Testing the alexithymia hypothesis: physiological and subjective responses during relaxation and stress.

Alexithymia has been linked to various disorders, including compulsive behaviors, anxiety disorders, and physical conditions with or without symptoms. It has been hypothesized that these disorders result from the alexithymic inability to differentiate and elaborate affect, which gives rise to physiological arousal and a negative subjective state, which are not regulated by psychological strategies. We tested these hypothesized mechanisms by comparing 42 alexithymic subjects with 42 sex- and race-matched non-alexithymic subjects on physiological and subjective responses to an autogenic relaxation exercise and three different laboratory stressors.

Silent versus symptomatic myocardial ischemia: the role of psychological and medical factors.

This study examined the relationship of psychological, cardiac, and general medical history factors to asymptomatic (silent) versus symptomatic myocardial ischemia among 102 patients who underwent treadmill exercise testing and had perfusion imaging indicative of ischemia. During exercise, 68 patients exhibited silent ischemia, and 34 experienced chest pain. Patients with silent ischemia rated higher than symptomatic patients on anger control, externally oriented thinking, and somatosensory amplification, but did not differ on depression or global alexithymia.

Measurement of patient positioning errors in three-dimensional conformal radiotherapy of the prostate.

Purpose/objective: To determine the spatial distribution of setup errors for patients treated with six-field, three-dimensional (3D) conformal radiation therapy for prostate cancer.

Methods And Materials: Port films for 50 patients were analyzed retrospectively. The port films were digitized and compared, using image registration software, to simulator films (representing the ideal treatment position).

Allogeneic peripheral blood stem cell transplantation for haematological malignancies--an analysis of kinetics of engraftment and GVHD risk.

We have carried out an analysis of 44 patients undergoing allogeneic PBSC transplants from fully HLA-matched related donors with particular emphasis on engraftment kinetics and the incidence and severity of GVHD. The recipients had a median age of 37 years (range 5-56 years), 16 patients had standard-risk disease and 28 had poor-risk disease. GVHD prophylaxis was with cyclosporin A and methotrexate (n = 41), cyclosporin A alone (n = 2) or cyclosporin A and methyl-prednisolone (n = 1).

Alexithymia, social support and health problems.

This article presents three studies examining whether alexithymia is associated with less perceived and network social support, whether such relationships are accounted for by reduced social skills associated with alexithymia, and whether limited social support links alexithymia to health problems. The relationships between alexithymia (Toronto Alexithymia Scale), social variables, and physical health and depression were examined in both healthy young adults and patients. Alexithymia (especially deficits in identifying and communicating feelings) was related to less perceived support, fewer close relationships, and less social skill: the social skills deficit accounted fully for the association between alexithymia and a smaller social network.

How are alexithymia and physical illness linked? A review and critique of pathways.

We review the empirical literature and critique four possible pathways linking alexithymia and physical illness; (a) alexithymia leads to organic disease through physiological or behavioral mechanisms: (b) alexithymia leads to illness behavior (physical symptoms, disability, excessive health care use) through cognitive or social mechanisms: (c) physical illness leads to alexithymia; and (d) both alexithymia and physical illness result from sociocultural or biological factors. Our review suggests that alexithymia is associated with tonic physiological hyperarousal, certain types of unhealthy behavior, and a biased perception and reporting of somatic sensations and symptoms. Alexithymia also appears to influence health care use, but in a complex fashion.

Quality assurance of CD34+ cell estimation in leucapheresis products.

In order to examine the feasibility of an external quality assurance (QA) scheme for CD34+ cell enumeration and to identify causes of the differences between laboratories for CD34 counts, we carried out a pilot QA exercise in two parts. There were eight participating laboratories in the initial study and each performed CD34 counts using their in-house method. A series of 12 samples of cryopreserved peripheral blood progenitor cells (PBPC) were analysed by each of the eight laboratories.

Family factors related to alexithymia characteristics.

There is little empirical research on the familial and parental correlates of alexithymia. A two-part study explored how the affective and cognitive characteristics of alexithymia are related to family dysfunction and maternal alexithymia. In Part I, 127 young adults were evaluated for alexithymia with the Toronto Alexithymia Scale-20 (TAS-20), for impaired imagination with the Scored Archetypal Test with Nine Elements, and for family dysfunction with the McMaster Family Assessment Device.

Alexithymia and health care utilization.

Alexithymia's link with health care utilization is unclear. Alexithymia may be overrepresented among clinical samples because of a proclivity to seek care, or alexithymia may prompt delay or avoidance of care, perhaps exacerbating illness. In 911 young adults, this study examined relationships between alexithymia (Toronto Alexithymia Scale-20; total and three factor scores) and the use of six health services during the past year: outpatient medical treatment, emergency room, hospitalization, psychotherapy, routine dental care, and nonprescription analgesics.

High lactate dehydrogenase level is associated with an adverse outlook in autografting for Hodgkin's disease.

Forty-two patients with relapsed or refractory Hodgkin's disease (HD) were treated with high-dose chemotherapy (BEAM regimen) followed by autologous bone marrow and/or peripheral blood progenitor cell (PBPC) rescue. There was one procedure-related death and the overall response rate at 6 months was 88% (95% confidence interval 78-98%). The 2 year overall and event-free survival was 81% (95% confidence interval 65-96%) and 74% (95% confidence interval 58-89%) respectively.

Psychosocial factors related to unrecognized acute myocardial infarction.

Acute myocardial infarction (AMI) often is unrecognized (i.e., a patient fails to notice or report the event to the physician, or the physician fails to diagnose it).

Effects of accuracy feedback versus monetary contingency on arousal in high and low frequency gamblers.

This study examined the effects on arousal of feedback regarding prediction accuracy without monetary gain or loss versus accuracy feedback combined with monetary contingency involved in most gambling. Physiological and subjective arousal was assessed in frequent (n = 35; 16 females) and infrequent gamblers (n = 35; 16 females) during participation in a laboratory gambling game. Both samples consisted of undergraduate student volunteers.

Alexithymia and physiological reactivity to emotion-provoking visual scenes.

Alexithymia, a syndrome that involves a marked inability to name feelings, has been linked to psychosomatic illness. This study addressed the question of whether alexithymic tendencies are related to heightened levels of autonomic response to extrinsic cues. Alexithymia was assessed with the Toronto Alexithymia Scale and by the emotional content of stories written to five TAT-like printed pictures.

Alexithymia and pathological gambling.

Alexithymia is increased in addictive disorders such as alcoholism, cocaine abuse, and binge eating. Pathological gambling is a form of addictive disorder and may be influenced by alexithymia. We examined the association of alexithymia (Toronto Alexithymia Scale) and pathological gambling (South Oaks Gambling Screen) in 1,147 young adults; 3.

Psychosocial functioning in the Ehlers-Danlos syndrome.

Ehlers-Danlos Syndrome (EDS) is a group of related genetic disorders of connective tissue presenting with joint hypermobility, skin extensibility, and tissue fragility. Although the pathophysiology of EDS is increasingly understood, the psychosocial effects of having EDS have not been examined. We psychologically tested and interviewed 41 adults and 7 children with EDS.

Alexithymia and negative affect: relationship to cigarette smoking, nicotine dependence, and smoking cessation.

Alexithymia is associated with substance abuse and may interfere with successful psychotherapy. Alexithymia's relation to smoking, nicotine dependence, and smoking cessation therapy is unknown, and potentially overlaps with negative affect. Three studies addressed the relations between alexithymia, negative affect, and smoking.

Effects of menstrual phase on nicotine, alcohol, and caffeine intake in smokers.

To determine whether cigarette smoking and other drug use are affected by menstrual phase, daily diaries rating menstrual symptomatology, smoking, and alcohol and caffeine intake in female smokers were examined. Women with premenstrual symptomatology were excluded. Menstrual symptomatology peaked during menses and was accounted for primarily by symptoms indicative of physical discomfort.

Gender differences in prospectively versus retrospectively assessed smoking withdrawal symptoms.

Investigations of gender differences in the frequency and/or intensity of smoking withdrawal symptomatology have yielded conflicting findings. Several studies using measures collected both before abstinence and at the peak of symptomatology have failed to find gender differences. Yet, when asked to rate symptomatology experienced during past quit attempts, women have repeatedly been shown to endorse significantly more symptomatology than men.

Intracranial arterial occlusion associated with high-activity iodine-125 brachytherapy for glioblastoma.

We describe two patients who developed devastating strokes due to intracranial arterial occlusion 15 weeks and 97 weeks following high dose stereotactic iodine-125 brachytherapy for glioblastoma multiforme. In both cases the occlusion was within the implant volume at points receiving 110-281 Gy and there was no other evidence of significant atherosclerosis in the patients. We therefore conclude that these complications were a direct result of the brachytherapy.

Predicting children's presurgical anxiety and subsequent behavior changes.

Addressed, in two studies, issues of children's medical anxiety having implications for efficient psychological preparation. Study 1 assessed behavioral distress and physiological arousal of 4- to 10-year-old, unprepared, nonsedated children (N = 50) as they separated from parents, waited in the operating room, and were given general anesthesia for minor surgery. Anxiety intensity varied widely among children and was most intense at mask presentation.

Dentist's reassuring touch: effects on children's behavior.

Physical contact with patients by health care providers has been found to benefit the patients by reducing their fearful or avoidant reactions. This study tested whether a reassuring touch could be used during a routine pediatric dental examination to reduce children's anxiety and improve their behavior. Thirty-eight children between 3.

Quantifying the density of Friedman's pathogenic emotions (AIAI).

Because of both psychoneuroendocrine and psychobehavioral mechanisms, the chronicity of negative emotional arousal is probably the final common pathway mediating the relationship of psychosocial factors (cognitions, environments and behaviors) on one side of the mind-brain chasm, and ischemic heart disease (IHD) on the other. But the problem of "denial" remains a potential source of measurement error in studies of the association of such factors and IHD endpoints. The present study examined the association of patient-reported and spouse/friend-reported AIAI (aggravation, irritation, anger and impatience) with four measures of Type A Behavior or hostility (the Framingham Type A Scale, Cook-Medley Hostility Scale, Type A Structured Interview and a Hostility rating from the Structured Interview) in two samples: 175 men undergoing coronary angiography; and 56 age and SES-matched males with no manifest history of occlusive atherosclerotic disease.

Vanishing bile duct syndrome: a possible mechanism for intrahepatic cholestasis in Hodgkin's lymphoma.

A syndrome of idiopathic intrahepatic cholestasis occurs in some patients with Hodgkin's lymphoma. The underlying mechanism is poorly understood. In this paper we describe three patients with Hodgkin's lymphoma in whom severe intrahepatic cholestasis of unknown pathogenesis developed.