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Biomedical subjects

Graeme J Taylor

Publications and source records attributed to Graeme J Taylor.

7 recordsLinked to original sources

The 20-Item Toronto Alexithymia Scale. III. Reliability and factorial validity in a community population.

OBJECTIVE: Some researchers have questioned the stability of the three-factor structure of the 20-Item Toronto Alexithymia Scale (TAS-20) or the reliability of one or more factors of the scale. The aim of this study was to assess the replicability of the factor structure of the TAS-20 in a large community sample and to determine also whether the same three-factor structure can be recovered in men and women. The study also assessed the reliability of the scale and the influence of gender, age, and education on TAS-20 scores. METHOD: The TAS-20 was administered to 1933 adults (880 men and 1053 women) residing in several small cities and towns in Ontario, Canada. The factor structure of the scale was assessed using confirmatory factor analysis (CFA). RESULTS: The three-factor structure of the TAS-20 was replicable in the entire community sample and also separately in men and women. The TAS-20 and its three factors demonstrated internal reliability, and the variables of gender, age, and education accounted for relatively small or modest amounts of variability in total TAS-20 and factor scale scores. CONCLUSION: The results provide strong support for the reliability and factorial validity of the TAS-20 and indicate the importance of using CFA when assessing the replicability and theoretical integrity of the factor structure of the scale.

Adult↗

The 20-Item Toronto Alexithymia Scale. IV. Reliability and factorial validity in different languages and cultures.

OBJECTIVE: The aim of this paper was to review findings from studies that have evaluated the reliability and factorial validity of the 20-item Toronto Alexithymia Scale (TAS-20) in different languages and cultures. METHOD: Data from published articles as well as unpublished data from various countries were reviewed to determine whether the three-factor structure of the TAS-20 is replicable in different cultures by the method of confirmatory factor analysis (CFA), and whether the scale and its three-factor scales show internal reliability in these cultures. RESULTS: The TAS-20 has been translated adequately into 18 different languages and evaluated by CFA in 19 different countries. There is strong support for the generalizability of the three-factor structure of the scale across languages and cultures. In addition, the full-scale TAS-20 and the first two factors show adequate to good internal reliability for most of the translations. In most cultures where English is not the primary language, however, the third factor lacks internal reliability; this might be due to cultural differences or a response bias to the several negatively keyed items on this factor. CONCLUSION: The findings support the use of the TAS-20 in cross-cultural research, and suggest that alexithymia may be a universal trait that transcends cultural differences.

Affective Symptoms↗

Somatization and conversion: distinct or overlapping constructs?

The terms somatization and conversion are used descriptively to define specific diagnostic entities, and phenomenologically to denote pathologic processes that underlie somatic symptom formation. There is a lack of clarity, and even controversy, however, as to whether somatization and conversion should be considered distinct or overlapping constructs, and whether they contribute to the pathogenesis of certain organic diseases or solely to medically unexplained somatic symptoms. This article attempts to resolve some of this confusion by reviewing the origins of the terms somatization and conversion, and describing how their meanings and uses have evolved over the last century. Whereas some psychoanalysts and psychiatrists adopted Stekel's view that somatization involves a psychological process analogous to conversion, others maintained Freud's distinction between the psychoneuroses and the actual neuroses and view somatization as a physiological process. Recent psychoanalytic attempts to understand somatization are based on a modern theory of emotional processing, which is rooted in cognitive science and open to empirical research. Maintaining a conceptual distinction between somatization and conversion has important implications for psychoanalytic therapy.

Adult↗

Mind-body-environment: George Engel's psychoanalytic approach to psychosomatic medicine.

OBJECTIVE: To provide an overview of George Engel's psychoanalytic approach and contributions to psychosomatic medicine. METHODS: Engel's publications were reviewed to identify his use of psychoanalytic methods and concepts to explore and conceptualize the interrelationships among mind, body and environment in health and disease. RESULTS: Engel's contributions include an interviewing method for accessing psychological data; insights into the psychobiology of anaclitic depression; a psychosomatic theory concerning the influence of relationships and loss on susceptibility to disease; an elucidation of psychodynamic factors in the pathogenesis of chronic pain; and a longitudinal self-analytic study of anniversary reactions. CONCLUSIONS: Engel successfully bridged the disciplines of medicine, psychiatry, and psychoanalysis, and broadened the scope of psychosomatic research and clinical practice by identifying the role of interpersonal relationships throughout life in regulating mental and bodily processes.

History, 20th Century↗

Alexithymia as predictor of treatment outcome in patients with functional gastrointestinal disorders.

OBJECTIVE: A previous study found a strong association between alexithymia and functional gastrointestinal disorders (FGID). The objective of this study was to investigate whether alexithymia might be a predictor of treatment outcome in patients with FGID. METHODS: A group of FGID outpatients classified by the 'Rome I' criteria was divided into improved (N= 68) and unimproved (N= 44) groups on the basis of pre-established criteria after 6 months of treatment. Patients were administered the 20-item Toronto Alexithymia Scale, the Hospital Anxiety and Depression Scale, and the Gastrointestinal Symptom Rating Scale both before and after 6 months of treatment. RESULTS: At the base-line assessment, compared with the improved patients, the unimproved patients had significantly higher levels of anxiety, depression, alexithymia, and gastrointestinal symptoms. Stability of alexithymia was demonstrated by significant correlations between base-line and follow-up TAS-20 scores in the entire sample. Moreover, hierarchical regression analyses showed that the stability of TAS-20 scores over the 6-month treatment period could not be accounted for by their associations with anxiety and depression scores. In logistic regression analyses, base-line alexithymia and depression emerged as significant predictors of treatment outcome. Relative to depression, however, alexithymia was the stronger predictor. CONCLUSIONS: Alexithymia is a reliable and stable predictor of treatment outcome in FGID patients. Although further studies are needed, clinicians might improve treatment outcome by identifying patients with high alexithymia, and attempting to improve these patients' skills for coping with emotionally stressful situations.

Adult↗

New trends in alexithymia research.

Research investigating the alexithymia construct is advancing rapidly and has broadened considerably in recent years as a result of interdisciplinary efforts, new methodologies, and experimental techniques. New developments in the field include a shift from measurement-based validational studies to experimental investigations, which explore the relation between alexithymia and various aspects of emotional processing; the use of functional brain imaging techniques to explore neural activity associated with alexithymia; and experimental studies that measure multiple indices of physiological response to standardized emotion-inducing stimuli. Developmental research and attachment studies are providing ways for investigating potential etiological sources of the construct; and experimental approaches are being used to explore relations between alexithymia and other health-related personality constructs. In addition, longitudinal and treatment studies are clarifying the relation between alexithymia and psychopathology and the extent to which alexithymia predicts treatment outcome. Investigators need to embrace the new methods and techniques for the field of research to further increase understanding of the alexithymia construct and its association with physical and mental illness.

Affective Symptoms↗

Alexithymia and psychopathology in patients with psychiatric and functional gastrointestinal disorders.

BACKGROUND: Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed. METHODS: Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared. RESULTS: Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different. CONCLUSION: Patients with 'functional' gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of 'functional' somatic symptoms and the type of health care utilization.

Adult↗