Alexithymia is not a stable personality trait in patients with substance use disorders

Abstract

The construct of alexithymia as a vulnerability factor for substance use disorders (SUD) is under debate, because of conflicting research results regarding alexithymia as a state or trait phenomenon. The absolute and relative stability of alexithymia were evaluated in a pre-post design as part of a randomised controlled trial, controlling for several co-variates. Assessments were done with the Toronto Alexithymia Scale (TAS-20) and the Addiction Severity Index (EuropASI) at baseline and follow-up of a 3-month trial of inpatient Cognitive Behavioural Therapy (CBT) with or without a Shared Decision Making intervention for 187 SUD patients. Paired sample t-tests and analyses of variance were performed to assess absolute stability, intraclass correlation coefficients were calculated for relative stability and multivariate linear regression models were used to evaluate the relation between co-variates and change in alexithymia. Mean level reduction of total TAS-20 and two subfactors demonstrated no absolute stability, but change in alexithymia differed for patients with low, moderate and high alexithymia scores. Relative stability of alexithymia was moderate to high for the total population, but differed according to low, moderate and high alexithymia scores. The EuropASI "psychiatry" domain, covering anxiety and depression, was related to alexithymia, but CBT-related variables were not. In conclusion, alexithymia is partly a state-dependent phenomenon, but not a stable personality trait in this SUD population.

Role of Alexithymia, Anxiety, and Depression in Predicting Self-Efficacy in Academic Students

“…Some argue that alexithymia is better defined as a state or trait. Various findings support the view that this construct represents a stable personality trait [2, 44]. Other evidence reported that alexithymia was a state-dependent personality construct and that TAS-20 scores changed after psychotherapy [45].…”

Relationship of Internet Addiction Severity with Depression, Anxiety, and Alexithymia, Temperament and Character in University Students

“…50 In contrast, some researchers suggest that alexithymia is a statedependent phenomenon in depressed people 51 and partly a state-dependent phenomenon in patients with substance use disorder. 52 Strong associations were also found between alexithymia and immature or maladaptive defense styles in students 53 and alcohol-dependent inpatients. 54 Students with negative emotions, such as anxiety or depression, may use the Internet to relieve these emotions externally 55,56 and may have alexithymia as a defense mechanism internally.…”

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

“…An alternative explanation is that alexithymic characteristics contribute to elevated psychological distress (Tolmunen et al, 2011) due to a failure to regulate distressing emotions (Berking et al, 2008). For instance, prospective studies have shown reductions in alexithymia to be largely independent of individual differences in clinical severity (de Haan, Joosten, et al, 2012;de Haan, van der Palen, Wijdeveld, Buitelaar, & De Jong, 2014;de Timary et al, 2008;Grabe et al, 2008;Luminet et al, 2001;Picardi et al, 2012). A study by Luminet et al (2001) found that following a very large reduction in clinical severity over the course of treatment, and despite a moderate reduction in alexithymia scores (mean-level), relative differences in alexithymia scores among patients remained the same (relative stability).…”