title: A longitudinal mediational study on the stability of alexithymia among alcohol-dependent outpatients in cognitive-behavioral therapy.
abstract: Alexithymia is characterized by difficulty identifying feelings, difficulty describing feelings, and an externally oriented thinking style. Alexithymia has been described as a trait-like risk factor for the development of alcohol use disorders. Few studies have investigated the absolute (whether mean scores change over time) and relative (extent to which relative differences among individuals remain the same over time) stability of alexithymia among men and women with alcohol dependence, or have considered potential underlying mechanisms. Social learning processes contribute to and maintain alcohol problems. The reinforcement of alcohol expectancies is one plausible mechanism that links the difficulties in emotional processing associated with alexithymia and alcohol use. The present study investigated the stability of alexithymia as well as alcohol expectancy as a mediator of alexithymia. Three hundred fifty-five alcohol-dependent patients were enrolled in a cognitive behavioral treatment program. Ninety-two alcohol-dependent patients completed assessments at baseline and at 3-month follow-up. Results indicated that total Toronto Alexithymia Scale (TAS-20; Bagby, Parker, & Taylor, 1994) mean score, difficulty identifying feelings, and difficulty describing feelings decreased significantly over time with a larger decrease in alexithymia mean scores for females. Externally oriented thinking mean scores did not change. The TAS-20 and its subfactors demonstrated significant correlations, from baseline to follow-up, which were stronger for males than for females. Regression analyses showed that the total TAS-20 mean scores, difficulty identifying feelings, and difficulty describing feelings were partially mediated through assertion alcohol expectancies. In conclusion, this suggests that alexithymia has relative stability and is a trait-like factor among alcohol-dependent treatment seekers.
authors.affiliation: Innlandet Hospital Trust.
authors.forename: Fred Arne
authors.initials: FA
authors.lastname: Thorberg
authors.affiliation: Institute of Health and Biomedical Innovation, and Faculty of Health, Queensland University of Technology.
authors.forename: Ross McD
authors.initials: RM
authors.lastname: Young
authors.affiliation: Institute of Health and Biomedical Innovation, and School of Psychology and Counseling, Queensland University of Technology.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Sullivan
authors.affiliation: Department of Psychology, Bond University.
authors.forename: Michael
authors.initials: M
authors.lastname: Lyvers
authors.affiliation: School of Public Health, Khon Kaen University.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Hurst
authors.affiliation: Alcohol & Drug Assessment Unit, Princess Alexandra Hospital.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Connor
authors.affiliation: Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo.
authors.forename: Reidar
authors.initials: R
authors.lastname: Tyssen
authors.affiliation: Institute of Neuroscience and Human Behavior, University of California Los Angeles.
authors.forename: Edythe D
authors.initials: ED
authors.lastname: London
authors.affiliation: Institute of Neuroscience and Human Behavior, University of California Los Angeles.
authors.forename: Ernest P
authors.initials: EP
authors.lastname: Noble
authors.affiliation: Alcohol & Drug Assessment Unit, Princess Alexandra Hospital.
authors.forename: Gerald F X
authors.initials: GF
authors.lastname: Feeney
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010045:Outpatients