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The Role of Alexithymia and Coping Strategies in Eating Disorders: a Pilot Study

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Activitas Nervosa Superior

Abstract

The majority of studies have found higher levels of alexithymia and a higher use of maladaptive coping strategies in individuals with eating disorders (ED). In this study, we consider the relationships between alexithymia and coping skills in different types of ED, in order to identify the specific role of these constructs in predicting dysfunctional eating symptoms. Thirty-four patients with anorexia nervosa (AN), 30 patients with bulimia nervosa (BN), 29 with binge eating disorder (BED) and 28 healthy control (HC) took part in the study. Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90-R (SCL-90-R), Toronto Alexithymia Scale (TAS-20) and Coping Inventory for Stressful Situation (CISS) were used to assess the constructs of interest. Patients with ED showed higher levels of alexithymia in comparison with HC. Moreover, they presented a higher use of Emotion oriented coping strategy than HC. Regression analysis showed that alexithymia difficult to identify feeling predicted the eating disorder risk in patients with AN, whereas the same risk was predicted by the Emotion oriented coping strategy in BED group. For AN group, the model remain significant also when controlling for anxiety and depression. Alexithymia appears to be a predictor of eating symptoms specifically in an AN group, whereas a high use of emotion-oriented coping strategy appears to be a predictor of ED specifically in BED patients. The present findings may orient various kinds of intervention specifically targeted to different levels of emotion processing.

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References

  • American Psychiatric Association (APA) (2000). DSM IV-TR. Manuale diagnostico e statistico dei disturbi mentali, tr. it. Masson, Milano, 2001.

  • American Psychiatric Association (APA) (2013), DSM-5. Manuale diagnostico e statistico dei disturbi mentali, tr. it. Raffaello Cortina, Milano, 2014.

  • Amigo Vázquez, I., Marchiol, F., & Luxardi, G. L. (2011). Coping e alessitimia nei disturbi del comportamento alimentare: uno studio pilota. Personalità/dipendenze, 17(2/3), 207–223.

  • Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale-I: item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32. https://doi.org/10.1016/0022-3999(94)90005-1.

    Article  Google Scholar 

  • Besharat, M. A. (2010). Relationship of alexithymia with coping styles and interpersonal problems. Procedia - Social and Behavioral Sciences, 5, 614–618. https://doi.org/10.1016/j.sbspro.2010.07.152.

    Article  Google Scholar 

  • Bloks, H., Hoek, H. W., Callewaert, N. V., & van Furth, E. (2004). Stability of personality traits in patients who received intensive treatment for a severe eating disorder. The Journal of Nervous and Mental Disease, 192(2), 129–138. https://doi.org/10.1097/01.nmd.0000110284.12816.fe.

    Article  PubMed  Google Scholar 

  • Brytek-Matera, A., & Schiltz, L. (2013). Comparative structural study of the configuration of coping strategies among female patients with eating disorders and a non-clinical control group. Psychiatria Danubina, 25(4), 359–365.

    PubMed  Google Scholar 

  • Bydlowski, S., Corcos, M., Jeammet, P., Paterniti, S., Berthoz, S., Laurier, C., Chambry, J., & Consoli, S. M. (2005). Emotion-processing deficits in eating disorders. The International Journal of Eating Disorders, 1, 321–329. https://doi.org/10.1002/eat.20132.

    Article  Google Scholar 

  • Cantor, M.B. (1981). Bad habits: Models of induced ingestion in satiated rats and people. In S. Miller (Ed.), Behavior and nutrition. Philadelphia: Franklin Institute Press

  • Carretti, V., La Barbera, D. (2005). Alessitimia. Valutazione e trattamento. Casa Editrice Astrolabio.

  • Cooper, M. J. (2005). Cognitive theory in anorexia nervosa and bulimia nervosa: progress, development and future directions. Clinical Psychology Review, 25, 511–531. https://doi.org/10.1016/j.cpr.2005.01.003.

    Article  PubMed  Google Scholar 

  • Cooper, M. J., Wells, A., & Todd, G. (2004). A cognitive model of bulimia nervosa. British Journal of Clinical Psychology, 43, 1–16. https://doi.org/10.1348/014466504772812931.

    Article  PubMed  Google Scholar 

  • De Berardis, D., Carano, A., Gambi, F., Campanella, D., Giannetti, P., Ceci, A., Mancini, E., La Rovere, R., Cicconetti, A., Penna, L., Di Matteo, D., Scorrano, B., Cotellessa, C., Salerno, R. M., Serroni, N., & Ferro, F. M. (2007). Alexithymia and its relationships with body checking and body image in a non-clinical female sample. Eating Behaviors, 1, 296–304. https://doi.org/10.1016/j.eatbeh.2006.11.005.

    Article  Google Scholar 

  • De Panfilis, C., Rabbaglio, P., Rossi, C., Zita, G., & Maggini, C. (2003). Body image disturbance, parental bonding and alexithymia in patients with eating disorders. Psychopathology., 1, 239–246. https://doi.org/10.1159/000073449.

    Article  Google Scholar 

  • Derogatis, L.R. (1994). Symptom Checklist-90-R: administration, scoring, and procedures manual (3rd). Minneapolis: National Computer Systems.

  • Di Tella, M., Tesio, V., Ghiggia, A., Romeo, A., Colonna, F., Fusaro, E., et al. (2018). Coping strategies and perceived social support in fibromyalgia syndrome: relationship with alexithymia. Scandinavian Journal of Psychology, 59(2), 167–176. https://doi.org/10.1111/sjop.12405.

    Article  PubMed  Google Scholar 

  • Dingemans, A., Danner, U., & Parks, M. (2017). Emotion regulation in binge eating disorder: a review. Nutrients, 9(11), 1274. https://doi.org/10.3390/nu9111274.

    Article  PubMed Central  Google Scholar 

  • Eizaguirre, A. E., de Cabezon, A. O. S., de Alda, I. O., Olariaga, L. J., & Juaniz, M. (2004). Alexithymia and its relationships with anxiety and depression in eating disorders. Pers Indiv Differ., 1, 321–331. https://doi.org/10.1016/S0191-8869(03)00099-0.

    Article  Google Scholar 

  • Endler, N. S., & Parker, J. D. A. (1999). Coping Inventory for Stressful Situations (CISS): manual (2nd ed.). Toronto: Multi-Health Systems.

    Google Scholar 

  • Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy, 41, 509–528. https://doi.org/10.1016/S00005-7967(02)00088-8.

    Article  PubMed  Google Scholar 

  • Fernandes, J., Ferreira-Santos, F., Miller, K., & Torres, S. (2017). Emotional processing in obesity: a systematic review and exploratory meta-analysis. Obesity Reviews, 19(1), 111–120. https://doi.org/10.1111/obr.12607.

    Article  PubMed  Google Scholar 

  • Garner, D. M. (1991). Eating disorder inventory-2 professional manual. Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Heatherton, T.F. & Baumeister, R.F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86–108.

  • Lazarus, R., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

    Google Scholar 

  • Macht, M. (2008). How emotions affect eating: a five-way model. Appetite, 50(1), 1–11.

  • Mas, N., Fusté Escolano, A., García Grau, E., & Bados López, A. (2015). Coping styles and vulnerability to eating disorders in adolescent girls, by age. Terapia Psicológica, 33(3), 161–168. https://doi.org/10.4067/S0718-48082015000300001.

    Article  Google Scholar 

  • Nemiah, J. C., & Sifneos, P. E. (1970). Affect and fantasy in patients with psychosomatic disorder. Modern Trends in Psychosomatic Medicine, 2, 26–34.

    Google Scholar 

  • Nowakowski, M. E., McFarlane, T., & Cassin, S. (2013). Alexithymia and eating disorders: a critical review of the literature. Journal of Eating Disorders, 1, 21. https://doi.org/10.1186/2050-2974-1-21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Okamoto, Y., Miyake, Y., Nagasawa, I., & Shishida, K. (2017). A 10-year follow-up study of completers versus dropouts following treatment with an integrated cognitive-behavioral group therapy for eating disorders. Journal of Eating Disorders, 5(1), 52. https://doi.org/10.1186/s40337-017-0182-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Olmsted, M. P., MacDonald, D. E., McFarlane, T., Trottier, K., & Colton, P. (2015). Predictors of rapid relapse in bulimia nervosa. The International Journal of Eating Disorders, 48(3), 337–340. https://doi.org/10.1002/eat.22380.

    Article  PubMed  Google Scholar 

  • Pinna, F., Sanna, L., & Carpiniello, B. (2014). Alexithymia in eating disorders: therapeutic implications. Psychology Research and Behavior Management, 8, 1–15. https://doi.org/10.2147/PRBM.S52656 eCollection 2015. Review.

    Article  PubMed  PubMed Central  Google Scholar 

  • Polivy, J., & Herman, C.P. (1999). Distress and eating: Why do dieters overeat? International Journal of Eating Disorders, 26, 153–164.

  • Rizzardi, M., Trombini, E., & Trombini, G. (1995). EDI-2 eating disorder inventory-2: manuale. Firenze: O.S. Organizzazioni Speciali.

    Google Scholar 

  • Rozenstein, M. H., Latzer, Y., Stein, D., & Eviatar, Z. (2011). Perception of emotion and bilateral advantage in women with eating disorders, their healthy sisters, and nonrelated healthy controls. Journal of affective disorders, 134(1–3), 386–395.

  • Sarno, I., Preti, E., Prunas, A., & Madeddu, F. (2011). SCL-90-R Symptom Checklist-90-R Adattamento italiano. Firenze: Giunti, Organizzazioni Speciali.

    Google Scholar 

  • Serier, K. N., Smith, J. E., Lash, D. N., Gianini, L. M., Harriger, J. A., Sarafin, R. E., & Wolfe, B. L. (2018). Obligatory exercise and coping in treatment-seeking women with poor body image. Eating and Weight Disorders, 23(3), 331–338. https://doi.org/10.1007/s40519-018-0504-3.

    Article  PubMed  Google Scholar 

  • Sierra-Baigrie, S., Lemos-Giráldez, S., Paino, M., & Fonseca-Pedrero, E. (2012). Exploring the relationship between coping strategies and binge eating in nonclinical adolescents. European Eating Disorders Review, 20(1), e63–e69. https://doi.org/10.1002/erv.1103.

    Article  PubMed  Google Scholar 

  • Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2), 255–262. https://doi.org/10.1159/000286529.

    Article  Google Scholar 

  • Sirigatti, S., & Stefanile, C (2009) Coping inventory for stressful situation standardizzazione e validazione italiana.

  • Taylor, G. J., Ryan, D., & Bagby, R. M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy and Psychosomatics, 44(4), 191–199. https://doi.org/10.1159/000287912.

    Article  PubMed  Google Scholar 

  • Thayer, R.E. (2001). Calm energy—How people regulate mood with food and exercise. Oxford: Oxford University Press

  • Westwood, H., Kerr-Gaffney, J., Stahl, D., & Tchanturia, K. (2017). Alexithymia in eating disorders: systematic review and meta-analyses of studies using the Toronto Alexithymia Scale. Journal of Psychosomatic Research, 99, 66–81. https://doi.org/10.1016/j.jpsychores.2017.06.007.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Life Sciences, University of Trieste, Trieste, Italy

    Fiorenza Marchiol, Barbara Penolazzi & Corrado Cavallero

  2. Center for Eating Disorders, ASL5 West Friuli, Pordenone, Italy

    Gian Luigi Luxardi

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  1. Fiorenza Marchiol
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  2. Barbara Penolazzi
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  3. Corrado Cavallero
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  4. Gian Luigi Luxardi
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Correspondence to Fiorenza Marchiol.

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Ethics approval for the study was obtained by the University of Trieste ethics board.

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Marchiol, F., Penolazzi, B., Cavallero, C. et al. The Role of Alexithymia and Coping Strategies in Eating Disorders: a Pilot Study. Act Nerv Super 62, 69–77 (2020). https://doi.org/10.1007/s41470-019-00066-9

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  • DOI: https://doi.org/10.1007/s41470-019-00066-9

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