Alexithymia, Defenses, and Ego Strength: Cross-sectional and Longitudinal Relationships with Psychological Well-Being and Depression.

Affect regulation is important to mental health. A deficit in one's ability to identify and express emotions (alexithymia), cognitive styles of regulating emotional conflict (defenses), and the capacity for integrative and complex self-other understanding (ego strength or maturity) need to be studied to understand how they relate to each other as well as to mental health and well-being. A sample of 415 community-dwelling adults from a major metropolitan area in the Midwest U.S., stratified for gender, age, and ethnicity, completed three methodologically different measures of affect regulation along with measures of well-being and depression. Six years later, 49% of the sample again reported their well-being and depression. At baseline, ego strength and the defenses of principalization and reversal correlated negatively with alexithymia and the other defenses (turning against self, turning against object and projection), even after controlling for negative affect. Cross-sectionally, relationships were largely as hypothesized, with low alexithymia, use of mature defenses, and greater ego strength correlating with less depression and greater well-being, although some of these relationships were attenuated after controlling for negative affect. Prospectively, each of the affect regulation measures predicted hypothesized changes in well-being after 6 years, after controlling for baseline well-being, but affect regulation did not predict changes in depression. These findings illuminate similarities and differences among these affect regulation constructs, suggest the importance of differentiating well-being from depression, and reveal that affect regulation uniquely predicts changes in long-term well-being.