This study aimed to examine the relationships between mental contamination, childhood trauma, alexithymia, and clinical characteristics in individuals diagnosed with obsessive-compulsive disorder (OCD), and to evaluate factors associated with mental contamination within a cross-sectional design. The study included 70 patients with OCD and 70 control groups (CGs). Participants completed a sociodemographic information form, the Vancouver Obsessional Compulsive Inventory-Mental Contamination Scale, the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale, and the Yale-Brown Obsessive Compulsive Scale. Group comparisons, correlation analyses with correction for multiple comparisons, and hierarchical regression analyses were conducted using IBM SPSS 26.0. The OCD had significantly higher scores for mental contamination, childhood trauma and alexithymia compared with CGs. In the OCD, mental contamination showed significant associations with childhood trauma and alexithymia; however, associations with obsession and compulsion severity were attenuated after correction for multiple comparisons. In hierarchical regression analyses, alexithymia remained the only variable significantly associated with mental contamination even after controlling for childhood trauma and contamination-related obsessions and cleaning compulsions. In the CG, alexithymia was also the only variable significantly associated with mental contamination. Our findings suggest that mental contamination in patients with OCD may be associated with childhood trauma and, in particular, alexithymic features rather than with OCD symptom severity or specific symptom subtypes. Future studies employing longitudinal and experimental designs are recommended to examine the causal nature of the relationships between mental contamination, alexithymia, and childhood trauma.

ABSTRACT Within prison settings, incarcerated individuals exhibit complex and specific psychological profiles. Statistical data indicate a prevalence rate of alexithymia exceeding 30% in this population. At the same time, various forms of aggressive behavior among inmates significantly impact on prison management and criminal rehabilitation. The purpose of our research is to explore the relationship between alexithymia and criminal aggression, and to examine the chain-mediated role of loneliness and anxiety in the influence of alexithymia on criminal aggression. A sample of 500 inmates from a prison in S Province, China, completed questionnaires including the Toronto Alexithymia Scale-20 (TAS-20), Aggression Questionnaire (AQ), UCLA Loneliness Scale Version 3 (ULS), and Self-Rating Anxiety Scale (SAS). The results indicated that alexithymia, loneliness, anxiety, and criminal aggression were significantly positively correlated with each other(r = 0.376 ~ 0.575,p ≤ 0.01). Three significant mediation pathways were identified: (1) the independent mediating role of loneliness; (2) the independent mediating role of anxiety; and (3) the chain mediation pathway through loneliness and anxiety sequentially. The 95% confidence intervals for the multiple mediating effects were [0.004,0.151], [0.231,0.250], [0.053,0.150], The effect sizes were 7.732%, 32.035%, 9.250%. Results indicated that alexithymia is significantly positively correlated with criminal aggression; loneliness works as an independent mediator between alexithymia and criminal aggression; anxiety works as an independent mediator between alexithymia and criminal aggression; loneliness and anxiety work as chain mediators between alexithymia and criminal aggression.

Background Childhood trauma is a significant risk factor for adolescents with major depressive disorder (MDD), but its associations with clinical features and inflammatory cytokines remain unclear across illness stages. This study aimed to investigate these associations by comparing adolescents with first-episode and recurrent MDD. Methods We recruited 170 adolescents with MDD and 76 healthy controls (HCs) between January 2021 and December 2022. The Childhood Trauma Questionnaire (CTQ), the Center for the Epidemiological Studies Depression Scale (CES-D), the Positive and Negative Suicidal Ideation Scale (PANSI), and the 20-item Toronto Alexithymia Scale (TAS-20) were used to assess childhood trauma, severity of depression, suicidal ideation, and alexithymia. Plasma levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, and tumor necrosis factor-alpha (TNF-α) were determined by electrochemiluminescence. Results The detection rate of childhood trauma was significantly higher in the MDD group than in HCs (80.59% vs. 31.58%). Patients also had significantly higher scores on all clinical scales and elevated levels of IL-1β, IL-6, IL-10, IL-17A, and TNF-α (all P < 0.001), except for IL-8 ( P = 0.543). Correlation analysis revealed that in first-episode patients, CTQ scores were positively linked to scores of CES-D, PANSI, and TAS-20 and levels of IL-1β, IL-6, IL-10, and IL-17A. However, in the total sample and recurrent patients, CTQ scores correlated solely with clinical features. Further multivariate linear stepwise regression analysis revealed that in first-episode patients, CTQ scores were independently associated with CES-D scores ( β = 0.396, t = 3.688, P < 0.001), PANSI scores ( β = 0.519, t = 5.190, P < 0.001), TAS-20 scores ( β = 0.454, t = 4.355, P < 0.001), and levels of IL-1β ( β = 0.264, t = 2.336, P = 0.022), IL-6 ( β = 0.228, t = 2.002, P = 0.049), IL-10 ( β = 0.253, t = 2.233, P = 0.029), and IL-17A ( β = 0.251, t = 2.215, P = 0.030). Conclusion Childhood trauma is common in adolescents with MDD and associated with more severity of depression, suicidal ideation, and alexithymia. Its link to inflammatory cytokines is exclusively observed in first-episode patients, suggesting trauma-related immune activation may be particularly important in initial onset.

Facial emotion recognition in temporal lobe epilepsy: Behavioral performance, reaction time and alexithymia.

Children with cystic fibrosis (CF) face significant physical and psychological challenges due to their chronic condition, which may affect emotional regulation and sleep quality. Alexithymia, characterized by difficulties in identifying and expressing emotions, has been linked to psychological distress and poor health outcomes in chronic illnesses. However, its prevalence and impact on CF patients and their caregivers remain underexplored. This study investigates alexithymia in children with CF and their mothers, examining its association with sleep disorders and depression. This cross-sectional study included 36 children with CF aged 9-18 years and their mothers. Emotional regulation was assessed using the Toronto Alexithymia Scale (TAS-20) for both groups. Sleep quality in children was evaluated by Sleep Disturbance Scale for Children (SDSC), and maternal depression was assessed using the Beck Depression Scale (BDS). Clinical parameters, including pulmonary function tests (PFTs), modified Shwachman-Kulczycki (mSK), and BMI z-scores, were analyzed for correlations with alexithymia. Alexithymia was prevalent in 58.3% of children and 55.6% of mothers. Higher TAS-20 scores in children correlated with worse SDSC scores (r = 0.55, p < 0.001), indicating significant sleep disturbances. Maternal TAS-20 scores correlated with BDS scores (r = 0.61, p < 0.001), reflecting a strong association with depression. No significant correlations were observed between TAS-20 scores and clinical parameters. Alexithymia is prevalent among children with CF and their mothers, contributing to poor sleep in children and maternal depression. Routine psychological screening for emotional regulation difficulties in both patients and caregivers may enhance the quality of CF care and improve emotional and clinical outcomes.

Pre-deployment prediction of partial and full PTSD in a French military cohort.

Association between disability and alexithymia in lumbar disc herniation: A cross-sectional study.

Background Improving Internet addiction among nursing students is of great significance to the future development of the nursing industry. Previous studies have proved that childhood trauma is closely related to Internet addiction. However, the direct relationship between alexithymia and childhood trauma and Internet addiction has not been fully explored. The aim of this study is to identify different subgroups of nursing students based on their childhood trauma and to examine the mediating role of alexithymia between childhood trauma and Internet addiction. Method From April to May 2025, 3,697 nursing students were recruited as samples from Shandong, Hubei, Hunan, and Henan provinces in China by convenient sampling. This survey collected social demographic data. Including The Childhood Trauma Questionnaire - Short Form (CTQ-SF), the Toronto Alexithymia Scale (TAS-26), and the Internet addiction Scale. Potential profile analysis was used to determine the potential categories of childhood trauma characteristics of nursing students, and Pearson correlation analysis, Bayesian factor robustness analysis and mediation analysis were used to determine the potential relationships among variables. Result LPA identified three distinct groups based on their dominant usage: low (77.4%), medium (19.5%), and high (3.1%). In the relationship between childhood trauma and Internet addiction based on potential profile analysis, alexithymia has a significant mediating effect (SE = 0.442,95%CI = 0.095, 1.824; SE = 0.219, 95%CI = 0.093, 0.962). Conclusion There is heterogeneity in childhood trauma among nursing students. Alexithymia plays an important mediating role in the relationship between childhood trauma and Internet addiction. It is suggested that nursing educators pay attention to the differences in childhood trauma among nursing students, provide corresponding psychological counseling for different students, improve them, thereby alleviating Internet addiction among nursing students and promoting their mental health.

Background: Breast cancer often requires mastectomy, leading to psychological distress and reduced quality of life. Objectives: This study examined the mediating role of alexithymia, specifically its 3 dimensions, in the relationship between body image concerns and marital quality of life in post-mastectomy patients. Methods: This cross-sectional study enrolled 120 married women (aged 20 - 50) with stage I – II breast cancer who had undergone mastectomy at Shohada Tajrish Hospital, Tehran, in 2024; participants completed 3 validated self-report questionnaires: The Toronto Alexithymia Scale (TAS-20), the Body Image Concern Inventory (BICI), and the Revised Dyadic Adjustment Scale (RDAS). Data were analyzed using descriptive statistics, Pearson’s correlations, and path analysis in SPSS and AMOS, with ethical approval obtained and informed consent secured from all participants. Results: Body image concerns were directly associated with lower marital quality of life (β = –0.300, P = 0.003) and with higher alexithymia, particularly difficulty identifying feelings (β = 0.609, P &lt; 0.001). Only difficulty identifying feelings significantly mediated this relationship (β = –0.240, P = 0.024). Notably, externally oriented thinking showed a positive direct association with marital quality of life (β = 0.239, P = 0.001). Conclusions: Body image concerns following mastectomy impair marital quality of life, primarily through impaired emotional identification. The unexpected positive role of externally oriented thinking suggests context-dependent functions of alexithymia traits. Findings support the integration of emotion-focused psychological support into surgical care pathways.

The current study examined (1) whether underlying facets of Detachment and Negative Affect are associated with the different components of alexithymia, and (2) whether these associations depend on the level of perceived stress. In total, 635 students (Mage = 20.02, 87.5% female) filled out online questionnaires on alexithymia (Toronto Alexithymia Scale), pathological personality traits (Personality Inventory for DSM-V), and perceived stress (Perceived Stress Scale). Two Multivariate Analysis of Covariance (MANCOVA) were used to test the hypotheses, which included the three subscales of alexithymia (i.e., difficulty identifying feelings [DIF], difficulty describing feelings [DDF], externally oriented thinking [EOT]) as dependent variables and the three underlying facet traits of either Detachment (i.e., withdrawal, anhedonia, intimacy avoidance) or Negative Affect (i.e., emotional lability, anxiousness, separation insecurity) as independent variables. Intimacy avoidance was most consistently associated with all alexithymia components. Other facets showed dimension-specific associations: DIF was positively associated with anhedonia, anxiousness, separation insecurity, and emotional lability; DDF was positively associated with withdrawal and anxiousness, but negatively with emotional lability; and EOT was positively associated with separation insecurity. These findings highlight the importance of facet traits characteristic of interpersonal difficulties in the association with specific alexithymia subscales. These associations were not dependent on the level of perceived stress. The present results point to interpersonal avoidance and emotion-regulation difficulties as relevant processes to address in interventions. Targeting these facet-linked difficulties may therefore be particularly useful in reducing alexithymic features among individuals with elevated pathological personality traits.

Background: despite the significant number of studies devoted to the study of compliance and its role in the recovery process, existing assessment methods often demonstrate limited prognostic potential. The aim of study: to investigate the specificity and differences of resourcefulness and resilience as factors of compliance in patients with qualitatively different mental disorders. Patients and Methods: using the Resourcefulness for Recovery Inventory Scale, the Emotional Intelligence (EmIn) Questionnaire developed by D.V. Lyusin, and the Toronto Alexithymia Scale (TAS-20), 120 patients aged 18–25 years (mean age 22 ± 3.5 years) were examined. The sample was divided into four equal diagnostic groups: patients with neurotic, stress-related and somatoform disorders (F40–F48), with emotionally unstable borderline personality disorder (F60.31), with schizophrenia (F20), with mental disorders and behavioral disorders associated with the use of psychoactive substances (F10–F19). Statistical analysis was performed using the Welch criterion and correlation analysis (Spearman). Results: significant differences were found between the groups in the level of resourcefulness and stability (RRI), emotional intelligence (EmIn) and alexithymia (TAS-20). Correlation analysis showed the presence of significant two-way relationships between emotional intelligence (EmIn) and factors contributing to recovery (RRI), as well as two-way positive correlations between the level of alexithymia (TAS-20) and the ability to recover (RRI). Conclusion: it has been established that patients with neurotic disorders and borderline personality disorder have a higher ability for compliance and recovery compared to patients dependent on psychoactive substances and patients with schizophrenia. These results can be used in the elaboration of psychotherapeutic strategies aimed at increasing compliance and treatment effectiveness through the development of resourcefulness and emotional regulation.

ABSTRACT Alexithymia, characterized by a diminished capacity to recognize and express emotions, may lead individuals to misinterpret emotional distress as physical symptoms, thereby influencing their patterns of seeking medical care. This study aimed to investigate the relationship between alexithymia, perception of somatic symptoms, and attitudes toward seeking psychological help in consultation-liaison psychiatry patients. The sample consisted of 50 patients who initially presented to non-psychiatric medical departments and were subsequently referred to psychiatry due to suspected comorbid psychiatric conditions. Participants completed the Toronto Alexithymia Scale (TAS-20), the Somatosensory Amplification Scale (SAS), the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS), and the Hospital Anxiety and Depression Scale (HADS). Alexithymia was detected in 20% of the referred patients. Among alexithymic participants, a statistically significant positive association was observed between scores on the HADS Anxiety Subscale and the ATSPPHS (p = 0.005). Furthermore, a significant positive relationship was found between HADS Depression Subscale scores and SAS scores (p = 0.023). Understanding the interplay between alexithymia and the expression of emotional and physical symptoms is of critical importance for medical professionals. Recognizing and addressing the emotional dimensions of health may enhance diagnostic accuracy, improve patient outcomes, and promote a more holistic, patient-centered approach to care.

This study looked into Alexithymia as a predictor of Mental Health Emotional Regulation in Young Female Facing gender discrimination in Pakistan. In this study a sample of 450 young female, aged 16 to 22, using a purposive sampling method. The participants filled out the Toronto Alexithymia Scale (TAS- 20), DASS-21, Emotional Regulation Questionnaire (ERQ), and the Perceived Gender Discrimination Scale. The study conducted descriptive statistics, correlations, and multiple regression analyses to explore the relationships among the study variables. The correlation results revealed significant links between the dimensions of alexithymia and various mental health indicators. However, the regression analyses indicated that alexithymia did not significantly predict perceived gender discrimination or stress, and it showed only weak to moderate predictive power for other mental health outcomes and emotional regulation. These findings imply that while alexithymia is connected to emotional and psychological functioning, it doesn't independently predict mental health or experiences of discrimination in this group. This study adds to the existing literature by delving into alexithymia in the context of South Asian culture, shedding light on the intricate relationship between how emotions are processed and the experiences of discrimination. It also discusses important implications for mental health professionals, suggests directions for future research, and offers policy recommendations.

Abstract Background Alopecia areata (AA) is an autoimmune hair loss disease, considered a psychosomatic disease with comorbid symptoms of depression and anxiety. Alexithymia, defined as difficulties in recognizing and describing feelings, has been found to be a vulnerability factor for developing anxiety and depression and somatic disease. The psychological burden of AA needs to be further investigated in larger studies by using standardized instruments developed to identify alexithymia, and clinical depression and anxiety. The outcome is important when treating patients with AA as well as for decisions on treatment. Objectives To explore the prevalence of alexithymia and its subtypes and how they relate to depressive and anxiety symptoms in patients with AA. Methods In this cohort study 100 patients with AA were interviewed about sociodemographic data, AA disease variables, and previous and present mental health. The Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI) and the Toronto Alexithymia Scale-20 (TAS-20) were used to identify alexithymia, depression and anxiety. Associations between alexithymia and subtype scores – difficulties identifying feelings (DIF), difficulties describing feelings (DDF) and externally oriented thinking (EOT) – were analysed in relation to depression and anxiety scores. Relations between alexithymia, depressive and anxiety scores, and AA and sociodemographic variables were examined. Results Prevalences of depression, anxiety and alexithymia in patients with AA were 16% (n = 16/100), 22% (n = 22/100) and 32% (n = 32/100), respectively. There was a statistically significant relation between DIF and anxiety and between DIF, DDF and depression. Lower levels of education were related to alexithymia, depression and anxiety symptoms. Alexithymia was statistically significantly more frequent among those who were younger at AA onset, in the relapsing form of AA and with nonfamilial AA. Previous mental affective illness was reported in 77% (n = 77/100) of patients with AA during the life course. Conclusions Patients with AA had a higher prevalence of depression, anxiety and alexithymia compared with normative data. Alexithymia was found among those with earlier AA onset, younger age at interview and lower educational levels. Higher EOT scores were found among those with anxiety and lower education.

Role of childhood trauma in interoception and alexithymia in schizophrenia.

Disconnected emotions, connected behaviors: Symptom network features of problematic mobile phone use across different alexithymia profiles.

Background: Chronic kidney disease (CKD) is increasingly recognized as a biopsychosocial condition, with emotional dysregulation and somatic symptoms representing important yet underexplored dimensions. This study aimed to examine the prevalence and predictors of alexithymia and somatic symptoms in CKD patients, highlighting clinical, laboratory and psychosocial interactions. Methods: A cross-sectional study was conducted among 130 CKD patients (mean age: 54.9±13.8 years; 58.5% male). Psychometric assessments included the Toronto Alexithymia Scale (TAS-20) and the Patient Health Questionnaire (PHQ-15). Data were analyzed using Kruskal-Wallis, Mann-Whitney U, Spearman correlations and univariate and multivariate regression models. Results: Alexithymia was present in 50.8% of participants, while somatic symptoms were reported in 46.9%. TAS scores were significantly associated with age (p=0.021) and diabetes mellitus (p=0.016). PHQ-15 scores showed limited associations, with significant differences across age groups (p=0.039) and borderline associations with CKD stage (p=0.052). Red blood cell (RBC) count emerged as the strongest predictor of both TAS (β=0.923, p&lt;0.001) and PHQ-15 (β=0.239, p=0.006) scores. The multivariate model explained 85.4% of TAS variance (Adjusted R²=0.854), whereas PHQ-15 scores were less predictable (Adjusted R²=0.068). Caregiver burden was significantly higher among patients with alexithymia (p&lt;0.0001). Conclusions: Alexithymia and somatic symptoms are highly prevalent in CKD and shaped by biological and psychosocial determinants. Incorporating broader psychosocial assessments and caregiver support into CKD management could enhance patient outcomes and alleviate family burden.

BackgroundSelf-directed learning ability is an essential competency for nursing undergraduates to develop professional skills and adapt to evolving healthcare needs. However, the psychological and behavioral factors affecting self-directed learning remain understudied.ObjectiveThe aim of this study is to explore the relationship between alexithymia, mobile phone addiction, and self-directed learning among nursing undergraduates.MethodsThis study involved 234 nursing undergraduates enrolled at a medical college located in southern China. The Scale of Competencies of Autonomous Learning of Nursing Undergraduates (SCALNU), the Mobile Phone Addiction Index Scale (MPAI) and the Toronto Alexithymia Scale (TAS-20) were employed to assess self-directed learning ability, alexithymia, and mobile phone addiction respectively. Correlation analyses were employed to examine pairwise relationships among the three variables. Subsequently, multiple linear regression analysis was used to identify significant influence factors of self-directed learning. Then a structural equation modeling approach was utilized to examine the mediating effect of mobile phone addiction in the relationship between alexithymia and self-directed learning.ResultsThe mean scores for the SCALNU were 90.19 ± 10.10. Correlation analysis revealed a significant negative correlation between higher SCALNU scores and lower scores on the MPAI (r=-0.294, p < 0.01) and the TAS-20 (r=-0.383, p < 0.01). A multiple linear regression analysis showed that grade, only-child status, experience as class officials in high school, alexithymia, and mobile phone addiction were associated with SDL (all p < 0.01). The structural equation model analysis with a relatively good fit (χ²/df = 2.228, RMSEA = 0.073, CFI = 0.905, GFI = 0.917, and SRMR = 0.066) indicated that alexithymia has both a direct effect on SDL (β=-0.305, p = 0.014) and an indirect effect through mobile phone addiction on SDL (β=-0.120, p = 0.007), with a mediation effect accounting for 28.2% of the total effect.ConclusionMobile phone addiction significantly mediates the relationship between alexithymia and self-directed learning ability among nursing undergraduates, highlighting its potential as a modifiable target for interventions to enhance self-directed learning.

An evaluation of the pain characteristics of patients with thoracic outlet syndrome.

Metabolic and bariatric surgery has significant positive effects on quality of life. The aim of the present study is to assess whether or not alexithymia is associated with weight-related self-esteem levels which is a concept assessed in quality of life after metabolic bariatric surgery. A cross-sectional study conducted at a university hospital. Before the surgery, patients who had no active psychiatric diagnosis or were not on psychiatric medication filled out the Hamilton anxiety rating scale and Hamilton depression rating scales. Total of 119 patients were revisited between the sixth and twelfth months after surgery and filled out a socio-demographic data form, the Hamilton anxiety rating scale, the Hamilton depression rating scale, the impact of weight on quality-of-life scale – self-esteem subscale (IWQOL-Lite), and the Toronto alexithymia scale. The mean time elapsed after the postoperative evaluation was 8.7 ± 3.1 months. About 29.5% of the patients applying to bariatric surgery were alexithymic. The mean scores on the HAM-D, HAM-A, difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking scales of the patients were significantly higher in alexithymic patients (P = .008; P = .004; P < .001; P < .001; P = .004, respectively). Additionally, the IWQOL-Lite scores of alexithymic individuals were statistically significantly lower than those of the group without alexithymia (P = .004). A weak negative correlation was found between the score of IWQOL-Lite self-esteem and the total Toronto alexithymia scale-20 item score and difficulty describing feelings value (r = −0.185, P = .044; r = −0.209, P = .023, respectively). The present study supported that individuals with high alexithymic characteristics have lower weight-related self-esteem after the surgery, and further studies are needed to elucidate the causal relationship of this condition.