Relation between alexithymia and the five-factor model of personality: a facet-level analysis

The relation between alexithymia and both the domain and the facet level of the five-factor model (FFM) of personality was examined in a sample of 101 university students by using the Twenty-Item Toronto Alexithymia Scale (TAS-20; Bagby, Taylor, & Parker, 1994) and the Revised NEO Personality Inventory (Costa & McCrae, 1992c). Consistent with the alexithymia construct, the TAS-20 was positively correlated with Neuroticism (N) and negatively correlated with Extraversion (E) and Openness (O), whereas no significant relations were found with Agreeableness (A) and Conscientiousness (C). Analysis of the lower order traits (i.e., facets) of the FFM revealed that depression for N; positive emotions and assertiveness for E; feelings and actions for O; altruism, tender-mindedness, and modesty for A; and competence for C predicted alexithymia. These results support the uniqueness of the alexithymia construct, which is represented by a cluster of traits across the dimensions and facets of the FFM.     

Understanding alexithymia in female adolescents: The role of attachment style

Adults with alexithymia retrospectively report emotional difficulties with caregivers during childhood. However, the association between attachment style and alexithymic traits may be evident at an earlier stage than adulthood, i.e. during adolescence. Sixty school-based healthy females aged 9–18 years (mean 14.08, SD 2.71 years) participated in an Attachment Style Interview (ASI) and completed the Toronto Alexithymia Scale (TAS-20). Greater levels of alexithymia were exhibited by both anxious and avoidant insecurely attached groups compared to securely attached participants. Fear of separation (characteristic of anxious attachment style) predicted both overall alexithymia scores and the specific alexithymic trait of ‘difficulty identifying feelings’ (DIF). Constraints on closeness (an avoidant attachment attitude) predicted ‘difficulty describing feelings’ (DDF). Low felt attachment to primary caregiver was a predictor of ‘externally oriented thinking’ (EOT). These findings indicate that features of anxious and avoidant insecure attachment styles are differentially related to the separate facets of alexithymia in female adolescents. Specifically, the findings concerning fear of separation may reflect the adolescent struggle for autonomy and the resulting effects on the affect regulation system. Our results also suggest that the normative differentiation of the emotional and cognitive aspects of alexithymia may occur on a developmental trajectory.     

Alexithymie bei Neurodermitis

Background

The study shows correlations between atopic dermatitis (AD) and alexithymia. Furthermore it examines their influences on skin-related quality of life.

Patients and methods

A total of 62 adult AD patients were compared with a control group (n=62) of skin healthy persons. Alexithymia (Toronto Alexithymia Scale-20, TAS-20) and impairment of the skin-related quality of life (Dermatology Life Quality Index, DLQI) were assessed as well as duration, severity [patients?? self-evaluation based on scoring of atopic dermatitis (SCORAD)] and onset of AD.

Results

The prevalence of alexithymia (TAS-20 ??61) in AD patients was 22.6% (control group 4.9%). Problems with identifying feelings (TAS-20 scale) and also the severity of AD were significant predictors for the impairment of skin-related quality of life.

Conclusions

Atopic dermatitis patients showed a prevalence of alexithymia (22.6%) similar to diseases found in the field of psychosomatic and psychiatric patients (Leweke & Bausch 2009). From a psychotherapeutic point of view the study may provide a further reason for the observance of mental features in AD treatment. A possible indication for a specific psychotherapy in atopic dermatitis is discussed.     

Investigating the role of alexithymia on the empathic deficits found in schizotypy and autism spectrum traits

Alexithymia, the inability to identify and describe one’s emotional experience, is elevated in many clinical populations, and related to poor interpersonal functioning. Alexithymia is also associated with empathic deficits in individuals with autism spectrum disorders. Accordingly, a better understanding of alexithymia could elucidate the nature of social-cognitive deficits transdiagnostically. We investigated alexithymia and components of empathy in relation to schizotypal and autism spectrum traits in healthy college students. Specifically, we examined higher-order components of empathic processing that involve perspective taking and other-oriented concern, which are reduced in alexithymia.Higher-order empathic processing was inversely correlated with both schizotypal and autism spectrum traits. Bootstrapping techniques revealed that alexithymia had a significant indirect effect on the relationship between higher-order empathy and these personality traits; thus, alexithymia contributes uniquely to their relationship. These findings suggest alexithymia represents one possible mechanism for the development of empathic deficits in these populations.These results are consistent with the perspective that awareness of one’s own emotional state may predicate a successful empathic response to another’s. This work highlights the importance of a consideration of alexithymia in elucidating the nature of empathic deficits in various clinical populations, and points to a potential point of social intervention.     

Dimensions of alexithymia and their relationships to anxiety and depression

Investigators have suggested that alexithymia is a multidimensional construct and that it is responsive to situational stressors. We tested these hypotheses in a sample of 110 freshman medical students. We conducted factor analyses on the Toronto Alexithymia Scale (TAS), the Beck Depression Inventory (BDI), and the state portion of the State-Trait Anxiety Inventory (STAI) and then used LISREL to examine the relationships among the various factors. The results indicated that the TAS consists of several independent dimensions and that the dimensions associated with difficulties identifying and communicating feelings are positively related to depression and anxiety. Thus, the evidence now affirms that alexithymia (as measured by the TAS) is multidimensional and that certain dimensions are state dependent.     

述情障碍与中学生人际关系:有调节的中介模型

为明确述情障碍与中学生人际关系间关系的内在机制,采用中学生人际关系量表、多伦多述情障碍量表、社交焦虑量表及领悟社会支持量表调查了北京市、石家庄市、佳木斯市三所中学7至11年级共998名学生,根据述情障碍的筛查标准,最终获得218份有效数据。结论如下：（1）述情障碍与社交焦虑呈显著正相关,与人际关系、社会支持呈显著负相关;人际关系与社交焦虑呈显著负相关,而与社会支持呈显著正相关;社交焦虑与社会支持呈显著负相关;（2）社交焦虑在述情障碍与中学生人际关系间起中介作用;社会支持在述情障碍与中学生人际关系间起调节作用;（3）"述情障碍→社交焦虑→中学生人际关系"这一中介路径的前半段,受到社会支持的调节。与高社会支持个体相比,述情障碍对低社会支持个体的社交焦虑影响更大。     

Negative Life Events and Posttraumatic Stress Disorder among Incarcerated Boys with Callous-Unemotional Traits

Historically, researchers have searched extensively for biological explanations regarding causes of psychopathy and its theorized developmental precursor, callous-unemotional (CU) traits (i.e., lack of empathy/guilt, shallow affect). In consequence, environmental factors such as exposure to negative life events and posttraumatic stress that often follows have been relatively overlooked. The present study tests whether exposure to negative life events and related symptoms of posttraumatic stress disorder (PTSD) are associated with CU traits among a sample of 238 incarcerated boys. Additionally, youth high on CU traits were disaggregated into primary and secondary variants based on the presence of anxiety to examine differences in their experiences of negative life events and PTSD symptoms. Results suggest that CU traits are significantly positively associated with both the experience of negative life events as well as PTSD symptomatology. Additionally, high-anxious youth scoring high on CU traits (secondary variant) were significantly more likely to report a history of negative life events and PTSD symptoms than were lower anxious boys scoring high on CU traits (primary type) and non-psychopathic youth. Thus, study findings warrant further exploration of how trauma might impact or maintain the development of CU traits over time and indicate that issues of differential diagnosis must be considered in order to more effectively tailor treatment for trauma-exposed CU youth.     

述情障碍与中学生人际关系:有调节的中介模型

为明确述情障碍与中学生人际关系间关系的内在机制,采用中学生人际关系量表、多伦多述情障碍量表、社交焦虑量表及领悟社会支持量表调查了北京市、石家庄市、佳木斯市三所中学7至11年级共998名学生,根据述情障碍的筛查标准,最终获得218份有效数据。结论如下：（1）述情障碍与社交焦虑呈显著正相关,与人际关系、社会支持呈显著负相关;人际关系与社交焦虑呈显著负相关,而与社会支持呈显著正相关;社交焦虑与社会支持呈显著负相关;（2）社交焦虑在述情障碍与中学生人际关系间起中介作用;社会支持在述情障碍与中学生人际关系间起调节作用;（3）"述情障碍→社交焦虑→中学生人际关系"这一中介路径的前半段,受到社会支持的调节。与高社会支持个体相比,述情障碍对低社会支持个体的社交焦虑影响更大。     

Incremental Validity of Alexithymia, Emotional Coping and Humor Style on Happiness and Psychological Well-Being

This study attempts to ascertain whether alexithymia, suppression and reappraisal coping, and humor styles account for incremental variance in happiness (Lyubomirsky’s scale) and psychological well-being (Ryff’s scale), after controlling for Big Five traits and emotional positivity ratio of previous day’s mood. A total of 355 psychology undergraduates (72 % women) responded to measures of each construct, and two hierarchical multiple regressions were carried out for happiness and psychological well-being. The Big Five were entered in the first regression block, alexithymia was entered in a second block, and affiliative, self-enhancing, aggressive and self-defeating humor style, reappraisal and suppression coping were entered in the third block, and previous day’s mood in the last step. Alexithymia accounted for a small proportion of variance in psychological well-being, controlling for the Big Five traits. Suppression and affiliative, self-enhancing and self-defeating humor explained a complementary amount of variance in happiness and psychological well-being, controlling for the previous day’s mood, confirming the association of emotional regulation and affect with judgments of happiness and well-being. Taking into account humor and suppression, the multivariate association of alexithymia disappears. Results suggest that low suppression, low self-critical use of humor and affiliative humor are correlates of psychological well-being, whereas self-enhancing humor and low suppression are correlates of happiness, playing a mediational role between personality traits and well-being.     

The Moderating Role of Anxiety in the Associations of Callous-Unemotional Traits with Self-Report and Laboratory Measures of Affective and Cognitive Empathy

In a sample of detained male adolescents (n = 107; Mean age = 15.50; SD = 1.30), we tested whether anxiety moderated the association of CU traits with self-report and computerized measures of affective (emotional reactivity) and cognitive (affective facial recognition and Theory of Mind [ToM]) empathy. Hierarchical regression analyses revealed that CU traits were negatively associated with self-reports of affective empathy and this association was not moderated by level of anxiety. Significant interactions revealed that CU traits were negatively associated with cognitive empathy (self-report) only at high levels of anxiety, whereas CU traits were positively associated with cognitive empathy on the ToM task only at low levels of anxiety. CU traits were also associated with greater fear recognition accuracy at low levels of anxiety. Implications for understanding and treating different variants of CU traits (i.e., primary and secondary) are discussed.     

Alexithymia, emotion, and somatic complaints

Alexithymia, by definition, involves difficulties in identifying and describing emotions and has been assumed to be associated with somatization (i.e., a tendency to express psychological distress in somatic rather than emotional form). Empirical research so far, however, has produced no convincing evidence that alexithymia is more associated with somatic complaints than with emotional complaints or that alexithymia correlates with somatic complaints when negative affect is controlled for. In the present study, alexithymia, as measured by the TAS-20, showed no association with somatic complaints in a community sample of 137 individuals when trait anxiety and depression were controlled. Alexithymia did correlate negatively with positive affect, and positively with negative affect. The former association, however, was much more robust, whereas the latter association was found mainly on subjective trait measures of negative affect (as distinct from state measures and more objective trait measures derived from daily recordings during an 8-week period). It is suggested that the association between alexithymia and lack of positive affect deserves more attention in future research.     

Cognitive Alexithymia Mediates the Association Between Avoidant Attachment and Interpersonal Problems in Patients With Somatoform Disorder

Patients with somatoform disorder (SFD) are characterized by the presence of chronic physical complaints that are not fully explained by a general medical condition or another mental disorder. Insecure attachment patterns are common in this patient group, which are often associated with interpersonal difficulties. In the present study, the mediational role of two types of alexithymia and negative affectivity (NA) was examined in the association between attachment styles and interpersonal problems in a group of 120 patients with SFD. Patients were requested to fill out several self-report questionnaires for the assessment of attachment strategies, alexithymia, NA, and interpersonal problems. Cognitive alexithymia (i.e., the inability to identify and verbalize emotions) mediated the relationship between avoidant attachment patterns and interpersonal problems, even after controlling for NA. Preliminary findings also suggested that NA acted as a moderator of the mediator cognitive alexithymia. These results have important implications for clinical practice, as this study clearly shows that interpersonal problems do not automatically follow from insecure attachment strategies, but are contingent upon alexithymic features. It is recommended to target alexithymic features in patients with SFD, particularly in the context of negative emotions. Therefore, cognitive alexithymia may be an important therapeutic focus, specifically in the treatment of avoidant ptients with SFD.     

Relationships Between Physical Symptoms,Emotional Distress,and Pain Appraisal in Fibromyalgia: The Moderator Effect of Alexithymia

Alexithymia is a personality construct that is frequently identified in fibromyalgia (FM). Previous studies have explored the relationship between alexithymia and emotional distress in this disease. Yet, the additional link with factors of pain appraisal is unknown. This study examined the moderating effect of alexithymia in the relationship between emotional distress and pain appraisal in 97 FM women. A control group of 100 healthy women also participated in the study. All participants completed several self-reports about pain experience, sleep quality, impairment, emotional distress, pain appraisal, and alexithymia. FM women showed significantly more difficulty in identifying and describing feelings, but less externally oriented thinking than healthy women. In the clinical group, difficulty in identifying feelings and difficulty in describing feelings significantly correlated with lower sleep quality, higher anxiety and depression, and increased pain catastrophizing and fear of pain. Difficulty in describing feelings significantly correlated with higher pain experience and vigilance to pain. Externally oriented thinking was not correlated with any of the clinical variables. Difficulty in identifying feelings moderated the relationship between anxiety and pain catastrophizing, and difficulty in describing feelings moderated the relationship between anxiety and fear of pain. Implications of the findings for the optimization of care of FM patients are discussed.     

The Social Correlates to Callous-Unemotional Traits in a Sample of High School Students

Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents’ social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (N = 563; 460 girls; mean age = 15.80, SD = 1.50). Measures for the social variables included assessment of peer rejection, adolescents’ prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent’s relational skills.     

An application of item response theory to alexithymia assessment among abstinent alcoholics.

An item response theory (IRT) model identified three dimensions assessed by the Toronto Alexithymia Scale (TAS) in a sample of 130 male applicants for inpatient care at a Veterans Administration (VA) medical center alcoholism treatment program. A unidimensional solution did not capture all of alexithymia's theoretical features. Subjects with lower alexithymia scores gave positive responses to items tapping emotional awareness deficits; only those with higher alexithymia scores gave positive responses to items tapping external, operative cognitive style. Thus, a total TAS score may not represent alexithymia accurately in substance-abusing patient populations.     

Alexithymia in schizophrenia: an exploratory study.

This study assessed a relationship between alexithymia and schizophrenia suggested by reports based on small samples of patients. Here, 50 outpatients with a diagnosis of paranoid schizophrenia were compared with 50 pair-matched healthy subjects. Alexithymia was measured by the Polish version of the Toronto Alexithymia Scale-20. The mean total score was significantly higher in the schizophrenia group (M = 52.3, SD = 13.47) than in the healthy controls (M = 45.8, SD = 11.39, p < .02). This replicates earlier findings showing that a group of patients with paranoid schizophrenia have higher scores on alexithymia scales than healthy controls. There seems a need for a comprehensive examination of relations between alexithymia and other concepts denoting pathology of affect in schizophrenia.     

The Assessment of Alexithymia in Medical Settings: Implications for Understanding and Treating Health Problems

The construct of alexithymia encompasses the characteristics of difficulty identifying feelings, difficulty describing feelings, externally oriented thinking, and a limited imaginal capacity. These characteristics are thought to reflect deficits in the cognitive processing and regulation of emotions and to contribute to the onset or maintenance of several medical and psychiatric disorders. In this article, we review recent methods for assessing alexithymia and examine how assessing alexithymia can inform clinical practice. Alexithymia is associated with heightened physiological arousal, the tendency to notice and report physical symptoms, and unhealthy compulsive behaviors. Alexithymic patients may respond poorly to psychological treatments, although perhaps not to cognitive-behavioral techniques, and it is unclear whether alexithymia can be improved through treatment. Interpretive problems regarding alexithymia include its overlap with other traits, whether it is secondary to illness or trauma, the possibility of subtypes, and low correlations among multiple measures. Nonetheless, we encourage the assessment of alexithymia in applied settings.     

The assessment of alexithymia in medical settings: implications for understanding and treating health problems

The construct of alexithymia encompasses the characteristics of difficulty identifying feelings, difficulty describing feelings, externally oriented thinking, and a limited imaginal capacity. These characteristics are thought to reflect deficits in the cognitive processing and regulation of emotions and to contribute to the onset or maintenance of several medical and psychiatric disorders. In this article, we review recent methods for assessing alexithymia and examine how assessing alexithymia can inform clinical practice. Alexithymia is associated with heightened physiological arousal, the tendency to notice and report physical symptoms, and unhealthy compulsive behaviors. Alexithymic patients may respond poorly to psychological treatments, although perhaps not to cognitive-behavioral techniques, and it is unclear whether alexithymia can be improved through treatment. Interpretive problems regarding alexithymia include its overlap with other traits, whether it is secondary to illness or trauma, the possibility of subtypes, and low correlations among multiple measures. Nonetheless, we encourage the assessment of alexithymia in applied settings.     

BRIEF REPORT

This study examined the different facets of emotional intelligence, alexithymia, and mood awareness. Undergraduate students (N = 129) completed the Trait Meta-Mood Scale (TMMS), the Toronto Alexithymia Scale (TAS-20), and the Mood Awareness Scale (MAS). A factor analysis revealed two dimensions, attention to and clarity of emotions, that cut across all three instruments. These two dimensions were differentially associated with personality, as measured by the neuroticism, extraversion, and openness to experience portions of the NEO-FFI, and with performance on an emotional Stroop task. We discuss the implications for the conceptualisation of broad constructs such as emotional intelligence and alexithymia, as well as the potential utility of more narrowly defined individual differences.     

The Association between Callous-Unemotional Traits and Behavioral and Academic Adjustment in Children: Further Validation of the Inventory of Callous-Unemotional Traits

Callous-unemotional (CU) traits have been associated with problems in behavioral adjustment in past research which has led to proposals to include them in diagnostic classification systems for child behavior problems. In the current study, the factor structure of a comprehensive measure of CU traits was tested in a sample of 540 Italian children in grades 6 and 8. Consistent with past factor analyses in other countries, CU traits could be described as having three subfactors (i.e., callousness, uncaring, unemotional) which load on an overarching general factor. Importantly, this factor structure was invariant across gender and grade. Consistent with past studies, CU traits were positively associated with school behavior problems, bullying, and reactive aggression and this was largely accounted for by the callousness and uncaring subscales. The current results advance past work in showing that these associations extend to cyberbullying and to bullying reported by both self-report and by peer nominations. Further, CU traits were also associated with lower levels of academic achievement, and this was also largely accounted for by the callousness and uncaring dimensions. Finally, although the unemotional subscale did not show consistent associations with problems in behavioral or academic adjustment, it did contribute independently to the prediction (negatively) of peer-reported prosocial behaviors.