Alexithymia and emotional regulation: A cluster analytical approach

BMC Psychiatry, Feb 2011

Background Alexithymia has been a familiar conception of psychosomatic phenomenon. The aim of this study was to investigate whether there were subtypes of alexithymia associating with different traits of emotional expression and regulation among a group of healthy college students. Methods 1788 healthy college students were administered with the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and another set of questionnaires assessing emotion status and regulation. A hierarchical cluster analysis was conducted on the three factor scores of the TAS-20. The cluster solution was cross-validated by the corresponding emotional regulation. Results The results indicated there were four subtypes of alexithymia, namely extrovert-high alexithymia (EHA), general-high alexithymia (GHA), introvert-high alexithymia (IHA) and non-alexithymia (NA). The GHA was characterized by general high scores on all three factors, the IHA was characterized by high scores on difficulty identifying feelings and difficulty describing feelings but low score on externally oriented cognitive style of thinking, the EHA was characterized by high score on externally oriented cognitive style of thinking but normal score on the others, and the NA got low score on all factors. The GHA and IHA were dominant by suppressive character of emotional regulation and expression with worse emotion status as compared to the EHA and NA. Conclusions The current findings suggest there were four subtypes of alexithymia characterized by different emotional regulation manifestations.

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Alexithymia and emotional regulation: A cluster analytical approach

Jie Chen 0 Ting Xu 0 Jin Jing Raymond CK Chan 0 0 Neuropsychology and Applied Cognitive Neuroscience Laboratory; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences , Beijing , PR China Background: Alexithymia has been a familiar conception of psychosomatic phenomenon. The aim of this study was to investigate whether there were subtypes of alexithymia associating with different traits of emotional expression and regulation among a group of healthy college students. Methods: 1788 healthy college students were administered with the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and another set of questionnaires assessing emotion status and regulation. A hierarchical cluster analysis was conducted on the three factor scores of the TAS-20. The cluster solution was cross-validated by the corresponding emotional regulation. Results: The results indicated there were four subtypes of alexithymia, namely extrovert-high alexithymia (EHA), general-high alexithymia (GHA), introvert-high alexithymia (IHA) and non-alexithymia (NA). The GHA was characterized by general high scores on all three factors, the IHA was characterized by high scores on difficulty identifying feelings and difficulty describing feelings but low score on externally oriented cognitive style of thinking, the EHA was characterized by high score on externally oriented cognitive style of thinking but normal score on the others, and the NA got low score on all factors. The GHA and IHA were dominant by suppressive character of emotional regulation and expression with worse emotion status as compared to the EHA and NA. Conclusions: The current findings suggest there were four subtypes of alexithymia characterized by different emotional regulation manifestations. - Background Alexithymia has been a familiar conception as no words for feeling in psychiatry and psychosomatic medicine since it was first termed by Sifneos [1]. Now its definition is more explicitly refined with five dominant features: (1) difficulty in identifying ones emotion; (2) difficulty in describing self feelings verbally; (3) a reduction or incapability to experience emotions; (4) an absence of tendencies to image one elses emotion, or an externally oriented cognitive style; and (5) poor capacity for fantasize or symbolic thought [2]. Alexithymia refers to a specific disturbance in emotional processing, especially reduced capabilities in verbalizing and realizing emotion. Longitudinal study also suggested that alexithymia was significantly associated with the severity of depression [3], anxiety [4] and schizophrenia [5]. The prevalence rate of alexithymia is significantly higher in patients with psychosomatic disorders, such as eating disorder [6], fibromyalgia syndrome [7] and low-back pain [8], than control groups. Researchers [9,10] found alexithymia overlaps with various dimensions like external locus of control and irrational beliefs, except impulsiveness, of the FiveFactor Model (FFM) of personality in an undergraduate student sample. It has been speculated that alexithymia is a cognitive state of externally oriented thinking with an emotional instability and unsecure performance in controlling stressful situation. However, alexithymia has also been criticized whether it is an affect-deficit disorder (state-orient) or a continuous personality variable (trait-orient). Tolmunen et al. [11] considered alexithymia as a stable personality trait in general. Their 11-year follow-up study also suggested that alexithymia might increase vulnerability to depressive symptoms [11]. Honkalampi [12] further demonstrated that depressive symptom might act as a mediator between alexithymia and psychiatric morbidity. Parker and Mattila used taxometric analysis to synthesize several studies about alexithymia in large sample pools including general population and psychotic patients [11,12]. These findings suggest that aleixhtymia is not a discrete affect deficit type of person but represents the lower tail of an emotion processing ability that is continuously distributed in the general population [11]. The purpose of this study was to examine whether there might be subtypes of alexithymia characterized by different behavioural manifestations. In so doing, the current study adopted a cluster analytical approach to examine whether there were natural grouping of people characterized by different psychological features associating with alexithymia. Cluster analysis is a statistical procedure for determining cases can be placed into groups if they share properties in common, while the cases in different clusters are as dissimilar as possible. It was hypothesized that there were various subtypes of alexithymia characterized by different psychological features associating with alexithymia. Individuals on various level of alexithymia would adopt different ways to express and regulate their emotion. The higher alexithymia groups would perform more seri (...truncated)


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Jie Chen, Ting Xu, Jin Jing, Raymond CK Chan. Alexithymia and emotional regulation: A cluster analytical approach, BMC Psychiatry, 2011, pp. 33, 11, DOI: 10.1186/1471-244X-11-33