Alexithymia in female patients with eating disorders

Abstract

Previous studies indicate that patients with eating disorders have alexithymic characteristics, as revealed by the Toronto Alexithymia Scale (TAS). The aim of the present study was to investigate the role of negative affect (anxiety and depression) in the relationship between eating disorders and alexithymia. In addition, we have evaluated whether the relationship between negative affect and alexithymia varies according to the type of eating disorder (anorexia and bulimia). Eighteen female patients and 16 female patients who met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria for restrictive anorexia nervosa and bulimia nervosa, respectively, and 18 healthy female controls matched by age and education were submitted to Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory to assess depression and anxiety and the Toronto Alexithymia Scale (TAS-20) and the Bermond Vorst Alexithymia Questionnaire (BVAQ) to evaluate alexithymic characteristics. The findings indicated that, although anorexic and bulimic patients showed higher alexithymia scores compared to controls, this result could be mainly related to negative affect. In fact, taking negative affect into account, anorexic and bulimic patients did not show higher TAS-20 and BVAQ scores compared to controls. The only variable useful to discriminate among anorexics, bulimics and controls is the perceived inability to experience emotional feelings, which is higher in anorexic patients compared to the other two groups.

Alexithymia and Its Relationships with Dissociative Experiences, Body Dissatisfaction and Eating Disturbances in a Non-Clinical Female Sample

“…Our findings seem to confirm this observation (Montebarocci et al 2006;Speranza et al 2007). Moreover, the results of our study seem to point out that the presence of alexithymia may be related to the presence of higher dissociative experiences and lower self-esteem.…”

“…As some of the core aspects of the alexithymic construct, such as a difficulty distinguishing emotional states from bodily sensations, may be more characteristic of patients with EDs, it was suggested that patients with EDs may appear dramatically and deeply incapable of being in touch with their inner emotive world (Andersen 1988). As a consequence, these subjects may focus their attention on negative perceptual aspects of body, bypassing emotional experiences and leading to higher body dissatisfaction (Montebarocci et al 2006;De Berardis et al 2007).…”

The Concept of Body Image Disturbance in Anorexia Nervosa: An Empirical Inquiry Utilizing Patients' Subjective Experiences

“…The absence of any or all of these components indicates the presence of difficulties in emotional regulation. To a great extent, previous studies have focused on the lack of emotional awareness and understanding in this patient group, such as the large body of research that has explored rates of alexithymia in AN Kessler, Schwarze, Filipic, Traue, & von Wietersheim, 2006;Montebarocci et al, 2006;Taylor, Parker, Bagby, & Bourke, 1996). In the present dissertation, the main focus is on the link between negative affective states and eating disorder behaviour.…”

Cognitive processing of emotions in anorexia nervosa

“…Studies using valid and reliable measures for the assessment of alexithymia have shown a high prevalence for this deficit in individuals with AN (Bourke et al, 1992;Cochrane et al, 1993;Montebarocci et al, 2006;Schmidt et al, 1993;Torres, Guerra, Lencastre, Brandão, & Roma-Torres, 2004). However, despite the evidence of this relationship, one main question remains unclear: are the affect regulation deficits a stable feature in AN?…”

“…In fact, several studies have recognized the cognitive impairment of emotional processing and regulation as a salient feature in AN, and as such have sought to analyse the relationship between AN and alexithymia (Bourke, Taylor, Parker, & Bagby, 1992;Cochrane, Brewerton, Wilson, & Hodges, 1993;Laquatra & Clopton, 1994;Montebarocci, Codispoti, Surcinelli, Franzoni, Baldaro, & Rossi, 2006;Schmidt, Jiwany, & Treasure, 1993;Taylor, Parker, Bagby, & Bourke, 1996). Alexithymia is an affective deficit where the main features are (a) a difficulty in identifying feelings and distinguishing emotions from physical sensations, (b) a difficulty in communicating emotional states to others, (c) a paucity of fantasy life (few dreams and fantasies) and (d) a tendency to focus on the concrete details of external events-an externally oriented style of thinking (Nemiah, Freyberger, & Sifneos, 1976;Taylor, 1994).…”