Using the Body When There Are No Words for Feelings: Alexithymia and Somatization in Self-Harming Adolescents

Abstract

The present case-control study aimed to investigate the relationship between alexithymia and somatic complaints in the psychopathological setting of non-suicidal self-injury (NSSI). A clinical sample of 134 adolescents (115 females; 85.5%) from 12 to 18 years old engaging in NSSI was compared with a control group of 243 high-school students (157 females; 64.6%) from 13 to 18 years old. Data were collected using two questionnaires: The Youth Self-Report 11-18 and the 20 Toronto Alexithymia Scale. In both cases and controls, the presence of somatization and alexithymia was associated with more severe psychopathological problems. Analyses were conducted to explore the association between somatic disorders and alexithymia. In the clinical group, somatic complaints were reported by 95.9% of alexithymic individuals, whereas only 44.3% of alexithymic adolescents reported somatic complaints. A one-way relationship emerged between somatization and alexithymia: while alexithymia would seem to be a factor associated with self-injury, somatic disorders were strongly associated with alexithymia, but not necessarily with self-injury. Among the self-harming adolescents, those with both alexithymia and somatization had a more severe psychopathological picture than the individuals with alexithymia but no somatization. This would suggest that, in the setting of NSSI, greater difficulty with identifying feelings is associated with somatization, and alexithymia would be an attribute common to self-harming behavior and somatization, both of which are characterized by the body being used to express psychological and emotional problems. Future research could further investigate alexithymia in self-harming individuals, in relation to any presence or absence of somatic disorders, with longitudinal assessments on any differences in their manifestation of self-injury and its psychopathological correlates.

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies

“…In this field, clinicians and researchers from a psychodynamic perspective have considered risky behaviors (including nonfatal injuries) as an adolescent’s real attempt to cope with psychological discomfort [ 67 , 112 ]. Our findings provide further support to this evidence, suggesting that the recurrence of accidents may be considered a result of adolescents’ difficulties in managing their emotions and psychological sufferance [ 113 , 114 , 115 ]. At the same time, as suggested by Carbone [ 112 ], subsequent recurrent ED visits due to MVCs may be interpreted as an unconscious attempt to receive both psychical and psychological help from health operators.…”

Prevalence and Correlation of Anxiety, Insomnia and Somatic Symptoms in a Chinese Population During the COVID-19 Epidemic

“…Some studies have identified that somatic symptoms are linked with psychological or physiological abnormalities, which could indicate a pathological condition (14). Meanwhile, Raffagnato A et al reported that patients expressed their mental state through somatization symptoms (15). For example, approximately, 15%-45% of patients with persistent pain suffer from various degrees of anxiety (16,17).…”

The Role of Alexithymia in Social Withdrawal during Adolescence: A Case–Control Study

“…Some published studies regarding adolescents have associated alexithymia with various psychopathological conditions [ 43 , 44 , 47 ], because it has been found to be related to an emotional dysregulation acquired already in infancy, and transmissible from one generation to the next [ 34 , 35 , 36 ]. The adolescents in the present study had a psychiatric diagnosis with which alexithymia may be associated.…”

“…The first binomial logistic regression was run to identify the dimension of alexithymia most impaired in socially-withdrawn adolescents. In fact, considering that the presence of alexithymic traits is a characteristic of different psychopathological disorders [ 43 , 44 , 47 ], we wanted to better investigate which specific aspect of alexithymia (i.e., difficulty in recognizing emotions, difficulty in expressing them, or concrete and externally-oriented thinking) was the most influential on social withdrawal. The presence or absence of social withdrawal (two levels) was input in the model as the dependent variable, with the three subscales of the TAS-20—difficulty describing feelings (DDF), difficulty identifying feelings (DIF) and externally-oriented thinking (EOT)—as predictors.…”

“…Referring more specifically to psychological disorders in adolescence, alexithymia has been associated particularly with internalizing disorders [ 36 , 37 , 38 , 39 ], eating disorders [ 40 , 41 ], social problems [ 42 ], self-harming [ 43 , 44 ], internet dependence [ 45 ], borderline personality disorder [ 46 ], substance dependence [ 47 ], and primary headache [ 48 , 49 ]. In short, studies have placed alexithymia in relation to disorders frequently found in comorbidity with social withdrawal, such as internet dependence, internalizing disorders, and social problems.…”