A comparison of the associations between alexithymia and both non‐suicidal self‐injury and risky drinking: The roles of explicit outcome expectancies and refusal self‐efficacy

Abstract

Both Non-Suicidal Self-Injury (NSSI) and risky drinking are positively associated with alexithymia, a personality trait characterised by difficulties appraising feelings and an externally orientated thinking style. Although researchers have studied the associations between alexithymia and both NSSI and risky drinking, the underlying factors of both associations are rarely compared. In the current study, we compare the indirect effects of behaviour-specific outcome expectancies and self-efficacy beliefs on the associations between alexithymia and both NSSI and risky drinking. A sample of 627 university students (76.10% female, Mage = 20.75, SD = 1.88) completed a battery of questionnaires. Alexithymia exhibited indirect effects on NSSI via affect regulation expectancies, pain expectancies, communication expectancies, and low self-efficacy to resist NSSI. Alexithymia exhibited indirect effects on risky drinking via expectations of increased confidence and negative consequences. However, the indirect effects differed depending on the valance of the emotion the individual had difficulties appraising. Our findings indicate that the underlying factors in the associations between alexithymia and both NSSI and risky drinking could differ. Where individuals who have difficulties appraising negative emotions may engage in NSSI to help regulate negative feelings, they may consume alcohol to gain more confidence in expressing their feelings. Clinical implications are discussed.

Assessing Alexithymia in Adolescents: Psychometric Properties of the Perth Alexithymia Questionnaire in High School Students

“…The factor structure of the PAQ in these high school students was well represented by the intended five subscale factors (N-DIF, P-DIF, N-DDF, P-DDF, G-EOT), as well as a general alexithymia factor. These results are consistent with previous findings using the PAQ in adults (e.g., Becerra et al, 2021;Greene et al, 2020a, Preece et al, 2018a, and suggest that the multidimensional structure of the alexithymia construct manifests in a similar way in adolescents to that previously observed in adults. Our results reinforce the view that DIF, DDF, and EOT are all central components of alexithymia (at least statistically in our sample), and that prior difficulties with the EOT component in adolescent samples likely reflect the properties of the TAS-20 (i.e., item phrasing not being designed for adolescents, and/or the presence of reverse-scored items in the EOT subscale reducing psychometric performance; Parker et al, 2010;Preece et al, 2018b;Meganck et al, 2008) 1 , rather than the nature of the alexithymia construct itself.…”

“…Studies testing a bifactor model have also found strong evidence for a general alexithymia factor within the PAQ (e.g., Becerra et al, 2021;Preece et al, 2018), thus supporting the summing of a total scale score as well as the notion that alexithymia is a coherent multidimensional construct. In terms of concurrent validity, PAQ scores have correlated highly with TAS-20 scores (with the PAQ so far demonstrating higher EOT reliability when directly compared to the TAS-20 within the same samples; see Bilge & Bilge, 2020;Chan et al, in press;Greene et al, 2020a;Preece et al, 2020b), and other established measures of emotion regulation difficulties and psychopathology symptoms. For example, high PAQ scores have been associated with severe depression and symptoms of anxiety (Bilge & Bilge, 2020;Preece et al, 2018aPreece et al, , 2022, borderline personality disorder (Mousavi Asl et al, 2020), non-suicidal self-injury (Greene et al, 2020a(Greene et al, , 2020b, and with increased usage of maladaptive emotion regulation strategies (e.g.…”

“…The psychometric properties of the PAQ have been so far examined across a number of published studies, all with adult samples from either Australia (Greene et al, 2020a(Greene et al, , 2020bFynn et al, 2022;Preece et al, 2018aPreece et al, , 2020c, Chile (Becerra et al, 2021), the United States (Preece et al, 2020b), Iran (Lashkari et al, 2021;Mousavi Asl et al, 2020), Turkey (Bilge & Bilge, 2020), or Singapore (Chan et al, in press). Consistent patterns have emerged supporting the utility of the PAQ across these studies, in that good internal consistency reliability has been obtained for all subscale and composite scores (α > .70), and confirmatory factor analyses have supported a 5-factor structure consistent with the PAQ's theoretical basis (N-DIF, P-DIF, N-DDF, P-DDF, G-EOT), with all items loading well on their intended ASSESSING ALEXITHYMIA IN ADOLESCENTS subscale factor.…”

“…Recently, Preece et al (2018a) introduced the Perth Alexithymia Questionnaire (PAQ), designed for self-report measurement of alexithymia in adults and adolescents. The ASSESSING ALEXITHYMIA IN ADOLESCENTS PAQ has so far performed well in adult samples (e.g., Preece et al, 2018aPreece et al, , 2020bPreece et al, , 2020cGreene et al, 2020aGreene et al, , 2020b, but its psychometric performance has not yet been assessed in adolescent samples. This paper reports on the first psychometric assessment of the PAQ in adolescents.…”

Mediating role of depression in the association between alexithymia and nonsuicidal self-injury in a representative sample of adolescents in Taiwan

“…Several studies also found the association between alexithymia and NSSI [ 30 – 32 ]. Individuals who have high levels of alexithymia may engage in NSSI to regulate negative feelings and escape from emotional experiences [ 33 ]. This link is found among different groups, such as adolescents [ 10 , 11 , 34 – 38 ], undergraduate students [ 39 – 41 ], and adults [ 2 , 42 , 43 ].…”