The objective was to investigate the relationship between possible disaster stressors and subsequent health problems among tourists experiencing the 2004 South-East Asia tsunami. A cross-sectional study was performed as a postal survey concerning the experiences of the disaster exposure in retrospect and the presence of psychological symptoms (GHQ-28) in Norwegian tsunami victims 6 months post disaster. The strongest predictors of health complaints were danger of death, witness impressions, and bereavements. Aggravated outcomes were also seen in those who helped others in the acute phase or had sole responsibility for children when the tsunami struck. Having a family member or close friend who was injured was reversely associated with health problems. Women reported more psychological distress than men, but the difference disappeared with increasing degree of danger exposure. Dose-response relationships to psychological distress were found for single exposure factors as well as for the cumulative effects of being exposed to several exposure variables.
Child and Adolescent Psychiatric Department, Mental Health Hospital and University Clinic, Region of Southern Denmark, University of Southern Denmark , Sdr. Boulevard 29, DK-5000 Odense C , Denmark.
The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events.
Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change.
Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group.
Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.
From a total population of 10,766 Swedish 50- to 59-year-old women, 6,917 (64.2%) participated in the Women's Health in Lund Area (WHILA) study, and among them 6,623 (95.7%) answered the questions on alcohol consumption. One out of 4 women (26.0%) consumed no alcohol in an ordinary week (non-drinkers), 57.4% consumed not more than 83 g alcohol, 12.5% consumed 84-167 g and 4.2% consumed 168 g or more. The weekly drinkers had a median consumption of 40.0 g alcohol (range 2.5-1,036.0) and the main sort of alcohol was wine. Comparing the four drinking groups, most differences occurred between the non-drinking and the weekly drinking women. The non-drinkers had lower socio-demographic status, poorer health and more symptoms, especially physical symptoms. In a multivariate logistic regression analysis, most associations between non-drinking and lower socio-demographic status remained.
An increasing amount of evidence indicates an association between alexithymia and eating disorder symptoms. This possible association was evaluated in a non-clinical sample of late adolescents. Seven hundred and twenty nine adolescents completed the questionnaire and formed the final sample. Alexithymia was measured using the 20-item Toronto Alexithymia Scale and eating disorder symptoms were assessed using the SCOFF questionnaire. The rate of alexithymia was 8.2%, without any gender difference. The mean SCOFF scores differed significantly between alexithymic and non-alexithymic subjects, and the share of SCOFF positive subjects was significantly higher among alexithymics. The results suggest that eating disorder symptoms are more common in alexithymic adolescents.
The association between alexithymia and maladaptive health behaviors was evaluated in 118 young, healthy men, aged 18-45 years. Subjects completed the Toronto Alexithymia Scale (TAS-26), and a health behaviors questionnaire, measuring alcohol and drug use, sedentary lifestyle, poor nutritional consumption, and risky sexual practices. In forced hierarchical regression analyses, the association between alexithymia and health behaviors was evaluated after adjusting for age, body mass index, social support, ambivalence over expression of emotion, and the expression of emotion. Results indicated that: (1) the TAS-26 and difficulty identifying feelings was associated with poor nutritional consumption; (2) difficulty identifying feelings was associated with greater alcohol and drug use; and (3) difficulty communicating feelings was associated with a more sedentary lifestyle. There was no association between risky sexual practices and alexithymia. These results suggest that, in young men, difficulties with identifying emotions and communicating emotions are associated with maladaptive nutritional habits, a sedentary lifestyle, and substance abuse, even after adjusting for other psychosocial and demographic variables. Such maladaptive health behaviors may help explain the association between alexithymia and premature mortality.
Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and, therefore, it may predispose individuals to both psychological and somatic symptoms.
The authors investigated the relationship between alexithymia and health-related quality of life (HRQoL) in a nationally representative population sample of 5,418 subjects, age 30 to 97 years.
Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and HRQoL measured with the 15D, a generic HRQoL measure.
Alexithymia was significantly associated with lower HRQoL independently of other variables. The TAS-20 subfactor Difficulties Identifying Feelings was the strongest common denominator between alexithymia and HRQoL.
Alexithymia may be a predisposing factor to poorer HRQoL.
The relationship between life satisfaction and alexithymia was studied in a sample of 229 patients as a part of a naturalistic follow-up study of depression in Finnish primary health care. The measures were the abbreviated Life Satisfaction Scale and the 20-item Toronto Alexithymia Scale. Depression was assessed by telephone with the short form of the Composite International Diagnostic Interview. Of all subjects, 19.2% were alexithymic, and 9.2% were depressed. Alexithymia was negatively associated with life satisfaction even when depression and other confounding factors were controlled for. Alexithymia is a risk factor for life dissatisfaction in primary-care patients.
The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients.
Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a random sample of 394 working-age primary health care patients. Frequent attendance was defined as a minimum of 11 visits during 1 year to different kinds of outpatient health care services, excluding specialized psychiatric care.
Frequently attending patients with psychological distress were found to be alexithymic more commonly than other patients, but this was not the case with other frequently attending patients. In other words, frequent attendance and alexithymia had an association mediated by psychological distress.
There is a subgroup of frequently attending patients, who are alexithymic and have psychological distress, too. They usually visit health-care services because of a somatic complaint. We hypothesize that their expression of psychological distress was masked and somatized just because of alexithymia.
Laboratory for Population Research, Department of Health and Functional Capacity, National Public Health Institute, Turku, Finland. jouko.salminen@ktl.fi
Temporal stability is a basic assumption underlying any personality trait construct. Previous research on the stability of alexithymia has led to a controversy over whether alexithymia should be viewed as a state-dependent phenomenon or as a stable personality trait. The aim of this 5-year longitudinal study was to examine the temporal stability of alexithymia in the general population in Finland.
Alexithymia was measured with the 20-Item Toronto Alexithymia Scale (TAS-20) at the baseline and 5 years later.
The test-retest correlations of the TAS-20 total and factor-specific scores at the baseline and at the 5-year follow-up ranged from moderate to high in both genders, reflecting a rather high relative stability of the TAS-20 scores over a period of 5 years.
The findings of our study suggest that alexithymia behaves like a stable personality trait in the general population.
Tinnitus is known to have an association with depression and other psychiatric disorders. As part of a larger epidemiological survey, we evaluated the associations among tinnitus, depression and alexithymia in a group of elderly people.
A survey of hearing loss, audiological rehabilitation and associated morbidity in a senior population was conducted in Turku, Finland. The study sample consisted of 583 participants aged between 70 and 85 years. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, whereas the 13-item version of the Beck Depression Inventory was used to measure depression; the subjective experience of tinnitus was queried with a questionnaire.
Depression had a clear association with subjectively annoying tinnitus. Contrary to expectations, the TAS-20 score did not correlate with the severity of tinnitus. In fact, the highest TAS-20 scores were found among the subjects who had tinnitus but did not find it to be subjectively annoying. No significant association between high TAS-20 scores and hearing loss was found.
Although we found an association between TAS-20 scores and the presence of tinnitus, alexithymia does not seem to be helpful in explaining tinnitus annoyance among elderly people.