Original articleAge is strongly associated with alexithymia in the general population
Introduction
In the early 1970s, Sifneos [1] coined the term alexithymia. Alexithymia means “no words for feelings” and refers to a personality construct characterized by impoverishment of fantasy, poor capacity for symbolic thought, and inability to experience and verbalize emotions. Increasing evidence shows that alexithymia is associated with several medical conditions and various psychopathological syndromes [2] and mental disorders [3], [4]. It is thought to reflect a deficit in the cognitive processing of emotion, and alexithymics are thought to lack the capacity for the mental representation of emotions [5], [6], [7]. These deficiencies are believed to cause an inability to regulate emotions and affect, and therefore to predispose alexithymic individuals to both psychological and somatic symptoms. According to previous studies, since alexithymia is more prevalent among depressed individuals and since alexithymia scores decrease as depression is alleviated, it has been claimed that alexithymia is associated with level of depression and may be a state-dependent phenomenon [8], [9], [10]. On the other hand, several studies have yielded evidence on both the absolute stability and the relative stability of alexithymia, suggesting that alexithymia is a personality trait [4], [11], [12], [13], [14], [15].
It is quite surprising that the epidemiology of alexithymia has been the subject of only a handful of papers. Three research groups have studied the epidemiology of alexithymia in different kinds of samples of working-age populations, all of them in Finland [16], [17], [18]. Two studies have focused on elderly people [19], [20]. Lane et al. [21] studied both working-age and elderly people. Alexithymia was associated with male gender in four earlier epidemiological studies [16], [17], [18], [21], with low educational level in four studies [16], [17], [18], [21], with low social status in four studies [16], [17], [18], [21], with psychological problems in three studies [17], [19], [20], and with singleness in one study [18]. The prevalence figures for alexithymia were quite similar across studies on working-age populations, with the prevalence being 9–17% among men and 5–10% among women. In elderly populations, the prevalence of alexithymia was notably higher.
All studies mentioned above differ from each other on several aspects. Disparities in size, age range, and stratification of the samples make it difficult to generalize the findings to adult general populations. The aim of our study was to determine the prevalence of alexithymia and its distribution in different age groups, the sociodemographic and health-related factors associated with it, and its co-occurrence with depression in a representative sample of the whole Finnish adult population.
Section snippets
Sample
Our study is a part of the Health 2000 Study. The gathering of data took place in Finland in 2000–2001 [22]. A large national network coordinated by the National Public Health Institute was responsible for the planning and execution of this multidisciplinary epidemiological survey. It was designed according to the concept of a two-stage stratified cluster sampling and comprised adults aged 30 years and above. The age limit was set at 30 years because the prevalence of somatic diseases is low in
Results
Cronbach's α coefficients were ≥.70 for TAS-20 and the subscales, except for the EOT subscale for the whole sample (.67) and for men (.57). The mean TAS-20 score for the whole sample was 45.8 (43.9 for women and 47.8 for men; P<.001). No sex differences between the scores of DIF subscales were found, but the scores of both the DDF and the EOT subscales were significantly higher for men than for women.
Discussion
The main findings of the present study were (a) the presence of sex difference in the prevalence of alexithymia and (b) the association of alexithymia with increasing age, low level of education, and poor perceived health. As far as we know, this was the first study on alexithymia that dealt with a sample representing the adult population aged 30 years and older in one country. Moreover, this was the first study with such a wide age range.
In this study, the prevalence of alexithymia was
References (51)
- et al.
Alexithymia and cognitive bias for emotional information
Pers Individ Differ
(2002) - et al.
Impairments of emotion situation priming in alexithymia
Pers Individ Differ
(2002) - et al.
Alexithymia, depression, and treatment outcome in bulimia-nervosa
Compr Psychiatry
(1995) - et al.
A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease
J Psychosom Res
(1996) - et al.
Stability in alexithymia levels: a longitudinal analysis on various emotional answers
Pers Individ Differ
(1998) - et al.
Alexithymia and depression: a 1-year follow-up study in outpatients with major depression
J Psychosom Res
(2001) Stability of neuroticism and alexithymia in somatization
Compr Psychiatry
(2003)- et al.
Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland
J Psychosom Res
(1999) - et al.
Depression is strongly associated with alexithymia in the general population
J Psychosom Res
(2000) - et al.
Prevalence and sociodemographic correlates of alexithymia in a population sample of young adults
Compr Psychiatry
(2001)
Alexithymia in a normal elderly population
Compr Psychiatry
Alexithymia in the elderly general population
Compr Psychiatry
Sociodemographic correlates of alexithymia
Compr Psychiatry
The twenty-item Toronto Alexithymia Scale: I. Item selection and cross-validation of the factor structure
J Psychosom Res
The twenty-item Toronto Alexithymia Scale: II. Convergent, discriminant, and concurrent validity
J Psychosom Res
The 20-item Toronto Alexithymia Scale: III. Reliability and factorial validity in a community population
J Psychosom Res
The 20-item Toronto Alexithymia Scale: IV. Reliability and factorial validity in different languages and cultures
J Psychosom Res
Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation
Clin Psychol Rev
Relationships among alexithymia, adverse childhood experiences, sociodemographic variables, and actual mood disorder: a 2-year clinical follow-up study of patients with major depressive disorder
Psychosomatics
Childhood abuse, alexithymia and personality disorder
J Psychosom Res
Age-related differences in brain activation during emotional face processing
Neurobiol Aging
Age-differential patterns of brain activation during perception of angry faces
Neurosci Lett
Facial expression recognition across the adult life span
Neuropsychologia
Alexithymia and somatisation: quantitative review of the literature
J Psychosom Res
Alexithymia and somatosensory amplification in functional dyspepsia
Psychosomatics
Cited by (281)
Alexithymia in chronic schizophrenia and its mediating effect between cognitive deficits and negative symptoms
2023, Schizophrenia ResearchDepression mediates the relationship between alexithymia and obesity in the Northern Finland Birth Cohort 1966 (NFBC1966)
2023, Journal of Affective DisordersAssociations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety
2024, European Journal of Oral SciencesType 1 Diabetes Mellitus, Psychopathology, Uncertainty and Alexithymia: A Clinical and Differential Exploratory Study
2024, Healthcare (Switzerland)The impact of family alexithymia on the severity of restrictive eating disorders in adolescent patients
2023, Child and Adolescent Psychiatry and Mental Health