Alexithymia or general psychological distress? Discriminant validity of the Toronto Alexithymia Scale and the Perth Alexithymia Questionnaire.

BACKGROUND: Alexithymia is an important transdiagnostic risk factor for emotion-based psychopathologies. However, it remains unclear whether alexithymia questionnaires actually measure alexithymia, or whether they measure emotional distress. Our aim here was to address this discriminant validity concern via exploratory factor analysis (EFA) of the 20-item Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). METHOD: United States general community adults (N = 508) completed the TAS-20, PAQ, and the Depression Anxiety Stress Scales-21 (DASS-21). EFA was used to examine the latent dimensions underlying these measures' scores. RESULTS: Our EFA extracted two higher-order factors, an "alexithymia" factor and a "general distress" factor (i.e., depression, anxiety, stress). All PAQ scores loaded cleanly on the alexithymia factor, with no cross-loadings on the distress factor. However, for the TAS-20, Difficulty Identifying Feelings (DIF) facet scores cross-loaded highly on the distress factor. LIMITATIONS: Our sample consisted of general community adults; future work in clinical settings will be useful. CONCLUSIONS: Our data indicate that the PAQ has good discriminant validity. However, the TAS-20 appears to have significant discriminant validity problems, in that much of the variance in its DIF facet reflects people's current levels of distress, rather than alexithymia. The TAS-20, which has traditionally been the most widely used alexithymia questionnaire, may therefore not be the optimal alexithymia tool. Our findings add to the body of evidence supporting the validity and utility of the PAQ and suggest that, moving forward, it is a superior option to the TAS-20 for alexithymia assessments.

Alexithymia profiles and depression, anxiety, and stress.

BACKGROUND: Alexithymia is a multidimensional trait comprised of difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is regarded as an important risk factor for emotional disorders, but there are presently limited data on each specific facet of alexithymia, or the extent to which deficits in processing negative emotions, positive emotions, or both, are important. In this study, we address these gaps by using the Perth Alexithymia Questionnaire (PAQ) to comprehensively examine the relationships between alexithymia and depression, anxiety, and stress symptoms. METHODS: University students (N = 1250) completed the PAQ and the Depression Anxiety Stress Scales-21. Pearson correlations, hierarchical regressions, and latent profile analysis were conducted. RESULTS: All facets of alexithymia, across both valence domains, were significantly correlated with depression, anxiety, and stress symptoms (r = 0.27-0.40). Regression analyses indicated that the alexithymia facets, together, could account for a significant 14.6 %-16.4 % of the variance in depression, anxiety, and stress. Difficulties identifying negative feelings and difficulties identifying positive feelings were the strongest unique predictors across all symptom categories. Our latent profile analysis extracted eight profiles, comprising different combinations of alexithymia facets and psychopathology symptoms, collectively highlighting the transdiagnostic relevance of alexithymia facets. LIMITATIONS: Our study involved a student sample, and further work in clinical samples will be beneficial. CONCLUSIONS: Our data indicate that all facets of alexithymia, across both valence domains, are relevant for understanding depression, anxiety, and stress. These findings demonstrate the value of facet-level and valence-specific alexithymia assessments, informing more comprehensive understanding and more targeted treatments of emotional disorder symptoms.

COVID-19 on mind: Daily worry about the coronavirus is linked to negative affect experienced during mind-wandering and dreaming.

Despite a surge of studies on the effects of COVID-19 on our well-being, we know little about how the pandemic is reflected in people's spontaneous thoughts and experiences, such as mind-wandering (or daydreaming) during wakefulness and dreaming during sleep. We investigated whether and how COVID-19-related general concern, anxiety, and daily worry are associated with the daily fluctuation of the affective quality of mind-wandering and dreaming, and to what extent these associations can be explained by poor sleep quality. We used ecological momentary assessment by asking participants to rate the affect they experienced during mind-wandering and dreaming in daily logs over a 2-week period. Our preregistered analyses based on 1,755 dream logs from 172 individuals and 1,496 mind-wandering logs from 152 individuals showed that, on days when people reported higher levels of negative affect and lower levels of positive affect during mind-wandering, they experienced more worry. Only daily sleep quality was associated with affect experienced during dreaming at the within-person level: on nights with poorer sleep quality people reported experiencing more negative and less positive affect in dreams and were more likely to experience nightmares. However, at the between-person level, individuals who experienced more daily COVID-19 worry during the study period also reported experiencing more negative affect during mind-wandering and during dreaming. As such, the continuity between daily and nightly experiences seems to rely more on stable trait-like individual differences in affective processing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Affect Across the Wake-Sleep Cycle.

Affective scientists traditionally have focused on periods of active wakefulness when people are responding to external stimuli or engaging in specific tasks. However, we live much of our lives immersed in experiences not related to the current environment or tasks at hand-mind-wandering (or daydreaming) during wakefulness and dreaming during sleep. Despite being disconnected from the immediate environment, our brains still generate affect during such periods. Yet, research on stimulus-independent affect has remained largely separate from affective science. Here, we suggest that one key future direction for affective science will be to expand our field of view by integrating the wealth of findings from research on mind-wandering, sleep, and dreaming to provide a more comprehensive account of affect across the wake-sleep cycle. In developing our argument, we address two key issues: affect variation across the wake-sleep cycle, and the benefits of expanding the study of affect across the full wake-sleep cycle. In considering these issues, we highlight the methodological and clinical implications for affective science.

The Perth Alexithymia Questionnaire-Short Form (PAQ-S): A 6-item measure of alexithymia.

BACKGROUND: Alexithymia is a trait characterized by difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is widely regarded as an important transdiagnostic risk factor for a range of psychopathologies, including depressive and anxiety disorders. Whilst several well-validated psychometric measures of alexithymia exist, these are relatively lengthy, thus limiting their utility in time-pressured settings. In this paper, we address this gap by introducing and validating a brief 6-item version of the Perth Alexithymia Questionnaire, called the Perth Alexithymia Questionnaire-Short Form (PAQ-S). METHOD: Across two studies with adult samples (Study 1 N = 508 United States community; Study 2 = 378 Australian college students), we examined the psychometric properties of the PAQ-S in terms of its factor structure, reliability, and concurrent/criterion validity. RESULTS: In exploratory and confirmatory factor analyses, all PAQ-S items loaded well on a single general alexithymia factor. The PAQ-S total score had high reliability, and correlated as expected with the long-form of the PAQ, as well as other established markers of alexithymia, emotion regulation, and affective disorder symptoms. LIMITATIONS: Our samples were general community or college student samples from two Western countries; future validation work in clinical samples and more diverse cultural groups is thus needed. CONCLUSIONS: The PAQ-S retains the psychometric strengths of the PAQ. As such, the PAQ-S can be used as a quick, robust measure of overall alexithymia levels. The introduction of the PAQ-S hence enables valid assessments of alexithymia in a more diverse range of settings and research designs.

Alexithymia and emotion regulation.

BACKGROUND: Alexithymia is a key transdiagnostic risk factor for emotion-based psychopathologies. Conceptual models specify that this is because alexithymia impairs emotion regulation. However, the extent of these putative emotion regulation impairments remains underexplored. Our aim in this study was to begin to address this gap by examining whether people with high, average, or low levels of alexithymia differ in the types of emotion regulation strategies they typically use. METHOD: General community adults from the United States (N = 501) completed a battery of alexithymia and emotion regulation measures. Participants were grouped into high, average, and low alexithymia quantiles. RESULTS: After controlling for demographics and current levels of distress, the high, average, and low alexithymia groups differed in their use of cognitive and behavioral emotion regulation strategies. Compared to the other groups, the high alexithymia group reported lesser use of generally adaptive regulation strategies (cognitive reappraisal, approaching problems, and seeking social support) and greater use of generally maladaptive regulation strategies (expressive suppression, behavioral withdrawal, ignoring). LIMITATIONS: Our data were cross-sectional and from self-report questionnaires. Future work in other cultural groups would be beneficial. CONCLUSIONS: Our results support the view that alexithymia is associated with impaired emotion regulation. In particular, people with high alexithymia seem to exhibit a less adaptive profile of emotion regulation strategies. Direct targeting of these emotion regulation patterns in psychotherapy may therefore be a useful pathway for the treatment of emotional disorder symptoms in people with high alexithymia.

Negative dream affect is associated with next-day affect level, but not with affect reactivity or affect regulation.

There is increasing evidence that sleep plays an important role in affective processing. However, it is unclear whether dreaming-the subjective experiences we have during sleep-also serves an affect regulation function. Here, we investigated the within-person relationship between negative affect experienced in dreams and next-day waking affect level, affect reactivity, and affect regulation. For 5 days, 40 participants reported their dreams and rated their dream affect and post-sleep waking affect level upon morning awakening. Thereafter, they performed an affect reactivity and regulation task which involved viewing neutral and negative pictures with the instruction either to simply view the pictures or to down-regulate the affect evoked by these pictures. Multilevel regression analyses showed that the more negative affect people experienced in their dreams at night, the more negative affect and the less positive affect they reported the next morning. However, negative dream affect was associated neither with affect reactivity to the pictures nor with the ability to down-regulate negative affect in response to these pictures. In fact, Bayesian analyses favored the null hypotheses. These findings fail to provide support for the affect regulation function of dreaming and, instead, speak for affective continuity between dreaming and post-sleep wakefulness.

The neural bases of expressive suppression: A systematic review of functional neuroimaging studies.

Expressive suppression refers to the inhibition of emotion-expressive behavior (e.g., facial expressions of emotion). Although it is a commonly used emotion regulation strategy with well-documented consequences for well-being, little is known about its underlying mechanisms. In this systematic review, we for the first time synthesize functional neuroimaging studies on the neural bases of expressive suppression in non-clinical populations. The 12 studies included in this review contrasted the use of expressive suppression to simply watching emotional stimuli. Results showed that expressive suppression consistently increased activation of frontoparietal regions, especially the dorsolateral and ventrolateral prefrontal cortices and inferior parietal cortex, but decreased activation in temporo-occipital areas. Results regarding the involvement of the insula and amygdala were inconsistent with studies showing increased, decreased, or no changes in activation. These mixed findings underscore the importance of distinguishing expressive suppression from other forms of suppression and highlight the need to pay more attention to experimental design and neuroimaging data analysis procedures. We discuss these conceptual and methodological issues and provide suggestions for future research.

Event-Related Potential Correlates of Learning to Produce Novel Foreign Phonemes.

Learning to pronounce a foreign phoneme requires an individual to acquire a motor program that enables the reproduction of the new acoustic target sound. This process is largely based on the use of auditory feedback to detect pronunciation errors to adjust vocalization. While early auditory evoked neural activity underlies automatic detection and adaptation to vocalization errors, little is known about the neural correlates of acquiring novel speech targets. To investigate the neural processes that mediate the learning of foreign phoneme pronunciation, we recorded event-related potentials when participants (N = 19) pronounced native or foreign phonemes. Behavioral results indicated that the participants' pronunciation of the foreign phoneme improved during the experiment. Early auditory responses (N1 and P2 waves, approximately 85-290 ms after the sound onset) revealed no differences between foreign and native phonemes. In contrast, the amplitude of the frontocentrally distributed late slow wave (LSW, 320-440 ms) was modulated by the pronunciation of the foreign phonemes, and the effect changed during the experiment, paralleling the improvement in pronunciation. These results suggest that the LSW may reflect higher-order monitoring processes that signal successful pronunciation and help learn novel phonemes.

The dynamics of affect across the wake-sleep cycle: From waking mind-wandering to night-time dreaming.

Affective experiences occur across the wake-sleep cycle-from active wakefulness to resting wakefulness (i.e., mind-wandering) to sleep (i.e., dreaming). Yet, we know little about the dynamics of affect across these states. We compared the affective ratings of waking, mind-wandering, and dream episodes. Results showed that mind-wandering was more positively valenced than dreaming, and that both mind-wandering and dreaming were more negatively valenced than active wakefulness. We also compared participants' self-ratings of affect with external ratings of affect (i.e., analysis of affect in verbal reports). With self-ratings all episodes were predominated by positive affect. However, the affective valence of reports changed from positively valenced waking reports to affectively balanced mind-wandering reports to negatively valenced dream reports. These findings show that (1) the positivity bias characteristic to waking experiences decreases across the wake-sleep continuum, and (2) conclusions regarding affective experiences depend on whether self-ratings or verbal reports describing these experiences are analysed.

Subjective ratings of fear are associated with frontal late positive potential asymmetry, but not with early brain activity over the occipital and centro-parietal cortices.

The human frontal cortex is asymmetrically involved in motivational and affective processing. Several studies have shown that the left-frontal hemisphere is related to positive and approach-related affect, whereas the right-frontal hemisphere is related to negative and withdrawal-related affect. The present study aimed to investigate whether evolutionarily threatening stimuli modulate asymmetrical frontal activity. We examined hemispheric differences in frontal late positive potentials (f-LPP asymmetry) and frontal alpha power activation (frontal alpha asymmetry, FAA) in response to images depicting snakes, spiders, butterflies, and birds. Results showed that the late component of f-LPP asymmetry, but not FAA, was modulated by the category of stimuli. Specifically, threatening stimuli (snakes and spiders) evoked a relatively large late f-LPP over the right-frontal hemisphere than non-threatening stimuli (birds and butterflies). Moreover, this relatively great right-frontal activity was positively associated with the subjective ratings of fear. Importantly, the subjective ratings of fear were not associated with early brain activity over the occipital or centro-parietal cortices. These results suggest that late f-LPP asymmetry may reflect higher order affective processes, specifically the subjective appraisal of threatening stimuli and the subjective experience of fear, that are independent of the fast and automatic processing of evolutionarily significant and affectively arousing stimuli.

EEG Frontal Alpha Asymmetry and Dream Affect: Alpha Oscillations over the Right Frontal Cortex during REM Sleep and Presleep Wakefulness Predict Anger in REM Sleep Dreams.

Affective experiences are central not only to our waking life but also to rapid eye movement (REM) sleep dreams. Despite our increasing understanding of the neural correlates of dreaming, we know little about the neural correlates of dream affect. Frontal alpha asymmetry (FAA) is considered a marker of affective states and traits as well as affect regulation in the waking state. Here, we explored whether FAA during REM sleep and during evening resting wakefulness is related to affective experiences in REM sleep dreams. EEG recordings were obtained from 17 human participants (7 men) who spent 2 nights in the sleep laboratory. Participants were awakened 5 min after the onset of every REM stage after which they provided a dream report and rated their dream affect. Two-minute preawakening EEG segments were analyzed. Additionally, 8 min of evening presleep and morning postsleep EEG were recorded during resting wakefulness. Mean spectral power in the alpha band (8-13 Hz) and corresponding FAA were calculated over the frontal (F4-F3) sites. Results showed that FAA during REM sleep, and during evening resting wakefulness, predicted ratings of dream anger. This suggests that individuals with greater alpha power in the right frontal hemisphere may be less able to regulate (i.e., inhibit) strong affective states, such as anger, in dreams. Additionally, FAA was positively correlated across wakefulness and REM sleep. Together, these findings imply that FAA may serve as a neural correlate of affect regulation not only in the waking but also in the dreaming state.SIGNIFICANCE STATEMENT We experience emotions not only during wakefulness but also during dreaming. Despite our increasing understanding of the neural correlates of dreaming, we know little about the neural correlates of dream emotions. Here we used electroencephalography to explore how frontal alpha asymmetry (FAA)-the relative difference in alpha power between the right and left frontal cortical areas that is associated with emotional processing and emotion regulation in wakefulness-is related to dream emotions. We show that individuals with greater FAA (i.e., greater right-sided alpha power) during rapid eye movement sleep, and during evening wakefulness, experience more anger in dreams. FAA may thus reflect the ability to regulate emotions not only in the waking but also in the dreaming state.

Peace of mind and anxiety in the waking state are related to the affective content of dreams.

Waking mental well-being is assumed to be tightly linked to sleep and the affective content of dreams. However, empirical research is scant and has mostly focused on ill-being by studying the dreams of people with psychopathology. We explored the relationship between waking well-being and dream affect by measuring not only symptoms of ill-being but also different types and components of well-being. Importantly, this is the first time peace of mind was investigated as a distinct aspect of well-being in a Western sample and in relation to dream content. Healthy participants completed a well-being questionnaire, followed by a three-week daily dream diary and ratings of dream affect. Multilevel analyses showed that peace of mind was related to positive dream affect, whereas symptoms of anxiety were related to negative dream affect. Moreover, waking measures were better related to affect expressed in dream reports rather than participants' self-ratings of dream affect. We propose that whereas anxiety may reflect affect dysregulation in waking and dreaming, peace of mind reflects enhanced affect regulation in both states of consciousness. Therefore, dream reports may possibly serve as markers of mental health. Finally, our study shows that peace of mind complements existing conceptualizations and measures of well-being.

Dream emotions: a comparison of home dream reports with laboratory early and late REM dream reports.

The aim of this study was to compare the emotional content of dream reports collected at home upon morning awakenings with those collected in the laboratory upon early and late rapid eye movement (REM) sleep awakenings. Eighteen adults (11 women, seven men; mean age = 25.89 ± 4.85) wrote down their home dreams every morning immediately upon awakening during a 7-day period. Participants also spent two non-consecutive nights in the sleep laboratory where they were awoken 5 min into each continuous REM sleep stage, upon which they gave a verbal dream report. The content of a total of 151 home and 120 laboratory dream reports was analysed by two blind judges using the modified Differential Emotions Scale. It was found that: (1) home dream reports were more emotional than laboratory early REM dream reports, but not more emotional than laboratory late REM dream reports; (2) home dream reports contained a higher density of emotions than laboratory (early or late REM) dream reports; and (3) home dream reports were more negative than laboratory dream reports, but differences between home and early REM reports were larger than those between home and late REM reports. The results suggest that differences between home and laboratory dream reports in overall emotionality may be due to the time of night effect. Whether differences in the density of emotions and negative emotionality are due to sleep environment or due to different reporting procedures and time spent in a sleep stage, respectively, remains to be determined in future studies.

I know how you felt last night, or do I? Self- and external ratings of emotions in REM sleep dreams.

We investigated whether inconsistencies in previous studies regarding emotional experiences in dreams derive from whether dream emotions are self-rated or externally evaluated. Seventeen subjects were monitored with polysomnography in the sleep laboratory and awakened from every rapid eye movement (REM) sleep stage 5 min after the onset of the stage. Upon awakening, participants gave an oral dream report and rated their dream emotions using the modified Differential Emotions Scale, whereas external judges rated the participants' emotions expressed in the dream reports, using the same scale. The two approaches produced diverging results. Self-ratings, as compared to external ratings, resulted in greater estimates of (a) emotional dreams; (b) positively valenced dreams; (c) positive and negative emotions per dream; and (d) various discrete emotions represented in dreams. The results suggest that this is mostly due to the underrepresentation of positive emotions in dream reports. Possible reasons for this discrepancy are discussed.

The existence of a hypnotic state revealed by eye movements.

Hypnosis has had a long and controversial history in psychology, psychiatry and neurology, but the basic nature of hypnotic phenomena still remains unclear. Different theoretical approaches disagree as to whether or not hypnosis may involve an altered mental state. So far, a hypnotic state has never been convincingly demonstrated, if the criteria for the state are that it involves some objectively measurable and replicable behavioural or physiological phenomena that cannot be faked or simulated by non-hypnotized control subjects. We present a detailed case study of a highly hypnotizable subject who reliably shows a range of changes in both automatic and volitional eye movements when given a hypnotic induction. These changes correspond well with the phenomenon referred to as the "trance stare" in the hypnosis literature. Our results show that this 'trance stare' is associated with large and objective changes in the optokinetic reflex, the pupillary reflex and programming a saccade to a single target. Control subjects could not imitate these changes voluntarily. For the majority of people, hypnotic induction brings about states resembling normal focused attention or mental imagery. Our data nevertheless highlight that in some cases hypnosis may involve a special state, which qualitatively differs from the normal state of consciousness.

D-Serine metabolism in C6 glioma cells: Involvement of alanine-serine-cysteine transporter (ASCT2) and serine racemase (SRR) but not D-amino acid oxidase (DAO).

D-serine is an endogenous N-methyl-D-aspartate (NMDA) receptor coagonist. It is synthesized from L-serine by serine racemase (SRR), but many aspects of its metabolism remain unclear, especially in the forebrain, which lacks active D-amino acid oxidase (DAO), the major D-serine degradative enzyme. Candidate mechanisms include SRR operating in alpha,beta-eliminase mode (converting D-serine to pyruvate) and regulation by serine transport, in which the alanine-serine-cysteine transporter ASCT2 is implicated. Here we report studies in C6 glioma cells, which "simulate" the forebrain, in that the cells express SRR and ASCT2 but lack DAO activity. We measured D-serine, ASCT2, SRR, and DAO expression and DAO activity in two situations: after incubation of cells for 48 hr with serine isomers and after increased or decreased SRR expression by transfection and RNA interference, respectively. Incubation with serine enantiomers decreased [(3)H]D-serine uptake and ASCT2 mRNA and increased SRR immunoreactivity but did not alter DAO immunoreactivity, and DAO activity remained undetectable. SRR overexpression increased D-serine and pyruvate and decreased [(3)H]D-serine uptake and ASCT2 mRNA but did not affect DAO. SRR knockdown did not alter any of the parameters. Our data suggest that D-serine transport mediated by ASCT2 contributes prominently to D-serine homeostasis when DAO activity is absent. The factors regulating D-serine are important for understanding normal NMDA receptor function and because D-serine, along with DAO and SRR, is implicated in the pathogenesis and treatment of schizophrenia.

Perception of successive targets presented in invariant-item streams.

When two successive, spatially overlapping, targets (S1 and S2) are presented on a blank background, S2 typically dominates in explicit perception. We tested whether S2 dominance is also found for the conditions of presenting S1 and S2 in a stream of irrelevant objects. Successive target letters were presented within a stream of invariant stimulus items (capital Is). The stream items were presented either as a perceptually continuous object where both type and token appeared invariant (60-Hz stream) or as a flickering stream of successive replicas of the invariant stationary object where the type appeared invariant but the token appearance seemed intermittent (20-Hz condition). Compared to the control condition where targets were presented on a blank background we found that (1) recognition rate was lower for targets embedded in a perceptually continuous type-and-token object (60 Hz), but was unchanged for targets in a perceptually flickering sequence of the invariant-object tokens (20 Hz); (2) S1 recognition rate was higher compared to S2 recognition rate within the first epoch of stream (0-150 ms) while within the later stream-epochs S2 dominated over S1 as usual; (3) the overall difference in recognition rates between S1 and S2 was decreased. The results are discussed in the theoretical context of visual masking and attentional blink.