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Shalimova A, Stoenoiu MS, Cubała WJ, Burnier M, Persu A, Narkiewicz K. The impact of war on the development and progression of arterial hypertension and cardiovascular disease: protocol of a prospective study among Ukrainian female refugees. Front Cardiovasc Med 2024; 10:1324367. [PMID: 38274316 PMCID: PMC10808621 DOI: 10.3389/fcvm.2023.1324367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Background Growing evidence supports the impact of psychological factors such as traumatic experiences and Post Traumatic Stress Disorder (PTSD) on the incidence of arterial hypertension (HTN) and cardiovascular diseases (CVD). The war in Ukraine is exposing million inhabitants to traumatic experiences and severe stress. Part of Ukrainians (mostly women and children) left the country to escape war. We report the protocol of a prospective study aiming at the assessment of the impact of war-induced stress on HTN and CVD in women Ukrainian refugees who moved to Poland. Methods and design The study will be conducted in 3 stages. Stage 1 will assess the prevalence of HTN and PTSD among Ukrainian refugees and will estimate the impact of war-related trauma exposure on these parameters. Data on office blood pressure (BP) will be compared to data already collected in STEPS data 2019 and May Measurement Month 2021 in Ukraine, matched for age and sex. Stage 2 will involve subjects diagnosed with HTN and/or PTSD referred for management and follow-up of these conditions. Psychologic targeted therapies will be offered to subjects with confirmed PTSD, with a periodical reassessment of the severity of PTSD-associated symptoms and of its impact on HTN and cardiovascular health. Clinical history and characteristics will be compared among three groups: subjects with HTN and PTSD, with HTN without PTSD, with PTSD but without HTN. Stage 3 will involve a subgroup among those screened in Stage 1, with the objective of investigating the biological mechanisms underlying the relation between HTN and trauma exposure, identifying early signs of subclinical target organ damage in subjects with HTN with/without PTSD. Discussion This study will test the hypothesis that trauma exposure and psychological stress contribute to BP elevation and progression of CVD in this population. It will provide new evidence on the effect of an integrated management, including psychological therapy, on BP and cardiovascular risk. Such approach may be further tested and extrapolated to other populations exposed to war and chronic violence, migrants and refugees around the world. Research Study Registration number 2022/45/P/NZ5/02812.
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Affiliation(s)
- A. Shalimova
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - M. S. Stoenoiu
- Department of Internal Medicine, Rheumatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - W. J. Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - M. Burnier
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - A. Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - K. Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
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Sancassiani F, Montisci R, Meloni L, Nardi AE, Carta MG. Why is it Important to Assess and Treat Alexithymia in the Cardiologic Field? An Overview of the Literature. Clin Pract Epidemiol Ment Health 2023; 19:e174501792307140. [PMID: 37916203 PMCID: PMC10507214 DOI: 10.2174/17450179-v19-230810-2022-ht15-4764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 11/03/2023]
Abstract
Background Alexithymia has been found to be associated with several somatic illnesses, such as cardiovascular, indicating that it might be a risk factor for early death in the long-term course of post-myocardial infarction. From the cardiology perspective, the aim was to collect current evidence about the relationship between alexithymia and somatic illness. Methods The literature was synthesized and summarized in a narrative format. The literature search was carried out in PubMed. Pertinent studies published in the last 50 years written in English were included and organized by three main topics ("The relation between alexithymia and somatic illness from the cardiology perspective"; "How do assess alexithymia?"; "Treating alexithymia") to be discussed. Results High alexithymia is a dimensional trait that affects around 10% of the general population and up to 55% of people with essential hypertension. Also, the link between alexithymia and cardiovascular activity has been pointed out. There are several validated tools to assess alexithymia, as well as treatment options. Conclusion Knowledge about the main features of alexithymia, as well as its assessment and treatment, can promote a multifactorial approach to the primary, secondary, and tertiary prevention of cardiac diseases.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Roberta Montisci
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Luigi Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Antonio Egidio Nardi
- Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
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Montisci R, Sancassiani F, Marchetti MF, Biddau M, Carta MG, Meloni L. Alexithymia for cardiologists: a clinical approach to the patient. J Cardiovasc Med (Hagerstown) 2023:01244665-990000000-00116. [PMID: 37129913 DOI: 10.2459/jcm.0000000000001487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Alexithymia literally meaning 'no words for emotions' is a term used in mental health settings to describe people who have difficulties in identifying and verbalizing their emotional states. There is evidence in the literature that this personality trait may influence negatively the illness behavior when an acute coronary event occurs. In fact, people with high alexithymia are more likely to experience wrong appraisal and interpretation of symptoms, and because of their difficulty in describing feelings to others, they can be poor in reporting symptoms at the first consultation with a physician. This behavioral pattern (alexithymic) may put patients with acute myocardial infarction at higher risk for delayed medical care. Here, we aim to present an overview of alexithymia from the perspective of the clinical cardiologist, with a focus on the definition, clinical recognition, and potential impact on cardiovascular health.
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Affiliation(s)
- Roberta Montisci
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health
| | - Federica Sancassiani
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Mattia Biddau
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health
| | - Mauro Giovanni Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Meloni
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health
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Kumari V, Antonova E, Mahmood S, Shukla M, Saifullah A, Pandey R. Dispositional mindfulness, alexithymia and sensory processing: Emerging insights from habituation of the acoustic startle reflex response. Int J Psychophysiol 2023; 184:20-27. [PMID: 36513183 DOI: 10.1016/j.ijpsycho.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/30/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
There is growing evidence of beneficial effects of mindfulness developed through engaging in mindfulness training/practices on sensory and cognitive processing, emotion regulation and mental health. Mindfulness has also been conceptualised as a dispositional 'trait', i.e. the naturally-occurring ability of meditation-naïve individuals to display, in varying degree, a non-judgmental non-reactive present-moment awareness in everyday life. In this study we examined possible associations between dispositional mindfulness, alexithymia and sensory processing. Eye-blink startle responses to acoustic stimuli of varying intensity [90-dB or 100-dB over 70-dB (A) background] were assessed in 26 meditation-naïve adults (50 % men) using electromyographic recordings of the orbicularis muscle. All participants completed the Five Facet Mindfulness Questionnaire and the 20-item Toronto Alexithymia Scale. A negative association was found between dispositional mindfulness and alexithymia (r = -0.513). There was stronger startle habituation to 100-dB, compared to 90-dB probes. Stronger startle habituation (larger negative habitation slope values) to 100-dB probes was significantly associated with higher dispositional mindfulness (r = -0.528) and with lower alexithymia at trend level (r = 0.333). As indicated by commonality analysis, 10.6 % of explained variance in habituation (100-dB probes) was common to both alexithymia and mindfulness, 17.3 % was unique to mindfulness, but alexithymia made negligible unique contribution (0.5 %). These findings indicate similar startle habituation pattern in people with a high level of dispositional mindfulness to that reported previously by Antonova et al. (2015) in people with moderate mindfulness meditation practice intensity. Future studies should investigate the mechanisms, such as interoceptive awareness, that might underly these relationships.
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Affiliation(s)
- V Kumari
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK.
| | - E Antonova
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - S Mahmood
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - M Shukla
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, India
| | - A Saifullah
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - R Pandey
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, India
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How induced self-focus versus other-focus affect emotional recognition and verbalization. JOURNAL OF CULTURAL COGNITIVE SCIENCE 2021. [DOI: 10.1007/s41809-021-00091-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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6
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The relationship between blood pressure regulation and alexithymia variability in newly diagnosed essential hypertension patients. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.819228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Reuille-Dupont S. Applications of somatic psychology: movement and body experience in the treatment of dissociative disorders. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2021. [DOI: 10.1080/17432979.2020.1844295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Arroyo-Anlló EM, Souchaud C, Ingrand P, Chamorro Sánchez J, Melero Ventola A, Gil R. Alexithymia in Alzheimer's Disease. J Clin Med 2020; 10:jcm10010044. [PMID: 33375608 PMCID: PMC7795069 DOI: 10.3390/jcm10010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Alexithymia is widely recognized as the inability to identify and express emotions. It is a construct which consists of four cognitive traits such as difficulty in identifying feelings, describing feelings to others, externally oriented thinking, and limited imaginative capacity. Several studies have linked alexithymia to cognitive functioning, observing greater alexithymia scores associated with poorer cognitive abilities. Despite Alzheimer's disease (AD) being a neurodegenerative pathology characterized by cognitive troubles from the early stages, associated to behavioral and emotional disturbances, very few investigations have studied the alexithymia in AD. These studies have shown that alexithymia scores-assessed with Toronto Alexithymia Scale (TAS)-were greater in AD patients than healthy participants. The objective of the study was to investigate if the alexithymia was present in patients with mild AD. We hypothesized that the AD group would show more alexithymia features than the control group. We evaluated 54 subjects, including 27 patients diagnosed with mild AD and 27 normal healthy controls, using the Shalling Sifneos Psychosomatic Scale (SSPS-R) and a neuropsychological test battery. Using non-parametric statistical analyses-Wilcoxon and Mann-Whitney U tests-we observed that the SSPS-R scores were similar in the AD and control groups. All participants showed SSPS-R scores below to 10 points, which means no-alexithymia. We did not find significant correlations between SSPS-R scores and cognitive variables in both groups (p > 0.22), but we observed a negative association between name abilities and alexithymia, but it does not reach to significance (p = 0.07). However, a significant correlation between SSPS-R score and mood state, assessed using Zerssen Rating Scale, was found in both groups (p = 0.01). Because we did not find a significant difference in the alexithymia assessment between both subject groups, pot hoc analyses were computed for each item of the SSPS-R. We made comparisons of alexithymic responses percentages in each SSPS-R item between AD and control groups, using Fisher's test. We observed that AD patients produced more alexithymic responses in some items of SSPS-R test than the control group, particularly about difficulties to find the words to describe feelings, as well as difficulties of imagination capacity and externally oriented thinking. The present results do not confirm our hypothesis and they do not support the results of previous studies revealing great alexithymia in AD.
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Affiliation(s)
- Eva Mª Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-629460944
| | - Corinne Souchaud
- Department of Neurology and Neuropsychology, University Hospital, CHU La Milétrie, 86000 Poitiers, France;
| | - Pierre Ingrand
- Department of Biostatistics, University of Poitiers, 86000 Poitiers, France;
| | - Jorge Chamorro Sánchez
- Faculty of Psychology, Pontifical University of Salamanca, 37002 Salamanca, Spain; (J.C.S.); (A.M.V.)
| | - Alejandra Melero Ventola
- Faculty of Psychology, Pontifical University of Salamanca, 37002 Salamanca, Spain; (J.C.S.); (A.M.V.)
| | - Roger Gil
- Department of Neurology, University Hospital, 86000 Poitiers, France;
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Casagrande M, Favieri F, Langher V, Guarino A, Di Pace E, Germanò G, Forte G. The Night Side of Blood Pressure: Nocturnal Blood Pressure Dipping and Emotional (dys)Regulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238892. [PMID: 33265925 PMCID: PMC7729863 DOI: 10.3390/ijerph17238892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
Introduction: The dipping phenomenon is a physiological drop in blood pressure (around 10-20%) during sleep and represents an event related to the circadian blood pressure trend. This phenomenon, in some cases, is characterized by some alterations that can be expressed by an increase (extreme dipping), a decrease (non-dipping), or a reverse (i.e., higher blood pressure during sleep compared to awake state; reverse-dipping) physiological decline of blood pressure. Few studies focused on the association between the circadian variation of blood pressure and psychological variables, although this information could help understanding how psychological characteristics (e.g., emotional regulation or dysregulation) interact with individuals' physiological processes. Given the association between emotional dysregulation and essential hypertension, this study aimed to investigate the relationship between alexithymia and dipping status in a sample of healthy and hypertensive adults in the absence of other medical conditions. Methods: Two hundred and ten adults took part in the study and were classified, according to ambulatorial blood pressure measure (ABPM), into three groups: dippers (n = 70), non-dippers (n = 70), and extreme dippers (n = 70). The participants completed a socio-demographic and anamnestic interview and the Toronto Alexithymia Scale-20 (TAS-20). Results: The ANOVAs on the TAS-20 subscales showed that the groups differed in the difficulty identifying feelings and difficulty describing feelings. In both the subscales, dippers showed lower scores than non-dippers and extreme dippers. The ANOVA on the global score of TAS-20 confirmed that dippers were less alexithymic than both extreme dippers and non-dippers. Conclusions: This study confirms that some psychological factors, like alexithymia, could represent a characteristic of patients who fail to exhibit an adaptive dipping phenomenon. Moreover, an association between an excessive reduction of BP (extreme dipping) or a lack of the decrease of BP during sleep (non-dipping) and a worse emotional regulation, considering alexithymia construct, was highlighted for the first time, confirming the relevant role of the emotional process in the modulation of an essential psychophysiological process such as the circadian variation of BP.
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Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma “Sapienza”, 00185 Roma, Italy;
- Correspondence:
| | - Francesca Favieri
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Viviana Langher
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma “Sapienza”, 00185 Roma, Italy;
| | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Enrico Di Pace
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
| | - Giuseppe Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma “Sapienza”, 00815 Roma, Italy;
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma “Sapienza”, 00185 Roma, Italy; (F.F.); (A.G.); (E.D.P.); (G.F.)
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Aluja A, Malas O, Urieta P, Worner F, Balada F. Biological correlates of the Toronto Alexithymia Scale (TAS-20) in cardiovascular disease and healthy community subjects. Physiol Behav 2020; 227:113151. [PMID: 32841673 DOI: 10.1016/j.physbeh.2020.113151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/24/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022]
Abstract
This research studies the relationship between Alexithymia, behavioural, biometric, biochemical and cardiovascular risk in clinical and healthy samples. There were 602 participants (mean age of 52.82 ± 10.59) divided into two groups. The first was made up of 202 patients (165 males and 37 females) who had suffered a cardiovascular disease (CVD), while the second was composed of 400 (285 males and 115 females) healthy volunteers without CVD diagnosis. A cardiovascular risk index (CRI) was developed with the high factorial loading of the following variables: systolic and diastolic blood pressure, total cholesterol/HDL, triglycerides, body mass index, glucose and alcohol and tobacco consumption. The results showed a significant correlation between Alexithymia and the CRI. After controlling for age, sex, occupation, alcohol and tobacco consumption, this correlation decreased, but remained significant for most values. Alexithymia predicted 6% of CRI in the entire sample, once age and sex effect were discounted. Alexithymic subjects with scores above a cut-off point set at higher than 60 had higher levels of glucose, systolic, diastolic, cholesterol/HDL and cardiovascular risk. We discuss that Alexithymia scores contribute to cardiovascular risk, supporting previous findings.
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Affiliation(s)
- Anton Aluja
- University of Lleida, Catalonia, Spain; Institute of Biomedical Research, Lleida, Catalonia, Spain.
| | - Olga Malas
- Institute of Biomedical Research, Lleida, Catalonia, Spain
| | - Patricia Urieta
- University of Lleida, Catalonia, Spain; Institute of Biomedical Research, Lleida, Catalonia, Spain
| | - Fernando Worner
- Institute of Biomedical Research, Lleida, Catalonia, Spain; Cardiology Service of the Hospital Arnau de Vilanova de Lleida, Spain
| | - Ferran Balada
- Institute of Biomedical Research, Lleida, Catalonia, Spain; Universitat Autònoma de Barcelona. Catalonia. Spain
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Dobrushina OR, Arina GA, Dobrynina LA, Suslina AD, Solodchik PO, Belopasova AV, Gubanova MV, Sergeeva AN, Kremneva EI, Krotenkova MV. The ability to understand emotions is associated with interoception‐related insular activation and white matter integrity during aging. Psychophysiology 2020; 57:e13537. [DOI: 10.1111/psyp.13537] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/17/2019] [Accepted: 01/11/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Olga R. Dobrushina
- Third Neurological Department Research Center of Neurology Moscow Russia
| | - Galina A. Arina
- Faculty of Psychology M.V. Lomonosov Moscow State University Moscow Russia
| | | | | | | | | | - Mariia V. Gubanova
- Third Neurological Department Research Center of Neurology Moscow Russia
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12
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The Night Effect of Anger: Relationship with Nocturnal Blood Pressure Dipping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082705. [PMID: 32326399 PMCID: PMC7216280 DOI: 10.3390/ijerph17082705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
Introduction: The circadian pattern of blood pressure is characterized by a physiological drop occurring after sleep onset. The alteration of this phenomenon (non-dipping, extreme dipping, or reverse dipping) is associated with an increased cardiovascular risk. Besides altered autonomic and endocrine circadian rhythms, psychological aspects seem to play a role in this modification. However, the few studies that have analyzed the influence of psychological dimensions on the dipping phenomenon have reported inconsistent results. This study aimed to examine the relationship between anger expression and blood pressure (BP) dipping. Methods: We obtained 24 h ambulatory BP measurements from 151 participants and used them to define three groups according to their dipping status: Dippers (N = 65), Non-Dippers (N = 42), and Extreme Dippers (N = 44). Sociodemographic and anamnestic information was collected, and the State–Trait Anger Expression Inventory was used to assess anger. Results: Analysis of variance evidenced significant higher scores for Trait Anger Temperament and Anger Expression in Extreme Dippers than in both Dippers and Non-Dippers. However, after controlling for confounding variables, there was no significant relationship with trait anger, and only the result concerning the suppression of anger was confirmed. Conclusions: These findings suggest that the analysis of some psychological factors, such as anger, could be necessary to better understand differences in nocturnal BP alterations. Trait anger and suppression of anger may contribute to the description and classification of patients who exhibit a maladaptive dipping phenomenon. However, modifiable (i.e., cigarette consumption) and unmodifiable (i.e., age) risk factors appear to mediate this relationship. Although further studies are necessary to explore this association, these results highlight that some aspects of anger can represent risk factors or markers of maladaptive modulation of the dipping phenomenon.
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Guidi J, Lucente M, Piolanti A, Roncuzzi R, Rafanelli C, Sonino N. Allostatic overload in patients with essential hypertension. Psychoneuroendocrinology 2020; 113:104545. [PMID: 31862612 DOI: 10.1016/j.psyneuen.2019.104545] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
The role of psychosocial stress in the development of essential hypertension has attracted increasing attention in the last decades, even though research findings have been often inconclusive. We specifically investigated allostatic overload (AO) in hypertensive patients using a clinimetric approach. Allostatic overload was assessed by a semi-structured research interview based on clinimetric criteria in 80 consecutive outpatients with essential hypertension (46.3 % females; mean age 62.18 ± 8.59 years; age range 47-74 years) and 80 normotensive matched controls. Three clinical interviews and two self-rating questionnaires for assessing psychological distress and well-being were also administered. Cardiac variables were collected. AO was present in 26 (32.5 %) of the hypertensive patients based on clinical interviewing, and in only 6 normotensive controls (p < .001). Hypertensive patients with AO had significantly higher levels of psychological distress than those without. Further, patients with AO displayed significantly lower levels of well-being and quality of life (p < .001). A significantly greater prevalence of psychosomatic syndromes was found to be associated with the presence of AO (p < .05), whereas no significant association was detected as to psychiatric diagnoses. Significantly greater cardiovascular risk was found among hypertensive patients reporting AO compared to those without (p < .05). The results of this study support the clinical relevance of a psychological assessment of hypertensive patients, with important implications for the non-pharmacological management of hypertension.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy.
| | | | | | - Renzo Roncuzzi
- Division of Cardiology, Bellaria Hospital, Bologna, Italy
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy; Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
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Laskoski PB, Serralta FB, Barros AJS, Teche SP, Hauck S, Eizirik CL. From Soma To Psyche: An Outcome Evaluation Of Psychodynamic Psychotherapy In A Patient With Somatic Symptoms And Chronic Diseases. BRITISH JOURNAL OF PSYCHOTHERAPY 2020. [DOI: 10.1111/bjp.12523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Casagrande M, Mingarelli A, Guarino A, Favieri F, Boncompagni I, Germanò R, Germanò G, Forte G. Alexithymia: A facet of uncontrolled hypertension. Int J Psychophysiol 2019; 146:180-189. [PMID: 31639379 DOI: 10.1016/j.ijpsycho.2019.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Proper control of blood pressure reduces the risk of developing cardiovascular and cerebrovascular complications in hypertensive people. However, this control remains mostly unsatisfactory. Although alexithymia has been associated with essential hypertension, no study has analysed the relationship between alexithymia and blood pressure control in drug-treated hypertension. This research aimed to analyse the presence and the characteristics of this relationship, considering both the pharmacological treatment and the achievement of adequate maintenance of blood pressure in a physiological range. METHOD One thousand two hundred and forty-one people participated in the study. Eight hundred and ten were hypertensive patients, and four hundred and thirty-one were normotensive people. The Toronto Alexithymia Scale-20 was used to assess alexithymia. RESULTS Results show that hypertensive people are more alexithymic than normotensive people. According to the presence of pharmacological treatment, treated hypertensive patients are more alexithymic than normotensive and not treated hypertensive patients. Considering the blood pressure control associated with the drug-therapy, people with uncontrolled hypertension are more alexithymic than normotensive and untreated hypertensive people. CONCLUSIONS These findings confirm a relationship between alexithymia and essential arterial hypertension, but they also highlight that alexithymia appears to be associated with higher severity of hypertension. Alexithymia could be a facet of uncontrolled hypertension.
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Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma "Sapienza", Italy.
| | | | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma "Sapienza", Italy
| | | | | | - Rosanna Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma "Sapienza", Italy
| | - Giuseppe Germanò
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche e Geriatriche, Università di Roma "Sapienza", Italy
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma "Sapienza", Italy
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Piotrowska-Półrolnik M, Holas P, Krejtz I, Symonides B. Relationship between alexithymia and variability of blood pressure measured with ABPM in hypertensive patients. Gen Hosp Psychiatry 2019; 60:1-5. [PMID: 31229676 DOI: 10.1016/j.genhosppsych.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/17/2019] [Accepted: 04/23/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Studies indicates that dysregulation of emotions plays an important role in the etiology of elevated blood pressure (BP). One of the signatures of emotional dysregulation is alexithymia defined as an impaired ability to experience and express emotions. Previous work indicated that primary hypertension (HT) is marked by higher alexithymia, but little research examined the relationship between alexithymia and variability of evaluated BP with 24 h Ambulatory Blood Pressure Monitoring (ABPM) in HT patients. METHOD Fifty-five participants diagnosed with hypertension and a matched group of thirty-nine healthy participants filled in The Toronto Alexithymia Scale (TAS-20), a clinical-demographic questionnaire, and were assessed with 24 h ABPM. RESULTS After removing those with white coat HT, as expected, hypertensive individuals had a higher total score and all three alexithymia subscales. Furthermore, alexithymia was positively correlated with average values of systolic BP. CONCLUSION These findings provided support for the contention that alexithymia is associated with elevated BP, the higher level of alexithymia the higher systolic BP in 24 h BP measurement. Future studies may examine the causal relationship between alexithymia and HT and evaluate the effectiveness of emotional regulation training interventions to reduce BP in people suffering from primary hypertension.
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Affiliation(s)
| | - Paweł Holas
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
| | - Izabela Krejtz
- Psychology Department, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Bartosz Symonides
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland
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An Initial Study of Alexithymia and Its Relationship With Cognitive Abilities Among Mild Cognitive Impairment, Mild Alzheimer's Disease, and Healthy Volunteers. J Nerv Ment Dis 2018; 206:628-636. [PMID: 30020208 DOI: 10.1097/nmd.0000000000000853] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present study examined the degree to which alexithymia is greater in mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) relative to healthy volunteers (healthy comparison [HC]), and investigated relationships between alexithymia and cognition. Eighty-five participants (MCI = 30, AD = 21, HC = 34) underwent a comprehensive neuropsychological examination and completed the 20-item Toronto Alexithymia Scale (TAS-20). Relative to HC, MCI and AD reported greater alexithymia total scores and higher scores on the TAS factor difficulty in identifying feelings (DIF). The remaining two factors, difficulty in describing feelings (DDF) and externally oriented thinking showed no significant group differences. In MCI, TAS-20 and DIF were negatively correlated with working and long-term verbal memory. In AD, TAS-20 was negatively correlated with general cognition, attention, memory, and visual spatial constructive and executive abilities. Also in AD, DIF was negatively correlated with general cognition, memory, and executive abilities. The correlation between DIF and long-term verbal memory in both MCI and AD suggests a potential common mechanism for alexithymia in these neurocognitive disorders. Declines in verbal memory may hinder a patient's ability to recall an association between a given sensation and the episodic experience of that sensation, thus leading to difficulty identifying feelings, as measured by the DIF factor of the TAS-20.
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Association Between Alexithymia and Risk of Incident Cardiovascular Diseases in the SUpplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) Cohort. Psychosom Med 2018; 80:460-467. [PMID: 29649036 DOI: 10.1097/psy.0000000000000592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although it has been suggested that alexythymia is associated with cardiovascular diseases, studies are scarce and a causal relationship is questionable. This study explored the prospective association between alexithymia and cardiovascular events in middle-aged participants without cardiovascular history at baseline. METHODS The 26-item Toronto Alexithymia Scale (TAS-26) was completed by 5586 participants of the French SUpplémentation en VItamines et Minéraux AntioXydants cohort (41.4% of men, M [SD] age = 52.2 [6.3] years) in 1996-1997. Covariates measured at baseline included age, occupational status, depressive symptoms, smoking status, body mass index, hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia. The follow-up ran from January 1, 1998, to the date of the first cardiovascular event, the date of death or September 1, 2007, whichever occurred first. Cardiovascular events were validated by an independent expert committee. Hazard ratios and 95% confidence intervals were computed with Cox regressions. RESULTS During an average of 8.9 years of follow-up, 171 first cardiovascular events were validated. After adjustment for age, sex, and occupational status, there was no association between baseline alexithymia and cardiovascular events at follow-up (hazard ratio [95% confidence interval] for 15 points of TAS-26 = 1.00 [0.81-1.23], p > .99). Adjusting for all covariates, using binary TAS-26 cut-offs or TAS-26 subscores yielded similar nonsignificant results. CONCLUSIONS In this large prospective study, alexithymia and cardiovascular events were not associated among a nonclinical population. This casts some doubt on whether alexithymia could be a meaningful target in the prevention of cardiovascular diseases. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov (NCT00272428).
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Carrozzino D, Porcelli P. Alexithymia in Gastroenterology and Hepatology: A Systematic Review. Front Psychol 2018; 9:470. [PMID: 29681874 PMCID: PMC5897673 DOI: 10.3389/fpsyg.2018.00470] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/21/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation. Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies. Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10-15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings. Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes.
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Affiliation(s)
- Danilo Carrozzino
- Department of Psychological, Health and Territorial Sciences, University “G.d'Annunzio” of Chieti-Pescara, Chieti, Italy
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - Piero Porcelli
- Department of Psychological, Health and Territorial Sciences, University “G.d'Annunzio” of Chieti-Pescara, Chieti, Italy
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Ogrodniczuk JS, Kealy D, Joyce AS, Abbass AA. Body talk: Sex differences in the influence of alexithymia on physical complaints among psychiatric outpatients. Psychiatry Res 2018; 261:168-172. [PMID: 29309955 DOI: 10.1016/j.psychres.2017.12.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/19/2017] [Accepted: 12/30/2017] [Indexed: 11/16/2022]
Abstract
This study investigated the relationship between alexithymia and physical complaints among psychiatric outpatients, and whether sex moderated this relationship. Participants (N = 185) completed measures of physical complaints (bodily symptom burden, pain severity, pain interference), alexithymia, current symptom (depression, anxiety) distress, and somatosensory amplification (i.e., a person's tendency to be bothered by physical sensations). Hierarchical regression analyses were conducted, controlling for the influence of current psychiatric symptom distress and somatosensory amplification. Findings revealed differential relationships between alexithymia and physical complaints (pain interference) for women and men, in addition to main effects for sex and alexithymia. The findings suggest that the negative influence of alexithymia on bodily-related problems may not be universal.
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Affiliation(s)
- John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, Canada.
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Anthony S Joyce
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Allan A Abbass
- Department of Psychiatry, Dalhousie University, Halifax, Canada
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Yuruyen M, Akcan FE, Batun GC, Gultekin G, Toprak M, Yavuzer H, Emul M. Alexithymia in people with subjective cognitive decline, mild cognitive impairment, and mild Alzheimer's disease. Aging Clin Exp Res 2017; 29:1105-1111. [PMID: 28110464 DOI: 10.1007/s40520-017-0725-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Behavioral and psychological symptoms are widely accepted as accelerator factors in progression to dementia. Although alexithymia is closely related to normal aging process and poor neurocognitive performance, alexithymia has not been included in these symptoms yet. AIMS Here, we aimed to investigate alexithymia features in people with prominent clinical memory complaints. METHODS The participants (n = 82) were classified into three groups as: subjective cognitive decline (n = 30), mild cognitive impairment (n = 27), and mild Alzheimer's disease (n = 25) after Mini-Mental State Examination, Clinical Dementia Rating Scale, neuropsychological test battery, Geriatric Depression Scale, and Hachinski Ischemic Scale. All participants were assessed with 20-item Toronto Alexithymia Scale. RESULTS The patients with mild Alzheimer's disease and mild cognitive impairment have significantly greater alexithymia features than individuals with subjective cognitive decline in Toronto Alexithymia Scale (p < 0.05 for all). The alexithymia features in patients with mild Alzheimer's disease and mild cognitive impairment did not significantly differ (p > 0.05, for all). DISCUSSION People who have objective cognitive decline seem to have more alexithymia features than people with subjective cognitive decline. Moreover, alexithymia features seem to be similar in people mild Alzheimer's disease and in mild cognitive impairment. CONCLUSION Alexithymia might be an important searching domain of behavioral-psychological symptoms in people with cognitive problems beyond aging.
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Chen L, Xu L, You W, Zhang X, Ling N. Prevalence and associated factors of alexithymia among adult prisoners in China: a cross-sectional study. BMC Psychiatry 2017; 17:287. [PMID: 28768497 PMCID: PMC5541430 DOI: 10.1186/s12888-017-1443-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/24/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prison is an extremely stressful environment and prisoners have an increasing risk of suffering from alexithymia. Therefore, this study aims to investigate the prevalence and associated factors of alexithymia among prisoners in China. METHODS A cross-sectional study was conducted in five main jails of the district of Zhejiang province in China, and a total of 1705 adult prisoners ultimately took part in the study. Toronto Alexithymia Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale and several short demographic questions were applied. RESULTS Over 30% of prisoners were classified as alexithymics and as high as 96.2% of prisoners suffered from at least one traumatic experience in their childhood, meanwhile, 81.5%, 53.4% and 85.8% were found to be positive for depression, anxiety and hopelessness symptoms respectively. Education, childhood trauma, negative emotional symptoms including depression, anxiety and hopelessness of the respondents, were negatively or positively associated with alexithymia among prisoners. CONCLUSIONS The results indicated that high prevalence of alexithymia among prisoners is linked with their level of education, experience of childhood trauma and symptoms of negative emotions. Accordingly, the findings in our study can be used for prevention and intervention of alexithymia among prisoners.
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Affiliation(s)
- Li Chen
- Department of Applied Psychology, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Linna Xu
- 0000 0001 2151 7947grid.265850.cDepartment of Economics, University at Albany, State University of New York, Albany, NY USA
| | - Weimin You
- Public Security Sub-Bureau of Huangyan, Taizhou Public Security Bureau, Huangyan, China
| | - Xiaoyan Zhang
- 0000 0004 1764 2632grid.417384.dDepartment of Children’s Health Care, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Cardiovascular Responses Associated with the Moving Beans Task: Influence of Psychological Characteristics. J Stroke Cerebrovasc Dis 2017; 26:2013-2018. [PMID: 28666804 DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/01/2017] [Accepted: 06/04/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE High blood pressure (BP) after stroke is associated with a poor outcome. However, exercise training or speech therapy for patients with stroke can raise the BP. The aim of this study was to examine cardiovascular responses during the moving beans task (MBT) used in occupational therapy and to study the influence of psychological characteristics on cardiovascular responses during this task in healthy subjects. MATERIALS AND METHODS In 34 healthy volunteers, the BP and the heart rate (HR) were continuously measured during the baseline period, the 5-minute MBT, and the 1-minute cold pressor test (CPT). All subjects completed self-reported questionnaires, including the Center for Epidemiologic Studies Depression Scale (CES-D), the State Trait Anxiety Inventory Y-2, and the Japanese version of the 20-item Toronto Alexithymia Scale (TAS-20). RESULTS The systolic blood pressure (SBP), the diastolic blood pressure (DBP), and the mean blood pressure (MBP) significantly increased during the MBT and the CPT compared with the baseline values. SBP, DBP, and MBP responses during the MBT significantly correlated with the TAS-20 scores. Moreover, DBP response during the MBT correlated with the CES-D scores. CONCLUSIONS The MBT significantly raised BP without increasing the HR. BP responses during this task were influenced by the psychological characteristics of depression and alexithymia.
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Living alone and activation of the renin-angiotensin-aldosterone-system: Differential effects depending on alexithymic personality features. J Psychosom Res 2017; 96:42-48. [PMID: 28545792 DOI: 10.1016/j.jpsychores.2017.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Living alone is considered as a chronic stress factor predicting different health conditions and particularly cardiovascular disease (CVD). Alexithymia is associated with increased psychological distress, less social skills and fewer close relationships, making alexithymic subjects particularly susceptible to chronic stress imposed by "living alone". Only few studies investigated the renin-angiotensin-aldosterone-system (RAAS) activity in response to chronic stress. We aimed at evaluating the effects of "living alone" as a paradigm for chronic stress on RAAS activity and putatively differential effects depending on alexithymic personality features. METHODS Alexithymia and serum concentrations of renin and aldosterone were measured in 944 subjects from the population-based SHIP-1 study. Subgroups were formed using the median of the Toronto Alexithymia Scale-20 (TAS-20) and a cohabitation status of "living alone" or "living together". Analyses were adjusted for various psychosocial, behavioral and metabolic risk factors. RESULTS "Living alone" was associated with elevated plasma renin (p<0.01, β=0.138) but not aldosterone concentrations in the total sample. On subgroup level, we found associations of "living alone" and elevated renin concentrations only in subjects low in TAS-20 scores (p<0.01, β=0.219). Interactional effects of alexithymia×cohabitation status were found for the aldosterone-to-renin ratio (p=0.02, β=-0.234). CONCLUSIONS The association of chronic stress imposed by "living alone" with increased RAAS activity contributes to explain the relationship of this psychosocial stress condition and increased risk for CVD. In contrast, alexithymic subjects may be less affected by the deleterious effects of "living alone".
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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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Taylor GJ, Bagby RM, Parker JD. What’s in the name ‘alexithymia’? A commentary on “Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud’s legacy.”. Neurosci Biobehav Rev 2016; 68:1006-1020. [DOI: 10.1016/j.neubiorev.2016.05.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/20/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
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The association between depression and craving in alcohol dependency is moderated by gender and by alexithymia factors. Psychiatry Res 2016; 239:28-38. [PMID: 27137959 DOI: 10.1016/j.psychres.2016.02.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 02/04/2016] [Accepted: 02/27/2016] [Indexed: 01/17/2023]
Abstract
Alexithymia is a multifaceted personality trait that involves difficulties in identifying and describing feelings to others, a poor fantasy life and an externally oriented cognitive style. Alexithymia has been described as a vulnerability factor for mental and physical diseases. We investigated in a group of 158 alcohol-dependent patients (103 men, 55 women) the association between depression and craving for alcohol when these patients were starting a detoxification program, and the moderating impact of gender and alexithymia on this relation. We first found an interaction between depression and gender in the prediction of craving in the sense that only for women an increase in depressive mood was related to an increase in total craving. When examining gender separately, we found that alexithymia factors acted as moderators. For women, the link between depression and craving was strengthened for the ones scoring higher on "difficulties describing feelings". But for men, the link between depression and craving was reduced for the ones scoring higher on "externally-oriented thinking". These findings suggest that in some cases that need to be identified more systematically in the future, the "externally-oriented thinking" alexithymia factor can exert - at least in the short term - some protective effects.
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Karukivi M, Jula A, Hutri-Kähönen N, Juonala M, Raitakari O. Is alexithymia associated with metabolic syndrome? A study in a healthy adult population. Psychiatry Res 2016; 236:58-63. [PMID: 26747214 DOI: 10.1016/j.psychres.2015.12.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/10/2015] [Accepted: 12/25/2015] [Indexed: 11/16/2022]
Abstract
Metabolic syndrome (MetS) is a constellation of risk factors for, in particular, cardiovascular diseases and increased mortality, and it constitutes a major clinical challenge affecting millions of lives. Alexithymia is a condition that has been linked with several mental diseases and symptoms, as well as somatic illnesses, including essential hypertension and diabetes mellitus. However, there is limited research on the association of alexithymia and MetS. The aim of the present study was to comprehensively explore this association in a large (n=1648) non-clinical sample of adults. Logistic regression analyses were applied to the five separate MetS components as well as the MetS diagnosis, and the analyses included a number of sociodemographic variables and depressive symptoms as covariates. The results confirmed the previous finding of alexithymic features being independently and significantly associated with hypertension. As a new finding, this association appears to be related to two particular dimensions of alexithymia, namely difficulty describing feelings and externally oriented thinking. Interestingly, alexithymic features were also separately significantly associated with waist circumference and triglycerides as well as the MetS diagnosis. Depressive symptoms did not have any significant effect on the relations of alexithymia and MetS.
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Affiliation(s)
- Max Karukivi
- Department of Psychiatry, University of Turku, Turku, Finland; Psychiatric Care Division, Satakunta Hospital District, Harjavalta, Finland.
| | - Antti Jula
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Francoeur RB. Symptom profiles of subsyndromal depression in disease clusters of diabetes, excess weight, and progressive cerebrovascular conditions: a promising new type of finding from a reliable innovation to estimate exhaustively specified multiple indicators-multiple causes (MIMIC) models. Diabetes Metab Syndr Obes 2016; 9:391-416. [PMID: 28003768 PMCID: PMC5158170 DOI: 10.2147/dmso.s118432] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Addressing subsyndromal depression in cerebrovascular conditions, diabetes, and obesity reduces morbidity and risk of major depression. However, depression may be masked because self-reported symptoms may not reveal dysphoric (sad) mood. In this study, the first wave (2,812 elders) from the New Haven Epidemiological Study of the Elderly (EPESE) was used. These population-weighted data combined a stratified, systematic, clustered random sample from independent residences and a census of senior housing. Physical conditions included progressive cerebrovascular disease (CVD; hypertension, silent CVD, stroke, and vascular cognitive impairment [VCI]) and co-occurring excess weight and/or diabetes. These conditions and interactions (clusters) simultaneously predicted 20 depression items and a latent trait of depression in participants with subsyndromal (including subthreshold) depression (11≤ Center for Epidemiologic Studies Depression Scale [CES-D] score ≤27). The option for maximum likelihood estimation with standard errors that are robust to non-normality and non-independence in complex random samples (MLR) in Mplus and an innovation created by the author were used for estimating unbiased effects from latent trait models with exhaustive specification. Symptom profiles reveal masked depression in 1) older males, related to the metabolic syndrome (hypertension-overweight-diabetes; silent CVD-overweight; and silent CVD-diabetes) and 2) older females or the full sample, related to several diabetes and/or overweight clusters that involve stroke or VCI. Several other disease clusters are equivocal regarding masked depression; a couple do emphasize dysphoric mood. Replicating findings could identify subgroups for cost-effective screening of subsyndromal depression.
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Affiliation(s)
- Richard B Francoeur
- School of Social Work, Adelphi University, Garden City, NY, USA
- Correspondence: Richard B Francoeur, School of Social Work, Social Work Building, Adelphi University, 1 South Avenue, Garden City, NY 11530, USA, Tel +1 917 254 7271, Email
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Karukivi M, Tolvanen M, Karlsson L, Karlsson H. Is alexithymia linked with marital satisfaction or attachment to the partner? A study in a pregnancy cohort of parents-to-be. Compr Psychiatry 2014; 55:1252-7. [PMID: 24813790 DOI: 10.1016/j.comppsych.2014.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate possible associations of alexithymia with marital satisfaction and mutual attachment between the partners in a group of parents-to-be during pregnancy. METHODS The present study was conducted in a pregnancy cohort. Cross-sectional data were available for 151 mothers and 106 fathers, and altogether 102 couples. The 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, the Index of Marital Satisfaction (IMS) to assess romantic relationship satisfaction and the Experiences in Close Relationships Scale (ECR) to evaluate attachment-related anxiety and avoidance. Kruskal-Wallis test was used for categorized variable comparisons. For continuous variables, Spearman correlation analyses and linear regression analyses were conducted. RESULTS The TAS-20 total score, as well as, two of its dimensions, difficulties in identifying and describing feelings, were significantly correlated (p<0.01) with both the IMS scores and the ECR anxiety and avoidance scores. In the regression analyses, the most significant predictive factor for the subjects' IMS scores was their partners' corresponding scores, although among fathers the IMS scores were partly explained by their own TAS-20 factor 1 scores (p=0.004). The subjects' own TAS-20 scores explained the ECR anxiety and avoidance scores to a significant extent, but the fathers' TAS-20 factor 3 scores were also associated with the mothers' avoidance scores (p=0.037). CONCLUSION Alexithymia was not directly related to marital satisfaction. However, alexithymia appears to have a significant effect on relationship-related anxiety and avoidance. This association should be further studied in parents and their offspring in a longitudinal setting.
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Affiliation(s)
- Max Karukivi
- Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland; Department of Psychiatry and FinnBrain Birth Cohort Study, University of Turku, Turku, Finland.
| | - Mimmi Tolvanen
- Institute of Clinical Medicine, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Institute of Clinical Medicine, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Hasse Karlsson
- Department of Psychiatry and FinnBrain Birth Cohort Study, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital, Turku, Finland
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Bujarborua D, Borooah S, Dhillon B. The stress response as a target for treatment of central serous chorioretinopathy. EXPERT REVIEW OF OPHTHALMOLOGY 2013. [DOI: 10.1586/17469899.2013.837298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Porcelli P, Guidi J, Sirri L, Grandi S, Grassi L, Ottolini F, Pasquini P, Picardi A, Rafanelli C, Rigatelli M, Sonino N, Fava GA. Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology, cardiology, oncology and dermatology. Gen Hosp Psychiatry 2013; 35:521-7. [PMID: 23664571 DOI: 10.1016/j.genhosppsych.2013.04.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/04/2013] [Accepted: 04/08/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria. METHOD Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis. RESULTS Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%). CONCLUSIONS The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.
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Affiliation(s)
- Piero Porcelli
- Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy.
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Emotional Dampening in Persons with Elevated Blood Pressure: Affect Dysregulation and Risk for Hypertension. Ann Behav Med 2013; 47:111-9. [DOI: 10.1007/s12160-013-9526-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Vieira RVDA, Vieira DC, Gomes WB, Gauer G. Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. J Headache Pain 2013; 14:18. [PMID: 23565860 PMCID: PMC3620425 DOI: 10.1186/1129-2377-14-18] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/13/2022] Open
Abstract
Background Migraine is a type of primary headache widely known for its impact on quality of life of patients. Although the psychological aspects of the disease are receiving increasing attention in current research, some of them, as alexithymia, are still seldom explored. This study aimed to provide evidence on the relationships between markers of depression, anxiety, alexithymia, self-reflection, insight and quality of life in migraine. Methods Forty female outpatients from a Brazilian specialized headache hospital service and a paired control group were compared. Results The results revealed that women with migraine had higher levels of depression, anxiety and alexithymia, and lower levels of quality of life, self-reflection and insight, compared to controls. Quality of life in women with migraine was predicted by levels of depression and one alexithymia factor (ability to express emotions and fantasies). A binary regression analysis between clinical and control groups revealed the migraine group to comprise individuals with high anxiety, low quality of life in the physical domain and the presence of a concrete thinking style. Conclusions The results highlight the relevance of considering psychological variables in the routine healthcare practices for migraine patients in general, while keeping steady attention to individual case features.
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Parruti G, Vadini F, Sozio F, Mazzott E, Ursini T, Polill E, Di Stefano P, Tontodonati M, Verrocchio MC, Fulcheri M, Calella G, Santilli F, Manzoli L. Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. PLoS One 2013; 8:e54555. [PMID: 23349927 PMCID: PMC3551818 DOI: 10.1371/journal.pone.0054555] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 12/12/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients. METHODOLOGY/PRINCIPAL FINDINGS HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure) and Carotid Plaques (CPs, focal thickening ≥1.5 mm) were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II), Type D personality (Distressed Personality or Type D) by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20). Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5%) attended IMT measurements; 201 (86.6%) attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4%) had CPs at baseline. Nineteen patients (9.5%) had ≥1 vascular event; 12 (6.0%) died due to such events (n = 4) or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression) and CPs (logistic regression). At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001), current smoking (p = 0.019) and alexithymia score≥50 (p = 0.013) were independently associated with vascular events. CONCLUSIONS/SIGNIFICANCE In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require confirmation from studies with larger sample size and longer follow-up.
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Affiliation(s)
- Giustino Parruti
- Unit of Infectious Diseases, Pescara General Hospital, Pescara, Italy.
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Eid P, Boucher S. Alexithymia and Dyadic Adjustment in Intimate Relationships: Analyses Using the Actor Partner Interdependence Model. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2012. [DOI: 10.1521/jscp.2012.31.10.1095] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alexithymia in Chinese chronic obstructive pulmonary disease (COPD) patients: the prevalence and related factors of alexithymia. Psychiatry Res 2012; 198:274-8. [PMID: 22401970 DOI: 10.1016/j.psychres.2011.10.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 07/17/2011] [Accepted: 10/24/2011] [Indexed: 11/21/2022]
Abstract
In this study, 53 Chinese COPD moderate outpatients and 50 health controls, matched for age, family income and education level, were recruited to assess the prevalence of Alexithymia and its relationship to socio-demographic factors and pulmonary function. Alexithymia was measured with 20-item Toronto Alexithymia Scale (TAS-20). The patients' socio-demographic variables and the forced expiratory volume in one second percentage of predicted (FEV(1)% predicted) were recorded. The results indicated that alexithymia was significantly more common in the Chinese COPD patients than in controls. Male patients presented higher TAS-20 total scores and externally oriented thinking (EOT) scores than the females. Elder age and higher family income were connected with the patients' lower TAS-20 indexes (except for difficulty identify feeling [DIF]). All the TAS-20 indexes were negatively associated with FEV(1)% predicted. These findings suggested that, in the management of COPD, alexithymia feature should not be ignored and the appropriate psychotherapeutic treatment for Alexithymia should be applied.
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Mann SJ. Psychosomatic research in hypertension: the lack of impact of decades of research and new directions to consider. J Clin Hypertens (Greenwich) 2012; 14:657-64. [PMID: 23031141 DOI: 10.1111/j.1751-7176.2012.00686.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Samuel J Mann
- Division of Nephrology and Hypertension, Department of Medicine, Weill/Cornell Medical Center, New York Presbyterian Hospital, New York, NY 10021,USA.
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Rafanelli C, Offidani E, Gostoli S, Roncuzzi R. Psychological correlates in patients with different levels of hypertension. Psychiatry Res 2012; 198:154-60. [PMID: 22386218 DOI: 10.1016/j.psychres.2011.09.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 06/20/2011] [Accepted: 09/17/2011] [Indexed: 11/18/2022]
Abstract
The evidence linking essential systemic arterial hypertension (SAH) with psychological characteristics remains equivocal. The aims of this study were to assess clinical and subclinical distress, psychosocial aspects and psychological well-being in treated hypertensive patients and to evaluate the psychosocial variables associated with higher levels of blood pressure according to guidelines for hypertension management. A consecutive series of 125 hypertensive patients were evaluated using both self- and observer-rated reliable measures. Generalized anxiety disorder, minor depression, demoralization and alexithymia were the most frequent diagnoses. Cluster analysis revealed an association of three distinct symptomatological groups such as the Anxiety-Depression, the Alexithymia and the Somatization groups, with different levels of hypertension. In particular, patients with moderate to severe hypertension were more frequently in the Anxiety-Depression and the Alexithymia groups, whereas the Somatization cluster has been shown to be associated with isolated systolic hypertension. The results provide new insight into the psychosocial characteristics among patients with different levels of SAH according to recent guidelines of the management of hypertension. They also outline the need to monitor the clinical course of hypertensive patients characterized by these specific clinical and subclinical psychological conditions.
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Affiliation(s)
- Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy.
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From Brain to Behavior: Hypertension's Modulation of Cognition and Affect. Int J Hypertens 2012; 2012:701385. [PMID: 22518290 PMCID: PMC3296233 DOI: 10.1155/2012/701385] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 10/24/2011] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence from animal models and human studies of essential hypertension suggest that brain regulation of the vasculature is impacted by the disease. Human neuroimaging findings suggest that the brain may be an early target of the disease. This observation reinforces earlier research suggesting that psychological factors may be one of the many contributory factors to the initiation of the disease. Alternatively or in addition, initial blood pressure increases may impact cognitive and/or affective function. Evidence for an impact of blood pressure on the perception and experience of affect is reviewed vis-a-vis brain imaging findings suggesting that such involvement in hypertensive individuals is likely.
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D'Andrea W, Sharma R, Zelechoski AD, Spinazzola J. Physical health problems after single trauma exposure: when stress takes root in the body. J Am Psychiatr Nurses Assoc 2011; 17:378-92. [PMID: 22142975 DOI: 10.1177/1078390311425187] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research has established that chronic stress, including traumatic events, leads to adverse health outcomes. The literature has primarily used two approaches: examining the effect of acute stress in a laboratory setting and examining the link between chronic stress and negative health outcomes. However, the potential health impact of a single or acute traumatic event is less clear. The goal of this literature review is to extend the literature linking both chronic trauma exposure and posttraumatic stress disorder to adverse health outcomes by examining current literature suggesting that a single trauma may also have negative consequences for physical health. The authors review studies on health, including cardiovascular, immune, gastrointestinal, neurohormonal, and musculoskeletal outcomes; describe potential pathways through which single, acute trauma exposure could adversely affect health; and consider research and clinical implications.
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The relationship between alexithymia and psychological factors in systemic lupus erythematosus. Compr Psychiatry 2011; 52:754-62. [PMID: 21193176 DOI: 10.1016/j.comppsych.2010.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Revised: 11/04/2010] [Accepted: 11/14/2010] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Alexithymia has been described as an important dimension in several medical diseases. Systemic lupus erythematosus (SLE) is a chronic condition characterized by unpredictable clinical manifestations. Our aim is to reveal which factors (psychological factors and quality of life dimensions) are associated with alexithymia in SLE patients. METHODS Fifty-three sequential SLE patients (ACR criteria) and 41 asthma patients were studied by means of validated scales for alexithymia (Toronto Alexithymia Scale), psychopathology (Brief Symptom Inventory, Hospital Anxiety and Depression Scale), personality dimensions (NEO-FFI), and quality of life (Short Form-36 Health Survey). Systemic lupus erythematosus patient's clinical and laboratorial evaluation was performed by indicators of activity (Systemic Lupus Erythematosus Disease Activity Index) of accumulated damage (Systemic Lupus International Collaborating Clinics/ACR Damage Index), length of disease, and therapy. RESULTS An association between alexithymia and psychopathological symptoms, and personality and quality of life dimensions was found. By means of multiple regression analysis, openness and depression were the 2 predictors for alexithymia in SLE patients. We found a high prevalence rate of alexithymia in SLE patients; however, when controlling for depression symptoms (Hospital Anxiety and Depression Scale-Depression, <7), we found a lower percentage of alexithymic traits than that of the total sample of SLE. CONCLUSION Alexithymia was associated with psychological distress and with quality of life impairment. Understanding the role of psychological factors in SLE patients may contribute to a more comprehensive perspective of the disease, its impact on patient's daily routine, and how patients adapt emotionally to a chronic disease.
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Konrath S, Grynberg D, Corneille O, Hammig S, Luminet O. On the social cost of interdependence: Alexithymia is enhanced among socially interdependent people. PERSONALITY AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.paid.2010.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
Consistent with the emotional changes associated with later life, higher alexithymia scores are widely reported in older adults, but their significance has not been fully examined. We posited that association between alexithymia and poorer neurocognition would support the deficit nature of alexithymia in later life. Widely used neurocognitive tests assessing the relative integrity of the left and right hemisphere functions were used to examine the extent to which alexithymia of older age is associated with poor left or right hemisphere functioning. Healthy community-dwelling volunteers (20 young and 20 elderly subjects) were studied with the 20-item Toronto Alexithymia Scale. Neurocognitive competence was assessed using a neuropsychological battery measuring attention, language, memory, visuospatial abilities, and executive functions. Neurocognitive abilities were strongly age-related and indirectly correlated with alexithymia. Alexithymia total score appeared to be uniquely predicted by Raven Matrices and Rey's Figure Recall. These results support the deficit hypothesis alexithymia of older age.
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Affiliation(s)
- MariaLuisa Onor
- Department of Clinical, Morphological and Technological Sciences—U.C.O. of Clinical Psychiatry—University of Trieste, Tireste, Italy
| | - Marianna Trevisiol
- Department of Clinical, Morphological and Technological Sciences—U.C.O. of Clinical Psychiatry—University of Trieste, Tireste, Italy
| | - Mariangela Spano
- Department of Clinical, Morphological and Technological Sciences—U.C.O. of Clinical Psychiatry—University of Trieste, Tireste, Italy
| | - Eugenio Aguglia
- Department of Clinical, Morphological and Technological Sciences—U.C.O. of Clinical Psychiatry—University of Trieste, Tireste, Italy
| | - Sergio Paradiso
- Department of Clinical, Morphological and Technological Sciences—U.C.O. of Clinical Psychiatry—University of Trieste, Tireste, Italy
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BAUSCH SANDRA, STINGL MARKUS, HARTMANN LUISAC, LEIBING ERIC, LEICHSENRING FALK, KRUSE JOHANNES, STARK RUDOLF, LEWEKE FRANK. Alexithymia and script-driven emotional imagery in healthy female subjects: no support for deficiencies in imagination. Scand J Psychol 2010; 52:179-84. [DOI: 10.1111/j.1467-9450.2010.00847.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Waldstein SR, Kauhanen J, Neumann SA, Katzel LI. Alexithymia and Cardiovascular Risk in Older Adults: Psychosocial, Psychophysiological, and Biomedical Correlates. Psychol Health 2010. [DOI: 10.1080/08870440290025803] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Differences in emotion processing in patients with essential and secondary hypertension. Am J Hypertens 2010; 23:515-21. [PMID: 20134404 DOI: 10.1038/ajh.2010.9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND An impaired ability to experience and express emotions, known as alexithymia, has previously been associated with hypertension. Alexithymia and related emotion-processing variables, however, have never been examined as a function of the type of hypertension, essential (EH) or secondary (SH). METHODS Our working hypothesis was that if dysregulated emotional processes play a key neurobiological role in EH, they would be less present in hypertension due to specific medical causes or SH. A total of 98 consecutive hypertensive patients (73 EH, 25 SH) with similar blood pressure levels completed two complementary measures of emotion processing: the 20-item Toronto Alexithymia Scale (TAS-20) and the Levels of Emotional Awareness Scale (LEAS). RESULTS After controlling for confounding variables, LEAS score was lower in EH than SH (estimated means: 46.4 vs. 52.0; P = 0.028; effect size 0.52). TAS-20 scores did not differentiate EH from SH, but the differences were in the expected direction, with an effect size of 0.34 for TAS-20 total score. Neither psychometric measure was associated with the duration of hypertension or the presence of cardiovascular (CV) complications. CONCLUSIONS These results are consistent with a contribution of an emotional or psychosomatic component in EH and may have practical implications for the nonpharmacological management of hypertension. They also demonstrate the utility of complementary measures of emotion processing in medically ill patients.
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Comparison of home and ambulatory blood pressure measurement in the diagnosis of masked hypertension. J Hypertens 2010; 28:709-14. [DOI: 10.1097/hjh.0b013e3283369faa] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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