Skip to main content
Log in

Alexithymia in female patients with eating disorders

  • Original Research Paper
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Previous studies indicate that patients with eating disorders have alexithymic characteristics, as revealed by the Toronto Alexithymia Scale (TAS). The aim of the present study was to investigate the role of negative affect (anxiety and depression) in the relationship between eating disorders and alexithymia. In addition, we have evaluated whether the relationship between negative affect and alexithymia varies according to the type of eating disorder (anorexia and bulimia). Eighteen female patients and 16 female patients who met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria for restrictive anorexia nervosa and bulimia nervosa, respectively, and 18 healthy female controls matched by age and education were submitted to Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory to assess depression and anxiety and the Toronto Alexithymia Scale (TAS-20) and the Bermond Vorst Alexithymia Questionnaire (BVAQ) to evaluate alexithymic characteristics. The findings indicated that, although anorexic and bulimic patients showed higher alexithymia scores compared to controls, this result could be mainly related to negative affect. In fact, taking negative affect into account, anorexic and bulimic patients did not show higher TAS-20 and BVAQ scores compared to controls. The only variable useful to discriminate among anorexics, bulimics and controls is the perceived inability to experience emotional feelings, which is higher in anorexic patients compared to the other two groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Taylor G.J.: Eating disorders. In: Taylor G.J., Bagby R.M., Parker J.D.A. (Eds.), Disorders of affect regulation. Alexithymia in medical and psychiatric illness. Cambridge University Press, 1997, pp. 190–215.

    Chapter  Google Scholar 

  2. Frawley W., Smith R.: A processing theory of alexithymia. J. Cognitive Systems Res., 2, 189–206, 2001.

    Article  Google Scholar 

  3. De Panfilis C., Rabbaglio P., Rossi C., Zita G., Maggini C.: Body image disturbance, parental bonding and alexithymia in patients with eating disorders. Psychopathology, 36, 239 246, 2003.

    Google Scholar 

  4. Bruch H.: Eating disorders. Obesity, anorexia nervosa, and the person within. New York, Basic Books, 1973.

    Google Scholar 

  5. Bruch H.: Four decades of eating disorders. In: Garner D.M., Garfinkel P.E., (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia. New York, Guilford Press, 1985, pp. 7–18.

    Google Scholar 

  6. Andersen A.E.: Anorexia nervosa and bulimia: A spectrum of eating disorders. J. Adolesc. Health Care, 4, 15–21, 1988.

    Article  Google Scholar 

  7. Davis M.S., Marsh L.: Self-love, self-control and alexithymia: Narcissistic features of two bulimic adolescents. Am. J. Psychotherapy, 40, 224–232, 1986.

    CAS  Google Scholar 

  8. Beales D.L., Dolton R.: Eating disordered patients: personality, alexithymia, and implications for primary care. Br. J. Gen. Pract., 50, 21–26, 2000.

    PubMed  CAS  Google Scholar 

  9. Bourke M.P., Taylor G.J., Parker J.D.A., Bagby R.M.: Alexithymia in women with anorexia nervosa: a preliminary investigation. Br. J. Psychiatry, 161, 240–243, 1992.

    Article  PubMed  CAS  Google Scholar 

  10. Taylor G.J., Parker J.D.A., Bagby R.M., Bourke M.P.: Relationships between alexithymia and psychological characteristics associated with eating disorders. J. Psychosom. Res., 41, 561–568, 1996.

    Article  PubMed  CAS  Google Scholar 

  11. Jimerson D.C., Wolfe B.E, Franko D.L., Covino N.A., Sifneos P.E.: Alexithymia ratings in bulimia nervosa: clinical correlates. Psychosom. Med., 56, 90–93, 1994.

    PubMed  CAS  Google Scholar 

  12. Schmidt U., Jiwany A., Treasure J.A.: Controlled study of alexithymia in eating disorders. Compr. Psychiatr., 34, 54–58, 1993.

    Article  CAS  Google Scholar 

  13. Cochrane C.E., Brewerton T.D., Wilson D.B., Hodges E.L: Alexithymia in eating disorders. Int. J. Eat. Disord., 14, 219–222, 1993.

    Article  PubMed  CAS  Google Scholar 

  14. Troop N.A., Schmidt U.H., Treasure J.L.: Feelings and fantasy in eating disorders: A factor analysis of the Toronto Alexithymia Scale. Int. J. Eat. Disord., 18, 151–157, 1995.

    Article  PubMed  CAS  Google Scholar 

  15. Parker J.D.A., Bagby R.M., Taylor G.J.: Alexithymia and depression: distinct or overlapping constructs? Compr. Psychiatry, 32, 387–394, 1991.

    Article  PubMed  CAS  Google Scholar 

  16. Rief W., Heuser J., Fichter M.M.: What does the Toronto Alexithymia Scale TAS-R measure? J. Clin. Psychol., 52, 423–429, 1996.

    Article  PubMed  CAS  Google Scholar 

  17. Zonnevy-Bender M.J., van Goozen S.H., Cohen- Kettenis P.T., van Elburg T.A., van Engeland H.: Emotional functioning in adolescent anorexia nervosa patients-a controlled study. Eur. Child Adolesc. Psychiatry, 13, 28–34, 2004.

    Article  Google Scholar 

  18. Hendryx M.S., Haviland M.G., Shaw D.G.: Dimensions of alexithymia and their relationship to anxiety and depression. J. Person. Assess., 56, 227–237, 1991.

    Article  CAS  Google Scholar 

  19. Honkalampi K., Hintikka J., Saarinen P., Lehtonen J., Viinamaki H.: Is alexithymia a permanent feature in depressed patients? Results from a 6-month followup study. Psychother. Psychosom., 69, 303–308, 2000.

    CAS  Google Scholar 

  20. Kirmayer L.J., Robbins J.M.: Cognitive and social correlates of the Toronto Alexithymia Scale. Psychosomatics, 34, 41–52, 1993.

    Article  PubMed  CAS  Google Scholar 

  21. Bach M., Bach D., de Zwaan M., Serim M., Bohmer F.: Validierung der deutschen Version der 20-Item Toronto-Alexithymic-Skala bei Normalpersonen und psychiatrischen Patienten. Psychother. Psychosom. Med. Psychol., 146, 23–28, 1996.

    Google Scholar 

  22. Haviland M.G., Shaw D.G., Cummings M.A., MacMurray J.P.: Alexithymia: subscales and relationship to depression. Psychother. Psychosom., 50, 164–173, 1988.

    Article  PubMed  CAS  Google Scholar 

  23. Wise T.N., Mann L.S., Mitchell J.D., Hryvniak M., Hill B.: Secondary alexithymia: an empirical validation. Compr. Psychiatry, 31, 284–288, 1990.

    Article  PubMed  CAS  Google Scholar 

  24. Braun D.L., Sunday S.R., Halmi K.A.: Psychiatric comorbidity in patients with eating disorders. Psychol. Med., 24, 859–867, 1994.

    Article  PubMed  CAS  Google Scholar 

  25. Brewerton T.D., Lydiard R.B., Herzog D.B., Brotman A.W., O’Neil P.M., Ballenger J.C.: Comorbidity of axis I psychiatric disorders in bulimia nervosa. J. Clin. Psychiatr., 56, 77–80, 1995.

    CAS  Google Scholar 

  26. Geist R., Davis R., Heinmaa M.: Binge/purge symptoms and comorbidity in adolescents with eating disorders. Can. J. Psychiatry, 43, 507–512, 1998.

    PubMed  CAS  Google Scholar 

  27. Herzog D.B., Keller M.B., Sacks N.R., Yeh C.J., Lavori P.W.: Psychiatric comorbidity in treatment-seeking anorexics and bulimics. J. Am. Acad. Child Adolesc. Psychiatry, 31, 810–818, 1992.

    Article  PubMed  CAS  Google Scholar 

  28. Guilbaud O., Corsos M., Chambry J., Paterniti S., Loas G., Jeammet P.: Alexithymia and depression in eating disorders. Encephale, 26, 1–6, 2000.

    PubMed  CAS  Google Scholar 

  29. Corcos M., Guillbaud O., Speranza M., Paternità S., Loas G., Stephen P., Jeammet P.: Alexithymia and depression in eating disorders. Psychiatr. Res., 93, 263–266, 2000.

    Article  CAS  Google Scholar 

  30. Larsen J.K., Brand N., Bermond B., Hijman R.: Cognitive and emotional characteristics of alexithymia A review of neurobiological studies. J. Psychosom. Res., 54, 533–541, 2003.

    Article  PubMed  Google Scholar 

  31. Vorst H.C.M., Bermond B.: Validity and reliability of the Bermond-Vorst Alexithymia Questionnaire. Person. Individ. Differ., 30, 413–434, 2001.

    Article  Google Scholar 

  32. American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders, 4th ed. (DSMIV). Washington, DC, APA Press, 1994.

    Google Scholar 

  33. Bagby R.M., Parker J.D.A., Taylor G.J.: The Twenty- Item Toronto Alexithymia Scale. J. Psychosom. Res., 38, 23–40, 1994.

    Article  PubMed  CAS  Google Scholar 

  34. Bressi C., Taylor G.J., Parker J.D.A., Bressi S., Brambilla V., Aguglia E., Allegranti I., Buongiorno A., Giberti F., Bucca M., Todarello O., Callegari C., Vender S., Gala C., Invernizzi G.: Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: an Italian multicenter study. J. Psychosom. Res., 41, 551–559, 1996.

    Article  PubMed  CAS  Google Scholar 

  35. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J.: An inventory for measuring depression. Arch. Gen. Psychiatry, 4, 561–571, 1961.

    Article  PubMed  CAS  Google Scholar 

  36. Pedrabissi L., Santinello M.: STAI, State-Trait Anxiety Inventory, Forma Y. In: Pedrabissi L., Santinello M. (Eds), Manuale di C.D. Spielberg. Firenze, Organizzazioni Speciali, 1996.

    Google Scholar 

  37. Spielberger C.D., Gorsuch R.L., Lushene R.E.: Manual for the State-Trait Anxiety Inventory. Palo Alto, CA, Consulting Psychologist Press, 1960.

    Google Scholar 

  38. Ricci Bitti P.E., Codispoti M.: Alexithymia hedonic capacity and dysphoria. The (non) expression of emotion. In: Vingerhoets A.J.J.M., van Bussel F.J.J. (Eds.), Health and disease (Tilburg, 9–11 June). Tilburg, Bohelhouwer Faculteit Sociale Wetenschappen, Catholieke Universiteit Brabant, 2002, pp. 32–34.

    Google Scholar 

  39. De Groot J.M., Rodin G., Olmsted M.P.: Alexithymia, depression, and treatment outcome in bulimia nervosa. Compr. Psychiatry, 36, 53–60, 1995.

    Article  PubMed  Google Scholar 

  40. Petterson R.: Nameless destre: alexithymia and the anorexic patient. Am. J. Psychoanal., 64, 77–90, 2004.

    Article  PubMed  Google Scholar 

  41. Eizaguirre A.E., Saenz de Cabezon A.O., Ochoa de Alda I., Olariaga L.J., Juaniz M.: Alexithymia and its relationships with anxiety and depression in eating disorders. Perons. Individ. Differ., 36, 321–331, 2004.

    Article  Google Scholar 

  42. Sexton M.C., Sunday S.R., Hurt S., Halmi K.A.: The relationship between alexithymia, depression, and axis II psychopathology in eating disorder inpatients. Int. J. Eat. Disord., 23, 277–286, 1998.

    Article  PubMed  CAS  Google Scholar 

  43. Mitchell K.S., Mazzeo S.E.: Binge eating and psychological distress in ethically diverse undergraduate men and women. Eating Disord., 157–169, 2004.

    Google Scholar 

  44. Algina J., Olejnik S.: Conducting power analyses for ANOVA and ANCOVA in between-subjects designs. Eval. Health Prof., 26, 288–314, 2003.

    Article  PubMed  Google Scholar 

  45. Larsen R.J.: Theory and measurement of affect intensity as an individual difference characteristics. Dissert Abst Intern 85:2298B (University Microfilms No. 84 22112), 1984.

    Google Scholar 

  46. Larsen R.J., Billings D.W., Cutler S.E.: Affect intensity and individual differences in informational style. J. Person., 64, 185–207, 1996.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ornella Montebarocci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montebarocci, O., Codispoti, M., Surcinelli, P. et al. Alexithymia in female patients with eating disorders. Eat Weight Disord 11, 14–21 (2006). https://doi.org/10.1007/BF03327739

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03327739

Key words

Navigation