Brief Report
Meta-analysis of alexithymia in posttraumatic stress disorder
Paul A. Frewen,
David J. A. Dozois,
Richard W. J. Neufeld,
Ruth A. Lanius,
Paul A. Frewen
Department of Psychology, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorCorresponding Author
David J. A. Dozois
Departments of Psychology and Psychiatry, The University of Western Ontario, Ontario, Canada
University of Western Ontario, London, Ontario, Canada, N6A 5C2Search for more papers by this authorRichard W. J. Neufeld
Departments of Psychology, Psychiatry, and Neuroscience, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorRuth A. Lanius
Departments of Psychiatry and Neuroscience, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorPaul A. Frewen,
David J. A. Dozois,
Richard W. J. Neufeld,
Ruth A. Lanius,
Paul A. Frewen
Department of Psychology, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorCorresponding Author
David J. A. Dozois
Departments of Psychology and Psychiatry, The University of Western Ontario, Ontario, Canada
University of Western Ontario, London, Ontario, Canada, N6A 5C2Search for more papers by this authorRichard W. J. Neufeld
Departments of Psychology, Psychiatry, and Neuroscience, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorRuth A. Lanius
Departments of Psychiatry and Neuroscience, The University of Western Ontario, Ontario, Canada
Search for more papers by this authorAbstract
The authors present a meta-analysis investigating the prevalence of alexithymia in 12 studies encompassing 1,095 individuals with posttraumatic stress disorder (PTSD). A large effect size was found associating PTSD with alexithymia. Effect sizes were higher in studies of male combat PTSD samples in comparison with studies of other PTSD samples. Clinical and research directions are discussed.
REFERENCES
- Badura, A. S. (2003). Theoretical and empirical exploration of the similarities between emotional numbing in posttraumatic stress disorder and alexithymia. Anxiety Disorders, 17, 349–360.
- Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale-1: Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.
- Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.
- Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 1041–1065.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
- Cloitre, M., Cohen, L. R., & Koenen, K. C. (2006). Treating survivors of childhood abuse: Psychotherapy for the interrupted life. New York: Guilford Press.
- Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting & Clinical Psychology, 70, 1067–1074.
- Cloitre, M., Scarvalone, P., & Difede, J. (1997). Posttraumatic stress disorder, self- and interpersonal dysfunction among sexually retraumatized women. Journal of Traumatic Stress, 10, 437–452.
- Dalgleish, T. (2004). Cognitive approaches to posttraumatic stress disorder: The evolution of multi-representational theorizing. Psychological Bulletin, 130, 228–260.
- Frewen, P. A., Lanius, R. A., Dozois, D. J. A., Neufeld, R. W. J., Pain, C., Hopper, J. W., et al. (2008). Clinical and neural correlates of alexithymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117, 171–181.
- Hedges, I. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York: Academic Press.
- Hyer, L., Woods, G., Summers, M. N., Boudewyns, P., & Harrison, W. R. (1990). Alexithymia among Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 51, 243–247.
- Kleiger, J. H., & Kinsman, R. A. (1980). The development of an MMPI alexithymia scale. Psychotherapy & Psychosomatics, 34, 17–24.
- Krystal, H. (1968). Massive psychic trauma. New York: International University Press.
- Krystal, H., & Krystal, J. H. (1988). Integration and self-healing: Affect, trauma, alexithymia. Hillsdale, NJ: Analytic Press.
- Lane, R. D., & Schwartz, G. E. (1987). Levels of emotional awareness: A cognitive-developmental theory and its application to psychopathology. American Journal of Psychiatry, 144, 133–143.
- Lane, R. D., Ahern, G. L., Schwartz, G. E., & Kaszniak, A. W. (1997). Is alexithymia the emotional equivalent of blindsight? Biological Psychiatry, 42, 834–844.
- Litz, B. T., Orsillo, S. M., Kaloupek, D., & Weathers, F. (2000). Emotional processing in posttraumatic stress disorder. Journal of Abnormal Psychology 109, 26–39.
- McCaslin, S. E., Metzler, T. J., Best, S. R., Liberman, A., Weiss, D. S., Fagan, J., et al. (2006). Alexithymia and PTSD symptoms in urban police officers: Cross-sectional and prospective findings. Journal of Traumatic Stress, 19, 361–373.
- Miller, M. W., & Litz, B. T. (2004). Emotional-processing in posttraumatic stress disorder II: Startle reflex modulation during picture processing. Journal of Abnormal Psychology, 113, 451–463.
- Monson, C. M., Price, J. L., Rodriguez, B. F., Ripley, M. P., & Warner, R. A. (2004). Emotional deficits in military-related PTSD: An investigation of content and process disturbances. Journal of Traumatic Stress, 17, 275–279.
- Orsillo, S. M., Batten, S. V., Plumb, J. C., Luterek, J. A., & Roessner, B. M. (2004). An experimental study of emotional responding in women with posttraumatic stress disorder related to interpersonal violence. Journal of Traumatic Stress, 17, 241–248.
- Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2003). The 20-item Toronto Alexithymia Scale III: Reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55, 269–275.
- Phan, K. L., Britton, J. C., Taylor, S. F., Fig, L. M., & Liberzon, I. (2006). Corticolimbic blood flow during nontraumatic emotional processing in posttraumatic stress disorder. Archives of General Psychiatry, 63, 184–192.
- Ramirez, S. M., Glover, H., Ohlde, C., Mercer, R., Goodnick, P., Hamlin, C., et al. (2001). Relationship of numbing to alexithymia, apathy, and depression. Psychological Reports, 88, 189–200.
- Rosenthal, R. (1979). The file drawer problem and tolerance for null results. Psychological Bulletin, 86, 638–641.
- Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy & Psychosomatics, 22, 255–262.
- Söndergaard, H. P., & Theorell, T. (2004). Alexithymia, emotions and PTSD: Findings from a longitudinal study of refugees. Nordic Journal of Psychiatry, 58, 185–191.
- Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1992). The Revised Toronto Alexithymia Scale: Some reliability, validity, and normative data. Psychotherapy & Psychosomatics, 57, 34–41.
-
Taylor, G. J.,
Bagby, R. M., &
Parker, J. D. A.
(1997).
Disorders of affect regulation: Alexithymia in medical and psychiatric illness.
Cambridge, UK: Cambridge University Press.
10.1017/CBO9780511526831 Google Scholar
- Taylor, G. J., Ryan, D., & Bagby, R. M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy & Psychosomatics, 44, 191–199.
- Wagner, A. W., Roemer, L., Orsillo, S. M., & Litz, B. T. (2003). Emotional experiencing in women with posttraumatic stress disorder: Congruence between facial expressivity and self-report. Journal of Traumatic Stress, 16, 67–75.
- Yehuda, R., Steiner, A., Kahana, B., Binder-Brynes, K., Southwick, S. M., Zemelman, S., et al. (1997). Alexithymia in holocaust survivors with and without PTSD. Journal of Traumatic Stress, 10, 93–100.
- Zeitlin, S. B., Lane, R. D., O'Leary, D. S., & Schrift, M. J. (1989). Interhemispheric transfer deficit and alexithymia. American Journal of Psychiatry, 146, 1434–1439.
- Zeitlin, S. B., McNally, R. J., & Cassiday, K. L. (1993). Alexithymia in victims of sexual assault: An effect of repeated traumatization? American Journal of Psychiatry, 150, 661–663.
- Zlotnick, C., Mattia, J. L., & Zimmerman, M. (2001). The relationship between posttraumatic stress disorder, childhood trauma and alexithymia in an outpatient sample. Journal of Traumatic Stress, 14, 177–188.
