Alexithymia, a Risk Factor in Alcohol Addiction? a Brief Research Report on Romanian Population
Birt, Mircea Al, Sandor, Vlaicu, Vaida, Aura, Birt, Maria Edita, Journal of Cognitive and Behavioral Psychotherapies
Alexithymia was evaluated on 30 alcoholic patients (23 male and 7 female) with ages between 20 and 55. Assessment was conducted at the time of hospital admission, 2 weeks (post-pharmacotherapy treatment), 24 weeks and 48 weeks after admission. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20). Alcohol use and abstinence were evaluated using the Obsessive Compulsive Drinking Scale (OCDS). Patients who became abstinent presented a 75% reduction in the total score after 2 weeks of pharmacological treatment. Total abstinence was observed in the case of 13 patients (43.33%) and persistent for 48 weeks. The prevalence of alexithymia in our group at baseline was 63.33%, and it predominated in the type II alcoholism group. Abstinence was found to be mainly related with the third factor of the TAS-20 scale (i.e., externally oriented thinking). There seems to be a relation between the absence of alexithymia and abstinence, and the presence of alexithymia and alcohol use. Thus, alexithymia might be considered a risk factor for alcohol addiction
Keywords: alcoholism, alexithymia, abstinence, dependence, risk factor
Alexithymia refers to the incapacity of verbalizing personal emotions or feelings. It is derived from the Greek a-lexis-thimia, meaning "absence of words to express emotions". Taylor describes alexithymia as a multidimensional concept organized around four axes (Taylor, Bagby, & Parker, 1992; 1997). On the one hand, there are the emotional components related to (1) deficiencies in the recognition or (2) identification of emotions and on the other hand, the cognitive components related to (3) difficulties in dreaming and (4) in using a nonintrospective concrete way of thinking. Sifneos (1967) describes four cardinal alexithymic manifestations: the incapacity of verbalizing emotions or feelings; a limitation of imaginary life; a tendency to resort to action in order to avoid or solve conflicts; and a detailed description of facts, events, physical symptoms. The nosological status of alexithymia indicates that it is not a disorder, a personality problem or a symptom part of the clinical picture of a medical or another type of illness. In nosological classifications, it never designates a particular clinical problem, and there is no such thing as alexithymic mood disorder, alexithymic psychosis or alexithymic borderline disorder. McDougall (1982) maintains that alexithymic patients are an independent category, characterized by a particular behavioral pattern rather than by the presence of a clinical entity. Thus, alexithymia is a clinical concept designating a behavior observable by clinicians, which coexists with other cognitive and psychological traits (Birt, 2006; Corcos & Speranza, 2003; Loas, Fremaux, Marchand et al., 1993). It can be found independent of clinical structures, and has an important trans-diagnostic feature. The prevalence of alexithymia in the general population varies between 18.8% and 3.5%. For example, Guilbaud (2003) reports a 20.7% incidence of alexithymia in the general population.
Freyberger (1977), as well as other authors, describes two types of alexithymia: primary (trait) and secondary alexithymia (state). According to McLean (1949) primary alexithymia is a biologically based predisposing factor for somatic disorders. This type of alexithymia is considered to be innate, nonresponsive to treatment, reflecting, to a certain extent, traditional psychosomatic views and reuniting their main characteristics (Birt, 2006; Corcos & Speranza, 2003). Secondary alexithymia is present in vital risk patient: kidney failure, cancer, natural or personal disasters (Fukunishi,1992) This type of alexithymia is a reaction to anxiety induced by illness or trauma, and can be transient in the case of illness or permanent following trauma (Taylor,1984;1990). Secondary alexithymia is sometimes conceptualized as a protective factor against the emotional impact and severity of the illness or the traumatic event, assimilated to a defense mechanism (Birt, 2006; Corcos & Speranza, 2003). …