Memory for Emotionally Provocative Words in Alexithymia: A Role for Stimulus Relevance

Alexithymia is associated with emotion processing deficits, particularly for negative emotional information. However, also common are a high prevalence of somatic symptoms and the perception of somatic sensations as distressing. Although little research has yet been conducted on memory in alexithymia, we hypothesized a paradoxical effect of alexithymia on memory. Specifically, recall of negative emotional words was expected to be reduced in alexithymia, while memory for illness words was expected to be enhanced in alexithymia. Eighty-five high or low alexithymia participants viewed and rated arousing illness-related ( pain ), emotionally positive ( thrill ), negative ( hatred ), and neutral words ( horse ). Recall was assessed 45 min later. High alexithymia participants recalled significantly fewer negative emotion words but also more illness-related words than low alexithymia participants. The results suggest that personal relevance can shape cognitive processing of stimuli, even to enhance retention of a subclass of stimuli whose retention is generally impaired in alexithymia

Parental bonding and alexithymia: A meta-analysis

Aim: The primary purpose of this meta-analysis was to explore, clarify and report the strength of the relationship between alexithymia, as measured by the Toronto Alexithymia Scale (TAS-20), and parenting style as measured by the Parental Bonding Instrument (PBI). Methods: Web of Science, PsycInfo, PubMed and ProQuest: Dissertations and Theses searches were undertaken, yielding nine samples with sufficient data to be included in the meta-analysis. Results: Evidence indicated moderate to strong relationships between maternal care and alexithymia, and between maternal care and two of the three TAS-20 alexithymia facets (Difficulties Describing Feelings and Difficulties Identifying Feelings, but not Externally Oriented Thinking). Moderate relationships were observed for both maternal- and paternal-overprotection and alexithymia respectively, and for overprotection (both maternal and paternal) and Difficulties Describing Feelings. Conclusion: This study is the first meta-analysis of the relationship between parenting styles and alexithymia, and findings confirm an especially strong association between maternal care and key elements of alexithymia. This review highlights the issues that still remain to be addressed in exploring the link between parenting style and alexithymia

Alexithymia in young adults with substance use disorders: Critical issues about specificity and treatment predictivity

Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent. The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: (a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and (b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2. Study 1 involved 90 late adolescents, aged 17-21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale-20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R. Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the "Distant" OAS subscale predicted the number rate relapses only in males. The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population

Default Mode Network alterations in alexithymia: An EEG power spectra and connectivity study

Recent neuroimaging studies have shown that alexithymia is characterized by functional alterations in different brain areas [e.g., posterior cingulate cortex (PCC)], during emotional/social tasks. However, only few data are available about alexithymic cortical networking features during resting state (RS). We have investigated the modifications of electroencephalographic (EEG) power spectra and EEG functional connectivity in the default mode network (DMN) in subjects with alexithymia. Eighteen subjects with alexithymia and eighteen subjects without alexithymia matched for age and gender were enrolled. EEG was recorded during 5 min of RS. EEG analyses were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Compared to controls, alexithymic subjects showed a decrease of alpha power in the right PCC. In the connectivity analysis, compared to controls, alexithymic subjects showed a decrease of alpha connectivity between: (i) right anterior cingulate cortex and right PCC, (ii) right frontal lobe and right PCC, and (iii) right parietal lobe and right temporal lobe. Finally, mediation models showed that the association between alexithymia and EEG connectivity values was directed and was not mediated by psychopathology severity. Taken together, our results could reflect the neurophysiological substrate of some core features of alexithymia, such as the impairment in emotional awareness

Binge eating disorder In adolescence: the role of alexithymia and impulsivity

Binge Eating Disorder (BED) is a disorder, recently included in DSM-5, often present in adolescence. Several studies highlight that adolescents with BED had high levels of impulsivity and alexithymia. Even though studies have underlined the importance of these variables, no studies have investigated their role on adolescents’ emotional-behavioral functioning. This study proposes to verify if adolescents affected by BED show higher levels of alexithymia and impulsivity than adolescents without diagnosis, and what is their role on adolescents’ emotional-behavioral functioning. Thanks to the collaboration with clinical centers for eating disorders, a group composed by 60 adolescents diagnosed with BED was paired to a 60 healthy controls. Participants completed validated self-report questionnaires investigating levels of alexithymia, impulsivity and emotional-behavioral functioning. Adolescents diagnosed with BED showed higher scores on alexithymia, impulsivity and maladaptive emotional-behavioral functioning than healthy controls. Moreover, alexithymia had a mediating effect on the relationship between impulsivity and emotional-behavioral functioning. These results show that alexithymia is a key variable influencing the emotional-behavioral functioning of adolescents affected by BED. Further studies are needed to also check other variables that might lead to the onset of BED. On the other hand, our findings can help clinicians suggesting the importance of promoting prevention and treatment polices focused on alexithymia

Modulation of Long-Term Memory by Arousal in Alexithymia: The Role of Interpretation

Moderate physiological or emotional arousal induced after learning modulates memory consolidation, helping to distinguish important memories from trivial ones. Yet, the contribution of subjective awareness or interpretation of arousal to this effect is uncertain. Alexithymia, which is an inability to describe or identify one’s emotional and arousal states even though physiological responses to arousal are intact, provides a tool to evaluate the role of arousal interpretation. Participants scoring high and low on alexithymia (N = 30 each) learned a list of 30 words, followed by immediate recall. Participants then saw either an arousing (oral surgery) or neutral video (tooth brushing). Memory was tested 24-h later. Physiological response to arousal was comparable between groups, but subjective response to arousal was impaired in high alexithymia. Yet, delayed word recognition was enhanced by arousal regardless of alexithymia status. Thus, subjective response to arousal, i.e., cognitive appraisal, was not necessary for memory modulation to occur

Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory

This document is the Accepted Manuscript version of the following article: Paul M. Jenkinson, Lauren Taylor, Keith R. Laws, ‘Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory’, Journal of Psychosomatic Research, Vol. 110: 38-45, July 2018, under embargo until 19 April 2019. The Version of Record is available online at DOI: https://doi.org/10.1016/j.jpsychores.2018.04.005Objective: An impairment of the ability to sense the physiological condition of the body – interoception – has long been proposed as central to the onset and maintenance of eating disorders. More recent attention to this topic has generally indicated the presence of interoceptive deficits in individuals with an eating disorder diagnosis; however, possible links with specific diagnosis, BMI, age, illness duration, depression, and alexithymia remain unclear from individual studies. This meta-analysis aimed to provide a necessary quantitative overview of self-reported interoceptive deficits in eating disorder populations, and the relationship between these deficits and the previously mentioned factors. Methods: Using a random effects model, our meta-analysis assessed the magnitude of differences in interoceptive abilities as measured using the Eating Disorder Inventory in 41 samples comparing people with eating disorders (n=4308) and healthy controls (n=3459). Follow-up and moderator analysis was conducted, using group comparisons and meta-regressions. Results: We report a large pooled effect size of 1.62 for eating disorders with some variation between diagnostic groups. Further moderator analysis showed that BMI, age and alexithymia were significant predictors of overall effect size. Conclusion: This meta-analysis is the first to confirm that large interoceptive deficits occur in a variety of eating disorders and crucially, in those who have recovered. These deficits may be useful in identifying and distinguishing eating disorders. Future research needs to consider both objective and subjective measures of interoception across different types of eating disorders and may fruitfully examine interoception as a possible endophenotype and target for treatment.Peer reviewe

Endoscopic findings and psychometric abnormalities: what is the relationship in upper endoscopic outpatients?

Background. Psychological disorders are often associated with diseases of the upper digestive tract. Although emotions can influence gastrointestinal function in healthy individuals, psychological setting in upper gastrointestinal patients are unclear. We evaluate the psychological alterations prevalence in outpatients submitted to upper endoscopy. Materials and Methods. A total of 130 patients (50 males and 80 females; mean age 54±17 years) submitted to upper gastrointestinal endoscopy, were enrolled over the period May 2009 - September 2010. Subjects were asked to complete questionnaires before endoscopic examination. Alexithymia, anxiety, depression and coping style were assessed using the Toronto Alexithymia Scale, Spielberger Trait Anxiety Inventory, Beck Depression Inventory and Coping Inventory for Stressful Situations, respectively. Results. Coping impairment, Alexithymia, Anxiety and Depression were found respectively in 80.3%, 25.4%, 24.6% and 17.2%, often in association. Task-oriented, emotion-oriented and avoidance-oriented alterations were found in 41.8%, 40% and 30.6%, respectively. No correlations were demonstrated between diagnosis of upper gastrointestinal disease and psychometric results. Conclusions. In our study, a high prevalence of psychometric alterations in gastrointestinal outpatients was unconnected with endoscopic findings, especially considering coping style alterations. This aspect should be taken into account in patients management and a long-term follow-up should clarify a possible role of these factors in patients prognosis and compliance