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Georgescu T, Nedelcea C, Gorbănescu A, Papasteri C, Cosmoiu AM, Vasile DL, Letzner RD. Psychometric evaluation of the PCL-5: assessing validity, diagnostic utility, and bifactor structures. Eur J Psychotraumatol 2024; 15:2333222. [PMID: 38699832 PMCID: PMC11073431 DOI: 10.1080/20008066.2024.2333222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/11/2024] [Indexed: 05/05/2024] Open
Abstract
Background: The changes DSM-5 brought to the diagnostic criteria for posttraumatic stress disorder (PTSD) resulted in revising the most widely used instrument in assessing PTSD, namely the Posttraumatic Checklist for DSM-5 (PCL-5).Objective: This study examined the psychometric properties of the Romanian version of the PCL-5, tested its diagnostic utility against the Structured Clinical Interview for DSM-5 (SCID-5), and investigated the latent structure of PTSD symptoms through correlated symptom models and bifactor modelling.Method: A total sample of 727 participants was used to test the psychometric properties and underlying structure of the PCL-5 and 101 individuals underwent clinical interviews using SCID-5. Receiver operating characteristic curve (ROC) analyses were performed to test the diagnostic utility of the PCL-5 and identify optimal cut-off scores based on Youden's J index. Confirmatory Factor Analyses (CFAs) and bifactor modelling were performed to investigate the latent structure of PTSD symptoms.Results: Estimates revealed that the PCL-5 is a valuable tool with acceptable diagnostic accuracy compared to SCID-5 diagnoses, indicating a cut-off score of >47. The CFAs provide empirical support for Anhedonia, Hybrid, and bifactor models. The findings are limited by using retrospective, self-report data and the high percentage of female participants.Conclusions: The PCL-5 is a psychometrically sound instrument that can be useful in making provisional diagnoses within community samples and improving trauma-informed practices.
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Affiliation(s)
- Teodora Georgescu
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Cătălin Nedelcea
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Adrian Gorbănescu
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Claudiu Papasteri
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Ana Maria Cosmoiu
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Diana Lucia Vasile
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Ramona Daniela Letzner
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
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2
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Kapadi R, Elander J, Bateman AH. Emotion Regulation and Psychological Dependence on Pain Medication among Hospital Outpatients with Chronic Spinal Pain: The Influence of Rumination about Pain and Alexithymia. Subst Use Misuse 2024; 59:1047-1058. [PMID: 38485654 DOI: 10.1080/10826084.2024.2320373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Objective: To examine the extent to which pain acceptance, pain catastrophising and alexithymia moderate associations between pain intensity and psychological pain medication dependence. Methods: Participants (106 hospital outpatients with chronic spinal pain) completed the Leeds Dependence Questionnaire (LDQ) to measure psychological dependence on pain medication, and the Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), the Pain Catastrophising Scale (PCS) and the Toronto Alexithymia Scale-20 (TAS-20), plus the Depression, Anxiety and Stress Scale-21 (DASS-21). Results: Multiple linear regression showed that degree of psychological dependence (measured dimensionally across the range of LDQ scores) was associated with TAS subscale difficulty identifying feelings (DIF) (β = 0.249, p = <0.002) and PCS subscale rumination (β = 0.193, p = 0.030), independently of pain intensity and risk behaviors for medication misuse. The effect of pain intensity was moderated by rumination, with pain intensity more strongly associated with dependence when rumination was high (interaction β = 0.192, p = 0.004). Logistic regression showed that the effect of pain intensity on severe dependence (measured categorically as LDQ score ≥ 20) was moderated by alexithymia, so that severe dependence was independently associated with the combination of intense pain and high alexithymia (interaction odds ratio = 7.26, 95% CIs = 1.63-32.42, p = 0.009). Conclusions: Rumination and alexithymia moderated the associations between pain intensity and psychological pain medication dependence, consistent with emotion regulation theory. This raises the possibility that specifically targeting rumination about pain and symptoms of alexithymia could potentially improve the effectiveness of psychological interventions for chronic pain and help people to avoid or reduce their psychological dependence on pain medication.
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Affiliation(s)
| | - James Elander
- School of Psychology, University of Derby, Derby, UK
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3
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Morie KP, Zhai ZW, Crowley MJ, Potenza MN, Mayes LC. Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults. Subst Use Misuse 2024; 59:388-397. [PMID: 37964628 DOI: 10.1080/10826084.2023.2275558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Zu Wei Zhai
- Department of Neuroscience, Middlebury College, Middlebury, VT, USA
| | - Michael J Crowley
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Linda C Mayes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Volkert J, Ilagan GS, Iliakis EA, Ren B, Schröder-Pfeifer P, Choi-Kain LW. What predicts psychosocial functioning in borderline personality disorder? Investigating the association with reflective functioning. Psychol Psychother 2024. [PMID: 38214456 DOI: 10.1111/papt.12516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/21/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES The aim of this study was to investigate factors associated with functioning in participants with and without borderline personality disorder (BPD). In particular, we were interested whether mentalizing and related social cognitive capacities, as factors of internal functioning, are important in predicting psychosocial functioning, in addition to other psychopathological and sociodemographic factors. METHOD This is a cross-sectional study with N = 53 right-handed females with and without BPD, without significant differences in age, IQ, and socioeconomic status, who completed semi-structured diagnostic and self-report measures of social cognition. Mentalizing was assessed using the Reflective Functioning Scale based on transcribed Adult Attachment Interviews. A regularized regression with the elastic net penalty was deployed to investigate whether mentalizing and social cognition predict psychosocial functioning. RESULTS Borderline personality disorder symptom severity, sexual abuse trauma, and social and socio-economic factors ranked as the most important variables in predicting psychosocial functioning, while reflective functioning (RF) was somewhat less important in the prediction, social cognitive functioning and sociodemographic variables were least important. CONCLUSIONS Borderline personality disorder symptom severity was most important in determining functional impairment, alongside trauma related to sexual abuse as well as social and socio-economic factors. These findings verify that BPD symptoms themselves most robustly predict functional impairment, followed by history of sexual abuse, then contextual factors (e.g. housing, financial, physical health), and then RF. These results lend marginal support to the conceptualization that mentalizing may enhance psychosocial functioning by facilitating social learning, but emphasize symptom reduction and stabilization of life context as key intervention targets.
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Affiliation(s)
- Jana Volkert
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | | | - Evan A Iliakis
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Boyu Ren
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Schröder-Pfeifer
- Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany
| | - Lois W Choi-Kain
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Gunderson Personality Disorders Institute, McLean Hospital, Belmont, Massachusetts, USA
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5
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Exploring alexithymia profiles and their associations with childhood adversity and COVID-19 burnout among Chinese college students: A person-centered approach. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Gatta M, Angelico C, Rigoni F, Raffagnato A, Miscioscia M. Alexithymia and Psychopathological Manifestations Centered on the Body: Somatization and Self-Harm. J Clin Med 2022; 11:jcm11082220. [PMID: 35456311 PMCID: PMC9026923 DOI: 10.3390/jcm11082220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to investigate alexithymia and psychopathological manifestations centered on the body in a sample of adolescents with somatizing and/or self-harming issues to analyze the phenomenon of NSSI linked to Somatic Symptom Disorders (SSD). A sample of 184 adolescents between 12 and 19 years of age, was divided into three groups, one with NSSI (n = 49) and the second group with SSD (n = 57), comparing them with a third group of adolescents with SSD and NSSI (n = 78) to investigate their differences and similarities in psychopathological correlates and to analyze the mediation role of alexithymia and emotional dysregulation in NSSI and SSD related to internalizing problems. The battery of tests included the Toronto Alexithymia Scale (TAS-20) and the Youth Self-Report 11–18 (YSR). The NSSI + SSD group scored higher than the other two groups on all the YSR scales. The affective syndromes were the only clinical condition that discriminated between the three groups. On all the other syndrome scales, the NSSI + SSD group differed from the other two groups, while there were no differences between the NSSI group and the SSD group. The NSSI + SSD group revealed a more severely deficient emotional self-regulation. Difficulty identifying feelings was a trait shared by adolescents with SSD and those engaging in NSSI, a more complex overall alexithymia profile was associated with the combination of self-harming behavior and somatization. Alexithymia and emotional dysregulation played a mediating role in the relationship between internalizing problems and somatization. We did not find a mediating role in alexithymia and emotional dysregulation in the relationship between internalizing problems and self-injurious behavior. The combination of NSSI and SSD gave rise to more severe psychopathological correlates, clinical levels of alexithymia, and more severe deficient emotional self-regulation. Results of mediation role indicated a link between alexithymia, emotional dysregulation, and somatization.
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Affiliation(s)
- Michela Gatta
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (M.G.); (F.R.); (A.R.)
| | - Caterina Angelico
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (M.G.); (F.R.); (A.R.)
- Correspondence: (C.A.); (M.M.)
| | - Francesca Rigoni
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (M.G.); (F.R.); (A.R.)
| | - Alessia Raffagnato
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (M.G.); (F.R.); (A.R.)
| | - Marina Miscioscia
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy; (M.G.); (F.R.); (A.R.)
- Department of Developmental Psychology and Socialisation, University of Padua, 35131 Padua, Italy
- Correspondence: (C.A.); (M.M.)
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El Archi S, Brunault P, De Luca A, Cortese S, Hankard R, Bourbao-Tournois C, Ballon N, Réveillère C, Barrault S. Do Emotion Dysregulation, Alexithymia and Personality Dimensions Explain the Association Between Attention-Deficit/Hyperactivity Disorder and Binge Eating Among Bariatric Surgery Candidates? Front Psychol 2021; 12:745857. [PMID: 34867628 PMCID: PMC8641657 DOI: 10.3389/fpsyg.2021.745857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE. Method: Two hundred and eighty-two (n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22. Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator. Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior.
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Affiliation(s)
| | - Paul Brunault
- Qualipsy, EE 1901, Université de Tours, Tours, France.,CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France.,INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France
| | - Arnaud De Luca
- CHRU de Tours, Centre Spécialisé de l'Obésité, Tours, France.,Inserm U1069 Université de Tours, Tours, France
| | - Samuele Cortese
- Academic Unit of Psychology, Center for Innovation in Mental Health, University of Southampton, Southampton, United Kingdom.,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Régis Hankard
- CHRU de Tours, Centre Spécialisé de l'Obésité, Tours, France.,Inserm U1069 Université de Tours, Tours, France
| | | | - Nicolas Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France.,INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France
| | | | - Servane Barrault
- Qualipsy, EE 1901, Université de Tours, Tours, France.,CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France.,Laboratoire de Psychopathologie et Processus de Santé, Université Paris Descartes, Paris, France
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8
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Macarenco MM, Opariuc-Dan C, Nedelcea C. Childhood trauma, dissociation, alexithymia, and anger in people with autoimmune diseases: A mediation model. CHILD ABUSE & NEGLECT 2021; 122:105322. [PMID: 34508924 DOI: 10.1016/j.chiabu.2021.105322] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/23/2021] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Despite research linking dissociation, alexithymia, and anger with childhood trauma and ADs, the investigation addressing the relationships between the potential mediators has not yet been established within the literature. OBJECTIVE The present study examined the relationship between childhood trauma and autoimmune disorders, using a multiple mediation model that included dissociation, alexithymia, and anger as hypothesized mediators. PARTICIPANTS AND SETTING 306 autoimmune patients and 292 self-declared healthy controls were included in the study. They completed self-report questionnaires regarding childhood abuse, alexithymia, dissociation, and anger. METHODS Multiple mediation analysis was conducted to investigate the study's proposed model. RESULTS The results of the Structural Equation Model (SEM) suggest an indirect relationship between childhood trauma and autoimmune disorders, mediated by dissociation [z = 4.57, p < .01, β = 0.19, 90% CI (0.08-0.10)], alexithymia [z = 10.74, p < .01, β = 0.43, 90% CI (0.08-0.10)], but not by anger [z = 1.58, p = .11, 90% CI (0.08-0.10)]. CONCLUSIONS These findings are in line with previous studies that show associations between childhood trauma, dissociation, alexithymia, and ADs. They indicate that mental health professionals and medical doctors should assess childhood trauma in autoimmune patients. They also should consider the possible maintaining role of dissociation and alexithymia in the treatment of autoimmune diseases.
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Linn BK, Zhao J, Bradizza CM, Lucke JF, Ruszczyk MU, Stasiewicz PR. Alexithymia disrupts emotion regulation processes and is associated with greater negative affect and alcohol problems. J Clin Psychol 2021; 77:2915-2928. [PMID: 34787929 DOI: 10.1002/jclp.23279] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/17/2021] [Accepted: 10/27/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Alexithymia is common among people who abuse alcohol, yet the mechanisms by which alexithymia exerts its influence remain unclear. This analysis tested a model whereby the three subscales of the Toronto Alexithymia Scale exert an indirect effect on alcohol problems through difficulties with emotion regulation and psychological distress. METHOD Men and women (n = 141) seeking alcohol use disorder (AUD) treatment completed the Toronto Alexithymia Scale, the Difficulties with Emotion Regulation Scale, the Brief Symptom Inventory, the Short Inventory of Problems, and the Alcohol Dependence Scale. RESULTS The Difficulty Identifying Feelings subscale of the Toronto Alexithymia Scale was positively associated with alcohol problems through emotion dysregulation and psychological distress. The other two subscales, Difficulty Describing Feelings and Externally oriented Thinking, were not associated with any other variables. CONCLUSION People with alexithymia may consume alcohol to help regulate undifferentiated states of emotional arousal. Given the prevalence of alexithymia among people who abuse alcohol, treatment supplements that enhance the identification of emotions are needed.
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Affiliation(s)
- Braden K Linn
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Junru Zhao
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Clara M Bradizza
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Joseph F Lucke
- Department of Psychiatry, University at Buffalo, Buffalo, New York, USA
| | | | - Paul R Stasiewicz
- School of Social Work, University at Buffalo, Buffalo, New York, USA
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Impaired complex theory of mind and low emotional self-awareness in outpatients with borderline personality disorder compared to healthy controls: A cross-sectional study. J Psychiatr Res 2021; 143:445-450. [PMID: 34656877 DOI: 10.1016/j.jpsychires.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/02/2021] [Accepted: 10/10/2021] [Indexed: 11/21/2022]
Abstract
Studies on the theory of mind (TOM) and alexithymia in borderline personality disorder (BPD) have yielded inconsistent results. Also, the relationship between TOM abilities and alexithymia facets as two domains of social cognition has not been studied in BPD. This study aimed to fill this gap. Participants were 50 outpatients with BPD and 50 age and gender-matched healthy controls. Assessments performed using Reading the Mind in Eyes Task (RMET), Toronto Alexithymia Scale (TAS-20), Faux Pas Task (FPT), and Digit Span subtest of Wechsler Adult Intelligence Scale. Results showed that BPD patients scored lower on overall FPT (p < .001) and its cognitive (p < .001) and affective TOM (p < .001) subtests but were comparable with healthy controls in emotion recognition ability assessed by RMET (p = .241). The BPD group also scored significantly lower in overall alexithymia (p < .001) and subscales of difficulty identifying feelings (DIF; p < .001) and difficulty describing emotions (DDF; p = .001). However, they performed similarly to the healthy control group in externally oriented thinking (EOT; p = .164). Correlation analysis revealed a significant negative correlation between EOT and RMET in the BPD group (r = -0.33, p < .05). No association, however, was found between FPT and RMET. This study suggests that BPD patients are impaired in the complex TOM abilities and have lower self-awareness of emotions, but their recognition of others' emotions is intact. Also, the results demonstrate that a heightened level of EOT is associated with difficulties in facial emotion recognition in BPD patients.
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11
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Zdankiewicz-Ścigała E, Ścigała D, Sikora J, Kwaterniak W, Longobardi C. Relationship between interoceptive sensibility and somatoform disorders in adults with autism spectrum traits. The mediating role of alexithymia and emotional dysregulation. PLoS One 2021; 16:e0255460. [PMID: 34428238 PMCID: PMC8384168 DOI: 10.1371/journal.pone.0255460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 07/16/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The purpose of the study is to analyses the relationship between interoceptive sensibility and somatoform disorders among persons with Autism Spectrum Disorder (ASD). It has been assumed that the interoceptive sensibility is accompanied by a high level of alexithymia and emotion dysregulation in somatoform disorders. METHODS Persons under the care of the foundation helping people with ASD were asked to participate in the study. In total, 205 people took part in the research. The participants aged from 18 to 63 (M = 34.91; SD = 8.44). The ASD group comprised 79 persons (38.5% of subjects). The control group comprised 126 individuals (61.5% of subjects). Participants completed self-report questionnaires measuring autism (AQ), interoceptive sensibility (BPQ), alexithymia (TAS20), emotional dysregulation (DERS), and somatoform disorder (SDQ). RESULTS The analyses showed a moderation effect of the group, which indicates the existence of a relationship between interoceptive sensibility and somatoform disorders to the greater extent in the clinical group than in the control group. In addition, the serial multiple mediation model analysis allowed to verify the mediating effect of emotion dysregulation and alexithymia on the abovementioned relationship. The indirect effect, which assumed the mediating role of alexithymia turned out to be significant, contrary to the indirect effect where emotion dysregulation was a mediator in a situation where both variables were applied simultaneously. CONCLUSIONS Interoceptive sensibility correlated with level of alexithymia, in particular, difficulties in identifying and verbalizing emotions and emotion dysregulation in the lack of emotional awareness and lack of emotional clarity and is associated with somatoform disorders in the investigated group regardless of participants' belonging to the ASD or control group.
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Affiliation(s)
| | - Dawid Ścigała
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
- * E-mail:
| | - Joanna Sikora
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Wanda Kwaterniak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Ryan C, Cogan S, Phillips A, O'Connor L. Objective and Subjective Measurement of Alexithymia in Adults with Autism. J Autism Dev Disord 2021; 51:2019-2028. [PMID: 32888165 DOI: 10.1007/s10803-020-04665-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
High rates of alexithymia, a condition characterised by difficulties identifying and describing emotions, are frequently reported in both children and adults with autism spectrum disorder (ASD). However, the dilemma of measuring alexithymia via self-report has rarely been addressed. In this study, we compared objective and subjective measures of alexithymia in adults with ASD and typically developing adults. We found significantly higher levels of alexithymia in the ASD sample as measured by both self-report on the Toronto Alexithymia Scale (TAS-20) and by the observer rated Alexithymia Provoked Response Scale (APRQ). However, the two measures did not correlate with each other. We explore the different facets of the alexithymia construct that these two measures may be distinguishing.
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Affiliation(s)
- Christian Ryan
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland.
| | | | - Ailish Phillips
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland
| | - Lorraine O'Connor
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland
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Haag C, Bellinghausen L, Jilinskaya-Pandey M. QEPro: An ability measure of emotional intelligence for managers in a French cultural environment. CURRENT PSYCHOLOGY 2021; 42:4080-4102. [PMID: 33935471 PMCID: PMC8064697 DOI: 10.1007/s12144-021-01715-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 12/30/2022]
Abstract
Managers' interest in the concept of emotional intelligence (EI) has grown steadily due to an accumulation of published articles and books touting EI's benefits. For over thirty years, many researchers have used or designed tools for measuring EI, most of which raise important psychometric, cultural and contextual issues. The aim of this article is to address some of the main limitations observed in previous studies of EI. By developing and validating QEPro we propose a new performance-based measure of EI based on a modified version of Mayer and Salovey's (1997) four-branch model. QEPro is an ability EI measure specifically dedicated to managers and business executives in a French cultural environment (N = 1035 managers and executives). In order to increase both the ecological and the face validity of the test for the target population we used the Situational Judgment Tests framework and a theory-based item development and scoring approach. For all items, correct and incorrect response options were developed using established theories from the emotion and management fields. Our study showed that QEPro has good psychometric qualities such as high measurement precision and internal consistency, an appropriate level of difficulty and a clear factorial structure. The tool also correlates in meaningful and theoretically congruent ways with general intelligence, Trait EI measures, the Big Five factors of personality, and the Affect measures used in this study. For all these reasons, QEPro is a promising tool for studying the role of EI competencies in managerial outcomes.
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Affiliation(s)
- Christophe Haag
- Emlyon Business School, 23 avenue Guy de Collongue, 69130 Écully, France
| | - Lisa Bellinghausen
- Emlyon Business School, 23 avenue Guy de Collongue, 69130 Écully, France
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Scigala DK, Fabris MA, Badenes-Ribera L, Zdankiewicz-Scigala E, Hintertan I, Longobardi C. Alexithymia and Adult Attachment: Investigating the Mediating Role of Fear of Intimacy and Negative Mood Regulation Expectancies. Psychol Rep 2021; 125:1896-1914. [PMID: 33878970 DOI: 10.1177/00332941211010252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Literature suggests an association between alexithymia and insecure adult attachment, but the mediation factors involved in this relationship are under-investigated. The study was carried out to test the possible mediation roles of the fear of intimacy and negative mood regulation expectancies in explaining this relationship. A convenience sample of 258 Polish adults (mean age: 30; 45% male), completed self-reporting measures related to adult attachment (RAAS), alexithymia (TAS-20), fear of intimacy (FIS) and negative mood regulation expectancies (NMRE). The results showed that alexithymia directly and indirectly predicts insecure adult attachment. Alexithymia positively predicts the fear of intimacy, which, in turn, positively predicts insecure adult attachment. Finally, alexithymia negatively predicts NMRE which, in turn, predict insecure adult attachment. It emerges from our data that the fear of intimacy and NMRE may be mediating factors in the relationship between alexithymia and adult attachment. Limitations, future directions of research and guidance for intervention are discussed.
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Affiliation(s)
| | | | - Laura Badenes-Ribera
- Department of Methodology of the Behavioral Sciences, Faculty of Psychology, University of Valencia, Spain
| | | | - Iwona Hintertan
- Faculty of Psychology, 86927SWPS University of Social Sciences and Humanities, Poland
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15
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DAYE M, MEVLİTOĞLU İ, ŞAHİNGÖZ M, ŞAHİN TK. Alexithymia And Behçet’s Disease. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.834163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Wang Z, Wang T, Goerlich KS, Pitliya RJ, Bermond B, Aleman A, Xu P, Luo Y. Psychometric Properties of the Chinese Bermond–Vorst Alexithymia Questionnaire: An Exploratory Structural Equation Modeling Study. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2021. [DOI: 10.1177/1834490921991429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Toronto Alexithymia Scale-20 (TAS-20) has been widely used to assess alexithymia. The Bermond–Vorst Alexithymia Questionnaire (BVAQ) assesses two additional features of alexithymia—the affective factors of emotionalizing and fantasizing, which are not included in the TAS-20. However, there is currently no Chinese version of the BVAQ. Here, the authors collected data from 439 college students (293 females, aged 17–27, mean ± SD = 20.25 ± 1.88) to evaluate the psychometric properties for a Chinese BVAQ translation. Exploratory structural equation modeling and confirmatory factor analysis provided satisfactory validity and acceptable reliability for a six-factor first-order solution of a 35-item Chinese BVAQ. This adaptation retained the five original BVAQ factors (identifying, analyzing, verbalizing, emotionalizing, and fantasizing) and further specified the factor of identifying (successful identifying and unsuccessful identifying feelings). The authors also found a two-factor second-order model of cognitive and affective components for alexithymia in the Chinese population. Higher correlations with the TAS-20 were observed for identifying, analyzing, and verbalizing feelings (0.34 ∼ 0.61) relative to fantasizing and emotionalizing (0.02 ∼ −0.05). These results support the construct validity of the adaptation. This work provides a reliable and valid Chinese adaptation of the BVAQ.
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Affiliation(s)
- Zhihao Wang
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Ting Wang
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Katharina S. Goerlich
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Riddhi J. Pitliya
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Bob Bermond
- Guangdong-Hong Kong-Macao Greater Bay Area Research Institute for Neuroscience and Neurotechnologies, Kwun Tong, Hong Kong, China
| | - André Aleman
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, Groningen, the Netherlands
| | - Pengfei Xu
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- Guangdong-Hong Kong-Macao Greater Bay Area Research Institute for Neuroscience and Neurotechnologies, Kwun Tong, Hong Kong, China
| | - Yuejia Luo
- Center for Brain Disorders and Cognitive Science, Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- College of Teacher Education, Qilu Normal University, Jining, China
- The Research Center of Brain Science and Visual Cognition, Kunming University of Science and Technology, Kunming, China *These authors contributed equally to this work
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Trentini C, Tambelli R, Maiorani S, Lauriola M. Gender Differences in Empathy During Adolescence: Does Emotional Self-Awareness Matter? Psychol Rep 2021; 125:913-936. [PMID: 33588646 DOI: 10.1177/0033294120976631] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Empathy refers to the capacity to experience emotions similar to those observed or imagined in another person, with the full knowledge that the other person is the source of these emotions. Awareness of one's own emotional states is a prerequisite for self-other differentiation to develop. This study investigated gender differences in empathy during adolescence and tested whether emotional self-awareness explained these differences. Two-hundred-eleven adolescents (108 girls and 103 boys) between 14 and 19 years completed the Interpersonal Reactivity Index (IRI) and the Toronto Alexithymia Scale (TAS-20) to assess empathy and emotional self-awareness, respectively. Overall, girls obtained higher scores than boys on IRI subscales like emotional concern, personal distress, and fantasy. Regarding emotional self-awareness, we found gender differences in TAS-20 scores, with girls reporting greater difficulty identifying feelings and less externally oriented thinking than boys. Difficulty identifying feelings explained the greatest personal distress experienced by girls. Lower externally oriented thinking accounted for girls' greater emotional concern and fantasy. These findings offer an insight into the role of emotional self-awareness-which is essential for self-other differentiation-as an account for gender differences in empathic abilities during adolescence. In girls, difficulty identifying feelings can impair the ability to differentiate between ones' and others' emotions, leading them to experience self-focused and aversive responses when confronted with others' suffering. Conversely, in boys, externally oriented thinking can mitigate personal distress when faced with others' discomfort.
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Affiliation(s)
| | | | - Silvia Maiorani
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome, Rome, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, "Sapienza" University of Rome, Rome, Italy
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Alexithymia and Self Differentiation: The Role of Fear of Intimacy and Insecure Adult Attachment. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09567-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractIt is suggested in literature that there is a link between Alexithymia and Self-Differentiation; however, little is known about possible mediation factors. The goal of this work is to test in a non-clinical population of adults the mediation role of Fear of Intimacy and Adult Attachment in the relationship between Alexithymia and Self-Differentiation. A sample of 258 participants self identified as gay or lesbian, aged 20–50 years (M: 30.29; SD: 7.27), 45% of whom were males, completed self-reported measures of Alexithymia (TAS-20), Self-Differentiation (SDI), Fear of Intimacy (FIS); and Insecure Adult Attachment (RAAS). Our results show that Alexithymia predicts Self-Differentiation both directly and indirectly, through Fear of Intimacy and Insecure adult attachment. In addition, Fear of Intimacy directly influences Self-Differentiation, and also mediates the relationship between Alexithymia and Adult Attachment which, in turn, negatively predicts Self-Differentiation. In conclusion, Alexithymia predicts Self-Differentiation while Fear of Intimacy and adult attachment may act as mediators of the report. Limitations of the study and directions of future research are described.
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Association of Anxiety Awareness with Risk Factors of Cognitive Decline in MCI. Brain Sci 2021; 11:brainsci11020135. [PMID: 33494279 PMCID: PMC7909770 DOI: 10.3390/brainsci11020135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
Studies demonstrate that anxiety is a risk factor for cognitive decline. However, there are also study findings regarding anxiety incidence among people with mild cognitive impairment (MCI), which mostly examined general anxiety evaluated by subjective questionnaires. This study aimed to compare subjective and objective anxiety (using autonomic measures) and anxiety as a general tendency and anxiety as a reaction to memory examination. Participants were 50 adults aged 59–82 years who were divided into two groups: MCI group and control group, according to their objective cognitive performance in the Rey Auditory Verbal Learning Test. Objective changes in the anxiety response were measured by skin conductivity in all tests and questionnaires. To evaluate subjective anxiety as a reaction to memory loss, a questionnaire on “state-anxiety” was used immediately after completing memory tests. Our main finding was that although both healthy and memory-impaired participants exhibited elevations in physiological arousal during the memory test, only healthy participants reported an enhanced state anxiety (p = 0.025). Our results suggest that people with MCI have impaired awareness of their emotional state.
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20
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Dafauce L, Romero D, Carpio C, Barga P, Quirce S, Villasante C, Bravo MF, Álvarez-Sala R. Psycho-demographic profile in severe asthma and effect of emotional mood disorders and hyperventilation syndrome on quality of life. BMC Psychol 2021; 9:3. [PMID: 33407846 PMCID: PMC7788781 DOI: 10.1186/s40359-020-00498-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/02/2020] [Indexed: 01/10/2023] Open
Abstract
Background Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients’ quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. Methods A cross-sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Results The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS-20 (p < 0.001) for the level of dyspnea (p = 0.021), and for emotional function (p = 0.017) on the Mini-AQLQ, compared with patients without anxiety or depression. Alexithymia (TAS-20 ≥ 61) was observed in 42.9% of patients; these patients were older (p = 0.037) and had a higher HADS score (p = 0.019) than patients with asthma without alexithymia. On the other hand, patients with hyperventilation syndrome (Nijmegen ≥ 23) scored higher on the HADS (p < 0.05), on the Mini-AQLQ (p = 0.002) and on the TAS-20 (p = 0.044) than the group without hyperventilation syndrome. Quality of life was related to anxiety-depression symptomatology (r = − 0.302; p = 0.016) and alexithymia (r = − 0.264; p = 0.036). Finally, the Mini-AQLQ total score was associated with the Nijmegen questionnaire total score (r = − 0.317; p = 0.011), and the activity limitation domain of the Mini-AQLQ correlated with the ACT total score (r = 0.288; p = 0.022). Conclusions The rate of anxiety, depression, alexithymia and hyperventilation syndrome is high in patients with severe asthma. Each of these factors is associated with a poor quality of life.
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Affiliation(s)
- Lucía Dafauce
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain.
| | - David Romero
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Carlos Carpio
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Paula Barga
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Santiago Quirce
- Allergology Services, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Carlos Villasante
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - María Fe Bravo
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Rodolfo Álvarez-Sala
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
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21
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Hao Z, Jin L. Alexithymia and Problematic Mobile Phone Use: A Moderated Mediation Model. Front Psychol 2020; 11:541507. [PMID: 33041910 PMCID: PMC7522167 DOI: 10.3389/fpsyg.2020.541507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022] Open
Abstract
Alexithymia has been studied with its impact on problematic mobile phone use. However, none of these studies has examined the roles of mindfulness facets in this relationship. To address this issue, a total of 901 Chinese undergraduate students participated in this study and were tested with questionnaires for measuring their levels of alexithymia, problematic mobile phone use, and mindfulness facets. A moderated mediation model was constructed to examine the roles of mindfulness facets in the association between alexithymia and problematic mobile phone use. The results showed that after controlling for age and sex, alexithymia positively predicted problematic mobile phone use both directly (β = 0.157, p < 0.001) and indirectly via mindfulness facet of acting with awareness (16th, 50th, and 84th percentiles of observing were −5.371, β = 0.019; −0.371, β = 0.216; and 4.629, β = 0.242, respectively, and the 95% confidence intervals were 0.142 to 0.246; 0.167 to 0.269; and 0.186 to 0.3, respectively). The facet of acting with awareness partially mediated this relationship in a negative way. Further, the facet of observing moderated the path between alexithymia and the facet of acting with awareness: with a higher level of observing, the negative association between alexithymia and acting with awareness became more negative (alexithymia × observing, β = −0.006, p = 0.001, 95% confidence interval −0.01 to −0.003). The current study advanced our understanding of the mechanism underlying the connection between alexithymia and problematic mobile phone use and helped to investigate how mindfulness skills benefited the individuals.
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Affiliation(s)
- Zejun Hao
- School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Liangyi Jin
- Shenyang Women's and Children's Hospital, Shenyang, China
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Hobson H, Chiu EG, Ravenscroft C, Partridge K, Bird G, Demeyere N. The association between communication impairments and acquired alexithymia in chronic stroke patients. J Clin Exp Neuropsychol 2020; 42:495-504. [PMID: 32576080 DOI: 10.1080/13803395.2020.1770703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Language dysfunction has recently been suggested to be one route to alexithymia, an impairment in recognizing and communicating one's own emotions. Neuropsychological evidence is needed to investigate the possibility that acquired language problems could underlie acquired alexithymia. METHOD This project examined data from a large group of chronic stroke patients (N = 118) to test whether self-reported or behavioral measures of language and communication problems were associated with alexithymia. We also examined the impact of hemisphere of damage on alexithymia. RESULTS We found no differences in alexithymia levels for patients with observed language impairments on brief tests of picture naming, comprehension, and reading vs unimpaired patients. However, self-reported communication difficulties were found to be associated with higher scores of alexithymia, even after controlling for depression and anxiety. Patients with left- versus right-hemisphere damage did not differ in their alexithymia scores. CONCLUSIONS We found partial support for the language hypothesis of alexithymia. We discuss potential reasons for the discrepant findings between the self-report and objective language measures and suggest that self-report measures may be more sensitive to milder, more pragmatic language impairments, as opposed to the severe structural language impairments measured by the cognitive screening tests.
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Affiliation(s)
- Hannah Hobson
- Department of Psychology, University of York , York, UK.,Department of Psychology Social Work & Counselling, University of Greenwich, Old Royal Naval College , London, United Kingdom
| | - Evangeline Grace Chiu
- Department of Experimental Psychology, Anna Watts Building, Radcliffe Observatory Quarter , Oxford, United Kingdom
| | - Chloe Ravenscroft
- Department of Experimental Psychology, Anna Watts Building, Radcliffe Observatory Quarter , Oxford, United Kingdom
| | - Kate Partridge
- Department of Experimental Psychology, Anna Watts Building, Radcliffe Observatory Quarter , Oxford, United Kingdom
| | - Geoffrey Bird
- Department of Experimental Psychology, Anna Watts Building, Radcliffe Observatory Quarter , Oxford, United Kingdom.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience , Denmark Hill, London, United Kingdom
| | - Nele Demeyere
- Department of Experimental Psychology, Anna Watts Building, Radcliffe Observatory Quarter , Oxford, United Kingdom
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Neumann D, Zupan B. Sex Differences in Emotional Insight After Traumatic Brain Injury. Arch Phys Med Rehabil 2020; 101:1922-1928. [PMID: 32445846 DOI: 10.1016/j.apmr.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. DESIGN Cross-sectional study. SETTING TBI rehabilitation facility in the United States and a university in Canada. PARTICIPANTS Sixty adults with moderate to severe TBI (62% men) and 60 uninjured controls (63% men) (N=120). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Toronto Alexithymia Scale-20 (TAS-20). RESULTS Uninjured men had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (P=.007), whereas, no sex differences were found in the TBI group (P=.698). Men and women with TBI had significantly higher alexithymia compared with uninjured same-sex controls (both P<.001). The prevalence of participants with scores exceeding alexithymia sex-based norms for men and women with TBI was 37.8% and 47.8%, respectively, compared with 7.9% and 0% for men and women without TBI. CONCLUSIONS Contrary to most findings in the general population, men with TBI were not more alexithymic than their female counterparts with TBI. Both men and women with TBI have more severe alexithymia than their uninjured same-sex peers. Moreover, both are equally at risk for elevated alexithymia compared with the norms. Alexithymia should be evaluated and treated after TBI regardless of patient sex.
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Affiliation(s)
- Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, Canada.
| | - Barbra Zupan
- Department of Applied Linguistics, Brock University, St. Catharines, ON, Canada
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Debeuf T, Verbeken S, Boelens E, Volkaert B, Van Malderen E, Michels N, Braet C. Emotion regulation training in the treatment of obesity in young adolescents: protocol for a randomized controlled trial. Trials 2020; 21:153. [PMID: 32039739 PMCID: PMC7011608 DOI: 10.1186/s13063-019-4020-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence rates of childhood obesity are increasing. The current multidisciplinary treatments for (childhood) obesity are effective but only moderately and in the short term. A possible explanation for the onset and maintenance of childhood obesity is that it reflects a maladaptive mechanism for regulating high levels of stress and emotions. Therefore, the current RCT study aims to test the effectiveness of adding an emotion regulation training to care as usual (multidisciplinary obesity treatment) in young inpatients (10-14) involved in an obesity treatment program compared to care as usual alone. The research model for this RCT study states that when high levels of stress are regulated in a maladaptive way, this can contribute to the development of obesity. METHODS The current study will recruit 140 youngsters (10-14 years) who are involved in an inpatient multidisciplinary obesity treatment (MOT) program. After giving consent to participate in the study, youngsters will be randomly assigned, during consecutive waves, to one of two conditions: care as usual (receiving MOT) or intervention (receiving MOT in addition to emotion regulation training). The training itself consists of 12 weekly sessions, followed by a booster session after 3 and 5 months. The participants will be tested pretraining, post-training, and at 6 months' follow-up. We hypothesize that, compared to the control condition, youngsters in the intervention condition will (1) use more adaptive emotion regulation strategies and (2) report less emotional eating, both primary outcome measures. Moreover, on the level of secondary outcome measures, we hypothesize that youngsters in the intervention condition, compared with the control condition, will (3) report better sleep quality, (4) undergo improved weight loss and weight loss maintenance, and (5) experience better long-term (6-months) psychological well-being. DISCUSSION This study will add to both the scientific and clinical literature on the role of emotion regulation in the development and maintenance of different psychopathologies, as emotion regulation is a transdiagnostic factor. TRIAL REGISTRATION The RCT study protocol is registered at ISRCTN Registry, with study ID "ISRCTN 83822934." Registered on 13 December 2017.
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Affiliation(s)
- Taaike Debeuf
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Elisa Boelens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Brenda Volkaert
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Eva Van Malderen
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Zdankiewicz-Ścigała E, Ścigała DK. Attachment Style, Early Childhood Trauma, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Structural Equation Model of Dependencies. Front Psychol 2020; 10:2957. [PMID: 32038366 PMCID: PMC6993624 DOI: 10.3389/fpsyg.2019.02957] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/13/2019] [Indexed: 11/16/2022] Open
Abstract
AIM Attachment theory is a broadly used paradigm for understanding human affective development. It is recognized that alexithymia is a key factor responsible for the non-adaptive strategies of regulating emotions in people addicted to alcohol. In addition, an important role is attributed to early childhood trauma and dissociation. The theoretical model was examined, in which connections between attachment styles, trauma, and alexithymia and dissociation were investigated in persons addicted to alcohol. METHODS The total number of study participants amounted to 268 persons, including 116 women (43% of all subjects) and 152 men (57% of all subjects) at the age of 18-73 (M = 39.19; SD = 13.45). In order to measure the analyzed variables, the following questionnaires were applied: Michigan alcoholism screening test (MAST), attachment styles questionnaire (ASQ), 20-item Toronto Alexithymia Scale (TAS-20), traumatic experiences checklist (TEC), and curious experiences survey (CES). RESULTS A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to attachment style, intensity of trauma, alexithymia, and dissociation. With structural equation models (i.e., AMOS and GLS), the adjustment of theoretical model to data was examined, which allowed the description of dependency paths. As a result of the conducted analysis of paths, it was found out that the model was accurately fitted to data, but only when an impact path related to a direct connection between an attachment style and an addiction was deleted. This impact is indirect, and from one side, it results from affective and cognitive deficits, i.e., alexithymia, and on the other side, from the intensity of traumatic experiences. No direct impact of dissociation on the development of an inclination to addiction was found, if contextual variables, i.e., alexithymia and trauma, are taken into account. The strongest direct relation was proven in the case of the anxious-ambivalent attachment style and alexithymia (β = 0.389; p < 0.01) and avoidant attachment style and alexithymia (β = 0.497; p < 0.01), which turned out a strong predictor fostering the development of alexithymia and the occurrence of traumas related to emotional negligence and mental violence and finally addiction. CONCLUSION Our studies revealed how important it is to investigate the role of individual variables in the context of developmental models. An extremely important element of the scientific achievement presented here is showing pillars of trauma, alexithymia, and dissociation in their cumulative impact on the development of emotional disorders resulting in addiction.
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Affiliation(s)
| | - Dawid Konrad Ścigała
- Institute of Psychology, Faculty of Applied Social Sciences, The Maria Grzegorzewska University, Warsaw, Poland
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Holmqvist Larsson K, Andersson G, Stern H, Zetterqvist M. Emotion regulation group skills training for adolescents and parents: A pilot study of an add-on treatment in a clinical setting. Clin Child Psychol Psychiatry 2020; 25:141-155. [PMID: 31419914 DOI: 10.1177/1359104519869782] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.
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Affiliation(s)
- Kristina Holmqvist Larsson
- Department of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | | | - Maria Zetterqvist
- Department of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Sweden
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Holmqvist Larsson K, Lowén A, Hellerstedt L, Bergcrona L, Salerud M, Zetterqvist M. Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting. J Eat Disord 2020; 8:12. [PMID: 32266070 PMCID: PMC7118896 DOI: 10.1186/s40337-020-00289-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/10/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Emotion regulation difficulties appear to play a role in the development and maintenance of several eating disorders. This pilot study aimed at examining whether a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting. We also investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of eating disorder, anxiety and depression, as well as clinical impairment. METHODS Six skills training groups were piloted with a total of 29 participants (M = 21.41 years, SD = 1.92). The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired samples t-test was used to compare differences between before-and-after measures. RESULTS The primary outcomes measures difficulties in emotion regulation (p < 0.001) and alexithymia (p < 0.001) showed significant improvement after treatment. The total eating disorder score (p = 0.009) was also significantly reduced, as was clinical impairment (p < 0.001). Acceptance/valued direction, identifying primary emotions and learning about secondary emotions was rated as especially helpful. CONCLUSIONS This preliminary pilot study showed that group training targeting emotion regulation skills was feasible and appreciated by participants, as well as being potentially promising as an adjunctive treatment for different eating disorders. Further controlled studies are needed. TRIAL REGISTRATION The study was retrospectively registered NCT04148014 on October 30th 2019.
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Affiliation(s)
- Kristina Holmqvist Larsson
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden.,2Department of Biomedical and Clinical Sciences, Linköping university, 581 83 Linköping, Sweden
| | - Anna Lowén
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden
| | - Linda Hellerstedt
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden
| | - Linn Bergcrona
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden
| | - Mimmi Salerud
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden
| | - Maria Zetterqvist
- Department of Child and Adolescent Psychiatry, Region Östergötland, 581 85 Linköping, Sweden.,2Department of Biomedical and Clinical Sciences, Linköping university, 581 83 Linköping, Sweden
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Gaggero G, Bonassi A, Dellantonio S, Pastore L, Aryadoust V, Esposito G. A Scientometric Review of Alexithymia: Mapping Thematic and Disciplinary Shifts in Half a Century of Research. Front Psychiatry 2020; 11:611489. [PMID: 33362614 PMCID: PMC7758403 DOI: 10.3389/fpsyt.2020.611489] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
The term "alexithymia" was introduced in the lexicon of psychiatry in the early '70s by Sifneos to outline the difficulties manifested by some patients in identifying and describing their own emotions. Since then, the construct has been broadened and partially modified. Today this describes a condition characterized by an altered emotional awareness which leads to difficulties in recognizing your own and others' emotions. In half a century, the volume of scientific products focusing on alexithymia has exceeded 5,000. Such an expansive knowledge domain poses a difficulty for those willing to understand how alexithymia research has developed. Scientometrics embodies a solution to this issue, employing computational, and visual analytic methods to uncover meaningful patterns within large bibliographical corpora. In this study, we used the CiteSpace software to examine a corpus of 4,930 publications on alexithymia ranging from 1980 to 2020 and their 100,251 references included in Web of Science. Document co-citation analysis was performed to highlight pivotal publications and major research areas on alexithymia, whereas journal co-citation analysis was conducted to find the related editorial venues and disciplinary communities. The analyses suggest that the construct of alexithymia experienced a gradual thematic and disciplinary shift. Although the first conceptualization of alexithymia came from psychoanalysis and psychosomatics, empirical research was pushed by the operationalization of the construct formulated at the end of the '80s. Specifically, the development of the Toronto Alexithymia Scale, currently the most used self-report instrument, seems to have encouraged both the entrance of new disciplines in the study of alexithymia (i.e., cognitive science and neuroscience) and an implicit redefinition of its conceptual nucleus. Overall, we discuss opportunities and limitations in the application of this bottom-up approach, which highlights trends in alexithymia research that were previously identified only through a qualitative, theory-driven approach.
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Affiliation(s)
- Giulia Gaggero
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Sara Dellantonio
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Fournier A, Luminet O, Dambrun M, Dutheil F, Pellissier S, Mondillon L. Importance of considering interoceptive abilities in alexithymia assessment. PeerJ 2019; 7:e7615. [PMID: 31768300 PMCID: PMC6874858 DOI: 10.7717/peerj.7615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/05/2019] [Indexed: 11/20/2022] Open
Abstract
Background Recent studies have shown that people with high alexithymia scores have decreased interoceptive abilities, which can be associated with psychological and physical disorders. Early assessments of the alexithymia trait included the evaluation of these abilities through the dimension measuring the difficulty in identifying and distinguishing between feelings and bodily sensations (the 26-item Toronto Alexithymia Scale; TAS-26). The revised version of the TAS, the TAS-20, contains a three-factor solution that does not involve a dimension assessing interoceptive abilities. However, the three items allowing the evaluation of these abilities are still present in the TAS-20. In this context, we hypothesized that the 3 items which assess interoceptive abilities in the TAS-20 should constitute an independent factor. In addition to exploring the internal structure of the TAS-20, we examined its external validity by assessing the relationships between the new factors and self-reported measures of personality trait and psychological and physical health. Method Two online studies (N = 253 and N = 287) were performed. The participants completed the TAS-20 and a set of psychological questionnaires (e.g., anxiety, depression) and health questions (e.g., “Do you suffer from a somatic disorder?”). The structure of the TAS-20 was examined using exploratory factor analysis (EFA), followed by an investigation of the relationships between the resulting new factors and other psychological and health data using regressions. In both studies, EFA revealed a new structure of the questionnaire consisting of four dimensions: (1) difficulty in the awareness of feelings, (2) externally oriented thinking, (3) difficulty in interoceptive abilities, and (4) poor affective sharing. The first factor was positively associated with all self-reported psychological and personality trait measures while the third factor was associated more with somatic disorders and medication intake. Results Our results suggest the presence of a new latent factor in the assessment of alexithymia that reflects interoceptive abilities specifically related to health and personality trait outcomes. In accordance with the results and the literature, it seems important to include an assessment of interoceptive abilities when considering the evaluation of alexithymia. The next step would be to develop a valid measure of these abilities.
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Affiliation(s)
- Alicia Fournier
- Laboratory Psy-DREPI, Université de Bourgogne, Dijon, France.,Behaviors, Risk and Health, CNRS, MSHE Claude-Nicolas Ledoux, Besançon, France
| | - Olivier Luminet
- Research Institute for Psychological Sciences, Université Catholique de Louvain, Louvain-La-Neuve, Belgium.,Belgium Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Michael Dambrun
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), CNRS UMR 6024, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), CNRS UMR 6024, Université Clermont Auvergne, Clermont-Ferrand, France.,Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.,Australian Catholic University, Melbourne, VIC, Australia
| | - Sonia Pellissier
- Laboratoire Inter-Universitaire de Psychologie, Personnalité, Cognition et Changement Social (LIP/PC2S), Université Savoie Mont Blanc, Chambéry, France
| | - Laurie Mondillon
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), CNRS UMR 6024, Université Clermont Auvergne, Clermont-Ferrand, France
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Nozaki Y, Puente-Martínez A, Mikolajczak M. Evaluating the higher-order structure of the Profile of Emotional Competence (PEC): Confirmatory factor analysis and Bayesian structural equation modeling. PLoS One 2019; 14:e0225070. [PMID: 31725760 PMCID: PMC6855477 DOI: 10.1371/journal.pone.0225070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023] Open
Abstract
Emotional competence (EC) reflects individual differences in the identification, comprehension, expression, regulation, and utilization of one’s own and others’ emotions. EC can be operationalized using the Profile of Emotional Competence (PEC). This scale measures each of the five core emotional competences (identification, comprehension, expression, regulation, and utilization), separately for one’s own and others’ emotions. However, the higher-order structure of the PEC has not yet been systematically examined. This study aimed to fill this gap using four different samples (French-speaking Belgian, Dutch-speaking Belgian, Spanish, and Japanese). Confirmatory factor analyses and Bayesian structural equation modeling revealed that a structure with two second-order factors (intrapersonal and interpersonal EC) and with residual correlations among the types of competence (identification, comprehension, expression, regulation, and utilization) fitted the data better than alternative models. The findings emphasize the importance of distinguishing between intrapersonal and interpersonal domains in EC, offer a better framework for differentiating among individuals with different EC profiles, and provide exciting perspectives for future research.
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Affiliation(s)
- Yuki Nozaki
- Department of Human Science, Faculty of Letters, Konan University, Kobe, Japan
- * E-mail:
| | - Alicia Puente-Martínez
- Department of Social Psychology and Methodology of Behavior Sciences, University of the Basque Country, Lejona, Spain
| | - Moïra Mikolajczak
- Department of Psychology, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Nalbant K, Kalaycı BM, Akdemir D, Akgül S, Kanbur N. Emotion regulation, emotion recognition, and empathy in adolescents with anorexia nervosa. Eat Weight Disord 2019; 24:825-834. [PMID: 31473987 DOI: 10.1007/s40519-019-00768-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 08/12/2019] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Emotional functions may play an important role in anorexia nervosa (AN). The onset of the disorder generally occurs during adolescence, which is a critical period of emotional development. However, most studies that evaluated emotional functions in AN were conducted in adult patients. The aim of this study was to evaluate emotion regulation, emotion recognition, and empathy skills in adolescent girls with AN by controlling for the effects of depression and anxiety symptoms, childhood traumatic experiences, and attachment security on emotional functions. METHODS Thirty-two adolescent girls with AN and 32 healthy counterparts completed the Difficulties in Emotion Regulation Scale, the Reading the Mind in the Eyes Test, Toronto Alexithymia Scale-20, and the Child and Adolescent KA-SI Empathic Tendency Scale-Adolescent Form. RESULTS The results revealed that adolescents with AN were found to have more difficulties in emotion regulation, higher alexithymic tendencies, and lower empathy skills compared with the control group. However, emotion recognition was not found to be significantly different between the two groups. These results were the same when controlling for the effects of depression and anxiety symptoms, childhood traumatic experiences, and attachment security except for empathy skills. Alexithymia and depressive symptoms were significantly related to emotion regulation difficulties in adolescents with AN. CONCLUSIONS Considering the results, it seems that emotion regulation and alexithymia may play a crucial role in the development and maintenance of AN. Accordingly, it is necessary to focus on the improvement of these skills during the treatment of AN. Furthermore, interventions promoting these skills during adolescence may be preventive. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Medical Faculty, Hacettepe University, Ankara, Turkey.
| | - Bilge Merve Kalaycı
- Department of Child and Adolescent Psychiatry, Medical Faculty, Training and Research Hospital, Yildirim Beyazıt University, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Medical Faculty, Hacettepe University, Ankara, Turkey
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Influences of Psychological Traits and PROP Taster Status on Familiarity with and Choice of Phenol-Rich Foods and Beverages. Nutrients 2019; 11:nu11061329. [PMID: 31200523 PMCID: PMC6627839 DOI: 10.3390/nu11061329] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022] Open
Abstract
Plant phenolics are powerful antioxidants and free radical scavengers that can contribute to the healthy functional properties of plant-based food and beverages. Thus, dietary behaviours rich in plant-based food and beverages are encouraged. However, it is well-known that the bitter taste and other low-appealing sensory properties that characterize vegetables and some other plant-based foods act as an innate barrier for their acceptance. The aim of this study was to investigate the influence of psychological traits and PROP status (the responsiveness to bitter taste of 6-n- propylthiouracil) on the choice of and familiarity with phenol-rich vegetables and beverages varying in recalled level of bitterness and astringency. Study 1 aimed at assessing the variations of the sensory properties of vegetable and coffee/tea items with two check-all-that-apply (CATA) questionnaires (n = 201 and n = 188 individuals, respectively). Study 2 aimed at investigating how sensitivity to punishment, to reward, and to disgust, food neophobia, private body consciousness, alexithymia, and PROP responsiveness affect choice and familiarity with phenol-rich foods (n = 1200 individuals). A Choice Index was calculated for vegetables (CV) and coffee/tea (CC) as a mean of the choices of the more bitter/astringent option of the pairs and four Familiarity Indices were computed for vegetables (FV) and coffee/tea (FC), higher (+) or lower (-) in bitterness and astringency. Subjects higher in food neophobia, sensitivity to punishment or sensitivity to disgust reported significantly lower choice indices than individuals lower in these traits, meaning that they systematically opted for the least bitter/astringent option within the pairs. Familiarity with vegetables was lower in individuals high in sensitivity to punishment, in food neophobia and in alexithymia, irrespective of their sensory properties. The Familiarity Index with coffee/tea characterized by higher bitterness and astringency was lower in individuals high in food neophobia, sensitivity to disgust, and alexithymia. No significant effect of PROP was found on any indices. The proposed approach based on product grouping according to differences in bitterness and astringency allowed the investigation of the role of individual differences in chemosensory perception and of psychological traits as modulators of phenol-rich foods preference and consumption.
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Grzegorzewski P, Kulesza M, Pluta A, Iqbal Z, Kucharska K. Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder. Psychiatry Res 2019; 273:798-807. [PMID: 30819534 DOI: 10.1016/j.psychres.2018.12.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Abstract
Self-report studies on empathy in adults with borderline personality disorder (BPD) have based upon the Interpersonal Reactivity Index (IRI) and generally identified deficits in perspective taking abilities in this group, but indicated less coherent results regarding empathic concern. These two constructs are considered subcomponents of cognitive (CE) and affective empathy (AE), respectively. However, the IRI does not enable for valid investigation of overall levels of these empathy types. Surprisingly, although some findings from the general population suggest that empathy types may be positively related to altruism, neither this link nor general altruism have been examined in BPD. Additionally, these constructs have not been sufficiently studied in this group in the context of alexithymia or potential clinical confounders. Hence, women with BPD (N = 30) and healthy women (N = 38) completed, i.a., the Questionnaire of Cognitive and Affective Empathy, Self-Report Altruism Scale, TAS-20, STAI, and CESD-R. Patients with BPD reported significantly decreased overall CE (including worse online simulation abilities - conceptually similar to perspective taking from the IRI), but a similar level of overall AE. They also demonstrated lower altruism. Taken together, these results suggest that BPD patients have difficulties with imagining what emotions others are feeling and with altruistic responding to their needs.
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Affiliation(s)
- Piotr Grzegorzewski
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Maria Kulesza
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Zaffer Iqbal
- NAViGO Health Care and Social Care CIC, Grimsby, United Kingdom; Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Katarzyna Kucharska
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland.
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Colle L, Gabbatore I, Riberi E, Borroz E, Bosco FM, Keller R. Mindreading abilities and borderline personality disorder: A comprehensive assessment using the Theory of Mind Assessment Scale. Psychiatry Res 2019; 272:609-617. [PMID: 30616131 DOI: 10.1016/j.psychres.2018.12.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 01/25/2023]
Abstract
Numerous studies have examined mindreading in borderline personality disorder (BPD). However, the empirical data obtained to date have not facilitated the development of a clear clinical profile of mindreading impairment in BPD due to a lack of consistency or incongruence across studies. One possible explanation for these inconsistencies and divergences in the current literature may lie in the multidimensional character of the mindreading construct; moreover, the heterogeneity of the experimental measures used to assess individuals with BPD mindreading skills may also need to be taken into account. The aim of the present study is to investigate mindreading skills and impairments in patients with BPD through direct comparison of a wide range of mindreading dimensions using a comprehensive semistructured interview, the Theory of Mind Assessment Scale (Th.o.m.a.s.) (Bosco et al., 2009). Our results show that the performance of patients with BPD differs from that of healthy controls only in certain specific dimensions of mindreading. The difficulties encountered by the patients with BPD typically emerge when mindreading tasks require them to disentangle their own subjective mindreading from that of another person, in other words, when they were required to assume an allocentric perspective.
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Affiliation(s)
- L Colle
- Department of Psychology, University of Turin, Italy; Neuroscience Institute of Turin, Italy
| | - I Gabbatore
- Department of Psychology, University of Turin, Italy; Child Language Research Center, University of Oulu, Finland.
| | - E Riberi
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
| | - E Borroz
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
| | - F M Bosco
- Department of Psychology, University of Turin, Italy; Neuroscience Institute of Turin, Italy
| | - R Keller
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
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Noël X, Saeremans M, Kornreich C, Bechara A, Jaafari N, Fantini-Hauwel C. On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity. J Gambl Stud 2018; 34:1049-1066. [PMID: 28866795 DOI: 10.1007/s10899-017-9715-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e., through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.
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Affiliation(s)
- Xavier Noël
- Laboratoire de Psychologie Médicale et d'Addictologie, Université Libre de Bruxelles (ULB) - Campus Brugmann, place Van Gehuchten, 4, Brussels, Belgium.
| | - Mélanie Saeremans
- Psychiatric Institut, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et d'Addictologie, Université Libre de Bruxelles (ULB) - Campus Brugmann, place Van Gehuchten, 4, Brussels, Belgium.,Psychiatric Institut, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Antoine Bechara
- Brain and Creativity Institute, University of Southern California (USC), Los Angeles, CA, USA
| | - Nematollah Jaafari
- Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France.,INSERM U 1084, Experimental and Clinical Neuroscience Laboratory, Groupement de Recherche CNRS 3557, Université de Poitiers, INSERM CIC-P 1402 du CHU de Poitiers, Poitiers, France
| | - Carole Fantini-Hauwel
- Research Center of Clinical Psychology, Psychopathology and Psychosomatic, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Taylor JK, Theiler S, Nedeljkovic M, Moulding R. A qualitative analysis of emotion and emotion regulation in hoarding disorder. J Clin Psychol 2018; 75:520-545. [PMID: 30431647 DOI: 10.1002/jclp.22715] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The role of emotion regulation (ER) has been receiving increased attention in relation to various forms of psychopathology including hoarding disorder (HD). However, questionnaire designs are limited to finding associations of ER with symptoms or symptom groups, without finding out how such constructs might be involved in the disorder. METHODS This study was a qualitative investigation of ER in a clinical HD sample (N = 11). RESULTS Prominent themes provided support for ER difficulties in hoarding. In particular, difficulties with identifying and describing feelings, unhelpful attitudes toward the emotional experience, the use of avoidance-based strategies, and a perceived lack of effective ER strategies were prominent themes. Furthermore, emotional factors were identified as being associated with the onset and/or exacerbation of hoarding behavior, and possessions and acquiring behavior appeared to serve an ER function. CONCLUSION The current paper provides a nuanced account of the role of ER in hoarding difficulties.
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Affiliation(s)
- Jasmine K Taylor
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Stephen Theiler
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Maja Nedeljkovic
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Richard Moulding
- School of Psychology, Deakin University, Geelong; Deakin University Centre for Drug Use, Addictive and Anti-Social Behaviour Research (CEDAAR), Geelong, Victoria, Australia
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Zdankiewicz-Ścigała E, Ścigała DK. Relationship Between Attachment Style in Adulthood, Alexithymia, and Dissociation in Alcohol Use Disorder Inpatients. Mediational Model. Front Psychol 2018; 9:2039. [PMID: 30425669 PMCID: PMC6218579 DOI: 10.3389/fpsyg.2018.02039] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/03/2018] [Indexed: 01/01/2023] Open
Abstract
Background: Attachment theory is a widely used framework for understanding emotion regulation as well as alexithymia, and dissociation and this perspective has also been applied to understand alcohol use disorders. Apart from these theoretical suggestions, there has been scarce empirical research on this subject-matter. Therefore, the objective of the present study was to investigate potential associations between attachment style in adulthood, alexithymia, and dissociation in alcohol use disorder inpatients. Methods: The Revised Adult Attachment Scale (RAAS), the Toronto Alexithymia Scale-20 (TAS-20), the Michigan Alcoholism Screening Test (MAST), and the Curious Experiences Survey (CES) were administered to a sample of 97 alcohol use disorder inpatients recruited from drug and alcohol treatment centers in Warsaw, and 104 persons in control groups, Poland. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: alexithymia, dissociation, and attachment styles. The analysis of models related to the impact of attachment styles on the level of alcohol addiction with regard to a mediatory role of alexithymia and dissociation showed that all models are well fitted to data and statistically significant: intimacy F(3.197) = 34.41; p < 0.001 and explains 34% (R 2 = 0.3438); depend F(3.197) = 36.55; p < 0.001, and explains 36% (R 2 = 0.3576); anxiety F(3.197) = 34.71; p < 0.001, and explains 35% (R 2 = 0.3458) of the variability of alcohol addiction scores. Mediation analysis found that alexithymia and dissociation enhance the fear of intimacy and rejection in a romantic relationship. Conclusion: These findings support the broad attachment theory suggesting that attachment is associated with and predicts alexithymia and dissociation in the sample of substance use disorder inpatients. Alexithymia and dissociation, by inhibiting the processes of emotions' identification and verbalization, cause that language does not serve for the purpose of changing self or others, as the communication is distorted. Absent are common meanings and accurate mutual understanding in a relationship.
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Affiliation(s)
| | - Dawid Konrad Ścigała
- Institute of Psychology, Faculty of Applied Social Sciences, The Maria Grzegorzewska University, Warsaw, Poland
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Zdankiewicz-Ścigała E, Ścigała DK. Trauma, Temperament, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Mediation Model of Dependencies. Front Psychol 2018; 9:1570. [PMID: 30245652 PMCID: PMC6137258 DOI: 10.3389/fpsyg.2018.01570] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The attachment theory has been conceptualized as an affect regulation theory, proposing that attachment is associated with the expression and recognition of emotions as well as interpersonal functioning. The purpose of the study was to examine a model, in which a relation was analyzed between childhood trauma, temperament, alexithymia, and dissociation in a group of individuals addicted to alcohol. Method: The total number of 201 persons were examined, comprising 67 women (33.3% of participants) and 134 men (66.7% of participants). The participants aged from 18 to 68 (M = 32.81; SD = 12.12). In order to measure the analyzed variables, the following questionnaires were applied: MAST, SSSV, TAS20, TEC, and CES. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: the intensity of trauma, temperament, alexithymia, and dissociation. The study of models related to the impact of traumatic experience intensity on the level of alcohol addiction with regard to a mediatory role of alexithymia, dissociation, and temperament showed the existence of several important indirect effects, and the model, which takes into account all three mediators, is statistically significant F(4,196) = 35.1964; p < 0.001. Conclusion: Childhood trauma, as well as alexithymia and dissociation block dealing with stress based on self-reflection and self-control, and contribute to affective disorders and their regulation with alcohol. Limitations: The selection of participants to homogeneous groups with regard to age and gender constituted the most important difficulty and limitation. A perfect age criterion for investigating the interaction between the temperament and the consequences of traumatic development would be early adulthood.
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Affiliation(s)
| | - Dawid K Ścigała
- Institute of Psychology, Faculty of Applied Social Sciences, The Maria Grzegorzewska University, Warsaw, Poland
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Redondo I, Herrero-Fernández D. Validation of the Reading the Mind in the Eyes Test in a healthy Spanish sample and women with anorexia nervosa. Cogn Neuropsychiatry 2018; 23:201-217. [PMID: 29635964 DOI: 10.1080/13546805.2018.1461618] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to build a Spanish version of the Reading the Mind in the Eyes Test (RMET) including limited time of response and an integrated glossary, and to test its validity. METHODS A total of 433 university students (121 men and 350 women) and 38 anorexic women completed the RMET and other related measures of empathy and alexithymia. The results of the Parallel Analysis suggested a unidimensional structure for 19 items, which was verified through a Confirmatory Factor Analysis. RESULTS Similarly to other research, this factor had a low reliability (α = .56, ρ = .59); however, regarding validity, the total score of the instrument showed positive correlations with empathy and negatives with alexithymia. Furthermore, healthy females were superior to males in RMET, and to anorexic women; but no significant differences appeared between healthy men and the anorexic group. CONCLUSION This study confirms the validity of the test and permits a relatively short and inexpensive means of administration in large samples of adults. Besides, it suggests the necessity of assessing and treating the theory of mind in anorexic women.
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Affiliation(s)
- Iratxe Redondo
- a Development and Educational Psychology , University of the Basque Country , Leioa , Spain
| | - David Herrero-Fernández
- b Department of Psychology, Faculty of Health Sciences , Universidad Europea del Atlántico , Santander , Spain
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Parolin M, Miscioscia M, De Carli P, Cristofalo P, Gatta M, Simonelli A. Alexithymia in Young Adults With Substance Use Disorders: Critical Issues About Specificity and Treatment Predictivity. Front Psychol 2018; 9:645. [PMID: 29872408 PMCID: PMC5972315 DOI: 10.3389/fpsyg.2018.00645] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/16/2018] [Indexed: 11/18/2022] Open
Abstract
Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent. The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: (a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and (b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop-outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2. Study 1 involved 90 late adolescents, aged 17-21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale-20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R. Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the "Distant" OAS subscale predicted the number rate relapses only in males. The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population.
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Affiliation(s)
- Micol Parolin
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Pietro De Carli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Michela Gatta
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Childhood Adolescence Family Unit, Ulss6 Veneto, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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The Interoception Sensory Questionnaire (ISQ): A Scale to Measure Interoceptive Challenges in Adults. J Autism Dev Disord 2018; 48:3354-3366. [DOI: 10.1007/s10803-018-3600-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Pluta A, Kulesza M, Grzegorzewski P, Kucharska K. Assessing advanced theory of mind and alexithymia in patients suffering from enduring borderline personality disorder. Psychiatry Res 2018; 261:436-441. [PMID: 29360051 DOI: 10.1016/j.psychres.2018.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 11/25/2022]
Abstract
Findings on the theory of mind (ToM) abilities in borderline personality disorder (BPD) have been inconsistent. Surprisingly, no studies have focused on the complex aspects of ToM while simultaneously measuring alexithymia as well as comorbid depressive and anxiety symptoms, therefore, our study aimed to fill this gap. 30 female patients with BPD and 38 healthy controls (HCs) completed the Faux Pas Test (FPT) and the Toronto Alexithymia Scale-20 (TAS-20). The clinical and intellectual assessment comprised of the Structured Clinical Interview for DSM-IV-TR Axis II Disorders (SCID-II), the Borderline Personality Inventory (BPI), the State-Trait Anxiety Inventory (STAI), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and the Raven's Progressive Matrices (RPM). Women with BPD scored significantly worse than HCs on overall ToM abilities. After controlling for the intelligence level, depressive symptoms, and state and trait anxiety, both groups presented a similar overall level of alexithymia. No correlation between the FPT and TAS-20 scores was found, suggesting that both constructs might be unrelated in BPD. Because ToM dysfunctions seem not to result from comorbid clinical symptoms, trait anxiety, or intellectual abilities, our study results suggest that ToM deficits might be considered a core feature of BPD.
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Affiliation(s)
- Agnieszka Pluta
- Faculty of Psychology, University of Warsaw, Warsaw, Poland, 5/7 Stawki Street, 00-183 Warsaw, Poland
| | - Maria Kulesza
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, 3 Pasteura Street, 02-093 Warsaw, Poland
| | - Piotr Grzegorzewski
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Katarzyna Kucharska
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland.
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Hobson H, Hogeveen J, Brewer R, Catmur C, Gordon B, Krueger F, Chau A, Bird G, Grafman J. Language and alexithymia: Evidence for the role of the inferior frontal gyrus in acquired alexithymia. Neuropsychologia 2018; 111:229-240. [PMID: 29360519 PMCID: PMC8478116 DOI: 10.1016/j.neuropsychologia.2017.12.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 11/08/2017] [Accepted: 12/22/2017] [Indexed: 11/25/2022]
Abstract
The clinical relevance of alexithymia, a condition associated with difficulties identifying and describing one's own emotion, is becoming ever more apparent. Increased rates of alexithymia are observed in multiple psychiatric conditions, and also in neurological conditions resulting from both organic and traumatic brain injury. The presence of alexithymia in these conditions predicts poorer regulation of one's emotions, decreased treatment response, and increased burden on carers. While clinically important, the aetiology of alexithymia is still a matter of debate, with several authors arguing for multiple 'routes' to impaired understanding of one's own emotions, which may or may not result in distinct subtypes of alexithymia. While previous studies support the role of impaired interoception (perceiving bodily states) in the development of alexithymia, the current study assessed whether acquired language impairment following traumatic brain injury, and damage to language regions, may also be associated with an increased risk of alexithymia. Within a sample of 129 participants with penetrating brain injury and 33 healthy controls, neuropsychological testing revealed that deficits in a non-emotional language task, object naming, were associated with alexithymia, specifically with difficulty identifying one's own emotions. Both region-of-interest and whole-brain lesion analyses revealed that damage to language regions in the inferior frontal gyrus was associated with the presence of both this language impairment and alexithymia. These results are consistent with a framework for acquired alexithymia that incorporates both interoceptive and language processes, and support the idea that brain injury may result in alexithymia via impairment in any one of a number of more basic processes.
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Affiliation(s)
- Hannah Hobson
- Department of Psychology, Social Work and Counselling, University of Greenwich, Avery Hill Road, Eltham, London SE9 2UG, UK
| | - Jeremy Hogeveen
- University of California Davis, M.I.N.D. Institute, 2825 50th St, Sacramento, CA 95817, USA
| | - Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK
| | - Caroline Catmur
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Barry Gordon
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Cognitive Science Department, Johns Hopkins University, Baltimore, MD, USA
| | - Frank Krueger
- Molecular Neuroscience Department, George Mason University, Fairfax, VA, USA
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Aileen Chau
- Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK
- Department of Experimental Psychology, University of Oxford, 5 Parks Rd, Oxford OX1 3PH, UK
| | - Jordan Grafman
- Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Cimino S, Simonelli A, Parolin M, Ballarotto G, Carbone P, Cerniglia L. A Theoretical and Empirical Linkage between Road Accidents and Binge Eating Behaviors in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020355. [PMID: 29462976 PMCID: PMC5858424 DOI: 10.3390/ijerph15020355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/13/2023]
Abstract
This study aimed at identifying specific clusters of maladaptive emotional–behavioral symptoms in adolescent victims of motorbike collisions considering their scores on alexithymia and impulsivity in addition to examining the prevalence of clinical binge eating behaviors (respectively through the Youth Self-Report (YSR), Toronto Alexithymia Scale-20 (TAS-20), Barratt Impulsiveness Scale-11 (BIS-11), and Binge Eating Scale (BES)). Emotional–behavioral profiles, difficulties in identifying and describing feelings, impulsivity, and binge eating behaviors have been assessed in 159 adolescents addressing emergency departments following motorbike collisions. Our results showed a cluster of adolescents with clinical binge eating behaviors, high rates of motorbike accidents, and high levels of internalizing and externalizing problems, alexithymia, and impulsivity (23.3% of the sample); a second cluster of adolescents with clinical binge eating behaviors, a moderate number of collisions, and moderate levels of emotional and behavioral problems on the above four dimensions (25.8% of the sample); and a third cluster of youth without clinical binge eating behaviors, with a moderate number of accidents, and with low scores on the four dimensions (50.9% of the sample). Adolescents of Cluster 1 showed a higher likelihood to be involved in motorbike collisions than the youth in Clusters 2 and 3 (p < 0.0001). We suggest that adolescents’ motor collisions could be associated with their difficulties in emotion regulation and with their impaired psychological profiles, which could also underpin their disordered eating. The identification of specific clusters of psychopathological symptoms among this population could be useful for the construction of prevention and intervention programs aimed at reducing motor collision recidivism and alleviating co-occurring psychopathologies.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Padua 35100, Italy.
| | - Micol Parolin
- Department of Developmental and Social Psychology, University of Padua, Padua 35100, Italy.
| | - Giulia Ballarotto
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Paola Carbone
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Luca Cerniglia
- Department of Psychology, International Telematic University, Rome 00100, Italy.
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Borhani K, Làdavas E, Fotopoulou A, Haggard P. "Lacking warmth": Alexithymia trait is related to warm-specific thermal somatosensory processing. Biol Psychol 2017; 128:132-140. [PMID: 28735971 PMCID: PMC5595273 DOI: 10.1016/j.biopsycho.2017.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 07/16/2017] [Accepted: 07/16/2017] [Indexed: 01/24/2023]
Abstract
Alexithymia is a personality trait involving deficits in emotional processing. The personality construct has been extensively validated, but the underlying neural and physiological systems remain controversial. One theory suggests that low-level somatosensory mechanisms act as somatic markers of emotion, underpinning cognitive and affective impairments in alexithymia. In two separate samples (total N=100), we used an established Quantitative Sensory Testing (QST) battery to probe multiple neurophysiological submodalities of somatosensation, and investigated their associations with the widely-used Toronto Alexithymia Scale (TAS-20). Experiment one found reduced sensitivity to warmth in people with higher alexithymia scores, compared to individuals with lower scores, without deficits in other somatosensory submodalities. Experiment two replicated this result in a new group of participants using a full-sample correlation between threshold for warm detection and TAS-20 scores. We discuss the relations between low-level thermoceptive function and cognitive processing of emotion.
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Affiliation(s)
- Khatereh Borhani
- Institute of Cognitive Neuroscience, University College London, London, UK; Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy; CSRNC, Centre for Studies and Research in Cognitive Neuroscience, University of Bologna, Viale Europa 980, 47521 Cesena, Italy; Institute of Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Elisabetta Làdavas
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy; CSRNC, Centre for Studies and Research in Cognitive Neuroscience, University of Bologna, Viale Europa 980, 47521 Cesena, Italy
| | | | - Patrick Haggard
- Institute of Cognitive Neuroscience, University College London, London, UK.
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Wielopolski J, Kleinjung T, Koch M, Peter N, Meyer M, Rufer M, Weidt S. Alexithymia Is Associated with Tinnitus Severity. Front Psychiatry 2017; 8:223. [PMID: 29163242 PMCID: PMC5681746 DOI: 10.3389/fpsyt.2017.00223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Alexithymia is considered to be a personality trait with a tendency to express psychological distress in somatic rather than emotional form and, therefore, may play a vital role in somatization. Although, such a propensity can be found in patients suffering from tinnitus, the relationship between alexithymic characteristics and the subjective experience of tinnitus severity remains yet unclear. Our aim was to evaluate which alexithymic characteristics are linked to the subjective experience of tinnitus symptomatology. METHODS We evaluated tinnitus severity (Tinnitus Handicap Inventory, THI), alexithymia (20-item Toronto Alexithymia Scale, TAS-20), and depression (Beck Depression Inventory, BDI) in 207 outpatients with tinnitus. Correlation analyses and multiple regression analyses were calculated in order to investigate the relationship between alexithymic characteristics, tinnitus severity, and depression. RESULTS Highly significant positive correlations were found between THI total score and TAS-20 total score as well as BDI score. Regarding the TAS-20 subscales, multiple regression analyses showed that only the TAS-20 subscale "difficulty in identifying feelings" (DIF) and the BDI significantly predicted the subjective experience of tinnitus severity. Regarding the THI subscales, only higher scores of the THI subscale "functional" demonstrated an independent moderate association with higher scores for DIF. CONCLUSION We found an independent association between the subjective experience of tinnitus severity and alexithymic characteristics, particularly with regard to limitations in the fields of mental, social, and physical functioning because of tinnitus and the difficulty of identifying feelings facet of alexithymia. These findings are conducive to a better understanding of affect regulation that may be important for the psychological adaptation of patients suffering from tinnitus.
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Affiliation(s)
- Jan Wielopolski
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Melanie Koch
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicole Peter
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Steffi Weidt
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Abstract
We investigated the association between alexithymic tendencies as measured by the 20-item Toronto Alexithymia Scale and the characteristics of aesthetic impressions for words and drawings. Impressions were measured using the semantic differential technique in three groups of Japanese students (High scores n = 31, Moderate scores n = 40, and a Control group n = 182) who were presented only words (Word condition), only drawings (Drawing condition), or pairs comprising one word plus one drawing that represented the same emotional categories (Drawing/Word condition). In a factor analysis on the data from participants, three factors (Evaluation, Activity, and Potency) were extracted. Based on the factor scores, the distances among the three conditions were calculated for each of the groups. For Potency, significant group differences were found between the Drawing/Word and other conditions. In the High-scoring alexithymia group, in particular, the Potency impressions based on tactile sensation, e.g., soft–hard, blunt–sharp, were amplified regardless of stimulus condition. These results are discussed in the context of somatosensory amplification associated with alexithymia and the difficulty of distinguishing between emotion and somatic sensations.
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Affiliation(s)
- Miho Suzuki
- Department of Psychology, Graduate School of Arts and Letters, Tohoku University, Kawauchi, Aoba-ku, Sendai 980-8576, Japan.
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Gohm CL, Clore GL. Individual Differences in Emotional Experience: Mapping Available Scales to Processes. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2016. [DOI: 10.1177/0146167200268004] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Increasing interest in individual differences related to emotion is evident in the recent appearance of a large number of self-report instruments designed to assess aspects of the feeling experience. In this article, the authors review a sample of 18 of these scales and report technical information on each (e.g., length, format, reliability, construct validity, and correlates). They propose that this domain of individual differences can be usefully structured into five conceptual categories, including measures of absorption, attention, clarity, intensity, and expression. The measures were administered to a sample of individuals, and the coherence of the proposed categories was examined through hierarchical cluster analyses. The results confirmed the proposed structure of this domain of individual difference measures. The authors argue for the usefulness of an individual differences approach to theory testing and specify some of the information-processing roles that might be played by the categories of individual differences found in the data.
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Schwarz J, Gottschalk JM, Ruckmann J, Rief W, Kleinstäuber M. An experimental paradigm to repeatedly induce somatic symptoms. J Psychosom Res 2016; 82:24-30. [PMID: 26944395 DOI: 10.1016/j.jpsychores.2016.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Experimental research in the field of medically unexplained physical symptoms (MUPS) is rare. We examined a method of script driven imagery in terms of manipulating the intensity of the symptom, the impairment by the symptom and the symptom tolerance. Additionally, we identified relevant predictors for the efficacy of symptom induction. METHODS We assessed the most impairing symptom in 48 subjects suffering from multiple, chronic MUPS and a severe physical illness that 48 age-matched healthy controls suffered from in the past. An individual script including thoughts and sensations accompanying the symptom was recorded. During the experiment, participants were exposed to the script repeatedly and then rated the intensity of, impairment by and tolerance of the symptom on a visual analog scale (VAS). RESULTS A mixed model repeated-measures-ANOVA revealed a significant main effect for the factor time (pre- and post-induction assessment; p<.001) but not for group (MUPS- vs. control-groups; p=.159-.314) indicating that the manipulation of all VASs was effective for both groups. The interaction time×group was significant for tolerance and post-hoc analyses showed no significant reduction for tolerance in the MUPS-group. The number of somatic symptoms and endurance behavior predicted higher induction efficacy in the MUPS-group for intensity. For healthy controls, endurance behavior and pain-persistence were associated with lower induction efficacy for all VAS. CONCLUSION Script-driven imagery could be a promising research procedure in the field of MUPS. It could be used to investigate short term effects of psychological interventions as well as physiological and cognitive processes accompanying symptom manipulation.
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Affiliation(s)
- Jeanine Schwarz
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany.
| | | | - Judith Ruckmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany
| | - Maria Kleinstäuber
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany
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