1
|
Linn BK, Stasiewicz PR, Fillo J, Bradizza CM. The Great Disrupter: Relationship of Alexithymia to Emotion Regulation Processes and Smoking among Pregnant Women. Subst Use Misuse 2020; 55:1113-1121. [PMID: 32153230 PMCID: PMC7401085 DOI: 10.1080/10826084.2020.1729198] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Many women continue to smoke during pregnancy, despite known risks, often in response to negative affect. Recent scholarship has begun to examine factors that decrease the success of behavioral treatments for smoking cessation in pregnancy, which are the preferred interventions. Alexithymia is one factor that may interfere with smoking cessation interventions. Alexithymia restricts access to emotional information and increases propensity toward maladaptive behaviors, including smoking. However, mechanisms underlying such effects are largely unknown. Objectives: Using data from a longitudinal treatment study, the present research examined difficulties with emotion regulation as a potential mechanism linking alexithymia and smoking. Pregnant smokers (n = 73; mean age = 24.78; SD = 4.50) completed measures related to alexithymia, smoking, emotion regulation, depression, anxiety, and anger at baseline and then again following eight sessions of Cognitive-Behavioral Smoking Cessation Treatment. Results: Nearly 40% of the sample met the criteria for alexithymia. The alexithymia group reported higher depression, anxiety, and anger. They also reported more difficulties with emotion regulation. In a path analysis, baseline alexithymia had a significant positive indirect effect on number of cigarettes smoked at the end of treatment through difficulties with emotion regulation. Conclusions/Importance: Similar to other studies, alexithymia limits the understanding of emotional information necessary for selection and implementation of adaptive coping responses. Our results extend the literature by suggesting that smoking may be an attempt to manage undifferentiated and unpleasant sensations created by alexithymia.
Collapse
Affiliation(s)
- Braden K Linn
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Paul R Stasiewicz
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Jennifer Fillo
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Clara M Bradizza
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| |
Collapse
|
2
|
Leshem R, van Lieshout PHHM, Ben-David S, Ben-David BM. Does emotion matter? The role of alexithymia in violent recidivism: A systematic literature review. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:94-110. [PMID: 30916846 DOI: 10.1002/cbm.2110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/28/2019] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Several variables have been evidenced for their association with violent reoffending. Resultant interventions have been suggested, yet the rate of recidivism remains high. Alexithymia, characterised by deficits in emotion processing and verbal expression, might interact with these other risk factors to affect outcomes. AIM Our goal was to examine the role of alexithymia as a possible moderator of risk factors for violent offender recidivism. Our hypothesis was that, albeit with other risk factors, alexithymia increases the risk of violent reoffending. METHOD We conducted a systematic literature review, using terms for alexithymia and violent offending and their intersection. RESULTS (a) No study that directly tests the role of alexithymia in conjunction with other potential risk factors for recidivism and actual violent recidivism was uncovered. (b) Primarily alexithymia researchers and primarily researchers into violence have separately found several clinical features in common between aspects of alexithymia and violence, such as impulsivity (total n = 24 studies). (c) Other researchers have established a relationship between alexithymia and both dynamic and static risk factors for violent recidivism (n = 16 studies). CONCLUSION Alexithymia may be a possible moderator of risk of violent offence recidivism. Supplementing offenders' rehabilitation efforts with assessments of alexithymia may assist in designing individually tailored interventions to promote desistance among violent offenders.
Collapse
Affiliation(s)
- Rotem Leshem
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Pascal H H M van Lieshout
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Boaz M Ben-David
- Communication, Aging and Neuropsychology lab (CANlab), Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Krause-Utz A, Erol E, Brousianou AV, Cackowski S, Paret C, Ende G, Elzinga B. Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties. Borderline Personal Disord Emot Dysregul 2019; 6:6. [PMID: 30873282 PMCID: PMC6399941 DOI: 10.1186/s40479-019-0101-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/05/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Childhood maltreatment, such as severe emotional, physical, and sexual abuse and neglect, has been linked to impulse control problems and dysfunctional emotional coping. In borderline personality disorder (BPD), a history of childhood maltreatment may worsen difficulties in emotion regulation, which may in turn give rise to impulsive behaviours. The aim of this self-report study was to investigate associations between childhood maltreatment severity, emotion regulation difficulties, and impulsivity in women with BPD compared to healthy and clinical controls. METHODS Sixty-one female patients with BPD, 57 clinical controls (CC, women with Attention Deficit Hyperactivity Disorder and/or Substance Use Disorder, without BPD), and 60 female healthy controls (HC) completed self-report scales on childhood trauma (Childhood Trauma Questionnaire, CTQ), difficulties in emotion regulation (Difficulties in Emotion Regulation Scale, DERS), and impulsivity (UPPS Impulsive Behaviour Scale). A conditional process analysis was performed to investigate whether emotion dysregulation statistically mediated the effect of childhood maltreatment severity on impulsivity depending on group (BPD vs. CC vs. HC). RESULTS Childhood maltreatment, particularly emotional maltreatment, was positively associated with impulsivity and emotion regulation difficulties across all groups. Difficulties in emotion regulation statistically mediated the effect of childhood maltreatment on impulsivity in BPD, but not in the other groups. CONCLUSION In the context of current conceptualizations of BPD and previous research, findings suggest that problems with emotion regulation may be related to a history of childhood maltreatment, which may in turn enhance impulsivity. Targeting emotion dysregulation in psychotherapy and discussing it in relation to childhood maltreatment can help decreasing impulsive behaviors in individuals with BPD. Given the correlational design of our study which does not allow causal conclusions, future studies have to employ prospective, experimental designs and include larger sample sizes to corroborate associations between childhood maltreatment, emotion dysregulation, and impulsivity.
Collapse
Affiliation(s)
- Annegret Krause-Utz
- Department of Clinical Psychology, Institute of Psychology, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Ezgi Erol
- Department of Clinical Psychology, Institute of Psychology, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands.,3Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.,4Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Athina V Brousianou
- Department of Clinical Psychology, Institute of Psychology, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Sylvia Cackowski
- 4Medical Faculty, University of Heidelberg, Mannheim, Germany.,5Department of Psychosomatic Medicine and Psychtherapy, Central Institute of Mental Health (CIMH), Mannheim, Germany
| | - Christian Paret
- 4Medical Faculty, University of Heidelberg, Mannheim, Germany.,5Department of Psychosomatic Medicine and Psychtherapy, Central Institute of Mental Health (CIMH), Mannheim, Germany
| | - Gabriele Ende
- 4Medical Faculty, University of Heidelberg, Mannheim, Germany.,6Department Neuoimaging, Central Institute of Mental Health (CIMH), Mannheim, Germany
| | - Bernet Elzinga
- Department of Clinical Psychology, Institute of Psychology, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| |
Collapse
|
4
|
Levy-Gigi E, Shamay-Tsoory SG. Help me if you can: Evaluating the effectiveness of interpersonal compared to intrapersonal emotion regulation in reducing distress. J Behav Ther Exp Psychiatry 2017; 55:33-40. [PMID: 27888748 DOI: 10.1016/j.jbtep.2016.11.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Although humans have developed abundant strategies to down regulate their own negative emotions, at times of distress they frequently turn to significant others to seek comfort. In the present study we use a novel performance-based paradigm to evaluate the effectiveness of this interaction. METHODS Forty-seven couples in a long-term relationship volunteered to participate in the study. In each couple the two partners were randomly assigned as either target or regulator. The target viewed pictures with negative valance. In response to each picture he/she was then instructed to choose and apply a regulatory strategy (i.e., intrapersonal emotion regulation) or to apply a regulatory strategy chosen by his/her partner, the regulator (i.e., interpersonal emotion regulation). RESULTS We found that the outside perspective of the regulator helped reducing distress more effectively than intrapersonal emotion regulation. Moreover, the cognitive, but not the emotional, empathy of the regulator predicted the added value of interpersonal emotion regulation. Specifically, regulators with a better ability to understand their partners' point of view, selected regulatory strategies that reduced levels of distress more effectively. LIMITATIONS While the present study examined possible effects of depression, anxiety and the ability to identify and describe feelings, a larger sample is needed in order to optimally address their potential moderating effect. CONCLUSIONS The results illuminate the value of non-professional interventions and the importance of cognitive empathy in reducing distress. The study has significant clinical implications, providing a simple behavioral tool that can be used to decrease and prevent psychopathology.
Collapse
Affiliation(s)
- Einat Levy-Gigi
- The School of Education and Gonda Multidisciplinary Brain Research Center, Bar- Ilan University, Ramat-Gan, Israel.
| | | |
Collapse
|
5
|
Di Trani M, Renzi A, Vari C, Zavattini GC, Solano L. Gambling Disorder and Affect Regulation: The Role of Alexithymia and Attachment Style. J Gambl Stud 2016; 33:649-659. [DOI: 10.1007/s10899-016-9637-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
6
|
Okita K, Ghahremani DG, Payer DE, Robertson CL, Mandelkern MA, London ED. Relationship of Alexithymia Ratings to Dopamine D2-type Receptors in Anterior Cingulate and Insula of Healthy Control Subjects but Not Methamphetamine-Dependent Individuals. Int J Neuropsychopharmacol 2015; 19:pyv129. [PMID: 26657175 PMCID: PMC4886668 DOI: 10.1093/ijnp/pyv129] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/25/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Individuals with substance-use disorders exhibit emotional problems, including deficits in emotion recognition and processing, and this class of disorders also has been linked to deficits in dopaminergic markers in the brain. Because associations between these phenomena have not been explored, we compared a group of recently abstinent methamphetamine-dependent individuals (n=23) with a healthy-control group (n=17) on dopamine D2-type receptor availability, measured using positron emission tomography with [(18)F]fallypride. METHODS The anterior cingulate and anterior insular cortices were selected as the brain regions of interest, because they receive dopaminergic innervation and are thought to be involved in emotion awareness and processing. The Toronto Alexithymia Scale, which includes items that assess difficulty in identifying and describing feelings as well as externally oriented thinking, was administered, and the scores were tested for association with D2-type receptor availability. RESULTS Relative to controls, methamphetamine-dependent individuals showed higher alexithymia scores, reporting difficulty in identifying feelings. The groups did not differ in D2-type receptor availability in the anterior cingulate or anterior insular cortices, but a significant interaction between group and D2-type receptor availability in both regions, on self-report score, reflected significant positive correlations in the control group (higher receptor availability linked to higher alexithymia) but nonsignificant, negative correlations (lower receptor availability linked to higher alexithymia) in methamphetamine-dependent subjects. CONCLUSIONS The results suggest that neurotransmission through D2-type receptors in the anterior cingulate and anterior insular cortices influences capacity of emotion processing in healthy people but that this association is absent in individuals with methamphetamine dependence.
Collapse
Affiliation(s)
- Kyoji Okita
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Doris E Payer
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Chelsea L Robertson
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Mark A Mandelkern
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern)
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences (Drs Okita, Ghahremani, and London), Department of Molecular and Medical Pharmacology (Drs Robertson and London), and Brain Research Institute (Dr London), University of California Los Angeles, Los Angeles, CA; Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Payer); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (Dr Payer); Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA (Drs Okita, Robertson, Mandelkern, and London); Department of Physics, University of California Irvine, Irvine, CA (Dr Mandelkern).
| |
Collapse
|
7
|
Interactions between the salience and default-mode networks are disrupted in cocaine addiction. J Neurosci 2015; 35:8081-90. [PMID: 26019326 DOI: 10.1523/jneurosci.3188-14.2015] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cocaine dependence is a complex neuropsychiatric disorder manifested as dysregulation of multiple behavioral, emotional, and cognitive constructs. Neuroimaging studies have begun to identify specific neurobiological circuit impairments in cocaine-dependent (CD) individuals that may underlie these symptoms. However, whether, where, and how the interactions within and between these circuits are disrupted remain largely unknown. We used resting-state fMRI and modularity network analysis to identify brain modules of a priori interest (default-mode network [DMN], salience network [SN], executive control network [ECN], medial temporal lobe [MTL], and striatum) in 47 CD and 47 matched healthy control (HC) participants and explored alterations within and between these brain modules as a function of addiction. At the module level, intermodule connectivity decreased between DMN and SN in CD. At the nodal level, several regions showed decreased connections with multiple modules in CD: the rostral anterior cingulate connection strength was reduced with SN and MTL; the posterior cingulate had reduced connections with ECN; and the bilateral insula demonstrated decreased connections with DMN. Furthermore, alexithymia, a personality trait previously associated with addiction, correlated negatively with intramodule connectivity within SN only in cocaine users. Our results indicate that cocaine addiction is associated with disrupted interactions among DMN, MTL, and SN, which have been implicated, respectively, in self-referential functions, emotion and memory, and coordinating between internal and external stimuli, providing novel and important insights into the neurobiological mechanisms of cocaine addiction.
Collapse
|
8
|
Zullig KJ, Teoli DA, Valois RF. Emotional self-efficacy and alcohol and tobacco use in adolescents. JOURNAL OF DRUG EDUCATION 2015; 44:51-66. [PMID: 25721321 DOI: 10.1177/0047237915573526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n = 2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by gender associations between lower ESE and alcohol and tobacco use. Results suggest that alcohol and cigarette use was significantly associated (p ≤ .05) with lower levels of ESE for certain race/gender groups. Results have implications for school- and community-based mental health services and substance use prevention/education programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health in fieldwork, research, and substance abuse prevention/education program evaluation efforts should be considered.
Collapse
Affiliation(s)
- Keith J Zullig
- Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Dac A Teoli
- School of Medicine, University of Pittsburgh, PA, USA
| | - Robert F Valois
- Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA Department of Family & Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA
| |
Collapse
|