Academic journal article The Israel Journal of Psychiatry and Related Sciences

Alexithymia in Patients with Antisocial Personality Disorder in a Military Hospital Setting

Academic journal article The Israel Journal of Psychiatry and Related Sciences

Alexithymia in Patients with Antisocial Personality Disorder in a Military Hospital Setting

Article excerpt

Abstract: We investigated the prevalence of alexithymic features and other psychometric correlates in patients diagnosed with antisocial personality disorder in a military hospital setting. Forty soldiers diagnosed with antisocial personality disorder in a general military hospital and 50 normal soldiers with no known medical or psychiatric disorder were assessed by sociodemographic data form, the Toronto Alexithymia Scale (TAS)-26 items, the Beck Depression Scale, the Beck Hopelessness Scale, the Brief Symptom Inventory and the State-Trait Anxiety Inventory. Antisocial patients showed significantly higher rates of unemployment, lower educational and socioeconomic status, higher rates of self mutilation, previous suicide attempts, substance abuse, history of incarceration and broken family bonds. The patient group also displayed significantly higher scores on alexithymia, depression, hopelessness and general psychological distress measures. Alexithymia was not associated with other psychological measures but was associated with socioeconomic and educational status. The failure in the socialization process of these patients may pave the way for an inability to identify and communicate their feelings. To draw a more definitive conclusion on this issue, a study which recruits ASPD patients from the community and compares them with a sociodemographically matched patient control group is necessary.

Introduction

The personality trait of alexithymia is used to describe individuals who display an inability to identify and express emotions, an externally oriented mode of thinking and a restricted fantasy life (1). Alexithymic characteristics have been observed in patients with various psychiatric disorders and also with certain personality characteristics such as social introversion, lack of psychological mindedness, persecutory ideation, impulse expression, perceived difficulties of self-disclosure, neuroticism and emotional suppression (2). Certain dimensions of alexithymia may be considered as state dependent, and alexithymic features may be predicted by both depressed mood and lowered quality of life (3). It is proposed that alexithymia may also be a failure of psychological discourse among the lower socioeconomic classes (4), although not all studies confirm a positive association between lower social class status and alexithymia (5). The correlation of alexithymia and educational status is documented; the more educated the men were, the less alexithymic they tended to be (5). Alexithymia has also been conceptualized as a defense mechanism against emotional distress and pain in substance abusers (6). Research at all epidemiological levels is reported to confirm a strong association between substance abuse and antisocial personality disorder (7). It is also proposed that more developed cognitive skills, particularly verbal abilities, protect against the development of antisocial behavior. Toddlers with better communication skills are easier to socialize and less frustrating to parents, and youths with greater cognitive ability may be better able to anticipate the consequences of antisocial behavior (8). In one study investigating the relationship of alexithymia to personality disorders, schizotypal, dependent and avoidant personality dimensions as well as a lack of histrionic features emerged as significant predictors of alexithymia (2). In this study we aimed to see whether alexithymia is a prevalent feature of antisocial personality disorder by using a control group. The correlation of alexithymia with depression, anxiety, hopelessness and general psychopathology as well as educational and economic status was also sought.

Method

All male citizens without clearcut evidence of physical or mental ailment are obliged to complete their military service in Turkey. Army service is required after 20 years of age and lasts for 18 months. Soldiers are not paid for military service. Criminal behavior of soldiers falls within the jurisdiction of a separate military court, and the request for a psychiatric opinion is common practice. …

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