Relationship of alexithymia and temperament and character dimensions with lifetime post‐traumatic stress disorder in male alcohol‐dependent inpatients

Abstract

Aims:The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions.Methods: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI).Results: Among alcohol-dependent inpatients 32.1%were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and selfdirectedness (S) were lower. Among age and other factors of TAS-20, 'difficulty in identifying feelings (DIF)' predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, 'impulsiveness versus reflection' (NS2) and 'congruent second nature versus bad habits' (S5) predicted PTSD.Conclusions: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.Key words: alcohol dependence, alexithymia, character, post-traumatic stress disorder, temperament.A N INCREASING BODY of literature has documented an association between post-traumatic stress disorder (PTSD) and alcohol use disorders, highlighting the importance of the relationship between them in both clinical and public health measures. [1][2][3] In this respect, high prevalence rates of comorbid PTSD and alcohol abuse has been documented to range from 36% to 52%. 4,5 In recent studies, rates of lifetime PTSD diagnosis among alcohol-dependent inpatients ranged from 27% to 31% in Turkey. 6,7 The majority of studies examining the order of onset among individuals with PTSD and alcohol-use disorders have found that PTSD is most often the primary disorder (i.e. temporally precedes the onset of the alcohol-use disorder). 2,8 Breslau et al. suggested that PTSD might be a causal risk factor for

Prediction of individual differences in fear response by novelty seeking, and disruption of contextual fear memory reconsolidation by ketamine

“…These observations not only add new evidence to the link between novelty seeking and the development of PTSD-like symptoms (Evren et al, 2010; Jakšić et al, 2012; Richman and Frueh, 1997; Wang et al, 1997), they suggest that novelty seeking can predict some aspects of an individual’s response to fear following exposure to a traumatic stressor. The HR/LR model thereby appears as a valuable tool with predictive value for the investigation of individual differences in vulnerability to the development of PTSD-like symptoms.…”

“…Notably, this association is further supported in animal models of individual differences in emotional response in which, for instance, predisposition to learned helplessness is predicted by novelty seeking and associated with differences in anxiety-like behaviors, acquisition of cued fear conditioning, and impaired fear extinction (Padilla et al, 2010; Shumake et al, 2005). Moreover, in combination with other personality traits, a few reports denote a predictive value for novelty seeking in PTSD vulnerability and symptoms vulnerability (Evren et al, 2010; Gil, 2005; Jakšić et al, 2012; Richman and Frueh, 1997; Wang et al, 1997), conferring both a preclinical and clinical relevance to the HR/LR model and individual differences in novelty seeking in a PTSD context. In addition, based on baseline differences in a behavioral paradigm with minimal impact on further experimental manipulations, the HR/LR model provides an interesting framework for the study of individual differences in vulnerability to the development of PTSD symptoms following exposure to traumatic stressor.…”

“…Indeed, among other personality traits, PTSD patients display higher scores of novelty seeking, which is predictive of PTSD symptoms severity in a population of combat-related PTSD patients (Evren et al, 2010; Jakšić et al, 2012; Richman and Frueh, 1997; Wang et al, 1997). However, one study analyzing personality traits prior to the exposure of a traumatic event revealed that novelty seeking was negatively associated with the risk for developing PTSD, which suggests a predictive value for novelty seeking in PTSD vulnerability and resiliency (Gil, 2005).…”

Traumatic experiences, alexithymia, and posttraumatic symptomatology: a cross-sectional population-based study in Germany

“…Because, according to their results, alexithymia seems more connected to posttraumatic symptoms than to trauma exposure itself, they conclude that alexithymia might be a preexisting condition that increases the probability of developing PTSD (Yehuda et al, 1997). Other studies showed that the inability to identify one's own feelings is highly congruent with the construct of PTSD (Evren, Dalbudak, Cetin, Durkaya, & Evren, 2010; Sondergaard & Theorell, 2004). Several studies indicate a phenomenological overlap between emotional numbing as a symptom of PTSD and alexithymia, which is also characterized by disordered affect regulation (Badura, 2003; Declercq et al, 2010; Fukunishi et al, 1996).…”

Obsessive-compulsive disorders and anxiety disorders: A comparison of personality and emotionality patterns

“…In Cloninger's model, a low self-directedness score is an indicator of poor individual maturity and of an enhanced risk of personality disorder without specificity to the underlying types of personality . Other studies have already shown that this trait is lower for OCD patients when compared to healthy subjects (Bejerot et al, 1998;Kusunoki et al, 2000;Lyoo et al, 2001;Alonso et al, 2008;Kim et al, 2009;Cruz-Fuentes et al, 2004) as well as subjects with social phobia (Pelissolo et al, 2002), panic disorder (Wachleski et al, 2008) or post-traumatic stress disorder (Evren et al, 2010) although without direct comparisons between these groups. However, in our study, the SD difference between AD and OCD groups seems to be due to a state effect and it is no longer significant when depressive symptoms (and age) are taken into account.…”