How are alexithymia and physical illness linked? A review and critique of pathways

Lumley, Mark A.; Stettner, Laurence J.; Wehmer, Francine

doi:10.1016/s0022-3999(96)00222-x

Cited by 295 publications

(225 citation statements)

References 94 publications

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“…First, we designed this study based on theories derived mainly from observational studies (3,5,9,12,17). Although we believe there were important clinical implications in our study, many issues have yet to be clarified.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous observational and some experimental studies revealed positive associations between alexithymia and pain intensity and sensitivity (16). However, there are some conflicting reports; alexithymia has been suggested to be associated with poor awareness of physical symptoms, such as cardiac pain, resulting in a delay of seeking treatment (17). One possible reason for this inconsistency may be the influence of negative affect.…”

Section: Introductionmentioning

confidence: 99%

“…It is speculated that RA patients with alexithymia may report more severe pain than the level estimated from CRP results when they are depressed because they are unable to modulate their own feelings and tend to amplify bodily sensations due to psychological distress (21). On the other hand, patients with alexithymia may be less responsive to inflammation when they are not depressive because of their external focus of attention (17).…”

Section: Introductionmentioning

confidence: 99%

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Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Kojima

Suzuki

et al. 2014

Arthritis Care & Research

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Objective. We previously reported that depression and inflammation have independent effects on pain severity in patients with rheumatoid arthritis (RA). Alexithymia is a personality trait characterized by deficits in cognitive processing and regulation of emotions. A broad association between alexithymia and various health problems has been suggested, including depression, inflammation, and pain. The objective of this study was to examine the independent influence of alexithymia on pain perception and its relationship to depression and inflammation. Methods. We evaluated 213 RA outpatients who completed self-administered questionnaires, including the Beck Depression Inventory-II (BDI-II) to measure depression severity, the 20-item Toronto Alexithymia Scale (TAS-20) to measure degree of alexithymia, and a visual analog scale to quantify perceived pain. Serum C-reactive protein (CRP) levels were measured to quantify inflammation severity.Results. An initial significant positive association between the TAS-20 score and pain severity (P ‫؍‬ 0.01) lost significance after controlling for BDI-II score and CRP level using regression analysis. An interaction was observed among alexithymia, depression, and inflammation with regard to perceived pain. Among those without alexithymia, pain severity increased linearly with the CRP tertile levels regardless of the presence of depression (P < 0.001 for trend). No linear association between pain severity and CRP level was observed among those with alexithymia. Moreover, depressed patients with alexithymia (BDI-II score >14 and TAS-20 score >61) reported severe pain even at low CRP levels. Conclusion. Alexithymia might have a substantial role in pain perception as well as depression in patients with RA. A biopsychosocial approach is essential to achieve better pain control. INTRODUCTIONRheumatoid arthritis (RA) is a chronic disease in which an autoimmune disorder causes inflammation of the joints and surrounding tissues. Patients with RA experience persistent pain, arising from inflammation. This pain is also known to possess a strong emotional component and is affected by mood and psychosocial factors (1). We previously reported the independent influences of depression severity and inflammation on perceived pain in patients with RA (2). Both the depression score and the serum levels of C-reactive protein (CRP), a biomarker of inflammation, were significantly associated with pain, even after controlling for each other and for clinical covariates by regression analysis. Alexithymia is defined as a personality construct with difficulties in affective self-regulation (3). It has been proposed to be a cluster of cognitive and affective characteristics that are commonly observed among classic psychosomatic patients for whom therapy has been unsuccessful (4). Individuals with alexithymia tend to experience difficulties in identifying and describing their inner feelings and have a limited imaginary capacity and a preference for externally oriented thinking rather than introspection (3)....

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Kojima

Suzuki

et al. 2014

Arthritis Care & Research

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“…It was originally hypothesized that alexithymia was a risk factor for the development of these diseases, but there has been little evidence indicating that alexithymia leads to the development of organic disease [2].…”

Section: Introductionmentioning

confidence: 99%

The predictive value of the Toronto Alexithymia Scale among patients with asthma

Feldman

Lehrer

Hochron

2002

Journal of Psychosomatic Research

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Objective-The present study examines how alexithymia, self-report of symptoms, and pulmonary function are related to each other among a sample of patients with asthma. The goal was to extend previous research showing that alexithymia may complicate treatment of asthma.Methods-Seventy-four participants with asthma completed the Toronto Alexithymia Scale (TAS), Asthma Symptom Checklist (ASC), Taylor Manifest Anxiety Scale (TMAS), and spirometry testing.Results-The "Difficulty identifying feelings" subscale (IDE) of the TAS was associated with increased report of emotional symptoms (panic-fear) as well as physical symptoms (fatigue) during the past week, but not pulmonary function on the day of testing. This relationship appeared to be influenced by trait anxiety. The "Difficulty communicating feelings" subscale (COM) was correlated with decreased pulmonary function, but not report of emotional or physical sensations experienced during the prior week. The "Externally oriented thinking" subscale (EOT) was not related to any of the dependent measures.Conclusion-These data suggest that alexithymia may complicate optimal management of asthma and this relationship is best studied by examining the subscales of the TAS separately.

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“…То же касается связи АТ и кардиоваску-лярных и бронхолегочных заболеваний (в частности, бронхиальной астмы). Ряд исследований [16,17] посвя-щен изучению влияния вредных привычек (алкогольная, никотиновая и наркотическая зависимость) на уровень алекситимичности личности. Показано, что АТ может яв-ляться фактором, предрасполагающим к развитию сахар-ного диабета [18].…”

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Alexithymia - baseline trends of research

Rg¹,

Gorobets

et al. 2014

Z. nevrol. psikhiatr. im. S.S. Korsakova

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ОБЗОРЫИзвестно, что ряд психосоматических патологиче-ских состояний оказывает влияние на течение сопутству-ющих заболеваний, в связи с чем зачастую приходится менять терапевтическую тактику. Одним из факторов, способных вызывать психосоматические проблемы, явля-ется алекситимия (АТ). Под АТ понимается неспособ-ность индивидуума адекватно понимать и выражать соб-ственные чувства и телесные ощущения, а также воспри-нимать чужие эмоции. Считается, что люди с разной сте-пенью выраженности АТ имеют достаточно скудную фан-тазию, у них, как правило, слабо или весьма умеренно развито воображение [1,2].Первым проблему АТ обозначил П. Сифнеос [1]. Дальнейшие исследования в данной области проводи лись и проводятся весьма интенсивно, и на сегодняшний день АТ является одной из значимых проблем неврологии и нейропсихологии. В течение последних двух десятилетий проблемы АТ широко и подробно освещаются в медицин-ской литературе. Основные результаты этих исследований обсуждаются в представленном обзоре.В настоящее время проводятся исследования, в кото-рых выясняют, является ли АТ специфическим свойством личности или же она может лишь предрасполагать к пси-хосоматическим заболеваниям, являясь их предиктором. Некоторые исследователи полагают, что АТ сама по себе не является заболеванием и представляет собой ряд харак- В обзоре рассматриваются современные представления о формировании алекситимии. Анализируется возможность ее возникновения при различных соматических и психосоматических заболеваниях, а также роль в развитии ряда психоневрологических заболеваний. Приведены данные о связи алекситимии и нарушений поведения, расстройств межличностных отношений. Рассматриваются способы диагностики алекситимии в условиях клинической практики при различных поражениях центральной нервной системы.Ключевые слова : алекситимия, когнитивные функции, нейролингвистический анализ, психосоматические заболевания, нейрофизиологический подход, боль. In this review, we considered current conceptions on the development of alexithymia. We analyzed the possibility of its development in different somatic and psychosomatic diseases as well as a role in the development of some psychoneurological diseases. The data on the relationship between alexithymia and behavioral disorders, disorders interpersonal relations are presented. Methods of diagnosis of alexithymia in clinical practice in patients with different lesions of the central nervous system are considered.

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How are alexithymia and physical illness linked? A review and critique of pathways

Cited by 295 publications

References 94 publications

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

The predictive value of the Toronto Alexithymia Scale among patients with asthma

Alexithymia - baseline trends of research

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