Alexithymia as a predictor of treatment response in post-traumatic stress disorder
Thomas R. Kosten
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorJohn H. Krystal
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorEarl L. Giller Jr
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorJulia Frank
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorElisheva Dan
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorThomas R. Kosten
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorJohn H. Krystal
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorEarl L. Giller Jr
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorJulia Frank
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorElisheva Dan
Department of Psychiatry and the West Haven V. A. Medical Center, Yale University School of Medicine and University of Connecticut Health Center
Search for more papers by this authorAbstract
Fifty-seven veterans with post-traumatic stress disorder (PTSD) completed the Alexithymia Provoked Response Questionnaire (APRQ) upon entering an 8-week randomized trial comparing phenelzine, imipramine, and placebo. Low alexithymia on the APRQ significantly predicted improvement on the avoidance items of the Impact of Events Scale (IES) particularly among patients treated with placebo, but was not associated with changes in the intrusion items of the scale.
References
- Apfel-Savitz, R. J., Silverman, D. and Bennett, M. (1977). Group psychotherapy of patients with somatic illness and alexithymia. Psychother. Psychosom. 28: 323–329.
- Apfel, R. J., and Sifneos, T. E. (1979). Alexithymia: Concept in measurement. Psychother. Psychosom. 32: 180–190.
- Blanchard, E. B., Arena, J. G. and Pallmeyer, T. P. (1981). Psychosomatic properties of a scale to measure alexithymia. Psychother. Psychosom. 35: 64–71.
- Blumer, D. and Heilbronn, M. (1982). Chronic pain as a variant of depressive disease. J. Nerv. Ment. Dis. 170: 381–406.
- Davidson, J., Cudler, H., Smith, R., Mahorney, S. L., et al. (1990). Treatment of posttraumatic stress disorder with amitriptylene and placebo. Arch. Gen. Psychiatry 47: 259–269.
- Gendorf, A., Kadushin, D., Laufer, R. S., et al. (1981). Legacies of Vietnam: Comparative Adjustments of Veterans and Their Peers, Center for Policy Research, New York,
- Frank, J. B., Kosten, T. R., Giller, E. L., and Dan, E. (1980). A preliminary study of phenelzine and imipramine for post traumatic stress disorder. Am. J. Psychiatry 145: 1289–1291.
- Horowitz, M., Wilner, N., and Alvarez, W. (1972). Impact of events scale: A measure of subjective distress. Psychosom. Med. 41: 209–218.
- Kosten, T. R., Frank, J. B., Dan, E., McDougle, C. J., and Giller, E. L. (1992). Pharmacotherapy for post-traumatic stress disorder using phenelzine or imipramine. J. Nervous Mental Dis. 179: 366–371.
- Krystal, H. (1971). Trauma: Consideration of severity and chronicity. In H. Krystal, and W. Niederland (eds.), Psychic Traumatization, Little, Brown, Boston, pp. 11–28.
- Krystal, H. (1977). Self-representation in the capacity for self care. Ann. Psychoanal. 6: 209–246.
- Krystal, H. (1982). Alexithymia and the effectiveness of psychoanalytic treatment. Int. J. Psychoanal. Psychother. 9: 353–378.
- Krystal, J. H., Giller, E. L., and Cicchetti, D. V. (1986). Assessment of alexithymia in post-traumatic stress disorder and somatic illness: Introduction of a reliable measure. Psychosom. Med. 48: 84–94.
- Lolas, F., Dela Parra, G., Aronsohn, S., et al, (1980). On the measurement of alexithymic behavior. Psychother. Psychosom. 33: 139–146.
- Marmor, J. (1979). Short term dynamic psychotherapy. Am. J. Psychiatry 136: 149–155.
- Pierce, M., Faryna, A., Davidson, A., Markert, R., and Krystal, J. H. (1989). A comparison of interview and self-report alexithymia measures. Psychosom. Med. 51: 254–255.
- Pierce, M., Krystal, J. H., Faryna, A., Markert, R., and Davidson, A. (1990). A comparison of alexithymia measures. Proc. American Psychiatric Association, New Research, New York,
- Sifneos, P. E. (1975). Problems of psychotherapy of patients with alexithymic characteristics and physical disease. Psychother. Psychosom. 26: 65–70.
- Sifneos, P. E., Apfel-Savitz, R., and Frankel, F. (1977). The phenomena “alexithymia”: Observations in neurotic and psychosomatic patients. Psychother. Psychosom. 28: 47–57.
- Taylor, G. J. (1984). Alexithymia: Concept, measurement, and implications for treatment. Am. J. Psychiatry 141: 725–732.
