Page 45 - JCBP-2-2

Journal of Clinical and
Basic Psychosomatics Alexithymia as a mediator relationship

avoidance strategies are likely a direct consequence of the (akin to high SPS) or as a consequence of specific situational
relationship between health anxiety and some emotion factors, which appears to be more consistent with the
and cognition-related dimensions, such as ruminations, context of the study. Furthermore, we aimed to explore the
intolerance of uncertainty, weighting of information, or links between the different components of these constructs.
between this specific health anxiety and a selective focus This study sought to address the following hypotheses:
on disease-related sensory and environmental stimuli. 34 • Hypothesis 1: SPS and alexithymia are positively
Several studies have examined the link between correlated with health anxiety.
alexithymia and SPS. 15,37,38 The results of Liss et al. • Hypothesis 2: The two components, EOE and LST, are
15
underlined a positive correlation between the components related to alexithymia.
EOE and LST with alexithymia and a negative correlation • Hypothesis 3: The AES component is negatively
between AES and the component externally oriented correlated with the OOT component of alexithymia.
thinking. This negative correlation may be attributed to • Hypothesis 4: Given the context of the study,
the introspective cognitive style implied by AES, which alexithymia is considered “secondary” here, and it
contrasts with the outward-looking thinking associated mediates the relationship between SPS and health
with externally oriented thinking. Furthermore, an anxiety.
interaction between EOE and the difficulty in identifying 2. Methods
feelings was observed to predict anxiety. In this case,
anxiety arises due to alexithymia. It is suggested that being 2.1. Measurement constructs
both easily aroused by stimuli and unable to identify 2.1.1. SPS
feelings accurately can be particularly anxiety-provoking.
14
Thus, the capacity to identify feelings appropriately may The French version of the HSPS (HSPS-FR) was used
serve as a protective factor against the anxiety often to assess sensitivity. The psychometric properties of the
42
1
associated with high sensitivity. However, this interaction original scale have been validated on several occasions.
did not correlate with depression scores, despite EOE and In our study, we calculated a Cronbach’s alpha
difficulty in identifying feelings being independent of each coefficient of 0.885 for HSPS-FR. This scale consists of
other. These results are intriguing, but it is worth noting 27 items designed to measure individuals’ cognitive and
that one limitation of the study was its focus on psychology emotional responses to various environmental stimuli.
students. Responses are rated using a 7-point Likert scale. We
used the model highlighted in the French adaptation,
1.1. Hypotheses which proposes 4 dimensions: (i) EOE (Items 1, 3, 4, 11,
In the present study, we aimed to investigate the relationship 13, 14, 16, 20, 21, 26, 27), (ii) LST (Items 5, 6, 7, 9, 18, 19,
between SPS, alexithymia, and health anxiety, addressing 23, 25), (iii) AES (Items 2, 8, 10, 15, 22), and (iv) CHA
a gap in the literature by examining a general population (Items 12, 17, 24).
sample. This research is significant because it explores these 2.1.2. Alexithymia
variables within the context of the general population,
particularly considering that sensory sensitivity (which is Alexithymia was measured using the 20-item Toronto
not a pathology) concerns a substantial proportion of the Alexithymia Scale (TAS-20). 43,44 The total alexithymia
population (nearly 30%). In addition, the study’s relevance score, ranging from 20 to 100, was obtained by summing
extends to its application in a specific context – the the scores of each of the 20 items. In the French version of
45
COVID-19 crisis and the associated lockdown imposed). the TAS-20, a score of 56 or higher indicates alexithymia.
To date, the literature lacks clarity regarding the distinction In our study, we calculated a Cronbach’s alpha coefficient
between the “primary” or “secondary” dimensions of of 0.826 for TAS-20. This self-report tool measures three
alexithymia. 39-41 However, the circumstances of the present distinct dimensions: (i) DIE (Items 1, 3, 6, 7, 9, 13, 14),
study, occurring during the anxiety-inducing COVID-19 (ii) DDE (Items 2, 4, 11, 12, 17), and (iii) OOT (Items 5, 8,
pandemic and lockdown period, alongside the inundation 10, 15, 16, 18, 19, 20). Items 4, 5, 10, 18, and 19 are reverse-
of information about the virus through media channels, coded. A 5-point Likert scale (ranging from “Complete
may have contributed to difficulties in identifying or disagreement” to “Complete agreement”) was used for
describing the emotions felt. While our tools used did not each item.
allow for differentiation between primary and secondary
alexithymia (an important epistemic limitation discussed 2.1.3. Health anxiety
in Section 4 [Discussion]), our primary aim was to identify The French version of the Health Anxiety Questionnaire
whether alexithymia was a trait inherent to personality (HAQ), adapted from Lucock and Morley, was used
46
47
Volume 2 Issue 2 (2024) 3 https://doi.org/10.36922/jcbp.2681