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Preece DA, Mehta A, Petrova K, Sikka P, Pemberton E, Gross JJ. Alexithymia profiles and depression, anxiety, and stress. J Affect Disord 2024; 357:116-125. [PMID: 38387670 DOI: 10.1016/j.jad.2024.02.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Alexithymia is a multidimensional trait comprised of difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is regarded as an important risk factor for emotional disorders, but there are presently limited data on each specific facet of alexithymia, or the extent to which deficits in processing negative emotions, positive emotions, or both, are important. In this study, we address these gaps by using the Perth Alexithymia Questionnaire (PAQ) to comprehensively examine the relationships between alexithymia and depression, anxiety, and stress symptoms. METHODS University students (N = 1250) completed the PAQ and the Depression Anxiety Stress Scales-21. Pearson correlations, hierarchical regressions, and latent profile analysis were conducted. RESULTS All facets of alexithymia, across both valence domains, were significantly correlated with depression, anxiety, and stress symptoms (r = 0.27-0.40). Regression analyses indicated that the alexithymia facets, together, could account for a significant 14.6 %-16.4 % of the variance in depression, anxiety, and stress. Difficulties identifying negative feelings and difficulties identifying positive feelings were the strongest unique predictors across all symptom categories. Our latent profile analysis extracted eight profiles, comprising different combinations of alexithymia facets and psychopathology symptoms, collectively highlighting the transdiagnostic relevance of alexithymia facets. LIMITATIONS Our study involved a student sample, and further work in clinical samples will be beneficial. CONCLUSIONS Our data indicate that all facets of alexithymia, across both valence domains, are relevant for understanding depression, anxiety, and stress. These findings demonstrate the value of facet-level and valence-specific alexithymia assessments, informing more comprehensive understanding and more targeted treatments of emotional disorder symptoms.
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Affiliation(s)
- David A Preece
- Curtin University, Curtin enAble Institute & School of Population Health, Australia; Stanford University, Department of Psychology, Stanford, United States of America; The University of Western Australia, School of Psychological Science, Australia.
| | - Ashish Mehta
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Kate Petrova
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Pilleriin Sikka
- Stanford University, Department of Psychology, Stanford, United States of America; University of Turku, Department of Psychology and Speech-Language Pathology, Finland; University of Turku, Turku Brain and Mind Center, Finland; University of Skövde, Department of Cognitive Neuroscience and Philosophy, Sweden
| | - Ethan Pemberton
- Edith Cowan University, Psychology Department, Perth, Australia
| | - James J Gross
- Stanford University, Department of Psychology, Stanford, United States of America
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2
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Avendano S, Moirangthem S, Taflet M, Heude B, Koehl M, van der Waerden J, Downes N. Prenatal maternal negative life events associated with child emotional and behavioral problems in the French EDEN cohort. J Affect Disord 2024; 356:224-232. [PMID: 38608762 DOI: 10.1016/j.jad.2024.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Prenatal negative life events (NLEs) have been linked to adverse health outcomes in children. However, few studies examine this relationship during late childhood using trajectory analyses. Additionally, the impact of specific NLEs domains on child development remains unclear. This study aims to longitudinally explore the association between NLEs (cumulative score and specific NLEs domains) and child outcomes from birth to late childhood. METHODS 1135 mother-child pairs from the French EDEN cohort were followed from 24 to 28 weeks of pregnancy up to 11 years of age. Maternal self-reports of prenatal NLEs were collected immediately after birth, then analyzed as a cumulative score and by NLEs domain. Children's emotional and behavioral symptoms were assessed at 4 timepoints through the Strengths and Difficulties Questionnaire. RESULTS Children of mothers exposed to ≥3 NLEs were more likely to follow trajectories of high levels of peer relationship problems (aOR [95 % CI] = 5.69 [1.74-18.69]), emotional symptoms (aOR [95 % CI] = 3.05 [1.08-8.63]), and conduct problems (aOR [95 %] = 3.53 [1.20-10.42]). Among the domains of NLEs, only events related to housing, finance, and living conditions were significantly associated with high emotional and behavioral difficulties trajectories (aOR [95%CI] = 2.71[1.26-5.81]). LIMITATIONS Potential attrition bias due to a higher dropout rate for children experiencing early indications of emotional and behavioral difficulties. CONCLUSION Findings support the relationship between prenatal NLEs and child outcomes, underscoring the importance of assessing prenatal stressors across life domains to identify mothers who might be in need of support.
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Affiliation(s)
- Sara Avendano
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Social Epidemiology Research Team, F 75012 Paris, France
| | - Simi Moirangthem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Social Epidemiology Research Team, F 75012 Paris, France
| | - Muriel Taflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F 75004 Paris, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F 75004 Paris, France
| | - Muriel Koehl
- Universtié Bordeaux, INSERM, Neurocentre Magendie, U1215, Neurogenesis and Pathophysiology Group, 33000 Bordeaux, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Social Epidemiology Research Team, F 75012 Paris, France.
| | - Naomi Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Social Epidemiology Research Team, F 75012 Paris, France
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Brancati GE, De Rosa U, Acierno D, Caruso V, De Dominicis F, Petrucci A, Moriconi M, Elefante C, Gemignani S, Medda P, Schiavi E, Perugi G. Development of a self-report screening instrument for emotional dysregulation: the Reactivity, Intensity, Polarity and Stability questionnaire, screening version (RIPoSt-SV). J Affect Disord 2024; 355:406-414. [PMID: 38570039 DOI: 10.1016/j.jad.2024.03.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Emotional dysregulation (ED) refers to the inability to manage emotional experiences or expressions hindering goal-oriented behavior. Moderate impairment on at least two domains among temper control, affective lability, and emotional over-reactivity has been proposed to identify ED in adults with attention-deficit/hyperactivity disorder (ADHD). No screening measure designed for use in diverse psychiatric samples exists. We aimed to develop a self-report screening tool for ED based on the 40-item version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-40). METHODS 150 adult outpatients with non-psychotic conditions were enrolled between February and July 2023 at the Second Psychiatry Unit of Pisa University Hospital. Clinically significant ED (CSED) was defined based on the previously suggested approach for ADHD. Differences between patients with and without CSED were tested. To develop our screening instrument, a decision tree algorithm was trained by hyperparameter tuning through 5-fold cross-validation in 120 subjects and tested on the remaining 30. RESULTS 75 subjects met criteria for CSED (50 %). CSED was associated with lower age and higher prevalence of psychiatric conditions, including minor mood disorders, ADHD, cannabis use disorders, and eating disorders. We identified a decision tree consisting of six items from RIPoSt-40 that effectively detected CSED, with accuracy, sensitivity, specificity, positive and negative predictive values of 80 % or higher in both the training and testing sets. LIMITATIONS Tertiary-level; no consensus on criteria; sample size. CONCLUSION The screening version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-SV) demonstrates promise as a valuable tool for ED screening in clinical settings.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Ugo De Rosa
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Donatella Acierno
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Valerio Caruso
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Francesco De Dominicis
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy; Mental Health Centre, Local Health Unit 2, Spoleto, Italy
| | - Alessandra Petrucci
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy; Mental Health Centre, Local Health Unit 2, Terni, Italy
| | - Martina Moriconi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Camilla Elefante
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Samuele Gemignani
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Pierpaolo Medda
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Elisa Schiavi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy.
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Iris SL, Ivonne MK, Liat AH, Noa BM, Alon L, Hila S, Shira B, Silvana F. Screening for Emotional Problems in Pediatric Hospital Outpatient Clinics: Psychometric Traits of the Pediatric Symptom Checklist (Hebrew Version). J Clin Psychol Med Settings 2024; 31:432-443. [PMID: 38001395 DOI: 10.1007/s10880-023-09982-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/26/2023]
Abstract
This study assessed feasibility and psychometric properties of the Hebrew parent version of the Pediatric Symptom Checklist (PSC-17), aiming to improve treatment access for children and adolescents with behavioral and mental needs through early screening. The PSC-17 and the Strengths and Difficulties Questionnaire (SDQ) were filled in the waiting room, at three ambulatory clinics in a tertiary pediatric center, by 274 parents using a tablet or their cellphone. Demographic and clinical data were retrieved from patients' files. PSC results were compared to SDQ results and assessed vis-a-vis a psychiatric diagnosis, determined previously and independently by trained pediatric psychiatrists for 78 pediatric patients who attended these clinics. Construct and discriminant validity of the PSC-17 Hebrew version were good. Sensitivity, specificity, and positive and negative predictive values are presented. The PSC-17 (Hebrew version) was found to be a feasible tool for mental health screening at pediatric ambulatory care clinics.
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Affiliation(s)
| | | | | | - Benaroya-Milshtein Noa
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Liberman Alon
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Segal Hila
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Brik Shira
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Fennig Silvana
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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5
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Ma EZ, Hooper SR, Seegan PL, Wan J. Association of atopic dermatitis with emotional and behavioral problems in childhood. J Am Acad Dermatol 2024; 90:1249-1252. [PMID: 38320626 PMCID: PMC11096002 DOI: 10.1016/j.jaad.2024.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/21/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Affiliation(s)
- Emily Z Ma
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; University of Maryland School of Medicine, Baltimore, Maryland
| | - Stephen R Hooper
- Department of Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Paige L Seegan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joy Wan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
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Zheng X, Huang L, Xie Z, Peng L, Zhou X. Relationship Between Warm Childhood Memories and Mobile Phone Addiction: A Moderated Mediation Model. Psychol Rep 2024; 127:1085-1099. [PMID: 36269848 DOI: 10.1177/00332941221135479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Childhood experiences have an important effect on mobile phone addiction, but the relationship between positive childhood experiences and mobile phone addiction and its underlying mechanisms should be explored further. This study aims to explore a model linking early memories of warmth and safeness to mobile phone addiction via the mediating role of alexithymia and moderating role of negative coping styles. A total of 379 Chinese college students (Mage = 19.80 years, SD = 1.38; 240 females) completed a questionnaire consisting of the Early Memories of Warmth and Safeness Scale, Toronto Alexithymia Scale, Mobile Phone Addiction Scale, and Negative Coping Styles Scale. Results indicate that early memories of warmth and safeness are negatively correlated with mobile phone addiction, and alexithymia plays a mediating role in the link between early memories of warmth and safeness and mobile phone addiction. In addition, negative coping styles significantly moderate the relationship between early memories of warmth and safeness and alexithymia, specifically, the negative association between early memories of warmth and safeness and alexithymia is highly significant at high (vs. low) negative coping styles levels. The findings suggest that early memories of warmth and safeness are an important protective factor against mobile phone addiction, which enrich the literature on mobile phone addiction and provide empirical support for the prevention of mobile phone addiction.
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Affiliation(s)
- Xianliang Zheng
- School of Educational Science, Gannan Normal University, Ganzhou, China
| | - Lijuan Huang
- School of Educational Science, Gannan Normal University, Ganzhou, China
| | - Zhihua Xie
- School of Educational Science, Gannan Normal University, Ganzhou, China
| | - Linlu Peng
- School of Educational Science, Gannan Normal University, Ganzhou, China
| | - Xiangsen Zhou
- School of Educational Science, Gannan Normal University, Ganzhou, China
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7
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Burghart M, Sahm AHJ, Schmidt S, Bulla J, Mier D. Understanding empathy deficits and emotion dysregulation in psychopathy: The mediating role of alexithymia. PLoS One 2024; 19:e0301085. [PMID: 38718018 PMCID: PMC11078418 DOI: 10.1371/journal.pone.0301085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
Psychopathy is a severe personality disorder marked by a wide range of emotional deficits, including a lack of empathy, emotion dysregulation, and alexithymia. Previous research has largely examined these emotional impairments in isolation, ignoring their influence on each other. Thus, we examined the concurrent interrelationship between emotional impairments in psychopathy, with a particular focus on the mediating role of alexithymia. Using path analyses with cross-sectional data from a community sample (N = 315) and a forensic sample (N = 50), our results yielded a statistically significant mediating effect of alexithymia on the relationship between psychopathy and empathy (community and forensic) and between psychopathy and emotion dysregulation (community). Moreover, replacing psychopathy with its three dimensions (i.e., meanness, disinhibition, and boldness) in the community sample revealed that boldness may function as an adaptive trait, with lower levels of alexithymia counteracting deficits in empathy and emotion dysregulation. Overall, our findings indicate that psychopathic individuals' limited understanding of their own emotions contributes to their lack of empathy and emotion dysregulation. This underscores the potential benefits of improving emotional awareness in the treatment of individuals with psychopathy.
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Affiliation(s)
- Matthias Burghart
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Alexander H. J. Sahm
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Sergej Schmidt
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Daniela Mier
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
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8
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Li S, Chen X, Liu L, Sun C. The relationship between social withdrawal and problematic social media use in Chinese college students: a chain mediation of alexithymia and negative body image. BMC Psychol 2024; 12:246. [PMID: 38702805 PMCID: PMC11067283 DOI: 10.1186/s40359-024-01755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
This study explores the relationship between social withdrawal and problematic social media use among college students, with a focus on the mediating roles of alexithymia and negative body image. Using the University Student Social Withdrawal Questionnaire, Social Media Addiction Scale, Toronto Alexithymia Scale, and Negative Body Image Scale, 2582 college students (33.46% male, average age = 19.46 years, SD = 2.23) were surveyed. Social withdrawal, alexithymia, negative body image, and problematic social media use were significantly correlated with each other. Social withdrawal positively predicted problematic social media use, and both alexithymia and negative body image played a chain mediating role between social withdrawal and problematic social media use. The findings indicate that individual social withdrawal is associated with college students' problematic use of social media. The results suggest that alexithymia and negative body image may mediate this association, highlighting a potential pathway through which social withdrawal influences social media use patterns.
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Affiliation(s)
- Shuang Li
- Jilin Normal University, Siping, China.
- School of Educational Science & Institute of Psychology, Jilin Normal University, Siping, 136000, Jilin Province, China.
| | | | - Lili Liu
- Northwest Normal University, Lanzhou, China
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9
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Utas-Akhan L, Avci D, Basak I. Art Therapy as a Nursing Intervention for Individuals With Schizophrenia. J Psychosoc Nurs Ment Health Serv 2024; 62:29-38. [PMID: 37956349 DOI: 10.3928/02793695-20231025-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The aim of the current study was to determine the effects of group art therapy on clinical symptoms, alexithymia, and quality of life among people with schizophrenia. This single-blinded, randomized controlled trial was performed with 66 individuals with schizophrenia from a community mental health center in western Turkey between September 2021 and February 2022. Following art therapy, the intervention group had lower severity of positive, negative, and general psycho-pathology symptoms; lower levels of alexithymia; and higher levels of psychological health, social relationships, and total quality of life than the control group; and the difference between groups was statistically significant (p < 0.05). Results reveal that art therapy combined with pharmacological therapy contributes to good clinical outcomes among individuals with schizophrenia. This evidence can guide psychiatric nurses to use art therapy to reduce psychopathology severity and increase functionality and quality of life among individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(5), 29-38.].
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10
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Preece DA, Petrova K, Mehta A, Sikka P, Gross JJ. Alexithymia or general psychological distress? Discriminant validity of the Toronto Alexithymia Scale and the Perth Alexithymia Questionnaire. J Affect Disord 2024; 352:140-145. [PMID: 38320659 DOI: 10.1016/j.jad.2024.01.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/15/2024] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Alexithymia is an important transdiagnostic risk factor for emotion-based psychopathologies. However, it remains unclear whether alexithymia questionnaires actually measure alexithymia, or whether they measure emotional distress. Our aim here was to address this discriminant validity concern via exploratory factor analysis (EFA) of the 20-item Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). METHOD United States general community adults (N = 508) completed the TAS-20, PAQ, and the Depression Anxiety Stress Scales-21 (DASS-21). EFA was used to examine the latent dimensions underlying these measures' scores. RESULTS Our EFA extracted two higher-order factors, an "alexithymia" factor and a "general distress" factor (i.e., depression, anxiety, stress). All PAQ scores loaded cleanly on the alexithymia factor, with no cross-loadings on the distress factor. However, for the TAS-20, Difficulty Identifying Feelings (DIF) facet scores cross-loaded highly on the distress factor. LIMITATIONS Our sample consisted of general community adults; future work in clinical settings will be useful. CONCLUSIONS Our data indicate that the PAQ has good discriminant validity. However, the TAS-20 appears to have significant discriminant validity problems, in that much of the variance in its DIF facet reflects people's current levels of distress, rather than alexithymia. The TAS-20, which has traditionally been the most widely used alexithymia questionnaire, may therefore not be the optimal alexithymia tool. Our findings add to the body of evidence supporting the validity and utility of the PAQ and suggest that, moving forward, it is a superior option to the TAS-20 for alexithymia assessments.
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Affiliation(s)
- David A Preece
- Curtin University, Curtin enAble Institute & School of Population Health, Perth, Australia; The University of Western Australia, School of Psychological Science, Perth, Australia.
| | - Kate Petrova
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Ashish Mehta
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Pilleriin Sikka
- Stanford University, Department of Psychology, Stanford, United States of America; University of Turku, Department of Psychology and Speech-Language Pathology, Finland; University of Turku, Turku Brain and Mind Center, Finland; University of Skövde, Department of Cognitive Neuroscience and Philosophy, Sweden
| | - James J Gross
- Stanford University, Department of Psychology, Stanford, United States of America
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11
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Palazzolo J. [Preventing emotional disorders in the elderly with programs based on cognitive-behavioral therapies]. Soins Gerontol 2024; 29:19-22. [PMID: 38677806 DOI: 10.1016/j.sger.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
The cognitive-behavioral approach is particularly well-suited to older people who are looking for a short-term therapeutic solution to many emotional problems, without necessarily resorting to psychotropic drugs. One of the major advantages of this type of psychological treatment is that it helps seniors develop coping skills that can be beneficial in both the short and long term. However, some adjustments are sometimes necessary to achieve this goal.
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Affiliation(s)
- Jérôme Palazzolo
- Nice; Université internationale Senghor, Alexandrie, Égypte; Université Côte d'Azur, France.
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12
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De Ronda AC, Rice L, Zhao Y, Rosch KS, Mostofsky SH, Seymour KE. ADHD-related sex differences in emotional symptoms across development. Eur Child Adolesc Psychiatry 2024; 33:1419-1432. [PMID: 37368082 PMCID: PMC10986680 DOI: 10.1007/s00787-023-02251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
To investigate developmental changes in emotion dysregulation (ED) and associated symptoms of emotional lability, irritability, anxiety, and depression, among girls and boys with and without ADHD from childhood through adolescence. Data were collected from a sample of 8-18-year-old children with (n = 264; 76 girls) and without (n = 153; 56 girls) ADHD, with multiple time-points from a subsample of participants (n = 121). Parents and youth completed rating scales assessing child ED, emotional lability, irritability, anxiety, and depression. Mixed effects models were employed to examine effects and interactions of diagnosis, sex [biological sex assigned at birth], age among boys and girls with and without ADHD. Mixed effects analyses showed sexually dimorphic developmental patterns between boys and girls, such that boys with ADHD showed a greater reduction in ED, irritability, and anxiety with age compared to girls with ADHD, whose symptom levels remained elevated relative to TD girls. Depressive symptoms were persistently elevated among girls with ADHD compared to boys with ADHD, whose symptoms decreased with age, relative to same-sex TD peers. While both boys and girls with ADHD showed higher levels of ED during childhood (compared to their sex-matched TD peers), mixed effects analyses revealed substantial sexually dimorphic patterns of emotional symptom change during adolescence: Boys with ADHD showed robust improvements in emotional symptoms from childhood to adolescence while girls with ADHD continued to show high and/or increased levels of ED, emotional lability, irritability, anxiety and depression.
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Affiliation(s)
- Alyssa C De Ronda
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Laura Rice
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Yi Zhao
- Department of Biostatistics, Indiana University School of Medicine, 410 West 10th Street, Indianapolis, IN, 46202, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University School of Medicine , 716 North Broadway, Baltimore, MD, 21205, USA
| | - Karen E Seymour
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Mental Health, Johns Hopkins University School of Public Health, 6701 Rockledge Drive, Bethesda, MD, 20892, USA.
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13
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Barrio-Martínez S, Ruiz-Rodríguez P, Medrano LA, Priede A, Muñoz-Navarro R, Moriana JA, Carpallo-González M, Prieto-Vila M, Cano-Vindel A, González-Blanch C. Effect of Reliable Recovery on Health Care Costs and Productivity Losses in Emotional Disorders. Behav Ther 2024; 55:585-594. [PMID: 38670670 DOI: 10.1016/j.beth.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/18/2023] [Accepted: 08/31/2023] [Indexed: 04/28/2024]
Abstract
Despite the high economic costs associated with emotional disorders, relatively few studies have examined the variation in costs according to whether the patient has achieved a reliable recovery. The aim of this study was to explore differences in health care costs and productivity losses between primary care patients from a previous randomized controlled trial (RCT)-PsicAP-with emotional symptoms who achieved a reliable recovery and those who did not after transdiagnostic cognitive-behavioral therapy (TD-CBT) plus treatment as usual (TAU) or TAU alone. Sociodemographic and cost data were obtained for 134 participants treated at five primary care centers in Madrid for the 12-month posttreatment period. Reliable recovery rates were higher in the patients who received TD-CBT + TAU versus TAU alone (66% vs. 34%, respectively; chi-square = 13.78, df = 1, p < .001). Patients who did not achieve reliable recovery incurred more costs, especially associated with general practitioner consultations (t = 3.01, df = 132, p = .003), use of emergency departments (t = 2.20, df = 132, p = .030), total health care costs (t = 2.01, df = 132, p = .040), and sick leaves (t = 1.97, df = 132, p = .048). These findings underscore the societal importance of achieving a reliable recovery in patients with emotional disorders, and further support the value of adding TD-CBT to TAU in the primary care setting.
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Affiliation(s)
| | | | | | - Amador Priede
- Valdecilla Biomedical Research Institute and Mental Health Centre, Hospital de Laredo
| | | | - Juan Antonio Moriana
- Universidad de Córdoba and Maimónides Institute for Research in Biomedicine of Cordoba
| | | | | | | | - César González-Blanch
- Mental Health Centre, Marqués de Valdecilla University Hospital and Universidad Europea del Atlántico
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14
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Aydın Rn A, Ersoy Özcan Rn B, Kaya Rn Y. The Effect of an Emotion Recognition and Expression Program on the Alexithymia, Emotion Expression Skills and Positive and Negative Symptoms of Patients with Schizophrenia in a Community Mental Health Center. Issues Ment Health Nurs 2024; 45:528-536. [PMID: 38563973 DOI: 10.1080/01612840.2024.2326951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This study aimed to examine the effect of an emotion recognition and expression program (EREP) on the alexithymia, emotion expression skills and positive and negative symptoms of patients with schizophrenia. The study had a non-randomized, quasi-experimental design including a pretest, post-test, and follow-up test. It was conducted with 36 patients with schizophrenia (n = 18 intervention group, n = 18 control group) who regularly visited a Community Mental Health Center (CMHC) in Türkiye and participated voluntarily. The EREP was applied to the intervention group for eight weeks. "Personal Information Form", "Emotion Expression Scale (EES)", "Toronto Alexithymia Scale (TAS)", and "Positive Negative Syndrome Scale (PANSS)" were applied to all participants in the pretest, post-test, and follow-up test. The follow-up test was applied one month after the end of the sessions. Number, percentage, chi-square test, and repeated measures analysis of variance were used for data evaluation. In the total alexithymia score, there was a significant difference in the group interaction by time in the intervention group compared to the control group. In terms of total alexithymia score, the post-test and follow-up test mean scores of the intervention group were lower than the control group (p < 0.05; η2 = 0.122). There was a significant time*group interaction in the positive emotion subscale of the EES (p < 0.05; η2 = 0.121). The findings of our study indicated that the EREP had a positive effect on the alexithymia scores of patients with schizophrenia. We found that the EREP used in our study contributed to the reduction of alexithymia levels in patients with schizophrenia.
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Affiliation(s)
- Adeviye Aydın Rn
- Mental Health Nursing Department, Necmettin Erbakan University Faculty of Nursing, Konya, Turkey
| | - Berna Ersoy Özcan Rn
- Social Work Department, Sinop University Faculty of Health Sciences, Sinop, Turkey
| | - Yunus Kaya Rn
- Child Development Department, Aksaray University Faculty of Health Sciences, Aksaray, Turkey
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15
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Liu Y, Duan L, Shen Q, Ma Y, Chen Y, Xu L, Wu Y, Zhang T. The mediating effect of internet addiction and the moderating effect of physical activity on the relationship between alexithymia and depression. Sci Rep 2024; 14:9781. [PMID: 38684733 PMCID: PMC11058241 DOI: 10.1038/s41598-024-60326-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
There is a certain relationship between alexithymia and depression, but further investigation is needed to explore their underlying mechanisms. The aims of this study was to explore the mediating role of internet addiction between alexithymia and depression and the moderating role of physical activity. A total of 594 valid responses were included in the analysis, with a mean age of 18.72 years (SD = 1.09). The sample comprised 250 males (42.09%) and 344 females (57.91%). These responses were utilized for descriptive analysis, correlation analysis, regression analysis, and the development of mediation and moderation models. Alexithymia showed positive correlations with depression and internet addiction, and physical activity was negatively correlated with internet addiction and depression. Internet addiction partially mediated the relationship between alexithymia and depression, while physical activity weakened the association between internet addiction and depression, acting as a moderator. Our findings suggest that excessive Internet engagement may mediate the relationship between alexithymia and depression as an emotional regulatory coping strategy, and that physical activity attenuates the predictive effect of Internet addiction on depression.
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Affiliation(s)
- Yang Liu
- School of Sports Science, Jishou University, Jishou, China
| | - Liangfan Duan
- School of Sports Science, Jishou University, Jishou, China
| | - Qingxin Shen
- School of Sports Science, Jishou University, Jishou, China
| | - Yuanyuan Ma
- School of Sports Science, Jishou University, Jishou, China
| | - Yiyi Chen
- School of Sports Science, Jishou University, Jishou, China
| | - Lei Xu
- School of Sports Science, Jishou University, Jishou, China
- Institute of Physical Education, Shanxi University of Finance and Economics, Taiyuan, China
| | - Yawen Wu
- School of Sports Science, Jishou University, Jishou, China
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16
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Alturki LE, Alofisan GM, Alsaif LK, Alharbi SA, Alturki NM, Aldahash SS, Almutairi RJ, Abd-Elhaleem ZA. Alexithymia and Quality of Life in Saudi Women with Polycystic Ovary Syndrome: A Community-Based Study. Med Sci Monit 2024; 30:e943594. [PMID: 38600677 PMCID: PMC11020573 DOI: 10.12659/msm.943594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/07/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The endocrine metabolic disorder polycystic ovary syndrome (PCOS) is quite common among women. Women with PCOS show a compromised health-related quality of life (HRQoL), impaired emotional well-being, and alexithymia, a neuropsychological phenomenon conceptualized as difficulty in recognizing and expressing one's emotions. However, the relationship between alexithymia and HRQoL in women with PCOS is unclear. This study aimed to investigate the impact of alexithymia on HRQoL in women with PCOS in Saudi Arabia. MATERIAL AND METHODS This descriptive cross-sectional, community-based study enrolled 518 female patients with a diagnosis of PCOS from all age groups. The patients were surveyed via a self-administered questionnaire from December 2022 to January 2023. The survey encompassed sociodemographic data, the 20-item Toronto Alexithymia Scale (TAS-20), and HRQoL 15-dimensional scale (15D). RESULTS This study included 320 participants (61.8%) with alexithymia. A significant association was found between alexithymia and low HRQoL 15D scores in patients with PCOS. Specifically, scores on the TAS-20 subscales related to difficulty in identifying feelings and describing feelings were positively correlated with HRQoL (P=0.000). However, externally oriented thinking subscale scores were not positively correlated with HRQoL (P=0.44). CONCLUSIONS The presence of alexithymia is associated with poor HRQoL in women with PCOS, which is more pronounced among those who received a diagnosis ≥4 years ago. Alexithymia must be considered when assessing the HRQoL of patients with PCOS, considering the relatively high prevalence of alexithymia in these patients.
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Affiliation(s)
- Leen E. Alturki
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Gomanh M. Alofisan
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Layan K. Alsaif
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Saja A. Alharbi
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Nora M. Alturki
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Shekhah S. Aldahash
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Razan J. Almutairi
- Medical Student, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Zeinab A. Abd-Elhaleem
- Department of Basic Science, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
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17
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Ogawa M, Saito A, Karukivi M, Lahti S. Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety. Eur J Oral Sci 2024; 132:e12973. [PMID: 38311805 DOI: 10.1111/eos.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024]
Abstract
We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20-item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment-related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment-related dental anxiety. The association between trait-like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety.
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Affiliation(s)
- Mika Ogawa
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Akihiro Saito
- Department of Business Administration, The University of Kitakyushu, Kitakyushu, Japan
| | - Max Karukivi
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
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18
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Daghigh A. Beyond sleepless nights: Unraveling the complexity of alexithymia and suicide risk among university students. Brain Behav 2024; 14:e3476. [PMID: 38622877 PMCID: PMC11019149 DOI: 10.1002/brb3.3476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/21/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND There is a solid relationship between alexithymia and suicide risk. Nonetheless, the specific impact of alexithymia's distinct subscales on suicide risk has received the attention it deserves. This article presents a comprehensive exploration of suicide risk among university students, focusing on the interconnections among alexithymia, insomnia, and suicidal behavior. Three components of alexithymia including difficulties in describing emotions or feelings (DDF), difficulties in identifying emotions or feelings (DIF), and the externally oriented thinking were considered. METHODS The study involved 208 participants from a Persian university sample, examining the significance of incorporating both alexithymia and insomnia in suicide risk assessment and intervention planning. Insomnia was positioned as a pivotal mediator. A secure electronic link in the Telegram application was employed to collect the data. Both linear and nonlinear prediction models were used to explore potential associations among alexithymia, insomnia, and suicide risk. RESULTS The study revealed substantial positive correlations between alexithymia and suicide risk, as well as between insomnia and suicide risk. Additionally, specific components of alexithymia exhibited noteworthy links to suicide risk. The inclusion of insomnia scores in suicide risk predictions is critical, as it greatly enhances the precision of risk assessments and facilitates the design of targeted and effective therapeutic interventions. The association between alexithymia and suicide risk showed a significant relationship (r = .29, p < .01). Moreover, a significant correlation was observed between alexithymia and insomnia (r = .32, p < .01). Additionally, insomnia exhibited a significant positive correlation with suicide (r = .35, p < .01). Interestingly, DDF and DIF showed positive correlations with suicide (r = .28, p < .01; r = .33, p < .01). CONCLUSION The findings carry profound implications for suicide prevention efforts, providing valuable insights to safeguard the well-being and resilience of university students facing suicide risk challenges.
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Affiliation(s)
- Ahmad Daghigh
- Department of Brain, Mind, and EducationInstitute for Cognitive Science StudiesTehranIran
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19
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Abstract
Whereas emotion theorists often keep their distance from the embodied approach, theorists of embodiment tend to treat emotion as a mainly physiologic process. However, intimate links between emotions and the body suggest that emotions are privileged phenomena to attempt to reintegrate mind and body and that the body helps the mind in shaping emotional responses. To date, research has favored the cerebrum over other parts of the brain as a substrate of embodied emotions. However, given the widely demonstrated contribution of the cerebellum to emotional processing, research in affective neuroscience should consider embodiment theory as a useful approach for evaluating the cerebellar role in emotion and affect. The aim of this review is to insert the cerebellum among the structures needed to embody emotions, providing illustrative examples of cerebellar involvement in embodied emotions (as occurring in empathic abilities) and in impaired identification and expression of embodied emotions (as occurring in alexithymia).
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Affiliation(s)
| | | | | | | | | | - Debora Cutuli
- Santa Lucia Foundation IRCCS, Rome, Italy
- Department of Psychology, University Sapienza of Rome, Rome, Italy
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20
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Khedr MA, El-Ashry AM, El-Sayed MM, Elkot MA, Hussein RM. The effect of physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders: A randomized control trial. Arch Psychiatr Nurs 2024; 49:83-92. [PMID: 38734459 DOI: 10.1016/j.apnu.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/15/2023] [Accepted: 02/09/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Despite evidence that physical exercises have been helpful in the treatment of various psychiatric disorders, it is unclear whether these data can be generalized to bipolar disorder. The use of physical exercises is challenging and hopeful among patients with bipolar disorders. Few studies have examined the efficacy of physical exercise for patients with bipolar disorders. OBJECTIVE Investigate the effect of applying physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders. METHODS This study followed a randomized control trial design "pre and post-test." Patients were randomly allocated to intervention (n = 25) and control groups (Waiting list) (n = 25). The Social Functioning Scale, Toronto Alexithymia Scale, and Sense of Coherence scales were applied in the study. Pre-test and post-tests were administered to investigate the effect of applying the physical exercises program between December 2022 to March 2023. RESULTS A statistically significant increase in the mean sense of coherence and social functioning scores among the study group. Mean alexithymia scores were significantly decreased among the study group between pre, immediately after, and after a three-month follow-up period. CONCLUSION Physical exercises are an adjunctive treatment modality that is helpful for patients with bipolar disorders. Nurse educators and service providers should reconsider the physical health care requirements for patients with bipolar disorders to equip them to manage the common comorbidities in people with mental illness.
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Affiliation(s)
- Mahmoud Abdelwahab Khedr
- Department of Nursing, College of Applied Medical Sciences, Hafr Albatin University, Hafr Albatin, Saudi Arabia.
| | - Ayman Mohamed El-Ashry
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Egypt.
| | - Mona Metwally El-Sayed
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Egypt.
| | - Mohamed Ali Elkot
- Department of Exercises, Faculty of Sports Education for Men, Alexandria University, Egypt.
| | - Rash Mohamed Hussein
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt; Department of Community and Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Buraidah, Saudi Arabia.
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21
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Ke J, Wu J, Zhao W, Wang Y, Zhang Z, Tong Q, Guo Z, Wen Y, Li N, Yu F, Xie S, Zhu C, Wang K, Zhang L. Childhood maltreatment and engaging in NSSI for automatic-negative reinforcement: The mediating role of alexithymia and moderating role of help-seeking attitudes. J Affect Disord 2024; 350:295-303. [PMID: 38211755 DOI: 10.1016/j.jad.2024.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND There is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. METHODS 3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. RESULTS The findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. LIMITATION The study's cross-sectional design hindered the inference of causality. CONCLUSION The present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement.
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Affiliation(s)
- Jing Ke
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jiayi Wu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Weixiang Zhao
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yuebing Wang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Ze Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Qing Tong
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zixuan Guo
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yan Wen
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Nan Li
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Affective Computing & Advanced Intelligent Machine, Hefei, China
| | - Fengqiong Yu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Sisi Xie
- Anhui Mental Health Center, Hefei, China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China.
| | - Lei Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention, Hefei, China.
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22
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Elahi H, Iosif AM, Mukherjee P, Hinshaw SP, Schweitzer JB. Using Hot and Cool Measures to Phenotype and Predict Functional Outcomes Across Dimensions of ADHD and Typical Development in Adolescents. Res Child Adolesc Psychopathol 2024; 52:579-593. [PMID: 38038753 DOI: 10.1007/s10802-023-01149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/02/2023]
Abstract
Multiple pathway models propose that attention deficit hyperactivity disorder (ADHD) arises from dysfunction in separate systems comprised of a "cool" or cognitive pathway versus a "hot" or emotional/reward pathway. Interactions between these pathways and the degree of maturation may further determine functional outcomes for adolescents ranging from those diagnosed with ADHD to typical development (TD). We used a latent profile analysis on rating scales and behavioral task performance assessing emotion, irritability, impulsivity, risk-taking, future orientation, and processing speed (PS) to identify subgroups of TD adolescents and adolescents with ADHD (N = 152) based on the hot and cool pathway model. We identified four classes: 1) High-Complex Challenges; 2) Moderate-Mixed Challenges; 3) Non-Emotive Impulsivity; and 4) High Regulation and Control. A multiple pathway model of ADHD is supported with classes differing in degree of emotional lability and irritability, types of impulsivity, and ability to use future consequences to modulate impulsivity and PS. The classes differed regarding functional behavior, with the High-Complex class demonstrating the most severe functional challenges in academic-related functioning. The Moderate-Mixed class also displayed significant functional challenges but with moderate emotional lability and irritability ratings. The Non-Emotive Impulsivity class exhibited low emotionality and low irritability, yet high impulsivity with limited negative functional consequences, and was composed of a mix of ADHD and TD adolescents. Differences between classes suggest ADHD symptomatology may represent both categorical and dimensional differences. Precision health interventions may be more effective in addressing the specific challenges associated with the classes rather than a one-size-fits-all approach to treating ADHD.
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Affiliation(s)
- Heather Elahi
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA
- MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, CA, USA
| | - Prerona Mukherjee
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA
- MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA.
- MIND Institute, University of California, Davis, Sacramento, CA, USA.
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23
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Hamel C, Rodrigue C, Clermont C, Hébert M, Paquette L, Dion J. Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence. Sci Rep 2024; 14:6359. [PMID: 38493260 PMCID: PMC10944459 DOI: 10.1038/s41598-024-56909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.
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Affiliation(s)
- Catherine Hamel
- Département de Psychologie, Université de Montréal, Montréal, H2V 2S9, Canada.
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada.
| | - Christopher Rodrigue
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Camille Clermont
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Martine Hébert
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Sexologie, Université du Québec À Montréal, Montréal, H2L 4Y2, Canada
| | - Linda Paquette
- Département Des Sciences de La Santé, Université du Québec À Chicoutimi, Chicoutimi, G7H 2B1, Canada
| | - Jacinthe Dion
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Psychologie, Université du Québec À Trois-Rivières, Trois-Rivières, G9A 5H7, Canada
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24
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Kapadi R, Elander J, Bateman AH. Emotion Regulation and Psychological Dependence on Pain Medication among Hospital Outpatients with Chronic Spinal Pain: The Influence of Rumination about Pain and Alexithymia. Subst Use Misuse 2024; 59:1047-1058. [PMID: 38485654 DOI: 10.1080/10826084.2024.2320373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Objective: To examine the extent to which pain acceptance, pain catastrophising and alexithymia moderate associations between pain intensity and psychological pain medication dependence. Methods: Participants (106 hospital outpatients with chronic spinal pain) completed the Leeds Dependence Questionnaire (LDQ) to measure psychological dependence on pain medication, and the Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), the Pain Catastrophising Scale (PCS) and the Toronto Alexithymia Scale-20 (TAS-20), plus the Depression, Anxiety and Stress Scale-21 (DASS-21). Results: Multiple linear regression showed that degree of psychological dependence (measured dimensionally across the range of LDQ scores) was associated with TAS subscale difficulty identifying feelings (DIF) (β = 0.249, p = <0.002) and PCS subscale rumination (β = 0.193, p = 0.030), independently of pain intensity and risk behaviors for medication misuse. The effect of pain intensity was moderated by rumination, with pain intensity more strongly associated with dependence when rumination was high (interaction β = 0.192, p = 0.004). Logistic regression showed that the effect of pain intensity on severe dependence (measured categorically as LDQ score ≥ 20) was moderated by alexithymia, so that severe dependence was independently associated with the combination of intense pain and high alexithymia (interaction odds ratio = 7.26, 95% CIs = 1.63-32.42, p = 0.009). Conclusions: Rumination and alexithymia moderated the associations between pain intensity and psychological pain medication dependence, consistent with emotion regulation theory. This raises the possibility that specifically targeting rumination about pain and symptoms of alexithymia could potentially improve the effectiveness of psychological interventions for chronic pain and help people to avoid or reduce their psychological dependence on pain medication.
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Affiliation(s)
| | - James Elander
- School of Psychology, University of Derby, Derby, UK
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25
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Putica A, Van Dam NT, Felmingham KL, O'Donnell ML. Alexithymia and treatment response for prolonged exposure therapy: An evaluation of outcomes and mechanisms. Psychotherapy (Chic) 2024; 61:44-54. [PMID: 37917810 DOI: 10.1037/pst0000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Alexithymia is the inability to identify and recognize emotions. The present study examined the impact of alexithymia on prolonged exposure (PE) therapy. Participants (n = 68) with PTSD underwent 10 PE sessions. Alexithymia was assessed via the Toronto Alexithymia Scale (TAS-20) and the emotional clarity and awareness subscales of the Difficulties in Emotion Regulation Scale. Treatment outcomes were assessed via the PTSD checklist and Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition at posttreatment and 6-month follow-up. Those with high alexithymia were more likely to endorse experiencing a full PTSD diagnosis immediately posttreatment, χ²(1) = 12.53, p = .002, and at 6-month follow-up, χ²(1) = 11.21, p = .004. Alexithymia was associated with delayed treatment effects on avoidance, with a significant reduction in symptomology observed from pre- to follow-up, t(51) = 4.52, p < .001, and not from pre- to posttreatment. Although both the low and high alexithymia groups showed significant changes in negative changes in thinking and mood, F(2, 14) = 9.18, p = .001, d = 1.57 and F(2, 50) = 13.86, p = .001, d = 1.49, respectively, the high alexithymia group exhibited a marginally lesser magnitude of treatment effect. Although those with significantly greater difficulties with emotional clarity were more likely to drop out of PE treatment, emotional clarity and awareness did not moderate treatment response. Our results confirm the efficacy of PE but also highlight that those with alexithymia show a delayed treatment response and may be at greater risk of pathology after treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Andrea Putica
- Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne
| | | | - Kim L Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne
| | - Meaghan L O'Donnell
- Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne
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26
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Li M, Yuan Y, Cheng X, Wang Y, Xu Z. Childhood maltreatment and insomnia in college students: The role of alexithymia and psychological distress. Acta Psychol (Amst) 2024; 243:104149. [PMID: 38245937 DOI: 10.1016/j.actpsy.2024.104149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Insomnia, which is highly prevalent among college students, has been identified as one of the negative consequences of childhood maltreatment. While prior studies have uncovered distinct correlations between childhood maltreatment, insomnia, and other variables, the potential underlying mechanisms need to be further explored. This study focused on the chain-mediating role of alexithymia and psychological distress in the relationship between childhood maltreatment and insomnia. An online cross-sectional survey was conducted among Chinese college students, yielding 999 valid questionnaires that included demographic information, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Toronto Alexithymia Scale (TAS), the 21-item Depression Anxiety Stress Scales (DASS-21), and the Insomnia Severity Index (ISI). A chain-mediating model was then tested. The results revealed significant positive correlations between each pair of the four variables. Alexithymia and psychological distress separately mediated the link between childhood maltreatment and insomnia (effect of alexithymia was 0.06 with 95 % CI [0.03, 0.09]; effect of psychological distress was 0.24 with 95 % CI [0.19, 0.29]). Additionally, a chain-mediating effect of alexithymia and psychological distress was observed (chain-mediating effect was 0.12 with 95 % CI [0.09, 0.15]). The findings suggest that emotional interventions may mitigate the long-term effect of childhood maltreatment on sleep problems among college students, by improving the ability to recognize emotions and decreasing emotional problems.
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Affiliation(s)
- Man Li
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin 300387, China
| | - Yidan Yuan
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Xinyue Cheng
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Yurou Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Zhansheng Xu
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin 300387, China.
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27
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Wycoff AM, Griffin SA, Helle AC, Haney AM, Watts AL, Trull TJ. The Brief Emotion Dysregulation Scale: Development, Preliminary Validation, and Recommendations for Use. Assessment 2024; 31:335-349. [PMID: 36960725 PMCID: PMC10518026 DOI: 10.1177/10731911231161800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Emotion dysregulation is a multi-faceted, transdiagnostic construct, and its assessment is crucial for characterizing its role in the development, maintenance, and treatment of psychiatric problems. We developed the Brief Emotion Dysregulation Scale (BEDS) to capture four components of emotion dysregulation: sensitivity, lability, reactivity, and consequences. We examined factor structure and construct validity in four independent samples of college students (N = 1,485). We elected to treat consequences as a separate index of problems associated with emotion dysregulation. Exploratory and confirmatory factor analyses did not support the reactivity subscale and instead supported a well-fitting two-factor solution for sensitivity and lability. Multi-group analyses demonstrated strong factorial invariance by gender. The resulting 12-item BEDS includes sensitivity and lability subscales and a separate consequences scale to indicate associated problems. Convergent correlations suggested good construct validity. This provides preliminary support for the BEDS as a brief transdiagnostic screening tool for emotion dysregulation and associated consequences.
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28
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Zahid A, Taylor GJ, Lau SCL, Stone S, Bagby RM. Examining the Incremental Validity of the Perth Alexithymia Questionnaire (PAQ) Relative to the 20-Item Toronto Alexithymia Scale (TAS-20). J Pers Assess 2024; 106:242-253. [PMID: 37144843 DOI: 10.1080/00223891.2023.2201831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/28/2023] [Indexed: 05/06/2023]
Abstract
The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used instrument for assessing alexithymia, with more than 25 years of research supporting its reliability and validity. The items that compose this scale were written to operationalize the components of the construct that are based on clinical observations of patients and thought to reflect deficits in the cognitive processing of emotions. The Perth Alexithymia Questionnaire (PAQ) is a recently introduced measure and is based on a theoretical attention-appraisal model of alexithymia. An important step with any newly developed measure is to evaluate whether it demonstrates incremental validity over existing measures. In this study using a community sample (N = 759), a series of hierarchical regression analyses were conducted that included an array of measures assessing constructs closely associated with alexithymia. Overall, the TAS-20 showed strong associations with these various constructs to which the PAQ was unable to add any meaningful increase in prediction relative to the TAS-20. We conclude that until future studies with clinical samples using several different criterion variables demonstrate incremental validity of the PAQ, the TAS-20 should remain the self-report measure of choice for clinicians and researchers assessing alexithymia, albeit as part of a multi-method approach.
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Affiliation(s)
- Aqsa Zahid
- Department of Psychological Clinical Science, University of Toronto
| | | | | | | | - R Michael Bagby
- Department of Psychological Clinical Science, University of Toronto
- Department of Psychiatry, University of Toronto
- Department of Psychology, University of Toronto
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29
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Monaco S, Massari MG, Renzi A, Di Trani M. COVID-19 post-traumatic stress disorder: the role of ACEs, alexithymia, and attachment in the Italian population. Eur Rev Med Pharmacol Sci 2024; 28:2615-2624. [PMID: 38567620 DOI: 10.26355/eurrev_202403_35767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The COVID-19 pandemic is considered a collective traumatic event. Several studies have highlighted high levels of post-traumatic stress disorder (PTSD) symptoms among the general population during the pandemic. The general aim of this research is to explore the role of adverse childhood experiences (ACEs), alexithymia, and anxiety and avoidance attachment dimensions as risk factors that are making individuals more vulnerable to PTSD-COVID-related symptoms. SUBJECTS AND METHODS The COVID-19-PTSD Questionnaire, 20-Item Toronto Alexithymia Scale (TAS-20), Adverse Childhood Experiences Questionnaire, and the Experiences in Close Relationships-Revised Form (ECR-R) were administered to 224 participants who were between 18 and 65 years of age, and residents of Italy. Socio-demographic variables were also collected. The data was collected between October 2021 and March 2022. RESULTS The findings of the Spearman correlation analysis showed several significant associations between alexithymia, attachment dimensions, and PTSD symptoms related to COVID-19 diagnosis and age. A multivariable logistic regression model was performed using the COVID-19-PTSD total scores over/under the clinical cut-off as dependent variables and age, gender, anxiety and avoidance attachment scores, ACEs, and total alexithymia as independent variables, with alexithymia total score (B = .071; p = .001), ECR-R Anxiety (B = .034; p = .001) and ECR-R Avoidance (B = -.033; p = .024) showing to respectively increase and reduce the possibility of reporting clinical symptomatology. CONCLUSIONS Emotional regulation and attachment have been shown to be risk factors for COVID-19 PTSD symptomatology. Focused intervention programs and emotional education can be useful tools for developing protective factors in the general population.
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Affiliation(s)
- S Monaco
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University, Rome, Italy.
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30
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Moussa S, Malaeb D, Achkouty I, Hallit S, Ghosn A, Obeid S. Association between work fatigue and cognitive function among Lebanese health-care professionals: the moderating effect of emotional intelligence. Int J Environ Health Res 2024; 34:1487-1498. [PMID: 37293934 DOI: 10.1080/09603123.2023.2222270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
The aim of this study was to assess the association between work-related fatigue and cognitive impairment among Lebanese health-care professionals with a closer look into the moderating role of emotional intelligence. This cross-sectional study was conducted between November 2021 and January 2022; 406 Lebanese health-care professionals were recruited through convenience sampling. Moderate analysis showed that with low levels of emotional intelligence, more physical, mental, or emotional work fatigue was significantly associated with lower cognitive function scores. These scores get better in people with moderate and high emotional intelligence for the same levels of work fatigue. Health-care workers, especially in Lebanon, are subject to a decline in their cognitive function when faced to high work fatigue loads in all its types, physical, mental, and emotional, along with the country's stressors. Here comes the role of emotional intelligence, where for the same level of fatigue, professionals with high emotional intelligence tend to have better cognitive functioning.
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Affiliation(s)
- Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Iris Achkouty
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Anthony Ghosn
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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31
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Putica A, Van Dam NT, Felmingham K, Lawrence-Wood E, McFarlane A, O'Donnell M. Interactive relationship between alexithymia, psychological distress and posttraumatic stress disorder symptomology across time. Cogn Emot 2024; 38:232-244. [PMID: 37987839 DOI: 10.1080/02699931.2023.2283934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
Alexithymia, psychological distress, and posttraumatic stress disorder (PTSD) are highly related constructs. The ongoing debate about the nature and relationship between these constructs is perpetuated by an overreliance on cross-sectional research. We examined the longitudinal interactive relationship between alexithymia, psychological distress, and PTSD. We hypothesised that there is an interactive relationship between the three constructs. Military personnel (N = 1871) completed the Toronto Alexithymia Scale, the Kessler 10 and a PTSD Checklist (PCL-C) at pre-deployment, post-deployment, and at 3-4 years following the post-deployment assessment. We initially tested whether psychological distress is either a moderator or mediator in the relationship between alexithymia and PTSD across the time points. General psychological distress was a partial mediator of total PTSD severity and hyperarousal symptomology at all three time points. Psychological distress fully mediated re-experiencing and avoidance symptomology at all three time points. Our results suggest that those with alexithymia are at longitudinal risk of developing more severe PTSD symptomology and experiencing hyperarousal irrespective of temporal proximity to traumatic exposure. Further, vulnerability to the emergence of re-experiencing and avoidance symptomology for those with alexithymia is increased when one experiences greater distress. Our results show that alexithymia is a persistent risk factor for PTSD symptomology.
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Affiliation(s)
- Andrea Putica
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Nicholas T Van Dam
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kim Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ellie Lawrence-Wood
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Alexander McFarlane
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Meaghan O'Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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32
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Gajperia C, McBride J, Treasure J, Cardi V, Brewer R. Recognition of others' interoceptive states in those with and without eating disorders. BMC Psychiatry 2024; 24:169. [PMID: 38418990 PMCID: PMC10900571 DOI: 10.1186/s12888-024-05615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The ability to recognize one's own emotions is associated with one's ability to recognize others' emotions. Beyond the domain of emotion, however, the relationship between recognition of one's own internal states (interoception) and others' interoceptive states has not been investigated, either in the typical population or clinical groups with interoceptive difficulties (e.g. eating disorders; EDs). METHOD This study investigated recognition of one's own and others' internal states in adults with and without eating disorders, using a high frequency visual noise paradigm. Participants completed self-report measures of interoception, alexithymia (difficulties recognising one's own emotional internal states) and ED symptomatology, and the Heartbeat Counting Task measure of cardiac interoceptive accuracy. RESULTS Alexithymia was significantly negatively correlated with recognition of others' interoceptive states. EDs were not associated with difficulties recognising others' interoceptive states. CONCLUSIONS The ability to recognise one's own emotional internal states is associated with the recognition of others' interoceptive states, which may contribute to social skills and the ability to care for others.
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Affiliation(s)
- Chandni Gajperia
- Royal Holloway, University of London, Egham Hill, Egham, London, TW20 0EX, UK
| | - Jennifer McBride
- Royal Holloway, University of London, Egham Hill, Egham, London, TW20 0EX, UK
| | | | - Valentina Cardi
- King's College London, London, UK
- University of Padova, Padova, Italy
| | - Rebecca Brewer
- Royal Holloway, University of London, Egham Hill, Egham, London, TW20 0EX, UK.
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Li X, Peng C, Qin F, Luo Q, Ren Z, Wang X, Feng Q, Liu C, Li Y, Wei D, Qiu J. Basolateral Amygdala Functional Connectivity in Alexithymia: Linking Interoceptive Sensibility and Cognitive Empathy. Neuroscience 2024; 539:12-20. [PMID: 38176608 DOI: 10.1016/j.neuroscience.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
Emotions rely on bodily states, and perceiving the emotions of others depends on awareness of one's own emotional state. However, the intercorrelations among interoception, alexithymia, and empathy are not well understood, and the neural mechanisms behind this connection are also largely unknown. To address these issues, 297 college students participated in this study, completing measures of interoceptive sensibility (IS), empathy and alexithymia and undergoing resting-state fMRI scans. The functional connectivity of the amygdala was analysed to identify the neural substrates of alexithymia, and mediation analyses were conducted to examine the mediation effect of alexithymia and alexithymia-specific amygdala functional connectivity on the relationship between IS and empathy. The results showed that higher levels of IS were associated with increased cognitive empathy through weakened alexithymia. Functional connectivity analysis indicated that right basolateral amygdala (BLA)-left precuneus connectivity was negatively related to alexithymia, while right BLA-left precentral gyrus connectivity was positively related to alexithymia. Furthermore, right BLA-left precuneus connectivity was found to mediate the impact of interoception on cognitive empathy. In conclusion, this study provides valuable insights into the relationships among IS, alexithymia, and empathy. The right BLA-left precuneus connectivity may serve as a shared neural substrate between interoception and cognitive empathy.
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Affiliation(s)
- Xianrui Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Chuyao Peng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Facai Qin
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Qian Luo
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Zhiting Ren
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Xueyang Wang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Qiuyang Feng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Cheng Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Yang Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China; Southwest University Branch, Collaborative Innovation Center of Assessment, Toward Basic Education Quality at Beijing Normal University, China.
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34
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Morie KP, Lord KA, Diefenbach GJ, Basuchoudhary O, Lewis S, Assaf M. Subscales of alexithymia show unique pathways through reappraisal and suppression to anxiety, depression and stress. J Affect Disord 2024; 347:445-452. [PMID: 38007105 PMCID: PMC10842914 DOI: 10.1016/j.jad.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
The goal of this work was to explore associations of constituent factors of alexithymia on mental health and potential mediating effects of emotion regulation strategies, specifically suppression and reappraisal. Data were collected through the crowd-sourcing platform Amazon Mechanical Turk (MTURK). Three hundred seventy-seven individuals completed questionnaires related to distress (Depression Anxiety Stress Scales [DASS]), emotion regulation (Emotion Regulation Questionnaire [ERQ]) and Alexithymia (Bermond-Vorst Alexithymia Questionnaire [BVAQ]). Three mediation models were constructed for depression, anxiety and stress, with BVAQ subscales (verbalizing, identifying, emotionalizing, fantasizing, and analyzing) as predictors and ERQ subscales (suppression and reappraisal) as mediators. Results indicated 37.3 % variance in depression, 25.2 % variance in anxiety, and 35.3 % variance in stress was explained by each model. Direct associations revealed emotionalizing and fantasizing were negatively associated with depression, anxiety, and stress, while verbalizing was additionally associated with depression, identifying was additionally associated with anxiety, and all four BVAQ subscales were associated with stress. BVAQ subscales demonstrated negative associations with reappraisal and positive associations with suppression that mediated anxiety and depression. However, suppression did not mediate relationships between BVAQ subscales with stress. Findings support the importance of examining multiple factors of alexithymia and associations with emotion regulation strategies and distress.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Kayla A Lord
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Gretchen J Diefenbach
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Oishani Basuchoudhary
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Stephanie Lewis
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Michal Assaf
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
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35
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Gibson J. Trauma, early life stress, and mindfulness in adulthood. BMC Psychol 2024; 12:71. [PMID: 38355582 PMCID: PMC10865675 DOI: 10.1186/s40359-024-01563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
This article is a review that was inspired by recent studies investigating the effects of childhood trauma or early life stress (ELS) and mindfulness in adulthood. One recent study found that some forms of abuse and neglect led to higher scores in several subscales of a self-report measure of mindfulness. The authors concluded that some forms of ELS can help cultivate certain aspects of mindfulness in adulthood. However, and in contrast to this recent finding, much of the extant literature investigating ELS and trauma are linked to emotional dysregulation, alexithymia, and a host of psychopathologies in adulthood which makes the results of this study surprising. Central to the mindfulness literature is cultivating an open, non-reactive, or non-judgment awareness of inner experiences which are important for emotional regulation. In this paper, I review some of the effects of trauma or ELS on critical neural circuits linked to mindfulness, interoception, attachment, and alexithymia which I hope may clarify some of the conflicting findings from this study and throughout the literature and provide additional context and a framework that may inform research investigating these two constructs going forward.
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Affiliation(s)
- Jonathan Gibson
- South Dakota School of Mines and Technology, 501 E St. Joseph Street, Rapid City, SD, 57701, United States of America.
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36
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Cooper H, Jennings BJ, Kumari V, Willard AK, Bennetts RJ. The association between childhood trauma and emotion recognition is reduced or eliminated when controlling for alexithymia and psychopathy traits. Sci Rep 2024; 14:3413. [PMID: 38341493 PMCID: PMC10858958 DOI: 10.1038/s41598-024-53421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Emotion recognition shows large inter-individual variability, and is substantially affected by childhood trauma as well as modality, emotion portrayed, and intensity. While research suggests childhood trauma influences emotion recognition, it is unclear whether this effect is consistent when controlling for interrelated individual differences. Further, the universality of the effects has not been explored, most studies have not examined differing modalities or intensities. This study examined childhood trauma's association with accuracy, when controlling for alexithymia and psychopathy traits, and if this varied across modality, emotion portrayed, and intensity. An adult sample (N = 122) completed childhood trauma, alexithymia, and psychopathy questionnaires and three emotion tasks: faces, voices, audio-visual. When investigating childhood trauma alone, there was a significant association with poorer accuracy when exploring modality, emotion portrayed, and intensity. When controlling for alexithymia and psychopathy, childhood trauma remained significant when exploring emotion portrayed, however, it was no longer significant when exploring modality and intensity. In fact, alexithymia was significant when exploring intensity. The effect sizes overall were small. Our findings suggest the importance of controlling for interrelated individual differences. Future research should explore more sensitive measures of emotion recognition, such as intensity ratings and sensitivity to intensity, to see if these follow accuracy findings.
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Affiliation(s)
- Holly Cooper
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - Ben J Jennings
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Veena Kumari
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Aiyana K Willard
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Rachel J Bennetts
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
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Lyvers M, Robinson M, Watt B, Thorberg FA. Alexithymia and aspects of dreaming: Differential associations of alexithymia facets with dream variables. Int J Psychol 2024; 59:132-142. [PMID: 37864284 DOI: 10.1002/ijop.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 10/01/2023] [Indexed: 10/22/2023]
Abstract
Research on aspects of dreaming associated with alexithymia has yielded mixed results. The present study recruited a young adult online sample of 577 participants who completed validated indices of alexithymia, emotion suppression, negative moods, and eight aspects of dreaming, with a focus on evaluating a counterintuitive previous finding that alexithymia and two of its core facets were associated with greater self-reported typical emotional intensity of dreams. Total alexithymia and facet scores showed differential relationships to aspects of dreaming including dream recall frequency, emotionality, meaningfulness, nightmare frequency, nightmare distress, usefulness of dreams in problem-solving and creativity, and learning about oneself through dreams. Planned hierarchical regression controlling for demographics, alcohol use, and dream recall frequency indicated that the difficulties identifying feelings (DIF) facet of alexithymia was a significant positive predictor of dream emotionality, whereas the externally oriented thinking (EOT) facet was a significant negative predictor. Stress, but not emotion suppression, mediated the positive relationship between DIF and dream emotionality. The likely role of dream emotionality in higher ratings of nightmare distress, dream meaningfulness, and learning about oneself through dreams among those with higher DIF scores is noted, along with other findings and the strengths and limitations of the study.
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Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, QLD, Gold Coast, Australia
| | - Morgana Robinson
- School of Psychology, Bond University, QLD, Gold Coast, Australia
| | - Bruce Watt
- School of Psychology, Bond University, QLD, Gold Coast, Australia
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Di Carlo F, Vicinelli MC, Pettorruso M, De Risio L, Migliara G, Baccolini V, Trioni J, Grant JE, Dell'Osso B, Martinotti G. Connected minds in disconnected bodies: Exploring the role of interoceptive sensibility and alexithymia in problematic use of the internet. Compr Psychiatry 2024; 129:152446. [PMID: 38159504 DOI: 10.1016/j.comppsych.2023.152446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/02/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION The ever-increasing prominence of the internet and digital technology in our society requires a deeper examination of how these developments alter perception of our bodies and emotions. One such consequence is the emergence of Problematic Use of the Internet (PUI) - an array of compulsive or addictive behaviors mediated by the web that detrimentally affect an individual's functioning. This suggests that some people may be shifting their consciousness from the physical realm to the digital world. The objective of this study was to investigate how shortcomings in interoception (the sensibility to bodily signals) and alexithymia (an inability to identify and express emotions) might contribute to PUI. METHODS The Internet Addiction Test (IAT), the Toronto Alexithymia Scale (TAS-20), and the Multidimensional Assessment of Interoceptive Awareness (MAIA) were used to assess a sample of 1076 adolescents and young adults aged between 16 and 26 years via an online survey. Data analysis was based on t-test, correlations and multivariate regression. RESULTS 26.8% (n = 288) of participants met the criteria for moderate PUI. Individuals with PUI displayed higher levels of alexithymia (p < 0.001) and diminished abilities in certain aspects of interoceptive sensibility, including placing trust in their own bodily signals (p = 0.006), not responding excessively to uncomfortable sensations with worry (p < 0.001), and not denying them (p = 0.006). Multivariate modelling revealed associations between PUI and the following factors: having a boyfriend/girlfriend (aOR = 5.70), substance use (aOR = 1.78), difficulty in identifying feelings (aOR = 1.09), externally oriented thinking (aOR = 1.05), low disposition in perceiving body sensations (aOR = 0.25), tendency to become distracted (aOR = 0.82) or excessively worried (aOR = 0.11) in the face of pain. Furthermore, the analysis indicated how these aspects of body perception may be interrelated, either enhancing or reducing the risk of PUI when examined individually, collectively, or in combination. CONCLUSIONS This study underlines the potential connection between difficulties in the mind-body interaction and the development of PUI. It suggests a bidirectional relationship between excessive digital device use and distorted bodily interoceptive processes in PUI, reinforcing the notion that individuals struggling with emotion identification and expression may be more prone to excessive internet usage. To further comprehend the relevance of these constructs in PUI, it is necessary to conduct more targeted investigations and longitudinal studies.
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Affiliation(s)
- Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Maria Chiara Vicinelli
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, Chieti, Italy.
| | - Luisa De Risio
- Department of Mental Health and Addiction, ASL Roma 5, Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Jacopo Trioni
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, Chieti, Italy; Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, UK
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van Dijl TL, Aben HP, Synhaeve NE, de Waardt DA, Videler AC, Kop WJ. Alexithymia and facial emotion recognition in patients with functional neurological disorder. Clin Neurol Neurosurg 2024; 237:108128. [PMID: 38325039 DOI: 10.1016/j.clineuro.2024.108128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Patients with functional neurological disorder (FND) are known to have difficulties recognizing and processing emotions. Problems recognizing internal emotional states (alexithymia) are common in FND, but little is known about recognizing emotions expressed by other people. This study investigates whether patients with FND have higher levels of alexithymia and reduced facial emotion recognition compared to healthy controls. METHODS Patients with FND (n = 31, mean age=42.7 [SD=14.8] years, 54.8% women) were compared to healthy controls (n = 33, mean age=45.1 [SD=16.2] years, 63.6% women). The Bermond-Vorst Alexithymia Questionnaire (BVAQ) was used for the assessment of alexithymia and the Ekman 60 Faces Test (EFT) for facial emotion recognition. RESULTS Patients with FND had higher levels of alexithymia than healthy controls (BVAQ=71.8 [SD=19.8] versus 59.3 [SD=20.3], p = .02, Cohen's d=0.62). Facial emotion recognition did not significantly differ between FND patients and controls (EFT total score FND: 46.1 [SD=5.9], Controls: 47.5 [SD=5.5], p = .34, Cohen's d=0.24). Only recognition of surprise differed between patients and controls (FND: 8.4 [SD=1.8], Controls: 9.2 [SD=1.0), p = .03, Cohen's d= 0.56). Higher levels of alexithymia were associated with poorer facial emotion recognition, but this relationship was not statistically significant (FND: β= -0.20, p = .28; Controls: β=-0.03; p = .87). CONCLUSIONS The current data confirm prior observations that patients with FND have higher alexithymia levels than controls without FND. Difficulties recognizing emotions among patients with FND primarily involves recognition of internal emotional states rather than recognition of facially expressed emotions by others. These findings require replication in a larger and more divers sample.
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Affiliation(s)
- T L van Dijl
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department of Medical and Clinical Psychology, Center for Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, the Netherlands; Department of Psychiatry, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands; Department of Child and Adolescent Psychiatry, De Hoop ggz, Dordrecht, the Netherlands.
| | - H P Aben
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - N E Synhaeve
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - D A de Waardt
- Department of Psychiatry, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - A C Videler
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands
| | - W J Kop
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department of Medical and Clinical Psychology, Center for Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, the Netherlands
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Treier AK, Döpfner M, Ravens-Sieberer U, Görtz-Dorten A, Boecker M, Goldbeck C, Banaschewski T, Aggensteiner PM, Hanisch C, Ritschel A, Kölch M, Daunke A, Roessner V, Kohls G, Kaman A. Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders. Eur Child Adolesc Psychiatry 2024; 33:381-390. [PMID: 36800039 PMCID: PMC10869411 DOI: 10.1007/s00787-023-02166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is part of the comprehensive Diagnostic Tool for Affective Dysregulation in Children (DADYS-Screen), by analyzing relationships with comprehensive measures of AD and related mental disorders in a community sample of children with and without AD. The sample comprised 1114 children aged 8-12 years and their parents. We used clinical, parent, and child ratings for our analyses. Across all raters, the DADYS-Screen showed large correlations with comprehensive measures of AD. As expected, correlations were stronger for measures of externalizing symptoms than for measures of internalizing symptoms. Moreover, we found negative associations with emotion regulation strategies and health-related quality of life. In receiver operating characteristic (ROC) analyses, the DADYS-Screen adequately identified children with AD and provided an optimal cut-off. We conclude that the DADYS-Screen appears to be a reliable and valid measure to identify school-aged children at risk of AD.
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Affiliation(s)
- A-K Treier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - M Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - M Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Goldbeck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - P-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - C Hanisch
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - A Ritschel
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - M Kölch
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - A Daunke
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - G Kohls
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - A Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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MacCormack JK, Bonar AS, Lindquist KA. Interoceptive beliefs moderate the link between physiological and emotional arousal during an acute stressor. Emotion 2024; 24:269-290. [PMID: 37498725 PMCID: PMC10818018 DOI: 10.1037/emo0001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Growing work suggests that interoception, that is, representations of one's internal bodily changes, plays a role in shaping emotional experiences. Past studies primarily examine how behavioral accuracy in detecting interoceptive signals (interoceptive ability) relates to emotional states, with less work examining self-reported interoceptive facets such as the characterizations of one's interoceptive abilities (interoceptive sensibility) or evaluative beliefs about the value versus danger of interoceptive signals (interoceptive beliefs). However, existing studies rarely examine physiological reactivity, behavioral, and self-reported dimensions of interoception together in the same sample. As such, it remains unclear whether and how much individual differences in interoceptive facets uniquely and in interaction with physiological reactivity may matter for emotional experience. Herein, 250 healthy young adults completed a heartbeat detection task assessing interoceptive ability and questionnaire measures of interoceptive sensibility and beliefs during an initial laboratory visit. At a follow-up session, 227 participants returned to undergo an acute psychosocial stressor. Measures of physiological arousal such as preejection period (PEP) and heart rate variability were acquired throughout the stressor with self-reported emotions acquired immediately after. Linear regressions revealed that greater sympathetic nervous system reactivity (i.e., PEP), poorer interoceptive ability (i.e., accuracy), and less positive interoceptive beliefs were related to more intense high arousal emotions during the stressor. Importantly, across models, interoceptive beliefs was the only interoceptive facet to moderate the concordance between physiological and emotional arousal. Implications for psychological theories of emotion, stress, and interoception are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Adrienne S Bonar
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Kristen A Lindquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Knapp KS, Bradizza CM, Zhao J, Linn BK, Wilding GE, LaBarre C, Stasiewicz PR. Emotion differentiation among individuals in a randomized clinical trial for alcohol use disorder: Within- and between-person associations with affect, craving, and alcohol use in daily life. Behav Res Ther 2024; 173:104474. [PMID: 38237447 PMCID: PMC10947467 DOI: 10.1016/j.brat.2024.104474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/07/2023] [Accepted: 01/01/2024] [Indexed: 02/02/2024]
Abstract
Emotion differentiation refers to cognitively distinguishing among discrete, same-valenced emotions. Negative emotion differentiation (NED) is a transdiagnostic indicator of emotional functioning. The role of positive emotion differentiation (PED) in clinical disorders, including alcohol use disorder (AUD), is less understood. Further, despite consensus that emotions are highly variable, little is known about within-person fluctuations in NED/PED. The current study leveraged 84 consecutive daily smartphone surveys from participants (N = 181) in a clinical trial of cognitive behavioral therapy for AUD to investigate whether between-person differences in overall NED/PED, or within-person variability in daily NED/PED, were associated with affect intensity, craving, drinking, and heavy drinking in daily life. Subsequent analyses explored whether associations were moderated by baseline alexithymia. At the between-persons level, greater average PED, but not NED, was associated with lower heavy drinking odds. At the within-persons level, higher-than-usual PED was associated with lower negative affect and odds of any drinking. Individuals with baseline alexithymia had stronger negative within-person associations between daily NED and both any and heavy drinking. PED is a skill linked to less alcohol use between- and within-persons irrespective of baseline alexithymia, whereas greater daily NED appears especially important for reduced alcohol use among individuals with co-morbid AUD and alexithymia.
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Affiliation(s)
- Kyler S Knapp
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States.
| | - Clara M Bradizza
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States
| | - Junru Zhao
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States
| | - Braden K Linn
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States
| | - Gregory E Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, 14214, United States
| | - Charles LaBarre
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States
| | - Paul R Stasiewicz
- School of Social Work, University at Buffalo, Buffalo, NY, 14214, United States
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Herman AM, Wypych M, Michałowski J, Marchewka A. Bodily confusion: Lower differentiation of emotional and physiological states in student alcohol users. Addict Biol 2024; 29:e13364. [PMID: 38380800 PMCID: PMC10898845 DOI: 10.1111/adb.13364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Alexithymia, difficulty in recognising and naming emotions, is common among people who use alcohol. There is also emerging evidence that people with alexithymia are unable to distinguish emotions from non-emotional physiological states. The project aimed to test if alcohol use is related to the way student drinkers experience emotions and physiological states in the body. METHODS We employed a novel method to study bodily sensations related to emotions and physiological states in the context of alcohol use: the emBODY tool, which allowed participants to mark areas of the body in which they experience various emotions and physiological states. RESULTS Students who showed a hazardous pattern of alcohol use (alcohol use disorders identification test [AUDIT] score ≥ 7, N = 91), overall, presented higher alexithymia levels and coloured larger areas for emotions and physiological states (showed less specificity) than those who show low-risk alcohol consumption (AUDIT ≤ 4, N = 90). Moreover, statistical classifiers distinguished feeling-specific maps less accurately for hazardous drinkers than low-risk drinkers [F(1,1998) = 441.16; p < 0.001], confirming that higher alcohol use is related to higher confusion of emotional and non-emotional bodily feelings. CONCLUSIONS Plausibly, this increased bodily confusion drives alcohol consumption: alcohol may serve as a means of dealing with undifferentiated changes in psychophysiological arousal accompanying emotional states.
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Affiliation(s)
- Aleksandra M. Herman
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
| | - Marek Wypych
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
| | - Jarosław Michałowski
- Laboratory of Affective Neuroscience in Poznań, Faculty of Psychology and LawSWPS University of Social Sciences and HumanitiesPoznańPoland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
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Klauser P, Cortese S, Hagstrøm J, Stringaris A, Hebebrand J, Hoekstra PJ, Schlaegel K, Revet A. The 2023 ESCAP Research Academy workshop: ADHD and emotional dysregulation. Eur Child Adolesc Psychiatry 2024; 33:633-635. [PMID: 37978054 DOI: 10.1007/s00787-023-02318-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Paul Klauser
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland.
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland.
| | - Samuele Cortese
- Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- New York University Child Study Center, Hassenfeld Children's Hospital at NYU Langone, New York City, USA
- Solent NHS Trust, Southampton, UK
- DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Julie Hagstrøm
- Child and Adolescent Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
| | - Argyris Stringaris
- Division of Psychiatry, Department of Clinical, Educational and Health Psychology, University College London, London, UK
- First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry & Accare Child Study Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Karen Schlaegel
- European Society for Child and Adolescent Psychiatry (ESCAP), Brussels, Belgium
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, Toulouse University, Inserm, UPS, Toulouse, France
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45
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Boni M, Violi S, Ciaramella A. Role of history of traumatic life experiences in current psychosomatic manifestations. Scand J Pain 2024; 24:sjpain-2023-0102. [PMID: 38661113 DOI: 10.1515/sjpain-2023-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Although the relationship between traumatic experiences (TEs) and psychosomatic manifestations (pain, somatization, somatosensory amplification [SSA], and alexithymia) has been widely described, very few studies have investigated how these variables correlate with each other and with a history of TEs. The aim of this study was to investigate whether and how current psychosomatic manifestations are correlated with major and minor adult- and childhood TEs. METHODS One hundred and forty-six patients (91 with pain) from the Pisa Gift Institute for Integrative Medicine Psychosomatics Lab., Italy, were assessed for pain, history of TEs (divided into major and minor based on whether or not they meet the DSM-5 Criterion A for post-traumatic stress disorder), alexithymia, somatization, and SSA. RESULTS TEs were positively correlated with age, the sensorial dimension and intensity of pain, somatization, psychopathology index, SSA, and alexithymia. Using the somatization score (controlled for age) as a covariate, the previous correlations between psychosomatic dimensions and TEs lost their statistical significance: SSA (total TEs: from r = 0.30, p = 0.000 to r = -0.04, p = 0.652); alexithymia (total TEs: from r = 0.28, p = 0.001 to r = 0.04, p = 0.663); sensorial dimension of pain (total TEs: from r = 0.30, p = 0.015 to r = 0.12, p = 0.373); and pain intensity (total TEs: from r = 0.38, p = 0.004 to r = -0.15, p = 0.317). Interestingly, the tendency to report more intense pain was mainly predicted by minor TEs in childhood (β = 0.28; p = 0.030). CONCLUSIONS The number of lifetime TEs is positively correlated with the sensorial dimension and intensity of pain but not its affective and cognitive dimensions. However, the former relationship depends on the presence of somatization. The intensity of pain is associated with minor rather than major TEs, especially when they occur in childhood.
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Affiliation(s)
- Melania Boni
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
| | - Simone Violi
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Pisa, Italy
| | - Antonella Ciaramella
- Aplysia APS, Education Programme Partner, University of Pisa, Florence, Italy
- GIFT Institute of Integrative Medicine, Pisa, Italy
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Espirito-Santo H, Paraíso L, Andrade D, Daniel F, Grasina A, Lemos L, Simões-Cunha L, Bjureberg J. Emotion dysregulation in older people: validity and reliability of an 8-item version of the Difficulties in Emotion Regulation Scale. Aging Ment Health 2024; 28:360-368. [PMID: 37771115 DOI: 10.1080/13607863.2023.2260329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES The abbreviated 16-item version of the Difficulties with Emotion Regulation Scale (DERS-16) is widely used to assess individuals' perceived challenges in regulating their emotions, a central aspect of psychological symptoms commonly experienced in old age. However, its psychometric properties have yet to be tested in this population. Furthermore, a shorter version of the DERS-16 could further minimize the assessment burden on older individuals. Thus, we aimed to test the DERS-16's psychometric performance and determine if any items were redundant to develop a psychometrically sound shorter version. METHODS We enrolled 302 Portuguese older adults (Mage = 75.22; SD = 8.99 years) in a cross-sectional study. RESULTS Exploratory factor analyses indicated a one-factor structure and a four-factor solution with eight items (69.3%-81.9% of the variance observed). The four-factor-8-item solution presented an interpretable structure and demonstrated good reliability values (> 0.70) and construct validity with the Twenty-Item Toronto Alexithymia Scale, Eight-Item Geriatric Depression Scale, and Geriatric Anxiety Inventory (r = 0.66, 0.40, 0.52; p < 0.001). CONCLUSION The robust psychometric properties of DERS-8 make it a valuable tool for clinical and longitudinal studies, facilitating targeted interventions in older adults and allowing for precise emotion dysregulation screening.
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Affiliation(s)
- Helena Espirito-Santo
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra University, Coimbra, Portugal
| | - Luís Paraíso
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
| | - Diogo Andrade
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
| | - Fernanda Daniel
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra University, Coimbra, Portugal
| | | | - Laura Lemos
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
| | - Luís Simões-Cunha
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
- Research and Development Center of the Military University Institute, Miguel Torga Higher Education Institute (ISMT), Lisboa, Portugal
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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47
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Shang Z, Fang C, Lang X, Zhang X. Gender difference in association between clinical symptoms and alexithymia in chronic schizophrenia: A large sample study based on Chinese Han population. J Affect Disord 2024; 344:519-527. [PMID: 37848090 DOI: 10.1016/j.jad.2023.10.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Alexithymia, a prevalent social cognitive impairment in schizophrenia, remains insufficiently studied. Though some studies propose a link between alexithymia and clinical symptoms of schizophrenia, this connection lacks consistent confirmation. Additionally, there is limited research on gender difference in alexithymia among schizophrenia patients. To fill this gap, our study aimed to conduct a large-sample survey of Chinese Han patients with chronic schizophrenia to explore whether there are gender differences between clinical symptoms and alexithymia. METHODS We obtained sociodemographic characteristics of 987 schizophrenia patients, measured their clinical symptoms using the Positive and Negative Syndrome Scale (PANSS), and assessed their self-reported alexithymia using the Toronto Alexithymia Scale (TAS-20). RESULTS In patients with chronic schizophrenia, the prevalence of alexithymia did not differ between genders (male: 35.51 % vs. female: 26.91 %, P = 0.018). Correlation and linear regression analyses revealed that PANSS scores and TAS-20 scores were widely correlated in both male and female patients. In particular, multiple linear regression analysis showed that the TAS total score was positively correlated with negative symptoms and cognitive symptoms in male patients, while it was positively correlated with negative symptoms and depressive symptoms in female patients. CONCLUSION Our study suggests that the prevalence of alexithymia in patients with chronic schizophrenia does not differ between genders. Negative symptoms are related to the TAS-20 total score in both male and female patients, while cognitive symptoms are only related to the TAS-20 total score in male patients, and depressive symptoms are only related to the TAS-20 total score in female patients.
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Affiliation(s)
- ZhaoXuan Shang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - ChunQing Fang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - XiangYang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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48
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Akman H, Serdengeçti N, Yavuz M, Kadak MT, Ercan O, Doğangün B. Attachment and comorbid anxiety in ADHD. Clin Child Psychol Psychiatry 2024; 29:368-380. [PMID: 37747351 DOI: 10.1177/13591045231204052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Anxiety comorbidity is quite common in children with attention-deficit hyperactivity disorder (ADHD). What is known about the relationship between anxiety, attachment and emotion regulation in such children is still limited. We aimed to investigate the associations between attachment, emotion regulation and comorbid anxiety in children with ADHD. 100 children with ADHD and 100 children without any diagnosis aged 8-13 years were included. After the participants were clinically evaluated, Turgay ADHD Scale, Emotion Regulation Checklist, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and Kerns' Security Scale were completed. According to the RCADS-CV scores, ADHD/ANX(+), ADHD/ANX(-), and control groups were formed. The emotional lability/negativity levels were higher in the ADHD groups compared to the non-ADHD controls. Paternal and maternal attachment security levels were lower in the ADHD/ANX(+) group compared to the controls. The regression analysis indicated that higher hyperactivity/impulsivity symptom levels and lower maternal attachment quality were associated with higher anxiety in children with ADHD. These results suggest that focusing on attachment quality and emotion regulation problems may be significant in management of core symptoms and comorbid anxiety problems in children with ADHD.
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Affiliation(s)
- Hazal Akman
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Nihal Serdengeçti
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Mesut Yavuz
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Oya Ercan
- Department of Pediatrics, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Ougrin D, Woodhouse E, Tucker G, Ronaldson A, Bakolis I. The Prevalence of Behavioural Symptoms and Psychiatric Disorders in Hadza Children. Sci Rep 2023; 13:22061. [PMID: 38086816 PMCID: PMC10716231 DOI: 10.1038/s41598-023-48114-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The worldwide pooled prevalence of psychiatric disorders in children is 13.4%. Studying the prevalence of childhood psychiatric disorders across radically different economic systems and social structures could indicate universal factors leading to their development. The prevalence of childhood psychiatric disorders in a mixed-subsistence foraging society has not been studied. The Strengths and Difficulties Questionnaire and the Development and Well-Being Assessment were used to compare the prevalence of behavioural symptoms and psychiatric disorders in Hadza children aged 5-16 years (n = 113) to a nationally representative sample from England (n = 18,029) using a cross-sectional study design. Emotional problems, conduct problems and hyperactivity were lower in the Hadza children. Prosocial behaviour and peer problems were higher in Hadza children. 3.6% of Hadza children met the criteria for a psychiatric disorder compared to 11.8% of English children. All psychiatric disorders in Hadza children were co-morbid with autism spectrum disorder. No child from the Hadza group met the criteria for an emotional, behaviour or eating disorder. Further work should study the factors which lead to the different prevalence of psychiatric disorders in Hadza children.
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Affiliation(s)
- Dennis Ougrin
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK.
| | - Emma Woodhouse
- Compass Psychology Services, Bromley, Kent, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gavin Tucker
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Amy Ronaldson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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50
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Loveless JP, Sullivan SN, Hall H, Danford J, Farley A, Trogdon N, Baldwin J. Linking Blood Pressure-Associated Emotional Dampening to Trait Empathy. Percept Mot Skills 2023; 130:2305-2326. [PMID: 37632294 DOI: 10.1177/00315125231197839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Gradual and sustained increases in resting blood pressure are accompanied by gradual and sustained reductions in the capacity to consciously experience several affective and somatosensory processes. Burgeoning theory suggests that this phenomenon, termed cardiovascular emotional dampening, contributes to heart disease risk by interfering with our ability to effectively respond to environmental demands. Interpersonal relationships are contexts in which this risk cascade likely occurs, but prior researchers have paid little attention to how emotional dampening might influence these relationships. As empathy is a construct used to describe facets of emotion-linked responding that facilitate interpersonal relationships, if emotional dampening influences interpersonal relationships, then we might expect resting blood pressure to covary with measures of empathy as it does with other previously studied aspects of affective responding. We recruited 175 healthy undergraduate college student participants (120 Women; M age = 19.17, SD age = 2.08) to complete a counterbalanced procedure in which we measured resting blood pressure and related it to participants' responses on the Toronto Alexithymia Scale, the Questionnaire of Cognitive and Affective Empathy, and a demographic survey. Bivariate comparisons revealed a significant inverse relationship between average resting systolic blood pressure (SBP) and cognitive empathy, as well as a significant inverse relationship between SBP and affective empathy. Multiple regression analyses revealed that SBP remained a significant predictor of cognitive empathy, but not affective empathy, after controlling for related covariates (i.e., sex, age, and alexithymia). SBP predicted cognitive empathy such that higher SBP was associated with lower cognitive empathy. Thus, people with higher resting blood pressures might experience increased interpersonal distress because of a reduced capacity for empathetic accuracy and perspective-taking. We discuss the implications and future directions of these findings.
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Affiliation(s)
- James P Loveless
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - S Nichole Sullivan
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Hailey Hall
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Jamie Danford
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Ally Farley
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Nicholas Trogdon
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Jameson Baldwin
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
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