Alexithymia, emotion, and somatic complaints

Department of Psychology, Stockholm University.
Journal of Personality (Impact Factor: 2.44). 07/2001; 69(3):483-510.
Source: PubMed


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.

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    • "The number of somatic complaints reported was not associated with difficulty identifying emotions, but was instead associated with the content of reported emotion (e.g., fear) [33]. Moreover, previous studies of adults and adolescents have suggested a relationship between DIF scores and depression and/or anxiety [28,34], suggesting that somatic symptoms are affected by negative mood even when alexithymia scores are high [35-37]. The TAS questionnaire appears to reflect specific aspects of depression or general distress, and a tendency to access and express negative emotions [38-40]. "
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    ABSTRACT: We examined developmental aspects of the emotional awareness of adolescents by evaluating their responses to a self-reported questionnaire based on the Toronto Alexithymia Scale-20 (TAS-20). The items of the TAS-20 were modified to make them more understandable by adolescents, and nine new items related to a limited capacity for imagination were added. The Japanese Linguistic Ability Test and the multi-dimensional empathy scale for adolescents were administered to examine concurrent validity. Two hundred and two normative young adolescents and thirty-two adolescent patients with psychosomatic and/or behavioral problems participated in the study. Eighty junior high school students also participated in a separate examination of test-retest reliability. Thirteen items were extracted after exploratory and confirmatory factor analyses, and four core factors were identified in the resulting scale: Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), Externally-Oriented Thinking (EOT) and Constricted Imaginal Capacities (CIC). Interestingly, scores on the multi-dimensional empathy scale correlated positively with DIF and DDF, but negatively with EOT and CIC. Higher DDF scores were associated with higher Japanese linguistic abilities. DIF/DDF scores were higher for females than males, irrespective of linguistic ability. Test-retest reliability coefficients were significant. The patient group showed significantly higher DIF scores than the normative students. The present findings indicated that subjective difficulties in identifying and describing feelings are associated with empathetic and linguistic abilities. The developmental aspect to emotional awareness herein described suggests that self-reported questionnaires for alexithymia must be carefully constructed and examined, even for adults.
    BioPsychoSocial Medicine 11/2009; 3(1):12. DOI:10.1186/1751-0759-3-12
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    • "Indeed, as alexithymic people have difficulty identifying and expressing emotions, it is not clear why they report higher anxiety than their non alexithymic counterparts (see also Woodman et al., 2008). This apparent paradox is likely associated with the alexithymic difficulty in differentiating between emotions (Lundh and Simonsson-Sarnecki, 2001 "
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    ABSTRACT: High-risk activities have typically been explored within a sensation seeking framework. They may, however, allow those with emotional difficulties to experience and regulate their emotions. Skydivers (n=87) completed anxiety and heart rate data four times on a single day before and after a skydive. A 2 (group: alexithymic; non alexithymic) x 4 (time) ANOVA with repeated measures on the second factor revealed a significant alexithymia x time interaction, F(2.27, 192.60)=45.48, p<.001, eta(2)=.35. Anxiety fluctuated significantly more for alexithymic skydivers than it did for their non alexithymic counterparts. This interaction was not mirrored by heart rate. The relationship between alexithymia and anxiety remained significant when accounting for sensation seeking. The results leave open interpretations that are based on anhedonia, which was not controlled for. Alexithymic individuals may find, in the high-risk domain, an environment that satisfies their emotion regulation needs.
    Journal of Affective Disorders 12/2008; 116(1-2):134-8. DOI:10.1016/j.jad.2008.11.022 · 3.38 Impact Factor
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    • "Nevertheless, even if a strong relationship between type I and/or type II alexithymia and somatization can be demonstrated, the relationship may not be direct. In particular , it has been shown that alexithymia may represent a vulnerability factor which predisposes individuals to experience increased negative affect (NA), which in turn leads to medically unexplained symptoms (Lundh and Simonsson-Sarnecki, 2001). Thus, NA should be considered as a possible mediating factor when studying the relationship between alexithymia and somatization. "
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    ABSTRACT: Whilst alexithymia has been consistently linked to somatization, two prominent theoretical models lead to opposite predictions as to which of two proposed typologies of alexithymia will be particularly associated with somatic symptom reporting. In the present study, participants were recruited from a cross-section of the general adult population (n=301), and asked to complete a battery of self-report questionnaires which assessed alexithymia, somatization and negative affect. Collapsed across the whole sample, specific facets of alexithymia (enhanced fantasy life and difficulty identifying emotions) were significantly associated with somatization, and these pathways were perfectly mediated by negative affectivity. Further, type II alexithymia (impairment in the cognitive but not the affective dimension of alexithymia) was more predictive of somatization relative to type I alexithymia (impairment in both the cognitive and affective dimensions of alexithymia) and non-alexithymia (unimpaired in the cognitive and affective dimensions of alexithymia). The theoretical and clinical implications of these results are discussed.
    Psychiatry Research 03/2007; 150(1):13-20. DOI:10.1016/j.psychres.2006.05.024 · 2.47 Impact Factor
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