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Heroin Addiction and Related Clinical Problems: 2021, 23, N3 (pages: 13 - 21)

The relationship of alexithymia with difficulty in emotional regulation, anxiety, and depression symptoms in a group of patients receiving opioid maintenance treatment

Karabulut V., Evren C., Alniak İ., Helin Carkcı O., and Yilmaz Cengel H.

Summary: Background: The purpose of this study was to evaluate the relationship between alexithymia and emotion regulation difficulties in a group of patients receiving opioid (buprenorphine). The study was directed to the problems of inpatients in the Alcohol and Substance Dependence Service of Bakırköy Mental and Nervous Diseases Training and Research Hospital. Data from 90 patients with opioid use disorders were evaluated. The following scales were adminstered to each of the patients particpating: the State-Trait Anxiety Inventory I-II (STAI I-II), Beck's Depression Inventory (BDI), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale (TAS-20). Results: 54.4% of the patients were found to have alexithymia or possible alexithymia. There were no statistically significant differences between those who had alexithymia and those who were free of it in terms of age, years of education, age at first substance use, duration of heroin use, marital status, and employment status. The alexithymic patients scored significantly higher than the non-alexithymic patients on DERS (104.35±16.70 vs. 77.88±12.48, p>0.001), STAI-I (37.69±9.42 vs. 33.15±6.68, p=0.009), and STAI-II (50.10±7.27 vs. 40.20±6.29, p>0.001) The BDI scores (17.81±12.40 vs. 11.31±12.90, p=0.056) did not differ significantly between the two groups. The MANCOVA analysis showed that difficulty in identifying feelings as a subdimension of alexithymia was predicted by trait anxiety and the awareness, strategies, and clarity subscales of DERS, and the externally-oriented thinking subdimension of alexithymia was predicted by the awareness subscale of DERS. Linear regression analysis showed that difficulty in emotion regulation (with special reference to clarity, strategies, and goals subscales), taken together with trait anxiety, predicted the severity of alexithymia. Conclusions: Our findings indicate that, in particular, the clarity, strategies, and goal subscales of DERS, along with trait anxiety, are associated with the severity of alexithymia in those with opioid use disorder who are receiving maintenance therapy with buprenorphine.