1
|
Li R, Karukivi M, Lindblom J, Korja R, Karlsson L, Karlsson H, Nolvi S. Trajectories of COVID-19 pandemic-related depressive symptoms and potential predictors: the FinnBrain Birth Cohort Study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:151-163. [PMID: 37668674 PMCID: PMC10799828 DOI: 10.1007/s00127-023-02559-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In the context of the COVID-19 pandemic, mental health problems have been reported, and parents of young children may be more vulnerable to psychological distress due to increased caregiving responsibilities. However, research on the heterogeneity of the longitudinal course of psychological symptoms during the pandemic and the predispositions linked with these courses is still scarce. This study aimed to identify differential trajectories of depressive symptoms among the parents of young children and investigate the role of temperament traits, alexithymia, and coping styles in the heterogeneity of the symptom trajectories. METHODS The sample consists of 844 parents from the FinnBrain Birth Cohort Study. Latent growth mixture modeling was utilized to identify trajectories of depressive symptoms from pre-pandemic between 2014 and 2019 (T0, the closest available measurement was used) to May/June 2020 (T1) and December 2020 (T2) during the pandemic. Multinomial logistic regression was used to examine temperament, alexithymia, and coping as predictors of symptom trajectories, controlling for various background factors. RESULTS Four trajectories of depressive symptoms were identified. Most parents experienced low and stable depressive symptoms. Negative affect, effortful control, alexithymia, emotion-diverting coping (self-distraction and venting), and avoidant coping (denial and behavioral disengagement) were predictors for subclinical stable depressive symptoms. Constructive coping (positive reframing, acceptance, and humor) protected the cohort parents from increasing or moderately high depressive symptoms. CONCLUSIONS The findings have implications for identifying vulnerable individuals with specific traits and strengthening of constructive coping strategies as possible foci in interventions for depression during global crises.
Collapse
Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland.
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jallu Lindblom
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- Department of Medical Psychology, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| |
Collapse
|
2
|
Li R, Kajanoja J, Karlsson L, Karlsson H, Nolvi S, Karukivi M. Longitudinal patterns of alcohol use and psychological symptoms during COVID-19 pandemic and role of alexithymia: A latent transition analysis in the FinnBrain Birth Cohort Study. J Affect Disord 2023; 338:440-448. [PMID: 37385387 PMCID: PMC10299841 DOI: 10.1016/j.jad.2023.06.056] [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: 03/21/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has been posing widespread influence on mental well-being. However, research on the dynamic relations between alcohol use and psychological symptoms in the context of the pandemic and the role of alexithymic traits in predicting the development of mental health problems longitudinally remains scarce. METHODS Latent profile and transition analyses were conducted to model the longitudinal patterns of transitions in the profiles of alcohol use and psychological symptoms across 10 months during the pandemic (from May 2020 to March 2021) and to investigate the role of alexithymia and its dimensions Difficulty Identifying and Describing Feelings (DIF and DDF), and Externally Oriented Thinking (EOT) in 720 parents from the FinnBrain Birth Cohort Study. RESULTS Three profiles, Risky Drinking, Distressed Non-Risky Drinking, and Non-Distressed, Non-Risky Drinking, and their transitions were identified. The role of alexithymia appeared to be stronger in Risky Drinking than Non-Distressed, Non-Risky Drinking. DIF predicted the development of symptoms in Risky Drinking, whereas DDF predicted Risky Drinking remaining stable over time and showed a trend towards psychological distress in Risky Drinking and Non-Distressed, Non-Risky Drinking. EOT was more likely to be a risk factor for Risky Drinking remaining constant and Non-Distressed, Non-Risky Drinking becoming Risky Drinking. LIMITATIONS This study was mainly limited by the generalizability of the findings. CONCLUSIONS Our findings add deeper insights into the longitudinal development of alcohol use and psychological symptoms as well as evidence on the role of alexithymia in shaping mental health, providing implications for tailoring clinical preventive and therapeutic measures.
Collapse
Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland.
| | - Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Finland; Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Finland
| |
Collapse
|
3
|
Exploring alexithymia profiles and their associations with childhood adversity and COVID-19 burnout among Chinese college students: A person-centered approach. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
4
|
Li R, Kajanoja J, Lindblom J, Korja R, Karlsson L, Karlsson H, Nolvi S, Karukivi M. The role of alexithymia and perceived stress in mental health responses to COVID-19: A conditional process model. J Affect Disord 2022; 306:9-18. [PMID: 35304231 PMCID: PMC8923745 DOI: 10.1016/j.jad.2022.03.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little is known about the psychological mechanisms underlying the mental health problems related to the COVID-19 pandemic. Hypothetically, perceived stress and alexithymia may be factors involved in the mental distress response to the pandemic; however, this remains largely unstudied. This study aims to explore the moderating role of alexithymia and the moderated mediation effects of perceived stress on the mental health change due to the pandemic. METHODS The conditional process model was used to examine the moderated mediation. The sample consists of 659 parents from the FinnBrain Birth Cohort Study who completed the Toronto Alexithymia Scale (TAS-20) at 6 months after delivery, the Edinburgh Postnatal Depression Scale (EPDS) and the Symptom Checklist-90 (SCL-90) at 2 or 4 years postpartum between 2014 and 2019; and a questionnaire for pandemic events, a brief 4-item version of the Perceived Stress Scale (PSS-4) and the follow-up EPDS/SCL-90 in 2020 after 3 months from the outbreak of COVID-19 pandemic in Finland. RESULTS Alexithymia moderated the perceived stress-mediated relations between the pandemic events and the changes of depressive and anxiety symptoms through enhancing the detrimental effect of perceived stress on mental health. LIMITATIONS This study was mainly limited by the causality and generalizability of the findings. CONCLUSIONS Our findings indicate the moderated mediation effects of alexithymia and perceived stress on the psychological symptoms, which has implications for understanding how and when stressful situations translate to mental health problems, identifying vulnerable individuals, and tailoring preventive and psychotherapeutic interventions.
Collapse
Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Jallu Lindblom
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Turku Institute for Advanced Studies, University of Turku, Turku, Finland; Department of Medical Psychology, Charité Universitätsmedizin, Berlin, Germany; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
5
|
Taylor GJ, Bagby RM. Examining Proposed Changes to the Conceptualization of the Alexithymia Construct: The Way Forward Tilts to the Past. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:145-155. [PMID: 33285546 DOI: 10.1159/000511988] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Graeme J Taylor
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,
| | - R Michael Bagby
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Personalized behavior management as a replacement for medications for pain control and mood regulation. Sci Rep 2021; 11:20297. [PMID: 34645900 PMCID: PMC8514566 DOI: 10.1038/s41598-021-99803-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a ‘resource matching’ hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual (‘out-of-touch-with-reality’) behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational (‘in-touch-with-reality’) behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual ‘resource’ of the pain experience from its ‘feeding’ to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.
Collapse
|
7
|
Bagby RM, Sanches M, Carnovale M, Taylor GJ. An evaluation of alexithymia subtypes using latent profile analysis. Psychiatry Res 2021; 299:113840. [PMID: 33667948 DOI: 10.1016/j.psychres.2021.113840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 02/23/2021] [Indexed: 11/17/2022]
Abstract
Four subtypes of the alexithymia construct have been proposed based on different response patterns to the Cognitive and Affective dimensions of the Bermond-Vorst Alexithymia Questionnaire (BVAQ). Previous studies investigating whether alexithymia subtypes can be statistically estimated have not found complete support for these specific subtypes. These previous studies, however, contained several methodological limitations such as relatively small sample sizes, and considerations of only a limited number of proposed subtypes. In the current investigation, we examined whether the four proposed subtypes could be statistically detected in a large sample of undergraduate students (N = 612) who completed the BVAQ, using latent profile analysis (LPA). Based on observed responses to the five BVAQ subscales, consistent with previous studies, our results did not find support for the four proposed alexithymia subtypes. Rather, our results suggested LPA solutions that correspond to individuals with various degrees of alexithymia 'severity'. Although further studies are needed, especially with clinical samples, these results question the idea of four alexithymia subtypes and suggest that the implementation of these subtypes into various research studies may be a premature endeavour.
Collapse
Affiliation(s)
- R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada.
| | - Marcos Sanches
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Carnovale
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Graeme J Taylor
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
8
|
Ideal cardiovascular health in adolescents and young adults is associated with alexithymia over two decades later: Findings from the cardiovascular risk in Young Finns Study: Department: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Psychiatry Res 2020; 289:112976. [PMID: 32413709 DOI: 10.1016/j.psychres.2020.112976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 12/17/2022]
Abstract
We evaluated the association of cardiovascular health in adolescence and young adulthood with alexithymia 25 years later. The study sample (n = 1122) participated in evaluations conducted in 1986 (baseline) and in 2011-2012 (T2). Baseline health factors and behaviors were assessed utilizing seven ideal cardiovascular health metrics (ICH index) including blood pressure, cholesterol and glucose levels, smoking, physical activity, body-mass-index, and diet. The stability of the ICH index was evaluated with corresponding assessments in 2007 (T1). At T2, alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). The main analyses were conducted using ANCOVA and adjusted for depression, age, and present social and lifestyle factors. TAS-20 subscales, Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking, were analyzed separately. The ICH index was significantly associated with the TAS-20 total score, as well as both with DIF and DDF. A less ideal cardiovascular health was associated with higher alexithymia scores. However, regarding the separate factors, only the association between non-ideal dietary habits and DIF was significant in the multivariate analyses. The baseline ICH index score was stable from baseline to T1. We conclude that non-ideal cardiovascular lifestyle habits in adolescence and young adulthood are significantly associated with later alexithymia.
Collapse
|
9
|
Bagby RM, Parker JDA, Taylor GJ. Twenty-five years with the 20-item Toronto Alexithymia Scale. J Psychosom Res 2020; 131:109940. [PMID: 32007790 DOI: 10.1016/j.jpsychores.2020.109940] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Twenty-five years ago, this journal published two articles reporting the development and initial validation of the 20-Item Toronto Alexithymia Scale (TAS-20). Since then the literature on alexithymia has burgeoned with the vast majority of this research using the TAS-20, including multiple language translations of the scale. METHOD In this article we review the psychometric literature evaluating various aspects of the reliability and validity of the TAS-20 and examine some of the controversies surrounding the scale and the construct it assesses. We reflect on the ways in which the TAS-20 has advanced the measurement of the construct and theory of alexithymia. We also discuss recent developments and some future directions for the measurement of alexithymia. RESULTS Although not without some controversy, the preponderance of the accumulated evidence over a 25-year period supports various aspects of the reliability and validity of the TAS-20, including findings from confirmatory factor analytic and convergent and discriminant validity studies which are consistent with Nemiah et al.'s (Nemiah et al., 1976 [3]) and Taylor and colleagues (Taylor et al., 1997 [9]) theoretical formulations and definition of the alexithymia construct. CONCLUSIONS Based on the accumulated empirical evidence of 25 years, we conclude that the TAS-20 is a reliable and valid instrument and accurately reflects and measures the construct as it was originally defined by Nemiah et al. Nemiah et al. (1976) [3] as composed of deficits in affect awareness and expression and pensée opératoire (operational thinking). Clinicians and researchers can use the TAS-20 to confidently measure alexithymia, the roots of which have foundations in psychosomatic medicine.
Collapse
Affiliation(s)
- R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - James D A Parker
- Department of Psychology, Trent University, Peterborough, Ontario, Canada
| | - Graeme J Taylor
- Department of Psychiatry (Emeritus), University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Raffagnato A, Angelico C, Valentini P, Miscioscia M, Gatta M. Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents. Front Psychiatry 2020; 11:262. [PMID: 32322222 PMCID: PMC7158949 DOI: 10.3389/fpsyt.2020.00262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/18/2020] [Indexed: 12/16/2022] Open
Abstract
The present case-control study aimed to investigate the relationship between alexithymia and somatic complaints in the psychopathological setting of non-suicidal self-injury (NSSI). A clinical sample of 134 adolescents (115 females; 85.5%) from 12 to 18 years old engaging in NSSI was compared with a control group of 243 high-school students (157 females; 64.6%) from 13 to 18 years old. Data were collected using two questionnaires: The Youth Self-Report 11-18 and the 20 Toronto Alexithymia Scale. In both cases and controls, the presence of somatization and alexithymia was associated with more severe psychopathological problems. Analyses were conducted to explore the association between somatic disorders and alexithymia. In the clinical group, somatic complaints were reported by 95.9% of alexithymic individuals, whereas only 44.3% of alexithymic adolescents reported somatic complaints. A one-way relationship emerged between somatization and alexithymia: while alexithymia would seem to be a factor associated with self-injury, somatic disorders were strongly associated with alexithymia, but not necessarily with self-injury. Among the self-harming adolescents, those with both alexithymia and somatization had a more severe psychopathological picture than the individuals with alexithymia but no somatization. This would suggest that, in the setting of NSSI, greater difficulty with identifying feelings is associated with somatization, and alexithymia would be an attribute common to self-harming behavior and somatization, both of which are characterized by the body being used to express psychological and emotional problems. Future research could further investigate alexithymia in self-harming individuals, in relation to any presence or absence of somatic disorders, with longitudinal assessments on any differences in their manifestation of self-injury and its psychopathological correlates.
Collapse
Affiliation(s)
- Alessia Raffagnato
- Child and Adolescent Neuropsychiatry Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Caterina Angelico
- Child and Adolescent Neuropsychiatry Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Perla Valentini
- Department of Communication Sciences, Humanistic and International Studies: History, Culture, Languages, Literature, Arts, Media, University of Urbino 'Carlo Bo', Urbino, Italy
| | - Marina Miscioscia
- Child and Adolescent Neuropsychiatry Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.,Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | - Michela Gatta
- Child and Adolescent Neuropsychiatry Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Kajanoja J, Karukivi M, Scheinin NM, Tuulari JJ, Ahrnberg H, Karlsson L, Karlsson H. Alexithymia, body mass index and gestational diabetes in pregnant women - FinnBrain birth cohort study. J Psychosom Res 2019; 124:109742. [PMID: 31443801 DOI: 10.1016/j.jpsychores.2019.109742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Overweight, obesity, and associated problems in metabolic health are an increasing public health concern. Personality traits and emotional processing styles may play a role in the regulation of food intake and reward. Alexithymia is a personality construct involving difficulties in identifying and expressing emotions and has been previously associated with eating disorders and metabolic problems. We examined associations between alexithymia dimensions, Body Mass Index (BMI) and gestational diabetes in pregnant women. METHODS The participants were 1660 pregnant women living in Finland from the FinnBrain Birth Cohort Study. We investigated the associations between alexithymia and its dimensions as measured by the Toronto Alexithymia Scale (TAS-20), overweight, and gestational diabetes. The effects of age, education, and depressive symptoms were controlled for using hierarchical regression analysis. RESULTS Alexithymic individuals had a higher prevalence of overweight compared to those with low or moderate levels of alexithymia (66.0% vs. 34.8%, OR 3.6, adjusted OR 3.6, CI95% 1.9-6.8, p < .001). The dimension of Externally Oriented Thinking (EOT) accounted for this association. Compared to the lowest quartile, women in the highest EOT quartile had a higher BMI (24.3 vs. 25.6, p < .001), and a higher prevalence of overweight [adjusted OR 1.94, CI95% 1.43-2.62, p < .001] and gestational diabetes [OR 1.75, CI95% 1.19-2.55, p = .005]. CONCLUSIONS Alexithymia, and especially its dimension of EOT is associated with overweight and gestational diabetes in pregnant women. Future studies should clarify causality and examine potential mechanisms and associations with pregnancy outcomes and fetal health.
Collapse
Affiliation(s)
- Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland.
| | - Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland
| | - Noora M Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland
| | - Jetro J Tuulari
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland; The Turku Collegium for Science and Medicine, University of Turku, Turku, Finland
| | - Hanna Ahrnberg
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; FinnBrain Birth Cohort Study, University of Turku, Finland
| |
Collapse
|
13
|
Kajanoja J, Scheinin NM, Karukivi M, Karlsson L, Karlsson H. Alcohol and tobacco use in men: the role of alexithymia and externally oriented thinking style. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:199-207. [DOI: 10.1080/00952990.2018.1528267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M. Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
14
|
Shin SH, McDonald SE, Conley D. Profiles of adverse childhood experiences and impulsivity. CHILD ABUSE & NEGLECT 2018; 85:118-126. [PMID: 30172413 PMCID: PMC6214760 DOI: 10.1016/j.chiabu.2018.07.028] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 05/28/2023]
Abstract
The influence of adverse childhood experiences (ACEs), which often include childhood exposure to maltreatment and household dysfunction, on health risk behaviors during young adulthood has been widely documented. A vulnerability marker for the increased risky behaviors among young ACEs victims such as impulsivity remains to be explored. The present study investigated how different profiles of ACEs influence impulsivity in young adulthood. Respondents were young people (N = 336; ages 18-25) who were recruited from the community. Latent class analysis (LCA) was used to identify subpopulations of individuals based on varying exposure to 13 types of ACEs, including childhood maltreatment, household dysfunction, and community violence. Four distinct classes emerged: Low ACEs (56%), Household Dysfunction/Community Violence (14%), Emotional ACEs (14%), and High/Multiple ACEs (16%). Multiple regression analyses found that compared to those in the Low ACEs class, young adults in the Emotional ACEs and High/Multiple ACEs respectively, reported increased levels of negative urgency, controlling for sociodemographic characteristics and other impulsivity traits. This result suggests that childhood exposure to multiple ACEs at high levels is particularly related to impulsive self-control in the context of intense negative emotionality.
Collapse
Affiliation(s)
- Sunny H Shin
- Virginia Commonwealth University, School of Social Work, Academic Learning Commons, 1000 Floyd Avenue, Third Floor, Box 842027, Richmond, VA 23284-2027, United States; Virginia Commonwealth University, School of Medicine, Department of Psychiatry, 1200 East Broad Street, P.O. Box 980710, Richmond, VA 23298-071, United States.
| | - Shelby Elaine McDonald
- Virginia Commonwealth University, School of Social Work, Academic Learning Commons, 1000 Floyd Avenue, Third Floor, Box 842027, Richmond, VA 23284-2027, United States.
| | - David Conley
- Virginia Commonwealth University, School of Social Work, Academic Learning Commons, 1000 Floyd Avenue, Third Floor, Box 842027, Richmond, VA 23284-2027, United States.
| |
Collapse
|
15
|
Kajanoja J, Scheinin NM, Karlsson L, Karlsson H, Karukivi M. Alexithymia as a health risk and resilience factor: Response to Dr. Davydov. J Psychosom Res 2017; 101:135-136. [PMID: 28802740 DOI: 10.1016/j.jpsychores.2017.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Kajanoja
- University of Turku, FinnBrain Birth Cohort Study, Finland.
| | - N M Scheinin
- University of Turku, FinnBrain Birth Cohort Study, Finland
| | - L Karlsson
- University of Turku, FinnBrain Birth Cohort Study, Finland
| | - H Karlsson
- University of Turku, FinnBrain Birth Cohort Study, Finland
| | - M Karukivi
- University of Turku, FinnBrain Birth Cohort Study, Finland; Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| |
Collapse
|
16
|
Kajanoja J, Scheinin NM, Karlsson L, Karlsson H, Karukivi M. Illuminating the clinical significance of alexithymia subtypes: A cluster analysis of alexithymic traits and psychiatric symptoms. J Psychosom Res 2017; 97:111-117. [PMID: 28606490 DOI: 10.1016/j.jpsychores.2017.04.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/05/2017] [Accepted: 04/08/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alexithymia is a personality construct involving difficulties identifying and verbalizing feelings, and an externally oriented thinking style. There is preliminary evidence for alexithymia subtypes that may carry different risk profiles for psychiatric illness. The aim of this study was to gain support for the existence of alexithymia subtypes and further characterize their clinical relevance. METHODS To identify possible subtypes, a cluster analysis was conducted for individuals with high alexithymic traits (N=113). Current depressive and anxiety symptoms, self-reported psychiatric medical history, and self-reported early life adversity were compared between subtypes. The cluster analysis was replicated with the low (N=2471) and moderate (N=290) alexithymia groups. RESULTS We identified two alexithymia subtypes. Compared to type A, type B alexithymia was associated with higher levels of difficulties in identifying feelings, and was more strongly associated with current depressive (Cohen's d=0.77, p<0.001) and anxiety symptoms (Cohen's d=0.82, p<0.001), and self-reported early life adversity (Cohen's d 0.42, p=0.048). Compared to type A, type B alexithymia was also associated with a higher prevalence of self-reported diagnosis of major depressive- (30.2% vs. 8.3%) and anxiety disorder (18.9% vs. 3.3%). CONCLUSIONS The results of this study support the hypothesis of alexithymia subtypes, and add support to the growing evidence showing that alexithymia is likely a heterogeneous and dimensional phenomenon. The subtype (type B) with most pronounced difficulties in identifying feelings may be associated with a higher risk for psychiatric illness compared to type A alexithymia, and may exhibit a more severe history of early life adversity.
Collapse
Affiliation(s)
- J Kajanoja
- University of Turku, FinnBrain birth cohort study, Finland.
| | - N M Scheinin
- University of Turku, FinnBrain birth cohort study, Finland
| | - L Karlsson
- University of Turku, FinnBrain birth cohort study, Finland
| | - H Karlsson
- University of Turku, FinnBrain birth cohort study, Finland
| | - M Karukivi
- University of Turku, FinnBrain birth cohort study, Finland
| |
Collapse
|
17
|
Rosenberg N, Rufer M, Lichev V, Ihme K, Grabe HJ, Kugel H, Kersting A, Suslow T. Observer-Rated Alexithymia and its Relationship with the Five-Factor-Model of Personality. Psychol Belg 2016; 56:118-134. [PMID: 30479433 PMCID: PMC5854197 DOI: 10.5334/pb.302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Studies examining the relationship between alexithymia and personality exclusively employed self-report measures of alexithymia. In the present study, we examined the relationship of both observer-rated and self-reported alexithymia with the Big Five personality dimensions. We administered the Toronto Structured Interview for Alexithymia (TSIA) as an interview-based measure of alexithymia and, in addition, two self-report questionnaires, the 20-item Toronto Alexithymia Scale (TAS-20) and the Bermond-Vorst Alexithymia Questionnaire (BVAQ). Fifty-one university students were interviewed and completed the alexithymia scales and the NEO Five-Factor Inventory. In contrast to TAS-20 and BVAQ, the Difficulty identifying feelings (DIF) scale of the TSIA was found to be unrelated to neuroticism, suggesting that the frequently reported association between DIF and neuroticism could be due to the use of self-report scales. In contrast, the affective dimension of alexithymia, measured by the BVAQ, was even negatively related with neuroticism. Thus, a paucity of fantasy and little emotional arousal goes together with increased emotional stability. Furthermore, we revealed negative correlations between interview-based alexithymia scores and openness to experience and agreeableness, which cross-validated the self-report findings. Finally, extraversion and conscientiousness each showed only one negative correlation, namely with subscales of the BVAQ. Taken together, our findings show that on the basis of interviews there is no evidence for a relation of DIF with neuroticism, while associations of alexithymia with low openness to experience and low agreeableness emerged irrespective of assessment approach. The relations of alexithymia with personality are discussed in the light of different measurement approaches.
Collapse
Affiliation(s)
- Nicole Rosenberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Michael Rufer
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Vladimir Lichev
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Klas Ihme
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| |
Collapse
|