Alexithymia, empathy, negative affect and physical symptoms in patients with asthma

Abstract

Although alexithymia has been found to be associated with physical symptoms in psychosomatic disorders such as asthma, mechanisms linking this association are unknown. However, affective alexithymic features may be associated with physical symptoms in the presence of deficits in affective characteristics such as low empathy and high negative affect. This study aimed to assess direct effects of alexithymic traits on physical symptoms and indirect effects of these subscales through empathy and negative affect (e.g. depressive, anxious and stress symptoms) by controlling for asthma severity in patients with asthma. Three hundred patients with asthma completed the Toronto Alexithymia Scale-20 (TAS-20), the Basic Empathy Scale (BES), the Depression Anxiety Stress Scales-21 (DASS-21) and the Physical Symptoms Inventory (PSI). After controlling for asthma severity, the results showed that alexithymia subscales of the TAS-20 had no direct effects on physical symptoms, but the difficulty in identifying feelings (DIF) subscale of the TAS-20 was associated with affective empathy and negative affect. Affective empathy was significantly related to negative affect. Affective empathy and negative affect were associated with physical symptoms. The affective subscale of alexithymia on the TAS-20, that is DIF, indirectly affected physical symptoms through affective empathy and negative affect. Findings suggest that patients with asthma who have high levels of DIF may show high physical symptoms in the presence of low affective empathy and high negative affect.

Distress tolerance and special alcohol metacognitions behave differently in the association of negative affect with alcohol‐related patterns in men with problematic alcohol use in the abstinence phase

“…All 21 items are scored from 0 to 3. Cronbach's alpha for the Persian scale was good in previous studies (Ghorbani, Khosravani, Mohammadzadeh, & Shadnia, 2019; Khosravani, Samimi Ardestani, Alvani, & Amirinezhad, 2020) and in the present research (0.66 and 0.76).…”

“…Simply put, distress intolerance and positive metacognitions are positively related to urgency states (i.e., alcohol craving), while negative alcohol metacognitions and alcohol craving are positively linked to long‐term problematic alcohol use in users experiencing high negative affect. Evidence also has reported that negative and positive alcohol‐related metacognitions were the strongest predictors of problematic alcohol use (Spada & Wells, 2010) and alcohol craving (Khosravani et al, 2020), respectively. Other studies have also shown different associations between alcohol‐related metacognitions and a continuum of drinking behaviours, including urgency states (craving) and problematic alcohol use, respectively (Caselli & Spada, 2010, 2015; Gierski et al, 2015; Khosravani, Zandifar, et al, 2019; Spada & Wells, 2009, 2010), especially in the presence of negative affect (Nikčević et al, 2017).…”

Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt

“…Various studies, usually non-clinical trials, have reported a correlation between alexithymia and multiple somatization interventions. Not all patients with MUPS have alexithymic features of the same magnitude; thus, the prognosis of patients with severe alexithymia is considered to be less positive than that of patients who have milder alexithymia [ 12 - 14 ].…”

Basic Empathy Scale: A Systematic Review and Reliability Generalization Meta-Analysis

“…There are a great number of proposed adaptations to other languages. The most recent examples include Spain [ 56 ], Turkey [ 57 ], Iran [ 58 ], Italy [ 59 ], Peru [ 24 ], Belgium [ 60 ], and China [ 61 ], among others. According to the number of publications, two main authors are highlighted for having a high number of studies reported in which they have used the BES.…”