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Alexithymia in People With Recurrent Suicide Attempts

A Niche Area for Targeted Treatment

Published Online:November 26, 2020https://doi.org/10.1027/0227-5910/a000738

Abstract

Abstract.Background: Alexithymia, an inability to identify or describe emotions, is associated with suicidality yet the correlation with single or repeated suicide attempts is less clear. Aims: We aimed to assess the modifiability of alexithymia following a group psychosocial intervention focused on improving emotional literacy in those with a history of recurrent suicide attempts (RSA). Method: A total of 169 participants with self-reported RSA completed pre- and postgroup assessments of a 20-week group therapy intervention. Questionnaires assessed alexithymia, depression, impulsivity, and hopelessness; the Toronto Alexithymia Scale (TAS-20) was the primary outcome. Data were analyzed using multiple imputation. Results: Participants had on average 7.8 lifetime suicide attempts, 73% were female, and 16.6% had a >13-point reduction in TAS-20 scores after 20 weeks. Directed acyclic graph (DAG) analysis demonstrated significant relationships between alexithymia, depression, hopelessness, problem-solving, and satisfaction with life. Age of onset of suicidality was the only factor predictive of postintervention TAS-20 score in univariate linear regression. Limitations: The study limitations were its sample size, insufficient resources, and missing data. Conclusion: A change in TAS scores indicated that alexithymia can be a modifiable treatment target. Being able to identify and describe feelings may lead to improvement in depression, hopelessness, problem-solving, and satisfaction with life in this population.

References

  • Angus, L. E., & Greenberg, L.S. (2011). Working with narrative in emotion-focused therapy. American Psychological Association. 10.1037/12325-000 First citation in articleCrossref, Google Scholar

  • Bagby, R. M., Parker, J. D., & Taylor, G. J. (2020). Twenty-five years with the Toronto Alexithymia Scale. Journal of Psychosomatic Research. 10.1016/j.jsychores.2020.109940 First citation in articleCrossref Medline, Google Scholar

  • Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32. 10.1016/0022-3999(94)90005-1 First citation in articleCrossref Medline, Google Scholar

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. 10.1001/archpsyc.1961.01710120031004 First citation in articleCrossref Medline, Google Scholar

  • Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42(6), 861. 10.1037/h0037562 First citation in articleCrossref Medline, Google Scholar

  • Bergmans, Y., Gordon, E., & Eynan, R.. (2017). Surviving moment to moment: The experience of living in a state of ambivalence for those with recurrent suicide attempts. Psychology and Psychotherapy: Theory, Research and Practice, 90(4), 633–648. 10.1111/papt.12130 First citation in articleCrossref Medline, Google Scholar

  • Bergmans, Y. (2016). Understanding and responding to recurrent suicide attempts. Doctoral dissertation, Dublin City University. First citation in articleGoogle Scholar

  • Bergmans, Y., Langley, J., Links, P., & Lavery, J. V. (2009). The perspectives of young adults on recovery from repeated suicide-related behaviour. Crisis, 30(3), 120–127. 10.1027/0227-5910.30.3.120 First citation in articleLink, Google Scholar

  • Bergmans, Y., & Links, P. S. (2009). Reducing potential risk factors for suicide-related behaviour with a group intervention for clients with recurrent suicide-related behavior. Annals of Clinical Psychiatry, 21, 17–25. First citation in articleMedline, Google Scholar

  • Chioqueta, A. P., & Stiles, T. C. (2007). The relationship between psychological buffers, hopelessness, and suicidal ideation: identification of protective factors. Crisis, 28(2), 67–73. 10.1027/0227-5910.28.2.67 First citation in articleLink, Google Scholar

  • Davey, S., Halberstadt, J., Bell, E., & Collings, S. (2018). A scoping review of suicidality and alexithymia: The need to consider interoception. Journal of Affective Disorders, 238, 424–441. 10.1016/j.jad.2018.06.027 First citation in articleCrossref Medline, Google Scholar

  • De Berardis, D., Fornaro, M., Orsolini, L., Valchera, A., Carano, A., Vellante, F., Perna, G., Serafini, G., Gonda, X., Pompili, M., Martinotti, G., & Di Giannantonio, M. (2017). Alexithymia and suicide risk in psychiatric disorders: A minireview. Frontiers in Psychiatry, 8, 148. 10.3389/fpsyt.2017.00148 First citation in articleCrossref Medline, Google Scholar

  • Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75. 10.1207/s15327752jpa4901_13 First citation in articleCrossref Medline, Google Scholar

  • Dozois, D. J., & Covin, R. (2004). The Beck depression inventory-II (BDI-II), Beck hopelessness scale (BHS), and Beck scale for suicide ideation (BSS). In M. J. HilsenrothD. L. SegalM. Hersen (Eds.), Comprehensive handbook of psychological assessment, Vol. 2: Personality Assessment (pp. 50–69). John Wiley & Sons. First citation in articleGoogle Scholar

  • Evans, C., Margison, F., & Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence-Based Mental Health, 1(3), 70–2. 10.1136/ebmh.1.3.70 First citation in articleCrossref, Google Scholar

  • Guney, S., Kalafat, T., & Boysan, M. (2010). Dimensions of mental health: life satisfaction, anxiety and depression: a preventive mental health study in Ankara University students population. Procedia – Social and Behavioral Sciences, 2(2), 1210–1213. 10.1016/j.sbspro.2010.03.174 First citation in articleCrossref, Google Scholar

  • Haight, B. K., & Hendrix, S. A. (1998). Suicidal intent/life satisfaction: Comparing the life stories of older women. Suicide and Life-Threatening Behavior, 28(3), 272–284. 10.1111/j.1943-278X.1998.tb00857.x First citation in articleCrossref Medline, Google Scholar

  • Heisel, M. J., & Flett, G. L. (2004). Purpose in life, satisfaction with life, and suicide ideation in a clinical sample. Journal of Psychopathology and Behavioral Assessment, 26(2), 127–135. 10.1023/B:JOBA.0000013660.22413.e0 First citation in articleCrossref, Google Scholar

  • Hemming, L., Haddock, G., Shaw, J., & Pratt, D. (2019). Alexithymia and its associations with depression, suicidality and aggression: An overview of the literature. Frontiers in Psychiatry, 10, 203. 10.3389/fpsyt.2019.00203 First citation in articleCrossref Medline, Google Scholar

  • Heppner, P. P., & Petersen, C. H. (1982). The development and implications of a personal problem-solving inventory. Journal of Counseling Psychology, 29(1), 66. 10.1037/0022-0167.29.1.66 First citation in articleCrossref, Google Scholar

  • Iskric, A., Ceniti, A., Bergmans, Y., McInerney, S., & Rizvi, S. (2020). Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Research, 288, Article 112920. 10.1016/j.psychres.​2020.112920 First citation in articleCrossref Medline, Google Scholar

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12. 10.1037//0022-006x.59.1.12 First citation in articleCrossref Medline, Google Scholar

  • Kirmayer, L. J. (1987). Languages of suffering healing: Alexithymia as a social and cultural process. Transcultural Psychiatric Research Review, 24(2), 119–136. 10.1177/​136346158702400204 First citation in articleCrossref, Google Scholar

  • Loas, G., Dalleau, E., Lecointe, H., & Yon, V. (2016). Relationships between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein and serum lipid levels among 122 inpatients with mood or anxious disorders. Psychiatry Research, 246, 296–302. 10.1016/j.psychres.2016.09.056 First citation in articleCrossref Medline, Google Scholar

  • Marchesi, C., Brusamonti, E., & Maggini, C. (2000). Are alexithymia, depression, and anxiety distinct constructs in affective disorders? Journal of Psychosomatic Research, 49(1), 43–49. 10.1016/S0022-3999(00)00084-2 First citation in articleCrossref Medline, Google Scholar

  • Monnin, J., Thiemard, E., Vandel, P., Nicolier, M., Tio, G., Courtet, P., Bellivier, F., Sechter, D., & Haffen, E. (2012). Sociodemographic and psychopathological risk factors in repeated suicide attempts: Gender differences in a prospective study. Journal of Affective Disorders, 136(1–2), 35–43. 10.1016/j.jad.2011.09.001 First citation in articleCrossref Medline, Google Scholar

  • Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S. (2011). Effect of alexithymia on the process and outcome of psychotherapy: A programmatic review. Psychiatry Research, 190(1), 43–48. 10.1016/j.psychres.2010.04.026 First citation in articleCrossref Medline, Google Scholar

  • Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology, 51(6), 768–774. 10.1002/1097-4679(199511)51:6<768::aid-jclp2270510607>3.0.co;2-1 First citation in articleCrossref Medline, Google Scholar

  • Pinna, F., Manchia, M., Paribello, P., & Carpiniello, B. (2020). The impact of alexithymia on treatment response in psychiatric disorders: A systematic review. Frontiers in Psychiatry, 11, 3211. 10.3389/fpsyt.2020.00311 First citation in articleCrossref, Google Scholar

  • Pitman, A. (2007). Policy on the prevention of suicidal behaviour; one treatment for all may be an unrealistic expectation. Journal of the Royal Society of Medicine, 100(10), 461–464. 10.1177/014107680710001014 First citation in articleCrossref Medline, Google Scholar

  • Pompili, M. (2018). The increase of suicide rates: the need for a paradigm shift. The Lancet, 392(10146), 474–475. 10.1016/S0140-6736(18)31498-3 First citation in articleCrossref Medline, Google Scholar

  • Raghunathan, T., Solenberger, P., Berglund, P., & van Hoewyk, J. (2016). IVEware: Imputation and Variance Estimation Software (Version 0.3) [Computer software]. https://www.src.isr.umich.edu/software/iveware/iveware-documentation/ First citation in articleGoogle Scholar

  • R Core Team. (2018). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/ First citation in articleGoogle Scholar

  • SAS Institute Inc. (2013). SAS/STAT® 9.4 [Computer software]. Cary, NC: SAS Institute Inc. First citation in articleGoogle Scholar

  • Spineli, L. M., Pandis, N., & Salanti, G. (2015). Reporting and handling missing outcome data in mental health: a systematic review of Cochrane systematic reviews and meta-analyses. Research Synthesis Methods, 6(2), 175–187. 10.1002/jrsm.1131 First citation in articleCrossref Medline, Google Scholar

  • Taylor, G. J., & Bagby, M. R. (2013). Psychoanalysis and empirical research: The example of alexithymia. Journal of the American Psychoanalytic Association, 61(1), 99–133. 10.1177/0003065112474066 First citation in articleCrossref Medline, Google Scholar

  • Van't Wout, M., Aleman, A., Bermond, B., & Kahn, R. S. (2007). No words for feelings: Alexithymia in schizophrenia patients and first-degree relatives. Comprehensive Psychiatry, 48(1), 27–33. 10.1016/j.comppsych.2006.07.003 First citation in articleCrossref Medline, Google Scholar

  • Wickham, H., & Henry, L. (2020). tidyr: Tidy Messy Data. R package version 1.1.1 [Computer software]. https://CRAN.R-project.org/package=tidyr First citation in articleGoogle Scholar