ABSTRACT
BACKGROUND: The relationship between alexithymia and dissociation is not known. Both mechanisms ward off overwhelming affective states; hence, this report examines the relationship between dissociation, alexithymia, depressed mood and the five-factor model of personality in a sample of psychiatric outpatients. METHODS: One hundred and sixteen outpatients were evaluated using the Toronto Alexithymia Scale (TAS), the Dissociative Experiences Scale (DES), NEO Five-Factor Inventory and visual analog scales assessing depression and anxiety. Data was analyzed using multivariate analysis of variance, logistic regression and linear regression techniques. RESULTS: Depressed mood accounted for the group differences between the global TAS and DES scores. Using DES both dimensionally and categorically with regression models, there was minimal contribution of DES or its subfactors to predict TAS. CONCLUSIONS: These data reaffirm previous findings that dissociation fundamentally differs from alexithymia. Dissociation involves a change of one's sense, of self, whereas alexithymia reflects a cognitive state of externally oriented thinking with an inability to identify and report discrete emotions.
Subject(s)
Affective Symptoms/diagnosis , Dissociative Disorders/diagnosis , Mental Disorders/diagnosis , Personality Disorders/diagnosis , Adult , Affective Symptoms/psychology , Ambulatory Care , Comorbidity , Diagnosis, Differential , Dissociative Disorders/psychology , Female , Humans , Male , Mental Disorders/psychology , Middle Aged , Personality Disorders/psychology , Personality Inventory , Risk FactorsABSTRACT
25 adult HIV patients were evaluated in a study of appointments, medication, and compliance with restrictions on sexual activity. The Executive Interview (EXIT) was useful in assessing these patients for cognitive difficulties; compliance with medication and countertransference issues were negatively correlated with EXIT scores.
Subject(s)
Cognition Disorders/diagnosis , HIV Seropositivity/psychology , Patient Compliance , Adult , Aged , Countertransference , Female , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To determine the effects of endotracheal intubation on respiratory mechanics during xylazine sedation and xylazine-diazepam-ketamine anesthesia in adult horses. ANIMALS: 5 healthy adult horses. PROCEDURE: Measurements were derived from recordings of respiratory gas flow, and transpulmonary and transtracheal pressures. Total pulmonary resistance (RT) was partitioned into upper airway resistance (extrathoracic portion of trachea, larynx, pharynx, nasal cavity, nares; RUA) and lower airway resistance (intrathoracic portion of trachea, bronchi, bronchioles). Baseline measurements were obtained in unsedated horses, after xylazine administration, and following nasotracheal intubation (ID, 18 mm). Measurements were obtained following induction of xylazine-diazepam-ketamine anesthesia and subsequent to endotracheal intubations (ID, 22, 20, and 16 mm). During recovery, horses were nasotracheally intubated (ID, 18 mm). Measurements were obtained upon standing, and repeated after extubation. Data were examined by use of ANOVA with repeated measures. RESULTS: Significant increases in mean work of breathing (W), RT, and RUA observed with xylazine sedation were variably attenuated by nasotracheal intubation. During xylazine-diazepam-ketamine anesthesia, the highest mean values for W, RT, RUA, transpulmonary and transtracheal pressures developed during non-intubation periods. The magnitudes of resistance and pressure values were inversely proportional to the internal diameter of the endotracheal tube. At recovery, values of the W and all measurements of resistances and pressures were significantly increased, compared with presedation values. Extubation resulted in further increases in these measurements. CONCLUSIONS: Work of breathing in horses is substantially increased when RUA is increased during xylazine sedation and xylazine-diazepam-ketamine anesthesia. Endotracheal intubation reduces W by reducing RUA.
Subject(s)
Anesthetics/pharmacology , Horses/physiology , Hypnotics and Sedatives/pharmacology , Intubation, Intratracheal/veterinary , Respiratory Mechanics/drug effects , Respiratory Mechanics/physiology , Airway Resistance/drug effects , Airway Resistance/physiology , Analysis of Variance , Anesthetics/administration & dosage , Anesthetics, Dissociative/administration & dosage , Anesthetics, Dissociative/pharmacology , Anesthetics, Intravenous/administration & dosage , Anesthetics, Intravenous/pharmacology , Animals , Diazepam/administration & dosage , Diazepam/pharmacology , Drug Combinations , Hypnotics and Sedatives/administration & dosage , Intubation, Intratracheal/methods , Ketamine/administration & dosage , Ketamine/pharmacology , Larynx/physiology , Nasopharynx/physiology , Trachea/physiology , Xylazine/administration & dosage , Xylazine/pharmacologyABSTRACT
To investigate the nature and treatment of pain complaints in psychiatric patients, 75 patients in a general hospital psychiatric unit who utilized any form of analgesic medication were studied. Patients with a primary or secondary diagnosis of substance abuse were excluded. The results indicate that most of the pain complaints were musculoskeletal or headaches and mild to moderate in degree. Nonopiod analgesics were commonly prescribed, and the degree of disability from the pain complaint was minimal. Patients who did utilize pain medications stayed in the hospital significantly longer than those who did not, and this was not an effect of age or diagnosis.
Subject(s)
Analgesics/therapeutic use , Hospitalization , Mental Disorders/complications , Pain/drug therapy , Pain/etiology , Adult , Drug Utilization , Female , Hospitals, General , Humans , Length of Stay , Male , Middle Aged , Retrospective Studies , Severity of Illness IndexABSTRACT
The attribution of common somatic symptoms was investigated in 100 psychiatric outpatients. Subjects who were more depressed and alexithymic as measured by the Toronto Alexithymia Scale (TAS) tended to endorse a psychological attribution for somatic complaints. Somatosensory amplification, anxiety, and inability to express and report specific feelings predicted psychological attribution. The data support the role of alexithymia in somatization and further explain a possible role of psychological attribution of somatic symptoms in the underrecognition of physical disorders in psychiatric patients.
Subject(s)
Affective Symptoms/psychology , Outpatients/psychology , Somatoform Disorders/psychology , Adult , Analysis of Variance , Anxiety , Chi-Square Distribution , Cognition , Depression , Female , Humans , Male , Mental Disorders/psychology , Middle Aged , Regression AnalysisABSTRACT
A total of 80 adults (40 normal volunteers, 40 substance abusers) participated in a study about alexithymia and five factors of personality, measured on the Toronto Alexithymia Scale and the NEO Five Factor Inventory, respectively, and their relationship to recognition of affect. The substance abusers scored the same as the age- and sex-matched normal volunteers on recognizing posed facial expressions, but higher on the alexithymia scale, while on Neuroticism and Extraversion they had lower scores on Agreeableness.
Subject(s)
Affect , Affective Symptoms/psychology , Awareness , Personality Inventory/statistics & numerical data , Substance-Related Disorders/psychology , Adult , Alcoholism/psychology , Alcoholism/rehabilitation , Anxiety/diagnosis , Anxiety/psychology , Depression/diagnosis , Depression/psychology , Facial Expression , Female , Humans , Male , Middle Aged , Psychometrics , Substance-Related Disorders/rehabilitationABSTRACT
The stability of alexithymia as measured by the Toronto Alexithymia Scale (TAS) and its relationship to depression were investigated in 50 depressed inpatients. The test-retest coefficient for TAS over a 5-day period was 0.57 (p < 0.001). A reliable change index for depressed mood indicated that mood covaried with the TAS, but changes in TAS were not clinically significant. The data support alexithymia as a stable personality construct.
Subject(s)
Affective Symptoms/psychology , Depressive Disorder/psychology , Adult , Affective Symptoms/diagnosis , Aged , Cohort Studies , Depressive Disorder/diagnosis , Female , Humans , Male , Middle Aged , Personality Inventory/statistics & numerical data , Psychometrics , Reproducibility of ResultsABSTRACT
Both amplification of normal visceral phenomena and the personality trait of alexithymia are factors in the process of somatization, whereby somatic symptoms become metaphors for emotional distress. The relationship between these two variables was investigated in 101 psychiatric out-patients. Each subject was administered the Somatosensory Amplification Scale (SSA); the Toronto Alexithymia Scale (TAS); the NEO-FFI, which measures five personality factors; and the health locus of control (HLC). In addition, anxiety and depression were quantitatively measured. SSA and TAS significantly correlated only in the female subjects. A regression model found neuroticism to contribute the most variance in predicting SSA while TAS did not fit into the model. Amplification is a perceptual element in potentiating somatization, whereas alexithymia contributes to the cognitive aspects of the process. The role of neuroticism is discussed as a mediating factor.
Subject(s)
Affective Symptoms/psychology , Arousal , Neurotic Disorders/psychology , Somatoform Disorders/psychology , Adjustment Disorders/diagnosis , Adjustment Disorders/psychology , Adult , Affective Symptoms/diagnosis , Anxiety Disorders/psychology , Attitude to Death , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Humans , Internal-External Control , Male , Middle Aged , Neurotic Disorders/diagnosis , Personality Inventory/statistics & numerical data , Psychometrics , Somatoform Disorders/diagnosisABSTRACT
The Illness Effects Questionnaire, Illness Behavior Questionnaire, and visual analog scales of mood were given to 100 adults with nonmalignant headaches. Using regression analysis, scores on IBQ Disease Conviction, IBQ Irritability, and depression accounted for 50.6% of the variance in predicting IEQ scores. Scores on the Illness Effects Questionnaire correlated with the Illness Behavior Questionnaire subscales of General Hypochondriasis (.33), Disease Conviction (.60), Affective Disturbance (.49), and Irritability (.40), and also with rated depression (.38) and anxiety (.26).
Subject(s)
Headache/psychology , Personality Inventory/statistics & numerical data , Sick Role , Adult , Anxiety/psychology , Depression/psychology , Female , Humans , Male , Middle Aged , Pain Measurement , Psychometrics , Reproducibility of ResultsABSTRACT
Research regarding psychological factors in head pain have generally focused upon personality traits and psychopathology. The role of illness beliefs offers another method of elucidating perceptions, attitudes and convictions towards a somatic complaint. One hundred patients, evaluated for head pain at a neurology clinic, were administered the illness Behavior Questionnaire (IBQ) to delineate illness beliefs; the illness Effects Questionnaire (IEQ) to quantify the disruptive aspects of head pain; and the Toronto Alexithymia Scale (TAS) to assess the subjects propensity to somatize as well as the ability to identify and report emotions. The data found no difference between subjects diagnosed with migraine syndrome and those with tension head pain in the IBQ dimensions, the TAS or in reported levels of anxiety or depression. However, chronicity of symptoms was associated with increased irritability. The clinical implications of the findings suggest that patients with head pain are psychologically distressed but often possess alexithymic characteristics that make insightful associations difficult.
Subject(s)
Affective Symptoms/etiology , Headache/psychology , Sick Role , Adult , Female , Headache/complications , Humans , Male , Middle Aged , Migraine Disorders/psychology , Stress, Psychological/physiopathology , Surveys and QuestionnairesABSTRACT
A total of 62 staff members from a general hospital participated in a study about alexithymia and the five-factor model of personality, measured by the Toronto Alexithymia Scale and the NEO Five Factor Inventory, respectively, and their relationship to recognition affect. Subjects with alexithymic characteristics were less able to recognize affective states in posed facial expressions and so may have modified their empathic capacity.
Subject(s)
Affective Symptoms/psychology , Mood Disorders/psychology , Personality , Adult , Affective Symptoms/diagnosis , Cognition , Empathy , Facial Expression , Female , Humans , Male , Middle Aged , Mood Disorders/diagnosis , Personality InventoryABSTRACT
The seclusion room is an integral component of hospital psychiatry. This study prospectively surveyed 50 patients shortly after each was released from an isolation room in a voluntary general hospital psychiatric unit. Fifty-eight percent of the sample were diagnosed with mood disorders. Previous studies found generally negative attitudes toward seclusion. These data revealed that patients often found seclusion to be restful and therapeutically helpful. The clinical implications of these data are discussed.
Subject(s)
Attitude , Dangerous Behavior , Patient Isolation/psychology , Patient Satisfaction , Psychiatric Department, Hospital/standards , Adult , Female , Humans , Length of Stay , Male , Mental Disorders/psychology , Mental Disorders/therapy , Middle Aged , Patient Compliance/psychology , Prospective Studies , Psychiatric Status Rating Scales , Suicide/psychology , Suicide PreventionABSTRACT
OBJECTIVE: Both locus of control and alexithymia have been considered personality factors fostering health concerns and behaviors. This study investigates the relationship between the health locus of control and alexithymia. METHOD: Seventy-eight psychiatric outpatients were administered the Wallston Health Locus of Control Scale (HLC), the Toronto Alexithymia Scale (HLC), and the Five Factor Inventory, which measures neuroticism, extraversion, openness, agreeableness, and conscientiousness. Depressive and anxious affect was also measured. Regression models were developed to assess the influence of the above variables upon alexithymia. RESULTS: Although there was a significant bivariant correlation between an external locus of control and increased alexithymia, regression models found that HLC did not significantly predict TAS. Neuroticism, however, provided the most significant contribution to predict increased alexithymia. CONCLUSION: Neuroticism may link HLC and TAS due to the face validity of each construct. A sense of vulnerability is stated in each measure. This may foster somatic preoccupation. The data suggest HLC and TAS to be separate phenomena and further support the validity of alexithymia as a unique personality trait.
Subject(s)
Affective Symptoms/diagnosis , Attitude to Health , Internal-External Control , Personality Inventory/statistics & numerical data , Adult , Affective Symptoms/classification , Affective Symptoms/psychology , Aged , Female , Humans , Male , Middle Aged , Psychometrics , Psychophysiologic Disorders/classification , Psychophysiologic Disorders/diagnosis , Psychophysiologic Disorders/psychology , Sick Role , Somatoform Disorders/classification , Somatoform Disorders/diagnosis , Somatoform Disorders/psychologyABSTRACT
The relationship between alexithymia assessed by the Toronto Alexithymia Scale (TAS) and the five-factor model of personality measured by the NEO Five-Factor Inventory (FFI) was investigated in a group of psychiatric outpatients (n = 114) and normal volunteers (n = 71). When controlling for depression, the domains of neuroticism, introversion, and low openness predicted alexithymia. These three dimensions accounted for 57.1% of the explained variance in the patient cohort and 38.1% in the volunteer group. In the patient cohort, neuroticism contributed the majority of explained variance, which may reflect the state effect of distress that elevates neuroticism. Introversion was the most significant predictor in the volunteer group. These data suggest alexithymia is a unique personality trait that is not fully explained by the five-factor model of personality.
Subject(s)
Affective Symptoms/psychology , Personality Development , Personality Inventory/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , Psychometrics , Psychophysiologic Disorders/psychologyABSTRACT
The Toronto Alexithymia Scale (TAS) offers a reliable method to measure alexithymia, a personality construct describing individuals endorsing the inability to identify and report emotions, processing a minimal fantasy life, utilizing an analytic cognitive style, and tending to somatize. Utilizing four cohorts of both patients and controls, a three-factor solution emerged from a principal-components analysis utilizing a varimax rotation. The factors of inability to identify and report feelings, an analytic cognitive style, and paucity of fantasy life were independent and internally reliable. These data are reviewed in the context of previous research and offer three subscales for future investigations utilizing the Toronto Alexithymia Scale.
Subject(s)
Affective Symptoms/diagnosis , Personality Inventory/statistics & numerical data , Adult , Affective Symptoms/psychology , Cohort Studies , Factor Analysis, Statistical , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , PsychometricsABSTRACT
Residents anddirectors of accredited child and adolescent psychiatry programs (N = 117) in the United States were surveyed (with a response rate of 89% and 76.9%, respectively) to determine the extent and adequacy of training offered for the identification and management of substance abuse disorders. Of the responders, 24% of the residents indicated some exposure (≥1 hour) to an adolescent drug abuse treatment facility during their training. In contrast, 46% of the directors reported that their residents had such exposure. Residents consistently reported training to be less adequate than did directors. Only half of the residents reported that they felt adequately prepared to identify and initially manage a substance-abusing adolescent, whereas a somewhat higher percentage of the directors (59%) felt that their residents were adequately prepared for this function.
Subject(s)
Internship and Residency , Psychiatry , Societies, Medical , Psychiatry/education , United States , WorkforceABSTRACT
Utilizing a systematic methodology (The Consultation-Liaison Outcome Evaluation System), the compliance of nonpsychiatric consultations within a general hospital psychiatric unit staffed by private practitioners was assessed. Thirty-one percent of the patients received such consultations and these patients had a longer length of stay than those without a consultation. Psychiatrists were generally compliant with both medication and diagnostic recommendations; but in only half the discharge summaries was the consultant's primary medical diagnosis fully reflected. The implications of these data are discussed.
Subject(s)
Hospitalization , Interprofessional Relations , Neurocognitive Disorders/diagnosis , Patient Care Team , Sick Role , Adult , Attitude of Health Personnel , Female , Hospitals, Community , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Mental Disorders/therapy , Middle Aged , Neurocognitive Disorders/psychology , Neurocognitive Disorders/therapy , Psychiatric Department, HospitalABSTRACT
Fifty-six mildly depressed psychiatric outpatients were evaluated for alexithymia measured by the Toronto Alexithymia Scale. Each subject also completed a Defensive Style Questionnaire that assessed the maturity of their ego defenses. Alexithymia was strongly associated with immature ego defenses, but not with depression. The data suggests that alexithymia and such primitive defensive operations are separate phenomena. These findings empirically support earlier observations regarding the nature of alexithymia.
