Somatoform disorders as disorders of affect regulation: a study comparing the TAS-20 with non-self-report measures of alexithymia

Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital of Freiburg, Hauptstr. 8, D-79104, Freiburg, Germany.
Journal of Psychosomatic Research (Impact Factor: 2.74). 10/2004; 57(3):239-47.
Source: PubMed


To determine the role of undifferentiated and dysregulated affects in somatoform disorders by using a multimethod assessment approach of alexithymia.
Forty patients with ICD-10 somatoform disorders (SoD) and 20 healthy controls, matched for age, education and sex, were included in the study. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20), the Affect Consciousness Interview (ACI), and the Levels of Emotional Awareness Scale (LEAS). All classifications were made blinded with regard to clinical status.
Scores of the ACI and the TAS-20 showed that alexithymia is higher in SoD than in healthy controls. No differences were found on the LEAS. In terms of the multidimensionality of the alexithymia construct, our results indicate a specific positive association between SoD and a proneness to experience undifferentiated affects. The three subfactors of the TAS-20 were differentially related to non-self-report measures of alexithymia and to negative affectivity (NA). Only the cognitive facet of the TAS-20 (externally oriented thinking [EOT]) was related to the LEAS and the ACI. In contrast, the affective facets of the TAS-20-difficulties identifying feelings (DIF) and difficulties describing feelings (DDF)-were substantially related to NA.
The findings highlight the important role of impaired affect regulation and NA in the process of somatization.

Download full-text


Available from: Elisabeth Maria Waller, Mar 21, 2014
    • "Instead, it may best be considered a measure of awareness of other people's emotions. Further, research suggests that the LEAS is primarily associated with attention to emotions (Waller & Scheidt, 2004), not the multiple facets of emotional awareness of interest here. This document is copyrighted by the American Psychological Association or one of its allied publishers. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Emotional clarity and attention to emotions represent the extent to which people understand and attend to their own emotions, respectively, and are broad facets of emotional awareness, alexithymia, and emotional intelligence. To examine the extent to which these two constructs are associated, we conducted a meta-analysis of studies including well-validated self-report measures of trait clarity and attention to emotion. Clarity and attention were moderately, positively associated. Assessment instrument, but not sample gender or age, moderated the association between clarity and attention. Analyses of between-study heterogeneity and publication bias suggested that results were valid and generalizable. We discuss potential causes of the association between clarity and attention, and elaborate on the implications of our results for emotion regulation, well-being, and psychopathology.
    No preview · Article · Jan 2016 · Emotion Review
  • Source
    • "First, we relied exclusively on self-reported measures. The literature suggests that multi-method assessments (e.g., self-reporting, interviews and observation) should be used when measuring alexithymia, to minimize measurement errors (e.g., Meganck, Inslegers, Vanheule, & Desmet, 2011; Taylor & Bagby, 2004; Waller & Scheidt, 2004). Moreover, it is arguable that the way people represent and regulate emotions is, to an important extent, implicit (e.g., Westen & Blagov, 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives We aimed to clarify the associations between negative emotionality, avoidant coping, and alexithymia. We hypothesized that negative emotionality and avoidance strategies would interact negatively in associating with alexithymia.DesignWe examined, in one study conducted in Italy and another in the US (total N = 415), the associations among avoidant coping, negative emotionality, and alexithymia, using cross-sectional designs.Method Study 1: Participants completed paper-and-pencil measures of alexithymia, avoidant coping, and negative emotionality. Study 2: Participants completed the above-mentioned measures plus a measure of experiential avoidance (EA), by means of an online questionnaire.ResultsAs expected, an antagonistic avoidant coping × negative emotionality interaction was found to relate to alexithymia in both studies. In Study 2, EA mediated the effects of such interaction on alexithymia (mediated moderation). The interaction found implied that alexithymia would be adopted as a defence against negative affect or as a consequence of avoidant strategies.Conclusions The studies suggested that two different psychological pathways to alexithymia may be at work: Preference for avoidance and negative emotionality. This result appeared theoretically relevant and may stimulate further research.Practitioner pointsAlexithymia may develop from habitual avoidance, regardless of negative emotionality.Practitioners could consider addressing negative emotional regulation or automatic and habitual avoidant responses in dealing with alexithymic patients.
    Full-text · Article · Oct 2015
  • Source
    • "[39] is a 33-item observer-measure, administrated to participants by the individual psychotherapists. An observer measure is fundamental in order to overcome a limit of selfreport tools to evaluate alexithymia: self-reports ask to the respondents to report on a capacity that they may lack, given the low rates of self-awareness and difficulties in emotion regulation that alexithymia itself implies [40]. For this reason, alexithymia assessment is most useful when used in combination with observational methods. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract— Introduction: Adolescence is a vulnerable age for experimenting with drugs, unfortunately early substance abuse has severe detrimental effects on cognitive functioning. Moreover, drug addiction is also characterized by affective dysregulation, in terms of high rates of sensation-seeking and alexithymia and poor emotional intelligence. Cognitive control and emotion regulation abilities are directly associated and are largely implemented by the same frontal cortex areas, which are also the main target of drug abuse. Objective: The present research aims to study the neuropsychological performance and the emotional functioning in young drug addicts, investigating possible interrelations between these two domains. Methods: a battery of neuropsychological tests (ENB-2) and self-report tools, addressing alexithymia (TAS-20), sensation seeking (SSS-VI) and emotional intelligence (EQ-i), were administered to 19 young drug-addicts. An observer scale to evaluate alexithymia (OAS) was also used. Results: subjects showed memory and attention deficits. High rates of alexithymia emerged, but only in the observer scale; also past experience of disinhibition and inadequate emotional intelligence abilities were identified. Several significant correlations were detected between cognitive functions and affective style, especially as regards executive functions and alexithymia. Conclusions: These findings suggest that drug-dependence in young age is not only characterized by neuropsychological deficits and difficulties in emotion regulations, but these two domains are associated, delineating a severe clinical conditions that requires specific treatment.
    Full-text · Conference Paper · Jun 2014
Show more