The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents

doi:10.1016/j.comppsych.2008.08.007

Comprehensive Psychiatry

Volume 50, Issue 3, May–June 2009, Pages 263-268

https://doi.org/10.1016/j.comppsych.2008.08.007 Get rights and content

Abstract

This study investigated the relationship between alexithymia, depressive symptoms, and Youth Self-Report (YSR) self-image profiles among 13 to 18-year-old adolescents (n = 7087) attending school in Kuopio, Finland. The final sample consisted of 3936 adolescents (1801 boys, 2135 girls) who completed structured self-rating questionnaires (Toronto Alexithymia Scale [TAS] 20, Beck Depression Inventory [BDI], and YSR) during class periods at school. The overall prevalence of alexithymia was 7.3%. However, girls in all age groups were more frequently alexithymic than boys. Regardless of sex, alexithymic youths reported more depressive symptoms as well as internalizing and externalizing problems than the others. A YSR total score of more than 70 was recorded among 33.4% of alexithymic compared with 3.7% of nonalexithymic adolescents. The TAS-20 correlated significantly with the BDI score, YSR total score, and with internalizing problems. This study revealed alexithymia among adolescents to be associated with various complications such as depressive symptoms, high scores in YSR problem scales, and difficulties in social relationships. Our findings indicate that these adolescents are at high risk of mental disorders and require treatment interventions.

Introduction

Alexithymia, the inability to recognize and describe emotions [1] and an externally oriented way of thinking, has been widely studied in various clinical samples as well as in general populations. The reported prevalence of alexithymia in population samples has ranged from 10% to 13% [2], [3], [4]. Many population studies have found males to be more often alexithymic than females [3], [4]. Interestingly, among British undergraduate students [5] and among 15 to 16-year-old Finnish adolescents [6], the prevalence of alexithymia was higher among females than among males.

A positive relationship between alexithymia and depressive symptoms has been recorded in several clinical studies, especially among depressive adult patients [7], [8], [9]. Among adolescents, the reported prevalence of depressive disorders ranged from 9% to 25% [10], [11]. Moreover, in a large sample of 18-year-old boys, depressive symptoms at the age of 8 predicted a more depressive symptoms 10 years later [12].

The most popular and widely used scale for assessing alexithymia is the Toronto Alexithymia Scale with 20 items (TAS-20) [13], [14]. This self-report scale has mainly been used with adults but seldom among adolescent populations. However, adolescents may be valuable informants on their own psychologic functioning [15].

Several studies using the Youth Self-Report (YSR), which assesses internalizing and externalizing problems of adolescents, have shown that boys and girls differently evaluate their problems [16], [17], [18]. Among 15 to 16-year-old Finnish adolescents, girls reported significantly more internalizing, withdrawn, somatic, and anxious-depressive symptoms and attention problems than boys [19]. However, boys reported more delinquent behavior than girls in a large sample of Norwegian adolescents [17]. In addition, earlier studies have revealed that self-image profiles can differentiate between normal and disturbed adolescents and can also predict future psychologic functioning [20]. It has also been noted that adolescent problems tend to persist into adulthood to a moderate degree [21].

In this study, we investigated the relationship between alexithymia, depressive symptoms, and YSR self-image profiles among 13 to 18-year-old Finnish adolescents. In addition, we examined whether adolescents with alexithymia (TAS-20 scores ≥61) differed from other youths in their self-reported problems. The aim of third study was to assess how the TAS-20 and its factors correlate with the Beck Depression Inventory with 21 items (BDI) and YSR subscales. We also investigated potential sex differences in the associations between alexithymia, depression, and YSR scores.

Section snippets

Participants

The participants were cohorts of 13 to 18-year-old adolescents (n = 7087) who, at the time of the study, were attending school in Kuopio, a city in Eastern Finland with approximately 90 000 inhabitants. Permission was obtained in advance from the headmasters of the schools in which the study was performed. The ethical committee of Kuopio University Hospital (Kuopio, Finland) and the University of Kuopio (Kuopio, Finland) granted permission for the study.

The study focused on comprehensive,

Results

The prevalence of alexithymia was 7.3% in total sample and varied between sexes and age-groups (χ² = 15.3; df = 5; P < .01). Girls in all age groups were more frequently alexithymic than boys. Statistically significant differences between sexes were found within the age groups of 13, 15, and 16 years. The prevalence of alexithymia was significantly higher among 13 than 18-year-olds and among 15 than 16, 17, and 18-year-olds (Table 1). There was no difference in mean TAS-20 scores between boys

Discussion

The prevalence of alexithymia in the total sample was 7.3% but differed between sexes and age groups. Girls in all age groups were more frequently alexithymic than boys. A recent study among Finnish adolescents [6] revealed that alexithymia measured categorically was more prevalent among girls than boys but that the mean TAS-20 score was higher among boys than girls. In this study, there was no difference between sexes in mean scores of the TAS-20.

In the total sample, the prevalence of

Conclusions

The findings of this study showed the prevalence of alexithymia among adolescents to differ between sexes and age groups and to associate with various complications including depressive symptoms, high scores in YSR problem scales, difficulties in social relationships, and problematic drinking. These findings indicate that these adolescents are at high risk of developing psychiatric disorders in adulthood and therefore require more attention from school health and mental health services.

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The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents

Abstract

Introduction

Section snippets

Participants

Results

Discussion

Conclusions

Compr Psychiatry

J Psychosom Res

J Psychosom Res

Psychosomatics

Aust N Z J Public Health

J Affect Disord

J Psychosom Res

J Psychosom Res

Psychiatr Clin North Am

Psychosomatics

J Am Acad Child Adolesc Psychiatry

The prevalence of “alexithymic” characteristics in psychosomatic patients

Psychother Psychosom

Sociodemographic correlates of alexithymia

Compr Psychiatry

Why do alexithymic features appear to be stable?—a 12-month follow-up study of a general population

Psychother Psychosom

Alexithymia: its prevalence and correlates in a British undergraduate sample

Psychol Psychother