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Chizhova OA, Iuzbashian PG. [Alexithymia and self-harm in people with borderline personality disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:102-108. [PMID: 38261291 DOI: 10.17116/jnevro2024124011102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To estimate the prevalence of alexithymia and self-harm in patients with borderline personality disorder (BPD). To assess the role of alexithymia in the emergence of self-harm in patients with BPD. MATERIAL AND METHODS We studied 104 patients (85 women, 19 men aged 21 to 25 years (64.4%)), including 54 patients with and 50 patients without BPD. Most of them had incomplete higher education (55%). We used the Russian version of the 20-item Toronto Alexithymia Scale (TAS-20) to reveal alexithymia and SCID-II to diagnose BPD. The presence of self-harm behavior was confirmed by the subjects' anamnesis data. RESULTS The prevalence of alexithymia in patients with BPD was 83.3%, in the control group it was 52% (p=0.001). The prevalence of self-aggression was 70.3% (n=38) in patients with BPD, and 12% (n=6) in people without BPD. Self-harm among persons with alexithymia was noted in 62.5% (n=45). During the analysis, a connection between auto-aggression and alexithymia was found at the level of a statistical trend (p=0.051). CONCLUSION Alexithymia and self-harm are more common in patients with BPD than in healthy people. This type of emotional dysregulation mediates self-harm in patients with BPD.
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Affiliation(s)
- O A Chizhova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - P G Iuzbashian
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Marazzi F, Orlandi M, De Giorgis V, Borgatti R, Mensi MM. The impact of family alexithymia on the severity of restrictive eating disorders in adolescent patients. Child Adolesc Psychiatry Ment Health 2023; 17:139. [PMID: 38115116 PMCID: PMC10731864 DOI: 10.1186/s13034-023-00692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Alexithymia is the inability to identify and describe one's own emotions. Adolescents who suffer from Restrictive Eating Disorders (REDs) show a higher prevalence of alexithymia than the general population. METHODS The study explored the correlation between levels of alexithymia in mothers, fathers, and adolescents affected by REDs and patients' ability to recognize their emotions. The study also aimed to evaluate if patients' emotional distress can significantly impact the severity of their disorder and functioning measured by the Clinical Global Impression Scale - Severity (CGI-S) and the Children's Global Assessment Scale (CGAS). We enrolled 67 families of adolescents affected by REDs. Parents and patients' levels of alexithymia were assessed through the Toronto Alexithymia Scale (TAS-20). Spearman's correlation shows a statistically significant correlation between mothers and patients' levels of alexithymia. RESULTS Our findings also suggest that fathers and mothers' TAS scores correlate with each other. However, there is no statistically significant relationship between the influence of the TAS scores of fathers and sons/daughters. CONCLUSIONS In conclusion, mothers' level of alexithymia could influence both fathers and patients' difficulty in identifying and describing their own emotions. This relationship can be investigated further when considering externally oriented thinking. However, the severity of the disease and overall functioning do not appear to be affected by patients' levels of alexithymia.
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Affiliation(s)
- Francesca Marazzi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Marika Orlandi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
| | - Valentina De Giorgis
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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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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Wang B, Kuroki T. Association between negatively perceived parenting attitudes and dissociation: a cross-sectional study on the general population in Japan. Front Psychol 2023; 14:1235447. [PMID: 37663354 PMCID: PMC10469974 DOI: 10.3389/fpsyg.2023.1235447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives Many studies have reported that early traumatic experiences, mainly abuse, are associated with forming dangerous attachments and a contributing factor to dissociation. On the other hand, other studies have investigated the association of non-abusive nurturing and attachment styles with dissociation. The aim of this study is to determine the frequency of dissociative experiences in the general Japanese population and investigate the effects of "overprotection" and "lack of care" as nurturing styles and "abandonment anxiety" and "avoidance of intimacy" as attachment styles on dissociation. Methods A total of 1,042 residents aged 18 to 69 years were administered with the Dissociative Experiences Scale (DES), the Japanese version of the WHO-5 Well-Being Index (WHO-5-J), the Parental Bonding Instrument (PBI), and the Experiences in Close Relationships Inventory-the-generalized-other-version (ECR-GO). Hierarchical multiple regression analyses on the effects of "overprotection" and "care" as nurturing attitudes "abandonment anxiety" and "avoidance of intimacy" as attachment styles on dissociation (DES-NDI and DES-T) were conducted. Results Based on the findings of this study, "care" and "overprotection" as nurturing attitudes were shown to be a contributing factor to dissociation (DES-NDI and DES-T). "Avoidance of intimacy" as an attachment style was shown to contribute to pathological dissociation. On the other hand, the influence of attachment style on the relationship between nurturing style and dissociation was not determined. Discussion This study provided essential data on the distribution of dissociative experiences in the general Japanese population. It was indicated that nurturing style, particularly overprotection, may be linked to nonfunctional stress coping and interpersonal anxiety and could be a contributing factor to mental disorders, including dissociation. Furthermore, considering that the effect of nurturing styles on dissociation does not vary with attachment styles, the effect of nurturing styles on dissociation may be more profound.
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Affiliation(s)
- Baihui Wang
- Faculty of Life Sciences, Center for Medical Education and Research, Kumamoto University, Kumamoto, Japan
| | - Toshihide Kuroki
- Department of Clinical Psychology, Kyushu University Graduate School of Human-Environment Studies, Fukuoka, Japan
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Longhurst P, Swami V. Feeling difficult to identify: Alexithymia is inversely associated with positive body image in adults from the United Kingdom. J Affect Disord 2023; 334:121-128. [PMID: 37156268 DOI: 10.1016/j.jad.2023.04.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Research has increasingly examined the ways in which internal bodily experiences influence body image, including the relationship between alexithymia - the reduced ability to identify and describe one's own emotional feelings and bodily sensations - and negative body image. However, relationships between facets of alexithymia and positive body image remain unexplored. METHODS To bridge this gap in the literature, we assessed relationships between facets of alexithymia and multiple, core indices of positive body image in an online sample of adults from the United Kingdom. A total of 395 participants (226 women, 169 men) aged 18 to 84 years completed measures of alexithymia, body appreciation, functionality appreciation, body image flexibility, body acceptance by others, and positive rational acceptance. RESULTS Once the effects of age had been accounted for, alexithymia was significantly and negatively associated with all five body image constructs in hierarchical multiple regressions. In the final models, the alexithymia facet of Difficulties Identifying Feeling emerged as a significant and negative predictor of all indices of positive body image. LIMITATIONS The use of cross-sectional data limits the causal conclusions that can be drawn. CONCLUSIONS These findings extend previous work by demonstrating the unique relationship between alexithymia and positive body image, providing important implications for body image research and practice.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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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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7
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Lee JH, Yun J, Hwang H, Kim SM, Han DH. The Study on the Identification of Musical Passages for an Emotion Perception Scale for People With Developmental Disabilities. J Korean Med Sci 2023; 38:e30. [PMID: 36747361 PMCID: PMC9902668 DOI: 10.3346/jkms.2023.38.e30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/27/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Emotion recognition is essential to the social adjustment and social interaction of people with intellectual and developmental disabilities (IDDs). Given that music is a medium for expressing and conveying human emotion, we conducted this preliminary study to identify musical passages representing the basic human emotions of happiness, sadness, and anger, with the goal of developing a music-based emotion perception scale for IDDs. METHODS To identify musical passages for emotion perception, 20 certified music therapists evaluated 100 selected musical passages and established 60 pieces that yielded the highest agreement for each emotion category. During the second phase of this study, 300 neurotypical participants rated 60 passages in terms of the perceived type and intensity of emotions expressed. RESULTS The 60 passages showed high reliability and were statistically classified into three factors: happiness, sadness, and anger. The k-means cluster analysis yielded a cut-off score of 41 for the low emotion perception group (F = 1120.63, P < 0.001). The hierarchical logistic regression analysis revealed that only model 3 (musical passages) was significantly associated with low emotion perception (step χ² = 227.8, P < 0.001). CONCLUSION The selected musical passages demonstrated high reliability and established three factors for identifying perceptions of happiness, sadness, and anger. Neither psychological status nor individual demographic characteristics affected the emotion perception results.
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Affiliation(s)
- Jin Hyung Lee
- Department of Psychiatry, Chung Ang University School of Medicine, Seoul, Korea
| | - Juri Yun
- Department of Music Therapy, Ewha Womans University, Seoul, Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung Ang University School of Medicine, Seoul, Korea
| | - Sun Mi Kim
- Department of Psychiatry, Chung Ang University School of Medicine, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University School of Medicine, Seoul, Korea.
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8
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Li R, Kajanoja J, Karlsson L, Karlsson H, Karukivi M. Sex-specific role of alexithymia in associations between parental bonding and mental health: A moderated mediation model. J Clin Psychol 2023; 79:126-142. [PMID: 35521753 PMCID: PMC10083977 DOI: 10.1002/jclp.23372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/11/2022] [Accepted: 04/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to explore the role of alexithymia and potential sex differences in the associations between perceived parental bonding and mental health. METHODS The sample consists of 2421 parents from the FinnBrain Birth Cohort Study who completed the parental bonding instrument, the Toronto alexithymia scale, the Edinburgh postnatal depression scale, and the anxiety subscale of the symptom checklist-90. Moderated mediation analyses were conducted to examine the possible mediating role of alexithymia and moderating role of sex in the associations between parental bonding and depressive/anxiety symptoms. RESULTS Alexithymia was found to be a potential mediator and sex be a moderator in the relations between perceived dysfunctional parental bonding and the psychological symptoms. Specifically, dysfunctional paternal bonding, especially paternal overprotection, had stronger indirect effects (via alexithymia) on the psychological symptoms in males. CONCLUSIONS This study indicates the importance of alexithymia in the parenting-related mental health impacts and highlights the significance of paternal bonding for the development of alexithymia and mental health problems in male populations. The findings improve the limited understanding of sex-related parental factors for alexithymia and mental health problems. Future studies in longitudinal designs are warranted to clarify the causal process of the mediation.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Jani Kajanoja
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Center for Population Health Research, Faculty of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Center for Population Health Research, Faculty of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Adolescent Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
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Kyranides MN, Christofides D, Çetin M. Difficulties in facial emotion recognition: taking psychopathic and alexithymic traits into account. BMC Psychol 2022; 10:239. [PMID: 36303236 PMCID: PMC9615175 DOI: 10.1186/s40359-022-00946-x] [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: 01/27/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alexithymic and psychopathic traits are closely associated, but distinct constructs. Both have been associated with facial emotion processing deficits reflecting empathy deficits, however the underlying mechanism contributing to these deficits is not well-understood. METHODS This study investigated facial emotion recognition performance in a non-clinical sample (N = 110) including both male and female participants, with varying levels of psychopathic and alexithymic traits. Facial emotion recognition was assessed using a computerized task, that presented different expressions depicting five emotional states (pain, fear, sadness, anger, happiness) and neutral expressions. RESULTS Results suggest that the high psychopathic traits group reported lower accuracy compared to the low psychopathic traits group, indicating a more generalized deficit in facial affect recognition, across all emotions. The alexithymic groups (high vs. low) on the other hand did not differ in their performance on the task for any of the emotions presented. CONCLUSION These findings add to the current body of research regarding face processing categorization deficits in relation to psychopathic and alexithymic traits and can inform prevention and intervention efforts that aim to facilitate facial emotion recognition in individuals with these personality traits.
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Affiliation(s)
| | - Demetris Christofides
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK.,Mind Mental Health Care, London, UK
| | - Melis Çetin
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
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Prentice F, Hobson H, Spooner R, Murphy J. Gender differences in interoceptive accuracy and emotional ability: An explanation for incompatible findings. Neurosci Biobehav Rev 2022; 141:104808. [PMID: 35932952 DOI: 10.1016/j.neubiorev.2022.104808] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/13/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022]
Abstract
Most theories of emotion describe a crucial role for interoceptive accuracy, the perception of the body's internal physiological signals, in emotional experience. Despite support for interoceptive accuracy's role in emotion, findings of gender differences in emotional and interoceptive processing are incompatible with theory; women typically show poorer interoceptive accuracy, but women often outperform men on measures of emotional processing and recognition. This suggests a need to re-evaluate the relationship between interoceptive accuracy and emotion considering sex and gender. Here we extend Pennebaker and Roberts' (1992) theory of gender differences in the use of interoceptive signals for emotional experience, proposing that language socialisation may result in gender differences in the propensity to label internal state changes as physiological or emotional, respectively. Despite outstanding questions concerning the fractionation of interoceptive and emotional domains, this theory provides a plausible explanation for seemingly incompatible findings of gender differences in interoceptive and emotional abilities.
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Affiliation(s)
- Freya Prentice
- Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health.
| | | | - Ria Spooner
- Department of Psychology, Royal Holloway, University of London
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London
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11
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Morris BJ, Moreton S, Bailis SA, Cox G, Krieger JN. Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review. J Evid Based Med 2022; 15:123-135. [PMID: 35785439 PMCID: PMC9540570 DOI: 10.1111/jebm.12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 06/16/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To conduct the first systematic review critically examining evidence on whether early male circumcision has short- and long-term adverse psychological effects. METHODS We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Google Scholar. RESULTS Twenty-four studies with original data met the inclusion criteria. These comprised 11,173 total males, 4340 circumcised in infancy and 6908 uncircumcised. Nineteen were rated 1+, 2++ or 2+, and 5 were rated 2- by SIGN criteria. Neonatal circumcision, particularly without anesthetic, increased vaccination pain response, but had little effect on breastfeeding or cognitive ability. Studies reporting associations with sudden infant death syndrome, autism, alexithymia and impaired sexual function and pleasure had design flaws and were rated 2-. Sexual arousal, touch, pain, and warmth thresholds measured by quantitative sensory testing were not diminished in neonatally circumcised men. Neonatal circumcision was not associated with empathy in men, contradicting the hypothesis that procedural pain causes central nervous system changes. After correcting all associations with socioaffective processing parameters for multiple testing only higher sociosexual desire, dyadic sexual libido/drive, and stress remained significant. The relatively greater sexual activity found in circumcised men might reflect reduced sexual activity in uncircumcised men overall owing to pain and psychological aversion in those with foreskin-related medical conditions (reverse causality). Most studies employed case-control designs with limited follow-up. Studies beyond childhood were prone to confounding. CONCLUSION The highest quality evidence suggest that neonatal and later circumcision has limited or no short-term or long-term adverse psychological effects.
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Affiliation(s)
- Brian J. Morris
- Faculty of Medicine and HealthSchool of Medical SciencesUniversity of SydneySydneyNew South WalesAustralia
| | | | | | - Guy Cox
- School of AerospaceMechanical & Mechatronic EngineeringUniversity of SydneySydneyAustralia
- Australian Centre for Microscopy and MicroanalysisUniversity of SydneySydneyAustralia
| | - John N. Krieger
- Department of UrologyUniversity of Washington School of MedicineSeattle
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Stability of alexithymia is low from adolescence to young adulthood, and the consistency of alexithymia is associated with symptoms of depression and dissociation. J Psychosom Res 2021; 150:110629. [PMID: 34598049 DOI: 10.1016/j.jpsychores.2021.110629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aims of this study were to investigate the stability of alexithymia from adolescence to young adulthood, as well as the association between alexithymia, peer relationships, and symptoms of depression and dissociation. METHODS The participants (n = 755, aged 13-18 years) were assessed with self-rated questionnaires and the 20-item Toronto Alexithymia Scale (TAS-20) at baseline in 2005 and on follow-up in 2011. RESULTS The changes in the TAS-20 total score (t = -12.26) and the scores for its subscales, difficulty identifying feelings (DIF) (t = -4.04), difficulty describing feelings (DDF) (t = -5.10), and externally oriented thinking (EOT) (t = -18.23), were statistically significant (p < 0.001). Effect sizes (Cohen's d) for the change indicating absolute stability were small for DIF (-0.15) and DDF (-0.19), medium for TAS-20 total (-0.45), and large for EOT (-0.66) scores. Moderate correlations in test-retests with Spearman's ρ (TAS-20 total 0.46, DIF 0.41, DDF 0.39, EOT 0.43) indicated relative stability, whereas low intraclass correlation coefficients (ICCs) (respectively 0.41, 0.39, 0.37, 0.37) indicated poor reliability of test-retests. In regression analyses, poor relationships with peers, loneliness, and symptoms of depression and dissociation at baseline associated with alexithymia at baseline and on follow-up. Unlike EOT, increases in the TAS-20 total, DIF, and DDF scores during the 6-year follow-up associated with baseline symptoms of depression and dissociation. CONCLUSIONS Alexithymia in adolescence is not always a reliable predictor of alexithymia in young adulthood. Mental health symptoms appear to affect the consistency of alexithymia during adolescent development.
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Çoban ÖG, Önder A. Alexithymia Is Associated With Internalizing Disorders in a Clinical Adolescent Outpatient Sample. J Nerv Ment Dis 2021; 209:636-639. [PMID: 34280177 DOI: 10.1097/nmd.0000000000001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The aim of this study was to investigate alexithymic traits in an adolescent clinical sample with internalizing and externalizing disorders. The study group consisted of 125 adolescents aged between 12 and 17 years who applied at our outpatient unit and diagnosed with an internalizing or externalizing disorder. The healthy control group consisted of 53 adolescents with no psychiatric disorder. All subjects fulfilled the Alexithymia Questionnaire for Children (AQC). Total AQC scores were higher in the study group than in the control group. When we divided the study group into two groups as internalizing and externalizing disorders, total AQC scores, AQC-difficulty identifying feelings, and AQC-difficulty describing feelings were significantly higher in the internalizing disorder group than in the externalizing disorder group. AQC-externally oriented thinking scores were significantly higher in the externalizing disorder group than in the internalizing disorder group. In future research, it would be useful to further increase understanding of alexithymia and its association with psychiatric disorders in adolescence.
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Affiliation(s)
- Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
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Hébert M, Smith K, Boisjoli C, Larouche S. Validation of the French version of the Children's Alexithymia Measure. L'ENCEPHALE 2021; 47:306-313. [DOI: 10.1016/j.encep.2020.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/10/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
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Hemming L, Shaw J, Haddock G, Carter LA, Pratt D. A Cross-Sectional Study Investigating the Relationship Between Alexithymia and Suicide, Violence, and Dual Harm in Male Prisoners. Front Psychiatry 2021; 12:670863. [PMID: 33995152 PMCID: PMC8116549 DOI: 10.3389/fpsyt.2021.670863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Suicide and violence are common within male prisoners. One suggested risk factor for both behaviors is alexithymia. Alexithymia describes a deficit in identifying and describing feelings and is also related to externally oriented thinking. This study aimed to explore the relationship between alexithymia, suicide, violence and dual harm in male prisoners. Methods: Eighty male prisoners were recruited from three prisons. Participants were asked to complete a battery of questionnaires including measures of alexithymia (TAS-20), suicide ideation (ASIQ), suicide behavior, violence ideation (SIV), violence behavior, depression (BDI-II), hopelessness (BHS), impulsivity (DII) and anger (NAS-PI). Regression analyses and ANOVAS were conducted to assess the association between alexithymia (and its subcomponents) with six outcomes; suicide ideation, suicide behavior, violence ideation, violence behavior, dual harm ideation and dual harm behavior. Results: Alexithymia was a univariate predictor of suicide ideation, though was not a significant predictor when considered in a multivariate model. Alexithymia was a significant multivariate predictor of suicide behavior. Alexithymia was not a significant multivariate predictor of violence ideation or behavior. There were no significant differences in alexithymia or subscales between those with suicide ideation/behavior alone, violence ideation/behavior alone and those with dual harm ideation/behavior. Conclusion: In male prisoners, alexithymia appears an important univariate predictor of suicide and violence, though the current study suggests no significant contribution above other well-known correlates of suicide and violence.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Science, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Science, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Science, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, United Kingdom
| | - Lesley-Anne Carter
- Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Science, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, United Kingdom
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Abstract
Moral reasoning and decision making help guide behavior and facilitate interpersonal relationships. Accounts of morality that position commonsense psychology as the foundation of moral development, (i.e., rationalist theories) have dominated research in morality in autism spectrum disorder (ASD). Given the well-documented differences in commonsense psychology among autistic individuals, researchers have investigated whether the development and execution of moral judgement and reasoning differs in this population compared with neurotypical individuals. In light of the diverse findings of investigations of moral development and reasoning in ASD, a summation and critical evaluation of the literature could help make sense of what is known about this important social-cognitive skill in ASD. To that end, we conducted a systematic review of the literature investigating moral decision making among autistic children and adults. Our search identified 29 studies. In this review, we synthesize the research in the area and provide suggestions for future research. Such research could include the application of an alternative theoretical framework to studying morality in autism spectrum disorder that does not assume a deficits-based perspective.
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Lyvers M, Holloway N, Needham K, Thorberg FA. Resilience, alexithymia, and university stress in relation to anxiety and problematic alcohol use among female university students. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
| | - Natalie Holloway
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
| | - Katarina Needham
- School of Psychology, Bond University, Gold Coast, Queensland, Australia,
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Norman H, Oskis A, Marzano L, Coulson M. The relationship between self‐harm and alexithymia: A systematic review and meta‐analysis. Scand J Psychol 2020; 61:855-876. [DOI: 10.1111/sjop.12668] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Hilary Norman
- Faculty of Science and Technology Middlesex University London UK
| | - Andrea Oskis
- Faculty of Science and Technology Middlesex University London UK
| | - Lisa Marzano
- Faculty of Science and Technology Middlesex University London UK
| | - Mark Coulson
- School of Psychology University of East Anglia Norwich UK
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The rs6311 of serotonin receptor 2A (5-HT2A) gene is associated with alexithymia and mental health. J Affect Disord 2020; 272:277-282. [PMID: 32553368 DOI: 10.1016/j.jad.2020.03.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/18/2020] [Accepted: 03/29/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUNDS Alexithymia, difficulties in identifying and describing one's own feelings, is related to substantial clinical practice. Inspired by the links between serotonin functions and affective disorders, this study investigated associations of the serotonin receptor 2A (5-HT2A) gene with alexithymia and mental health. METHODS We differentiated subjects according to two functional polymorphisms (i.e., rs6311 and rs6313) of 5-HT2A gene and scored alexithymia and mental health of college students with the Toronto Alexithymia Scale (TAS-20) and the Symptom Check List-90 (SCL-90), respectively. RESULTS The analyses basing on sample 1 (N = 566) and sample 2 (N = 602) indicated that the G allele of rs6311 was related to higher score on the TAS-20 as compared to the AA genotype. The analysis with 467 individuals from sample 2 indicated that the rs6311 was associated with mental health, and this association was mediated by alexithymia. LIMITATIONS The potential confounding variables such as depression and anxiety were neglected in the analyses. CONCLUSIONS These findings demonstrate the contribution of the 5-HT2A to alexithymia, and highlight the link between alexithymia and mental health at genetic level.
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Tang W, Xu D, Xu J. The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Reyno SM, Simmons M, Kinley J. A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and nonclinical populations. RESEARCH IN PSYCHOTHERAPY (MILANO) 2020; 23:439. [PMID: 32913826 PMCID: PMC7451292 DOI: 10.4081/ripppo.2020.439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/06/2020] [Indexed: 11/23/2022]
Abstract
Alexithymia and dissociation have been consistently linked in the literature, particularly in psychiatric populations. Both arise from a disconnection between conscious aspects of self-experiences and perceptions at both the mental self and bodily levels. This results in difficulty integrating thoughts, feelings and experiences into consciousness and memory, negatively impacting emotion awareness/regulation and reflective functioning. We conducted a meta-analysis to examine the strength of the relationship between alexithymia and dissociation in both clinical and non-clinical populations. Studies using two common measures of these constructs were included (i.e., the Toronto Alexithymia Scale - TAS, and the Dissociative Experiences Scale - DES). Analyzing the effect sizes derived from 19 studies (including a total of 4664 participants) revealed moderate to strong relationships between alexithymia and dissociation. The strength of the association was higher in clinical and younger aged non clinical populations. These findings are discussed in the context of treatment recommendations..
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Affiliation(s)
| | - Maria Simmons
- Queen Elizabeth II Health Sciences Centre, Halifax NS
| | - Jackie Kinley
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada
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Thorberg F, Young R, Sullivan K, Lyvers M. Parental bonding and alexithymia: A meta-analysis. Eur Psychiatry 2020; 26:187-93. [DOI: 10.1016/j.eurpsy.2010.09.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 08/13/2010] [Accepted: 09/10/2010] [Indexed: 10/18/2022] Open
Abstract
AbstractAimThe primary purpose of this meta-analysis was to explore, clarify and report the strength of the relationship between alexithymia, as measured by the Toronto Alexithymia Scale (TAS-20), and parenting style as measured by the Parental Bonding Instrument (PBI).MethodsWeb of Science, PsycInfo, PubMed and ProQuest: Dissertations and Theses searches were undertaken, yielding nine samples with sufficient data to be included in the meta-analysis.ResultsEvidence indicated moderate to strong relationships between maternal care and alexithymia, and between maternal care and two of the three TAS-20 alexithymia facets (Difficulties Describing Feelings and Difficulties Identifying Feelings, but not Externally Oriented Thinking). Moderate relationships were observed for both maternal- and paternal-overprotection and alexithymia respectively, and for overprotection (both maternal and paternal) and Difficulties Describing Feelings.ConclusionThis study is the first meta-analysis of the relationship between parenting styles and alexithymia, and findings confirm an especially strong association between maternal care and key elements of alexithymia. This review highlights the issues that still remain to be addressed in exploring the link between parenting style and alexithymia.
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Ridout N, Smith J, Hawkins H. The influence of alexithymia on memory for emotional faces and realistic social interactions. Cogn Emot 2020; 35:540-558. [PMID: 32268841 DOI: 10.1080/02699931.2020.1747991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
High levels of alexithymia are typically associated with impaired memory for emotional, but not neutral words. We conducted two experimental studies to establish if this effect generalises to non-verbal socially relevant stimuli. Thirty-nine female undergraduates (Study 1) viewed faces with different expressions (neutral, angry, happy or sad) and 38 female students (Study 2) viewed videos of realistic social interactions (featuring anger, happiness, sadness or neutral affect). Participants were asked to identify the emotion portrayed and were subsequently given an intentional recognition memory test for the stimuli. They also completed self-report measures of alexithymia and mood (depression & anxiety). In Study 1, memory for emotional (especially angry), but not neutral faces was negatively related to the "difficulty describing feelings" facet of alexithymia. In Study 2, memory for emotional (particularly those featuring anger), but not neutral videos was negatively related to the "difficulty identifying feelings" and "externally oriented thinking" facets of alexithymia. In both studies, these memory deficits were independent of the effects of age and mood. Furthermore, the deficits appear to be most evident in the conscious recollection of the emotional stimuli. Our findings confirm that the memory deficit for emotional words in alexithymia generalises to important non-verbal socially relevant stimuli.
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Affiliation(s)
- Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Jade Smith
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Holly Hawkins
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
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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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Elkholy H, Elhabiby M, Ibrahim I. Rates of Alexithymia and Its Association With Smartphone Addiction Among a Sample of University Students in Egypt. Front Psychiatry 2020; 11:304. [PMID: 32425823 PMCID: PMC7212412 DOI: 10.3389/fpsyt.2020.00304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/26/2020] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Alexithymia is characterized by difficulties in describing feelings. Many studies have shown that there is a relation between alexithymia and different types of addictions. Nowadays, smartphone addiction is proposed to be a global problem. The current study focuses on the rates of alexithymia and its association with smartphone addiction in an Egyptian university. MATERIALS AND METHODS This is a cross-sectional study that was conducted in Ain Shams University. A sample of 200 university students was surveyed using Toronto Alexithymia Scale (TAS) and Smartphone Addiction Scale - Short Version (SAS-SV). RESULTS The results showed that 44 students (22%) had alexithymia. It was also found that around one third of the sample (N=65, 32.5%) met the criteria of smartphone addiction. There was a strong association between alexithymia and smartphone addiction (OR=4.33, 95% CI 2.15-8.74, p= < 0.001). CONCLUSION This study supports existing literature indicating the strong association between alexithymia and smartphone addiction.
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Affiliation(s)
- Hussien Elkholy
- Department of Neurology and Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elhabiby
- Department of Neurology and Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Islam Ibrahim
- Department of Neurology and Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Nam G, Lee H, Lee JH, Hur JW. Disguised Emotion in Alexithymia: Subjective Difficulties in Emotion Processing and Increased Empathic Distress. Front Psychiatry 2020; 11:698. [PMID: 32765327 PMCID: PMC7379392 DOI: 10.3389/fpsyt.2020.00698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/02/2020] [Indexed: 11/22/2022] Open
Abstract
Despite decades of speculation, many causal aspects that contribute to the heterogeneity of alexithymia still must be clarified. This study examined the extent of the alexithymia phenotype and its contribution to social function in the general population. In total, 200 participants (females = 111) completed the Toronto Alexithymia Scale-20 (TAS-20), multiple self-reporting questionnaires measuring emotion intelligence, empathy, hostility and impulsivity, and the Reading the Mind in the Eyes Test (RMET). In the multivariate analysis, highly alexithymic individuals appeared to report subjective deficits in emotion recognition and regulation as well as increased impulsivity; however, their empathy skills were intact, and even the proneness to experiencing empathic distress with others' suffering was increased among alexithymic individuals. We also compared the clinical and behavioral manifestations of highly alexithymic male and female subjects to those of each gender control group. As a result, in contrast to their subjective self-reports of emotion processing impairment, the RMET performance appeared to be preserved in alexithymic females; however, highly alexithymic males showed actual deficits in the emotion identification task. Future research needs to further refine the constructs of alexithymia to incorporate the phenotypic changes in affected individuals in relation to measuring instruments, the extent of empathic distress, and gender.
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Affiliation(s)
- Gieun Nam
- Clinical Neuro-Psychology Lab, Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Hyerin Lee
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Jang-Han Lee
- Clinical Neuro-Psychology Lab, Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Ji-Won Hur
- Department of Psychology, Korea University, Seoul, South Korea
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YILMAZ ONUR, MIRÇIK ALIBARLAS, KUNDUZ MERVE, ÇOMBAŞ MÜGE, ÖZTÜRK AHMET, DEVECI ERDEM, KIRPINAR ISMET. Does psychotherapy improve alexithymia? A comparison study among patients with mild or moderate depression. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- ONUR YILMAZ
- Bezmialem Foundation University Medical Faculty, Turkey
| | | | - MERVE KUNDUZ
- Bezmialem Foundation University Medical Faculty, Turkey
| | - MÜGE ÇOMBAŞ
- Bezmialem Foundation University Medical Faculty, Turkey
| | - AHMET ÖZTÜRK
- Bezmialem Foundation University Medical Faculty, Turkey
| | - ERDEM DEVECI
- Bezmialem Foundation University Medical Faculty, Turkey
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Stange JP, Kleiman EM, Mermelstein RJ, Trull TJ. Using ambulatory assessment to measure dynamic risk processes in affective disorders. J Affect Disord 2019; 259:325-336. [PMID: 31610996 PMCID: PMC7250154 DOI: 10.1016/j.jad.2019.08.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/30/2019] [Accepted: 08/18/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rapid advances in the capability and affordability of digital technology have begun to allow for the intensive monitoring of psychological and physiological processes associated with affective disorders in daily life. This technology may enable researchers to overcome some limitations of traditional methods for studying risk in affective disorders, which often (implicitly) assume that risk factors are distal and static - that they do not change over time. In contrast, ambulatory assessment (AA) is particularly suited to measure dynamic "real-world" processes and to detect fluctuations in proximal risk for outcomes of interest. METHOD We highlight key questions about proximal and distal risk for affective disorders that AA methods (with multilevel modeling, or fully-idiographic methods) allow researchers to evaluate. RESULTS Key questions include between-subject questions to understand who is at risk (e.g., are people with more affective instability at greater risk than others?) and within-subject questions to understand when risk is most acute among those who are at risk (e.g., does suicidal ideation increase when people show more sympathetic activation than usual?). We discuss practical study design and analytic strategy considerations for evaluating questions of risk in context, and the benefits and limitations of self-reported vs. passively-collected AA. LIMITATIONS Measurements may only be as accurate as the observation period is representative of individuals' usual life contexts. Active measurement techniques are limited by the ability and willingness to self-report. CONCLUSIONS We conclude by discussing how monitoring proximal risk with AA may be leveraged for translation into personalized, real-time interventions to reduce risk.
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Affiliation(s)
- Jonathan P Stange
- University of Illinois at Chicago, Department of Psychiatry, 1601 W Taylor St., Chicago, IL, 60612, USA.
| | - Evan M Kleiman
- Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Robin J Mermelstein
- University of Illinois at Chicago, Department of Psychology and Institute for Health Research and Policy, 1747 W Roosevelt Rd., Chicago, IL, 60608, USA
| | - Timothy J Trull
- University of Missouri, Department of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211, USA
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Morris BJ, Moreton S, Krieger JN. Critical evaluation of arguments opposing male circumcision: A systematic review. J Evid Based Med 2019; 12:263-290. [PMID: 31496128 PMCID: PMC6899915 DOI: 10.1111/jebm.12361] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/03/2019] [Accepted: 05/12/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To systematically evaluate evidence against male circumcision (MC). METHODS We searched PubMed, Google Scholar, EMBASE and Cochrane databases. RESULTS Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high-quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high-quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk-benefit analyses reported that benefits exceed risks by 100-200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low-risk, high-benefit interventions such as MC for better health. Expert evaluations of case-law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost-saving to health systems. CONCLUSIONS Arguments opposing MC are supported mostly by low-quality evidence and opinion, and are contradicted by strong scientific evidence.
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Affiliation(s)
- Brian J Morris
- School of Medical SciencesUniversity of SydneySydneyNew South WalesAustralia
| | | | - John N Krieger
- Department of UrologyUniversity of Washington School of MedicineSeattleWashington
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An examination of the relationship between alexithymia and somatic complaints of mothers and obsessive-compulsive features of children. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/jcm.559584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hughes L, Betka S, Longarzo M. Validation of an electronic version of the Self-Awareness Questionnaire in English and Italian healthy samples. Int J Methods Psychiatr Res 2019; 28:e1758. [PMID: 30506757 PMCID: PMC7938397 DOI: 10.1002/mpr.1758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Interoception is a general sensitivity to bodily sensations that informs motivational processes and behaviours. Interoceptive abilities seem to be impaired in several clinical conditions, and the development of new pragmatic instruments to assess subjective components of interoception are crucially needed. An easy to use paper and pencil questionnaire measuring sensitivity to bodily sensations was validated in an Italian sample (Self-Awareness Questionnaire; SAQ). METHODS In the present study, we created and evaluated an electronic version of the SAQ in Italian and English language. RESULTS Psychometric properties of both electronic versions of the SAQ were validated in an Italian (n = 206) and an English (n = 275) sample, using factorial analyses. Differences in factorial structures observed between the two samples were discussed in terms of cultural impact on emotional regulation and bodily sensations processing. CONCLUSIONS The electronic version of SAQ in English and Italian provides a pragmatic and validated tool to evaluate bodily signal sensitivity in clinical settings, informing the development of a new therapy targeting interoceptive processes, in a wide range of psychopathological conditions.
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Affiliation(s)
- Laura Hughes
- Neuroscience Department, Brighton and Sussex Medical School, Brighton, UK
| | - Sophie Betka
- Neuroscience Department, Brighton and Sussex Medical School, Brighton, UK
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Öksüz E, Guvenc G. Relationship of premenstrual and menstrual symptoms to alexithymia among nursing students. Perspect Psychiatr Care 2018; 54:391-397. [PMID: 29570793 DOI: 10.1111/ppc.12271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/16/2018] [Accepted: 02/17/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study is to determine the relationship of premenstrual and menstrual symptoms to alexithymia among nursing students. DESIGN AND METHODS This descriptive study was conducted with 284 undergraduate nursing students. Data were collected using Premenstrual Syndrome Scale (PMSS), Menstrual Symptom Scale (MSQ), and Toronto Alexithymia Scale-20 (TAS-20). FINDINGS The PMSS, MSQ, and TAS-20 mean scores were 103.56 ± 35.08, 2.92 ± 0.8, and 45.22 ± 9.17, respectively. There was statistically significant positive correlation between TAS-20 and PMSS and MSQ mean scores (p < .05). PRACTICAL IMPLICATIONS Women should be evaluated for alexithymia to prevent the adverse effects of premenstrual and menstrual symptoms.
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Affiliation(s)
- Emine Öksüz
- Department of Psychiatric and Mental Health Nursing, University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Turkey
| | - Gulten Guvenc
- Department of Obstetrics and Gynecology Nursing, University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Turkey
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Hamaideh SH. Alexithymia among Jordanian university students: Its prevalence and correlates with depression, anxiety, stress, and demographics. Perspect Psychiatr Care 2018; 54:274-280. [PMID: 28726284 DOI: 10.1111/ppc.12234] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/09/2017] [Accepted: 07/02/2017] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of the article is to identify the prevalence, levels, and associated factors of alexithymia among Jordanian university students. DESIGN AND METHODS Using stratified cluster random sampling, data were collected from 492 students using Toronto Alexithymia Scale (TAS-20), and Depression, Anxiety, and Stress Scale (DASS-21). FINDINGS The prevalence of alexithymia, depression, anxiety, and stress were 24.6, 28.5, 38.4, and 22.6%, respectively, and were all higher among females. Alexithymia correlated with five factors: depression, anxiety, stress, female gender, and satisfaction with life. PRACTICAL IMPLICATIONS There is a need for screening and interventional programs that prevent or alleviate the symptoms of alexithymia, depression, anxiety, and stress among university students.
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Affiliation(s)
- Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Yilmaz O, Şengül Y, Şengül HS, Parlakkaya FB, Öztürk A. Investigation of alexithymia and levels of anxiety and depression among patients with restless legs syndrome. Neuropsychiatr Dis Treat 2018; 14:2207-2214. [PMID: 30214210 PMCID: PMC6120575 DOI: 10.2147/ndt.s174552] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study was to examine alexithymia among restless legs syndrome (RLS) patients, compare with healthy controls, and argue the clinical inferences of this relationship. We searched for anxiety and depression and their clinical outcomes among patients and searched whether the results are similar to previous studies. PATIENTS AND METHODS Eighty-seven RLS patients and 88 age, gender, and educationally matched healthy controls were assessed in Bezmialem Foundation University Hospital. RLS patients and healthy controls were assessed with the Sociodemographic Data Form constructed for the present study, 20-item Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI), and Beck Anxiety Scale (BAS). The patient group was also assessed with the International Restless Legs Syndrome Study Group (IRLSSG) RLS Severity Scale. RESULTS RLS patients were found to have greater TAS-20, BDI, and BAS scores compared with the control group (P < 0.05). RLS severity score was positively correlated with the scores of anxiety and depression scales. However, no significant relationship was found between scores of IRLSSG RLS scale and TAS-20 total and subscale scores. CONCLUSION RLS patients were found to be more alexithymic than healthy controls, whereas no significant relationship was found between RLS severity and levels of alexithymia. Still, alexithymia might be a predictor for early diagnosis and may be considered in the treatment and follow-up of RLS. RLS patients have higher depression and anxiety scores than healthy individuals. Thus, depression and anxiety should be taken into consideration throughout the RLS treatment.
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Affiliation(s)
- Onur Yilmaz
- Bezmialem Foundation University Medical Faculty, Department of Psychiatry, Istanbul, Turkey,
| | - Yildizhan Şengül
- Bezmialem Foundation University Medical Faculty, Department of Neurology, IIstanbul, Turkey
| | - Hakan Serdar Şengül
- Gaziosmanpaşa Taksim Research and Training Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Fatma Büşra Parlakkaya
- Bezmialem Foundation University Medical Faculty, Department of Psychiatry, Istanbul, Turkey,
| | - Ahmet Öztürk
- Bezmialem Foundation University Medical Faculty, Department of Psychiatry, Istanbul, Turkey,
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Westwood H, Kerr-Gaffney J, Stahl D, Tchanturia K. Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale. J Psychosom Res 2017; 99:66-81. [PMID: 28712432 PMCID: PMC5986724 DOI: 10.1016/j.jpsychores.2017.06.007] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this review was to synthesise the literature on the use of the Toronto Alexithymia Scale (TAS) in eating disorder populations and Healthy Controls (HCs) and to compare TAS scores in these groups. METHOD Electronic databases were searched systematically for studies using the TAS and meta-analyses were performed to statistically compare scores on the TAS between individuals with eating disorders and HCs. RESULTS Forty-eight studies using the TAS with both a clinical eating disorder group and HCs were identified. Of these, 44 were included in the meta-analyses, separated into: Anorexia Nervosa; Anorexia Nervosa, Restricting subtype; Anorexia Nervosa, Binge-Purge subtype, Bulimia Nervosa and Binge Eating Disorder. For all groups, there were significant differences with medium or large effect sizes between the clinical group and HCs, with the clinical group scoring significantly higher on the TAS, indicating greater difficulty with identifying and labelling emotions. CONCLUSION Across the spectrum of eating disorders, individuals report having difficulties recognising or describing their emotions. Given the self-report design of the TAS, research to develop and evaluate treatments and clinician-administered assessments of alexithymia is warranted.
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Affiliation(s)
- Heather Westwood
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK.
| | - Jess Kerr-Gaffney
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK.
| | - Daniel Stahl
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Biostatistics, London, UK.
| | - Kate Tchanturia
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK; South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, UK; Ilia State University, Tbilisi, Georgia.
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Zhu Y, Luo T, Liu J, Qu B. Influencing factors of alexithymia in Chinese medical students: a cross-sectional study. BMC MEDICAL EDUCATION 2017; 17:66. [PMID: 28372565 PMCID: PMC5379661 DOI: 10.1186/s12909-017-0901-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 03/14/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND A much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors. METHODS A cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach's α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student's t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0. RESULTS Of the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach's α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05). CONCLUSIONS Gender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.
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Affiliation(s)
- Yaxin Zhu
- School of Public Health, China Medical University, Shenyang, Liaoning Province People’s Republic of China
| | - Ting Luo
- Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province Postal Code: 110122 People’s Republic of China
| | - Jie Liu
- School of Public Health, China Medical University, Shenyang, Liaoning Province People’s Republic of China
| | - Bo Qu
- Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province Postal Code: 110122 People’s Republic of China
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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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Role of Alexithymia, Anxiety, and Depression in Predicting Self-Efficacy in Academic Students. ScientificWorldJournal 2017; 2017:5798372. [PMID: 28154839 PMCID: PMC5244027 DOI: 10.1155/2017/5798372] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/01/2016] [Accepted: 12/18/2016] [Indexed: 11/21/2022] Open
Abstract
Objective. Little research is available on the predictive factors of self-efficacy in college students. The aim of the present study is to examine the role of alexithymia, anxiety, and depression in predicting self-efficacy in academic students. Design. In a cross-sectional study, a total of 133 students at Babol University of Medical Sciences (Medicine, Dentistry, and Paramedicine) participated in the study between 2014 and 2015. All participants completed the Toronto Alexithymia Scale (TAS-20), College Academic Self-Efficacy Scale (CASES), and 14 items on anxiety and depression derived from the 28 items of the General Health Questionnaire (28-GHQ). Results. Pearson correlation coefficients revealed negative significant relationships between alexithymia and the three subscales with student self-efficacy. There was no significant correlation between anxiety/depression symptoms and student self-efficacy. A backward multiple regression analysis revealed that alexithymia was a negative significant predictor of self-efficacy in academic students (B = −0.512, P < 0.001). The prevalence of alexithymia was 21.8% in students. Multiple backward logistic analysis regression revealed that number of passed semesters, gender, mother's education, father's education, and doctoral level did not accurately predict alexithymia in college students. Conclusion. As alexithymia is prevalent in college students and affects self-efficacy and academic functioning, we suggest it should be routinely evaluated by mental physicians at universities.
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Abstract
There has been a marked increase in research aimed at studying dynamic (e.g., day-to-day, moment-to-moment) changes in mental disorders and related behavior problems. Indeed, the number of scientific papers published that focus on real-time monitoring has been nearly doubling every five years for the past several decades. These methods allow for a more fine-grained description of phenomena of interest as well as for real-world tests of theoretical models of human behavior. Here we comment on the recent study by van Winkel and colleagues (this issue)as an excellent example of the use of real-time monitoring methods to better understand mental disorders. We also discuss the expanding universe of new technologies (e.g., smartphones, wearable biosensors) that can be used to make discoveries about psychopathology and related constructs and describe what we perceive to be some of the most exciting scientific possibilities that can be achieved in the near term by taking advantage of these new and rapidly developing tools.
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Atari M, Yaghoubirad M. The Big Five personality dimensions and mental health: The mediating role of alexithymia. Asian J Psychiatr 2016; 24:59-64. [PMID: 27931909 DOI: 10.1016/j.ajp.2016.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/19/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
The role of personality constructs on mental health has attracted research attention in the last few decades. The Big Five personality traits have been introduced as parsimonious dimensions of non-pathological traits. The five-factor model of personality includes neuroticism, agreeableness, conscientiousness, extraversion, and openness to experience. The present study aimed to examine the relationship between the Big Five dimensions and mental health considering the mediating role of alexithymia as an important emotional-processing construct. A total of 257 participants were recruited from non-clinical settings in the general population. All participants completed the Ten-Item Personality Inventory (TIPI), 20-item Toronto Alexithymia Scale (TAS-20), and General Health Questionnaire-28 (GHQ-28). Structural equation modeling was utilized to examine the hypothesized mediated model. Findings indicated that the Big Five personality dimensions could significantly predict scores of alexithymia. Moreover, alexithymia could predict mental health scores as measured by indices of depression, anxiety, social functioning, and somatic symptoms. The fit indices (GFI=0.94; CFI=0.91; TLI=0.90; RMSEA=0.071; CMIN/df=2.29) indicated that the model fits the data. Therefore, the relationship between the Big Five personality dimensions and mental health is mediated by alexithymia.
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Affiliation(s)
- Mohammad Atari
- Department of Psychology, University of Tehran, Tehran, Iran.
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Maladaptive Parenting, Temperament, Early Maladaptive Schemas, and Depression: A Moderated Mediation Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9559-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Muir K, Madill A, Brown C. Individual differences in emotional processing and autobiographical memory: interoceptive awareness and alexithymia in the fading affect bias. Cogn Emot 2016; 31:1392-1404. [DOI: 10.1080/02699931.2016.1225005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kate Muir
- Faculty of Business and Law, Centre for the Study of Behaviour Change and Influence, University of the West of England, Bristol, UK
| | - Anna Madill
- School of Psychology, University of Leeds, Leeds, UK
| | - Charity Brown
- School of Psychology, University of Leeds, Leeds, UK
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Ling Y, Zeng Y, Yuan H, Zhong M. Cross-cultural validation of the 20-item Toronto Alexithymia Scale in Chinese adolescents. J Psychiatr Ment Health Nurs 2016; 23:179-87. [PMID: 27028136 DOI: 10.1111/jpm.12298] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The TAS-20 is the most widely used self-reported questionnaire to assess the level of alexithymia in students and community and clinical samples. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The TAS-20-C exhibited high levels of reliability and validity, indicating that it is appropriate for the assessment of alexithymia in Chinese adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Screening adolescents who are at risk of alexithymia through the TAS-20 could help to perform necessary and effective precautions to decrease the adverse effects of alexithymia, such as the risks of developing depressive mood and behavioral problems. ABSTRACT Purpose The aim of this study was to examine the psychometric properties of the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) in a sample of Chinese adolescents. Method Adolescents (n = 1260) recruited from three schools in mainland China completed the TAS-20-C, the somatization subscale of the Symptom Checklist 90 (SCL-90) and Center for Epidemiological Studies Depression Scale (CES-D). Five different factorial models of the TAS-20 were tested using confirmatory factor analysis (CFA). Cronbach's α, mean inter-item correlations and predictive validity were also evaluated. Results Among those five different factorial models, the four-factor structure model was suitable and invariant across gender and age in this sample. The TAS-20-C demonstrated adequate internal reliability. Gender and age accounted for insignificant amounts of variability in total TAS-20-C and factor scores. TAS-20-C total and subscale scores were correlated significantly with SCL-90 somatization subscale and CES-D. Girls scored higher than boys on difficulty identifying feelings (DIF) and pragmatic thinking (PR) subscales. DIF and lack of subjective significance or importance of emotions (IMs) subscale scores were higher among younger than among middle and older adolescents. Implications for Practice Validating the TAS-20 in adolescents is quite important to use it in evaluating adolescents' alexithymia, and screen those at risk of alexithymia.
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Affiliation(s)
- Y Ling
- College of Education, Hunan Agriculture University, Changsha, Hunan, China
| | - Y Zeng
- College of Education, Hunan Agriculture University, Changsha, Hunan, China
| | - H Yuan
- Students Affairs Department, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - M Zhong
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Loas G, Braun S, Linkowski P, Luminet O. Determination of the Cutoff Threshold on the Bermond-Vorst Alexithymia Questionnaire–20 Form B: A Study of 560 Young Adults. Psychol Rep 2015; 117:754-62. [DOI: 10.2466/03.pr0.117c24z2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Stéphanie Braun
- Department of Psychiatry & Laboratory of Psychiatric Research, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Paul Linkowski
- Department of Psychiatry & Laboratory of Psychiatric Research, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Olivier Luminet
- Department of Psychology, Catholic University of Louvain (UCL), Louvain-la-Neuve, Belgium
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Cuzzocrea F, Barberis N, Costa S, Larcan R. RELATIONSHIP BETWEEN ALEXITHYMIA, PARENTING STYLE, AND PARENTAL CONTROL. Psychol Rep 2015; 117:580-96. [PMID: 26444844 DOI: 10.2466/21.10.pr0.117c22z7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on the relationship between parental alexithymia and parenting is relatively scarce. The purpose of this study was to investigate the relationships between parental alexithymia and three styles of parenting (authoritarian, authoritative, and permissive) and the relationships between parental alexithymia and two domains of psychological control (dependency and achievement). The participants were 946 parents ages 29-60 years (mothers: n = 473, M age = 44.6 yr., SD = 4.7; fathers: n = 473, M age = 48.1 yr., SD = 5.1) of children ages 11-18 years. All participants completed a sociodemographic questionnaire, the Toronto Alexithymia Scale-20 (TAS-20), the Parental Authority Questionnaire-Revised (PAQ-R), and the Dependency-Oriented and Achievement-Oriented Psychological Control Scale (DAPCS). Structural Equation Modeling (SEM) was used to examine whether alexithymia could predict the three parenting styles (authoritarian, authoritative, and permissive) and the two domains of psychological control (dependency and achievement). The first model showed that alexithymia was a positive predictor of authoritative and permissive parenting and a negative predictor of authoritarian parenting in both paternal and maternal data. The second model showed that, in both paternal and maternal data, alexithymia was a positive predictor of both dependency-oriented psychological control (DPC) and achievement-oriented psychological control (APC).
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Affiliation(s)
| | - Nadia Barberis
- 1 Department of Human and Social Science, University of Messina, Italy
| | - Sebastiano Costa
- 1 Department of Human and Social Science, University of Messina, Italy
| | - Rosalba Larcan
- 1 Department of Human and Social Science, University of Messina, Italy
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Chio PH, Zaroff CM. Traditional Chinese medicinal herbal tea consumption, self-reported somatization, and alexithymia. Asia Pac Psychiatry 2015; 7:127-34. [PMID: 25355450 DOI: 10.1111/appy.12161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/02/2014] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Somatic presentations of distress are common cross-culturally, although perhaps more so in Asian cultures. Somatic presentations of distress may be associated with alexithymia, a difficulty in experiencing and expressing emotions. Although the constructs of somatization and alexithymia have been examined in depth both within and across cultures, there is minimal information on culture-specific behaviors utilized to cope with stress in individuals who tend to somaticize distress or are alexithymic. The current report investigates the association between somatization and alexithymia, and a culture-specific behavior of traditional Chinese medicinal herbal tea consumption, in a nonclinical, young adult sample. METHODS A sample of 222 undergraduate university students of Chinese ethnicity completed self-report measures of somatization and the related construct of somatosensory amplification, alexithymia, and attitude toward the consumption of herbal tea possessing traditional Chinese medicinal value. RESULTS After controlling for gender, alexithymia was significantly correlated with somatization (r[220] = 0.29, P < 0.05) and somatosensory amplification (r[220] = 0.19, P < 0.05). Attitudes toward herbal tea consumption were significantly correlated with somatosensory amplification (r[220] = 0.16, P < 0.05). DISCUSSION The connection between alexithymia and somatization was confirmed in the current report in a nonclinical sample. A culture-specific behavior (consumption of traditional Chinese medicinal herbal tea) was significantly associated with somatosensory amplification. Potential etiologies and implications of the current findings are discussed.
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Affiliation(s)
- Pit Hoi Chio
- Department of Psychology, University of Macau, Taipa, Macao, China
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Morris BJ, Krieger JN. Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/asm.2015.53007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Karukivi M, Saarijärvi S. Development of alexithymic personality features. World J Psychiatry 2014; 4:91-102. [PMID: 25540724 PMCID: PMC4274591 DOI: 10.5498/wjp.v4.i4.91] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/06/2014] [Accepted: 12/10/2014] [Indexed: 02/05/2023] Open
Abstract
The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymia with different aberrations in brain function related to emotion regulation; however, the development of these deviations is poorly understood. A notable amount of research covers the relation of alexithymia to different environmental factors. Many of these associations, for example, with low socio-economic status and general psychopathology in childhood, are well established. However, the retrospective and cross-sectional designs commonly used in these studies, as well as the use of self-report measures, hinder the ability to firmly establish causality. Certain individual developmental factors, such as lagging speech development and congenital cardiac malformations in childhood, have been associated with the development of alexithymia. Regarding the stability of alexithymia, a systematic review of the literature was conducted for this paper. In addition to being characterized as a personality feature in the general population, alexithymia also clearly has a state-like dimension that results in increases and decreases in alexithymic features in conjunction with mental disorder symptoms. An essential question is whether the alexithymic features in adulthood are, in fact, infantile features of a restricted ability to identify and describe emotions that simply persist in individuals through adolescence to adulthood. To firmly establish the roots of alexithymia development, longitudinal studies, particularly in younger populations, are needed. Furthermore, multifaceted study settings are encouraged.
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Stability of alexithymia in late adolescence: results of a 4-year follow-up study. Psychiatry Res 2014; 219:386-90. [PMID: 24953425 DOI: 10.1016/j.psychres.2014.05.058] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/26/2014] [Accepted: 05/30/2014] [Indexed: 01/12/2023]
Abstract
The aim of the present study was to assess the stability of alexithymia in adolescents and the effects of parental factors and social support thereon. The sample comprised 315 late adolescents, of whom 259 were female and 56 male. At baseline, the mean age of the subjects was 19 years (range 17-21 years). The follow-up period was 4 years (2008-2012). The 20-item Toronto Alexithymia Scale (TAS-20) was used for the assessment of alexithymia both at baseline and follow-up. The Multidimensional Scale of Perceived Social Support (MSPSS) and the Parental Bonding Instrument (PBI) were used as measures at baseline. Regarding absolute stability, the changes in the TAS-20 total scores and two subscales (DIF and EOT) were statistically significant but the effect sizes for the changes were small (Cohen׳s d 0.21-0.24). The test-retest correlations for the TAS-20 total and subscale scores were high (ρ=0.50-0.64, P<0.001), indicating relative stability. While several parental and social support variables were associated with alexithymia at baseline, low social support from friends was the only to predict higher alexithymia at follow-up. Alexithymia is a stable personality trait also in late adolescence. Low social support from friends is related to alexithymia in young adulthood.
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Hussain S, Ahmed Z. Parental Acceptance-Rejection as Predictor of Alexithymia among Students in Gilgit-Pakistan. ACTA ACUST UNITED AC 2014. [DOI: 10.7763/ijiet.2014.v4.414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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