Non-declarative representational and regulatory systems in alexithymia

Journal of Trauma and Dissociation

Volumn 10, Issue 4, 2009, Pages 469-487

  Helling, Jim ^a  

^a Traumaterapiakeskus   (Finland)

Author keywords

Alexithymia; Dissociation; Interoception; Neurovisceral integration; Procedural processing; Trauma

Indexed keywords

ADAPTIVE BEHAVIOR; ALEXITHYMIA; APRAXITHYMIA; ARTICLE; BEHAVIOR THERAPY; COGNITION; DISSOCIATIVE DISORDER; EMOTION; HUMAN; MEMORY; MENTAL DISEASE; NEUROIMAGING; POSTTRAUMATIC ALEXITHYMIA; POSTTRAUMATIC STRESS DISORDER; PRIORITY JOURNAL; PSYCHOTHERAPY; SENSORIMOTOR INTEGRATION;

AFFECTIVE SYMPTOMS; DISSOCIATIVE DISORDERS; HUMANS; PERSONALITY INVENTORY; PSYCHIATRIC STATUS RATING SCALES; STRESS DISORDERS, POST-TRAUMATIC;

EID: 70449107842     PISSN: 15299732     EISSN: 15299740     Source Type: Journal    
DOI: 10.1080/15299730903143675     Document Type: Article

References (109)

1. Badura, A. S. (2003). Theoretical and empirical exploration of the similarities between emotional numbing in posttraumatic stress disorder and alexithymia. Journal of Anxiety Disorders, 17, 349-360.
2. Bermond, B., Vorst, H. C., & Moormann, P. (2006). Cognitive neuropsychology of alexithymia: Implications for personality typology. Cognitive Neuropsychiatry, 11, 332-360.
3. Berthoz, S., Artiges, E., Van De Moortele, P. F., Poline, J. B., Rouquette, S., Consoli, S. M., et al. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. American Journal of Psychiatry 159, 961-967.
4. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 231-240.
5. Bremner, J. D. (2005). Does stress damage the brain? Understanding trauma-related disorders from a mind-body perspective. New York: Norton.
6. Bremner, J. D., Vermetten, E., Afzal, N., & Vythilingam, M. (2004). Deficits in verbal declarative memory function in women with childhood sexual abuse-related posttraumatic stress disorder. Journal of Nervous and Mental Disease, 192, 643-649.
7. Bremner, J. D., Vermetten, E., Schmahl, C., Vaccarino, V., Vythilingam, M., Afzal, N., et al. (2005). Positron emission tomographic imaging of neural correlates of a fear acquisition and extinction paradigm in women with childhood sexualabuse- related post-traumatic stress disorder. Psychological Medicine, 35, 791-806.
8. Brewin, C. R. (2005a). Encoding and retrieving traumatic memories. In J. J. Vaseterling & C. R. Brewin (Eds.), Neuropsychology of PTSD (pp. 131-152). New York: Guilford Press.
9. Brewin, C. R. (2005b). Implications for psychological intervention. In J. J. Vaseterling & C. R. Brewin (Eds.), Neuropsychology of PTSD (pp. 271-291). New York: Guilford Press.
10. Brewin, C., Dagliesh, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670-686.
11. Briere, J., & Spinazzola, J. (2005). Phenomenology and psychological assessment of complex posttraumatic states. Journal of Traumatic Stress, 18, 401-412.
12. Brown, R. P., & Gerbarg, P. (2005). Sudarshan kriya yogic breathing in the treatment of stress, anxiety, and depression: Part II - Clinical applications and guidelines. Journal of Alternative and Complementary Medicine, 11, 711-717.
13. Cacioppo, J. T., Berntson, G. G., Sheridan, J. F., & McClintock, M. K. (2002). Multilevel integrative analyses of human behavior: Social neuroscience and the complementing nature of social and biological approaches. In J. T. Cacioppo, G. G. Berntson, R. Adolphs, S. C. Carter, R. Davidson, M. K. McClintock, et al. (Eds.), Foundations in social neuroscience (pp. 21-45). Cambridge, MA: MIT Press.
14. Cacioppo, J. T., Gardner, W. L., & Berntson, G. G. (2002). The affect system has parallel and integrative processing components: Form follows function. In J. T. Cacioppo, G. G. Berntson, R. Adolphs, S. C. Carter, R. Davidson, M. K. McClintock, et al. (Eds.), Foundations in social neuroscience (pp. 493-522). Cambridge, MA: MIT Press.
15. Clayton, K. (2004). The interrelatedness of disconnection: The relationship between dissociative tendencies and alexithymia. Journal of Trauma & Dissociation, 5, 77-101.
16. Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70, 1067-1074.
17. Cloitre, M., Stovall-McClough, K. C., Miranda, R., & Chemtob, C. M. (2004). Therapeutic alliance, negative mood regulation, and treatment outcome in child abuse-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72, 411-416.
18. Clyman, R. (1991). The procedural organization of emotions: A contribution from cognitive science to the psychoanalytic theory of therapeutic action. Journal of the American Psychoanalytic Association, 39, 349-381.
19. Craig, A. D. (2002). How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience, 3, 655-666.
20. Craig, A. D. (2003). Interoception: The sense of the physical condition of the body. Current Opinion in Neurobiology, 13, 500-505.
21. Craig, A. D. (2004). Human feelings: Why are some more aware than others? Trends in Cognitive Sciences, 8, 239-241.
22. Critchley, H. D. (2005). Neural mechanisms of autonomic, affective, and cognitive integration. Journal of Comparative Neurology, 493 154-166.
23. Critchley, H. D., Mathias, C. J., Josephs, O., O'Doherty, J., Zanini, S., & Dewar, B. (2003). Human cingulate cortex and autonomic control: Converging neuroimaging and clinical evidence. Brain, 126, 1239-1252.
24. Critchley, H. D., Wiens, S., Rothstein, P., Öhman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7, 189-195.
25. Damasio, A. R. (1994). Descartes error: Emotion, reason and the human brain. New York: Avon Books.
26. Damasio, A. R. (1998). Emotion in the perspective of an integrated nervous system. Brain Research Reviews, 26, 83-86.
27. Damasio, A. R. (1999). The feeling of what happens: Body and emotion in the making of consciousness. New York: Harcourt.
28. Elzinga, B. M., Bermond, B., & van Dyck, R. (2002). The relationship between dissociative proneness and alexithymia. Psychotherapy and Psychosomatics, 71, 104-111.
29. Elzinga, B. M., & Bremner, J. D. (2002). Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)? Journal of Affective Disorders, 70, 1-17.
30. Fonagy, P., Gergely, G., Jurist, E., & Target, M. (2004). Affect regulations, mentalization, and the development of the self. New York: Other Press.
31. Ford, J. D. (2005). Treatment implications of altered affect regulation and information processing following child maltreatment. Psychiatric Annals, 35, 410-423.
32. Frewen, P. A., Dozois, D. J., Neufeld, R. W., & Lanius, R. A. (2008). Meta-analysis of alexithymia in posttraumatic stress disorder. Journal of Traumatic Stress, 21, 243-246.
33. Frewen, P. A., Lanius, R. A., Dozois, D. J., Neufeld, R. W., Pain, C., Hopper, J. W., et al. (2008). Clinical and neural correlates of alexithymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117, 171-181.
34. Frewen, P. A., & Lanius, R. A. (2006a). Neurobiology of dissociation: Unity and disunity in mind-body-brain. Psychiatric Clinics of North America, 29, 113-128.
35. Frewen, P. A., & Lanius, R. A. (2006b). Toward a psychobiology of posttraumatic self-dysregulation: Reexperiencing, hyperarousal, dissociation, and emotional numbing. Annals of the New York Academy of Sciences, 1071, 110-124.
36. Frewen, P. A., Pain, C., Dozois, D. J. A., & Lanius, R. A. (2006). Alexithymia in PTSD: Psychometric and FMRI studies. Annals of the New York Academy of Sciences, 1071, 397-400.
37. Friedman, B. H. (2007). An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone. Biological Psychiatry, 74, 185-199.
38. Gordon, J. S., Staples, J. K., Blyta, A., & Bytyqi, M. (2004). Treatment of posttraumatic stress disorder in postwar Kosovo high school students using mind-body skills group: A pilot study. Journal of Traumatic Stress, 17, 143-147.
39. Grabe, H. J., Frommer, J., Ankerhold, A., Ulrich, C., Groger, R., Franke, G. H., et al. (2008). Alexithymia and outcome in psychotherapy. Psychotherapy and Psychosomatics, 77, 189-194.
40. Grabe, H. J., Rainerman, S., Spitzer, C., Gansicke, M., & Freyberger, H. J. (2000). The relationship between dimensions of alexithymia and dissociation. Psychotherapy and Psychosomatics, 69, 128-131.
41. Grigsby, J., & Stevens, S. (2002). Memory neurodynamics and human relationships. Psychiatry, 65, 13-34.
42. Honkalampi, K., Koivumaa-Honkanen, H., Antikainen, R., Haatainen, K., Hintikka, J., & Viinamäki, H. (2004). Relationships among alexithymia, adverse childhood experiences, sociodemographic variables, and actual mood disorder: A 2-year clinical follow-up study of patients with major depressive disorder. Psychosomatics, 45, 197-204.
43. Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte.
44. Kano, M., Fukudo, S., Gyoba, J., Kamachi, M., Tagawa, M., Mochizuki, H., et al. (2003). Specific brain processing of facial expressions in people with alexithymia: An H2 15O-PET study. Brain, 26, 1474-1484.
45. King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: Evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.
46. Koenan, K. (2006). Developmental epidemiology of PTSD: Self-regulation as a central mechanism. Annals of the New York Academy of Sciences 1071, 255-266.
47. Kokkonen, P., Veijola, J., Karvonen, T. J., Läsky, K., Jokelainen, J., Järvelin, M. R., et al. (2003). Ability to speak at the age of 1 year and alexithymia 30 years later. Journal of Psychosomatic Research, 54, 491-495.
48. Krystal, H. (1988). Integration and self-healing: Affect, trauma, alexithymia. Hillsdale, NJ: Analytic Press.
49. Lane, R. D., Ahern, G. L., Schwartz, G. E., & Kaszniak, A. W. (1997). Is alexithymia the emotional equivalent of blindsight? Biological Psychiatry, 42, 834-844.
50. Lane, R. D., Nadel, L., Allen, J. J. B., & Kaszniak, A. W. (2000). Study of emotion from the perspective of cognitive neuroscience. In R. D. Lane & L. Nadel (Eds.), Cognitive neuroscience of emotion (pp. 3-11). New York: Oxford University Press.
51. Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A., & Zeitlin, S. B. (1990). The Levels of Emotional Awareness Scale: A cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124-134.
52. Lane, R. D., Reiman, E. M., Axelrod, B., Yun, L. S., Holmes, A., & Schwartz, G. E. (1998). Neural correlates of levels of emotional awareness: Evidence of an interaction between emotion and attention in the anterior cingulate cortex. Journal of Cognitive Neuroscience, 10, 525-535.
53. Lane, R. D., Sechrest, L., Reidel, R., Weldon, V., Kaszniak, A., & Schwartz, G. E. (1996). Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosomatic Medicine, 58, 203-210.
54. Lanius, R. A., Bluhm, R., Lanius, U., & Pain, C. (2006). A review of neuroimaging studies in PTSD: Heterogeneity of response to symptom provocation. Journal of Psychiatric Research, 40, 709-729.
55. Lanius, R. A., Williamson, P. C., Bluhm, R. L., Densmore, M., Boksman, K., Neufeld, R. W., et al. (2005). Functional connectivity of dissociative responses in posttraumatic stress disorder: A functional magnetic resonance imaging investigation. Biological Psychiatry, 55, 873-884.
56. Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M. A., Neufeld, R. W., et al. (2002). Brain activation during script-driven imagery induced dissociative responses in PTSD: A functional magnetic resonance imaging investigation. Biological Psychiatry, 52, 305-311.
57. Lanius, R. A., Williamson, P. C., Densmore, M., Boksman, K., Gupta, M. A., Neufeld, R. W., et al. (2004). The nature of traumatic memories: A 4-T FMRI functional connectivity analysis. American Journal of Psychiatry, 161, 36-44.
58. Larsen, J. K., Brand, N., Bermond, B., & Hijman, R. (2003). Cognitive and emotional characteristics of alexithymia: A review of neurobiological studies. Journal of Psychosomatic Research, 54 533-541.
59. LeDoux, J. (1996). The emotional brain. New York: Simon & Schuster.
60. Lemche, E., Klann-Delius, G., Koch, R., & Joraschky, P. (2004). Mentalizing language development in a longitudinal attachment sample: Implications for alexithymia. Psychotherapy & Psychosomatics, 73, 336-374.
61. Liberzon, I., & Martis, B. (2006). Neuroimaging studies of emotional responses in PTSD. Annals of the New York Academy of Sciences, 1071, 87-109.
62. Litz, B. T., & Gray, M. J. (2002). Emotional numbing in posttraumatic stress disorder: Current and future research directions. Australia and New Zealand Journal of Psychiatry, 36, 198-204.
63. Luminet, O., Rimé, B., Bagby, R. M., & Taylor, G. J. (2004). A multimodal investigation of emotional responding in alexithymia. Cognition and Emotion, 18, 741-766.
64. Lumley, M. (2004). Alexithymia, emotional disclosure, and health: A program of research. Journal of Personality, 72, 1271-1300.
65. Lumley, M. A., Gustavson, B. J., Partridge, R. T., & Labouvie-Vief, G. (2005). Assessing alexithymia and related emotional ability constructs using multiple methods: Interrelationships among measures. Emotion 5, 329-342.
66. Lumley, M. A., Neely, L. C., & Burger, A. J. (2007). The assessment of alexithymia in medical settings: Implications for understanding and treating health problems. Journal of Personality Assessment, 89 230-246.
67. Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62, 459-480.
68. McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: The central role of the brain. Physiological Reviews, 87, 873-904.
69. Monson, C. M., Price, J. L., Rodriguez, B. F., Ripley, M. P., & Warner, R. A. (2004). Emotional deficits in military-related PTSD: An investigation of content and process disturbances. Journal of Traumatic Stress, 17, 275-279.
70. Moorman, P. P., Bermond, B., Albach, F., & van Dorp, I. (1996). The etiology of alexithymia from the perspective of childhood sexual abuse Paper presented at the meeting of the Third International Conference on Emotion and Health, Tilburg, The Netherlands.
71. Mueller, J., Alpers, G. W., & Reim, N. (2006). Dissociation of rated emotional valence and Stroop interference in observer-rated alexithymia. Journal of Psychosomatic Research, 61, 261-269.
72. Nemeroff, C. B., Bremner, J. D., Foa, E. B., Mayberg, H. S., North, C. S., & Stein, M. B. (2006). Posttraumatic stress disorder: A state of the science review. Journal of Psychiatric Research, 40, 1-21.
73. Nemiah, J. C. (2000). A psychodynamic view of psychosomatic medicine. Psychosomatic Medicine, 62, 299-303.
74. Nijenhuis, E. R. S. (2004). Somatoform dissociation: Phenomena, measurement, & theoretical issues. New York: Norton.
75. Ogden, P., & Minton, K. (2000). Sensorimotor psychotherapy: One method for processing traumatic memory. Traumatology, 3. Retrieved September 24, 2006, from the Trauma Information Pages Web site: http://www.fsu.edu/~trauma/v6i3/v6i3a3.html
76. Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: Norton.
77. Ogden, P., Pain, C., & Fisher, J. (2006). A sensorimotor approach to the treatment of trauma and dissociation. Psychiatric Clinics of North America, 29, 263-279.
78. Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S. (2004). Alexithymia as a predictor of residual symptoms in depressed patients who respond to short-term psychotherapy. American Journal of Psychotherapy, 58 150-161.
79. Ozsahin, A., Uzun, O., Cansever, A., & Gulcat, Z. (2003). The effect of alexithymic features on response to antidepressant medication in patients with major depression. Depression and Anxiety, 18, 62-66.
80. Panksepp, J. (1998). Affective neuroscience: The foundations of human and animal emotions. London: Oxford University Press.
81. Porges, S. W. (2003). The polyvagal theory: Phylogenetic contributions to social behavior. Physiology & Behavior, 79, 503-513.
82. Rauch, S. L., van der Kolk, B. A., Fisler, R. E., Alpert, N. M., Orr, S. M., Savage, C. R., et al. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Archives of General Psychiatry, 53, 380-387.
83. Schore, A. N. (2003a). Affect dysregulation and disorders of the self New York: Norton.
84. Schore, A. N. (2003b). Affect regulation and the repair of the self New York: Norton.
85. Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd ed.). New York: Guilford Press.
86. Shin, L. M., Rauch, S. L., & Pitman, R. K. (2005). Structural and functional anatomy of PTSD: Findings from neuroimaging research. In J. J. Vaseterling & C. R. Brewin (Eds.), Neuropsychology of PTSD (pp. 83-104). New York: Guilford Press.
87. Siegel, D. J. (1999). The developing mind. New York: Guilford Press.
88. Sifneos, P. E. (1973). The prevalence of "alexithymic" characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22 255-262.
89. Sifneos, P. E. (1988). Alexithymia and its relationship to hemispheric specialization, affect and creativity. Psychiatric Clinics of North America, 11, 287-292.
90. Sifneos, P. E. (1991). Affect, emotional conflict and deficit: An overview. Psychotherapy and Psychosomatics, 56, 116-122.
91. Sifneos, P. E. (1994). Affect deficit and alexithymia. New Trends in Experimental and Clinical Psychiatry, 10, 193-195.
92. Söndergaard, H. P., & Theorell, T. (2004). Alexithymia, emotions and PTSD: Findings from a longitudinal study of refugees. Nordic Journal of Psychiatry, 58, 185-191.
93. Squire, L. R. (2004). Memory systems of the brain: A brief history and current perspective. Neurobiology of Learning and Memory, 82 171-177.
94. Tabibnia, G., & Zaidel, E. (2005). Alexithymia, interhemispheric transfer, and right hemispheric specialization: A critical review. Psychotherapy & Psychosomatics, 74, 81-92.
95. Taylor, G. J. (1997). Treatment considerations. In G. J. Taylor, R. M. Bagby, & J. D. A. Parker (Eds.), Disorders of affect regulation: Alexithymia in medical and psychiatric illness (pp. 248-266). Cambridge, England: Cambridge University Press.
96. Taylor, G. J. (2000). Recent developments in alexithymia theory and research. Canadian Journal of Psychiatry, 45, 134-142.
97. Taylor, G. J., & Bagby, R. M. (2004). New trends in alexithymia research. Psychotherapy and Psychosomatics, 73, 68-77.
98. Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (Eds.). (1997). Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge, England: Cambridge University Press.
99. Thayer, J. F., & Brosschot, J. F. (2005). Psychosomatics and psychopathology: Looking up and looking down from the brain. Psychoneuroendocrinology, 30, 1050-1058.
100. Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61, 201-216.
101. Tull, M. T., Medaglia, E., & Roemer, L. (2005). An investigation of the construct validity of the 20-item Toronto Alexithymia Scale through the use of a verbalization task. Journal of Psychosomatic Research, 59, 77-84.
102. Van der Hart, O., Nijenhuis, E. R., & Steele, K. (2005). Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder. Journal of Traumatic Stress, 18, 413-424.
103. Van der Hart, O., Nijenhuis, E. R., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. New York: Norton.
104. van der Kolk, B. A. (2002). Beyond the talking cure: Somatic experience, subcortical imprints and the treatment of trauma. In F. Shapiro (Ed.), EMDR as an integrative psychotherapy approach: Experts of diverse orientations explore the paradigm prism (pp. 57-83). New York: APA Press.
105. van der Kolk, B. A. (2006). Clinical implications of neuroscience research in PTSD. Annals of the New York Academy of Sciences, 1071, 277-293.
106. van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: Empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18 389-400.
107. van der Kolk, B. A., Van der Hart, O., & Marmar, C. R. (1996). Dissociation and information processing in posttraumatic stress disorder. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body and society (pp. 303-327). New York: Guilford Press.
108. Yehuda, R., Schmeidler, J., Siever, L. J., Binder-Brynes, K., & Elkin, A. (1997). Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding. Journal of Traumatic Stress, 10, 453-463.
109. Zlotnick, C., Mattia, J., & Zimmerman, M. (2001). The relationship between posttraumatic stress disorder, childhood trauma and alexithymia in an outpatient sample. Journal of Traumatic Stress, 14, 177-188.