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Psychiatry Research May 2015Patients with depression exhibit high rates of alexithymia, representing a major public health concern. We sought to examine relationships between depression severity... (Meta-Analysis)
Meta-Analysis Review
Patients with depression exhibit high rates of alexithymia, representing a major public health concern. We sought to examine relationships between depression severity and alexithymia as assessed by the Toronto Alexithymia Scale (TAS-20) and the TAS-20 subscales of difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). Potentially relevant studies were obtained independently by two reviewers. Chi-square statistics based on the Q-test and I(2) index assessed statistical heterogeneity between studies. Subgroup analyses were mainly used to explore sources of heterogeneity. Begg׳s test and Duval and Tweedie' trim and fill were used to assess potential publication bias. Altogether, 3572 subjects from 20 study groups across 19 studies were included. Medium relationships were observed between depression and TAS-total score (TAS-TS), DIF, and DDF. There was also a weak relationship between EOT and depression. Subgroup analyses showed a stronger correlation between TAS-TS and depression assessed by self-reported tools than that assessed by the Hamilton Rating Scale for Depression. The heterogeneity significantly decreased only in the subgroup analysis by depression tool. We conclude that alexithymia, as assessed by the TAS-20 and its subscales DIF and DDF, is closely related to depression. These relationships were affected by depression measurement tools.
Topics: Affective Symptoms; Depression; Depressive Disorder; Emotions; Humans; Psychiatric Status Rating Scales; Severity of Illness Index
PubMed: 25769520
DOI: 10.1016/j.psychres.2015.02.006 -
Epilepsy & Behavior : E&B Jan 2021The relationship between epilepsy and alexithymia, characterized by the inability to feel or express emotion, remains incompletely understood. We investigated...
PURPOSE
The relationship between epilepsy and alexithymia, characterized by the inability to feel or express emotion, remains incompletely understood. We investigated alexithymia and its association with epilepsy-related factors in patients with epilepsy (PWE).
METHODS
In this cross-sectional study, PWE and healthy control subjects were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20). The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) were also administered to assess depression and anxiety, respectively. Mediation analysis was conducted using a two-stage regression method.
RESULTS
Ninety adult PWE and 161 healthy control subjects were included in the study. PWE had significantly higher TAS-20 scores (B = 2.445, p = 0.014) than controls, but the prevalence of alexithymia, defined as TAS-20≥61, did not differ between PWE and control subjects after controlling for confounders (15.6% vs. 6.2%, respectively; p = 0.873). Uncontrolled seizures significantly increased alexithymia through depression (B = 3.536, p = 0.006), and this effect was responsible for 61.2% of the total effect on alexithymia. The direct effects of uncontrolled seizures on alexithymia were not significant. In contrast, AED polytherapy had significant direct effects on alexithymia (B = 4.489, p = 0.037) independent of depression. The indirect effects of AED polytherapy via depression did not reach statistical significance (B = 2.371, p = 0.066).
CONCLUSIONS
Alexithymia was more severe, but not more prevalent, in PWE than in healthy controls. AED polytherapy was directly associated with alexithymia, while uncontrolled seizures were indirectly related to alexithymia through depressive symptoms.
Topics: Adult; Affective Symptoms; Anxiety Disorders; Cross-Sectional Studies; Epilepsy; Humans; Seizures
PubMed: 33268019
DOI: 10.1016/j.yebeh.2020.107582 -
Psychiatry Research. Neuroimaging Nov 2018Past research suggests an association between reactive aggression and alexithymia, but neural mechanisms underlying this association remain unknown. Furthermore, the...
Past research suggests an association between reactive aggression and alexithymia, but neural mechanisms underlying this association remain unknown. Furthermore, the relationship between proactive aggression and alexithymia remains untested. This study aimed to: (1) test whether alexithymia is more related to reactive than proactive aggression; and (2) determine whether amygdala, insula, and/or anterior cingulate cortical (ACC) volume could be neurobiological mechanisms for this association. One hundred and fifty-six community males completed the Reactive-Proactive Aggression Questionnaire and the Toronto Alexithymia Scale. Amygdala, insula, and ACC volumes were assessed using MRI. Alexithymia was positively associated with reactive but not proactive aggression. Alexithymia was positively and bilaterally associated with amygdala and anterior cingulate volumes. Reactive aggression was positively associated with right amygdala volume. Controlling for right amygdala volume rendered the alexithymia-reactive aggression relationship non-significant. Results suggest that increased right amygdala volume is a common neurobiological denominator for both alexithymia and reactive aggression. Findings suggest that greater right hemisphere activation may reflect a vulnerability to negative affect, which in turn predisposes to experiencing negative emotions leading to increased aggression. Findings are among the first to explicate the nature of the alexithymia-aggression relationship, with potential clinical implications.
Topics: Adult; Affective Symptoms; Aggression; Amygdala; Cerebral Cortex; Female; Gyrus Cinguli; Humans; Magnetic Resonance Imaging; Male; Organ Size; Psychiatric Status Rating Scales; Surveys and Questionnaires
PubMed: 30273792
DOI: 10.1016/j.pscychresns.2018.09.003 -
Brain and Behavior Dec 2019Phenotypic variants of progressive supranuclear palsy (PSP) are all characterized by the combination of motor symptoms of parkinsonism with a number of neuropsychiatric...
INTRODUCTION
Phenotypic variants of progressive supranuclear palsy (PSP) are all characterized by the combination of motor symptoms of parkinsonism with a number of neuropsychiatric and cognitive disorders. Despite the strong effort in characterizing these features in PSP, alexithymia and anhedonia have not been investigated at present. Here, we aimed at investigating the qualitative and quantitative differences of alexithymia and anhedonia in the two more frequent variants of PSP, Richardson's syndrome (PSP-RS) and PSP with predominant parkinsonism (PSP-P) compared to Parkinson's disease (PD) patients recruited within 24 months after the onset of motor symptoms.
METHODS
One hundred fifty-five PD, 11 PSP-P, and 14 PSP-RS patients underwent clinical, neuropsychiatric, and neuropsychological evaluations. Alexithymia was assessed using the Toronto Alexithymia Scale-20 item (TAS-20), and hedonic tone was measured by the Snaith-Hamilton Pleasure Scale (SHAPS).
RESULTS
In PSP-P and PSP-RS patients, the frequency of alexithymia diagnosis was higher than in PD. On the TAS-20 scores, PSP-RS performed worse in the total score and in F2 sub-scale when compared to PD. Among patients with diagnosis of depression, PSP-RS showed higher scores in TAS-20 total and TAS-20 F2 than PD. No significant differences in TAS-20 scores were found in nondepressed patients. Finally, we did not find significant differences among PD, PSP-P, and PSP-RS groups in the SHAPS scores.
CONCLUSIONS
Alexithymia is identifiable very early in PSP-P and PSP-RS patients. Alexithymic symptoms differentiate PSP-RS group from PD group but not between the two subtypes of PSP. Further, alexithymia in PSP seems to be predicted by the presence of depression. Altered emotional capability could be related to specific neurophysiological dysfunction occurring precociously in PSP; therefore, its identification could orient the diagnosis toward PSP cases.
Topics: Affective Symptoms; Aged; Anhedonia; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Parkinsonian Disorders; Supranuclear Palsy, Progressive
PubMed: 31743601
DOI: 10.1002/brb3.1448 -
Epilepsy & Behavior : E&B Oct 2022The objective of this study was to investigate alexithymia, emotion dysregulation, suicidality, and personality traits in people with epilepsy (PWE) and to evaluate...
OBJECTIVE
The objective of this study was to investigate alexithymia, emotion dysregulation, suicidality, and personality traits in people with epilepsy (PWE) and to evaluate their effects on quality of life.
MATERIALS AND METHODS
Forty-six consecutive PWE and forty healthy control subjects (HC) were recruited for the study. Both PWE and HC were interviewed and completed the following questionnaires: Toronto Alexithymia Scale-20(TAS-20), Difficulties in Emotion Regulation Scale (DERS), Eysenck Personality Questionnaire, Suicidal Ideation Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, and Quality Of Life In Epilepsy-31.
RESULTS
TAS-20 and difficulty identifying feelings which was the subgroup of TAS-20, scores of total and non-acceptance, goals, impulse, strategies, and clarity subgroups of DERS were statistically significantly higher in PWE (p = 0.01, 0.004, 0.01, 0.07, 0.009, 0.06, 0.01, respectively). Considering the personality characteristics, neuroticism was more common in PWE, while extraversion was less common. Suicidal ideation and anxiety scores were higher in PWE than HC (p = 0.02, p = 0.003). Anxiety, suicidal ideation, neuroticism, alexithymia and emotion dysregulation had a negative relationship on quality of life. (r = -0.54, p < 0.001; r = -0.54, p < 0.001; r = -0.62, p < 0.001; r = -0.32, p = 0.02; r = -0.52, p < 0.001).
CONCLUSION
Difficulty identifying feelings, dysregulation of emotions especially nonacceptance, goals, impulse, strategies, and clarity are common in PWE. Anxiety, suicidal ideation, neuroticism, alexithymia, and emotion dysregulation had a negative impact on quality of life. Each of these are important for psychosocial wellbeing of our patients and must be questioned considering their effects on quality of life.
Topics: Affective Symptoms; Emotional Regulation; Epilepsy; Extraversion, Psychological; Humans; Neuroticism; Quality of Life; Suicidal Ideation; Suicide
PubMed: 36037582
DOI: 10.1016/j.yebeh.2022.108887 -
Schizophrenia Research Nov 2023Although cognition is known to impact clinical symptoms of schizophrenia, few studies investigate the potential mediators of this relationship. This study aimed to...
BACKGROUND
Although cognition is known to impact clinical symptoms of schizophrenia, few studies investigate the potential mediators of this relationship. This study aimed to examine the relationship between cognitive deficits and negative symptoms in schizophrenia, considering the mediating role of alexithymia as an important psychological variable. Moreover, the prevalence of alexithymia in patients with schizophrenia was investigated.
METHODS
A total of 689 patients with schizophrenia were recruited from two psychiatric hospitals. All patients completed the Positive and Negative Syndrome Scale (PANSS), 20-item Toronto Alexithymia Scale (TAS-20), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We used structural equation modeling to examine the hypothesized mediated model.
RESULTS
In total, 31.5 % of patients with schizophrenia were classified as alexithymia. The path analyses showed that two factors of alexithymia (i.e., the difficulty in identifying feelings and difficulty in describing feelings), played a mediating role in the pathway from cognitive deficits to negative symptoms (all p < .001).
LIMITATIONS
Self-reported measurement for alexithymia may not be sufficiently reliable due to response bias.
CONCLUSION
Our findings demonstrated a high occurrence of alexithymia in patients with schizophrenia. Moreover, the mediating role of alexithymia suggests that targeting emotion processing and cognition may be a feasible way to mitigate negative symptoms.
Topics: Humans; Affective Symptoms; Schizophrenia; Emotions; Cognition; Cognitive Dysfunction
PubMed: 37866075
DOI: 10.1016/j.schres.2023.10.006 -
Journal of Psychosocial Nursing and... Aug 2022The purpose of the current study was to examine prediction power of psychological factors (i.e., alexithymia and psychological distress) on fibromyalgia among high...
The purpose of the current study was to examine prediction power of psychological factors (i.e., alexithymia and psychological distress) on fibromyalgia among high school students. A cross-sectional, correlational design was used. Data related to alexithymia, psychological distress, and fibromyalgia were collected from 483 high school students from the northern part of Jordan using stratified cluster random sampling. Results showed that psychological distress is a significant predictor of fibromyalgia (odds ratio = 1.1, < 0.001). Significant differences were found between males and females in relation to alexithymia ( = -4.87, < 0.001), psychological distress ( = -6.0, < 0.001), and fibromyalgia (χ = 4.14, = 0.04, phi = 0.07). Age was only significantly correlated with alexithymia ( = 0.06, < 0.05). Given the relationship among psychological distress, alexithymia, and fibromyalgia, mental health professionals should carefully observe psychological disturbances among high school students. [(8), 19-25.].
Topics: Affective Symptoms; Cross-Sectional Studies; Female; Fibromyalgia; Humans; Jordan; Male; Stress, Psychological; Students
PubMed: 35412876
DOI: 10.3928/02793695-20220325-04 -
Clinical Psychology & Psychotherapy 2023Compared to community adolescents (COM), adolescents placed in residential care (RC) or late adopted (LA) appear to show more emotional-behavioural problems. They also...
Attachment and alexithymia predict emotional-behavioural problems of institutionalized, late-adopted and community adolescents: An explorative multi-informant mixed-method study.
OBJECTIVE
Compared to community adolescents (COM), adolescents placed in residential care (RC) or late adopted (LA) appear to show more emotional-behavioural problems. They also appear vulnerable in variables linked to emotional-behavioural problems, such as insecure-disorganized attachment and alexithymia. This study employs a mixed-method multi-informant approach to (1) compare adolescents placed in RC, LA and COM in emotional-behavioural problems, attachment and alexithymia and (2) investigate relationships and interplay of attachment and alexithymia concerning emotional-behavioural problems in these three groups.
METHOD
Participants were 174 adolescents (50 RC, 33 LA and 91 COM; M = 15, 53% boys and 47% girls). Adolescents' internalizing and externalizing problems were assessed through both caregiver-reported and self-reported questionnaires, while attachment and alexithymia were assessed with a mixed method, using interviews and self-report questionnaires.
RESULTS
The results showed RC adolescents as more vulnerable in all variables, while LA and COM did not differ. Accounting for the group, attachment and alexithymia cumulatively predicted 25-43% of internalizing problems, and 19-43% of externalizing problems depending on the method of assessment or problems' informant (all p < 0.01). Alexithymia was both an independent predictor and interacted with preoccupied attachment in predicting internalizing problems, while no predictors were isolated for externalizing ones, and the group never indicate an effect on problems' rates.
CONCLUSIONS
The authors discuss the utility to maintain a research focus on attachment and alexithymia, also suggesting future directions of research. A need to determine potential distortions of results because of problems' informant and method of assessment is also highlighted.
Topics: Male; Female; Humans; Adolescent; Affective Symptoms; Problem Behavior; Emotions; Adolescent Behavior
PubMed: 37259169
DOI: 10.1002/cpp.2862 -
The Prevalence and Characteristics of Alexithymia in Adults Following Brain Injury: A Meta-Analysis.Neuropsychology Review Dec 2021Alexithymia is the inability to identify and describe one's own emotions. Some research suggests that organic alexithymia may occur after acquired brain injury (ABI).... (Meta-Analysis)
Meta-Analysis Review
Alexithymia is the inability to identify and describe one's own emotions. Some research suggests that organic alexithymia may occur after acquired brain injury (ABI). However, the results in the literature are inconsistent, when comparisons are made against healthy controls. Furthermore, a precise estimate of alexithymia prevalence in the ABI population has not yet been reported. Consequently, this meta-analysis aimed to estimate the prevalence and characteristics of alexithymia in ABI, as measured by the Toronto Alexithymia Scale-20 (TAS-20). Based on 22 unique ABI samples, a series of random-effects meta-analyses estimated moderate to large positive effect sizes (i.e., greater alexithymia in ABI samples) for the TAS-20 total scale (Hedges' g = 1.00, 95% CI [0.75, 1.35]), as well as the subscales: difficulty identifying feelings (Hedges' g = 0.92, 95% CI [0.66, 1.17]), difficulty describing feelings (Hedges' g = 0.69, 95% CI [0.50, 0.87]) and externally oriented thinking (Hedges' g = 0.75, 95% CI [0.64, 0.85]). Furthermore, a meta-regression identified a larger effect size (TAS-20 total scale score) for traumatic brain injury (TBI) samples, in comparison to non-TBI samples. Finally, the prevalence of clinically significant levels of alexithymia (TAS-20 total scale ≥ 68.4; i.e., two SDs above the general population mean) in ABI patients was estimated at 15.2%. We interpreted the results to suggest that ABI may have a substantial negative impact on affective processing abilities and, thus, comprehensive assessment of emotional functioning deficits following ABI should be considered by practitioners.
Topics: Adult; Affective Symptoms; Brain Injuries; Emotions; Humans; Prevalence
PubMed: 33624197
DOI: 10.1007/s11065-021-09484-6 -
The Journal of Nervous and Mental... Apr 2021Mindfulness and acceptance have demonstrated associations with alexithymia facets. As a very limited body of research has explored the predictive strength among...
Mindfulness and acceptance have demonstrated associations with alexithymia facets. As a very limited body of research has explored the predictive strength among alexithymia-related constructs, this study aimed to investigate the prediction of alexithymia based on acceptance and mindfulness among students. The study group consisted of 586 university students, 237 (40.9%) females and 349 (59.1%) males. As for data collection, the five-factor mindfulness questionnaire, Acceptance and Commitment Questionnaire, and the Toronto Alexithymia Scale-2 were applied. A stepwise multiple linear regression was calculated to predict alexithymia based on components of commitment and action, mindfulness facets, and demographic variables (F[5,578] = 77.26, p ≤ 0.001), with an R2 of 0.41. The predictive variables including description (B = -0.59, t = -8.02, p < 0.001), commitment and action (B = -0.13, t = -4.38, p < 0.001), observation (B = -0.15, t = -2.94, p < 0.01), and no judgment (B = -0.16, t = -2.56, p < 0.05) exhibited significant prediction effects on the adjusted index of alexithymia. The findings contribute to the potential mechanism between mindfulness and alexithymia in intervention that seeks to improve mindfulness and acceptance skills and could prove more effective in treating patients with alexithymia.
Topics: Adult; Affective Symptoms; Female; Humans; Male; Mindfulness; Psychiatry; Students; Surveys and Questionnaires; Young Adult
PubMed: 33476108
DOI: 10.1097/NMD.0000000000001295