Personnalité dépendante et alexithymie

Abstract

Alexithymia has been described in several psychiatric disorders as well as in borderline personality but there is no study that explores this emotional deficiency in dependent personality. The aim of the study was to test the hypothesis that dependent personalities were more alexithymic than nondependent personality disorders. Methods Three hundred and five subjects were recruited among a population of patients requesting descriptive certificates of assault and battery after aggressions have occurred. The subjects filled out three questionnaires: the Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI), the questionnaire of the Structured Clinical Interview for DSM-IV (SCID-II). Using the SCID-II, the 305 subjects were divided into three subgroups: 179 without personality disorders, 108 with nondependent personality disorders and 18 with dependent personality disorders. Analyses of variance and chi square tests were done to compare the TAS-20 scores or the rates of alexithymic subjects among the three subgroups. To control the potential effect of depression analysis of covariance (ANCOVA) was also done using the BDI score as covariate. Results Dependent personalities had higher scores on the TAS-20 than nondependent personality disorders or controls. The means ( m) and standard deviations (S.D.) of the TAS-20 scores were respectively: m = 61.17 (S.D. = 11.28), m = 52.53 (S.D. = 12.44), m = 43.62 (S.D. = 12.5). Moreover, this difference remains significant when depressive severity was controlled using analysis of covariance (F (2, 301) = 5.28, p < 0.001). The rates of alexithymic subjects among the three groups were respectively: 19.4% (without personality disorders), 40.8% (nondependent personality disorder), 77.8% (dependent personality disorder). The difference was significant (χ 2 = 28.42, df = 2, p < 0.001). Discussion Dependent personalities were significantly more alexithymic than other personality disorders and these differences cannot be explained by depression. One of the main limitations of the study was the use of questionnaires rather than clinical interviews to diagnose personality disorders. Moreover, anxiety and stress were not rated although they can explain elevated levels of alexithymia. Our results must be confirmed using prospective methodology to test the hypothesis that alexithymia constitutes a stable characteristic in dependent personality disorders.