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Koppelberg P, Kersting A, Suslow T. Alexithymia and interpersonal problems in healthy young individuals. BMC Psychiatry 2023; 23:688. [PMID: 37735376 PMCID: PMC10515237 DOI: 10.1186/s12888-023-05191-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Alexithymia refers to a multidimensional personality trait with the facets difficulties identifying feelings (DIF), difficulties describing feelings (DDF), and externally orientated thinking (EOT). Alexithymia is a risk factor for mental and somatic disorders. Previous research with patients suffering from various disorders showed positive relationships between alexithymia and interpersonal problems. Only one study analyzed the link between alexithymic features and interpersonal difficulties in healthy individuals but yielded inconclusive findings because participants' negative affects were not controlled. A widely accepted conceptualization of interpersonal problems relies on the interpersonal circumplex, which is defined by two orthogonal dimensions, agency and communion. In the present study, we analyzed which facets of alexithymia are associated with the two interpersonal problem dimensions and the global severity of interpersonal distress, after adjusting for negative affect. METHODS Two-hundred healthy young individuals (100 women) participated in the study. Alexithymic features were assessed using the 20-Item Toronto Alexithymia Scale (TAS-20). Interpersonal problems were measured with the Inventory of Interpersonal Problems (IIP-D). Participants' state and trait anxiety, depressive symptoms, and verbal intelligence were also assessed. RESULTS All alexithymia scales were positively correlated with general interpersonal distress. Regression results suggested that the TAS-20 subscale DIF was the primary predictor of general interpersonal distress after controlling for negative affectivity. The scale DDF correlated negatively with the IIP-D dimension agency. According to our regression analysis, DDF was a predictor of (low) agency controlling for negative affects. Moreover, DDF correlated negatively with the IIP-D dimension communion. Our regression results indicate that DDF was a predictor of (low) communion independent of negative affect. Correlations between alexithymia facets and IIP-D subscales did not differ between genders. CONCLUSIONS Difficulties identifying feelings seem to be linked to a high level of general interpersonal distress. Difficulties in recognizing one's feelings may disrupt emotion regulation, which could heighten the general risk of interpersonal problems. Difficulties describing feelings could be a central factor contributing to interpersonal problems related to low communion as well as low agency, since emotion expression and communication are crucial in establishing experiences of social closeness and directing other people's behavior.
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Affiliation(s)
- Pauline Koppelberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr, 10, 04103, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr, 10, 04103, Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr, 10, 04103, Leipzig, Germany.
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Sharafkhani R, Nukpezah RN, Lathabhavan R, Kallmen H, Fournier A, Hosseini Marznaki Z. Factors that affect levels of alexithymia, empathy and communication skills of nursing students in northern Iran. Nurs Open 2023; 10:3936-3945. [PMID: 36808820 PMCID: PMC10170927 DOI: 10.1002/nop2.1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/03/2022] [Accepted: 02/04/2023] [Indexed: 02/23/2023] Open
Abstract
AIM The inability of nurses to express their own emotions, understand others' emotions and show empathy could result in communication gaps that could affect patient care outcomes. This study investigates the factors associated with the levels of alexithymia, empathy and communication skills among nursing students. DESIGN A survey was conducted among 365 nursing students, and data were collected using an online questionnaire. METHODS Data analyses were done using SPSS software version 22. RESULTS There was a significant positive association between age and empathy and a negative association between the number of times a nurse took the entrance exam. The level of education and interest in nursing correlate with communication skills. All the predictor variables of alexithymia in this current study were not significant. Emphasis should be placed on improving nursing students' empathy and communication skills. Student nurses should be taught how to recognize and express their emotions. To assess their mental health, they must be screened regularly.
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Affiliation(s)
- Rahim Sharafkhani
- Department of Public health, Khoy University of Medical Sciences, Khoy, Iran
| | - Ruth Nimota Nukpezah
- Department of General Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | | | - Hakan Kallmen
- Department of Clinical Neuroscience, STAD, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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The relationship between alexithymia and theory of mind: A systematic review. Neurosci Biobehav Rev 2021; 131:497-524. [PMID: 34599917 DOI: 10.1016/j.neubiorev.2021.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022]
Abstract
Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.
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Simonsen S, Eikenaes IUM, Bach B, Kvarstein E, Gondan M, Møller SB, Wilberg T. Level of alexithymia as a measure of personality dysfunction in avoidant personality disorder. Nord J Psychiatry 2021; 75:266-274. [PMID: 33146059 DOI: 10.1080/08039488.2020.1841290] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Avoidant Personality Disorder (AvPD) is considered a mild to moderate personality disorder. However, few studies have focused on the heterogeneity of AvPD in terms of symptoms and severity. In the current study we set out to replicate and extend earlier findings showing that there is variation among patients with AvPD in terms of alexithymia and, further, that this variation is especially associated with specific facets of personality functioning and is not explained by measures of depression, symptom severity, or co-occurring personality disorder traits. METHOD We used intake data from a sample of AvPD patients (n = 56) who had been treated in similar outpatient services. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Patients filled out questionnaires that were analysed using linear regression models. RESULTS AND CONCLUSIONS Using well-established cut-off points for low, intermediate and high levels of alexithymia we found an almost equal distribution of alexithymia groups in our sample. Alexithymia was associated with higher personality dysfunction on twelve out of sixteen facets of personality functioning. For eight of these personality facets the alexithymia total score explained significant variance even after controlling for self-reported depression, symptom severity and clinician ratings of personality disorder. Results suggest that AvPD is heterogeneous and that alexithymia may be important as an indicator of severity of specific personality dysfunction.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Elfrida Kvarstein
- Section for Personality Psychiatry and Specialized Treatments, Oslo University Hospital/Institute for Clinical medicine, University of Oslo, Oslo, Norway
| | | | | | - Theresa Wilberg
- Department for Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bagby RM, Parker JDA, Taylor GJ. Twenty-five years with the 20-item Toronto Alexithymia Scale. J Psychosom Res 2020; 131:109940. [PMID: 32007790 DOI: 10.1016/j.jpsychores.2020.109940] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Twenty-five years ago, this journal published two articles reporting the development and initial validation of the 20-Item Toronto Alexithymia Scale (TAS-20). Since then the literature on alexithymia has burgeoned with the vast majority of this research using the TAS-20, including multiple language translations of the scale. METHOD In this article we review the psychometric literature evaluating various aspects of the reliability and validity of the TAS-20 and examine some of the controversies surrounding the scale and the construct it assesses. We reflect on the ways in which the TAS-20 has advanced the measurement of the construct and theory of alexithymia. We also discuss recent developments and some future directions for the measurement of alexithymia. RESULTS Although not without some controversy, the preponderance of the accumulated evidence over a 25-year period supports various aspects of the reliability and validity of the TAS-20, including findings from confirmatory factor analytic and convergent and discriminant validity studies which are consistent with Nemiah et al.'s (Nemiah et al., 1976 [3]) and Taylor and colleagues (Taylor et al., 1997 [9]) theoretical formulations and definition of the alexithymia construct. CONCLUSIONS Based on the accumulated empirical evidence of 25 years, we conclude that the TAS-20 is a reliable and valid instrument and accurately reflects and measures the construct as it was originally defined by Nemiah et al. Nemiah et al. (1976) [3] as composed of deficits in affect awareness and expression and pensée opératoire (operational thinking). Clinicians and researchers can use the TAS-20 to confidently measure alexithymia, the roots of which have foundations in psychosomatic medicine.
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Affiliation(s)
- R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - James D A Parker
- Department of Psychology, Trent University, Peterborough, Ontario, Canada
| | - Graeme J Taylor
- Department of Psychiatry (Emeritus), University of Toronto, Toronto, Ontario, Canada
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Montebarocci O, Surcinelli P. Correlations between TSIA and TAS-20 and their relation to self-reported negative affect: A study using a multi-method approach in the assessment of alexithymia in a nonclinical sample from Italy. Psychiatry Res 2018; 270:187-193. [PMID: 30261408 DOI: 10.1016/j.psychres.2018.09.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/02/2018] [Accepted: 09/16/2018] [Indexed: 11/17/2022]
Abstract
The 20 item Toronto Alexithymia Scale (TAS-20) has been set as the golden standard in assessing alexithymia despite its limitation due to its self-report structure. Overcoming this bound is the main reason that in 2006 brought Bagby, Taylor and Parker to develop the Toronto Structured Interview for Alexithymia (TSIA): a structured interview composed of 24 questions with the purpose of assessing four dimensions of alexithymia: Identifying emotional feelings (DIF), Describing emotional feelings (DDF), Imaginal processes (IMP), and Externally oriented thinking (EOT). The present study aimed to confirm the validity of the TSIA in the assessment of alexithymia, using internal consistency (alpha) and convergent validity (comparing TSIA and TAS-20). Since it has been demonstrated an association between alexithymia, measured with the TAS-20, and negative affect, an additional goal was to evaluate the correlation of TSIA with two measures of depression and anxiety (BDI-II and STAI-Y2). Our results showed a significant capability of the TSIA in assessing alexithymia while clearing the limitation of the TAS-20 in keeping aside partially overlapping construct such as depression and anxiety. The final suggestion is that a reliable assessment of alexithymia might come from the application of both a self-report and an observer-rated instrument.
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Affiliation(s)
| | - Paola Surcinelli
- University of Bologna, Department of Psychology, BOLOGNA, Bologna 40127, Italy
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Developing a short version of the Toronto Structured Interview for Alexithymia using item response theory. Psychiatry Res 2018; 266:218-227. [PMID: 29609989 DOI: 10.1016/j.psychres.2018.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 11/23/2022]
Abstract
The Toronto Structured Interview for Alexithymia (TSIA) was developed to provide a structured interview method for assessing alexithymia. One drawback of this instrument is the amount of time it takes to administer and score. The current study used item response theory (IRT) methods to analyze data from a large heterogeneous multi-language sample (N = 842) to investigate whether a subset of items could be selected to create a short version of the instrument. Samejima's (1969) graded response model was used to fit the item responses. Items providing maximum information were retained in the short model, resulting in the elimination of 12-items from the original 24-items. Despite the 50% reduction in the number of items, 65.22% of the information was retained. Further studies are needed to validate the short version. A short version of the TSIA is potentially of practical value to clinicians and researchers with time constraints.
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Gender typical patterns and the link between alexithymia, dyadic coping and psychological symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wells R, Rehman US, Sutherland S. Alexithymia and social support in romantic relationships. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.11.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marchesi C, Ossola P, Scagnelli F, Mellini L, Tonna M, Ardissino D, De Panfilis C. The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome. Compr Psychiatry 2015; 62:86-92. [PMID: 26343471 DOI: 10.1016/j.comppsych.2015.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/09/2015] [Accepted: 06/17/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Alexithymia has been considered both to predispose to depression and to worsen cardiac prognosis after an acute coronary syndrome. Nonetheless, no studies have evaluated its role as a risk factor for incident depression, in patients with acute coronary syndrome. METHODS In 251 consecutive patients, the presence of a first-ever depressive episode was evaluated with the Primary Care Evaluation of Mental Disorders at baseline and 1, 2, 4, 6, 9, 12 and 24 months after their first acute coronary syndrome. At baseline, patients completed the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale. RESULTS Out of 251 subjects (80.9% males), a first-ever depressive episode was diagnosed in 66 patients. Depressed and never-depressed patients differed in female gender, living status, alexithymic scores at TAS-20 and depressive symptoms. Nonetheless, nor the TAS-20 factors nor its total score were predictive of developing a depressive episode in a Cox regression. Moreover, baseline differences in TAS-20 scores between the two groups, disappeared after controlling for anhedonic symptoms. CONCLUSION Our results do not support the hypothesis that alexithymia at TAS-20 is a risk factor for incident depression after acute coronary syndrome.
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Affiliation(s)
- Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
| | - Paolo Ossola
- Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
| | - Francesca Scagnelli
- Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy.
| | - Lorenzo Mellini
- Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy.
| | | | - Diego Ardissino
- Department of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
| | - Chiara De Panfilis
- Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
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Koelen JA, Eurelings-Bontekoe EHM, Stuke F, Luyten P. Insecure attachment strategies are associated with cognitive alexithymia in patients with severe somatoform disorder. Int J Psychiatry Med 2015; 49:264-78. [PMID: 26060261 DOI: 10.1177/0091217415589303] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperactivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology. METHOD In a cross-sectional study among patients with somatoform disorder, self-report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strategies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology. RESULTS Only cognitive alexithymia, i.e., the inability to analyze, identify, and verbalize emotions, was associated with personality dysfunction, in particular insecure attachment strategies. Affective alexithymia, i.e., the inability to fantasize and to experience emotions, was associated (negatively) with negative affectivity but not with the personality variables. CONCLUSIONS This study, therefore, indicates that both types of alexithymia are relevant for the assessment and treatment of severe somatoform disorder, yet each type may tap into different features of somatoform disorder.
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Affiliation(s)
| | | | | | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Belgium Research Department of Clinical, Educational and Health Psychology, University College London, UK
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Semerari A, Colle L, Pellecchia G, Buccione I, Carcione A, Dimaggio G, Nicolò G, Procacci M, Pedone R. Metacognitive dysfunctions in personality disorders: correlations with disorder severity and personality styles. J Pers Disord 2014; 28:751-66. [PMID: 24689762 DOI: 10.1521/pedi_2014_28_137] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Metacognitive impairment is crucial to explaining difficulties in life tasks of patients with personality disorders (PDs). However, several issues remain open. There is a lack of evidence that metacognitive impairments are more severe in patients with PDs. The relationship between severity of PD pathology and the extent of metacognitive impairment has not been explored, and there has not been any finding to support the linking of different PDs with specific metacognitive profiles. The authors administered the Metacognitive Assessment Interview to 198 outpatients with PDs and 108 outpatients with no PDs, differentiating overall severity from stylistic elements of personality pathology. Results showed that metacognitive impairments were more severe in the group with PDs than in the control group, and that metacognitive dysfunctions and the severity of the PD were highly associated. Positive correlations were found between specific metacognitive dysfunctions and specific personality styles. Results suggest that metacognitive impairments could be considered a common pathogenic factor for PDs.
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Karukivi M, Tolvanen M, Karlsson L, Karlsson H. Is alexithymia linked with marital satisfaction or attachment to the partner? A study in a pregnancy cohort of parents-to-be. Compr Psychiatry 2014; 55:1252-7. [PMID: 24813790 DOI: 10.1016/j.comppsych.2014.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate possible associations of alexithymia with marital satisfaction and mutual attachment between the partners in a group of parents-to-be during pregnancy. METHODS The present study was conducted in a pregnancy cohort. Cross-sectional data were available for 151 mothers and 106 fathers, and altogether 102 couples. The 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, the Index of Marital Satisfaction (IMS) to assess romantic relationship satisfaction and the Experiences in Close Relationships Scale (ECR) to evaluate attachment-related anxiety and avoidance. Kruskal-Wallis test was used for categorized variable comparisons. For continuous variables, Spearman correlation analyses and linear regression analyses were conducted. RESULTS The TAS-20 total score, as well as, two of its dimensions, difficulties in identifying and describing feelings, were significantly correlated (p<0.01) with both the IMS scores and the ECR anxiety and avoidance scores. In the regression analyses, the most significant predictive factor for the subjects' IMS scores was their partners' corresponding scores, although among fathers the IMS scores were partly explained by their own TAS-20 factor 1 scores (p=0.004). The subjects' own TAS-20 scores explained the ECR anxiety and avoidance scores to a significant extent, but the fathers' TAS-20 factor 3 scores were also associated with the mothers' avoidance scores (p=0.037). CONCLUSION Alexithymia was not directly related to marital satisfaction. However, alexithymia appears to have a significant effect on relationship-related anxiety and avoidance. This association should be further studied in parents and their offspring in a longitudinal setting.
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Affiliation(s)
- Max Karukivi
- Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland; Department of Psychiatry and FinnBrain Birth Cohort Study, University of Turku, Turku, Finland.
| | - Mimmi Tolvanen
- Institute of Clinical Medicine, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Institute of Clinical Medicine, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Hasse Karlsson
- Department of Psychiatry and FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital, Turku, Finland
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Balottin L, Nacinovich R, Bomba M, Mannarini S. Alexithymia in parents and adolescent anorexic daughters: comparing the responses to TSIA and TAS-20 scales. Neuropsychiatr Dis Treat 2014; 10:1941-51. [PMID: 25336959 PMCID: PMC4200172 DOI: 10.2147/ndt.s67642] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A growing body of literature has been focusing on individual alexithymia in anorexia nervosa, while there are only scarce and conflicting studies on alexithymia in the families of anorexic patients, despite the important role played by family dynamics in the development of the anorexic disorder, especially in adolescent patients. The aim of this study is to assess alexithymia in anorexic adolescent patients and in their parents using a multimethod measurement to gain more direct, in-depth knowledge of the problem. METHODS Forty-six subjects, anorexic adolescent patients and their parents, underwent the Toronto Alexithymia Scale (TAS-20) along with the Toronto Structured Interview for Alexithymia (TSIA), which represents the first comprehensive clinically structured interview focused specifically on assessing alexithymia. The use of latent trait Rasch analysis allowed a comparison of the two instruments' sensitivity and ability to detect the presence and intensity of alexithymic components in patients and parents. RESULTS Significant discordance was found between the two measures. The clinical instrument allowed detection of a greater level of alexithymia compared with the self-report, in particular in our adult parent sample. Moreover, a significant alexithymic gap emerged within families, particularly within parental couples, with noticeably more alexithymic fathers compared with the mothers. CONCLUSION The TSIA clinical interview may be a more sensitive instrument in detecting alexithymia, minimizing parents' negation tendency. Clinical questions have arisen on how useful it would be to give greater weight to family functioning (ie, alexithymic gap) in order to predict the possibility of establishing a therapeutic alliance, and thus the outcome of the anorexic adolescent.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center of Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Renata Nacinovich
- Childhood and Adolescence Neuropsychiatric Unit, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Monica Bomba
- Childhood and Adolescence Neuropsychiatric Unit, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Stefania Mannarini
- Interdepartmental Center of Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
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