Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

Abstract

Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.

Family support, anger and aggression in health workers during the first wave of the pandemic

“…In the present study, 15% of the variance in aggression was explained by anger, and it seems that family support mediates this by preventing anger from turning into aggression. It is possible that there are more psychological factors hindering this diversion, so a sense of coherence is suggested in studies to impede the expression of aggression, at least in patients with schizophrenia [30] . Additionally, cross-cultural factors are likely to be involved in the expression of anger [49] , [50] .…”

“…The questionnaire asks participants to rate, the extent to which the statements are typical of themselves on a scale of 1 (strongly agree) to 5 (strongly disagree). The BAQ has been proposed as a valid and reliable instrument, with a good retest reliability and convergent validity compared to other aggression instruments [28] – [30] . The internal reliability in the present study had a Cronbach's alpha of 0.762.…”

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

“…Research involving healthcare workers during the pandemic has consistently highlighted resilience as a safeguard against various mental health conditions, encompassing anxiety, depression, post-traumatic stress and sleep disturbances [85] – [87] . While there are other protective intrinsic factors such as sense of coherence [88] , [89] or even extrinsic ones such as family support [90] , [91] what makes a person resilient is the mixture of intrinsic and extrinsic characteristics [92] , [93] . Therefore, interventions aimed at bolstering resilience should consider this holistic perspective, incorporating elements from both dimensions.…”

Alexithymia in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates, and relationship with neurocognition and empathy

“…Studies have consistently reported higher alexithymia levels in patients with schizophrenia than that in healthy subjects (McGillivray et al, 2017; van't Wout et al, 2007). Notably, alexithymia is found to correlate with adverse outcomes in schizophrenia, including aggression (Pachi et al, 2022), suicide (Zhou et al, 2023), and more severe functional impairment (Ospina et al, 2019).…”