Alexithymia and PTSD: psychometric and fMRI studies

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Annals of the New York Academy of Sciences (Impact Factor: 4.38). 08/2006; 1071(1):397-400. DOI: 10.1196/annals.1364.029
Source: PubMed


Two studies examined correlates of alexithymia in posttraumatic stress disorder (PTSD). In study 1 (n = 77 individuals with PTSD and 45 controls) Toronto alexithymia scale (TAS-20) scores were positively correlated with PTSD symptoms, dissociation, and childhood abuse and neglect. In study 2, TAS-20 scores were examined as correlates of functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) response to trauma script imagery. In 16 controls, TAS-20 scores correlated positively with response in medial prefrontal cortex (mPFC), and negatively with response in anterior cingulate cortex (ACC) and thalamus. In 26 individuals with PTSD, TAS-20 scores correlated positively with response in insula, posterior cingulate cortex (PCC), and thalamus, and negatively with response in ACC.

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    • "Although the 5-HTTLPR does not affect the availability of 5-HTT in the living human brain of healthy adult (Murthy et al., 2010), the effects of 5- HTTLPR genotypes on brain function in adults are likely attributable to earlier developmental changes (Frodl et al., 2010; Mueller et al., 2010). During the childhood, the L allele of 5-HTTLPR in 5-HTT increases the gray matter volumes in anterior cingulate and amygdale (Pezawas et al., 2005), which are related to the development of alexithymia (Frewen et al., 2006; Radaelli et al., 2014), and leads to a higher risk of alexithymic symptoms (Kano et al., 2012). Unlike the 5-HTTLPR, the C-1019G in 5-HT1A regulates the serotonin levels in synaptic cleft with the G allele linked to the decreased serotonin level (Lemonde et al., 2003; Albert and Lemonde, 2004; Czesak et al., 2012) and exerts significant effects on the reactivity and volumes of amygdala (Le Francois et al., 2008; Zetzsche et al., 2008). "
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    ABSTRACT: Previous studies have indicated that alexithymia is associated with the availability of serotonin in the brain and with the insecure attachment orientation. Inspired by the finding that the receptor 5-HT1A modulates the level of serotonin in the brain, this study investigated to what extent a polymorphism (C-1019G, rs6295) of 5-HT1A gene modulates individuals’ alexithymic characteristics and attachment orientation in 504 Chinese Han people. Results showed significantly higher total scores on the 20-item Toronto Alexithymia Scale (TAS-20) for individuals carrying the CG/GG genotype than for individuals carrying the CC genotype. Specifically, individuals with the CG/GG genotype reported greater difficulty in identifying own feelings than individuals with the CC genotype. Results also showed that individuals carrying the CG/GG genotype seemed to be less comfortable with having close relationships to others than individuals with the CC genotype. These findings provide the first evidence for the link between 5-HT1A and the development of alexithymic characteristics and attachment orientation.
    Full-text · Article · Sep 2014 · Psychoneuroendocrinology
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    • "With respect to clinical alexithymia, recent findings typically suggest a strong interrelation with dissociation with regard to posttraumatic stress, emotional numbing, and alexithymia (Frewen et al., 2008). In individuals with posttraumatic stress disorder (PTSD), TAS-20 scores correlated positively with neural responses in insula, posterior cingulate cortex (PCC), and thalamus, and negatively with response in anterior cingulate cortex (ACC) (Frewen et al., 2006). "
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    ABSTRACT: It is unclear to what degree depersonalization disorder (DPD) and alexithymia share abnormal brain mechanisms of emotional dysregulation. We compared cerebral processing of facial expressions of emotion in individuals with DPD to normal controls (NC). We presented happy and sad emotion expressions in increasing intensities from neutral (0%) through mild (50%) to intense (100%) to DPD and non-referred NC subjects in an implicit event-related fMRI design, and correlated respective brain activations with responses on the 20-item Toronto Alexithymia Scale (TAS-20) and its three subscales F1-F3. The TAS-20 predicts clinical diagnosis of DPD with a unique variance proportion of 38%. Differential regression analysis was utilized to ascertain brain regions for each alexithymia subscale. Differential regions of total alexithymia severity for happy emotion were the globus pallidus externus; for identifying feelings (TAS-20 F1 subscale), the right anterior insula; for description of feelings (F2), the right dorsal mid-anterior cingulate gyrus (BA 24); and for externally oriented cognitive style (F3), the left paracingulate gyrus (BA 32). For sad emotion, the differential region for the total TAS-20 score was the dorsal anterior cingulate gyrus (BA 24); for TAS-20 F1, the left inferior anterior insula; for TAS-20 F2, the right PCC (BA 31); and for TAS-20 F3, the right orbital gyrus (BA 10). Supporting our hypotheses, the ascertained brain regions for TAS-20 subscales subserve interoception, monitoring and reflection of internal states and emotion. The presented analyses provide evidence that alexithymia plays a substantial role in emotional dysregulation in DPD, presumably based on restrictions in interoception.
    Full-text · Article · Aug 2013 · Psychiatry Research: Neuroimaging
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    • "Interestingly, previous studies have found a correlation between alexithymia and PTSD symptoms. Studies have reported an association between a perceived difficulty in identifying and describing emotional states and the severity of PTSD symptoms [26, 27]. "
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    ABSTRACT: The aim of this study was to investigate the prevalence of migraine, alexithymia, and post-traumatic stress disorder among medical students at Cumhuriyet University of Sivas in Turkey. A total of 250 medical students participated in this study and answered the questionnaires. The study was conducted in three stages: the self-questionnaire, the neurological evaluation, and the psychiatric evaluation. In the first stage, the subjects completed a questionnaire to assess migraine symptoms and completed the three-item Identification of Migraine Questionnaire, the Toronto Alexithymia Scale, and the Post-Traumatic Stress Disorder Checklist-Civilian Version Scale. The subjects who reported having a migraine underwent a detailed neurological evaluation conducted by a neurologist to confirm the diagnosis. In the final stage, the subjects with a migraine completed a psychiatric examination using the structured clinical interview for DSM-IV-R Axis I. The actual prevalence of migraine among these medical students was 12.6 %. The students with a migraine were diagnosed with alexithymia and post-traumatic stress disorder more frequently than those without migraine. The Migraine Disability Assessment Scale scores correlated with the post-traumatic stress disorder scores. The results of this study indicate that migraine was highly prevalent among medical students in Turkey and was associated with the alexithymic personality trait and comorbid psychiatric disorders including post-traumatic stress disorder. Treatment strategies must be developed to manage these comorbidities.
    Preview · Article · Apr 2012 · The Journal of Headache and Pain
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