Search

Introduction: Adverse childhood experiences (ACEs) associate with various mental disorders, including personality features. Our understanding of how ACEs influence alexithymia features in the general population is limited. In a prospective population setting, we studied whether ACEs associate with alexithymia, and the role of sex and emotional symptoms in this association. Methods: In a Finnish population-based prospective study, 3,142 individuals aged between 30 and 64 years completed eleven ACE questions and the Toronto Alexithymia Scale in 2000 and 2011, and the Hopkins Symptoms Checklist in 2011. The effect of ACEs on alexithymia and its subdomains - difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT) in 2000 and 2011 - was analysed using repeated measures ANOVA. Results: The number of ACEs and their main component, childhood social disadvantage, associated positively with total alexithymia scores and its subdomains DIF and DDF, and negatively with EOT. After controlling for the effect of depression and anxiety, the strength of these associations was reduced, but the effect of social disadvantage on DIF and EOT remained significant in females. Childhood family conflicts associated positively with DIF in males and negatively with EOT in females. Additionally, maternal mental problems associated positively with DIF and DDF in females. Discussion: In the general population, ACEs, particularly social disadvantage, are associated with adult alexithymia features. Alexithymia features, detectable from youth, may predispose individuals to emotional disturbances caused by childhood adversities. The effect of family conflicts and maternal mental problems on alexithymia features varies between sexes.

Background: Childhood adversities and emotional dysregulation are connected with chronic pain, alexithymia, and depression. Longitudinal studies exploring the impact of their co-occurrence on the pain situation are rare., Aims: The influence of alexithymia, depression, baseline pain situation, and treatment options on the course of chronic pain in a clinical sample was studied., Methods: The baseline data was collected from chronic pain patients (n = 154) before their first pain clinic visit, and the follow-up data after 1 year by self-report questionnaires. Study variables consisted of pain intensity, pain disability, alexithymia (TAS-20), depression (BDI-II), and treatment interventions. Statistical analyses were performed to find out differences between baseline and follow-up, as well as between alexithymic and non-alexithymic patients, and to estimate the effect of the treatment provided., Results: At follow-up, the majority of the patients had pain intensity and disability severe enough to disrupt with their daily living. None of treatment interventions was related to better outcome. Alexithymic patients reported more pain disability and depression at both baseline and at follow-up. The effect of alexithymia on pain disability was mediated by depression. The use of opioids was connected to alexithymia and depressiveness. Alexithymia and depression made a substantial contribution to poorer outcome., Conclusions: Severe pain intensity and disability with depression and alexithymia predicted difficulties in achieving improvement. Depression and alexithymia probably impair compliance with treatment and adherence to interventions. Their co-occurrence with a more severe pain situation and with the use of opioids indicates psychological problems underlying the pain experience.

Objective: The aim of this 8-year follow-up study was to ascertain changes in alexithymia, depressiveness and pain situation in a sample of chronic pain patients and to explore the impact of alexithymia and depression on the outcome., Methods: Participants (n=83) were chronic non-malignant pain patients who completed self-report study questionnaires before their first visit to the pain clinic and again 8years later. Study variables consisted of pain intensity measured by the Visual Analogous Scale, the Pain Disability Scale, the Toronto Alexithymia Scale and the Beck Depression Inventory. The moderate improvement in the pain situation was estimated as a decrease of 30% or more in pain intensity or pain disability., Results: In the whole sample there was a significant decrease in pain intensity, pain disability and depressiveness, but only some of the patients achieved moderate improvement in their pain situation. Alexithymia remained stable during the 8-year period. The alexithymic patients had poorer pain situation and more depressiveness both at baseline and at follow-up. Unfavorable outcome in the pain situation was connected with male gender and alexithymia at baseline but not with depressiveness. Alexithymia and depressiveness were closely related to each other and the connection strengthened during the follow-up period., Conclusion: Alexithymic depressive chronic pain patients represent a special, more disabled subgroup among chronic pain patients. The authors recommend screening for and identifying alexithymia and depression in chronic pain patients. Structural treatment protocols such as cognitive-behavioral therapy may benefit these patients. More research is needed to develop treatment interventions for alexithymic patients., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale-20, the Finnish version of the Young Schema Questionnaire short form-extended, the Beck Depression Inventory-II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co-occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients., (© 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Objective: The aim of the present study was to assess the prevalence of alexithymia in a sample of general chronic pain patients, to explore possible differences in depression and pain variables between alexithymic and nonalexithymic chronic pain patients and to analyze if depression is a mediator between alexithymia and pain disability., Methods: Two hundred and seventy-one patients making their first visit to a pain clinic completed the study questionnaire including various pain measures, the Beck Depression Inventory-II (BDI-II) and the 20-item Toronto Alexithymia Scale (TAS-20). The sample was dichotomized to alexithymic and nonalexithymic groups. The means of the study variables were compared between the groups. The correlation analysis of the variables was carried out separately in both groups. Path analysis was done to ascertain the mediation effect of BDI-II between the TAS-20 and pain disability., Results: Every fifth chronic pain patient was alexithymic. The BDI-II and pain variable scores were significantly higher in the alexithymic group than in the nonalexithymic group. Pain variables were not associated with alexithymia when BDI-II was controlled for. BDI-II worked as a full mediator between TAS-20 and pain disability., Conclusion: The alexithymic patient group was more morbid than the nonalexithymic group. The results suggest that depression is the main factor in pain conditions of alexithymic chronic pain patients. The authors recommend screening and treatment of depression in alexithymic chronic pain patients., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: Assessment of the etiology of alexithymia is in most studies hindered by recall bias. The aim of the present study was to assess the significance of individual developmental factors at the age of 5 years for alexithymia in late adolescence. By using data from a child welfare center check-up at the age of 5 years, it was possible to avoid recall bias., Methods: The sample consisted of 723 subjects who were comprehensively examined at the age of 5 years at a child welfare center where their state of health and verbal, gross motor, visuomotor, socioemotional, and cognitive development were assessed. In late adolescence (mean age, 19 years) their alexithymic features were measured using the 20-item Toronto Alexithymia Scale., Results: In females, none of the developmental factors remained associated with later alexithymic features in the multivariate analyses. However, in males, emphasis on the variables measuring speech development was important. In particular, a variable measuring the ability to comply with multipart instructions, thus receptive language skills, was strongly related with alexithymic features in late adolescence., Conclusion: The results suggest that speech development is a significant factor in the developmental process of alexithymia, at least in males. It is possible that children who have impaired language skills and therefore struggle in social situations have a higher risk of developing alexithymia. This emphasizes the need for further research to assess how the inadequate speech development predisposes to the emergence of alexithymic features and whether it is a sex-specific phenomenon., (Copyright © 2012 Elsevier Inc. All rights reserved.)

This study aimed to examine alexithymic features and associations between alexithymia and psychiatric symptoms among adolescents living in a closed institution because of severe behavioral problems. Forty-seven adolescents (29 boys and 18 girls) aged 15 to 18 years completed the 20-item Toronto Alexithymia Scale (TAS-20) Questionnaire and the Youth Self-Report, whereas their foster parents completed the Child Behavior Checklist. The TAS-20 scores of the participants were compared with those of an extensive population sample (N = 6000) matched by age and birth year. Reform school adolescents are significantly more alexithymic than the control group, and the TAS-20 scores are correlated with numerous psychiatric problems, mainly in the internalizing spectrum, but also with thought problems and self-reported aggression. Promoting abilities in identifying and describing feelings is important when treating delinquent adolescents.

population sample, controlling for age, gender, education and marital status as well as depressive and anxiety disorders. An additional aim was to evaluate whether gender modified this association. MATERIAL AND METHODS. The two-stage stratified cluster sample (n = 8028) represented the Finnish population aged 30 years and older. Participants (n = 5241) answered the question 'How afraid are you of visiting a dentist?' They also filled out the 20-Item Toronto Alexithymia Scale (TAS-20), which included three sub-scales, i.e. difficulties in identifying feelings (DIF), difficulties in describing feelings (DDF) and externally oriented thinking (EOT). Anxiety and depressive disorders were assessed with a standardized structured psychiatric interview according to DSM-IV criteria. To evaluate the association between dental fear and alexithymia, multiple logistic regression analyses were performed, adjusting simultaneously for the effects of possible confounding variables. RESULTS. Gender modified the association between dental fear and alexithymia. Among women, those reporting higher scores for TAS-20, DIF and EOT sub-scale scores were more likely to have high dental fear than were those reporting lower scores. Among men no such association was observed. Those participants who reported high DDF sub-scale scores were more likely to have high dental fear than were those reporting lower scores. CONCLUSIONS. Alexithymics are more likely to have high dental fear than non-alexithymics are. The findings support the suggestion that some people with dental fear may have internal personality vulnerability to anxiety disorders.

The aim of the present study was to explore the associations of perceived social support and parental attitude with alexithymia in a Finnish adolescent population sample. Of the initial sample of 935 adolescents, 729 (78%) answered the questionnaire and formed the final sample. The mean age of the subjects was 19 years (range 17-21 years). The 20-item Toronto Alexithymia Scale (TAS-20) was used for assessment of alexithymia. Perceived social support from family, friends, and significant other people was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Perceived parental care and overprotection were assessed using the Parental Bonding Instrument (PBI), and separately for mother and father. After controlling for the sociodemographic factors, alexithymia was significantly associated with a lower degree of experienced social support and higher parental overprotection both in females and males. Maternal overprotection was associated (p<0.04) with TAS-20 total score as well as the Difficulty Identifying Feelings (DIF) and Difficulty Describing Feelings (DDF) subscales. The lack of social support from friends appeared to predict alexithymia more strongly than lack of support from family and significant other people. Against our hypothesis, maternal and paternal care was not directly associated with alexithymic features. This study highlights the significance of intrusive and overprotective parental attitudes as a possible risk factor for development of alexithymia. However, to assess causality, we need longitudinal studies. The results also emphasize the need for further studies to establish the significance of peer relationships in the development of alexithymia., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Alexithymia is a personality trait associated with difficulties in identifying feelings, difficulties in describing feelings to other people, constricted imaginal processes, and an externally oriented cognitive style. It has been found to be associated with personality features that may cause interpersonally avoidant behavior and other interpersonal problems. The present study explored, in a sample of primary care patients (N = 491), whether alexithymia is associated with mobile phone usage, and whether the perceived quality and quantity of human relationships mediate its effect. Even controlling for sociodemographic variables and symptoms of depression, mania and psychoses, alexithymia, measured by the 20-Item Toronto Alexithymia Scale, was associated with less frequent mobile phone use. Not having enough relationships or a close friend, and relationships being less satisfactory mediated the effect of alexithymia on less frequent mobile phone use. The results support the findings of earlier studies that have linked interpersonal problems with alexithymia.

Background: The aim of this study was to explore the possible association between alexithymia and anxiety in a non-clinical sample of late adolescents., Methods: The questionnaire was sent to 935 adolescents of whom 729 (78%) responded, thus forming the final sample. The mean age of the subjects was 19 years (range 17-21 years). The Finnish versions of the following scales were used: the 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, and anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and depression symptoms were evaluated using the short form of the Beck Depression Inventory, as modified by Raitasalo (RBDI)., Results: The prevalence of alexithymia in the sample was 8.2%, with no statistically significant gender difference. The alexithymic subjects had significantly (p<0.001) higher mean STAI scores than the non-alexithymic subjects. A vast majority of the alexithymic subjects were highly anxious, in contrast to the low proportion among the non-alexithymic subjects. The highly anxious alexithymic subjects differed statistically and significantly from the highly anxious non-alexithymic subjects, with higher scores both in the AUDIT and the RBDI., Limitations: The results are based on self-reported material alone and the cross-sectional design used in this study precludes the assessment of causal links., Conclusions: The results suggest that anxiety symptoms are independently associated with alexithymia among late adolescents in general population., (2010 Elsevier B.V. All rights reserved.)

An increasing amount of evidence indicates an association between alexithymia and eating disorder symptoms. This possible association was evaluated in a non-clinical sample of late adolescents. Seven hundred and twenty nine adolescents completed the questionnaire and formed the final sample. Alexithymia was measured using the 20-item Toronto Alexithymia Scale and eating disorder symptoms were assessed using the SCOFF questionnaire. The rate of alexithymia was 8.2%, without any gender difference. The mean SCOFF scores differed significantly between alexithymic and non-alexithymic subjects, and the share of SCOFF positive subjects was significantly higher among alexithymics. The results suggest that eating disorder symptoms are more common in alexithymic adolescents.

Objective: Earlier studies have shown an association between alexithymia and health-related quality of life (HRQoL). There has been some controversy as to whether this is attributable solely to psycho-social domains of HRQoL or also to physical domains. Furthermore, there are no studies on HRQoL profiles in representative general population samples controlling for sociodemographic variables, mental health and somatic health., Methods: The study forms part of the Health 2000 Study. Altogether 5090 participants from general population, aged 30-97 years, filled in the 20-item Toronto Alexithymia Scale and the 15D HRQoL scale. Depressive and anxiety disorders were assessed in a structured psychiatric interview. Physical health was examined by physicians. The 15-dimension HRQoL profiles of both alexithymic and non-alexithymic subjects were obtained by analysis of covariance, controlling for sociodemographic and health-related variables., Results: The alexithymic group had significantly (P<.001) lower mean scores on every dimension of the 15D even after controlling for confounding demographic variables, somatic diagnoses and depressive and anxiety disorders. The differences were greatest in the psycho-social domains., Conclusions: Alexithymia seems to be a personality trait with a statistically significant association to every dimension of HRQoL, not only to psychosocial domains. However, the associations between alexithymia and some somatic dimensions may be of little clinical significance., (Copyright 2010 Elsevier Inc. All rights reserved.)

Objective: Alexithymia refers to a personality construct that is characterized by impoverishment of imagination, poor capacity for symbolic thought, and inability to experience and describe feelings. Our aim was to investigate the association of alexithymia and dental anxiety in patients attending dental practice. A further aim was to discover whether gender differences exist in this association when adjusting for the effect of age., Material and Methods: The data were collected among adult (18 +years) patients attending the public dental health centers in Pori, Finland. Patients received a questionnaire assessing dental anxiety (Modified Dental Anxiety Scale, MDAS), alexithymia (20-item Toronto Alexithymia Scale, TAS-20), and demographic profile. Total score and scores for three TAS factors: 1) "difficulty identifying with feelings", 2) "difficulty describing feelings", and 3) "externally orientated thinking", were computed., Results: Of 823 patients, 81% correctly completed the questionnaires. Nine percent belonged to the high anxiety (MDAS score 19 or higher) group and 7% reported alexithymia (total score 61 or higher). The prevalence of alexithymia was 15.5% among those reporting high dental anxiety compared with 5.9% among those reporting low dental anxiety (p = 0.005). Those with high dental anxiety scored higher in TAS factor 1 than those with lower dental anxiety. No statistically significant bivariate associations with other TAS factors were found. When adjusting for the effect of age and gender, the association between TAS factors and dichotomized MDAS was significant in all TAS scores except TAS factor 3., Conclusions: In a sample representing Finnish adult dental patients, alexithymia was associated with dental anxiety.

Background: Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and, therefore, it may predispose individuals to both psychological and somatic symptoms., Objective: The authors investigated the relationship between alexithymia and health-related quality of life (HRQoL) in a nationally representative population sample of 5,418 subjects, age 30 to 97 years., Method: Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and HRQoL measured with the 15D, a generic HRQoL measure., Results: Alexithymia was significantly associated with lower HRQoL independently of other variables. The TAS-20 subfactor Difficulties Identifying Feelings was the strongest common denominator between alexithymia and HRQoL., Conclusion: Alexithymia may be a predisposing factor to poorer HRQoL.

Objective: Even though the association between alexithymia and somatization seems plausible according to several studies with selected populations, it has not been verified in carefully controlled and nationally representative population studies. We conducted such a study to find out whether alexithymia is associated with somatization at population level., Methods: This study was a part of the Finnish Health 2000 Study. The nationally representative sample comprised 5129 subjects aged 30 to 97 years. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and somatic symptom reporting with the 12-item somatization scale derived from the Hopkins Symptom Checklist. Sociodemographic and health-related variables, including depressive and anxiety disorders, and physician verified somatic diagnoses, were treated as confounders in multivariate analyses., Results: Alexithymia was associated with somatization independently of somatic diseases, depression and anxiety and confounding sociodemographic variables. The TAS-20 factor scale "Difficulties Identifying Feelings" was the strongest common denominator between alexithymia and somatization., Conclusions: This was the first time the independent association between alexithymia and somatization was established in a large, nationally representative nonclinical sample of both young and old adults with and without mental disorders and somatic diseases.

Background: Some authors have suggested that the background of alexithymia is related to affective development during early childhood., Objective: Authors studied the associations between alexithymia and childhood emotional neglect and sexual and physical abuse, also taking into account the significance of concomitant psychopathology., Method: Associations between childhood difficulties and adulthood alexithymia were studied with samples of primary-care (N=1,033) and mental-health center (N=243) outpatients assessed by The Toronto Alexithymia Scale and questionnaires for depressive, manic, and psychotic symptoms, and childhood difficulties., Results: No association between alexithymia and childhood abuse was found in mental-health center patients. Among primary-care patients, alexithymia total score and difficulty in identifying feelings and difficulty in describing feelings were associated with childhood emotional, sexual, and physical abuse., Conclusion: After controlling for psychopathology, there still remained an association with difficulty in identifying feelings and most abuse and neglect variables. These findings serve to strengthen the theory of alexithymia as a developmental process starting in childhood.

Objective: Depression, psychological problems and the impairment of quality of life are reported to occur in untreated coeliac disease. Alexithymia ("no words for feelings") is associated with various gastrointestinal disorders. The aim of this study was to evaluate whether patients with coeliac disease suffer from psychoneurotic symptoms or alexithymia, and whether a gluten-free diet has an impact on the symptoms., Material and Methods: The Crown-Crisp Experiential Index (CCEI) and its six subscales were applied to measure neurotic psychopathology, and the 20-item version of the Toronto Alexithymia Scale (TAS-20) and its 3-factor scales to measure alexithymia. The testing was carried out in 20 consecutive adult patients with biopsy-proven coeliac disease before and after one year of treatment on a gluten-free diet. The data were compared with those obtained earlier in non-coeliac Finnish subjects., Results: Somatic anxiety was higher in coeliac disease patients before the introduction of the gluten-free diet than after adhering to the diet. Otherwise, the diet had no significant impact on the CCEI scores. The patients were not suffering from alexithymia, but the TAS-20 score improved significantly during the follow-up. The scores did not differ from those published in the Finnish population., Conclusions: Psychological problems were not common in adult coeliac disease patients. Gluten-free diet had only a minor influence on the symptoms. Common knowledge about coeliac disease and the readily available gluten-free products may have had an impact on these results.

Objective: The objective of this study was to examine how the outcomes of a structured diagnostic interview for depression are related to the results of a self-report scale in alexithymic and nonalexithymic groups., Materials and Methods: Subjects (N=389) recruited from primary care and psychiatric care completed the Depression Scale (DEPS) and the 20-item Toronto Alexithymia Scale. Major depression was diagnosed using the Composite International Diagnostic Interview-Short-Form by telephone., Results: In the group without major depression, the DEPS scores of the alexithymic subjects were significantly higher than those of the nonalexithymic subjects. In the group with major depression, the ideal cutoff points of the DEPS, assessed by receiver operating characteristic analyses, were essentially higher for the alexithymic patients., Conclusions: Alexithymic subjects without major depression may be rated as depressive if the only criterion is the score on a self-report scale. Furthermore, alexithymic patients may require higher cutoff points in a self-report depression scale.

The relationship between life satisfaction and alexithymia was studied in a sample of 229 patients as a part of a naturalistic follow-up study of depression in Finnish primary health care. The measures were the abbreviated Life Satisfaction Scale and the 20-item Toronto Alexithymia Scale. Depression was assessed by telephone with the short form of the Composite International Diagnostic Interview. Of all subjects, 19.2% were alexithymic, and 9.2% were depressed. Alexithymia was negatively associated with life satisfaction even when depression and other confounding factors were controlled for. Alexithymia is a risk factor for life dissatisfaction in primary-care patients.

Objective: In recent years, the occurrence of alexithymia among the general population has been ascertained in a handful of studies. There are no data concerning the epidemiology of alexithymia among teenagers in the general population. We studied the prevalence of alexithymia among a representative sample of 15-16-year olds., Methods: This study forms part of the Northern Finland Birth Cohort 1986 Study. The original material consisted of all live-born children (N=9432) in the provinces of Lapland and Oulu in Finland, with an expected delivery date between July 1, 1985, and June 30, 1986. In 2001, when the subjects were 15-16 years old, a comprehensive follow-up survey was conducted. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was the measure of alexithymia. Six thousand subjects filled in the TAS-20 correctly. Subjects having a TAS-20 score over 60 were considered to be alexithymic., Results: Of the girls, 10%, and of the boys, 7% were alexithymic. On the other hand, when the alexithymia (TAS-20) score was analysed as a continuous variable, boys had a higher mean value than girls. Mother's low education, broken childhood home, and living in a rural area were associated with high alexithymia score., Conclusions: The rate of alexithymia among 15-16-year olds was similar to that among adults but with a less obvious gender difference than in an adult population. The association of alexithymia with disadvantageous living conditions in childhood resembles, in a way, its association with poor social situation in studies on working-age subjects.

Objective: Tinnitus is known to have an association with depression and other psychiatric disorders. As part of a larger epidemiological survey, we evaluated the associations among tinnitus, depression and alexithymia in a group of elderly people., Methods: A survey of hearing loss, audiological rehabilitation and associated morbidity in a senior population was conducted in Turku, Finland. The study sample consisted of 583 participants aged between 70 and 85 years. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, whereas the 13-item version of the Beck Depression Inventory was used to measure depression; the subjective experience of tinnitus was queried with a questionnaire., Results: Depression had a clear association with subjectively annoying tinnitus. Contrary to expectations, the TAS-20 score did not correlate with the severity of tinnitus. In fact, the highest TAS-20 scores were found among the subjects who had tinnitus but did not find it to be subjectively annoying. No significant association between high TAS-20 scores and hearing loss was found., Conclusion: Although we found an association between TAS-20 scores and the presence of tinnitus, alexithymia does not seem to be helpful in explaining tinnitus annoyance among elderly people.

Objective: The relationship between alexithymia and occupational burnout has not previously been studied. We investigated the association between alexithymia and occupational burnout in a representative nationwide population health study., Methods: This study was a part of the Finnish Health 2000 Study. The nationally representative sample comprised 3322 employees aged 30-64 years. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and occupational burnout with the Maslach Burnout Inventory-General Survey. Sociodemographic and health-related variables including depression were treated as confounders in the logistic regression analyses, which were performed alternately with TAS-20 total score and the scores of the three TAS-20 factor scales as alexithymia variables., Results: Alexithymia and its three facets were significantly associated with occupational burnout even when controlled for confounding factors., Conclusions: Even though both alexithymia and depression are associated with burnout, alexithymia may be an independent risk factor for occupational burnout.

The authors assessed, in an adolescent population sample, the internal consistency, test-retest stability, and factor structure of the Toronto Alexithymia Scale (TAS-20) and established the frequency of alexithymia in this age-group. Pupils (N=882; age-groups: 14-, 15-, and 16-year-olds) from two secondary schools completed the TAS-20 questionnaire twice, with a 5-week interval, in a classroom survey setting. TAS total and subscale scores and proportion of subjects exceeding the cut-point for alexithymia are reported for boys and girls. In confirmatory factor analysis, all estimates except one item were statistically significant; there was no gender difference. The authors conclude that the TAS-20 has good psychometric properties in adolescent samples. Alexithymia rate decreases from early to middle adolescence and remains essentially on a level similar to that among adults.

Objective: We studied the prevalence of alexithymia, its distribution in different age groups in a wide age range, its association with sociodemographic and health-related variables, and its co-occurrence with depression., Methods: The study forms part of the Health 2000 Study. The original sample comprised 8028 subjects representing the general adult population of Finland. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), and depression was measured with the 21-item Beck Depression Inventory. Altogether, 5454 participants filled in TAS-20 in their mother tongue., Results: The prevalence of alexithymia was 9.9%. Men (11.9%) were more commonly alexithymic than women (8.1%). Alexithymia was associated with male gender, increasing age, low educational level, poor perceived health, and depression., Conclusions: The findings were in line with earlier population studies. For the first time, it was possible to analyze the prevalence of alexithymia in a wide age range (30-97 years). International comparative studies are needed.

Objective: People with traumatic brain injury (TBI) were studied to assess the prevalence of alexithymia and its relationship to magnetic resonance imaging (MRI) findings and psychiatric disorders., Methods: Fifty-four participants, 67% men, were evaluated after a median of 30 years since TBI. A control group was matched for age, gender, and severity of depression. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). In patients with TBI, axis I psychiatric disorders were assessed with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN, version 2.1), and axis II disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). MRI examinations were carried out with a 1.5 T MRI scanner., Results: Alexithymia was significantly more common in patients with TBI than in controls (31.5% versus 14.8%; odds ratio 2.64, 95% confidence interval 1.03-6.80). None of the variables representing TBI, ie, severity of TBI or the presence, laterality, or location of contusions on MRI, was associated with the TAS-20 total scores. Several current axis I and II psychiatric disorders, particularly organic personality syndrome, were connected to higher TAS-20 scores., Conclusion: Alexithymia is common, along with psychiatric disorders, in patients with TBI. Both of them may reflect dysfunction of the injured brain. In clinical practice, alexithymic features should be taken into consideration in psychosocial rehabilitation after TBI.

Background: We assessed alexithymia and alexithymic features among young adult subjects with and without somatization symptoms in an epidemiological setting with a sample of young adults., Methods: The sample consisted of urban 31-year-old subjects (N=1002). Data on somatization were gathered from a review of all public health outpatient records. Subjects with four or more somatization symptoms according to the DSM-III-R criteria were considered somatizers. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia. Subjects with a total TAS score over 60 were considered as being alexithymic, and those with a score under 52 were considered nonalexithymic. Subjects with a total TAS score from 52 to 60 were considered as having alexithymic features., Results: The prevalence of alexithymia was 6.0% among somatizers and 4.8% among subjects without somatization symptoms, and the prevalence of alexithymic features was 7.5% and 12.6%, respectively., Conclusions: No association was found between alexithymia and somatization in young adult general population. The earlier theory of the association between alexithymia and somatization may be questionable.

Two research traditions, the one on Asperger syndrome (AS) and the other on alexithymia, have produced similar findings independently of each other indicating a possible association between these two phenomena. Both conditions are also associated with impaired initiation and continuity of sleep. Twenty AS adults were compared with 10 healthy controls using the Toronto Alexithymia Scale and the Basic Nordic Sleep Questionnaire. AS subjects were significantly more alexithymic and reported lower sleep quality as compared with controls. AS and alexithymia are associated although the mediating factors are unknown. It is possible that alexithymic traits predispose to anxiety, which in turn lowers the sleep quality in AS adults. Alternatively, low sleep quality might be due to AS itself., (Copyright 2004 S. Karger AG, Basel)

Objective: We studied the association between speech development in the first year of life and alexithymia in young adulthood., Methods: The study forms a part of the Northern Finland 1966 Birth Cohort. The original material consisted of all liveborn children in the provinces of Lapland and Oulu in Finland with an expected delivery date during 1966. The comprehensive data collection began during the antenatal phase. In 1997, a 31-year follow-up study was made on a part of the initial sample. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was given to 5983 subjects. Of them, 84% returned the questionnaire properly filled in. The ability to talk was classified according to whether the child spoke no words, one or two words, or three or more words at the age of 1 year. Statistical analyses on the association between the ability to speak at the age of 1 year and alexithymia at the age of 31 years were performed, adjusted for birth weight, mother's parity, place of residence and wantedness of pregnancy., Results: The mean of the total TAS score was lowest among early speakers and for both genders separately. The differences were statistically significant. A parallel significant difference was found among males on TAS Factors 2 and 3 and in case of females on TAS Factors 1 and 3., Conclusions: We found evidence for an association between speaking development in early childhood and later alexithymia. Our results support the theory that alexithymia may be a developmental process starting in early childhood and reinforcing itself in a social context.

Objective: We studied the association between alexithymia in adulthood and social situation of the child's family at the time of the child's birth., Methods: The study forms part of the prospective Northern Finland 1966 Birth Cohort Project. The original material consisted of all 12,058 live-born children in the provinces of Lapland and Oulu in Finland with an expected delivery date during 1966. The material represents 96% of all births in the region. In 1997 a 31-year follow-up study was made on part of the initial sample. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was given to 5983 participants of the field study. Of them, 85% returned the questionnaire properly completed. Factors indicative of the social situation of the child's family were already gathered during pregnancy and the time of birth from the mothers, thus eliminating recall bias., Results: Alexithymia was more common in subjects from rural than urban dwelling areas. Unwanted children or subjects born into families with many children also exhibited an association with alexithymia in adulthood., Conclusions: Maternal social situation and environment predict alexithymia in the offspring.

Random samples of 25 voluntary Finnish winter swimmers (7 males, 18 females) and 11 controls (3 males, 8 females were followed prospectively during the winter season from October 1999 to May 2000 to (determine whether winter swimming is beneficial for mental well-being, as many of its practitioners claim. The Crown-Crisp Experimental Index (CCEI) was used for measuring free-floating anxiety, phobic anxiety, obsessionality, depression, somatic anxiety and hysteria, and the 20-item version of the Toronto Alexithymia Scale (TAS-20) for measuring alexithymia. Self-reported somatic and mental health and the reasons for and the frequency of winter-swimming were asked, too. As resealed by open questions, the winter swimmers reported positive effects of winter swimming. Several of the swimmers also told that they had started winter swimming to improve their physical and mental health. Their experience was that the swimming had relieved physical symptoms and made their mood more positive. However, we found no major differences between winter swimmers and controls in any CCEI or TAS variables. The structured questionnaires do not necessarily, however, reach subjective feelings and experiences.

Childhood family atmosphere is a frequent topic in psychotherapy. Our aim was to assess the stability of affect associated with autobiographical memories. In a 7-year follow-up study of depression, 414 primary care patients and psychiatric outpatients both at baseline and at follow-up completed the self-inquiry Depression Scale (DEPS) and answered simple questions about the mental atmosphere in their childhood families. The prevalence and the distribution of changes in affect were calculated by cross-tabulation. Logistic regression analyses were used to assess associations between depressiveness and changes in affect. Nearly 50% of the sample had at least one change in the responses. Young age and male gender were significant predictors for changes. Depressiveness was associated with changes in miserable affect of the childhood home. Affect associated with autobiographical memories seems to change over a longer period. The association between depressiveness and changes in recollections is convoluted. The large number of changes of affects concerning autobiographical memories should be taken into account both in psychotherapy and in studies of life-long experiences. Future long follow-up studies with more specific multi-item measures on family atmosphere are needed. [ABSTRACT FROM AUTHOR]