Affect regulation in alexithymia: an ethological study of displacement behavior during psychiatric interviews.

Displacement activities (i.e., self-directed behaviors such as self-touching, scratching, and self-grooming) are a reliable ethological indicator of increased emotional and physiological arousal throughout the phylogenetic scale. We hypothesized that, in alexithymic individuals, the failure to regulate cognitively distressing emotions might result in increased displacement behavior. The nonverbal behavior of 30 patients with depressive or anxiety disorders was video-recorded during psychiatric interviews and analyzed using an ethological scoring system. Before being interviewed, each patient completed the Twenty-Item Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI), and the state form of the State-Trait Anxiety Index (STAI-S). Ethological data confirmed the hypothesis of the study. The patients with more pronounced alexithymic features showed a significantly higher frequency of displacement activities during interviews. At the same time, these patients reported levels of self-rated anxiety and depression equivalent to those reported by nonalexithymic patients. Such a dissociation between cognitive appraisal of emotion and nonverbal behavior reflecting increased emotional arousal supports the view that alexithymia implies a failure to elevate emotions from a preconceptual level of organization to the conceptual level of mental representations.

Percept-genetic codings of defense in chronic schizophrenia.

Hitherto available studies on the percept-genetic defensive organization of Schizophrenia have not distinguished between acute and chronic stages of the disorder. The present research with the Defense Mechanism Test included 30 chronic inpatients with several years of hospitalization and with acceptable perceptual thresholds. Compared with 30 sex- and age-matched nonschizophrenic psychiatric control patients, schizophrenics resorted significantly more often to (a) regression, (b) disappearance of the peripheral figure, (c) introjection (wrong sex attribution to the hero), and (d) significantly less often to the most mature variants of repression. In a further comparison of a subgroup of 16 women schizophrenic patients and a matched group of melancholic inpatients, the findings on regression, introjection, and repression were replicated.

Microgenetic styles of regulation among two nonpsychotic psychiatric groups.

The serial version of the Color-Word Test was employed to assess the regulative styles (or adaptive patterns) of two nonpsychotic psychiatric groups, one with Panic Disorder and Agoraphobia, the other without either of the latter two diagnoses. Agoraphobics (n = 30) were individually matched for sex, age, and education with nonagoraphobic patients and with nonclinical controls. Compared with normals, nonagoraphobic patients had fewer Stabilized (S) and more Cumulative-Dissociative (CD) Primary Types, fewer Cumulative (Cr) and more Dissociative (Dr) and Cumulative-Dissociative R-types (CDr), more Dissociative V-types (Dv). The agoraphobic sample showed styles more akin to those of normal persons than to the other psychiatric group with the exception of an elevated frequency of R-Dissociation (Vr type). Interestingly, very low scores on several secondary variables were more frequent in the clinical groups than in the nonclinical sample.