• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.42-50
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• 1999

Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in the capacity to verbalize affect and to elabolate fantasies. Although it was initially described in the context of psychosomatic illness, alexithymic charateristics may be observed in patients with a wide range of medical and psychiatric disorders. This study was designed to investigate alexithymic characteristics in the patients with alcoholism using Scored Archetypal 9 Test(SAT9) and Toronto Alexithymia Scale-20 Korea version(TAS-20K). Twenty patients with alcoholism and twenty-four normal controls completed these tests. The results were as follows. 1) Patient group with alcoholism were significantly more alexithymic than normal control group in both SAT9 and TAS-20K. 2) No significant difference in the alexithymic measures was found between genders of both group. 3) No significant correlation was found between alexithymic measures and age or education level in both group. 4) Measures between SAT9 and TAS-20K showed significant correlation in the patient group.

• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.239-244
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• 2011

Objectives Schizophrenic patients have been shown to be impaired in both emotional self-awareness and recognition of others' facial emotions. Alexithymia refers to the deficits in emotional self-awareness. The relationship between alexithymia and recognition of others' facial emotions needs to be explored to better understand the characteristics of emotional deficits in schizophrenic patients. Methods Thirty control subjects and 31 schizophrenic patients completed the Toronto Alexithymia Scale-20-Korean version (TAS-20K) and facial emotion recognition task. The stimuli in facial emotion recognition task consist of 6 emotions (happiness, sadness, anger, fear, disgust, and neutral). Recognition accuracy was calculated within each emotion category. Correlations between TAS-20K and recognition accuracy were analyzed. Results The schizophrenic patients showed higher TAS-20K scores and lower recognition accuracy compared with the control subjects. The schizophrenic patients did not demonstrate any significant correlations between TAS-20K and recognition accuracy, unlike the control subjects. Conclusions The data suggest that, although schizophrenia may impair both emotional self-awareness and recognition of others' facial emotions, the degrees of deficit can be different between emotional self-awareness and recognition of others' facial emotions. This indicates that the emotional deficits in schizophrenia may assume more complex features.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.77-88
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• 2003

Objectives: The purpose of this study was to compare reliability and validity of three Korean versions of the 20-item Toronto Alexithymia scale and to confirm the most reliable and validated Korean translation of the 20-item Toronto Alexithymia Scale for both clinical and research purpose in Korea. The first one was a Korean version of the 20-Item Toronto Alexithymia Scale developed by Lee YH et al in 1996 which was designated as TAS-20K(1996) in this study. This scale had a problem with one item due to the cultural difference regarding the word 'analyzing' between western culture and Korean culture. The second one was the revised version of TAS-20K(1996) on that point by Lee YH et al in 1996 without validation which was designated as TAS-20K(2003) in this study. The third one was a 23-item Korean version developed by Sin HG and Won HT in 1997, which was somewhat different from the 20-item Toronto Alexithymia Scale(TAS-20) in the number of total item, the content of some items and the scoring method. This scale was designated as S-TAS here. Methods: 408 medical students were tested with one scale composed of all the different items randomly arranged from the three versions. We evaluated goodness-of-fit and Cronbach $\alpha$ coefficients of three scales for reliability. We used confirmatory factor analysis to compare validity. Results: TAS-20K(2003) showed that it had better internal consistency than TAS-20K(1996), which implied that the cultural difference should be considered in the Korean translation. Both TAS-20K(2003) and S-TAS replicated three-factor structures and had adequacy of fit, good internal consistency and acceptable validity. However, S-TAS had one item with poor item-factor correlation and didn't show high correlation between item 2 and factor 1 as before in 1997. Conclusion: Although S-TAS had added 3 items and changed the content of two items, it didn't show better reliability and validity than TAS-20K(2003). Therefore it is proposed to use TAS-20K (2003) as the Korean version of the 20-item Toronto Alexithymia Scale(TAS-20K) for international communication of results of Alexithymia research. It has good internal consistency and validity and maintains original items, the same construct and scoring method as the 20-item Toronto Alexithymia Scale.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.69-76
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• 2003

Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

• Korean Journal of Culture and Social Issue
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• v.25 no.2
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• pp.101-118
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• 2019

Alexithymia refers to a psychological deficit of identifying and describing one's feelings. It has benn reported that the level of alexithymia of East-Asians is generally higher than that of Western Europeans. Recently one research conducted in U.S. suggested that the interdependent self-construal from East-Asians' collectivism culture might be a cause of this cross-cultural difference. In the current study, we examined the relationship between the level of independent and interdependent self-construal of Korean college students and their level of alexithymia, as well as their ambivalence over emotional expressiveness and emotion suppression. The correlation analysis shows that the Korean students' alexithymia level does not correlate with their level of interdependent self-construal, but negatively correlates with their level of independent self-construal. Moreover, it is also correlated with the level of ambivalence over emotional expressiveness(AEE) and emotion suppression(ES). Thus, we setup a double-mediation model between the deficiency of independent self-construal and alexithymia via AEE and ES, and estimate mediation effects using Hayes and Preacher(2014)s' Process analysis. The results show that the deficiency of independent self-construal has a direct effect as well as indirect effects of AEE and ES on the alexithymia level. Further analysis on the indirect effects reveals that the mediation effect of AEE and the double mediation effect of ES via AEE are significant, but the mediation effect of ES is not significant. Current results imply that the interdependent self-construal from the traditional collectivistic culture may not cause Korean college students' problems on the emotional expression, but the relatively lower independent self-construal may cause them. The deficiency of independent self-constural may raise up the level of self-defensive ambivalence over emotional expressiveness and suppress emotional expression by themselves, which can result in alexithymia.

• Korean Journal of Culture and Social Issue
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• v.29 no.2
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• pp.171-197
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• 2023

The traditional Korean society has been classified as an Eastern collectivist culture, but in the flow of globalization and digitalization along with the post-Cold War era of the 1970s, Western individualistic culture and values quickly permeated the Korean younger generation. Since rapid changes occurred within a short period of time, there may be differences in cultural self-construal between generations living in the same era. Due to this, psychological problems related to emotional expression and suppression may appear differently depending on generations. Therefore, in the current study, 1,000 Korean adult men and women from their 20s to 60s were investigated for their level of independent and interdependent self-construal, alexithymia, ambivalence over emotional expression(AEE) and emotional suppression(ES). Then the relationship between the variables(self-construal and alexithymia,) and the mediating process of AEE and ES were examined. The generation of participants were divided into the industrialization cohort (birth year < 1970) and the digitalization cohort (birth year starting from 1970). Using the PROCESS macro(Hayes, 2022), we tested a serial mediation model of AEE and ES between the relative independent self-construal(RIS) and alexithymia. The results indicate that the level of alexithymia increases by the serial increase of AEE and ES when RIS decreases. Next, we examined a moderation effect of generatione on the mediation process of AEE and ES, and found that generation moderates the relationship between ES and alexithymia. That is, the effect of ES on alexithymia is significant for the digitalization cohort, while it is not significant for the industrialization cohort. The current results imply that emotion regulation strategies of Koreans have been differently developed according to prevailing cultural values in each generation, and that the negative influence of emotion suppression could be different according to the cultural background of each generation.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.30-37
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• 2004

The objective of this study was to make a comparison between chronic superficial gastritis and gastric ulcer patients regarding stress responses, anger expression and alexithymia. The subjects included 100 patients with chronic superficial gastritis and 40 patients with gastric ulcer confirmed by gastroscopy. Stress responses were measured by the Stress Response Inventory(SRI) and anxiety, depression, somatization and hostility subscales of the Symptom Checklist-90-revised(SCL-90-R). Anger expression and anger suppression were assessed by the Anger Expression Scale. The level of alexithymia was assessed by the Toronto Alexithymia Scale(TAS). Multiple regression analysis showed that the patients with chronic gastritis scored significantly higher on tension subscale and somatization subscale of the SRI, and anxiety subscale of the SCL-90-R than those with gastric ulcer. However, no significant differences were found in the score of anger expression and anger suppression subscales and total score of TAS between the two groups. In chronic gastritis patients, women scored significantly higher on somatization subscale of the SRI than men, whereas in gastric ulcer patients, men scored significantly higher on somatization subscale of the SRI than women. These results suggest that chronic gastritis patients are more likely to have higher level of stress responses and higher susceptibility to stress than gastric ulcer patients. In addition, in chronic gastritis patients, women are more likely to somatize than men, but in gastric ulcer patients, men are more likely to somatize than women. However, there were no differences between the two groups in anger expression, anger suppression and alexithymia.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.100-106
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• 2007

Objectives : The objective of the present study was to investigate alexithymia in major depressive disorder(MDD) and subclinical depression(SCD). Methods : Three hundred eighty-six community-dwelling adults(238 females and 148 males, age 19-79; mean age $43.0{\pm}13.9$) were recruited. Structured clinical Interview for DSM-IV(SCID) was conducted for the diagnosis of MDD or other Axis I psychiatric disorders. The Center for Epidemiological Studies for Depression Scale(CES-D) and the Totonto Alexithymia Scale(TAS) were administered to assess depressive symptom and alexithymia, respectively. Among subjects without MDD, those who had minor depressive disorder on the SCID or high scores(i.e. over 16) on the CES-D were defined as subjects with SCD. TAS total score and factor I, II, III scores of TAS in MDD, SCD, and non-depressive controls were compared. Results : Among 386 subjects, 38 subjects(9.8%) were diagnosed as MDD by DSM-IV criteria, while 57 subjects(14.8%) were classified into SCD group. There were significant differences between 3 groups(MDD, SCD and non-depressive controls) in total score($F_{2,383}=14.0$, p<0.01), factor I(difficulty in identifying feeling)($F_{2,383}=23.4$, p<0.01) and factor II(difficulty in describing feeling)($F_{2,383}=7.8$, p<0.01), but not factor III(external oriented thinking)($F_{2,383}=1.8$, p=0.16) of TAS. In post-hoc analysis, both MDD subjects and SCD subjects had higher scores in TAS total, factor I and factor II, compared to non-depressive controls(all p<0.01). In contrast, there were no significant differences between MDD subjects and SCD subjects in any TAS factor. Conclusion : In this study, both MDD subjects and SCD subjects were more alexithymic than non-depressive control subjects. These findings suggest that SCD, as well as MDD, is also related to alexithymia.

• Journal of Oriental Neuropsychiatry
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• v.24 no.4
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• pp.363-372
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• 2013

Objectives: The purpose of this study is to investigate the usefulness of psychological measurements in depression symptoms as compared with non-depressions and hwabyung. Methods: A total of 21 patients, who were diagnosed with depression and hwabyung, were evaluated by using the SCL-90-R, BDI, STAI, STAXI, ISI, HRSD, 20-Item Alexithymia Scale, BSDS and NEO-PI. Thereafter, they were statistically analyzed. Results: 1) In the results of SCL-90-R, the PST score group of hwa-byung group without depression was significantly higher when compared to the score from the depression group without hwa-byung. 2) In the results of NEO-PI, the NEO-PI-O score of hwa-byung group without depression was significantly higher when compared to the score from the depression group without hwa-byung. 3) In the results of 20-Item Alexithymia Scale, the total score and score of difficulty for identifying feelings scale from the depression group was significantly higher when compared to the score of non depression group. Conclusions: The results found are expected to serve as a useful resource for future studies when developing the instruments of oriental medical evaluations for hwa-byung.