Alexithymia in relation to alcohol expectancies in alcohol-dependent outpatients

Abstract

in relation to alcohol expectancies in alcohol-dependent outpatients, Psychiatry Research, http://dx.doi.org/10.1016Research, http://dx.doi.org/10. /j.psychres.2016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Social Interaction Anxiety, Alexithymia, and Drinking Motives in Australian University Students

“…In both clinical and nonclinical samples, alexithymia is associated not only with coping motives for drinking but also with expectancies of alcohol-induced affective change (Lyvers et al, 2014;Thorberg et al, 2016) including intensification of emotions -even negative emotionssuggesting anticipation of emotionally disinhibiting effects of alcohol. Thus a simple interpretation of alcohol use as a "tension reducer" among the socially anxious may not be entirely accurate when considering those who are also highly alexithymic.…”

“…As discussed earlier, the heritability of alexithymia has recently been estimated at only 30-33% (Jorgensen et al, 2007), thus many instances of this trait in the population likely reflect developmental and/or environmental influences, especially among those suffering from anxiety - including social anxiety (Evren & Evren, 2007;Freyberger, 1977;Fukunishi et al, 1997). There has been speculation that in some cases alexithymia may be an outcome of social interaction anxiety, which interferes with normal emotional development by restricting social engagement during childhood and adolescence; in adulthood the resulting deficits of emotional selfregulation may lead to reliance on pharmacological sources of mood regulation such as alcohol (Lyvers et al, 2012;Thorberg et al, 2011aThorberg et al, , 2016 instead of seeking social support or engaging in other adaptive coping strategies. Alternatively, alexithymia may be an outcome of inadequate parental bonding experiences in childhood (Thorberg et al, 2011b) and/or childhood neglect (Aust et al, 2013;Evren et al, 2009), which would be likely to restrict acquisition of social and self-regulation skills, thereby promoting social interaction anxiety due to poor interpersonal functioning; this again would increase the risk of problematic drinking and alcohol dependence in adulthood due to a tendency to rely on alcohol to cope with anxiety or other negative affect instead of seeking social support.…”

Parental bonding, adult attachment, and theory of mind: A developmental model of alexithymia and alcohol‐related risk

“…Inadequate parental bonding during infancy and childhood is theorized to result in deficits of self‐regulation, emotion recognition, and interpersonal attachment security (note that in the present context “bonding” is used in reference to the early parent–child relationship whereas “attachment” is used more broadly to include adult relationships). The deficient capacity to identify and express emotions, in concordance with insecure adult attachment, may encourage reliance on substances such as alcohol instead of social support for coping with stress as well as for mood effects such as emotional disinhibition and/or alleviation of the negative affect (Thorberg, Young, Lyvers, et al, ). Deficient interoceptive awareness associated with high alexithymia (Brewer, Cook, & Bird, ) may mean there is limited recognition of internal cues of overconsumption, further promoting risky or harmful levels of drinking.…”

A need for intervention: Childhood adversities are asignificant determinant of health-harming behavior and poor self-efficacy in patients with alcohol dependence. An observational, cross-sectional study on the population of Central Poland

“…The literature states that social disabilities in patients with AD may be either primary or secondary to alcohol misuse and may be produced by both social and biological factors. [1][2][3] Patients with AD were found to present a loss of behavioral flexibility, significant impairment in facial emotion recognition and a generally impaired ability to recognize one's own and others' mental states. 1,2 Patients with AD and impairment in facial emotion recognition were found to consider alcohol misuse as a tool for improving social abilities.…”

“…1,2 Patients with AD and impairment in facial emotion recognition were found to consider alcohol misuse as a tool for improving social abilities. 3 However, alcohol misuse, especially in adolescence, was found in animal studies to result in lifelong neurobiological changes and a permanent loss of hippocampal neurogenesis with the further phenotype result of impairment in behavioral flexibility. 1 General self-efficacy, which is an important measure of social ability, is referred to as global confidence in one's coping ability in demanding or new situations, which require a variety of stressful experiences to be dealt with and which characterize one's social skills.…”