Relationships among alexithymia and pain intensity, pain interference, and vitality in persons with neuromuscular disease: Considering the effect of negative affectivity

Abstract

Alexithymia, the inability to identify or label emotions, has been shown to be associated with pain in patients with a number of chronic pain conditions. We sought to: (1) replicate this association in samples of persons with chronic pain secondary to neuromuscular disease; (2) extend this finding to other important pain-related measures, and (3) to determine whether relationships among alexithymia and study variables existed after controlling for negative affect. One hundred and twenty-nine individuals with muscular dystrophy and chronic pain were administered measures of alexithymia (Toronto Alexithymia Scale, TAS-20), pain intensity (0-10 NRS), pain interference (Brief Pain Inventory Interference scale), mental health (SF-36 Mental Health scale; as a proxy measure of negative affect) and vitality (SF-36 Vitality scale). Higher TAS scores were associated significantly with higher pain intensity and interference, and less vitality. Although the strengths of these associations were reduced when mental health was used as a control, the associations between the Difficulty Identifying Feelings scale and vitality, and the Externally Oriented Thinking and Total TAS scales and pain intensity remained statistically significant. The findings replicate and extend previous findings concerning the associations between alexithymia and important pain-related variables in a sample of persons with chronic pain and neuromuscular disease. Future research is needed to determine the extent to which the associations are due to (1) a possible causal effect of alexithymia on patient functioning that is mediated via its effects on negative affect or (2) the possibility that alexithymia/outcome relationships reflect response bias caused by general negative affectivity.

Temporal stability of alexithymia in cancer patients following a psychological intervention

“…Moreover, pain, which is one of the most distressing symptoms affecting about 50% of cancer patients (World Health Organization, 1990), is strictly associated with alexithymia in several chronic pain illnesses (Glaros & Lumley, 2005;Hosoi et al, 2010;Lumley, Smith, & Longo, 2002;Mehling & Krause, 2005;Neyal Muftuoglu, Herken, Demirci, Virit, & Neyal, 2004;Pecukonis, 2009;Porcelli et al, 2007;Sipila¨et al, 2001). The present article reports the findings of the additional analysis of a previously published dataset (Tulipani et al, 2010).…”

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

“…The independent effect of alexithymia on pain perception has rarely been examined so far. Hosoi et al examined 129 patients with neuromuscular disorders and found that the association between alexithymia and pain intensity is greatly diminished when controlling for baseline negative affect (19). Another shortcoming of previous studies is that most of them evaluated the output of pain without considering the inputs of pain (13).…”

Emotional Experiences Induced Alexithymia

“…Specific aspects of alexithymia such as enhanced fantasy and difficulty identifying emotions were significantly associated with somatization along with other prominent symptoms such as pain, anxiety etc. These pathways were facilitated by negative affectivity [34,35] with medically unexplained symptoms [36,37].…”