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Tijdschrift voor Psychiatrie 41 (1999) 6, 341 - 348

New research

Posttraumatic stress-disorder: The relationship with alexithymia and coping

M.A.G. van Hest, A.J.J.M. Vingerhoets, G.C. Zwartjes, J.S. de Smet

The aim of the present study was to examine the relationship between posttraumatic stress-disorder (ptsd), on the one hand, and coping and alexithymia on the other. It was expected that ptsd-patients revealed more alexithymic characteristics and a more passive and emotionfocussed coping style than healthy controls. We further explored the possible differential effects of type 1 and type 2 traumas and the effects of psychotherapy on coping and alexithymia.
Data were obtained from 30 traumatized women (average age = 31.3), who met dsm-iv-criteria for ptsd, and 31 nontraumatized women (average age = 37.1). Questionnaires applied were the experimental Dutch version of the Toronto Alexithymia Scale (tas), with three subscales (1) Identification of emotions, (2) Describing of emotions and (3) Externally-oriented thinking, and the Utrecht Coping Checklist containing the following seven subscales (1) Active coping, (2) Palliative reaction, (3) Avoidance, (4) Seeking Social Support, (5) Passive coping, (6) Expression of emotions and (7) Reassuring thoughts.
The trauma group scored significantly higher on the total tas-score, on its subscales 'Identification of emotions' and 'Describing of emotions' and on the coping subscales 'Palliative coping', 'Avoidance', and 'Passive coping'. The results thus suggest that patients with ptsd have difficulty with describing and recognizing emotions. They also tend to cope in a passive, palliative way and seem to avoid dealing with stressors. No differences were found between type 1 and type 2 traumatized women. We further provided evidence suggesting that psychotherapy has positive effects on alexithymia features and coping. These results suggest that alexithymia and the changed coping behavior may be considered to be mechanisms serving to alleviate painful feelings. Further research should evaluate the possible value of these variables as outcome measures in the evaluation of interventions for traumatized subjects.

keywords alexithymia, coping, posttraumatic stress disorder, psychotrauma