Alcohol and tobacco use in men: the role of alexithymia and externally oriented thinking style

ABSTRACT

Background: A high prevalence of alexithymia has been consistently reported in alcohol- and drug-dependent populations. However, less is known about the role of alexithymia, and its individual dimensions on substance use in healthier populations. Objectives: To examine how different alexithymia dimensions associate with substance use, while controlling for confounding factors. Methods: In the FinnBrain Birth Cohort Study, we analyzed a sample of 994 men. We assessed alexithymia levels (difficulty identifying feelings, difficulty describing feelings and externally oriented thinking (EOT) style), self-reported quantity and frequency of alcohol use in two different time points during and after their partners’ pregnancy, as well as cigarette smoking status. Age, education level, and anxiety scores were used as control variables. Results: Men scoring high on EOT style drank more alcohol per occasion, compared to low scorers (Cohen’s d = 0.43, p < 0.001 during pregnancy, and Cohen’s d = 0.3, p = 0.012 after pregnancy). Individuals in the high EOT quartile were also more likely to be daily smokers (8.7% vs. 17.3%, p = 0.023), and engage in binge drinking (23.7% vs. 43.6%, p = 0.001). Conclusions: The association of alexithymia and substance use may be specifically explained by EOT, a trait characterized by low levels of introspection and pragmatic thinking. It is important for future studies to distinguish between individual alexithymia dimensions and their specific roles in shaping mental health.

KEYWORDS:

• Alexithymia
• substance use
• alcohol
• tobacco

Acknowledgments

We assert that all authors contributed to this paper in a significant way, and that all authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

We wish to thank the Finnish Cultural Foundation Satakunta Regional Fund, Signe and Ane Gyllenberg Foundation, Jane and Aatos Erkko Foundation, and Academy of Finland (Grant number 287908) for funding this study. In addition, the FinnBrain Birth Cohort Study has received funding for this part of the project from the Academy of Finland (Grant numbers 134950 and 253270) and Finnish State Grants for Clinical Research (ERVA project numbers P3003, P3498, and P3654).