Alexithymia Scores Research Articles

Ideal cardiovascular health in adolescents and young adults is associated with alexithymia over two decades later: Findings from the cardiovascular risk in Young Finns Study: Department: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

We evaluated the association of cardiovascular health in adolescence and young adulthood with alexithymia 25 years later. The study sample (n = 1122) participated in evaluations conducted in 1986 (baseline) and in 2011−2012 (T2). Baseline health factors and behaviors were assessed utilizing seven ideal cardiovascular health metrics (ICH index) including blood pressure, cholesterol and glucose levels, smoking, physical activity, body-mass-index, and diet. The stability of the ICH index was evaluated with corresponding assessments in 2007 (T1). At T2, alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). The main analyses were conducted using ANCOVA and adjusted for depression, age, and present social and lifestyle factors. TAS-20 subscales, Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking, were analyzed separately. The ICH index was significantly associated with the TAS-20 total score, as well as both with DIF and DDF. A less ideal cardiovascular health was associated with higher alexithymia scores. However, regarding the separate factors, only the association between non-ideal dietary habits and DIF was significant in the multivariate analyses. The baseline ICH index score was stable from baseline to T1. We conclude that non-ideal cardiovascular lifestyle habits in adolescence and young adulthood are significantly associated with later alexithymia.

Relevant associations between alexithymia and health-literacy in persons with psoriasis

Objective To explore possible associations between alexithymia and health literacy (HL) in persons with psoriasis. Methods We conducted a cross-sectional study, including 825 persons with moderate to severe psoriasis, using the Toronto Alexithymia Scale, and the Health Literacy Questionnaire. Descriptive statistics compare HL means between alexithymic and not alexithymic participants. Associations between alexithymia and HL are analyzed using a linear multiple regression model. Results Twenty-six percent of the participants were characterized as alexithymic, and 26.8% had borderline alexithymia. Higher alexithymia scores were associated with lower education, biological medicines, and more comorbidities, together with lower self-efficacy. The HL domains with the strongest associations with alexithymia were those focusing on managing and getting support for health, as well as the ability to find health information. Conclusion A more elevated alexithymia score is associated with lower HL. Further studies of these associations may contribute to a more comprehensive perspective of psoriasis. To know a patient’s alexithymia level and HL needs may guide health care personnel’s understanding of possible associations between health status, clinical presentation, behavior, and response to treatment.

Alexithymia and help-seeking attitudes in college-aged students

Aim This epidemiological study focused on prevalence of the personality trait, alexithymia – the inability to recognize and describe one’s own emotions – among college-aged students. Method Levels of normative alexithymia (measured by the NMAS), clinical alexithymia (measured by the TAS), as well as attitudes towards help seeking behavior (measured by the ATSPPH) were assessed. Results A total of 547 participants were collected from over 48 colleges and universities, primarily in Western New York. Results indicated that 89.5% of college students displayed moderate to high levels of normative alexithymia and 48.7% displayed moderate to high levels of clinical alexithymia. Additionally, there were no significant differences between the scores of men and women on either alexithymia measure. Significant findings indicated that there was a positive relationship between clinical alexithymia scores and attitudes toward help-seeking. Conclusion These results call into question previous literature, which states that there is no correlation between alexithymia and help-seeking behavior (Berger et al., 2005, https://doi.org/10.1037/1524-9220.6.1.73). The results of this study suggest a shift in culture, as well as a need for more research regarding alexithymia.

The relationship between alexithymia, anxiety, depression, and severity of the disease in psoriasis patients

Aim: It is known that psychological factors are significant in the onset and exacerbation periods of psoriasis. The purpose of this study is to evaluate the levels of anxiety, depression, and alexithymia in psoriasis patients and to determine their relationship with the severity of disease and quality of life.Methods: In this case-control study, 71 patients with psoriasis and 86 healthy people constituted the study and control groups, respectively. The clinical severity of psoriasis was determined by the “Psoriasis Area Severity Index” (PASI). “Dermatological Life Quality Index” (DLQI) form was conducted on the patients, and the “Toronto Alexithymia Scale”, “Beck Depression Scale” and “Beck Anxiety Scale” questionnaires were used for both the patients and the controls.Results: Anxiety and depression scores in psoriasis patients were significantly higher than controls (P=0.029, P=0.003, respectively), but there was no significant difference between alexithymia scores (P=0.158). A positive correlation was found between PASI and alexithymia scores (P=0.004), and between the DLQI score of psoriasis patients and anxiety, depression, alexithymia, and PASI scores (P<0.001, P=0.006, P=0.004, P=0.001, respectively).Conclusion: In our study, anxiety and depression levels were high in psoriasis. As the levels of anxiety, depression, and alexithymia increased, the quality of life deteriorated. Psoriasis patients should be not evaluated dermatologically only, but also be assessed psychologically and directed to the psychiatry outpatient clinic when necessary.

Exploring autobiographical memory specificity and narrative emotional processing in alexithymia

Abstract Alexithymia encompasses difficulties in identifying and expressing feelings along with an externally oriented cognitive style. While previous studies found that higher alexithymia scores were related to an impaired memory for emotional content, no study so far investigated how alexithymia affects autobiographical narratives. Narrating personal events, however, is impaired in emotionally disturbed patients in that they tend to recall overgeneral descriptions instead of specific episodes, which impairs their narrative emotional processing. Adopting a qualitative approach, this pilot study explored autobiographical memory specificity, cognitive, perceptual and emotional word use, and narrative closure in eight alcohol-dependent participants scoring very high or low in alexithymia. High alexithymia participants showed no reduced memory specificity but impaired emotional processing and narrative elaboration, especially when talking about negative events. Presumably because of this we found no group differences regarding narrative closure. Results are discussed in terms of cognitive and emotional processing, avoidance strategies, and narrative psychology.

Deciphering the neural underpinnings of alexithymia in multiple sclerosis

ObjectivesAlexithymia is a personality construct that could occur in up to 53 % of patients with multiple sclerosis (MS). It entails difficulties in identifying and describing one’s feelings and an externally oriented thinking. The current work aims to assess the neural underpinnings of alexithymia in this population. MethodsForty-five patients with MS filled in the Toronto Alexithymia Scale (n = 17 with high alexithymia and n = 28 with low alexithymia). Brain magnetic resonance imaging was obtained for each patient and a morphometry algorithm (MorphoBox) was applied to calculate regional brain volumes. All patients underwent a clinical and neuropsychological evaluation which included measures for anxiety, depression, fatigue, daytime sleepiness, and basic and social cognition. ResultsCompared to patients with low alexithymia, patients with high alexithymia had significantly higher fatigue and depression ratings, and lower empathy scores. In addition, they had lower volumes of corpus callosum, deep white matter, pallidum bilaterally, and left thalamus. In the whole cohort, alexithymia scores were inversely correlated with gray matter (thalamus and pallidum bilaterally) and white matter volumes (corpus callosum and bilateral deep white matter) after controlling for covariates (ps<0.05). ConclusionThis study offers insights on the neuropsychological and neural substrates of alexithymia in MS. The current findings are consistent with alexithymia reports in other clinical populations, and suggest an association between alexithymia and atrophy of thalami, pallidum, corpus callosum and deep white matter in MS. Further research is needed to enhance the understanding of alexithymia mechanisms in this clinical context.

Corticospinal inhibition and alexithymia in multiple sclerosis patients–An exploratory study

ObjectivesAlexithymia is a multicomponent personality construct that could occur in up to 53% of patients with multiple sclerosis (MS), with recent works proposing higher rates of alexithymia in progressive MS. Among the available models of alexithymia, some propose a deficient interhemispheric communication and an aberrant GABAergic transmission at its origin. However, no single study has addressed the underlying physiological mechanisms of alexithymia in MS. The aim of this work was to assess the relationship between GABAergic neurotransmission and alexithymia in progressive MS by means of transcranial magnetic stimulation (TMS). MethodsTwelve patients with high alexithymia and fifteen patients with low alexithymia were included based on Toronto Alexithymia Scale (TAS). Sociodemographic, clinical and neuropsychological data were recorded. The following corticospinal excitability measures were obtained: resting motor threshold, cortical silent period (CSP which reflects cortical GABAergic function), and interhemispheric inhibition (i.e., GABAergic function mediated by interhemispheric fibers). ResultsNo significant group differences were observed regarding sociodemographic, clinical or neuropsychological variables. Patients with high alexithymia scores exhibited shorter CSP than those with low alexithymia scores (81.87 ± 45.72 ms vs. 145.27 ± 77.26 ms, respectively, p < 0.05). A significant inverse correlation was also found between TAS scores and CSP duration (r = −0.59, p < 0.05). ConclusionThis study offers insights into the neurophysiological mechanisms of alexithymia in MS. Reduced GABAergic transmission, as reflected by short CSP, seems to be associated with alexithymia in this population. Future studies would benefit from a more comprehensive evaluation of cortical and interhemispheric mechanisms in MS patients with alexithymia.

Brain structural correlates of alexithymia in patients with major depressive disorder

Alexithymia is a risk factor for major depressive disorder (MDD) and has been associated with diminished treatment response. Neuroimaging studies have revealed structural aberrations of the anterior cingulate cortex and the fusiform gyrus in healthy controls with high levels of alexithymia. The present study tried to corroborate and extend these results to patients with MDD compared with healthy controls. We investigated the relationship between alexithymia, depression and grey matter volume in 63 patients with MDD (mean age ± standard deviation = 42.43 yr ± 11.91; 33 female) and 46 healthy controls (45.35 yr ± 8.37; 22 female). We assessed alexithymia using the Toronto Alexithymia Scale. We conducted an alexithymia × group analysis of covariance; we used a region-of-interest approach, including the fusiform gyrus and anterior cingulate cortex, and conducted whole brain analysis using voxelbased morphometry. Our analysis revealed a significant alexithymia × group interaction in the fusiform gyrus (left, pFWE = 0.031; right, pFWE = 0.010). Higher alexithymia scores were associated with decreased grey matter volume in patients with MDD (pFWE = 0.009), but with increased grey matter volume of the fusiform gyrus in healthy controls (pFWE = 0.044). We found no significant main effects in the region-of-interest analysis. Owing to the naturalistic nature of our study, patients with MDD and healthy controls differed significantly in their alexithymia scores. Our results showed the fusiform gyrus as a correlate of alexithymia. We also found differences related to alexithymia between patients with MDD and healthy controls in the fusiform gyrus. Our study encourages research related to the transition from risk to MDD in people with alexithymia.

Alexithymic Traits and Somatic Symptoms in Children and Adolescents: a Screening Approach to Explore the Mediation Role of Depression

The association among alexithymia, somatic symptoms and clinical correlates has been scantly investigated in children. The present study examined alexithymic features and somatic symptomatology in schoolchildren with high and low levels of depression, testing the role of depressive symptoms in mediating the associations between alexithymia and somatic symptoms. Seven-hundred schoolchildren were involved in this study and divided into two subgroups (8-10years and 11-14years) in order to test differences according to the age. Participants completed the Children's Somatization Inventory-24 for the assessment of somatic symptoms, the Alexithymia Questionnaire for Children to evaluate alexithymic features and the Children's Depression Inventory-2 to investigate depressive symptoms. Results showed that children with high levels of depression reported both higher alexithymia and somatic symptoms levels. Despite a direct effect of alexithymia on somatic symptoms, the mediation analyses also highlighted an indirect effect of alexythimia on somatic symptoms through depressive symptoms. Findings suggested that a depressive symptomatology may clarify why schoolchildren with high alexithymia scores tend to report higher levels of health problems. Results also support the possibility that depressive symptoms may contribute to the development of somatic symptomatology among schoolchildren in the presence of high levels of alexithymia.

Alexithymia and its relationships with job burnout, personality traits, and shift work among hospital nurses: A cross-sectional study

Background: Due to the characteristics of their work, nurses experience high levels of stress and burnout. Alexithymia (defined as the inability to identify and express emotions) and personality traits can be risk factors for burnout. However, there is limited information about the relationships of alexithymia and personality traits with job burnout among Iranian nurses. Objective: This study examined the relationships between alexithymia, personality traits, job burnout, and shift work among hospital nurses in Iran. Methods: This cross-sectional study was conducted in 2017 on a random sample of 225 nurses recruited from 10 hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. Data collection instruments were the Toronto Alexithymia Scale, the Maslach Burnout Inventory, the Neuroticism, Extraversion, Openness Five-Factor Inventory, and a demographic questionnaire. Pearson's correlation analysis, independent-samples t-test, one-way analysis of variance, and multiple linear regression analysis were used for data analysis. Results: The mean scores of alexithymia and burnout were 56.78 ± 8.64 and 49.78 ± 13.67, respectively, and these two variables were significantly correlated (r = 0.258; P 0.05). Conclusion: Nurses with higher levels of alexithymia are more at risk for burnout. As alexithymia has significant relationships with gender and employment status, interventions are needed, especially for women, to alleviate their alexithymia and burnout.

Auditory sensation with affective agnosia: A prevalence of alexithymia among tinnitus patients.

Objectives:The aim of the present study was to determine the prevalence and association of alexithymia, depression, and anxiety in patients affected by tinnitus.Methods:The study was conducted among the patients referred for audiometric evaluation for tinnitus. They were further evaluated with the Hospital Anxiety and Depression Scale, the Tinnitus Handicap Inventory, and the Toronto Alexithymia Scale. Analysis was done for prevalence and the sample was categorized as high and low tinnitus handicap subgroups, and mean scores of alexithymia, anxiety, and depression were compared.Results:A total of 70 patients (55.7% – male and 44.3% – female) with a mean age of 33.17 ± 12.24 years were finally analyzed. The severity of tinnitus was most severe (34.3%), followed by moderate (20%), catastrophic (18.6%), mild (17.1%), and slight (10%). The prevalence of alexithymia, anxiety, and depression among patients of tinnitus was found to be 65.7%, 37.1%, and 20%, respectively. The high tinnitus handicap group showed higher scoring on total alexithymia score, anxiety, and depression and higher scoring with describing emotion and identification of emotion, but there was no difference for the subscale of externally oriented thinking.Conclusions:The study found a prevalence of alexithymia, anxiety, and depression as 65.7%, 37.1%, and 20%, respectively, among patients of tinnitus, and problem of describing and identification of emotion are associated with higher tinnitus handicap.

Relationship of Alexithymia, Rumination and Coping Style with Psoriasis and Their Effects on The Clinical Features

A relationship has been demonstrated between stress and the increase in the skin plaques in psoriasis. In addition, psoriasis is observed in cases of severe alexithymia and stress. In depression and various psychiatric disorders, there is a relationship between rumination and both the onset and persistence of the disease. The role of rumination, being a stress related factor, was investigated in this study. The study included 91 patients with psoriasis and 93 healthy controls. All participants were evaluated with the Toronto Alexithymia Scale, Coping Style Scale, the Ruminative Thought Style Questionnaire and the Hospital Anxiety and Depression Scale. Any increase in the plaque formation after the duration of 1 month was recorded by the clinician. In both the patient and the control groups, rumination scores were significantly correlated with the alexithymia severity scores (psoriasis group r=0.46, p<0.01; control group r=0.38, p<0.01) and the helpless coping styles scores (psoriasis group r=0.56, p<0.01; healthy r=0.57, p<0.01). When depression and anxiety scores were controlled, significant positive correlations were observed in the patient group between rumination scores and the scores on the difficulty of identifying feelings (r=0.42, p<0.01), the difficulty of describing feelings (r=0.25, p<0.05) and the scores on helpless coping styles (r=0.41, p<0.01); and also significant positive correlations were observed in the control group between the rumination scores and the scores on the difficulty of identifying feelings (r=0.27, p<0.05) and on helpless coping styles (r=0.42, p<0.01). Comparing the patients with and without increase in the plaques showed significant differences in the scores on rumination (p<0.01), difficulty of describing feelings (p <0.05) and total alexithymia scores (p<0.05). The relationship of alexithymia and of passive stress coping styles with rumination may have an effect on the course of psoriasis.

Valoración de los niveles de alexitimia en pacientes en hemodiálisis

INTRODUCCIÓN La alexitimia es una alteración del estado de ánimo que se manifiesta en forma de dificultad para tomar conciencia sobre los propios sentimientos y fantasías, así como para poder expresarlos verbalmente. Ha sido relacionada con el desarrollo de otras patologías y con la presencia de enfermedades crónicas. En el caso particular de la insuficiencia renal, se ha relacionado con una peor adherencia al tratamiento y mayor riesgo de mortalidad. Por ello, nos planteamos valorar su presencia en un grupo de pacientes en hemodiálisis en nuestro centro. MÉTODO Muestra de 63 pacientes en hemodiálisis, hombres y mujeres, con edades entre 22 y 83 años. Se recogió también el tiempo que cada uno llevaba en tratamiento en hemodiálisis. Estudio descriptivo de corte transversal con datos recogidos entre febrero y abril de 2019. Se aplicó individualmente la Escala de Alexitimia de Toronto. Se cuantificaron los valores de frecuencia para las puntuaciones obtenidas en el test y se realizaron comparaciones de medias para sexo, edad y tiempo en diálisis. RESULTADOS Encontramos que un 22,2% de la muestra (14 sujetos) muestra valores de alexitimia clínicamente relevantes. No se encontraron diferencias significativas en los puntajes de alexitimia según el sexo, edad o tiempo en diálisis. CONCLUSIONES Los hallazgos de este estudio permiten concluir que casi una cuarta parte de los pacientes en diálisis presenta alexitimia, alertando sobre la necesidad de que estas personas reciban tratamiento psicológico especializado.

An investigation on Negative Activity, Alexithymia, Emotion Regulation, and Internet addiction in a sample of high school students: A randomized controlled trial

This research was conducted on students that studying in high schools in Sanandaj city, Kurdistan Province, Iran. In total, 743 students were selected from all of the interested students, and then participants completed a sociodemographic questionnaire, the Internet Addiction Test (IAT), Negative Activities test (DASS-21), Emotion Regulation test (ER), and Farsi Toronto Alexithymia test (FTAS-20). In total, 287 students marked as moderate and severe addicted users. Among all 287 students, 243 students agreed to attend the rest of the tests (Main group). Also, 137 students are selected as control group. The study shows that IA score is associated with NA, ER, and alexithymia scores. Students with high scores in IA showed higher scores on the other test. Although we could not find any correlation between some subscales, still the research indicates that most addicted users are involved with the other psychological impairments. Clinical results were discussed.

Importance of considering interoceptive abilities in alexithymia assessment.

BackgroundRecent studies have shown that people with high alexithymia scores have decreased interoceptive abilities, which can be associated with psychological and physical disorders. Early assessments of the alexithymia trait included the evaluation of these abilities through the dimension measuring the difficulty in identifying and distinguishing between feelings and bodily sensations (the 26-item Toronto Alexithymia Scale; TAS-26). The revised version of the TAS, the TAS-20, contains a three-factor solution that does not involve a dimension assessing interoceptive abilities. However, the three items allowing the evaluation of these abilities are still present in the TAS-20. In this context, we hypothesized that the 3 items which assess interoceptive abilities in the TAS-20 should constitute an independent factor. In addition to exploring the internal structure of the TAS-20, we examined its external validity by assessing the relationships between the new factors and self-reported measures of personality trait and psychological and physical health.MethodTwo online studies (N = 253 and N = 287) were performed. The participants completed the TAS-20 and a set of psychological questionnaires (e.g., anxiety, depression) and health questions (e.g., “Do you suffer from a somatic disorder?”). The structure of the TAS-20 was examined using exploratory factor analysis (EFA), followed by an investigation of the relationships between the resulting new factors and other psychological and health data using regressions. In both studies, EFA revealed a new structure of the questionnaire consisting of four dimensions: (1) difficulty in the awareness of feelings, (2) externally oriented thinking, (3) difficulty in interoceptive abilities, and (4) poor affective sharing. The first factor was positively associated with all self-reported psychological and personality trait measures while the third factor was associated more with somatic disorders and medication intake.ResultsOur results suggest the presence of a new latent factor in the assessment of alexithymia that reflects interoceptive abilities specifically related to health and personality trait outcomes. In accordance with the results and the literature, it seems important to include an assessment of interoceptive abilities when considering the evaluation of alexithymia. The next step would be to develop a valid measure of these abilities.

Violence interpersonnelle et empathie. Prévention par une recherche-action en milieu scolaire

Purpose of the studyThis research-action focuses on the prevention of interpersonal violence in primary schools through a work on emotions and situations of otherness with children and educational teams. In a context of school climate marked by violence, the study particularly questions the possible evolution of empathy, alexithymia and self-esteem in children following a research-action device based on the theatrical game. Patients and methodThe research-action methodology was carried out in a primary school in the department of Bouches-du-Rhône in France with an intervention and a research component. The device of the “Game of Three Figures” (Jeu des Trois Figures) (Tisseron, 2012), which aims to develop empathy, was conducted with n=45 students of CM1 and CM2 classes during a school year. Data collection was performed prior to (T1) and after (T2) using the device from the same children as well as from a control group (n=60). Self-esteem, alexithymia and empathy were measured respectively by means of the ETES scales (Bardou et al., 2012), TAS-20 (Loas, 1995) and CEC (Favre et al., 2009). ResultsThe results show that the differences that existed between the two groups in the scores of alexithymia and empathy in T1 no longer observed in T2. Between T1 and T2, the fall in alexithymia scores occurred only in control school children. There were no significant differences between T1 and T2 in the self-esteem scores. The statistical analyses by means of Paired sample test and the ANOVA analyses show that between T1 and T2 the evolution of the Empathy takes place only for the children of the school having benefited from the device thus supporting the hypothesis of an effect of the device on empathy. ConclusionThis study shows an effect of the J3F device on the development of empathy in children in primary school. This effect is to be qualified by both the environmental (neighborhood, social context, school climate) and singular (normal variations in development, singularity of each child) factors. This is because empathy develops in the encounter with an environmental context and is modulated according to collective and singular learning and experiences, especially those relating to disagreements and otherness. Our study corroborates the relevance of research action and interventional research devices that should be used more often in educational, clinical and social work and be more highlighted through quantitative and qualitative evaluation.

Social media usage and alexithymia in nursing students.

To determine the relationship between social media usage characteristics and alexithymia in nursing students. The study was conducted with 272 nursing students between November and December 2018 in Turkey. Data were collected using an information form to determine the sociodemographic and social media usage characteristics of the students, and the Toronto Alexithymia Scale. According to the results of this study, nursing students use Instagram the most. As time spent on social media increases, the alexithymia score increases and students have difficulty recognizing their feelings. As the use of social media by nursing students affects their mental process and behavior patterns, the results of social media applications, which witness a wide range of feelings, thoughts, attitudes, and behaviors, should be included in the nursing curriculum.

Alexithymia in adolescents with and without chronic pain.

Alexithymia refers to reduced emotional awareness and is associated with higher levels of burden and disability in adults with chronic pain. Limited research has examined alexithymia in adolescents with chronic pain. The current study aimed to (a) determine whether alexithymia was higher in adolescents with (vs. without) chronic pain and (b) examine the relationship between alexithymia and pain experiences in youth. Research Method/Design: We assessed alexithymia in 22 adolescents with chronic pain and in 22 adolescents without chronic pain (otherwise healthy), and its relation to pain experiences (i.e., self-reported pain intensity, pain bothersomeness, and pain interference), while controlling for the concomitant effects of psychological distress (i.e., depressive and anxiety symptoms). After controlling for psychological distress, adolescents with versus without chronic pain had higher total alexithymia scores (p = .042; η2 = .10), and specifically, greater difficulty identifying feelings (p = .001; η2 = .23). Difficulty identifying feelings was related to worse pain interference (r = .55; p = .015) and pain bothersomeness (r = .55; p = .015). These preliminary findings suggest that adolescents with chronic pain may have greater difficulty identifying their emotions, and that this might be related to increased pain interference and pain bothersomeness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Insula Activity to Visceral Stimulation and Endocrine Stress Responses as Associated With Alexithymia in Patients With Irritable Bowel Syndrome.

Few studies have investigated associations between alexithymia and physiological mechanisms in psychosomatic diseases. We examined associations between alexithymia and 1) perception and brain processing of visceral stimulation and 2) the endocrine responses to corticotrophin-releasing hormone (CRH) in healthy individuals and patients with irritable bowel syndrome (IBS). The study included 29 patients with IBS and 35 age- and sex-matched healthy controls (HCs). Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20). Brain responses to rectal distention and its anticipation were measured by functional magnetic resonance imaging and analyzed at a voxel-level threshold of puncorrected < .001 combined with a cluster-level threshold of pFWE-corrected < .05. On a different day, plasma adrenocorticotropic hormone and cortisol responses after intravenous CRH administration were measured. TAS-20 scores did not differ significantly between patients with IBS and HCs (p = .18). TAS-20 scores correlated positively with the individual rectal discomfort thresholds (βrobust = 0.49, p = .03) and negatively with the rating of fear before rectal distention (βrobust = -1.63, p = .04) in patients with IBS but not in HCs. Brain responses to rectal distention in the right insula and other brain regions were positively associated with TAS-20 scores to a greater extent in patients with IBS than in HCs. Individuals with higher TAS-20 scores (both patients with IBS and HCs) demonstrated stronger adrenocorticotropic hormone responses to CRH administration (F(4,224) = 3.54, p = .008). Higher alexithymia scores are associated with stronger physiological responses, but lower anticipatory fear ratings and higher discomfort thresholds, particularly in patients with IBS.

Take me back to move me forward: Re-enactment of the family system as a pathway to better quality of life for alexithymic patients in group therapy.

Despite much attention in the clinical literature, research on alexithymia in the treatment setting has only recently gained traction. While several reports indicate limited benefit from therapy amongst patients with high alexithymia, this seems to be less so in the context of group therapy. This study considers a specific aspect of the group therapy process - family re-enactment - in facilitating improvement in overall quality of life for patients with high levels of alexithymia. Family re-enactment was examined as a potential mediator of the relationship between alexithymia and change in quality of life among 50 patients who completed treatment in an intensive, integrative group therapy programme. Patients completed three self-report measures: Toronto Alexithymia Scale-20 (baseline), Quality of Life Inventory (baseline, post-therapy), and Therapeutic Factors Inventory-Short Form (week 8). Regression with mediation analysis was employed using the change score for the QOLI as the dependent variable, alexithymia scores as the independent variable, and the family re-enactment score as the mediator; baseline quality of life was included in the model as a control variable. Family re-enactment emerged as a significant mediator of the relationship between alexithymia and treatment outcome, implicating it as a contributing mechanism of change for alexithymic patients who participate in group therapy. Patients with higher levels of alexithymia (in particular, difficulty identifying and describing feelings) were more likely to positively endorse aspects of family re-enactment during group therapy, which in turn were significantly associated with greater improvement in patients' overall quality of life.