Relationships Between Alexithymia and Psychopathy in Heroin Dependent Individuals

Abstract

BackgroundPsychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are also central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well-understood and has been particularly understudied among substance dependent individuals.AimOur goal was to evaluate the levels of psychopathy and alexithymia in a relatively homogeneous sample of heroin dependent individuals (HDIs) and healthy controls and to examine group differences in the pattern of associations between these constructs.MethodsWe examined 62 participants (31 heroin dependent individuals and 31 healthy controls) with the Psychopathy Checklist: Screening version (PCL:SV, Hart et al., 1995) and the Toronto Alexithymia Scale-20 (TAS-20, Bagby et al., 1994).ResultsHeroin dependent individuals were characterized by higher levels of both psychopathy and alexithymia as compared to the control group. In addition, HDIs with higher levels of psychopathy reported more difficulties in identifying and verbalizing emotional states. In the heroin group, alexithymia was more strongly associated with the impulsive/antisocial characteristics (impulsivity, irresponsibility, antisocial behavior) than with the interpersonal/affective features of psychopathy (grandiosity, manipulativeness, lack of empathy, and remorse).ConclusionOur findings suggest that alexithymia may be one potential mechanism linking psychopathy with opioid use disorders. The development of interventions targeting alexithymia could have significant applications in relapse prevention programs and psychotherapy of substance use disorders with concurrent psychopathy.

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

“…Consequently, the importance of considering alexithymia in the context of related constructs such as private self‐consciousness, emotion differentiation, and interoception is the potential value of this comparison for gaining greater insight into the nature of emotional processes and their relationship to AUD. Emotion‐focused interventions that improve emotion identification and differentiation skills may help moderate the influence of alexithymia and improve alcohol treatment outcomes, which is consistent with recent appeals to address the ability to attend to internal states as a target of clinical interventions (Psederska et al, 2019; Swan et al, 2020). Emotion regulation treatment for AUD, dialectical behavior therapy, and cognitive‐behavioral therapy for depression address emotion regulation deficits and may provide information on treatment content that could be adapted to supplement AUD treatment (Asnaani et al, 2020; Cavicchioli et al, 2020; Stasiewicz et al, 2018; Strauss et al, 2019).…”

Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients

“…The relationship between alexithymia and addictions has been documented and discussed many times, including in such fields as heroin dependent [ 44 ], alcohol addiction [ 20 ], internet addiction [ 9 ], pathological gambling [ 45 ], etc.…”

“…The frequency of drug use reflects a degree of craving, and patients with high subjective cravings will repeatedly self-administer drugs. One study on alcohol consumption found that alexithymia is associated with subjective hypersensitivity to bodily sensations, and difficulty identifying feelings mediated the relationship between sensitivity to bodily sensations and alcohol consumption [ 44 ]. Consistent with our research, one study tested cue-elicited craving responses in methamphetamine-dependent individuals and found a positive correlation between the difficulty identifying feelings and cue-elicited craving responses [ 22 ].…”

Do Individuals with Internet Gaming Disorder Share Personality Traits with Substance-Dependent Individuals?

“…People with addictive disorders have been already characterized as more prone to alexithymia than controls, even when evaluated after a prolonged period of abstinence [ 59 ]. However, no distinction between different addictive disorders had been made.…”