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Tatsumi T. Individual-differences affecting emotion regulation behaviors of injured athletes: A retrospective quantitative study. PLoS One 2023; 18:e0294551. [PMID: 37988355 PMCID: PMC10662789 DOI: 10.1371/journal.pone.0294551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/05/2023] [Indexed: 11/23/2023] Open
Abstract
Suppressing the expression of negative emotions caused by injuries prevents athletes from fully accepting their sports injuries. However, acceptance is maintained and promoted when positive reappraisal and suppression are synchronized. This study analyzes individual-differences affecting the use of these two emotion regulation behaviors. A questionnaire consisting of personal variables regarding athletic identity, commitment to sports ethics and emotion regulation behavior scale for suppression and positive reappraisal was conducted on athletes with previous injuries (N = 180). A model estimate using correlation analysis and multiple regression analysis was examined utilizing structural equation modeling. The results indicated that commitment to sports ethics and athletic identity promoted the suppression of expressiveness toward negative emotions and positive reappraisal. In contrast, difficulty describing feelings facilitated suppression and hindered positive reappraisal. These results seem to suggest that commitment to sports ethics and athletic identity might facilitate suppression and positive reappraisal, as well as function as variables maintaining and promoting accepting sports injuries. On the other hand, difficulties in describing feelings might lead to abnormal responses caused by accumulated negative emotions due to the suppression of expressing negative emotions and lack of positive reappraisal promotion.
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Affiliation(s)
- Tomonori Tatsumi
- Department of Education, Faculty of Education, Kio University, Umami-naka, Koryo-cho, Kitakatsuragi-gun, Nara, Japan
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2
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Silvestro O, Ricciardi L, Catalano A, Vicario CM, Tomaiuolo F, Pioggia G, Squadrito G, Schwarz P, Gangemi S, Martino G. Alexithymia and asthma: a systematic review. Front Psychol 2023; 14:1221648. [PMID: 37609491 PMCID: PMC10441120 DOI: 10.3389/fpsyg.2023.1221648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Growing evidence from scientific research elucidates the important role of alexithymia in chronic immune diseases. This Review aims to explore the presence of alexithymia in patients affected by asthma and clarify its associations with other involved psychological and physical factors. In January 2023, according to PRISMA guidelines, a systematic search using PubMed and Scopus was conducted. Twenty-six studies were eligible based on inclusion criteria. Alexithymia was significantly present in asthma patients, with most studies reporting a higher prevalence (from 9 to 62.8%) than in control groups (approximately 10%). The coexistence of asthma and alexithymia was associated with a worse quality of life, psychiatric comorbidity, poor symptom control, and difficulty in recognizing exacerbations of the disease. These results suggest that alexithymia can negatively impact the management of asthma. For this reason, we recommend an accuracy assessment in clinical settings and the implementation of psychological interventions to promote the emotional and physical wellbeing of asthmatic patients.
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Affiliation(s)
- Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luisa Ricciardi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Endocrinology, Research Centre for Ageing and Osteoporosis, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
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Pei JH, Wei YT, Tao HX, Yang QX, Zhang GL, Guo XJ, Guo JL, Yan FH, HanPhD L. The prevalence and characteristics of alexithymia in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. J Psychosom Res 2022; 162:111018. [PMID: 36088789 DOI: 10.1016/j.jpsychores.2022.111018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Alexithymia is common in patients with type 2 diabetes mellitus (T2DM). Although the estimated prevalence of alexithymia in patients with T2DM is widely reported, these results have not been synthesized. AIM To systematically assess the prevalence and characteristics of alexithymia in patients with T2DM. METHODS We searched for relevant publications in PubMed, Embase, Web of Science, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database, and Weipu Database. The prevalence of alexithymia, the mean scores, and standard deviations of the total scale of the 20-item Toronto Alexithymia Scale (TAS-20) were pooled using random effects meta-analysis in Stata 13.0, with studies stratified by study location in this meta-analysis. RESULTS This meta-analysis included thirteen articles. Pooled prevalence of alexithymia (TAS-20 total scores ≥61) were 43.0% (95%CI 35.0-51.0%), and the prevalence of alexithymia was higher in China (45.0%, 95%CI 36.0-54.0%) compared with non-China (41.0%, 95%CI 29.0-54.0%). The pooled mean score for the TAS-20 total scale was 57.70 (95% CI 55.25-60.15). Leave-one-out analysis showed that none of the studies significantly impacted the overall pooled results. CONCLUSIONS This meta-analysis indicated a high prevalence of alexithymia in patients with T2DM. Thus, clinicians need to be aware of and assess appropriately for alexithymia in patients with T2DM.
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Affiliation(s)
- Ju-Hong Pei
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Yu-Ting Wei
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Hong-Xia Tao
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Qiu-Xia Yang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Guo-Li Zhang
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xiao-Jing Guo
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Jia-Li Guo
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Fang-Hong Yan
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Lin HanPhD
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China; Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, China.
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Ma X, Jiang X, Jiang Y. Increased spontaneous fronto-central oscillatory power during eye closing in patients with multiple somatic symptoms. Psychiatry Res Neuroimaging 2022; 324:111489. [PMID: 35537300 DOI: 10.1016/j.pscychresns.2022.111489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/20/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022]
Abstract
Functional somatic symptoms (FSS) are typically associated with excessive thoughts, feelings and behaviors related to the physical symptoms whether these symptoms are unequivocally associated with a diagnosed medical condition. However, less evidence is available concerning the neurocognitive deficits underlying these features of FSS. This study aimed to examine the resting-state oscillatory activities during both eye-opening and eye-closure states in individuals with FSS. Sixty-six FSS patients screened with PHQ-15 received two 10-minute sessions of EEG assessments. All completed clinical measurements on depression, anxiety, and psychological measurements on personality traits and alexithymia. Patients scoring high on PHQ-15 (the multiple somatic symptom (MSS) or SS-high group) demonstrated increased powers in central channels (C3 and C4) in low-beta band and in the left-frontal channel (F3) in high-gamma band, during eye-closure states. Patients with higher scores in depression were more likely to be classified as the SS-high group. SS-high patients demonstrated increased difficulties in describing and identifying emotions, and less reduced day-dreaming. The combined findings in increased fronto-central high-frequency activities and alexithymia measures suggest MSS patients are associated with enhanced internally-oriented thinking and cognitive simulation which may lead to intensified feelings of simulated events and misattribution of symptoms. Future treatments should focus on eliminating cognitive bias and enhancing accuracy in interoceptive awareness.
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Affiliation(s)
- Xiquan Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoming Jiang
- Institute of Linguistics, Shanghai International Studies University, Shanghai, China.
| | - Yu Jiang
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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La Touche R, García-Salgado A, Cuenca-Martínez F, Angulo-Díaz-Parreño S, Paris-Alemany A, Suso-Martí L, Herranz-Gómez A. Alexithymia and facial emotion recognition in patients with craniofacial pain and association of alexithymia with anxiety and depression: a systematic review with meta-analysis. PeerJ 2021; 9:e12545. [PMID: 34909277 PMCID: PMC8638568 DOI: 10.7717/peerj.12545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background We aimed to determine the presence of alexithymia in patients with craniofacial pain (CFP) compared with asymptomatic individuals. Our secondary aims were to assess the relationship of alexithymia with anxiety and depression levels, as well as to assess the presence of facial emotion recognition deficit. Methods Medline, Scielo and Google Scholar were searched, with the last search performed in 8 September 2021. Standardized mean differences (SMDs) and 95% CIs were calculated for relevant outcomes and were pooled in a meta-analysis using the random effects model. In addition, meta-analyses of correlations and a meta-regression of alexithymia with depression and anxiety were performed. Results Regarding alexithymia, assessed through the Toronto Alexithymia Scale (TAS), the results showed significant differences, with higher values in patients compared with asymptomatic individuals, with a large clinical effect (SMD 0.46; 95% CI [0.22–0.71]; heterogeneity-Q 66.86; p < 0.001; inconsistency (I2) = 81%). We found statistically significant correlations with a small clinical effect of alexithymia with anxiety and depression. The meta-regression showed no significant association between the TAS and anxiety or depression. With respect to facial emotion recognition, the results showed statistically significant differences, with greater recognition difficulty in patients compared with asymptomatic individuals, with a large clinical effect (SMD −1.17; 95% CI [−2.01 to −0.33]; heterogeneity-Q 2.97; p = 0.080; I2 = 66%). Conclusions Patients with CFP showed alexithymia with moderate evidence. There was also moderate evidence indicating that these patients had significant deficits in facial emotion recognition compared with asymptomatic individuals. Furthermore, alexithymia showed statistically significant correlations with anxiety and depression levels.
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Affiliation(s)
- Roy La Touche
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain.,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alberto García-Salgado
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain
| | - Alba Paris-Alemany
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Fisioterapia, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Aida Herranz-Gómez
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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The relationship between alexithymia and theory of mind: A systematic review. Neurosci Biobehav Rev 2021; 131:497-524. [PMID: 34599917 DOI: 10.1016/j.neubiorev.2021.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022]
Abstract
Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.
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Alvarado-Bolaños A, Cervantes-Arriaga A, Zuazua-Vidal L, Esquivel-Zapata Ó, Alcocer-Salas Á, Rodríguez-Violante M. Determinants and impact of alexithymia on quality of life in Parkinson's disease. Neurologia 2020; 38:S0213-4853(20)30338-8. [PMID: 33317969 DOI: 10.1016/j.nrl.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.
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Affiliation(s)
- A Alvarado-Bolaños
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - A Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - L Zuazua-Vidal
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ó Esquivel-Zapata
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Á Alcocer-Salas
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - M Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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Alexithymia Is Associated with Reduced Quality of Life and Increased Caregiver Burden in Parkinson's Disease. Brain Sci 2020; 10:brainsci10060401. [PMID: 32599704 PMCID: PMC7348697 DOI: 10.3390/brainsci10060401] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is the second most frequent neurodegenerative disease of people who are beyond 50 years of age. People with PD (PwP) suffer from a large variety of motor and non-motor symptoms resulting in reduced health-related quality of life (HR-QoL). In the last two decades, alexithymia was identified as an additional non-motor symptom in PD. Alexithymia is defined as a cognitive affective disturbance resulting in difficulty to identify and distinguish feelings from bodily sensations of emotional arousal. In PD, the frequency of patients suffering of alexithymia is increased compared to healthy controls. The aim of the present study was to determine the relationship of alexithymia to HR-QoL of the PwP and caregiver burden of the corresponding caregiver. This cross-sectional questionnaire-based study used disease specific questionnaires for HR-QoL and caregiver burden. In total 119 PwP and their corresponding caregivers were included in the study. HR-QoL of the PwP correlated significantly with alexithymia (p < 0.001), especially the sub-components "identifying feelings" (p < 0.001) and "difficulties describing feelings" (p = 0.001). Caregiver burden also correlated significantly with PwP alexithymia (p < 0.001). However, caregiver burden was associated with sub-components "identifying feelings" (p < 0.008) and "external oriented thinking" (p < 0.004). These data support the importance of alexithymia as a non-motor symptom in PD.
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Association Between Alexithymia and Risk of Incident Cardiovascular Diseases in the SUpplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) Cohort. Psychosom Med 2018; 80:460-467. [PMID: 29649036 DOI: 10.1097/psy.0000000000000592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although it has been suggested that alexythymia is associated with cardiovascular diseases, studies are scarce and a causal relationship is questionable. This study explored the prospective association between alexithymia and cardiovascular events in middle-aged participants without cardiovascular history at baseline. METHODS The 26-item Toronto Alexithymia Scale (TAS-26) was completed by 5586 participants of the French SUpplémentation en VItamines et Minéraux AntioXydants cohort (41.4% of men, M [SD] age = 52.2 [6.3] years) in 1996-1997. Covariates measured at baseline included age, occupational status, depressive symptoms, smoking status, body mass index, hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia. The follow-up ran from January 1, 1998, to the date of the first cardiovascular event, the date of death or September 1, 2007, whichever occurred first. Cardiovascular events were validated by an independent expert committee. Hazard ratios and 95% confidence intervals were computed with Cox regressions. RESULTS During an average of 8.9 years of follow-up, 171 first cardiovascular events were validated. After adjustment for age, sex, and occupational status, there was no association between baseline alexithymia and cardiovascular events at follow-up (hazard ratio [95% confidence interval] for 15 points of TAS-26 = 1.00 [0.81-1.23], p > .99). Adjusting for all covariates, using binary TAS-26 cut-offs or TAS-26 subscores yielded similar nonsignificant results. CONCLUSIONS In this large prospective study, alexithymia and cardiovascular events were not associated among a nonclinical population. This casts some doubt on whether alexithymia could be a meaningful target in the prevention of cardiovascular diseases. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov (NCT00272428).
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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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Loas G, Braun S, Delhaye M, Linkowski P. The measurement of alexithymia in children and adolescents: Psychometric properties of the Alexithymia Questionnaire for Children and the twenty-item Toronto Alexithymia Scale in different non-clinical and clinical samples of children and adolescents. PLoS One 2017; 12:e0177982. [PMID: 28542508 PMCID: PMC5444663 DOI: 10.1371/journal.pone.0177982] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 05/05/2017] [Indexed: 01/17/2023] Open
Abstract
This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18–0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.
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Affiliation(s)
- Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
- * E-mail:
| | - Stéphanie Braun
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Marie Delhaye
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Paul Linkowski
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Mattila AK, Saarni SI, Salminen JK, Huhtala H, Sintonen H, Joukamaa M. Alexithymia and health-related quality of life in a general population. PSYCHOSOMATICS 2009; 50:59-68. [PMID: 19213974 DOI: 10.1176/appi.psy.50.1.59] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and, therefore, it may predispose individuals to both psychological and somatic symptoms. OBJECTIVE The authors investigated the relationship between alexithymia and health-related quality of life (HRQoL) in a nationally representative population sample of 5,418 subjects, age 30 to 97 years. METHOD Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and HRQoL measured with the 15D, a generic HRQoL measure. RESULTS Alexithymia was significantly associated with lower HRQoL independently of other variables. The TAS-20 subfactor Difficulties Identifying Feelings was the strongest common denominator between alexithymia and HRQoL. CONCLUSION Alexithymia may be a predisposing factor to poorer HRQoL.
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Affiliation(s)
- Aino K Mattila
- Tampere School of Public Health, FIN-33014, University of Tampere, Tampere, Finland.
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Mattila AK, Poutanen O, Koivisto AM, Salokangas RK, Joukamaa M. Alexithymia and Life Satisfaction in Primary Healthcare Patients. PSYCHOSOMATICS 2007; 48:523-9. [DOI: 10.1176/appi.psy.48.6.523] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Müller J, Bühner M, Ellgring H. Is there a reliable factorial structure in the 20-item Toronto Alexithymia Scale? A comparison of factor models in clinical and normal adult samples. J Psychosom Res 2003; 55:561-8. [PMID: 14642988 DOI: 10.1016/s0022-3999(03)00033-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used instrument for measuring alexithymia. However, different studies did not always yield identical factor structures of this scale. The present study aims at clarifying some discrepant results. METHODS Maximum likelihood confirmatory factor analyses of a German version of the TAS-20 were conducted on data from a clinical sample (N=204) and a sample of normal adults (N=224). Five different models with one to four factors were compared. RESULTS A four-factor model with factors (F1) "Difficulty identifying feelings" (F2), "Difficulty describing feelings" (F3), "Low importance of emotion" and (F4) "Pragmatic thinking" and a three-factor model with the combined factor "Difficulties in identifying and describing feelings" described the data best. Factors related to "externally oriented thinking" provided no acceptable level of reliability. CONCLUSIONS Results from the present and other studies indicate that the factorial structure of the TAS-20 may vary across samples. Whether factor structures different from the common three-factor structure are an exception in some mainly clinical populations or a common phenomenon outside student populations has still to be determined. For a further exploration of the factor structure of the TAS-20 in different populations, it would be important not only to test the fit of the common three-factor model, but also to consider other competing solutions like the models of the present study.
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Affiliation(s)
- Jochen Müller
- Institute for Psychology (I), University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany.
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Ramirez SM, Glover H, Ohlde C, Mercer R, Goodnick P, Hamlin C, Perez-Rivera MI. Relationship of numbing to alexithymia, apathy, and depression. Psychol Rep 2001; 88:189-200. [PMID: 11293028 DOI: 10.2466/pr0.2001.88.1.189] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study assessed the relationship between numbing and three associated conditions of alexithymia, apathy, and depression, utilizing data collected on 353 Vietnam combat veterans diagnosed with Posttraumatic Stress Disorder from in- and out-patient settings and an outreach center at various Department of Veterans Affairs Medical centers. All subjects completed four self-report measures: the Glover Numbing Scale, the Beck Depression Inventory, the Apathy Evaluation Scale, and the Toronto Alexithymia Scale-20. The correlation matrix indicated that scores on the four measures were moderately to highly correlated. Principal components analysis with a varimax rotation indicated a five-factor solution that provided evidence for the factorial validity of each of the constructs assessed. Results of the factor analysis of items from the four measures were consistent with numbing being a separate and distinct construct from alexithymia, apathy, and depression. In general, results indicated that all constructs measured were separate and distinct from one another.
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