Abstract
One aim of this study was to examine the strength of association between posttraumatic stress disorder (PTSD) and alexithymia relative to other psychiatric disorders in a sample of 252 treatment-seeking psychiatric patients. The other aim of this study was to explore which type of childhood trauma was associated with a greater level of adult alexithymia. The study found that PTSD and borderline personality disorder (BPD) were the two disorders among selected psychiatric disorders to contribute independently to a higher degree of alexithymia. Another finding was that a greater severity of emotional neglect and physical neglect, rather than abuse, was significantly related to higher levels of alexithymia. In addition, the study found that among these variables, BPD had the strongest relationship to alexithymia.
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References
Bach, M., de Zwaan, M., Ackard, D., Nutzinger, D. O., & Mitchell, J. E. (1994). Alexithymia: Relationship to personality disorders. Comprehensive Psychiatry, 35, 239–243.
Bernstein, D. P., Fink, L., Handelman, L., Foote, J., Lovejoy, M., & Wenzel, K. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132–1136.
First, M. B., Gibbon, M., Spitzer, R. I., Williams, J. B., & Benjamin, L. (1997). User's guide for the Structured Clinical Interview for DSM-IV Axis II personality disorders. American Psychiatry Press.
Gross, J. J., & Munoz, R. F. (1995). Emotional regulation and mental health. Clinical Psychology: Science and Practice, 2, 151–164.
Grotstein, J. S. (1986). The psychology of powerlessness: Disorders of self-regulation and interactional regulation as a newer paradigm for psychopathology. Psychoanalytic Inquiry, 6, 93–118.
Gunderson, J. G., & Sabo, A. N. (1993). The phenomenology and conceptual interface between borderline personality disorder and PTSD. American Journal of Psychiatry, 150, 19–27.
Herman, J. L., Perry, I. C., & van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490–495.
Hyer, L., Woods, G., Summers, M. N., Boudewyns, P., & Harrison, W. R. (1990). Alexithymia among Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 51, 243–246.
Kauhanen, J., Kaplan, J., Julkunen, J., Wilson, T. W., & Salonen, J. T. (1993). Social factors in alexithymia. Comprehensive Psychiatry, 34, 330–335.
Krystal, H. (1982). Alexithymia on the effectiveness of psychoanalytic treatment. International Journal of Psychotherapy, 33, 353–388.
Krystal, H. (1988). Integration and self healing: Affect, trauma, alexithymia. Hillsdale NJ: Analytic press.
Krystal, J. H., Giller, E. L., & Cicchetti, D. V. (1986). Assessment of alexithymia in posttraumatic stress disorder and somatic illness: Introduction of a reliable measure. Psychosomatic Medicine, 48, 84–94.
Kudler, H. S. (1993). Borderline personality disorder and PTSD [Letter to the Editor]. American Journal of Psychiatry, 150, 1906.
Lane, R. D., Seechrest, L., & Riedel, R. (1998). Sociodemographic correlates of alexithymia. Comprehensive Psychiatry, 39, 377–385.
Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York: The Guilford Press.
Linehan, M. M., & Kehrer, C. A. (1993). Borderline personality disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders (2nd ed., pp. 396–441). New York: Guilford Press, 396–441.
Pfohl, B., Blum, N., & Zimmerman, M. (1997). Structured interview for DSM-IV personality. Washington, DC: American Psychiatric press.
Stern, D. N. (1985). The interpersonal world of the infant. New York: Basic Books.
Stone, A. M. (1993). Trauma and affect: Applying the language of affect theory to the phenomenon of traumatic stress. Psychiatric Annals, 23, 567–584.
Swartz, M., Blazer, D., George, L., & Winfield, I. (1990). Estimating the prevalence of borderline personality disorder in the community. Journal of Personality Disorders, 4, 257–272.
Taylor, G. I. (1984). Alexithymia: Concept, measurement and implications for treatment. American Journal of Psychiatry, 141, 725–732.
Taylor, G. I. (1995). Psychoanalysis and empirical research: The example of patients who lack psychological mindedness. Journal of American Academy of Psychoanalysis, 23, 263–281.
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1997). Disorders of affect regulation. Alexithymia in medical and psychiatric illness. Cambridge, UK: Cambridge University Press.
Taylor, G. J., Bagby, R. M., Ryan, D. P., Parker, J. D. A., Doody, K. F., & Keefe, P. (1988). Criterion validity of the Toronto Alexithymia Scale. Psychosomatic Medicinex, 50, 500–509.
van der Kolk, B. A., & Fisler, R. E. (1994). Child abuse and neglect and loss of self-regulation. Bulletin of the Menninger Clinic, 58, 145–168.
van der Kolk, B. A., Pelcovitz, D., Roth, S., Mandel, F. S., McFarlene, A., & Herman, J. L. (1996). Dissociation, somatization, and affect dysregulation: The complexity of adaptation to trauma. American Journal of Psychiatry, 153 (Festschrift Suppl.), 83–93.
Yehuda, R., Steiner, A., Kahn, B., Binder-Brynes, K., Southwick, S. M., Zemelman, S., & Giller, E. L. (1997). Alexithymia in holocaust survivors with and without PTSD. Journal of Traumatic Stress, 10, 93–100.
Zeitlin, S. B., Lane, R. D., O'Leary, D. S., & Schrift, M. J. (1989). Interhemispheric transfer deficit and alexithymia. American Journal of Psychiatry, 146, 1434–1439.
Zeitlin, S. B., McNally, R. J., & Cassiday, K. L. (1993). Alexithymia in vicitms of sexual assault: An effect of repeated traumatization? American Journal of Psychiatry, 150, 658–660.
Zimmerman, M., & Mattia, J. I. (1998). Body dysmorphic disorder in psychiatric outpatients: Recognition, prevalence, comorbidity, demographic, and clinical correlates. Comprehensive Psychiatry, 39(5), 265–270.
Zimmerman, M., & Mattia, J. I. (1999). Psychotic subtyping of major depressive disorder and posttraumatic stress disorder. Journal of Clinical Psychiatry, 60, 311–314.
Zlotnick, C. (1997). Posttraumatic stress disorder (PTSD), PTSD, comorbidity, and childhood abuse in incarcerated women. Journal of Nervous and Mental Disease, 12, 761–763.
Zlotnick, C., Shea, MT., Rosen, K., Simpson, E., Mulrenin, K., Begin, A., & Pearlstein, T. (1997). An affect-management group for survivors of sexual abuse with PTSD. Journal of Traumatic Stress, 10(3), 425–436.
Zlotnick, C., Zakrinski, A., Shea, M. T., Costello, E., Pearlstein, T., & Simpson, E. (1996). Long-term effects of sexual abuse: Support for complex post-traumatic stress disorder. Journal of Traumatic Stress Disorder, 9, 195–205.
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Zlotnick, C., Mattia, J.I. & Zimmerman, M. The Relationship Between Posttraumatic Stress Disorder, Childhood Trauma and Alexithymia in an Outpatient Sample. J Trauma Stress 14, 177–188 (2001). https://doi.org/10.1023/A:1007899918410
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DOI: https://doi.org/10.1023/A:1007899918410