Effects of Alexithymia to Stigma of Patients with Lymphedema

BACKGROUND: Secondary lymphedema is one of the common complications after malignant tumor surgery. It is a chronic and complex disease. Once lymphedema occurs, there will be discomfort such as limb swelling, pain, numbness and tension, which will eventually lead to changes in the appearance of the affected limb and will seriously affect the quality of life and require lifelong treatment and psychosocial support. This study investigated the current situation of stigma and alexithymia in patients with lymphedema, and discussed the impact of alexithymia on stigma in patients with lymphedema. AIMS: To understand the current situation of stigma and alexithymia in patients with lymphedema, and to analyze the influence of alexithymia on stigma. METHODS: 195 patients with lymphedema in a hospital were selected by convenient sampling. General information questionnaire, Toronto Alexithymia Scale and social impact scale were used to investigate respectively, to study the general situation, stigma and alexithymia of the respondents. RESULTS: The results showed that the total score of stigma in 195 patients with lymphedema was (60.36 ± 11.08), and the total score of alexithymia was (56.53 ± 8.43). Multiple linear regression analysis showed that alexithymia and family relationship were the influencing factors of stigma in patients with lymphedema. CONCLUSIONS: The patients with lymphedema have obvious stigma, and alexithymia and family relationship are the influencing factors.

Alexithymia, Psychopathology and Alcohol Misuse in Adolescence: A Population Based Study on 3556 Teenagers

Objectives: To analyze the association between alexithymia and alcohol intake during adolescence, also in relation to psychopathology, in order to identify psychological risk factors for alcohol misuse. Method: 3556 students [mean age (range) 14.5 years (11-18)] were recruited in the Padua area. Each was administered a set of three questionnaires: the Toronto Alexithymia Scale for children (TAS-20) to measure alexithymia, the Questionnaire Adolescent Saturday evening (QAS) to estimate of alcohol intake, and the Youth Self-Report (YSR 11-18) to value psychopathology. Results: Externalizing problems appeared to increase with age and with the amount of alcohol consumed, unlike internalizing problems. The prevalence of alexithymia was 18%, decreasing with age, and it was not associated with alcohol consumption, and used except in younger subjects (≤13), for whom a positive correlation was observed between alexithymia, internalizing problems and alcohol intake. Conclusions: Younger adolescents are more psycho-emotionally vulnerable (internalizing problems and alexithymia) and at a greater risk of alcohol misuse.

A Pilot Study of the Impact of Stimulant Pharmacotherapy in College Students with ADHD on Alexithymia and Psychological Mindedness

Objective: Alexithymia is increasingly recognized in a number of psychiatric disorders, but a possible relationship between alexithymia and adult attention-deficit/hyperactivity disorder (ADHD) has not been studied. It is not known if psychostimulants decrease symptoms of both ADHD and alexithymia. This relationship is examined in a small naturalistic and longitudinal study. Participants: Ten consecutive stimulant-naive college students seek assessment and treatment for ADHD during the academic year. Method: Participants completed three self-report instruments quantifying ADHD symptomatology, alexithymia, and psychological mindedness prior to initiation of stimulant pharmacotherapy and after three and six months of medication treatment without formal psychotherapy. Results: ADHD symptoms decreased significantly from baseline to three months and remained low at six months. Decreases in alexithymia and increases in psychological mindedness changed more slowly, with significant differences occurring at six months compared to baseline. Conclusions: This study suggests that stimulant pharmacotherapy in college students with ADHD decreases ADHD symptoms and alexithymia while increasing psychological mindedness. These results have implications for untreated adult ADHD patients seeking psychotherapy.

Differential Relationships among Facets of Alexithymia and BDNF- and Dopamine-Related Polymorphisms

Alexithymia refers to a cluster of emotion-related deficits such as difficulty attending to and identifying one’s feelings. Although not a diagnosable psychiatric condition, alexithymia is considered a personality risk factor for multiple pathologies, including somatoform, substance use, eating, and mood disorders. Evidence suggests heritability, but few studies have examined the influence of specific genes on alexithymic traits. Candidate genes explored thus far include those involved in modulation of brain-derived neurotrophic factor (BDNF) and dopamine, two neurotransmitters whose functions have been implicated in human emotion processing. This study investigated the relationship between the C270T polymorphism of the BDNF gene, facets of alexithymia, and possible interactions with the COMT, DAT1, and ANKK1 genes in a sample of 130 healthy adults. Given the multidimensionality of the alexithymia construct and its overlap with the related constructs of emotional intelligence and mood awareness, we used principal components analysis to derive Clarity of Emotion and Attention to Emotion as specific facets of alexithymia. Results showed that the C270T C/C genotype group had lower Clarity of Emotion scores relative to the C/T genotype group, even after covarying for COMT, DAT1, and ANKK1 genotypes. Dopamine-related genes had no association with alexithymia dimensions, nor did they interact with the C270T polymorphism to predict Clarity of Emotion. Although the molecular mechanisms by which this polymorphism influences BDNF are unknown, this study suggests a role for BDNF in modulating aspects of alexithymia. We discuss these results in the context of BDNF’s trophic effects in the nervous system.

Regional homogeneity of intrinsic brain activity related to the main alexithymia dimensions

Background Alexithymia is a multidimensional personality construct.Objective This study aims to investigate the neuronal correlates of each alexithymia dimension by examining the regional homogeneity(ReHo) of intrinsic brain activity in a resting situation.Methods From university freshmen, students with alexithymia and non-alexlthymia were recruited. Their alexithymic traits were assessed using the Toronto Alexithymia Scale-20. The ReHo was examined using a resting-state functional MRI approach.Results This study suggests significant gro叩 differences in ReHo in multiple brain regions distributed in the frontal lobe, parietal lobe, temporal lobe, occipital lobe and insular cortex. However, only the ReHo in the insula was positively associated with difficulty identifying feelings, a main dimension of alexithymia. The ReHo in the lingual gyrus,precentral gyrus and postcentral gyrus was positively associated with difficulty describing feelings in participants with alexithymia. Lastly, the ReHo in the right dorsomedial prefrontal cortex(DMPFC_R) was negatively related to the externally oriented thinking style of participants with alexithymia.Conclusion In conclusion, these results suggest that the main dimensions of alexithymia are correlated with specific brain regions' function, and the role of the insula,lingual gyrus, precentral gyrus, postcentral gyrus and DMPFC_R in the neuropathology of alexithymia should be further investigated.

青少年抑郁症述情障碍和家庭功能及其与抑郁的相关性研究

目的探索青少年抑郁症患儿述情障碍和家庭功能特征及其与抑郁的相关性。方法选取2020年12月至2023年5月于杭州市第一人民医院就诊的131例青少年抑郁症患儿作为研究组,另选取280例健康青少年作为对照组,采用儿童抑郁量表(CDI)评定抑郁严重程度、多伦多述情障碍20条目量表中文版(TAS-20)评定述情障碍、中文版儿童用家庭功能评估量表(FFAS-C)评估家庭功能。比较两组儿童的CDI、TAS-20和FFAS-C量表评分,并采用Pearson相关分析法分析研究组CDI评分与TAS-20和FFAS-C量表评分的相关性。结果研究组儿童的CDI总分及各因子分、TAS-20总分及各因子分、FFAS-C总分及各因子分明显高于对照组,差异均有统计学意义(P<0.05);研究组儿童的TAS-20和FFAS-C总分异常比例分别为88.3%和48.3%,明显高于对照组的26.1%和13.3%,差异均有统计学意义(P<0.05);经Pearson相关分析结果显示,研究组患者的抑郁症严重程度与述情障碍严重程度和家庭功能异常严重程度均呈正相关(P<0.05)。结论青少年抑郁症存在述情障碍问题和家庭功能异常,其中青少年抑郁症状与述情障碍和家庭功能相关。

社区慢性病共病老年人述情障碍与认知情绪调节策略关系的网络分析

目的:探讨社区慢性病共病老年人述情障碍与认知情绪调节策略网络中的核心节点和桥梁节点。方法:选取社区慢性病共病老年人436名,采用多伦多述情障碍量表(TAS)和认知情绪调节问卷(CERQ)进行调查。基于R语言进行网络估计、中心性及可预测性测量、准确性及稳定性验证和网络比较,以识别网络中的核心节点和桥梁节点,比较不同性别和居住地的网络结构差异。结果:CERQ灾难化维度是网络中强度最高的节点(strength=1.28),被确定为核心节点。TAS情感识别障碍维度(bridge strength=0.52)的桥梁强度最高,然后是TAS外向型思维维度(bridge strength=0.48)、CERQ自我责难维度(bridge strength=0.41),被确定为桥梁节点。网络比较测试结果显示,不同性别及居住地的慢性病共病老年人述情障碍与认知情绪调节策略网络结构差异无统计学意义(P>0.05),但网络内各节点均紧密连接。结论:慢性病共病老年人以灾难化作为主要的认知情绪调节策略,情感识别障碍、外向型思维和自我责难是其述情障碍与认知情绪调节策略连接的主要途径。

中国青少年述情障碍变迁的横断历史研究

为探讨2011-2021年我国青少年述情障碍水平的变化趋势及性别差异,检索中国知网、维普、万方、Web of Science数据库,采用横断历史研究方法,对2011-2021年的35项使用多伦多述情障碍量表(TAS)测量我国青少年述情障碍水平的研究进行总结,同时采用一般元分析的方法探讨宏观纵向角度上的青少年述情障碍水平的性别差异。结果发现:(1)近10年以来,我国青少年述情障碍与年代呈显著正相关(r=0.15,P<0.001);(2)我国青少年述情障碍水平在2011—2021年的增加量为2.43,说明相比于2011年,2021年我国青少年述情障碍整体水平上升0.24个标准差(d=0.24);(3)述情障碍性别差异的平均效果量为小效应(d=-0.02)。研究表明我国青少年述情障碍水平在这10年间呈上升趋势,但上升速率较为缓慢,青少年述情障碍水平整体上的性别差异并不明显。

语言沟通联合心理护理对躯体形式障碍患者述情障碍、情绪、治疗依从性的影响

目的观察语言沟通联合心理护理对躯体形式障碍(SD)患者述情障碍、情绪、治疗依从性的影响。方法选取2021年1月至2022年8月赣州市第三人民医院收治的76例SD患者为研究对象,采用随机数字表法分为对照组(n=38)和研究组(n=38)。对照组接受常规护理,基于此,研究组接受语言沟通联合心理护理,干预2个月。于干预前后比较两组患者述情障碍[多伦多述情障碍量表(TAS-20)]、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分,比较两组患者的依从性及满意度情况。结果干预后,两组的TAS-20、HAMA、HAMD评分均低于干预前,且研究组干预后的TAS-20、HAMA、HAMD评分均低于对照组,差异有统计学意义(P<0.05);研究组患者干预2个月的依从性高于对照组,差异有统计学意义(P<0.05);研究组患者的沟通技巧、健康教育、服务态度、基础护理、人文关怀满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论语言沟通联合心理护理应用于SD患者中,能够减轻述情障碍程度,改善患者焦虑、抑郁情绪,提高治疗依从性及患者满意度。

大学生述情障碍对抑郁的影响:孤独感和羞怯的链式中介作用

目的:探讨大学生述情障碍与抑郁之间的关系,以及孤独感和羞怯在两者之间的单独中介作用和链式中介作用。方法:使用多伦多述情障碍量表(TAS-20)、流调中心抑郁量表(SES-D)、孤独感量表(UCLA)、羞怯量表对河南省596名大学生施测。结果:①大学生述情障碍与抑郁显著正相关(r=0.600,P<0.01);述情障碍与孤独感显著正相关(r=0.507,P<0.01),述情障碍与羞怯显著正相关(r=0.520,P<0.01);抑郁与孤独感显著正相关(r=0.658,P<0.01),抑郁与羞怯显著正相关(r=0.502,P<0.01);孤独感和羞怯显著正相关(r=0.500,P<0.01);②大学生的述情障碍直接影响其抑郁(β=0.324,P<0.001),且孤独感和羞怯在二者之间的中介效应显著,中介效应量分别为32.7%、12.3%;孤独感和羞怯在大学生述情障碍与抑郁之间的链式中介作用显著,效应量为4.9%。结论:大学生的述情障碍正向影响其抑郁,且孤独感和羞怯在大学生的述情障碍与抑郁之间起单独中介作用及链式中介作用。

基于述情障碍量表评估的适应性情绪调节策略对精神分裂症康复期患者病耻感及心理状态的影响

目的:探究基于述情障碍量表评估的适应性情绪调节策略对精神分裂症康复期患者病耻感及心理状态的影响。方法:选取吉安市第三人民医院2021年1月—2023年3月收治的80例精神分裂症康复期患者作为研究对象,将80例患者按随机数字表法分为观察组(n=40)和对照组(n=40),对照组采用常规适应性情绪调节策略,观察组采用基于述情障碍量表评估的适应性情绪调节策略。比较两组患者述情障碍、病耻感、心理状态、精神状态、社会功能。结果:(1)相较于干预前,干预后两组患者述情障碍得分均有下降(P<0.05),且观察组相较于对照组均更低(P<0.05);(2)相较于干预前,干预后两组患者病耻感得分均有下降(P<0.05),且观察组相较于对照组均更低(P<0.05);(3)相较于干预前,干预后两组患者心理状态得分均有下降(P<0.05),且观察组相较于对照组更低(P<0.05);(4)相较于干预前,干预后两组患者精神状态得分均有下降(P<0.05),且观察组相较于对照组更低(P<0.05);(5)相较于干预前,干预后两组患者社会功能得分均有下降(P<0.05),且观察组相较于对照组均更低(P<0.05)。结论:相较于采用常规适应性情绪调节策略,采用基于述情障碍量表评估的适应性情绪调节策略对于精神分裂症康复期患者而言,更能改善述情障碍、心理状态及精神状态,更能减轻病耻感和提升社会功能。

中学生述情障碍及其影响因素的潜在转变

目的:运用追踪研究设计和潜在转变分析法研究中学生述情障碍潜在类别的转变特点及其影响因素。方法:以湖南省7所中学的1447名中学生为被试进行为期6个月的追踪,对数据进行潜在转变分析。结果:①中学生述情障碍可分为高述情障碍组、普通组和低述情障碍组3个类别;②高述情障碍组稳定性最弱,保持原潜在状态的概率为37.7%,普通组和低述情障碍组保持原潜在状态的概率分别是58.1%和50.7%;③高述情障碍组倾向于向普通组转变,转变概率为50.2%;④社交焦虑和性别在述情障碍类别转变中起显著作用。结论:中学生述情障碍存在高述情障碍组、普通组和低述情障碍组3个潜在类别;述情障碍转变呈现出“缓解模式”,高述情障碍组会转变到普通组和低述情障碍组;且转变方向受性别和社交焦虑影响。

述情障碍对问题性手机使用的影响:自尊和主观幸福感的序列中介作用

目的:探讨大学生述情障碍、自尊、主观幸福感和问题性手机使用之间的关系及其内在作用机制。方法:采用多伦多述情障碍量表、自尊量表、主观幸福感量表和智能手机成瘾量表简版对514名大学生施测。结果:1述情障碍、自尊、主观幸福感和问题性手机使用4个因素间存在显著相关(r=-0.25~0.54,P<0.01)。2自尊和主观幸福感在述情障碍和手机成瘾间起序列中介作用,中介效应值为0.04,占总效应的22.22%。结论:述情障碍不仅可以直接作用于大学生问题性手机使用行为,还可以通过自尊和主观幸福感对其问题性手机使用行为产生间接作用。

COPD病人心理弹性在领悟社会支持与述情障碍间的中介效应

目的:探讨慢性阻塞性肺疾病(COPD)病人心理弹性在领悟社会支持和述情障碍之间的中介作用,为减轻病人述情障碍提供有效可行的理论依据。方法:采用便利抽样法选取2022年10月—2023年3月在辽宁省锦州市锦州医科大学附属第一医院呼吸内科确诊为COPD的病人300例为研究对象,应用一般资料调查表、多伦多述情障碍量表(TAS-20)、心理弹性量表(CD-RISC)及领悟社会支持量表(PSSS)进行调查。结果:COPD病人领悟社会支持均分为(54.37±7.49)分,心理弹性均分为(53.16±9.06)分,述情障碍均分为(57.42±9.38)分。COPD病人领悟社会支持与心理弹性呈正相关(r=0.454,P<0.01);领悟社会支持与述情障碍呈负相关(r=-0.528,P<0.01);心理弹性与述情障碍呈负相关(r=-0.553,P<0.01)。COPD病人心理弹性在领悟社会支持与述情障碍间的中介作用为-0.326,占总效应的34.83%。结论:COPD病人的心理弹性在领悟社会支持和述情障碍之间起部分中介作用,提高COPD病人的领悟社会支持能力及心理弹性水平有利于降低病人述情障碍及不良情绪的发生。

Interrelation among alexithymia and negative psychology of nursing personnel and their coping style

Objective:The purpose of the current study was to discuss the interrelation among alexithy-mia and negative psychology of nursing personnel and their coping style,so as to provide a theoret-ical basis for better mental health education and psychological intervention for nursing personnel.Methods:A questionnaire survey was administered to 503 nursing personnel sampled from a hospital in Henan Province between May and June 2010 by means of survey instruments of the Toronto Alexithymia Scale-20 Items(TAS-20),the Trait Coping Style Questionnaire(TCSQ),and the General Health Questionnaire(GHQ-20).Results:(1)Alexithymia and a negative coping style had a positive correlation with negative psychology(P<0.01),while a positive coping style had a negative correlation with negative psy-chology(P<0.01).(2)The model fitting indices of coping style as intermediate variables between alexithymia and negative psychology were χ^(2)/df=1.459,RMSEA=0.030,CFI=0.995,IFI=0.995,RFI=0.966,TCI=0.989,and NEI=0.985,indicating a good model fitting.Ninety-nine percent of the total variation of negative psychology could be explained by alexithymia and coping style,of which the indirect effect affecting negative psychology by coping style accounted for 94.59%of the total.Conclusion:Alexithymia and coping style were very important factors for improvement of current mental status of the nursing personnel,especially for a change in negative coping style and selection of good coping style.

老年慢性病患者述情障碍影响因素的研究进展

老年慢性病患者普遍存在较高水平的述情障碍,对临床医护人员在科研实践和临床干预方面提出了新的挑战。述情障碍在老年慢性病患者中呈现出多系统、多疾病、高发生率和对疾病影响大等特点,对患者身心健康产生了显著的负面影响。当前研究主要集中在老年慢性病患者述情障碍的现况调查和影响因素分析上,尚缺乏针对这一群体的有效干预措施和适用于中国老年患者的本土化述情障碍测量工具。综述其起源、分类、发生机制、测量工具、发生情况及影响因素,可以揭示述情障碍在这一特定人群中的普遍性和复杂性,为临床实践提供参考依据。建议未来研究结合老年慢性病患者的患病特点,深入理解其述情障碍的发生机制,并开发适用于中国老年人的评估工具和有效干预措施。

以同感心理论为指导的心理干预对乳腺癌手术患者述情障碍及创伤后成长的影响

目的探讨以同感心理论为指导的心理干预对乳腺癌手术患者述情障碍及创伤后成长的影响。方法将210例行乳腺癌根治术患者依据入院时间顺序分为研究组和对照组,各105例。对照组给予常规干预,研究组给予以同感心理论为指导的心理干预。干预前后比较两组患者医学应对方式问卷、多伦多述情障碍量表、简体中文版创伤后成长评定量表、自测健康评定量表评分情况、患者疾病相关知识掌握度及干预满意度。结果干预后研究组患者的多伦多述情障碍量表各维度评分,医学应对方式问卷回避、屈服维度评分均低于对照组;医学应对方式问卷面对维度评分,简体中文版创伤后成长评定量表各维度评分,自测健康评定量表社会支持、角色活动与社会适应、日常生活功能、正向情绪、心理症状与负向情绪、社会资源与社会接触、认知功能、健康总体自测等维度评分均高于对照组,差异均有统计学意义,(P<0.01)。干预后研究组患者健康知识掌握度、干预满意度高于对照组(94.29%vs.85.71%、95.24%vs.87.62%,P<0.05)。结论以同感心理论为指导的心理干预应用于乳腺癌手术患者,可提高其健康知识掌握度及创伤成长水平,降低患者述情障碍程度,改善应对方式,并提高干预满意度。

Use of metaphors when treating unexplained medical symptoms

The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effective in the psychotherapy of such conditions. I provide a case history of a 45 year old woman referred to psychiatry because of extreme ‘burning’ pain in her mouth and tongue. She had been to numerous doctors, had undergone a variety of tests, had tried many medical treatments, and had been prescribed a number of different pharmaceutical agents. She had changed her diet, done her daily dental mouth exercises, drunk a lot of water, but the burning continued and interfered, with her job(she was a teacher), her friendships, and her everyday life. This made her angry and recalcitrant to therapy, but the metaphor ‘burning with rage,’ as applicable to her pain, worked to establish a good alliance that led to a decrease of symptoms. Burning Mouth Syndrome is a medically unexplained condition of complex etiology that psychotherapy alone cannot reverse. The literature bears out, however, that the use of metaphors can help to open avenues of psychological exploration that accelerate adaptation to pain and improve quality life.

职业院校学生述情障碍对手机依赖的影响:负面评价恐惧的中介和性别的调节

目的:探讨职业院校学生述情障碍、负面评价恐惧、性别和手机依赖水平之间的关系。方法:采用多伦多述情障碍量表(TAS-20)、简版负面评价恐惧量表(FNE)和手机依赖指数中文版(MPAI)对1158名职业院校学生进行调查。结果:(1)述情障碍、负面评价恐惧、性别和手机依赖水平之间存在显著相关(r=0.060~0.551;P<0.05);(2)述情障碍正向预测手机依赖(β=0.445,P<0.001),负面评价恐惧在述情障碍与手机依赖之间起中介作用(β=0.240,P<0.001);(3)性别在述情障碍和负面评价恐惧之间起调节作用,其中性别为女性时,负面评价恐惧的中介效应占比为18.2%(SE=0.015,95%CI[0.087,0.148]),性别为男性时,负面评价恐惧的中介效应占比为12.1%(SE=0.077,95%CI[0.045,0.111])。结论:述情障碍既可以直接影响职业院校学生手机依赖,又可以通过负面评价恐惧和性别调节作用来间接影响手机依赖,无论调节变量性别为男性或女性,间接效应都显著,女性青少年比男性青少年对负面消极情绪的敏感程度更高,更容易形成手机依赖。