Higher Alexithymia Scores Research Articles

Longitudinal Investigation of Alexithymia as a Predictor of Empathy, Emotional Functioning, Resilience, and Life Satisfaction 2 Years After Brain Injury

ObjectiveTo examine the unique contribution of alexithymia at 1 year after traumatic brain injury (TBI) to the prospective prediction of emotional and social health outcomes at 2 years after injury. DesignMulticenter, longitudinal cohort study. SettingData were collected during year 1 and year 2 postinjury follow-up interviews across 4 TBI Model System centers. ParticipantsPersons with TBI (N=175; 134 men and 41 women) who had English fluency and were capable of providing self-reported data. InterventionsNot applicable. Main Outcome MeasuresPrimary independent variable was the Toronto Alexithymia Scale-20. Outcome measures included the Interpersonal Reactivity Index, National Institute of Health Toolbox Emotion Battery Anger, Difficulty with Emotion Regulation Scale, Connor-Davidson Resilience Scale, Posttraumatic Stress Disorder Checklist – Civilian, Satisfaction with Life Scale, General Anxiety Disorder-7, Patient Health Questionnaire 9, suicidal ideation, and problematic substance use. ResultsSimple adjusted models demonstrated that after controlling for the specific outcome at year 1, Toronto Alexithymia Scale-20 scores significantly predicted year 2 scores for perspective-taking, physical aggression, emotional dysregulation, resilience, anxiety, depression, and suicidal ideation. All of these predictive findings except for physical aggression were maintained in the fully adjusted models that also controlled for age, sex, education level, number of prior TBIs, and motor and cognitive functioning. ConclusionsCompared with those with lower alexithymia scores, persons with TBI who had higher alexithymia scores at 1 year after injury reported poorer emotional health at 2 years after TBI, even after controlling for year 1 outcome scores, sociodemographic characteristics, and injury-related factors. These results support the need to assess for elevated alexithymia and to provide interventions targeting alexithymia early in the TBI recovery process.

2D:4D ratio, alexithymia, impulsivity, aggression, and ADHD in men with opioid and methamphetamine use disorders: A comparative analysis with healthy controls

Substance use disorder is an important mental health problem with increasing frequency. This study aims to investigate the 2D:4D ratio, Dr-I values (right-left differences), alexithymia, aggression, impulsivity, and attention deficit hyperactivity disorder (ADHD) symptoms in male patients with methamphetamine use disorder (MUD), opioid use disorder (OUD), and healthy controls. The study included a total of 57 male patients diagnosed with OUD, 42 male patients diagnosed with MUD, and 72 healthy male controls. The study indicated that the OUD and MUD patients were significantly different from the healthy controls in terms of the 2D:4D ratio, alexithymia, impulsivity, aggression, and ADHD. Compared to healthy controls, 2D:4D ratios, and Dr-I values were lower in OUD and MUD patients. OUD and MUD patients had higher scores of alexithymia, impulsivity, aggression, and ADHD compared to healthy controls. There were statistically significant negative correlations between the right-hand 2D:4D ratios and the ADHD, impulsivity, alexithymia and aggression scores and a significant negative correlation between Dr-I scores and the impulsivity scores of MUD and OUD patients. These findings contribute to the existing literature examining the complex relationship between prenatal testosterone exposure, substance use disorders and related psychological traits.

The Relationship Between Emotional Dysregulation, Alexithymia and Somatization in Patients with Bipolar Disorder.

Emotional dysregulation is a basic feature found in patients with bipolar disorder. It was also reported that higher alexithymia scores are a predictive factor for a decrease in social functionality. It is known that patients with bipolar disorder experience more somatic symptoms than the general population. No study has yet been conducted on the interrelation of these 3 clinical domains, which are known to negatively affect the functionality and quality of life in bipolar disorder patients. This study included 72 bipolar disorder-1 patients. The Difficulties in Emotion Regulation Scale was used to determine the emotional state of the patients, the Toronto Alexithymia Scale was used to determine the alexithymia scores, and the Somatization Scale was used to determine the somatization scores. As a result of hierarchical multiple linear regression analysis, the first model was found to be significant (P < .001), and the emotional dysregulation total scale score significantly predicted the Toronto Alexithymia Scale total scale score (P < .001). The second model was also found to be significant (P < .001), and the emotional dysregulation total scale score significantly predicted the somatization total scale score (P < .001). This study found that ED predicted alexithymia and somatization in euthymic bipolar patients. The therapeutic approaches targeting these 3 clinical domains that negatively affect patients' quality of life and functionality may provide positive clinical outcomes.

The Description of Alexithymia in Nursing Students at Padjadjaran University with Social Media Addiction

Aim: People’s inability to recognize and express their emotions (alexithymia) seems to be a risk factor in causing social media addiction, where the higher level of social media addiction, the higher level of alexithymia. This study aims to determine the prevalence of alexithymia among nursing students at Padjadjaran University who experience social media addiction. Method: This study used a quantitative descriptive design. The research samples were 216 nursing students at Padjadjaran University who experienced social media addiction after being screened using the IAT instrument, with a total sampling technique. The instrument used to see alexithymia was TAS-20 instrument. In this study, the data are analyzed by univariate analysis and presented in the form of frequency distribution tables. Result: The result of this study showed that less than half of the respondents, which were 94 (43.5%) experienced a high level of alexithymia, with alexithymia subscales average scores were 20,68 + 7.90 for DIF, DDF 16 + 5.54, and EOT 22,52 + 8.32. Conclusion: The conclusion of this study is that respondents who experienced moderate and severe social media addiction have higher alexithymia scores. Therefore, it is necessary to have preventive and promotive solutions for nursing students who don’t or have alexithymia.

Attentional processing of unpleasant stimuli in alexithymia: Early avoidance followed by attention maintenance bias

Alexithymia is a multifaceted personality trait linked to increased risk for psychological, psychosomatic, and physical health problems. One hypothesized mechanism through which alexithymia predisposes individuals to such problems is the interference of alexithymic characteristics in processing affective, particularly unpleasant content. This study aimed to investigate the relationship between alexithymia and biases in attentional processing of threatening vs. neutral pictorial stimuli, disentangling early (vigilance) from late (maintenance) attentional biases. One hundred participants (77 female; 18–35 years old) completed the Toronto Alexithymia Scale and underwent a free viewing task with picture pairs presenting illness, fear and neutral content, during which dwell time on each picture was recorded at time intervals of 0–500 ms, 501–1000 ms and 1001–6500 ms of exposure. Results from multilevel modeling showed that alexithymia interacted with time interval and picture type. Higher alexithymia scores were related to less dwell time towards fear pictures at 501 ms-1000 ms, but more dwell time at 1001 ms-6500 ms after stimulus onset. This effect was particularly observed for the externally oriented thinking and the difficulty in describing feelings facets of alexithymia, but not the difficulty in identifying feelings. There was no effect of alexithymia on early vigilance at 0–500 ms. This study provides evidence on the association between alexithymic traits and early avoidance, along with late maintenance bias to fear, which appears consistent with the view that alexithymia is associated with avoidant emotion regulation processes, but also greater requirements of cognitive resources for processing affective information.

The Impact of Resilience, Alexithymia and Subjectively Perceived Helplessness of Myocardial Infarction on the Risk of Posttraumatic Stress

The aim of this study was to investigate the impact of resilience, alexithymia and the subjectively perceived severity (fear of death, pain intensity, helplessness) of myocardial infarction (MI) on posttraumatic symptom severity (PTSS) after MI. Patients were assessed with the Posttraumatic Diagnostic Scale (PDS), Resilience Scale (RS-11) and Toronto Alexithymia Scale (TAS-20). Subjectively perceived severity of MI was measured with three items on a 10-point Likert scale. To test our hypothesis, we applied Pearson correlations as well as multiple hierarchical linear regression analyses. A higher resilience score was significantly associated with lower (r = − .39, p < .001) PTSS. Higher scores of alexithymia (r = .38, p < .01) and subjectively perceived helplessness (r = .42, p < .001) were associated with higher PTSS. Multiple hierarchical linear regression analyses revealed that resilience, the TAS-20 subscale difficulty identifying feelings (DIF) and especially subjectively perceived helplessness were independent significant predictors for the PTSS, adjusted R2 = .29, F(5, 102) = 9.57, p < .001. Our results suggest that resilience reduces the PTSS whereas alexithymia and subjectively perceived helplessness increase the risk. Especially the subjectively perceived helplessness explains a high degree of variance of PTSS and should be assessed to hindering further mental health burden.

Internet addiction, substance use and alexithymic dimensions in two different faculties' students.

The aim of this study was to evaluate the relationship between internet addiction, substance use and alexithymia among students of education faculty and medical faculty. This cross-sectional analytical study included 1,257 faculty students aged 18 and over, studying at Meram Medical Faculty and Ahmet Keleşoğlu Faculty of Education. Young's Internet Addiction Scale, Toronto Alexithymia Scale, Fagerström Tobacco Addiction Test and CAGE alcohol use tests were applied to collect data. The mean age of the participants was 21.12 ± 1.96 years, 71% (n = 893) of them were females and 29% (n = 364) were males, 37.9% (n = 477) were training at medical faculty, 62.1% (n = 780) were training at the faculty of education. Of the students, 1.5% were internet addicts, 15.3% were possible addicts, and 22.8% had alexithymia. Internet addiction was higher in those with higher alexithymia scores (p < 0.001). Internet addiction was significantly higher in male students, the third grade, ones with lower academic success, students who work their lessons less than 2 hours a week. Internet addiction was also significantly higher in smokers and alcohol users (p < 0.001). While there was a low negative correlation between the first internet using age and internet addiction (p < 0.001), there was a moderately significant positive correlation between spending uninterrupted time on the internet and internet addiction (p < 0.001). In this study, it was determined that the teacher and doctor candidates, who are studying at the faculties of education and medicine, were at risk of internet addiction. A teacher or a doctor who cannot develop social skills due to excessive internet use will not be a good model to communicate correctly with the target population.

Alexithymia, dissociation and emotional regulation in eating disorders: Evidence of improvement through specialized inpatient treatment.

The research into emotional regulation in eating disorders (EDs) has shown specific impairments and maladaptive coping strategies in patients, and there is an increasing interest in the role of the emotional domain in the treatment outcome. This study aims to evaluate the effect of a specialized inpatient treatment characterized by both an intensive and comprehensive standardized multidisciplinary programme based on cognitive–behavioural therapy and a flexible and personalized component implemented by third‐wave interventions. A cohort of 67 female ED patients (anorexia nervosa = 28, bulimia nervosa = 28 and binge eating disorder = 11) underwent an evaluation of emotional regulation difficulties, alexithymia and dissociative symptomatology at admission to a specialized ED ward. The psychological modifications were subsequently re‐evaluated upon discharge, after an inpatients treatment of 60 days, examining specific changes in the specific psychopathology. A significant improvement after specialized ED treatment was shown in alexithymia, emotional regulation difficulties and dissociation symptoms, with higher effect sizes in patients with higher alexithymia scores. As regards the specific effect of the psychological improvement, changes into alexithymia scores have shown specific correlations with ED psychopathology (p < 0.010) and with difficulties in emotional regulation (p < 0.010) in patients with higher alexithymia levels at admission. Emotional regulation and dissociation should therefore be evaluated in ED patients and may be improved with specific therapeutic approaches, while alexithymia remains a clinical trait, even with a significant reduction.

Trait emotional intelligence and eating problems in adults: associations with alexithymia and substance use

Background: Eating Disorders (EDs) often co-occur with substance use contributing to increasing concern about the individual’s health; both the conditions share several core features such as the tendency to use maladaptive emotion regulation strategies. The present study investigated associations between trait emotional intelligence (Trait EI), alexithymia and EDs, namely dieting, bulimia and oral control, in a nonclinical sample of adults. Moreover, the relationships with substance use frequencies were also examined with the aim of exploring the links between personality emotional competence traits (trait EI and alexithymia) and different addictive risk behaviours (EDs and substance use) in adulthood. Methods: Data were collected from a convenience sample composed of 394 (312 women; between ages 18 and 65; mean age = 32.34; SD = 11.97) participants, through online administration of questionnaires assessing trait emotional intelligence (TEIQue-SF), eating problems (EAT-26), alexithymia (TAS-20) and frequency of substance use (in the last year). Results: The group that exceeds the cut-off for EDs (n = 58; 14.7 %) has significantly lower trait EI scores (in all dimensions) and higher alexithymia scores than the other group. Some differences between the two groups were found on frequencies of nicotine and diuretics use. Age and all trait EI factors were negatively associated with eating disorders and alexithymia. Weak inverse correlations have emerged between EI and frequencies of substance use (namely cocaine, amphetamines, alcohol and tobacco). Female gender, well-being and self-control factors of EI emerged as significant predictors of EDs in adulthood. Conclusions: Our results suggest the importance of targeting emotion dysregulation for EDs and substance use behaviours. Interventions aimed at promoting healthy lifestyles could benefit from trait EI enhancement efforts. Practitioners and health educators need to recognize the potential efficacy of including trait EI within gender specific interventions planned to address ED symptoms and addictive behaviours in general.

The Association between Parent and Child-Report Measures of Alexithymia in Children with and without Developmental Language Disorder.

Accurate measures of alexithymia, an inability to recognise and describe one’s own emotions, that are suitable for children are crucial for research into alexithymia’s development. However, previous research suggests that parent versus child reports of alexithymia do not correlate. Potentially, children may report on the awareness of their emotions, whereas parent-report measures may reflect children’s verbal expression of emotion, which may be confounded by children’s communicative abilities, especially in conditions such as Developmental Language Disorder (DLD). Given theoretical arguments that alexithymia may develop due to language impairments, further research into alexithymia in DLD is also needed. This project examined parent and child report measures of alexithymia in children with DLD (n = 106) and without DLD (n = 183), and their association to children’s communication skills. Parent and child reports were not significantly correlated in either group, and children with DLD had higher alexithymia scores on the parent-report measure only. Thus, parent and child measures of alexithymia likely reflect different constructs. Pragmatic language problems related to more parent-reported alexithymia, over and above group membership. Structural language abilities were unrelated to alexithymia. We suggest decreased social learning opportunities, rather than a language measure artefact, underlie increased alexithymic difficulties in DLD.

Alexithymia in Patients With Substance Use Disorders and Its Relationship With Psychiatric Comorbidities and Health-Related Quality of Life.

Background: Alexithymia frequently correlates with several psychiatric disorders, including substance use disorder (SUD). However, most studies reporting the associations between alexithymia and psychiatric disorders have been performed in populations without SUD. This research, therefore, evaluates alexithymia in Spanish patients with SUD and the relationship among alexithymia, psychiatric comorbidities, psychological symptoms/traits, SUD variables, and health-related quality of life (HRQoL).Methodology: A cross-sectional study was conducted with 126 Spanish outpatients with SUD (75.4% males; mean age 43.72 ± 14.61 years), correlating their alexithymia levels (using the Toronto Alexithymia Scale 20 [TAS-20]) to their psychiatric comorbidities, psychological symptoms/traits, SUD variables, and HRQoL.Results: Alexithymia was significantly higher in patients who had cannabis use disorder. Higher alexithymia scores were also related to higher levels of depression, anxiety, impulsivity, and lower HRQoL. After multivariate analysis, trait anxiety, impulsivity, and the physical component summary of the HRQoL were found to be independently related to alexithymia.Conclusions: SUD patients with higher alexithymia levels have more frequently psychiatric comorbidities, present specific psychological features, and have worse HRQoL. Hence, it is important to evaluate these factors and offer more accurate psychotherapeutic approaches for this patient population.

Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress

Due to the spread of COVID 2019, the Italian government imposed a lockdown on the national territory. Initially, citizens were required to stay at home and not to mix with others outside of their household (Phase 1); eventually, some of these restrictions were lifted (Phase 2). To investigate the impact of lockdown on emotional and binge eating, an online survey was conducted to compare measures of self-reported physical (BMI), psychological (Alexithymia), affective (anxiety, stress, and depression) and social (income, workload) state during Phase 1 and Phase 2. Data from 365 Italian residents showed that increased emotional eating was predicted by higher depression, anxiety, quality of personal relationships, and quality of life, while the increase of bingeing was predicted by higher stress. Moreover, we showed that higher alexithymia scores were associated by increased emotional eating and higher BMI scores were associated with both increased emotional eating and binge eating. Finally, we found that from Phase 1 to Phase 2 binge and emotional eating decreased. These data provide evidence of the negative effects of isolation and lockdown on emotional wellbeing, and, relatedly, on eating behaviour.

The association between communication impairments and acquired alexithymia in chronic stroke patients

ABSTRACT Introduction Language dysfunction has recently been suggested to be one route to alexithymia, an impairment in recognizing and communicating one’s own emotions. Neuropsychological evidence is needed to investigate the possibility that acquired language problems could underlie acquired alexithymia. Method This project examined data from a large group of chronic stroke patients (N = 118) to test whether self-reported or behavioral measures of language and communication problems were associated with alexithymia. We also examined the impact of hemisphere of damage on alexithymia. Results We found no differences in alexithymia levels for patients with observed language impairments on brief tests of picture naming, comprehension, and reading vs unimpaired patients. However, self-reported communication difficulties were found to be associated with higher scores of alexithymia, even after controlling for depression and anxiety. Patients with left- versus right-hemisphere damage did not differ in their alexithymia scores. Conclusions We found partial support for the language hypothesis of alexithymia. We discuss potential reasons for the discrepant findings between the self-report and objective language measures and suggest that self-report measures may be more sensitive to milder, more pragmatic language impairments, as opposed to the severe structural language impairments measured by the cognitive screening tests.

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.

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.

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.

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.