Alexithymia
From Wikipedia, the free encyclopedia
Alexithymia (pronounced:
/ˌeɪlɛksəˈθaɪmiə/) from the Greek words λεξις and
θυμος, literally "without
words for emotions") was a term coined by Peter Sifneos
in 1972 to describe people who appeared to have deficiencies
in understanding, processing, or describing their emotions.
Deficiencies may include:
- problems identifying, describing,
and working with one's own feelings, often marked by a lack of understanding
of the feelings of others;
- confusion of physical sensations often associated
with emotions;
- few dreams or fantasies due to restricted imagination; and
- concrete, realistic, logical thinking, often
to the exclusion of emotional responses to problems.
- Those who have Alexithymia also
report very logical and realistic dreams, such as going
to the store or eating supper.
Alexithymia is classified as a mental disorder in the DSM IV. It is also a personality
trait that varies in severity from person to person. A
person's alexithymia score can be measured with questionnaires,
such as the Toronto Alexithymia Scale.
It is unclear what causes alexithymia. Some neuropsychological studies indicate
that alexithymia may be due to a disturbance to the right
hemisphere of the brain, which is largely responsible
for processing emotions
Alexithymia is a manifestation of
a deficit in emotional cognition. People with this
problem are mostly unaware of their feelings, or don't
know what they signify, and hence they rarely talk about
their emotions or their emotional preferences; they operate
in a very functional manner and rarely use imagination
to focus their drives and motivations. Alexithymia refers
to this distinctive cluster of characteristics.
Alexithymics have been described as human
robots, or emotional illiterates. They score
very low on measures of emotional intelligence and are
likely to fare rather poorly in life, whatever their intellectual
abilities. Their interpersonal relationships are frequently
hampered by poor emotional communication. Many also suffer
chronic medical problems, particularly psychosomatic or
somatoform illnesses.
Although alexithymia is a clinical construct,
it does not constitute a diagnostic illness in its own
right. It is a clinical feature associated with a range
of medical diagnoses, such as Post-Traumatic Stress Disorder,
Anorexia Nervosa or Asperger's Syndrome. There is, however,
a strong case for construing it (or more properly the
associated psychological deficit) as an independent condition
or cognitive-affective dysfunction. It is arguably inappropriate
to say that alexithymics have a disorder or disability,
although their inability to interpret their own emotional
signals may have profoundly disruptive effect on their
personal lives.
If
you have a marked deficiency in emotional understanding,
there will be various clues evident in everyday life.
For example, you might:
find
it difficult to talk about your own emotions;
be perceived by others as excessively logical, or unsentimental
without being unfriendly;
be perplexed by other people's emotional reactions;
give pedantic and long-winded answers to practical questions;
rarely daydream or fantasize about personal prospects;
have a subdued reaction to art, literature or music;
make personal decisions according to principles rather
than feelings;
suffer occasional inexplicable physiological disturbances
such as palpitations, stomach ache, or hot flushes.
During
the 1950s and 60s the psychiatrists Peter E. Sifneos and
John C. Nemiah, working at the Beth Israel Hospital at
Harvard, noted that a large proportion of patients with
psychosomatic complaints had extreme difficulty talking
about their emotions. These patients had other characteristics
in common, including a stiff posture, a focus on functional
details and a barren fantasy life. In 1972 Sifneos coined
the term alexithymia to refer to this bundle of
characteristics. He introduced it in two publications;
in an article entitled "The Prevalence of 'Alexithymic' Characteristics in Psychosomatic
Patients" published in the book Topics
of Psychosomatic Research in 1972 and in the journal
Psychotherapy and Psychosomatics in 1973; and (briefly)
in his 1972 book Short-Term Psychotherapy and Emotional
Crisis.
Difficulty identifying different types of feelings
Difficulty distinguishing between emotional feelings and
bodily feelings
Limited understanding of what caused the feelings
Difficulty verbalising feelings
Limited emotional content in the imagination
Functional style of thinking
Lack of enjoyment and pleasure-seeking
Stiff, wooden posture
Titre du document / Document
title
Prevalence
and sociodemographic correlates of Alexithymia in a population
sample of young adults
Auteur(s) / Author(s)
KOKKONEN Pirkko
; KARVONEN Juha T. ; VEIJOLA Juha ; LÄKSY Kristian
; JOKELAINEN Jari ; JÄRVELIN Marjo-Riitta ;
JOUKAMAA Matti ;
Affiliation(s) du ou des
auteurs / Author(s) Affiliation(s)
Department
of Psychiatry, Oulu University Hospital, Oulu, FINLANDE
Department of Public Health, University of Oulu, Department
of Epidemiology and Public Health, Oulu, FINLANDE
Imperial College School of Medicine, London, ROYAUME-UNI
Résumé / Abstract
We
examined the prevalence of alexithymia and its associations
with sociodemographic factors in a population cohort.
The study forms part of the Northern Finland 1966 Birth
Cohort. The original material consisted of all 12,058
live-born children in the provinces of Lapland and Oulu
in Finland with an expected delivery date during 1966.
The material represents 96% of all births in the region.
In 1997, a 31-year follow-up study was conducted on a
part of the initial sample. The 20-item version of the
Toronto Alexithymia Scale (TAS-20) was given to 5,993
subjects; 84% returned the questionnaire properly answered.
It is known that alexithymia is associated with psychological
distress. This was measured with the 25-item version
of the Hopkins Symptom Check List (HSCL-25). The prevalence
of alexithymia (TAS-20 score > 60) was 9.4% in male
and 5.2% in female subjects. Alexithymia was associated
with poor education and low income level and it was more
common among unmarried subjects. After adjusting for
psychological distress, these associations remained statistically
significant. The prevalence of alexithymia was higher
in men than in women and alexithymia was associated with
poor social situation. As far as we know, this was the
first study to assess the prevalence of alexithymia and
its associations with sociodemographic factors in a large
and representative cohort sample, adjusted for psychological
distress.
Revue / Journal Title
Comprehensive
psychiatry (Compr. psych.) ISSN 0010-440X
CODEN COPYAV
Source / Source
2001, vol. 42, no6, pp. 471-476 (23
ref.)
Titre du document / Document
title
The
prevalence of alexithymia in primary care patients
Auteur(s) / Author(s)
POSSE M.
(1) ; HÄLLSTRÖM T. (1) ;
Affiliation(s) du ou des
auteurs / Author(s) Affiliation(s)
(1) Department of Clinical Neuroscience and Family Medicine, Section
of Psychiatry, Karolinska Institutet at Huddinge Hospital, Huddinge, SUEDE
Résumé / Abstract
The
aim of this study was to describe how the scores of the
test designed to measure alexithymia were distributed
in this primary care outpatient population. We also wanted
to examine the relationship of alexithymia to sociodemographic
variables and personality traits. 450 consecutive patients
at the Primary Health Care Centre; were asked to voluntarily
complete an inventory consisting of several scales designed
to test alexithymia and somatisation as well as general
personality traits. The prevalence of alexithymia as
measured using the Schalling Sifneos Personality Scale
(SSPS) was 20.0% ( men 28%, women 12%). Alexithymia
was significantly associated with higher age, having a
lower educational background, living alone but having
more children. The personality traits associated with
SSPS scores were Suspicion and Distance. High grade SSPS
scores were also associated with high scores on Somatic
Anxiety, Psychastenia, and Irritability and with low scores
for socialisation (p<0.01). The conclusions reached
regarding prevalence rate, age, sex and education are
consistent with other findings. When data was analyzed
as continuous variables, high grade scores for alexithymia
became significantly associated with Somatic Anxiety,
Psychastenia, Irritability as well as low grade reability
to socialise.
Revue / Journal Title
The
European journal of psychiatry (Eur. j. psychiatry)
ISSN 0213-6163 CODEN EJOPEO
Source / Source
1999, vol. 13, no1, pp. 5-11 (25
ref.)
The assessment and prevalence of alexithymia
Alexithymia
(which literally translates as 'without words for emotion')
is a construct used to encompass a constellation of features,
including having difficulty identifying emotions within
oneself, difficulty expressing one's emotions verbally,
and using a particular style of thinking which can described
as utilitarian and externally oriented. Although there
has been much debate over the last two decades about the
nature and content of the alexithymia construct, nonetheless
it is viewed by researchers in the field as valid and
as having a number of potential clinical applications
(Taylor, 2000). As
for several individual difference constructs that are
quasi-clinical, the concept and its measurement is most
usually dimensional, although prevalence is sometimes
calculated using a cut-off score. On the basis of an albeit-small
clinical sample of 39, Taylor, Bagby, and Parker (1997)
suggest a cut-off of 61 and above on the Toronto Alexithymia
Scale (TAS-20). Studies of alexithymia using a cut-off
on the earlier 26-item TAS have reported rates of 17.1%
in France (Loas, Fremaux, Otmani, & Verrier,
1995), and 18.8% in Canada
(Parker, Taylor, & Bagby, 1989).
In Finland, one study using the TAS-20 has resulted
in rates of 13% (Salminen, Saarijarvi, Aarela, Toikka,
& Kauhanen, 1999), while another
study reported rates of 9.4% in males and 5.2% in
females in a very large-scale cohort (Kokkonen et al., 2001).
However, the cultural appropriateness of retaining a particular
psychometric cut-off is unknown. Leff (1973) suggested
that there might be variation across cultures, given differing
values attached to both emotional awareness and expression
in different countries.
To
date there has been little study of alexithymia prevalence
within a British population, and there is a general dearth
of data about its nature and correlates in the UK. Although
there is a range of measures that include interview schedules,
the TAS-20 was chosen as it remains the most widely used
because of its easy administration and well-developed
psychometric pedigree. This is not to claim that it necessarily
assesses all aspects of alexithymia comprehensively, as
any assessment based on self-report probably suffers where
insight into one's own psychological processes may be
lacking.
In
addition to putative cultural differences, Blanchard, Arena, and Pallmeyer (1981)
have proposed that there may be gender differences in
alexithymia, following an earlier investigation in which
the levels of alexithymia in males were found to be much
higher than in females. This study did not use a reliable
or valid measure of alexithymia and later studies have
not unequivocally supported the notion of gender differences
(Parker, Taylor, & Bagby, 1989;
Elzinga, Bermond, & Dyck, 2002).
Kokkonen et al. (2001) found that males exceeded
females by around 4%. Most recently, Parker et al. (2003)
found that while males scored more highly, the difference
was a trivial one. Potential gender differences in an
undergraduate UK sample are unknown and therefore difficult
to hypothesize about.
Prevalence
studies to date have sampled both the general and undergraduate
populations. Where the latter have been used, no attempt
has been made to divide participants according to their
subject of study, the common assumption being that undergraduates
constitute a homogeneous group. However, previous research
has indicated that students studying arts and science
subjects differ with respect to personality variables
that may be likely to be linked to alexithymia. Hudson (1966), for
example, following a series of studies of boys in British
secondary schools, noted a tendency among science students
to concentrate 'upon the impersonal aspects of [their]
culture, both in school and out' (p. 84). He goes on to
comment that 'at some stage of his life [the science student]
seems to have turned his back on the sphere of personal
relations, and focused all his attention on areas
where people and personal emotions are least likely to
obtrude' (p. 85). The arts student on the other hand was
found to appear drawn 'towards the human aspects of his
culture' and to 'enjoy expressing his feelings about matters
that are personal' (pp. 90-91). In later investigations,
Butcher (1969) and
Bamber, Bill, Boyd, and Corbett (1983)
showed that science students scored significantly higher
than their arts counterparts on Eysenck's psychoticism
scale, a dimension which may have a diminished capacity
for empathy in common with alexithymia. For these
reasons, the present study chose to record degree subject
and to recruit from a wide range of disciplines.
Prevalence rates of alexithymia
Overall,
17.92% were identified as alexithymic in
the sample (defined by the recommended cut-off rate of
61 on the TAS-20). Rates of alexithymia are reported by
gender, faculty (arts or science), and gender/faculty
in Table 1.
The
gender difference in prevalence (according to cut-offs)
for females and males was statistically significant (χ2=11.85,
df=1, p<.01). |
