Emotion Regulation and Mental Representation of Attachment in Patients With Systemic Lupus Erythematosus

Department of Psychology, University of Turin, Turin, Italy.
The Journal of nervous and mental disease (Impact Factor: 1.69). 04/2013; 201(4):304-10. DOI: 10.1097/NMD.0b013e318288e215
Source: PubMed


Mental representations of attachment and emotion regulation influence individual patterns of stress response and vulnerability to illness. The present study investigates the adult attachment states of mind of 40 women with systemic lupus erythematosus (SLE) using the Adult Attachment Interview. We also assessed alexithymia using the Toronto Alexithymia Scale and dissociation using the Dissociative Experiences Scale. The results showed a high prevalence of the unresolved state of mind (13 patients, 32.5%) and the entangled state of mind (10 patients, 25%). The alexithymia score also varied significantly as a function of the mental representation of attachment and was modulated by amnestic dissociation. These findings suggest that adult attachment in patients with SLE influences the presence of alexithymic features. Moreover, these also indicate that dissociative states mediate the perception of painful memories and feelings, thus contributing to the partial avoidance of emotions and the failure to fully experience and recognize them. The clinical implications of these findings are also discussed.

8 Reads
  • Source
    • "In the present study, we sought to explore the factorial structure of an Italian version of the DES-II, using a combined sample of inmates and community-dwelling participants . It is noteworthy that to date there have been no studies that have investigated the psychometric properties and the factorial structure of the DES in Italian samples, let alone used it with Italian offender samples, even though the Italian translation has been available and widely used for almost 20 years (Barbasio and Granieri, 2013; Conti, 2000; Fabbri Bombi et al., 1996). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim of the study: Notwithstanding its clinical and empirical relevance, there is no consensus on how to conceptualize dissociation. This may be partly due to the conflicting results yielded on the factor structure of the gold-standard self-report measure of dissociation (the Dissociative Experiences Scale-Revised; DES-II, Carlson and Putnam, 1993). In an attempt to advance research on this topic, we sought to explore the factorial structure of an Italian version of the DES-II. Material and methods: A sample of 320 subjects (122 inmates and 198 community participants) was administered the Italian version of the DES-II. Results: The Italian version of the DES-II showed good psychometric properties and replicated a two-factor structure. Items content seemed to support the distinction into two qualitatively different forms of dissociative experiences, described as detachment and compartmentalization phenomena. In line with the expectations, participants in the inmate sample reported higher rates of dissociative experiences than community participants, on both dimensions. Conclusions: This study provides further support for the validity of the Italian version of the DES-II for use with community and inmate samples. Furthermore, we corroborated previous evidence on a two-factor structure of the DES-II, which is consistent with theoretical assumptions describing two distinct, albeit overlapping, dissociative dimensions (i.e., detachment and compartmentalization). Streszczenie Cel badania: Niezależnie od wartości klinicznej i empirycznej pojęcia, jakim jest dysocjacja, nie ma zgody co do właściwego sposobu jego konceptualizacji. Częściowo może to być spowodowane sprzecznymi wynikami analizy struktury czynnikowej złotego standardu wśród narzędzi do samooceny zjawisk dysocjacyjnych, jakim jest Skala Przeżyć Dysocjacyjnych (Dissociative Experiences Scale-Revised; DES-II, Carlson i Putnam, 1993). Mając na celu pogłębienie badań na ten temat, autorzy podjęli się analizy struktury czynnikowej włoskiej wersji skali DES-II. Materiał i metody: Badanie obejmowało próbę 320 osób (122 więźniów i 198 osób należących do populacji ogólnej). Zastosowano w nim włoską wersję skali DES-II. Wyniki: Włoska wersja skali DES-II wykazała dobre właściwości psychometryczne i została w niej zreplikowana struktura dwuczynnikowa. Treść pozycji na skali wydawała się potwierdzać istnienie podziału na dwie jakościowo inne formy przeżyć dysocjacyjnych, ujmowane jako oddzielenie (ang. detachment) i szufladkowanie (ang. compartmentalization). Zgodnie z oczekiwaniami więźniowie częściej zgłaszali występowanie przeżyć dysocjacyjnych niż osoby należące do populacji ogólnej, na obu wymiarach. Wnioski: Niniejsze badanie dostarcza kolejnych dowodów na zasadność stosowania włoskiej wersji skali DES-II w badaniach na populacji ogólnej oraz więziennej. Potwierdzono również poprzednie dane świadczące o dwuczynnikowej strukturze skali DES-II, co jest zgodne z założeniami teoretycznymi opisującymi dwa odrębne, choć nakładające się na siebie wymiary dysocjacji (tj. oddzielenie i szufladkowanie).
    Full-text · Article · May 2015
  • Source
    • "Using a sample of healthy pregnant women, this study extended previously published studies examining relations between alexithymia and attachment, as well as studies that have investigated the associations of one or other of these constructs with perceived relationship adjustment or the domains of the FFM of personality. Our finding that women classified as insecure on the AAI were more alexithymic than women classified as secure is consistent not only with findings from two previous studies that measured attachment with the AAI [46] [47], but also with multiple studies that assessed attachment styles with self-report questionnaires [38] [39] [40] [41] [42] [43] [44] [45]. In addition, our study is the first to examine relations between alexithymia and coherence of mind, which is rated as a continuous variable and is considered " theoretically and empirically the single best indicator of AAI security " [26]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Several studies have demonstrated associations between alexithymia, adult attachment styles, personality traits, and relationship adjustment. Only two studies, however, have explored associations between alexithymia and attachment representations. As part of a larger investigation of maternal and infant attachment, the current study explored this association in a sample of 97 pregnant women; in addition, measures of alexithymia and domains of the five-factor model (FFM) of personality were compared in predicting attachment security, assessed with the Adult Attachment Interview Coherence of Mind mind scale, and perceived relationship adjustment. Alexithymia negatively predicted coherence of mind; the domains of the FFM did not add significantly to the prediction. The Openness-to-Experience domain predicted relationship adjustment better than alexithymia. Contrary to findings from studies that assessed adult attachment styles, coherence of mind was unrelated to relationship adjustment and the FFM. The results suggest that alexithymia does not uniquely predict relationship adjustment beyond the domains of the FFM.
    Full-text · Article · Mar 2014 · Comprehensive psychiatry
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This prospective study aims to examine alexithymia, mood states and pain experience in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients. We enrolled 49 patients with SLE or RA. All patients were evaluated through a set of questionnaires: (1) the Toronto Alexithymia Scale-20 (TAS), (2) the Profile of Mood States (POMS) and (3) visual analogue scale (VAS) and Questionario Italiano sul Dolore, self-report measures to assess pain intensity. Alexithymia was more prevalent in RA (44 %) than in SLE (37.5 %). The mean values of VAS were significantly higher in RA than in SLE population (p < 0.05). A linear relation between TAS and VAS values has been found in SLE (R = 0.714, p < 0.0001). The mean values of POMS regarding all negative dimensions of mood were higher in SLE than in RA. There was a linear relationship between TAS and POMS values in SLE patients (R = 0.7, p < 0.001). We found a high prevalence of alexithymia in SLE and RA. The chronic pain is influenced by emotional status as documented by a linear relation between TAS and VAS values in SLE patients. The difficulty in reporting emotional responses in these patients seems to be mediated by negative mood states.
    Full-text · Article · Apr 2014 · Clinical Rheumatology
Show more