Alexithymia and therapist reactions to the patient: expression of positive emotion as a mediator.
This study examined patient's expression of emotion as a mediator of the relationship between patient alexithymia and therapist reactions to the patient. We analyzed data from 107 psychiatric outpatients who participated in a randomized controlled trial of two forms of group therapy for complicated grief. Patient alexithymia was assessed using the Toronto Alexithymia Scale-20. Patient's expression of emotion was assessed via sociometric ratings provided by other group members. Therapist reactions to the patient were assessed via therapist's ratings of each member in the group. Patient's expression of positive emotion met all the requirements for being considered a mediator. The findings indicated that the higher the level of alexithymia (specifically, greater difficulty communicating feelings and greater tendency to engage in externally oriented thinking), the less expression of positive emotion by the patient, and the more negative the therapist's reactions to the patient. The mediation provided by expression of positive emotion accounted for over half of the direct effect of alexithymia on therapist reactions to the patient. Future work needs to consider whether a therapist's awareness of a patient's limited capacity to express positive emotions and the negative influence that this can have on his/her reactions to his/her patients can help improve the therapeutic experience with alexithymic patients.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. ogrodnic@interchange.ubc.ca
John S
JS
Ogrodniczuk
William E
WE
Piper
Anthony S
AS
Joyce
D000342:Affective Symptoms / Q000523:psychology*; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019260:Expressed Emotion; D006304:Health Status; D006801:Humans; D011369:Professional-Patient Relations; D012720:Severity of Illness Index