Mediation role of alexithymia, sensory processing sensitivity and emotional-mental processes between childhood trauma and adult psychopathology: a self-report study

The Bridge Between Childhood Trauma and Alexithymia Among Adolescents with Depressive and Bipolar Disorders: A Network Bridge Analysis

Childhood trauma and alexithymia are significant risk factors for adolescent mental health issues. Prior research has linked these factors to psychopathology, but the complexities of their interrelation remain underexplored. This study aims to elucidate the relationship between various forms of childhood trauma and alexithymia in adolescents with depressive and bipolar disorders. Structural Equation Modeling (SEM) and network analysis were utilized on data from 2343 Chinese adolescents (aged 12-18 years, 77.93% female) diagnosed with depression or bipolar disorder. Measures included the Childhood Trauma Questionnaire (CTQ) and the Toronto Alexithymia Scale (TAS-20). SEM demonstrated a significant correlation between childhood trauma and alexithymia. Network analysis identified emotional abuse and difficulty identifying feelings as central nodes. Emotional abuse emerged as a key factor for difficulty in emotional identification among adolescents. This study highlights the need for early intervention and the importance of emotional nurturing in childhood to prevent long-term socioemotional difficulties.

Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis

Introduction

Victims of child abuse have an elevated risk of developing mental health issues later in life. Several variables have been suggested as mediators of this correlation, but little is known about the possible influence of alexithymia. Alexithymia is a sub-clinical personality trait that manifests as difficulties recognizing and verbalizing emotions.

Methods

In this study, two separate meta-analyses were conducted using questionnaire data, and Pearson correlations for overall effects were estimated.

Results

The correlation between child abuse and alexithymia showed to be significant (r = .26), as did the correlation between alexithymia and general psychopathology (r = .44). Further analyses revealed no indication for possible publication bias. When investigating differences between various subtypes of child maltreatment, each subtype significantly correlated with alexithymia. Emotional abuse, emotional neglect, and physical neglect had stronger correlations than physical and sexual abuse.

Discussion

These results suggest that alexithymia plays a mediating role, at least in part, in the relationship between experiences of child abuse and general psychopathology in adulthood. Therefore, alexithymia may be relevant to further research and deserves attention in the prevention of and therapy for mental health issues in victims of child abuse.

Cross-cultural adaptation and validation of the Spanish sensory processing sensitivity questionnaire (S-SPSQ)

Sensory Processing Sensitivity (SPS) is a temperament trait rooted in biology, and is distinguished by heightened awareness, emotional responsiveness, and sensitivity to environmental stimuli. In this study, we aimed to enable the assessment of SPS within Spanish-speaking populations. To achieve this, we translated, adapted, and validated the Sensory Processing Sensitivity Questionnaire (SPSQ), which offers a comprehensive evaluation of SPS, encompassing both positive and negative aspects of the trait. Participants were 1,004 (844 females, mean age 37) mainly from Chile (964), and 40 were from other Spanish-speaking regions. Confirmatory factor analysis, utilizing the diagonally weighted least squares method, was applied to validate the internal structure of the Spanish version of the SPSQ (S-SPSQ). Fit indices such as GFI, CFI, TLI, RMSEA, and SRMR were scrutinized. Reliability assessment utilized Cronbach's alpha and McDonald's Omega. Three models were examined: Model I (six factors) displayed robustness, Model II (six factors plus a general factor) did not show substantive improvement, and Model III (Higher Order and Bifactor) excelled in fit while balancing complexity and representation, thus validating the findings of the original SPSQ and indicating similar reliability coefficients. The study offers a balanced perspective on SPS and contributes to cross-cultural validation of an SPS instrument which may facilitate research and guide personalized therapeutic interventions, thus enhancing outcomes for highly sensitive persons.

Genetics of environmental sensitivity and its association with variations in emotional problems, autistic traits, and wellbeing

Greater environmental sensitivity has been associated with increased risk of mental health problems, especially in response to stressors, and lower levels of subjective wellbeing. Conversely, sensitivity also correlates with lower risk of emotional problems in the absence of adversity, and in response to positive environmental influences. Additionally, sensitivity has been found to correlate positively with autistic traits. Individual differences in environmental sensitivity are partly heritable, but it is unknown to what extent the aetiological factors underlying sensitivity overlap with those on emotional problems (anxiety and depressive symptoms), autistic traits and wellbeing. The current study used multivariate twin models and data on sensitivity, emotional problems, autistic traits, and several indices of psychological and subjective wellbeing, from over 2800 adolescent twins in England and Wales. We found that greater overall sensitivity correlated with greater emotional problems, autistic traits, and lower subjective wellbeing. A similar pattern of correlations was found for the Excitation and Sensory factors of sensitivity, but, in contrast, the Aesthetic factor was positively correlated with psychological wellbeing, though not with emotional problems nor autistic traits. The observed correlations were largely due to overlapping genetic influences. Importantly, genetic influences underlying sensitivity explained between 2 and 12% of the variations in emotional problems, autistic traits, and subjective wellbeing, independent of trait-specific or overlapping genetic influences. These findings encourage incorporating the genetics of environmental sensitivity in future genomic studies aiming to delineate the heterogeneity in emotional problems, autistic traits, and wellbeing.

Traits linked to sensory processing sensitivity mediate the relationship between externally oriented thinking and fantasizing

Introduction

Alexithymia is characterized by difficulties identifying and describing feelings but expression of externally oriented thinking (EOT) and difficulty fantasizing is more variable. In two studies, we investigated whether links between EOT and fantasizing are mediated by sensory processing sensitivity (SPS).

Methods

University students completed measures of alexithymia, SPS, and fantasizing.

Results

In Study 1 (N = 700) we identified two clusters of SPS traits: a positive facet (sensitivity to subtle stimuli) and a negative facet (sensitivity to uncomfortable stimuli). In the 499 participants who completed the fantasy measure, low EOT scores predicted stronger SPS positive and negative traits, which predicted a stronger tendency to mentally project oneself into the lives of characters in books, movies, and plays. In Study 2 (N = 600), the link between EOT and this same fantasizing tendency was again mediated by features of SPS-in this case fantasy proneness and emotional reactivity.

Discussion

We suggest that, whereas individuals who score high on EOT have an impoverished fantasy life, those who score relatively low on EOT and turn their attention inward are able to maintain stronger representations of imagined events in working memory (enhancing the likelihood that they will be recalled) and react more strongly to these events (enhancing their salience). Stronger expression of these features of SPS, in turn, increases the likelihood that one will develop a cognitive style that involves the application of imagery-based strategies to support deep processing of the thoughts and feelings of characters depicted in narratives.

Isolating unique variance in mental health outcomes attributable to personality variables and childhood emotional abuse

Introduction

University students are at high risk for anxiety and depression. Our main objective was to tease apart variance in symptom severity that was uniquely attributable to four associated variables that are frequently confounded: exposure to childhood emotional abuse, alexithymia, sensory processing sensitivity (SPS), and anxiety sensitivity (AS).

Methods

University students (N = 410) completed an online survey designed to measure our four key study variables along with several other potentially relevant variables including sex, physical activity levels, and perceived COVID-19 impacts.

Results

Over half of the participants reported moderate to extremely severe symptoms of anxiety and depression. Females reported stronger signs of SPS and AS and were more likely than males to have increased their moderate/vigorous exercise since the pandemic began. After controlling for the other variables, the best predictors of perceived COVID-19 impacts were SPS, childhood emotional abuse, and current levels of physical activity. Whereas all three personality variables and childhood emotional abuse emerged as significant predictors of both depression and anxiety, neither COVID-19 impacts nor physical activity levels accounted for unique variance in either model. Unexpectedly, male sex emerged as an additional risk factor for depression, raising the possibility that males experience unique stressors and societal pressures that increase their risk of depression.

Discussion

These findings help to clarify the links between childhood emotional abuse, personality traits implicated in emotional awareness and self-regulation, and mental health. They may have important implications for the development and implementation of individualized treatments for common mental disorders.

Childhood Trauma, Emotional Awareness, and Neural Correlates of Long-Term Nicotine Smoking

Importance

Temporal dynamic measures provide insight into the neurobiological properties of nicotine use. It is critical to determine whether brain-based measures are associated with substance use risk factors, such as childhood trauma-related emotion dysregulation.

Objective

To assess temporal dynamic differences based on smoking status and examine the associations between childhood trauma, alexithymia, nicotine smoking, and default mode network (DMN) states.

Design, Setting, and Participants

This cross-sectional study was conducted in the Baltimore, Maryland, area at the National Institute on Drug Abuse. Participants included individuals aged 18 to 65 years who smoked nicotine long term and matched controls with no co-occurring substance use or psychiatric disorders. Participants were enrolled from August 8, 2013, to August 9, 2022. Analysis was conducted from August 2022 to July 2023.

Exposure

Long-term nicotine smoking.

Main Outcomes and Measures

The main outcome was temporal dynamic differences based on smoking status. Coactivation pattern analysis was conducted based on 16-minute resting-state functional magnetic resonance imaging; total time in, persistence of, and frequency of transitions into states were evaluated. The associations between childhood trauma (Childhood Trauma Questionnaire), alexithymia (20-item Toronto Alexithymia Scale), and DMN temporal dynamics were assessed.

Results

The sample included 204 participants (102 individuals who smoked nicotine and 102 control individuals) with a mean (SD) age of 37.53 (10.64) years (109 [53.4%] male). Compared with controls, individuals who smoked nicotine spent more time in the frontoinsular DMN (FI-DMN) state (mean difference, 25.63 seconds; 95% CI, 8.05-43.20 seconds; η2p = 0.04; P = .004 after Bonferroni correction). In those who smoked nicotine, greater alexithymia was associated with less time spent in the FI-DMN state (r, -0.26; 95% CI, -0.44 to -0.07; P = .007). In a moderated mediation analysis, alexithymia mediated the association between childhood trauma and time spent in the FI-DMN state only in individuals who smoked nicotine (c' = -0.24; 95% CI, -0.58 to -0.03; P = .02).

Conclusions and Relevance

Compared with controls, individuals who smoked nicotine spent more time in the FI-DMN state. Among those who smoked nicotine, childhood trauma-related alexithymia was associated with less time spent in the FI-DMN state, indicating that considering trauma-related factors may reveal alternative neurobiological underpinnings of substance use. These data may aid in reconciling contradictory findings in prior literature regarding the role of FI-DMN regions in substance use.

Exploring specific associations of childhood maltreatment with social cognition in drug-naive first-episode major depressive disorder: a sex-centric approach

Childhood maltreatment (CM) has been linked to social cognition deficits in major depressive disorder (MDD), but little is known about sex-specific effects. This study aimed to investigate the sex-specific associations of CM with social cognition in first-episode drug-naive patients with MDD. A total of 117 first-episode drug-naive patients with MDD and 134 healthy controls (HCs) were recruited and assessed for demographic and clinical characteristics. All participants completed the Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS-20), Interpersonal Reactivity Index-C (IRI), and Facial Emotion Recognition Test. Partial correlation analysis was used to explore the sex-specific association of CM with social cognition. Our findings revealed significant differences in the associations of CM with social cognition between males and females in MDD patients. In comparison to HCs, the associations of CM with social cognition displayed distinct and even contrasting sex-specific patterns in MDD patients. Specifically, male MDD patients exhibited unique imbalanced associations between emotional neglect and alexithymia, while both female and male MDD patients shared imbalanced associations of childhood abuse with empathy. These results emphasize the importance of considering the sex-specific associations of CM with social cognition in MDD and highlight the need for personalized interventions and treatments based on sex for MDD patients with a history of CM.

Hypnotic analgesia in chronic pain: role of psychopathology and alexithymia

Although the belief that hypnotizability is a mental dysfunction has been refuted over time, there is still research today that seeks to explore and clarify this preconception. The results of recent research indicate that, on the contrary, greater psychopathology is more frequent in subjects with low hypnotic susceptibility. Using the Stanford Hypnotic Susceptibility Scale type A (SHSS-A) for hypnotizability, Symptom Checklist-Revised (SCL-90-R) for psychopathology, and the Somatosensory Amplification Scale (SSAS) and Toronto Alexithymia Scale (TAS-20) for psychosomatic dimensions, we found no relationship between baseline psychopathology, alexithymia and hypnotizability in 69 subjects with chronic pain in this retrospective observational study. Psychopathology did not affect the 2-month outcomes of hypnotic suggestions for pain in terms of either pain (assess using Italian Pain Questionnaire), anxiety or depression (assessed through Hospital Anxiety and Depression Scale) scores. Furthermore, i) no relationships were found between hypnotizability and degree of either psychopathology or alexithymia, definitively eliminating any doubts about the belief that hypnosis is a mental dysfunction; ii) only single hypnotic phenomena (SHSS-A) could be linked to some psychopathological dimensions; iii) analgesia suggestions also acted on anxiety and depression; and iv) the use of hypnotic suggestions for analgesia revealed a close relationship between improvements in sensorial and evaluative dimensions of pain and mitigation of anxiety. Hypnosis thereby seems to be a powerful tool in psychosomatic medicine whose effects on mind and body are inextricably linked.

Alexithymia and sensory processing sensitivity account for unique variance in the prediction of emotional contagion and empathy

Introduction

Empathy-the ability to identify and share another person's emotional state-is an important socio-emotional process arising, in part, from emotional contagion. In the current study, we assessed unique variance in emotional contagion and other empathy-related constructs accounted for by two personality traits, alexithymia and sensory processing sensitivity (SPS), when controlling for childhood emotional abuse and current depressed mood.

Methods

A sample of 305 adults (M _age = 20.1 years) watched brief film clips chosen to induce various emotional states. After each film, the participants rated how strongly they experienced each of nine different emotions. They then completed self-report measures of alexithymia, SPS, empathy-related constructs, childhood emotional abuse, and current mood.

Results

Those scoring high (vs. low) on SPS reported stronger primary emotions and a larger range of emotions when watching the films and were more apt to believe that their emotions matched those of the individuals featured in the films. They also scored higher on both self-oriented processes (such as the tendency to feel personal distress in tense situations) and other-oriented processes (such as perspective taking and empathic concern) related to empathy. Individuals scoring high (vs. low) on alexithymia reported feeling a larger range of emotions while watching the films but scored lower on other-oriented processes related to empathy. After controlling for SPS and alexithymia, current depressed mood predicted experiencing less varied reactions to mixed valence films that elicited strong feelings of embarrassment/humiliation, and less amusement when watching positive films. Childhood emotional abuse did not emerge as a predictor of emotional contagion or empathy.

Discussion

We propose that the strong and nuanced feelings elicited in those scoring high on SPS by observing others support their personal view that they are highly empathic. In contrast, by failing to closely examine their own mixed reactions to others, individuals with alexithymia may find it difficult to connect with, understand, and respond to others' feelings.

Internet Addiction among Young Adult University Students during the COVID-19 Pandemic: The Role of Peritraumatic Distress, Attachment, and Alexithymia

The literature focused on the effect of the COVID-19 pandemic on young adult university students' mental health shows a significant increase in psychopathological symptoms and Internet Addiction (IA). The key role played by attachment and alexithymia has also been suggested, but no study has explored the possible dynamic relationship between these variables. We recruited a sample of n = 410 young adult university students online. We assessed the attachment to parents and peers (through IPPA), alexithymia (through TAS-20), peritraumatic distress symptoms due to COVID-19 (through CPDI), and IA (through IAT). The results showed that the relationship between the attachment to mothers and IA was partially mediated by alexithymia and by the serial mediation of alexithymia and peritraumatic distress, whereas the influence of the attachment to fathers on IA was fully mediated by peritraumatic distress. The direct effects of the attachment to peers on alexithymia, peritraumatic distress, and IA were all significant, as were the indirect paths via the simple mediation of both alexithymia and peritraumatic distress and the multiple serial mediation of alexithymia and peritraumatic distress. Our findings suggested that the relationship between attachment, alexithymia, and psychopathological risk is dynamic in predicting IA during the pandemic among young adult university students and that the different attachment figures exert a peculiar contribution to these processes.

Emotions and sensory processing in adolescents: The effect of childhood traumatic experiences

Reportedly, maltreated children are more likely to have a mental illness, interpersonal violence, and other social behavior problems than those without trauma experience. However, there are few studies regarding childhood trauma and sensory processing relationship and the relationship is not clear until today. To verify the association between childhood trauma emotions and sensory processing in adolescents is the aim of this study. To gather traumatized adolescents, we conducted survey questionnaires from six alternative schools and one general high school in South Korea. A total of 260 students has answered the questions: trauma/parenting/school adaptation factors, childhood trauma, the difficulty of emotion regulation, positive and negative emotional measure, shortened self-control measure, and adolescent/adult sensory profile. We analyzed linear regression between childhood trauma and other emotions/sensory processing in total subjects and conducted group comparisons between general school and alternative school. With childhood trauma, negative emotion, emotion dysregulation, sensory profile including subscales showed positive correlations. A significant negative correlation was observed between the self-control scale and childhood trauma score. In group comparison results, trauma factors, primary caregiver, custody transfer, and school life adaptation factors were significantly higher in alternative school students (p < 0.002) while the parental relationship did not show a difference. Childhood trauma score, vision, and tactile were significantly higher in alternative school students. To summarize, our results present a direct effect of childhood trauma on sensory function in adolescents and was confirmed the importance of family environments in adolescents.