|
1
|
Paradas O, Pradier S, Decilap M, Viaud A, Chibani L, De-Montaudouin M, Gradel A, Michel V, Aupy J. Prevalence and correlates of alexithymia in drug-resistant epilepsies. Epilepsy Behav 2025; 163:110222. [PMID: 39673991 DOI: 10.1016/j.yebeh.2024.110222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 12/09/2024] [Accepted: 12/09/2024] [Indexed: 12/16/2024]
Abstract
INTRODUCTION Alexithymia, characterized by difficulty identifying and expressing emotions, is commonly observed in individuals with psychiatric and neurological disorders. However, its prevalence in patients with epilepsy (PWE), particularly in those with drug-resistant epilepsy (DRE), remains under-researched. This study investigates the prevalence of alexithymia in patients with DRE and explores its associated factors. METHODS We conducted a retrospective observational study of 118 adult patients with focal DRE undergoing presurgical evaluation at Bordeaux University Hospital. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20), while psychiatric symptoms were evaluated with validated scales. Data on demographic characteristics, epilepsy duration, seizure frequency, antiepileptic drug use, and localization of the epileptogenic zone (EZ) were collected and analyzed using logistic regression models. RESULTS Alexithymia was identified in 40.7 % of patients. Depression and anxiety were significantly associated with alexithymia (p < 0.01), whereas no correlation was observed between alexithymia and the localization or lateralization of the EZ. DISCUSSION These findings suggest that alexithymia is prevalent among patients with DRE, with significant associations to depression and anxiety. The high prevalence of affective symptoms underscores the importance of early identification and intervention for alexithymia to improve outcomes in patients with DRE.
Collapse
Affiliation(s)
- O Paradas
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - S Pradier
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - M Decilap
- CHU de Bordeaux, Department of Public Health, Bordeaux, F-33000 Bordeaux, France
| | - A Viaud
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - L Chibani
- Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
| | - M De-Montaudouin
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - A Gradel
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - V Michel
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France
| | - J Aupy
- CHU de Bordeaux, Department of Clinical Neurosciences, F-33000 Bordeaux, France; Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France.
| |
Collapse
|
|
2
|
Hamdan HM, Alislimah G, Alshalawi H, Alharbi K, Alsaif MI, Sulimany AM. Prevalence of Alexithymia and Associated Factors Among Dental Students in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:2193. [PMID: 39517403 PMCID: PMC11545285 DOI: 10.3390/healthcare12212193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 10/19/2024] [Accepted: 11/01/2024] [Indexed: 11/16/2024] Open
Abstract
Background: Mental health challenges among university students are pervasive, with alexithymia posing a particularly significant yet understudied challenge. This condition significantly affects an individual's ability to cope with stress due to difficulties in recognizing, describing, and processing emotions. Objectives: This study aims to evaluate alexithymia prevalence and its associated factors among dental undergraduate students and interns enrolled at King Saud University in Riyadh, Saudi Arabia. Methods: Data were collected through a self-administered online survey that assessed alexithymia symptoms (using the Toronto Alexithymia Scale [TAS-20]), sociodemographic profiles, lifestyle-related factors, and health-related factors. The associations between participant factors and alexithymia were assessed using chi-square and multiple logistic regression analyses. Results: Of the 421 eligible participants, 369 completed the survey (87.6% response rate), revealing a significant prevalence of alexithymia (37.9%). Female gender (AOR = 1.7, p = 0.04), depression (AOR = 5.6, p < 0.0001), chronic diseases (AOR = 3.5, p = 0.003), and childhood abuse (AOR = 2.2, p = 0.047) were independent factors significantly associated with alexithymia. Conclusions: These findings highlight the pressing need for mental health support within dental education. Early interventions targeting alexithymia could mitigate its adverse consequences, promoting better student well-being and academic success.
Collapse
Affiliation(s)
- Hebah M. Hamdan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Ghaida Alislimah
- Dental Intern, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (G.A.); (H.A.)
| | - Hessa Alshalawi
- Dental Intern, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (G.A.); (H.A.)
| | - Khawlah Alharbi
- General Dentist, Center of Advanced Consultants in Healthcare Education and Training, Riyadh 13216, Saudi Arabia;
| | - Mohammed I. Alsaif
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Ayman M. Sulimany
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| |
Collapse
|
|
3
|
Chaim CH, Almeida TM, de Vries Albertin P, Santana GL, Siu ER, Andrade LH. The implication of alexithymia in personality disorders: a systematic review. BMC Psychiatry 2024; 24:647. [PMID: 39354408 PMCID: PMC11443833 DOI: 10.1186/s12888-024-06083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 09/13/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Alexithymia, characterized by difficulty identifying and expressing emotions, is often associated with various psychiatric disorders, including personality disorders (PDs). This study aimed to explore the relationship between alexithymia and PD, focusing on their common origins and implications for treatment. METHODS A systematic review was conducted following PRISMA guidelines using databases such as MEDLINE (PubMed), Scopus, and Web of Science. The inclusion criteria were studies assessing adults with DSM-5-diagnosed personality disorders using validated alexithymia scales. The Newcastle‒Ottawa Scale was used to assess the quality of the included studies. RESULTS From an initial yield of 2434 citations, 20 peer-reviewed articles met the inclusion criteria. The findings indicate a significant association between alexithymia and personality disorders, particularly within Clusters B and C. Patients with these disorders exhibited higher levels of alexithymia, which correlated with increased emotional dysregulation and interpersonal difficulties. The review also highlighted the comorbidity burden of conditions such as psychosomatic disorders, eating disorders, depression, anxiety, suicidal behavior, and substance use disorders. CONCLUSIONS These findings underscore the need for integrating alexithymia-focused assessments into clinical practice to enhance therapeutic approaches, allowing for more personalized and effective interventions. Addressing the emotional processing challenges in patients with personality disorders could significantly improve patient outcomes. Future research should prioritize establishing clinical guidelines and conducting longitudinal studies to explore the relationship between alexithymia and specific personality disorder subtypes, ensuring the practical translation of these findings into clinical practice.
Collapse
Affiliation(s)
- Carolina Hanna Chaim
- Núcleo de Epidemiologia Psiquiátrica, Instituto de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Thales Marcon Almeida
- Mental Health Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | | | - Geilson Lima Santana
- Núcleo de Epidemiologia Psiquiátrica, Instituto de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Erica Rosanna Siu
- Núcleo de Epidemiologia Psiquiátrica, Instituto de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica, Instituto de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
|
4
|
Brugnera A, Remondi C, La Tona A, Nembrini G, Lo Coco G, Compare A, Cardinali A, Scollato A, Marchetti F, Bonetti M, Pigozzi MG. Quality of Life and Its Psychosocial Predictors among Patients with Disorders of Gut-Brain Interaction: A Comparison with Age- and Sex-Matched Controls. Healthcare (Basel) 2024; 12:757. [PMID: 38610179 PMCID: PMC11011672 DOI: 10.3390/healthcare12070757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/07/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The disorders of gut-brain interaction (DGBIs) are a heterogeneous group of chronic conditions that greatly reduce patients' quality of life (QoL). To date, biopsychosocial factors (such as gastrointestinal symptoms, alexithymia, and interpersonal problems) are believed to contribute to the development and maintenance of DGBIs, but their role in affecting patients' QoL is still under investigation. Out of 141 patients seeking treatment for their gastrointestinal symptoms, 71 were diagnosed with a DGBI (47 females, 66.2%; Mage: 41.49 ± 17.23 years) and were age- and sex-matched to 71 healthy controls (47 females, 66.2%; Mage: 40.45 ± 16.38 years) without any current gastrointestinal symptom or diagnosis. Participants completed a sociodemographic and clinical questionnaire and a survey investigating several psychosocial risk factors. We found greater symptom severity and difficulties in identifying feelings among patients compared to controls. Further, multiple linear regression analyses evidenced that, among patients, higher expressive suppression of emotions, difficulties in identifying feelings and interpersonal problems, and a lower cognitive reappraisal of emotions predicted lower QoL. Data suggest that the QoL of patients with DGBIs is affected not only by common risk factors (e.g., interpersonal problems) but also by specific difficulties in processing and regulating emotions. The implications of these findings are discussed.
Collapse
Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Chiara Remondi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Antonino La Tona
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Greta Nembrini
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Gianluca Lo Coco
- Department of Psychological Sciences, University of Palermo, 90133 Palermo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | | | | | | | | | | |
Collapse
|
|
5
|
van Dijl TL, Aben HP, Synhaeve NE, de Waardt DA, Videler AC, Kop WJ. Alexithymia and facial emotion recognition in patients with functional neurological disorder. Clin Neurol Neurosurg 2024; 237:108128. [PMID: 38325039 DOI: 10.1016/j.clineuro.2024.108128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Patients with functional neurological disorder (FND) are known to have difficulties recognizing and processing emotions. Problems recognizing internal emotional states (alexithymia) are common in FND, but little is known about recognizing emotions expressed by other people. This study investigates whether patients with FND have higher levels of alexithymia and reduced facial emotion recognition compared to healthy controls. METHODS Patients with FND (n = 31, mean age=42.7 [SD=14.8] years, 54.8% women) were compared to healthy controls (n = 33, mean age=45.1 [SD=16.2] years, 63.6% women). The Bermond-Vorst Alexithymia Questionnaire (BVAQ) was used for the assessment of alexithymia and the Ekman 60 Faces Test (EFT) for facial emotion recognition. RESULTS Patients with FND had higher levels of alexithymia than healthy controls (BVAQ=71.8 [SD=19.8] versus 59.3 [SD=20.3], p = .02, Cohen's d=0.62). Facial emotion recognition did not significantly differ between FND patients and controls (EFT total score FND: 46.1 [SD=5.9], Controls: 47.5 [SD=5.5], p = .34, Cohen's d=0.24). Only recognition of surprise differed between patients and controls (FND: 8.4 [SD=1.8], Controls: 9.2 [SD=1.0), p = .03, Cohen's d= 0.56). Higher levels of alexithymia were associated with poorer facial emotion recognition, but this relationship was not statistically significant (FND: β= -0.20, p = .28; Controls: β=-0.03; p = .87). CONCLUSIONS The current data confirm prior observations that patients with FND have higher alexithymia levels than controls without FND. Difficulties recognizing emotions among patients with FND primarily involves recognition of internal emotional states rather than recognition of facially expressed emotions by others. These findings require replication in a larger and more divers sample.
Collapse
Affiliation(s)
- T L van Dijl
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department of Medical and Clinical Psychology, Center for Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, the Netherlands; Department of Psychiatry, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands; Department of Child and Adolescent Psychiatry, De Hoop ggz, Dordrecht, the Netherlands.
| | - H P Aben
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - N E Synhaeve
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - D A de Waardt
- Department of Psychiatry, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - A C Videler
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands
| | - W J Kop
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department of Medical and Clinical Psychology, Center for Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, the Netherlands
| |
Collapse
|
|
6
|
Torunsky NT, Knauz S, Vilares I, Marcoulides KM, Koutstaal W. What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 214:112308. [PMID: 37637074 PMCID: PMC10455047 DOI: 10.1016/j.paid.2023.112308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, t = 82.383, p < .01), experiential avoidance significantly predicted general distress (β = 0.810, t = 2.017, p < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (βindirect = -0.159, t = -0.398, p > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.
Collapse
Affiliation(s)
| | - Sara Knauz
- Department of Psychology, University of Minnesota – Twin Cities, USA
| | | | | | | |
Collapse
|
|
7
|
Van Bael K, Ball M, Scarfo J, Suleyman E. Assessment of the mind-body connection: preliminary psychometric evidence for a new self-report questionnaire. BMC Psychol 2023; 11:309. [PMID: 37803484 PMCID: PMC10557351 DOI: 10.1186/s40359-023-01302-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 08/23/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES While interoceptive self-report scales provide a foundation for measuring the mind-body connection, they variably consider other important factors that could influence interpretations of internal bodily sensations and perceptions related to mind-body integration. The proposed Body-Mind Connection Questionnaire (BMCQ) aimed to operationalise the notion that this construct involves three major components: (a) Interoceptive Attention, (b) Sensation-Emotion Articulation, and (c) Body-Mind Values. METHODS Following panel review and piloting with the target population, the developed BMCQ was evaluated in 316 participants (189 identifying as female) aged 18-50 (MAge=30.78), alongside established self-report measures of interoceptive sensibility, body awareness, sensory processing sensitivity, and alexithymia. We examined the BMCQ factor structure through exploratory factor analysis and analysed convergent and discriminant validity. RESULTS Exploratory factor analysis supported three scales of the BMCQ, which explained 54.03% of variance. Factor loadings (>0.44) and reliability indices (0.74 to 0.85) were acceptable. Inter-scale correlations suggested that the scales are distinct but related (rs=0.38 to 0.59). BMCQ scales were supported by convergent (r=0.33 to 0.67) and discriminant evidence (rs=0.01 to 0.39, p range n.s. to <.05). CONCLUSIONS Preliminary psychometric properties indicate that the BMCQ is multidimensional and consists of three constructs that differentially relate to theoretically associated measures. Interoceptive Attention, Sensation-Emotion Articulation, and Body-Mind Values may serve as a basis for efficiently assessing the mind-body connection more holistically, which could be useful for developing interventions aimed at enhancing mind-body integration.
Collapse
Affiliation(s)
- Kristen Van Bael
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.
| | - Michelle Ball
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Jessica Scarfo
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Emra Suleyman
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| |
Collapse
|
|
8
|
Ruitenberg GM, Booij SHS, Batelaan NMN, Hoogendoorn AWA, Visser HAH. Transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and depressive disorders. BMC Psychiatry 2023; 23:443. [PMID: 37328822 PMCID: PMC10273546 DOI: 10.1186/s12888-023-04919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Both anxiety and depressive disorders are associated with significant long-term disability. Since experienced impairments vary between patients independent of diagnosis and disease severity, identifying transdiagnostic factors that predict the course of disability may provide new targets to reduce disability. This study examines transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and/or depressive disorders (ADD), focusing on potentially malleable factors. METHODS Six hundred fifteen participants with a current diagnosis of ADD from the Netherlands Study of Depression and Anxiety (NESDA) were included. Disability was assessed at baseline and after 2 years of follow-up, using the 32-item WHODAS II questionnaire. Transdiagnostic predictors of 2-year disability outcome were identified using linear regression analysis. RESULTS In univariable analyses, transdiagnostic factors associated with the 2-year disability outcome were locus of control (standardized β = -0.116, p = 0.011), extraversion (standardized β = -0.123 p = 0.004) and experiential avoidance (standardized β = 0.139, p = 0.001). In multivariable analysis, extraversion had a unique predictive value (standardized β = -0.143 p = 0.003). A combination of sociodemographic, clinical and transdiagnostic variables resulted in an explained variance (R2) of 0.090). The explained variance of a combination of transdiagnostic factors was 0.050. CONCLUSION The studied transdiagnostic variables explain a small but unique part of variability in the 2-year disability outcome. Extraversion is the only malleable transdiagnostic factor predictive of the course of disability independent of other variables. Due to the small contribution to the variance in the disability outcome, the clinical relevance of targeting extraversion seems limited. However, its predictive value is comparable to that of accepted disease severity measures, supporting the importance of looking beyond using disease severity measures as predictors. Furthermore, studies including extraversion in combination with other transdiagnostic and environmental factors may elucidate the unexplained part of variability of the course of disability in patients with ADD.
Collapse
Affiliation(s)
| | - S H Sanne Booij
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Huispostcode CC72, Postbus 30.001, 9700 RB, Groningen, The Netherlands.
- Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands.
| | - N M Neeltje Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Specialized Mental Health Care, GGZ InGeest, Amsterdam, The Netherlands
| | - A W Adriaan Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - H A Henny Visser
- Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
| |
Collapse
|
|
9
|
Cengiz G, Şaş S, Kaplan H, Özsoy S, Çalış M. The influence of alexithymia on disease activity and quality of life in patients with axial spondyloarthritis: A cross-sectional study. Int J Rheum Dis 2023. [PMID: 37186380 DOI: 10.1111/1756-185x.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/16/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To evaluate the prevalence of alexithymia and its influence on disease activity, quality of life, and clinical outcomes in axial spondyloarthritis (axSpA) patients. PATIENTS AND METHODS This cross-sectional study included 110 (59 men and 51 women) consecutive axSpA patients who agreed to participate at our rheumatology outpatient clinic. Patient demographics, pain, disease activity measures, functionality, quality of life, alexithymia, psychological status, neuropathic pain, and fibromyalgia were evaluated. Patients were divided into 2 groups (without vs with alexithymia) and compared. The risk factors for alexithymia were evaluated. RESULTS The prevalence of alexithymia in axSpA patients was 31.8% according to a Toronto Alexithymia Scale-20 cutoff of ≥61. The mean age and body mass index of patients were 41.25 ± 9.64 years and 27.73 ± 4.51 kg/m2 , respectively. Most patients with alexithymia were women. Patients with alexithymia had significantly high scores for depression, anxiety, fibromyalgia, disease activity, enthesitis, worse quality of life, and poor functionality (all P < 0.05). Female gender (odds ratio [OR] = 22.359), patient global assessment (OR = 7.873), Bath Ankylosing Spondylitis Functional Index (OR = 1.864), and fibromyalgia symptom severity (OR = 1.303) were found to be independent risk factors for alexithymia. CONCLUSION The present study results showed that about one-third of axSpA patients had alexithymia, and the patients with alexithymia had higher disease activity, worse quality of life, and worse functional status than those without alexithymia. Female gender, patient global assessment, functional status, and fibromyalgia symptom severity were found to be important contributing factors to alexithymia.
Collapse
Affiliation(s)
- Gizem Cengiz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Senem Şaş
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Hüseyin Kaplan
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Saliha Özsoy
- Department of Psychiatry, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mustafa Çalış
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Erciyes University, Kayseri, Turkey
| |
Collapse
|
|
10
|
Alexithymia as a Risk Factor for Social Indifference: A Quantitative Study with a Large Sample of Female Adolescents. SCHOOL MENTAL HEALTH 2023. [DOI: 10.1007/s12310-023-09568-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
|
11
|
The Relationship among Dyadic Adjustment and Disease Burden in Patients with Bipolar Disorder and Their Spouses. Behav Sci (Basel) 2023; 13:bs13020091. [PMID: 36829320 PMCID: PMC9952473 DOI: 10.3390/bs13020091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 ± 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 ± 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 ± 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers' perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.
Collapse
|
|
12
|
Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients. Healthcare (Basel) 2022; 10:healthcare10061078. [PMID: 35742130 PMCID: PMC9223291 DOI: 10.3390/healthcare10061078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.
Collapse
|
|
13
|
Mason D, Happé F. The role of alexithymia and autistic traits in predicting quality of life in an online sample. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 90:None. [PMID: 35116075 PMCID: PMC8763252 DOI: 10.1016/j.rasd.2021.101887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Autistic people tend to report poorer Quality of Life (QOL) than comparison groups, though some studies do report more optimistic findings. Higher autistic traits are also related to poorer QOL. However, the role of alexithymia in this relationship has not been explored. METHOD A total of 163 participants (N = 53 autistic and N = 111 comparison) consented to take part; however, 30 participants were excluded due to missing data (who did not differ from those who were retained on age, gender, education, employment, or living status), leaving a final sample of 133 (N = 42 Autistic and 91 Comparison participants). Demographic information (including age, gender) was collected, alongside self-report measures of autistic traits, mental health, alexithymia, and QOL. We estimated regression models based on pre-registered analysis, and we conducted exploratory network analyses. RESULTS Alexithymic traits did not predict QOL when controlling for covariates. Depression significantly predicted Physical, Psychological, and Social QOL. When examining the impact of just alexithymic traits and autistic traits, both were significantly associated with Physical and Psychological QOL. For participants with a low depression score, the correlation between alexithymia and QOL was strong; suggesting that depression occludes the association between alexithymia and QOL. Network analyses suggested that depression and anxiety exert direct effects on Physical and Psychological QOL, whereas alexithymia scores may influence Physical QOL via autistic traits. CONCLUSION In sum, depression is a pervasive negative predictor of multiple QOL domains. The role of alexithymia in predicting QOL dimensionally and categorically was not ruled out, given our exploratory analyses, we suggest that interventions which target alexithymia may positively impact QOL for those who score low on depressive symptoms.
Collapse
Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| |
Collapse
|
|
14
|
Mohi S, Deane FP, Mooney-Reh D, Bailey A, Ciaglia D. Experiential avoidance and depression predict values engagement among people in treatment for borderline personality disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
|
15
|
Martino G, Caputo A, Vicario CM, Catalano A, Schwarz P, Quattropani MC. The Relationship Between Alexithymia and Type 2 Diabetes: A Systematic Review. Front Psychol 2020; 11:2026. [PMID: 32982843 PMCID: PMC7484475 DOI: 10.3389/fpsyg.2020.02026] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background: This systematic review analyzed the relationship between alexithymia, considered as the inability to recognize and express thoughts and emotions, and type 2 diabetes mellitus (T2DM), one of the most common chronic illness, characterized by a metabolic disorder burdened by high morbidity and mortality worldwide due to its outcomes. Methods: PRISMA guidelines were followed throughout this systematic review of the recent literature indexed in the databases PubMed, PsycInfo, Scopus, and Web of Science. Search terms for eligible studies were: "Type 2 diabetes" OR "T2DM" AND "Toronto Alexithymia Scale" OR "TAS-20"[All Fields]. Results: The initial search identified 61 indexed scientific publications. After screening we found that seven publications met the established scientific inclusion and exclusion criteria. It emerged that alexithymic patients ranged from 25 to 50% across the examined publications and it appeared that patients with T2DM generally reflected greater values of alexithymia, revealing particular differences among TAS domains. Moreover, emlpoyed participants were alexithymic to a greater extent compared to non-working participants (77.8 vs. 35.4%) and alexithymia was 2.63 times more severe among working participants when examining predictors of alexithymia. When evaluating the correlations between alexithymia and HbA1c or fasting blood glucose levels we found strong associations equal to 0.75 and 0.77 for TAS-20 total scores, respectively. While alexithymic participants showed significantly higher levels of HbA1c and blood glucose when compared to the non-alexithymic participants. Conclusions: The results of this systematic review of the current literature highlight the need of alexithymia evaluation in patients with T2DM. The high prevalence in T2DM and strong associations with poorly regulated diabetes and psychological distress, indicate a significant relationship between poor glycemic control and psychological distress, such as anxiety and depression, and quality of life. Further studies are needed focusing on age and gender differences in order to be able to improve clinical psychological care and prevention.
Collapse
Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| |
Collapse
|
|
16
|
Martino G, Caputo A, Schwarz P, Bellone F, Fries W, Quattropani MC, Vicario CM. Alexithymia and Inflammatory Bowel Disease: A Systematic Review. Front Psychol 2020; 11:1763. [PMID: 32973596 PMCID: PMC7466427 DOI: 10.3389/fpsyg.2020.01763] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Given the role of alexithymia-as the inability to identify, differentiate, and express emotions-in chronic and immune-mediated illness, this systematic review analyzed the prevalence of alexithymia in patients with inflammatory bowel diseases (IBDs), mainly represented by Crohn's disease (CD) and ulcerative colitis (UC). Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed throughout this systematic review of the literature published between 2015 and 2020 in indexed sources from PubMed, PsycINFO, Scopus, and Web of Science databases. Search terms for eligible studies were: "Inflammatory bowel disease" AND "Alexithymia" [Titles, Abstract, Keywords]. Inclusion criteria were: articles written and published in English from 2015 and up to April 2020, reporting relevant and empirical data on alexithymia and IBD. Results: The initial search identified 34 indexed scientific publications. After screening, we found that five publications met the established scientific inclusion criteria. Overall, the mean value of alexithymia ranged from 39 to 53.2 [Toronto Alexithymia Scale (TAS-20) score], thus mostly falling in non-clinical range for alexithymia (≤51). Comparisons of alexithymia between patients with UC and CD highlighted that patients with CD showed externally oriented thinking and difficulties identifying feelings to a greater extent. Regarding comparisons with other samples or pathologies, patients with IBD were more alexithymic than healthy controls and less alexithymic than patients with major depressive disorder, but no difference was found when compared with patients with irritable bowel syndrome (IBS). Then, regarding correlations with other variables, alexithymia was positively associated with anxiety and depression, as well as with psychopathological symptoms and somatic complaints. Conclusion: This systematic review suggests that patients with IBD cannot be generally considered alexithymic at a clinically relevant extent. However, their greater alexithymic levels and its associations with psychological variables and somatic distress may suggest a reactivity hypothesis, in which living with IBD may progressively lead to impaired emotion recognition over time. Specifically, the relationship between IBD and IBS should be further explored, paying deeper attention to the clinical psychological functioning of CD, as IBD requires more emotional challenges to patients.
Collapse
Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Walter Fries
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M. C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - C. M. Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| |
Collapse
|
|
17
|
Quinto RM, Sampogna F, Fania L, Ciccone D, Fusari R, Mastroeni S, Iani L, Abeni D. Alexithymia, Psychological Distress, and Social Impairment in Patients with Hidradenitis Suppurativa. Dermatology 2019; 237:103-110. [PMID: 31743903 DOI: 10.1159/000503319] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/12/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a rare, chronic, inflammatory skin disease characterized by deep-seated nodules, abscesses, and draining fistulas. HS has a substantial adverse impact on patients' lives. Only a few studies investigated the relationship between health-related quality of life, psychological distress, and emotional dysregulation in patients with HS. Alexithymia, namely the difficulty in describing or recognizing emotions, has been associated with various psychological disorders, such as anxiety, depression, and psychological distress. OBJECTIVE The aim of this study was to examine the prevalence of alexithymia in patients with HS and its association with demographic and clinical variables, quality of life indices, and psychological distress. METHODS Ninety outpatients with HS completed the 20-item Toronto Alexithymia Scale, the 12-item General Health Questionnaire (GHQ-12), the Dermatology Life Quality Index, the Skindex-17, and the 36-Item Short-Form Health Survey. Information on sociodemographic and clinical variables was retrieved from clinical records. RESULTS Alexithymia or borderline alexithymia was observed in 44.4% of patients with HS, with a higher prevalence of the alexithymic trait in women than in men (51.7 vs. 31.2%). We did not find any association between alexithymia and clinical variables. Of the entire sample analyzed, 46.1% reported high psychological distress; among them, 78% reported alexithymia or borderline alexithymia compared to 16.7% among GHQ noncases. Furthermore, HS patients with alexithymia or borderline alexithymia showed significantly higher scores on the Skindex-17 psychosocial scale and the Dermatology Life Quality Index, and a lower score on the mental component of the 36-item Short-Form Health Survey, than nonalexithymic patients. CONCLUSIONS Dermatologists should consider alexithymia in the diagnosis and treatment of HS patients, given its important role in psychological and psychosocial distress.
Collapse
Affiliation(s)
- Rossella Mattea Quinto
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy, .,Department of Human Sciences, European University of Rome, Rome, Italy,
| | | | - Luca Fania
- 1st Dermatological Unit, IDI-IRCCS, Rome, Italy
| | | | | | | | - Luca Iani
- Department of Human Sciences, European University of Rome, Rome, Italy
| | | |
Collapse
|
|
18
|
Vadini F, Sozio F, Madeddu G, De Socio G, Maggi P, Nunnari G, Vichi F, Di Stefano P, Tracanna E, Polilli E, Sciacca A, Zizi B, Lai V, Bartolozzi C, Flacco ME, Bonfanti P, Santilli F, Manzoli L, Parruti G. Alexithymia Predicts Carotid Atherosclerosis, Vascular Events, and All-Cause Mortality in Human Immunodeficiency Virus-Infected Patients: An Italian Multisite Prospective Cohort Study. Open Forum Infect Dis 2019; 6:ofz331. [PMID: 31660407 PMCID: PMC6761942 DOI: 10.1093/ofid/ofz331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/18/2019] [Indexed: 01/08/2023] Open
Abstract
Background Psychological factors (PFs) are known predictors of cardiovascular disease (CVD) in many clinical settings, but data are lacking for human immunodeficiency virus (HIV) infection. We carried out a prospective study to evaluate (1) psychological predictors of preclinical and clinical vascular disease and (2) all-cause mortality (ACM) in HIV patients. Methods We conducted a cross-sectional analysis of baseline data to evaluate the predictors of carotid plaques (CPs) and a prospective analysis to explore predictors of vascular events (VEs) and ACM over 10 years. Human immunodeficiency virus patients monitored at the Infectious Disease Units of 6 Italian regions were consecutively enrolled. Traditional CVD risk factors, PFs (depressive symptoms, alexithymia, distress personality), and CPs were investigated. Vascular events and ACM after enrollment were censored at March 2018. Results A multicenter cohort of 712 HIV-positive patients (75.3% males, aged 46.1 ± 10.1 years) was recruited. One hundred seventy-five (31.6%) patients had CPs at baseline. At the cross-sectional analysis, alexithymia was independently associated with CPs (odds ratio, 4.93; 95% confidence interval [CI], 2.90–8.50; P < .001), after adjustment for sociodemographic, clinical, and psychological variables. After an average follow-up of 4.4 ± 2.4 years, 54 (7.6%) patients developed a VE, whereas 41 (5.68%) died. Age, current smoking, hypertension, and alexithymia (hazard ratio [HR], 3.66; 95% CI, 1.80–7.44; P < .001) were independent predictors of VE. Likewise, alexithymia was an independent predictor of ACM (HR, 3.93; 95% CI, 1.65–9.0; P = .002), regardless of other clinical predictors. Conclusions The present results validate our previous monocentric finding. Alexithymia may be an additional tool for the multifactorial assessment of cardiovascular risk in HIV.
Collapse
Affiliation(s)
| | - Federica Sozio
- Infectious Disease Unit, Pescara General Hospital, Italy
| | - Giordano Madeddu
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | | | - Paolo Maggi
- Infectious Diseases Clinic, Policlinico Hospital, Bari, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Francesca Vichi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy
| | | | - Elisa Tracanna
- Infectious Disease Unit, Pescara General Hospital, Italy
| | - Ennio Polilli
- Clinical Pathology Laboratory, Pescara General Hospital, Italy
| | | | - Bernardetta Zizi
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | - Vincenzo Lai
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Italy
| | - Claudio Bartolozzi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy
| | | | - Paolo Bonfanti
- Infectious Diseases Unit, A. Manzoni Hospital, Lecco, Italy
| | - Francesca Santilli
- Department of Medicine and Aging and Center of Aging Science and Translational Medicine, University of Chieti, Italy
| | | | | |
Collapse
|
|
19
|
Ospina LH, Shanahan M, Perez-Rodriguez MM, Chan CC, Clari R, Burdick KE. Alexithymia predicts poorer social and everyday functioning in schizophrenia and bipolar disorder. Psychiatry Res 2019; 273:218-226. [PMID: 30658205 PMCID: PMC6561815 DOI: 10.1016/j.psychres.2019.01.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/28/2022]
Abstract
Alexithymia, or the inability to identify and describe one's emotions, is significantly higher in bipolar disorder (BD) and schizophrenia (SZ), compared to healthy controls (HC). Alexithymia has also been observed to predict psychosocial functioning in SZ. We investigated whether alexithymia predicted social and everyday functioning in BD, as well as transdiagnostically in HC, BD, and SZ patients. 56 BD, 45 SZ, and 50 HC were administered and compared on tests measuring neurocognition, social cognition, functioning and alexithymia. We conducted linear regressions assessing whether alexithymia predicted functional outcomes in BD. Next, we conducted hierarchical stepwise linear regressions investigating the predictive ability of neurocognition, social cognition and alexithymia on everyday and social functioning in our overall sample. BD and SZ patients were comparable on most demographics and demonstrated higher alexithymia compared to HCs. In BD, alexithymia predicted social functioning only. In the overall sample, difficulty identifying and describing feelings predicted everyday functioning; difficulty describing feelings predicted social functioning. Results suggest that aspects of alexithymia significantly predict functioning among these psychiatric groups, above and beyond the contributions of previously identified factors such as neurocognition and social cognition. Results may aid in developing proper interventions aimed at improving patients' ability to articulate their feelings.
Collapse
Affiliation(s)
- L H Ospina
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States.
| | - M Shanahan
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States; Brigham and Women's Hospital, Department of Psychiatry, Boston MA, United States
| | - M M Perez-Rodriguez
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - C C Chan
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - R Clari
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - K E Burdick
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States; Brigham and Women's Hospital, Department of Psychiatry, Boston MA, United States; James J. Peters VA Medical Center, Bronx NY, United States; Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| |
Collapse
|
|
20
|
Fang S, Chung MC. The impact of past trauma on psychological distress among Chinese students: The roles of cognitive distortion and alexithymia. Psychiatry Res 2019; 271:136-143. [PMID: 30472509 DOI: 10.1016/j.psychres.2018.11.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 11/26/2022]
Abstract
Past traumatic events are distressing experiences which can result in the emergence of posttraumatic stress disorders (PTSD) and other psychological symptoms among university students. However, little is known as to whether or not cognitive distortion and alexithymia would influence the severity of these distress outcomes. This study examined a cognitive-emotional framework depicting potential roles that cognitive distortion and alexithymia could play in influencing the relationship between past trauma and psychiatric co-morbidities among university students in China. One thousand one hundred and eleven participants completed the PTSD Checklist for DSM-5, Cognitive Distortion Scale (CDS), Toronto Alexithymia Scale (TAS-20), and General Health Questionnaire (GHQ-28). Results indicated that PTSD following past trauma was significantly associated with increased psychiatric co-morbidities after controlling for covariates. Both alexithymia and distorted cognition mediated the association between PTSD and psychiatric co-morbidities. To conclude, university students can develop PTSD from past trauma and other mental health problems. The severity of psychological distress can be influenced by their distorted perceptions of themselves, the world, and the future, as well as their ability to identify, describe, and express distressing emotions.
Collapse
Affiliation(s)
- Siqi Fang
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, People's Repulic of China.
| | - Man Cheung Chung
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, People's Repulic of China.
| |
Collapse
|
|
21
|
Saikkonen S, Karukivi M, Vahlberg T, Saarijärvi S. Associations of social support and alexithymia with psychological distress in Finnish young adults. Scand J Psychol 2018; 59:602-609. [DOI: 10.1111/sjop.12478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 06/14/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Suvi Saikkonen
- Adolescent Psychiatry; University of Turku and Turku University Hospital; Turku Finland
| | - Max Karukivi
- Adolescent Psychiatry; University of Turku and Turku University Hospital; Turku Finland
- Unit of Adolescent Psychiatry; Satakunta Hospital District; Pori Finland
| | - Tero Vahlberg
- Biostatistics; University of Turku and Turku University Hospital; Turku Finland
| | - Simo Saarijärvi
- Adolescent Psychiatry; University of Turku and Turku University Hospital; Turku Finland
| |
Collapse
|
|
22
|
Benbrika S, Doidy F, Carluer L, Mondou A, Buhour MS, Eustache F, Viader F, Desgranges B. Alexithymia in Amyotrophic Lateral Sclerosis and Its Neural Correlates. Front Neurol 2018; 9:566. [PMID: 30087649 PMCID: PMC6066614 DOI: 10.3389/fneur.2018.00566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/22/2018] [Indexed: 12/11/2022] Open
Abstract
Introduction: Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease that causes progressive and extensive motor deficits. Patients may also have cognitive impairments or alteration of emotional processing. Very few studies, however, have looked at deficits in how they experience their own feelings (alexithymia). Methods: We assessed alexithymia in 28 patients with ALS using the 20-item Toronto Alexithymia Scale (TAS-20), comparing them with a control group matched for sex, age, and education level. We took into account both the total score of the TAS-20 and its three subscores corresponding to the three dimensions of alexithymia: Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Patients also underwent a neuropsychological assessment and anatomical magnetic resonance imaging (MRI) in order to correlate cognitive performances and gray matter volume and level of alexithymia. Results: On average, ALS subjects had a significantly higher total score and DIF sub-score of the TAS-20 than controls indicating an increased alexithymia in patients. Total and DIF Scores correlated significantly and negatively to gray matter volume of the prefrontal cortex, right superior temporal pole and parahippocampal gyri. No correlations were found between scores on executive functions and those on the TAS-20. Conclusion: The first stage of one's own emotional processing seems to be affected in ALS independently of executive dysfunction. This trouble seems to be underpinned by cerebral regions that are well known to be both implicated in alexithymia in healthy subjects and altered in ALS.
Collapse
Affiliation(s)
- Soumia Benbrika
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Franck Doidy
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Laurence Carluer
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Audrey Mondou
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Marie-Sonia Buhour
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Fausto Viader
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| | - Béatrice Desgranges
- Neuropsychology and Imaging of Human Memory, Caen-Normandy University, PSL Research University, EPHE, INSERM, Caen University Hospital, Caen, France
| |
Collapse
|
|
23
|
Donisan T, Bojincă VC, Dobrin MA, Bălănescu DV, Predețeanu D, Bojincă M, Berghea F, Opriș D, Groșeanu L, Borangiu A, Constantinescu CL, Ionescu R, Bălănescu AR. The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients. Clin Rheumatol 2017; 36:1511-1519. [PMID: 28451872 DOI: 10.1007/s10067-017-3654-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 04/07/2017] [Accepted: 04/20/2017] [Indexed: 01/26/2023]
Abstract
We hypothesized that clinical outcomes might be influenced by personality type (A, B, C, D) in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). One hundred ninety-four patients (104 with RA, 90 with AS) participated in a questionnaire study. We evaluated health-related quality of life (HRQoL) using the Medical Outcome Study Short-Form 36 (SF-36), personality type A/B with the Jenkins Activity Survey, type C with the State-Trait Anger Expression Inventory Anger-in Scale, type D with the Type D Personality Scale, and disease activity with Disease Activity Score with 28 joints for RA and Bath Ankylosing Spondylitis Disease Activity Index for AS. We used Pearson's correlation coefficient, independent samples t tests, and multivariate analyses of variance. In the RA group, type D personality was significantly correlated with 7/12 SF-36 components. AS patients with type D personality had deficits in all SF-36 subscales. Type D was related with higher disease activity in RA and AS. Both RA and AS type C patients had more active disease forms and negatively affected HRQoL subscales. In the RA group, type A personality did not correlate with HRQoL, but it positively influenced pain visual analog scale scores. In AS patients, type A personality was linked with higher HRQoL and with less active disease. Type C and type D personality types were correlated with decreased HRQoL and higher disease activity in RA and AS patients. Type A personality was associated with less active disease and higher HRQoL in AS patients and with less pain in RA patients.
Collapse
Affiliation(s)
- T Donisan
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - V C Bojincă
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania. .,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania.
| | - M A Dobrin
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania
| | - D V Bălănescu
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - D Predețeanu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - M Bojincă
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania.,Department of Internal Medicine and Rheumatology "Dr. I. Cantacuzino" Hospital, 5-7 Ion Movilă Str, Bucharest, Romania
| | - F Berghea
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - D Opriș
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - L Groșeanu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - A Borangiu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - C L Constantinescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - R Ionescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - A R Bălănescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| |
Collapse
|
|
24
|
Bailer J, Witthöft M, Erkic M, Mier D. Emotion dysregulation in hypochondriasis and depression. Clin Psychol Psychother 2017; 24:1254-1262. [PMID: 28444850 DOI: 10.1002/cpp.2089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of this study was to explore whether certain aspects of emotion dysregulation (i.e., facets of alexithymia and rumination) are more closely linked to hypochondriasis than to depression and vice versa. METHODS Nineteen patients with hypochondriasis (HYP), 33 patients with depression, and 52 healthy control participants completed the Toronto Alexithymia Scale, the Response Styles Questionnaire, and additional symptom and illness behaviour scales. A clinical interview was used to establish DSM-IV diagnoses and to exclude all cases with more than one axis I diagnosis. RESULTS Depression patients reported more difficulties describing feelings and more symptom- and self-focused rumination than both HYP patients and healthy individuals, whereas HYP patients differed only from healthy individuals in regard to more difficulties in identifying feelings and more symptom-focused rumination. Multiple regression analyses, including all assessed facets of emotion dysregulation, showed that the degree of somatoform features (somatic symptoms, health anxiety, and illness behaviour) was specifically predicted by higher difficulties in identifying feelings scores, whereas depressive symptom levels were specifically predicted by higher rumination scores. CONCLUSIONS Specific associations were found between difficulties in identifying feelings and key features of HYP, whereas depression was linked to a more generalized pattern of emotion regulation deficits. KEY PRACTITIONER MESSAGE Emotion dysregulation can be found in hypochondriasis and depression Difficulties in identifying own feelings are specifically linked to somatic symptoms, health anxiety, and illness behaviour, whereas a more generalized pattern of emotion dysregulation is found in relation to depression Further research is needed to investigate whether the effectiveness of current treatments for depression, hypochondriasis, health anxiety, and related disorders could be improved by additional emotion regulation interventions.
Collapse
Affiliation(s)
- Josef Bailer
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, Germany
| | - Maja Erkic
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| | - Daniela Mier
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| |
Collapse
|
|
25
|
Bantum EO, Elhadad N, Owen JE, Zhang S, Golant M, Buzaglo J, Stephen J, Giese-Davis J. Machine Learning for Identifying Emotional Expression in Text: Improving the Accuracy of Established Methods. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2017; 2:21-27. [PMID: 32885036 PMCID: PMC7467127 DOI: 10.1007/s41347-017-0015-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Expression of emotion has been linked to numerous critical and beneficial aspects of human functioning. Accurately capturing emotional expression in text grows in relevance as people continue to spend more time in an online environment. The Linguistic Inquiry and Word Count (LIWC) is a commonly used program for the identification of many constructs, including emotional expression. In an earlier study (Bantum & Owen, 2009) LIWC was demonstrated to have good sensitivity yet poor positive predictive value. The goal of the current study was to create an automated machine learning technique to mimic manual coding. The sample included online support groups, cancer discussion boards, and transcripts from an expressive writing study, which resulted in 39,367 sentence-level coding decisions. In examining the entire sample the machine learning approach outperformed LIWC, in all categories outside of Sensitivity for negative emotion (LIWC Sensitivity = .85; Machine Learning Sensitivity = .41), although LIWC does not take into consideration prosocial emotion, such as affection, interest, and validation. LIWC performed significantly better than the machine learning approach when removing the prosocial emotions (p = <.0001). The sample over-represented examples of emotion that fit into the overarching category of positive emotion. Remaining work is needed to create more effective machine learning features for codes that are thought to be important emotionally but were not well represented in the sample (e.g., frustration, contempt, and belligerence), and Machine Learning could be a fruitful method for continued exploration.
Collapse
Affiliation(s)
- Erin O Bantum
- University of Hawaii Cancer Center; Cancer Prevention & Control Program
| | | | - Jason E Owen
- VA Palo Alto Health Care System; Dissemination & Training Division
| | | | | | | | | | - Janine Giese-Davis
- University of Calgary; Cumming School of Medicine; Department of Oncology, Calgary, Alberta, Canada
| |
Collapse
|
|
26
|
Lennartsson AK, Horwitz EB, Theorell T, Ullén F. Creative Artistic Achievement Is Related to Lower Levels of Alexithymia. CREATIVITY RESEARCH JOURNAL 2017. [DOI: 10.1080/10400419.2017.1263507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Töres Theorell
- Karolinska Institutet
- Stress Research Institute, Stockholm University
| | | |
Collapse
|
|
27
|
Atari M, Yaghoubirad M. The Big Five personality dimensions and mental health: The mediating role of alexithymia. Asian J Psychiatr 2016; 24:59-64. [PMID: 27931909 DOI: 10.1016/j.ajp.2016.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/19/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
The role of personality constructs on mental health has attracted research attention in the last few decades. The Big Five personality traits have been introduced as parsimonious dimensions of non-pathological traits. The five-factor model of personality includes neuroticism, agreeableness, conscientiousness, extraversion, and openness to experience. The present study aimed to examine the relationship between the Big Five dimensions and mental health considering the mediating role of alexithymia as an important emotional-processing construct. A total of 257 participants were recruited from non-clinical settings in the general population. All participants completed the Ten-Item Personality Inventory (TIPI), 20-item Toronto Alexithymia Scale (TAS-20), and General Health Questionnaire-28 (GHQ-28). Structural equation modeling was utilized to examine the hypothesized mediated model. Findings indicated that the Big Five personality dimensions could significantly predict scores of alexithymia. Moreover, alexithymia could predict mental health scores as measured by indices of depression, anxiety, social functioning, and somatic symptoms. The fit indices (GFI=0.94; CFI=0.91; TLI=0.90; RMSEA=0.071; CMIN/df=2.29) indicated that the model fits the data. Therefore, the relationship between the Big Five personality dimensions and mental health is mediated by alexithymia.
Collapse
Affiliation(s)
- Mohammad Atari
- Department of Psychology, University of Tehran, Tehran, Iran.
| | | |
Collapse
|
|
28
|
San Giorgi MRM, Aaltonen LM, Rihkanen H, Tjon Pian Gi REA, van der Laan BFAM, Hoekstra-Weebers JEHM, Dikkers FG. Quality of life of patients with recurrent respiratory papillomatosis. Laryngoscope 2016; 127:1826-1831. [DOI: 10.1002/lary.26413] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Michel R. M. San Giorgi
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Helsinki, Helsinki University Hospital; Helsinki Finland
| | - Heikki Rihkanen
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Helsinki, Helsinki University Hospital; Helsinki Finland
| | - Robin E. A. Tjon Pian Gi
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
| | - Bernard F. A. M. van der Laan
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
| | | | - Frederik G. Dikkers
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
| |
Collapse
|
|
29
|
Forti AM, Cashwell CS, Henson R. Mindfulness and Quality of Life in Cancer Survivors: The Mediating Role of Self-Kindness and Alexithymia. ACTA ACUST UNITED AC 2016. [DOI: 10.17744/mehc.38.4.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to understand the relationship among mindfulness, self-kindness, alexithymia and quality of life in post-treatment breast cancer survivors and to examine whether self-kindness and alexithymia mediate the relationship between mindfulness and quality of life. Results suggested that the overall model accounted for significant variance in quality of life and that alexithymia partially mediated the relationship between mindfulness and quality of life. Implications for practice and further research are discussed.
Collapse
|
|
30
|
Avci D, Kelleci M. Alexithymia in patients with type 2 diabetes mellitus: the role of anxiety, depression, and glycemic control. Patient Prefer Adherence 2016; 10:1271-7. [PMID: 27499615 PMCID: PMC4959761 DOI: 10.2147/ppa.s110903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study was aimed at determining the prevalence of alexithymia in patients with type 2 DM and the factors affecting it. METHODS This cross-sectional study was conducted with 326 patients with type 2 DM. Study data were collected with the Personal Information Form, Toronto Alexithymia Scale, and Hospital Anxiety and Depression Scale. Glycemic control was assessed by glycated haemoglobin (HbA1c) results. The analysis was performed using descriptive statistics, chi-square test, Pear-son's correlation, and logistic regression analysis. RESULTS Of the patients, 37.7% were determined to have alexithymia. A significant relationship was determined between alexithymia and HbA1c, depression, and anxiety. According to binary logistic regression analyses, alexithymia was 2.63 times higher among those who were in a paid employment than those who were not, 2.09 times higher among those whose HbA1c levels were ≥7.0% than those whose HbA1c levels were <7.0%, 3.77 times higher among those whose anxiety subscale scores were ≥11 than those whose anxiety subscale scores were ≤10, and 2.57 times higher among those whose depression subscale scores were ≥8 than those whose depression subscale scores were ≤7. CONCLUSION In this study, it was determined that two out of every five patients with DM had alexithymia. Therefore, their treatment should be arranged to include mental health care services.
Collapse
Affiliation(s)
- Dilek Avci
- Department of Nursing, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir
| | - Meral Kelleci
- Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
|
31
|
Cozzolongo R, Porcelli P, Lanzilotta E, Giannuzzi V, Leandro G. The role of alexithymia in quality of life impairment in patients with chronic hepatitis C during antiviral treatment. Compr Psychiatry 2015; 60:17-25. [PMID: 25941158 DOI: 10.1016/j.comppsych.2015.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the role of alexithymia in the quality of life of patients with chronic hepatitis C treated with antiviral therapy. A consecutive sample of 124 patients were evaluated at baseline, during, and 6months after treatment with interferon and ribavirin. At baseline past mood disorders and alexithymia and, at each index visit, adverse events, psychological distress, and disease-specific quality of life were assessed with validated instruments. Patients with past mood disorders and alexithymia had impaired levels of quality of life, psychological distress, and treatment-related adverse events. However, after controlling for covariates, poor quality of life was independently predicted by alexithymia and psychological distress before (R(2)=0.60) and 6months after (R(2)=0.69) the antiviral treatment while during treatment (at 3months and the end of therapy) by depression and somatic adverse events (R(2)=0.67 and 0.69, respectively). Alexithymia rather than history of mood disorders resulted to be an independent predictor of impaired quality of life not only before but also 6months after the end of treatment. Given the association with proneness to health-compromising behaviors, clinicians are encouraged to pay closer attention to long-term psychological and somatic effects of antiviral treatment in patients with alexithymic characteristics.
Collapse
Affiliation(s)
- Raffaele Cozzolongo
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Piero Porcelli
- Clinical Psychology Unit, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Elsa Lanzilotta
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Vito Giannuzzi
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy.
| | - Gioacchino Leandro
- Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; Department of Liver and Digestive Health, University College of London, UK.
| |
Collapse
|
|
32
|
Emotion processing deficits in alexithymia and response to a depth of processing intervention. Biol Psychol 2014; 103:212-22. [DOI: 10.1016/j.biopsycho.2014.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/20/2022]
|
|
33
|
Alkan Härtwig E, Crayen C, Heuser I, Eid M. It's in the mix: psychological distress differs between combinations of alexithymic facets. Front Psychol 2014; 5:1259. [PMID: 25429275 PMCID: PMC4228974 DOI: 10.3389/fpsyg.2014.01259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/17/2014] [Indexed: 11/25/2022] Open
Abstract
Alexithymia is a personality trait characterized by difficulties in identifying, describing, and communicating one's emotions. The aim of the present study is to examine the usefulness of a typological approach considering the interaction between distinct alexithymic features within a population of high-alexithymic German adults (N = 217). Latent profile analysis (LPA) was employed to test for possible underlying profiles. A 3-profile solution showed the best fit: The profiles can be described as (1) "low": lower load on all facets of alexithymia, (2) "mixed": specific problems on identifying emotions, and (3) "high": higher load on all facets of alexithymia. Moreover, this study tested how these profiles differed in psychological distress. "Mixed" profile, with specific problems on identifying emotions showed the highest levels of psychological distress. The present study suggests the importance of a specific combination of alexithymic features, rather than total alexithymia scores, as a risk factor for psychological distress.
Collapse
Affiliation(s)
- Elif Alkan Härtwig
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Psychiatry, Charitè University MedicineBerlin, Germany
| | - Claudia Crayen
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
| | - Isabella Heuser
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Psychiatry, Charitè University MedicineBerlin, Germany
| | - Michael Eid
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
| |
Collapse
|
|
34
|
Mnif L, Damak R, Mnif F, Ouanes S, Abid M, Jaoua A, Masmoudi J. Alexithymia impact on type 1 and type 2 diabetes: A case-control study. ANNALES D'ENDOCRINOLOGIE 2014; 75:213-9. [DOI: 10.1016/j.ando.2014.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/27/2014] [Accepted: 06/13/2014] [Indexed: 10/24/2022]
|
|
35
|
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: 0.5] [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.
Collapse
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
| |
Collapse
|
|
36
|
Alexithymia and non-treatment: an Internet based study of 312 people with chronic anxiety. Compr Psychiatry 2014; 55:179-87. [PMID: 23916091 DOI: 10.1016/j.comppsych.2013.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/31/2013] [Accepted: 06/10/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Despite the availability of highly efficacious treatments, many individuals with anxiety disorders never receive adequate treatment. Alexithymic deficits, such as difficulties in recognizing feelings and focusing on emotional experiences, may contribute to low rates of help seeking. METHODS Multiple Internet-based strategies (announcements of anxiety disorder websites, postings in online self-help forums, notices in anxiety chat rooms) were used to recruit a sample of 312 participants with chronic and clinically relevant anxiety symptoms. Those who had never received professional treatment (n = 49) were compared to those with current or previous treatment (n=263) with regard to alexithymia, anxiety, depression and health-related quality of life. RESULTS Logistic regression analysis revealed that the strongest predictor for belonging to the never treated group was the externally oriented thinking facet of alexithymia. In addition, substantially more participants in the never treated group (49%) were considered high-alexithymic (20-item Toronto Alexithymia Scale total score ≥ 61) compared to the treated group (35%). CONCLUSIONS The main finding was a strong relationship between the externally oriented thinking facet of alexithymia and the non-use of professional help for anxiety. Internet-based programs could be a promising first step in supporting this group of people to overcome their anxiety.
Collapse
|
|
37
|
Nardelli S, Pentassuglio I, Pasquale C, Ridola L, Moscucci F, Merli M, Mina C, Marianetti M, Fratino M, Izzo C, Merkel C, Riggio O. Depression, anxiety and alexithymia symptoms are major determinants of health related quality of life (HRQoL) in cirrhotic patients. Metab Brain Dis 2013; 28:239-43. [PMID: 23296469 DOI: 10.1007/s11011-012-9364-0] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/21/2012] [Indexed: 12/16/2022]
Abstract
HRQoL is impaired in cirrhosis. Establishing the relevance of depression, anxiety, alexithymia and cirrhosis stage on the patients' HRQoL. Sixty cirrhotics underwent a neuropsychological assessment, including ZUNG-SDS, STAI Y1-Y2 and TAS-20. Minimal hepatic encephalopathy (MHE) was detected by PHES, HRQoL by Short-Form-36 (SF-36). Depression was detected in 34 patients (57 %, 95%CI = 44-70 %), state-anxiety in 16 (27 %, 95%CI = 15-38 %), trait-anxiety in 17 (28 %, 95%CI = 17-40 %), alexithymia in 14 (31 % 95%CI = 16-46 %) and MHE in 22 (37 %, 95%CI = 24-49 %). Neuropsychological symptoms were unrelated to cirrhosis stage, hepatocellular carcinoma or MHE. A significant correlation was observed among psychological test scores and summary components of SF-36. At multiple linear regression analysis including Child-Pugh and MELD scores, previous-HE and the psychological test scores as possible covariates, alexithymia and depression as well as to the Child-Pugh score were significantly related to the SF-36 mental component; while trait-anxiety was the only variable significantly and independently related to the SF-36 physical component. Depression, state and trait-anxiety and alexithymia symptoms are frequent in cirrhotics and are among the major determinants of the altered HRQoL.
Collapse
Affiliation(s)
- Silvia Nardelli
- Department of Clinical Medicine, Centre for Diagnosis and Treatment of Portal Hypertension, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
38
|
von Rimscha S, Moergeli H, Weidt S, Straumann D, Hegemann S, Rufer M. Alexithymia and health-related quality of life in patients with dizziness. Psychopathology 2013; 46:377-83. [PMID: 23296255 DOI: 10.1159/000345357] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 09/29/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alexithymia is a personality trait characterized by deficits in regulating, experiencing and verbalizing emotions and has been assumed to be associated with a tendency to express emotional arousal through somatization. Although such a tendency is often observed in patients with dizziness, the exact relationship of alexithymia to dizziness is not yet known. The aim of this study was to examine alexithymic characteristics in patients with dizziness and its relation to health-related quality of life (HRQoL). SAMPLING AND METHODS We assessed 208 patients from an interdisciplinary center for vertigo and balance disorders for characteristics of alexithymia (20-item Toronto Alexithymia Scale), HRQoL (Short-Form 12 Health Survey, SF-12), dizziness (Dizziness Handicap Inventory), depression and anxiety (Hospital Anxiety and Depression Scale). Hierarchical regression analyses were used to evaluate the relationship between alexithymia, dizziness and HRQoL. RESULTS We found that difficulties in identifying and describing feelings, two important factors of alexithymia, were significantly related to more severe symptoms of dizziness. More pronounced alexithymic characteristics were associated with lower HRQoL, especially in the mental dimension of the SF-12. The results remained significant after controlling for possibly confounding variables such as socioeconomic status and depression. CONCLUSIONS These findings contribute to a better understanding of affect regulation in patients with dizziness, which is important for the development of psychotherapeutic interventions suitable for alexithymic patients with dizziness.
Collapse
Affiliation(s)
- Sonja von Rimscha
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | | |
Collapse
|
|
39
|
Dickey CC, Vu MAT, Voglmaier MM, Niznikiewicz MA, McCarley RW, Panych LP. Prosodic abnormalities in schizotypal personality disorder. Schizophr Res 2012; 142:20-30. [PMID: 23068317 PMCID: PMC3502641 DOI: 10.1016/j.schres.2012.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/31/2012] [Accepted: 09/05/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Patients with schizophrenia speak with blunted vocal affect but little is known regarding the prosody of persons with schizotypal personality disorder (SPD). This work examined expressive prosody in SPD, its relationship to brain structure, and outlined a framework for measuring elements of prosody in clinical populations. METHODS Twenty-eight antipsychotic-naïve SPD subjects were matched with 27 healthy comparison (HC) subjects. Subjects read aloud short sentences and responded to probes to record both predetermined and self-generated speech samples. Samples were analyzed acoustically (pause proportion, duration, attack, and pitch variability) and subjectively by raters (amount of pauses, degree of emotion portrayed, and how much they wanted to hear more from the subjects) on paragraph, sentence, word, word-fragment, and syllable levels. Alexithymia and ability to self-monitor behavior were compared between groups. The pars opercularis was manually traced on structural MRI data. RESULTS SPD subjects' speech had significantly more pauses, was slower, had less pitch variability, and expressed less emotion than HC subjects. Pitch variability correlated with socio-economic status achievement. There was no difference between groups in left or right pars opercularis volumes. A statistically significant correlation suggested that smaller left pars opercularis volumes in SPD subjects correlated with more pauses and less emotion. SPD subjects reported more alexithymia and difficulty self-monitoring their behavior compared with controls. In SPD subjects the high alexithymia correlated with raters not wanting to hear more from them and SPD subjects' inability to modulate their social behavior correlated with their having fewer friends. Thus, the SPD subjects exhibited insight. CONCLUSIONS SPD subjects displayed significant prosodic deficits that were measurable in speech samples as brief as a word-fragment. The determinants of these deficits are not known although these may include a dysfunctional pars opercularis. These data add to the nascent literature describing social cognition deficits in SPD.
Collapse
Affiliation(s)
- Chandlee C. Dickey
- VA Boston Healthcare System, Harvard Medical School Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301,Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Corresponding Author: Chandlee Dickey, M.D. VA Boston Healthcare System, Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301 Phone: (774) 826-2457 Fax: (774) 826-1859
| | - Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Martina M. Voglmaier
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Margaret A. Niznikiewicz
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Robert W. McCarley
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Lawrence P. Panych
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School 75 Francis St., Boston, MA 02216
| |
Collapse
|
|
40
|
Mattila AK, Pohjola V, Suominen AL, Joukamaa M, Lahti S. Difficulties in emotional regulation: association with poorer oral health-related quality of life in the general population. Eur J Oral Sci 2012; 120:224-31. [DOI: 10.1111/j.1600-0722.2012.00953.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A K Mattila
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | | | | | | | | |
Collapse
|
|
41
|
Surdea-Blaga T, Băban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol 2012; 18:616-626. [PMID: 22363132 PMCID: PMC3281218 DOI: 10.3748/wjg.v18.i7.616] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 09/22/2011] [Accepted: 01/18/2012] [Indexed: 02/06/2023] Open
Abstract
From a pure motor disorder of the bowel, in the past few years, irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity, alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system, alteration of the gut microflora, an increased intestinal permeability and minimum intestinal inflammation. Psychological and social factors can interfere with the communication between the central and enteric nervous systems, and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome. There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders. In order to explain clustering of IBS in families, genetic factors and social learning mechanisms have been proposed. The psychological features, such as anxiety, depression as well as the comorbid psychiatric disorders, health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.
Collapse
|
|
42
|
Soppi V, Karamanakos PN, Koivisto T, Kurki MI, Vanninen R, Jaaskelainen JE, Rinne J. A randomized outcome study of enteral versus intravenous nimodipine in 171 patients after acute aneurysmal subarachnoid hemorrhage. World Neurosurg 2011; 78:101-9. [PMID: 22120252 DOI: 10.1016/j.wneu.2011.09.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 08/24/2011] [Accepted: 09/09/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Delayed ischemic neurologic deficit (DIND) is a serious complication of acute aneurysmal subarachnoid hemorrhage (aSAH). Although oral nimodipine is accepted as standard care for the prevention of DIND, the intravenous route is preferred by several centers. In the present study we compared the clinical efficacy between enteral and intravenous nimodipine after aSAH. METHODS A total of 171 aSAH patients were randomly assigned to either the enteral (84 patients) or the intravenous (87 patients) nimodipine group and were compared regarding the incidence of DIND, number of new ischemic lesions on 12-month brain magnetic resonance image, and clinical outcome 12 months after aSAH as assessed by Glasgow Outcome scale, modified Rankin scale, and Karnofsky scale. Health-related quality of life was also assessed by the 15D questionnaire 12 months after aSAH. RESULTS The incidence of DIND did not differ significantly between the groups (20% in the enteral versus 16% in the intravenous group, P=0.61), whereas no differences were observed, neither in the number of new ischemic lesions (34% in both groups, P=0.99), nor in the clinical outcome 12 months after aSAH (P=0.34 for Glasgow Outcome scale, P=0.74 for modified Rankin scale, and P=0.71 for Karnofsky scale). The mean 15D health-related quality of life sums were also similar in the 2 groups (P=0.43). CONCLUSIONS Our pilot study suggested no differences in the clinical efficacy of enteral and intravenous nimodipine after aSAH. However, a much larger phase III clinical trial would be needed to show or exclude meaningful clinical differences.
Collapse
Affiliation(s)
- Ville Soppi
- Neurosurgery of NeuroCenter, Department of Radiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | | | | | | | | | | | | |
Collapse
|
|
43
|
Sepede G, Racciatti D, Gorgoretti V, Nacci M, Pizzigallo E, Onofrj M, Di Giannantonio M, Niolu C, Salerno R, Gambi F. Psychophysical Distress and Alexithymic Traits in Chronic Fatigue Syndrome with and without Comorbid Depression. Int J Immunopathol Pharmacol 2011; 24:1017-25. [DOI: 10.1177/039463201102400419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with Chronic Fatigue Syndrome (CFS) often report a comorbid depressive disorder. Comorbid depression may negatively influence the long-term outcome of CFS therefore it must be correctly diagnosed and treated. The aim of the present study is to provide a clinical and psychometric assessment of CFS patients with and without depressive features. A comparative analysis between 57 CFS subjects (CDC, 1994), 17 of whom with a comorbid depression, and 55 matched healthy volunteers was assessed to evaluate the presence of any psychophysical distress and alexithymic traits, by means of Symptom Checklist-90-R (SCL-90R) and Toronto Alexithymia Scale (TAS-20). The severity of fatigue was also assessed in all CFS patients using the Fatigue Impact Scale (FIS). With regard to psychiatric comorbidity, the SCL-90R scores showed higher levels of somatic complaints in CFS patients than in healthy subjects, whereas augmented depressive and obsessive-compulsive symptoms were observed only in the depressed CFS subgroup. When comparing the TAS-20 scores, we observed a selective impairment in the capacity to identify feelings and emotions, as measured by the Difficulty in Identifying Feelings subscale (DIF), non-depressed CFS patients showing an intermediate score between depressed CFS and healthy controls. Finally, in terms of FIS scores, a statistical trend versus a higher fatigue severity in depressed CFS patients, with respect to non-depressed ones, was observed. In conclusion, comorbid depression in CFS significantly increased the level of psychophysical distress and the severity of alexithymic traits. These findings suggest an urgent need to address and treat depressive disorders in the clinical care of CFS cases, to improve social functioning and quality of life in such patients.
Collapse
Affiliation(s)
- G. Sepede
- Department of Neuroscience and Imaging, “G. d'Annunzio” University, Chieti
| | - D. Racciatti
- Clinic of Infectious Diseases, Department of Medicine and Aging, “G. d'Annunzio” University, Chieti
| | - V. Gorgoretti
- Clinic of Infectious Diseases, Department of Medicine and Aging, “G. d'Annunzio” University, Chieti
| | - M. Nacci
- Department of Mental Health, National Health Trust, Taranto
| | - E. Pizzigallo
- Clinic of Infectious Diseases, Department of Medicine and Aging, “G. d'Annunzio” University, Chieti
| | - M. Onofrj
- Department of Neuroscience and Imaging, “G. d'Annunzio” University, Chieti
| | - M. Di Giannantonio
- Department of Neuroscience and Imaging, “G. d'Annunzio” University, Chieti
- Center of Mental Health, National Health Trust, Chieti, Italy
| | - C. Niolu
- Psychiatric Unit, Tor Vergata University, Rome, Italy
| | - R.M. Salerno
- Department of Neuroscience and Imaging, “G. d'Annunzio” University, Chieti
| | - F. Gambi
- Department of Neuroscience and Imaging, “G. d'Annunzio” University, Chieti
| |
Collapse
|
|
44
|
Abstract
This study aimed to examine alexithymic features and associations between alexithymia and psychiatric symptoms among adolescents living in a closed institution because of severe behavioral problems. Forty-seven adolescents (29 boys and 18 girls) aged 15 to 18 years completed the 20-item Toronto Alexithymia Scale (TAS-20) Questionnaire and the Youth Self-Report, whereas their foster parents completed the Child Behavior Checklist. The TAS-20 scores of the participants were compared with those of an extensive population sample (N = 6000) matched by age and birth year. Reform school adolescents are significantly more alexithymic than the control group, and the TAS-20 scores are correlated with numerous psychiatric problems, mainly in the internalizing spectrum, but also with thought problems and self-reported aggression. Promoting abilities in identifying and describing feelings is important when treating delinquent adolescents.
Collapse
|
|
45
|
Abstract
We investigated alexithymia, a deficit in the ability to identify and describe one's emotions, in a sample that included patients with neurodegenerative disease and healthy controls. In addition, we investigated the relationship that alexithymia has with behavioral disturbance and with regional gray matter volumes. Alexithymia was examined with the Toronto Alexithymia Scale-20, behavioral disturbance was assessed with the Neuropsychiatric Inventory, and regional gray matter volumes were obtained from structural magnetic resonance images. Group analyses revealed higher levels of alexithymia in patients than controls. Alexithymia scores were positively correlated with behavioral disturbance (apathy and informant distress, in particular) and negatively correlated with the gray matter volume of the right pregenual anterior cingulate cortex, a region of the brain that is thought to play an important role in self and emotion processing.
Collapse
Affiliation(s)
- Virginia E. Sturm
- Department of Neurology, University of California San Francisco, 350 Parnassus Ave., Suite 905, San Francisco, California 94143-1207, USA
| | - Robert W. Levenson
- Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA
| |
Collapse
|
|
46
|
Baiardini I, Braido F, Ferraioli G, Menoni S, Bruzzone M, Conte ME, Gani F, Ridolo E, Scordamaglia A, Canonica GW. Pitfalls in respiratory allergy management: alexithymia and its impact on patient-reported outcomes. J Asthma 2010; 48:25-32. [PMID: 21121763 DOI: 10.3109/02770903.2010.535883] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Alexithymia is a personality trait characterized by a limited ability to identify and express emotions and it represents a possible risk factor for disease development and management. The objective of the study is to evaluate alexithymia in patients with persistent asthma and comorbid rhinitis and its relation with patient-reported outcomes (PROs). METHODS Alexithymia, quality of life, illness perception, and stress were assessed, as well as rhinitis symptoms and asthma control in out-patients classified according to GINA and ARIA guidelines. RESULTS Out of 115 patients, 19% turned out to be alexithymic (TAS-20 ≥ 61). Concerning alexithymia level, no difference was detected between males and females (χ(2) = 0.317) and among GINA levels (χ(2) = 0.22). Alexithymics had significantly lower Asthma Control Test scores when compared with non-alexithymics (15.86 vs. 19; p = .02). Alexithymics had a worse quality of life (p< .001) and, concerning illness perception, they ascribed to respiratory allergy symptoms that are not strictly disease related and referred to asthma and rhinitis more serious negative consequences (p < .001) and emotional representations (p < .035). Moreover, they had lower illness coherence (p < .001) and lived their disease as a cyclical rather than a chronic disorder (p < .035). As regards stress, alexithymics reported less energy (p < .001), higher levels of tension (p < .001), depression (p < .001), confusion (p > .001), and inertia (p < .001). CONCLUSION Alexithymia is present in a relevant percentage of subjects and, as it can modulate illness perception, quality of life, and stress, it should be considered in disease management.
Collapse
Affiliation(s)
- Ilaria Baiardini
- Allergy and Respiratory Disease Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
47
|
Vazquez I, Sández E, González-Freire B, Romero-Frais E, Blanco-Aparicio M, Verea-Hernando H. The role of alexithymia in quality of life and health care use in asthma. J Asthma 2010; 47:797-804. [PMID: 20528585 DOI: 10.3109/02770900903560217] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Alexithymia is a personality trait characterized by difficulties in perceiving and expressing emotions. The relationship between alexithymia and health outcomes in asthma has been shown in a scarce number of studies, in which alexithymia has been considered as an homogeneous construct and the confounding potential effect of anxiety and depression has not been controlled for. OBJECTIVES To determine the relationship between each of the three dimensions of alexithymia as assessed with the Twenty-Item Toronto Alexithymia Scale--Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking--and health-related quality of life and utilization of health care services, controlling anxiety and depression. METHODS Patients with moderate to severe asthma between 18 and 65 years old filled in the Twenty-Item Toronto Alexithymia Scale, the Short-Form 36 Health Survey, the St. George's Respiratory Questionnaire, the Trait Anxiety Inventory, and the Cognitive Depression Index. Sociodemographic and clinical data were collected and the frequency of emergency room visits and hospitalizations due to asthma during the following 24 months was recorded. Data were analyzed using the ?2 test, the Mann-Whitney U test, Spearman correlations and multiple linear regression analyses. RESULTS A total of 76 patients took part in the study (42.67 ± 15.33 years; 59.2% female; 81.6% severe asthma). Data on emergency room visits during the 24-month follow-up were collected for 42 patients; 13 of them (30.95%) with at least one emergency room visit during the follow-up. After controlling for sociodemographic variables, clinical variables, anxiety, and depression, the Difficulty Describing Feelings factor was related to dimensions of the Short-Form 36 Health Survey: Physical Functioning (p = .021), Role-Physical (p = 0.025), and the Physical Component Score (p = .012). The Difficulty Identifying Feelings factor was associated with a higher frequency of emergency room visits (p = .005). The Externally Oriented Thinking factor was not related to any of the dependent measures. CONCLUSIONS Two dimensions of alexithymia, Difficulty Identifying Feelings and Difficulty Describing Feelings, are complicating factors in the management of asthma, but they operate via different mechanisms and over different outcomes and the effects of alexithymia remain even while controlling for the confounding effect of anxiety and depression.
Collapse
Affiliation(s)
- Isabel Vazquez
- Facultad de Psicología, Psicología Clínica y Psicobiología, Campus Universitario Sur, Santiago de Compostela, Spain.
| | | | | | | | | | | |
Collapse
|
|
48
|
Staniloiu A, Markowitsch HJ, Brand M. Psychogenic amnesia – A malady of the constricted self. Conscious Cogn 2010; 19:778-801. [DOI: 10.1016/j.concog.2010.06.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 06/22/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
|
|
49
|
Huang MF, Yeh YC, Tsang HY, Chen CS. Alexithymia Associated With Bilateral Globus Pallidus Lesions After Carbon Monoxide Poisoning. Kaohsiung J Med Sci 2010; 26:333-6. [DOI: 10.1016/s1607-551x(10)70048-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 10/09/2009] [Indexed: 10/19/2022] Open
|
|
50
|
Abstract
The Diagnostic Criteria for Psychosomatic Research (DCPR) represent a diagnostic and conceptual framework that aims to translate psychosocial variables derived from psychosomatic research into operational tools whereby individual patients can be identified. A set of 12 syndromes was developed: disease phobia, thanatophobia, health anxiety, illness denial, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, conversion symptoms, anniversary reaction, irritable mood, type A behavior, demoralization, and alexithymia. The aim of this article is to survey the research evidence that has accumulated on the DCPR in several clinical settings (cardiology, oncology, gastroenterology, endocrinology, primary care, consultation psychiatry, nutrition, and community), to examine prevalence and specific diagnostic clusters of the more prevalent DCPR syndromes, and to review their clinical utility in terms of clinical decision, prediction of psychosocial functioning, and treatment outcomes. The implications for classification purposes (DSM-V) are also discussed.
Collapse
|