Alexithymia and Its Associations With Depression, Suicidality, and Aggression: An Overview of the Literature (original) (raw)

Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review

Frontiers in psychiatry, 2017

It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.

Alexithymia and suicidal ideation: A 12-month follow-up study in a general population

Comprehensive Psychiatry, 2004

Alexithymic features are often associated with depression, which is the most important risk factor for suicidal behaviors. Nevertheless, little is known about the associations between alexithymia and suicidality. In this 12-month follow-up study we investigated the relationship between alexithymia and suicidal ideation in a sample of the general population (N ‫؍‬ 1,563) using the 20-item Toronto Alexithymia Scale (TAS-20) and the 21-item Beck Depression Inventory (BDI). Suicidal ideation was more common among subjects with alexithymia than among nonalexithymic subjects (32% v 9% at baseline and 36% v 9% after 12 months). In cross-sectional analyses, alexithymia associated with the presence of suicidal ideation even after adjustment for sex, age, and several psychosocial and socioeconomic factors and the presence of depression. Moreover, after adjustment for depression at baseline, the decrease and increase in alexithymic features during the study period associated independently with recovery from and the occurrence of suicidal ideation, respectively. Nevertheless, these associations were no longer independent when adjusted for concomitant changes in the level of depressive symptoms. In conclusion, if depression presents alexithymic features the subject has an additive impact on the risk of suicidal ideation.

Alexithymia in suicide attempters

Acta Psychiatrica Scandinavica, 1996

Taiminen TJ, Saarijärvi S, Helenius H, Keskinen A, Korpilahti T. Alexithymia in suicide attempters. Acta Psychiatr Scand 1996: 93: 195–198. © Munksgaard 1996.Alexithymia seems to share some common features with psychological constriction, a phenomenon described in suicidal individuals. Fifty suicide attempters were interviewed within 24 h after arrival at a hospital, and measures of lethality of the attempt, suicidal intent, depression and alexithymia were carried out with structured instruments. Almost all the attempters were depressive, and about half of them were also alexithymic. However, alexithymia was not more prevalent in this population than in non-suicidal depressive patients. Depression and alexithymia correlated significantly with each other, but there was no correlation between alexithymia and lethality of the suicide attempt or suicidal intent. The authors conclude that alexithymia in suicide attempters seems to be associated with depression, but not with suicidality per se. Therefore, measurement of alexithymia may not yield extra information in suicide risk assessment.

Suicide Attempt, Suicidal Ideation and Hopelessness Levels in Major Depressive Patients with and Without Alexithymia

2020

Suicide attempt, suicidal ideation and hopelessness levels in major depressive patients with and without alexithymia Objective: It is known that hopelessness and alexithymia levels are increased in patients with depressive disorder. In the literature, reports are suggesting that high levels of hopelessness in patients with depressive disorder increase suicide attempts and ideations. Here we aimed to investigate whether there are any differences in terms of suicidal ideation, suicide attempt and hopelessness levels in major depressive disorder patients with and without alexithymia. Method: In this study, 99 patients diagnosed with major depressive disorder according to structured interview for DSM-IV (SCID-I/CV) and 50 healthy subjects were included. Sociodemographic questionnaire, Toronto Alexithymia Scale (TAS-20), Beck Hopelessness Scale (BHS), Scale for Suicidal Ideation (SSI) and Hamilton Rating Scale for Depression (HRSD) were administered to patients and controls. Additionally...

Prevalence and Demographic Correlates of Alexithymia: A Comparison Between Australian Psychiatric and Community Samples

Objectives: A cross-sectional empirical design was used to compare differences in alexithymia between Australian psychiatric and community samples and examine the influence of sample type on the relation between alexithymia and psychological distress. Method: Psychiatric outpatients (N = 151) and a convenience sample of the general community (N = 216) completed questionnaires measuring alexithymia and psychological distress. Results: Alexithymia was several times more prevalent in the psychiatric sample than the community sample. While the psychiatric sample reported greater psychological distress, no difference was found in the strength of the association between alexithymia and psychological distress between the study samples. Conclusion: These findings emphasize the pervasive problem alexithymia presents within the Australian psychiatric population and the importance of increasing recognition of alexithymia for the future research about and treatment of psychiatric patients. C 2016 Wiley Periodicals, Inc. J. Clin. Psychol. 00:1–12, 2016.

Alexithymia and Depression: Distinct or Overlapping Constructs

Previous research showing moderate to high correlations between the Toronto Alexithymia Scale (TAS) and Beck Depression Inventory (BDI) has generated controversy as to whether alexithymia and depression are distinct or overlapping constructs. The present study addressed this controversy using the statistical method of factor analysis. In a sample of undergraduate university students. 8 correlation matrix comprising items from both the TAS and BDI yielded a four-factor solution with virtually no overlap of the significant factor loadings for the items from each scale. and with the factors corresponding closely with their respective construct. These results were replicated and cross-validated with a sample of psychiatric outpatients. The findings support the view that alexlthymia is a construct that is distinct and separate from depression.

A Cross-Sectional Study Investigating the Relationship Between Alexithymia and Suicide, Violence, and Dual Harm in Male Prisoners

Frontiers in Psychiatry, 2021

Background: Suicide and violence are common within male prisoners. One suggested risk factor for both behaviors is alexithymia. Alexithymia describes a deficit in identifying and describing feelings and is also related to externally oriented thinking. This study aimed to explore the relationship between alexithymia, suicide, violence and dual harm in male prisoners.Methods: Eighty male prisoners were recruited from three prisons. Participants were asked to complete a battery of questionnaires including measures of alexithymia (TAS-20), suicide ideation (ASIQ), suicide behavior, violence ideation (SIV), violence behavior, depression (BDI-II), hopelessness (BHS), impulsivity (DII) and anger (NAS-PI). Regression analyses and ANOVAS were conducted to assess the association between alexithymia (and its subcomponents) with six outcomes; suicide ideation, suicide behavior, violence ideation, violence behavior, dual harm ideation and dual harm behavior.Results: Alexithymia was a univariate ...

Are alexithymia and depression distinct or overlapping constructs?: A study in a general population

Comprehensive Psychiatry, 2001

The aim of this study was to investigate the relationship between alexithymia and depression in a general population sample (N ‫؍‬ 1,888), as measured by the 20-item Toronto Alexithymia Scale (TAS-20) and the 21-item Beck Depression Inventory (BDI-21), using factor analysis. The items of the TAS-20 and the BDI-21 loaded on separate factors with only a minor overlap concerning physical worries. However, in a subset of subjects, who were both alexithymic and depressed, loadings were highly overlapping. These findings suggest that alexithymia and depression may be highly associated. Another conclusion might be that psychometric properties of the TAS should be further developed to make differentiation between alexithymia and depression possible.

Alexithymia and suicidality in panic disorder

Comprehensive Psychiatry, 2001

To evaluate the prevalence of suicidal behavior in patients with panic disorder (PD) and to study the role of alexithymia (AL), an affect component, as a predictor of suicidal behavior in PD, we compared 42 patients with PD with or without agoraphobia with 24 healthy controls with regards to depression, AL and suicide risk. Only 5% of the PD patients reported previous suicide attempts. A higher frequency of positive AL (score > 73) was found among the PD patients (39% v 4% among the controls). PD patients had a higher suicide risk and AL as compared to controls, but only the increased suicide risk reached statistical significance. AL subjects had higher suicide risk scores as compared to non-AL subjects. Significant correlations were found between the AL score and suicide risk, although the most significant correlation was, as expected, between the depression level and the suicide risk. A low rate of previous suicide attempts was found in the PD group, perhaps reflecting the low comorbidity in our sample. We suggest that AL may have a role in the causation of suicidal behavior in PD patients, although further studies should re-examine this issue with larger samples.

Alexithymia: Relationship to personality disorders

Comprehensive Psychiatry, 1994

Previous studies suggested an association of alexithymia with other personality models, as well as with various psychiatric syndromes. However, with regard to current diagnostic systems, the clinical validity of alexithymia remains to be established. In a sample of 182 psychiatric outpatients, the lifetime prevalence of DSM-III-R axis I disorders was determined by Structured Clinical Interview for DSM-III-R (SCID) interviews. In addition, DSM-III-R personality disorders were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R). On the Toronto Alexithymia T HE PERSONALITY TRAIT of alexithymia is used to describe individuals who display an inability to identify and express emotions, an externally oriented mode of thinking, and a restricted fantasy life.1-3 Alexithymic characteristics have been observed in patients with various psychiatric disorders, including psychosomatic diseases,4J functional somatic syndromes and somatoform disorders,6-11 affective disorders,i2-l4 posttraumatic stress disorders,15-r6 psychoactive substance use disorders,"-'" and eating disorders.20-22 In addition, previous studies have suggested an association between alexithymia and certain other descriptors and personality characteristics, such as social introversion,23 lack of psychological mindedness, persecutory ideation, impulse expres-sionZ4 perceived difficulties of self-disclosure,25 obsessional features,'6 neuroticism, low open-ness2' emotion suppression, depressive symptoms, illness worry, and self-consciousness.28