Alexithymia in post-traumatic stress disorder is not just emotion numbing: Systematic review of neural evidence and clinical implications

Putica, Andrea; Dam, Nicholas T. Van; Steward, Trevor; Agathos, James; Felmingham, Kim L.; O’Donnell, Meaghan

doi:10.1016/j.jad.2020.09.100

Cited by 25 publications

(24 citation statements)

References 60 publications

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“…The patient also described himself as an introvert and said that he did not like to talk about his experiences and difficulties, preferring to suffer in solitude. The patient was found to exhibit alexithymic traits [ 17 , 18 ]. Therefore, the Polish version of the Toronto Alexithymia Scale-20 [TAS-20] was used to measure the level of alexithymia [ 19 ].…”

Section: Case Presentationmentioning

confidence: 99%

Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances

Ogłodek

2022

Case Reports in Psychiatry

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Background. Posttraumatic stress disorder (PTSD) is a debilitating mental disorder that develops in the aftermath of traumatic life experiences, especially those that occurred in childhood. PTSD is associated with intrusive memories, distressing dreams, dissociative reactions, avoidance of trauma-related stimuli, negative mood and sense of well-being, increased arousal and irritability, and clinically significant distress and impaired functioning. Case Presentation. The following case report presents a 42-year-old male displaying symptoms of PTSD, alexithymia, and depression. Conclusion. Untreated alexithymia may aggravate the trauma and cause the development of PTSD and depression.

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Section: Case Presentationmentioning

confidence: 99%

Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances

Ogłodek

2022

Case Reports in Psychiatry

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“…11 Also, DSM-5 PTSD and ICD-11 CPTSD omit an important form of emotion dysregulation, alexithymia. 12 In the relational dysregulation domain, both DSM-5 PTSD and ICD-11 CPTSD assess only detachment and withdrawal. DTD incorporates a broader range of relational problems consistent with transdiagnostic formulations 8 : separation anxiety (i.e., attachment insecurity/ disorganization 13 -DTD symptom D2) and intimacy avoidance (i.e., expectancy of betrayal 14 -DTD symptom D3).…”

Section: Introductionmentioning

confidence: 99%

“…DTD includes somatic forms of emotion dysregulation that are absent from CPTSD owing to their network centrality with traumatized children 11 . Also, DSM ‐5 PTSD and ICD ‐11 CPTSD omit an important form of emotion dysregulation, alexithymia 12 …”

Section: Introductionmentioning

confidence: 99%

Toward an empirically based Developmental Trauma Disorder diagnosis and semi‐structured interview for children: The DTD field trial replication

Ford

Spinazzola

Kolk³

et al. 2022

Acta Psychiatr Scand

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Objective Developmental trauma disorder (DTD) is a childhood psychiatric syndrome designed to include sequelae of trauma exposure not fully captured by PTSD. This study aimed to determine whether the assessment of DTD with an independent sample of children in mental health treatment will replicate results from an initial validation study. Methods The DTD semi‐structured interview (DTD‐SI) was administered to a convenience sample in six sites in the United States (N = 271 children in mental health care, 8–18 years old, 47% female, 41% Black or Latinx) with measures of trauma history, DSM‐IV PTSD, probable DSM‐IV psychiatric diagnoses, emotion regulation/dysregulation, internalizing/externalizing problems, and quality of life. Confirmatory factor (CFA) and item response theory (IRT) analyses tested DTD’s structure and DTD‐SI’s information value. Bivariate and multivariate analyses tested DTD’s criterion and convergent validity. Results A three‐factor solution (i.e., emotion/somatic, attentional/behavioral, and self/relational dysregulation) best fit the data (CFI = 0.91; TLI = 0.89; BIC = 357.17; RMSEA = 0.06; SRMR = 0.05). DTD‐SI items were informative across race/ethnicity, gender, and age with three exceptions. Emotion dysregulation was the most informative item at low levels of DTD severity. Non‐suicidal self‐injury was rare but discriminative in identifying children with high levels of DTD severity. Results supported the criterion and convergent validity of the DTD construct. Conclusion This replication provides empirical support for DTD as a construct and potential psychiatric syndrome, and the DTD‐SI’s validity as a clinical research tool.

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“…Alexithymia is a sub-clinical, dimensional construct most commonly defined by (1) a difficulty in identifying feelings; (2) a difficulty in describing feelings to other people and (3) Externally Orientated Thinking (Bagby & Taylor, 1997). A hyperinhibition of limbic regions necessary for emotion processing is also observed among those with alexithymia (Putica et al, 2021). Further, those with alexithymia exhibit hypersensitivity to interoceptive sensations (processing of internal bodily stimuli; Craig, 2015), that is, exhibit high interoceptive sensibility (Longarzo et al, 2015).…”

Section: Functional Neurological Disorders and Alexithymiamentioning

confidence: 99%

Prolonged Exposure Therapy in the Treatment of Functional Neurological Disorder and Posttraumatic Stress Disorder

Putica

O’Donnell

Felmingham

2022

Clinical Case Studies

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Functional neurological disorder (FND) symptoms resemble neurological symptoms but are unexplained by disease or injury to the body. Psychological trauma and posttraumatic stress disorder (PTSD) are prevalent among patients with FND. This is a case report of a 64-year-old female who began treatment 2 years after developing PTSD, generalised anxiety disorder, major depressive disorder and agoraphobia following a physical assault. She subsequently developed FND approximately 18 months later. Her FND symptomology was characterised by aphasia and paraplegia. These symptoms usually lasted for a period of hours to days and usually occurred on a weekly basis. She had not previously engaged in psychological therapy due to limited insight into the relationship between her psychological and physiological symptomology. She was treated with Prolonged Exposure for PTSD (PE), and by the last session, she no longer met the diagnostic criteria for either FND or PTSD disorder. PE successfully treated both PTSD and FND. Theoretical understandings of the mechanisms underpinning this improvement are discussed.

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Alexithymia in post-traumatic stress disorder is not just emotion numbing: Systematic review of neural evidence and clinical implications

Cited by 25 publications

References 60 publications

Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances

Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances

Toward an empirically based Developmental Trauma Disorder diagnosis and semi‐structured interview for children: The DTD field trial replication

Prolonged Exposure Therapy in the Treatment of Functional Neurological Disorder and Posttraumatic Stress Disorder

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