Alexithymia in alcohol-dependent patients is mediated by stress, anxiety and loss of self-control over drinking

Aims: Up to 67% of alcohol-dependent patients in treatment have alexithymia, a personality trait associated with emotion regulation difficulties. A single study reported that alcohol expectancies related to affective change and social enhancement partially mediated the relationship of alexithymia and alcohol dependence. However, no research has explored the potential explanatory power of other key factors such as stress, anxiety and obsessive thoughts about alcohol use and compulsive behaviors associated with alcohol dependence as mechanisms to elucidate the role of alcohol in alcohol-dependent patients with alexithymia. By integrating frontal lobe theory, the stress-alexithymia hypothesis and the hyperarousal model, the objective of the present study, was to examine the extent to which these factors mediate the relationship of alexithymia and alcohol dependence.

Methods: 354 outpatients in Cognitive-Behavioral Therapy for alcohol dependence were recruited. Participants were detoxified prior to assessment, and completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS), Obsessive Compulsive Drinking Scale (OCDS) and Alcohol Use Disorder Identification Test (AUDIT).

Results: Path analyses showed that DASS-Stress, DASS-Anxiety and total OCDS-scores fully mediated the relationship of alexithymia with alcohol dependence.

Conclusions: Taken together this research highlights the importance of future interventions that address stress, anxiety and a loss of control over drinking when tailoring treatment for alcohol-dependent patients with alexithymia.

Financial support: Innlandet Hosp Trust.