Prospective relations between alexithymia, substance use and depression: findings from a National Birth Cohort

Abstract

Purpose: This study examined a developmental model that links affect-regulation difficulties in childhood with three dimensions of alexithymia in adolescence (difficulty identifying feelings, difficulty describing feelings, and externally-oriented thinking) and substance use and depression in adulthood, while accounting for cumulative contextual risk in childhood, and testing potential gender moderation. Methods: Multiple group path analyses were conducted using data from the Northern Finland Birth Cohort 1986 (N = 6,963). Analyses used data collected during prenatal/birth, childhood, adolescence, and young adulthood periods. Results: Our examination of early precursors for alexithymia indicated that the associations of affect-regulation problems in childhood with alexithymia were stronger for girls, potentially putting girls with affect-regulation difficulties in childhood at higher risk for developing alexithymia in adolescence. The associations of cumulative contextual risk in childhood with alexithymia, substance use disorder, and depression diagnosis in adulthood were significant for both girls and boys. Our findings in regard to substance use and depression disorders revealed that alexithymia in adolescence predicted depression diagnosis in adulthood, particularly due to a contribution from the alexithymia domain of "difficulties identifying feelings." However, none of the alexithymia domains was directly associated with substance use disorder in adulthood. Conclusions: Our study contributes to research that links alexithymia with difficulties in affect regulation and cumulative contextual risk in childhood, yielding findings that may be relevant for preventive interventions.

Alexithymia disrupts emotion regulation processes and is associated with greater negative affect and alcohol problems

“…Although contrary to study predictions, the Difficulty Describing Feelings and the Externally oriented Thinking subscales of the TAS‐20 did not have significant associations with other variables in the study, which is consistent with prior research (Carton et al, 2010; Patwardhan et al, 2019). The Difficulty Describing Feelings subscale may not have demonstrated a significant association given that theories of emotion and emotion regulation propose that one must first identify an emotion before describing it to others (Gross, 2014).…”

Factors associated with depression among the Lebanese population: Results of a cross‐sectional study

“…Furthermore, previous research found a higher chance of association of depression in patients with common mental disorders such as alexithymia, 32 alcohol, 33 social phobia, 34‐37 and anxiety 38 . In addition, previous research supported the effect of stress and burnout on depression 39 .…”

“…29,30 Age was also shown to be associated with depression, with the highest level seen between 20 and 24 years, followed by a progressive decline to the lowest level for those aged 75 years and above. 31 Furthermore, previous research found a higher chance of association of depression in patients with common mental disorders such as alexithymia, 32 alcohol, 33 social phobia, [34][35][36][37] and anxiety. 38 In addition, previous research supported the effect of stress and burnout on depression.…”

Association between alexithymia and substance use: A systematic review and meta‐analysis

“…In Table 1 the type of substance use has described in detail whenever it was possible. Several studies mentioned the diagnosed substance use disorder but did not specify the used substance (Bulai & Enea, 2016;Ghalehban & Besharat, 2011;Hamidi et al, 2010;Loas, Corcos, Stephan et al, 2001;Marchesi, Ossola, Tonna & De Panfilis, 2014;Parolin, Simonelli, Cristofalo et al, 2017;Patwardhan et al, 2019;Payer et al, 2011;Verrocchio, Conti & Fulcheri, 2010).…”

“…All publications reported cross-sectional findings, with the exception of two Finnish studies (Honkalampi, Koivumaa-Honkanen, Lehto et al, 2010;Patwardhan et al, 2019). A total of 22,712 individuals had participated in these studies, the number of participants in individual studies varying between 29 (Lyvers, Hayatbakhsh, Stalewski & Thorberg, 2019e) and 6,963 (Patwardhan et al, 2019). The majority, 23 studies, included clinical samples (Bulai & Enea, 2016;Chaudhury, Das & Ukil, 2006;Hamidi et al, 2010;Loas, Otmani, Lecercle & Jouvent, 2000;Loas et al, 2001;Lyvers, Hinton, Gotsis, Roddy, Edwards & Thorberg, 2014d;Meziou, Ghali, Khelifa et al, 2019;Parolin et al, 2017;Payer et al, 2011;Rasheed, 2001;Speranza, Corcos, Stephan et al, 2004;Verrocchio et al, The majority of the studies concerned alcohol use or alcohol disorders (n = 36) (Andres et al, 2014;Bauer & Ceballos 2014;Betka et al, 2018;Bladt, 2002;Bruce et al, 2012;Bujarski et al, 2010;Bulai & Enea, 2016;Chaudhury et al, 2006;Craparo, Ardino, Gori & Caretti, 2014;Founta, Adamzik, Tobin, Kirby & Hevey, 2019;Ghorbani, Khosravani, Sharifi Bastan & Jamaati Ardakani, 2017;Greene et al, 2020;Hahn et al, 2016;Hasking & Claes, 2020;Honkalampi et al, 2010;Knapton et al, 2018, Kopera, Trucco, Jakubczyk et al, 2018Loas et al, 2000;…”