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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 2010 June;51(2):105-26
Alexithymia in eating disorders: a useful association? A review
Zappa L. E. 1, Caslini M. 1,2, Pini E. 1,2, Clerici M. 2
1 Unità “Disturbi del Comportamento Alimentare”, Dipartimento di Salute Mentale, Azienda Ospedaliera San Gerardo dei Tintori
2 Psichiatria, Dipartimento di Neuroscienze e Tecnologie Biomediche, Università degli Studi di Milano-Bicocca, Milano, Italia
A rough and confused use in literature of the concept of alexithymia has led, over time, to blur the meaning and consequently to the inevitable dismission of an even valid concept. Perhaps the problem was caused by a vague use of the term, associated to a mixture of different models, merged accordingly to the historical context. This paper proposes to revise the concept of alexithymia, from an historical and theoretical perspective, highlighting the connections of this construct with others (Multiple Code, Emotional Intelligence, Mentalization, Insecure Attachment) of higher actuality, showing affinities. Furthermore, it proposes to evaluate, with the help of Taylor affect regulation theory, the complex role of alexithymia within eating disorders. Alexithymia relates the basic psychological traits of eating disorder patients according to a non-linear model of complex causality; Alexi-thymia is characterized by the object relation, defined by neurobiological findings and in the therapeutic relationship connected to a poor response to treatment, to relapses or to chronic disorders.
The relationship among alexithymia, eating disorders and insecure attachment style, and the relationship between alexithymia and anorexia from a dynamic point of view are discussed. The neurobiological points of view of alexithymia and a review of the key articles of recent years related to alexithymia in eating disorders are proposed. The possibility of appropriate treatments for alexithymic patients are reviewed, leaving the reader to the evaluation on whether to retrieve, in the context of the DCA, the meaning and the usefulness of a construct.