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Alexithymia, Emotional Awareness and Perceived Dysfunctional Parental Behaviors in Heroin Dependents

  • Marco Vicente TorradoEmail author
  • Sílvia Soares Ouakinin
  • Leonor Bacelar-Nicolau
Article

Abstract

The aim of this study was to analyse alexithymia and deficits in emotional awareness, in heroin addicts, and their relationship with perceptions of early parental interactions. The sample included 99 opiate dependent outpatients and 43 healthy controls. Assessment was performed using the Toronto Alexithymia Scale, the Levels of Emotional Awareness Scale, the Inventory for Assessing Memories of Parental Rearing Behavior, the Mini-Mental State Examination and the Hospital Anxiety and Depression Scale. Findings suggest parental representations, which were mostly characterized by emotional unavailability and a rejection interaction pattern, significantly related to alexithymia. Emotional awareness was associated with the number of years of drug use and methadone level. Negative affect was associated with alexithymia but not to emotional awareness. Regression analyses emphasized the influence of perceived dysfunctional parenting behaviors in alexithymia and difficulties in identifying feelings, particularly an interaction with paternal rejection, moderated by self-reported anxiety. These results are discussed addressing comprehensive issues of emotion regulation and treatment strategies in heroin dependence.

Keywords

Alexithymia Emotional awareness Parental rearing behaviors Heroin dependence Negative affect 

References

  1. Andersson, P., & Eisemann, M. (2003). Parental rearing and individual vulnerability to drug addiction: a controlled study in a Swedish sample. Nordic Journal of Psychiatry, 57(2), 147–156.PubMedCrossRefGoogle Scholar
  2. Arrindell, W. A., Perris, C., Eisemann, M., van der Ende, J., Gazner, P., Iwawaki, S., . . . Zhang, J. (1994). Parental rearing behaviour from a crosscultural perspective: a summary of data obtained in 14 nations. In C. Perris, W. A. Arrindel & M. Eisemann (Eds.), Parenting and psychopathology (pp. 145–171). Chichester: Wiley.Google Scholar
  3. Arrindell, W. A., Sanavio, E., Aguilar, G., Sica, C., Hatzichristou, C., Eisemann, M., . . . van der Ende, J. (1999). The development of a short form of the EMBU: its appraisal with students in Greece, Guatemala, Hungary and Italy. Personality and Individual Differences, 27(4), 613–628.Google Scholar
  4. Arrindell, W. A., Richter, J., Eisemann, M., Garling, T., Rydén, O., Hansson, S., . . . Gustafsson, M. (2001). The short-EMBU in East-Germany and Sweden: a cross-national factorial validity extension. Scandinavian Journal of Psychology, 42(2), 157160.Google Scholar
  5. Bermond, B., Vorst, H. C., & Moorman, P. (2006). Cognitive neuropsychology of alexithymia: implications for personality typology. Cognitive Neuropsychiatry, 11(3), 332–360.PubMedCrossRefGoogle Scholar
  6. Blatt, A. J., Wein, S. J., Chevron, E., & Quinlan, D. M. (1979). Parental representations and depression in normal young adults. Journal of Abnormal Psychology, 88, 388–397.PubMedCrossRefGoogle Scholar
  7. Canavarro, M. C. (1996). A avaliação das práticas educativas através do EMBU: estudos psicométricos. Psychologica, 16, 5–18.Google Scholar
  8. Carton, S., Bayard, S., Paget, V., Jouanne, C., Varescon, I., Edel, Y., et al. (2010). Emotional awareness in substance-dependent patients. Journal of Clinical Psychology, 66(6), 599–610.PubMedGoogle Scholar
  9. Cleland, C., Magura, S., Foote, J., Rosenblum, A., & Kosanke, N. (2005). Psychometric properties of the Toronto Alexithymia Scale (TAS-20) for substance users. Journal of Psychosomatic Research, 58, 299–306.PubMedCrossRefGoogle Scholar
  10. Gerlsma, C., Kramer, J. J., Scholing, A., & Emmelkamp, P. M. (1994). The influence of mood on memories of parental rearing practices. British Journal of Clinical Psychology, 33(2), 159–172.PubMedCrossRefGoogle Scholar
  11. Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In J. Gross (Ed.), Handbook of emotion regulation. New York: Guilford Press.Google Scholar
  12. Guerreiro, M. M. G. (1998). Contributo da neuropsicologia para o estudo das demências. Lisboa: Faculdade de Medicina de Lisboa.Google Scholar
  13. Hovdestad, W. E., Tonmyr, L., Wekerle, C., & Thornton, T. (2011). Why is childhood maltreatment associated with adolescent substance abuse? a critical review of explanatory models. International Journal of Mental Health and Addiction, 9(5), 525–542.CrossRefGoogle Scholar
  14. Jouanne, C., Edel, Y., & Carton, S. (2005). Déficits émotionnels chez des patients polytoxicomanes. Annales Médico-Psychologiques, 8, 625–630.CrossRefGoogle Scholar
  15. Jurich, A. P., Polson, C. J., Jurich, J. A., & Bates, R. A. (1985). Family factors in the lives of drug users and abusers. Adolescence, 77, 143–159.Google Scholar
  16. Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. The American Journal of Psychiatry, 142, 1259–1264.PubMedGoogle Scholar
  17. Krystal, H. (1979). Alexithymia and psychotherapy. American Journal of Psychotherapy, 33(1), 17–31.PubMedGoogle Scholar
  18. Krystal, H., & Raskin, H. A. (1970). Drug dependence aspects of ego function. Detroit: Wayne State University Press.Google Scholar
  19. Lane, R. (2000). Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosomatic Medicine, 62, 492–501.PubMedGoogle Scholar
  20. Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A., & Zeitlin, S. B. (1990). The levels of emotional awareness scale: a cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124–134.PubMedGoogle Scholar
  21. Lane, R., Kivley, L. S., DuBois, M. A., Shamasundara, P., & Schwartz, G. (1995). Levels of emotional awareness and the degree of right hemispheric dominance in the perception of facial emotion. Neuropsychologia, 33, 525–538.PubMedCrossRefGoogle Scholar
  22. Lane, R., Sechrest, L., Weldon, V., Kasniak, A., & Schwartz, G. (1996). Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosomatic Medicine, 58, 203–210.PubMedGoogle Scholar
  23. Lane, R. D., Sechrest, L., & Riedel, R. (1998). Sociodemographic correlates of alexithymia. Comprehensive Psychiatry, 39(6), 377–385.PubMedCrossRefGoogle Scholar
  24. Lumley, M. (2000). Alexithymia and negative emotional conditions. Journal of Psychosomatic Research, 49, 51–54.PubMedCrossRefGoogle Scholar
  25. Lumley, M. A., Neely, L. C., & Burger, A. J. (2007). The assessment of alexithymia in medical settings: implications for understanding and treating health problems. Journal of Personality Assessment, 89(3), 230–246.PubMedCrossRefGoogle Scholar
  26. McDougall, J. (1984). The ‘disaffected’ patient: reflections on affect pathology. Psychoanalytic Quarterly, 53, 386–409.PubMedGoogle Scholar
  27. Measelle, J., Stice, E., & Springer, D. (2006). A prospective test of the negative affect model of substance use and abuse: moderating effects of social support. Psychology of Addictive Behaviors, 20(3), 225–233.PubMedCrossRefGoogle Scholar
  28. Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the hospital anxiety and depression scale. Psychology, Health & Medicine, 12(2), 225–237.CrossRefGoogle Scholar
  29. Paivio, S., & Laurent, C. (2001). Empathy and emotion regulation: reprocessing memories of childhood abuse. Journal of Clinical Psychology, 57(2), 213–226.PubMedCrossRefGoogle Scholar
  30. Perris, C., Jacobson, L., Lindström, H., von Knorring, L., & Perris, H. (1980). Development of a new inventory assessing memories of parental rearing behaviour. Acta Psychiatrica Scandinavica, 61(4), 265–274.PubMedCrossRefGoogle Scholar
  31. Prazeres, N., Parker, D., & Taylor, J. (2000). Adaptação Portuguesa da Escala de Alexitimia de Toronto de 20 Itens (TAS-20). Revista iberoamericana de diagnóstico y evaluación psicológica, 9, 9–21.Google Scholar
  32. Richter, J., & Eisemann, M. (2000). Stability of memories of parental rearing among psychiatric inpatients. Clinical Psychology & Psychotherapy, 7, 256–261.CrossRefGoogle Scholar
  33. Snaith, R. P. (2003). The hospital anxiety and depression scale. Health and Quality of Life Outcomes. Retrieved from http://www.hqlo.com/content/1/1/29.
  34. Subic-Wrana, C., Bruder, S., Thomas, W., Lane, R., & Kohle, K. (2005). Emotional awareness deficits in inpatients of a psychosomatic ward: a comparison of two measures of alexithymia. Psychosomatic Medicine, 67, 483–489.PubMedCrossRefGoogle Scholar
  35. Taylor, G. J., & Bagby, R. M. (2004). New trends in alexithymia research. Psychotherapy and Psychosomatics, 73, 68–77.PubMedCrossRefGoogle Scholar
  36. Taylor, G. J., Bagby, R. M., & Parker, J. (1997). Disorders of affect regulation, alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  37. Taylor, J., Lloyd, D. A., & Warheit, G. J. (2005). Self-derogation, peer factors, and drug dependence among a multiethnic sample of young adults. Journal of Child & Adolescent Substance Abuse, 15, 39–51.CrossRefGoogle Scholar
  38. Thorberg, F. A., Young, R. M., Sullivan, K. A., & Lyvers, M. (2011). Parental bonding and alexithymia: a meta-analysis. European Psychiatry, 26(3), 187–193.PubMedCrossRefGoogle Scholar
  39. Torrado, M., & Ouakinin, S. (2008). Identidade e Toxicodependência no Masculino: relação paterna, auto-conceito e identidade de género. Toxicodependências, 14(1), 57–72.Google Scholar
  40. Torrado, M., & Ouakinin, S. (2011). Alexithymia, emotional experience organization and parental rearing memories in opiates addiction: a comparative study. 21st World Congress on Psychosomatic Medicine–New Vision for Psychosomatic Medicine: Beyond Science and Borders, Abstract Book. Seoul.Google Scholar
  41. Torresani, S., Favaretto, E., & Zimmerman, C. (2000). Parental representations in drug-dependent patients and their parents. Comprehensive Psychiatry, 41(2), 123–129.PubMedCrossRefGoogle Scholar
  42. van der Kolk, B. A., & Fisler, R. E. (1994). Childhood abuse and neglect and loss of self-regulation. Bulletin of the Menninger Clinic, 58(2), 145–168.PubMedGoogle Scholar
  43. Vanheule, S. (2007a). Alexithymia and interpersonal problems. Journal of Clinical Psychology, 63(1), 109–117.PubMedCrossRefGoogle Scholar
  44. Vanheule, S. (2007b). Challenges for alexithymia research: a commentary on “the construct of alexithymia: associations with defense mechanisms”. Journal of Clinical Psychology, 64(3), 332–337.CrossRefGoogle Scholar
  45. Wearden, A., Lamberton, N., Crook, N., & Walsh, V. (2005). Adult attachment, alexithymia, and symptom reporting: an extension to the four category model of attachment. Journal of Psychosomatic Research, 58, 279–288.PubMedCrossRefGoogle Scholar
  46. Ziolkowski, M., Gruss, T., & Rybakowski, J. K. (1995). Does alexithymia in male alcoholics constitute a negative factor for maintaining abstinence? Psychotherapy and Psychosomatics, 63, 169–173.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marco Vicente Torrado
    • 1
    Email author
  • Sílvia Soares Ouakinin
    • 1
  • Leonor Bacelar-Nicolau
    • 2
  1. 1.Department of Medical Psychology, University Clinic of Psychiatry - Faculty of MedicineUniversity of LisbonLisbonPortugal
  2. 2.Institute of Preventive Medicine, Faculty of MedicineUniversity of LisbonLisbonPortugal

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