Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Psychol Psychother. 2020 Sep;27(5):736-748. doi: 10.1002/cpp.2458. Epub 2020 Apr 20.
Although alexithymia has been found to be associated with physical symptoms in psychosomatic disorders such as asthma, mechanisms linking this association are unknown. However, affective alexithymic features may be associated with physical symptoms in the presence of deficits in affective characteristics such as low empathy and high negative affect. This study aimed to assess direct effects of alexithymic traits on physical symptoms and indirect effects of these subscales through empathy and negative affect (e.g. depressive, anxious and stress symptoms) by controlling for asthma severity in patients with asthma. Three hundred patients with asthma completed the Toronto Alexithymia Scale-20 (TAS-20), the Basic Empathy Scale (BES), the Depression Anxiety Stress Scales-21 (DASS-21) and the Physical Symptoms Inventory (PSI). After controlling for asthma severity, the results showed that alexithymia subscales of the TAS-20 had no direct effects on physical symptoms, but the difficulty in identifying feelings (DIF) subscale of the TAS-20 was associated with affective empathy and negative affect. Affective empathy was significantly related to negative affect. Affective empathy and negative affect were associated with physical symptoms. The affective subscale of alexithymia on the TAS-20, that is DIF, indirectly affected physical symptoms through affective empathy and negative affect. Findings suggest that patients with asthma who have high levels of DIF may show high physical symptoms in the presence of low affective empathy and high negative affect.
尽管在哮喘等身心障碍中发现述情障碍与身体症状有关，但这种关联的机制尚不清楚。然而，在情感特征（如低同理心和高负性情绪）缺陷的情况下，情感性述情障碍特征可能与身体症状有关。本研究旨在评估在控制哮喘严重程度的情况下，哮喘患者的述情障碍特征对身体症状的直接影响，以及这些子量表通过同理心和负性情绪（如抑郁、焦虑和压力症状）的间接影响。300 名哮喘患者完成了多伦多述情障碍量表-20（TAS-20）、基本同理心量表（BES）、抑郁焦虑压力量表-21（DASS-21）和身体症状量表（PSI）。在控制哮喘严重程度后，结果表明，TAS-20 的述情障碍子量表对身体症状没有直接影响，但 TAS-20 的难以识别感受（DIF）子量表与情感同理心和负性情绪有关。情感同理心与负性情绪显著相关。情感同理心和负性情绪与身体症状有关。TAS-20 的述情障碍情感子量表，即 DIF，通过情感同理心和负性情绪间接影响身体症状。研究结果表明，DIF 水平较高的哮喘患者在情感同理心低和负性情绪高的情况下可能会表现出较高的身体症状。
