Reductions in Alexithymia and Emotion Dysregulation After Training Emotional Self-Awareness Following Traumatic Brain Injury: A Phase I Trial

Abstract

Objectives To examine the acceptability and initial efficacy of an emotional self-awareness treatment at reducing alexithymia and emotion dysregulation in participants with traumatic brain injury (TBI). Setting Outpatient rehabilitation hospital. Participants Seventeen adults with moderate to severe TBI and alexithymia. Time post-injury ranged 1–33 years. Design Within subject design, with 3 assessment times: baseline, posttest, and 2-month follow-up. Intervention Eight lessons incorporated psycho-educational information and skill-building exercises teaching emotional vocabulary, labeling and differentiating self-emotions; interoceptive awareness; and distinguishing emotions from thoughts, actions and sensations. Measures Alexithymia (TAS-20); Emotional Awareness (LEAS); Trait Anxiety (TAI); Depression (PHQ-9); Anger (STAXI); Emotion Dysregulation (DERS); and Positive and Negative affect (PANAS). Results Thirteen participants completed the treatment. Repeated measures ANOVA revealed changes on the TAS-20 (p=.003), LEAS (p<.001), TAI (p=.014), STAXI (p=.015), DERS (p=.020) and Positive Affect (p<.005). Paired t-tests indicated significant baseline to posttest improvements on these measures. Gains were maintained at follow-up for the TAS, LEAS, and Positive Affect. Treatment satisfaction was high. Conclusion This is the first study published on treating alexithymia post-TBI. Positive changes were identified for emotional self-awareness and emotion regulation; some changes were maintained several months post-treatment. Findings justify advancing to the next investigational phase for this novel intervention.

Reading habits and emotional vocabulary in adolescents

“…As mentioned in the Introduction, numerous studies have found clear connections between emotional vocabulary, emotional awareness, and emotion regulation, particularly adaptive emotion regulation (e.g. Denham, 1986;Kumschick et al, 2014;Neumann et al, 2017aNeumann et al, , 2017bOrnaghi et al, 2017;Wood & Doughty, 2013), and that higher emotional competence can lead to higher levels of social competence, peer acceptance and even academic success for children and adolescents (e.g. Denham, 1986Denham, , 2007Denham et al, 2003Denham et al, , 2015Halberstadt, Denham, & Dunsmore, 2001;Schultz et al, 2001;Sette et al, 2017;Smith, 2001;Trentacosta & Fine, 2010).…”

“…Emotion awareness, in turn, can lead to enhanced, or more adaptive emotion regulation (e.g. Neumann, Malec, & Hammond, 2017a, 2017bWood & Doughty, 2013), which may have important implications for the education domain. Higher levels of emotion awareness or emotion knowledge has consistently been linked with pro-social behaviour and social competence (as well as peer acceptance and popularity) in children (e.g.…”

The Relationship Between Alexithymia and Emotional Awareness: A Meta-Analytic Review of the Correlation Between TAS-20 and LEAS

“…For healthy participants (including healthy controls) the results have been mixed, with a few studies showing positive correlations (Lundh et al, 2002 ; Waller and Scheidt, 2004 ; Bydlowski et al, 2005 ) although most studies show a negative association (Lane et al, 1998b ; Subic-Wrana et al, 2001 ; Lumley et al, 2005 ; Parling et al, 2010 ; Igarashi et al, 2011 ; Baeza-Velasco et al, 2012 ; Baker et al, 2014 ; Lichev et al, 2014 ; Maroti et al, 2017 ). In the few studies including medical conditions (or medical controls), the results have also been mixed, with some studies showing positive associations (Baeza-Velasco et al, 2012 ; Maroti et al, 2017 ), while others do not (Consoli et al, 2009 ; Lane et al, 2015a ; Burger et al, 2016 ; Neumann et al, 2017 ).…”

The construction of emotional experience: State‐related emotional awareness and its application to psychotherapy research and practice

“…Given the importance of emotion and emotional awareness, and the evidence that EA is often lower in clients with mental health conditions, a general goal of psychotherapy is to improve emotional awareness (Burum & Goldfried, 2007). To date, six studies have found increases in EA due to interventions (Subic‐Wrana et al., 2005; Radice‐Neumann, Zupan, Tomita, & Willer, 2009; Montag et al, 2014; Burger et al., 2016; Neumann, Malec, & Hammond, 2017; Killgore et al, 2020). Three studies involved clinical groups in which the intervention was designed to place primary emphasis on improving emotional awareness: one in fibromyalgia (Burger et al., 2016) and two in head injury (Montag et al, 2014; Neumann et al., 2017) clients.…”