Interoception moderates the association between alexithymia and anxiety symptoms / La interocepción modera la asociación entre la alexitimia y los síntomas de ansiedad

In 2019, 301 million people were living with an anxiety disorder. Recently, alexithymia and interoception has been considered to play a key role to understand anxiety symptoms. Both constructs are related to each other and together interfere with emotional regulation; however, its relationship has been much debated. A recent two-stage model proposed interoception as a moderator in the relation between alexithymia and anxiety symptoms. Therefore, the aim of the present research was to study how this model could explain the anxiety symptoms. Two hundred forty-one healthy participants completed the General Health Questionnaire, the Toronto Alexithymia Scale and the Multidimensional Assessment of Interoceptive Awareness. Results verified that interoception moderates the association between alexithymia and anxiety symptoms, showing that, for alexithymia to be positively associated with the magnitude of these symptoms, at least a medium level of interoception is necessary. (AU)

En 2019, se estimaba que 301 millones de personas vivían con un trastorno de ansiedad. Recientemente, se ha considerado que tanto la alexitimia como la interocepción desempeñan un papel clave en la comprensión de los síntomas de ansiedad. Ambos constructos están relacionados entre sí y juntos interfieren en la regulación emocional; sin embargo, su relación ha sido objeto de mucho debate. Recientemente, un nuevo modelo de dos etapas propuso la interocepción como moderador en la relación entre la alexitimia y los síntomas de ansiedad. El objetivo de la presente investigación es estudiar cómo este modelo podría explicar los síntomas de ansiedad. 241 participantes sanos completaron el Cuestionario de Salud General, la Escala de Alexitimia de Toronto y la Evaluación Multidimensional de la Conciencia Interoceptiva. Los resultados verificaron que la interocepción modera la asociación entre la alexitimia y los síntomas de ansiedad, mostrando que, para que la alexitimia esté positivamente relacionada con la magnitud de estos síntomas, es necesario al menos un nivel medio de interocepción. (AU)

How does it feel? An exploration of neurobiological and clinical correlates of alexithymia in trauma-exposed police-officers with and without PTSD.

Background: Alexithymia, an inability to recognise one's emotions, has been associated with trauma-exposure and posttraumatic stress disorder (PTSD). Previous research suggests involvement of the oxytocin system, and socio-emotional neural processes. However, the paucity of neurobiological research on alexithymia, particularly in trauma-exposed populations, warrants further investigation.Objective: Explore associations between alexithymia, endogenous oxytocin levels, and socio-emotional brain function and morphometry in a trauma-exposed sample.Method: Dutch trauma-exposed police officers with (n = 38; 18 females) and without PTSD (n = 40; 20 females) were included. Alexithymia was assessed with the Toronto Alexithymia Scale (TAS-20). Endogenous salivary oxytocin was assessed during rest, using radioimmunoassay. Amygdala and insula reactivity to socio-emotional stimuli were assessed with functional MRI, amygdala and insula grey matter volume were derived using Freesurfer.Results: Alexithymia was higher in PTSD patients compared to trauma-exposed controls (F(1,70) = 54.031, p < .001). Within PTSD patients, alexithymia was positively associated with PTSD severity (ρ(36) = 0.497, p = .002). Alexithymia was not associated with childhood trauma exposure (ß = 0.076, p = .509), police work-related trauma exposure (ß = -0.107, p = .355), oxytocin levels (ß = -0.164, p = .161), insula (ß = -0.170, p = .158) or amygdala (ß = -0.175, p = .135) reactivity, or amygdala volume (ß = 0.146, p = .209). Insula volume was positively associated with alexithymia (ß = 0.222, p = .016), though not significant after multiple testing corrections. Bayesian analyses supported a lack of associations.Conclusions: No convincing neurobiological correlates of alexithymia were observed with any of the markers included in the current study. Yet, the current study confirmed high levels of alexithymia in PTSD patients, independent of trauma-exposure, substantiating alexithymia's relevance in the clinical phenotype of PTSD.

Little is known about neurobiological correlates of alexithymia in trauma-exposed and posttraumatic stress disorder (PTSD) populations.In this highly trauma-exposed sample, alexithymia was associated with PTSD symptoms, but not with childhood or adult trauma exposure, suggesting alexithymia is not a direct consequence of trauma.Alexithymia was not convincingly associated with salivary oxytocin, amygdala and insula reactivity to socio-emotional stimuli, amygdala or insula grey matter volume.

Interplay between alexithymia, emotion regulation, and positive and negative affect as predictors of gambling and gaming disorders in adolescents and young adults

Introduction/Objectives: Gambling and gaming disorder are usually comorbid addictive behaviours in which alexithymia and emotional regulation have been proved to be of relevance. The present study aimed to analyse the relationship between those variables and their differences depending on the presence or absence of gambling and gaming behaviours. Method: The sample consisted of 1,219 people between 12 and 20 years of age (M = 15.55, SD = 2.07; 51.8% females). Results: The results showed significant differences between players and non-players in gambling disorder, alexithymia and emotional regulation. The findings also indicated that there were differences in alexithymia, emotional regulation, negative affect, gambling disorder and gaming disorder among the different profiles of video game players. The comparison of participants with gaming disorder, gambling disorder, both, or neither of them, showed differences in alexithymia, emotional regulation, negative affect, gambling disorder and gaming disorder. Furthermore, correlations between gambling disorder and age, gaming disorder, negative affect, alexithymia and emotional regulation were found. Similarly, gaming dis-order was associated with gambling disorder, negative affect, alexithymia, emotional regulation and age. Conclusions: The hierarchical regression analyses demonstrated the predictive role of alexithymia and age in gambling disorder as well as the predictive role of age, sex and negative affect in gaming disorder.

Introducción/Objetivos: Los trastornos de juego y videojuego son conductas adictivas habitualmente comórbidas en las que se ha demostrado la relevancia de la alexitimia y la regulación emocional. Este estudio analiza la relación entre dichas variables y sus diferencias en función de la presencia o ausencia de conductas de juego y videojuego. Método: La muestra estuvo formada por 1219 personas de entre 12 y 20 años (M = 15.55, SD = 2.07; 51.8 % mujeres). Resultados: Los resultados mostraron diferencias significativas entre jugadores y no jugadores en el juego patológico, la alexitimia y la regulación emocional. Los resultados también indicaron que había diferencias en alexitimia, regulación emocional, afecto negativo, trastorno de juego y videojuego entre los distintos perfiles de jugadores de videojuegos. La comparación de los participantes con trastorno de juego y videojuego, con ambos o con ninguno de ellos, mostró diferencias en la alexitimia, la regulación emocional, el afecto negativo, el trastorno de juego y videojuego. Además, se encontraron correlaciones entre el juego patológico y la edad, el trastorno por videojuego, el afecto negativo, la alexitimia y la regulación emocional. Del mismo modo, el trastorno por videojuego se asoció con el juego patológico, el afecto negativo, la alexitimia, la regulación emocional y la edad. Conclusiones: Los análisis de regresión jerárquica demostraron el papel predictivo de la alexitimia y la edad en el trastorno de juego y el papel predictivo de la edad, el sexo y el afecto negativo en el trastorno por videojuego.

Psiquiatría transcultural y depresión en China: un relato clínico / Cross-cultural psychiatry and depression in the eastern population

El siguiente trabajo presenta la historia de una paciente de 19 años oriunda de China, que cursó una internación en una sala de psiquiatría de un hospital general por un cuadro de características depresivas. El caso es notable por el polimorfismo en la sintomatología clínica que presentó. El objetivo es analizar, a partir de él, la necesidad de un enfoque interdisciplinario que trate a la cultura como una variable significativa en la construcción de una enfermedad, entendiendo que los modelos fisiopatológicos resultan necesarios pero no suficientes para comprender de qué modo se constituye. Para dicho fin se hará un breve recorrido por los estudios efectuados en la década del 80 en China por el psiquiatra y antropólogo Arthur Kleiman y se desarrollará la perspectiva de la psicoanalista Helena Lunazzi, quien en su libro Alexitimia desarrolla cómo la cultura influye en la expresión verbal de las emociones. (AU)

The following work presents the history of a 19-year-old patient from China who was hospitalized in a psychiatric ward of a general hospital due to a depressive illness, being the case remarkable for the polymorphism in the clinical symptoms that she presented. The objective is to analyze the need for an interdisciplinary approach that treats culture as a significant variable in the construction of a disease, understanding that pathophysiological models are necessary but not sufficient to comprehend how they are constituted. For this purpose, a brief review will be made of the studies carried out in the 1980s in China by the psychiatrist and anthropologist Arthur Kleiman and the perspective of the psychoanalyst Lunazzi Helena, who in her book "Alexithymia" develops how culture influences the verbal expression of emotions. (AU)

Análisis factorial confirmatorio dela escala de alexitimia de toronto de20 ítems en pacientes españoles contrastorno por uso de sustancias / Confirmatory factor analysis of 20-item toronto alexithymia scale in spanish patients with substance use disorder

La alexitimia es altamente prevalente en pacientes con trastorno por uso de sustancias (TUS) y ha sido relacionado conla patogénesis y la evolución del TUS. Sin embargo, el instrumento más frecuentemente usado para la medición de laalexitimia (la Escala de Alexitimia de Toronto de 20 ítems- TAS-20) ha sido poco estudiado en cuanto a sus propiedades psicométricas en pacientes con TUS. Solamente cincoestudios han evaluado las características psicométricas de laTAS-20 en pacientes con TUS y ninguno en población española con TUS. Por lo anterior, se realizó un análisis factorialconfirmatorio y de fiabilidad en una muestra de pacientesespañoles con TUS (n=126; 75,4% hombres; edad media de43,7±14,6 años). El análisis factorial confirmatorio se realizóconsiderando que la TAS-20 tiene una estructura de tres factores (Dificultad para Identificar Sentimientos [DIF]; Dificultad para Describir Sentimientos [DDF]; Pensamiento Orientado hacia lo Externo [EOT]). En general, la TAS-20 tiene unaspropiedades psicométricas adecuadas en pacientes españolescon TUS. Sin embargo, el modelo clásico de tres factores dela TAS-20 se ajusta solo moderadamente bien en pacientesespañoles con TUS, siendo los factores DIF y DDF los constructos fiables y válidos, mientras que el factor EOT necesitamás investigación y debe analizarse con cautela en pacientescon adicciones. (AU)

Alexithymia is highly prevalent in patients withsubstance use disorders (SUDs) and has been implied inSUD pathogenesis and treatment outcomes. However, thepsychometric properties of the most-used instrument forevaluating alexithymia (the 20-item Toronto AlexithymiaScale, TAS-20) have been scarcely studied in relation toSUD patients. Specifically, only five psychometric studieshave been performed with samples of SUD patients, andno studies have focused exclusively on Spanish patientswith SUDs. Therefore, the aim of the present study was toexamine the internal accuracy and reliability of the TAS20 with a sample of Spanish SUD patients (n = 126; 75.4%male; mean age 43.7 ± 14.6 years). A reliability analysis and aconfirmatory factor analysis were executed, considering thatTAS-20 has a three-factor structure (difficulty identifyingfeelings [DIF]; difficulty describing feelings [DDF]; externallyoriented thinking [EOT]). The results indicated that TAS20’s psychometric properties are acceptable for assessingalexithymia in Spanish patients with SUDs. However,the three-factor model of TAS-20 was found to fit onlymoderately well with the patient sample, with DIF and DDFbeing the most reliable and valid constructs. In contrast, theEOT factor needs further research and should be cautiouslyanalyzed in the context of patients with addictions. (AU)

Alexithymia, masculinity and sexual behavior among Brazilian men / Alexitimia, masculinidade e comportamento sexual entre homens Brasileiros

Normative masculinity and alexithymia may negatively affect sexual life and men's well-being. In this study, the endorsement of traditional male norms, alexithymia and sexual behavior were assessed through an online survey directed to Brazilian men. Relationship status and religion were also addressed, and associations and correlations between variables were carried out. The survey presented 66 items, including standardized questionnaires, such as Meanings of Adolescent Masculinity Scale, Toronto Alexithymia Scale and Male Sexual Quotient. The sample consisted in 528 Brazilian men with high socioeconomic and educational levels. Alexithymia was negatively correlated with sexual satisfaction. The endorsement of traditional male norms was positively correlated with pornography use and was also associated with sharing of pornographic material through social media. Married men had the lowest levels of alexithymia, with significant difference when compared with men who are not currently in a relationship. Furthermore, having a religion was associated with greater endorsement of traditional male norms. These findings suggest that alexithymia may have greater influence on behaviors associated with interpersonal relations, including sexual satisfaction and relationship status. Conversely, normative masculinity was linked to personal variables, which did not involve a partner, including pornography consumption and religion.

A masculinidade normativa e alexitimia podem afetar negativamente a vida sexual e o bem-estar dos homens. Neste estudo, a concepção de masculinidade, alexitimia e comportamento sexual foram avaliados por meio de uma pesquisa online dirigida aos homens brasileiros. O status de relacionamento e religião também foram abordados, efetivando-se associações e correlações entre as diferentes variáveis. A pesquisa apresentou 66 itens, incluindo questionários estandardizados, como a Escala de Concepções de Masculinidade, Escala de Alexitimia de Toronto e Quociente Sexual - versão masculina. A amostra consistiu em 528 homens brasileiros com altos níveis socioeconômicos e educacionais. Alexitimia foi negativamente correlacionada com a satisfação sexual. O endosso das normas tradicionais masculinas foi positivamente correlacionado com o uso de pornografia, bem como associado ao compartilhamento de material pornográfico por meio das mídias sociais. Os homens casados obtiveram os níveis mais baixos de alexitimia, com diferença significativa quando comparados com homens que não mantém atualmente um relacionamento. Além disso, ter uma religião foi associado a uma maior percepção de importância das normas tradicionais masculinas. Os achados sugerem que a alexitimia pode possuir maior influência sobre os comportamentos associados às relações interpessoais, incluindo satisfação sexual e status de relacionamento. Por outro lado, a masculinidade normativa foi ligada a variáveis pessoais, que não envolviam um parceiro, incluindo o consumo de pornografia e a religião.

Frecuencia de alexitimia y factores relacionados en pacientes con fibromialgia tratados en un hospital público de Lima, Perú / Frequency and related factors of alexithymia in patients with fibromyalgia treated at a public hospital in Lima, Peru

RESUMEN Objetivo : Determinar la frecuencia de alexitimia y factores relacionados en pacientes con fibromialgia, y la relación entre alexitimia y capacidad funcional, intensidad de dolor, depresión y variables generales (edad, sexo, tiempo de enfermedad, grado de instrucción y años de estudio) en fibromialgia. Material y métodos : Se realizó un estudio descriptivo transversal en pacientes con fibromialgia del Servicio de Reumatología de un hospital público de Lima, Perú. Se aplicó una ficha sociodemográfica, la TAS-20, el MD-HAQ y la CES-D. Resultados : De los 126 pacientes con fibromialgia, 60 (47,62 %) mostraron alexitimia, 24 de ellos presentaron depresión (40%) y 39, discapacidad funcional (65%). En el análisis bivariado la alexitimia se relacionó significativamente con mayor comorbilidad, menor grado de instrucción, mayor intensidad de dolor, mayor fatiga y más síntomas reportados. En el análisis multivariado, años de estudio (£11 años) fue el único factor relacionado a alexitimia (TAS-20) (p=0,010, OR: 2,589 [1,249 - 5,365]). Conclusiones : Se demuestra una frecuencia considerable de alexitimia en pacientes con fibromialgia y, en el análisis multivariado, este hallazgo se relaciona significativamente con un número menor de años de estudio.

SUMMARY Objective : To determine the frequency of alexithymia and associated factors in patients with fibromyalgia, and the relationship between alexithymia with functional capacity, pain intensity, depression and general variables (age, sex, time of illness, degree of instruction, and years of study) in fibromyalgia. Material and methods : Descriptive cross-sectional study of patients with fibromyalgia from the Rheumatology service of a public hospital in Lima, Perú. A sociodemographic record, TAS-20, MD-HAQ and CES-D were applied. Results . Of the 126 patients with fibromyalgia, 60 had alexithymia (47.62%); 24 alexithymic patients had depression (40 %), and 39 had functional disability (65 %). In the bivariate analysis, alexithymia was significantly related to greater comorbidity, less education, greater pain intensity, greater fatigue and more reported symptoms. In the multivariate analysis, years of study (£ 11 years) were the only factor related to alexithymia (TAS-20) (p=0.010, OR: 2.589 [1.249 - 5.365]). Conclusions : This study shows a considerable frequency of alexithymia in fibromyalgia patients and, in the multivariate analysis, the finding is significantly related to a lower number of years of study.

Non-suicidal self-injury in patients with eating disorders: nuclear aspects / Autolesiones no suicidas en pacientes con trastornos de la conducta alimentaria: Aspectos nucleares

Abstract Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. Results: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. Conclusions: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

Resumen Introducción: A través de la cultura de la delgadez, cada vez más promovida en nuestra sociedad como canon de belleza, no es de extrañar que este aumentado el número de personas afectadas por Trastornos de Conducta alimentaria. Objetivo: Estudiar la relación entre las autolesiones no suicidas y aspectos nucleares del trastorno de conducta alimentaria que se especifican a lo largo de este artículo. Métodos: La muestra ha sido formada por 60 mujeres diagnosticadas de anorexia y bulimia. Se administraron cuestionarios que evaluaban la impulsividad, satisfacción corporal, alexitimia, actitud corporal y autoestima. Se compararon aquellas participantes que presentaban autolesiones no suicidas con las que no lo presentaban, además se compararon participantes con anorexia con y sin autolesiones y participantes con bulimia con y sin autolesiones. Resultados: Se encontraron diferencias en insatisfacción corporal = 5,71; p ≤0.01), en actitudes corporales= 4.80; p ≤0.02), autoestima= 14.09; p ≤0.00) e impulsividad, (t= 3.39; p ≤0.01) entre participantes con y sin autolesiones no suicidas. Conclusiones: Estos son factores clave para la clínica en el tratamiento de los trastornos de conducta alimentaria para prevenir la presencia de autolesiones, ya que permite enfocar el objetivo del tratamiento a aquellos aspectos como la insatisfacción e impulsividad, que son claves en el desarrollo de autolesiones.

Alexitimia y Psoriasis. Revisión bibliográfica / Alexithymia and Psoriasis a review

Resumen La psoriasis es considerada una enfermedad dentro del espectro de las patologías psicosomáticas. Este cuadro presenta diversas comorbilidades tanto somáticas como psicológicas. Dentro de esta última dimensión, las más prevalentes son los trastornos de ansiedad y depresión. Históricamente se ha asociado la evolución de la psoriasis con factores como el estrés; sin embargo, recientes investigaciones destacan que serían más influyentes aspectos propios de la personalidad del paciente, como la alexitimia, más que el evento estresante en particular. La alexitimia presenta alta prevalencia en pacientes con psoriasis y conforme a diversos estudios se relacionaría con implicancias adversas en el curso de la patología cutánea en lo que respecta a la calidad de vida, percepción de enfermedad, comorbilidades, evolución y vulnerabilidad al estrés.

Summary Psoriasis is considered a Psychosomatic disease. It is associated with several comorbidities, not only somatic but also psychiatric and psychological, such as anxiety and depression. Historically, this cutaneous disease has been associated with environmental factors including stress. Recent studies reported that psychological aspects of the patient such as personality traits, including alexithymia, may be more important in the course of the pathology than a stressor factor. Patients affected by psoriasis and alexithymia may be more vulnerable to stress, and this association would be one of the reasons for the disease exacerbations. There is a high prevalence between alexithymia and psoriasis. In accordance with the reviewed articles, alexithymia is related with poor quality of life, abnormal perception of the illness, somatic and psychiatric comorbidities, worse prognosis and vulnerability to stress influence. The intention of this review is to bring an update of the impact of alexithymia in patients affected by psoriasis.

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients.

INTRODUCTION: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. OBJECTIVE: The present study has as purpose to the instrument validation. METHODS: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. RESULTS: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. DISCUSSION: The scale satisfies the criteria of validity necessary for use in this population.

INTRODUCCIÓN: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. OBJETIVO: Realizar la validación de dicho instrumento. MÉTODO: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. RESULTADOS: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. DISCUSIÓN: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

The role of long-term psychodynamic psychotherapy in improving attachment patterns, defense styles, and alexithymia in patients with depressive/anxiety disorders / O papel da psicoterapia psicodinâmica de longo prazo na melhora de padrões de apego, estilos de defesa e alexitimia em pacientes com transtornos depressivos e de ansiedade

Abstract Introduction Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders. Objective To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP. Methods In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments. Results The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up. Conclusion Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.

Resumo Introdução A psicoterapia psicodinâmica de longo prazo (PPLP) enfatiza a centralidade dos conflitos intrapsíquicos e inconscientes e sua relação com o desenvolvimento. Apesar da evidência em favor da eficácia da PPLP em transtornos mentais, há poucos dados sobre a eficácia da PPLP em transtornos de depressão/ansiedade. Objetivo Examinar se pacientes com transtornos de depressão/ansiedade demonstram melhora em seus estilos de apego, estilos defensivos, sintomas psiquiátricos, sintomas de ansiedade/depressão e alexitimia com PPLP. Métodos Neste estudo retrospectivo, descritivo, os desfechos psicológicos de pacientes tratados na clínica psicanalítica da Babol University of Medical Sciences foram avaliados. Quatorze pacientes com diagnóstico de transtorno de depressão ou ansiedade participaram do estudo sobre PPLP com abordagem de psicologia do self. O Inventário de Depressão de Beck II, o Inventário de Ansiedade de Beck, a Escala de Apego do Adulto, o Questionário de Estilo de Defesa-40 e a Escala de Alexitimia de Toronto-20 foram administrados antes e após o tratamento e no seguimento de 6 meses. Equações de estimação generalizadas foram usadas para analisar mudanças nos desfechos psicológicos após cada avaliação. Resultados Os escores médios de depressão/ansiedade e apego seguro melhoraram significativamente após PPLP com abordagem de psicologia do self do início do estudo ao pós-tratamento e seguimento. Além disso, os escores médios de defesas neuróticas e imaturas, dificuldade em identificar sentimentos, dificuldade em descrever sentimentos, pensamentos orientados externamente e escores totais de alexitimia diminuíram significativamente do início do estudo ao pós-tratamento e seguimento. Conclusão Sintomas de transtornos de ansiedade, transtornos depressivos, estilos de apego inseguro, alexitimia e estilos de defesa neuróticos/imaturos melhoraram após PPLP com abordagem de psicologia do self. Além disso, as melhoras persistiram no seguimento de 6 meses.

Memory for emotional information and alexithymia: a systematic review / Memória para informações emocionais e alexitimia: uma revisão sistemática

ABSTRACT: Alexithymia is a deficit in the recognition, expression and regulation of emotions, which has the following features: difficulty in identifying or describing feelings, difficulty distinguishing between feelings and bodily sensations, stringent imaginal processes, and externally oriented cognitive style. This personality trait is associated with many psychiatric and psychosomatic disorders, as well as with risky behaviors. Objective: To investigate whether this trait is also associated with reduced memory for emotional information. Methods: A review of articles investigating the possible damage caused by alexithymia to implicit and explicit memory for emotional information was conducted. Results: Although the studies concerning implicit memory presented divergent results, most studies on explicit memory suggested a deficit for emotional information retention in high-alexithymia individuals. Conclusion: The reviewed data support the notion that the typical increase in episodic memory for emotional information is reduced in high-alexithymia individuals.

RESUMO: A alexitimia é um déficit no reconhecimento, expressão e regulação das emoções, que possui as seguintes características: dificuldade em identificar sentimentos, dificuldade em descrever sentimentos, dificuldade em distinguir sentimentos e sensações corporais, processos de imaginação dificultados e estilo de cognição externamente orientado. Este traço de personalidade está associado a muitos transtornos psiquiátricos e psicossomáticos, bem como a comportamentos de risco aumentados. Objetivo: Investigar se este traço também está associado a redução de memória para informações emocionais. Métodos: Artigos que investigam os possíveis danos causados ​​pela alexitimia na memória implícita e explícita para informações emocionais foram revisados. Resultados: Embora os estudos sobre memória implícita tenham apresentado resultados divergentes, a maioria dos estudos sobre memória explícita sugeriu déficits na retenção de informação emocional em indivíduos com altos índices de alexitimia. Conclusão: Os dados revisados ​​sugerem que o aumento típico na memória episódica para informações emocionais é reduzido em indivíduos com alta alexitimia.

Bizygomatic width and personality traits of the relational field / Ancho bizigomático y rasgos de personalidad del campo relacional

SUMMARY: The bizygomatic width when compared to the bigonial width (WD) has been proposed as a craniofacial marker of some social and personality traits, such us self-reliance or the ability to express emotions. However, no studies have examined the association between WD and psychopathic traits, as happens with other craniofacial variables such us the facial width-to-height ratio (fWHR). In a sample of 70 adults (male and female) we took measures of the bizygomatic and the bigonial arches. Subjects performed self-assessment tests to evaluate their self-reliance, their alexithymia and emotional expressiveness and their coldheartedness or callousunemotional. Results showed a significant relationship between WD and self-reliance, emotional expression and alexithymia, and a tendency towards significance with general psychopathic scores. Additionally, we found a modificatory effect of the variables sex and age when analyzing the influence of the WD on the Factor 3 - "Coldheartedness" of the Psychopathic Personality Inventory-Revised (PPI-R), where this effect diminished depending on the subject's sex and age. Results suggested that the WD seem to be a good marker to be taken into consideration in further research that examines craniofacial traits and personality traits of the socio-emotional field.

RESUMEN: La anchura bicigomática en comparación con la anchura bigonial (WD) se ha propuesto como marcador craneofacial de algunos rasgos sociales y de personalidad, como la independencia/gregarismo o la capacidad de expresión emocional. Sin embargo, ningún estudio ha examinado la asociación entre la WD y los rasgos psicopáticos, como ocurre con otras variables craneofaciales, como la ratio anchura / altura facial (fWHR). En una muestra de 70 adultos (hombres y mujeres) tomamos medidas de los arcos bizigomático y bigonial. Los sujetos realizaron pruebas de autoevaluación para evaluar la capacidad de incorporarse al grupo, la alexitimia y la expresividad emocional, y la frialdad o la insensibilidad emocional. Los resultados mostraron una relación significativa entre WD con independencia/gregarismo, expresión emocional y alexitimia, así como una tendencia hacia la significación con la psicopatía en general. Adicionalmente, encontramos un efecto modificador de las variables sexo y edad al analizar la influencia de la WD en el Factor 3 - "Coldheartness" del Inventario de Personalidad Psicopática-Revisado (PPI-R), donde este efecto disminuye según sexo y edad. Los resultados sugieren que el WD parece ser un buen marcador para tener en cuenta en futuras investigaciones que examinen los rasgos craneofaciales y los rasgos de personalidad del campo socioemocional.

Theory of mind and alexithymia: emotional self-awareness and the other's face in a sample of cancer patients and contrast group / Teoría de la mente y alexitimia: autoconciencia emocional y el rostro del otro en una muestra de pacientes oncológicos y grupo de contraste

Resumen A través de esta investigación se buscó ver si existe relación entre alexitimia y el reconocimiento de estados mentales afectivos en la mirada; e indagar al mismo tiempo, en la posible influencia que la condición de cáncer pudiera tener. De este modo, se pretendió establecer diferencias en estas variables, en un grupo con y sin alexitimia de pacientes con cáncer (n = 98) y un grupo de contraste (n = 79) sin condición clínica. Para este estudio se trabajó con pacientes del área de oncología de dos hospitales en Chile, puesto que de manera consistente se ha vinculado a la alexitimia e inhibición como un rasgo de personalidad asociado a personas que padecen cáncer. Los resultados indicaron que el reconocido déficit en auto-conciencia emocional en alexitímicos se manifestaría, a su vez, en una capacidad disminuida en dar cuenta del trasfondo mental de los demás, y este resultado sería independiente de la condición de padecer o no cáncer.

Abstract This research study sought to determine the existence of a relationship between alexithymia and the recognition of emotion in people's eyes. Similarly, to investigate the possible influence that the cancer condition has in this emotional recognition deficits. Thus, we sought to identify differences in these variables in a group with and without alexithymia of patients with cancer and a contrast group without clinical condition. For this study, we worked with oncology patients in two hospitals in Chile, as it consistently has been linked to inhibition and alexithymia as a personality trait associated with people with cancer. The results indicated that the recognized deficit in self-consciousness emotional in alexithymics would manifest, in turn, in a diminished capacity in accounting for the mental background of others, and this result would be independent of the condition of suffering or not cancer.

High levels of alexithymia in patients with multiple sclerosis / Altos índices de alexitimia foram observados em pacientes com esclerose múltipla

ABSTRACT: Alexithymia is a personality trait characterized by difficulties identifying and describing feelings. Some researchers describe high levels of alexithymia among patients with multiple sclerosis (MS) but literature data on this subject are scarce. Objective: The objective of the present study was to characterize findings of alexithymia in patients with MS. Methods: This cross-sectional case-control study included 180 patients with MS and a matched control group. Data for patients with MS included disease duration, number of demyelinating relapses and degree of neurological disability, as assessed by the Expanded Disability Scale Score (EDSS). In addition, the Hospital Anxiety and Depression (HAD) scale and the Toronto Alexithymia Scale (TAS) were used. Results: There were 126 women and 54 men in each group, with median age of 37 years and median education of 16 years. Patients with MS had higher degrees of depression (p<0.01), anxiety (p=0.01) and alexithymia (p<0.01) than did control subjects. For individuals with MS, depressive traits (p<0.01), anxious traits (p=0.03), higher age (p=0.02), lower education level (p=0.02), higher degree of disability (p<0.01) and not being actively employed (p=0.03) were associated with higher rates of alexithymia. Conclusion: Alexithymia was a relevant finding in patients with MS.

RESUMO: Alexitimia é um traço de personalidade caracterizado pelas dificuldades na identificação e descrição dos sentimentos. Alguns pesquisadores descrevem altos índices de alexitimia em pacientes com esclerose múltipla (EM), porém os dados na literatura são escassos. Objetivo: O objetivo do presente estudo foi caracterizar achados de alexitimia em pacientes com EM. Métodos: Este estudo transversal incluiu 180 pacientes com EM e um grupo controle pareado. Dados de pacientes com EM incluíram a duração da doença, número de surtos clínicos de desmielinização e grau de incapacidade neurológica avaliados pela Escala Expandida do Grau de Incapacidade (EDSS). Foram também utilizadas a escala Hospitalar de Ansiedade e Depressão (HAD) e a escala de Alexitimia de Toronto (TAS) foram utilizadas. Resultados: Cada grupo era constituído por 126 mulheres e 54 homens, com mediana de idade de 37 anos e mediana de escolaridade de 16 anos. Pacientes com EM apresentaram maior grau de depressão (p<0.01), ansiedade (p=0.01) e alexitimia (p<0.01) que os controles. Para pessoas com EM, traços depressivos (p<0.01), ansiosos (p=0.03), maior idade (p=0.02), menor nível educacional (p=0.02), maior grau de incapacidade (p<0.01) e o fato de não estar ativamente trabalhando (p=0.03) levaram a maiores níveis de alexitimia. Conclusão: Alexitimia foi um importante achado em pacientes com EM.

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients. / Prevalencia de alexitimia en los trastornos de la conducta alimentaria en una muestra clínica de 800 pacientes mexicanas

Introduction: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. Objective: The present study has as purpose to the instrument validation. Methods: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. Results: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. Discussion: The scale satisfies the criteria of validity necessary for use in this population.

Introducción: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. Objetivo: Realizar la validación de dicho instrumento. Método: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. Resultados: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. Discusión: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

Anorexia Nervosa and Comorbid Psychopathology.

BACKGROUND AND OBJECTIVE: There is great interest, supported by clinical experience, in the relationship between Eating Disorders (EDs) and psychiatric symptoms and diseases. The psychopathology of EDs is also referred to many risk and protective factors, and there is some evidence in the literature, also about genetic and neurobiological factors involved. The aim of this review is to examine and synthesize the recent scientific literature on this topic, in particular the complex relationship between Anorexia Nervosa and Neuropsychiatric Disorders. METHODS: We analyzed the best of published literature on the topic, identifying keywords and MeSH terms in Pubmed and then searching them. The last search was performed on November 2017. RESULTS: Psychiatric comorbidities are very common in anorexia nervosa. Mood disorders, major depressive disorders, anxiety disorders, obsessive-compulsive disorders, developmental disorders among autistic spectrum and attention-deficit hyperactivity disorder and even some personality disorders, substance abuse and borderline traits have been reported, and some observations suggest a positive genetic correlation between anorexia nervosa and schizophrenia. CONCLUSION: The great amount of scientific articles dealing with the relationship between EDs and psychopathology confirms the complexity of these problems and the difficulties in diagnosis and treatment. An accurate diagnosis and assessment of clinical risk about psychological, psychiatric, nutritional and somatic aspects are therefore essential for an appropriate therapeutic management of patients affected by anorexia nervosa.

Alexitimia en pacientes con asma bronquial atendidos en el servicio de alergia de previsora, Camagüey, Cuba / Alexitimia in patients with bronchial asthma treated in the allergy service of Previsora, Camagüey, Cuba

Antecedentes. Algunas conductas y enfermedades humanas están asociadas con alexitimia, que es la incapacidad de hacer corresponder las palabras con las emociones. Material y método. Del universo de 2490 individuos mayores de 15 años pertenecientes al área de salud Previsora, se obtuvo una muestra constituida por 351 asmáticos (casos) y 355 sanos (controles). Se aplicó la Escala de Alexitimia de Toronto (TAS-20); estadística descriptiva; razón de posibilidades (RP) e intervalo de confianza (IC) de 95% para asociación de alexitimia en los casos y en los controles. Chi-cuadrado (chi 2) y análisis de varianza para diferencias. Resultados. La prevalencia de alexitimia fue de 5,9% en los casos y de 4,2 % en los controles (p=0,18); RP de 1,44; IC95,0%: 0,73-2,84. No se detectaron diferencias entre sexo (p=0,322). Las puntuaciones más altas de alexitimia fueron para edades de 40 a 80 años (p=0,056). En comorbilidad, el predominio de alexitimia fue para asma/rinitis (p=0,034). Hubo asociación de alexitimia con asma moderada y grave (p=0,014). Discusión. En la muestra, la prevalencia de alexitimia fue inferior a estudios realizados en otros contextos, resultado éste que requiere nuevos investigaciones que incluyan también a otras disciplinas. Conclusiones. La prevalencia de alexitimia es baja en los pacientes con asma. Sin embargo, en asma/rinitis y en asmáticos moderados/ severos en nuestra muestra se observó incremento de alexitimia. (AU)

Background: Some human behaviors and diseases are associated with alexithymia, which is the inability to match words with emotions. Material and Method: A sample consisting of 351 asthmatics (cases) and 355 healthy (controls) was obtained from a population of 2490 individuals over 15 years of age belonging to the health area of Previsora. The Toronto Alexithymia Scale (TAS-20) was applied; Descriptive statistics; odds ratio (RR) and 95% confidence interval (CI) for association of alexithymia in cases and controls. Chi-square (chi 2) and, analysis of variance for differences.Results: The prevalence of alexithymia was 5.9% in the cases and 4.2% in the controls (p = 0, 18); RP of 1.44; CI (95.0%), 0.73-2.84. No differences were detected between sex (p = 0.322). The highest scores for alexithymia were for ages 40 to 80 years (p = 0.056). In co morbidity, the predominance of alexithymia was for asthma / rhinitis (p = 0.034). There was association of alexithymia with moderate and severe asthma (p = 0.014). Discussion: In the sample, the prevalence of alexithymia was lower than studies performed in other contexts; a result that requires new research that also includes other disciplines. Conclusions: The prevalence of alexithymia is low in patients with asthma. However, in asthma / rhinitis and in moderate / severe asthmatics in our sample, increased alexithymia was observed(AU)