Emotion-processing deficits in eating disorders

OBJECTIVE: First, we measured both emotional awareness and alexithymia to understand better emotion-processing deficits in eating disorder patients (EDs). Second, we increased the reliability of the measures by limiting the influence of confounding factors (negative affects). METHOD: Seventy females with eating disorders were compared with 70 female controls. Participants completed the Beck Depression Inventory (BDI; depression), the Hospital and Anxiety Depression Scale (HADS; anxiety), the Toronto Alexithymia Scale (TAS; alexithymia), and the Level of Emotional Awareness Scale (LEAS). RESULTS: EDs exhibited higher alexithymia scores and lower LEAS scores, with an inability to identify and describe their own emotions, as well as an impairment in mentalizing others' emotional experience. Whereas alexithymia scores were related to depression scores, LEAS scores were not. After controlling for depression, alexithymia scores were similar in EDs and controls. DISCUSSION: The marked impairment in emotion processing found in EDs is independent of affective disorders. Thus, the joint use of TAS and LEAS suggests a global emotion-processing deficit in EDs.     

青少年偏头痛患者述情障碍与父母教养方式、心理症状的关系

目的 调查分析青少年偏头痛患者述情障碍的特点,探讨述情障碍与父母教养方式及焦虑抑郁等心理症状的关系,为改善青少年偏头痛患者临床症状、提高其生活质量、维护其身心健康提供理论依据。方法 筛选2017年10月—2019年2月在石家庄市人民医院确诊的110名青少年偏头痛患者为研究对象,采用一般资料调查表、多伦多述情障碍评定量表(TAS-20)、父母教养方式评价量表(EMBU)、视觉模拟量表(VAS)、汉密尔顿焦虑量表、汉密尔顿抑郁量表进行问卷调查及评估。结果 1)青少年偏头痛患者的述情障碍检出率为47.3%,述情障碍总分为(49.33±17.02)分。焦虑、抑郁症状的发生率分别为68.1%、47.3%。2)述情障碍组父母情感温暖因子得分(t=1.350、4.064)低于非述情障碍组,父母过分干涉(t=1.069、2.621)、拒绝否认(t=3.611、2.020)、过度保护因子得分(t=3.578、2.621)高于非述情障碍组,差异有统计学意义(P<0.05)。述情障碍组青少年对疼痛、焦虑、抑郁情绪的感知得分高于非述情障碍组,差异有统计学意义(t=3.640、3.801、5.318,P&...     

Emotional eating,alexithymia, and binge-eating disorder in obese women

OBJECTIVE: To investigate the relationships between alexithymia and emotional eating in obese women with or without Binge Eating Disorder (BED). RESEARCH METHODS AND PROCEDURES: One hundred sixty-nine obese women completed self-report questionnaires, including the Beck Depression Inventory, the State Trait Anxiety Inventory, the Stress Perceived Scale, the Dutch Eating Behaviour Questionnaire, and the Toronto Alexithymia Scale. The presence of BED, screened using the Questionnaire of Eating and Weight Patterns, was confirmed by interview. RESULTS: Forty obese women were identified as having BED. BED subjects and non-BED subjects were comparable in age, body mass index, educational level, and socioeconomic class. According to the Dutch Eating Behaviour Questionnaire, BED subjects exhibited higher depression, anxiety, perceived stress, alexithymia scores, and emotional and external eating scores than non-BED subjects. Emotional eating and perceived stress emerged as significant predictors of BED. The relationships between alexithymia and emotional eating in obese subjects differed between the two groups according to the presence of BED. Alexithymia was the predictor of emotional eating in BED subjects, whereas perceived stress and depression were the predictors in non-BED subjects. DISCUSSION: This study pointed out different relationships among mood, alexithymia, and emotional eating in obese subjects with or without BED. Alexithymia was linked to emotional eating in BED. These data suggest the involvement of alexithymia in eating disorders among obese women.     

Alexithymia and emotional awareness in anorexia nervosa: Time for a shift in the measurement of the concept?

The present study compared 35 patients with anorexia nervosa (AN) with an age matched control group using the Toronto Alexithymia Scale (TAS-20; a self-report instrument) and the Levels of Emotional Awareness Scale (LEAS; a performance-based instrument). Depression and anxiety have been shown to account for elevated levels of alexithymia in AN, and an elevated level of perfectionism might affect self-reporting in general. The AN-group reported a higher level of alexithymia on the TAS-20 compared to the control group, a difference that disappeared after controlling for depression or anxiety (but not for perfectionism). The findings suggest that the AN-patients believe that they have difficulties in identifying and reporting emotions, but actually perform as well as the control group when confronted with the task of identifying and reporting their emotions according to LEAS. It might be time to rethink the measurement of alexithymia. Maybe, similar to assessment of personality disorders, it should not be assessed when patients are depressed, or it should be assessed through instruments and modalities that are not sensitive to the mood state of the patient.     

大学生述情障碍的潜在类别类型与抑郁症状及社交焦虑的关联

  目的  识别大学生述情障碍的潜在类别及其与社交焦虑、抑郁症状的关联,为促进大学生积极情绪发展和心理健康提供理论依据。  方法  于2020年9月,在河北省、吉林省、辽宁省4所高校方便整群抽取1 338名大学生进行横断面调查,使用多伦多述情障碍量表(TAS-20)、交往焦虑量表(SIAS)以及流调中心抑郁自评量表(CES-D)进行问卷调查,对数据主要进行潜在剖面分析及Logistic回归分析。  结果  大学生述情障碍分为情感表达良好组(33.3%)、情感辨别良好组(9.6%)和情感表达困难组(57.1%)3个潜在类别。多元Logistic回归分析结果显示,对人口学变量进行控制后,情感表达良好、情感辨别良好与抑郁症状(β值分别为-1.92,-1.44,P值均 < 0.01)、社交焦虑(β值分别为-0.71,-2.04,P值均 < 0.01)呈负相关。  结论  大学生述情障碍呈现类别分布,各潜在类别与社交焦虑、抑郁症状关联不同。高校应在心理健康教育工作中制定针对大学生情绪调节能力培养的干预方案,缓解大学生社交焦虑及抑郁症状,促进心理积极发展。     

述情障碍在慢性阻塞性肺疾病中的流行及影响因素分析

目的 分析慢性阻塞性肺疾病(慢阻肺)合并述情障碍的流行特征及相关影响因素。方法 对842例慢阻肺患者进行调查采用多伦多述情障碍量表评价述情障碍,并测量肺功能,采用logistic回归分析慢阻肺合并述情障碍的影响因素。 结果 慢阻肺患者中合并述情障碍组与慢阻肺组相比,男性、BMI、吸烟、FEV1%预测值、抑郁和焦虑评分、mMRC评级和SGRQ评分均有统计学意义(P<0.05)。Logistic分析结果显示,FEV1%预测值、焦虑和抑郁、mMRC、SGRQ为慢阻肺合并述情障碍的独立危险因素[OR值及95%CI分别为1.296(1.256～1.337)、1.238(1.097～1.396)和1.178(1.034～1.340)、1.297(1.274～1.320)、1.627(1.401～1.890)],年龄和BMI为其保护因素[OR值及95%CI分别为0.886(0.794～0.998)和0.879(0.781～0.989)]。结论 FEV₁%预测值、抑郁和焦虑、mMRC、SGRQ评分为慢阻肺合并述情障碍的独立危险因素。     

Alexithymia and facial emotion recognition in patients with eating disorders

OBJECTIVE: Patients with anorexia or bulimia nervosa are reported to show high levels of alexithymia and to have difficulties recognizing facially displayed emotions. The current study tested whether it could be that facial emotion recognition is a basic skill that is independent from alexithymia. METHOD: We assessed emotion recognition skills and alexithymia in a group of 79 female inpatients with eating disorders and compared them with a group of 78 healthy female controls. Instruments used were the Toronto Alexithymia Scale, the Facially Expressed Emotion Labeling (FEEL) test, and the revised Symptom Check List (SCL-90-R). RESULTS: There were no significant differences between patients and controls in their emotion recognition scores, but patients with eating disorders displayed significantly more alexithymia and psychopathology. Emotion recognition in patients was not related to alexithymia, psychopathology, or clinical symptoms. CONCLUSION: We suggest that the reported alexithymia of patients with eating disorders is complex and independent from basic facial emotion recognition.     

服刑人员抑郁、述情障碍与童年创伤的关系研究

目的 探究服刑人员抑郁、述情障碍与童年创伤的关系。方法 采用贝克抑郁量表第二版 （Beck depression inventory -Ⅱ）、多伦多述情障碍问卷（Toronto alexithymia scale）和童年创伤问卷（Childhood trauma questionnaire），对广东某监狱456名服刑人员进行调查。结果 服刑人员抑郁症状、述情障碍和童年创伤的检出率分别为78.6%，28.9%和59.8%。入狱时间较长的服刑人员，其抑郁得分较高（t = - 2.261，P＜0.05）；受教育程度越高的服刑人员，其述情障碍得分越低（F = 5.121，P＜0.01）。童年创伤和抑郁、述情障碍均呈正相关（r值为0.355、0.298，均P＜0.001），抑郁和述情障碍呈正相关（r = 0.436，P＜0.001）。结论 服刑人员心理健康问题较严重，其抑郁、述情障碍与童年创伤有着紧密的关系，在心理矫治中应给予充分考虑。     

Alexithymia, Negative Emotions, and Sexual Behavior in Heterosexual University Students from Italy

Alexithymia is a construct which denotes thought characterized by pragmatic content, an inability to recognize and verbally express emotion, a difficulty in distinguishing between feelings and bodily sensations, and a limitation in fantasy life. Research has revealed a role for alexithymia in different kinds of sexual dysfunctions; it was also associated with reduced frequency of penile-vaginal intercourse but not with sexual behaviors—like masturbation—which do not include an emotional interaction in normal individuals. The aim of this research was to further investigate the association between alexithymia scores and sexual behavior in a sample of normal individuals, taking into account the role of gender differences and the possible effect of negative emotions (depression, anxiety, and anger). Participants were 300 university students (142 men and 158 women); sexual behavior was measured by the Sex and the Average Woman (or Man) Scale while alexithymia was measured with the Toronto Alexithymia Scale. The findings of the study showed that higher alexithymia scores were associated with lower levels of sexual satisfaction and higher levels of sexual detachment for females, and with sexual shyness and sexual nervousness for both genders. Results also suggested that the correlations between alexithymia scores and sexual behavior are partially influenced by the effect of negative emotions. Overall, it seems that the same detachment which denotes the alexithymic interpersonal style also characterizes sexual behavior.     

Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior

This article reports the findings of a study investigating alexithymia, emotional instability, and vulnerability to stress proneness among individuals (N = 120) seeking help for hypersexual behavior. At the onset of treatment at an outpatient community clinic, subjects completed the Sexual Compulsivity Scale (SCS), the 20-item Toronto Alexithymia Scale (TAS-20), and the NEO Personality Inventory Revised (NEO-PI-R). The results of a hierarchical regression analysis revealed the best model in predicting severity of hypersexual behavior included the facets of depression and vulnerability to stress from the NEO and the Difficulty Identifying Feelings (DIF) factor of the TAS-20. Although the NEO domain of neuroticism appeared to capture the majority of variance in hypersexual behavior, the difficulty identifying feelings factor of the TAS-20 did make some modest, but significant, contribution to the severity of hypersexual behavior after controlling for depression and vulnerability to stress. These data provide evidence for the hypothesis that individuals who manifest symptoms of hypersexual behavior are more likely to experience deficits in affect regulation and negative affect (including alexithymia, depression, and vulnerability to stress). Possible reasons for these results are suggested and future recommendations for research are offered.     

Alexithymia and body image in adult outpatients with binge eating disorder

OBJECTIVE: The current study elucidates the relations between alexithymia and body image in patients with binge eating disorder (BED). METHOD: One hundred one patients with BED were evaluated. Alexithymia was measured with the Toronto Alexithymia Scale (TAS-20). The severity of BED was measured with the Binge Eating Scale (BES). Body concerns were assessed with the Body Shape Questionnaire-Short Version (BSQ-S), the Body Uneasiness Test (BUT), and the Body Attitude Test (BAT). Additional measures were the Rosenberg Self-Esteem Scale (RSES) and the Beck Depression Inventory (BDI). RESULTS: The prevalence of alexithymia in our sample was 39.6% (n = 40) and individuals with alexithymia showed higher scores on all rating scales. Higher body dissatisfaction, lower self-esteem, depressive symptoms, and the Difficulty in Identifying Feelings/Difficulty in Describing Feelings subscales of the TAS-20 were predictors of the severity of BED in the linear regression analysis. CONCLUSION: Alexithymia was associated with more severe BED. Individuals with alexithymia and BED exhibited significantly poorer appearance evaluation and body satisfaction as well as higher depressive symptoms than individuals without alexithymia.     

Alexithymia and eating behaviour in severely obese patients

Background: Alexithymia is the inability to express feelings with words and comprises a psychological construct frequently found in obese individuals. In eating disordered patients who show a tendency to lose control over food intake, personality traits with alexithymic characteristics have been demonstrated. The present cross‐sectional study investigated the relationships between alexithymia and eating behaviour in severely obese patients. Methods: This study analysed 150 obese patients undergoing bariatric surgery and 132 subjects at more than 1 year after biliopancreatic diversion (BPD), when body weight has steadily normalised and any preoccupation with weight, food and diet has been completely abandoned. Obese and operated subjects completed the Toronto Alexithymia Scale (TAS), and eating behaviour was assessed via a semi‐structured interview exploring binge eating disorder (BED), night eating and emotional eating, as well as by utilisation of the Three Factor Eating Questionnaire (TFEQ). Results: Although alexithymic patients showed deranged eating behaviour, as evaluated by the TFEQ scores, the frequency of BED, night eating and emotional eating was similar in alexithymic (TAS > 60) and non‐alexithymic patients. However, the prevalence of alexithymia was similar in obese and BPD subjects, whereas, in the operated subjects, TFEQ scores were lower (P < 0.005) than those in obese patients. Conclusions: These data suggest that, in severely obese patients, alexithymia does not influence eating behaviour; in severely obese patients, the tendency to lose control over food intake apparently represents a psychological construct that is substantially independent from alexithymia.     

学龄期矮小儿童焦虑抑郁状况及其与心理弹性的关系

目的 探讨学龄期矮小儿童焦虑、抑郁状况及其与心理弹性的关系,为进一步进行心理干预提供依据.方法 选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表和(或)心理弹性量表(RS)个性问卷,对2008年8月-2011年8月扬州大学临床医学院儿科矮小门诊确诊为矮小症的82例9 ～ 14岁身材矮小儿童和78名正常对照儿童进行问卷调查.结果 矮小儿童有焦虑障碍的比例(43.90％)与对照组( 16.70％)差异有统计学意义(x2=13.96,P＜0.01);有抑郁障碍的比例(18.30％)高于对照组(12.80％),差异无统计学意义(x2=0.91,P＞0.05);两组儿童焦虑总分以及躯体化/惊恐、广泛性焦虑、社交恐怖、学校恐怖分量表评分差异有统计学意义(P值均＜0.05);矮小儿童抑郁评分与正常对照组差异无统计学意义(P＞0.05).矮小儿童心理弹性评分焦虑组与非焦虑组、抑郁组与非抑郁组差异均有统计学意义(P值均＜0.05).矮小儿童焦虑各因子及总分,抑郁评分与心理弹性总分及各因子评分均呈显著负相关(r=-0.10～-0.33,P值均＜0.05).结论 学龄期矮小儿童较正常儿童有更多的焦虑等情绪,心理弹性好的学生焦虑抑郁症状较轻.应注重儿童心理弹性的培养.     

反复呼吸道感染儿童情绪障碍对照研究

目的:分析反复呼吸道感染(RRTIs)儿童焦虑、抑郁等情绪障碍的发生情况,以揭示在关心反复呼吸道感染儿童的躯体健康的同时,也应关注其心理健康的必要性。方法:用上海惠诚咨询有限公司出版的《儿童青少年心理测验系统2.0版》中的"焦虑自评量表(SAS)"和"抑郁自评量表(SDS)",将46例反复呼吸道感染儿童作为观察组进行问卷调查和评定,并选择59例正常儿童作为对照组,探讨儿童焦虑和抑郁症状检出率和状态水平与反复呼吸道感染的相关性,以及儿童性别、年龄、母亲焦虑水平、母亲文化程度、家庭关系、经济状况对儿童焦虑、抑郁的影响。母亲焦虑水平用"汉密顿焦虑量表"进行测评。结果:反复呼吸道感染儿童的焦虑、抑郁症状检出率、焦虑水平、抑郁水平显著高于正常儿童,差异有统计学意义(P均0.05);比较不同年龄、性别的焦虑、抑郁状态水平,显示10~13岁儿童比7~9岁儿童的焦虑、抑郁状态水平更高(P0.01和P0.05),不同性别儿童的焦虑、抑郁状态水平差异无统计学意义(P均0.05);反复呼吸道感染儿童的焦虑水平与母亲焦虑水平明显相关(P0.01),而抑郁与母亲焦虑水平以及焦虑、抑郁水平与母亲文化程度、家庭关系、经济条件等没有明显的相关性。结论:反复呼吸道感染儿童焦虑、抑郁等情绪障碍发生水平高于正常儿童,提示反复呼吸道感染儿童比正常儿童更需要心理上的帮助和支持。     

抑郁症患者心理韧性在述情障碍与情绪自我效能感间的中介效应

目的 探讨抑郁症患者心理韧性在述情障碍与情绪自我效能感间的中介效应。方法 选择2018年3月—2020年6月本院收治的130例抑郁症患者,其中123例患者符合研究要求。应用心理韧性量表、述情障碍量表及情绪自我效能感量表分别评估患者心理韧性、述情障碍及情绪自我效能感等。应用Pearson法分析心理韧性、述情障碍和情绪自我效能感的相关性;应用AMOS 21.0软件构成以心理韧性为中介变量的拟合模型,采用最大似然比法修正并拟合模型,并通过Boostrap法验证心理韧性的中介效应。结果 123例抑郁症患者心理韧性评分、述情障碍及情绪自我效能感分别为(58.37±6.54)、(54.91±8.99)和(28.17±4.08)分。心理韧性和情感自我效能呈现正相关(r=0.478, P<0.001),心理韧性和情感自我效能感与述情障碍呈负相关(r=-0.56、-0.424, P<0.001)。抑郁症患者情绪自我效能感对述情障碍的直接效应为-0.645,情绪自我效能感对心理韧性的直接效应为0.741,心理韧性对述情障碍的直接效应为-0.235,且情绪自我效能感通过心理韧性对述情障碍产生的间...     

妊娠期异常情绪与围生期结局相关性探讨

目的:探讨妊娠期异常情绪与围生期结局的相关性。方法:对妊娠24～28周开始在该院进行产前检查及分娩的孕妇215例进行对照研究。应用汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)评定孕妇的情绪状态。据HAMA评定结果将研究对象分为两组,即焦虑组(观察组37例)及非焦虑组(对照组178例),以探讨不良情绪对围生期结局的影响。结果:①具有焦虑症状孕妇37例(17.21%),无焦虑症状者178例(82.79%),观察组孕妇HAMA及HAMD总分、GST(50g糖筛查)值显著升高,妊娠期糖尿病患者亦显著增多,与焦虑和抑郁情绪呈正相关(P<0.05);②两组分娩方式有显著性差异,观察组剖宫产者率显著增多,与焦虑和抑郁情绪呈正相关(P<0.05);③观察组新生儿体重显著降低,并发症显著增多,与焦虑和抑郁情绪呈正相关(P<0.05)。结论:妊娠期焦虑、抑郁等异常情绪与围生期结局有正相关关系。     

Depression and anxiety in people with inflammatory bowel disease

STUDY OBJECTIVE—To determine whether depression or anxiety co-occurs with ulcerative colitis (UC) or Crohn's disease (CD) more often than expected by chance, and, if so, whether the mental disorders generally precede or follow the inflammatory bowel diseases (IBD).
DESIGN—Nested case-control studies using a database of linked hospital record abstracts.
SETTING—Southern England.
MAIN RESULTS—Both depression and anxiety preceded UC significantly more often than would be predicted from the control population's experience. The associations were strongest when the mental conditions were diagnosed shortly before UC, although the association between depression and UC was also significant when depression preceded UC by five or more years. Neither depression nor anxiety occurred before CD more often than expected by chance. However, depression and anxiety were significantly more common after CD; the associations were strongest in the year after the initial record of CD. UC was followed by anxiety, but not by depression, more often than expected by chance and, again, the association was strongest within one year of diagnosis with UC.
CONCLUSIONS—The concentration of risk of depression or anxiety one year or less before diagnosis with UC suggests that the two psychiatric disorders might be a consequence of early symptoms of the as yet undiagnosed gastrointestinal condition. The data are also, however, compatible with the hypothesis that the psychiatric disorders could be aetiological factors in some patients with UC. Most of the excess anxiety or depression diagnosed subsequent to diagnosis of IBD occurs during the year after IBD is diagnosed and the probable explanation is that the mental disorders are sequelae of IBD.


Keywords: record linkage; ulcerative colitis; Crohn's disease; anxiety; depression     

哈尔滨市留守与非留守小学生焦虑、抑郁和共患情况及其影响因素调查

目的 了解城市留守小学生与非留守小学生焦虑、抑郁和焦虑抑郁共患状况,并研究监护人焦虑、抑郁,亲子依恋,生活质量和安全感对其的影响。 方法 2016年6-9月选取前期初筛的城市留守儿童89人,并按1∶1配对设立对照组,对两组进行问卷调查。问卷内容包括:一般情况、儿童焦虑性情绪障碍筛查表、儿童抑郁量表、儿童焦虑和抑郁问卷、儿少主观生活质量问卷、亲子依恋量表、安全感量表、家长焦虑自评问卷、家长抑郁自评问卷。 结果 1)留守组和对照组小学生焦虑检出率(43.2% vs.32.1%,χ²=2.023,P=0.155)、共患检出率(22.2% vs. 17.3%,χ²=0.314,P=0.575)比较差异都无统计学意义。留守组和对照组小学生抑郁检出率比较,差异有统计学意义(25.9% vs. 13.6%,χ²=6.261,P=0.012)。2)留守组小学生焦虑、抑郁和共患与家庭生活、同伴交往、学校生活、躯体情感、认知成分、情感成分呈显著负相关(P＜0.05),同时焦虑和抑郁还与人际安全感和确定控制感呈显著负相关(P＜0.05);对照组小学生的焦虑、抑郁和共患均与同伴交往、学校生活、躯体情感、认知成分和情感成分、人际安全感、确定控制感呈负相关(P＜0.05),除此之外焦虑和抑郁分别与学校生活和家庭生活呈显著负相关(P＜0.05)。3)留守组小学生情感成分对焦虑、抑郁和共患的回归系数分别为-0.42、-0.173、-0.515;对照组小学生,情感成分对抑郁和共患的回归系数分别为-0.134、-3.252,学校生活对共患的回归系数为-3.998。 结论 城市留守小学生的焦虑、抑郁和共患情况较非留守小学生严重,生活质量、亲子依恋、安全感等均会对其产生一定影响,应引起广泛关注。     

多学科合作健康教育对肾衰患者心理状况的影响

目的：探讨多学科合作式健康教育对改善肾衰患者焦虑抑郁心理状态的影响。方法：随机选择58例终末期肾脏病入院患者分为两组,对干预组除与对照组一样给予常规护理外,开展多学科合作式健康教育。使用焦虑自评量表(SAS)、抑郁自评量表(SDS)对两组患者进行评估,比较两组患者透析治疗前、透析治疗过程中的焦虑和抑郁状况。结果：多学科合作干预组患者的认知程度、治疗信心、合作程度明显提高,而焦虑、抑郁症状明显减轻。结论：多学科合作健康教育对改善透析患者的焦虑抑郁心理状况和提升患者依从性有显著作用。