TAS-20 Total Score Research Articles

Relationship between childhood trauma and suicidal risk in prisoners: the mediating effect of alexithymia

To explore the relationship between childhood trauma and suicidal risk in prisoners and the mediating effect of alexithymia in this relationship. We investigated a total of 362 male prisoners in Guangdong Province using Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Twenty-item Toronto Alexithymia Scale (TAS-20) and Suicidal Behaviors-Revised Questionnaire (SBQ-R). Thirty-five (9.7%) prisoners had a high risk of suicide. The total score and the dimension scores of the CTQ-SF was positively correlated with the total score of SBQ-R (r=0.065-0.358, P < 0.01) and the total score of TAS-20 (except for the dimension score of sexual abuse) (r=0.156-0.255, P < 0.01). The total score of TAS-20, the dimensions scores for difficulty in identifying and describing feeling and the dimension score for externally oriented thinking were positively correlated with the total score of SBQ-R (r=0.330, P < 0.01; r=0.294-0.305, P < 0.01; and r=0.130, P < 0.05, respectively). The results of structural equation analysis showed that alexithymia had a partial mediating effect on childhood trauma and suicide risks (β=0.07, 95%CI: 0.023-0.12, P < 0.05). Childhood trauma affects suicidal risk in prisoners not only directly but also indirectly through the mediating effect of alexithymia.

Problem gambling during Covid-19

Background: Problem gambling could progressively grow in a period of isolation due to the COVID-19 pandemic to the possibility of gambling directly from home. Objectives: This pilot study highlights if the problem gambling, during a period of isolation such as that of COVID-19, can be explained by personality or sociodemographic characteristics, therefore it investigates the emotional and impulsive characteristics of problem gamblers and examines whether those who are adults, those who have more years of study or who work are less likely to have problem gambling. Methods: A total of 200 subjects completed an online survey to examine the associations between problem gambling, alexithymia, and impulsiveness. The standardized tools used were the South Oaks Gambling Screen (SOGS), the Toronto Alexithymia Scale (TAS-20), and the Barratt Impulsiveness Scale (BIS-11). Results: Problem gambling was positively correlated with male gender, TAS-20 total score, difficulty describing feelings, externally-oriented thinking, attentional, and nonplanning impulsiveness. Furthermore, there was a significant inverse correlation between higher SOGS scores and fewer years of study. Multivariate analysis showed that age, gender, years of study, BIS-11 total score, attentional impulsiveness, and nonplanning impulsiveness were predictors of gambling. Conclusions: The results of this exploratory research suggest that in a period characterized by a pandemic, problem gambling is associated with some personality and sociodemographic characteristics. Moreover, age, male gender, low levels of study and impulsive characteristics play a decisive role in problem gambling.

Alexithymia, depression, and cognition in patients with Parkinson's disease.

Basal ganglia are connected to dorsal prefrontal and orbitofrontal structures, which have an important role in emotional experience. Alexithymia is defined as the inability to recognize and verbalize emotions. There is little known about alexithymia and cognitive dysfunction and its relationship with depression. In this study, we examined the relation of alexithymia with cognition and depression in non-demented patients with Parkinson's disease (PD). Fort-two consecutive non-demented patients PD and 40 healthy controls were enrolled in the study. The Turkish version of the Montreal Cognitive Assessment scale (MOCA-TR), 20-item Toronto Alexithymia Scale (TAS-20) (F1, F2, F3 subgroups), and Beck Depression Inventory (BDI-I) were used to evaluate cognitive functions, alexithymia, and depression, respectively, in both groups. The total TAS-20 score was 55.71 ± 19 in the PD group and 46.33 ± 8.21 in the control group. There was a statistically significant difference in the total TAS-20 scores between the groups (p < 0.001). In subgroups of alexithymia, all mean scores of F1, F2, and F3 were higher in the PD group (p = 0.019, p < 0.001, and p = 0.005, respectively). In the MOCA-TR test, the mean scores in visuospatial and delayed recall of patients with PD were statistically lower than in the control group (p = 0.044 and p = 0.04, respectively). The MOCA-TR and BDI total scores were significantly correlated with TAS-20 total scores. In subgroup analysis, we only found an association between the visuospatial domain of MOCA-TR and the F3 subgroup of TAS-20 (r = -0.22, p = 0.03). There was no relation between alexithymia and disease duration or total levodopa dose (p < 0.05). Alexithymia is not a rare symptom in PD. It should be accepted as an independent non-motor symptom, and patients should be interrogated accordingly.

Alexithymia in Children with Traumatic Dental Injuries- A Cross-sectional Study

Introduction: Alexithymia is a personality trait that affects the emotional regulation. It has been found associated especially with pain disorders. It is a personality construct which is characterised by inability to experience and describe feelings, making an alexithymia patient suffer from mental clouding. Therefore, it is important to diagnose patients with alexithymia in dental clinics since it may adversely affect the doctor patient relationship and treatment outcome. Aim: To find the prevalence of alexithymia and to find any difference in alexithymia traits between children with Traumatic Dental Injury (TDI) and those without it. Materials and Methods: This cross-sectional study was conducted on 10-19 years old adolescents reporting to K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India, from February 2018 to September 2018. A total of 420 participants were enrolled with 210 in each group (with TDI and without TDI). Toronto Alexithymia Scale (TAS-20) was used to identify alexithymia. Andreasen’s classification for TDI was used to classify the TDI. Chi-square was used to compare the non parametric data between the groups. Unpaired t-test was performed for the comparison of scores between groups for total TAS-20 score and as well as for the nine dimensions. Results: The prevalence of alexithymia was found to be 86.1% in children with TDI compared to 30.9% in children without TDI. The difference in prevalence of alexithymia between children with TDI and those without was statistically significant (p-value=0.0001). Children with TDI reported with significantly higher total TAS scores. However, difference with respect to gender was not statistically significant. Conclusion: The prevalence of alexithymia was found significantly higher in children with TDI. Also, the TAS-20 score and the individual domain scores were higher in children with TDI. Hence, alexithymia may be associated with TDI.

Evaluation of alexithymia in individuals with chronic pain in a Mexican population: Alexithymia in a Mexican population.

Alexithymia is the difficulty in identifying and describing feelings. Several studies have suggested that chronic pain can be linked to alexithymia. The aims of this study were to determine the presence of alexithymia in a sample of Mexican individuals who attended public health services, to assess if alexithymia is higher in medically ill individuals with pain than in those without pain, and to determine which alexithymia dimensions are more affected by the presence of pain. Demographic and clinical features were evaluated in 250 Mexican outpatients of the General Hospital of Comalcalco, Tabasco. Pain was evaluated using the Visual Analogue Scale for Pain Assessment (VAS-P) and alexithymia was evaluated using the Toronto Alexithymia Scale (TAS-20). 38.8% of the sample was identified with probable/definite alexithymia and up to 61.2% of individuals were currently experiencing pain. Individuals with pain exhibited higher scores in the TAS-20 dimensions: difficulty describing feelings (p = 0.02), difficulty identifying feelings (p < 0.001) and higher total TAS-20 score (p < 0.001). Also, Probable/definite alexithymia was more frequently reported in individuals with pain (49% vs. 21.6%, p < 0.001). Our results show that a large proportion of individuals who attend public health services in a Mexican population present pain. We also identified that pain could be associated with alexithymia, in particular with a difficulty in describing and identifying feelings. An early identification and treatment of alexithymia could help in reducing the clinical burden of chronic pain in Mexican outpatients.

Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention.

Expressive writing techniques are methods focusing on written emotional expression that require people to write about traumatic or difficult experiences, with the objective of promoting an elaboration of these events. The general aim of the study is to investigate the influence of alexithymia, a deficit in emotional regulation processes, on the effects of an expressive writing intervention, analyzing the writing protocols through the use of the Linguistic Inquiry and Word Count (LIWIC) and Referential Process (RP) linguistic measures via IDAAP software. Thirty-five women undergoing an assisted reproductive treatment participated in the study and filled out a sociodemographic questionnaire, the 20-item Toronto Alexithymia Scale. They also underwent three session of writing, following a request that they write about their emotions regarding their current situation. The women enrolled were divided into two groups: low alexithymia and high alexithymia, comprising individuals with a TAS-20 total score lower or higher than the mean, respectively. Analyses within the groups during the three writing sessions revealed that the women with low alexithymia reported a greater number of words expressing affectivity, sadness and future perspective, whereas no significances in the high alexithymia group emerged. Moreover, when analysing differences between the groups, high-alexithymia women reported lower scores in RP indexes and fewer words expressing sadness, future perspectives and we verbal. In conclusion, these preliminary findings may confirm the hypothesis that alexithymia affects the effectiveness of expressive writing through a difficulty in becoming involved in the writing process and a lack of symbolizing processes.

Myocardial infarction-induced acute stress and post-traumatic stress symptoms: the moderating role of an alexithymia trait – difficulties identifying feelings

ABSTRACT Background It has been acknowledged that medical life-threatening experiences such as an acute myocardial infarction (MI) often lead to acute stress disorder symptoms (ASS), which in turn can result in the development of post-traumatic stress symptoms (PTSS). Previous studies have suggested an association between various traumatic experiences and alexithymia. The association of alexithymia with ASS and PTSS in patients with MI is elusive. Objectives The aim of this study was to examine the association of alexithymia with MI-induced ASS and PTSS in patients at high risk of developing PTSD. Method Patients (N = 154) were examined twice, once within 48 hours, and then again three months after acute MI. All patients completed the self-rating Acute Stress Disorder Scale (ASDS) within 48 hours after the cardiac event. Three months after hospital discharge, all patients completed the Toronto Alexithymia Scale (TAS-20) and underwent the Clinician-Administered PTSD Scale (CAPS), a structured interview to assess the severity of PTSS. Descriptive statistics, correlations, multivariate linear regressions, and moderation analysis were conducted. Results The linear regression model explained 23% of the variance in MI-induced PTSS-symptoms (F(6.109) = 5.58, p < 0.001, R 2 = 0.23. ASS was significantly related to PTSS severity (r (152) = p < 0.001). The scores of the TAS-20 subscale difficulties identifying feelings (DIF) were found to significantly moderate this relationship (R2 = 0.03, p = 0.04). The scores of TAS-20 subscales DDF and EOT as well as the TAS-20 total score had no influence on the relationship between ASS and PTSS (p > 0.05). Conclusion In MI patients with high levels of DIF, ASS predicted the development of PTSS. If replicated, the finding may inform emotion-oriented interventions to investigate whether increasing the capacity to identify feelings following acute MI could be beneficial in preventing the development of PTSS.

The role of alexithymia and empathy on radiation therapists' professional quality of life.

Physical and mental well-being are crucial for oncology professionals as they affect performance at work. Personality traits, as alexithymia and empathy, may influence professional quality of life. Alexithymia involves diminished skills in emotion processing and awareness. Empathy is pertinent to the ability to understand another's 'state of mind/emotion'. The PROject on Burn-Out in RadiatioN Oncology (PRO BONO) investigates professional quality of life amongst radiation oncology professionals, exploring the role of alexithymia and empathy. The present study reports on data pertinent to radiation therapists (RTTs). An online survey targeted ESTRO members. Participants were asked to fill out 3 questionnaires for alexithymia, empathy and professional quality of life: (a) Toronto Alexithymia Scale (TAS-20); (b) Interpersonal Reactivity Index (IRI); (c) Professional Quality of Life Scale (ProQoL). The present analysis focuses on RTTS to evaluate compassion satisfaction (CS), secondary traumatic stress (STS) and Burnout and their correlation with alexithymia and empathy, using generalized linear modeling. Covariates found significant at univariate linear regression analysis were included in the multivariate linear regression model. A total of 399 RTTs completed all questionnaires. The final model for the burnout scale of ProQoL found, as significal predictors, the TAS-20 total score (β = 0.46, p < 0 0.001), and the individual's perception of being valued by supervisor (β = -0.29, p < 0.001). With respect to CS, the final model included TAS-20 total score (β = -0.33, p < 0.001), the Empatic Concern domain (β = 0.23, p < 0.001) of the IRI questionnaire and the individual's perception of being valued by colleagues (β = 0.22, p < 0.001). Alexithymia increased the likelyhood to experience burnout and negatively affected the professional quality of life amongst RTTs working in oncology. Empathy resulted in higher professional fulfillment together with collegaues' appreciation. These results may be used to benchmark preventing strategies and implement organization-direct and/or individual-directed interventions.

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.

Association between parental alexithymic traits and self-reported postnatal reflective functioning in a birth cohort population. Findings from the FinnBrain Birth Cohort Study

Parental reflective functioning (PRF) refers to a parent's effort to see his/her child as a separate individual person from early on, and to be curious of the child's own thoughts and feelings. Parenting abilities are affected by the parent's emotion regulation and emotional availability. Alexithymia as a personality construct with emotional deficits and poor imagination could potentially affect also PRF, but studies on parental alexithymia are still scarce. The aim of the present study was to examine the association between parental alexithymic traits and PRF, which to date has not been explored. As most of the parenting research concern only mothers, an additional aim was to study also fathers. The 20-item Toronto Alexithymia Scale (TAS-20) and the 14-item Parental Reflective Functioning Questionnaire (PRFQ-Fi) were filled by 1882 mothers and 994 fathers at six months postpartum as part of the FinnBrain Birth Cohort Study. A significant negative association between TAS-20 total score and PRFQ-Fi total score among both genders was found. The main alexithymia dimension responsible for this association was Externally Oriented Thinking. The results suggest that alexithymic traits indeed are related to parental reflective functioning, but more studies are needed to explore the direction of this relation.

Alexithymia and obesity: controversial findings from a multimethod assessment.

The aim of the study is to assess alexithymia levels in obese patients using a multimethod measurement (TAS-20 and TSIA) to evaluate both possible differences between the two instruments and their relationship with body weight. 54 obese patients, seeking surgical treatment, were enrolled. They completed a socio-demographic questionnaire, 20-items Toronto Alexithymia Scale and the Toronto Structured Interview for Alexithymia. Data analysis showed a significant positive association between TAS-20 and TSIA total scores (r=.28, p<.05), but only the TSIA score was positively related to body weight (r=.39; p<.001). Multivariable linear regression models showed the predictive effects of TSIA total score (beta=.41; p<.001) and difficulty in identifying feelings (DIF) (beta=.56; p<.001) respectively on weight. The findings showed a different association between body weight and alexithymia according to the instrument employed to evaluate alexithymia, supporting the importance of a multimethod assessment in some clinical conditions.

The relationship study on alexithymia and interoception in patents with panic disorder

Objective To explore the characteristics of alexithymia and interoception in patients with panic disorder(PD) and its relationship. Methods Thirty-seven patients with PD and 45 healthy controls who met the diagnostic criteria of DSM-Ⅳ were selected.Toronto Alexithymia Scale (TAS) and state-trait anxiety inventory (STAI) were used to assess the characteristics of alexithymia and anxiety symptoms respectively.The heartbeat perception levels were tested by the Mental Tracking Paradigm. Results The detection rate of alexithymia in patients with panic disorder was 37.83%(14/37), but the rate in the normal control group was only 4.44%(2/45), and the difference was statistically significant (χ2=14.42, P<0.05). The total score of TAS (55.11±10.99), factor Ⅰ (20.62±6.78) and factor Ⅱ (14.68±3.70) in the PD group were higher than those in the control group (42.93±9.25, 12.82±4.99, 11.42±3.04; F=20.72, 31.08, 15.31, P<0.01). The levels of the heartbeat perception were higher in the PD group than that in the control group (0.75±0.15, 0.58±0.19; t=4.13, P<0.05). In PD group, the score of STAI were positively correlated with TAS total score and factor Ⅰ and Ⅱ scores(r=0.57, 0.61, 0.47; r=0.54, 0.62, 0.39, P<0.05). There was no significant correlation between the scores of STAI and the level of interoception.The mediating effect of interoception level on alexithymia and state anxiety was not significant while the mediating effect on alexithymia and trait anxiety was also not significant. Conclusions The alexithymia detection rate and interoception sensitivity in patients with panic disorder were higher than those of healthy people.There may be interaction between alexithymia and anxiety symptoms.Interoception may be a clinical feature of panic disorder. Key words: Panic disorder; Alexithymia; Interoception; Heartbeat perception

Alexithymia and binge eating in obese outpatients who are starting a weight‐loss program: A structural equation analysis

To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE. Three hundred sixty one obese BE-patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Patients with BE reported significantly higher TAS-20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**). Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client-focused interventions.

Impact of alexithymia on glycemic control among Lebanese adults with type 2 diabetes.

Alexithymia, defined as the inability of a person to identify, describe and express emotions, has been found to influence glycemic control in type 2 diabetes patients (D2). The characteristics and influencing factors of alexithymia and the association of this psychological construct with D2 has not yet been studied in Lebanon where 14.6% of adults are diagnosed with the disease. This study aims at evaluating the prevalence of alexithymia and its relationship with glycemic control among Lebanese adults with D2. Alexithymia was assessed in 104 patients diagnosed with D2 and 100 healthy controls using the 20-item Toronto Alexithymia Scale (TAS-20). The impact of alexithymia on glycemic control was evaluated using HbA1c values, fasting blood glucose levels, number of severe hyperglycemic episodes and hospitalizations for hyperglycemia within the past months. Alexithymia prevalence was significantly higher in D2 patients compared to controls (35.5% vs 15%). Patients with alexithymia showed higher levels of HbA1c and glucose in comparison to those without alexithymia. Consistently, significant positive correlations were found between the TAS-20 total and subscale scores and both HbA1c and glucose levels. Alexithymic patients had three times more severe hyperglycemic episodes and five times more hospitalizations for hyperglycemia compared to those without alexithymia. According to multivariate regression analysis, lifestyle factors alone were not found predictive of alexithymia in D2 patients. Given the impact of alexithymia on D2 regulation, screening of alexithymia in case of D2 and appropriate psychological follow-up are important for a better prognosis, management and treatment of the disease.

Predicting physical and mental health symptoms: Additive and interactive effects of difficulty identifying feelings, neuroticism and extraversion

ObjectiveAlexithymia, neuroticism, and extraversion have been described as relevant predictors of mental and physical health conditions, but their putative interactive effects remain poorly understood and their prospective effects are not well studied. The present study has investigated the differential contributions of distinct personality traits in predicting mental and somatic health symptoms in cross-sectional and longitudinal analyses. MethodsAdditive and interactive effects of neuroticism and extraversion (NEO-FFI), the TAS-20 total score (20-Item Toronto Alexithymia Scale) and its factors (Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF) and External Oriented Thinking (EOT)) have been investigated on depressive symptoms, the number of chronic diseases, somatic and mental subjective health complaints. Analyses have been based on data from the population-based “Study of Health in Pomerania” (SHIP) in cross-sectional (N = 1704) and longitudinal (N = 1244) analyses. ResultsIn cross-sectional and longitudinal analyses, additive associations of the TAS-20 total score and neuroticism on somatic and mental health complaints have been observed. The effects of the TAS-20 total score have been mainly carried by DIF. Further, in interaction effetcs extraversion has attenuated the negative impact of neuroticism, whereas DIF has augmented it. ConclusionThe present study is the first demonstrating longitudinal effects of alexithymia, particularly DIF, neuroticism, and extraversion in predicting mental and somatic health symptoms. Associations between DIF, neuroticism, and extraversion have been additive and interactive. Hence, subjects high in neuroticism and DIF but low in extraversion have reported most health symptoms and thus might be in need for prevention strategies. Treatments chould be adapted to the associated combination of the personality characteristics.

Alexithymia, impulsivity and sensation seeking in Buprenorphine addiction: A comparative study

ABSTRACTBackground: Addiction to Subutex® can be conceptualized as a consequence of the interaction between individual, environmental and substance-related risk factors. Impulsivity, alexithymia and sensation seeking form part of the personality traits that have been implicated in the development of addiction.Methods: We conducted a cross-sectional comparative study including 50 patients with addiction to Subutex® (PSA) and 50 witnesses. We estimated alexithymia with the Toronto Alexithymia Scale(TAS-20), impulsiveness with the BARRATT Impulsiveness Scale and we assessed seeking sensation with the Brief Seeking Sensation Scale.Results: Alexithymia (total TAS-20 score superior to 56) was significantly more frequent in the PSA group (54%) compared to the control group (24%) (p < 0.05). A high level of impulsivity, was found in 60% of the PSA group participants. That rate was significantly higher than in the control group.PSA scored significantly higher in three of the four dimensions of sensation seeking as well as in the BSSS-8 total score, compared to the control group.Conclusion: Such personality traits may alter the therapeutic course and promote poly-addiction as well as riskier addictive behaviors such as using injections. Therapeutic interventions should include reducing the consequences of alexithymia, impulsivity and sensation seeking.

Associations of social support and alexithymia with psychological distress in Finnish young adults.

The positive influence of social support on psychological wellbeing is well documented but the research among young adults is scarce. Additionally, it is still unclear what type of social support explains the positive influence in this age group. Alexithymia has been linked to lacking social support and higher levels of psychological distress, but the underlying mechanisms are not well known. We aimed to assess the association of social support and alexithymia with psychological distress in a sample of young adults. The non-clinical sample comprised 316 young Finnish adults (mean age 23 years). Psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12), alexithymia was measured with the Toronto Alexithymia Scale (TAS-20) and social support with the Multidimensional Scale of Perceived Social Support (MSPSS). The associations were assessed using regression analyses. The TAS-20 (p = 0.002) and MSPSS (p = < 0.001) total scores were significantly associated with the GHQ-12 scores even after adjustment for sociodemographic variables. For the model with the TAS-20 and MSPSS subscales, the Difficulty Identifying Feelings subscale score of the TAS-20 scale (p < 0.001) and the Family subscale score of the MSPSS scale (p = 0.010) were significantly associated with the GHQ-12 scores. Our results show that low social support and high levels of alexithymia are associated with increased psychological distress both in females and males. Perceived social support from family explained the association between social support and psychological distress to a significant extent. Regarding alexithymia, the association with psychological distress was mainly related to difficulties identifying feelings.

Maternal Alexithymia and Attachment Style: Which Relationship with Their Children's Headache Features and Psychological Profile?

A growing body of literature has shown an association between somatic symptoms and insecure "attachment style." In a recent study, we found a relationship between migraine severity, ambivalent attachment style, and psychological symptoms in children/adolescents. There is evidence that caregivers' attachment styles and their way of management/expression of emotions can influence children's psychological profile and pain expression. To date, data dealing with headache are scarce. Our aim was to study the role of maternal alexithymia and attachment style on their children's migraine severity, attachment style, and psychological profile. We enrolled 84 consecutive patients suffering from migraine without aura (female: 45, male: 39; mean age 11.8 ± 2.4 years). According to headache frequency, children/adolescents were divided into two groups: (1) high frequency (patients reporting from weekly to daily attacks), and (2) low frequency (patients having ≤3 episodes per month). We divided headache attacks intensity into two groups (mild and severe pain). SAFA "Anxiety," "Depression," and "Somatization" scales were used to explore children's psychological profile. To evaluate attachment style, the semi-projective test SAT for patients and ASQ Questionnaire for mothers were employed. Maternal alexithymia traits were assessed by TAS-20. We found a significant higher score in maternal alexithymia levels in children classified as "ambivalent," compared to those classified as "avoiding" (Total scale: p = 0.011). A positive correlation has been identified between mother's TAS-20 Total score and the children's SAFA-A Total score (p = 0.026). In particular, positive correlations were found between maternal alexithymia and children's "Separation anxiety" (p = 0.009) and "School anxiety" (p = 0.015) subscales. Maternal "Externally-oriented thinking" subscale correlated with children's school anxiety (p = 0.050). Moreover, we found a correlation between TAS-20 Total score and SAFA-D "Feeling of guilt" subscale (p = 0.014). Our data showed no relationship between TAS-20 and ASQ questionnaires and children's migraine intensity and frequency. Maternal alexithymia and attachment style have no impact on children's migraine severity. However, our results suggest that, although maternal alexithymic traits have no causative roles on children's migraine severity, they show a relationship with patients' attachment style and psychological symptoms, which in turn may impact on migraine severity.

Influencing factors of alexithymia in Chinese medical students: a cross-sectional study

BackgroundA much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors.MethodsA cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach’s α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student’s t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0.ResultsOf the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach’s α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05).ConclusionsGender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.

Alexithymia and weight loss in obese patients underwent laparoscopic sleeve gastrectomy.

Obesity is a multifactorial disease characterized by genetic, social, cultural and psychological factors. Currently, bariatric surgery represents the gold-standard intervention to treat morbid obesity in order to counteract associated disabling comorbidities. Several studies showed correlation between post-surgery weight loss and psychological factors. Also, the alexithymia may have a role in affecting post-surgery outcomes in bariatric patients, even if there are no studies investigating its role at 12-month follow-up. The purpose of the present study was to investigate the association between alexithymia and the postoperative weight loss 12 months after laparoscopic sleeve gastrectomy. Seventy-five patients undergoing laparoscopic sleeve gastrectomy were enrolled. The Toronto Alexithymia Scale (TAS-20) was administered to patients. A postoperative weight loss check was performed at 3 and then 12months after surgery. The TAS-20 total score was negatively correlated with the percent of excess weight loss (%EWL) at the 12-month follow-up (r = -0.24; p = 0.040). The analysis showed that non-alexithymic patients had a greater weight loss at 12 months after surgery compared to both probably alexithymics (71.88 ± 18.21 vs. 60.7 ± 12.5; p = 0.047) and probably alexithymic patients (71.88 ± 18.21 vs. 56 ± 22.8; p = 0.007). The preoperative BMI was a significant covariate [F(1,70) = 6.13 (p = 0.016)]. In the present study, the patients with higher preoperative BMI and identified as alexithymic showed lower %EWL at 12months after laparoscopic sleeve gastrectomy. Findings point out the importance to take into consideration possible psychological treatments focused on improving emotional regulations of patients who are seeking bariatric surgery.