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Front. Psychol. | doi: 10.3389/fpsyg.2018.00645

Alexithymia in young adults with substance use disorders: critical issues about specificity and treatment predictivity

Micol Parolin1,  Marina Miscioscia1,  Pietro De Carli1, Patrizia Cristofalo2,  Michela Gatta3 and  Alessandra Simonelli1*
  • 1Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università degli Studi di Padova, Italy
  • 2Comunità Terapeutica Villa Renata, Italy
  • 3Dipartimento di Salute della Donna e del Bambino, Università degli Studi di Padova, Italy

Several studies have reported high rates of alexithymia in drug-dependent individuals, but supporting evidence attests association between alexithymia and a variety of psychiatric disorders, raising doubts about its specificity. Moreover, controversies are emerging about alexithymia assessment: self-report measures present shortcomings with respect to discriminant validity and reliability. As regards treatment for substance use disorders (SUDs), alexithymia has been linked to poorer outcomes, but the results are inconsistent.
The aim of the present study is to investigate alexithymia in substance-dependent young adults by examining: a) the specificity of alexithymia in drug-dependent inpatients, compared to healthy individuals and patients with psychiatric disorders (behavioral and emotional disorders) and b) the predictivity of alexithymia in determining treatment outcomes in terms of relapses, drop-outs from treatment and the rate of relapse per month of treatment. Two studies were conducted to fulfill these aims: Study 1 and Study 2.
Study 1 involved 90 late adolescents, aged 17–21. To fulfill the first aim, 30 inpatients diagnosed with SUD were compared with 30 healthy controls and 30 individuals referred to an outpatient neuropsychiatric unit (a). The participants completed the Toronto Alexithymia Scale–20 (TAS-20) and the Symptom Checklist-90-Revised (SCL-90-R). The results indicated that both clinical groups reported higher TAS-20 scores than the non-clinical subjects, but they did not differ from each other (a); moreover, a large correlation was detected between alexithymia and depressive symptoms, as assessed by the SCL-90-R.
Study 2 involved 55 inpatients with SUD recruited in a therapeutic community. The participants completed the TAS-20, and clinicians filled out the Observer Alexithymia Scale (OAS). No association was found between self-report and observational measures. Neither self-reported nor observed alexithymia predicted the number of relapses, drop-out from treatment, or the rate of relapses per month of treatment (b). When the interaction with gender was explored, the global score of alexithymia and the “Distant” OAS subscale predicted the number rate relapses only in males.
The TAS-20 did not discriminate between the clinical groups. The limited ability of both observed and self-reported measures in predicting treatment outcome raises questions on the specificity of alexithymia among the substance-dependent inpatient population.

Keywords: alexithymia, substance use disorder, young adulthood, treatment outcome, 20 Item - Toronto Alexithymia Scale

Received: 07 Nov 2017; Accepted: 16 Apr 2018.

Edited by:

Lorys Castelli, Università degli Studi di Torino, Italy

Reviewed by:

Sara Bottiroli, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
Federica Galli, Università degli Studi di Milano, Italy  

Copyright: © 2018 Parolin, Miscioscia, De Carli, Cristofalo, Gatta and Simonelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Alessandra Simonelli, Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università degli Studi di Padova, Padua, Italy, alessandra.simonelli@unipd.it