The Relations of Self-Reported Aggression to Alexithymia, Depression, and Anxiety After Traumatic Brain Injury

Abstract

This was the first empirical study showing that poor emotional insight (alexithymia) significantly contributes to aggression after TBI. This relation, and the potential clinical implications it may have for the treatment of aggression, warrants further investigation.

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

“…Participants had to score a ≥52 for treatment eligibility. The TAS-20 has been used in the TBI population 10–13,15,17 , and is reported to have good internal consistency, validity, and test-retest reliability. 11,27 …”

“…11 The prevalence of alexithymia after TBI ranges from 30–61% 10,12,13 compared to 10% 14 in the non-TBI population. Since alexithymia has been associated with emotion dysregulation deficits after TBI, such as anxiety, depression, and anger, 13,15–17 it is a deficit that warrants considerable attention and concern.…”

“…One assumption is that emotional awareness is needed to consciously regulate emotions. 17 Also, reduced awareness and difficulty describing emotions has been associated with avoidant coping skills. 13 If one avoids a problem that causes emotional distress, that problem is likely to remain unresolved and may compound and/ or surface through behavior.…”

Treatments for Emotional Issues After Traumatic Brain Injury

“…2–6 Notably, many studies show a link between alexithymia and poor emotional control, and it is believed that emotional awareness is a critical foundation for regulating emotions. 7 This Issue presents findings from a small phase I study trialing a computer-based training program to reduce alexithymia in participants with TBI. The outcomes from this study concern changes in emotional self-awareness as well as generalization to emotion regulation including anxiety, depression, anger, and affect.…”

“…We know that many challenges often accompany anger and aggression including interpersonal difficulties and relationship problems, caregiver burden, social isolation, violent criminal offenses, and decreased community re-integration (e.g., employment failures). 7,12 With very little evidence for strategies to effectively manage anger and aggression in persons with TBI, there is an urgent need for progress in this area, and the two articles in this issue are steps in the right direction. The study by Dr. Hart and colleagues examines the effect of a behavioral intervention, while Dr. Hammond and colleagues investigate the effectiveness of a pharmaceutical treatment for anger and aggression.…”