Alexithymia in People With Recurrent Suicide Attempts

Abstract

Abstract. Background: Alexithymia, an inability to identify or describe emotions, is associated with suicidality yet the correlation with single or repeated suicide attempts is less clear. Aims: We aimed to assess the modifiability of alexithymia following a group psychosocial intervention focused on improving emotional literacy in those with a history of recurrent suicide attempts (RSA). Method: A total of 169 participants with self-reported RSA completed pre- and postgroup assessments of a 20-week group therapy intervention. Questionnaires assessed alexithymia, depression, impulsivity, and hopelessness; the Toronto Alexithymia Scale (TAS-20) was the primary outcome. Data were analyzed using multiple imputation. Results: Participants had on average 7.8 lifetime suicide attempts, 73% were female, and 16.6% had a >13-point reduction in TAS-20 scores after 20 weeks. Directed acyclic graph (DAG) analysis demonstrated significant relationships between alexithymia, depression, hopelessness, problem-solving, and satisfaction with life. Age of onset of suicidality was the only factor predictive of postintervention TAS-20 score in univariate linear regression. Limitations: The study limitations were its sample size, insufficient resources, and missing data. Conclusion: A change in TAS scores indicated that alexithymia can be a modifiable treatment target. Being able to identify and describe feelings may lead to improvement in depression, hopelessness, problem-solving, and satisfaction with life in this population.

A Pre-Adolescent and Adolescent Clinical Sample Study about Suicidal Ideation, Suicide Attempt, and Self-Harming

“…To be more specific, alexithymia is characterized by the inability to identify and communicate emotions with appropriate words and was found to be a risk factor for several problems in adolescent age, such as risk behaviors (e.g., [ 65 ]), social withdrawal (e.g., [ 68 ]) somatization (e.g., [ 66 , 67 ]), and suicidal behavior (e.g., [ 63 ]). On the basis of the aforementioned results, we assume that general difficulties in emotion regulation and, in particular, in identifying and communicating feelings may be involved in NSSI, thus differentiating adolescents with mere suicidal ideation from those with suicidal ideation/attempt together with NSSI.…”

“…In particular, people with emotion dysregulation and alexithyimic traits may be more likely to use maladaptive coping strategies; therefore, as also noted in the literature [ 79 ], suicidal and nonsuicidal self-harm could be interpreted as a dysfunctional attempt to cope with emotions in the face of an inability to find more functional strategies. To further support this, recent literature has highlighted that improving the ability to identify and describe emotions in individuals who attempted suicide could improve mood and problem solving strategies and reduce states of hopelessness [ 63 ].…”

“…The dependent variables were the internalizing problems, externalizing problems, total problems, somatic problems, and DESR scales of the YSR, and all the scales of the TAS-20 and BIS-11. These scales were selected because they evaluate constructs and psychopathological aspects that were found to be related to suicidal phenomena in general, namely impulsiveness and externalizing disorders (e.g., [ 33 ]), alexithymia (e.g., [ 63 ]), somatic complaints (e.g., [ 69 ]), emotion dysregulation (e.g., [ 77 ]), and internalizing difficulties (e.g., [ 83 ]). For significant effects, Dunn’s post-hoc tests with Bonferroni correction were conducted.…”

“…NSSI, suicidal ideation, and suicide attempt share several risk factors, psychiatric comorbidity, and high prevalence in young people. At a symptomatological and psychopathological level, the main risk factors associated with suicidal and nonsuicidal self-harm are impulsiveness [ 32 , 33 , 58 , 59 ], alexithymia [ 60 , 61 , 62 , 63 , 64 ]—considered a transdiagnostic risk factor [ 65 , 66 , 67 , 68 ]—somatic problems [ 69 , 70 , 71 , 72 , 73 , 74 , 75 ], emotion dysregulation [ 76 , 77 , 78 , 79 , 80 ], affective disorders [ 81 , 82 , 83 , 84 , 85 ], borderline functioning and borderline personality disorder [ 86 , 87 , 88 , 89 ]. However, it seems still unclear what differences exist in the psycho-behavioral profiles of patients with both suicidal ideation/attempt and NSSI.…”

Beyond sleepless nights: Unraveling the complexity of alexithymia and suicide risk among university students

“…Some studies reported a positive association between alexithymia and suicide ideation and behavior (Álvarez et al., 2021 ; Bordalo & Carvalho, 2022 ; Wood et al., 2010 ). However, complexities emerged as other studies highlighted factors like depression severity and sex influencing this relationship (Bergmans et al., 2020 ; Hintikka et al., 2004 ; Sleuwaegen et al., 2017 ). Moreover, certain investigations found no significant connection between alexithymia and suicide (Xie et al., 2021 ).…”