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Tan Y, An X, Cao M, Van den Bergh O. Somatosensory Amplification Scale-Chinese version: psychometric properties and its mediating role in the relationship between alexithymia and somatization. Front Psychol 2024; 15:1392351. [PMID: 39100552 PMCID: PMC11294251 DOI: 10.3389/fpsyg.2024.1392351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
The Somatosensory Amplification Scale (SSAS) was designed to measure individual's tendency to experience visceral and somatic sensations as unusually intense, disturbing and alarming. In this study, we aimed to investigate the reliability and validity of the SSAS in the Chinese general population, as well as the mediating effect of somatosensory amplification in the relationship between alexithymia and somatization. A total of 386 healthy adults were enrolled in this study. Participants completed the Chinese versions of the Somatosensory Amplification Scale (SSAS-C), the somatization subscale of the Symptom Check List 90 (SCL-90 som), the Toronto Alexithymia Scale (TAS-20), and the Short form Health Anxiety Inventory (SHAI). One hundred and thirty-three participants were randomly selected to complete the SSAS-C again two weeks after the initial assessment. The reliability and validity of the SSAS-C were analyzed. Confirmatory factor analysis showed that the one-factor model achieved adequate model fits; one item was deleted due to low factor loading. The revised SSAS-C showed good internal consistency and test-retest reliability. The SSAS-C scores correlated positively with the scores of SCL-90 som, TAS-20 and the SHAI, showing good convergent validity. In addition, somatosensory amplification mediated the association between alexithymia and somatization. The Chinese version of SSAS has acceptable reliability and validity for the general population. In addition, alexithymia may increase somatization through higher somatosensory amplification.
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Affiliation(s)
- Yafei Tan
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
| | - Xiaoran An
- School of Psychology, Central China Normal University, Wuhan, China
| | - Menglu Cao
- Faculty of Psychology, Southwest University, Chongqing, China
- Center of Students’ Mental Health, Sichuan Technology and Business University, Chengdu, China
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Liu Y, Shen Q, Duan L, Xu L, Xiao Y, Zhang T. The relationship between childhood psychological abuse and depression in college students: a moderated mediation model. BMC Psychiatry 2024; 24:410. [PMID: 38816793 PMCID: PMC11141024 DOI: 10.1186/s12888-024-05809-w] [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: 03/15/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Childhood psychological abuse (CPA) are highly correlated with depression among college students, but the underlying mechanisms between variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia as a moderating factor, in order to further elucidate the potential risk factors between CPA and depression among college students. METHODS A self-report survey was conducted among 1196 college students from four universities in three provinces in China. The survey included measures of CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed. RESULTS CPA was positively correlated with depression among college students, as well as internet addiction with alexithymia. Internet addiction partially mediated the relationship between CPA and depression among college students, while alexithymia strengthened the relationships among the paths in the moderated mediation model. CONCLUSION This study provides further insights into the psychological mechanisms underlying the relationship between CPA and depression among college students. Internet addiction serves as a mediating factor in this relationship, while alexithymia may enhance the strength of the relationships among the three variables.
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Affiliation(s)
- Yang Liu
- School of Sports Science, Jishou University, Jishou, China
| | - Qingxin Shen
- School of Sports Science, Jishou University, Jishou, China
| | - Liangfan Duan
- School of Sports Science, Jishou University, Jishou, China
| | - Lei Xu
- School of Sports Science, Jishou University, Jishou, China
- Institute of Physical Education, Shanxi University of Finance and Economics, Taiyuan, China
| | - Yongxiang Xiao
- School of Sports Science, Jishou University, Jishou, China
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Shipp L, Musatova A, Černis E, Waite P. The relationship between dissociation and panic symptoms in adolescence and the exploration of potential mediators. JCPP ADVANCES 2024; 4:e12202. [PMID: 38486953 PMCID: PMC10933600 DOI: 10.1002/jcv2.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/12/2023] [Indexed: 03/17/2024] Open
Abstract
Background Dissociative experiences have been linked to panic symptoms in adolescents, yet the nature of the association remains unclear. Methods In the present study, we investigated the longitudinal relationship between dissociative experiences (focusing on the felt sense of anomaly subtype) and panic, as well as the potential mediating roles of emotion regulation strategies (expressive suppression and cognitive reappraisal), alexithymia, and cognitive appraisals of dissociation. Four thousand five hundred one adolescents aged 13-18 years were recruited via social media advertising to take part in an online survey at two timepoints, 1 month apart. Results Analysis of 421 datasets found a significant positive relationship between initial dissociative experiences and panic symptoms reported 1 month later. This was mediated by the emotion regulation strategy of cognitive reappraisal, and cognitive appraisals of dissociation. These two variables were no longer significant mediators when controlling for panic symptoms at the first time point, likely due to the stability of panic symptoms across both assessments. Neither alexithymia nor expressive suppression were significant mediators. Conclusions Thus, dissociative experiences that are persistently misinterpreted in a catastrophic manner may lead to escalating anxiety and panic symptoms, which could in turn heighten and maintain the feared dissociation sensation. These results indicate that dissociative experiences are associated with panic symptoms in adolescence, with cognitive appraisals of dissociation and cognitive reappraisal playing a role in this relationship.
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Affiliation(s)
- Lottie Shipp
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Alisa Musatova
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Emma Černis
- School of PsychologyUniversity of BirminghamBirminghamUK
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Polly Waite
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
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Morie KP, Lord KA, Diefenbach GJ, Basuchoudhary O, Lewis S, Assaf M. Subscales of alexithymia show unique pathways through reappraisal and suppression to anxiety, depression and stress. J Affect Disord 2024; 347:445-452. [PMID: 38007105 PMCID: PMC10842914 DOI: 10.1016/j.jad.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
The goal of this work was to explore associations of constituent factors of alexithymia on mental health and potential mediating effects of emotion regulation strategies, specifically suppression and reappraisal. Data were collected through the crowd-sourcing platform Amazon Mechanical Turk (MTURK). Three hundred seventy-seven individuals completed questionnaires related to distress (Depression Anxiety Stress Scales [DASS]), emotion regulation (Emotion Regulation Questionnaire [ERQ]) and Alexithymia (Bermond-Vorst Alexithymia Questionnaire [BVAQ]). Three mediation models were constructed for depression, anxiety and stress, with BVAQ subscales (verbalizing, identifying, emotionalizing, fantasizing, and analyzing) as predictors and ERQ subscales (suppression and reappraisal) as mediators. Results indicated 37.3 % variance in depression, 25.2 % variance in anxiety, and 35.3 % variance in stress was explained by each model. Direct associations revealed emotionalizing and fantasizing were negatively associated with depression, anxiety, and stress, while verbalizing was additionally associated with depression, identifying was additionally associated with anxiety, and all four BVAQ subscales were associated with stress. BVAQ subscales demonstrated negative associations with reappraisal and positive associations with suppression that mediated anxiety and depression. However, suppression did not mediate relationships between BVAQ subscales with stress. Findings support the importance of examining multiple factors of alexithymia and associations with emotion regulation strategies and distress.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Kayla A Lord
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Gretchen J Diefenbach
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Oishani Basuchoudhary
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Stephanie Lewis
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Michal Assaf
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
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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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Iannuzzo F, De Stefano R, Silvestri MC, Lombardo C, Muscatello MRA, Mento C, Bruno A. The Role of Hyperarousal and Aberrant Salience in the Acceptance of Anti-COVID-19 Vaccination. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1403. [PMID: 37629693 PMCID: PMC10456341 DOI: 10.3390/medicina59081403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: This present study was aimed at exploring hyperarousal and aberrant salience in a sample of the Italian general population to understand their possible role in the acceptance of anti-COVID-19 vaccination. Materials and Methods: Sociodemographic data questions, the "Acceptance of Vaccination" measure, the Hyperarousal Scale (H-Scale), and the Aberrant Salience Inventory (ASI) were sent as an unpaid online survey to the general population (age range 18-80 years) within the Italian territory. Results: The enrolled subjects were divided into two subgroups: "Pro-vax" (n = 806; 87.4%) and "No-vax" (n = 116; 12.6%). Statistical analysis showed significant differences between groups in the "Education Level" (p = 0.001) category, higher in the "Pro-vax" group, and in the ASI "Senses Sharpening" (p = 0.007), "Heightened Emotionality" (p = 0.008), and "Heightened Cognition" (p = 0.002) subscales with the "Total Score" (p = 0.015), all higher in "No-vax" subjects. Furthermore, a linear regression model evidenced that only "Education Level" (β = 0.143; p < 0.0001) and "Senses Sharpening" (β = -0.150; p = 0.006) were, respectively, direct and inverse predictors of "Acceptance of Vaccination". Conclusions: Our results show that several subthreshold conditions, such as somatosensory amplification, anxiety traits, and panic experiences, should be taken into account by authoritative sources involved in health education, communication, and policy to alleviate public concerns about vaccine safety, for the present and also future pandemics, and to provide more inclusive, informed, and accurate public health preventive and treatment programs.
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Affiliation(s)
- Fiammetta Iannuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (F.I.); (M.C.S.); (M.R.A.M.); (A.B.)
| | - Rosa De Stefano
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (R.D.S.); (C.L.)
| | - Maria Catena Silvestri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (F.I.); (M.C.S.); (M.R.A.M.); (A.B.)
| | - Clara Lombardo
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (R.D.S.); (C.L.)
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (F.I.); (M.C.S.); (M.R.A.M.); (A.B.)
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (R.D.S.); (C.L.)
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (F.I.); (M.C.S.); (M.R.A.M.); (A.B.)
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (R.D.S.); (C.L.)
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (F.I.); (M.C.S.); (M.R.A.M.); (A.B.)
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125 Messina, Italy; (R.D.S.); (C.L.)
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Oussi A, Hamid K, Bouvet C. Managing emotions in panic disorder: A systematic review of studies related to emotional intelligence, alexithymia, emotion regulation, and coping. J Behav Ther Exp Psychiatry 2023; 79:101835. [PMID: 36680910 DOI: 10.1016/j.jbtep.2023.101835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 12/05/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Panic disorder is defined by recurring and unexpected panic attacks, accompanied by anticipatory anxiety about future attacks and their consequences. This generally involves avoiding situations and behaviors that can produce panic attacks (American Psychiatric Association [APA], 2013). Among anxiety disorders, panic disorder is associated with some of the greatest burdens in terms of personal suffering, occupational disability, and societal cost. The objective of this article is to systematically identify and review the empirical literature on emotional management processes and strategies associated with panic disorder, with the aim of evaluating their role in the development and maintenance of panic disorder, in order to better understand the pathogenesis of the disorder and guide clinicians to improve their current treatments. METHODS Four databases were searched for studies which were based on self-reported questionnaires or a methodology based on an experimental procedure. RESULTS Of the 1719 articles identified, 61 referred to different aspects of emotional management. People living with PD are characterized by low emotional intelligence levels, excessive use of suppression, impaired cognitive reappraisal, high levels of alexithymia and maladaptive coping strategies. LIMITATIONS Most of the reviewed studies used measures of emotional management in cross-sectional models and were based on self-assessment reports. CONCLUSIONS Improving emotional intelligence levels is key to increasing emotion regulation flexibility for people living with PD. Automatic cognitive reappraisal impairment in these people indicates low importance of cognitive restructuring in psychotherapeutic treatment.
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Affiliation(s)
- Abdellah Oussi
- CLIPSYD Research Unit, UFR SPSE, Paris Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France.
| | | | - Cyrille Bouvet
- CLIPSYD Research Unit, UFR SPSE, Paris Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France.
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Han Y, Yan H, Shan X, Li H, Liu F, Xie G, Li P, Guo W. Can the aberrant occipital-cerebellum network be a predictor of treatment in panic disorder? J Affect Disord 2023; 331:207-216. [PMID: 36965626 DOI: 10.1016/j.jad.2023.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND This study aimed to detect altered brain activation pattern of patients with panic disorder (PD) and its changes after treatment. The possibilities of diagnosis and prediction of treatment response based on the aberrant brain activity were tested. METHODS Fifty-four PD patients and 54 healthy controls (HCs) were recruited. Clinical assessment and resting-state functional magnetic resonance imaging scans were conducted. Then, patients received a 4-week paroxetine treatment and underwent a second clinical assessment and scan. The fractional amplitude of low-frequency fluctuations (fALFF) was measured. Support vector machine (SVM) and support vector regression (SVR) analyses were conducted. RESULTS Lower fALFF values in the right calcarine/lingual gyrus and left lingual gyrus/cerebellum IV/V, whereas higher fALFF values in right cerebellum Crus II were observed in patients related to HCs at baseline. After treatment, patients with PD exhibited significant clinical improvement, and the abnormal lower fALFF values in the right lingual gyrus exhibited a great increase. The abnormal fALFF at pretreatment can distinguish patients from HCs with 80 % accuracy and predict treatment response which was reflected in the significant correlation between the predicted and actual treatment responses. LIMITATIONS The impacts of ethnic, cultural, and other regional differences on PD were not considered for it was a single-center study. CONCLUSIONS The occipital-cerebellum network played an important role in the pathophysiology of PD and should be a part of the fear network. The abnormal fALFF values in patients with PD at pretreatment could serve as biomarkers of PD and predict the early treatment response of paroxetine.
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Affiliation(s)
- Yiding Han
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haohao Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Wenbin Guo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Brunetti V, Marotta J, Simoncini Malucelli G, Marano G, Mazza M, Della Marca G. Dissociative episode and panic attacks triggered by pitolisant in a narcoleptic patient. Int Clin Psychopharmacol 2023; 38:114-116. [PMID: 36165509 DOI: 10.1097/yic.0000000000000430] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pitolisant is a histamine 3-receptor antagonist/inverse agonist effective and safe for the treatment of excessive daytime sleepiness and cataplexy in narcolepsy. We report a 19-year-old woman affected by narcolepsy type 1 who presented panic attacks and dissociative symptoms induced by pitolisant. The patient medical history was unremarkable except that for familiarity for anxiety disorder and chronic insomnia. Moreover, a detailed psychometric evaluation revealed a profile of low resilience, a severe grade of depression, an anxiety trait and a propension to dissociative symptoms. Our report suggests that caution should be used in patients with predisposing factors to psychiatric disorders, especially during the first period of treatment with pitolisant. In consideration of the high prevalence of psychiatric comorbidities in narcolepsy, it seems worth to carefully investigate psychiatric background of narcoleptic patients.
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Affiliation(s)
- Valerio Brunetti
- UOC Neurologia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Università Cattolica del Sacro Cuore
| | | | | | - Giuseppe Marano
- Università Cattolica del Sacro Cuore
- UOC Psichiatria Clinica e d'Urgenza, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marianna Mazza
- Università Cattolica del Sacro Cuore
- UOC Psichiatria Clinica e d'Urgenza, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Della Marca
- UOC Neurologia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Università Cattolica del Sacro Cuore
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Lada G, Talbot PS, Chinoy H, Warren RB, Mcfarquhar M, Kleyn CE. Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank. Brain Behav Immun Health 2022; 26:100565. [PMID: 36471870 PMCID: PMC9719019 DOI: 10.1016/j.bbih.2022.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/02/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Psoriasis is a chronic systemic inflammatory skin disease, coexisting with depression in up to 25% of patients. Little is known about the drivers of comorbidity, including shared neurobiology and depression brain imaging patterns in patients. An immune-mediated crosstalk between the brain and skin has been hypothesized in psoriasis. With the aim of investigating brain structure and connectivity in psoriasis in relation to depression comorbidity, we conducted a brain imaging study including the largest psoriasis patient sample to date (to our knowledge) and the first to investigate the role of depression and systemic inflammation in brain measures. Effects of coexisting psoriatic arthritis (PsA), which represents joint involvement in psoriasis and a higher putative inflammatory state, were further explored. Methods Brain magnetic resonance imaging (MRI) data of 1,048 UK Biobank participants were used (131 comorbid patients with psoriasis and depression, age-and sex-matched to: 131 non-depressed psoriasis patients; 393 depressed controls; and 393 non-depressed controls). Interaction effects of psoriasis and depression on volume, thickness and surface of a-priori defined regions of interest (ROIs), white matter tracts and 55x55 partial correlation resting-state connectivity matrices were investigated using general linear models. Linear regression was employed to test associations of brain measures with C-reactive protein (CRP) and neutrophil counts. Results No differences in regional or global brain volumes or white matter integrity were found in patients with psoriasis compared to controls without psoriasis or PsA. Thickness in right precuneus was increased in psoriasis patients compared to controls, only when depression was present (β = 0.26, 95% CI [Confidence Intervals] 0.08, 0.44; p = 0.02). In further analysis, psoriasis patients who had PsA exhibited fronto-occipital decoupling in resting-state connectivity compared to patients without joint involvement (β = 0.39, 95% CI 0.13, 0.64; p = 0.005) and controls (β = 0.49, 95% CI 0.25, 0.74; p < 0.001), which was unrelated to depression comorbidity. Precuneus thickness and fronto-occipital connectivity were not predicted by CRP or neutrophil counts. Precuneus thickening among depressed psoriasis patients showed a marginal correlation with recurrent lifetime suicidality. Conclusions Our findings provide evidence for a combined effect of psoriasis and depression on the precuneus, which is not directly linked to systemic inflammation, and may relate to suicidality or altered somatosensory processing. The use of the UK Biobank may limit generalizability of results in populations with severe disease.
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11
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Impact of Alexithymia on the Lipid Profile in Major Depressed Individuals. J Lipids 2022; 2022:5450814. [PMID: 35755481 PMCID: PMC9225907 DOI: 10.1155/2022/5450814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background The cooccurrence of major depression and dyslipidaemia is associated with negative cardiovascular outcome, which seems to justify a better identification of the factors favouring the development of dyslipidaemia in major depressed individuals. In the literature, there are arguments in favour of a special relationship between dyslipidaemia and alexithymia. However, despite a high prevalence of alexithymia in major depressed individuals, no study has investigated the impact of this personality trait on the lipid profile in this particular subpopulation. Given these elements, the aim of this study was therefore to investigate the risk of dyslipidaemia associated with alexithymia in major depressed individuals to allow better cardiovascular prevention in this subpopulation. Subjects and Methods. Demographic and polysomnographic data from 242 major depressed individuals recruited from the clinical database of the sleep laboratory were analysed. Only individuals with a diagnosis of dyslipidaemia according to the diagnostic criteria of the International Diabetes Federation at admission were included in the “dyslipidaemia” group. Logistic regression analyses were used to determine the risk of dyslipidaemia associated with alexithymia in major depressed individuals. Results The prevalence of dyslipidaemia was 43.8% in our sample of major depressed individuals. After adjusting for the main confounding factors, multivariate logistic regression analyses demonstrated that alexithymia was a risk factor for dyslipidaemia in major depressed individuals. Conclusions In this study, we found that alexithymia is a risk factor for dyslipidaemia in major depressed individuals, which seems to justify better identification and adequate management of this personality trait in order to allow a better lipid profile in this subpopulation at high cardiovascular risk.
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12
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Alexithymia and Mobile Phone Addiction Among College Students With and Without Siblings: a Moderated Mediation of Depression and Gender. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00761-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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13
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Roohafza H, Bagherieh S, Feizi A, Khani A, Yavari N, Saneian P, Teimouri Z, Sadeghi M. How is type D personality associated with the major psychological outcomes in noncardiac chest pain patients? Personal Ment Health 2022; 16:70-78. [PMID: 34505402 DOI: 10.1002/pmh.1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/25/2021] [Accepted: 08/09/2021] [Indexed: 11/10/2022]
Abstract
Noncardiac chest pain (NCCP) may lead many problems on the health-care system. Having type D personality has been shown to adversely affect NCCP patients. This study aimed to determine the psychological comorbidities that type D personality is associated with, in patients with NCCP. The participants of this cross-sectional study were 360 patients diagnosed with NCCP. Patients filled out questionnaires about sociodemographic, behavioral, and clinical factors (severity of pain, somatization, cardiac anxiety, fear of body sensations, depression, and type D personality). Type D personality was more prevalent among female (p < 0.005), and those people having this personality showed lower sleep quality (p = 0.001) and sexual life satisfaction (p < 0.001) and more likely to be smoker (p < 0.001). Type D personality is strongly associated with fear of body sensations (β = 5.92, SE = 1.95, p = 0.003), pain intensity (β = 3.53, SE = 0.98, p < 0.001), depression (β = 2.91, SE = 0.62, p < 0.001), and somatization (β = 1.75, SE = 0.55, p < 0.001). Type D personality and major psychological comorbidities were strongly associated. Physicians should consider that having type D personality can be linked to NCCP in an effort to help patients receive effective psychological consultations.
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Affiliation(s)
- Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Bagherieh
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health and Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Khani
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Yavari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parsa Saneian
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Teimouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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"Medical Student Syndrome"-A Myth or a Real Disease Entity? Cross-Sectional Study of Medical Students of the Medical University of Silesia in Katowice, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189884. [PMID: 34574807 PMCID: PMC8471263 DOI: 10.3390/ijerph18189884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
The description of Medical Student Syndrome is based on the assumption that inexperienced medical students are prone to develop a pathological fear of medical conditions they are taught about. The aim of this study is to examine the sample of students (medical and non-medical) in order to assess and compare their level of hypochondriacal attitudes and health-related anxiety. We also examined other factors which might have had an influence on hypochondria and nosophobia attitudes among students. Methods: The study was conducted in two groups of students: 313 medical students at the Medical University of Silesia and 293 students at non-medical universities in Katowice, Poland. The study used the medical student syndrome self-explanatory questionnaire constructed for the study, taking into account the specificity of the group and the research problem. The research questionnaire was completed in an online survey by 606 students. Results: The results of the study showed that medical students obtained the same scores on a nosophobic scale as the non-medical students (p = 0.5). The analysis of hypochondriacal behavior showed significantly higher results in the non-medical student group (p = 0.02). In the entire study group, females and participants with mental disorders obtained higher scores in relation to nosophobia. Symptoms of depression and anxiety were more common in the group of medical students. Conclusions: Medical studies are not a risk factor for the occurrence of health anxiety and hypochondrial attitudes. Such factors are female gender and having a mental illness.
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15
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Petrini L, Arendt-Nielsen L. Understanding Pain Catastrophizing: Putting Pieces Together. Front Psychol 2020; 11:603420. [PMID: 33391121 PMCID: PMC7772183 DOI: 10.3389/fpsyg.2020.603420] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/16/2020] [Indexed: 01/02/2023] Open
Abstract
The present narrative review addresses issues concerning the defining criteria and conceptual underpinnings of pain catastrophizing. To date, the concept of pain catastrophizing has been extensively used in many clinical and experimental contexts and it is considered as one of the most important psychological correlate of pain chronicity and disability. Although its extensive use, we are still facing important problems related to its defining criteria and conceptual understanding. At present, there is no general theoretical agreement of what catastrophizing really is. The lack of a consensus on its definition and conceptual issues has important consequences on the choice of the pain management approaches, defining and identifying problems, and promoting novel research. Clinical and research work in absence of a common theoretical ground is often trivial. It is very surprising that clinical and experimental work has grown extensively in the past years, without a common ground in the form of a clear definition of pain catastrophizing and overview of its conceptual basis. Improving the efficacy and efficiency of pan catastrophizing related treatments requires an understanding of the theoretical construct. So far, most interventions have only demonstrated modest effects in reducing pain catastrophizing. Therefore, clarifying the construct may be an important precursor for developing more targeted and effective interventions, thereby easing some of the burden related to this aspect of pain. In our review, we have extracted and de-constructed common elements that emerge from different theoretical models with the aim to understand the concept of catastrophizing, which components can be modulated by psychological interventions, and the general role in pain processing. The analysis of the literature has indicated essential key elements to explain pain catastrophizing: emotional regulation, catastrophic worry (as repetitive negative thinking), rumination, behavioral inhibition and behavioral activation (BIS/BAS) systems, and interoceptive sensitivity. The present paper attempts to integrate these key elements with the aim to re-compose and unify the concept within a modern biopsychosocial interpretation of catastrophizing.
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Affiliation(s)
- Laura Petrini
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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16
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Perna G, Cuniberti F, Daccò S, Nobile M, Caldirola D. Impact of respiratory protective devices on respiration: Implications for panic vulnerability during the COVID-19 pandemic. J Affect Disord 2020; 277:772-778. [PMID: 33065816 PMCID: PMC7476564 DOI: 10.1016/j.jad.2020.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The wearing of respiratory protective devices (RPDs) correctly and continually in situations where people are at risk of respiratory infections is crucial for infection prevention. Certain people are poorly compliant with RPDs due to RPD-related annoyance, including respiratory discomfort. We hypothesized that individuals vulnerable to panic attacks are included in this group. No published studies on this topic are available. The evidence for our hypothesis was reviewed in this study as a starting point for future research. METHODS We selected a set of experimental studies that measured the respiratory physiological burden in RPD wearers through objective and validated methods. We conducted a bibliographic search of publications in the PubMed database (January 2000-May 2020) to identify representative studies that may be of interest for panic respiratory pathophysiology. RESULTS Five studies were included. Wearing RPDs exerted significant respiratory effects, including increased breathing resistance, CO2 rebreathing due to CO2 accumulation in the RPD cavity, and decreased inhaled O2 concentration. We discussed the implications of these effects on the respiratory pathophysiology of panic. LIMITATIONS Most studies had a small sample size, with a preponderance of young participants. Different methodologies were used across the studies. Furthermore, differences in physical responses between wearing RPDs in experimental settings or daily life cannot be excluded. CONCLUSIONS This research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing RPDs, thereby reducing their tolerance for these devices. Strategies to decrease discomfort should be identified to overcome the risk of poor compliance.
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Affiliation(s)
- Giampaolo Perna
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy.
| | - Francesco Cuniberti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Maria Nobile
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini 23842, Lecco, Italy
| | - Daniela Caldirola
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
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17
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De Berardis D, Fornaro M, Valchera A, Rapini G, Di Natale S, De Lauretis I, Serroni N, Orsolini L, Tomasetti C, Bustini M, Carano A, Vellante F, Perna G, Core L, Alessandrini M, Fraticelli S, Martinotti G, Di Giannantonio M. Alexithymia, resilience, somatic sensations and their relationships with suicide ideation in drug naïve patients with first-episode major depression: An exploratory study in the "real world" everyday clinical practice. Early Interv Psychiatry 2020; 14:336-342. [PMID: 31402575 DOI: 10.1111/eip.12863] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/20/2019] [Accepted: 07/14/2019] [Indexed: 12/15/2022]
Abstract
AIM The present study is aimed at revaluating alexithymia, somatic sensations, resilience and their relationships with suicide ideation in drug naïve adult outpatients suffering from first episode major depression (MD). METHODS Data of 103 adult outpatients (49 men, 56 women) with a diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) diagnosis of MD were analysed. Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20) and resilience with the 25 items Connor-Davidson Resilience Scale (CD-RISC) whereas depression was evaluated using the 17-item Hamilton Depression Rating Scale, somatic sensations with the Body Sensations Questionnaire and suicide ideation with Scale of Suicide Ideation (SSI). RESULTS Gender comparisons between all demographic and clinical variables showed no significant differences in all variables. Subjects who were found positive for alexithymia showed higher scores on all clinical variables controlling for age, gender and duration of the current episode. In a linear regression model, lower scores on CD-RISC and Difficulty in Identifying Feelings dimension of TAS-20 were significantly predictive of higher scores on SSI. CONCLUSIONS Alexithymia and low resilience were significant predictors of increased suicide ideation in a first MD episode. However, study limitations must be considered and future research needs are being discussed.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy.,Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine Federico II, Naples, Italy.,Polyedra Research Group, Teramo, Italy
| | - Alessandro Valchera
- Polyedra Research Group, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | - Serena Di Natale
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | - Ida De Lauretis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Nicola Serroni
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Laura Orsolini
- Polyedra Research Group, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | | | - Alessandro Carano
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", San Benedetto del Tronto, Italy
| | - Federica Vellante
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Italy.,Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, Florida
| | - Laura Core
- NHS, Department of Mental Health, Center of Mental Health, ASL 4, Giulianova, Italy
| | - Marco Alessandrini
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Silvia Fraticelli
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
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18
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Park J, Naragon-Gainey K. Is more emotional clarity always better? An examination of curvilinear and moderated associations between emotional clarity and internalising symptoms. Cogn Emot 2020; 34:273-287. [PMID: 31122138 PMCID: PMC6874711 DOI: 10.1080/02699931.2019.1621803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/23/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Low emotional clarity has been a target for psychological interventions due to its association with increased internalising symptoms. However, theory suggests that very high emotional clarity may also lead to increased symptoms, particularly in combination with high levels of neuroticism. As an initial empirical test of this hypothesis, the present study examined curvilinear associations of emotional clarity with internalising symptoms (i.e. dysphoria, social anxiety, panic, traumatic intrusions) and a moderating role of neuroticism/negative affect in the association across two student samples and two clinical samples (total N = 920). Evidence of curvilinear associations and moderation varied across samples, with some supporting evidence in three samples. Specifically, neuroticism/negative affect moderated the curvilinear association of emotional clarity with traumatic intrusions in Clinical Sample 2 as well as the linear association between emotional clarity and dysphoria in Student Sample 2 and Clinical Sample 1. Simple slope analyses indicated that high emotional clarity was not consistently associated with lower symptoms. Also, the hypothesised quadratic effects of emotional clarity were found in Student Sample 2 and Clinical Sample 1 for panic, and in Clinical Sample 1 for dysphoria. Implications and limitations of these findings for conceptualisations of emotional clarity and current treatments were discussed.
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Affiliation(s)
- Juhyun Park
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kristin Naragon-Gainey
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
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19
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Cheng CH, Liu CY, Hsu SC. Altered functional connectivity between primary and secondary somatosensory areas in panic disorder. Psychiatry Res 2020; 285:112808. [PMID: 32004761 DOI: 10.1016/j.psychres.2020.112808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/30/2022]
Abstract
Disturbance in the interpretation of bodily sensation has been widely reported in patients with panic disorder (PD). However, it remains substantially unknown whether patients with PD exhibit any defect in cortical somatosensory processing of non-threatening stimuli. Thus, the present study aimed to examine the functional integrity of the cortical somatosensory system in patients with PD using neurophysiological recordings. A total of 20 patients with PD and 20 healthy controls (HC) were recruited to investigate the cortical responses to median nerve stimulation through whole-head magnetoencephalographic (MEG) imaging. To comprehensively investigate all somatosensory functioning, we studied the regional activation of the primary somatosensory cortex (SI), contralateral (SIIc), and ipsilateral (SIIi) secondary somatosensory cortices, as well as functional connectivity among the SI, SIIc, and SIIi in alpha, beta, and gamma frequency bands. We found that patients with PD demonstrated a reduction in SI activity compared with those in the HC group. Furthermore, a significantly weaker gamma-band functional connectivity between SI and SIIc was found in the PD group relative to the HC group. Our data suggest that patients with PD exhibit abnormal responses to non-threatening (i.e., pain-free) stimuli in the cortical somatosensory system.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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20
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Šago D, Babić G, Bajić Ž, Filipčić I. Panic Disorder as Unthinkable Emotions: Alexithymia in Panic Disorder, a Croatian Cross-Sectional Study. Front Psychiatry 2020; 11:466. [PMID: 32581863 PMCID: PMC7282461 DOI: 10.3389/fpsyt.2020.00466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/06/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Previous research on alexithymia has led to controversy over its prevalence in panic disorder. The aim of this study was to assess the difference in the prevalence of alexithymia in panic disorder and other anxiety disorders. DESIGN AND METHODS We performed a cross-sectional study on a sample of 71 patients diagnosed with panic disorder and 113 patients diagnosed with other anxiety disorders; both groups were 18-50 years old. Primary outcome was the 20-item Toronto Alexithymia Scale (TAS) score. Secondary outcome was the prevalence of alexithymia defined as a TAS score ≥61. RESULTS Patients diagnosed with panic disorder had a 25% higher score on the TAS subscale of difficulty identifying feelings than patients diagnosed with other anxiety disorders. The prevalence of alexithymia was 27% in patients with panic disorder and 13% in patients with other anxiety disorders. Patients diagnosed with panic disorder had significantly higher odds for alexithymia. CONCLUSIONS The results of our study support the hypothesis of higher prevalence of alexithymia in individuals with panic disorder than in individuals with other anxiety disorders. In addition, difficulty identifying feelings as a salient feature of alexithymia is higher in panic disorder than in other anxiety disorders.
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Affiliation(s)
- Daniela Šago
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Goran Babić
- Independent Researcher, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Žarko Bajić
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia
| | - Igor Filipčić
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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21
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De Berardis D, Fornaro M, Orsolini L. Editorial: "No Words for Feelings, Yet!" Exploring Alexithymia, Disorder of Affect Regulation, and the "Mind-Body" Connection. Front Psychiatry 2020; 11:593462. [PMID: 33061929 PMCID: PMC7530238 DOI: 10.3389/fpsyt.2020.593462] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Sciences, and Dentistry, Federico II University, Naples, Italy
| | - Laura Orsolini
- Section of Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Ancona, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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22
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Anxiety, depression, type D personality, somatosensory amplification levels and childhood traumas in patients with panic disorders. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.518289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lai CH. Fear Network Model in Panic Disorder: The Past and the Future. Psychiatry Investig 2019; 16:16-26. [PMID: 30176707 PMCID: PMC6354036 DOI: 10.30773/pi.2018.05.04.2] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 05/04/2018] [Indexed: 01/04/2023] Open
Abstract
The core concept for pathophysiology in panic disorder (PD) is the fear network model (FNM). The alterations in FNM might be linked with disturbances in the autonomic nervous system (ANS), which is a common phenomenon in PD. The traditional FNM included the frontal and limbic regions, which were dysregulated in the feedback mechanism for cognitive control of frontal lobe over the primitive response of limbic system. The exaggerated responses of limbic system are also associated with dysregulation in the neurotransmitter system. The neuroimaging studies also corresponded to FNM concept. However, more extended areas of FNM have been discovered in recent imaging studies, such as sensory regions of occipital, parietal cortex and temporal cortex and insula. The insula might integrate the filtered sensory information via thalamus from the visuospatial and other sensory modalities related to occipital, parietal and temporal lobes. In this review article, the traditional and advanced FNM would be discussed. I would also focus on the current evidences of insula, temporal, parietal and occipital lobes in the pathophysiology. In addition, the white matter and functional connectome studies would be reviewed to support the concept of advanced FNM. An emerging dysregulation model of fronto-limbic-insula and temporooccipito-parietal areas might be revealed according to the combined results of recent neuroimaging studies. The future delineation of advanced FNM model can be beneficial from more extensive and advanced studies focusing on the additional sensory regions of occipital, parietal and temporal cortex to confirm the role of advanced FNM in the pathophysiology of PD.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,PhD Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan.,Department of Psychiatry, Yeezen General Hospital, Taoyuan, Taiwan
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24
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Kumar V, Avasthi A, Grover S. Correlates of worry and functional somatic symptoms in generalized anxiety disorder. Ind Psychiatry J 2019; 28:29-36. [PMID: 31879444 PMCID: PMC6929227 DOI: 10.4103/ipj.ipj_31_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/11/2019] [Accepted: 10/23/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Worry and functional somatic symptoms (FSS) are important clinical features of generalized anxiety disorder (GAD). Although there is literature on the prevalence of worry and FSS in GAD, there is limited data on psychological correlates of worry and somatic symptoms in patients with GAD. OBJECTIVE The purpose of this research was to evaluate the relationship of worry and FSS with somatosensory amplification, health anxiety (hypochondriasis), and alexithymia in patients with GAD. METHODS Forty patients with the diagnosis of GAD were assessed with Penn State Worry Questionnaire, Bradford Somatic Inventory (BSI), GAD-7 Scale, somatosensory amplification Scale (SSAS), Whiteley Index (WI), and Toronto Alexithymia Scale-20 Hindi version (TAS-H-20). RESULTS Worry had significant positive correlation with total scores of BSI, GAD-7 scale, TAS-H-20 subscale 1, SSAS, and WI. Younger age of onset was associated with higher FSS as assessed on BSI. BSI total score had positive correlation with total scores of GAD-7 scale, TAS-H-20 and its subscales, SSAS, WI, and with the severity grades of BSI and GAD. CONCLUSION Worry and FSS are associated with somatosensory amplification and hypochondriasis. In addition, somatic symptoms are associated with alexithymia.
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Affiliation(s)
- Vijaya Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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25
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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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26
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Mei S, Xu G, Gao T, Ren H, Li J. The relationship between college students' alexithymia and mobile phone addiction: Testing mediation and moderation effects. BMC Psychiatry 2018; 18:329. [PMID: 30309326 PMCID: PMC6182810 DOI: 10.1186/s12888-018-1891-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To explore the relationship between college students' alexithymia and mobile phone addiction as well as the mediating effects of mental health and the moderating role of being a single child or not. METHODS A total of 1034 college students from Changchun were assessed with the Toronto Alexithymia Scale (TAS-20), General Health Questionnaire (GHQ) and Mobile Phone Addiction Index (MPAI). RESULTS Alexithymia was positively correlated with mental health and mobile phone addiction. Alexithymia had not only a direct impact on mobile phone addiction but also an indirect impact via mental health. For college students who were not only children, higher levels of alexithymia led to an increase in mobile phone addiction, whereas the influence of alexithymia on mobile phone addiction was much weaker among only children. CONCLUSION Mental health has a partial mediating effect on the relationship between alexithymia and mobile phone addiction, and the relationship was significantly moderated by whether students were only children or not.
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Affiliation(s)
- Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun, Jilin Province China
| | - Gang Xu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun, Jilin Province China
| | - Tingting Gao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun, Jilin Province China
| | - Hui Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun, Jilin Province China
| | - Jingyang Li
- Department of Mental Health, The First Hospital of Jilin University, NO. 71 Xinmin Street, Changchun, Jilin Province China
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27
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Alexithymia mediates the relationship between interoceptive sensibility and anxiety. PLoS One 2018; 13:e0203212. [PMID: 30212484 PMCID: PMC6136731 DOI: 10.1371/journal.pone.0203212] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023] Open
Abstract
A number of empirical and theoretical reports link altered interoceptive processing to anxiety. However, the mechanistic understanding of the relationship between the two remains poor. We propose that a heightened sensibility for interoceptive signals, combined with a difficulty in attributing these sensations to emotions, increases an individual’s vulnerability to anxiety. In order to investigate this, a large sample of general population adults were recruited and completed self-report measures of interoceptive sensibility, trait anxiety and alexithymia. Results confirmed that the positive association between interoceptive sensibility and trait anxiety was partially mediated by alexithymia, such that those most at risk for clinically significant levels of trait anxiety have both significantly higher levels of interoceptive sensibility and alexithymia. A subsequent factor analysis confirmed the independence of the three measures. Altered interoceptive processing in combination with alexithymia, increased the risk for anxiety above and beyond altered interoceptive processing alone. We suggest that a heightened sensibility for interoceptive signals, combined with a difficulty in attributing these sensations to emotions, leaves these sensations vulnerable to catastrophizing interpretation. Interventions that target the attribution of bodily sensations may prove valuable in reducing anxiety.
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28
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Grammes J, Schäfer M, Benecke A, Löw U, Klostermann AL, Kubiak T, Witthöft M. Fear of hypoglycemia in patients with type 2 diabetes: The role of interoceptive accuracy and prior episodes of hypoglycemia. J Psychosom Res 2018; 105:58-63. [PMID: 29332635 DOI: 10.1016/j.jpsychores.2017.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Fear of hypoglycemia (FoH) is a limiting factor for diabetes self-management and can have detrimental effects on quality of life. However, relatively little is known about its underlying mechanisms. In line with findings on patients with anxiety disorders, we hypothesized that interoceptive accuracy (IA) might be positively linked to FoH in patients with type 2 diabetes (T2DM). METHODS 133 patients with T2DM were screened according to the extreme quartiles of the Hypoglycemia Fear Survey worry subscale (HFS-W). Overall, 66 participants (HFS-W<4; HFS-W>17) were included in the present study. Participants completed questionnaires on sociodemographic and diabetes-related measures. Accuracy of heartbeat perception was assessed using the mental tracking task. RESULTS Contrary to expectations, IA did not differ significantly between patients with low and high FoH. A linear regression analysis demonstrated that the experience of mild hypoglycemia (β=0.32, p≤0.01) and its interaction with IA (β=-0.26, p=0.040) were significant predictors of FoH, indicating that low IA and a history of experiencing mild hypoglycemia are positively associated with FoH. CONCLUSION Our findings suggest a positive association of low IA in combination with prior episodes of hypoglycemia and FoH in patients with T2DM. The results are in line with recent findings on IA in patients with chronic somatic symptom distress more generally and contribute to our understanding of the relations between interoception, body related fears, and physical symptom perception.
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Affiliation(s)
- Jennifer Grammes
- Health Psychology, Johannes Gutenberg University Mainz, Germany.
| | - Manuela Schäfer
- Outpatient Clinic for Psychotherapy, Johannes Gutenberg University Mainz, Germany
| | - Andrea Benecke
- Outpatient Clinic for Psychotherapy, Johannes Gutenberg University Mainz, Germany
| | - Ulrike Löw
- Outpatient Clinic for Psychotherapy, Johannes Gutenberg University Mainz, Germany
| | | | - Thomas Kubiak
- Health Psychology, Johannes Gutenberg University Mainz, Germany
| | - Michael Witthöft
- Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Germany
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29
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Gritti P, Lombardi S, Nobile B, Trappoliere P, Gambardella A, Di Caprio EL, Resicato G. Alexithymia and Cancer-Related Fatigue: A Controlled Cross-Sectional Study. TUMORI JOURNAL 2018; 96:131-7. [DOI: 10.1177/030089161009600121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background The study aims to investigate the alexithymia construct in patients with a recent or longtime diagnosis of cancer as well as in healthy people, and whether alexithymia and fatigue are linked in the mentioned groups. Methods A first group, diagnosed less than 3 months previously (n = 63), and a second group whose cancer diagnosis dated back more than 30 months (n = 53), matched for sex, age, educational level and cancer site were assessed. Matched healthy controls (n = 50) were also evaluated. Alexithymia was assessed with the Toronto Alexithymia Scale-20, while fatigue was assessed with the Brief Fatigue Inventory. Results Alexithymia scores were higher in the recently diagnosed group than in the group with a longtime cancer diagnosis (t = 2.18, P <0.05). Both groups had higher scores than controls (t = 4.3, P <0.001; t = 2.01, P <0.05). Alexithymic subjects were 45.6% in the recently diagnosed and 21.4% in the longtime diagnosed group (χ2 = 6.3, P <0.05) and 18% in controls. Fatigue was more severe in patients with a longtime diagnosis compared with recently diagnosed patients (t = 7.079, P = 0.000). A weak but significant association between fatigue and alexithymia was found in recently diagnosed patients (r = 0.27.2; P <0.05). Conclusions Our study confirms that alexithymia scores are higher in cancer patients than in controls. The study suggests that alexithymia could be considered a dynamic reaction to illness in recently diagnosed patients, declining during subsequent phases. High fatigue rates in patients with a longtime diagnosis of cancer underline the role of the long course of illness in the perception of fatigue. The association between fatigue and alexithymia was weak in the recently diagnosed group and not significant in patients with a longtime diagnosis, in whom fatigue was an important complaint.
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Affiliation(s)
- Paolo Gritti
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | | | - Barbara Nobile
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Paola Trappoliere
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Antonio Gambardella
- Department of Geriatric Medicine and Metabolic Diseases, Second University of Naples, Naples, Italy
| | | | - Gianluca Resicato
- Department of Psychiatry, Second University of Naples, Naples, Italy
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30
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Kumar V, Avasthi A, Grover S. Somatosensory amplification, health anxiety, and alexithymia in generalized anxiety disorder. Ind Psychiatry J 2018; 27:47-52. [PMID: 30416291 PMCID: PMC6198604 DOI: 10.4103/ipj.ipj_72_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM The aim of this study was to study somatosensory amplification, health anxiety (hypochondriasis), and alexithymia among patients with generalized anxiety disorder (GAD) and to evaluate the association of these variables with the severity of GAD. MATERIALS AND METHODS Cross-sectional design was employed, and patients were recruited from the outpatient clinic of the psychiatry department of a multispecialty tertiary care medical institute in North India. The patients who were clinically diagnosed to have GAD by the two independent qualified psychiatrists were screened with Mini International Neuropsychiatry Interview to confirm the diagnosis. Forty patients with GAD meeting the inclusion criteria were assessed with GAD-7 scale, somatosensory amplification scale (SSAS), the Whiteley Index (WI) and Toronto alexithymia scale - 20 Hindi version (TAS-H-20). RESULTS The mean scores of patients with GAD on SSAS, WI, TAS-H-20, and GAD-7 scale were 25.70 (SD-5.84), 7.75 (SD-3.30), 59.77 (SD- 8.63), and 13.37 (SD- 3.58), respectively. Half of the patients with GAD had significant health anxiety as defined by WI score of >7. Around 40% of GAD patients were alexithymic as defined with TAS-H-20 scores of >60. SSAS, WI, TAS-H-20 had a positive correlation with the severity of GAD as measured with GAD-7 scale. CONCLUSIONS GAD patients have significant somatosensory amplification, health anxiety (hypochondriasis), and alexithymia. Accordingly, there is a need to develop effective psychological interventions focused on these factors in GAD.
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Affiliation(s)
- Vijaya Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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31
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Suslow T, Donges US. Alexithymia Components Are Differentially Related to Explicit Negative Affect But Not Associated with Explicit Positive Affect or Implicit Affectivity. Front Psychol 2017; 8:1758. [PMID: 29062297 PMCID: PMC5640715 DOI: 10.3389/fpsyg.2017.01758] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/22/2017] [Indexed: 11/13/2022] Open
Abstract
Alexithymia represents a multifaceted personality construct defined by difficulties in recognizing and verbalizing emotions and externally oriented thinking. According to clinical observations, experience of negative affects is exacerbated and experience of positive affects is decreased in alexithymia. Findings from research based on self-report indicate that all alexithymia facets are negatively associated with the experience of positive affects, whereas difficulties identifying and describing feelings are related to heightened negative affect. Implicit affectivity, which can be measured using indirect assessment methods, relates to processes of the impulsive system. The aim of the present study was to examine, for the first time, the relations between alexithymia components and implicit and explicit positive and negative affectivity in healthy adults. The 20-item Toronto Alexithymia Scale, the Implicit Positive and Negative Affect Test and the Positive and Negative Affect Schedule (PANAS) were administered to two hundred and forty-one healthy individuals along with measures of depression and trait anxiety. Difficulties identifying feelings were correlated with explicit negative trait affect, depressive mood and trait anxiety. Difficulties describing feelings showed smaller but also significant correlations with depressive mood and trait anxiety but were not correlated with explicit state or trait affect as assessed by the PANAS. Externally oriented thinking was not significantly correlated with any of the implicit and explicit affect measures. According to our findings, an externally oriented, concrete way of thinking appears to be generally unrelated to dispositions to develop positive or negative affects. Difficulties identifying feelings seem to be associated with increased conscious negative affects but not with a heightened disposition to develop negative affects at an automatic response level.
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Affiliation(s)
- Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Uta-Susan Donges
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Gropius Krankenhaus, Eberswalde, Germany.,Department of Psychiatry and Psychotherapy, Campus Charité Mitte - Universitätsmedizin, Berlin, Germany
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32
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Köteles F, Witthöft M. Somatosensory amplification - An old construct from a new perspective. J Psychosom Res 2017; 101:1-9. [PMID: 28867412 DOI: 10.1016/j.jpsychores.2017.07.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
Abstract
The paper reviews and summarizes the history and the development of somatosensory amplification, a construct that plays a substantial role in symptom reports. Although the association with negative affect has been supported by empirical findings, another key elements of the original concept (i.e. body hypervigilance and the tendency of focusing on mild body sensations) have never been appropriately addressed. Recent findings indicate that somatosensory amplification is connected with phenomena that do not necessarily include symptoms (e.g. modern health worries, or expectations of symptoms and medication side effects), and also with the perception of external threats. In conclusion, somatosensory amplification appears to refer to the intensification of perceived external and internal threats to the integrity of the body ("somatic threat amplification") rather than amplification of perceived or actual bodily events only. Practical implications of this new approach are also discussed.
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Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Bogdánfy Ödön u. 10, H-1117 Budapest, Hungary.
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33
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Meuret AE, Kroll J, Ritz T. Panic Disorder Comorbidity with Medical Conditions and Treatment Implications. Annu Rev Clin Psychol 2017; 13:209-240. [PMID: 28375724 DOI: 10.1146/annurev-clinpsy-021815-093044] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Panic disorder (PD) is unique among the anxiety disorders in that panic symptoms are primarily of a physical nature. Consequently, comorbidity with medical illness is significant. This review examines the association between PD and medical illness. We identify shared pathophysiological and psychological correlates and illustrate how physiological activation in panic sufferers underlies their symptom experience in the context of the fight-or-flight response and beyond a situation-specific response pattern. We then review evidence for bodily symptom perception accuracy in PD. Prevalence of comorbidity for PD and medical illness is presented, with a focus on respiratory and cardiovascular illness, irritable bowel syndrome, and diabetes, followed by an outline for potential pathways of a bidirectional association. We conclude by illustrating commonalities in mediating mechanistic pathways and moderating risk factors across medical illnesses, and we discuss implications for diagnosis and treatment of both types of conditions.
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Affiliation(s)
- Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
| | - Juliet Kroll
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
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34
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Valenzuela-Moguillansky C, Reyes-Reyes A, Gaete MI. Exteroceptive and Interoceptive Body-Self Awareness in Fibromyalgia Patients. Front Hum Neurosci 2017; 11:117. [PMID: 28348526 PMCID: PMC5346579 DOI: 10.3389/fnhum.2017.00117] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 02/24/2017] [Indexed: 12/17/2022] Open
Abstract
Fibromyalgia is a widespread chronic pain disease characterized by generalized musculoskeletal pain and fatigue. It substantially affects patients' relationship with their bodies and quality of life, but few studies have investigated the relationship between pain and body awareness in fibromyalgia. We examined exteroceptive and interoceptive aspects of body awareness in 30 women with fibromyalgia and 29 control participants. Exteroceptive body awareness was assessed by a body-scaled action-anticipation task in which participants estimated whether they could pass through apertures of different widths. Interoceptive sensitivity (IS) was assessed by a heartbeat detection task where participants counted their heartbeats during different time intervals. Interoceptive awareness was assessed by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The “passability ratio” (the aperture size for a 50% positive response rate, divided by shoulder width), assessed by the body-scaled action-anticipation task, was higher for fibromyalgia participants, indicating disrupted exteroceptive awareness. Overestimating body size correlated positively with pain and its impact on functionality, but not with pain intensity. There was no difference in IS between groups. Fibromyalgia patients exhibited a higher tendency to note bodily sensations and decreased body confidence. In addition, the passability ratio and IS score correlated negatively across the whole sample, suggesting an inverse relationship between exteroceptive and interoceptive body awareness. There was a lower tendency to actively listen to the body for insight, with higher passability ratios across the whole sample. Based on our results and building on the fear-avoidance model, we outline a proposal that highlights possible interactions between exteroceptive and interoceptive body awareness and pain. Movement based contemplative practices that target sensory-motor integration and foster non-judgmental reconnection with bodily sensations are suggested to improve body confidence, functionality, and quality of life.
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Affiliation(s)
- Camila Valenzuela-Moguillansky
- Centro de Estudios de Argumentación y Razonamiento, Facultad de Psicología, Universidad Diego PortalesSantiago, Chile; Instituto de Sistemas Complejos de ValparaísoValparaíso, Chile
| | | | - María I Gaete
- Department of Psychiatry and Mental Health, Universidad de Chile Santiago, Chile
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35
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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.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.,Department of Neurosciences and Imaging, Chair of Psychiatry, 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
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Limmer J, Kornhuber J, Martin A. Panic and comorbid depression and their associations with stress reactivity, interoceptive awareness and interoceptive accuracy of various bioparameters. J Affect Disord 2015; 185:170-9. [PMID: 26186533 DOI: 10.1016/j.jad.2015.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 07/04/2015] [Accepted: 07/08/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND While current theories on perception of interoceptive signals suggest impaired interoceptive processing in psychiatric disorders such as panic disorder or depression, heart-rate (HR) interoceptive accuracy (IAc) of panic patients under resting conditions is superior to that of healthy controls. Thus, in this study, we chose to assess further physiological parameters and comorbid depression in order to get information on how these potentially conflicting findings are linked together. DESIGN We used a quasi-experimental laboratory design which included multi-parametric physiological data collection of 40 panic subjects and 53 matched no-panic controls, as well as experimental induction of stress and relaxation over a time-course. METHODS Stress reactivity, interoceptive awareness (IAw; from the Body Perception Questionnaire (BPQ)) and IAc (as correlation between self-estimation and physiological data) were major outcome variables. Self-estimation of bioparametrical change was measured via numeric rating scales. RESULT Panic subjects had stronger HR-reaction and more accurate HR-interoception. Concurrently, though, their IAc of skin conductance level, pulse amplitude and breathing amplitude was significantly lower than that of the control group. Interestingly, comorbid depression was found to be associated with increased IAw but attenuated IAc. LIMITATIONS Demand characteristics and a categorical approach to panic confine the results. CONCLUSION The potentially conflicting findings coalesce, as panic was associated with an increase of the ability to perceive the fear-related parameter and a simultaneous decrease of the ability to perceive other parameters. The superordinate integration of afferent signals might be impaired.
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Affiliation(s)
- Jan Limmer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Alexandra Martin
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany; Clinical Psychology and Psychotherapy, University of Wuppertal, Germany
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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.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy; Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" 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
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Alexithymia and non-treatment: an Internet based study of 312 people with chronic anxiety. Compr Psychiatry 2014; 55:179-87. [PMID: 23916091 DOI: 10.1016/j.comppsych.2013.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/31/2013] [Accepted: 06/10/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Despite the availability of highly efficacious treatments, many individuals with anxiety disorders never receive adequate treatment. Alexithymic deficits, such as difficulties in recognizing feelings and focusing on emotional experiences, may contribute to low rates of help seeking. METHODS Multiple Internet-based strategies (announcements of anxiety disorder websites, postings in online self-help forums, notices in anxiety chat rooms) were used to recruit a sample of 312 participants with chronic and clinically relevant anxiety symptoms. Those who had never received professional treatment (n = 49) were compared to those with current or previous treatment (n=263) with regard to alexithymia, anxiety, depression and health-related quality of life. RESULTS Logistic regression analysis revealed that the strongest predictor for belonging to the never treated group was the externally oriented thinking facet of alexithymia. In addition, substantially more participants in the never treated group (49%) were considered high-alexithymic (20-item Toronto Alexithymia Scale total score ≥ 61) compared to the treated group (35%). CONCLUSIONS The main finding was a strong relationship between the externally oriented thinking facet of alexithymia and the non-use of professional help for anxiety. Internet-based programs could be a promising first step in supporting this group of people to overcome their anxiety.
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Alexithymia and emotional intelligence in patients with panic disorder, generalized anxiety disorder and major depressive disorder. Psychiatr Q 2013; 84:303-11. [PMID: 23076764 DOI: 10.1007/s11126-012-9246-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Emotional Intelligence (EI) is a broad personality construct signifying the ability to perceive and to regulate affects within oneself. Alexithymia is another personality construct denoting difficulty in identifying and expressing emotions, with an externally oriented thinking style. Although previously considered to be independent, some studies have shown that these constructs overlap. The aim of this study was to evaluate and compare the levels of EI and alexithymia in patients with panic disorder, major depressive disorder (MDD), and generalized anxiety disorder (GAD). The subjects included 171 psychiatric patients and 56 non-clinical controls. Psychiatric diagnoses were based on DSM-IV criteria. The Emotional Intelligence Scale-34 (EIS-34) and the Toronto Alexithymia Scale (TAS-20) were used to assess EI and alexithymia. All three patient groups scored statistically significantly higher than the non-clinical controls on TAS-20 total score and the TAS-20 subfactors of difficulty identifying feelings and difficulty describing feelings. EIS-34 scores were lower in patient groups than in the non-clinical controls, but only the EIS-34 intrapersonal subscale was significant difference. Total TAS-20 and EIS-34 scores in the patient cohort were inversely and significantly correlated These results reaffirm an overlap between EI and alexithymia with the intrapersonal factor of EI to be more dependent on the difficulty identifying feelings dimension of alexithymia in subjects with MDD and GAD.
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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.
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Affiliation(s)
- Domenico De Berardis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Italy.
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Bridou M, Aguerre C. Validity of the French form of the Somatosensory Amplification Scale in a Non-Clinical Sample. Health Psychol Res 2013; 1:e11. [PMID: 26973888 PMCID: PMC4768601 DOI: 10.4081/hpr.2013.e11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 12/10/2012] [Accepted: 12/11/2012] [Indexed: 12/02/2022] Open
Abstract
The SomatoSensory Amplification Scale (SSAS) is a 10-item self-report instrument designed to assess the tendency to detect somatic and visceral sensations and experience them as unusually intense, toxic and alarming. This study examines the psychometric properties of a French version of the SSAS in a non-clinical population and, more specifically, explores its construct, convergent and discriminant validities. The SSAS was completed by 375 university students, together with measures of somatization propensity (SCL-90-R somatization subscale) and trait anxiety (STAI Y form). The results of principal component and confirmatory factor analyses suggest that the French version of the SSAS evaluates essentially a single, robust factor (Somatosensory amplification) and two kinds of somatic sensitivity (Exteroceptive sensitivity and Interoceptive sensitivity). Somatosensory amplification correlated with somatization tendency and anxiety propensity. These results encourage further investigations in French of the determinants and consequences of somatosensory amplification, and its use as a therapeutic strategy.
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Affiliation(s)
- Morgiane Bridou
- Department of Psychology, François Rabelais University , France
| | - Colette Aguerre
- Department of Psychology, François Rabelais University , France
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Lai CH, Wu YT. Patterns of fractional amplitude of low-frequency oscillations in occipito-striato-thalamic regions of first-episode drug-naïve panic disorder. J Affect Disord 2012; 142:180-5. [PMID: 22770722 DOI: 10.1016/j.jad.2012.04.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 04/13/2012] [Accepted: 04/13/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study was designed to investigate patterns of fractional amplitude of low-frequency fluctuations (fALFF, an indicator for the intensity of regional brain spontaneous activities) of patients with first-episode drug-naïve panic disorder (PD). METHODS Thirty patients (17 females, 13 males, age: 47.70±10.69 years old) and twenty healthy controls (10 females, 10 males, age: 41.40±13.94 years old) received 3-Tesla resting-state functional magnetic resonance imaging (RFMRI) scanning and the rating of clinical scales. RFMRI data was processed and analyzed by the REST toolbox (resting-state functional MRI data analysis toolbox) to calculate fALFF. fALFF were compared between patients and controls to detect endophenotype of fALFF in patients with first-episode drug-naïve PD. RESULTS We found decreased fALFF in right middle occipital gyrus [FDR (false discovery rate) corrected p<0.05, cluster >5 voxles, volume >135mm(3), T threshold: 6.1168, surface connected theory] and increased fALFF in right putamen and right ventral lateral nucleus of thalamus of patients (uncorrected p<0.00005, cluster >5 voxles, volume >135mm(3), T threshold: 4.5439, surface connected theory). fALFF of patients also showed a positive correlation with clinical rating scores of PD in right cuneus. CONCLUSIONS Occipito-striato-thalamic dysfunction of fALFF might represent a kind of endophenotype biomarker of first-episode drug-naïve PD.
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Affiliation(s)
- Chien-Han Lai
- Division of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC.
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Cucchi M, Cavadini D, Bottelli V, Riccia L, Conca V, Ronchi P, Smeraldi E. Alexithymia and anxiety sensitivity in populations at high risk for panic disorder. Compr Psychiatry 2012; 53:868-74. [PMID: 22406182 DOI: 10.1016/j.comppsych.2012.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 01/26/2012] [Accepted: 01/30/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Populations at high risk for panic disorder (PD) probably share with subjects with PD an underlying vulnerability involving features like anxiety sensitivity (AS) and alexithymia. The present study would verify if PD relatives (R) and subjects who have experienced 1 or more panic attacks (PAs) show different levels of AS and alexithymia with respect to healthy controls (HC). METHODS One hundred fifty-seven HCs, 30 subjects with PA, 64 R subjects, and 139 outpatients with PD were evaluated and compared on AS, alexithymia, and control variables. RESULTS Subjects with PD show higher alexithymia and AS levels compared with HCs; R subjects do not differ on ASI total score; and R females show more alexithymic features. Subjects with PA are comparable with HCs both on AS and alexithymia. CONCLUSIONS Results confirm an impairment in emotional and bodily sensations information processing in subjects with PD but partially disconfirm the expectation of a difference between R subjects and subjects with PA with respect to HCs on AS and alexithymia. Emotional and bodily sensation competencies could be protective factors for PD in high-risk populations.
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Affiliation(s)
- Michele Cucchi
- Department of Clinical Neurosciences, Scientific Institute and University, Vita-Salute San Raffaele, Milan, Italy.
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Abstract
OBJECTIVE The goal of this cross-sectional study was to evaluate the relationships between alexithymia and suicide ideation in 80 adult outpatients with a DSM-IV diagnosis of binge eating disorder (BED). METHODS Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); suicide ideation was assessed with the Scale of Suicide Ideation (SSI); severity of BED was assessed with the Binge Eating Scale (BES); and depressive and anxiety symptoms were evaluated, respectively, with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Rating Scale (Ham-A). RESULTS Prevalence of current suicide ideation was 27.5% (n = 22) in this sample and 10 subjects (12.5%) had attempted suicide at some time in their lives. Subjects with alexithymia had more significant suicide ideation, a higher prevalence of current suicide ideation, and more previous suicide attempts than those without alexithymia. In a linear regression model, higher MADRS scores and higher scores on the Difficulty in Identifying Feelings/Difficulty in Describing Feelings dimensions of the TAS-20 were associated with increased suicide ideation. DISCUSSION Suicidal behavior is no less common in BED than in other eating disorders. Individuals with BED may show increased suicide ideation, especially in the presence of alexithymia and depressive symptoms, even if these symptoms are subclinical. The authors also discuss limitations of this study and future research needs.
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Abstract
Conditions that impede the regulation of emotional arousal, such as alexithymia and dissociation, may underlie panic attacks. This study aimed to evaluate the relationship between alexithymia and dissociation in patients with panic disorder (PD). We assessed 95 PD outpatients with regard to alexithymia (20-item Toronto Alexithymia Scale), dissociation (Dissociation Experience Scale), and overall psychological distress (Symptom Checklist 90-Revised, Global Severity Index). Regression analyses revealed a positive correlation between alexithymia and dissociation, even when the Global Severity Index was controlled for. A specific link was observed between "difficulty in identifying feelings" and "depersonalization/derealization." Patients who showed the pathological form of dissociation had higher levels of alexithymia, with particular regard to "difficulty in identifying feelings" and, to a smaller extent, "difficulty in describing feelings." These results support a strong relationship between alexithymia and dissociation in patients with PD. Assessing alexithymia and dissociation at the outset of therapy may be helpful for individualized therapy planning.
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Meltzer MA, Nielson KA. Memory for emotionally provocative words in alexithymia: A role for stimulus relevance. Conscious Cogn 2010; 19:1062-8. [DOI: 10.1016/j.concog.2010.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Revised: 05/10/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
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Thorberg FA, Young RM, Sullivan KA, Lyvers M, Connor JP, Feeney GF. A psychometric comparison of the Toronto Alexithymia Scale (TAS-20) and the Observer Alexithymia Scale (OAS) in an alcohol-dependent sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2010.03.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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P01-195 - Alexithymia, somatic complaints and depressive symptoms in a sample of italian adolescents: preliminary results of a one-year longitudinal study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Domschke K, Stevens S, Pfleiderer B, Gerlach AL. Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings. Clin Psychol Rev 2009; 30:1-11. [PMID: 19751958 DOI: 10.1016/j.cpr.2009.08.008] [Citation(s) in RCA: 337] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 08/24/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022]
Abstract
Interoceptive sensitivity, particularly regarding heartbeat, has been suggested to play a pivotal role in the pathogenesis of anxiety and anxiety disorders. This review provides an overview of methods which are frequently used to assess heartbeat perception in clinical studies and summarizes presently available results referring to interoceptive sensitivity with respect to heartbeat in anxiety-related traits (anxiety sensitivity, state/trait anxiety), panic disorder and other anxiety disorders. In addition, recent neurobiological studies of neuronal activation correlates of heartbeat perception using positron emission tomography (PET), functional magnetic resonance imaging (fMRI) or electroencephalographic (EEG) techniques are presented. Finally, possible clinical and therapeutic implications (e.g., beta-blockers, biofeedback therapy, cognitive interventions and interoceptive exposure) of the effects of heartbeat perception on anxiety and the anxiety disorders and the potential use of interoceptive sensitivity as an intermediate phenotype of anxiety disorders in future neurobiological and genetic studies are discussed.
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Affiliation(s)
- Katharina Domschke
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Strasse 11, D-48149 Münster, Germany.
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