Page 44 - JCBP-2-2

Journal of Clinical and
Basic Psychosomatics Alexithymia as a mediator relationship

individuals to cope with environmental stressors, a high recognition of emotional facial expressions, empathy,
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SPS is estimated to affect between 20% and 30% of the and pro-social behaviors. It is sometimes referred to as
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population. A high SPS is defined as the characteristic of “primary” (alexithymia-trait) and appears to be a major
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individuals exhibiting higher sensory sensitivity than their predisposing factor for illness. It is also sometimes
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peers, manifesting in heightened emotional sensitivity considered “secondary” (alexithymia-state). In this case, it
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and reactivity to both external and internal stimuli. appears as a defense or adaptation mechanism implemented
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In addition, it entails the ability to process and register following a stressor to protect the individual. Thus,
both positive and negative environmental influences or alexithymia could be used to mitigate negative and painful
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experiences. However, despite not being pathological, a emotions and to counteract the problematic consequences
high SPS is often considered a vulnerability factor. Indeed, of the stressor (e.g., by avoiding depression and allowing
a high level of SPS is generally associated with greater the individual to focus resources on incorporating the
perceived stress, higher levels of depressive affect, anxiety stressor). Thus, alexithymia represents either a stable
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symptomatology, and sometimes both. Highly sensitive personality factor that conditions a maladaptive reaction
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people also appear to be more susceptible to burnout to stress or a secondary factor to stressful situations, in
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situations and may experience poorer health. SPS is a which case it serves a more defensive purpose. Regarding
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multidimensional construct, in which three, sometimes anxiety and depression, certain studies have demonstrated
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four, components coexist. The first three components are that alexithymia may act as a vulnerability factor for
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ease of excitation (EOE) and low sensory threshold (LST), depression, anxiety, or both. 29
both of which refer to stimuli that can be experienced as However, anxiety, in certain cases, can sometimes be
negative and esthetic sensitivity (AES), which refers to specifically related to health. Health anxiety, defined as
fine discriminations related, for example, to the arts. To the fear of suffering from a serious and/or chronic illness
these, three components, a fourth is sometimes added: or of contracting or developing such an illness, arises
controlled harm avoidance (CHA), which refers to certain from a misinterpretation of somatic symptoms. The
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strategies people use to avoid certain stimuli, such as anxiety felt when confronted with changes in one’s health
being conscientious. Each component seems to play a status, bodily alterations, or the expectation of medical
specific role. For instance, EOE and LST generally tend to test results, typically represents a healthy and transient
increase the level of distress related to general anxiety and reaction. This reaction activates individuals’ vigilance
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depression. The propensity to develop a depressive state thresholds, prompting them to adopt health-promoting
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could be mainly related to either EOE or LST. Conversely, behaviors appropriate to the situation. On the other hand,
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the importance of depressive symptomatology is rarely persistent and disabling psychological distress stemming
correlated and sometimes even negatively correlated with from health anxiety is a more severe form, the prevalence
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AES propensity, while the latter seems to be proportional of which remains poorly understood. Although women
to anxiety in general. 13,17 appear more susceptible to moderate forms of health
The relationship between alexithymia and anxiety and anxiety, its prevalence tends to increase with age. Genetic
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depression parallels that of SPS. Several definitions of factors play a role in its development, yet psychosocial
alexithymia exist, varying depending on the populations factors, such as exposure to illness during youth or
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under consideration. Some scholars define it as an inability pessimistic cognitive structuring, also play significant
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to find appropriate words to describe one’s feelings. It roles. Dysfunctional beliefs related to diseases, symptoms,
can be conceptualized as a deficit in affect perception: “A mortality, frequency, and treatment may underpin health
poor fantasy life resulting in a utilitarian form of thinking, anxiety. In a quest for reassurance, individuals anxious
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a tendency to use action to avoid conflict and stressful about their health may seek to reduce their anxiety-
situations, a marked restriction in the expression of provoking thoughts by consulting health professionals,
emotions and particularly a difficulty in finding words to repeating medical or self-reported examinations, or
describe one’s feelings,” and it refers to the inability to make seeking information from multiple sources. Health
connections between emotions and ideas, thoughts, and anxiety is composed of four dimensions: fear of illness
fantasies. Alexithymia consists of three dimensions, i.e., a and death (FID), search for reassurance (SFR), impact of
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deficiency or difficulty in identifying emotions and feelings anxiety on daily life (IAD) (such as lack of concentration,
(DIE), a difficulty in verbally describing emotions (DDE), psychomotor slowdown, and sleep disorders), and health-
and a pragmatic, external, and utilitarian style of thinking 19 related worries and concerns (HWC). People may also
called operational and outward-looking thinking (OOT), engage in avoidance strategies and behaviors, such as
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especially notable in patients experiencing psychosomatic avoiding health facilities, information about the disease, or
illnesses. Notably, alexithymia negatively impacts the appropriate prevention and precautionary measures. These
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Volume 2 Issue 2 (2024) 2 https://doi.org/10.36922/jcbp.2681