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.

Current research on alexithymia in elderly people in nursing institutions: a scoping review

To describe and analyze the research status of alexithymia in elderly people in nursing institutions,and summarizes the existing research results and shortcomings.The literature in PubMed,CochraneLibrary,Web of Science,EBSCO,Proquest,Scopus,Sinomed,CNKI,WanFang,VIP was computer searched,and the time frame was build to October 30,2023.A total of 15 articles were included,comprising 10 in Chinese and 5 in English.Among them,14 articles were cross-sectional studies reporting the prevalence and influencing factors of communication disorders in elderly people residing in nursing homes.A total of three assessment tools were used.Additionally,three articles described preventive or intervention measures targeting alexithymia.Alexithymia has a high incidence and severity among elderly individuals in nursing institutions.Currently,there are only a few assessment tools available,and experimental studies are notably scarce.Future research should focus on enhancing the understanding of alexithymia in this population by developing and validating more comprehensive assessment tools,diversifying research methodologies,and conducting intervention studies that consider the various 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.

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-alexithymia 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 signifcant group 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 diffculty identifying feelings, a main dimension of alexithymia. The ReHo in the lingual gyrus, precentral gyrus and postcentral gyrus was？positively associated with diffculty 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 specifc 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.

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.

Relation between Interparental Conflict and Non-Suicidal Self-Injury in Adolescents:Mediating Role of Alexithymia and Moderating Role of Resilience

Background:Adolescents frequently engage in Non-Suicidal Self-Injury(NSSI),with recent trends indicating an increase in this behavior.At the same time,Chinese adolescents have a higher incidence of NSSI than Western adolescents.Therefore,it is necessary to explore the relationship between interparental conflict and NSSI among adolescents within the context of Chinese families.Methods:The research sample comprised 755 senior high school students(46.62%male;age M=16.82,SD=0.94 years)who completed the Interparental Conflict Child Perception Scale(CPIC),Adolescent Self-Injury Behavior Questionnaire(ASHS),Toronto Alexithymia Scale-20(TAS-20),and Scale of Adolescent Resilience(RSCA).Results:Findings suggest that interparental conflict is a significant positive predictor of NSSI(r=0.22,p<0.01).Alexithymia mediates the relation between interparental conflict and NSSI(effect size=0.09,95%CI[0.05,0.13]).Additionally,resilience moderates both the direct relation(β=−0.08,p<0.05)and the latter half of the mediating pathway(β=−0.08,p<0.05)in the moderated mediation model.Conclusion:This study indicates that interparental conflict have an impact on adolescents’NSSI in Chinese families,and alexithymia and resilience play important roles in the relationship.These findings offer valuable guidance for the prevention and intervention efforts targeting NSSI among adolescents in China and in similar family contexts.

焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响

目的·评估焦虑障碍患者的焦虑水平、述情障碍程度与其生活质量之间的关系。方法·选择2020年10月1日-2023年3月31日期间在上海交通大学医学院附属精神卫生中心门诊收治的焦虑障碍患者为研究对象,经排除后最终纳入患者438例;其中,广泛性焦虑障碍患者271例,惊恐障碍患者101例,社交焦虑障碍患者48例,场所恐惧症患者12例,特定恐惧症患者6例。分别采用汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表-17项(Hamilton Depression Scale-17,HAMD-17)、多伦多述情障碍量表-20项(the twenty-item Toronto Alexithymia Scale,TAS-20)、世界卫生组织生活质量测定简表(World Health Organization Quality of Life Scale-Brief Form Questionnaire,WHOQOL-BREF)评估患者的焦虑水平、抑郁水平、述情障碍程度及生活质量,并对不同亚型焦虑障碍患者的量表得分进行评估。采用Spearman相关系数对焦虑障碍患者的焦虑水平、抑郁水平、述情障碍程度与生活质量进行相关分析,并使用逐步回归模型探索影响焦虑障碍患者生活质量的关键变量。结果·不同亚型焦虑障碍患者在HAMA评分、HAMD-17评分、TAS-20评分间的差异无统计学意义,但在WHOQOL-BRIEF评分上差异具有统计学意义(H=10.076,P=0.039)。Spearman相关分析的结果显示,焦虑障碍患者的WHOQOL-BRIEF评分与HAMA评分、HAMD-17评分、TAS-20评分均呈负相关(r=−0.256,P=0.000;r=−0.311,P=0.000;r=−0.342,P=0.000)。逐步回归分析的结果显示,年龄、HAMA评分、HAMD-17评分及TAS-20评分均对患者的生活质量有较大影响(均P<0.05)。结论·不同亚型焦虑障碍患者的生活质量有所不同,焦虑水平、抑郁水平及述情障碍程度均是影响焦虑障碍患者生活质量的关键变量。

儿童青少年精神障碍患者家长自杀倾向及危险因素分析

目的探讨儿童青少年精神障碍患者家长自杀倾向及其危险因素,并构建自杀倾向的预测模型。方法采用横断面调查的方法,收集2022年8月至2023年7月就诊于安徽省内两所医院共299名儿童青少年精神障碍家长的社会人口学资料,并采用自杀相关的标准化问题、患者健康问卷-9(PHQ-9)以及多伦多述情障碍量表(TAS-20)分别评估调查对象自杀倾向、抑郁症状及述情障碍的程度。结果自杀倾向的总体检出率为15.4%,其中自杀意念、自杀计划和自杀未遂检出率分别为11.0%、3.3%和8.0%。Logistic回归分析结果显示,躯体疾病史、抑郁症状、述情障碍以及情感辨别不能因子与较高的自杀倾向风险有关(均P<0.05)。基于回归分析结果,构建预测患儿家长自杀倾向风险预测模型,并绘制受试者工作特征(ROC)曲线下面积(AUC)为0.80(95%CI:0.72~0.87,P<0.05)。结论儿童青少年精神障碍患者家长自杀倾向检出率较高,提示临床上在注重青少年精神障碍患者的同时,亦不能忽视患儿家长的心理健康,应加强对患儿和家长的护理,必要时应提供个体化的综合干预措施。

精神分裂症病人述情障碍现状及影响因素

目的:探讨精神分裂症(SCZ)病人述情障碍现状,并分析其影响因素。方法:采用便利抽样法选取2022年5月—11月在北京市某三级精神卫生医院住院的134例SCZ病人为研究对象,采用一般资料调查表、多伦多述情障碍量表(TAS-20)、疾病不确定感量表(MUIS)对其进行调查。结果:SCZ病人TAS-20得分为(52.85±10.57)分,MUIS得分为(86.04±15.22)分;相关性分析结果显示,SCZ病人TAS-20总分及各维度得分与MUIS总分及各维度得分(除不可预测性维度)呈正相关(P<0.05);多重线性回归分析结果显示,文化程度和病程是SCZ病人述情障碍的影响因素(P<0.05)。结论:SCZ病人述情障碍和疾病不确定感处于中等水平,且两者密切相关;病人文化程度越低、病程越长,其述情障碍越严重,护理人员可基于疾病不确定感构建针对性的护理方案,帮助病人减轻述情障碍。

述情障碍与大学生认知失败的关系:一项序列中介模型

为了探究述情障碍与大学生认知失败的关系以及无聊倾向和问题性移动社交媒体使用的中介作用机制,采用述情障碍量表、无聊倾向问卷、问题性移动社交媒体使用量表和中文版认知失败量表对600名在校大学生进行了调查。结果显示,述情障碍、无聊倾向、问题性移动社交媒体使用和大学生认知失败之间彼此呈现显著性正相关;述情障碍显著预测大学生认知失败;无聊倾向在述情障碍与大学生认知失败之间的中介效应显著,问题性移动社交媒体使用在述情障碍与大学生认知失败之间的中介效应显著,无聊倾向和问题性移动社交媒体使用在述情障碍与大学生认知失败之间的链式中介效应显著。因此,述情障碍可以直接预测大学生认知失败,也可以通过无聊倾向和问题性移动社交媒体使用形成的序列中介作用预测大学生认知失败。

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。

述情障碍对临床护士工作投入的影响

目的:探讨临床护士的述情障碍对工作投入的影响。方法:采用一般资料问卷、多伦多述情障碍量表(TAS-20)、工作投入量表对134名临床护士进行问卷调查,并使用SPSS 26.0软件对数据进行分析。结果:临床护士述情障碍得分为(55.87±14.46)分,达临界述情障碍水平;工作投入得分为(54.31±16.97)分,处于中度水平。Pearson相关性分析显示,述情障碍各维度得分及总分和工作投入各维度得分及总分均呈显著负相关(r=-0.419~-0.581,P<0.01);多元逐步回归分析显示,描述情感障碍(β=-0.294,P=0.011)、外向性思维(β=-0.331,P=0.004)对临床护士工作投入有负向预测作用。结论:临床护士述情障碍有待改善,述情障碍对临床工作的投入有负向影响作用,护理管理者应重视临床护士述情障碍的问题,采取有效措施改善临床护士情绪管理能力,提高临床护士工作投入水平。

青少年抑郁症患者述情障碍、孤独感、心理弹性与非自杀型自我伤害行为的关系

目的 探讨青少年抑郁症患者的述情障碍、孤独感、心理弹性与非自杀型自我伤害(nonsuicidal self-injury, NSSI)行为的关系及其作用机制。方法 采用自残功能评估量表、多伦多述情障碍量表、UCLA孤独感量表和心理弹性量表简化版对326名青少年抑郁症患者施测。分析各变量间的关系及其相关的中介效应及调节作用。结果 NSSI行为与述情障碍和孤独感呈显著正相关,与心理弹性呈显著负相关。与无NSSI行为的青少年抑郁症患者比较,有NSSI行为者的述情障碍总分及其情感识别困难、情感描述困难、外向性思维维度得分以及孤独感总分均较高,心理弹性总分较低,差异均有统计学意义(P<0.01)。述情障碍正向预测NSSI行为,心理弹性负向预测NSSI行为。述情障碍通过心理弹性的中介作用对NSSI产生影响,孤独感对中介模型的前半段路径具有调节作用。结论 青少年抑郁症患者的孤独感、心理弹性和述情障碍均与NSSI行为显著相关。述情障碍是NSSI行为发生的危险因素,心理弹性是减少NSSI行为发生的保护因素。心理弹性在述情障碍与NSSI行为的关系中起中介作用,孤独感在其中发挥调节作用。

偏头痛患者的述情障碍

述情障碍是表现为难以识别自我感受、难以描述感受及外向型思维的一种多重人格特征。述情障碍被认为可能是发作性、慢性偏头痛和药物过量性头痛的潜在特征。目前对偏头痛与述情障碍相关性的研究较少,本研究通过对述情障碍概念、分型、危险因素及机制、述情障碍与偏头痛相关性进行综述,探讨偏头痛患者述情障碍的特点,提高临床医生在头痛诊治过程中对述情障碍的识别水平,使患者得到及时的干预和治疗。

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。

老年抑郁症病人述情障碍、社会支持对快感缺失与抑郁症状的影响

目的探讨老年抑郁症(LLD)病人述情障碍与社会支持对快感缺失及抑郁症状的影响。方法选取2020—2023年在东南大学附属中大医院心身医学科病房及门诊就诊的216例年龄≥60岁的LLD病人。采用17项汉密尔顿抑郁量表(HAMD-17)、斯奈思-汉密尔顿快感缺失量表(SHAPS)、多伦多述情障碍量表(TAS)和社会支持评定量表(SSRS)对所有病人进行评估。使用Pearson相关分析探讨量表之间的关联。构建包含LLD病人社会支持、述情障碍、快感缺失、抑郁症状的结构方程模型并进行路径分析。结果TAS得分与HAMD-17(r=0.294,P<0.001)、SHAPS得分(r=0.455,P<0.001)呈正相关,与SSRS得分(r=-0.210,P=0.002)呈负相关;SSRS得分与HAMD-17(r=-0.299,P<0.001)、SHAPS(r=-0.230,P=0.001)得分呈负相关。路径分析结果显示,述情障碍越严重,抑郁症状和快感缺失越严重;社会支持越少,述情障碍、抑郁症状和快感缺失越严重。最终模型的拟合优度良好(χ2=0.211,df=1,χ2/df=0.211,RMSEA<0.001,CFI=1.000,GFI=1.000)。结论提高LLD病人的社会支持水平可以减轻述情障碍和抑郁症状,改善病人的整体心理健康状况。

非自杀性自伤者的心理困境及临床干预思路

非自杀性自伤(non-suicidal self-injury,NSSI)是一个日益严重的公共卫生问题,在青少年和成年早期群体中最为常见,临床心理咨询中伴随NSSI症状的患者也越来越多。NSSI者面临的困境可概括为四个方面:自我被涵容的失败,表达失能的述情障碍,不能忍受人际冲突和矛盾,应对方式的僵化。相应的临床干预思路包括:以共情和稳定的陪伴提供“涵容”的氛围,鼓励并协助当事人学习情感表达,提升忍受人际冲突的钝感力等几个方面。深刻地理解NSSI者面临的具体心理困境是临床干预的起点,打破NSSI惯性,逐步地帮助来访者建立新的应对方式和健康行为来替代NSSI行为,有助于消除来访者的心理困境并最终获得疗愈。