the Generalized Unsafety Theory of Stress (GUTS) states that prolonged stress responses are due to generalized and largely unconsciously perceived unsafety rather than stressors. This novel perspective necessitates a reconstruction of current stress theory, which we address in this paper. We discuss a variety of very common situations without stressors but with prolonged stress responses, that are not, or not likely to be caused by stressors, including loneliness, low social status, adult life after prenatal or early life adversity, lack of a natural environment, and less fit bodily states such as obesity or fatigue. We argue that in these situations the default stress response may be chronically disinhibited due to unconsciously perceived generalized unsafety. Also, in chronic stress situations such as work stress, the prolonged stress response may be mainly caused by perceived unsafety in stressor-free contexts. Thus, GUTS identifies and explains far more stress-related physiological activity that is responsible for disease and mortality than current stress theories.
Collapse
Affiliation(s)
- Jos F Brosschot
- Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, 2300 RB Leiden, The Netherlands.
| | - Bart Verkuil
- Institute of Psychology, Unit Clinical Psychology, Leiden University, 2300 RB Leiden, The Netherlands.
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA.
| |
Collapse
|
17
|
Kealy D, Ogrodniczuk JS, Rice SM, Oliffe JL. Alexithymia, suicidal ideation and health-risk behaviours: a survey of Canadian men. Int J Psychiatry Clin Pract 2018; 22:77-79. [PMID: 28509577 DOI: 10.1080/13651501.2017.1324992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Restricted emotional abilities may present significant implications for men's health. The purpose of this study was to examine the relationship between alexithymia and several health-risk behaviours: substance misuse, aggressive and risky behaviours and suicidal ideation. METHODS A nationally representative sample of 1000 Canadian men responded to a survey containing measures of alexithymia, maladaptive coping behaviours, suicidal ideation and depressive symptoms. A series of hierarchical regressions were conducted using alexithymia as the predictor variable and each health-risk behaviour as the criterion variable, controlling for depressive symptom severity. RESULTS Alexithymia was found to be significantly associated with drug use, alcohol use, angry/aggressive behaviour and risk-taking behaviour - as well as suicidal ideation - beyond the effects of depressive symptoms. CONCLUSIONS The findings provide evidence for the link between alexithymia and several problematic behaviours that pose risks to men's health.
Collapse
Affiliation(s)
- David Kealy
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - John S Ogrodniczuk
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Simon M Rice
- b Orygen , The National Centre of Excellence in Youth Mental Health , Parkville , VIC , Australia.,c Centre for Youth Mental Health , The University of Melbourne , Parkville , VIC , Australia
| | - John L Oliffe
- d School of Nursing , University of British Columbia , Vancouver , BC , Canada
| |
Collapse
|
18
|
Epifanio MS, Ingoglia S, Alfano P, Lo Coco G, La Grutta S. Type D Personality and Alexithymia: Common Characteristics of Two Different Constructs. Implications for Research and Clinical Practice. Front Psychol 2018; 9:106. [PMID: 29479327 PMCID: PMC5811501 DOI: 10.3389/fpsyg.2018.00106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/22/2018] [Indexed: 11/18/2022] Open
Abstract
In the last few decades, particular attention has been paid to the role of personality specific traits that can affect the loss of health, i.e., Type D personality and Alexithymia. They have been conceptualized in a different period, this means that they are different both for their theoretical positions and their empirical studies. Some authors have speculated that there is a potential conceptual overlap between Type D personality and alexithymia constructs but there is a shortcoming in the literature. The aim of the study was to examine the potential overlap between the constructs of type D personality and alexithymia, replicating previous two studies, to extend these findings to Italian population. The participants were 247 Italian adults (males = 43%), recruited in primary health care practices of Palermo. All participants did not have chronic diseases during tests administration. They ranged in age from 35 to 69 years old (M = 52.34 years, SD = 9.76). Participants were administered Type D Personality Scale (DS-14) and Toronto Alexithymia Scale (TAS-20). A series of confirmatory factor analyses was performed to evaluate the factorial structure underlying the TAS-20 and DS-14 items. Globally results showed that alexithymia and type D personality are distinct constructs, but they are also strictly positively related with each other. Negative affectivity (NA) was highly correlated with Difficulties in identifying feelings and Difficulties in describing feelings, while Social inhibition (SI) was highly correlated with Difficulties in describing feelings. These results are consistent with those of other studies conducted in this area. Future research should consider evaluating the relationship between a deficit of affect regulation and type D personality to improve the effectiveness of interventions of health cure.
Collapse
Affiliation(s)
- Maria S. Epifanio
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Sonia Ingoglia
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Pietro Alfano
- Consiglio Nazionale delle Ricerche, Institute of Biomedicine and Molecular Immunology, Rome, Italy
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Sabina La Grutta
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| |
Collapse
|
19
|
Tatar A, Saltukoğlu G, Alioğlu S, Çimen S, Güven H, Ay ÇE. Measuring Alexithymia via Trait Approach-I: A Alexithymia Scale Item Selection and Formation of Factor Structure. Noro Psikiyatr Ars 2017; 54:216-224. [PMID: 29033633 DOI: 10.5152/npa.2017.12769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 06/03/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION It is not clear in the literature whether available instruments are sufficient to measure alexithymia because of its theoretical structure. Moreover, it has been reported that several measuring instruments are needed to measure this construct, and all the instruments have different error sources. The old and the new forms of Toronto Alexithymia Scale are the only instruments available in Turkish. Thus, the purpose of this study was to develop a new scale to measure alexithymia, selecting items and constructing the factor structure. METHODS A total of 1117 patients aged from 19 to 82 years (mean = 35.05 years) were included. A 100-item pool was prepared and applied to 628 women and 489 men. Data were analyzed using Explanatory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory and 28 items were selected. The new form of 28 items was applied to 415 university students, including 271 women and 144 men aged from 18 to 30 (mean=21.44). RESULTS The results of Explanatory Factor Analysis revealed a five-factor construct of "Solving and Expressing Affective Experiences," "External Locused Cognitive Style," "Tendency to Somatize Affections," "Imaginary Life and Visualization," and "Acting Impulsively," along with a two-factor construct representing the "Affective" and "Cognitive" components. All the components of the construct showed good model fit and high internal consistency. The new form was tested in terms of internal consistency, test-retest reliability, and concurrent validity using Toronto Alexithymia Scale as criteria and discriminative validity using Five-Factor Personality Inventory Short Form. CONCLUSION The results showed that the new scale met the basic psychometric requirements. Results have been discussed in line with related studies.
Collapse
Affiliation(s)
- Arkun Tatar
- Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Gaye Saltukoğlu
- Department of Psychology, Fatih Sultan Mehmet Vakıf University School of Literature, İstanbul, Turkey
| | | | | | - Hülya Güven
- Private Practice, Psychology, İstanbul, Turkey
| | | |
Collapse
|
20
|
Roberts R, Woodman T. Personality and performance: moving beyond the Big 5. Curr Opin Psychol 2017; 16:104-108. [PMID: 28813330 DOI: 10.1016/j.copsyc.2017.03.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/20/2017] [Accepted: 03/30/2017] [Indexed: 12/25/2022]
Abstract
In this review, we examine the literature in relation to personality and performance. Much of the extant work in this area has focused on the role of the Big 5 traits (i.e., extraversion, conscientiousness, openness to experience, agreeableness, and neuroticism), at the expense of other personality variables that have a strong performance-focused rationale. Further, a focus on main effects has dominated the literature, without recourse to consider person×environment interactions. In this review we go beyond the Big 5 and consider the role of two personality traits, narcissism and alexithymia, in relation to performance. We demonstrate that both traits have considerable potential to explain differences in performance and that the personality-performance relationship is best viewed from an interactionist perspective. We close with a call for researchers to give more attention to personality in relation to performance.
Collapse
Affiliation(s)
- Ross Roberts
- Institute for the Psychology of Elite Performance, School of Sport, Health and Exercise Sciences, Bangor University, LL57 2PZ, UK.
| | - Tim Woodman
- Institute for the Psychology of Elite Performance, School of Sport, Health and Exercise Sciences, Bangor University, LL57 2PZ, UK
| |
Collapse
|
21
|
Living alone and activation of the renin-angiotensin-aldosterone-system: Differential effects depending on alexithymic personality features. J Psychosom Res 2017; 96:42-48. [PMID: 28545792 DOI: 10.1016/j.jpsychores.2017.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Living alone is considered as a chronic stress factor predicting different health conditions and particularly cardiovascular disease (CVD). Alexithymia is associated with increased psychological distress, less social skills and fewer close relationships, making alexithymic subjects particularly susceptible to chronic stress imposed by "living alone". Only few studies investigated the renin-angiotensin-aldosterone-system (RAAS) activity in response to chronic stress. We aimed at evaluating the effects of "living alone" as a paradigm for chronic stress on RAAS activity and putatively differential effects depending on alexithymic personality features. METHODS Alexithymia and serum concentrations of renin and aldosterone were measured in 944 subjects from the population-based SHIP-1 study. Subgroups were formed using the median of the Toronto Alexithymia Scale-20 (TAS-20) and a cohabitation status of "living alone" or "living together". Analyses were adjusted for various psychosocial, behavioral and metabolic risk factors. RESULTS "Living alone" was associated with elevated plasma renin (p<0.01, β=0.138) but not aldosterone concentrations in the total sample. On subgroup level, we found associations of "living alone" and elevated renin concentrations only in subjects low in TAS-20 scores (p<0.01, β=0.219). Interactional effects of alexithymia×cohabitation status were found for the aldosterone-to-renin ratio (p=0.02, β=-0.234). CONCLUSIONS The association of chronic stress imposed by "living alone" with increased RAAS activity contributes to explain the relationship of this psychosocial stress condition and increased risk for CVD. In contrast, alexithymic subjects may be less affected by the deleterious effects of "living alone".
Collapse
|
22
|
|
23
|
De Berardis D, Serroni N, Campanella D, Marini S, Rapini G, Valchera A, Iasevoli F, Mazza M, Fornaro M, Perna G, Di Iorio G, Martinotti G, Di Giannantonio M. Alexithymia, Suicide Ideation, C-Reactive Protein, and Serum Lipid Levels Among Outpatients with Generalized Anxiety Disorder. Arch Suicide Res 2017; 21:100-112. [PMID: 25856390 DOI: 10.1080/13811118.2015.1004485] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the present study was to investigate the relationships between alexithymia, suicide ideation, C-Reactive Protein (CRP), and serum lipid levels in adult outpatients with a DSM-IV diagnosis of Generalized Anxiety Disorder (GAD). Seventy consecutive patients with GAD were recruited and evaluated. Measures were the Hamilton Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI), and the Montgomery Åsberg Depression Rating Scale (MADRS). All patients were assessed for: CRP, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceridaemia (TG), and very-low-density lipoprotein cholesterol (VLDL-C). TC/HDL-C and LDL-C/HDL-C ratios were also evaluated. Alexithymic patients showed higher scores on almost all rating scales and altered serum CRP and lipid levels vs. non-alexithymics. In the hierarchical regression model, the presence of higher MADRS scores together with higher scores at the Difficulty in Identifying Feelings dimension of TAS-20 were associated with higher rates of suicide ideation. Although alexithymic subjects with GAD may show a CRP and cholesterol dysregulation, this latter seems independent on increased suicide ideation, rather to Difficulty in Identifying Feelings, and subthreshold depressive symptoms. Study limitations and future research implications are discussed.
Collapse
|
24
|
De Berardis D, Fornaro M, Orsolini L, Valchera A, Carano A, Vellante F, Perna G, Serafini G, Gonda X, Pompili M, Martinotti G, Di Giannantonio M. Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review. Front Psychiatry 2017; 8:148. [PMID: 28855878 PMCID: PMC5557776 DOI: 10.3389/fpsyt.2017.00148] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/28/2017] [Indexed: 11/18/2022] Open
Abstract
It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.
Collapse
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, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Michele Fornaro
- New York Psychiatric Institute, Columbia University, New York City, NY, United States.,Polyedra, Teramo, Italy
| | - Laura Orsolini
- Polyedra, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Carano
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", NHS, San Benedetto del Tronto, Italy
| | - Federica Vellante
- 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, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, 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, Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Genova, Italy
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.,Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| |
Collapse
|
25
|
Taylor GJ, Bagby RM, Parker JD. What’s in the name ‘alexithymia’? A commentary on “Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud’s legacy.”. Neurosci Biobehav Rev 2016; 68:1006-1020. [DOI: 10.1016/j.neubiorev.2016.05.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/20/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
|
26
|
The association between depression and craving in alcohol dependency is moderated by gender and by alexithymia factors. Psychiatry Res 2016; 239:28-38. [PMID: 27137959 DOI: 10.1016/j.psychres.2016.02.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 02/04/2016] [Accepted: 02/27/2016] [Indexed: 01/17/2023]
Abstract
Alexithymia is a multifaceted personality trait that involves difficulties in identifying and describing feelings to others, a poor fantasy life and an externally oriented cognitive style. Alexithymia has been described as a vulnerability factor for mental and physical diseases. We investigated in a group of 158 alcohol-dependent patients (103 men, 55 women) the association between depression and craving for alcohol when these patients were starting a detoxification program, and the moderating impact of gender and alexithymia on this relation. We first found an interaction between depression and gender in the prediction of craving in the sense that only for women an increase in depressive mood was related to an increase in total craving. When examining gender separately, we found that alexithymia factors acted as moderators. For women, the link between depression and craving was strengthened for the ones scoring higher on "difficulties describing feelings". But for men, the link between depression and craving was reduced for the ones scoring higher on "externally-oriented thinking". These findings suggest that in some cases that need to be identified more systematically in the future, the "externally-oriented thinking" alexithymia factor can exert - at least in the short term - some protective effects.
Collapse
|
27
|
Housiaux M, Luminet O, Dorchy H. Difficulties describing feelings to others still predicts glycaemic control up to 24 months later in children with type 1 diabetes. DIABETES & METABOLISM 2016; 42:207-10. [PMID: 26782009 DOI: 10.1016/j.diabet.2015.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 01/09/2023]
Affiliation(s)
- M Housiaux
- Department of Psychology, Université catholique de Louvain (UCL), Research Institute for Psychological Sciences, 10, Place Cardinal-Mercier, 1348 Louvain-la-Neuve, Belgium
| | - O Luminet
- Department of Psychology, Université catholique de Louvain (UCL), Research Institute for Psychological Sciences, 10, Place Cardinal-Mercier, 1348 Louvain-la-Neuve, Belgium; Belgian National Fund for Scientific Research (FRS-FNRS), Belgium.
| | - H Dorchy
- Diabetology Clinic, University Children's Hospital Queen Fabiola, Université libre de Bruxelles (ULB), 15, Avenue J.J.-Crocq, 1020 Bruxelles, Belgium
| |
Collapse
|
28
|
Lane RD, Weihs KL, Herring A, Hishaw A, Smith R. Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud's legacy. Neurosci Biobehav Rev 2015; 55:594-611. [DOI: 10.1016/j.neubiorev.2015.06.007] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/04/2015] [Accepted: 06/02/2015] [Indexed: 12/30/2022]
|
29
|
Cozzolongo R, Porcelli P, Lanzilotta E, Giannuzzi V, Leandro G. The role of alexithymia in quality of life impairment in patients with chronic hepatitis C during antiviral treatment. Compr Psychiatry 2015; 60:17-25. [PMID: 25941158 DOI: 10.1016/j.comppsych.2015.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the role of alexithymia in the quality of life of patients with chronic hepatitis C treated with antiviral therapy. A consecutive sample of 124 patients were evaluated at baseline, during, and 6months after treatment with interferon and ribavirin. At baseline past mood disorders and alexithymia and, at each index visit, adverse events, psychological distress, and disease-specific quality of life were assessed with validated instruments. Patients with past mood disorders and alexithymia had impaired levels of quality of life, psychological distress, and treatment-related adverse events. However, after controlling for covariates, poor quality of life was independently predicted by alexithymia and psychological distress before (R(2)=0.60) and 6months after (R(2)=0.69) the antiviral treatment while during treatment (at 3months and the end of therapy) by depression and somatic adverse events (R(2)=0.67 and 0.69, respectively). Alexithymia rather than history of mood disorders resulted to be an independent predictor of impaired quality of life not only before but also 6months after the end of treatment. Given the association with proneness to health-compromising behaviors, clinicians are encouraged to pay closer attention to long-term psychological and somatic effects of antiviral treatment in patients with alexithymic characteristics.
Collapse
Affiliation(s)
- Raffaele Cozzolongo
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Piero Porcelli
- Clinical Psychology Unit, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Elsa Lanzilotta
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Vito Giannuzzi
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Gioacchino Leandro
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; Department of Liver and Digestive Health, University College of London, UK.
| |
Collapse
|
30
|
Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N. Toward a new definition of mental health. World Psychiatry 2015; 14:231-3. [PMID: 26043341 PMCID: PMC4471980 DOI: 10.1002/wps.20231] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Berlin, Germany
| | - Marianne Kastrup
- Competence Center for Transcultural Psychiatry, Psychiatric Center Ballerup, Hellerup, Denmark
| | - Julian Beezhold
- Hellesdon Hospital and Norwich Medical School, University of East Anglia, Norwich, UK
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| |
Collapse
|
31
|
De Berardis D, Serroni N, Campanella D, Rapini G, Olivieri L, Feliziani B, Carano A, Valchera A, Iasevoli F, Tomasetti C, Mazza M, Fornaro M, Perna G, Di Nicola M, Martinotti G, Di Giannantonio M. Alexithymia, responsibility attitudes and suicide ideation among outpatients with obsessive-compulsive disorder: an exploratory study. Compr Psychiatry 2015; 58:82-7. [PMID: 25591904 DOI: 10.1016/j.comppsych.2014.12.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/27/2014] [Accepted: 12/23/2014] [Indexed: 11/28/2022] Open
Abstract
AIMS Obsessive-compulsive disorder (OCD) is psychiatric disorder with a significant suicide risk, and the presence of alexithymia may increase this risk. As several studies attribute an important role, in OCD, to responsibility, the aims of this study were to evaluate possible clinical differences between patients positive or not for alexithymia concerning disorder severity, responsibility attitudes and suicide ideation and investigate which variables were associated with increased suicide ideation. METHODS 104 adult outpatients with OCD were recruited. Alexithymia was measured with Toronto Alexithymia Scale (TAS-20), attitude about responsibility was tested with Responsibility Attitude Scale (RAS), suicide ideation was assessed with Scale of Suicide Ideation (SSI) and depressive symptoms were evaluated with Montgomery Åsberg Depression Rating Scale (MADRS). Score of item #11 on the Y-BOCS was considered as a measure of insight. RESULTS Patients positive for alexithymia showed higher responsibility attitudes and more severe suicide ideation. In a blockwise regression model, the presence of lower insight, higher RAS scores and difficulty in identifying feelings dimension of TAS-20 were associated with higher SSI scores. CONCLUSIONS OCD patients with alexithymia may show higher disorder severity, lower insight and inflated responsibility, all related to suicide ideation, independently from depressive symptoms. Implications were discussed and study limitations considered and reported.
Collapse
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" of Chieti, Chieti Scalo, Italy.
| | - Nicola Serroni
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Daniela Campanella
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Luigi Olivieri
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Barbara Feliziani
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Alessandro Carano
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy
| | - Alessandro Valchera
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy
| | - Felice Iasevoli
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Monica Mazza
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Michele Fornaro
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Giampaolo Perna
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands; Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, FL, USA
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Martinotti
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy
| |
Collapse
|
32
|
De Berardis D, Serroni N, Marini S, Rapini G, Carano A, Valchera A, Iasevoli F, Mazza M, Signorelli M, Aguglia E, Perna G, Martinotti G, Varasano PA, Pressanti GL, Di Giannantonio M. Alexithymia, suicidal ideation, and serum lipid levels among drug-naïve outpatients with obsessive-compulsive disorder. ACTA ACUST UNITED AC 2014; 36:125-30. [PMID: 24554275 DOI: 10.1590/1516-4446-2013-1189] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/17/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE As obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder with a significant suicide risk, the individuation of potential biomarkers of suicidality, such as cholesterol levels, may enable recognition of at-risk subjects. Therefore, the aims of this study were to: 1) evaluate potential differences in clinical and laboratory parameters between patients with and without alexithymia and compare them with healthy controls; and 2) investigate which clinical and laboratory variables were associated with suicidal ideation. METHODS 79 drug-naïve adult outpatients with a DSM-IV diagnosis of OCD were recruited. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), suicidal ideation was assessed with the Scale for Suicide Ideation, and depressive symptoms were evaluated with the Montgomery-Åsberg Depression Rating Scale (MADRS). Serum lipid levels of 40 healthy controls were also evaluated. RESULTS Alexithymic patients had altered serum lipid levels in comparison with non-alexithymics and healthy controls. Using a linear regression model, the presence of symmetry/ordering obsessions and compulsions, lower HDL-C levels, and difficulty in identifying feelings dimension of the TAS-20 were associated with higher suicidal ideation. CONCLUSIONS Alexithymic individuals with OCD may exhibit dysregulation of the cholesterol balance, which in turn may be linked to suicidal ideation. Further prospective studies are required to elucidate this potential association.
Collapse
Affiliation(s)
- Domenico De Berardis
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Nicola Serroni
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Stefano Marini
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Gabriella Rapini
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Alessandro Carano
- Department of Neurosciences and Imaging, Chair of Psychiatry, Universitè degli Studi G. d'Annunzio Chieti e Pescara, Chieti Scalo, Italy
| | | | - Felice Iasevoli
- Section of Psychiatry, Department of Neuroscience, School of Medicine, Universitè degli Studi di Napoli Federico II, Naples, Italy
| | - Monica Mazza
- Department of Science of Health, Universitè degli Studi dell'Aquila, L'Aquila, Italy
| | - Maria Signorelli
- Department of Clinical and Molecular Biomedicine, Universitè degli Studi di Catania, Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Universitè degli Studi di Catania, Catania, Italy
| | - Giampaolo Perna
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands
| | | | - Paola A Varasano
- Department of Immunohematology and Transfusional Medicine, G. Mazzini Hospital, Teramo, Italy
| | | | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, Universitè degli Studi G. d'Annunzio Chieti e Pescara, Chieti Scalo, Italy
| |
Collapse
|
33
|
Godin I, Montplaisir J, Gagnon JF, Nielsen T. Alexithymia associated with nightmare distress in idiopathic REM sleep behavior disorder. Sleep 2013; 36:1957-62. [PMID: 24293771 PMCID: PMC3825446 DOI: 10.5665/sleep.3238] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Idiopathic REM sleep behavior disorder (iRBD) is characterized by atypical REM sleep motor activity, vivid dreams and nightmares, and dream-enacting behaviors that can result in injuries to the patient and bed partner. It is also a known predictor of Parkinson disease (PD). Alexithymia has been associated with disturbances in sleep and dreaming (e.g., nightmares) and is a non-motor symptom of PD. We assessed alexithymia and disturbed dreaming in iRBD patients with the aim of determining if these two factors are elevated and interrelated among this population. DESIGN Questionnaire study of clinically diagnosed patients. SETTING Clinical sleep disorders center. PATIENTS OR PARTICIPANTS Thirty-two iRBD patients and 30 healthy age- and sex-matched control participants. MEASUREMENTS AND RESULTS Participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Dream Questionnaire, and the Beck Depression Inventory. iRBD patients obtained higher TAS-20 total scores (62.16 ± 13.90) than did controls (52.84 ± 7.62; F 1,59 = 10.44, P < 0.01), even when controlling for depressive symptoms, and more frequently attained the suggested cutoff for alexithymia than did controls (P < 0.01). iRBD patients obtained higher scores on the Difficulty Identifying Feelings alexithymia subscale. For both iRBD and control groups, the Difficulty Indentifying Feelings subscale correlated positively with the Nightmare Distress scale of the Dream Questionnaire. CONCLUSIONS Elevated alexithymia scores among idiopathic rapid eye movement sleep behavior disorder patients, and especially a difficulty in identifying feelings, parallels evidence of dysautonomia in this population. The higher incidence of distressing nightmares and the association of nightmares with alexithymia further extend similar findings for both clinical and non-clinical samples and suggest that an affect regulation disturbance may be common to the two sets of symptoms.
Collapse
Affiliation(s)
- Isabelle Godin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Québec, Canada
| | - Jaques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Québec, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychology, Université du Québec à Montréal, Québec, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Québec, Canada
| |
Collapse
|
34
|
Emotion suppression and mortality risk over a 12-year follow-up. J Psychosom Res 2013; 75:381-5. [PMID: 24119947 PMCID: PMC3939772 DOI: 10.1016/j.jpsychores.2013.07.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 07/16/2013] [Accepted: 07/26/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Suppression of emotion has long been suspected to have a role in health, but empirical work has yielded mixed findings. We examined the association between emotion suppression and all-cause, cardiovascular, and cancer mortality over 12 years of follow-up in a nationally representative US sample. METHODS We used the 2008 General Social Survey-National Death Index (GSS-NDI) cohort, which included an emotion suppression scale administered to 729 people in 1996. Prospective mortality follow up between 1996 and 2008 of 111 deaths (37 by cardiovascular disease, 34 by cancer) was evaluated using Cox proportional hazards models adjusted for age, gender, education, and minority race/ethnicity. RESULTS The 75th vs. 25th percentile on the emotional suppression score was associated with hazard ratio (HR) of 1.35 (95% Confidence Interval [95% CI]=1.00, 1.82; P=.049) for all-cause mortality. For cancer and cardiovascular disease mortality, the HRs were 1.70 (95% CI=1.01, 2.88, P=.049) and 1.47 (95% CI=.87, 2.47, P=.148) respectively. CONCLUSIONS Emotion suppression may convey risk for earlier death, including death from cancer. Further work is needed to better understand the biopsychosocial mechanisms for this risk, as well as the nature of associations between suppression and different forms of mortality.
Collapse
|
35
|
De Berardis D, Campanella D, Serroni N, Moschetta FS, Di Emidio F, Conti C, Carano A, Acciavatti T, Di Iorio G, Martinotti G, Siracusano A, Di Giannantonio M. Alexithymia, suicide risk and serum lipid levels among adult outpatients with panic disorder. Compr Psychiatry 2013; 54:517-22. [PMID: 23332553 DOI: 10.1016/j.comppsych.2012.12.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 12/04/2012] [Accepted: 12/06/2012] [Indexed: 11/18/2022] Open
Abstract
To elucidate the relationships between alexithymia, suicide ideation and serum lipid levels in drug-naïve adult outpatients with a DSM-IV diagnosis of Panic Disorder (PD), 72 patients were evaluated. Measures were the Panic Attack and Anticipatory Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI) and the Montgomery Åsberg Depression Rating Scale (MADRS). Alexithymic patients showed higher scores on all rating scales and altered serum lipid levels than non-alexithymics. In the hierarchical regression model, the presence of lower HDL-C and higher VLDL-C levels and Difficulty in Identifying Feelings dimension of TAS-20 were associated with higher suicide ideation. In conclusion, alexithymic individuals with PD may show a cholesterol dysregulation that may be linked to suicide ideation. The authors discuss study limitations and future research needs.
Collapse
Affiliation(s)
- Domenico De Berardis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Nardelli S, Pentassuglio I, Pasquale C, Ridola L, Moscucci F, Merli M, Mina C, Marianetti M, Fratino M, Izzo C, Merkel C, Riggio O. Depression, anxiety and alexithymia symptoms are major determinants of health related quality of life (HRQoL) in cirrhotic patients. Metab Brain Dis 2013; 28:239-43. [PMID: 23296469 DOI: 10.1007/s11011-012-9364-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/21/2012] [Indexed: 12/16/2022]
Abstract
HRQoL is impaired in cirrhosis. Establishing the relevance of depression, anxiety, alexithymia and cirrhosis stage on the patients' HRQoL. Sixty cirrhotics underwent a neuropsychological assessment, including ZUNG-SDS, STAI Y1-Y2 and TAS-20. Minimal hepatic encephalopathy (MHE) was detected by PHES, HRQoL by Short-Form-36 (SF-36). Depression was detected in 34 patients (57 %, 95%CI = 44-70 %), state-anxiety in 16 (27 %, 95%CI = 15-38 %), trait-anxiety in 17 (28 %, 95%CI = 17-40 %), alexithymia in 14 (31 % 95%CI = 16-46 %) and MHE in 22 (37 %, 95%CI = 24-49 %). Neuropsychological symptoms were unrelated to cirrhosis stage, hepatocellular carcinoma or MHE. A significant correlation was observed among psychological test scores and summary components of SF-36. At multiple linear regression analysis including Child-Pugh and MELD scores, previous-HE and the psychological test scores as possible covariates, alexithymia and depression as well as to the Child-Pugh score were significantly related to the SF-36 mental component; while trait-anxiety was the only variable significantly and independently related to the SF-36 physical component. Depression, state and trait-anxiety and alexithymia symptoms are frequent in cirrhotics and are among the major determinants of the altered HRQoL.
Collapse
Affiliation(s)
- Silvia Nardelli
- Department of Clinical Medicine, Centre for Diagnosis and Treatment of Portal Hypertension, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Ferguson E. Personality is of central concern to understand health: towards a theoretical model for health psychology. Health Psychol Rev 2013; 7:S32-S70. [PMID: 23772230 PMCID: PMC3678852 DOI: 10.1080/17437199.2010.547985] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 12/11/2010] [Indexed: 12/15/2022]
Abstract
This paper sets out the case that personality traits are central to health psychology. To achieve this, three aims need to be addressed. First, it is necessary to show that personality influences a broad range of health outcomes and mechanisms. Second, the simple descriptive account of Aim 1 is not sufficient, and a theoretical specification needs to be developed to explain the personality-health link and allow for future hypothesis generation. Third, once Aims 1 and 2 are met, it is necessary to demonstrate the clinical utility of personality. In this review I make the case that all three Aims are met. I develop a theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality. I identify traits (i.e., alexithymia, Type D, hypochondriasis, and empathy) that are of particular concern to health psychology and set these within evolutionary cost-benefit analysis. The literature is reviewed within a three-level hierarchical model (individual, group, and organisational) and it is argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels.
Collapse
Affiliation(s)
- Eamonn Ferguson
- Department of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK
| |
Collapse
|
38
|
Landstra JMB, Ciarrochi J, Deane FP, Hillman RJ. Identifying and describing feelings and psychological flexibility predict mental health in men with HIV. Br J Health Psychol 2013; 18:844-57. [DOI: 10.1111/bjhp.12026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 01/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Jodie M. B. Landstra
- School of Psychology; University of Wollongong; New South Wales Australia
- HIV; Hepatitis C and Mental Health; St Vincent's Hospital; Darlinghurst New South Wales Australia
| | - Joseph Ciarrochi
- School of Social Sciences and Psychology University of Western Sydney; New South Wales Australia
| | - Frank P. Deane
- School of Psychology; University of Wollongong; New South Wales Australia
- Illawarra Institute for Mental Health; University of Wollongong; New South Wales Australia
| | - Richard J. Hillman
- STI Research Centre; University of Sydney; Parramatta New South Wales Australia
- Centre for Applied Medical Research; St Vincent's Hospital; Darlinghurst New South Wales Australia
| |
Collapse
|
39
|
Kano M, Fukudo S. The alexithymic brain: the neural pathways linking alexithymia to physical disorders. Biopsychosoc Med 2013; 7:1. [PMID: 23302233 PMCID: PMC3563604 DOI: 10.1186/1751-0759-7-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 12/13/2012] [Indexed: 01/18/2023] Open
Abstract
Alexithymia is a personality trait characterized by difficulties in identifying and describing feelings and is associated with psychiatric and psychosomatic disorders. The mechanisms underlying the link between emotional dysregulation and psychosomatic disorders are unclear. Recent progress in neuroimaging has provided important information regarding emotional experience in alexithymia. We have conducted three brain imaging studies on alexithymia, which we describe herein. This article considers the role of emotion in the development of physical symptoms and discusses a possible pathway that we have identified in our neuroimaging studies linking alexithymia with psychosomatic disorders. In terms of socio-affective processing, alexithymics demonstrate lower reactivity in brain regions associated with emotion. Many studies have reported reduced activation in limbic areas (e.g., cingulate cortex, anterior insula, amygdala) and the prefrontal cortex when alexithymics attempt to feel other people's feelings or retrieve their own emotional episodes, compared to nonalexithymics. With respect to primitive emotional reactions such as the response to pain, alexithymics show amplified activity in areas considered to be involved in physical sensation. In addition to greater hormonal arousal responses in alexithymics during visceral pain, increased activity has been reported in the insula, anterior cingulate cortex, and midbrain. Moreover, in complex social situations, alexithymics may not be able to use feelings to guide their behavior appropriately. The Iowa gambling task (IGT) was developed to assess decision-making processes based on emotion-guided evaluation. When alexithymics perform the IGT, they fail to learn an advantageous decision-making strategy and show reduced activity in the medial prefrontal cortex, a key area for successful performance of the IGT, and increased activity in the caudate, a region associated with impulsive choice. The neural machinery in alexithymia is therefore activated more on the physiologic, motor-expressive level and less in the cognitive-experiential domains of the emotional response system. Affects may play an important role in alleviating intrinsic physiologic reactions and adapting to the environment. Deficient development of emotional neural structures may lead to hypersensitivity to bodily sensations and unhealthy behaviors, a possible mechanism linking alexithymia to psychosomatic disorders.
Collapse
Affiliation(s)
- Michiko Kano
- Behavioral Medicine, Tohoku University Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Shin Fukudo
- Behavioral Medicine, Tohoku University Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| |
Collapse
|
40
|
Kojima M. Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies. Biopsychosoc Med 2012; 6:21. [PMID: 23244192 PMCID: PMC3546882 DOI: 10.1186/1751-0759-6-21] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 12/13/2012] [Indexed: 11/30/2022] Open
Abstract
The number of articles on alexithymia has been steadily increasing since the word “alexithymia” was coined in the 1970s to denote a common characteristic that is observed among classic psychosomatic patients in whom therapy was unsuccessful. Alexithymia, a disorder of affect regulation, has been suggested to be broadly associated with various mental and physical health problems. However, most available evidence is based on anecdotal reports or cross-sectional observations. To clarify the predictive value of alexithymia for health problems, a systematic review of prospective studies was conducted. A search of the PubMed database identified 1,507 articles on “alexithymia” that were published by July 31, 2011. Among them, only 7 studies examined the developmental risks of alexithymia for health problems among nonclinical populations and 38 studies examined the prognostic value of alexithymia among clinical populations. Approximately half of the studies reported statistically significant adverse effects, while 5 studies demonstrated favorable effects of alexithymia on health outcomes; four of them were associated with surgical interventions and two involved cancer patients. The studies that showed insignificant results tended to have a small sample size. In conclusion, epidemiological evidence regarding alexithymia as a prognostic risk factor for health problems remains un-established. Even though alexithymia is considered to be an unfavorable characteristic for disease control and health promotion overall, some beneficial aspects are suggested. More prospective studies with sufficient sample sizes and follow-up period, especially those involving life course analyses, are needed to confirm the contribution of alexithymia to health problems.
Collapse
Affiliation(s)
- Masayo Kojima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| |
Collapse
|
41
|
Kojima M. Epidemiologic studies of psychosocial factors associated with quality of life among patients with chronic diseases in Japan. J Epidemiol 2011; 22:7-11. [PMID: 22156289 PMCID: PMC3798574 DOI: 10.2188/jea.je20110114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A link between affective disturbances and physical disorders has been suggested since the Greco-Roman era. However, evidence supporting an association between mind and body is limited and mostly comes from North America and Europe. Additional local epidemiologic studies are needed so that more evidence can be collected on effective treatments and health management. Epidemiologic studies of Japanese with rheumatoid arthritis (RA) and those on chronic hemodialysis examined the association between psychosocial factors and patient quality of life (QOL). Strong associations among depression, social support, and patient QOL were confirmed, which supports the findings of studies performed in Western countries. In addition, disparities between the perspectives of patients with RA and their doctors were observed. Alexithymia, a personality construct that reflects a deficit in the cognitive processing of emotion, had a stronger independent association with increased risk of 5-year mortality than did depression among patients with chronic hemodialysis. Physiological, biological, and psychosocial factors are associated and independently and interactively determine our health. Epidemiology is a powerful tool for identifying effective points of intervention, after considering all possible confounders. Future studies must clarify how health can be improved by using a psychosocial approach.
Collapse
Affiliation(s)
- Masayo Kojima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Japan.
| |
Collapse
|
42
|
Bollinger D, Howe RSV. Alexithymia and Circumcision Trauma: A Preliminary Investigation. ACTA ACUST UNITED AC 2011. [DOI: 10.3149/jmh.1002.184] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
43
|
Abstract
OBJECTIVE Individuals with alexithymia have a reduced ability to use their feelings to guide their behavior appropriately in social situations. To reveal the capacity to use emotional signals in alexithymia under conditions of uncertainty, this study investigates neural substrates and performance on the Iowa Gambling Task (IGT), which was developed to assess decision making based on emotion-guided evaluation. METHODS The participants were 10 men with alexithymia and 13 without. Alexithymia was assessed by the 20-item Toronto Alexithymia Scale. Regional cerebral blood flow (rCBF) was measured by [¹⁵O]-H₂O positron emission tomography during four trials of the IGT and two visuomotor control tasks. RESULTS The participants with alexithymia failed to learn an advantageous decision-making strategy, with performance differing significantly from the nonalexithymic group in the fourth IGT trial (p = .029). Comparing performance between the IGT and the control tasks, both groups showed brain activation in the dorsolateral frontal area, inferior frontal lobe, pre-supplementary motor area, inferior parietal lobe, fusiform gyrus, and cerebellum. Men with alexithymia showed lower rCBF in the medial frontal area (Brodmann area [BA] 10) and higher rCBF in the caudate and occipital areas in the first and second IGT trials, which are within a learning phase according to test performance data. All brain data were significant at p ≤ .001, uncorrected. CONCLUSIONS BA10 activity may be associated with using internal signals accompanying affective evaluation of the stimuli, which is crucial for successful decision making. Reduced BA10 activity in participants with alexithymia suggests that they may not use an emotion-based biasing signal to lead to advantageous decision making.
Collapse
|
44
|
Luminet O, Grynberg D, Ruzette N, Mikolajczak M. Personality-dependent effects of oxytocin: Greater social benefits for high alexithymia scorers. Biol Psychol 2011; 87:401-6. [DOI: 10.1016/j.biopsycho.2011.05.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 05/12/2011] [Accepted: 05/19/2011] [Indexed: 11/16/2022]
|
45
|
De Santo RM, Livrea A, De Santo NG, Conzo G, Bilancio G, Celsi S, Cirillo M. The high prevalence of alexithymia in hemodialyzed patients with secondary hyperparathyroidism unsuppressed by medical therapy is cured by parathyroidectomy. J Ren Nutr 2011; 20:S64-70. [PMID: 20797574 DOI: 10.1053/j.jrn.2010.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
There are scanty data available on alexithymia in patients with end-stage renal disease, which point to an independent association with depression and social support. This study was devised to investigate the prevalence of alexithymia and sleep disorders in patients maintenance hemodialysis with insuppressible secondary hyperparathyroidism, who need parathyroidectomy (PTX), because previous data from our laboratories as well as those of others showed that this patient-group are the worst sleepers among hemodialysis patients with end-stage renal disease. A total of 40 patients needing PTX were enrolled and studied before the surgery. As for the control group, 80 patients on maintenance hemodialysis not needing PTX were enrolled. We measured alexithymia with the Toronto Alexithymia Score (TAS-20), sleep disorders with the Pittsburgh Sleep Quality Index (PSQI), and depression with Beck Depression Inventory (BDI), intact parathyroid hormone (iPTH), calcium, phosphate, use of antihypertensives, systolic and diastolic blood pressure, hemoglobin concentration, and albumin concentration. Patients needing PTX in comparison with those not needing PTX had significantly higher iPTH, calcium, and phosphate; they also had significantly higher systolic and diastolic blood pressure. They were more significantly alexithymic (P < .001), had more severe sleep disorders (P < .001), and were more depressed (P < .043). In multivariate analysis, BDI correlated significantly with iPTH concentration (r = 0.505, P < .001). A reduction of TAS-20 occurred after PTX which correlated with the number of patients on antihypertensive drugs, PSQI, BDI, hemoglobin concentration in the univariate and multivariate analysis. When TAS-20 and PSQI were adjusted for BDI (using analysis of variance) there was still a significant difference of TAS-20 and PSQI between patients needing PTX and not needing PTX (P < .001). This study confirms the high prevalence of sleep disorders in patients with unsuppressed secondary hyperparathyroidism and discloses a high prevalence of Alexithymia which is ameliorated by PTX. However, the correlation of Alexithymia with sleep disorders does not depend on depression.
Collapse
|
46
|
Baiardini I, Braido F, Ferraioli G, Menoni S, Bruzzone M, Conte ME, Gani F, Ridolo E, Scordamaglia A, Canonica GW. Pitfalls in respiratory allergy management: alexithymia and its impact on patient-reported outcomes. J Asthma 2010; 48:25-32. [PMID: 21121763 DOI: 10.3109/02770903.2010.535883] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Alexithymia is a personality trait characterized by a limited ability to identify and express emotions and it represents a possible risk factor for disease development and management. The objective of the study is to evaluate alexithymia in patients with persistent asthma and comorbid rhinitis and its relation with patient-reported outcomes (PROs). METHODS Alexithymia, quality of life, illness perception, and stress were assessed, as well as rhinitis symptoms and asthma control in out-patients classified according to GINA and ARIA guidelines. RESULTS Out of 115 patients, 19% turned out to be alexithymic (TAS-20 ≥ 61). Concerning alexithymia level, no difference was detected between males and females (χ(2) = 0.317) and among GINA levels (χ(2) = 0.22). Alexithymics had significantly lower Asthma Control Test scores when compared with non-alexithymics (15.86 vs. 19; p = .02). Alexithymics had a worse quality of life (p< .001) and, concerning illness perception, they ascribed to respiratory allergy symptoms that are not strictly disease related and referred to asthma and rhinitis more serious negative consequences (p < .001) and emotional representations (p < .035). Moreover, they had lower illness coherence (p < .001) and lived their disease as a cyclical rather than a chronic disorder (p < .035). As regards stress, alexithymics reported less energy (p < .001), higher levels of tension (p < .001), depression (p < .001), confusion (p > .001), and inertia (p < .001). CONCLUSION Alexithymia is present in a relevant percentage of subjects and, as it can modulate illness perception, quality of life, and stress, it should be considered in disease management.
Collapse
Affiliation(s)
- Ilaria Baiardini
- Allergy and Respiratory Disease Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Abstract
A high frequency of suicide ideation (SI) has been reported following traumatic brain injury (TBI) (Simpson & Tate, 2002; Teasdale & Engberg, 2001). This study examined the frequency of SI following TBI, and its relationship to alexithymia, and depression, plus two components of depression-hopelessness and worthlessness. One hundred and five TBI patients and 74 demographically matched controls completed the Toronto Alexithymia Scale-20 (TAS-20) and the Beck Depression Inventory (BDI-II). Ratings of SI, hopelessness, and worthlessness were extracted from the BDI-II. Results confirm a high frequency of SI (33%) and alexithymia (61%) after TBI compared with healthy controls (1.4% and 6.5%, respectively). A high frequency of alexithymia was also found in a sub-group of moderate-severely depressed TBI patients (70.68%) compared with two non-TBI depressed samples (53.92% and 44.8%). A significant association was found between SI and alexithymia in the TBI group, with the SI group reporting significantly higher TAS-20 total scores. However, logistic regression analysis found that worthlessness was the strongest predictor of SI after TBI. The results of this study suggest that increased attention should be directed toward emotional change after TBI, as alexithymia may mediate the development of worthlessness and, in turn, increase the risk of SI.
Collapse
|
48
|
Waldstein SR, Kauhanen J, Neumann SA, Katzel LI. Alexithymia and Cardiovascular Risk in Older Adults: Psychosocial, Psychophysiological, and Biomedical Correlates. Psychol Health 2010. [DOI: 10.1080/08870440290025803] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
49
|
|
50
|
Abstract
OBJECTIVE To explore the associations between alexithymia and increased somatic morbidity. The mechanisms underlying these associations, however, are still unclear. Furthermore, data on the association between alexithymia and mortality are scarce. METHODS A total of 2321 Finnish men, aged 46 to 61 years, were followed up for an average of 20 years. Mortality rates were obtained from the national register. The associations between baseline alexithymia and cardiovascular disease (CVD), all-cause, injury, and cancer deaths were examined with adjustments for age and several behavioral (smoking, alcohol consumption, physical activity), physiological (low- and high-density lipoprotein cholesterol, body mass index, systolic blood pressure, history of CVD), and psychosocial (marital status, education, depression) factors. RESULTS After all adjustments, the risk of CVD death was increased by 1.2% for each 1-point increase in Toronto Alexithymia Scale-26 scores. CONCLUSIONS Alexithymia is associated with increased cardiovascular mortality.
Collapse
|