Examining mindfulness and its relation to self-differentiation and alexithymia

Published online first in 10 July 2013

Qualités psychométriques de la version française de la TAS-20 et prévalence de l'alexithymie chez 264 adolescents tout-venant [The 20-item Toronto alexithymia scale: structural validity, internal consistency and prevalence of alexithymia in a Swiss adolescent sample]

L'objectif de cette étude est d'examiner la structure factorielle et la consistance interne de la TAS-20 sur un échantillon d'adolescents (n = 264), ainsi que de décrire la distribution des caractéristiques alexithymiques dans cet échantillon. La structure à trois facteurs de la TAS-20 a été confirmée par notre analyse factorielle confirmatoire. La consistance interne, mesurée à l'aide d'alpha de Cronbach, est acceptable pour le premier facteur (difficulté à identifier les sentiments (DIF)), bonne pour le second (difficulté à verbaliser les sentiments (DDF)), mais en revanche, faible pour le troisième facteur (pensées orientées vers l'extérieur (EOT)). Les résultats d'une Anova mettent en évidence une tendance linéaire indiquant que plus l'âge augmente plus le niveau d'alexithymie (score total TAS-20), la difficulté à identifier les sentiments et les pensées orientées vers l'extérieur diminuent. En ce qui concerne la prévalence de l'alexithymie, on remarque en effet que 38,5 % des adolescents de moins de 16 ans sont considérés comme alexithymiques, contre 30,1 % des 16-17 ans et 22 % des plus de 17 ans. Notre étude indique donc que la TAS-20 est un instrument adéquat pour évaluer l'alexithymie à l'adolescence, tout en suggérant quelques précautions étant donné l'aspect développemental de cette période.

Delinquency in male adolescents: the role of alexithymia and family structure

The purpose of this study was to examine the linkages between alexithymia and delinquency in male adolescents (age ranging from 14 to 18 years), and to investigate whether alexithymia was a good discriminatory factor for juvenile delinquency. Thirty-six offender adolescents and 46 non-offender control adolescents participated in the study and completed the 20-item Toronto Alexithymia Scale (TAS-20) (alexithymia), the Revised Children's Manifest Anxiety Scale (R-CMAS) (anxiety), the Liste d'Adjectifs Bipolaires et en Echelles de Likert (LABEL) (personality-Big Five) and demographic data. Findings revealed that the adolescents of the offender group scored high on alexithymia and that proportion of disrupted family structure in the offender group is higher than in the control group. Logistic regressions confirmed that alexithymia and family structure are the strongest discriminatory factors for juvenile delinquency. Limitations and clinical implications are discussed, and recommendations for future research are provided

Alexithymia in cancer patients: review of the literature.

Objective: To summarize the literature on alexithymia in cancer patients. Methods: The empirical literature published between 1972 and January 2010 was searched through MEDLINE, PSYINFO, EMBASE and the Cochrane Library. Key words were: alexithymia, affective symptoms, cancer, neoplasms. Results: The search identified 16 relevant studies which are methodologically problematic and show conflicting results. However, several interesting hypotheses emerge such as a possible link between alexithymia and the immune system, between alexithymia and quality of life, or between alexithymia, anxiety and depression. The question to what degree alexithymia in cancer patients is a trait or a state cannot be answered by these studies. Conclusions: A lack of methodologically sound studies and the large variations of results among studies suggest that the role of alexithymia in patients with cancer deserves more systematic research. Consequently, studies are needed which investigate the nature (state or trait) of alexithymia, its impact on cancer development and progression, as well as its influence on compliance and on the underestimation of psychological distress and psychiatric outcome in cancer patients.

Alexithymie et psychopathologie de patients atteints de cancer = Alexithymia and psychopathology of patients with cancer

Résumé Objectif : Décrire l'alexithymie chez des patientsnouvellement diagnostiqués de cancer.Méthode : Les données sociodémographiques, médicales etpsychométriques (HADS, SCL-90, EORTC-QLQ-C30 etTAS-20) ont été enregistrées chez des patients récemment(< 4 mois) pris en charge pour un cancer.Résultats : Chez 70% des 419 patients inclus dans l'étude, unscore qualifiant pour un diagnostic d'alexithymie (TAS > 56)a été observé avec une corrélation négative avec les symptômespsychiatriques, qui par ailleurs ne dépassaient pas lesseuils d'anxiété et de dépression mesurés avec le HADS,et une corrélation positive avec la qualité de vie.Conclusion : La haute prévalence de l'alexithymie, considéréecomme une protection, questionne la nécessité et letype d'éventuelles interventions psycho-oncologiques.Pour citer cette revue : Psycho-Oncol. 5 (2011).

Etude des liens entre l'alexithymie, l'expérience dépressive et la dépendance interpersonnelle chez des sujets addictifs [Relationships between alexithymia, depression and interpersonal dependency in addictive subjects].

In the scientific literature, the term of addiction is currently used to describe a whole range of phenomena characterized by an irresistible urge to engage in a series of behaviors carried out in a repetitive and persistent manner despite accruing adverse somatic, psychological and social consequences for the individual. It has been suggested that subjects presenting such behaviors would share specific features of personality which support the appearance or are associated with these addictive behaviors. Dimensions such as alexithymia and depression have been particularly well investigated. The aim of this study was to explore the hypothesis of a specific psychopathological model relating alexithymia and depression in different addictive disorders such as alcoholism, drug addiction or eating disorders. Alexithymic and depressive dimensions were explored and analyzed through the statistical tool of path analysis in a large clinical sample of addicted patients and controls. The results of this statistical method, which tests unidirectional causal relationships between a certain number of observed variables, showed a good adjustment between the observed data and the ideal model, and support the hypothesis that a depressive dimension can facilitate the development of dependence in vulnerable alexithymic subjects. These results can have clinical implications in the treatment of addictive disorders.

Profile of male adolescents with conduct disorder on intellectual efficacy, cognitive flexibility, cognitive coping, impulsivity and alexithymia: a comparison with high-risk controls

Background and Objectives: To specify which of the documented cognitive and emotional deficits characterize adolescents with conduct disorder (CD) compared with high-risk controls. Methods: High-risk adolescent males with and without CD were compared on intellectual efficiency, cognitive flexibility, impulsivity, alexithymia, and cognitive coping strategies. Substance use was controlled for in analyses. Results: Both groups showed normal intellectual efficiency and cognitive flexibility, as weil as heightened alexithymia and bebavioral impulsivity. Youths with CD evidenced more self-defeating and black-and-white tbinking under stress, and more acting-out under negative affect, than those without CD. Conclusions: Deficits specifie to CD resided in facets of emotional functioning and cognitive coping that might be targeted by a coping skills intervention.

Alexithymia in patients recently diagnosed with cancer

Background: Contrary to the frequent assumption that alexithymia is a rather static personality trait hampering psychotherapeutic approaches, we have observed that cancer patients who qualify for the criteria of alexithymia may benefit from psychotherapy. Therefore, in patients facing a cancer diagnosis, alexithymia can often be considered as a state due to the threat of the disease (secondary alexithymia).Aims: To identify prevalence of alexithymia in newly diagnosed cancer patients and to document its evolution with and without psychotherapeutic interventions.Methods: Between 2006 and summer 2009, every newpatient of the Oncology Service of the University Hospital Lausanne was invited to benefit from psychotherapeutic support. Accepting patients were randomly assigned to a psychotherapeutic intervention or to a 4-month waiting list. Psychotherapies were formalized as psychodynamic-oriented short interventions (1-4 sessions) or brief psychodynamic psychotherapies (16 sessions). Patients who declined psychotherapeutic support were asked to participate in an observational group. Socio-demographic and medical data, alexithymia (TAS), anxiety and depression (SCL-90, HADS) and quality of life (EORTC) of participants of all groups were recorded at base line and at 1, 4, 8 and 12-months follow-up. Results: Of the 419 patients included, 190 desired psychotherapeutic support (94 were assigned to an immediate and 96 to a delayed intervention) and 229 patients accepted to be followed in the observational group. A very high proportion, almost 2/3 of the patients in all groups, qualified for alexithymia. With regard to the evolution of alexithymia, no significant changes were observed within and between groups and psychological symptoms also remained almost stable.Conclusions: Secondary alexithymia seems to be highly prevalent in newly diagnosed cancer patients. This raises important clinical and scientific questions: are these patients deprived from psychological support? How should interventions be conceptualized? Are interventions necessary and beneficial? Does alexithymia neutralize the effect of interventions on symptoms of anxiety and depression? Which outcome should be chosen for patients with secondary alexithymia?Keywords: Alexithymia, cancer, psycho-oncology, psychotherapy, secondary alexithymia

Alexithymia and depression in eating disorders.

We compared alexithymia and depression ratings for non-hospitalized women meeting DSM-IV criteria for anorexia nervosa (n=32) and bulimia nervosa (n=32) to ratings for healthy women (n=74). Alexithymia was evaluated by the Toronto Alexithymia Scale (TAS-20) and depression by the Hospital Anxiety and Depression Scale (HAD). TAS and HAD scores were significantly higher in anorexic compared to bulimic patients, although these two scales were significantly and positively correlated (r=0.53, P=0.001). After taking depression into account as a confounding variable, rates of alexithymia did not vary according to the type of eating disorder (anorexia or bulimia).

Associations between alexithymia and mental well-being in adolescents

Nuorten tunneilmaisun yhteys psyykkiseen oireiluun Aleksitymialla tarkoitetaan persoonallisuuden piirteistöä, jolle on tyypillistä heikko kyky tunnistaa ja ilmaista tunteita sekä vähäinen mielikuvitus ja konkreettinen, ulkokohtainen ajattelutapa. Tämän tutkimuksen tarkoituksena on tarkastella aleksitymian yhteyttä psyykkiseen oireiluun nuorilla sekä tutkia aleksitymian kehittymiselle altistavia yksilöllisiä lapsuudenaikaisia tekijöitä. Tutkimusaineisto koostui aiempaan nuorten syömishäiriöoireilua tarkastelevaan tutkimukseen osallistuneista nuorista (n = 320) ja heille satunnaisotannalla poimituista verrokeista (n = 640). Seurantakyselyssä käytettiin vastaajan itsensä täytettäviä mittareita ja aineisto kerättiin postikyselynä. Yhteensä 729 henkilöä (78 %) palautti lomakkeen täytettynä, muodostaen näin lopullisen tutkimusaineiston. Tyttöjä vastanneista oli 74 % ja poikia 26 %. Aineiston keski-ikä oli 19 vuotta tämän tutkimuksen aikaan. Aineistosta oli käytettävissä neuvolatiedot syntymästä lähtien. Tutkimusaineistossa todettiin aleksitymian yleisyydeksi tytöillä 8,2 % ja pojilla 8,5 %. Sukupuolten välillä ei todettu eroa 20-osioisella Toronto Alexithymia Scale-kyselyllä (TAS-20) pistemäärissä (tytöillä 44.7 ja pojilla 46.0). Syömishäiriöoireiden todettiin olevan yleisempiä aleksityymisillä nuorilla verrattuna ei-aleksityymisiin. Syömishäiriöoireita mitattiin SCOFF-mittarilla (“Sick”, “Control”, “One”, “Fat”, “Food”). Aleksityymisten nuorten keskimääräinen SCOFF-pistemäärä oli merkitsevästi korkeampi kuin ei-aleksityymisten ja SCOFF-positiivisten (pistemäärä vähintään 2) osuus oli aleksityymisten ryhmässä kolminkertainen ei-aleksityymisten ryhmään verrattuna. Myös ahdistuneisuuden todettiin olevan yhteydessä aleksitymiaan nuorilla. Ahdistuneisuutta mitattiin State-Trait Anxiety Inventory-mittarilla (STAI) ja lisäksi mitattiin masennusoireita ja alkoholinkäyttöä. Aleksityymisten nuorten STAI-pisteet olivat merkitsevästi korkeammat kuin eialeksityymisten. Ahdistuneet aleksityymiset nuoret olivat myös yleisemmin masentuneita ja käyttivät runsaammin alkoholia kuin yhtä ahdistuneet ei-aleksityymiset nuoret. Tutkimuksessa selvitettiin aleksitymian yhteyttä sosiaaliseen tukeen sekä koettuun vanhempien hoivaan ja ylisuojelevaisuuteen. Käytetyt mittarit olivat Multidimensional Scale of Perceived Social Support ja Parental Bonding Instrument. Aleksitymia oli merkitsevästi yhteydessä sekä heikompaan koettuun sosiaaliseen tukeen – erityisesti ystäviltä saatavaan − että korkeampaan vanhempien ylisuojelevaisuuteen. Tutkimuksessa käytettiin 5-vuotisneuvolatarkastuksen tietoja sen arviointiin, mitkä kehitykselliset tekijät saattavat olla yhteydessä aleksitymian ilmenemiseen. Puheenkehityksen ongelmien todettiin olevan miehillä selvästi yhteydessä aleksitymiaan. Tutkimuksen perusteella aleksityymisillä nuorilla esiintyy ei-aleksityymisiin ikätovereihin verrattuna selvästi yleisemmin psyykkisiä oireita. Koska aleksitymia heikentää hoitovastetta todennäköisesti myös nuorilla, tulisi aleksitymian mahdollisuus selvittää tehokkaasti psyykkisesti oireilevilla nuorilla. Lisääntyvä tutkimustieto aleksitymian kehittymisestä mahdollistaa riskitapausten varhaisemman tunnistamisen ja tilanteeseen puuttumisen.

Beliefs about the effects of social sharing of emotion in alexithymia

Resumen tomado de la publicación

Deficit in the Emotional Embodiment in Alexithymia

Alexithymia refers to difficulties in recognizing one’s own emotions and others emotions. Theories of emotional embodiment suggest that, in order to understand other peoples’ feelings, observers re-experience, or simulate, the relevant component (i.e. somatic, motor, visceral) of emotion’s expressed by others in one’s self. In this way, the emotions are “embodied”. Critically, to date, there are no studies investigating the ability of alexithymic individuals in embodying the emotions conveyed by faces. In the present dissertation different implicit paradigms and techniques falling within the field of affective neuroscience have been employed in order to test a possible deficit in the embodiment of emotions in alexithymia while subjects were requested to observe faces manifesting different expression: fear, disgust, happiness and neutral. The level of the perceptual encoding of emotional faces and the embodiment of emotions in the somato-sensory and sensory-motor system have been investigated. Moreover, non-communicative motor reaction to emotional stimuli (i.e. visceral reactions) and interoceptive abilities of alexithymic subjects have been explored. The present dissertation provided convergent evidences in support of a deficit in the processing of fearful expression in subjects with high alexithymic personality traits. Indeed, the pattern of fear induced changes in the perceptual encoding, in the somato-sensory and in the somato-motor system (both the communicative and non communicative one) is widely and consistently altered in alexithymia. This support the hypothesis of a diminished responses to fearful stimuli in alexithymia. In addition, the overall results on happiness and disgust, although preliminary, provided interesting results. Indeed, the results on happiness revealed a defective perceptual encoding, coupled with a slight difficulty (i.e. delayed responses) at the level of the communicative somato-motor system, and the emotion of disgust has been found to be abnormally embodied at the level of the somato-sensory system.