title: Alexithymia, emotional empathy, and self-regulation in anorexia nervosa.
abstract: BACKGROUND
  Individuals with anorexia nervosa (AN) who are starved have poor awareness (alexithymia), reduced understanding of others' mental states (cognitive empathy), and difficulty regulating personal emotions (self-regulation). Despite its important role in social interaction, sympathy for others (emotional empathy) has not been measured in AN. Furthermore, it is unknown how restoring weight affects the relationship among alexithymia, empathy, and self-regulation in AN.
  
  
  METHODS
  Women with AN were tested longitudinally during their starvation period (N = 26) and after weight was restored (N = 20) and compared with 16 age-matched healthy women. Alexithymia, empathy, and self-regulation were assessed with the Toronto Alexithymia Scale, the Interpersonal Reactivity Index, and items measuring self-regulation from the Minnesota Multiphasic Personality Inventory-2, respectively.
  
  
  RESULTS
  Relative to comparison participants, individuals with AN during both starvation and weight restoration reported greater alexithymia and emotional empathy in one domain, personal distress (vicarious negative arousal to others' suffering). Among AN participants, personal distress was positively correlated with alexithymia and negatively correlated with self-regulation, when accounting for depression.
  
  
  CONCLUSIONS
  High levels of alexithymia and personal distress may be persistent features of AN because they do not resolve upon weight restoration. Greater personal distress in AN may be a function of poor emotional awareness and regulation.
authors: Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. janelle-beadle@uiowa.edu
authors: Janelle N
authors: JN
authors: Beadle
authors: Sergio
authors: S
authors: Paradiso
authors: Alexandria
authors: A
authors: Salerno
authors: Laurie M
authors: LM
authors: McCormick
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000856:Anorexia Nervosa / Q000150:complications / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy; D018450:Disease Progression; D004645:Empathy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D012938:Social Perception; D013217:Starvation / Q000209:etiology / Q000523:psychology; D015430:Weight Gain; D055815:Young Adult
references: Biol Psychiatry. 2010 Mar 1;67(5):439-45
references: 20034615
references: Int J Eat Disord. 2000 Jul;28(1):8-19
references: 10800009
references: Psychol Med. 1979 May;9(2):273-9
references: 472072
references: Psychother Psychosom. 1973;22(2):255-62
references: 4770536
references: J Psychosom Res. 1994 Jan;38(1):33-40
references: 8126688
references: Behav Neurol. 1992;5(1):27-32
references: 24487658
references: J Clin Exp Neuropsychol. 2010 Apr;32(4):358-65
references: 19856232
references: Eat Behav. 2010 Dec;11(4):205-10
references: 20850053
references: Br J Med Psychol. 1959;32(1):50-5
references: 13638508
references: Neuroimage. 2006 Sep;32(3):1472-82
references: 16798016
references: Psychiatry Res. 2000 Apr 10;93(3):263-6
references: 10760385
references: Psychiatry (Edgmont). 2010 Oct;7(10):14-8
references: 21103140
references: Rev Fr Psychanal. 1963;27:SUPPL345-56
references: 14055333
references: Compr Psychiatry. 2002 Nov-Dec;43(6):448-55
references: 12439832
references: Annu Rev Psychol. 2002;53:187-213
references: 11752484
references: J Psychosom Res. 2003 Dec;55(6):553-60
references: 14642987
references: J Pers Disord. 2000 Winter;14(4):352-9
references: 11204342
references: Int J Eat Disord. 1995 Nov;18(3):237-45
references: 8556019
references: J Psychosom Res. 1996 Dec;41(6):561-8
references: 9032719
references: Psychosom Med. 2010 Jan;72(1):73-9
references: 19995886
references: Philos Trans R Soc Lond B Biol Sci. 2003 Mar 29;358(1431):459-73
references: 12689373
references: J Pers Soc Psychol. 1994 Apr;66(4):776-97
references: 8189352
references: Int J Eat Disord. 2012 Dec;45(8):962-9
references: 22693046
references: Clin Psychol Psychother. 2013 Jul-Aug;20(4):319-33
references: 23166105
references: J Psychiatr Res. 1994 Sep-Oct;28(5):425-45
references: 7897615
references: J Am Acad Child Adolesc Psychiatry. 1999 Nov;38(11):1389-95
references: 10560225
references: J Psychosom Res. 1994 Jan;38(1):23-32
references: 8126686
references: Br J Clin Psychol. 2008 Sep;47(Pt 3):335-9
references: 18208640
references: Int J Eat Disord. 2002 May;31(4):370-5
references: 11948642
references: Behav Res Ther. 2003 May;41(5):509-28
references: 12711261
references: J Pers Soc Psychol. 1975 Dec;32(6):1134-46
references: 1214217
references: Psychol Med. 1982 Nov;12(4):871-8
references: 6961471
references: Psychiatry Res. 2009 Aug 15;168(3):181-5
references: 19467562
references: Eur Eat Disord Rev. 2012 Nov;20(6):502-9
references: 22241653
references: Br J Clin Psychol. 2011 Sep;50(3):310-25
references: 21810109
references: Int J Eat Disord. 2011 Sep;44(6):531-9
references: 20957704
references: Eat Weight Disord. 2006 Mar;11(1):14-21
references: 16801741
references: Arch Gen Psychiatry. 2011 Apr;68(4):400-8
references: 21464364
references: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
references: 14399272
references: J Affect Disord. 2012 Dec 10;141(2-3):286-93
references: 22542863
references: Cognition. 1995 Oct;57(1):1-29
references: 7587017
references: Br J Clin Psychol. 2006 Sep;45(Pt 3):343-66
references: 17147101
references: Q J Exp Psychol (Hove). 2008 Jan;61(1):157-70
references: 18038346
references: Int J Eat Disord. 2006 Apr;39(3):245-51
references: 16485269
references: Int J Eat Disord. 1998 Apr;23(3):277-86
references: 9547662
references: Clin Psychol Psychother. 2009 Jul-Aug;16(4):348-56
references: 19517577
references: Int J Eat Disord. 1993 Dec;14(4):403-16
references: 8293022
references: J Psychosom Res. 2007 Oct;63(4):365-71
references: 17905043
references: World J Biol Psychiatry. 2013 Dec;14(8):622-33
references: 22424288
references: Fam Process. 2000 Fall;39(3):345-58
references: 11008652
references: Am J Psychiatry. 1982 Dec;139(12):1531-8
references: 6816075
references: Eur Eat Disord Rev. 2012 Nov;20(6):476-83
references: 21948284