Does alexithymia expose to mental disorder symptoms in late adolescence? A 4-year follow-up study

ObjectiveTo investigate the possible causal link between alexithymia and the emergence of anxiety and depression symptoms, as well as alcohol consumption in a sample of late adolescents.MethodThe nonclinical sample comprised late adolescents (n= 315), including both females (n= 256) and males (n= 59). The follow-up period was 4 years, and at baseline, the mean age of the subjects was 19 years (range 17−21 years). Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), depression symptoms with the short form of the Beck Depression Inventory (RBDI), anxiety with the State-Trait Anxiety Inventory (STAI) and alcohol consumption with the Alcohol Use Disorders Identification Test (AUDIT). The three TAS-20 subscales were assessed separately. Linear and cumulative logistic regression analyses were used for the evaluation of associations, and the analyses were adjusted with the corresponding baseline scores.ResultsThe TAS-20 total and subscale scores did not predict the RBDI or AUDIT scores at follow-up. However, the TAS-20 subscale “difficulty identifying feelings” was significantly associated with both STAI-State (P= .007) and STAI-Trait (P= .004) scores at follow-up.ConclusionsAlexithymic features may be individual predictors of later anxiety symptoms. The significant differences between the various dimensions of alexithymia should be considered in future studies.     

Relation entre alexithymie et impulsivité dans un échantillon d’adolescents scolarisés de la région de Sfax,Tunisie

ObjectivesThe study of alexithymia in adolescence seems particularly interesting for various reasons. First, physical, psychological and social changes create new experiences of emotional reactivation. Second, the adolescent period coincides with the maturation of the hormonal, neuronal, and cognitive systems that underlie the development of emotional regulation. Finally, evidence suggests that alexithymia may have detrimental consequences in adolescents, including substance use disorders, depression, anxiety, behavioral disorders and self-injury. Also, alexithymia is associated with impulsivity because of a deficit in the cognitive processing of emotions with tendencies to act rather than talking about feelings. The purpose of the current study is to estimate the prevalence of alexithymia in a sample of school-aged adolescents in the Sfax region (Tunisia) and to evaluate its links with impulsivity.Materials and methodsCross-sectional study involving 474 students from public institutions in the Sfax region. Participants completed, after consent, an epidemiological fact sheet, the Toronto Alexithymia Scale (TAS-20) and the Barratt Impulsiveness Scale (BIS-11).ResultsThe average age of the students was 14.77 ± 1.75 years with extremes ranging from 13 to 18 years old. The sex ratio was 0.96. The prevalence of alexithymia was 35.86% and that of impulsivity 39%. The analytical study showed that alexithymic adolescents had a higher degree of impulsivity (27.4% vs 11.8%, p = 0.001) with a positive correlation between TAS20 and Barratt scores (p < 10⁻³ ; r = 0,33).ConclusionOur study shows that alexithymia is common in our adolescents and is associated with impulsivity. The prevention of alexithymia seems essential to reduce the frequency of impulsive behavior.     

Determinants and impact of alexithymia on quality of life in Parkinson's disease

IntroductionAlexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease.MethodsSubjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model.Results98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p < 0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL.ConclusionsAlexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.     

Alexithymia,temperament and character as predictors of psychopathology in patients with major depression

The study investigated the capacity of alexithymic personality features, in combination with temperament and character traits, age and gender, to predict psychopathological symptoms in patients with major depression. Consecutive patients (n = 339) were investigated using the Toronto Alexithymia Scale-20 (TAS-20), the Temperament and Character Inventory (TCI), the Symptom Checklist-90-R (SCL-90-R), and the Hamilton Depression and Anxiety Rating Scales (HDRS, HARS). The amount of variance in SCL-90-R subscales and Hamilton scales predicted by TAS-20, TCI, age and gender was calculated by linear regression analyses. The ‘difficulties identifying feeling’ facet of alexithymia appeared to be a significant predictor of all dimensions of psychopathology. Among TCI scales harm avoidance was the strongest predictor for somatization, phobic anxiety, and anxiety (SCL-90-R, HARS); low self-directedness was the strongest predictor for obsessionality, depression (SCL-90-R, HDRS), interpersonal sensitivity and psychoticism; and low cooperativeness was the strongest predictor for hostility and paranoia. In conclusion, many psychopathological symptoms in major depression are associated with difficulties in the identification of emotions. Relative to alexithymia, Cloninger's psychobiological model of personality could predict psychopathological symptoms in a distinct and meaningful manner. The TAS-20 and the TCI are useful questionnaires for a better understanding of the relationship between psychopathology and personality in major depression.     

Alexithymia in adolescents with chronic fatigue syndrome

BACKGROUND: Alexithymia is postulated as an important factor in the development of medically unexplained physical symptoms. Chronic fatigue syndrome (CFS) is presently medically unexplained. The aim of this study was to investigate whether the prevalence of alexithymia was higher in adolescents with CFS compared to healthy adolescents. Comorbidity such as anxiety and depression were analyzed as possible confounding factors. Secondly, alexithymia was investigated as a prognostic factor for the recovery of CFS. METHODS: A cross-sectional study was performed among 40 adolescent outpatients diagnosed with CFS and 36 healthy controls. The 20-item Toronto Alexithymia Scale was used to assess all participants for alexithymia. Additionally, all participants completed a number of questionnaires regarding fatigue (Checklist Individual Strength), somatic complaints (Checklist Somatization Inventory), depression (Children's Depression Inventory), and trait anxiety (Spielberger State Trait Anxiety Questionnaire). A follow-up study was performed among the CFS adolescents 1 1/2 years after the initial assessment. RESULTS: CFS adolescents scored higher only on the subscale identifying feelings of the TAS-20 [mean difference after adjustment for depression and anxiety 2.8 (95% CI: 0.6; 4.9]. Twelve CFS adolescents (30%) fulfilled criteria for alexithymia. This subgroup was characterized by higher scores for depression and anxiety and equal scores for fatigue and somatic complaints. At follow-up, no differences in recovery were established between the alexithymic and nonalexithymic CFS adolescents. CONCLUSIONS: Alexithymia neither appears to be a unique correlate of CFS nor to be a prognostic factor for recovery of the CFS illness.     

Does alexithymia differentiate between patients with nonepileptic seizures, patients with epilepsy, and nonpatient controls?

Considering the evidence of an association between alexithymia and somatization, this study aimed to discover whether alexithymia could distinguish patients with psychogenic nonepileptic seizures (NES) from those with epilepsy (ES) and nonpatient controls (C). Toronto Alexithymia Scale (TAS-20) scores were obtained from 21 matched participants from each of these groups, together with measures of anxiety and depression. Overall TAS-20 scores did not differentiate the three groups after controlling for anxiety and depression, but scores on certain subscales of the TAS-20 differed significantly between the patient groups and the controls. Although alexithymia could not discriminate individuals with NES from those with organic manifestations, whether the etiology of alexithymia may differ according to patient group was discussed. Given that 90.5% of NES patients were identified as alexithymic, treatment approaches used for individuals with alexithymia may be usefully applied to those with NES.     

The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression,panic disorder,eating disorders and substance use disorders

Background

This study evaluates whether the difference in Toronto Alexithymia Scale-20 item (TAS-20) between patients with major depression (MD), panic disorder (PD), eating disorders (ED), and substance use disorders (SUD) and healthy controls persisted after controlling for the severity of anxiety and depression.

Methods

Thirty-eight patients with MD, 58 with PD, 52 with ED, and 30 with SUD and 78 healthy controls (C) completed the TAS-20, the Hamilton Rating Scale for Anxiety (Ham-A), the Hamilton Rating Scale for Depression (Ham-D).

Results

The differences in TAS-20 scores observed between patient groups, regardless of the type of their disorders, and controls disappeared after controlling for the effect of anxiety and depression severity. In contrast, the differences in severity of anxiety and depression between patients and controls were still present, after excluding the effect of alexithymic levels.

Conclusions

Our data suggest that alexithymic levels, as measured by the TAS-20, are modulated by the severity of symptoms, supporting the view that alexithymia can represent a state phenomenon in patients with MD, PD, ED and SUD, because the TAS-20 seems overly sensitive to a general distress syndrome, and it is more likely to measure negative affects rather than alexithymia itself.     

Characterization of alexithymia in clinically isolated syndrome

BackgroundIn multiple sclerosis (MS), the prevalence of alexithymia, defined as an inability to identify and describe emotions, is close to 50% but the prevalence of this symptom in clinically isolated syndrome (CIS) is unknown. Characterizing alexithymia at an early stage of the disease can help to clarify psychobehavioural disturbances in CIS patients.MethodsForty CIS patients, who fulfilled the MRI criteria for dissemination in space, were matched with 40 healthy subjects. They completed self-assessment scales for alexithymia, depression, anxiety, apathy and empathy. Cognitive functions were assessed using a battery of neuropsychological tests.ResultsThe mean delay (± standard deviation) between the occurrence of CIS and inclusion in the study was 3.9 (2.8) months. The frequency of alexithymia was higher in CIS patients than in controls, with a prevalence of 42% (P < 0.0001). Alexithymia correlated with anxiety and depression but not with cognition. Alexithymia was dependent only on depression (P = 0.003).ConclusionAlexithymia, characterized by difficulty identifying feelings, is present in patients in the early stage of MS, and seems to be strongly associated with depression. Difficulty in social interaction could be a risk of future affective disorders.     

The effect of alexithymic features on response to antidepressant medication in patients with major depression

There has been no follow-up study regarding the effect of alexithymic features on antidepressant treatment. This study was planned to observe whether alexithymia effects short-term treatment outcome in depression. The study included 32 alexithymic and 33 nonalexithymic outpatients with major depression. Depression was assessed on the basis of the Structured Clinical Interview for DSM-IV (SCID-I). Level of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Alexithymia was screened using the Turkish version of Toronto Alexithymia Scale (TAS-20). All patients received 20 mg/d paroxetine for 10 weeks. Alexithymic and nonalexithymic patients were compared on the HAM-D scores, TAS-20 scores, and rate of response to antidepressant medication. The rate of responders, defined by a reduction of >50% from baseline in HAM-D total score, was 21.9% in the alexithymic group and 54.5% in the nonalexithymic group. Changes in the HAM-D scores were significantly correlated with the TAS-20 scores. TAS-20 scores dropped below 61 in only 31.2% of the alexithymic patients, and 68.8% of patients remained alexithymic. Whereas 50% of patients whose TAS-20 scores dropped below 61 responded to antidepressant medication, this rate was only 9.1% among patients who remained alexithymic. These findings indicated that the stability of alexithymic features had a negative effect on antidepressant treatment in depression.     

The role of alexithymia: An 8-year follow-up study of chronic pain patients

ObjectiveThe aim of this 8-year follow-up study was to ascertain changes in alexithymia, depressiveness and pain situation in a sample of chronic pain patients and to explore the impact of alexithymia and depression on the outcome.MethodsParticipants (n = 83) were chronic non-malignant pain patients who completed self-report study questionnaires before their first visit to the pain clinic and again 8 years later. Study variables consisted of pain intensity measured by the Visual Analogous Scale, the Pain Disability Scale, the Toronto Alexithymia Scale and the Beck Depression Inventory. The moderate improvement in the pain situation was estimated as a decrease of 30% or more in pain intensity or pain disability.ResultsIn the whole sample there was a significant decrease in pain intensity, pain disability and depressiveness, but only some of the patients achieved moderate improvement in their pain situation. Alexithymia remained stable during the 8-year period. The alexithymic patients had poorer pain situation and more depressiveness both at baseline and at follow-up. Unfavorable outcome in the pain situation was connected with male gender and alexithymia at baseline but not with depressiveness. Alexithymia and depressiveness were closely related to each other and the connection strengthened during the follow-up period.ConclusionAlexithymic depressive chronic pain patients represent a special, more disabled subgroup among chronic pain patients. The authors recommend screening for and identifying alexithymia and depression in chronic pain patients. Structural treatment protocols such as cognitive–behavioral therapy may benefit these patients. More research is needed to develop treatment interventions for alexithymic patients.     

The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome

ObjectiveAlexithymia has been considered both to predispose to depression and to worsen cardiac prognosis after an acute coronary syndrome. Nonetheless, no studies have evaluated its role as a risk factor for incident depression, in patients with acute coronary syndrome.MethodsIn 251 consecutive patients, the presence of a first-ever depressive episode was evaluated with the Primary Care Evaluation of Mental Disorders at baseline and 1, 2, 4, 6, 9, 12 and 24 months after their first acute coronary syndrome. At baseline, patients completed the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale.ResultsOut of 251 subjects (80.9% males), a first-ever depressive episode was diagnosed in 66 patients. Depressed and never-depressed patients differed in female gender, living status, alexithymic scores at TAS-20 and depressive symptoms. Nonetheless, nor the TAS-20 factors nor its total score were predictive of developing a depressive episode in a Cox regression. Moreover, baseline differences in TAS-20 scores between the two groups, disappeared after controlling for anhedonic symptoms.ConclusionOur results do not support the hypothesis that alexithymia at TAS-20 is a risk factor for incident depression after acute coronary syndrome.     

Alexithymia and Self-Esteem in a Sample of Opioid Dependent Males: a Controlled Study

The aim of this study was to evaluate the prevalence of alexithymia in opioid dependents compared to the controls and to examine the relationship between alexithymia and depression, anxiety, and self-esteem in opioid dependents. Fifty male heroin-dependent outpatients who completed the detoxification process according to DSM-IV TR diagnostic criteria and 50 control subjects matched for age, gender, and education status who do not abuse heroin or any other substances were included in the study. Subjects were interviewed by using the Structured Clinical Interview for DSM-IV (SCID-I). Variables of interest were assessed according to Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Forty-two percent of the opioid dependents were estimated as alexithymic according to the cut-off scores of TAS-20 (> 61), while this ratio was 10% for the control group. The mean TAS-20 score in the dependent group was significantly higher than in the control group. BDI, BAI, and RSES scores were also found to be significantly higher in the dependent group, particularly in the alexithymic opioid dependent group. There were significant positive correlations between TAS-20 and BDI, BAI, and RSES scores. Further studies are needed to understand the negative effects of alexithymia and lower self-esteem on opioid dependence.

     

Alexithymia and temperament and character model of personality in patients with major depressive disorder

Alexithymia is thought to be a stable personality trait and a predisposing risk factor for depression. In this study, we aimed to identify the prevalence of alexithymia in a depressed and nondepressed sample and examined the relationship between Cloninger's psychobiological model of personality with alexithymia. The Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20), the Turkish version of the Temperament and Character Inventory, and the 21-item Beck Depression Inventory (BDI) were administered to 81 depressed patients and 51 controls. The mean age of the groups was 30.5 ± 7.7 and 32.75 ± 8.73, respectively. Depression severity was evaluated with the BDI. In the depressed group, 33.3% were alexithymic, and alexithymic subjects had significantly higher BDI scores. Depressed individuals were significantly more alexithymic than the controls on the total and all the 3 subscales of TAS-20. The TAS-20 total score was negatively correlated with the temperament dimension of Reward Dependence (RD) and the character dimension of Self-Directedness (SD). In the TAS-20 subscale, difficulties in identifying feelings was positively correlated with Self-Transcendence and negatively correlated with SD. The difficulties in expressing feelings subscale was negatively correlated with RD and SD. In the depressed patient group, the temperament dimension of RD was significantly lower in the alexithymic group. The rate of alexithymia is found high among this sample of Turkish depressed patients, and the results suggested a strong connection between alexithymia and depression. Alexithymia is explained by specific dimensions and subscale within Cloninger's psychobiological model of personality in this sample of depressed Turkish patients.     

L’efficacité thérapeutique du Montage Composite Réceptif à visée Projective (MCR-P) contre la dépression en psychiatrie

ObjectivesThe Receptive Projective Composite Montage (RPCM) is a short-term therapy associating musicotherapy and clinical psychology in order to improve the psychiatric treatment of depression. This study aims at showing the therapeutic efficiency of the RPCM on depression and anxiety symptoms and on the in-patient's alexithymia level. Furthermore, this study explores the explanatory processes of the therapeutic effects in order to bring an additional dimension to this approach.MethodThe sample consists of 23 patients diagnosed with depression, aged between 27 and 73 (average age = 49.91 ± 10.47) who receive psychiatric treatment. Participants have been categorized into two experimental groups: the therapeutic group who received 3 sessions of RPCM (n = 13) and the control group who received psychiatric treatment only (n = 10). These two groups allowed us to achieve a test re-test method over three weeks with a comparative group. The evaluation tools are the Beck's Depression Inventory (BDI) for the evaluation of depression, the Hospital Anxiety and Depression Scale (HADS) for the anxiety level and the Toronto Alexithymia Scales-20 (TAS) for the alexithymia level.ResultsOver a three-week therapy with the RPCM, in-patients from the therapeutic group have a significantly lower level of depression, anxiety and alexithymia after therapeutic process (P = .002; P = .001 and P = .009 respectively). Moreover, depression scores of experimentals groups are significantly different during second evaluation (P = .006). Finally, therapeutic group depression and anxiety scores have a medium effect size (d = .5).Discussion and conclusionWith these results, the RPCM seem to be a tool with beneficial effects on the in-patient's symptomatology of depression. The RPCM can be used as a support technique in order to maximize the treatment of depression. We recommend using a minima three RPCM section at the start of internment by a trained therapist. More experimental and complementary studies are necessary to confirm these results.     

Validity of the BVAQ: a study in eating disorder patients and controls

Alexithymia core features are the difficulties in identifying and describing feelings; the difficulties in distinguishing feelings from the bodily sensations of emotional arousal; an impaired symbolization, as evidenced by a paucity of fantasies and other imaginative activity; and a tendency to focus on external events rather than inner experience. Several measures of alexithymia have been developed, including interviewer-rated questionnaires and self-report questionnaires. Among the self-report questionnaires, the 20-item Toronto Alexithymia scale (TAS-20) is the most commonly used, but it fails to measure all the core features of alexithymia. A recently developed instrument, the Bermond-Vorst Alexithymia Questionnaire (BVAQ), allows the measurement of the alexithymia core features, as well as an additional one. It appeared to present good psychometric properties, notably the abbreviated BVAQ-form B. The results of recent studies comparing the psychometric properties of the TAS-20 and the BVAQ have recommended the BVAQ over the TAS-20. However, this questionnaire needed further validation. OBJECTIVES: Thus, the aim of the present study was to determine the convergent, discriminant and concurrent validity of the Bermond-Vorst Alexithymia Questionnaire -- form B (BVAQ-B) in a clinical sample of 59 eating disorder patients, as well as in 191 controls. The TAS-20 constituted the gold standard for the assessment of the BVAQ-B' convergent validity. To compare the concurrent validity of the BVAQ-B and the TAS-20, participants also completed several self-reports investigating different dimensions of emotion regulation capacities: the 13-item Beck Depression Inventory (BDI), the Spielberger State and Trait Anxiety Inventory (STAI-form Y), as well as the Chapman and Chapman Physical and Social Anhedonia Scales (PAS and SAS). One way analyses of variance were used for mean scores comparisons. Convergent validity was determined using Pearson coefficients of correlation. RESULTS: Results of the analyses suggested the BVAQ-B has a satisfying convergent and discriminant validity. This was observed in both the clinical and control samples. Moreover, the comparison of the convergent validity of the BVAQ-B and the TAS-20 revealed several differences between these two alexithymia self-report questionnaires. The BVAQ-B appeared less sensitive to the subjective emotional state of the participants than the TAS-20. Whereas it was argued the TAS-20 overlaps with other emotional state scores, the BVAQ-B would allow to measure alexithymia more specifically. In addition, the present results allowed to further determine the relations between alexithymia and other dimensions of emotion regulation capacities. The analyses confirmed that alexithymia is linked to other emotion regulation dimensions such as depression and anxiety. Moreover, alexithymia was associated with physical and social anhedonia, two dimensions that received less interest in the alexithymia literature to date. This study also showed that control and clinical sample have different emotion regulation capacities. Eating disorder patients were not only more alexithymic and more depressed, but also more anxious and more anhedonic than the controls. Finally, this study revealed that alexithymia differs whether the alexithymic individuals are patients or controls. Healthy alexithymic individuals (ie, individuals categorized as alexithymic in the control group) seemed characterised by a selective deficit of emotional cognition, with sparing of emotional experience (Bermond's type II alexithymia). Alexithymics individuals of the eating -disorder group seemed particularly unabled to experience affect. This pattern could correspond to Bermond's type I alexithymia, which is characterised by the absence of emotional experience and, consequently, by the absence of the cognition accompanying the emotion. In summary, results of the present study add to the literature debating on whether alexithymia is similar in different types of population.     

Alexithymia is common among adolescents with severe disruptive behavior

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.     

Alexithymia,empathy, and psychological symptoms in a family context

Levels of alexithymia were measured with the Toronto Alexithymia Scale (TAS-20) in families of women with borderline personality disorder (BPD), restricting anorexia nervosa (AN) and a nonclinical (NC) group. Measures were correlated with sociodemographic information, empathy (as measured by the Interpersonal Reactivity Index [IRI]), emotional distress (using the Symptom Checklist-90-R [SCL-90-R]), and experiences of abuse. We have found that male gender, age, and low socioeconomic status are correlated with factor 3 of the TAS-20; that women with BPD and AN are more alexithymic than control subjects; that women with AN are more alexithymic than their parents; and that alexithymia is inversely related to the capacity for empathy. Family members of women with BPD have the highest levels of alexithymia and in these families there seems to be a complementary association between alexithymia in one parent and low levels of empathy in the other. There may be an association between the general emotional distress, history of abuse, and high levels of alexithymia that occur in women with BPD.     

Psychopathological constellation in patients with PNES: A new hypothesis

Depression symptoms have often reported in patients with psychogenic nonepileptic seizures (PNES), although the underlying psychopathological symptomatology has been poorly understood. Our aim was to compare constellations of psychological and behavioral disturbance in PNES with respect to patients with mild-major depressive disorder (MDD), hypothesizing that the construct of depression might be different in the two groups.Ten patients with PNES and ten sex-/age-matched patients with mild-MDD newly-diagnosed, were enrolled in this study. A wide neuropsychiatric battery was employed including the following: symptoms checklist 90-R (SCL-90-R), Toronto alexithymia scale (TAS-20), Hamilton anxiety rating scale (HAMA), Beck depression inventory (BDI II), dissociative experiences scale (DES), traumatic experience checklist (TEC), somatoform dissociation questionnaire (SDQ-20), and temperament and character inventory-revised (TCI-R).No significant difference was detected in the large part of psychopathological examination including personality profile between the two groups. However, PNES showed high scores in alexithymia (p = 0.02); anxiety (p = 0.03), and somatoform symptomatology (p's < 0.03) with respect to patients with mild-MDD. Moreover, somatoform symptoms strongly correlated with depression scores in both groups, whereas alexithymia was influenced by high anxiety level only in the group with PNES. No significant relationship was found between traumatic experience (as measured by TEC) and construct of depression.Our proof-of-concept study suggests that patients with PNES are characterized by their inability to verbalize emotions when dealing with anxiety symptoms, therefore expressing them in a somatic dimension. Further researches, including the investigation of the relationship between anxiety status and emotional expression, are warranted to better understand the pathogenesis of PNES.     

Le questionnaire d’alexithymie pour enfants (QAE) : étude sur une population clinique de 105 adolescents hospitalisés en pédopsychiatrie

Objective

The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used measure of alexithymia in non-clinical or clinical populations. The TAS-20 evaluates three dimensions of the alexithymia construct: the difficulty identifying feelings (DIF), the difficulty describing feelings (DDF) and externally oriented thinking (EOT). The TAS-20 is also used in adolescents or children, and the psychometric properties of the scale have not been systematically evaluated in these populations. Recently several studies have shown systematic age differences in the factor structure and a decrease of the quality of the measurement with age. Notably, low reliability measured by the Cronbach α coefficient has been found for the EOT factor. Taking into account the limitations of the TAS-20 in pre-adult populations the Alexithymia Questionnaire for Children (AQC), an adaptation of the TAS-20, has been proposed by a reformulation of the TAS-20 items (Rieffe et al., 2006). Two studies in healthy children found satisfactory psychometric properties with the three-factor structure demonstrating adequate parameters in the confirmatory factorial analyses (CFA). In the two studies low reliabilities of the EOT factor were reported, and recent studies in adolescents using the TAS-20 found that a two-factor model (DDF, DIF) had a better fit than the original three-factor model. Thus, the aim of the present study was firstly to verify the psychometric properties of the AQC in a sample of adolescents presenting various psychiatric disorders and secondly to test the adequacy of the bi- or tridimensional model of the scale.

Alexithymic features in migraine patients

Abstract. The aims of the present study were 1) to investigate the alexithymic features in migraine patients and, 2) if alexithymia has any relation with the results of other psychological scales that are widely used in clinical practice to describe the psychopathologies, such as depression and anxiety. Demographic and clinical data of 50 cases with migraine without aura and 50 normal volunteers were supplied. All cases completed the Beck Depression Inventory, Hamilton Depression Rating Scale, State and Trait Anxiety Inventory and Toronto Alexithymia Scale. Migraine patients were significantly more depressive, anxious and alexithymic than the control group; there was no correlation between TAS scores and demographic variables; not depression but anxiety was significantly correlated with alexithymia in the migraine group, whereas none of the scores were found to be related to alexithymia in controls. According to our results, alexithymia is a frequent finding in migraine patients and is associated with anxiety to a considerable extent but not with depression.