Abstract
Background: Suicide and violence are common within male prisoners. One suggested risk factor for both behaviors is alexithymia. Alexithymia describes a deficit in identifying and describing feelings and is also related to externally oriented thinking. This study aimed to explore the relationship between alexithymia, suicide, violence and dual harm in male prisoners.Methods: Eighty male prisoners were recruited from three prisons. Participants were asked to complete a battery of questionnaires including measures of alexithymia (TAS-20), suicide ideation (ASIQ), suicide behavior, violence ideation (SIV), violence behavior, depression (BDI-II), hopelessness (BHS), impulsivity (DII) and anger (NAS-PI). Regression analyses and ANOVAS were conducted to assess the association between alexithymia (and its subcomponents) with six outcomes; suicide ideation, suicide behavior, violence ideation, violence behavior, dual harm ideation and dual harm behavior.Results: Alexithymia was a univariate predictor of suicide ideation, though was not a significant predictor when considered in a multivariate model. Alexithymia was a significant multivariate predictor of suicide behavior. Alexithymia was not a significant multivariate predictor of violence ideation or behavior. There were no significant differences in alexithymia or subscales between those with suicide ideation/behavior alone, violence ideation/behavior alone and those with dual harm ideation/behavior.Conclusion: In male prisoners, alexithymia appears an important univariate predictor of suicide and violence, though the current study suggests no significant contribution above other well-known correlates of suicide and violence.
Highlights
A significant bivariate correlation was found between alexithymia and suicide ideation, in regression models which accounted for known confounders of this relationship such as depression, hopelessness and anger, neither alexithymia nor its subscales were significantly associated with suicide ideation
The findings of this study suggest that there is no relationship between alexithymia or subcomponents and suicide ideation in male prisoners when accounting for known correlates of depression, hopelessness, and anger
The fact that this study reports results that contrast with those in the extant literature further suggests that there may be a more complicated relationship between alexithymia, confounders, suicide and violence, that the present study has been unable to elucidate
Summary
There are several well-established psychological correlates of suicide. Anger and impulsivity have been established as key correlates of suicide behavior [4,5,6,7]. Emotion dysregulation is considered to play a key role in the development of suicidal ideation and behaviors. One specific form of emotion dysregulation found to have an association with suicide outcomes is alexithymia. The most frequently used measure of alexithymia is the Toronto-Alexithymia Scale (TAS-20), which comprises three main factors; a difficulty identifying feelings; a difficulty describing feelings and an externally oriented thinking style [13]. Suicide and violence are common within male prisoners. This study aimed to explore the relationship between alexithymia, suicide, violence and dual harm in male prisoners
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