Alexithymia, anger and anger expression styles as predictors of psychological symptoms
Bukre Kahramanol, Ihsan Dag
Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2018;31:30-39
PDF
Article No: 3   Article Type :  Research
Objective: A review of the literature shows that alexithymia, anger, and anger expression styles have been important variables in predicting psychological symptoms. Furthermore, alexithymic characteristics may cause various difficulties in anger and its expression. From this point of view, the aim of our study was to investigate the extent to which alexithymia, anger, and anger expression styles predicted psychological symptoms in the university sample.

Method: The present study included 434 students (244 women, 190 men) from different departments of Hacettepe University. In addition to the Demographic Information Form, participants were administered the 20-item Toronto Alexithymia Scale (TAS-20) to assess the presence of alexithymic characteristics; to evaluate their anger and anger expression styles, the State-Trait Anger Expression Inventory (STAXI) was used, and participants’ psychological symptoms were examined using the Brief Symptom Inventory (BSI). After carrying out a correlation analysis to evaluate the relationships between all variables of the study, hierarchical regression analysis was conducted to investigate the degree to which alexithymia, anger, and anger expression styles predicted psychological symptoms.

Results: According to the regression analysis, it was concluded that alexithymia, trait anger, and anger-in positively predicted psychological symptoms.

Conclusion: Our study indicates that alexithymic characteristics, anger, and anger expression styles explain psychological symptoms. Additionally, it emphasizes the benefit of addressing alexithymic characteristics, the frequency of anger experience, and healthy ways of anger expression simultaneously and as a whole rather than individually in psychotherapies aiming to reduce psychological symptoms, even in persons that do not require a diagnosis.
Keywords : Alexithymia, anger expression styles, psychological symptoms, trait anger
Psikolojik belirtilerin yordayıcıları olarak aleksitimi, öfke ve öfke ifade tarzları
PDF
Makale No: 3   Makale Türü :  Araştırma
Amaç: Alanyazın incelendiğinde aleksitimi, öfke ve öfke ifade tarzlarının psikolojik belirtileri yordamada önemli değişkenler olduğu görülmektedir. Bununla birlikte, aleksitimik özelliklerin öfke ve öfkenin ifade edilmesi konusunda çeşitli zorluklara neden olabileceği anlaşılmaktadır. Buradan hareketle, bu çalışmanın amacı üniversite örnekleminde aleksitimi, öfke ve öfke ifade tarzlarının bir araya gelerek psikolojik belirtilerdeki artışı ne derece yordadığını incelemektir.

Yöntem: Çalışmada Hacettepe Üniversitesi’nin farklı bölümlerinden 434 öğrenciye (244 kadın, 190 erkek) Demografik Bilgi Formu ile birlikte aleksitimik özellikler taşıyıp taşımadıklarını değerlendirmek amacıyla 20 maddelik Toronto Aleksitimi Ölçeği (TAÖ-20), öfke duygularını ve öfke ifade tarzlarını değerlendirmek amacıyla Sürekli Öfke-Öfke Tarz Ölçeği (SÖÖTÖ), psikolojik belirtilerini taramak için de Kısa Semptom Envanteri (KSE) uygulanmıştır. Çalışmanın tüm değişkenleri arasındaki ilişkileri değerlendirmek amacıyla uygulanan korelasyon analizinin ardından, aleksitimi, öfke ve öfke ifade tarzlarının psikolojik belirtileri yordama gücünün incelenmesi amacıyla hiyerarşik regresyon analizi yürütülmüştür.

Bulgular: Regresyon analizi, aleksitimi, sürekli öfke ve içte tutulan öfkenin bir araya gelerek psikolojik belirtileri pozitif yönde yordadığını göstermiştir.

Sonuç: Mevcut çalışma aleksitimik özelliklerin, öfkenin ve öfke ifade tarzlarının psikolojik belirtileri açıklayabileceğine işaret etmektedir. Ayrıca mevcut çalışma, bir tanı almayı gerektirmeyecek bile olsa, psikolojik belirtileri azaltmayı hedefleyen psikoterapilerde aleksitimik özelliklerin, öfkeyi deneyimleme sıklığının ve öfkenin sağlıklı şekillerde ifade edilmesinin ayrı ayrı değil, eşzamanlı olarak ve bir bütün şeklinde ele alınmasının yararına vurgu yapmaktadır.
Anahtar kelimeler : Aleksitimi, öfke ifade tarzları, psikolojik belirtiler, sürekli öfke
REFERENCES
1.Taylor GJ, Bagby RM, Parker JDA. Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. First ed., Cambridge: Cambridge University Press, 1997.

2.Lesser IM. A review of the alexithymia concept. Psychosom Med 1981; 43:531-543.

3.Kooiman CG. The status of alexithymia as a risk factor in medically unexplained physical symptoms. Compr Psychiatry 1998; 39:152-159.

4.Nicolò G, Semerari A, Lysaker PH, Dimaggio G, Conti L, D’Angerio S, Procacci M, Popolo R, Carcione A. Alexithymia in personality disorders: correlations with symptoms and interpersonal functioning. Psychiatry Res 2011; 190:37-42.

5.Kojima M, Senda Y, Nagaya T, Tokudome S, Furukawa TA. Alexithymia, depression and social support among Japanese workers. Psychother Psychosom 2003; 72:307-314.

6.Holder MD, Love AB, Timoney LR. The poor subjective well-being associated with alexithymia is mediated by romantic relationships. J Happiness Stud 2015; 16:117-133.

7.Sifneos PE. Short-term Psychotherapy and Emotional Crisis. First ed., Cambridge: Harvard University Press, 1972.

8.Kocak R. Alexithymia: theoretical framework, therapeutic approaches, and related studies. Ankara University Journal of Faculty of Educational Sciences 2002; 35:183-212. (Turkish)

9.Batigun AD, Buyuksahin A. Alexithymia: psychological symptoms and attachment styles. Turkish Journal of Clinical Psychiatry 2008; 11:105-114. (Turkish)

10.Demet MM, Deveci A, Ozmen E, Sen FS, Icelli I. The effect of alexithymia on symptomatology in patients with major depressive disorder. Noro Psikiyatr Ars 2002; 39:67-74. (Turkish)

11.Evren C, Dalbudak E, Cakmak D. Alexithymia and personality in relation to dimensions of psychopathology in male alcohol-dependent inpatients. Bulletin of Clinical Psychopharmacology 2008; 18:1-8.

12.Rief W, Heuser J, Fichter MM. What does the Toronto Alexithymia Scale TAS-R measure? J Clin Psychol 1996; 52:423-429.

13.Saarijärvi S, Salminen JK, Toikka T. Temporal stability of alexithymia over a five-year period in outpatients with major depression. Psychother Psychosom 2006; 75:107-112.

14.Leweke F, Leichsenring F, Kruse J, Hermes S. Is alexithymia associated with specific mental disorders? Psychopathology 2012; 45:22-28.

15.Mattila AK, Kronholm E, Jula A, Salminen JK, Koivisto AM, Mielonen RL, Joukamaa M. Alexithymia and somatization in general population. Psychosom Med 2008; 70:716-722.

16.Kojima M, Frasure-Smith N, Lespérance F. Alexithymia following myocardial infarction: psychometric properties and correlates of the Toronto Alexithymia Scale. J Psychosom Res 2001; 51:487-495.

17.Eizaguirre AE, de Cabezon AOS, de Alda IO, Olariaga LJ, Juaniz M. Alexithymia and its relationships with anxiety and depression in eating disorders. Pers Individ Dif 2004; 36:321-331. 18.Stasiewicz PR, Bradizza CM, Gudleski GD, Coffey SF, Schlauch RC, Bailey ST, Bole CW, Gulliver SB. The relationship of alexithymia to emotional dysregulation within an alcohol dependent treatment sample. Addict Behav 2012; 37:469-476.

19.Spielberger CD, Reheiser EC, Sydeman SJ. Measuring The Experience, Expression, and Control of Anger: In Kassinove H (editor). Anger Disorders: Definition, Diagnosis, and Treatment. Washington: Taylor & Francis, 1995, 49-67.

20.Deffenbacher JL, Oetting ER, Lynch RS, Morris CD. The expression of anger and its consequences. Behav Res Ther 1996; 34:575-590.

21.Atasayar M. Psychological symptoms of alexithymic characteristics in adolescents and their relationship with life satisfaction. Master’s dissertation, Sakarya University, Institute for Educational Sciences, Sakarya, 2011. (Turkish)

22.Berenbaum H, Prince JD. Alexithymia and the interpretation of emotion-relevant information. Cogn Emot 1994; 8:231-244.

23.Bagby RM, Taylor GJ, Parker JDA. Construct validity of the Toronto Alexithymia Scale. Psychother Psychosom 1988; 50:29-34.

24.Berenbaum H, James T. Correlates and retrospectively reported antecedents of alexithymia. Psychosom Med 1994; 56:353-359.

25.Berenbaum H, Irvin S. Alexithymia, anger, and interpersonal behavior. Psychother Psychosom 1996; 65:203-208.

26.Gulec MY, Kilic A, Gul U, Gulec H. Alexithymia and anger in patients with psoriasis. Noro Psikiyatr Ars 2009; 46:169-174. (Turkish)

27.Conrad R, Geiser F, Haidl G, Hutmacher M, Liedtke R, Wermter F. Relationship between anger and pruritus perception in patients with chronic idiopathic urticaria and psoriasis. J Eur Acad Dermatol Venereol 2008; 22:1062-1069.

28.Engin E, Keskin G, Dulgerler S, Bilge A. Anger and alexithymic characteristics of the patients diagnosed with insomnia: a control group study. J Psychiatr Ment Health Nurs 2010; 17:692-699.

29.Gulec H, Sayar K, Ozkorumak E. Somatic symptoms of depression. Turk Psikiyatri Derg 2005; 16:90-96. (Turkish)

30.Koh KB, Kim CH, Park JK. Predominance of anger in depressive disorders compared with anxiety disorders and somatoform disorders. J Clin Psychiatry 2002; 63:486-492.

31.Diong SM, Bishop GD, Enkelmann HC, Tong EMW, Why YP, Ang JCH, Khader M. Anger, stress, coping, social support and health: modelling the relationships. Psychol Health 2005; 20:467-495.

32.Painuly N, Sharan P, Mattoo S K. Relationship of anger and anger attacks with depression: a brief review. Eur Arch Psychiatry Clin Neurosci 2005; 255:215-222.

33.Koh KB. Anger and somatization. J Psychosom Res 2003; 55:113.

34.Sahin NH, Batigun AD, Koc V. The relationship between depression, and ınterpersonal style, self-perception, and anger. Turk Psikiyatri Derg 2011; 22:17-25. (Turkish)

35.Hawkins KA, Cougle JR. Anger problems across the anxiety disorders: findings from a population-based study. Depress Anxiety 2011; 28:145-152.

36.Fava M, Rappe SM, West J, Herzog DB. Anger attacks in eating disorders. Psychiatry Res 1995; 56:205-212.

37.Sayar K, Gulec, H, Topbas, M. Alexithymia and anger in patients with fibromyalgia. Clin Rheumatol 2004; 23:441-448.

38.Koh KB, Cho SY, Kim JW, Rho KS, Lee SH, Park IH. The relationship of anger expression and alexithymia with coronary artery stenosis in patients with coronary artery diseases. Yonsei Med J 2004; 45:181-186.

39.Bagby RM, Taylor GJ, Parker JD. The twenty-item Toronto Alexithymia Scale—II: Convergent, discriminant, and concurrent validity. J Psychosom Res 1994; 38:33-40.

40.Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale—I: Item selection and cross-validation of the factor structure. J Psychosom Res 1994; 38:23-32.

41.Gulec H, Kose S, Gulec MY, Citak S, Evren C, Borckardt J, Sayar K. Reliability and factorial validity of the Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20). Bulletin of Clinical Psychopharmacology 2009; 19:214-220.

42.Spielberger CD, Jacobs G, Russell FS, Crane RS. Assessment of Anger: The State Trait Anger Scale: In Butcher JN, Spielberger CD (editors). Advances in Personality Assessment. Second ed. New York: Routledge, 1983, 159-187.

43.Ozer AK. Preliminary study for trait anger and anger expression scales. Turkish Journal of Psychology 1994; 9:26-35. (Turkish)

44.Derogatis LR. The Brief Symptom Inventory-BSI administration, scoring and procedures manual-II. Second ed., Baltimore MD: Clinical Pscyhometric Research Inc., 1992.

45. Sahin NH, Durak A. A study of the Brief Symptom Inventory in Turkish Youth. Turkish Journal of Psychology 1994; 9:44-56. (Turkish)

46.Lambie JA, Marcel AJ. Consciousness and the varieties of emotion experience: a theoretical framework. Psychol Rev 2002; 109:219-259.

47.Rieffe C, Oosterveld P, Terwogt MM, Novin S, Nasiri H, Latifian M. Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents: Evidence from an Iranian sample. Pers Individ Dif 2010; 48:425-430.

48.Watson D, Pennebaker JW. Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol Rev 1989; 96:234-254.

49.Lumley MA, Stettner L, Wehmer F. How are alexithymia and physical illness linked? A review and critique of pathways. J Psychosom Res 1996; 41:505-518.
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi
Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi
Yayıncı
Yerküre Tanıtım ve Yayıncılık Hizmetleri A.Ş.