title: The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees.
abstract: OBJECTIVE
  The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms.
  
  
  METHODS
  The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D).
  
  
  RESULTS
  TAS-20 scores were positively correlated with IES-R scores (r=0.21, p<0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r=0.32, p<0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t=2.10, p<0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t=2.90, p<0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas.
  
  
  CONCLUSIONS
  The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms.
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Juhyun
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Psychiatry, Settlement Support Center for North Korean Refugee, Ansung, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Jun
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Soohyun
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, National Medical Center, Seoul, Republic of Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, National Medical Center, Seoul, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Yoo
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: psychical@hanmail.net.
authors.forename: Seog Ju
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications*; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data*; D056911:Democratic People's Republic of Korea / Q000208:ethnology; D004644:Emotions; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D014705:Verbal Behavior
keywords: Alexithymia; Posttraumatic stress disorder; Refugees; Trauma