Alexithymia stability and therapeutic outcome in an Australian psychiatric outpatient sample

Abstract

Background The aim was to examine the role of alexithymia on therapeutic outcome in a naturalistic group therapy setting, as well as the effectiveness of cognitive‐behavioural group therapy in reducing alexithymia. Methods A pre‐test/post‐test research design was used to examine alexithymia before and after treatment. Pre‐ and post‐alexithymia and psychological distress scores from routinely administered measures were retrieved for 61 psychiatric outpatients referred for group therapy at a mental health facility. Correlation, repeated measures t‐test, and regression analyses were conducted to explore the data. Results Baseline alexithymia was not a significant predictor of group therapy outcome (change in psychological distress) once baseline psychological distress was controlled for. There was a small but significant reduction in mean‐level alexithymia scores over the course of therapy. A high level of relative stability was observed in alexithymia scores, independent of change in psychological distress severity. A reduction in alexithymia during treatment was a significant predictor of a reduction in psychological distress over the course of therapy. Conclusions High baseline alexithymia does not present a therapeutic disadvantage for patients receiving cognitive‐behavioural group therapy. However, cognitive‐behavioural group therapy is somewhat effective at improving alexithymic features, and this improvement can provide symptom relief by the end of treatment. Thus, it may advantageous for clinicians to treat alexithymia in order to enhance therapeutic intervention.

The Impact of Alexithymia on Treatment Response in Psychiatric Disorders: A Systematic Review

“…In the study carried out by Zorzella et al (56) in a sample of patients with PTSD, an improvement in alexithymia levels over the course of treatment was found to correlate significantly with a better response to treatment, in relation to both PTSD symptoms and levels of dissociation and interpersonal difficulties. This was in line with the findings of McGillivray et al (55) who investigated a sample of psychiatric outpatients with different diagnoses, all of whom treated with CBT. In some studies, the evaluation was limited to alexithymia levels post-treatment and outcome variables (36,40).…”

“…In other cases, the correlation between improvement in alexithymia levels during treatment and outcome variables was analyzed (45). In yet others, both aspects were taken into account, at times yielding discordant findings (55,56). In the study carried out by Zorzella et al (56) in a sample of patients with PTSD, an improvement in alexithymia levels over the course of treatment was found to correlate significantly with a better response to treatment, in relation to both PTSD symptoms and levels of dissociation and interpersonal difficulties.…”

“…The results obtained highlight the higher impact of the SD variable on treatment outcome compared to alexithymia. More recently, McGillivray et al (55) evaluated the role of alexithymia on treatment outcome in a naturalistic group therapy setting. Sixty-one psychiatric outpatients affected by mood disorders (54.1%), neurotic, stress-related, and somatoform disorders (19.7%), disorders of adult personality and behavior (14.8%), schizophrenia, schizotypal, and delusional disorders (9.8%) and behavioral syndromes associated with physiological disturbances and physiological factors (1.6%) were enrolled in the study and assessed both pre-and posttreatment.…”

Alexithymia and therapeutic alliance: a multiple case study comparing good and poor outcome cases

“…Studies that directly targeted alexithymic symptoms tend to report significant reductions in alexithymia scores following treatment, whereas studies that measured changes in alexithymia but did not employ any psychological interventions specifically intended to treat alexithymia have more inconsistent results (for a review see Cameron, Ogrodniczuk, & Hadjipavlou, 2014 ). For example, in a study with an outpatient psychiatric sample (McGillivray, Becerra, & Harms, 2018 ) a high level of relative stability was observed in alexithymia scores, independent of change in psychological distress severity, but a reduction in alexithymia during treatment was a significant predictor of a reduction in psychological distress over the course of therapy. In other study, aimed to assess the effectiveness of intensive psychological treatment for eating disorders, there was an effectiveness of psychotherapy as regards dissociative moments, impulsivity and body dissatisfaction, but not alexithymia (Caslini, Rivolta, Zappa, Carra, & Clerici, 2015 ).…”