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The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal–familial relationships as a factor risk for alexithymia.

Objectives: The incidence of psychological and behavioral problems and depression among adolescents is increasing year by year, which has become an important public health problem. Alexithymia, as an important susceptible factor of adolescent depression, may continue to develop and strengthen under the stimulation of COVID-19-related stressors. However, no studies have focused on alexithymia in adolescent depression during the pandemic in China. This study aims to investigate the incidence and related factors of alexithymia in adolescent depression during the pandemic.Methods: Three hundred adolescent patients were enrolled from October 2020 to May 2021. The general demographic information of all participants was collected, and the clinical characteristics were assessed by the 20-item Toronto Alexithymia Scale (TAS-20), the Adolescent Self-Rating Life Events Check (ASLEC) List, the Childhood Trauma Questionnaire (CTQ), and the Positive and Negative Suicide Ideation (PANSI) Inventory.Results: The incidence of alexithymia was significantly higher among adolescents with depression (76.45%) during the pandemic. There were significant differences in school bullying, disease severity, ASLEC score, CTQ score and PANSI score between adolescents with and without alexithymia. In addition, learning stress, health and adaptation problems during the pandemic may be influential factors in alexithymia of adolescent depression (P < 0.05).Conclusions: According to the results, we found a high incidence of alexithymia in adolescent depression during the pandemic. More support and attention from families, schools and society is needed to develop preventive and targeted psychological interventions as early as possible.

Background: High prevalence of emotional and behavioral problems among Chinese adolescence has been reported. This study seeks to investigate the mediating effect of alexithymia and dependency on anxiety and emotional-behavioral problems among adolescents.The study focused a serial mediation model of alexithymia and dependency adolescents from Haikou, China.Methods: The study population included 519 adolescents. The assessments included the completion of standardized scales such as the Multidimensional Anxiety Scale (MASC), the Toronto Alexithymia Scale (TAS-20), the Depressive Experiences Questionnaire (DEQ), the Strengths and Difficulties Questionnaire (SDQ). Independent-sample t-tests, bivariate correlation, and serial mediation analyses were performed using SPSS23.0.Results: Bivariate analyses revealed that anxiety, emotional-behavioral problem, alexithymia, and dependency were positively correlated. Alexithymia and dependency play a significant role in mediating the effect of multidimensional anxiety on emotional-behavioral problems. The effects of the three mediating paths were 69.86%,17.81% and 12.33% for paths 1, 2 and 3 respectively.Conclusions: Anxiety and emotional-behavioral problems mediate the relationship between alexithymia and dependency.

We evaluated gender-specific associations of two dimensions of dental anxiety (anticipatory and treatment-related dental anxiety) with three dimensions of alexithymia: difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. The sample comprised 2558 parents from the general population participating in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale and alexithymia with the 20-item Toronto Alexithymia Scale. Associations between dental anxiety and alexithymia dimensions were modelled using linear regression analysis adjusting for general anxiety and depressive symptoms, age, and education. Structural equation modeling assessed their interrelationships. In women, anticipatory dental anxiety was associated only with difficulty in identifying feelings, but treatment-related dental anxiety was associated with difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. In men, anticipatory dental anxiety was associated with only externally oriented thinking, whereas treatment-related dental anxiety was associated with difficulty in describing feelings, and with externally oriented thinking. Structural equation modelling showed that difficulty in identifying feelings was associated with anticipatory and treatment-related dental anxiety in women, whereas in men, only difficulty in describing feelings was associated with both types of dental anxiety. Anticipatory and treatment-related dental anxiety have different associations with alexithymia dimensions.

Background and aims: Based on previous research, it was hypothesized that negative affect (e.g., depression, anxiety, and loneliness) and low level of emotion regulation (i.e., alexithymia) are risk factors for internet gaming disorder (IGD). Research utilizing a network analysis approach to psychopathology has increased rapidly, and is used to examine the pattern of interactions between causal factors of mental health disorders. Previous research has investigated the relationship between gaming disorder (GD), depression, alexithymia, boredom, and loneliness by pair-wise correlation and correlation of three or four variables. However, to date, network analysis has rarely been utilized to examine the relationship between the aforementioned multi-variables. Therefore, the present study used network analysis to examine the relationship between GD, depression, alexithymia, boredom, and loneliness among a sample of Chinese university students.\ud \ud Methods: A sample comprising 1635 Chinese university students (913 males) completed a survey including the Gaming Disorder Test, Patient Health Questionnaire, and Toronto Alexithymia Scale, alongside single-item measures of loneliness and boredom.\ud \ud Results: Depression, alexithymia, boredom, and loneliness were significantly and positively associated with GD. Loneliness and boredom had the closest edge intensity, and loneliness was the strongest central node in the domain-level network. The facet-level and the item-level network analysis also showed that GD was connected with depression, alexithymia, boredom, and loneliness. The domain-level network comparison test (NCT) showed the global strengths had significant difference among gender group (males = 1.90 vs. females = 1.77, p = 0.013).\ud \ud Conclusions: The findings indicate that there is a close relationship between GD, depression, alexithymia, boredom, and loneliness. Negative affect and low emotion regulation may induce or worsen GD, resulting in a vicious cycle. Practitioners developing interventions to overcome GD should consider aspects aimed at adjusting and improving negative emotion, especially loneliness and related negative affect as well as facilitating positive emotion.

As with other addictions, exercise addiction can severely impact individuals’ lives and have significant psychophysical consequences. Consequently, the study of the mechanisms involved in this psychopathological condition has great clinical and practical relevance. Therefore, the goal of the present study was to explore the risk factors and protective factors for exercise addiction, with a particular focus on the roles of alexithymia, body image concerns, and self-esteem. A sample of 288 regular exercisers (mean age = 28.35 years, SD = 8.26, 72% females, 18% males) completed the Exercise Addiction Inventory, 20-Item Toronto Alexithymia Scale, Body Image Concern Inventory, and Rosenberg Self-Esteem Scale. Data were analyzed by implementing a moderated mediation model. Results showed a significant and positive association between alexithymia and exercise addiction, totally mediated by body image concerns. Furthermore, self-esteem showed a relevant moderating effect, such that at high levels of self-esteem the effect of alexithymia on body image concerns became insignificant. Such data have important implications, highlighting some core variables on which it might be useful to keep a focus in order to elaborate tailored interventions, from both preventive and treatment perspectives.

ObjectiveEmotional states are expressed in body and mind through subjective experience of physiological changes. In previous work, subliminal priming of anger prior to lexical decisions increased systolic blood pressure (SBP). This increase predicted the slowing of response times (RT), suggesting that baroreflex-related autonomic changes and their interoceptive (feedback) representations, influence cognition. Alexithymia is a subclinical affective dysfunction characterized by difficulty in identifying emotions. Atypical autonomic and interoceptive profiles are observed in alexithymia. Therefore, we sought to identify mechanisms through which SBP fluctuations during emotional processing might influence decision-making, including whether alexithymia contributes to this relationship.MethodsThirty-two male participants performed an affect priming paradigm and completed the Toronto Alexithymia Scale. Emotional faces were briefly presented (20ms) prior a short-term memory task. RT, accuracy and SBP were recorded on a trial-by-trial basis. Generalized mixed-effects linear models were used to evaluate the impact of emotion, physiological changes, alexithymia score, and their interactions, on performances.ResultsA main effect of emotion was observed on accuracy. Participants were more accurate on trials with anger primes, compared to neutral priming. Greater accuracy was related to increased SBP. An interaction between SBP and emotion was observed on RT: Increased SBP was associated with RT prolongation in the anger priming condition, yet this relationship was absent under the sadness priming. Alexithymia did not significantly moderate the above relationships.ConclusionsOur data suggest that peripheral autonomic responses during affective challenges guide cognitive processes. We discuss our findings in the theoretical framework proposed by Lacey and Lacey (1970).

The possible correlation between nausea and vomiting during pregnancy (NVP) with obsessive-compulsive disorder (OCD) and alexithymia were examined in this cross-sectional study. A cohort of pregnant women at the first trimester of pregnancy experiencing NVP were divided into three groups, according to severity (mild, moderate and severe) with the Pregnancy Unique Quantification of Emesis and Nausea (PUQE) test. The Maudsley Obsessive Compulsive Disorder Scale (MOCQ) and the Toronto Alexithymia Scale (TAS-20) were applied. Scores of scales were compared in all three groups, and the relationship between NVP severity and OCD and alexithymia was evaluated. On the 110 enrolled pregnant women, 42 had mild, 36 had moderate and 32 had severe NVP. Pregnant women with mild NVP had lower MOCQ scores than those with severe NVP (p = .010). Total scores of TAS-20 were higher among subjects with greater NVP severity (p

BACKGROUND AND OBJECTIVES: Prescription opioid (PO) use disorder is a national public health crisis. Distress tolerance and alexithymia are two separate but related components of emotion regulation that are known to impact substance use disorders. No studies to date, however, have examined the role of distress tolerance and alexithymia in PO use disorder. Thus, the current study examined the association between distress tolerance, alexithymia, and specific motivations for PO use. METHODS: Participants were non-treatment seeking individuals with current PO use disorder (N = 81; average age = 35.0). Assessments included the Distress Tolerance Scale, Toronto Alexithymia Scale, and the Inventory of Drug Taking Situations.(16,28,29) RESULTS: The findings indicate that distress tolerance mediated the association between alexithymia and PO use in negative situations. Specifically, distress tolerance mediated the association between alexithymia and unpleasant emotions, testing personal control, and conflict with others. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The results provide novel information regarding emotional states that may contribute to PO use and are malleable intervention targets. Additionally, this study adds to existing literature exploring the relationship between distress tolerance and substance use and is the first to expand upon the connection between alexithymia and distress tolerance in an opioid using population. Implications for clinical practice and future research are discussed.

Introduction: China has 1.18 million methamphetamine abusers. Among the illegal drugs in China, methamphetamine has the highest abuse rate. Although previous studies have indicated a positive relationship between alexithymia and declining social support, the incidence of alexithymia, the total duration of methamphetamine dependence, social support, and the relationships between them among methamphetamine-dependent patients in the Chinese population have been rarely reported.Methods: A total of 113 methamphetamine-dependent patients (all male, mean age 30.45 ± 3.81 years) were enrolled in this cross-sectional study. General demographic data were collected. Alexithymia and social support were measured by Toronto Alexithymia Scale and Social Support Rating Scale.Results: Duration of methamphetamine use among Chinese male methamphetamine-dependent patients in compulsory detoxification was 8.01 ± 3.80 years on average, 23% (26/113) methamphetamine-dependent patients were considered to have alexithymia personality traits. Compared with short-duration methamphetamine-dependent patients (≤8 years), long-duration methamphetamine-dependent patients (> 8 years) were characterized by older age, higher incidence of alexithymia, less subjective social support and support availability, and greater difficulty in identifying feelings. The results of correlation analysis and multiple linear regression analysis indicated that the total duration of methamphetamine use was positively correlated with difficulty in identifying feelings, but negatively correlated with subjective social support.Conclusions: This study provides support for an association between the duration of methamphetamine use and difficulty in identifying feelings or subjective social support. Although the causality is still unclear, this finding should be considered in the psychotherapy of methamphetamine rehabilitation.

AIM AND OBJECTIVE This study was conducted to assess whether there is an association between alexithymia in patients with diabetes and the levels of perceived social support and glycaemic control. BACKGROUND In the literature, whether inadequate perceived social support is a cause or effect of alexithymia has also not been clearly explained. It is stated that it is difficult to determine from where these contradictions arise, and there is a need for more studies on this topic. METHOD This cross-sectional and correlational study included 537 patients with type I and type 2 diabetes. The data were collected using a Patient Information Form including the patient's HbA1c value that reflected their glycaemic control level, the Toronto Alexithymia Scale and the Multidimensional Scale of Perceived Social Support. The study was reported according to the STROBE Declaration. RESULTS Among the patients with diabetes, 63.9% showed signs of alexithymia. Alexithymia had a negative relationship with perceived social support and a positive relationship with HbA1c. Additionally, it was determined that the patients who showed signs of alexithymia had lower levels of perceived social support in comparison with those who did not show such signs, whereas the HbA1c levels of the former were also higher than those of the latter. Moreover, it was found that the duration of the disease, HbA1c levels and levels of perceived social support from family and a significant other explained 30% of the total variance in the level of alexithymia. CONCLUSION Alexithymia was seen prevalently among the patients with diabetes, and it was associated with a reduced level of perceived social support and weak glycaemic control. RELEVANCE TO CLINICAL PRACTICE It is recommended to provide patients with psychosocial support in the scope of holistic care and include the individuals who provide care for and support the patient in the patient's management of the disease.

This study examined whether patients with hopelessness and those without may significantly differ regarding their main presentations and clinical course in a large Italian population.The recruited sample included 583 currently euthymic outpatients with major affective disorders. The Beck Hopelessness Scale (BHS) assessed hopelessness using a cutoff score of 9 or higher. Participants were categorized based on the presence/absence of hopelessness. A binary logistic regression analysis -accounting for age and gender and considering history of psychotherapy, emotional/physical abuse, depressive symptoms, Toronto Alexithymia Scale (TAS) total score, difficulties identifying and communicating feelings as potential predictors- was carried out in order to detect the variables associated with hopelessness.Individuals with hopelessness, compared to those without, were more likely to be older (p=0.005), females (p=0.01), to have a unipolar depressive disorder (p≤0.05), be prescribed antidepressants and psychotherapy in the past (p=0.001 and p≤0.05). Moreover, individuals with hopelessness scored higher on the Montgomery-Asberg Depression Rating Scale (p≤0.05) and on the emotional (p=0.001), physical abuse (p≤0.01) and physical neglect (p≤0.05) subscales of the Childhood Trauma Questionnaire - Short form, and reported more difficulties identifying (p≤0.001) and communicating feelings (p≤0.001) than those without hopelessness. The multivariate analysis showed that having difficulties identifying feelings is independently associated with hopelessness.These findings indicate that individuals with difficulties identifying feelings are at higher risk of hopelessness and of negative outcomes. Further studies need to explore the impact of alexithymia on hopelessness and clinical outcomes in the lifetime illness course.

Patients with alexithymia have difficulties in verbal description of their sensations. The reasons of this specific cognitive modality have not been explained entirely yet, so there is an urge to use psychometric instruments to analyze this peculiarity and to measure alexithymia simultaneously with other parameters (in neurology, different types of pain, anxiety, depression, dizziness). The aim of the study was to identify the presence or absence of statistically significant correlation between nonspecific cervical and back pain, anxiety, depression, and alexithymia. The authors observed 435 patients with cervical and back pain complaints. After neurological examination, there were revealed 156 patients aged 18–50 years (average age 38.2 ± 10.1 years, 89 females and 67 males) with nonspecific cervical and back pain. All patients passed through the Russian language version of the 20-point Toronto alexithymia scale (TAS-20) and were divided into three groups: high level of alexithymia (group A), border zone (group B), and low level of alexithymia (group C). The patients were also divided into 2 subgroups: acute pain and chronic pain. All patients passed through the assessment of pain severity, disability index, satisfaction with life index (according to VAS scale), and anxiety and depression (according to Hospital Anxiety and Depression Scale (HADS)). Statistical assessment included the Shapiro–Wilk test for determining the type of data distribution, methods of descriptive statistics with the presentation of data in the form of an average value and standard deviation, and contingency table method for comparing the studied groups. The critical level of significance (p) in testing statistical hypotheses in the study was taken 0.05. Processing of the obtained data showed that patients with high level of alexithymia had statistically significant higher rates of pain severity, disability index, and level of anxiety and depression, and significantly lower satisfaction with life index than patients with border and low levels of alexithymia. The results also show that the concrete type on nonspecific pain (acute or chronic) is not connected with the risk of comorbidity with anxiety, depression, and alexithymia. Thus, in clinical practice, it is advisable to test patients with pain complaints also presenting tools to identify the level of anxiety and alexithymia.

Objective The aim: The research aim was to study features of emotional-volitional sphere and its association in mens with different forms of Substance Addictions. Patients and methods Materials and methods: We examined 146 patients with alcohol and drug addictions using Toronto Alexithymia Scale, Zverkov-Eidmann`s questionnaire and Buss-Durkee questionnaire. Results Results: The study showed an increase in the overall level of alexithymia, a moderate level of aggressiveness and a sufficient level of volitional self-regulation without a significant difference between the groups. The indirect correlation of "persistence" with the "general level of alexithymia", "difficulty identifying feelings" and "physical aggression" in group 1 and at the same time the indirect correlation between "self-control" and "verbal aggression" and "volitional self-regulation" with "difficulty describing feelings" can be explained by the opposite meaning of these concepts and phenomena themselves.However, it is interesting that the indicators "physical aggression" and "difficulty describing feelings" in group 2 were significantly lower, but at the same time correlated with "general level of alexithymia" and "irritability", respectively. On other hand in group 1 the indicator "suspiciousness" is directly related to the "general level of alexithymia", but its level is significantly lower in comparison with group 2. Conclusion Conclusions: The phenomenon of alexithymia is not only recorded in the clinical picture of patients with various forms of addiction, but can also induce the development of manifestations of aggressiveness and hostility in them. Correction of alexithymia is necessary to understand the emotional state of these patients and choose the right approach to their treatment and rehabilitation.

Background: Alexithymia is one's incapacity to identify, comprehend, and describe emotions. There is almost no literature data about the levels of alexithymia among patients with relapse remitting type of multiple sclerosis. Aim: The objective of the present study was to assess the levels of alexithymia in patients with relapse remitting type of multiple sclerosis in relation to their sociodemographic variables and clinical characteristics of the disease. Methods: This cross-sectional study included 106 consecutively assessed patients with relapse remitting type of multiple sclerosis. In addition to the data regarding disease duration, number of demyelinating relapses, and degree of neurological disability, assessed by the expanded disability scale score (EDSS), we used Toronto alexithymia scale (TAS), fatigue severity scale (FSS) and, Hamilton scale for the assessment of anxiety and depression and sociodemographic questionnaire. Results: Study included 74 female and 32 male patients, with a median age of 44 years, median disease duration 90 months, and median EDSS 4. About 29.55% of patients had alexithymia and borderline alexithymia was observed in 31.15% patients. Alexithymia correlated with anxiety and depression (P < 0.01) on all TAS subscales. Higher levels of neurological disability based on EDSS, severe fatigue based on FSS scores, and severe relapse remitting type of multiple sclerosis with more relapses and longer disease duration correlated with alexithymia (P < 0.01), depression (P < 0.01), and anxiety (P < 0.01). Higher rates of alexithymia were noticed in older, unemployed, single patients, and those having fewer children. Conclusions: Alexithymia was found in a relatively high percentage in patients with relapse remitting type of multiple sclerosis.

OBJECTIVE The aim of the study was to determine the psychological nature and mechanisms of alexithymia formation by way of the analysis of its relation to the properties of the nervous system, mental states, and characteristics of the emotional sphere of the personality. PATIENTS AND METHODS Materials and methods: In the process of the study, for the diagnostics of alexithymia, we used the 26-item Toronto Alexithymia Scale (TAS-26) developed by G.J. Taylor and a block of psycho-diagnostic methods aimed at the diagnostics of properties of the nervous systems, the emotional sphere and mental states of respondents. The relationships were evaluated using Spearman's rank correlation coefficient and Pearson's correlation coefficient. RESULTS Results: The main factors related to alexithymia were weak nervous system, low stress resistance and such characteristics of the emotional sphere as marked extraversion, high level of trait anxiety, neuroticism, indirect verbal aggression, low levels of aggressiveness. The emotional exhaustion and reduction of personal achievements, the Resistance Phase, chronic fatigue and depression were the most pronounced within the alexithymia group. The alexithymic personality type demonstrated less developed spatial anticipation. CONCLUSION Conclusion: In accordance with our results, the weakness of the nervous system and high Trait Anxiety facilitate the adaption to stressful situations by avoiding and crowding out negative emotions, lead to the inability of verbal description and expression of emotions. A low level of stress resistance conduces to neurotization, chronic fatigue, and emotional burnout. The predominance of refractory and dysphoric reactions causes a negative vision of the situation and can provoke the development of psychosomatic disorders.

Background: Due to the characteristics of their work, nurses experience high levels of stress and burnout. Alexithymia (defined as the inability to identify and express emotions) and personality traits can be risk factors for burnout. However, there is limited information about the relationships of alexithymia and personality traits with job burnout among Iranian nurses. Objective: This study examined the relationships between alexithymia, personality traits, job burnout, and shift work among hospital nurses in Iran. Methods: This cross-sectional study was conducted in 2017 on a random sample of 225 nurses recruited from 10 hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. Data collection instruments were the Toronto Alexithymia Scale, the Maslach Burnout Inventory, the Neuroticism, Extraversion, Openness Five-Factor Inventory, and a demographic questionnaire. Pearson's correlation analysis, independent-samples t-test, one-way analysis of variance, and multiple linear regression analysis were used for data analysis. Results: The mean scores of alexithymia and burnout were 56.78 ± 8.64 and 49.78 ± 13.67, respectively, and these two variables were significantly correlated (r = 0.258; P < 0.001). Alexithymia also had significant relationships with gender (P = 0.035), employment status (P = 0.045), and personality trait (P < 0.01) but had no significant relationship with shift schedule (P > 0.05). Conclusion: Nurses with higher levels of alexithymia are more at risk for burnout. As alexithymia has significant relationships with gender and employment status, interventions are needed, especially for women, to alleviate their alexithymia and burnout.

The article is dedicated to empirical investigation of Theory of Mind of persons dependent on psychoactive substances. Searching new approaches to medical treatment, psychological and social rehabilitation retains an actual subject of scientific interest. Inclusion of the Theory of Mind to rehabilitation and corrective programs can be a perspective direction. The purpose of this article is to analyze the Theory of Mind peculiarities in persons who are addicted to psychoactive substances, as well as to determine the interconnection between the Theory of Mind, alexithymia, and personality dispositions. The following methods have been used: Theory of Mind assessment scale (Th.o.m.a.s), Toronto Alexithymia Scale (TAS-26), Big Five Personality Test (5PFQ). Statistical tools: descriptive statistics and non-parametric (Spearman’s correlation coefficient, Mann-Whitney U test). Study sample – 32 persons, who are addicted to psychoactive substances (median 41 y.o., SD 11,83). As a result of this empirical study, we have found several peculiarities of the Theory of Mind in persons dependent on psychoactive substances. We have compared this result to previous findings obtained by authors of the Th.o.m.a.s test. There were determined the number of connections between the Theory of Mind and other psychological features. Theory of Mind in persons dependent on psychoactive substances is characterized by a reduced understanding of their own emotions and feelings. This appears as poor differentiation of emotional experiences and physiological manifestations of the body. Another peculiarity of Theory of Mind dependent on psychoactive substances is a poor allocative perspective. It means that dependent on psychoactive substances cannot or do not want to «walk in someone else’s shoes», this is why they project their own beliefs.

Background: The purpose of this study is to examine the factor structure of the Korean version of the 20-Item Toronto Alexithymia Scale. The TAS-20 (source of the TAS-20K) has been supported the three-factor correlated model. However, some factor structure studies of the TAS-20 rejected the three-factor correlated model and adopted alternative models. Methods: In study 1, we conducted a comparison study of the alternative measurement models by using CFA. In study 2, we examined scale reliability and gender measurement invariance of the factor structure. To examine the alternative models and scale reliability, we using the bifactor model reliability indices. Results: As a result, the DIF and DDF factors have a close relationship but the EOT factor has some differences with DIF and DDF. So we adopted a two-factor correlated model with group factor. And the adopted factor structure has partial measurement invariance. Therefore we can compare gender differences of the TAS-20K. Conclusions: This study has significance that examining TAS-20K’s factor structure and examining measurement invariance in gender.

Introduction. Diabetes mellitus 2 type has become a global health problem and is by far one of the most common chronic diseases, so there is an urgent need to provide high quality medical and social care to this patient population. It is known that this group of patients is characterized by a number of specific features that distinguish them and create difficulties for physicians in the treatment process. Purpose. Study has been devoted to the comprehensive assessment of affecting factors on the quality of life of patients with type 2 Diabetes Mellitus (T2DM) in relationship with their psychological status indicators and level of compliance. Materials and Methods. Study population consisted of T2DM (n=40) equivalented by the indicators of age, body mass index, blood pressure, laboratory level of blood glucose and glycated hemoglobin (HbA1c). All patients signed a voluntary informed consent before the study. Study data has been collected using informed patients form and 6 validated psychometric scales: Chaban Quality of Life Scale (CQLS), Medication Compliance Scale (MCS), Toronto Alexithymia Scale (TAS-20), Dysfunctional Attitudes Scale (DAS), Depression, Anxiety and Stress Scale (DASS-21)) and Holmes and Rahe Stress Scale (HRSS). Glycemic control has been based on HbA1c results and blood glucose level. Results. Statistically significant difference has been found between the groups of the patients with high, middle and low level of their commitment to therapy according to MCS results. A significant correlation has been found between the following indicators: HbA1c and body mass index of patients with T2DM (p = .19; r = .368) and presence of alexithymia (p = .039; r = - .328). Depending on the level of quality of life with numeral scores of results with other scales: MCS (p = .361; r = .022); DAS (p = .027; r = - .350), stress level (DASS - 21) (p = .038; r = - .339), depression (DASS - 21) (p = .002; r = -. 471) and HRSS (p = .006; r = - .425). Conclusion: Psychological indicators identified by results of research such as, level of: compliance, cognitive distortions, depression, stress resistance and social adaptation — affected quality of life of T2DM patients, as well as indicators of alexithymia, anxiety, and quality of life affected the level of their commitment to treatment. Patients with low level of compliance and quality of life had the increased risk of treatment non-efficiency as a result. Therefore, multidisciplinary approach in the treatment of each individual patient, would potentially improving the adherence and effectiveness of T2DM treatment

Objective We designed this study to determine the frequency of alexithymia in Ecuadorian patients with psoriasis, as well as possible associations between demographic factors, disease severity, and treatment adherence. Methods A cross-sectional study involving 99 Ecuadorian patients with psoriasis was conducted. Multinomial logistic regressions were performed to ascertain whether age, gender, educational level, years with disease, psoriasis area and severity index (PASI) scores, and treatment adherence categories are prediction factors in patients with psoriasis to present alexithymia, possible alexithymia or no alexithymia. Results A total of 99 patients participated in the study with a gender distribution of 57.6% male, and an average age and years with disease of 48.3 and 7.4, respectively. Out of all patients, 33.3% presented alexithymia, and 22.2% possible alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). The multiple regression model statistically significantly predicted the TAS-20 score from age, gender, educational level, years with psoriasis, PASI score and level of adherence F (7,88) = 4.171, p = 0.001, adj. R2= 0.189. Only having the highest educational level added statistical significance to the prediction of having a lower TAS-20 score, whilst the remainder variables did not. Conclusion We found a similar proportion of alexithymia, as well of average TAS-20 scores among Ecuadorian patients with psoriasis in comparison to previous studies. Only having the highest educational level was found to decrease the TAS-20 score. Age, gender, years with psoriasis, PASI score and level of adherence were not identified as factors that influence the TAS-20 score.

Alexithymia has been linked to reduced emotional awareness and increased aggression. One line of evidence suggests that authoritarian parenting contributes to the development of alexithymia. To elucidate the relationship between experienced parenting style, alexithymia and aggression the Parental Authority Questionnaire, the Toronto Alexithymia Scale and the Buss–Perry Aggression Questionnaire were administered to a group of emerging adults. Current findings show a positive relationship between: (i) authoritarian parenting style and alexithymia, (ii) alexithymia and aggression, iii) authoritarian parenting style and aggression. This study also found that paternal authoritarian parenting predicted alexithymia and aggression when controlling for maternal authoritarian style, but not the other way round. In addition, alexithymia mediated the relationship between paternal authoritarian parenting and aggression when controlling for maternal authoritarian style suggesting that elevated alexithymia which is likely to be a consequence of authoritarian parenting, especially when it is practiced by a father, contributes to increased aggression in adulthood.

Objective Chronic pain has a great prevalence in the society of adults which causes important problems for health and quality of life. The present study aims to investigate a hypothetical model of pain perception in patients with chronic pain, considering the role of unconscious, emotional, behavioral and meta-cognitive factors. Methods A total of 391 patients (155 males, 236 females) who referred to the pain centers in Tehran suffering from chronic musculoskeletal pain, participated in the study. Participants were asked to complete the Defense Style Questionnaire (DSQ-40), Toronto Alexithymia Scale (TAS-20), The Inhibition/Activation System Scale (BIS/BAS), Meta-Cognitions Questionnaire (MCQ-30), and Numeric Rating Scale (NRS). Results The results revealed that the model could anticipate the intensity of pain in patients with chronic pain. Immature defense style, behavioral inhibition system, alexithymia, and meta-cognitive beliefs predicted the intensity of pain in patients with chronic pain. Conclusion Evaluation of results indicated that the perception of the intensity of pain in patients with chronic pain, is affected by unconscious, emotional, behavioral and meta-cognitive factors.

Objectives. The study aimed to investigate the psychosocial predictors of bruxism. The association of various psychosocial factors such as alexithymia, emotional processing, state and trait anxiety, and stress with awake bruxism was analysed.Methods. The study involved 52 volunteers diagnosed with awake bruxism. The toolkit that was used included the Toronto Alexithymia Scale (TAS-20), the Emotional Processing Scale (EPS), the Cohen Perceived Stress Scale (PSS-10), and the State- and Trait-Anxiety Inventory (STAI), with independent individual psychological diagnoses being made for every patient. The results were statistically analysed using IBM SPSS Statistics 24.Results. The obtained data clearly show that psychological traits—both permanent dispositions (e.g., state anxiety and alexithymia) and temporary states (e.g., trait anxiety, emotional processing deficits, and psychological stress)—are significant determinants of awake bruxism. The percentage of explained variance indicates the presence of other factors as well.Conclusions. Psychosocial factors such as state anxiety and trait anxiety, alexithymia, and perceived stress are as important as somatic causes in the occurrence and maintenance of awake bruxism. The profile of the obtained data suggests the possibility of preventing or minimizing the symptoms of awake bruxism through properly constructed psychoprophylactic interactions.

One characteristic of human nature is the ability to align our behavior with others. Previous research has linked poor communication skills to alexithymia. This may suggest the possibility that individuals with high alexithymia do not adhere to the principles of social alignment. One form of cognitive alignment is consensus with a group. So far, little research attention has been given to the possible link between alexithymia and this form of cognitive social alignment. In this study, we address this gap by investigating the association between consensus-reaching abilities and alexithymia. A sample comprising of 122 participants completed the Toronto Alexithymia Scale and then played a specially designed game called "Consensus under a deadline". In each game, a participant played with either seven bots designed to act rationally and always seek a consensus, or with seven other participants. The participants were unaware who they were playing with. The results of the study confirm the link between alexithymia and impaired cognitive social alignment, showing that the alexithymia cognitive component (EOT) is associated with a deficit in reaching a consensus with humans (that sometimes act irrationally). However, this association was not evident when group members were bots (that always act rationally).

Background: With the introduction of highly active antiretroviral therapy (HAART) in 1996, the quality of life of people living with HIV has improved. Although people diagnosed and living with HIV are overwhelmed by emotions, we found that various emotional manifestations are understudied within this group of patients. One such aspect is alexithymia which is seen at exorbitantly high rates among patients with depression, causing a major public health concern. In our study, we hypothesized that clinically significant changes with HAART would be associated with changes in depression, anxiety, and alexithymia. Materials and Methods: A cross-sectional study was conducted with a convenient sample of 44 HIV-seropositive children and 30 healthy school children of age 12–15 years. We obtained permission from participants to access their medical records to obtain data regarding their CD4 cell counts and viral loads over the entire study period. The enrolled participants were administered a validated 20-item Toronto alexithymia scale (TAS-20) to assess their alexithymic levels. Results: Mean alexithymia score of healthy children was 0.67 ± 1.26 and mean of children living with HIV was 4.48 ± 7.80. When comparing the TAS-20 scores of children living with HIV and healthy children, children living with HIV revealed scores slightly higher than healthy children, but none showed scores equal to 40. There was statistically significant difference between both groups (P = 0.003). Conclusion: Our study revealed that there was a significant difference between the TAS scores of HIV-seropositive children on HAART and healthy children, none of their scores indicated alexithymic condition. In the health sector, alexithymia has been emphasized as barriers to patient-practitioner communication. Clinicians should be aware of the decrease in alexithymic traits among HIV subjects who are under HAART. This study highlights the benefits of the HAART era, namely the chronicity of the infection and the possibility of disease management, thus improving the mental status of such population.

Obesity and overweight are significant risk factors for many serious diseases. Several studies have investigated the relationship between emotional regulation and overweight or obesity in people with eating disorders. Although a few studies have explored alexithymia in individuals with severe obesity without eating disorders, no attention has been paid to individuals with overweight and preclinical form of obesity. This study aims to assess whether overweight and obesity are related to emotional dysregulation and alexithymia. The study involved 111 undergraduate students who had not been diagnosed with an eating disorder. The sample was divided into two groups according to their body mass index (BMI): normal weight (N = 55) and overweight (N = 56). All of them completed the Toronto Alexithymia Scale (TAS-20), the Emotional Regulation Questionnaire (ERQ), and the Eating Disorder Inventory-2 (EDI-2). Results showed higher levels of alexithymia, and specifically higher difficulty in identifying feelings and an externally oriented thought, in participants with overweight. Multiple correlation analysis highlighted the positive relations between some EDI-2 subscales and both alexithymia and emotional regulation scores. Linear regressions revealed a significant relationship between body BMI and both alexithymia and emotional regulation strategies. The condition of overweight/obesity seems to be associated with higher emotional dysregulation compared to normal weight condition. It is essential to study this relationship because it could represent a risk factor for the worsening of problems related to overeating and excessive body weight. These findings suggest that an integrated approach aimed at considering the promotion of emotional regulation could contribute to the effectiveness of a program designed to reduce overweight and obesity. Level III: case-control analytic study.

Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18-71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02-0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07-0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.

OBJECTIVE To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE. METHOD Three hundred sixty one obese BE-patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). RESULTS Patients with BE reported significantly higher TAS-20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**). DISCUSSION Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client-focused interventions.

Background Smoking is the most important modifiable factor in increased morbidity and premature mortality. This study aims to examine the psychological factors associated with smoking and quitting in a broad, nationally representative sample. Participants and methods The sample included a total of 24.494 adult individuals. Participants were divided into three groups as smokers, non-smokers, and "ex-smokers" who had stopped smoking since at least last one year. For the current smokers, cigarettes per day also noted. Brief Symptom Inventory, Toronto Alexithymia Scale (TAS), Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Experiences in Close Relationships-Revised Scales were used. Results 43.6% (n=10,672) of the participants were smokers; 5.7% (1386) were ex-smokers; 50.7% (n=12,414) were non-smokers. A higher number of daily smoked cigarettes was related to all subscales of Brief Symptom Inventory, TAS - Difficulty in Recognition of emotions, TAS - Difficulty in Expressing Emotions, Positive Affect Score, Negative Affect Score, Avoidance and Anxious Attachment scores (p

PURPOSE: Alexithymia, defined as the inability of a person to identify, describe and express emotions, has been found to influence glycemic control in type 2 diabetes patients (D2). The characteristics and influencing factors of alexithymia and the association of this psychological construct with D2 has not yet been studied in Lebanon where 14.6% of adults are diagnosed with the disease. This study aims at evaluating the prevalence of alexithymia and its relationship with glycemic control among Lebanese adults with D2. METHODS: Alexithymia was assessed in 104 patients diagnosed with D2 and 100 healthy controls using the 20-item Toronto Alexithymia Scale (TAS-20). The impact of alexithymia on glycemic control was evaluated using HbA1c values, fasting blood glucose levels, number of severe hyperglycemic episodes and hospitalizations for hyperglycemia within the past months. RESULTS: Alexithymia prevalence was significantly higher in D2 patients compared to controls (35.5% vs 15%). Patients with alexithymia showed higher levels of HbA1c and glucose in comparison to those without alexithymia. Consistently, significant positive correlations were found between the TAS-20 total and subscale scores and both HbA1c and glucose levels. Alexithymic patients had three times more severe hyperglycemic episodes and five times more hospitalizations for hyperglycemia compared to those without alexithymia. According to multivariate regression analysis, lifestyle factors alone were not found predictive of alexithymia in D2 patients. CONCLUSION: Given the impact of alexithymia on D2 regulation, screening of alexithymia in case of D2 and appropriate psychological follow-up are important for a better prognosis, management and treatment of the disease.

Backgrounds Alexithymia refers to the difficulties in identifying and describing one's own emotions, lacking of imagination, and an externally oriented thinking style. Studies up to date have examined the associations of 5-HTTLPR and COMT Val158Met polymorphisms with alexithymia. However, the previous findings were mixed. Methods We replicated the associations by scoring on alexithymia with the 20-item Toronto Alexithymia Scale and genotyping the polymorphisms of 5-HTTLPR and COMT Val158Met in a large population of college students (N = 1698). Moreover, we also meta-analyzed the associations with five samples (N = 7517) for the 5-HTTLPR and with five samples (N = 2186) for the COMT Val158Met. Results Neither the replicated study nor the meta-analyses indicated the 5-HTTLPR and COMT Val158Met were associated with alexithymia. Conclusions The findings suggest that the 5-HTTLPR and COMT Val158Met polymorphisms are not associated with alexithymia. However, genetic-environmental studies with different ethnicity and psychopathology should be carried in future.

Internationally, the most widely used self-report instrument to assess alexithymia (a clinical condition characterized by serious deficits in the cognitive processing of emotions) is the Toronto Alexithymia Scale (TAS-20). Because this measure has been poorly investigated in Brazil and emerging research suggests that TAS-20 scores might vary from one culture to another, we sought to: (1) investigate the psychometric properties of a Brazilian TAS-20; and (2) examine the degree to which Brazilian non-clinical TAS-20 scores differ from the scores of non-clinical samples from other cultures. A sample of 850 non-clinical Brazilian adults were administered a number of questionnaires and performance-based measures via online data collection. Data analyses inspected internal consistency and factor structure of the TAS-20, and tested the association of TAS-20 scores to emotional functioning and psychopathology. In line with previous international research, the Brazilian TAS-20 showed acceptable to adequate psychometric properties. Furthermore, TAS-20 scores associated negatively with empathy and emotional perception, and positively with emotion dysregulation and personality traits like dependency, abrupt changes in mood, and avoidance of criticism. Also noteworthy, our non-clinical Brazilian TAS-20 scores were very similar to those observed in other previously published non-clinical TAS-20 scores from seven non-Brazilian cultures.

Voice signal has been widely investigated to characterize mood and emotional states. A further interesting dimension could regard the personality traits. The relationship between personality traits and specific speech features is known, however this topic requires further investigation. Specifically, most studies are focused on perceived personality traits, without adopting dedicated personality tests. Moreover, the relationship among speaker personality traits and specific speech features have still to be clarified. In this study, a correlational analysis between some speech-related features and the personality traits, as described by the Zuckerman-Kuhlman model and the Toronto Alexithymia Scale, is performed. An experimental protocol, consisting of two structured speech tasks, was administered to eighteen healthy subjects. Speech features were estimated to describe fundamental frequency (F0) and voice quality related features from whole speech recording and tilt-related features, describing F0 dynamics at voiced segment level. Significant correlations among personality traits and speech features were observed using both feature sets. Interestingly, the adopted speech task was found to influence the obtained results. Specifically, no feature reports the same significant correlation in both adopted tasks. The impact of personality traits and speech production studies on the characterization of mental disorders and the estimation of emotional/mood state of the speaker are discussed.

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.

OBJECTIVE In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. PATIENTS AND METHODS Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). RESULTS No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. CONCLUSION In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases.

OBJECTIVE: The COVID-19 pandemic process caused many physiological and psychological effects on individuals. This study aims to examine the ruminative thinking and alexithymia levels of people in the COVID-19 pandemic process. METHODS: The descriptive, cross-sectional, and the correlational designed study was conducted with 852 people in ?stanbul\Turkey during the COVID-19 pandemic process between March and May 2020. The data of the research was collected with the Sociodemographic Form Toronto Alexithymia Scale and Ruminative Thought Style Questionnaire. RESULTS: It was found that the average of ruminative thought score of the people was 92.49±19.89 and the alexithymia score average was 71.76±13.70. A positive and significant relationship was found between the Ruminative Thought Style Questionnaire and the Toronto Alexithymia Scale and subscale scores (p

Objectives: There is an empirical evidence that symptoms of internalizing disorders such as alexithymia and anxiety increase in adolescence and these symptoms varies across gender and age groups. The purpose of this study was to explore these differences in adolescents. Method: In this cross-sectional study conducted since November 2018 to March 2019, the sample of 185 adolescents selected through random sampling method from different schools. They were assessed on alexithymia and anxiety symptoms by administering Toronto Alexithymia Scale and Hamilton Anxiety Scale respectively. Multiple Analysis of Variance (MANOVA) was applied to determine the direct and interactive effect of age groups and gender on alexithymia and anxiety symptoms. Results: The results demonstrate that boys reported significantly (p

Background There is overwhelming evidence for a strong association between childhood trauma and adult psychopathology. This study aimed to investigate the mediation roles of alexithymia, sensory processing sensitivity, and emotional-mental processes in the relationship between childhood traumas and adult psychopathology. Methods The sample consisted of 337 people (78.9% female, 21.1% male) aged between 20 and 64 years. Participants filled the scales online via a Google form. Reading Mind in the Eyes (EYES), Sensory Processing Sensitivity Scale (SPS), Toronto Alexithymia Scale (TAS-26), Childhood Trauma Questionnaire (CTQ), and the Brief Symptom Inventory (BSI) were used. PROCESS (Model 4) macro was used to examine the mediating role of sensory processing sensitivity, alexithymia, and the EYES test results in the relationship between childhood trauma and psychopathology. Results The results of mediation analysis demonstrated that sensory processing sensitivity and alexithymia mediated the relationship between childhood trauma and adult psychopathology. However, the EYES test (mentalization) did not mediate in this relationship. Conclusion This study shows that childhood traumas may relate to more psychological symptoms in individuals with high sensory processing sensitivity and alexithymia. Our study may contribute to the understanding of what may lead to a person’s vulnerability to experiencing psychological symptoms after childhood trauma. It may be crucial that future treatment and intervention programs should include sensory sensitivity and alexithymia. Sensory processing sensitivity and alexithymia can be examined in the treatment of psychological problems of individuals who have experienced childhood trauma.

Background Questions have been raised about whether items of alexithymia scales assess the construct alexithymia and its key features, and no other related constructs. This study assessed the (discriminant) content validity of the most widely used alexithymia scale, i.e., the Toronto Alexithymia Scale (TAS-20). Methods Participants (n = 81) rated to what extent TAS-20 items and items of related constructs were relevant for assessing the constructs ‘alexithymia’, ‘difficulty identifying feelings’, ‘difficulty describing feelings’, ‘externally-oriented thinking’, ‘limited imaginal capacity’, ‘anxiety’, ‘depression’, and ‘health anxiety’. Results Results revealed that, overall, the TAS-20 did only partly measure ‘alexithymia’. Only the subscales ‘difficulty identifying feelings’ and ‘difficulty describing feelings’ represented ‘alexithymia’ and their intended construct, although some content overlap between these subscales was found. In addition, some items assessed (health) anxiety equally well or even better. Conclusions Revision of the TAS-20 is recommended to adequately assess all key features of alexithymia. Findings with the TAS-20 need to be interpreted with caution in people suffering from medical conditions.

Alexithymia, a personality trait characterized by difficulties interpreting one’s own emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies a number of cognitive and emotional differences previously attributed to autism, such as difficulties in facial emotion recognition and reduced empathy. Although questionnaires such as the twenty-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have attempted to determine the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 verbal autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study (the Human Penguin Project). The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to further refine the scale based on local model misfit and I-DIF between the groups. Correlations between alexithymia and other clinical outcomes such as autistic traits, anxiety, and quality-of-life were used to assess the nomological validity of the revised alexithymia scale in the SPARK sample. The TAS-20 did not exhibit adequate global model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an eight-item unidimensional scale (TAS-8) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that TAS-8 scores meaningfully predict autistic trait levels, anxiety and depression symptoms, and quality of life, even after controlling for trait neuroticism. Limitations of the current study include a sample of autistic adults that was overwhelmingly female, later-diagnosed, and well-educated; clinical and control groups drawn from different studies with variable measures; and an inability to test several other important psychometric characteristics of the TAS-8, including sensitivity to change and I-DIF across multiple administrations. These results indicate the potential of the TAS-8 as a psychometrically robust tool to measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced TAS-8 latent trait scores in research applications (available at http://asdmeasures.shinyapps.io/TAS8_Score ).

Emotion-processing impairment represents a risk factor for the development of somatic illness, affecting negatively both health-related quality of life (HRQoL) and disease management in several chronic diseases. The present pilot study aims at (i) investigating the associations between alexithymia and depression, anxiety, and HRQoL in patients with Hashimoto’s thyroiditis (HT); (ii) examining the association between these three psychological conditions together with HRQoL, and thyroid autoantibodies status as well as thyroid echotexture in patients with HT; and (iii) comparing the intensity of all these clinical psychological features in patients with HT versus controls. Twenty-one patients with serologically or ultrasonographically verified HT and 16 controls with non-toxic goiter or postsurgical hypothyroidism were recruited for this study. Serum thyrotropin (TSH) and free thyroxine, as well as thyroid autoantibodies (thyroglobulin antibodies and thyroid peroxidase antibodies), were assayed. Alexithymia, depression, anxiety, and HRQoL were assessed with Toronto Alexithymia Scale; Beck Depression Inventory, second edition; Hamilton Anxiety Rating Scale; and Health Survey Short-Form 36, respectively. A negative relationship between the difficulty to describe feelings and the cognitive component of depression was found (r = -0.46, p = 0.04). Besides, patients with seronegative HT had lower somatic anxiety than patients with HT who tested positive (r = -0.68, p = 0.01 and r = -0.59, p = 0.04, respectively). Besides, no statistically significant difference was found between patients with HT and controls with regard to somatic anxiety. The present study suggests the relevance of alexithymia in patients suffering from HT, which may be intertwined with a possible state of underreported depression that is mainly expressed through physical complaints. Promoting the capability to describe and communicate feelings could contribute to psychological elaboration and coping with the disease and, consequently, to the improvement of self-management and perceived HRQoL.

Purpose To evaluate the effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students. Design and methods This prospective, randomized, controlled trial study was implemented among 70 nursing students. Based on transformative learning theory, the affective learning method was applied to the intervention group. Toronto Alexithymia Scale (TAS), Empathic Tendency Scale (ETS), and Attitudes Toward Disabled Person Scale (ATDPS) were administered to both groups. Results The intervention group showed a statistically and significantly lower score at TAS and higher score at ATDPS compared to the control group, whereas no statistically significant difference was found in ETS score. Practice implications Affective learning methods could be implemented in the nursing course for improving students' attitude toward disabled persons, and reducing alexithymia.

This study was conducted to determine the changes in sexual functioning and alexithymia levels in patients with type 2 diabetes during the COVID-19 pandemic. This descriptive, cross-sectional study was conducted with 162 patients with type 2 diabetes. Data were collected using the Information Form, Toronto Alexithymia Scale, Hospital Anxiety and Depression Scale. For 83.3% of the participants, there was a decrease in sexual functioning after diabetes, 69.8% after the COVID-19 pandemic, and 67.2% due to both conditions. The majority of the patients stated the reasons for experiencing sexual problems related to not seeing sexuality as a priority (77.1%), and stress/anxiety experienced during the COVID-19 pandemic (67.9%). Moreover, patients' alexithymia, anxiety, and depression levels were found to be high during the pandemic, when the study was conducted. A positive correlation was identified between alexithymia and anxiety and depression. Further, multiple regression results indicated that about 50% of alexithymia levels could be explained by anxiety and depression levels. The anxiety, depression, and alexithymia scores of those who had decreased sexual functioning before and during the pandemic period were statistically significantly higher than those who did not have any change (p

Aim Sleep spindles have an important role in the pathophysiology and perception of sleep. We aimed to investigate the link between sleep spindles and microstructural architecture of sleep in regard to psychiatric characteristics in paradoxical insomnia. Method A total of 40 participants (20 with paradoxical insomnia, 20 healthy controls) were included in the study. All participants were evaluated by somnologists and undergone a full-night polysomnography at sleep laboratory. In addition, psychiatric interview was made by the same psychiatrist, and questionnaires were performed to assess the dimensions of the personality such as the neuroticism or extroversion (Eysenck Personality Questionnaire, EPQR-A); to evaluate the tendency to exaggerate somatic perceptions (Somatosensory Amplification Scale, SSAS), somatic parts of dissociation (Somatoform Dissociation Questionnaire, SDQ-20), and somatization (Somatization Scale, SS); to measure participants' feelings about their health and disease anxiety (Health Anxiety Inventory, HAI-18), and the level of uncontrollable and persistent anxiety (Penn State Worry Questionnaire, PSWQ); to investigate the tendency to ruminative thinking (Ruminative Thought Style Questionnaire, RTSQ), alexithymia (Toronto Alexithymia Scale, TAS-20); and to define the presence and the severity of depressive symptoms (Beck Depression Inventory, BDI). Results The duration and frequency of the sleep spindles were similar between two groups, while the density was significantly decreased in paradoxical insomnia. The duration of sleep spindles, on the other hand, showed positive correlations with the extroversion dimension scores of EPQR-A and PSWQ scores. Discussion Sleep protective mechanisms are disturbed in paradoxical insomnia as shown by the lower density of sleep spindles. In addition, fast spindle activity is associated with the personality traits, characterized by an increase in the expression of feelings and the level of anxiety.

Objective: Alexithymia is frequent in patients with some chronic dermatological conditions. The aim of the study was to measure the prevalence of alexithymia in patients with systemic sclerosis (SSc) using two different tools.Methods: Consecutive patients diagnosed with SSc were recruited at day hospital and hospitalization regimen. Alexithymia was measured using the self-administered questionnaire 20-item Toronto Alexithymia scale (TAS-20) and the semi-structured interview 24-item Toronto Structured Interview for Alexithymia (TSIA).Results: The study sample consisted of 67 female patients, aged from 29 to 82 years. According to TAS-20, 22.4% of patients were alexithymic and 17.9% were borderline alexithymic. Also, in our sample mean TAS-20 value was 48.9 and TSIA mean value was 20.3. Spearman’s correlation coefficient between TAS-20 total score and TSIA total score was 0.603. A high correlation was observed between TAS total score and the “Affective Awareness” (AA) scale of the TSIA. TSIA total score significantly correlated with the “Difficulty describing feeling to others” (DDF) scale of the TAS-20. The highest correlation between scales of the two instruments was that between TAS-20 DDF and TSIA AA (r = 0.675).Conclusion: The prevalence of alexithymia in SSc patients was higher than in the general population, and similar to that of psoriasis patients. The measurements obtained using the TAS-20 and the TSIA were highly correlated. However, they also showed some diversities in the scales, indicating that they may measure different domains.