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The percentage and clinical correlates of alexithymia in stable patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 273:679-686. [PMID: 36239818 PMCID: PMC10085932 DOI: 10.1007/s00406-022-01492-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/13/2022] [Indexed: 11/03/2022]
Abstract
Alexithymia is a common, but less-recognized affective deficit in patients with schizophrenia. To date, no definitive conclusions have been drawn about the relationship between alexithymia and the clinical symptoms or their clinical correlates, particularly in stable patients with schizophrenia. The purpose of this study was to investigate the link between alexithymia and psychopathological symptoms, as well as any associated correlates, in stable patients with schizophrenia. A total of 435 Chinese patients with schizophrenia were recruited. The Positive and Negative Symptoms Scale (PANSS) was used to evaluate each patient's psychopathological symptoms. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia. The percentage of alexithymia was 35.2% in stable patients with schizophrenia. Compared to non-alexithymia patients, patients with alexithymia had higher PANSS total scores, negative subscores, depressive subscores, and cognitive subscores (all p < 0.05). Multivariate regression analysis revealed that the following variables were positively associated with TAS-20 total scores: PANSS negative subscores (β = 0.274, t = 3.198, p = 0.001) and PANSS depressive subscores (β = 0.366, t = 2.500, p = 0.013). Education years (β = - 0.453, t = - 2.824, p = 0.005) was negatively associated with TAS-20 total scores. Our results suggest that the percentage of alexithymia was relatively higher in stable patients with schizophrenia. Education levels, negative symptoms, and depressive symptoms were independently associated with alexithymia in this specific population.
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Young AC, Kyranides MN. Understanding Emotion Regulation and Humor Styles in Individuals with Callous-Unemotional Traits and Alexithymic Traits. THE JOURNAL OF PSYCHOLOGY 2022; 156:147-166. [PMID: 35015960 DOI: 10.1080/00223980.2021.2017831] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Alexithymia is a personality trait which is characterized by impairments in identifying and describing emotions. Both psychopathic and alexithymic personality traits have been associated with impairments in emotion processing. This study aims to clarify the conceptual overlap between psychopathic traits (focusing on callous-unemotional traits) and alexithymic traits, with emotion regulation strategies and humor styles using a community sample. A battery of self-report measures was distributed through an online platform to 538 male and female participants between the ages of 18 to 65. Hierarchal linear regression analyses demonstrated that emotion regulation strategies were the strongest predictors and accounted for the largest variance of callous-unemotional traits and alexithymic traits. More specifically, expressive suppression arose as a positive predictor while cognitive reappraisal arose as a negative predictor for both personality traits. Aggressive humor (maladaptive) arose as a positive predictor while self-defeating humor (maladaptive) and affiliative humor (adaptive) arose as negative predictors for callous-unemotional traits. In contrast, self-defeating humor arose as a positive predictor for alexithymic traits while affiliative humor and self-enhancing humor arose as negative predictors. Findings indicate that there are similarities and differences between these personality traits. The implications regarding tailoring interventions that target specific deficits associated with each personality trait are discussed.
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Edwards DJ, Lowe R. Associations Between Mental Health, Interoception, Psychological Flexibility, and Self-as-Context, as Predictors for Alexithymia: A Deep Artificial Neural Network Approach. Front Psychol 2021; 12:637802. [PMID: 33868110 PMCID: PMC8044902 DOI: 10.3389/fpsyg.2021.637802] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Alexithymia is a personality trait which is characterized by an inability to identify and describe conscious emotions of oneself and others. Aim: The present study aimed to determine whether various measures of mental health, interoception, psychological flexibility, and self-as-context, predicted through linear associations alexithymia as an outcome. This also included relevant mediators and non-linear predictors identified for particular sub-groups of participants through cluster analyses of an Artificial Neural Network (ANN) output. Methodology: Two hundred and thirty participants completed an online survey which included the following questionnaires: Toronto alexithymia scale; Acceptance and Action Questionnaire 2 (AQQII); Positive and Negative Affect Scale (PANAS-SF), Depression, Anxiety, and Stress Scale 21 (DAS21); Multidimensional Assessment of Interoceptive Awareness (MAIA); and the Self-as-Context (SAC) scale. A stepwise backwards linear regression and mediation analysis were performed, as well as a cluster analysis of the non-linear ANN upper hidden layer output. Results: Higher levels of alexithymia were associated with increased psychological inflexibility, lower positive affect scores, and lower interoception for the subscales of “not distracting” and “attention regulation.” SAC mediated the relation between emotional regulation and total alexithymia. The ANNs accounted for more of the variance than the linear regressions, and were able to identify complex and varied patterns within the participant subgroupings. Conclusion: The findings were discussed within the context of developing a SAC processed-based therapeutic model for alexithymia, where it is suggested that alexithymia is a complex and multi-faceted condition, which requires a similarly complex, and process-based approach to accurately diagnose and treat this condition.
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Affiliation(s)
- Darren J Edwards
- Department of Public Health, Policy, and Social Sciences, Swansea University, Swansea, United Kingdom
| | - Rob Lowe
- Department of Psychology, Swansea University, Swansea, United Kingdom
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The mediating role of social connectedness in the effect of positive personality, alexithymia and emotional granularity on life satisfaction: Analysis based on a structural equation model. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110473] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Wang Z, Wang T, Goerlich KS, Pitliya RJ, Bermond B, Aleman A, Xu P, Luo Y. Psychometric Properties of the Chinese Bermond–Vorst Alexithymia Questionnaire: An Exploratory Structural Equation Modeling Study. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2021. [DOI: 10.1177/1834490921991429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Toronto Alexithymia Scale-20 (TAS-20) has been widely used to assess alexithymia. The Bermond–Vorst Alexithymia Questionnaire (BVAQ) assesses two additional features of alexithymia—the affective factors of emotionalizing and fantasizing, which are not included in the TAS-20. However, there is currently no Chinese version of the BVAQ. Here, the authors collected data from 439 college students (293 females, aged 17–27, mean ± SD = 20.25 ± 1.88) to evaluate the psychometric properties for a Chinese BVAQ translation. Exploratory structural equation modeling and confirmatory factor analysis provided satisfactory validity and acceptable reliability for a six-factor first-order solution of a 35-item Chinese BVAQ. This adaptation retained the five original BVAQ factors (identifying, analyzing, verbalizing, emotionalizing, and fantasizing) and further specified the factor of identifying (successful identifying and unsuccessful identifying feelings). The authors also found a two-factor second-order model of cognitive and affective components for alexithymia in the Chinese population. Higher correlations with the TAS-20 were observed for identifying, analyzing, and verbalizing feelings (0.34 ∼ 0.61) relative to fantasizing and emotionalizing (0.02 ∼ −0.05). These results support the construct validity of the adaptation. This work provides a reliable and valid Chinese adaptation of the BVAQ.
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Affiliation(s)
- Zhihao Wang
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Ting Wang
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Katharina S. Goerlich
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Riddhi J. Pitliya
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Bob Bermond
- Guangdong-Hong Kong-Macao Greater Bay Area Research Institute for Neuroscience and Neurotechnologies, Kwun Tong, Hong Kong, China
| | - André Aleman
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Pengfei Xu
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- Guangdong-Hong Kong-Macao Greater Bay Area Research Institute for Neuroscience and Neurotechnologies, Kwun Tong, Hong Kong, China
| | - Yuejia Luo
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- College of Teacher Education, Qilu Normal University, Jining, China
- The Research Center of Brain Science and Visual Cognition, Kunming University of Science and Technology, Kunming, China *These authors contributed equally to this work
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Alexithymia Is Associated with Reduced Quality of Life and Increased Caregiver Burden in Parkinson's Disease. Brain Sci 2020; 10:brainsci10060401. [PMID: 32599704 PMCID: PMC7348697 DOI: 10.3390/brainsci10060401] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is the second most frequent neurodegenerative disease of people who are beyond 50 years of age. People with PD (PwP) suffer from a large variety of motor and non-motor symptoms resulting in reduced health-related quality of life (HR-QoL). In the last two decades, alexithymia was identified as an additional non-motor symptom in PD. Alexithymia is defined as a cognitive affective disturbance resulting in difficulty to identify and distinguish feelings from bodily sensations of emotional arousal. In PD, the frequency of patients suffering of alexithymia is increased compared to healthy controls. The aim of the present study was to determine the relationship of alexithymia to HR-QoL of the PwP and caregiver burden of the corresponding caregiver. This cross-sectional questionnaire-based study used disease specific questionnaires for HR-QoL and caregiver burden. In total 119 PwP and their corresponding caregivers were included in the study. HR-QoL of the PwP correlated significantly with alexithymia (p < 0.001), especially the sub-components "identifying feelings" (p < 0.001) and "difficulties describing feelings" (p = 0.001). Caregiver burden also correlated significantly with PwP alexithymia (p < 0.001). However, caregiver burden was associated with sub-components "identifying feelings" (p < 0.008) and "external oriented thinking" (p < 0.004). These data support the importance of alexithymia as a non-motor symptom in PD.
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Dafsari HS, Ray-Chaudhuri K, Mahlstedt P, Sachse L, Steffen JK, Petry-Schmelzer JN, Dembek TA, Reker P, Barbe MT, Visser-Vandewalle V, Fink GR, Timmermann L. Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease. Eur J Neurol 2018; 26:222-e17. [PMID: 30107062 DOI: 10.1111/ene.13773] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/09/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL) and motor and non-motor symptoms in advanced Parkinson's disease (PD). However, its effect on alexithymia and its relationship to other neuropsychiatric symptoms and QoL in PD is unclear. METHODS In this prospective, observational study of 39 patients with PD undergoing STN-DBS, we examined the Parkinson's Disease Questionnaire-8 (PDQ-8), 20-item Toronto Alexithymia Scale (TAS-20), Hospital Anxiety and Depression Scale (HADS), Self-Report Manic Inventory (SRMI), Apathy Evaluation Scale (AES), Unified Parkinson's Disease Rating Scale (UPDRS) activities of daily living, UPDRS motor examination and UPDRS complications (UPDRS-II/-III/-IV) and levodopa-equivalent daily dose (LEDD) pre-operatively and at 5-month follow-up. Outcome changes were tested with Wilcoxon signed-rank or paired t-test when parametric tests were applicable and corrected for multiple comparisons. The relationship between outcome changes was explored with bivariate correlations. Additionally, partial correlations between PDQ-8 and TAS-20 were computed controlling for HADS, SRMI and AES change scores. Predictor analyses for PDQ-8 improvement were calculated for all baseline parameters. RESULTS The baseline prevalence of alexithymia was 17.9%. We observed significant beneficial effects of STN-DBS on PDQ-8, TAS-20, HADS, UPDRS-II, -III and -IV scores and significant LEDD reduction. The correlation between TAS-20 and PDQ-8 improvements remained significant after controlling for all other aforementioned outcomes. Predictor analyses for PDQ-8 improvement were significant for PDQ-8 and TAS-20. CONCLUSIONS This is the first report of beneficial effects of STN-DBS on alexithymia. Alexithymia was significantly associated with QoL outcome independent of anxiety, depression, mania and apathy. Our study highlights the importance of alexithymia for holistic assessments of DBS outcomes.
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Affiliation(s)
- H S Dafsari
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - K Ray-Chaudhuri
- National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - P Mahlstedt
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - L Sachse
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - J K Steffen
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | | | - T A Dembek
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - P Reker
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - M T Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - V Visser-Vandewalle
- Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne
| | - G R Fink
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - L Timmermann
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Germany
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Hamaideh SH. Alexithymia among Jordanian university students: Its prevalence and correlates with depression, anxiety, stress, and demographics. Perspect Psychiatr Care 2018; 54:274-280. [PMID: 28726284 DOI: 10.1111/ppc.12234] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/09/2017] [Accepted: 07/02/2017] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of the article is to identify the prevalence, levels, and associated factors of alexithymia among Jordanian university students. DESIGN AND METHODS Using stratified cluster random sampling, data were collected from 492 students using Toronto Alexithymia Scale (TAS-20), and Depression, Anxiety, and Stress Scale (DASS-21). FINDINGS The prevalence of alexithymia, depression, anxiety, and stress were 24.6, 28.5, 38.4, and 22.6%, respectively, and were all higher among females. Alexithymia correlated with five factors: depression, anxiety, stress, female gender, and satisfaction with life. PRACTICAL IMPLICATIONS There is a need for screening and interventional programs that prevent or alleviate the symptoms of alexithymia, depression, anxiety, and stress among university students.
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Affiliation(s)
- Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Esin R, Gorobets E, Esin O, Khayrullin I, Sakhapova L, Martyanov D. Alexithymia as a Predictor of Worse Prognosis in Postural Phobic Vertigo. BIONANOSCIENCE 2018. [DOI: 10.1007/s12668-017-0490-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Lennartsson AK, Horwitz EB, Theorell T, Ullén F. Creative Artistic Achievement Is Related to Lower Levels of Alexithymia. CREATIVITY RESEARCH JOURNAL 2017. [DOI: 10.1080/10400419.2017.1263507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Töres Theorell
- Karolinska Institutet
- Stress Research Institute, Stockholm University
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Gender typical patterns and the link between alexithymia, dyadic coping and psychological symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Assogna F, Cravello L, Orfei MD, Cellupica N, Caltagirone C, Spalletta G. Alexithymia in Parkinson's disease: A systematic review of the literature. Parkinsonism Relat Disord 2016; 28:1-11. [PMID: 27086264 DOI: 10.1016/j.parkreldis.2016.03.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/29/2016] [Accepted: 03/28/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION In this systematic review, we aimed to evaluate the role of alexithymia in Parkinson's disease (PD) and its relationship to neurological, neuropsychiatric, cognitive, and neuroimaging correlates. METHODS The database was selected using PubMed Services, Cochrane, PsycNET and Scopus and a number of key words. Further studies were sought by manually searching for secondary sources, including relevant journals and references in primary articles. The search was restricted to articles written in English between January 1980 and August 2015. RESULTS Ten studies reported that alexithymia prevalence was about double in PD patients compared to control subjects and that specific dimensions of alexithymia might be related to depression, anxiety, apathy and impulsivity. Some studies investigated the relationship between alexithymia and neuropsychological symptoms and found correlations with frontal and parietal lobe functions. Two studies on neurological features reported a link between alexithymia and disease stage or a specific motor subtype of PD; the remaining studies found that alexithymia was independent from neurological symptoms, dopaminergic therapy and laterality of motor symptom onset. Data on neuroimaging correlates and therapeutic intervention on alexithymia in PD patients are still lacking. CONCLUSION Although results suggest that alexithymia is a primary characteristics of PD, further studies with larger patient samples are needed to definitively clarify the impact of alexithymia on the clinical features of PD patients.
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Affiliation(s)
| | - Luca Cravello
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy; ASST-Rhodense, Rho, Milan, Italy
| | | | | | - Carlo Caltagirone
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy; Department of Medicine of Systems, University "Tor Vergata", Rome, Italy
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Cozzolongo R, Porcelli P, Lanzilotta E, Giannuzzi V, Leandro G. The role of alexithymia in quality of life impairment in patients with chronic hepatitis C during antiviral treatment. Compr Psychiatry 2015; 60:17-25. [PMID: 25941158 DOI: 10.1016/j.comppsych.2015.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the role of alexithymia in the quality of life of patients with chronic hepatitis C treated with antiviral therapy. A consecutive sample of 124 patients were evaluated at baseline, during, and 6months after treatment with interferon and ribavirin. At baseline past mood disorders and alexithymia and, at each index visit, adverse events, psychological distress, and disease-specific quality of life were assessed with validated instruments. Patients with past mood disorders and alexithymia had impaired levels of quality of life, psychological distress, and treatment-related adverse events. However, after controlling for covariates, poor quality of life was independently predicted by alexithymia and psychological distress before (R(2)=0.60) and 6months after (R(2)=0.69) the antiviral treatment while during treatment (at 3months and the end of therapy) by depression and somatic adverse events (R(2)=0.67 and 0.69, respectively). Alexithymia rather than history of mood disorders resulted to be an independent predictor of impaired quality of life not only before but also 6months after the end of treatment. Given the association with proneness to health-compromising behaviors, clinicians are encouraged to pay closer attention to long-term psychological and somatic effects of antiviral treatment in patients with alexithymic characteristics.
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Affiliation(s)
- Raffaele Cozzolongo
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Piero Porcelli
- Clinical Psychology Unit, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Elsa Lanzilotta
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Vito Giannuzzi
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Gioacchino Leandro
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; Department of Liver and Digestive Health, University College of London, UK.
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van der Velde J, Swart M, van Rijn S, van der Meer L, Wunderink L, Wiersma D, Krabbendam L, Bruggeman R, Aleman A. Cognitive alexithymia is associated with the degree of risk for psychosis. PLoS One 2015; 10:e0124803. [PMID: 26030357 PMCID: PMC4451258 DOI: 10.1371/journal.pone.0124803] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/18/2015] [Indexed: 01/22/2023] Open
Abstract
Alexithymia is a personality construct denoting emotion processing problems. It has been suggested to encompass two dimensions: a cognitive and affective dimension. The cognitive dimension is characterized by difficulties in identifying, verbalizing and analyzing emotions, while the affective dimension reflects the level of emotional arousal and imagination. Alexithymia has been previously proposed as a risk factor for developing psychosis. More specifically, the two alexithymia dimensions might be differentially related to the vulnerability for psychosis. Therefore, we examined the two dimensions of alexithymia, measured with the BVAQ in 94 siblings of patients with schizophrenia, 52 subjects at ultra-high risk (UHR) for developing psychosis, 38 patients with schizophrenia and 109 healthy controls. The results revealed that siblings and patients had higher levels of cognitive alexithymia compared to controls. In addition, subjects at UHR for psychosis had even higher levels of cognitive alexithymia compared to the siblings. The levels of affective alexithymia in siblings and patients were equal to controls. However, UHR individuals had significantly lower levels of affective alexithymia (i.e. higher levels of emotional arousal and fantasizing) compared to controls. Alexithymia was further related to subclinical levels of negative and depressive symptoms. These findings indicate that alexithymia varies parametrically with the degree of risk for psychosis. More specifically, a type-II alexithymia pattern, with high levels of cognitive alexithymia and normal or low levels of affective alexithymia, might be a vulnerability factor for psychosis.
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Affiliation(s)
- Jorien van der Velde
- Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Academy for sociale studies, Hanze University of Apllied Sciences, Groningen, The Netherlands
- * E-mail:
| | - Marte Swart
- Lentis, Center for Mental Healthcare, Groningen, The Netherlands
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sophie van Rijn
- Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
| | | | - Lex Wunderink
- Department of Psychosis studies, Mental Health Care Friesland, Leeuwarden, The Netherlands
| | - Durk Wiersma
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lydia Krabbendam
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Educational Neuroscience, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
| | - André Aleman
- Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Alexithymia components in excessive internet users: a multi-factorial analysis. Psychiatry Res 2014; 220:348-55. [PMID: 25149129 DOI: 10.1016/j.psychres.2014.07.066] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 07/13/2014] [Accepted: 07/27/2014] [Indexed: 11/20/2022]
Abstract
The increasing use of computers and the internet - especially among young people - apart from its positive effects, sometimes leads to excessive and pathological use. The present study examined the relationship among the excessive use of the internet by university students, the alexithymia components and sociodemographic factors associated with internet users and their online activities. 515 university students from the University of Thessaly participated in the study. Participants anonymously completed: a) the Internet Addiction Test (IAT), b) the Toronto Alexithymia Test (TAS 20) and c) a questionnaire covering various aspects of internet use and demographic characteristics of internet users. Excessive use of the internet among Greek university students was studied within a multi-factorial context and was associated with the alexithymia and demographic factors in nonlinear correlations, forming thus a personalized emotional and demographic profile of the excessive internet users.
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Lichev V, Rufer M, Rosenberg N, Ihme K, Grabe HJ, Kugel H, Donges US, Kersting A, Suslow T. Assessing alexithymia and emotional awareness: relations between measures in a German non-clinical sample. Compr Psychiatry 2014; 55:952-9. [PMID: 24439560 DOI: 10.1016/j.comppsych.2013.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 12/12/2013] [Accepted: 12/17/2013] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate psychometric properties and relations between two different methods of measuring alexithymia and one measure of emotional awareness in a German non-clinical sample. The 20-Item Toronto Alexithymia Scale (TAS-20), the Toronto Structured Interview for Alexithymia (TSIA), and the Levels of Emotional Awareness Scale (LEAS), which is a performance-based measure of emotional awareness, were administered to 84 university students. Both internal reliability and inter-rater reliability for the TSIA were acceptable. Results from exploratory factor analysis (EFA) based on all measures supported a three factorial solution previously obtained in an American sample using multiple methods of alexithymia and emotional ability measurement. In our three factor model direct self (TAS-20), direct other (TSIA), and indirect self (LEAS) measures were differentiated. The convergent validity of the TSIA was supported by a significant correlation with the LEAS. Our findings suggest that future research on alexithymia and emotional awareness can benefit from the use of a multi-method approach and should include objective measures.
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Affiliation(s)
- Vladimir Lichev
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Michael Rufer
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - Nicole Rosenberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Klas Ihme
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry, University Medicine, Greifswald, Germany; Department of Psychiatry, HELIOS Hospital, Stralsund, Germany
| | - Harald Kugel
- Department of Cinical Radiology, University of Münster, Münster, Germany
| | - Uta-Susan Donges
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany; Department of Psychiatry, University of Münster, Münster, Germany.
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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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Esin RG, Gorobets EA, Galiullin KR, Esin OR. Alexithymia - baseline trends of research. Zh Nevrol Psikhiatr Im S S Korsakova 2014; 114:148-151. [DOI: 10.17116/jnevro2014114121148-151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Godin I, Montplaisir J, Gagnon JF, Nielsen T. Alexithymia associated with nightmare distress in idiopathic REM sleep behavior disorder. Sleep 2013; 36:1957-62. [PMID: 24293771 PMCID: PMC3825446 DOI: 10.5665/sleep.3238] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Idiopathic REM sleep behavior disorder (iRBD) is characterized by atypical REM sleep motor activity, vivid dreams and nightmares, and dream-enacting behaviors that can result in injuries to the patient and bed partner. It is also a known predictor of Parkinson disease (PD). Alexithymia has been associated with disturbances in sleep and dreaming (e.g., nightmares) and is a non-motor symptom of PD. We assessed alexithymia and disturbed dreaming in iRBD patients with the aim of determining if these two factors are elevated and interrelated among this population. DESIGN Questionnaire study of clinically diagnosed patients. SETTING Clinical sleep disorders center. PATIENTS OR PARTICIPANTS Thirty-two iRBD patients and 30 healthy age- and sex-matched control participants. MEASUREMENTS AND RESULTS Participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Dream Questionnaire, and the Beck Depression Inventory. iRBD patients obtained higher TAS-20 total scores (62.16 ± 13.90) than did controls (52.84 ± 7.62; F 1,59 = 10.44, P < 0.01), even when controlling for depressive symptoms, and more frequently attained the suggested cutoff for alexithymia than did controls (P < 0.01). iRBD patients obtained higher scores on the Difficulty Identifying Feelings alexithymia subscale. For both iRBD and control groups, the Difficulty Indentifying Feelings subscale correlated positively with the Nightmare Distress scale of the Dream Questionnaire. CONCLUSIONS Elevated alexithymia scores among idiopathic rapid eye movement sleep behavior disorder patients, and especially a difficulty in identifying feelings, parallels evidence of dysautonomia in this population. The higher incidence of distressing nightmares and the association of nightmares with alexithymia further extend similar findings for both clinical and non-clinical samples and suggest that an affect regulation disturbance may be common to the two sets of symptoms.
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Affiliation(s)
- Isabelle Godin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Québec, Canada
| | - Jaques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Québec, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychology, Université du Québec à Montréal, Québec, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Québec, Canada
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van der Velde J, Servaas MN, Goerlich KS, Bruggeman R, Horton P, Costafreda SG, Aleman A. Neural correlates of alexithymia: A meta-analysis of emotion processing studies. Neurosci Biobehav Rev 2013; 37:1774-85. [DOI: 10.1016/j.neubiorev.2013.07.008] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 07/08/2013] [Accepted: 07/12/2013] [Indexed: 12/19/2022]
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Vieira RVDA, Vieira DC, Gomes WB, Gauer G. Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. J Headache Pain 2013; 14:18. [PMID: 23565860 PMCID: PMC3620425 DOI: 10.1186/1129-2377-14-18] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/13/2022] Open
Abstract
Background Migraine is a type of primary headache widely known for its impact on quality of life of patients. Although the psychological aspects of the disease are receiving increasing attention in current research, some of them, as alexithymia, are still seldom explored. This study aimed to provide evidence on the relationships between markers of depression, anxiety, alexithymia, self-reflection, insight and quality of life in migraine. Methods Forty female outpatients from a Brazilian specialized headache hospital service and a paired control group were compared. Results The results revealed that women with migraine had higher levels of depression, anxiety and alexithymia, and lower levels of quality of life, self-reflection and insight, compared to controls. Quality of life in women with migraine was predicted by levels of depression and one alexithymia factor (ability to express emotions and fantasies). A binary regression analysis between clinical and control groups revealed the migraine group to comprise individuals with high anxiety, low quality of life in the physical domain and the presence of a concrete thinking style. Conclusions The results highlight the relevance of considering psychological variables in the routine healthcare practices for migraine patients in general, while keeping steady attention to individual case features.
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von Rimscha S, Moergeli H, Weidt S, Straumann D, Hegemann S, Rufer M. Alexithymia and health-related quality of life in patients with dizziness. Psychopathology 2013; 46:377-83. [PMID: 23296255 DOI: 10.1159/000345357] [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: 05/07/2012] [Accepted: 09/29/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alexithymia is a personality trait characterized by deficits in regulating, experiencing and verbalizing emotions and has been assumed to be associated with a tendency to express emotional arousal through somatization. Although such a tendency is often observed in patients with dizziness, the exact relationship of alexithymia to dizziness is not yet known. The aim of this study was to examine alexithymic characteristics in patients with dizziness and its relation to health-related quality of life (HRQoL). SAMPLING AND METHODS We assessed 208 patients from an interdisciplinary center for vertigo and balance disorders for characteristics of alexithymia (20-item Toronto Alexithymia Scale), HRQoL (Short-Form 12 Health Survey, SF-12), dizziness (Dizziness Handicap Inventory), depression and anxiety (Hospital Anxiety and Depression Scale). Hierarchical regression analyses were used to evaluate the relationship between alexithymia, dizziness and HRQoL. RESULTS We found that difficulties in identifying and describing feelings, two important factors of alexithymia, were significantly related to more severe symptoms of dizziness. More pronounced alexithymic characteristics were associated with lower HRQoL, especially in the mental dimension of the SF-12. The results remained significant after controlling for possibly confounding variables such as socioeconomic status and depression. CONCLUSIONS These findings contribute to a better understanding of affect regulation in patients with dizziness, which is important for the development of psychotherapeutic interventions suitable for alexithymic patients with dizziness.
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Affiliation(s)
- Sonja von Rimscha
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
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Wingbermühle E, Theunissen H, Verhoeven WMA, Kessels RPC, Egger JIM. The neurocognition of alexithymia: evidence from neuropsychological and neuroimaging studies. Acta Neuropsychiatr 2012; 24:67-80. [PMID: 26952949 DOI: 10.1111/j.1601-5215.2011.00613.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Alexithymia refers to an ineffective regulation and expression of emotions. It constitutes a major risk factor for a range of medical and psychiatric problems, including chronic pain, somatisation, anxiety and depression. Alexithymia is a multi-faceted concept, described in terms of cognitive and affective aspects. From a neuropsychological perspective, alexithymia can be defined as a disturbance in affective information processing and social cognition. As the growing literature on brain structures involved in alexithymia is fragmented and sometimes even contradictory, the aim of this article was to review findings on neural substrates with regard to their convergence. METHODS A narrative review was performed, including both early neuropsychological and more recent imaging studies, in order to achieve a better understanding of the aetiology of alexithymia. RESULTS Corpus callosum, cingulate cortex and insula are clearly involved in alexithymia. The amygdala and the orbitofrontal part of the cortex appear to be implicated as mediators, because of their broader involvement in emotional processing and executive control. CONCLUSION Notwithstanding the diffuse neural representation, the alexithymia construct can be usefully applied in the clinical and empirical studies of social cognition, particularly when adopting a dimensional neuropsychological approach.
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Affiliation(s)
- Ellen Wingbermühle
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Hanneke Theunissen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Willem M A Verhoeven
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Roy P C Kessels
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Jos I M Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Wingbermühle E, Egger JIM, Verhoeven WMA, van der Burgt I, Kessels RPC. Affective functioning and social cognition in Noonan syndrome. Psychol Med 2012; 42:419-426. [PMID: 21740625 DOI: 10.1017/s0033291711001115] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Noonan syndrome (NS) is a common genetic disorder, characterized by short stature, facial dysmorphia, congenital heart defects and a mildly lowered IQ. Impairments in psychosocial functioning have often been suggested, without, however, systematic investigation in a clinical group. In this study, different aspects of affective processing, social cognition and behaviour, in addition to personal well-being, were assessed in a large group of patients with NS. METHOD Forty adult patients with NS were compared with 40 healthy controls, matched with respect to age, sex, intelligence and education level. Facial emotion recognition was measured with the Emotion Recognition Task (ERT), alexithymia with both the 20-item Toronto Alexithymia Scale (TAS-20) and the Bermond-Vorst Alexithymia Questionnaire (BVAQ), and mentalizing with the Theory of Mind (ToM) test. The Symptom Checklist-90 Revised (SCL-90-R) and the Scale for Interpersonal Behaviour (SIB) were used to record aspects of psychological well-being and social interaction. RESULTS Patients showed higher levels of cognitive alexithymia than controls. They also experienced more social distress, but the frequency of engaging in social situations did not differ. Facial emotion recognition was only slightly impaired. CONCLUSIONS Higher levels of alexithymia and social discomfort are part of the behavioural phenotype of NS. However, patients with NS have relatively intact perception of emotions in others and unimpaired mentalizing. These results provide insight into the underlying mechanisms of social daily life functioning in this patient group.
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Affiliation(s)
- E Wingbermühle
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - J I M Egger
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - W M A Verhoeven
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - I van der Burgt
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R P C Kessels
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Rosik CH, Soria A. Spiritual well-being, dissociation, and alexithymia: examining direct and moderating effects. J Trauma Dissociation 2012; 13:69-87. [PMID: 22211442 DOI: 10.1080/15299732.2011.606739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
In the present study we surveyed 131 adults seeking psychotherapy and pastoral care in an intensive outpatient psychotherapy program for full-time religious workers. We sought to determine whether dissociation and alexithymia are associated with spiritual well-being. We utilized the Dissociative Experiences Scale-II (DES-II), the Toronto Alexithymia Scale (TAS-20), the Spiritual Well-Being Scale (SWB) as well as the subscales of these instruments in a series of linear multiple regression analyses. DES-II total scores were inversely related to SWB total scores. No association was found between alexithymia and SWB, nor did alexithymia moderate the relationship between dissociation and SWB. Subscale analyses revealed that lower SWB and Existential Well-Being (EWB) were associated with greater nonpathological dissociation (DES-NP), which was unrelated to Religious Well-Being (RWB). By contrast, lower RWB was predicted by higher pathological dissociation (DES-T), which displayed no relationship to SWB or EWB. We conclude with a discussion of some implications of these findings.
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Abstract
OBJECTIVE Individuals with alexithymia have a reduced ability to use their feelings to guide their behavior appropriately in social situations. To reveal the capacity to use emotional signals in alexithymia under conditions of uncertainty, this study investigates neural substrates and performance on the Iowa Gambling Task (IGT), which was developed to assess decision making based on emotion-guided evaluation. METHODS The participants were 10 men with alexithymia and 13 without. Alexithymia was assessed by the 20-item Toronto Alexithymia Scale. Regional cerebral blood flow (rCBF) was measured by [¹⁵O]-H₂O positron emission tomography during four trials of the IGT and two visuomotor control tasks. RESULTS The participants with alexithymia failed to learn an advantageous decision-making strategy, with performance differing significantly from the nonalexithymic group in the fourth IGT trial (p = .029). Comparing performance between the IGT and the control tasks, both groups showed brain activation in the dorsolateral frontal area, inferior frontal lobe, pre-supplementary motor area, inferior parietal lobe, fusiform gyrus, and cerebellum. Men with alexithymia showed lower rCBF in the medial frontal area (Brodmann area [BA] 10) and higher rCBF in the caudate and occipital areas in the first and second IGT trials, which are within a learning phase according to test performance data. All brain data were significant at p ≤ .001, uncorrected. CONCLUSIONS BA10 activity may be associated with using internal signals accompanying affective evaluation of the stimuli, which is crucial for successful decision making. Reduced BA10 activity in participants with alexithymia suggests that they may not use an emotion-based biasing signal to lead to advantageous decision making.
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Abstract
Studies have found higher levels of alexithymia in schizophrenic subjects relative to controls, with an overall higher level of emotional arousal and social withdrawal. The present study is an extension of this research to the assessment of schizotypy in a nonclinical sample. Seventy-two undergraduate students (40 female; 21.6 ± 6.38 years) were recruited to participate in this study. Consistent with earlier research, our results show that both schizotypy and alexithymia are associated with relatively poor socioemotional functioning across the variables of depression, anxiety, social functioning, and overall quality of life. Further, our results show that the significant associations found between alexithymia and these 4 outcome variables was predicated on shared variance with schizotypy. When both alexithymia and schizotypy were regressed onto these variables as independent predictors, the contribution of alexithymia was consistently nonsignificant. The implications of these findings are discussed in terms of hypothesized substrates of alexithymia.
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Health-related quality-of-life profiles in nonalexithymic and alexithymic subjects from general population. J Psychosom Res 2010; 68:279-83. [PMID: 20159214 DOI: 10.1016/j.jpsychores.2009.09.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Revised: 08/17/2009] [Accepted: 09/17/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Earlier studies have shown an association between alexithymia and health-related quality of life (HRQoL). There has been some controversy as to whether this is attributable solely to psycho-social domains of HRQoL or also to physical domains. Furthermore, there are no studies on HRQoL profiles in representative general population samples controlling for sociodemographic variables, mental health and somatic health. METHODS The study forms part of the Health 2000 Study. Altogether 5090 participants from general population, aged 30-97 years, filled in the 20-item Toronto Alexithymia Scale and the 15D HRQoL scale. Depressive and anxiety disorders were assessed in a structured psychiatric interview. Physical health was examined by physicians. The 15-dimension HRQoL profiles of both alexithymic and non-alexithymic subjects were obtained by analysis of covariance, controlling for sociodemographic and health-related variables. RESULTS The alexithymic group had significantly (P<.001) lower mean scores on every dimension of the 15D even after controlling for confounding demographic variables, somatic diagnoses and depressive and anxiety disorders. The differences were greatest in the psycho-social domains. CONCLUSIONS Alexithymia seems to be a personality trait with a statistically significant association to every dimension of HRQoL, not only to psychosocial domains. However, the associations between alexithymia and some somatic dimensions may be of little clinical significance.
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Swart M, Kortekaas R, Aleman A. Dealing with feelings: characterization of trait alexithymia on emotion regulation strategies and cognitive-emotional processing. PLoS One 2009; 4:e5751. [PMID: 19492045 PMCID: PMC2685011 DOI: 10.1371/journal.pone.0005751] [Citation(s) in RCA: 187] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 05/01/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alexithymia, or "no words for feelings", is a personality trait which is associated with difficulties in emotion recognition and regulation. It is unknown whether this deficit is due primarily to regulation, perception, or mentalizing of emotions. In order to shed light on the core deficit, we tested our subjects on a wide range of emotional tasks. We expected the high alexithymics to underperform on all tasks. METHOD Two groups of healthy individuals, high and low scoring on the cognitive component of the Bermond-Vorst Alexithymia Questionnaire, completed questionnaires of emotion regulation and performed several emotion processing tasks including a micro expression recognition task, recognition of emotional prosody and semantics in spoken sentences, an emotional and identity learning task and a conflicting beliefs and emotions task (emotional mentalizing). RESULTS The two groups differed on the Emotion Regulation Questionnaire, Berkeley Expressivity Questionnaire and Empathy Quotient. Specifically, the Emotion Regulation Quotient showed that alexithymic individuals used more suppressive and less reappraisal strategies. On the behavioral tasks, as expected, alexithymics performed worse on recognition of micro expressions and emotional mentalizing. Surprisingly, groups did not differ on tasks of emotional semantics and prosody and associative emotional-learning. CONCLUSION Individuals scoring high on the cognitive component of alexithymia are more prone to suppressive emotion regulation strategies rather than reappraisal strategies. Regarding emotional information processing, alexithymia is associated with reduced performance on measures of early processing as well as higher order mentalizing. However, difficulties in the processing of emotional language were not a core deficit in our alexithymic group.
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Affiliation(s)
- Marte Swart
- NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Bibliography. Current world literature. Genetics and epidemiology. Curr Opin Allergy Clin Immunol 2008; 8:489-93. [PMID: 18769207 DOI: 10.1097/aci.0b013e32830f1c83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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