Alexithymia as a risk factor for poor emotional outcomes in adults with acquired brain injury

ABSTRACT

Emotional disorders are pervasive in the acquired brain injury (ABI) population, adversely affecting quality of life and rehabilitation. This study aimed to explore the unique associative effects of alexithymia as measured by the Perth Alexithymia Questionnaire (PAQ; i.e., difficulty identifying positive/negative feelings, difficulty describing positive/negative feelings, and externally orientated thinking), on emotional outcomes as measured by the Depression Anxiety Stress Scale-21 (DASS-21) and Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment index, in 83 adults with ABI. The addition of alexithymia to hierarchical multiple regression models (controlling for demographic, injury-related, and functional outcome variables) yielded statistically significant changes in R² for all emotional outcome measures (i.e., Depression, Anxiety, Stress, and Adjustment). Difficulty identifying negative feelings was found to be a significant unique predictor of Depression (β = .43 p = <.001), Anxiety (β = .40, p <.001), Stress (β = .49, p <.001), and Adjustment (β = .26, p = .001). Externally oriented thinking was found to be a significant unique predictor of Adjustment (β = -.15, p = .033). These findings strengthen the argument that alexithymia, especially difficulties identifying negative feelings, may be an important risk factor for psychological distress in ABI and should be considered during early rehabilitation.

KEYWORDS:

• Acquired brain injury
• Alexithymia
• DASS-21
• Adjustment
• PAQ

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Some conceptualisations (e.g., Gratz & Roemer, 2004) of emotion regulation consider emotional awareness problems (i.e., alexithymia) to be a component of emotion dysregulation; however, psychometric studies indicate that alexithymia is better conceptualised as a factor separate from emotion regulation (i.e., emotional awareness does not load on the same general factor as the other components of emotion regulation (e.g., Bardeen et al., 2012; Lee et al., 2016; Osborne et al., 2017).