Alexithymia, a compounding factor for eating and social avoidance symptoms in anorexia nervosa
Comprehensive Psychiatry. 2015-01-01; 56: 217-228
DOI: 10.1016/j.comppsych.2014.09.011
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1. Compr Psychiatry. 2015 Jan;56:217-28. doi: 10.1016/j.comppsych.2014.09.011.
Epub 2014 Sep 16.
Alexithymia, a compounding factor for eating and social avoidance symptoms in
anorexia nervosa.
Courty A(1), Godart N(2), Lalanne C(3), Berthoz S(4).
Author information:
(1)LPPS – EA 4057, Institut de Psychologie, Paris Descartes University, France;
Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste
Montsouris, Paris, France; Inserm U669 – Maison de Solenn, Paris Descartes and
Paris Sud Universities, France.
(2)Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste
Montsouris, Paris, France; Inserm U669 – Maison de Solenn, Paris Descartes and
Paris Sud Universities, France.
(3)Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste
Montsouris, Paris, France; AP-HP, Department of Clinical Research, Saint-Louis
Hospital, Paris, France.
(4)Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste
Montsouris, Paris, France; Inserm U669 – Maison de Solenn, Paris Descartes and
Paris Sud Universities, France. Electronic address: .
Socio-affective difficulties, in particular difficulties in representing,
communicating and feeling emotions, may play a critical role in anorexia nervosa
(AN). The aim of this longitudinal study was to explore the links between
alexithymia and two types of difficulties in AN: eating symptoms and social
avoidance. Sixty adolescent girls with AN were recruited following
hospitalisation in a specialised department. They completed self-administered
questionnaires of alexithymia (TAS-20), of central symptoms of the eating
disorders (EDI), and of anxious and depressive affects (SCL-90). Anxiety and
social avoidance were assessed in the course of a standardised interview (LSAS).
These measures were performed at inclusion, and at 6-, 12- and 18-months’
follow-up. The relationship between TAS-20 and EDI or LSAS total scale scores
across the four time points was assessed using mixed-effects models, including
anxiety, depression, BMI, anorexia subtype, and age as co-factors. Partial least
square regression was used to refine this multivariate analysis at subscale
level, at inclusion and 18 months. Robust associations between TAS-20 and EDI
scores were found, independently from anxious and depressive scores, nutritional
state and AN subtype. These effects appeared more particularly linked to the
implication of the dimensions difficulties identifying and describing feelings,
interpersonal mistrust, feelings of inadequacy and interoceptive awareness
deficit. There was also a durable association between alexithymia and social
anxiety and avoidance, after adjusting for the confounding effects of
depression, and anxiety, and the state of starvation. Difficulties in describing
feelings appeared particularly involved here. Thus alexithymia does appear as a
factor in the persistence of disorders in AN, and difficulties identifying and
describing feelings could compound the social difficulties and major the
relational isolation of these patients.
Copyright © 2014 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.comppsych.2014.09.011
PMID: 25443977 [Indexed for MEDLINE]