Alcohol and tobacco use in men: the role of alexithymia and externally oriented thinking style

Men's peer support for mental health challenges: future directions for research and practice

Peer support has a long history of helping people navigate mental health challenges and is increasingly utilized within men's mental health promotion initiatives. Despite considerable research conceptualizing and evaluating peer support in various contexts, little is known about the gendered dimensions of men's peer support and mutual help for mental health. This article provides an empirically informed commentary on men's peer support and informal help-seeking preferences to make recommendations for future directions for research and practice. Research examining men's peer support is emergent and the available evidence suggests that there is potential to conceptually align with many men's values and preferences for mental health help-seeking. Peer support offers a non-clinical, strength-based adjunct to professional support that may aid men in navigating a range of mental health challenges. Consideration must be given to the influence of gender socialization and men's diverse experiences with developing and maintaining peer relationships. It should not be assumed that authentic and supportive relationships will naturally form when men congregate together. As a growing number of interventions and programs emerge targeted at boys and men, there are important opportunities to leverage these health promotion efforts to encourage and coach men to engage in mutual help. Opportunities for research and practice are discussed to better understand and harness the health-promoting potential of peer support for men's mental health.

Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool

OBJECTIVE

Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use.

METHOD

As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator.

RESULTS

The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher).

CONCLUSION

These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects.

PLAIN LANGUAGE TITLE

Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

Young hearts at risk: Unveiling novel factors in myocardial infarction susceptibility and prevention

The increasing incidence of acute myocardial infarction (AMI) among the young population represents a significant and emerging health concern, contributing substantially to both mortality and morbidity. Unlike myocardial infarctions occurring in older individuals, traditional risk factors such as diabetes and hypertension exhibit a weaker association in the younger demographic. Consequently, there is a pressing need for a deeper understanding of novel risk factors that contribute to AMI in young patients. In this review, we explore distinct risk factor profiles associated with young-onset AMI in comparison to older patients. Special attention is given to novel risk factors, examining their susceptibility factors and exploring preventive measures. The comprehensive risk profile of extremely young South Asians who develop early coronary arterial disease is not yet fully understood. There are many novel evolving risk factors associated with young AMI which need intervention to reduce morbidity and mortality. It has been seen that established inflammatory markers like lipoprotein (a), dyslipidaemia, long COVID, and new emerging risk factors like air pollution (micro- and nanoplastics), periodontitis, acute stress, energy drinks, misuse of recreational drugs may increase risk and influence treatment, and outcomes of AMI in this young population. Screening of emerging novel risk markers and their optimization is important in preventing young patients with AMI. The role of conventional risk factors should not be overlooked and should be treated aggressively. Sex and geographic-specific base approaches are required to reduce risk factors and prevent AMI in young. More prospective studies are needed to evaluate the increasing incidence of young AMI and its associated novel risk factors.

Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations

Purpose

Insomnia is related to alexithymia in adults, but the relationship between insomnia and alexithymia in adolescents with major depressive disorder remains unclear. This study aimed to investigate the sex differences and the association between insomnia and alexithymia in adolescents with major depressive disorder.

Patients and Methods

From October 2020 to April 2022, adolescent patients with major depressive disorder were recruited from psychiatric departments of seven hospitals in Anhui Province, China. Their general demographic and clinical information were collected. The 20-item Toronto Alexithymia Scale, the Center for Epidemiologic Studies of Depression Scale, and the Insomnia Severity Index Scale were used to assess their alexithymia, depression, and insomnia symptoms, respectively. The analysis of variance (ANOVA), Student's t-test and Mann-Whitney U-test were used for continuous variables and chi-square tests for categorical variables. Pearson's correlation analysis and Spearman correlation analysis were used to examine the correlation between ISI and demographic and clinical variables. Multiple binary logistic regression analyses with the "Enter" method were carried out to explore the correlations of insomnia.

Results

The prevalence of insomnia in female adolescent patients was similar to that of male patients (χ2=1.84, p = 0.175). Compared with those without insomnia, patients with insomnia had worse family relationships (F = 7.71, p = 0.021), perceived heavier academic stress (F = 6.32, p = 0.012), more likely to take sedative-hypnotics (F = 5.51, p = 0.019), had higher levels of depression (F = 81.57, p < 0.001) and alexithymia (F = 28.57, p < 0.001). Correlation analysis showed that alexithymia was significantly associated with insomnia in adolescent patients (r = 0.360, p < 0.01). Binary logistic regression analyses showed that, alexithymia was significantly associated with insomnia in female patients (OR = 1.050, p < 0.05) but not male patients.

Conclusion

In female adolescent patients, alexithymia is a risk factor of insomnia, which is of great importance in the understanding of the psychopathological mechanisms, treatments and psychological interventions of insomnia in adolescents with major depressive disorder.

Relationships between alexithymia and food addiction: The Finnish version of Yale Food Addiction Scale and preliminary test of its psychometric properties

Background

It has long been suggested that addictive behaviors are associated with alexithymia, a personality trait characterized by difficulties in emotional awareness and expression. However, little is known about the role of alexithymia in food addiction.

Objectives

The aim of this study was to investigate the relationship between alexithymia and food addiction. As part of the study, the validity of the Finnish version of Yale Food Addiction Scale (YFAS-F) was also investigated.

Methods

The sample consisted of 360 parents from the FinnBrain Birth Cohort Study. The structural validity of the YFAS-F was evaluated by confirmatory factor analysis (CFA). Exploratory factor analysis (EFA) was used to explore the structure when proposed models were not supported by CFA. The associations of alexithymia as measured by the 20-item Toronto Alexithymia Scale and food addiction were examined using regression analyses followed by structural equation modeling.

Results

Higher alexithymia was associated with more food addiction by conducting linear regression analysis (B = 0.013, p = 0.011) and structural equation modeling (β = 0.24, p < 0.001). Furthermore, a single-factor model for the 8 criteria of the YFAS-F was supported by CFA and showed acceptable internal reliability (KR-20 = 0.72), and a three-factor solution for the 20 items of the scale was suggested by EFA with good internal reliability (McDonald's ω = 0.91 for the YFAS-F, 0.91 for component 1, 0.87 for component 2, and Spearman-Brown coefficient = 0.89 for component 3).

Conclusion

The current study determined a significant relationship between alexithymia and food addiction, which suggests alexithymia as a relevant factor for food addiction and may provide clinical implications for interventions. Moreover, the YFAS-F appeared to be a valid and reliable tool to evaluate food addiction in our Finnish general population sample. Further studies on the psychometric properties of the YFAS-F in more diverse populations are recommended.

Poor respiratory health outcomes associated with high illness worry and alexithymia: Eleven-year prospective cohort study among the working-age population

OBJECTIVE

Poor respiratory health outcomes have been associated with poorer physical health and higher psychological distress. The aim of this study was to investigate whether illness worry, alexithymia or low sense of coherence predict i) the onset of new respiratory disease, ii) respiratory symptoms or iii) lung function among the working-age population, independently of comorbidity mood-, anxiety, or alcohol abuse disorders.

METHODS

The study was conducted among a nationally representative sample of the Finnish population (BRIF8901) aged 30-54 years (N = 2310) in 2000-2001 and was followed up in 2011. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder at baseline were excluded. Lung function was measured by a spirometry test and psychiatric disorders were diagnosed using a structured clinical interview. Structured questionnaires were used to measure self-reported respiratory symptoms and diseases, illness worry, alexithymia, and sense of coherence.

RESULTS

High illness worry predicted an 11-year incidence of asthma (OR 1.47, 95% CI 1.09-1.99, p = 0.01). Alexithymia predicted shortness of breath (OR 1.32, 95% CI 1.13-1.53, p < 0.01) and 11-year incidence of COPD (OR 2.84, 95% CI 1.37-5.88, p < 0.01), even after several adjustments for physical and mental health. Psychological dispositions did not associate with lung function in 2011.

CONCLUSIONS

In the general population, psychological factors that modify health behaviour predicted adverse respiratory health outcomes independently of lung function after 11 years of follow-up. This indicates that considering them part of personalized treatment planning is important for promoting health-related behaviour among the working-age population.

Alexithymia Is Associated With Internalizing Disorders in a Clinical Adolescent Outpatient Sample

ABSTRACT

The aim of this study was to investigate alexithymic traits in an adolescent clinical sample with internalizing and externalizing disorders. The study group consisted of 125 adolescents aged between 12 and 17 years who applied at our outpatient unit and diagnosed with an internalizing or externalizing disorder. The healthy control group consisted of 53 adolescents with no psychiatric disorder. All subjects fulfilled the Alexithymia Questionnaire for Children (AQC). Total AQC scores were higher in the study group than in the control group. When we divided the study group into two groups as internalizing and externalizing disorders, total AQC scores, AQC-difficulty identifying feelings, and AQC-difficulty describing feelings were significantly higher in the internalizing disorder group than in the externalizing disorder group. AQC-externally oriented thinking scores were significantly higher in the externalizing disorder group than in the internalizing disorder group. In future research, it would be useful to further increase understanding of alexithymia and its association with psychiatric disorders in adolescence.

Alexithymic Traits and Hair Cortisol Concentrations in Pregnant Women

INTRODUCTION

Alexithymia, a personality construct characterized by difficulties in identifying and expressing emotions, and an externally oriented thinking style, has been associated with a number of stress-related disorders, and physiological markers of stress. We examined the relationships of alexithymia and hair cortisol concentrations (HCC), a measure of long-term cortisol levels, in pregnant women.

METHODS

Participants were 130 women from the FinnBrain Birth Cohort study. Alexithymia was measured with the Toronto Alexithymia Scale (TAS-20). Analysis of covariance and regression analyses were used to assess the associations between alexithymia and HCC. Educational level, current depressive symptoms, and body mass index (BMI) were applied as covariates.

RESULTS

In the adjusted analyses, individuals with moderate to high alexithymic traits had significantly higher HCC (F = 5.11, partial η² = 0.040 , p = 0.026) compared to non-alexithymics. Regression analyses in the whole sample revealed that, of the individual dimensions of alexithymia, Difficulty Identifying Feelings (DIF) was associated with HCC (β = 0.187, t = 2.064, p = 0.041).

CONCLUSIONS

Alexithymia, and especially its dimension DIF, were associated with higher HCC and, therefore, may be linked to increased chronic physiological stress. Implications for pregnancy outcomes and infant development are discussed.