Alexithymia Severity Research Articles

Adverse childhood experiences and alexithymia intensity as predictors of temporal dynamics of functioning in individuals with irritable bowel syndrome: A three-wave latent transition analysis

ObjectiveDespite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group. MethodBased on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics. ResultsThe IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants. ConclusionChildhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.

Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool.

Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

Visual perception of facial expressions of emotions and alexithymia among people suffering from schizophrenia

Aim of the studyThe aim of the study is to find out whether there is a relationship between the severity of alexithymia and the visual perception of facial expressions of emotions among people suffering from schizophrenia.Subject or material and methods41 people suffering from schizophrenia and 41 healthy people participated in the study. In the first stage, the subjects completed the Toronto Alexithymia Scale (TAS-20) questionnaire. The second stage was based on eye-tracking measurements made during a computer experiment of recognising facial expressions.ResultsPeople with schizophrenia showed significantly higher intensity of alexithymia than healthy people. In the group of patients with schizophrenia, a negative correlation between alexithymia and the length of saccades on the nose was found.DiscussionIn the group of people with schizophrenia, alexithymia is associated with less intensive exploration of the nasal area. A wrinkled nose is an important area, first of all, in the manifestation of negative emotions, in recognition of which the sick people make the most mistakes.ConclusionsProblems with recognising emotions in people suffering from schizophrenia are associated with neuronal dysfunction and abnormalities in the eye movement. These factors disrupt the early stages of sensory processing. The relationship of alexithymia with the visual perception of patients with schizophrenia suggests that top-down processes may also contribute to the development of these deficits.

Alexithymia characteristics are associated with salience network activity in healthy participants: an arterial spin labeling study

BackgroundAlexithymia, a personality trait characterized by difficulties in identifying and expressing their emotions despite having a range of emotional experiences, can impact individuals’ stress coping mechanisms. While many studies have investigated brain functions associated with specific tasks in relation to emotion processing, research focusing on resting-state brain functions has been limited. Thus, the aim of this study was to investigate the relationship between alexithymia and brain function by analyzing arterial spin labeling (ASL) data obtained during the resting state.MethodsA brain structural and functional imaging study was conducted on 42 healthy adult men and women using ASL and the 20-item Toronto Alexithymia Scale (TAS-20) questionnaire survey. Cerebral blood flow and functional connectivity values were calculated for regions of interest in the default mode network, saliency network, and central executive network from the ASL data. Correlation analysis was performed with TAS20 scores, and partial correlation analysis was conducted to control for anxiety and depression.ResultsThe functional connectivity analysis revealed a negative correlation between the functional connectivity of the right insular cortex and left anterior cingulate cortex and the total score of TAS, as well as difficulty identifying feelings and difficulty describing feeling subscores, indicating that the higher the scores, the weaker the functional connectivity between these regions (T = -3.830, p = 0.0013, R = -0.5180). This correlation remained significant even after controlling for anxiety and depression using partial correlation analysis.ConclusionThe present study revealed differences in the activity of the Saliency Network at rest as measured by ASL, which were independent of anxiety and depression, and varied depending on the severity of alexithymia. This functional change may underlie the neural basis of decreased emotional processing observed in alexithymia. These findings may contribute to the elucidation of the neural mechanisms of alexithymia, which can lead to social impairments, and suggest the usefulness of ASL measurement as a biomarker of alexithymia.

ПСИХОСОМАТИЧЕСКИЕ АСПЕКТЫ В ТЕЧЕНИИ КРАСНОГО ПЛОСКОГО ЛИШАЯ СЛИЗИСТОЙ ОБОЛОЧКИ РТА

Objectives. To determine the prevalence and severity of alexithymia in patients with oral manifestation of lichen planus (LP).
 Methodology. The study involved 90 young and middle-aged patients (mean age 49.4 ± 8.9 years). The patients were divided into 3 groups: group 1 – 34 people with oral manifestations of LP, group 2 – 16 people with leukoplakia, group 3 – 40 people without clinical manifestations of diseases of the oral mucosa. A dental examination was conducted, including an assessment of the condition of the oral mucosa, and a standardized questionnaire survey using a Russian-language validated version of the 20-point Toronto Alexithymia Scale.
 Results. Alexithymia was detected in 55.88% with various forms of LP, which is statistically 2.2 times higher (p < 0.001) than in patients with leukoplakia of the oral mucosa (25%) and 5.6 times higher (p < 0.001) than in patients of group 3 who do not have diseases of the oral mucosa. The average score of alexithymia in patients with LP was 80.5 ± 2.7 points, which is statistically significantly higher than in the group of patients with leukoplakia (61.0 ± 4.2 points, p = 0.006) and in the control group (44.1 ± 2.9 points, p < 0.001). A higher incidence of alexithymia was revealed in patients with exudative hyperemic form (58.33%, P1 = 0.041) and erosive-ulcerative form of LP (57.14%, p = 0.049). Quantitative assessment of alexithymia showed that among patients with LP, the greatest severity of alexithymia was found in patients with exudative hyperemic form of LP – 85.9 = 1.5 points, (p < 0.001).
 Conclusion. The data obtained allow us to consider LP as a disease in the development of which there is a psychosomatic component. The presence of alexithymia and the degree of its severity can be considered as a predictive or predictive candidate factor.

Alexithymia and psychosomatic diseases in adolescents: primary headaches

Background. Alexithymia is traditionally regarded as a factor which influences the development of psychosomatic diseases and contribute to a more severe and prolonged course of somatic diseases the high level of alexithymia indicates the deficit in cognitive processes associated with awareness, exteriorization and regulation of feelings and emotions. In recent years, a lot of research has been conducted on the comorbidity of alexithymia and psychosomatic diseases in adults, but there are very few studies in relation to children and adolescents.The aim. To analyze psychosomatic diseases associated with the high level of alexithymia in adolescents, to study the correspondence of alexithymia and central sensitization (CS) in adolescents with primary headaches (migraine and tension-type headache).Methods. The diagnosis of headache was based on the criteria for the International Classification of Headache, 3rd edition. The study group included 84 adolescents, average age – 14 [13; 16] (51 females, 33 males). CS was assessed using the Russian version of “Central Sensitization Inventory” (2020) for adolescents. Alexithymia was assessed using the Russian version of “Alexithymia questionnaire for children” (2019). Headache intensity was measured using the Visual Analogue Scale. There were also assessed the number of months and days per month with headaches; duration of night sleep; age of phrasal speech start.Results and discussion. The results showed the direct correlation between levels of alexithymia and central sensitization (rS = 0.49; p = 0.00001), the number of days with headaches per month and central sensitization severity (rS = 0.24; p = 0.027). There was no significant correlation between alexithymia severity and headaches duration (rS= 0.06; p = 0.5), no reliable results on the correspondence of alexithymia severity, age of phrasal speech start and nocturnal sleep.Conclusion. A high level of alexithymia is observed in adolescents with various somatic diseases. Primary headaches are associated with a high level of alexithymia and the severity of central sensitization. Pediatricians and neurologists should be advised to assess the level of alexithymia and central sensitization in adolescents with headaches.

Assessment of the level of professional burnout of employees of SBHI «Regional narcological hospital

The article investigates and analyzes the level and manifestations of professional burnout among medical workers of the Regional Narcological Hospital of Penza and the influence of the level of personal anxiety in the formation of symptoms of professional burnout. Target. To determine the presence of professional burnout among employees of the Regional Narcological Hospital in Penza. Results. In the course of the research work, the symptoms of the burnout syndrome from the position of the general adaptation syndrome of G. Selye were identified, the stage of professional burnout was determined, the state of reduced performance was assessed, satisfaction or dissatisfaction with work was determined, the presence or absence of symptoms of depression was revealed, the level of situational and personal anxiety was assessed, the severity of alexithymia. Conclusion. The largest number of people with severe professional burnout, the presence of severe depressive symptoms, was found in the department of ONNP, which may be due to unsatisfactory working conditions, as well as an increased level of responsibility and complexity of work.

The relationship between alexithymia, interoception, and neural functional connectivity during facial expression processing in autism spectrum disorder

Neural processing differences of emotional facial expressions, while common in autism spectrum disorder (ASD), may be related to co-occurring alexithymia and interoceptive processing differences rather than autism per se. Here, we investigate relationships between alexithymia, interoceptive awareness of emotions, and functional connectivity during observation of facial expressions in youth (aged 8–17) with ASD (n = 28) compared to typically developing peers (TD; n = 37). Behaviorally, we found no significant differences between ASD and TD groups in interoceptive awareness of emotions, though alexithymia severity was significantly higher in the ASD group. In the ASD group, increased alexithymia was significantly correlated with lower interoceptive sensation felt during emotion. Using psycho-physiological interaction (PPI) analysis, the ASD group showed higher functional connectivity between the left ventral anterior insula and the left lateral prefrontal cortex than the TD group when viewing facial expressions. Further, alexithymia was associated with reduced left anterior insula-right precuneus connectivity and reduced right dorsal anterior insula-left ventral anterior insula connectivity when viewing facial expressions. In the ASD group, the degree of interoceptive sensation felt during emotion was positively correlated with left ventral anterior insula-right IFG connectivity when viewing facial expressions. However, across all participants, neither alexithymia nor interoceptive awareness of emotions predicted connectivity between emotion-related brain regions when viewing emotional facial expressions. To summarize, we found that in ASD compared to TD: 1) there is stronger connectivity between the insula and lateral prefrontal cortex; and 2) differences in interhemispheric and within left hemisphere connectivity between the insula and other emotion-related brain regions are related to individual differences in interoceptive processing and alexithymia. These results highlight complex relationships between alexithymia, interoception, and brain processing in ASD.

The relationship between alexithymia, health literacy, and diet quality in obese adolescents

Alexithymia and low health literacy are the barriers of self-management. This study aims to examine therelationship between alexithymia, health literacy and diet quality in obese adolescents, and their effects on anthropometric and biochemical markers. The 20-item Toronto alexithymia scale (TAS-20) was used to determine the alexithymic traits of the adolescents, and "The Newest Vital Sign" (NVS) scales were used to determine their health literacy levels. Diet quality was evaluated with the Healthy Eating Index-2010 (HEI-2010). 39.7% of the obese adolescents were alexithymic, and 69.4% of alexithymics and 35.1% of non-alexithymics had metabolic syndrome. Alexithymic adolescents were lackof adequate health literacy. There were positive correlations between alexithymia scores and insulin, triglyceride, systolic and diastolic blood pressure levels, andall anthropometric values except height (p<0.05). There wasa negative correlation between alexithymia scores andhealth literacy scores (p<0.05). There were negative correlations between health literacy and alexithymia scores, insulin, total cholesterol, triglyceride, ALT, systolic, diastolic blood pressure levels and all anthropometric values except height, and positive correlation was observed between health literacy scores and diet quality (p<0.05). Total HEI score was negatively correlated with waist circumference, neck circumference, body weight, BMI, triglyceride, AST, ALT, systolic and diastolic blood pressure, and positively correlated with health literacy and HDL levels (p<0.05). As alexithymia severity increased in obese adolescents, the degree of obesity and the incidence of metabolic syndrome increased while the level of health literacy decreased. The increase in health literacy levels, on the other hand, decreased the level of alexithymia and increased the quality of the diet.

OXTR polymorphisms and parental bonding modulate alexithymia: The main effects and interaction

Alexithymia is a subclinical personality disorder characterized by difficulties in identifying and expressing one's own emotion. Individual differences in alexithymia are influenced by both genetic and environmental factors. However, the interplay between these factors and their influences on alexithymia are unclear. Considering that oxytocin plays important roles in emotion processing and that parental bonding influences the development of alexithymia, we explored the associations between OXTR polymorphisms and alexithymia and examined whether the potential associations are moderated by parental bonding. To this end, we genotyped the OXTR polymorphisms (rs53576 and rs1042778) and scored alexithymia and parental bonding with the Toronto Alexithymia Scale and the Parental Bonding Instrument. Results indicated that: (1) the characteristics of alexithymia were negatively associated with parental care and positively with parental overprotection; (2) the OXTR rs53576 was significantly associated with the characteristics of alexithymia, such that the AA genotype was associated with fewer difficulties in identifying feelings and describing feelings than the AG/GG genotypes; and (3) the OXTR rs1042778 interacted with parental care in alexithymia with the vantage sensitivity model: the GG genotype was related to less severity of alexithymia than the AG/GG genotypes only in individuals with higher parental care. Overall, these findings suggest that the OXTR is related to alexithymia and that the quality of parental care influences the relationship. However, considering that the evidence from this study is weak, more research is needed to understand the roles of OXTR in alexithymia.

Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder.

Empathy, the ability to understand and share the emotions of others, is a necessary skill for social functioning and can be categorized into cognitive and emotional empathy. There is evidence to suggest that individuals with autism spectrum disorder have difficulties with cognitive empathy, the ability to imagine how another person is thinking or feeling. However, it is unclear if individuals with autism spectrum disorder struggle with emotional empathy, the ability to share and feel emotions others are experiencing. Self-report and interview data were collected to explore the relationships between interoception (individuals' self-reported awareness of sensation from their body such as thirst, heartbeat, etc.), alexithymia (an individual's ability to describe and distinguish between their own emotions), and emotional empathy in 35 youth with autism spectrum disorder and 40 typically developing youth. Greater personal distress to others' emotions and greater difficulty describing and recognizing self-emotions were associated with reporting fewer physical sensations in the body when experiencing emotion in the autism spectrum disorder group. The results of this study suggest that while autism spectrum disorder youth with concomitant alexithymia may experience emotional empathy differently, it should not be characterized as an absence of a capacity for emotional empathy.

Cognitive, emotional and expressive factors determining the quality and variability of mentalization styles

IntroductionIn contemporary context the difficulties of making sense of social ambiguity becomes one of the most important appeals for seeking the psychological help. This grounds the importance of studying the mechanism underlying the quality of mentalization and its individual variations.ObjectivesThe objective of the study was to find empirical relations between the quality of mentalization and its cognitive, emotional and expressive mediating factors.Methods(1) The Adult Attachment Interview, scored using Social Cognition and Object Relations-Global rating method for mentalization ability. (2) Group embedded figures test. (3) New Tolerance-Intolerance to ambiguity and (4) Toronto alexithymia scale questionnaires. Twenty participants, aged 18-38, looking for psychological consultation, took part in the study.ResultsCorrelation analysis suggests positive relation between field-independency and tolerance to ambiguity (r = .47; p &lt; .05). The complexity of representations of the mind positively correlates with the understanding of social causality (r = .92; p &lt; .01). The affective quality of relationships’ representations positively correlates with the ability to emotionally invest into relationships (r = .66; p &lt; .01), and with the understanding of social causality (r = .47; p &lt; .05). The ability of emotional investment into relationships also positively correlates with the understanding of social causality (r = .93; p &lt; .01). There is a negative link between the severity of alexithymia and the presence of long-term relationships with a partner (r = -.53; p &lt; .05).ConclusionsMentalization should be understood as a system, with underplaying cognitive, expressive and emotional factors.DisclosureNo significant relationships.

Prevalence and correlates of alexithymia in older persons with medically (un)explained physical symptoms.

ObjectivesMuch is unknown about the combination of Medically Unexplained Symptoms (MUS) and alexithymia in later life, but it may culminate in a high disease burden for older patients. In the present study we assess the prevalence of alexithymia in older patients with either MUS or Medically Explained Symptoms (MES) and we explore physical, psychological and social correlates of alexithymia.Methods and DesignA case control study was performed. We recruited older persons (>60 years) with MUS (N = 118) or MES (N = 154) from the general public, general practitioner clinics and hospitals. Alexithymia was measured by the 20‐item Toronto Alexithymia Scale, correlates were measured by various questionnaires.ResultsPrevalence and severity of alexithymia were higher among older persons with MUS compared to MES. Alexithymia prevalence in the MUS subgroup was 23.7%. We found no association between alexithymia and increasing age. Alexithymia was associated with depressive symptoms, especially in the MUS population.ConclusionsAlexithymia prevalence was lower than generally found in younger patients with somatoform disorder, but comparable to studies with similar diagnostic methods for MUS. Considering the high prevalence and presumed etiological impact of alexithymia in older patients with MUS, as well as its association with depression, this stresses the need to develop better understanding of the associations between alexithymia, MUS and depression in later life.

Facial emotion recognition difficulties may be specific to skin picking disorder, but could also be related to the presence of alexithymia in trichotillomania

Background and objectivesPrevious research has shown high rates of alexithymia and emotion dysregulation in trichotillomania (TTM) and skin picking disorder (SPD). Unfortunately, there are no data on facial emotion recognition (FER) in TTM and SPD. The present study aimed to compare patients with TTM and SPD and a healthy control group for the severity of alexithymia and rates of FER. MethodsForty patients with SPD, 30 patients with TTM, and 30 healthy controls were enrolled in this study. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Clinical Global Impression (CGI), Toronto Alexithymia Scale (TAS-20), and the Facial Emotion Recognition Test were applied to the participants. ResultsPatients with TTM and SPD had less FER accuracy and higher alexithymia scores compared with healthy controls. According to ANCOVA analysis, when anxiety, depression, and alexithymia were fixed as covariates, disgusted facial expressions and total facial emotion recognition were still significantly lower in patients with SPD compared with the control group, but there was no difference between the TTM and control groups and TTM and SPD groups. ConclusionAlexithymia rates were high in patients with TTM and SPD. Interestingly, difficulty in recognizing disgusted facial expressions may be a distinctive sign in SPD. Future neuroimaging studies are needed to support possible FER impairment in patients with TTM/SPD.

Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

Personality traits as risk factors for the development of cognitive impairment and affective symptoms in patients with COVID-19

To identify possible associations between premorbid personality traits and cognitive impairment and affective symptoms in patients who have recovered from COVID-19. The study included 30 people with the so-called post-COVID syndrome. The diagnosis of COVID-19 was previously confirmed by laboratory tests in each patient. The control group included 15 healthy individuals. The Hospital Anxiety and Depression Scale was used to assess depression and anxiety. Cognitive function was assessed using the Verbal Fluency Test (VF), the Montreal Cognitive Scale (MOCA), and the Wisconsin Card Sorting Test (WCST). The Munich Personality Test (MRT) and the Toronto Alexithymia Scale (TAS-26) were used to assess premorbid personality characteristics. Multiple stepwise regression analysis was used as the main statistical method to identify the relationship between premorbid personality constructs and cognitive test results and affective and anxiety symptoms. The presence of frustration tolerance in the personality structure reduced the number of incorrect answers (beta coefficient -0.811) in WCST and decreased the delay in responses with positive reinforcement (-0.630), and also reduced the level of depression (-0.465). Extraversion decreased the MOCA test score (-0.675) and increased the percentage of perseverative incorrect answers on the WCST test (0.573). The constructs of adherence to social norms and propensity to isolate lowered the final MOCA score (beta coefficients are -0.725 and -0.527, respectively). The esoteric tendencies construct decreased the latency of positive and negative reinforcement responses in WCST (-0.441 and -0.528, respectively). The severity of alexithymia was positively correlated with depression (beta 0.577), while neuroticism was positively correlated with anxiety (0.737). Low levels of frustration tolerance and esoteric tendencies have negative effects on cognition in COVID-19 survivors, while high levels of these constructs are protective against cognitive decline and depression.

COVID-19 and chronic pain: online survey in the domestic population

The problems caused by the COVID-19 epidemic have the worst impact on chronic patient populations. People with chronic pain are one of the most vulnerable groups due to stress, disruption of daily routine, family problems, illness and difficulty in hospital care. It is therefore essential to assess the situation and mental well-being of this group. The aim of this survey was to assess chronic pain patients during the COVID-19 pandemic, addressing psychological background factors that might affect pain symptoms, such as depression, emotion regulation, alexithymia, well-being, health literacy and social support. 158 people participated in the survey, reporting pain for at least 3 months but had not received medical treatment. Data was collected at two dates: February and December 2021. Participants completed an online questionnaire due to the pandemic situation. The following six psychological questionnaires were used in the survey: Toronto Alexithymia Scale, Beck Depression Inventory 9-item version, Difficulty in Emotion Regulation Scale, Multidimensional Scale of Perceived Social Support, Chew-questions measuring health literacy, WHO Well-being Index. The participants ranged from 20 to 80 years in age, of whom 140 (88%) were female. 42 participants (27%) achieved severe alexithymia. 118 people (75%) had depression, of which 72 people (46%) had mild depression, 26 (16%) had moderate depression, and 20 (13%) had severe depression. The degree of pain and alexithy-mia (r(158) = 0.16, p = 0.004), depression (r(158) = 0.41, p < 0.001), difficulties in emotion regulation (r(158) = 0.26, p = 0.004), and health literacy, and difficulties in emotion regulation (r(158) = 0.25, p = 0.001) were positively and significantly related. In addition to the characteristic comorbidities of people living with pain (e.g. anxiety, emotion disorder, sleep disorder), the epidemic-induced prolonged social isolation, stress and fear of illness may explain the proportion of high depression, emotion regulation difficulties or health literacy problems in the study sample which exacerbate alexithymia and the degree of pain. Based on these results it is important to draw the attention of professionals to the appropriate health care and educational needs of those affected.

DEPENDENCE OF ALEXITHYMIA INTENSITY ON COMPONENTS OF PSYCHOSOCIAL ADAPTATION IN MEN WITH PSYCHOTROPIC SUBSTANCE USE DISORDERS

Introduction. Levels of alexithymia and psychosocial adaptation can influence on the treatment and rehabilitation of patients with substance use disorders. The investigation of the state of the adaptation system is often used to examine these patients, despite its complexity and multilevel character. It is still unclear what characteristics of psychosocial adaptation may indicate increasing level of alexithymia. Therefore the aim of this study is to investigate their association for future prediction of alexithymia level in men with substance use disorders. Methods. We examined 28 men who took the treatment at the detoxication therapy stage. We studied severity of alexithymia by Russian version of the Toronto Alexithymia Scale and analyzed peculiarities of psycho-social adaptation by C.R. Rogers and R.F. Dymond methods. To analyze the dependence between variances, multiple linear regression with Akaike information criteria and stepwise variable method was used. Results. The average level of alexithymia in the subjects was 57.6 ± 14.1 scores: it points out an elevated severity of the condition. The patients have “difficulty identifying feelings” at 18.9±6.6 scores, “difficulty describing feelings” at 13.7±4.9 scores and “externally oriented thinking” at 25.04±5.4 scores. The average levels of the subscales of the psychosocial adaptation questionnaire demonstrate no difference from normal values, but integral indices were increased. After stepwise variable method we selected the minimum set of factor characteristics associated with the original variable. Two factors related to the level of alexithymia were identified: internality and emotional comfort. The analysis shows the adequacy of the linear two-factor model for predicting the level of alexithymia in men with substance use disorders that based on values of internality and emotional comfort. Conclusion. We found that increased level of internality and emotional comfort in men with substance use disorders can predict an elevating level of alexithymia.

EMOTIONAL DISTRESS AS A RISK FA CTOR FOR CORONARY HEART DISEASE IN CLINICALLY HEALTHY MEN WITH ALEXITHYMIA

Objective: To identify emotional distress as a risk factor for development of coronary heart disease (CHD) in clinically healthy males with alexithymia. Materials and methods: We examined 89 clinically healthy males (mean age — 43.7 [39.0; 43.5] years) using Ch. Spielberger–Yu.Khanina tests, S. Subbotin and the Toronto Alexithymic Scale (TAS). Results: It was found that more than half of the respondents can be associated with alexithymia or they had its obvious clinical manifestations. As the severity of alexithymia increased, there was an increase in the levels of personal anxiety and a decrease in stress resistance that may increase the risk of developing coronary heart disease. Conclusion. Therefore, clinically healthy males with alexithymia of varying severity need psychological support to increase the effectiveness of primary prevention of CHD.

Differential Contribution of Alexithymia Factors to PTSD Severity in TBI

<h3>Research Objectives</h3> Traumatic brain injury (TBI) is commonly associated with neuropsychiatric symptoms, such as alexithymia and posttraumatic stress disorder (PTSD). However, the relation between these conditions is not well understood. Alexithymia, a dysfunction of affective and cognitive emotional processing, have been associated with TBI and PTSD. We examined the interaction of alexithymia factors and PTSD dimensions in Veterans with TBI. <h3>Design</h3> Cross-sectional. <h3>Setting</h3> Outpatient research unit. <h3>Participants</h3> Sixty veterans with mild TBI (medical records and clinical evaluation) and chronic cognitive (neuropsychological evaluation) and neuropsychiatric symptoms (clinical interview). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> All participants were administered a series of standardized neuropsychiatric measures, including Toronto Alexithymia Scale-20 (TAS-20), PTSD Checklist (PCL-M), and standardized neuropsychological and functional status measures. <h3>Results</h3> Alexithymia levels were strongly associated with TBI and PTSD severity. PTSD severity was strongly related to alexithymia Factor 1 (difficulty describing feelings, p < .001) and Factor 2 (difficulty identifying feelings, p < .001), but not Factor 3. Alexithymia and PTSD severity were strongly related to cognitive (executive) dysfunction. However, further analyses demonstrated that alexithymia level was the strongest predictor of executive dysfunction. <h3>Conclusions</h3> These findings highlight the prevalence of alexithymia in veterans with TBI. Our results suggest that increased alexithymia level is associated with more severe levels of PTSD in TBI. In this study more severe alexithymia was also associated with cognitive dysfunction. These results underscore the importance of identification and treatment of alexithymia, as it may improve the quality of life and reduce disability in individuals with TBI. <h3>Author(s) Disclosures</h3> No disclosures