Laurence J. Stettner

How are alexithymia and physical illness linked? A review and critique of pathways

We review the empirical literature and critique four possible pathways linking alexithymia and physical illness; (a) alexithymia leads to organic disease through physiological or behavioral mechanisms: (b) alexithymia leads to illness behavior (physical symptoms, disability, excessive health care use) through cognitive or social mechanisms: (c) physical illness leads to alexithymia; and (d) both alexithymia and physical illness result from sociocultural or biological factors. Our review suggests that alexithymia is associated with tonic physiological hyperarousal, certain types of unhealthy behavior, and a biased perception and reporting of somatic sensations and symptoms. Alexithymia also appears to influence health care use, but in a complex fashion. Although trauma may give rise to alexithymia, whether physical illness such as chronic pain does so is not known, and there is little evidence that sociocultural or biological factors lead to both alexithymia and physical illness. We conclude that alexithymia probably influences illness behavior, but there is little support for the hypothesis that alexithymia leads to chronic organic disease, especially when one distinguishes organic disease from illness behavior.

Alexithymia, social support and health problems

This article presents three studies examining whether alexithymia is associated with less perceived and network social support, whether such relationships are accounted for by reduced social skills associated with alexithymia, and whether limited social support links alexithymia to health problems. The relationships between alexithymia (Toronto Alexithymia Scale), social variables, and physical health and depression were examined in both healthy young adults and patients. Alexithymia (especially deficits in identifying and communicating feelings) was related to less perceived support, fewer close relationships, and less social skill: the social skills deficit accounted fully for the association between alexithymia and a smaller social network. Additionally, alexithymia was related to both somatic complaints and depression, but social support generally was not. It is concluded that alexithymia is associated with reduced perceived and network social support, that these associations are likely due to alexithymia-related deficiencies in social skills but that reduced social support does not account for the relationship between alexithymia and health problems.

Alexithymia and Physiological Reactivity to Emotion-Provoking Visual Scenes

Alexithymia, a syndrome that involves a marked inability to name feelings, has been linked to psychosomatic illness. This study addressed the question of whether alexithymic tendencies are related to heightened levels of autonomic response to extrinsic cues. Alexithymia was assessed with the Toronto Alexithymia Scale and by the emotional content of stories written to five TAT-like printed pictures. Seventy-two college students were exposed to a series of emotion-provoking slides while their heart rates and electrodermal responses were recorded. Results indicated a trend for alexithymic tendencies to be associated with less heart rate increase and fewer electrodermal responses while viewing the slides. Alexithymia was also associated with a small but significant elevation in baseline heart, rate. These findings are discussed as part of a pattern of results which calls into question the hypothesis that alexithymia is related to illness because it produces hyperarousal to situational stressors; it is suggested that future research on the relationship between alexithymia and health status should be broadened to explore health-maintenance behaviors and other possible mechanisms.

Alexithymia and negative affect: Relationship to cigarette smoking, nicotine dependence, and smoking cessation

Alexithymia is associated with substance abuse and may interfere with successful psychotherapy. Alexithymias relation to smoking, nicotine dependence, and smoking cessation therapy is unknown, and potentially overlaps with negative affect. Three studies addressed the relations between alexithymia, negative affect, and smoking. In Study 1, 67 young adult smokers were more depressed than 370 past or never smokers, but no different on the Toronto Alexithymia Scale total or subscale scores. In Study 2, negative affect--but not alexithymia--was related to greater nicotine dependence among 99 chronic smokers. In Study 3, alexithymia tended to predict increased patient participation in cognitive-behavioral therapy for smoking; low nicotine dependence--but neither alexithymia nor negative affect--predicted abstinence from smoking at treatment end. Alexithymia appears to be independent of negative affect and unrelated to cigarette smoking or nicotine dependence, suggesting that the affect regulation deficits in alexithymia play a negligible role in nicotine addiction.

Effect of deprivation level on span of attention in a multi-dimension discrimination task

Twelve male hooded rats were trained on a discrimination task in which two perfectly correlated cues (size and shape) were present. Half of the Ss were trained under moderate level of water deprivation (MOD group) while the other group was highly water-deprived (HI group). Not only did MOD Ss learn the task more quickly than HI Ss, but the former made fewer errors on tests utilizing only the shape cues. This study supports the hypothesis that span of attention is inversely related to drive level.

Effect of presence of an imprinted object on response of ducklings in an open field and when exposed to a fear stimulus

This study was designed to determine whether ducklings would show evidence of attachment to a previously “imprinted” object when they were placed in an open field at 14 days of age. It was found that they did show attachment, spending considerably more time in the center of the field when the object was there than when it was absent. It was also found that when a fear object was placed in the field, half the ducklings stayed close to the imprinted object despite the fact that it meant being closer to the fear object than any duckling would tolerate in the absence of the imprinted object.

The use of stimulus fading in assessing behavioral deficits produced by brain damage

Abstract A brain-damaged quail, who had extreme difficulty in learning and reversing a visual pattern discrimination, was subsequently trained to do so with very few errors by superimposing a bright red circle upon one of the pattern stimuli and gradually reducing its intensity to zero as training progressed. This success with the stimulus fading technique indicates its possible utility in more exact assessments of learning deficits due to neurological factors.

Safe and reliable general anesthesia in birds

Abstract The use of Halothane as a safe and reliable general anesthetic agent for birds is described with sufficient detail to enable the setting up and utilization of this general anesthetic agent for use with birds. Use of this agent has the strong advantage of high degree of reliability, control, and a surprisingly low mortality rate for birds. A distinct advantage of this system is the capability of respiring the animal artificially utilizing oxygen as a vehicle for the Halothane.

Effect of deprivation level on responses to novel alleys in albino rats

After learning to run an L-shaped alley for sucrose solution, male albino rats were presented novel alleys (N-alleys) in the same and opposite direction as the goal turn-off alley. Moderately water deprived Ss (MOD group) entered both types of N-alleys more frequently than highly deprived Ss (HI group). MODs also showed the typical exploration gradient, of entering alleys nearest the start box more frequently than those nearer to the goal. HIs, however, entered an N-alley on the goal side most frequently when it was nearest the goal. The results were interpreted as based on combined goal anticipatory and exploratory behavior.

Effect of antibiotics on retention of visual discrimination training and on protein synthesis in the pigeon

Forty-three pigeons were trained for one day on a visual discrimination (horizontal vs. vertical stripes) and then immediately injected with either puromycin (PM), cycloheximide (CXM), control saline, or combined PM and CXM solution. PM produced a marked amnesic effect, CXM a weaker effect. PM injected animals (but not CXMs) also took significantly more than 1 day longer than controls to reach criterion levels, indicating an effect on continued acquisition of the discrimination beyond the amnesia for Day 1. Combination with CXM did not attenuate the PM effects. Protein inhibition profiles showed maximum PM activity of 90% inhibition, whereas CXMs maximum was 98% and was distributed more widely throughout different brain regions. In a second experiment, PM (N = 8), CXM (N = 8) or saline (N = 8) were again injected immediately after training, but the S+ was reversed on all postinjection training trials. In this case, PM animals were superior in percentage of S+ pecks on Day 2 to controls and CXMs. Further, the continued acquisition deficit was absent in the PM group, indicating that this effect is highly specific to those behavioral circuits active at the time of injection.