Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study
BackgroundThe majority of mental health services include patients with personality disorder (PD) and comorbid conditions. Alexithymia, a psychological construct referring to difficulties in identifying and describing internal mental states, may represent a challenge to the psychotherapeutic treatmen...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1558654/full |
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| author | Hanna Sayar Theresa Wilberg Theresa Wilberg Ingeborg Ulltveit-Moe Eikenæs Andreas Ekberg Andreas Ekberg Kai Leitemo Katharina Teresa Enehaug Morken Katharina Teresa Enehaug Morken Eileen Oftedal Eileen Oftedal Siri Omvik Dag Anders Ulvestad Dag Anders Ulvestad Geir Pedersen Elfrida Hartveit Kvarstein Elfrida Hartveit Kvarstein |
| author_facet | Hanna Sayar Theresa Wilberg Theresa Wilberg Ingeborg Ulltveit-Moe Eikenæs Andreas Ekberg Andreas Ekberg Kai Leitemo Katharina Teresa Enehaug Morken Katharina Teresa Enehaug Morken Eileen Oftedal Eileen Oftedal Siri Omvik Dag Anders Ulvestad Dag Anders Ulvestad Geir Pedersen Elfrida Hartveit Kvarstein Elfrida Hartveit Kvarstein |
| author_sort | Hanna Sayar |
| collection | DOAJ |
| description | BackgroundThe majority of mental health services include patients with personality disorder (PD) and comorbid conditions. Alexithymia, a psychological construct referring to difficulties in identifying and describing internal mental states, may represent a challenge to the psychotherapeutic treatment of patients with PD. This study aimed to investigate the prevalence of alexithymia among patients in specialized PD mental health services, differences according to PD severity and PD type, and the longitudinal course of alexithymia during treatment.MethodsThe study included 1,019 patients treated in specialized PD treatment units, with 70% of them with personality difficulties above the PD diagnostic threshold [borderline PD, 31%; avoidant PD, 39%; PD not otherwise specified (PD-NOS), 15%; other PDs, 15%; and more than one PD, 24%]. Alexithymia was measured repeatedly throughout treatment using the Toronto Alexithymia Scale (TAS-20) self-report questionnaire. Supplementary outcomes included global psychosocial function and health-related life quality. Linear mixed models were applied for data analysis.ResultsAlexithymia was highly prevalent in the sample: 53% of subjects reported high levels and 20% moderate levels. The TAS-20 subscale Difficulty Identifying Feelings was more strongly associated with borderline PD, while the subscale Difficulty Describing Feelings was more closely linked to avoidant PD. For all TAS subscales, poorer abilities were associated with more severe PD, higher levels of anxiety and depression, and poorer psychosocial functioning and life quality. Both alexithymia and measures of psychological functioning improved significantly during treatment with moderate effect sizes regardless of initial PD status. In total, 19% of the patients reported full remission of alexithymia.ConclusionAlexithymia is a common problem among patients with PDs and is associated with mental health difficulties and psychosocial dysfunction, with rates varying across PD type and severity. The study demonstrates moderate improvement of alexithymia during treatment in specialized PD mental health services. Further research should evaluate the effectiveness of different treatments and interventions in reducing alexithymia among PD patients. |
| format | Article |
| id | doaj-art-8edbabf153ca45b1a543a97e363c9480 |
| institution | DOAJ |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-8edbabf153ca45b1a543a97e363c94802025-08-20T02:40:48ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-03-011610.3389/fpsyt.2025.15586541558654Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational studyHanna Sayar0Theresa Wilberg1Theresa Wilberg2Ingeborg Ulltveit-Moe Eikenæs3Andreas Ekberg4Andreas Ekberg5Kai Leitemo6Katharina Teresa Enehaug Morken7Katharina Teresa Enehaug Morken8Eileen Oftedal9Eileen Oftedal10Siri Omvik11Dag Anders Ulvestad12Dag Anders Ulvestad13Geir Pedersen14Elfrida Hartveit Kvarstein15Elfrida Hartveit Kvarstein16Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayDepartment of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayDepartment of Addiction Treatment, Division Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayDepartment of Addiction Treatment, Division Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayNydalen Mental Health Center, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, NorwaySection for Group Therapy, Lovisenberg Diaconal Hospital, Oslo, NorwayDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Psychology, University of Bergen, Bergen, NorwayGroup Outpatient Clinic, Stavanger District Psychiatric Center, Division of Adult Mental Health Care, Stavanger University Hospital, Stavanger, Norway0Department of Caring and Ethics, Faculty of Health Services, University of Stavanger, Stavanger, Norway1Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayNydalen Mental Health Center, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayDepartment of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayDepartment of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, NorwayBackgroundThe majority of mental health services include patients with personality disorder (PD) and comorbid conditions. Alexithymia, a psychological construct referring to difficulties in identifying and describing internal mental states, may represent a challenge to the psychotherapeutic treatment of patients with PD. This study aimed to investigate the prevalence of alexithymia among patients in specialized PD mental health services, differences according to PD severity and PD type, and the longitudinal course of alexithymia during treatment.MethodsThe study included 1,019 patients treated in specialized PD treatment units, with 70% of them with personality difficulties above the PD diagnostic threshold [borderline PD, 31%; avoidant PD, 39%; PD not otherwise specified (PD-NOS), 15%; other PDs, 15%; and more than one PD, 24%]. Alexithymia was measured repeatedly throughout treatment using the Toronto Alexithymia Scale (TAS-20) self-report questionnaire. Supplementary outcomes included global psychosocial function and health-related life quality. Linear mixed models were applied for data analysis.ResultsAlexithymia was highly prevalent in the sample: 53% of subjects reported high levels and 20% moderate levels. The TAS-20 subscale Difficulty Identifying Feelings was more strongly associated with borderline PD, while the subscale Difficulty Describing Feelings was more closely linked to avoidant PD. For all TAS subscales, poorer abilities were associated with more severe PD, higher levels of anxiety and depression, and poorer psychosocial functioning and life quality. Both alexithymia and measures of psychological functioning improved significantly during treatment with moderate effect sizes regardless of initial PD status. In total, 19% of the patients reported full remission of alexithymia.ConclusionAlexithymia is a common problem among patients with PDs and is associated with mental health difficulties and psychosocial dysfunction, with rates varying across PD type and severity. The study demonstrates moderate improvement of alexithymia during treatment in specialized PD mental health services. Further research should evaluate the effectiveness of different treatments and interventions in reducing alexithymia among PD patients.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1558654/fullalexithymiapersonality disorderstreatmentlongitudinalimprovementborderline personality disorder |
| spellingShingle | Hanna Sayar Theresa Wilberg Theresa Wilberg Ingeborg Ulltveit-Moe Eikenæs Andreas Ekberg Andreas Ekberg Kai Leitemo Katharina Teresa Enehaug Morken Katharina Teresa Enehaug Morken Eileen Oftedal Eileen Oftedal Siri Omvik Dag Anders Ulvestad Dag Anders Ulvestad Geir Pedersen Elfrida Hartveit Kvarstein Elfrida Hartveit Kvarstein Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study Frontiers in Psychiatry alexithymia personality disorders treatment longitudinal improvement borderline personality disorder |
| title | Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study |
| title_full | Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study |
| title_fullStr | Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study |
| title_full_unstemmed | Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study |
| title_short | Improvement of alexithymia in patients treated in mental health services for personality disorders: a longitudinal, observational study |
| title_sort | improvement of alexithymia in patients treated in mental health services for personality disorders a longitudinal observational study |
| topic | alexithymia personality disorders treatment longitudinal improvement borderline personality disorder |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1558654/full |
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