Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T23:29:50.248Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological correlates of organic alexithymia

Published online by Cambridge University Press:  20 March 2007

RODGER Ll. WOOD  and
CLAIRE WILLIAMS
RODGER Ll. WOOD
Affiliation:
Brain Injury Research Group, Department of Psychology, University of Wales Swansea, Singleton Park, Swansea, United Kingdom
CLAIRE WILLIAMS
Affiliation:
Brain Injury Research Group, Department of Psychology, University of Wales Swansea, Singleton Park, Swansea, United Kingdom
Get access Rights & Permissions [Opens in a new window]

Abstract

Deficits in emotional recognition and perception following traumatic brain injury (TBI) have been associated with alexithymia (Henry et al., 2006; Williams et al., 2001). This study examined the prevalence of alexithymia in a TBI population, and its relationship to injury severity, neuropsychological ability and affective disorder. A total of 121 patients completed the Toronto Alexithymia Scale-20 (TAS-20), a measure that addresses 3 distinct characteristics of the alexithymia concept; difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. Patients also completed a neuropsychological assessment and measures of depression and anxiety. Results confirm a high prevalence of alexithymia after TBI, relative to the general population and an orthopedic control group. There was no relationship between injury severity and the presence of alexithymia. A negative relationship was found between alexithymia and verbal and sequencing abilities, but there was no relationship with executive dysfunction or any other cognitive domain. Moderate correlations were obtained between alexithymia and affective disorder; regression analyses indicated that alexithymia, depression, and anxiety should be considered distinct, but overlapping constructs. The results of this study suggest that increased neuropsychological attention should be directed towards emotional change after head injury and its relationship with cognition and psychosocial outcome. (JINS, 2007, 13, 471–479.)

Keywords

Traumatic brain injuryEmotional perceptionExecutive functionAffective disorderCognitive functionTAS 20
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 13 , Issue 3 , May 2007 , pp. 471 - 479
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adolphs, R., Damasio, H., Tranel, D., Cooper, G., & Damasio, A.R. (2000). A role for the somatosensory cortices in the visual recognition of emotions as revealed by three dimensional lesion mapping. Journal of Neuroscience, 20, 2683–2690.Google Scholar
Adolphs, R., Damasio, H., Tranel, D., & Damasio, A.R. (1996). Cortical systems for the recognition of emotion in facial expressions. The Journal of Neuroscience, 16, 7678–7687.Google Scholar
Baddeley, A., Emslie, H., & Nimmo Smith, I. (1992). The speed and capacity of language-processing test. England: Thames Valley Test Company.
Bagby, R.M., Parker, J.D.A., & Taylor, G.J. (1994a). The Twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.Google Scholar
Bagby, R.M., Taylor, G.J., & Parker, J.D.A. (1994b). The Twenty-Item Toronto Alexithymia Scale-II. Convergent discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40.Google Scholar
Becerra, R., Amos, A., & Jongenelis, S. (2002). Case Study. Organic alexithymia: A study of acquired emotional blindness. Brain Injury, 16, 633–645.Google Scholar
Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1981). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
Borod, J.C. (2000). The neuropsychology of emotion. New York: Oxford University Press.
Brooks, D.N. (1990). Cognitive deficits. In M. Rosenthal, E.R. Griffith, M.R. Bond, & J.D. Miller (Eds.), Rehabilitation of the adult and child with traumatic brain injury (pp. 163–178). Philadelphia: F. A. Davis.
Burgess, P.W. & Alderman, N. (2004). Executive dysfunction. In L.H. Goldstein & J.E. McNeil (Eds.), Clinical Neuropsychology: A practical guide to assessment and management for clinicians. Chichester, UK: John Wiley & Sons, Ltd.
Burgess, P.W. & Shallice, T. (1997). The Hayling and Brixton Tests. Bury St. Edmunds, England: Thames Valley Test Company Limited.
Hendryx, M.S., Haviland, M.G., & Shaw, D.G. (1991). Dimensions of alexithymia and their relationships to anxiety and depression. Journal of Personality Assessment, 56, 227–37.Google Scholar
Henry, J.D., Phillips, L.H., Crawford, J.R., Theodorou, G., & Summers, F. (2006). Cognitive and psychosocial correlates of alexithymia following traumatic brain injury. Neuropsychologia, 44, 62–72.Google Scholar
Hoppe, K.D. & Bogen, J.E. (1976). Alexithymia in twelve commissurotomized patients. Psychotherapy and Psychosomatics, 28, 148–155.Google Scholar
Hornak, J., Rolls, E.T., & Wade, D. (1996). Face and voice expression identification in patients with emotional and behavioural changes following ventral frontal lobe damage. Neuropsychologia, 34, 247–261.Google Scholar
Houtveen, J.H., Bermond, B., & Elton, M.R. (1997). Alexithymia: A disruption in a cortical network? An EEG power and coherence analysis. Journal of Psychophysiology, 11, 147–157.Google Scholar
Jessimer, M. & Markham, R. (1997). Alexithymia: A right hemisphere dysfunction specific to recognition of certain facial expressions? Brain Cognition, 34, 246–258.Google Scholar
Johnstone, B.M., Hexum, C.L., & Ashkanazi, G. (1995). Extent of cognitive decline in traumatic brain injury based on estimates of pre-morbid intelligence. Brain Injury, 9, 377–384.Google Scholar
Kandel, E.J., Schwartz, J.H., & Jessel, T.M. (1991). Principles of neural science. East Norwalk, CT: Appleton and Lange.
Kooiman, C.G., Spinhoven, P., & Trijsburg, R.W. (2002). The assessment of alexithymia: A critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. Journal of Psychosomatic Research, 53, 1083–1090.Google Scholar
Kucharska-Pietura, K., Philips, M.L., Gernand, W., & David, A.S. (2003). Perception of emotions from faces and voices following unilateral brain damage. Neuropsychologia, 41, 1082–1090.Google Scholar
Lamberty, G.J. & Holt, C.S. (1995). Evidence for a verbal deficit in alexithymia. Journal of Neuropsychiatry, 7, 320–324.Google Scholar
Lezak, M.D. (1995). Neuropsychological Assessment (3rd ed.). New York: Oxford University Press.
Loas, G., Corcos, M., Stephan, P., Pellet, J., Bizouard, P., Venisse, J.L., Perez-Diaz, F., Guelfi, J.D., & Jeammet, P. (2001). Factorial structure of the 20-item Toronto Alexithymia Scale: Confirmatory factorial analyses in non-clinical and clinical samples. Journal of Psychosomatic Research, 50, 255–261.Google Scholar
Mandal, M.K., Borod, J.C., Asthana, H.S., Mohanty, A., Mohanty, S., & Koff, E. (1999). Effects of lesion variables and emotion type on the perception of facial emotion. Journal of Nervous Mental Disorders, 187, 603–609.Google Scholar
Marchesi, C., Brusamonti, E., & Maggini, C. (2000). Are alexithymia, depression, and anxiety distinct constructs in affective disorders? Journal of Psychosomatic Research, 49, 43–49.Google Scholar
Mayes, L.C. & Cohen, D.J. (1992). The development of a capacity for imagination in early childhood. Psychoanalytic Study of the Child, 47, 23–47.Google Scholar
McDonald, S. & Flanagan, S. (2004). Social perception deficits after traumatic brain injury: Interaction between emotion recognition, mentalizing ability, and social communication. Neuropsychology, 18, 572–579.Google Scholar
McDonald, S., Flanagan, S., Martin, I., & Saunders, C. (2004). The ecological validity of TASIT: A test of social perception. Neuropsychological Rehabilitation, 14, 285–302.Google Scholar
McDonald, S. & Saunders, J.C. (2005). Differential Impairment in recognition of emotion across different media in people with severe traumatic brain injury. Journal of the International Neuropsychological Society, 11, 392–399.Google Scholar
Milders, M., Fuchs, S., & Crawford, J.R. (2003). Neuropsychological Impairments and Changes in Emotional and Social Behaviour Following Severe Traumatic Brain Injury. Journal of Clinical and Experimental Neuropsychology, 25, 157–172.Google Scholar
Muller, J., Buhner, M., & Ellgring, H. (2003). Is there a reliable factorial structure in the 20-item Toronto Alexithymia Scale? A comparison of factor models in clinical and normal adult samples. Journal of Psychosomatic Research, 55, 561–568.Google Scholar
Nelson, H.E. (1982). National Adult Reading Test (NART): Test Manual. Windsor, UK: NFER-Nelson.
Parker, J.D.A., Bagby, R.M., & Taylor, G.J. (1991). Alexithymia and depression: Distinct or overlapping constructs? Comprehensive Psychiatry, 32, 387–394.Google Scholar
Parker, R.M., Taylor, G.J., & Bagby, J.D.A. (1992). The 20-item Toronto Alexithymia Scale Manual.
Pasini, A., Chiaie, D., & Serpia, S. (1992). Alexithymia as related to sex, age, and educational level: Results of the Toronto Alexithymia Scale in 417 normal subjects. Comprehensive Psychiatry, 33, 42–46.Google Scholar
Prigatano, G.P. (1986). Neuropsychological Rehabilitation after Brain Injury. Baltimore, MD: Johns Hopkins University Press.
Schlosser, D. & Ivison, D. (1989). Assessing memory deterioration with the Wechsler Memory Scale, The National Adult Reading Test, and the Schonell Graded Word Reading Test. Journal of Clinical and Experimental Neuropsychology, 11, 785–92.Google Scholar
Smith, S.D. & Bulman-Fleming, M.B. (2004). A hemispheric asymmetry for the unconscious perception of emotion. Brain Cognition, 55, 452–457.Google Scholar
Solomon, D. & Malloy, P. (1992). Alcohol, head injury, and neuropsychological function. Neuropsychological Review, 3, 249–280.Google Scholar
Stuss, D.T., Gow, C.A., & Hetherington, C.R. (1992). “No Longer Gage”: Frontal lobe dysfunction and emotional changes. Journal of Consulting Clinical Psychology, 60, 349–359.Google Scholar
Tate, R.L., Fenelon, B., Manning, M.L., & Hunter, M. (1991). Patterns of neuropsychological impairment after severe blunt head injury. Journal of Nervous and Mental Disease, 179, 117–126.Google Scholar
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.
Taylor, G.J., Ryan, D., & Bagby, M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy and Psychosomatics, 44, 191–199.Google Scholar
TenHouten, W.D., Hoppe, K.D., Bogen, J.E., & Walter, D.O. (1985). Alexithymia and the split brain: II. Sentential-level content analysis. Psychotherapy and Psychosomatics, 44, 89–94.Google Scholar
TenHouten, W.D., Hoppe, K.D., Bogen, J.E., & Walter, D.O. (1987). Alexithymia and the split brain: V. EEG alpha-band interhemispheric coherence analysis. Psychotherapy and Psychosomatics, 47, 1–10.Google Scholar
Tulsky, D., Zhu, J., & Ledbetter, M.F. (1997). The WAIS-III, WMS-III Technical Manual. San Antonio, TX: The Psychological Corporation.
Wechsler, D. (1997). Wechsler Adult Intelligence Scale (3rd. ed.). San Antonio, TX: The Psychological Corporation.
Williams, K.R., Jeffrey, G., Light, D., Pepper, C., Ryan, C., Kleinmann, A.E., Burright, R., & Donovick, P. (2001). Head injury and alexithymia: Implications for family practice care. Brain Injury, 15, 349–356Google Scholar
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J. (1996). Behavioural Assessment of the Dysexecutive Syndrome. Bury St. Edmunds, England: Thames Valley Test Company.
Wood, R.Ll. & Rutterford, N.A. (2006a). The impact of mild developmental learning difficulties on neuropsychological recovery from head trauma. Brain Injury, 20, 1–8.Google Scholar
Wood, R.Ll. & Rutterford, N.A. (2006b). Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury. Journal of the International Neuropsychological Society, 12, 350–358.Google Scholar
Wood, R.Ll. & Liossi, C., (in press). Neuropsychological and neurobehavioural correlates of aggression following traumatic brain injury. Journal of Neuropsychiatry and Clinical Neurosciences.