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Published in: ADHD Attention Deficit and Hyperactivity Disorders 4/2013

01-12-2013 | Original Article

Attention-deficit/hyperactivity disorder and alexithymia: a pilot study

Authors: Renato Donfrancesco, Michela Di Trani, Paola Gregori, Giovanna Auguanno, Maria Grazia Melegari, Sabrina Zaninotto, Joan Luby

Published in: ADHD Attention Deficit and Hyperactivity Disorders | Issue 4/2013

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Abstract

Although the relationship between alexithymia and psychopathology has been studied extensively in adults, research is lacking on alexithymia in childhood psychopathology. The aim of this study was to investigate the relationship between alexithymia and attention-deficit/hyperactivity disorder (ADHD). The Italian version of the Alexithymia Questionnaire for Children was administered to a sample of 50 children with a DSM-IV diagnosis of ADHD, as assessed by means of the K-SADS PL, and to 100 healthy, age- and sex-matched children without ADHD. The total alexithymia score as well as the difficulty in identifying feelings (DIF) and externally oriented thinking factors were significantly associated with ADHD. The total alexithymia score, the DIF, and the difficulty in describing feelings factors were also significantly associated with symptoms of hyperactivity/impulsivity. No significant relationship between alexithymia and inattentiveness symptoms emerged. Results provide preliminary data on the relationship between alexithymia and ADHD. Findings point to an association between difficulty in identifying emotions and hyperactivity/impulsivity. Future studies conducted on larger patient samples, as well as longitudinal designs, are warranted to confirm our findings.
Literature
go back to reference Achenbach TM (1991) Manual for the child behavior checklist 4-18 and 1991 profiles. University of Vermont, Department of Psychiatry, Burlington Achenbach TM (1991) Manual for the child behavior checklist 4-18 and 1991 profiles. University of Vermont, Department of Psychiatry, Burlington
go back to reference American Psychiatric Association—APA (1994) Diagnostic and statistical manual of mental disorders. Washington DC American Psychiatric Association—APA (1994) Diagnostic and statistical manual of mental disorders. Washington DC
go back to reference American Psychiatric Association—APA (2000) Diagnostic and statistical manual of mental disorders: text revision (DSM-IV-TR). Washington DC American Psychiatric Association—APA (2000) Diagnostic and statistical manual of mental disorders: text revision (DSM-IV-TR). Washington DC
go back to reference Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32PubMedCrossRef Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32PubMedCrossRef
go back to reference Barkey RA (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 121:65–94CrossRef Barkey RA (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 121:65–94CrossRef
go back to reference Beales DL, Dolton R (2000) Eating disordered patients: personality, alexithymia, and implications for primary care. Br J Gen Pract 50:21–26PubMed Beales DL, Dolton R (2000) Eating disordered patients: personality, alexithymia, and implications for primary care. Br J Gen Pract 50:21–26PubMed
go back to reference Cadesky EB, Mota VL, Schachar RJ (2000) Beyond words: how do children with ADHD and/or conduct problems process nonverbal information about affect? J Am Ac Child Adol Psychiatry 39:1160–1167CrossRef Cadesky EB, Mota VL, Schachar RJ (2000) Beyond words: how do children with ADHD and/or conduct problems process nonverbal information about affect? J Am Ac Child Adol Psychiatry 39:1160–1167CrossRef
go back to reference Casey RJ (1996) Emotional competence in children with externalizing and internalizing disorders. In: Lewis M, Sullivan M (eds) Emotional development in atypical children. Erlbaum, Hillsdale, pp 161–183 Casey RJ (1996) Emotional competence in children with externalizing and internalizing disorders. In: Lewis M, Sullivan M (eds) Emotional development in atypical children. Erlbaum, Hillsdale, pp 161–183
go back to reference Corbett B, Glidden H (2000) Processing affective stimuli in children with attention deficit/hyperactivity disorder. Child Neuropsych 6:144–155CrossRef Corbett B, Glidden H (2000) Processing affective stimuli in children with attention deficit/hyperactivity disorder. Child Neuropsych 6:144–155CrossRef
go back to reference Da Fonseca D, Seguier V, Santos A, Poinso F, Deruelle C (2009) Emotion understanding in children with Adhd. Child Psych Hum Dev 40:111–121CrossRef Da Fonseca D, Seguier V, Santos A, Poinso F, Deruelle C (2009) Emotion understanding in children with Adhd. Child Psych Hum Dev 40:111–121CrossRef
go back to reference Di Trani M, Tomassetti N, Bonadies M, Capozzi F, De Gennaro L, Presaghi F, Solano L (2009) Un Questionario Italiano per l’Alessitimia in Età Evolutiva: struttura fattoriale e attendibilità. Psic Salute 2:131–143 Di Trani M, Tomassetti N, Bonadies M, Capozzi F, De Gennaro L, Presaghi F, Solano L (2009) Un Questionario Italiano per l’Alessitimia in Età Evolutiva: struttura fattoriale e attendibilità. Psic Salute 2:131–143
go back to reference Di Trani M, Presaghi F, Solano L (2010) Un Questionario per l’Alessitimia in Età Evolutiva: validazione italiana e prime applicazioni. 2° international conference new prospectives in developmental psichology. Rome, 11–12 novembre Di Trani M, Presaghi F, Solano L (2010) Un Questionario per l’Alessitimia in Età Evolutiva: validazione italiana e prime applicazioni. 2° international conference new prospectives in developmental psichology. Rome, 11–12 novembre
go back to reference DuPaul GJ, Power TJ, Anastopoulos AD (1998) ADHD rating scale—IV. Guilford Publications, New York DuPaul GJ, Power TJ, Anastopoulos AD (1998) ADHD rating scale—IV. Guilford Publications, New York
go back to reference Edel MA, Rudel A, Hubert C, Scheele D, Brüne M, Juckel G, Assion HJ (2010) Alexithymia, emotion processing and social anxiety in adults with ADHD. Eur J Med Res 24:403–409 Edel MA, Rudel A, Hubert C, Scheele D, Brüne M, Juckel G, Assion HJ (2010) Alexithymia, emotion processing and social anxiety in adults with ADHD. Eur J Med Res 24:403–409
go back to reference Fukunishi I, Tsuruta T, Hirabayashi N, Asukai N (2001) Association of alexithymic characteristics and posttraumatic stress response following medical treatment for children with refractory hematological diseases. Psychol Rep 89:527–534PubMed Fukunishi I, Tsuruta T, Hirabayashi N, Asukai N (2001) Association of alexithymic characteristics and posttraumatic stress response following medical treatment for children with refractory hematological diseases. Psychol Rep 89:527–534PubMed
go back to reference Honkalampi K, Tolmunenc T, Hintikkad J, Rissanena ML, Kylmäe J, Laukkanenc E (2009) The prevalence of alexithymia and its relationship with youth self-report problem scales among Finnish adolescents. Compreh Psychiatry 50:263–268CrossRef Honkalampi K, Tolmunenc T, Hintikkad J, Rissanena ML, Kylmäe J, Laukkanenc E (2009) The prevalence of alexithymia and its relationship with youth self-report problem scales among Finnish adolescents. Compreh Psychiatry 50:263–268CrossRef
go back to reference Jessimer M, Markham R (1997) Alexithymia: a right hemisphere dysfunction specific to recognition of certain facial expression? Brain Cogn 34:246–258PubMedCrossRef Jessimer M, Markham R (1997) Alexithymia: a right hemisphere dysfunction specific to recognition of certain facial expression? Brain Cogn 34:246–258PubMedCrossRef
go back to reference Karukivi M, Hautala L, Kaleva O, Haapasalo-Pesu KM, Liuksila PR, Joukamaa M, Saarijärvi S (2010a) Alexithymia is associated with anxiety among adolescents. J Affect Dis 125:383–387PubMedCrossRef Karukivi M, Hautala L, Kaleva O, Haapasalo-Pesu KM, Liuksila PR, Joukamaa M, Saarijärvi S (2010a) Alexithymia is associated with anxiety among adolescents. J Affect Dis 125:383–387PubMedCrossRef
go back to reference Karukivi M, Hautala L, Korpelainen J, Haapasalo-Pesu KM, Liuksila PR, Joukama M, Saarijarvi S (2010b) Alexithymia and eating disorder symptoms in adolescents. Eating Dis J Treat Prev 18:226–238CrossRef Karukivi M, Hautala L, Korpelainen J, Haapasalo-Pesu KM, Liuksila PR, Joukama M, Saarijarvi S (2010b) Alexithymia and eating disorder symptoms in adolescents. Eating Dis J Treat Prev 18:226–238CrossRef
go back to reference Kaufman J, Birmaher B, Brent D, Rao U (1997) Schedule for affective disorders and schizophrenia for school-age children-present lifetime version (K-SADS-PL): initial reliability and validity data. J Am Ac Child Adolesc Psychiatry 36:980–988CrossRef Kaufman J, Birmaher B, Brent D, Rao U (1997) Schedule for affective disorders and schizophrenia for school-age children-present lifetime version (K-SADS-PL): initial reliability and validity data. J Am Ac Child Adolesc Psychiatry 36:980–988CrossRef
go back to reference Krystal H (1979) Alexithymia and psychotherapy. Am J Psychoth 33:17–31 Krystal H (1979) Alexithymia and psychotherapy. Am J Psychoth 33:17–31
go back to reference Lane RD, Sechrest L, Reidel R (2000) Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosom Med 62:492–501PubMed Lane RD, Sechrest L, Reidel R (2000) Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosom Med 62:492–501PubMed
go back to reference Madioni F, Mammana LA (2001) Toronto Alexithymia Scale in outpatients with sexual disorders. Psychopath 34:95–98CrossRef Madioni F, Mammana LA (2001) Toronto Alexithymia Scale in outpatients with sexual disorders. Psychopath 34:95–98CrossRef
go back to reference Mann LS, Wise TN, Trinidad A, Kohanski R (1994) Alexithymia, affect recognition, and the five-structure model of personality in normal subjects. Psychol Rep 74:563–567PubMedCrossRef Mann LS, Wise TN, Trinidad A, Kohanski R (1994) Alexithymia, affect recognition, and the five-structure model of personality in normal subjects. Psychol Rep 74:563–567PubMedCrossRef
go back to reference Manninen M, Therman S, Suvisaari J, Ebeling H, Moilanen I, Huttunen M, Joukamaa M (2011) Alexithymia is common among adolescents with severe disruptive behavior. J Nervous Mental Dis 199:506–509CrossRef Manninen M, Therman S, Suvisaari J, Ebeling H, Moilanen I, Huttunen M, Joukamaa M (2011) Alexithymia is common among adolescents with severe disruptive behavior. J Nervous Mental Dis 199:506–509CrossRef
go back to reference Markovska-Simoska S (2010) Face emotive recognition by ADHD and normal adults. Acta Neuropsychol 8:99–122 Markovska-Simoska S (2010) Face emotive recognition by ADHD and normal adults. Acta Neuropsychol 8:99–122
go back to reference Marzocchi GM, Cornoldi C (2000) Una scala di facile uso per la rilevazione dei comportamenti problematici dei bambini con deficit di attenzione e iperattività. Psic Clin Sviluppo 4:43–64 Marzocchi GM, Cornoldi C (2000) Una scala di facile uso per la rilevazione dei comportamenti problematici dei bambini con deficit di attenzione e iperattività. Psic Clin Sviluppo 4:43–64
go back to reference Nemiah JC, Freyberger H, Sifneos PE (1976) Alexithymia: a view of the psychosomatic process. In modern trends in psychosomatic medicine, vol. 3. O. Hill (ed). London, Butterworths, pp 430–439 Nemiah JC, Freyberger H, Sifneos PE (1976) Alexithymia: a view of the psychosomatic process. In modern trends in psychosomatic medicine, vol. 3. O. Hill (ed). London, Butterworths, pp 430–439
go back to reference Parker JDA, Taylor GJ, Bagby RM (1993) Alexithymia and recognition of facial expression of emotion. Psychother Psychosom 59:197–202PubMedCrossRef Parker JDA, Taylor GJ, Bagby RM (1993) Alexithymia and recognition of facial expression of emotion. Psychother Psychosom 59:197–202PubMedCrossRef
go back to reference Rapport LJ, Friedman SR, Tzelepis A, Van Voorhis A (2002) Experienced emotions and affect recognition in adult attention deficit/hyperactivity disorder. Neuropsych 16:102–110CrossRef Rapport LJ, Friedman SR, Tzelepis A, Van Voorhis A (2002) Experienced emotions and affect recognition in adult attention deficit/hyperactivity disorder. Neuropsych 16:102–110CrossRef
go back to reference Rieffe C, Terwogt M, Bosch JD (2004) Emotion understanding in children with frequent somatic complaints. Eur J Devel Psychol 1:31–47CrossRef Rieffe C, Terwogt M, Bosch JD (2004) Emotion understanding in children with frequent somatic complaints. Eur J Devel Psychol 1:31–47CrossRef
go back to reference Rieffe C, Oosterveld P, Terwogt M (2006) An alexithymia questionnaire for children: factorial and concurrent validation results. Pers Ind Diff 40:123–133CrossRef Rieffe C, Oosterveld P, Terwogt M (2006) An alexithymia questionnaire for children: factorial and concurrent validation results. Pers Ind Diff 40:123–133CrossRef
go back to reference Rieffe C, Oosterveld P, Terwogt M, Novin S, Nasiri H, Latifian M (2010) Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents: evidence from an Iranian sample. Pers Ind Diff 48:425–430CrossRef Rieffe C, Oosterveld P, Terwogt M, Novin S, Nasiri H, Latifian M (2010) Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents: evidence from an Iranian sample. Pers Ind Diff 48:425–430CrossRef
go back to reference Shapiro EG, Hughes SJ, August GJ, Bloomquist ML (1993) Processing of emotional information in children with attention deficit/hyperactivity disorder. Dev Neuropsych 9:225–240CrossRef Shapiro EG, Hughes SJ, August GJ, Bloomquist ML (1993) Processing of emotional information in children with attention deficit/hyperactivity disorder. Dev Neuropsych 9:225–240CrossRef
go back to reference Sifneos PE (1973) The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychother Psychosom 22:255–262PubMedCrossRef Sifneos PE (1973) The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychother Psychosom 22:255–262PubMedCrossRef
go back to reference Singh SD (1998) Recognition of facial expressions of emotion by children with attention-deficit hyperactivity disorder. Behav Modif 22:128–142PubMedCrossRef Singh SD (1998) Recognition of facial expressions of emotion by children with attention-deficit hyperactivity disorder. Behav Modif 22:128–142PubMedCrossRef
go back to reference Sinzig J, Morsch D, Lehmkuhl G (2008) Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur Child Adolesc Psychiatry 17:63–72PubMedCrossRef Sinzig J, Morsch D, Lehmkuhl G (2008) Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur Child Adolesc Psychiatry 17:63–72PubMedCrossRef
go back to reference Sonnby-Borgstro M (2009) Alexithymia as related to facial imitation, metallization, empathy, and internal working models-of-self and -others. Neuropsychoan 11:111–128 Sonnby-Borgstro M (2009) Alexithymia as related to facial imitation, metallization, empathy, and internal working models-of-self and -others. Neuropsychoan 11:111–128
go back to reference Taylor GJ, Bagby RM (2013) Psychoanalysis and empirical research: the example of alexithymia. J Am Psychoan Ass 61:99–133CrossRef Taylor GJ, Bagby RM (2013) Psychoanalysis and empirical research: the example of alexithymia. J Am Psychoan Ass 61:99–133CrossRef
go back to reference Taylor GJ, Bagby RM, Parker JDA (1997) Disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge University Press, CambridgeCrossRef Taylor GJ, Bagby RM, Parker JDA (1997) Disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge University Press, CambridgeCrossRef
go back to reference van de Putte EM, Engelbert RHH, Kuis W, Kimpen JLL, Uiterwaal CSPM (2007) Alexithymia in adolescents with chronic fatigue syndrome. J Psychosom Res 63:377–380PubMedCrossRef van de Putte EM, Engelbert RHH, Kuis W, Kimpen JLL, Uiterwaal CSPM (2007) Alexithymia in adolescents with chronic fatigue syndrome. J Psychosom Res 63:377–380PubMedCrossRef
go back to reference Yuill N, Lyon J (2007) Selective difficulty in recognising facial expressions of emotions in boys with ADHD: general performance impairments or specific problems in social cognition? Eur Child Adolesc Psychiatry 16:398–404PubMedCrossRef Yuill N, Lyon J (2007) Selective difficulty in recognising facial expressions of emotions in boys with ADHD: general performance impairments or specific problems in social cognition? Eur Child Adolesc Psychiatry 16:398–404PubMedCrossRef
go back to reference Zimmermann G (2006) Delinquency in male adolescents: the role of alexithymia and family structure. J Adolesc 29:321–332PubMedCrossRef Zimmermann G (2006) Delinquency in male adolescents: the role of alexithymia and family structure. J Adolesc 29:321–332PubMedCrossRef
go back to reference Zonnevylle-Bender MJS, van Goozen SHM, Cohen-Kettenis PT, van Elburg A, van Engeland H (2004) Emotional functioning in adolescent anorexia nervosa patients: a controlled study. Eur Child Adolesc Psychiatry 13:28–34PubMedCrossRef Zonnevylle-Bender MJS, van Goozen SHM, Cohen-Kettenis PT, van Elburg A, van Engeland H (2004) Emotional functioning in adolescent anorexia nervosa patients: a controlled study. Eur Child Adolesc Psychiatry 13:28–34PubMedCrossRef
Metadata
Title
Attention-deficit/hyperactivity disorder and alexithymia: a pilot study
Authors
Renato Donfrancesco
Michela Di Trani
Paola Gregori
Giovanna Auguanno
Maria Grazia Melegari
Sabrina Zaninotto
Joan Luby
Publication date
01-12-2013
Publisher
Springer Vienna
Published in
ADHD Attention Deficit and Hyperactivity Disorders / Issue 4/2013
Print ISSN: 1866-6116
Electronic ISSN: 1866-6647
DOI
https://doi.org/10.1007/s12402-013-0115-9

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