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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Available from: Lars-Gunnar Lundh
    • "Some authors have understood that alexithymia may mediate the onset of unexplained physical symptoms by a misinterpretation of physical anxiety symptoms (Demartini et al., 2014), by an impaired monitoring of internal states when patients were exposed to emotional stimuli (SánchezGarcía et al., 2011) or by an increase in the activation of the somatosensory cortex and motor supplementary area (Ihme et al., 2014). Other authors have postulated that autonomic dysregulation could be linking up the increases in negative affect, the decreases in positive affect and the onset of physical symptoms (Rief et al., 1998;Lundh and Simonsson-Sarnecki, 2001;Papousek et al., 2002). The presence of emotional impoverishment, decreased fantasy, increased operational thinking, emotion recognition impairments and more empathic distress is also remarkable in this disorder (PedrosaGil et al., 2009;Van Dijke et al., 2013). "
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    ABSTRACT: Emotion regulation impairments with traumatic origins have mainly been studied from posttraumatic stress disorder (PTSD) models by studying cases of adult onset and single-incident trauma exposure. The effects of adverse traumatic experiences, however, go beyond the PTSD. Different authors have proposed that PTSD, borderline personality, dissociative, conversive and somatoform disorders constitute a full spectrum of trauma-related conditions. Therefore, a comprehensive review of the neurobiological findings covering this posttraumatic spectrum is needed in order to develop an all-encompassing model for trauma-related disorders with emotion regulation at its center. The present review has sought to link neurobiology findings concerning cortico-limbic function to the field of emotion regulation. In so doing, trauma-related disorders have been placed in a continuum between under- and over-regulation of affect strategies. Under-regulation of affect was predominant in borderline personality disorder, PTSD with re-experiencing symptoms and positive psychoform and somatoform dissociative symptoms. Over-regulation of affect was more prevalent in somatoform disorders and pathologies characterized by negative psychoform and somatoform symptoms. Throughout this continuum, different combinations between under- and over-regulation of affect strategies were also found.
    No preview · Article · Jan 2016 · Reviews in the neurosciences
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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.
    Full-text · Article · Nov 2009 · BioPsychoSocial Medicine
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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.
    Full-text · Article · Dec 2008 · Journal of Affective Disorders
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