Alexithymia Symptoms Research Articles

Alexithymia and Eating Disorder Symptoms in Adolescents

An increasing amount of evidence indicates an association between alexithymia and eating disorder symptoms. This possible association was evaluated in a non-clinical sample of late adolescents. Seven hundred and twenty nine adolescents completed the questionnaire and formed the final sample. Alexithymia was measured using the 20-item Toronto Alexithymia Scale and eating disorder symptoms were assessed using the SCOFF questionnaire. The rate of alexithymia was 8.2%, without any gender difference. The mean SCOFF scores differed significantly between alexithymic and non-alexithymic subjects, and the share of SCOFF positive subjects was significantly higher among alexithymics. The results suggest that eating disorder symptoms are more common in alexithymic adolescents.

The “Repeater” Phenomenon in Migraine Patients: A Clinical and Psychometric study

Headache is one of the most common symptoms in an emergency department (ED), while migraine is the most frequently observed headache in this setting. The aim of our study was to evaluate the influence of clinical and psychometric variables on the repeater phenomenon, ie, patients who make at least 3 visits to the ED at least 1 week apart during a 6-month period. According to the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, we consecutively recruited Italian-speaking migraine subjects who came to the ED or outpatient service. All the patients underwent the Migraine Disability Assessment Scale for the evaluation of migraine disability. We also administered the Beck Depression Inventory, State and Trait Anxiety Inventory, and Toronto Alexithymia Scale-20 for the evaluation of depressive, anxiety, and alexithymic symptoms, respectively. A personality profile was also obtained by means of the Tridimensional Personality Questionnaire (TPQ). We consecutively enrolled 465 migraine patients, diagnosed according to the ICHD-II criteria. Seventy (15%) of these patients met the repeater definition. The repeater group had more severe disability and was affected to a greater degree by chronic migraine, regardless of symptomatic drug overuse, than the non-repeater group. As regards the psychometric variables, repeaters were more alexithymic, anxious, and depressed than non-repeaters. The personality profile, as measured by the TPQ, revealed that the repeater patients scored higher on the harm avoidance scale and their subscales than the non-repeater patients. According to the findings of our study, the repeater migraineur is typically triptan-naïve, more alexithymic, and more depressed than the non-repeater migraineur. A clinical and psychometric evaluation of repeater patients who go to the ED because of migraine attacks may help to understand this epidemiological and clinical phenomenon. From a clinical point of view, these psychometric findings may not only shed light on the epidemiology of migraine in the ED, but may also help to design a specific therapeutic protocol for this subgroup of migraine patients.

Facial emotion recognition and alexithymia in adults with somatoform disorders

The primary aim of this study was to investigate facial emotion recognition (FER) in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and 20 healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of FER and the 26-item Toronto Alexithymia Scale. Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistics. This suggests that the deficit in FER observed in the patients with SFD was most likely a consequence of concurrent alexithymia. It should be noted that neither depression nor anxiety was significantly related to emotion recognition accuracy, suggesting that these variables did not contribute the emotion recognition deficit. Impaired FER observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning.

Health-related quality of life in a population-based sample of men with long-term mental symptoms

It is not known whether somatic factors related to overall health and lifestyles or psychological factors, including confirmed psychiatric diagnoses, are associated with the health-related quality of life (HRQL) of men in a population-based sample. The aim of this study was to investigate socio-demographic, somatic and psychological factors associated with HRQL in men having mental symptoms during the 7 previous years. This cross-sectional sample of men (n=63) was investigated in 2004–05 and was based on a previous three-phase follow-up study that began in 1998. Blood pressure, body mass index, waist circumference, serum lipids and testosterone levels were measured. Psychiatric diagnoses were confirmed with using the Structured Clinical Interview for DSM-IV. Several mental symptoms were assessed with standardized scales. HRQL was measured with the RAND-36 using the physical (PCS) and mental component summary (MCS) scores. A poor HRQL in PCS was found in 73% of men and in MCS in 54%. Depressive symptoms, life dissatisfaction, male symptoms of aging and alexithymia were associated with both impaired PCS and MCS scores. Hopelessness, lifetime and current diagnoses of major depressive disorder and signs of suicidality only associated with a poorer MCS score. Somatic factors describing lifestyles and overall health only weakly associated with HRQL. In general, HRQL was poor in men having long-term mental symptoms. Mental health factors were strongly associated with PCS and MCS scores of HRQL. In improving HRQL in men, both physical and mental domains should be targeted in preventive and curative strategies.

Facial emotion recognition and alexithymia in adults with somatoform disorders

The primary aim of this study was to investigate facial emotion recognition in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and twenty healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of facial emotion recognition and the 26-item Toronto Alexithymia Scale (TAS-26). Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistically. This suggests that the deficit in facial emotion recognition observed in the patients with SFD was most likely a consequence of concurrent alexithymia. Impaired facial emotion recognition observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning.

Relationship Between Alexithymia and Social Anxiety in Female Outpatients with Dermatological Disorder Presenting for Psychiatric Consultation

The aim of this study was to evaluate the relationship between alexithymia and social anxiety symptoms in female outpatients with dermatological disorder. Fifty consecutive patients sent to a psychiatry outpatient clinic for consultation from a dermatology outpatient clinic were included in the study. Social anxiety symptoms showed significant correlations with depression, trait anxiety, alexithymia and global psychiatric symptom severity. A multivariate analysis of covariance demonstrated that subscales of the Liebowitz Social Anxiety Scale (LSAS) were related to alexithymia and trait anxiety. The “difficulty in describing feelings” (DDF) dimension of alexithymia and trait anxiety appear to be important factors in this relationship between social anxiety and alexithymia. Results of this study suggest that patients with dermatological disorder may benefit from both treatment of social anxiety symptoms and learning how to regulate their affects and emotional expression.

The Influence of Alexithymia on Persistent Symptoms of Dyspepsia after Laparoscopic Cholecystectomy

The aim of this study was to evaluate whether preoperative alexithymia might play a role in the persistence of gastrointestinal symptoms after laparoscopic cholecystectomy. A sample of 52 consecutive patients with gallstone disease and symptoms of dyspepsia were assessed with validated scales for alexithymia (20-item Toronto Alexithymia Scale), and psychological (90-item Symptom Checklist) and gastrointestinal (GI) (Gastrointestinal Symptom Rating Scale) symptoms before surgery. GI symptoms were evaluated also one year after surgery. Change from preoperative to postoperative GI symptoms and level of GI symptoms after surgery were used to form groups of improved (n = 31) and unimproved (n = 21) patients. Unimproved patients had significantly higher preoperative alexithymia, psychological distress, and gastrointestinal symptom scores than patients who had improved. Regression analyses showed that alexithymia predicted the persistence of gastrointestinal symptoms more strongly than did psychological distress, even after controlling for preoperative gastrointestinal symptoms. Alexithymia played a substantial and predictive role in the persistence of GI symptoms in gallstone patients after surgery. Treatment planning and outcome of gallstone disease might be improved by preoperative assessment of alexithymia.

Theoretical and empirical exploration of the similarities between emotional numbing in posttraumatic stress disorder and alexithymia

This study rationally and scientifically examines the similarities between the emotional numbing symptoms of posttraumatic stress disorder (PTSD) and alexithymia. A clinical database from the Iowa City Department of Veterans Affairs Medical Center consisting of data from 274 combat veterans was used. Significant positive correlations were found between measures of PTSD, alexithymia, and combat exposure. Principal components analysis supported a lack of independence between PTSD subscales and alexithymia, as all variables loaded on one factor best labeled PTSD. This article presents both theoretical and empirical evidence suggesting that in traumatized persons, alexithymia may be better conceptualized as the emotional numbing aspect of PTSD rather than as a distinct construct.

Organic alexithymia: a study of acquired emotional blindness

The phrase 'organic alexithymia' is introduced as a clinically and theoretically useful construct for furthering understanding of alexithymia and the occurrence of alexithymic symptoms in patients with acquired brain injury (ABI). The construct is illustrated by the case study of HR, a 21-year-old man seen at the State Head Injury Unit, Perth, for neuropsychological and clinical assessment 2 years following a motor vehicle accident. HR's case supports the hypotheses that a syndrome substantially similar to alexithymia can occur in patients with acquired brain injury, and that the acquired nature of the organic disorder may cause it to be systematically different from the established syndrome. The case demonstrates the clinical relevance of a construct like organic alexithymia when treating patients with ABI. It also highlights the need to develop instruments capable of identifying the condition and differentiating it from symptoms of depression.

ALEXITHYMIA AND PSYCHIATRIC SYMPTOMS IN A POPULATION OF NURSERY WORKERS: A STUDY USING THE 20-ITEM TORONTO ALEXITHYMIA SCALE

This study investigated alexithymia in a sample of professional nursery workers in Huddinge community, Sweden. In a previous study in general practice it was found that alexithymia, in a mixed population seeking medical advice, was associated with higher age, male gender, low education and the personality traits suspicion and distance as well as undetected depression. The choice of a professional female population allowed alexithymia to be studied in a refined way without the impact of some of the confounding elements of previous studies. The six variables investigated apart from alexithymia were feelings of well-being, symptoms of somatic and psychic anxiety, depressive symptoms, gastro-intestinal symptoms, and level of social dysfunction. The prevalence of alexithymia was 7.9%. Fifty percent of the items assessing somatic anxiety and 28.5% of those assessing depressive symptoms were related to high TAS- 20 scores in this healthy all-female population. The feeling factors of TAS-20, difficulty in identifying and expressing feelings, accounted in this study for the majority of relations to the other variables whilst the third factor, externally oriented thinking, remained independent and mainly nonrelated to the other measured variables. It had been hypothesised that a deficit in the cognitive processing and modulation of emotions may leave alexithymic individuals prone to states of heightened sympathetic arousal. Confirmation of these theories was found in this study where subjects expressing high levels of vegetative and visceral symptoms of anxiety also scored high for alexithymia and depressive symptoms.

The Relationship Between Child Sexual Abuse and Alexithymic Symptoms in a Population of Recovering Adult Substance Abusers

ABSTRACTRecovering substance abusers with a history of childhood sexual abuse (n = 69) or no history of childhood sexual abuse (n = 68) completed the Toronto Alexithymia Scale (TAS) and a background survey assessing demographic data and (In the case of sexually abused respondents) parameters of the childhood abuse experienced. The sexually abused group scored significantly higher than the non-abused group on the TAS. Within the abused group, measured alexithymic symptomatology was found to be related positively to the duration of the abuse. Alexithymia was significantly higher when the sexual abuse first occurred after the victim had reached the age of 12, when a perpetrator of the sexual abuse was a father or stepfather, and when the abuse involved oral, vaginal, and/or anal penetration. Results were interpreted as indicating that the development of alexithymic symptoms may represent another defense victims may employ to insulate themselves from painful affect, along with dissociative symptoms and substance abuse, which have been shown previously to characterize adult survivors of child sexual abuse.

Psychiatric symptoms in male cannabis users not using other illicit drugs.

To assess the prevalence of DSM-III-R axes I and II disorders and the severity of psychiatric symptoms in cannabis users who did not use other illicit drugs. Cross-sectional psychiatric examination of subjects with different patterns of cannabis use: cannabis dependence, abuse and occasional use. One hundred and thirty-three cannabis users identified through random urine testing of draftees to the Italian army and interviewed after 2-5 days of abstinence from drug use. The subjects completed the Beck Depression Inventory, the Spielberger State-Trait Anxiety Index and the 20-item revised Toronto Alexithymia Scale and were then interviewed with the Structured Clinical Interview for DSM-III-R. The prevalence of co-morbid psychiatric disorders varied with the pattern of cannabis use: 83% of subjects with DSM-III-R cannabis dependence, 46% of those with DSM-III-R cannabis abuse and 29% of occasional users received at least one DSM-III-R psychiatric diagnosis. The severity of depressive, anxious and alexithymic symptoms increased progressively with the degree of involvement with cannabis. In this sample of young men, the risk of associated psychiatric disabilities varied with the pattern of cannabis use. Chronic use of cannabis was associated with a high prevalence of co-morbid psychiatric disorders.

The long‐term sequelae of sexual abuse: Support for a complex posttraumatic stress disorder

AbstractThis study examined the relationship between childhood sexual abuse and symptoms of a newly proposed complex posttraumatic stress disorder or disorder of extreme stress not otherwise specified (DESNOS). Compared to 34 women without histories of sexual abuse, 74 survivors of sexual abuse showed increased severity on DESNOS symptoms of somatization, dissociation, hostility, anxiety, alexithymia, social dysfunction, maladaptive schemas, self‐destruction, and adult victimization. In addition, a logistic regression found that a complex of symptoms representing DESNOS was significantly related to a history of sexual abuse. Consistent with other studies, the results of this study provide support for the idea that symptoms of DESNOS characterize survivors of sexual abuse.

Posttraumatic Stress Disorder and Alexithymia in Burn Patients

We examined symptoms of posttraumatic stress and alexithymia in a sample of 24 burn patients. Of these burn patients, those in the chronic phase (more than 10 months after the burn) indicated alexithymia more strongly. Among symptoms of Posttraumatic Stress Disorder, symptoms of avoidance and emotional numbing were also stronger in patients in the chronic phase. The manifestation of the alexithymic features was closely related to symptoms of avoidance and emotional numbing. These findings suggest the possibility that alexithymia as a state reaction may be evident when avoidance and emotional numbing appear among symptoms of Posttraumatic Stress Disorder.

Alexithymia and Perceived Symptoms: Criterion Validity of the Toronto Alexithymia Scale

The associations between alexithymia and somatization, perceived symptoms and subjective health, were investigated in a population sample of 2,297 middle-aged Finnish men. A modified translated version of the Toronto Alexithymia Scale (TAS) was used to assess alexithymia. A graded and statistically significant relationship was observed between the TAS score for alexithymia and self-reported recent symptoms. The alexithymia score, adjusted for age, smoking and socioeconomic status, was also positively associated with the MMPI hypochondriasis index and inversely with perceived level of health. One of the factors of the TAS appeared to have a weak but significant correlation with a variety of diagnosed disorders that previously have been considered psychosomatic.

Relation of psychopathology in general medical inpatients to use and cost of services

The authors investigated the relation between psychopathology in medically ill inpatients and use and cost of medical care services. Of 455 medical inpatients, the Medical Inpatient Screening Test identified 27.9% as very depressed, 27.5% as very anxious, 20.2% as having cognitive dysfunction, and 8.6% as having high pain levels. Overall, the test identified 51% of the patients as having high levels of psychopathology or pain. These subjects had a 40% longer median length of hospital stay and 35% greater mean hospital costs than those with low levels of psychopathology or pain. Patients with greater psychopathology also had higher hospital charges, more procedures during hospitalization, and more discharge diagnoses but did not differ from the other patients in sex, race, age, diagnosis-related group (DRG) major diagnostic category, or DRG weight.

Alexithymia: concept, measurement, and implications for treatment.

Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in the capacity to verbalize affect and to elaborate fantasies. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders. The author reviews the concept of alexithymia, including its historical background, clinical and demographic features, and possible etiology. He critically evaluates the different methods used to measure alexithymia and discusses the important implications it has for medical and psychiatric treatment.