Comparison of Alexithymia in Individuals with and without Attention Deficit/ Hyperactivity Disorder

Document Type : Original Article

Authors

1 کارشناسی ارشد روانشناسی شناختی دانشگاه سمنان، سمنان، ایران

2 Assistant Professor of Psychology, Department of Clinical Psychology, Semnan University, Semnan, Iran

3 استادیار، گروه زبان شناسی همگانی دانشگاه سمنان، سمنان، ایران

4 استادیار، گروه آمار دانشگاه سمنان، سمنان، ایران

Abstract

Introduction:The main objective of this research was to compare Alexithymia features in individuals with and without Attention Deficit/ Hyperactivity Disorder (ADHD).
Method: The Method of study was expo-facto and the statistical population included all students of University of Tehran. Conners’Adult Rating Scales (CAARS) was used to screen 580 students in terms of Attention Deficit/ Hyperactivity Disorder (ADHD). In the second stage, 40 participants who gained the highest scored (i.e. in Conners’ scales) were invited to clinical interview. The diagnostic interview based on Utah Rating Scale (DSM-5) was conducted by a psychiatrist to diagnose ADHD. 10 patients out of the total40 individuals who have been invited to the interview, were excluded according to the psychiatric diagnosis. At the end, two groups of 30 people (30= patients, 30= normal) were compared together by using Toronto Alexithymia Scale (TAS).
Results: The results of multivariate analysis of variance showed that scores of people with Attention Deficit/ Hyperactivity Disorder (ADHD) in components of alexithymia contains;difficulty in identifying and describing feelings was significantly higher than normal populationbut there was no significant difference in externally oriented thinking.
Conclusion:Based on the findings of this study, it can be concludedpeople with Attention Deficit/ Hyperactivity Disorder (ADHD) have some features of alexithymia and in emotional responses are inferiority. Therefore, attention to the emotional issues of people with attention deficit / hyperactivity disorder is more important than the past.

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Main Subjects


1- O’Malley G, McHugh L, Mac Giollabhui N, Bramham J. Characterizing adult attention-deficit/hyperactivity-disorder and comorbid borderline personality disorder: ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors. European Psychiatry. 2016; 31: 29-36.
2- Allah-Gholilo K, Abolghasemi A, Dehghan H, Imani H. The Association of Alexithymia and Sense of Coherence With Life Satisfaction in Attention Deficit Hyperactivity Disorder. Zahedan Journal of Research in Medical Sciences. 2015; 17(4).
3- Cubillo A, Halari R, Smith A, Taylor E, Rubia K. A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. Cortex. 2012; 48(2): 194-215.
4- Feinberg TE, Farah MJ. Patient-based approaches to cognitive neuroscience: Mit Press. 2000.
5- Marchetta ND, Hurks PP, Krabbendam L, Jolles J. Interference control, working memory, concept shifting, and verbal fluency in adults with attention-deficit/hyperactivity disorder (ADHD). Neuropsychology. 2008; 22(1): 74.
6- Masunami T, Okazaki S, Maekawa H. Decision-making patterns and sensitivity to reward and punishment in children with attention-deficit hyperactivity disorder. International Journal of Psychophysiology. 2009; 72(3): 283-8.
7- Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub. 2013.
8- Rajabi S. Efficacy of neurofeedback in the correct bran's wave's amplitude and the  visual-motor continous performance with ADHD. Journal of Psychology. 2015: 53-70.
9- Resnick RJ. Attention deficit hyperactivity disorder in teens and adults: They don't all outgrow it. Journal of clinical psychology. 2005; 61(5): 529-33.
10- Kibiuk LV, Stuart D, Miller M. Brain facts: A primer on the brain and nervous system: The Society For Neuroscience. 2008.
11- Wender PH. Attention-deficit hyperactivity disorder in adults. Psychiatric Clinics of North America. 1998; 21(4): 761-74.
12- Wixted EK, Sue IJ, Dube M, Sarahjane L. Cognitive Flexibility and Academic Performance in College Students with ADHD: An fMRI Study. 2016.
13- Wasserstein J, Wasserstein A, Wolf LE. Adults with Attention Deficit Hyperactivity Disorder (ADHD). ERIC Digest. 2001.
14- Mannuzza S, Klein RG. Long-term prognosis in attention-deficit. Child and adolescent psychiatric clinics of North America. 2000; 9: 711-26.
15- Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of psychiatry. 2006; 163(4): 716-23.
16- Garnier-Dykstra LM, Pinchevsky GM, Caldeira KM, Vincent KB, Arria AM. Self-reported adult attention-deficit/hyperactivity disorder symptoms among college students. Journal of American College Health. 2010; 59(2): 133-6.
17- Williamson D, Johnston C. Gender differences in adults with ADHD: a narrative review. Clinical psychology review: University of British Columbia. 2015.
18- Donfrancesco R, Di Trani M, Gregori P, Auguanno G, Melegari MG, Zaninotto S, et al. Attention-deficit/hyperactivity disorder and alexithymia: a pilot study. ADHD Attention Deficit and Hyperactivity Disorders. 2013; 5(4): 361-7.
19- Rapport LJ, Friedman SL, Tzelepis A, Van Voorhis A. Experienced emotion and affect recognition in adult attention-deficit hyperactivity disorder. Neuropsychology. 2002; 16(1): 102.
20- Tolmunen T, Heliste M, Lehto SM, Hintikka J, Honkalampi K, Kauhanen J. Stability of alexithymia in the general population: an 11-year follow-up. Comprehensive psychiatry. 2011; 52(5): 536-41.
21- Jonason PK, Krause L. The emotional deficits associated with the Dark Triad traits: Cognitive empathy, affective empathy, and alexithymia. Personality and Individual Differences. 2013; 55(5): 532-7.
22- Müller J, Bühner M, Ziegler M, Şahin L. Are alexithymia, ambivalence over emotional expression, and social insecurity overlapping constructs? Journal of psychosomatic research. 2008; 64(3): 319-25.
23- Lundh L-G, Johnsson A, Sundqvist K, Olsson H. Alexithymia, memory of emotion, emotional awareness, and perfectionism. Emotion. 2002; 2(4): 361.
24- Lumley MA, Neely LC, Burger AJ. The assessment of alexithymia in medical settings: implications for understanding and treating health problems. Journal of personality assessment. 2007; 89(3): 230-46.
25- Mattila AK, Kronholm E, Jula A, Salminen JK, Koivisto A-M, Mielonen R-L, et al. Alexithymia and somatization in general population. Psychosomatic Medicine. 2008; 70(6): 716-22.
26- Walker S, O’Connor DB, Schaefer A. Brain potentials to emotional pictures are modulated by alexithymia during emotion regulation. Cognitive, Affective, & Behavioral Neuroscience. 2011; 11(4): 463-75.
27- Dimaggio G, Carcione A, Nicolò G, Lysaker PH, d'Angerio S, Conti ML, et al. Differences between axes depend on where you set the bar: associations among symptoms, interpersonal relationship and alexithymia with number of personality disorder criteria. Journal of personality disorders. 2013; 27(3): 371-82.
28- Hesse C, Floyd K. Affection mediates the impact of alexithymia on relationships. Personality and Individual Differences. 2011; 50(4): 451-6.
29- Pollatos O, Gramann K. Attenuated modulation of brain activity accompanies emotion regulation deficits in alexithymia. Psychophysiology. 2012; 49(5): 651-8.
30- Wotschack C, Klann-Delius G. Alexithymia and the conceptualization of emotions: A study of language use and semantic knowledge. Journal of research in Personality. 2013; 47(5): 514-23.
31- Korkoliakou P, Christodoulou C, Kouris A, Porichi E, Efstathiou V, Kaloudi E, et al. Alexithymia, anxiety and depression in patients with psoriasis: a case–control study. Annals of general psychiatry. 2014; 13(1): 38.
32- Chen J, Xu T, Jing J, Chan RC. Alexithymia and emotional regulation: A cluster analytical approach. BMC psychiatry. 2011; 11(1): 33.
33- Mason O, Tyson M, Jones C, Potts S. Alexithymia: its prevalence and correlates in a British undergraduate sample. Psychology and Psychotherapy: Theory, Research and Practice. 2005; 78(1): 113-25.
34- Saariaho AS, Saariaho TH, Mattila AK, Karukivi MR, Joukamaa MI. Alexithymia and depression in a chronic pain patient sample. General hospital psychiatry. 2013; 35(3): 239-45.
35- Han S, Pistole MC. College student binge eating: Insecure attachment and emotion regulation. Journal of College Student Development. 2014; 55(1): 16-29.
36- Pérusse F, Boucher S, Fernet M. Observation of couple interactions: Alexithymia and communication behaviors. Personality and Individual Differences. 2012; 53(8): 1017-22.
37- Joukamaa M, Taanila A, Miettunen J, Karvonen JT, Koskinen M, Veijola J. Epidemiology of alexithymia among adolescents. Journal of Psychosomatic Research. 2007; 63(4): 373-6.
38- Grynberg D, Chang B, Corneille O, Maurage P, Vermeulen N, Berthoz S, et al. Alexithymia and the processing of emotional facial expressions (EFEs): systematic review, unanswered questions and further perspectives. PloS one. 2012; 7(8): 42429.
39- Kessler H, Kammerer M, Hoffmann H, Traue HC. Regulation von Emotionen und Alexithymie: Eine korrelative Studie. PPmP-Psychotherapie· Psychosomatik· Medizinische Psychologie. 2010; 60(05): 169-74.
40- Thorberg FA, Young RM, Sullivan KA, Lyvers M. Alexithymia and alcohol use disorders: a critical review. Addictive behaviors. 2009; 34(3): 237-45.
41- Dubey A, Pandey R, Mishra K. Role of Emotion R Emotion R Emotion Regulation Difficulties and P iculties and P iculties and Positive/Negative Affectivity in Explaining Alexithymia-Health Relationship: An overview. J Soc Sci Res. 2010; 7(1): 20-31.
42- Christiansen H, Kis B, Hirsch O, Philipsen A, Henneck M, Panczuk A, et al. German validation of the Conners Adult ADHD Rating Scales–self-report (CAARS-S) I: Factor structure and normative data. European Psychiatry. 2011; 26(2): 100-7.
43- Association AP. Diagnostic and statistical manual of mental disorders. Washington Google Scholar: American Psychological Association; 1994.
44- Conners CK, Erhardt D, Sparrow EP, editors. Conners' adult ADHD rating scales (CAARS): technical manual1999: MHS North Tonawanda.
45- Sadeghi-Bazargani H, Amiri S, Hamraz S, Malek A, Abdi S, Shahrokhi H. Validity and reliability of the Persian version of Conner’s adult ADHD rating scales: observer and self-report screening versions. Journal of Clinical Research & Governance. 2014; 3(1): 42-7.
46- Besharat MA. Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a sample of Iranian students. Psychological reports. 2007; 101(1): 209-20.
47- Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of psychosomatic research. 1994; 38(1): 23-32.
48- Ebrahimi AE, Moulavi H, Mousavi SG, BornaManesh A, Yaghoubi M. Psychometric properties and factor structure of General Health Questionnaire 28 (GHQ-28) in Iranian psychiatric patients. 2007.
49- Noorbala AA, Bagheri Yazdi SA, Asadi Lari M, Mahdavi V, Reza M. Mental health status of individuals fifteen years and older in Tehran-Iran (2009). Iranian journal of psychiatry and clinical psychology. 2011; 16(4): 479-83.
50- Edel M, Rudel A, Hubert C, Scheele D, Brüne M, Juckel G, et al. Alexithymia, emotion processing and social anxiety in adults with ADHD. European journal of medical research. 2010; 15(9): 403.
51- Matuszak J, Miller G, Kemmelmeier M, Mason N. A Pilot Study of the Impact of Stimulant Pharmacotherapy in College Students with ADHD on Alexithymia and Psychological Mindedness. Open Journal of Medical Psychology. 2013; 2(04): 139.
52- Heshmati R. The Study of Alexithymia and Coherence Self Knowledge in Patients with Psychotic Disorders, Non-psychotic and Normal People Tehran: Tehran University. 2009.