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Komaki G, Baba T, Yoshida T, Arimura T, Moriguchi Y, Maeda M. Development of a structured interview for the modified version of the Beth Israel Hospital psychosomatic questionnaire for alexithymia. Front Psychiatry 2024; 15:1356643. [PMID: 39156611 PMCID: PMC11327022 DOI: 10.3389/fpsyt.2024.1356643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/03/2024] [Indexed: 08/20/2024] Open
Abstract
Background An observer-rated questionnaire for alexithymia based on the original 17-item Beth Israel Hospital Psychosomatic Questionnaire for Alexithymia (BIQ) was developed by Sifneos in 1973 and modified into a 12-item version of BIQ by Taylor et al. in 1997. However, it has rarely been used in a clinical or research context and studies have not given satisfactory inter-rater reliability for the 12-item version. Objective To develop a structured interview in Japanese for the12-item modified version of BIQ (m-SIBIQ) to determine the reliability and validity of the m- scores and its factor structure model. Methods Ninety-two Japanese young adults were interviewed. The inter-rater reliability of the m-SIBIQ was assessed by exploratory factor analysis. For the concurrent and convergent validities, correlation analysis was done between the scores of m-SIBIQ and the self-reported questionnaires: 20-Item Toronto Alexithymia Scale (TAS-20), NEO Five-Factor Inventory (NEO-FFI), Emotional Empathy Scale (EES), Interpersonal Reactivity Index (IRI), Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI). Goodness of fit of the structure model of the m-SIBIQ was evaluated using confirmatory factor analysis, and the results were examined through stepwise multiple regression analysis. Results Good reliability was obtained for the total score of m-SIBIQ: Cronbach's α.950 (p<.001) and ICC.75(p<.05). The validity of the factor structure was obtained by confirmatory factor analysis using covariance. The model of the alexithymia constructs was configured by the operative thinking (la pensée opératoire) and affect awareness components. The stepwise multiple regression analysis extracted the total score of m-SIBIQ as significantly, negatively correlated with the Openness to experience score of NEO-FFI and significantly, positively correlated with the emotionally chilly score of EES and the score of difficulty describing feelings (DDF) of TAS-20. There were no correlations between the m-SIBIQ and BDI-II scores. Conclusion For Japanese young adults, the m-SIBIQ is a reliable and valid instrument for overcoming weaknesses of the self-reported procedures by bringing to light the alexithymia construct and principal dimensions.
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Affiliation(s)
- Gen Komaki
- Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Takanobu Baba
- Faculty of Psychology, Otemon Gakuin University, Osaka, Japan
| | - Toshiyuki Yoshida
- Department of Social and Clinical Psychology, Hijiyama University, Hiroshima, Japan
| | | | - Yoshiya Moriguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Motonari Maeda
- College of Art and Design, Joshibi University of Art and Design, Sagamihara, Japan
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Shang Z, Fang C, Lang X, Zhang X. Gender difference in association between clinical symptoms and alexithymia in chronic schizophrenia: A large sample study based on Chinese Han population. J Affect Disord 2024; 344:519-527. [PMID: 37848090 DOI: 10.1016/j.jad.2023.10.088] [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: 06/14/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Alexithymia, a prevalent social cognitive impairment in schizophrenia, remains insufficiently studied. Though some studies propose a link between alexithymia and clinical symptoms of schizophrenia, this connection lacks consistent confirmation. Additionally, there is limited research on gender difference in alexithymia among schizophrenia patients. To fill this gap, our study aimed to conduct a large-sample survey of Chinese Han patients with chronic schizophrenia to explore whether there are gender differences between clinical symptoms and alexithymia. METHODS We obtained sociodemographic characteristics of 987 schizophrenia patients, measured their clinical symptoms using the Positive and Negative Syndrome Scale (PANSS), and assessed their self-reported alexithymia using the Toronto Alexithymia Scale (TAS-20). RESULTS In patients with chronic schizophrenia, the prevalence of alexithymia did not differ between genders (male: 35.51 % vs. female: 26.91 %, P = 0.018). Correlation and linear regression analyses revealed that PANSS scores and TAS-20 scores were widely correlated in both male and female patients. In particular, multiple linear regression analysis showed that the TAS total score was positively correlated with negative symptoms and cognitive symptoms in male patients, while it was positively correlated with negative symptoms and depressive symptoms in female patients. CONCLUSION Our study suggests that the prevalence of alexithymia in patients with chronic schizophrenia does not differ between genders. Negative symptoms are related to the TAS-20 total score in both male and female patients, while cognitive symptoms are only related to the TAS-20 total score in male patients, and depressive symptoms are only related to the TAS-20 total score in female patients.
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Affiliation(s)
- ZhaoXuan Shang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - ChunQing Fang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - XiangYang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Sarman A, Tuncay S. The associations of parental attitudes and peer bullying with alexithymia in adolescents: A structural equality model. J Pediatr Nurs 2023; 73:e372-e380. [PMID: 37806855 DOI: 10.1016/j.pedn.2023.10.003] [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: 08/17/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
AIM The aim of this study is to investigate the relationship between parental attitude and peer bullying and alexithymia in adolescents. METHODS This cross-sectional descriptive study was conducted with adolescents aged 13-18 years within high schools in eastern Turkey. Cluster sampling method was applied, and the study was completed within four high schools determined by random selection method. Sociodemographic characteristics questionnaire form, Peer Bullying Scale Adolescent Form, and Twenty-item Toronto Alexithymia Scale (TAS-20) were used to collect the data. RESULTS Among the adolescents, 52% were female, 60% had a medium income level, 25.3% were in the 11th grade, 83% were living with their parents, 7.4% had chronic illnesses, 9.2% had psychiatric illnesses, 25.3% had suicidal thoughts, 10.1% engaged in suicidal behavior, and 25.3% used TV, smartphones, or tablets for 3-4 h a day. Rejecting and indifferent parental attitudes were found to be a possible risk factor for alexithymia, bullying and victimization. CONCLUSIONS This study highlights the connections between parental attitudes, peer bullying, and alexithymia in adolescents. By targeting positive parental attitudes and addressing peer interactions, nurses can effectively contribute to reducing the risk of alexithymia. PRACTICE IMPLICATIONS Through collaboration with parents, nurses can establish supportive environments that nurture emotional understanding. Remaining attentive to risk factors, such as chronic illnesses and mental health issues in adolescents, empowers nurses to offer timely support or referrals. Partnerships with educators further enhance emotional awareness and encourage positive peer relationships.
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Affiliation(s)
- Abdullah Sarman
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey.
| | - Suat Tuncay
- Bingöl University, Faculty of Health Science, Department of Pediatric Nursing, Bingöl, Turkey
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Huo L, Qu D, Pei C, Wu W, Ning Y, Zhou Y, Zhang XY. Alexithymia in chronic schizophrenia and its mediating effect between cognitive deficits and negative symptoms. Schizophr Res 2023; 261:275-280. [PMID: 37866075 DOI: 10.1016/j.schres.2023.10.006] [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: 01/04/2023] [Revised: 06/01/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Although cognition is known to impact clinical symptoms of schizophrenia, few studies investigate the potential mediators of this relationship. This study aimed to examine the relationship between cognitive deficits and negative symptoms in schizophrenia, considering the mediating role of alexithymia as an important psychological variable. Moreover, the prevalence of alexithymia in patients with schizophrenia was investigated. METHODS A total of 689 patients with schizophrenia were recruited from two psychiatric hospitals. All patients completed the Positive and Negative Syndrome Scale (PANSS), 20-item Toronto Alexithymia Scale (TAS-20), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We used structural equation modeling to examine the hypothesized mediated model. RESULTS In total, 31.5 % of patients with schizophrenia were classified as alexithymia. The path analyses showed that two factors of alexithymia (i.e., the difficulty in identifying feelings and difficulty in describing feelings), played a mediating role in the pathway from cognitive deficits to negative symptoms (all p < .001). LIMITATIONS Self-reported measurement for alexithymia may not be sufficiently reliable due to response bias. CONCLUSION Our findings demonstrated a high occurrence of alexithymia in patients with schizophrenia. Moreover, the mediating role of alexithymia suggests that targeting emotion processing and cognition may be a feasible way to mitigate negative symptoms.
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Affiliation(s)
- Lijuan Huo
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, Guangzhou, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chenran Pei
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, Guangzhou, China
| | - Weibin Wu
- Foshan Mental Health Center, The Third People's Hospital of Foshan, Foshan, China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen 5180005, China.
| | - Xiang Yang Zhang
- Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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Motomura Y, Fukuzaki A, Eto S, Hirabayashi N, Gondo M, Izuno S, Togao O, Yamashita K, Kikuchi K, Sudo N, Yoshihara K. Alexithymia characteristics are associated with salience network activity in healthy participants: an arterial spin labeling study. J Physiol Anthropol 2023; 42:18. [PMID: 37674183 PMCID: PMC10483865 DOI: 10.1186/s40101-023-00336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties in identifying and expressing their emotions despite having a range of emotional experiences, can impact individuals' stress coping mechanisms. While many studies have investigated brain functions associated with specific tasks in relation to emotion processing, research focusing on resting-state brain functions has been limited. Thus, the aim of this study was to investigate the relationship between alexithymia and brain function by analyzing arterial spin labeling (ASL) data obtained during the resting state. METHODS A brain structural and functional imaging study was conducted on 42 healthy adult men and women using ASL and the 20-item Toronto Alexithymia Scale (TAS-20) questionnaire survey. Cerebral blood flow and functional connectivity values were calculated for regions of interest in the default mode network, saliency network, and central executive network from the ASL data. Correlation analysis was performed with TAS20 scores, and partial correlation analysis was conducted to control for anxiety and depression. RESULTS The functional connectivity analysis revealed a negative correlation between the functional connectivity of the right insular cortex and left anterior cingulate cortex and the total score of TAS, as well as difficulty identifying feelings and difficulty describing feeling subscores, indicating that the higher the scores, the weaker the functional connectivity between these regions (T = -3.830, p = 0.0013, R = -0.5180). This correlation remained significant even after controlling for anxiety and depression using partial correlation analysis. CONCLUSION The present study revealed differences in the activity of the Saliency Network at rest as measured by ASL, which were independent of anxiety and depression, and varied depending on the severity of alexithymia. This functional change may underlie the neural basis of decreased emotional processing observed in alexithymia. These findings may contribute to the elucidation of the neural mechanisms of alexithymia, which can lead to social impairments, and suggest the usefulness of ASL measurement as a biomarker of alexithymia.
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Affiliation(s)
- Yuki Motomura
- Department of Human Life Design, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan.
| | - Ayaka Fukuzaki
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
| | - Sanami Eto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Satoshi Izuno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tei S, Itahashi T, Aoki YY, Kubota M, Hashimoto RI, Nakamura M, Okuzumi S, Takahashi H, Ohta H, Fujino J. Neural correlates of perceptual switching and their association with empathy and alexithymia in individuals with and without autism spectrum disorder. J Psychiatr Res 2023; 164:322-328. [PMID: 37393797 DOI: 10.1016/j.jpsychires.2023.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/28/2023] [Accepted: 06/25/2023] [Indexed: 07/04/2023]
Abstract
Individuals with autism spectrum disorder (ASD) often show limited empathy (poor recognition of others' emotions) and high alexithymia (poor recognition of own emotions and external thinking), which can negatively impact their social functioning. Previous experimental studies suggest that alterations in cognitive flexibility play key roles in the development of these characteristics in ASD. However, the underlying neural mechanisms that link cognitive flexibility and empathy/alexithymia are still largely unknown. In this study, we examined the neural correlates of cognitive flexibility via functional magnetic resonance imaging during perceptual task-switching in typical development (TD) adults and adults with ASD. We also investigated associations between regional neural activity and psychometric empathy and alexithymia scores among these populations. In the TD group, stronger activation of the left middle frontal gyrus was associated with better perceptual switching and greater empathic concern. Among individuals with ASD, stronger activation of the left inferior frontal gyrus was associated with better perceptual switching, greater empathy, and lower alexithymia. These findings will contribute to develop a better understanding of social cognition, and could be informative for the development of new ASD therapies.
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Affiliation(s)
- Shisei Tei
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan; Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan; School of Human and Social Sciences, Tokyo International University, 2509 Matoba, Kawagoe, Saitama, Japan.
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Yuta Y Aoki
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Manabu Kubota
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan; Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Ryu-Ichiro Hashimoto
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo, Japan
| | - Motoaki Nakamura
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Kanagawa Psychiatric Center, 2-5-1 Serigaya, Yokohama, Kanagawa, Japan
| | - Shoko Okuzumi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | - Hidehiko Takahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan; Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan; Center for Brain Integration Research, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | - Haruhisa Ohta
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Psychiatry, School of Medicine, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Junya Fujino
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan; Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan; Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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Karki S, Shrestha O, Thapa N, Gupta S, Chaudhary A, Yadav A, Manandhar P. Prevalence of alexithymia among medical students in Nepal: A cross-sectional study based on a self-administered questionnaire. Health Sci Rep 2023; 6:e1262. [PMID: 37205935 PMCID: PMC10189862 DOI: 10.1002/hsr2.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/12/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
Background and Aims Alexithymia is a state in which one cannot comprehend and put their emotions or feelings into words. It is a disturbance that is common among general population as well as people with mental health disorders. Medical students are at higher risk of developing alexithymia due to the extensive nature of their course and clinical postings. The presence of alexithymia is negatively correlated with the self-efficacy of the students eventually affecting self-care and patient care in the future. The aim of this study is to find the prevalence of alexithymia among medical students in Nepal and know its associated factors. Methods This cross-sectional study used convenient sampling for selecting responders and the TAS-20 tool for data collection. Data were analyzed by using SPSS 20. Frequency was calculated for all the variables. Prevalence with 95% confidence interval [CI] is reported and the χ 2 test is used to see the difference in alexithymia status among different categories of dichotomous independent variables. Results Out of 386 students, 380 of them responded. The ratio of male and female was 1.8 with the mean age of 22.22 ± 1.77 years. The prevalence of alexithymia was found to be 22.89% (95% CI, 18.9-27.1). There was no statistically significant difference between the presence and absence of alexithymia among categories of sex, year of study, staying at hostel, involvement in extracurricular activities, involvement in daily exercise/yoga/outdoor sports, and smoking habit. Conclusion The prevalence of alexithymia in our study was 22.89% with no association with known factors.
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Affiliation(s)
- Sagun Karki
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Oshan Shrestha
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Niranjan Thapa
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Satish Gupta
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Amit Chaudhary
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Abijeet Yadav
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Pradeep Manandhar
- Department of Psychiatry, Nepalese Army Institute of Health SciencesShree Birendra HospitalKathmanduNepal
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Zhang H, Wang Y, Lou H, Zhu Y, Dong Z, Dong D, Chen P, Zhu X, Chen B, Zhang P. Prevalence of and factors associated with alexithymia among patients with chronic obstructive pulmonary disease in China: a cross-sectional study. BMC Pulm Med 2023; 23:40. [PMID: 36717796 PMCID: PMC9885611 DOI: 10.1186/s12890-023-02335-5] [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: 08/24/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Alexithymia is a common psychological disorder. However, few studies have investigated its prevalence and predictors in patients with chronic obstructive pulmonary disease (COPD). Therefore, we aimed to determine the prevalence and predictors of alexithymia in Chinese patients. METHODS This cross-sectional study included 842 COPD patients to assess the prevalence and predictors of alexithymia using the 20-item Toronto Alexithymia Scale (TAS-20). We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression, the modified British Medical Research Council dyspnea Rating Scale (mMRC) to assess dyspnea, St. George's Respiratory Questionnaire (SGRQ) to assess quality of life, and the age-adjusted Charlson comorbidity index (ACCI) to assess comorbidities. Alexithymia-related predictors were identified using univariate and multivariate logistic regression analyses. RESULTS The prevalence of alexithymia in COPD patients was 23.6% (199/842). Multivariate analysis showed that age [odds ratio (OR) 0.886; 95% confidence interval (CI) 0.794-0.998], body mass index (OR 0.879; 95% CI 0.781-0.989), HADS-anxiety (OR 1.238; 95% CI 1.097-1.396), HADS-depression (OR 1.178; 95% CI 1.034-1.340), mMRC (OR 1.297; 95% CI 1.274-1.320), SGRQ (OR 1.627; 95% CI 1.401-1.890), ACCI (OR 1.165; 95% CI 1.051-1.280), and GOLD grade (OR 1.296; 95% CI 1.256-1.337) were independent predictors for alexithymia in patients with COPD. CONCLUSIONS The prevalence of alexithymia was high in Chinese COPD patients. Anxiety, depression, dyspnea, quality of life, comorbidities, and disease severity are independent risk factors, and age and BMI are predictive factors for alexithymia in COPD patients.
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Affiliation(s)
- Huaizhong Zhang
- grid.501121.6Department of Psychiatry, Xuzhou Cancer Hospital, Xuzhou, 221000 Jiangsu China
| | - Yixuan Wang
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Heqing Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Yanan Zhu
- grid.413389.40000 0004 1758 1622Department of Respiratory Medicine of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zongmei Dong
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Dong Dong
- grid.501121.6Department of Psychiatry, Xuzhou Cancer Hospital, Xuzhou, 221000 Jiangsu China
| | - Peipei Chen
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Xuan Zhu
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
| | - Bi Chen
- grid.413389.40000 0004 1758 1622Department of Respiratory Medicine of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Pan Zhang
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221006 China
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Exploring alexithymia profiles and their associations with childhood adversity and COVID-19 burnout among Chinese college students: A person-centered approach. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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10
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Preliminary efficacy of cognitive-behavioral therapy on emotion regulation in adults with autism spectrum disorder: A pilot randomized waitlist-controlled study. PLoS One 2022; 17:e0277398. [PMID: 36417403 PMCID: PMC9683545 DOI: 10.1371/journal.pone.0277398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
Previous studies have demonstrated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in children on the autism spectrum. However, no studies have elucidated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in autistic adults. The aim of the present pilot study was to explore the preliminary clinical utility of a group-based cognitive-behavioral therapy program designed to address emotion regulation skills in autistic adults. We conducted a clinical trial based on a previously reported protocol; 31 participants were randomly allocated to the intervention group and 29 to the waitlist control group. The intervention group underwent an 8-week program of cognitive-behavioral therapy sessions. Two participants from the intervention group withdrew from the study, leaving 29 participants (93.5%) in the group. Compared with the waitlist group, the cognitive-behavioral therapy group exhibited significantly greater pre-to-post (Week 0-8) intervention score improvements on the attitude scale of the autism spectrum disorder knowledge and attitude quiz (t = 2.21, p = 0.03, d = 0.59) and the difficulty describing feelings scale of the 20-item Toronto Alexithymia Scale (t = -2.07, p = 0.04, d = -0.57) in addition to pre-to-follow-up (Week 0-16) score improvements on the emotion-oriented scale of the Coping Inventory for Stressful Situations (t = -2.14, p = 0.04, d = -0.59). Our study thus provides preliminary evidence of the efficacy of the group-based cognitive-behavioral therapy program on emotion regulation in autistic adults, thereby supporting further evaluation of the effectiveness of the cognitive-behavioral therapy program in the context of a larger randomized clinical trial. However, the modest and inconsistent effects underscore the importance of continued efforts to improve the cognitive-behavioral therapy program beyond current standards.
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Renzi A, Conte G, Tambelli R. Somatic, Emotional and Behavioral Symptomatology in Children during COVID-19 Pandemic: The Role of Children's and Parents' Alexithymia. Healthcare (Basel) 2022; 10:2171. [PMID: 36360512 PMCID: PMC9691013 DOI: 10.3390/healthcare10112171] [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] [Received: 09/12/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic has deeply affected the psychophysical wellbeing of children worldwide. Alexithymia, a personality trait involving difficulties in identifying and expressing feelings represents a vulnerability factor for stress-related disorders. Under pandemic stress exposure, we aimed to investigate the role of parents' and children's alexithymia in the psychophysical symptomatology shown by children and to evaluate possible differences according to age, gender and history of COVID-19 infections. The perception of parents and children about the impact of the pandemic on children's emotional, social and physiological wellbeing was also explored. Sixty-five familial triads were surveyed in the period from March to May 2022: children (n = 33 males; mean age = 9.53, sd = 1.55), mothers (mean age = 44.12; sd = 6.10) and fathers (mean age = 47.10; sd = 7.8). Both parental and children's alexithymia scores were significantly associated with somatic and externalizing symptomatology in children. Self-reported anger and externally oriented thinking scores were higher in younger children (age 8-9.9 years) than in older ones (10-12 years). Girls scored higher than boys in somatic complaints, as reported by parents. No difference emerged between children affected/not affected by COVID-19. Notably, children reported a greater negative impact of the pandemic on their emotional and psychosocial well-being than their parents. The findings emphasize the role of alexithymia in the occurrence of psychophysical symptoms in children during the COVID-19 pandemic. The reduced parental awareness of the emotional burden imposed by the pandemic on children indicates the need to better consider how epidemics affect children's mental health and to develop adequate preventive strategies to support them in these exceptional times.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Giulia Conte
- Department of Human Neurosciences, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Renata Tambelli
- Department of Human Neurosciences, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
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12
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Luo H, Gong X, Chen X, Hu J, Wang X, Sun Y, Li J, Lv S, Zhang X. Exploring the links between alexithymia and cognitive emotion regulation strategies in internet addiction: A network analysis model. Front Psychol 2022; 13:938116. [PMID: 35978791 PMCID: PMC9376254 DOI: 10.3389/fpsyg.2022.938116] [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: 05/07/2022] [Accepted: 07/14/2022] [Indexed: 12/24/2022] Open
Abstract
Alexithymia and emotion regulation are closely related to internet addiction. However, no research has examined how the different components of alexithymia are associated with cognitive emotion regulation in the context of multi-strategy use in internet addiction. The current study aimed to investigate the relation between alexithymia and cognitive emotion regulation in individuals with internet addiction via network analysis. Participants included 560 students with Young’s Internet Addiction Test scores greater than 50 points; they were also asked to complete the Toronto Alexithymia Scale (TAS-20) and the Cognitive Emotion Regulation Questionnaire (CERQ). The results revealed two bridge nodes emerging within the combined alexithymia and cognitive emotion regulation network model: “catastrophizing” and “externally oriented thoughts.” These findings indicate a more specific relation between alexithymia and cognitive emotion regulation and provide empirical evidence for targeted prevention and targeted interventions for internet addiction.
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Affiliation(s)
- Hongge Luo
- School of Public Health, North China University of Science and Technology, Tangshan, China
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Xun Gong
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Xiaomei Chen
- The Department of Marxist Teaching, North China University of Science and Technology, Tangshan, China
| | - Jianing Hu
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Xiaoyi Wang
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Yekun Sun
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Jiating Li
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Shaobo Lv
- College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Xiujun Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
- *Correspondence: Xiujun Zhang,
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Chan J, Becerra R, Weinborn M, Preece D. Assessing Alexithymia across Asian and Western Cultures: Psychometric Properties of the Perth Alexithymia Questionnaire and Toronto Alexithymia Scale-20 in Singaporean and Australian Samples. J Pers Assess 2022; 105:396-412. [PMID: 35900047 DOI: 10.1080/00223891.2022.2095641] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Alexithymia refers to difficulties identifying feelings (DIF), describing feelings (DDF), and externally orientated thinking (EOT). Originally conceptualized by American psychiatrists, some researchers have since questioned the validity and application of this construct in Asian cultures. However, to date, there is little empirical work formally assessing the invariance of alexithymia across Asian and Western cultures. The present study aimed to help address this gap, by examining the psychometric properties and measurement invariance of two alexithymia measures, the Perth Alexithymia Questionnaire (PAQ) and Toronto Alexithymia Scale-20 (TAS-20), across samples from Singapore (n = 434) or Australia (n = 489). The same theoretically congruent factor structure was supported across both samples; this structure was fully invariant across samples for the PAQ, and partially invariant for the TAS-20. Both measures had good internal consistency and concurrent validity across samples, except the TAS-20 EOT subscale which had low internal consistency and factor loadings in both samples. The Singaporean sample reported higher DIF and DDF for positive emotions than the Australian sample. Overall, our results support the cross-cultural validity and application of the alexithymia construct. The PAQ and TAS-20 both appear to have good utility in this respect, though the PAQ may provide a more detailed facet-level profile.
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Affiliation(s)
- Joan Chan
- University of Western Australia, Perth, Australia
| | | | | | - David Preece
- University of Western Australia, Perth, Australia.,School of Psychology, Curtin University, Perth, Australia
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Oka T, Lkhagvasuren B. Effects of practicing yoga on alexisomia: an open-label trial. Biopsychosoc Med 2022; 16:14. [PMID: 35659341 PMCID: PMC9166595 DOI: 10.1186/s13030-022-00243-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alexisomia refers to difficulties in the awareness and expression of somatic feelings. This idea was proposed by Dr. Yujiro Ikemi as a characteristic observed in patients with psychosomatic diseases and is based on his observations that patients with psychosomatic diseases have difficulty in the awareness and expression of not only their emotions, i.e., alexithymia, but also somatic feelings and sensations, i.e., alexisomia. He also proposed that treating alexisomia is important in the treatment of psychosomatic diseases and that yoga might help improve alexisomia. However, no study has investigated if yoga actually affects alexisomia. This open-label pilot study investigated whether practicing yoga in a class results in change in patients with alexisomia and alexithymia. METHODS The Shitsu-taikan-sho Scale (STSS) and the Toronto Alexithymia Scale (TAS-20) were administered to 305 participants, including 64 healthy participants, 111 participants who had subjective symptoms without abnormal findings, and 130 participants with chronic diseases. Participants were tested before and 3 months after attending yoga classes. RESULTS Yoga practice reduced the STSS and the TAS-20 difficulty in identifying feelings (DIF) subscale scores. Multiple linear regression indicated that a reduction in the TAS-20 DIF subscale scores predicted a decrease in the STSS score, whereas reductions in the STSS difficulty in identifying bodily feelings (DIB) and the lack of health management based on bodily feelings (LHM) subscale scores predicted a decrease in the TAS-20 scores. CONCLUSION We found that regular yoga practice improves alexisomia. Yoga-induced improvement of alexisomia may be mediated, at least in part, by an improvement of DIF in alexithymia. Yoga would be a promising therapeutic approach to improve alexisomia.
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Affiliation(s)
- Takakazu Oka
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan.
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Battuvshin Lkhagvasuren
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
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Uono S, Egashira Y, Hayashi S, Takada M, Ukezono M, Okada T. No Influence of Emotional Faces or Autistic Traits on Gaze-Cueing in General Population. Front Psychol 2022; 13:864116. [PMID: 35558687 PMCID: PMC9088812 DOI: 10.3389/fpsyg.2022.864116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The present study addressed the controversial issue of whether autistic traits in the general population are associated with the automatic and fundamental aspects of joint attention through eye gaze. Specifically, we examined whether the degree of autistic traits is associated with the magnitude of reflexive attention orienting in the direction of another's eye gaze embedded in neutral and emotional (angry, fearful, and happy) faces. The cue stimuli changed gaze direction and facial expressions simultaneously. Participants were asked to detect a target that appeared at the left or right of the cue stimuli. The results revealed a robust gaze-cueing effect, such that the reaction time to the target was shorter under the gazed-at-target condition than under the non-gazed-at-target condition. However, emotional expressions did not modulate the gaze-cueing effect. Furthermore, individual differences in autistic traits and emotional characteristics (social anxiety, alexithymia, and emotional disturbances) did not influence the magnitude of the gaze-cueing effect. Although the ability to orient attention in the direction of another's gaze is a fundamental function of social development, the gaze-cueing effect measured in a controlled experiment might not be an elaborate representation of the current social cognitive function, at least in typically developing adults.
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Affiliation(s)
- Shota Uono
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yuka Egashira
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Sayuri Hayashi
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Miki Takada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Masatoshi Ukezono
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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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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Williams ZJ, Gotham KO. Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory. Mol Autism 2021; 12:56. [PMID: 34376227 PMCID: PMC8353782 DOI: 10.1186/s13229-021-00463-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/31/2021] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties interpreting emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies several cognitive and emotional differences previously attributed to autism. Although questionnaires such as the 20-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have investigated the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. METHODS This study is a revised version of a previous article that was retracted due to copyright concerns (Williams and Gotham in Mol Autism 12:1-40). We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 cognitively able autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study. The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to generate a subset of the items that were strong indicators of a "general alexithymia" factor. Correlations between alexithymia and other clinical outcomes were used to assess the nomological validity of the new alexithymia score in the SPARK sample. RESULTS The TAS-20 did not exhibit adequate model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an 8-item general alexithymia factor score (GAFS-8, with "TAS" no longer referenced due to copyright) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that GAFS-8 scores, as derived from the TAS-20, meaningfully predict autistic trait levels, repetitive behaviors, and depression symptoms, even after controlling for trait neuroticism. The GAFS-8 also presented no meaningful decrement in nomological validity over the full TAS-20 in autistic participants. LIMITATIONS Limitations of the current study include a sample of autistic adults that was majority female, later diagnosed, and well educated; clinical and control groups drawn from different studies with variable measures; only 16 of the TAS-20 items being administered to the non-autistic sample; and an inability to test several other important psychometric characteristics of the GAFS-8, including sensitivity to change and I-DIF across multiple administrations. CONCLUSIONS These results indicate the potential of the GAFS-8 to robustly measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced GAFS-8 latent trait scores in research applications (available at https://asdmeasures.shinyapps.io/alexithymia ).
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232 USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN USA
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Williams ZJ, Gotham KO. Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale. Mol Autism 2021; 12:20. [PMID: 33653400 PMCID: PMC7971146 DOI: 10.1186/s13229-021-00427-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties interpreting one's own emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies a number of cognitive and emotional differences previously attributed to autism, such as difficulties in facial emotion recognition and reduced empathy. Although questionnaires such as the twenty-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have attempted to determine the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. METHODS We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 verbal autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study (the Human Penguin Project). The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to further refine the scale based on local model misfit and I-DIF between the groups. Correlations between alexithymia and other clinical outcomes such as autistic traits, anxiety, and quality-of-life were used to assess the nomological validity of the revised alexithymia scale in the SPARK sample. RESULTS The TAS-20 did not exhibit adequate global model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an eight-item unidimensional scale (TAS-8) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that TAS-8 scores meaningfully predict autistic trait levels, anxiety and depression symptoms, and quality of life, even after controlling for trait neuroticism. LIMITATIONS Limitations of the current study include a sample of autistic adults that was overwhelmingly female, later-diagnosed, and well-educated; clinical and control groups drawn from different studies with variable measures; and an inability to test several other important psychometric characteristics of the TAS-8, including sensitivity to change and I-DIF across multiple administrations. CONCLUSIONS These results indicate the potential of the TAS-8 as a psychometrically robust tool to measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced TAS-8 latent trait scores in research applications (available at http://asdmeasures.shinyapps.io/TAS8_Score ).
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232 USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN USA
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Trentini C, Tambelli R, Maiorani S, Lauriola M. Gender Differences in Empathy During Adolescence: Does Emotional Self-Awareness Matter? Psychol Rep 2021; 125:913-936. [PMID: 33588646 DOI: 10.1177/0033294120976631] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Empathy refers to the capacity to experience emotions similar to those observed or imagined in another person, with the full knowledge that the other person is the source of these emotions. Awareness of one's own emotional states is a prerequisite for self-other differentiation to develop. This study investigated gender differences in empathy during adolescence and tested whether emotional self-awareness explained these differences. Two-hundred-eleven adolescents (108 girls and 103 boys) between 14 and 19 years completed the Interpersonal Reactivity Index (IRI) and the Toronto Alexithymia Scale (TAS-20) to assess empathy and emotional self-awareness, respectively. Overall, girls obtained higher scores than boys on IRI subscales like emotional concern, personal distress, and fantasy. Regarding emotional self-awareness, we found gender differences in TAS-20 scores, with girls reporting greater difficulty identifying feelings and less externally oriented thinking than boys. Difficulty identifying feelings explained the greatest personal distress experienced by girls. Lower externally oriented thinking accounted for girls' greater emotional concern and fantasy. These findings offer an insight into the role of emotional self-awareness-which is essential for self-other differentiation-as an account for gender differences in empathic abilities during adolescence. In girls, difficulty identifying feelings can impair the ability to differentiate between ones' and others' emotions, leading them to experience self-focused and aversive responses when confronted with others' suffering. Conversely, in boys, externally oriented thinking can mitigate personal distress when faced with others' discomfort.
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Affiliation(s)
| | | | - Silvia Maiorani
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome, Rome, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, "Sapienza" University of Rome, Rome, Italy
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Lee ES, Ryu V, Lee JH, Hong H, Han H, Park S. Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale. Front Psychiatry 2021; 12:685423. [PMID: 34526919 PMCID: PMC8435786 DOI: 10.3389/fpsyt.2021.685423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients. Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise. Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups. Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals. Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.
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Affiliation(s)
- Eun Sol Lee
- Division of Mental Health Research, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Vin Ryu
- Division of Mental Health Research, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Ji Hyun Lee
- Division of Mental Health Research, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Hyeon Hong
- Division of Mental Health Research, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Hyeree Han
- Division of Mental Health Research, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
| | - Subin Park
- Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea
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Kashimura M, Ishizu K, Shimoda Y. Factor Structure and Psychometric Properties of a New Scale to Assess Alexithymia-Like Features in Japanese Youth. J NIPPON MED SCH 2020; 87:285-293. [PMID: 32074538 DOI: 10.1272/jnms.jnms.2020_87-507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies of alexithymia have primarily targeted adult populations. Although some recent studies of alexithymia have focused on children and young adolescents, the literature is not sufficient for development of an assessment tool. The aim of this study was to develop, and evaluate the psychometric properties of, a new scale to measure alexithymia-like features in young adolescents. METHODS A total of 1,444 Japanese junior high school students (701 males, 743 females; age range 12-15; mean [SD] age, 13.37 [0.98] years) participated in 2 surveys conducted at their own schools. RESULTS First, exploratory factor analysis of the first survey data (n=981) demonstrated that this new scale had a unifactor structure, as determined by minimum average partial analysis and parallel analysis. Second, confirmatory factor analysis of the second survey data (n=463) confirmed the unifactor structure of this new scale and acceptable goodness of model fit. The new scale had modest internal consistency. CONCLUSIONS The correlations of this new alexithymia scale with related variables were weak but significant, in accordance with our hypothesis. The scale had acceptable reliability and convergent validity and thus might be useful for measuring alexithymic tendency in young adolescents.
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Affiliation(s)
| | - Kenichiro Ishizu
- Graduate School of Teacher Training Development, University of Toyama
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Kühnel A, Widmann A, Colic L, Herrmann L, Demenescu LR, Leutritz AL, Li M, Grimm S, Nolte T, Fonagy P, Walter M. Impaired cognitive self-awareness mediates the association between alexithymia and excitation/inhibition balance in the pgACC. Psychol Med 2020; 50:1727-1735. [PMID: 31328716 DOI: 10.1017/s0033291719001806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous research showed that automatic emotion regulation is associated with activation of subcortical areas and subsequent feedforward processes to cortical areas. In contrast, cognitive awareness of emotions is mediated by negative feedback from cortical to subcortical areas. Pregenual anterior cingulate cortex (pgACC) is essential in the modulation of both affect and alexithymia. We considered the interplay between these two mechanisms in the pgACC and their relationship with alexithymia. METHOD In 68 healthy participants (30 women, age = 26.15 ± 4.22) we tested associations of emotion processing and alexithymia with excitation/inhibition (E/I) balance represented as glutamate (Glu)/GABA in the pgACC measured via magnetic resonance spectroscopy in 7 T. RESULTS Alexithymia was positively correlated with the Glu/GABA ratio (N = 41, p = 0.0393). Further, cognitive self-awareness showed an association with Glu/GABA (N = 52, p = 0.003), which was driven by a correlation with GABA. In contrast, emotion regulation was only correlated with glutamate levels in the pgACC (N = 49, p = 0.008). CONCLUSION Our results corroborate the importance of the pgACC as a mediating region of alexithymia, reflected in an altered E/I balance. Furthermore, we could specify that this altered balance is linked to a GABA-related modulation of cognitive self-awareness of emotions.
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Affiliation(s)
- A Kühnel
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - A Widmann
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Experimental and Molecular Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - L Colic
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, Mood Disorders Research Program, Yale School of Medicine, New Haven, CT, USA
| | - L Herrmann
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - L R Demenescu
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - A L Leutritz
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - M Li
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, OVGU Magdeburg, Magdeburg, Germany
| | - S Grimm
- Department of Psychiatry, Charité, CBF, Berlin, Germany
- MSB Medical School Berlin, Calandrellistraße 1-9, 12247Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032Zurich, Switzerland
| | - T Nolte
- The Anna Freud National Centre for Children and Families, London, UK
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - P Fonagy
- The Anna Freud National Centre for Children and Families, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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Franzoi IG, Sauta MD, Granieri A. State and Trait Anxiety Among University Students: A Moderated Mediation Model of Negative Affectivity, Alexithymia, and Housing Conditions. Front Psychol 2020; 11:1255. [PMID: 32587555 PMCID: PMC7298066 DOI: 10.3389/fpsyg.2020.01255] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
Abstract
Objective Starting university education is a crucial period for the mental health of students, who report higher levels of distress compared to the general population. This study sought to better understand the distress experienced by students by considering contextual facets (e.g., housing conditions) as well as stable clinical variables (e.g., negative affectivity, emotion regulation, and anxiety). Methods A total of 177 University students (71.2% females) aged 18-29 were administered the State-Trait Anxiety Inventory-Y, the Beck Depression Inventory-II, the Suicidal History Self-Rating Screening Scale, the Personality Inventory for DSM-5-Brief Form, and the Toronto Alexithymia Scale-20. Results University students showed concerning levels of distress, particularly concerning anxiety, and depression. We found that the relationship between negative affectivity and both state and trait anxiety was mediated by alexithymia but housing conditions did not act as a moderator for the indirect effect of negative affectivity on state or trait anxiety through alexithymia. Conclusion Undoubtedly, university lifestyle can be demanding, but experiencing distress is not inevitable nor inexplicable. The present study sought to gain insight into the anxiety experienced by Italian University students while taking into account the importance of personality and clinical characteristics that have previously been widely underestimated. We found that these characteristics can be of extreme importance for developing preventative and therapeutic interventions tailored to the clinical characteristics of students, as well taking into account their living environment.
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Trentini C, Pagani M, Lauriola M, Tambelli R. Neural Responses to Infant Emotions and Emotional Self-Awareness in Mothers and Fathers during Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3314. [PMID: 32397541 PMCID: PMC7246792 DOI: 10.3390/ijerph17093314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 01/16/2023]
Abstract
Neuroscientific research has largely investigated the neurobiological correlates of maternal and (to a much lesser extent) paternal responsiveness in the post-partum period. In contrast, much less is known about the neural processing of infant emotions during pregnancy. Twenty mothers and 19 fathers were recruited independently during the third trimester of pregnancy. High-density electroencephalography (hdEEG) was recorded while expectant parents passively viewed images representing distressed, ambiguous, happy, and neutral faces of unknown infants. Correlational analyses were performed to detect a link between neural responses to infant facial expressions and emotional self-awareness. In response to infant emotions, mothers and fathers showed similar cerebral activity in regions involved in high-order socio-affective processes. Mothers and fathers also showed different brain activity in premotor regions implicated in high-order motor control, in occipital regions involved in visuo-spatial information processing and visual mental imagery, as well as in inferior parietal regions involved in attention allocation. Low emotional self-awareness negatively correlated with activity in parietal regions subserving empathy in mothers, while it positively correlated with activity in temporal and occipital areas implicated in mentalizing and visual mental imagery in fathers. This study may enlarge knowledge on the neural response to infant emotions during pregnancy.
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Affiliation(s)
- Cristina Trentini
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, 00185 Rome, Italy;
| | - Marco Lauriola
- Department of Social and Developmental Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
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Triffaux JM, Nasello J, Luminet O, Servais C, Close M, Quertemont E, Blavier A. Relative stability of alexithymia and openness to emotions in one psychiatric day hospital setting. Clin Psychol Psychother 2020; 27:714-726. [PMID: 32285578 DOI: 10.1002/cpp.2456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 11/11/2022]
Abstract
Alexithymia (literally, difficulty finding words for emotions) and openness to emotions (OE: referring to the cognitive representation, communication, regulation, perception of internal and external bodily sensations, and social restriction of emotions) are strongly linked to psychopathology. The absolute and relative stability hypotheses were tested in order to determine whether significant changes occurred on these constructs after therapy, a condition where changes were expected for both constructs. Negative attitudes toward treatment (NTI) and perceived social support (PSS) were expected to significantly predict alexithymia and OE. Patients (N = 179) who participated in this longitudinal study filled in the Toronto Alexithymia Scale, the Dimensions of Openness to Emotions Scale, the NTI subscale, the Multidimensional Scale of Perceived Social Support, and the Social Desirability Scale. After treatment, we observed significant decrease of all alexithymia scores and significant increases of three OE scores, that is, cognitive representation, communication, and regulation of emotions. Regression analyses revealed that gender, age, NTI, and PSS were significant predictors of alexithymia and OE. NTI strongly predicted lower OE levels and higher alexithymia levels, whereas PSS had opposite predicting effects on these constructs. In conclusion, the significant changes, and the moderate to high correlational levels observed between before and after alexithymia and OE scores, strengthen the relative stability hypothesis for both constructs. In addition, PSS represents a protective factor and NTI a vulnerability indicator for therapists. Our aim is to optimize treatment by providing therapists treating emotion difficulties a more concrete array of variables that potentially either promote or subvert recovery.
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Affiliation(s)
- Jean-Marc Triffaux
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy.,Department of Medical Psychology, University of Liège, CHU of Liège, Liège, Belgium
| | - Julian Nasello
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy.,Department of Psychology, University of Liège, Liège, Belgium
| | - Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain and Belgian Fund for Scientific Research (FRS-FNRS)
| | - Catherine Servais
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy
| | - Mireille Close
- Day Psychiatric Hospital "La Clé", Psychosomatic Medicine and Group Psychotherapy
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Alexithymia in individuals with chronic pain and its relation to pain intensity, physical interference, depression, and anxiety: a systematic review and meta-analysis. Pain 2020; 160:994-1006. [PMID: 31009416 DOI: 10.1097/j.pain.0000000000001487] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Numerous studies have examined how alexithymia (difficulty identifying and describing one's emotions and a preference for externally oriented thinking) relates to chronic pain and associated disability. We conducted a systematic review and meta-analysis to summarize individual studies that either assessed alexithymia in individuals with chronic pain vs controls or related alexithymia to pain intensity, physical interference, depression, and anxiety. We searched MEDLINE, Embase, and PsycINFO from inception through June 2017; 77 studies met the criteria (valid assessment of alexithymia in adults or children with any chronic pain condition) and were included in analyses (n = 8019 individuals with chronic pain). Primary analyses indicated that chronic pain samples had significantly higher mean alexithymia scores compared with nonclinical (d = 0.81) and clinical nonpain (d = 0.55) controls. In chronic pain samples, alexithymia was significantly positively associated with pain intensity (d = 0.20), physical interference (d = 0.17), depression (d = 0.46), and anxiety (d = 0.43). Secondary meta-analyses of 14 studies that conducted partial correlations that controlled for negative affect-related measures revealed that alexithymia was no longer significantly related to pain intensity or interference. Meta-analysis findings demonstrated that alexithymia is elevated in individuals with chronic pain and related to greater pain intensity and physical interference, although the latter relationships may be accounted for by negative affect. Critical future work is needed that examines alexithymia assessed using non-self-report measures, develops a person-centered perspective on this construct, and identifies how alexithymia is relevant to the assessment and treatment of individuals with chronic pain.
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Hasuo H, Sakuma H, Fukunaga M. Alexithymia in Family Caregivers of Advanced Cancer Patients Is Associated with High Personalized Pain Goal Scores: A Pilot Study. J Palliat Med 2020; 23:930-936. [PMID: 31910341 DOI: 10.1089/jpm.2019.0257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: Alexithymia, or difficulty identifying and describing emotions and sensations, contributes to an increased risk of chronic pain, and low help-seeking. Objective: To investigate whether family caregivers of advanced cancer patients visiting a palliative care department had alexithymia, and whether this was related to their pain intensity, personalized pain goals, and help-seeking for chronic musculoskeletal pain. Design: A single-center cross-sectional survey. Measurements: Pain intensity was evaluated using a numerical rating scale. Pain improvement was evaluated against personal goals. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20), and anxiety and depression using the Hospital Anxiety and Depression Scale. Setting/Subjects: Of 320 family caregivers visiting the palliative care department, 152 (47.5%) had chronic musculoskeletal pain; all 152 were included in the study. Results: Alexithymia was observed in 36.2% of participants. Participants with higher scores on the TAS-20 tended to have higher pain intensity scores and personal pain goal scores. TAS-20 score had the strongest correlation with personal pain goals, with a correlation coefficient of 0.555 (p < 0.001). Conclusions: Pain intensity in family caregivers with alexithymia tended to be high. These participants set higher personal pain goals (lower goals for symptom improvement) than those without alexithymia. We found no difference in personal pain goal response between family caregivers with and without alexithymia. When we examine pain in family members with alexithymia who are caring for cancer patients, we need to recognize that they may set higher personal pain goals and seek less help.
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Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Hiroko Sakuma
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
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ABE N, ABE K, NAKASHIMA K. THE ROLE OF PERCEIVED STRESS AND FEAR OF NEGATIVE EVALUATION IN THE PROCESS FROM ALEXITHYMIA TO OVER-ADAPTATION. PSYCHOLOGIA 2020. [DOI: 10.2117/psysoc.2020-a001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Natsuki ABE
- Hiroshima University
- Japan Society for the Promotion of Science
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Alzahrani SH, Coumaravelou S, Mahmoud I, Beshawri J, Algethami M. Prevalence of alexithymia and associated factors among medical students at King Abdulaziz University: a cross-sectional study. Ann Saudi Med 2020; 40:55-62. [PMID: 32026718 PMCID: PMC7012024 DOI: 10.5144/0256-4947.2020.55] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Medical students are at higher risk of developing alexithymia due to the nature of their studies. OBJECTIVES Determine the prevalence of alexithymia and potential risk factors among medical students in Saudi Arabia. DESIGN A cross-sectional analytic study. SETTINGS University medical school. PATIENTS AND METHODS An institutional cross-sectional survey of medical students was conducted using the Toronto Alexithymia Scale (TAS-20) to assess the prevalence of alexithymia and potentially associated factors (gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity). MAIN OUTCOME MEASURES Gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity. SAMPLE SIZE 347. RESULTS The prevalence of alexithymia among medical students was 49% (95% confidence interval [43.8-54.2]). A binary logistic regression model showed significant associations between alexithymia and academic year of study (lower risk of alexithymia in the clerkship (5th, 6th years); odds ratio [OR]: 0.43, 95% CI: 0.26-0.72), smoking (OR: 3.52, 95% CI: 1.60-3.34), grade point average (lowest; OR: 10.44, 95% CI: 4.24-25.77), history of childhood abuse (OR: 2, 95% CI: 1.20-8.77), and history of psychiatric illness (OR: 14.40, 95% CI: 4.76-21.06). CONCLUSION Almost half of the medical students suffer from alexithymia. Increasing the awareness about alexithymia among students and directing them where to seek help would facilitate the management of these problems. LIMITATIONS Limited only to medical students from the second year to the sixth year in a single medical college, which affects generalizability. The cross-sectional design might have also limited generalizability. CONFLICT OF INTEREST None.
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Affiliation(s)
- Sami Hamdan Alzahrani
- From the Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saravanan Coumaravelou
- From the Family and Community Medicine and Behavioral Sciences Department, University of Sharjah College of Medicine, Sharjah, United Arab Emirates
| | - Ibrahim Mahmoud
- From the Family and Community Medicine and Behavioral Sciences Department, University of Sharjah College of Medicine, Sharjah, United Arab Emirates
| | - Jameel Beshawri
- From the Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Algethami
- From the Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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UMEMURA K. THE RELATIONSHIP OF ALEXITHYMIA TO THE HOUSE-DRAWING-TEST AND THE ROOM-DRAWING-TEST. PSYCHOLOGIA 2020. [DOI: 10.2117/psysoc.2020-b011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Takakura S, Aso CS, Toda K, Hata T, Yamashita M, Sudo N. Physical and psychological aspects of anorexia nervosa based on duration of illness: a cross-sectional study. Biopsychosoc Med 2019; 13:32. [PMID: 31889996 PMCID: PMC6929428 DOI: 10.1186/s13030-019-0173-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background We evaluated physical and psychological features of patients with anorexia nervosa (AN) who differed by duration of illness. Methods Data were obtained from 204 female patients with AN, divided into two groups based on illness duration: short-term illness duration (less than 5 years; n = 118); and long-term duration (5 years or more; n = 86). Physical parameters were measured using blood serum testing and psychological aspects were assessed using various instruments. Results A significantly higher proportion of restricting type AN was observed in the short-term group while the proportion of binge eating/purging type AN was higher in the long-term group. There was no difference in body mass index (BMI) between the groups. Serum total protein, albumin, potassium, chloride, and calcium in the long-term group were significantly lower than in the short-term group. Overall scores on the Eating Disorder Inventory as well as most of the subscales, except maturity fears, were higher in the long-term group than in the short-term group. The care subscale of the Parental Bonding Instrument (PBI) was lower in the long-term group than in the short-term group, while the overprotection subscale of the PBI was higher in the long-term group than in the short-term group. Results of a multiple regression analysis indicated that the overprotection subscale of the PBI was the only significant predictor of duration of illness. Conclusions Duration of illness may be associated with physical and psychological features of AN; thus, adapting therapeutic approaches to illness duration might be necessary.
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Affiliation(s)
- Shu Takakura
- 1Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, higashi-ku, Fukuoka, 812-8582 Japan
| | - Chie Suzuyama Aso
- 2Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Kenta Toda
- 1Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, higashi-ku, Fukuoka, 812-8582 Japan
| | - Tomokazu Hata
- 1Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, higashi-ku, Fukuoka, 812-8582 Japan
| | - Makoto Yamashita
- 1Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, higashi-ku, Fukuoka, 812-8582 Japan
| | - Nobuyuki Sudo
- 1Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, higashi-ku, Fukuoka, 812-8582 Japan.,2Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
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Obeid S, Akel M, Haddad C, Fares K, Sacre H, Salameh P, Hallit S. Factors associated with alexithymia among the Lebanese population: results of a cross-sectional study. BMC Psychol 2019; 7:80. [PMID: 31829280 PMCID: PMC6907355 DOI: 10.1186/s40359-019-0353-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022] Open
Abstract
Background To our knowledge, no research project on alexithymia has been conducted in Lebanon. The objective of this study was to assess risk factors associated with alexithymia in a representative sample of the Lebanese population. Methods This is a cross-sectional study, conducted between November 2017 and March 2018, which enrolled 789 participants from al districts of Lebanon. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Alcohol Use Disorders Identification Test to assess alcohol use, drinking patterns, and alcohol-related issues, the Rosenberg self-esteem scale to evaluate self-worth, the Hamilton depression rating scale and Hamilton Anxiety Scale to screen for depression and anxiety respectively, the Three-Dimensional Work Fatigue Inventory to measure physical, mental and emotional work fatigue respectively, the Columbia–Suicide Severity Rating Scale to evaluate suicidal ideation and behavior, the Perceived Stress Scale to measure stress, the Liebowitz Social Anxiety Scale to help identify a social anxiety disorder and the Quick Emotional Intelligence Self-Assessment to measure emotional intelligence. Results The results showed that 395 (50.4%) were not alexithymic, 226 (28.8%) were possible alexithymic, whereas 163 (20.8%) were alexithymic according to established clinical cutoffs. Stress (Beta = 0.456), emotional exhaustion (Beta = 0.249), the AUDIT score (Beta = 0.225) and anxiety (Beta = 0.096) were associated with higher alexithymia, whereas low emotional work fatigue (Beta = −0.114) and being married (Beta = −1.933) were associated with lower alexithymia. People in distress (Beta = 7.33) was associated with higher alexithymia scores, whereas people with high wellbeing (Beta = −2.18), an intermediate (Beta = −2.90) and a high (Beta = −2.71) family monthly income were associated with lower alexithymia compared to a low one. Conclusion Alexithymia appears to be influenced by many factors, including stress, anxiety, and burnout. To reduce its prevalence, it is important that health professionals educate the public about these factors. Further studies on a larger scale are needed to confirm our findings.
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Affiliation(s)
- Sahar Obeid
- Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon. .,Faculty of Arts and Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Marwan Akel
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon
| | - Kassandra Fares
- Faculty of Arts and Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Salas Muñoz RM, López Morales P, Fernández Jiménez AJ. Valoración de los niveles de alexitimia en pacientes en hemodiálisis. ENFERMERÍA NEFROLÓGICA 2019. [DOI: 10.4321/s2254-28842019000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCCIÓN La alexitimia es una alteración del estado de ánimo que se manifiesta en forma de dificultad para tomar conciencia sobre los propios sentimientos y fantasías, así como para poder expresarlos verbalmente. Ha sido relacionada con el desarrollo de otras patologías y con la presencia de enfermedades crónicas. En el caso particular de la insuficiencia renal, se ha relacionado con una peor adherencia al tratamiento y mayor riesgo de mortalidad. Por ello, nos planteamos valorar su presencia en un grupo de pacientes en hemodiálisis en nuestro centro. MÉTODO Muestra de 63 pacientes en hemodiálisis, hombres y mujeres, con edades entre 22 y 83 años. Se recogió también el tiempo que cada uno llevaba en tratamiento en hemodiálisis. Estudio descriptivo de corte transversal con datos recogidos entre febrero y abril de 2019. Se aplicó individualmente la Escala de Alexitimia de Toronto. Se cuantificaron los valores de frecuencia para las puntuaciones obtenidas en el test y se realizaron comparaciones de medias para sexo, edad y tiempo en diálisis. RESULTADOS Encontramos que un 22,2% de la muestra (14 sujetos) muestra valores de alexitimia clínicamente relevantes. No se encontraron diferencias significativas en los puntajes de alexitimia según el sexo, edad o tiempo en diálisis. CONCLUSIONES Los hallazgos de este estudio permiten concluir que casi una cuarta parte de los pacientes en diálisis presenta alexitimia, alertando sobre la necesidad de que estas personas reciban tratamiento psicológico especializado.
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Ebara T, Yamada Y, Shoji N, Ito Y, Nakagawa A, Miyachi T, Ozaki Y, Omori T, Suzuki S, Kojima M, Ueyama J, Tomizawa M, Kato S, Oguri T, Matsuki T, Sato H, Oya N, Sugiura-Ogasawara M, Saitoh S, Kamijima M. Cohort profile: Aichi regional sub-cohort of the Japan Environment and Children's Study (JECS-A). BMJ Open 2019; 9:e028105. [PMID: 31722936 PMCID: PMC6858231 DOI: 10.1136/bmjopen-2018-028105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Effects of fetal, perinatal and childhood environment on the health of children at birth and during later life have become a topic of concern. The Aichi regional sub-cohort of the Japan Environment and Children's Study (JECS-A) is an ongoing birth cohort of pregnant women and their children which has been used to provide unique data, as adjunct studies of JECS, on multifaceted potential factors affecting children's health. PARTICIPANTS The JECS-A is part of the JECS which follows a total of 100 000 pairs of children and their mothers (fathers' participation is optional) across 15 regions in Japan. In JECS-A, of the 8134 pregnant women living in Ichinomiya City and Nagoya City, Japan, a total of 5721 pregnant women and their 5554 children were included. Sociodemographic and psychological data as well as biological specimens were collected from the pregnant women and their spouses (if available) in the cohort during their pregnancy. Information on children included in the JECS-A was collected from their mothers and includes demographic, behavioural, childcare, psychological and psychiatric data. Urine extracted from disposable diapers and anthropometric data were also obtained from the children. FINDINGS TO DATE A similar distribution trend for age at delivery was confirmed between the pregnant women enrolled in the JECS-A and the national statistics of the relevant areas. However, differences in education level and household income were observed. A total of 5502 children remained in the cohort at 18 months after delivery. Compared with the national statistics, the basic demographics of the children in the cohort represented the population in the study areas. FUTURE PLANS The enrolled children in the JECS-A will be followed until the age of 13 years. The studies that come from JECS-A will complement JECS and bring novel results with a high level of generalisability.
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Affiliation(s)
- Takeshi Ebara
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Yasuyuki Yamada
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Department of Sports Management, Juntendo University School of Health and Sports Science, Graduate School of Health and Sports Science, Inzai, Chiba, Japan
| | - Naoto Shoji
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Department of Health and Sport Sciences, School of Health Sciences, Asahi University, Mizuho, Gifu, Japan
| | - Yuki Ito
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Atsuko Nakagawa
- Faculty of Psychological Development, Nagoya City University Graduate School of Humanities and Social Sciences, Nagoya, Aichi, Japan
| | - Taishi Miyachi
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Nagoya West District Care Center for Disabled Children, Nagoya, Japan
| | - Yasuhiko Ozaki
- Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Toyonori Omori
- Health Care Policy and Management, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Masayo Kojima
- Medical Education, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Field of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine Faculty of Medicine, Nagoya, Aichi, Japan
| | - Motohiro Tomizawa
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Sayaka Kato
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Tomoko Oguri
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Taro Matsuki
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Hirotaka Sato
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Naoko Oya
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Research Fellow of Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Mayumi Sugiura-Ogasawara
- Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Shinji Saitoh
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
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Oka T, Tanahashi T, Lkhagvasuren B, Yamada Y. The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study. Biopsychosoc Med 2019; 13:28. [PMID: 31709006 PMCID: PMC6836361 DOI: 10.1186/s13030-019-0168-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/04/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice. METHODS Fifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS). RESULTS Practicing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS (P = 0.002) and HADS-depression (P = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels (P = 0.048), the high frequency component of HR variability (P = 0.042), and TAS-20 scores (P = 0.001). CONCLUSIONS Regular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN CTR) UMIN000009646. Registered Dec 27, 2012.
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Affiliation(s)
- Takakazu Oka
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
- Department of Psychosomatic Medicine, International University of Health and Welfare Hospital, Iguchi 537-3, Nasushiobara-shi, Tochigi-ken, 329-2763 Japan
| | - Tokusei Tanahashi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
| | - Battuvshin Lkhagvasuren
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
- Brain Science Institute, Mongolian National University of Medical Sciences, Zorig Street 3, Ulaanbaatar, 14210 Mongolia
| | - Yu Yamada
- Department of Psychosomatic Medicine, International University of Health and Welfare Hospital, Iguchi 537-3, Nasushiobara-shi, Tochigi-ken, 329-2763 Japan
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Khosravani V, Najafi M, Naragon-Gainey K, Mohammadzadeh A. Investigation of the factorial structure and psychometric properties of the Persian version of the Toronto Alexithymia Scale-20 in patients with psychiatric disorders. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00329-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tuliao AP, Klanecky AK, Landoy BVN, McChargue DE. Toronto Alexithymia Scale-20: Examining 18 Competing Factor Structure Solutions in a U.S. Sample and a Philippines Sample. Assessment 2019; 27:1515-1531. [PMID: 30661362 DOI: 10.1177/1073191118824030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Toronto Alexithymia Scale-20 is arguably the most utilized measure of alexithymia. Although a three-factor solution has been found by numerous studies, these findings are not universal. This article examined and compared 18 competing factor structures for the Toronto Alexithymia Scale-20, which included between one and four correlated latent factor structures, common methods models that accounts for negatively worded items, and bifactor models. Although the two-factor bifactor model with a common methods factor had the better model fit compared with the other 17 models examined, it still did not achieve the requisites of a good model fit across all model fit indices. Issues stemmed primarily from the externally oriented thinking factor and the negatively worded items. Post hoc analyses indicated that a two-factor bifactor model with the negatively worded items dropped achieved the requisites of a good model fit and can be treated as a unidimensional measure despite the presence of multidimensionality. Multiple-group analysis indicated that the factor loadings were invariant across U.S. and Philippines samples. After controlling for noninvariance at the item intercept level, the Philippines sample had a higher alexithymia general score compared with the U.S. sample.
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Skumlien M, Sederevicius D, Fjell AM, Walhovd KB, Westerhausen R. Parallel but independent reduction of emotional awareness and corpus callosum connectivity in older age. PLoS One 2018; 13:e0209915. [PMID: 30596756 PMCID: PMC6312250 DOI: 10.1371/journal.pone.0209915] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/13/2018] [Indexed: 11/19/2022] Open
Abstract
Differential functional specialization of the left and right hemispheres for linguistic and emotional functions, respectively, suggest that interhemispheric communication via the corpus callosum is critical for emotional awareness. Accordingly, it has been hypothesized that the age-related decline in callosal connectivity mediates the frequently demonstrated reduction in emotional awareness in older age. The present study tests this hypothesis in a sample of 307 healthy individuals between 20-89 years using combined structural and diffusion-tensor magnetic resonance imaging (MRI) of the corpus callosum. As assumed, inter-hemispheric connectivity (midsagittal callosal area and thickness, as well as fractional anisotropy, FA) and emotional awareness (i.e., increase in externally-oriented thinking, EOT; assessed with the Toronto Alexithymia Scale, TAS-20) were found to be reduced in older (> 60 years) compared to younger participants. Furthermore, relating callosal measures to emotional awareness, FA in the genu of the corpus callosum was found to be negatively correlated with EOT in male participants. Thus, "stronger" structural connectivity (higher FA) was related with higher emotional awareness (lower EOT). However, a formal mediation analysis did not support the notion that age-related decline in emotional awareness is mediated by the corpus callosum. Thus, the observed reduction of emotional awareness and callosal connectivity in older age likely reflects parallel but not inter-dependent processes.
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Affiliation(s)
- Martine Skumlien
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
| | - Donatas Sederevicius
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
| | - Anders M. Fjell
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Kristine B. Walhovd
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - René Westerhausen
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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Tang HS, Chen PF, Lung FW. Personality and Alexithymic Disparity in Obsessive-Compulsive Disorder Based on Washing and Checking. Psychiatr Q 2018; 89:371-381. [PMID: 29038990 DOI: 10.1007/s11126-017-9541-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate pathway relationship of personality characteristics and alexithymic traits in OCD symptoms of obsession, and compulsive behavior of washing and checking. Two-hundred and seventy patients diagnosed with OCD were consecutively recruited from the psychiatric outpatient department of a teaching hospital. Structural equation modeling showed those more neurotic, less extraverted and with higher levels of alexithymia difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally oriented thinking (EOT) were more likely to develop obsessive thoughts. Those less extraverted was more prone to develop washing compulsions, and those more neurotic were more likely to develop checking compulsions. EOT was the only alexithymic trait to have no gender difference within this group of patients with OCDs. The different personality and alexithymic trait pathways found between OCD obsession, washing and checking symptoms provide support that they may be different subtypes within the OCD diagnosis. Obsession was associated with washing, but not checking. Furthermore, no gender difference was found between the obsession and compulsive symptoms. Extraversion and neuroticism can be used to differentiate washing and checking, and alexithymia to differentiate washing and obsessions. This should be taken into consideration for intervention targeting patients with different OCD symptoms.
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Affiliation(s)
- Hwa-Sheng Tang
- Songde Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Po-Fei Chen
- Calo Psychiatric Center, No.12-200, Jinhua Rd., Xinpi Township, Pingtung County, 925, Taiwan
| | - For-Wey Lung
- Calo Psychiatric Center, No.12-200, Jinhua Rd., Xinpi Township, Pingtung County, 925, Taiwan. .,Graduate Institute of Medical Sciences, National Defense Medical University, Taipei, Taiwan.
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Factorial Validity of the Toronto Alexithymia Scale (TAS-20) in Clinical Samples: A Critical Examination of the Literature and a Psychometric Study in Anorexia Nervosa. J Clin Psychol Med Settings 2018; 26:33-46. [DOI: 10.1007/s10880-018-9562-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Hasuo H, Kanbara K, Abe T, Fukunaga M, Yunoki N. Relationship between Alexithymia and latent trigger points in the upper Trapezius. Biopsychosoc Med 2017; 11:31. [PMID: 29238400 PMCID: PMC5725834 DOI: 10.1186/s13030-017-0116-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/24/2017] [Indexed: 12/27/2022] Open
Abstract
Background Latent trigger points (LTrPs) can be activated by future events, leading to pain. Few studies have reported LTrP risk factors. It has been suggested that alexithymia is associated with myofascial pain and diminished awareness of physical sensation. This study was designed to evaluate the relation between alexithymia and LTrPs found the upper trapezius of healthy individuals. Methods The correlation between LTrPs and alexithymia, and between LTrPs and depression was analyzed in 160 healthy participants (80 male, mean age: 40.5 years [20 to 66 years]). Each participant was evaluated for potential LTrPs by careful manual examination and completed the Toronto Alexithymia Scale-20 (TAS-20) and the Beck Depression Inventory (BDI) to assess potential alexithymia and depressive symptoms, respectively. Results LTrPs were observed in the upper trapezius of 76 participants (47.5%). TAS-20 scores were significantly higher in subjects with LTrPs than without LTrPs (p < 0.001); in contrast, there was no significant BDI score difference between these groups (p = 0.451). The LTrP risk for alexithymia was 2.74 (95% confidence interval [95% CI]: 2.10–3.58). There was no correlation between the TAS-20 and BDI scores (correlation coefficient: −0.04). Significant risk factors associated with LTrPs included the TAS-20 score (odds ratio [OR]: 1.11, 95% CI: 1.07–1.15) and age (OR: 1.05, 95% CI: 1.01–1.09). Conclusions Alexithymia was associated with LTrPs in the upper trapezius of healthy individuals, suggesting that it may serve as a useful predictive factor. Trial registration UMIN000027468. Registered 23 May 2017(retrospectively registered).
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Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090 Japan
| | - Kenji Kanbara
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090 Japan
| | - Tetsuya Abe
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090 Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090 Japan
| | - Naoko Yunoki
- Department of Internal Medicine, Akaiwa Medical Association Hospital, Okayama, Japan
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Do Emotional Components of Alexithymia Mediate the Interplay between Cyberbullying Victimization and Perpetration? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121530. [PMID: 29292720 PMCID: PMC5750948 DOI: 10.3390/ijerph14121530] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 11/17/2022]
Abstract
A substantial amount of research has revealed that cyberbully-victims have more emotional and behavioral problems than either cyberbullying victims or perpetrators. However, until now, little research has been conducted into the factors that contribute to the interplay between cyberbullying victimization and perpetration. The purpose of this study was to examine the relationship between cyberbullying victimization, perpetration, and two emotional components of alexithymia, namely difficulties in identifying and describing one’s own feelings. Self-report questions were administered to 1549 adolescents between 12 and 18 years old (M = 14.51; SD = 1.68; 42.1% (n = 652) male) from Germany and Thailand. Results showed that cyberbullying victimization and alexithymia are associated with cyberbullying perpetration. Moreover, alexithymia mediated the associations between cyberbullying victimization and adolescents’ cyberbullying perpetration. Consequently, we suggest that the ability to describe and identify one’s own feelings might be important for understanding the link between cyberbullying, victimization, and perpetration. The results may help develop prevention and intervention programs focused on reducing cyberbullying.
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Li X, Lu J, Li B, Li H, Jin L, Qiu J. The role of ventromedial prefrontal cortex volume in the association of expressive suppression and externally oriented thinking. J Affect Disord 2017; 222:112-119. [PMID: 28688264 DOI: 10.1016/j.jad.2017.06.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 06/04/2017] [Accepted: 06/26/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Studies have suggested that expressive suppression (ES) is linked to externally oriented thinking (EOT) through the ventromedial prefrontal cortex (vmPFC), and there are gender differences in their association. The present structural magnetic resonance imaging study was to investigate the neural bases of ES and EOT and their association in females versus males in a Chinese college sample. METHODS A total of 142 participants (83 females) were enrolled, and they completed the ES subscale of the Emotion Regulation Questionnaire, 20-item Toronto Alexithymia Scale, and anatomical scanning. Voxel-based morphometry, region of interest, and whole brain analyses with peak-level significance (family-wise error corrected at p < .05) were conducted to investigate the association of gray matter volume (GMV) variations with ES and EOT. A bootstrapping analysis was conducted to examine the role of vmPFC volume in the ES-EOT association. RESULTS The ES scores were positively linked to the GMV of the vmPFC in females and negatively related to right dorsolateral PFC volume in males. The EOT scores were positively correlated with the GMV of the vmPFC in females and supplementary motor area in males. Furthermore, vmPFC volume mediated the relationship between ES and EOT LIMITATIONS: The cross-sectional design limited causal conclusions. CONCLUSIONS The vmPFC may be the only neural base of ES and EOT and their association. In addition, these results were sex-specific.
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Affiliation(s)
- Xu Li
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Jiamei Lu
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China.
| | - Bingbing Li
- School of Psychology, Southwest University, Chongqing 400715,China; Center for Mental Health Education, Southwest University, Chongqing 400715,China
| | - Haijiang Li
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Li Jin
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing 400715,China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
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Brown S, Fite PJ, Stone K, Richey A, Bortolato M. Associations between emotional abuse and neglect and dimensions of alexithymia: The moderating role of sex. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2017; 10:300-308. [PMID: 28414491 DOI: 10.1037/tra0000279] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Child maltreatment, specifically emotional maltreatment (i.e., an act, such as belittling, blaming, or rejection, that is potentially harmful to a child's emotional development), has emerged as an important correlate of alexithymia. However, the evidence is mixed with regard to how emotional abuse and neglect might relate to dimensions of alexithymia (i.e., externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings). Furthermore, research is needed to identify individual factors that might influence these associations. The current study examined the links between emotional abuse and neglect and externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings and evaluated whether sex moderated these associations. METHOD Participants included 500 emerging adults (49.6% male) who completed an online battery of questionnaires assessing history of child maltreatment and dimensions of alexithymia. RESULTS Regression analyses revealed that emotional abuse was associated with difficulty describing feelings and externally oriented thinking, but not difficulty identifying feelings. Emotional neglect was associated with difficulty identifying feelings, but not difficulty describing feelings or externally oriented thinking. There were no sex differences associated with difficulty describing feelings or externally oriented thinking. However, sex moderated the associations between emotional abuse and neglect and difficulty identifying feelings such that emotional abuse and neglect were both more strongly associated with difficulty identifying feelings for females. CONCLUSION These results suggest that, in the aftermath of emotional maltreatment, sex may play an important role in the development of difficulty identifying feelings. (PsycINFO Database Record
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Affiliation(s)
| | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
| | - Katie Stone
- Clinical Child Psychology Program, University of Kansas
| | - Allora Richey
- Clinical Child Psychology Program, University of Kansas
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, University of Utah
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Taycan O, Özdemir A, Erdoğan Taycan S. Alexithymia and Somatization in Depressed Patients: The Role of the Type of Somatic Symptom Attribution. Noro Psikiyatr Ars 2017; 54:99-104. [PMID: 28680305 DOI: 10.5152/npa.2016.12385] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/11/2015] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION This study aimed to establish the association between alexithymia and various factors, mainly somatization, and to determine the predictors of alexithymia in depressed patients. METHODS A total of 90 patients with major depressive disorder who met The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Symptom Checklist-90 (SCL-90), Somatosensory Amplification Scale, and Symptom Interpretation Questionnaire. The patients were classified into two groups as alexithymic and non-alexithymic with respect to the TAS cut-off points (≥59=alexithymic). Predictors of alexithymia were tested by multiple linear regression analysis. RESULTS Of all patients, 36 (40%) were in the alexithymic group. The percentage of women, depression severity, level of general psychopathology and distress, and somatic symptom reporting (SCL-90), as well as the tendency to somatosensory amplification and three forms of somatic symptom attributions, were significantly higher in alexithymic patients than in non-alexithymic patients. Furthermore, age, depression severity, somatic symptom reporting, and the tendency to attribute physical symptoms to somatic causes were predictors of alexithymia. CONCLUSION The results indicated an intimate association between alexithymia and somatization in depressed patients. Therefore, when evaluating depressed patients with alexithymia, their tendency for somatization should be considered, and alexithymic individuals should be assessed with particular attention, considering that somatization can mask the underlying depressive condition.
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Affiliation(s)
- Okan Taycan
- Clinic of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Armağan Özdemir
- Clinic of Psychiatry, Bakırköy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
| | - Serap Erdoğan Taycan
- Clinic of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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Alexithymia affects the time from symptom onset to calling the emergency system in STEMI patients referred for primary PCI. Int J Cardiol 2016; 219:428-32. [DOI: 10.1016/j.ijcard.2016.06.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/12/2016] [Indexed: 11/23/2022]
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The association between depression and craving in alcohol dependency is moderated by gender and by alexithymia factors. Psychiatry Res 2016; 239:28-38. [PMID: 27137959 DOI: 10.1016/j.psychres.2016.02.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 02/04/2016] [Accepted: 02/27/2016] [Indexed: 01/17/2023]
Abstract
Alexithymia is a multifaceted personality trait that involves difficulties in identifying and describing feelings to others, a poor fantasy life and an externally oriented cognitive style. Alexithymia has been described as a vulnerability factor for mental and physical diseases. We investigated in a group of 158 alcohol-dependent patients (103 men, 55 women) the association between depression and craving for alcohol when these patients were starting a detoxification program, and the moderating impact of gender and alexithymia on this relation. We first found an interaction between depression and gender in the prediction of craving in the sense that only for women an increase in depressive mood was related to an increase in total craving. When examining gender separately, we found that alexithymia factors acted as moderators. For women, the link between depression and craving was strengthened for the ones scoring higher on "difficulties describing feelings". But for men, the link between depression and craving was reduced for the ones scoring higher on "externally-oriented thinking". These findings suggest that in some cases that need to be identified more systematically in the future, the "externally-oriented thinking" alexithymia factor can exert - at least in the short term - some protective effects.
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Koh MJ, Kang JI, Namkoong K, Lee SY, Kim SJ. Association between the Catechol-O-Methyltransferase (COMT) Val¹⁵⁸Met Polymorphism and Alexithymia in Patients with Obsessive-Compulsive Disorder. Yonsei Med J 2016; 57:721-7. [PMID: 26996573 PMCID: PMC4800363 DOI: 10.3349/ymj.2016.57.3.721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Alexithymia, defined as a deficit in the ability to recognize and describe one's own feelings, may be related to the development and maintenance of obsessive-compulsive symptoms. The aim of this study was to evaluate the association between the catechol-O-methyltransferase (COMT) Val¹⁵⁸Met polymorphism and alexithymia in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS We recruited 244 patients with OCD (169 males, 75 females). Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20), and genotyping of the COMT Val¹⁵⁸Met polymorphism was evaluated. RESULTS Patients with the COMT Val/Val genotype had significantly higher total and "difficulty identifying feelings" (DIF) subdimension scores than those with the Val/Met or Met/Met genotypes. Patients with the COMT Val/Val genotype had significantly higher "difficulty describing feelings" (DDF) subdimension scores than those with the COMT Val/Met genotype. However, there were no differences in the scores for the "externally oriented thinking" (EOT) subdimension among the three genotypes. CONCLUSION These results indicate that the high-activity Val allele of the COMT Val¹⁵⁸Met polymorphism is associated with increased alexithymic traits in patients with OCD. The present finding suggests that alexithymia is an endophenotype of OCD that is mediated by the COMT Val¹⁵⁸Met polymorphism.
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Affiliation(s)
- Min Jung Koh
- Department of Psychiatry, Bundang Jesaeng Hospital, Seongnam, Korea
- Department of Psychiatry, Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee In Kang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Su Young Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Se Joo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
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Sawamoto R, Nozaki T, Furukawa T, Tanahashi T, Morita C, Hata T, Komaki G, Sudo N. Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss. Obes Facts 2016; 9:29-38. [PMID: 26745715 PMCID: PMC5644900 DOI: 10.1159/000442761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/24/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. METHODS 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. RESULTS 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. CONCLUSION Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women.
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Affiliation(s)
- Ryoko Sawamoto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- *Dr. Ryoko Sawamoto, Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan,
| | - Takehiro Nozaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomokazu Furukawa
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tokusei Tanahashi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Chihiro Morita
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Gen Komaki
- School of Health Sciences Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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50
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Colic L, Demenescu LR, Li M, Kaufmann J, Krause AL, Metzger C, Walter M. Metabolic mapping reveals sex-dependent involvement of default mode and salience network in alexithymia. Soc Cogn Affect Neurosci 2015; 11:289-98. [PMID: 26341904 DOI: 10.1093/scan/nsv110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/31/2015] [Indexed: 11/14/2022] Open
Abstract
Alexithymia, a personality construct marked by difficulties in processing one's emotions, has been linked to the altered activity in the anterior cingulate cortex (ACC). Although longitudinal studies reported sex differences in alexithymia, what mediates them is not known. To investigate sex-specific associations of alexithymia and neuronal markers, we mapped metabolites in four brain regions involved differentially in emotion processing using a point-resolved spectroscopy MRS sequence in 3 Tesla. Both sexes showed negative correlations between alexithymia and N-acetylaspartate (NAA) in pregenual ACC (pgACC). Women showed a robust negative correlation of the joint measure of glutamate and glutamine (Glx) to NAA in posterior cingulate cortex (PCC), whereas men showed a weak positive association of Glx to NAA in dorsal ACC (dACC). Our results suggest that lowered neuronal integrity in pgACC, a region of the default mode network (DMN), might primarily account for the general difficulties in emotional processing in alexithymia. Association of alexithymia in women extends to another region in the DMN-PCC, while in men a region in the salience network (SN) was involved. These observations could be representative of sex specific regulation strategies that include diminished internal evaluation of feelings in women and cognitive emotion suppression in men.
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Affiliation(s)
- L Colic
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - L R Demenescu
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Department of Neurology, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - M Li
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Department of Neurology, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - J Kaufmann
- Department of Neurology, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - A L Krause
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - C Metzger
- Leibniz Institute for Neurobiology, Magdeburg, Germany Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany Institute for Cognitive Neurology and Dementia Research (IKND), Magdeburg, Germany
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany Leibniz Institute for Neurobiology, Magdeburg, Germany Department of Neurology, Otto von Guericke University of Magdeburg, Magdeburg, Germany Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany Center for Behavioral Brain Sciences, Magdeburg, Germany
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