Exploring the interrelationship between alexithymia, defense style, emotional suppression, homicide-related posttraumatic stress disorder and psychiatric co-morbidity

Posttraumatic Stress and Alexithymia: Symptom Associations

ABSTRACT

There is a demonstrated association between alexithymia and posttraumatic stress disorder (PTSD). However, work has largely focused on male-dominant, high-risk occupation populations. We aimed to explore the relationship between posttraumatic stress (PTS) and alexithymia among 100 trauma-exposed female university students. Participants completed a Life Events Checklist, the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PCL-5), and the Toronto Alexithymia Scale (TAS-20). Multiple regressions were run to examine whether alexithymia was associated with each of the PCL-5 subscales. The TAS-20 total scores were associated with total PTS scores, β = 0.47, t(99) = 5.22, p < 0.001. On a subscale level, Difficulty in Identifying Feelings (DIF) was positively associated (β = 0.50 to 0.41) with all PCL-5 subscales except for Avoidance. Our results align with research showing that for women, the DIF subscale is most strongly associated with PTS, in contrast with the literature on male samples, showing strongest associations with the Difficulties in Describing Feelings subscale, suggesting sex differences in associations between PTS and alexithymia. Our study supports the universality of the associations between alexithymia and PTS.

The Contribution of Bullying Involvement and Alexithymia to Somatic Complaints in Preadolescents

Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement-as perpetrators, victims, or outsiders-and alexithymia on somatic complaints in a sample of 179 Italian middle-school students (aged 11-15). Findings revealed an indirect association between bullying perpetration and victimization complaints through alexithymia. We also found a significant direct association between victimization and somatic complaints. No significant association between outsider behavior and somatization was found. Our results revealed that bullying perpetration and victimization could increase youths' risk for somatic complaints and clarify one of the processes underlying this association. The current findings further emphasize the relevance of emotional awareness for youths' well-being and propose that implementing social-emotional skills might prevent some of the adverse consequences of being involved in bullying episodes.

The effect of COVID-19 on employees' mental health

Long lockdowns, food shortages, and the inability to receive basic primary healthcare have aggravated the effects of pandemics. However, most studies have focused on the health problems of the infected people or the measures employed to keep the disease under control. This cross-sectional study focused primarily on the mental health issues of employees. By employing a convenient sampling method, we reached 237 respondents (135 with coronavirus history) to assess the impact of the pandemic on employees. Multivariate causal relationships were assessed with Structural Equation Modeling (SEM). The predictors included internal entrapment (INT) and difficulty identifying feelings (DIF), which are significant predictors of depression (DEPR). DIF was found to be a significant predictor of INT and EXT feelings, while FEAR was found to be a significant predictor of INT, DIF, and DEPR. Quality of life (QoL) was found to be a significant predictor of DIF and DDF, DEPR, EXT and INT, and FEAR. The results also showed that DIF mainly manifested its effect on depression through INT. The DEPR level of employees working only from home was higher than that of other employees. The depression levels of women, young employees, and those whose QoL was adversely affected by the coronavirus were higher than the rest.

Social Self-Efficacy and Internet Gaming Disorder Among Chinese Undergraduates: The Mediating Role of Alexithymia and the Moderating Role of Empathy

As an increasingly serious social problem, Internet gaming disorder (IGD) of college students may be related to their social self-efficacy. However, the relationship and its internal mechanisms underlying are still unclear. The current study tested the mediating effect of alexithymia in the association between social self-efficacy and IGD, and whether this mediating process was moderated by empathy. Social Self-Efficacy Scale (PSSE), Chinese version of Internet Game Addiction Scale (IGAS-C), Toronto Alexithymia Scale (TAS-20) and Interpersonal Response Scale (IRI-C) were adopted to examine the model on 888 Chinese college students. The results indicated that social self-efficacy was significantly negatively associate with IGD. Mediation analysis illustrated that alexithymia mediated the association between social self-efficacy and IGD. Further, moderated mediation analysis manifested that the mediated effects was stronger for lower level of empathy. The conclusions corroborate and clarify the mechanisms that alexithymia mediated the association between social self-efficacy and IGD, and the mediation effects is moderated via empathy. Besides, these findings provide available references for colleges to conduct educational activities, and at the same time provide scientific suggestions for preventing IGD among undergraduates.

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.

Homicide as a Source of Posttraumatic Stress?: A Meta-Analysis of the Prevalence of Posttraumatic Stress Disorder After Committing Homicide

There is a growing body of literature on the diagnosis of posttraumatic stress disorder (PTSD) after committing homicide that has examined the prevalence of this phenomenon among individuals who have been convicted, but these studies considerably vary. The present study was the first meta-analysis to synthesize scientific evidence regarding the prevalence of offense-related PTSD among convicted killers. A total of 691 articles were identified through an initial screening process, and the final analysis included 11 studies that met the analysis criteria. We examined the prevalence of PTSD after committing homicide and explored how these rates varied by sample type, offender type, diagnosis timeframe, and diagnosis type. Among adult offenders, the pooled prevalence was 42.6%, 95% CI [38.0%, 47.4%], for current full-criteria homicide-related PTSD and 13.1%, 95% CI [9.9%, 17.2%], for current partial-criteria homicide-related PTSD. For mixed offenders (i.e., killers and violent offenders), the pooled prevalence of current full-criteria offense-related PTSD was 33.1% (95% CI [14.1, 59.8]). Thus, we found that PTSD prevalence was higher in killers than mixed offenders, although this difference was not statistically significant. Finally, among youth mixed offenders, the pooled prevalence for current full-criteria offense-related PTSD was 5.3%, 95% CI [2.9%, 9.5%]. These findings provide evidence of the high rate of this phenomenon, especially among convicted adults.

The Mediating Roles of Emotional Regulation on Negative Emotion and Internet Addiction Among Chinese Adolescents From a Development Perspective

Previous researches indicated that emotional regulation can be associated with depression and anxiety, which may be an important mediating factor between emotional regulation and internet addiction. However, the mechanism between these associations has received little attention and it is still unclear. This study has examined 716 Chinese adolescents, 341 were males (47.6%), aged 13 to 18(Mean = 14.58, SD = 1.50), using a cross-sectional survey involving Young's Diagnostic Questionnaire for Internet Addiction, the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety (GAD-7) scale, and the Emotion Regulation Questionnaire (ERQ). Correlation analysis, multiple-group analysis and structural equation modeling were carried out in SPSS Statistics version 23 (IBM, Armonk, NY) and AMOS version 21. Cognitive reappraisal had a significantly negative direct effect on Internet addiction (β = -0.118, p < 0.05). Furthermore, negative emotions mediated the relationships between expression suppression and Internet addiction [β = 0.149, 95% CI = (0.099, 0.212)] and the relationship between cognitive reappraisal and Internet addiction [β = -0.101, 95% CI = (-0.147, -0.065)]. The differences in the structure path coefficients for different development stages demonstrated that recognitive reappraisal showed more protective roles for negative emotion (p < 0.01), and negative emotion also predict Internet addiction more effectively in high school students (p < 0.001). However, cognitive reappraisal directly predicted negative Internet addiction in junior high school students. Therefore, the intervention on adolescents for internet addiction should not only focus on emotional regulation and negative emotion, but also development stages of adolescents.

Posttraumatic stress disorder and psychiatric co-morbidity among Syrian refugees: the role of trauma exposure, trauma centrality, self-efficacy and emotional suppression

Background: The devastation of the Syrian war can lead to a drastic re-evaluation of oneself and alteration in self-capacities. Yet, little is known regarding its impact on these domains among Syrian refugees.Aims: To investigate the inter-relationship between trauma characteristics, trauma centrality, self-efficacy, emotional suppression, PTSD and psychiatric co-morbidity among Syrian refugees.Methods: 1197 refugees from Turkey and Sweden completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale, Generalized Self-Efficacy Scale and Courtauld Emotional Control Scale.Results: Using the DSM-IV criteria for PTSD from the Harvard Trauma Questionnaire, 43% met the criteria. The PTSD group reported significantly higher levels of trauma characteristics, trauma centrality and psychiatric co-morbidity but a lower level of self-efficacy than the non-PTSD group. Trauma characteristics were positively associated with trauma centrality; trauma centrality was negatively correlated with self-efficacy. Contrary to hypothesis, self-efficacy was positively correlated with emotional suppression which was positively correlated with psychiatric co-morbidity but not PTSD.Conclusions: The experience of war can lead to the emergence of PTSD among Syrian refugees. Exposure to war can alter self-perception, belief of personal mastery over one's future and the way emotion is expressed, all of which can have specific effects on general psychological symptoms.

Posttraumatic Stress and Interpersonal Sensitivity: Alexithymia as Mediator and Emotional Expressivity as Moderator

This study examined 1) the link between PTSD from past trauma, interpersonal sensitivity and psychiatric co-morbidity, 2) mediational effects of alexithymia on 1), and 3) moderated mediational effects with emotional expressivity as the moderator. Five hundred and fifteen Kazakh students completed the Posttraumatic Stress Diagnostic Scale, General Health Questionnaire-28, Toronto Alexithymia Scale-20, Berkeley Expressivity Questionnaire and Interpersonal Sensitivity Measure. The results showed that 28% met the criteria for full-PTSD. Controlling for academic year, age and university major, PTSD from past trauma was significantly correlated with interpersonal sensitivity and psychiatric co-morbidity. Alexithymia mediated the impact of PTSD on interpersonal sensitivity and psychiatric co-morbidity. Alexithymia, however, did not interact with type of emotional expressivity to influence outcomes. Moderated mediational effects were not found. To conclude, following trauma, Kazakh students can experience heightened levels of interpersonal sensitivity and psychological symptoms. These problems are particularly severe for those who have difficulty getting in touch with their emotions.

Posttraumatic Stress Among Syrian Refugees: Trauma Exposure Characteristics, Trauma Centrality, and Emotional Suppression

OBJECTIVES

This study revisited the prevalence of posttraumatic stress disorder (PTSD) and examined a hypothesized model describing the interrelationship between trauma exposure characteristics, trauma centrality, emotional suppression, PTSD, and psychiatric comorbidity among Syrian refugees.

METHODS

A total of 564 Syrian refugees participated in the study and completed the Harvard Trauma Questionnaire, General Health Questionnaire (GHQ-28), Centrality of Event Scale, and Courtauld Emotional Control Scale.

RESULTS

Of the participants, 30% met the cutoff for PTSD. Trauma exposure characteristics (experiencing or witnessing horror and murder, kidnapping or disappearance of family members or friends) were associated with trauma centrality, which was associated with emotional suppression. Emotional suppression was associated with PTSD and psychiatric comorbid symptom severities. Suppression mediated the path between trauma centrality and distress outcomes.

CONCLUSIONS

Almost one-third of refugees can develop PTSD and other psychiatric problems following exposure to traumatic events during war. A traumatized identity can develop, of which life-threatening experiences is a dominant feature, leading to suppression of depression with associated psychological distress.