Alexithymia is associated with anxiety among adolescents

Abstract

Background

The aim of this study was to explore the possible association between alexithymia and anxiety in a non-clinical sample of late adolescents.

Methods

The questionnaire was sent to 935 adolescents of whom 729 (78%) responded, thus forming the final sample. The mean age of the subjects was 19 years (range 17–21 years). The Finnish versions of the following scales were used: the 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, and anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and depression symptoms were evaluated using the short form of the Beck Depression Inventory, as modified by Raitasalo (RBDI).

Results

The prevalence of alexithymia in the sample was 8.2%, with no statistically significant gender difference. The alexithymic subjects had significantly (p < 0.001) higher mean STAI scores than the non-alexithymic subjects. A vast majority of the alexithymic subjects were highly anxious, in contrast to the low proportion among the non-alexithymic subjects. The highly anxious alexithymic subjects differed statistically and significantly from the highly anxious non-alexithymic subjects, with higher scores both in the AUDIT and the RBDI.

Limitations

The results are based on self-reported material alone and the cross-sectional design used in this study precludes the assessment of causal links.

Conclusions

The results suggest that anxiety symptoms are independently associated with alexithymia among late adolescents in general population.

Introduction

Alexithymia signifies a personality construct representing reduced ability to identify and describe feelings, a limited imagination, and externally oriented thinking (Sifneos, 1973). In adults, the estimated prevalence of alexithymia is approximately 10% (Mattila et al., 2006, Franz et al., 2008), and the prevalence in adolescents appears to be at the same level (Säkkinen et al., 2007, Honkalampi et al., 2009). Alexithymia is more frequent in adult men than in women, but in adolescents no gender difference has been shown (Joukamaa et al., 2007, Honkalampi et al., 2009).

In several previous studies with adult populations, alexithymia has been associated with anxiety (Devine et al., 1999, Marchesi et al., 2005). However, the causation is still somewhat unclear. It is possible that alexithymic individuals are more susceptible to anxiety (Devine et al., 1999), but there is also evidence suggesting that, depression or anxiety could result in reactive regression of emotional development and thus evoke alexithymic features (Honkalampi et al., 2000a). However, the data accumulated on this association up to date are mostly from clinical patient groups, whereas only a few studies have dealt with non-clinical populations.

The aim of the present study was to explore this possible association in a population sample of late adolescents. It has been suggested that alexithymia is influenced by anxiety directly whereas the influence of depression would be indirect and mediated through anxiety (Berthoz et al., 1999). Hence, in order to assess the association reliably, we included depression and alcohol consumption as covariates.