Page 50 - JCBP-2-2

Journal of Clinical and
Basic Psychosomatics Alexithymia as a mediator relationship

Table 8. Mediation effect between HSPS and health anxiety through alexithymia
Components Not standardized SC t Significance level 95% CI
B SE β Lower Upper
(Constant) 9.54 3.29 - 2.90 0.004 3.09 15.99
HSPS 0.24 0.02 0.34 10.54 <0.001 0.19 0.28
TAS-20 0.26 0.04 0.20 6.04 <0.001 0.18 0.35
Model of Indirect mediating effect Effect coefficient Boot SE Boot lower CI Boot Upper CI
TAS-20 (overall) 0.036 0.009 0.0196 0.0546
Notes: r =0.179; Interaction=F (1;810)=0.028; P=0.868.
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Abbreviations: AES: Esthetic sensitivity; CHA: Controlled harm avoidance; CI: Confidence interval; EOE: Ease of excitation; HSPS: Highly sensitive
person scale; LST: Low sensory threshold; SC: Standardized coefficient; SE: Standard Error; TAS-20: Toronto Alexithymia Scale 20.
behaviors in response to potentially unpleasant stimuli.
Alexithymia
Consequently, highly sensitive individuals with high scores
(a) β=0.183 (P<0.001) (b) β=0.195 (P<0.001) on AES and CHA components are more likely to report
Sensory Processing Health anxiety lower alexithymia scores. Conversely, highly sensitive
Sensitivity
β=0.341 (P<0.001) individuals with high scores on EOE and LST components
Figure 1. Mediation model of the relationship between sensory processing are more likely to report high alexithymia scores. For these
sensitivity and health anxiety through alexithymia. people, stressful situations could exacerbate difficulties in
identifying or describing emotions.
than men on these constructs. Interestingly, gender did not
significantly influence alexithymia, although it appeared However, while the AES was positively correlated
to affect younger individuals with educational attainment with health anxiety, consistent with previous findings on
below a 4-year bachelor’s degree and/or those in roles anxiety in general, 13,15-17 our results demonstrate that only
such as students or employees/workers. In addition, our EOE emerged as a predictor of health anxiety. This finding
research aimed to test a model in which alexithymia was confirms the immediate and context-oriented dimension
considered a secondary factor – potentially stemming of health anxiety. Indeed, health beliefs may remain latent
from the COVID-19 pandemic and its surrounding health until triggered by a particular event, such as a change in
context. We tested alexithymia as a mediating variable the body, the announcement of the illness of a loved one,
between SPS and health anxiety. or a crisis like the COVID-19 pandemic. A recent study
highlighted the link between high SPS and COVID-19-
This study confirmed the first two hypotheses related stress in adolescents and young adults. These
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concerning the correlation between SPS and alexithymia, latent health beliefs can then become a source of anxiety
i.e., (i) both EOE and LST were correlated with alexithymia and hypervigilance when a sign suggestive of illness
in general, and (ii) AES was negatively correlated with the appears.
operational and outward-looking thinking of alexithymia,
validating a previous result. It also confirmed the third A mediation effect emerged, confirming our fourth
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hypothesis concerning AES and CHA. While existing hypothesis: alexithymia positively influenced health
literature predominantly supports a three-dimensional anxiety, and the influence of high SPS on health anxiety
structure, 13,17 some authors have considered the existence of is partially explained by alexithymia. An intriguing
a fourth component (CHA) in their model. 14,49 Our findings aspect of our findings is that while DIE appeared to be a
support this four-dimension model, indicating that AES vulnerability factor, DDE acted as a protective factor, with
and CHA also predict alexithymia. Although the statistical scores on this component negatively influencing health
significance of the CHA component in the four-dimension anxiety scores. This finding suggests that alexithymia, like
model may be subject to debate, its clinical relevance SPS, plays a rather complex role, as it can either render
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warrants further investigation. Our study demonstrated individuals more vulnerable (through DIE) or protect
its predictive value for alexithymia as a protective factor, them from health anxiety (through DDE), thus serving a
akin to AES. Thus, EOE and LST emerged as vulnerability defensive function. In this case, alexithymia could then be
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factors, while AES and CHA emerged as protective factors. considered for its defensive value. This warrants further
Both of the latter components could be construed as discussion because viewing alexithymia as a defense mode
strategies: AES through the focus on fine discriminations is rather counterintuitive. Instinctively, we would probably
and CHA through the implementation of avoidance assume the contrary: articulating the effects generated

Volume 2 Issue 2 (2024) 8 https://doi.org/10.36922/jcbp.2681