title: The relationship of Alexithymia with anxiety-depression-stress, quality of life, and social support in Coronary Heart Disease (A psychological model).
abstract: BACKGROUND
  Although psychological factors are now recognized as playing a significant and independent role in the development of coronary heart disease (CHD) and its complications, many of these factors are correlated with each other. The present study is aimed at examining the association between alexithymia and anxiety depression, stress, quality of life, and social support in CHD patients.
  
  
  METHODS
  In this research 398 patients with coronary heart disease (166 females and 232 males) from the city of Isfahan were selected using random sampling. The tools used included depression, anxiety, and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data were analyzed using structural equation modeling by using the Statistical Package for Social Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software.
  
  
  RESULTS
  Results of the structural equation model showed an acceptable goodness of fit, for the explanation alexithymia that was significantly associated with lower HRQOL and social support and increasing anxiety, depression, and stress.
  
  
  CONCLUSIONS
  Alexithymia may increase anxiety, depression, and stress and can be a predisposing factor to poorer HRQOL and social support.
authors: Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
authors: Zohreh Khayyam
authors: ZK
authors: Nekouei
authors: Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
authors: Hamid Taher Neshat
authors: HT
authors: Doost
authors: Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Alireza
authors: A
authors: Yousefy
authors: Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
authors: Gholamreza
authors: G
authors: Manshaee
authors: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors: Masoumeh
authors: M
authors: Sadeghei
keywords: Alexithymia; anxiety; coronary heart disease; depression; quality of life; social support; stress