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De Berardis D, Ceci A, Zenobi E, Rapacchietta D, Pisanello M, Bozzi F, Ginaldi L, Marasco V, Di Giosia M, Brucchi M, Graffigna G, Santambrogio J, Ventriglio A, Mazza M, Muttillo G. Alexithymia, Burnout, and Hopelessness in a Large Sample of Healthcare Workers during the Third Wave of COVID-19 in Italy. Brain Sci 2023; 13:1550. [PMID: 38002510 PMCID: PMC10669783 DOI: 10.3390/brainsci13111550] [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: 08/07/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
In the present study, we aimed to assess the frequency of and the relationships between alexithymia, burnout, and hopelessness in a large sample of healthcare workers (HCWs) during the third wave of COVID-19 in Italy. Alexithymia was evaluated by the Italian version of the 20-item Toronto Alexithymia Scale (TAS-20) and its subscales Difficulty in Identifying Feelings (DIF), Difficulty in Describing Feelings (DDF), and Externally Oriented Thinking (EOT), burnout was measured with the scales emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA) of the Maslach Burnout Test (MBI), hopelessness was measured using the Beck Hopelessness Scale (BHS), and irritability (IRR), depression (DEP), and anxiety (ANX) were evaluated with the Italian version of the Irritability' Depression' Anxiety Scale (IDA). This cross-sectional study recruited a sample of 1445 HCWs from a large urban healthcare facility in Italy from 1 May to 31 June 2021. The comparison between individuals that were positive (n = 214, 14.8%) or not for alexithymia (n = 1231, 85.2%), controlling for age, gender, and working seniority, revealed that positive subjects showed higher scores on BHS, EE, DP IRR, DEP, ANX, DIF, DDF, and EOT and lower on PA than the not positive ones (p < 0.001). In the linear regression model, higher working seniority as well as higher EE, IRR, DEP, ANX, and DDF scores and lower PA were associated with higher hopelessness. In conclusion, increased hopelessness was associated with higher burnout and alexithymia. Comprehensive strategies should be implemented to support HCWs' mental health and mitigate the negative consequences of alexithymia, burnout, and hopelessness.
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Affiliation(s)
- Domenico De Berardis
- Department of Mental Health, Azuenda Sanitaraia Locale 4 Teramo, Contrada Casalena, 64100 Teramo, Italy
| | - Anna Ceci
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | - Emanuela Zenobi
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | - Dosolina Rapacchietta
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | | | - Filippo Bozzi
- Azienda Socio Sanitaria Territoriale G.Pini-CTO, Via Pini, 9, 20122 Milan, Italy; (F.B.); (G.M.)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Viviana Marasco
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | - Maurizio Di Giosia
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | - Maurizio Brucchi
- Azuenda Sanitaraia Locale 4 Teramo, Circonvallazione Ragusa 1, 64100 Teramo, Italy; (A.C.); (E.Z.); (D.R.); (V.M.); (M.D.G.); (M.B.)
| | - Guendalina Graffigna
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20157 Milan, Italy;
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy;
| | - Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Giovanni Muttillo
- Azienda Socio Sanitaria Territoriale G.Pini-CTO, Via Pini, 9, 20122 Milan, Italy; (F.B.); (G.M.)
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Young AC, Kyranides MN. Understanding Emotion Regulation and Humor Styles in Individuals with Callous-Unemotional Traits and Alexithymic Traits. THE JOURNAL OF PSYCHOLOGY 2022; 156:147-166. [PMID: 35015960 DOI: 10.1080/00223980.2021.2017831] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Alexithymia is a personality trait which is characterized by impairments in identifying and describing emotions. Both psychopathic and alexithymic personality traits have been associated with impairments in emotion processing. This study aims to clarify the conceptual overlap between psychopathic traits (focusing on callous-unemotional traits) and alexithymic traits, with emotion regulation strategies and humor styles using a community sample. A battery of self-report measures was distributed through an online platform to 538 male and female participants between the ages of 18 to 65. Hierarchal linear regression analyses demonstrated that emotion regulation strategies were the strongest predictors and accounted for the largest variance of callous-unemotional traits and alexithymic traits. More specifically, expressive suppression arose as a positive predictor while cognitive reappraisal arose as a negative predictor for both personality traits. Aggressive humor (maladaptive) arose as a positive predictor while self-defeating humor (maladaptive) and affiliative humor (adaptive) arose as negative predictors for callous-unemotional traits. In contrast, self-defeating humor arose as a positive predictor for alexithymic traits while affiliative humor and self-enhancing humor arose as negative predictors. Findings indicate that there are similarities and differences between these personality traits. The implications regarding tailoring interventions that target specific deficits associated with each personality trait are discussed.
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Rady A, Alamrawy RG, Ramadan I, El Raouf MA. Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt. Clin Pract Epidemiol Ment Health 2021; 17:136-145. [PMID: 34880925 PMCID: PMC8595980 DOI: 10.2174/1745017902117010136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds. OBJECTIVE This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data. METHODS In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale. RESULTS General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the 'difficulty identifying feelings' dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05). CONCLUSION Alexithymia is associated with the development of MUPS.
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Affiliation(s)
- Ahmed Rady
- Department of Psychiatry, Alexandria University, School of Medicine, Alexandria, Egypt
| | - Roa Gamal Alamrawy
- Mamoura Psychiatric Hospital, Secretariat of Mental Health and Addiction Treatment, Alexandria, Egypt
| | - Ismail Ramadan
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
| | - Mervat Abd El Raouf
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
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Alexithymia and emotion dysregulation in adult patients with epilepsy. Epilepsy Behav 2020; 113:107537. [PMID: 33242774 DOI: 10.1016/j.yebeh.2020.107537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The concept of alexithymia refers to difficulty perceiving, identifying, and describing emotions. We aimed at evaluating the prevalence of alexithymia in a sample of adult people with epilepsy (PWE) with and without psychogenic nonepileptic seizures (PNES) and healthy control subjects (HC) and identifying major factors able to affect it. MATERIALS AND METHODS We enrolled consecutively 91 PWE (12 of which with PNES in addition to seizures) and 146 HC age- and gender-matched. Both groups' subjects completed the following questionnaires: TAS-20, Beck Depression Inventory-II (BDI-II), Difficulties in Emotion Regulation Scale (DERS) and the Italian translation of Stigma Scale of Epilepsy (SSE), able to evaluate stigma related to epilepsy both in epileptic and nonepileptic subjects. Moreover, PWE completed the well-known Jacoby's Stigma Scale (JSS), dedicated to the evaluation of stigma only by patients with epilepsy and QOLIE-31 (Q31) for evaluating the quality of life. We analyzed correlations between alexithymia and several epilepsy-related (seizure frequency, antiseizure medications-ASMs) and psychosocial factors. Finally, a stepwise multiple regression analysis was performed to identify major factor affecting alexithymia in both groups. RESULTS Alexithymia was prevalent in PWE compared to controls (17.6% of alexithymic subjects in PWE vs 11% in HC), without discriminating epileptic subjects with and without PNES. This predominance disappeared when depressive symptoms (DS) were controlled for. The difficulties of identifying feelings and emotions resulted to be clearly higher in PWE, even when DS are controlled for, and significantly correlated with stigma perception. Alexithymia in PWE was also strongly associated with lower quality of life and education and greater number of ASMs and difficulties in emotion regulation (ER), that turned out to be the main factor affecting alexithymia in both groups (PWE and HC). CONCLUSIONS Alexithymia is prevalent in PWE, mostly influenced by DS and significantly associated with worse quality of life and higher emotion dysregulation and stigma perception. The latter finding could be explained by difficulty identifying emotions (DIE) that selectively characterizes PWE.
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