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Temperament, character traits and alexithymia in patients with obsessive compulsive disorder

Year 2020, Volume: 5 Issue: 2, 45 - 52, 30.09.2020

Mehmet Üstündağ , Pınar Şen Gökçeimam

https://doi.org/10.22391/fppc.756632
Cited By: 1

Abstract

Introduction: Alexithymia levels have generally been found high in patients with obsessive compulsive disorder (OCD). It is thought that there is a correlation between alexithymia and the severity of OCD symptoms. One of the factors influencing alexithymia is temperament-character traits. In this study, it was aimed to investigate the temperament-character traits in OCD patients and the correlation of these traits with alexithymia.


Methods: This study included 43 OCD patients who applied to Atatürk University Psychiatry Outpatient Clinic and 33 healthy individuals as the control group. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV), Sociodemographic and clinical data form, and Temperament and Character Inventory (TCI), Toronto Alexithymia Scale (TAS-20) were applied to participants whereas Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was additionally applied to the patient group.


Results: No difference was detected between both groups in terms of age and gender. In the OCD group, harm avoidance (HA) and self-transcendence (ST) scores were found high, and self-directedness (SD), cooperativeness (C) and novelty seeking (NS) were found low when compared to the control group. In the OCD group, difficulty in expressing feelings (TAS-B), extroverted thinking (TAS-C) and TAS-20 scores were found to be higher than the control group. In the alexithymic OCD group, the mean disorderliness and persistence(P) scores were found to be lower compared to the non-alexithymic group. A positive correlation was discovered between Y-BOCS scores and TAS-C scores in OCD patients.


Conclusion: Alexithymia is observed at a high rate in OCD. The extroverted thinking sub-dimension of alexithymia is correlated with the severity of OCD symptoms. Some temperament-personality traits differ in alexithymic-OCD patients compared to those who are not alexithymic. The evaluation of alexithymia and the factors influencing alexithymia has the potential to offer a new approach to understand the etiology and treatment of OCD.  

Keywords

Obsessive compulsive disorder Alexithymia temperament personality

References

  • 1. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). American Psychiatric Association. Translated to Turkish by Ertugrul Koroglu. Ankara: Hekimler Yayin Birligi, 2014.
  • 2. Rice, E. Reflections on obsessive-compulsive disorders: a psychodynamic and therapeutic perspective. Psychoanal Rev 2004;91(1):23-44. https://doi.org/10.1521/prev.91.1.23.33826
  • 3. Cloninger CR. A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatr Dev 1986;4(3):167-226. https://pubmed.ncbi.nlm.nih.gov/3809156
  • 4. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arc Gen Psychiatry 1993;50(12):97590. https://doi.org/10.1001/arcpsyc.1993.01820240059008
  • 5. Bejerot S, Schlette P, Ekselius L, Adolfsson R, VonKnorring L. Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 1998;98(3):243-9. https://doi.org/10.1111/j.1600-0447.1998.tb10075.x
  • 6. Bejerot S, VonKnorring L, Ekselius L. Personality traits and smoking in patients with obsessive-compulsive disorder. Eur Psychiatry 2000;15(7):395-401. https://doi.org/10.1016/s0924-9338(00)00509-5
  • 7. Sifneos PE. Alexithymia and its relationship to hemispheric specialization affect and creativity. Psychiatr Clin North Am 1988;11(3):287-93. https://pubmed.ncbi.nlm.nih.gov/3067225
  • 8. Bankier B, Aigner M, Bach M. Alexithymia in DSM-IV disorder: comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder and depression. Psychosomatics 2001;42(3):235-40. https://doi.org/10.1176/appi.psy.42.3.235
  • 9. Herbert BM, Herbert C, Pollatos O. On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? J Pers 2011;79(5):1149-75. https://doi.org/10.1111/j.1467-6494.2011.00717.x
  • 10. Katz IM, Campbell JD. Ambivalence over emotional expression and well-being: Nomothetic and idiographic tests of the stress-buffering hypothesis. J Personality Social Psychol 1994;67(3):513–24. https://doi.org/10.1037/0022-3514.67.3.513
  • 11. Pozza A, Giaquinta N, Dèttore D. The contribution of alexithymia to Obsessive-Compulsive Disorder Symptoms Dimensions: an ınvestigation in a Large Community Sample in Italy. Psychiatry J 2015;2015:707850. https://doi.org/10.1155/2015/707850
  • 12. Roh D, Kim WJ, Kim CH. Alexithymia in obsessive-compulsive disorder clinical correlates and symptom dimensions. J Nerv Ment Dis 2011;199(9):690-5. https://doi.org/10.1097/NMD.0b013e318229d209
  • 13. Kosturek A, Gregory RJ, Sousou AJ. Alexithymia and somatic amplification in chronic pain. Psychosomatics 1998;39(5):399-404. https://doi.org/10.1016/S0033-3182(98)71298-8
  • 14. Rufer M, Ziegler A, Alsleben H, Fricke S, Ortmann J, Bruckner E, et al. A prospective long-term follow-up study of alexithymia in obsessive-compulsive disorder. Compr Psychiatry 2006;47(5):394–8. https://doi.org/10.1016/j.comppsych.2005.12.004
  • 15. Goodman WK, Price LH, Rasmussen SA, Mazure CM, Fleischmann RL, Hill CL, et al. The yale–Brown obsessive compulsive scale. I. Development use and reliability. Arch Gen Psychiatry 1989;46(11):1006-11. https://doi.org/10.1001/archpsyc.1989.01810110048007
  • 16. Karamustafalioglu KO, Ucisik AM, Ulusoy M, Erkmen H. Validity and reliability study of Yale Brown obsession compulsion rating scale. Presented in 29th National Psychiatry Congress, 1993;p(86)
  • 17. Kose S, Sayar K, Ak I, Kalelioglu U, Kirpinar I, Reeves RA, et al. Temperament and character inventory (Turkish TCI): validity, reliability and factor structure. Bull Clin Psychopharmacol 2004;14:107-31.
  • 18. Bagby MR, Taylor GJ, Parker JDA. The twenty-item Toronto Alexithymia Scale-II: Convergent, discriminant, and concurrent validity. J Psychosom Res 1994;38(1):33-40. https://doi.org/10.1016/0022-3999(94)90006-x
  • 19. Gulec H, Kose S, Yazici GM, Citak S, Evren C, Borckardt JJ, et al. Reliability and factorial validity of the Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20). Bull Clin Psychopharmacol 2009;19(3):213-19.
  • 20. De Berardis D, Campanella D, Gambi F, Sepede G, Salini G, Carano A, et al. Insight and alexithymia in adult outpatients with obsessive–compulsive disorder. Eur Arc Psychiatry Clin Neurosci 2005;255(5):350-8. https://doi.org/10.1007/s00406-005-0573-y
  • 21. Alonso P, Menchón JM, Jiménez S, Segalàs J, Mataix-Cols D, Jaurrieta N, et al. Personality dimensions in obsessive-compulsive disorder: relation to clinical variables. Psychiatry Res 2008;157(1-3):159-68. https://doi.org/10.1016/j.psychres.2006.06.003
  • 22. Chamberlain SR, Fineberg NA, Menzies LA, Blackwell AD, Bullmore ET, Robbins TW, et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry 2007;164(2):335-8. https://doi.org/10.1176/ajp.2007.164.2.335
  • 23. Grassi G, Pallanti S, Righi L, Figee M, Mantione M, Denys D, et al. Think twice: impulsivity and decision making in obsessive-compulsive disorder. J Behav Addict 2015;4(4):263–72. https://doi.org/10.1156/2006.4.2015.039
  • 24. Jylhä P, Isometsä, E. Temperament, character and symptoms of anxiety and depression in the general population. Eur Psychiatry 2006;21(6): 389-95. https://doi.org/10.1016/j.eurpsy.2005.09.003
  • 25. Lyoo IK, Yoon T, Kang DH, Kwon JS. Patterns of changes in temperament and character inventory scales in subjects with obsessive–compulsive disorder following a 4-month treatment. Acta Psychiatr Scand 2003;107(4):298–304. https://doi.org/10.1034/j.1600-0447.2003.00054.x
  • 26. Bach M, Bach D. Predictive value of alexithymia: a prospective study in somatizing patients. Psychother Psychosom 1995;64(1):43-8. https://doi.org/10.1159/000288989
  • 27. Casey JE, Joyce PR. Personality disorder and TCI in the elderly. Acta Psychiatr Scand 1999;100(4):302-8. https://doi.org/10.1111/j.1600-0447.1999.tb10865.x
  • 28. Soderstrom H, Rastam M, Gillberg C. Temperament and character in adults with Asperger syndrome. Autism 2002;6(3):287-97. https://doi.org/10.1177/1362361302006003006
  • 29. Rufer M, Hand I, Braatz A, Alsleben H, Fricke S, Peter H. A prospective study of alexithymia in obsessive-compulsive patients treated with multimodal cognitive behavior therapy. Psychother Psychosom 2004;73(2):101-6. https://doi.org/10.1159/000075541
  • 30. Dere J, Tang Q, Zhu X, Cai L, Yao S, Ryder AG. The cultural shaping of alexithymia: values and externally oriented thinking in a Chinese clinical sample. Compr Psychiatry 2013;54(4):362-8. https://doi.org/10.1016/j.comppsych.2012.10.013

Obsesif kompulsif bozukluk hastalarında mizaç, karakter özellikleri ve aleksitimi

Year 2020, Volume: 5 Issue: 2, 45 - 52, 30.09.2020

Mehmet Üstündağ , Pınar Şen Gökçeimam

https://doi.org/10.22391/fppc.756632
Cited By: 1

Abstract

Giriş: Obsesif kompulsif bozukluk (OKB) hastalarında aleksitimi düzeyleri genellikle yüksek olarak bulunmuştur. Aleksitimi ile OKB semptomlarının şiddeti arasında ilişki olduğu düşünülmektedir. Aleksitimiye etki eden faktörlerden biri mizaç-karakter özellikleridir. Bu çalışmada OKB hastalarında mizaç-karakter özellikleri ve bu özelliklerin aleksitimiyle ilişkisinin araştırılması amaçlanmıştır.


Yöntem: Bu çalışmaya Atatürk Üniversitesi Psikiyatri Polikliniği’ne başvuran 43 OKB tanılı hasta ile 33 sağlıklı birey kontrol grubu olarak alınmıştır. Katılımcılara DSM–IV Eksen-I Bozuklukları için Yapılandırılmış Klinik Görüşme Ölçeği (SCID-I), sosyodemografik ve klinik veri formu, Mizaç ve Karakter Envanteri (MKE), Toronto Aleksitimi Ölçeği (TAÖ-20) ile hasta grubuna ek olarak Yale-Brown Obsesyon Kompulsiyon Ölçeği (Y-BOKÖ) uygulanmıştır.


Bulgular: Her iki grup arasında yaş ve cinsiyet yönünden fark saptanmamıştır. OKB grubunda kontrol grubuna göre zarardan kaçınma (ZK), kendini aşma (KA) skorları yüksek, kendini yönetme (KY), işbirliği yapma (İY), yenilik arayışı (YA) düşük bulunmuştur. OKB grubunda; duyguları söze dökmede güçlük (TAS-B), dışa dönük düşünme (TAS-C) ve total OKB skorları kontrol grubuna göre yüksek saptanmıştır. Aleksitimik OKB grubunda aleksitimik olmayan gruba göre, düzensizlik ve sebat Etme (SE) skor ortalamaları düşük saptanmıştır. OKB'li hastalarda Y-BOCS puanları ile TAS-C puanları arasında pozitif korelasyon saptanmıştır.


Sonuç: Aleksitimi OKB’de yüksek oranda görülmektir. Aleksitimin dışa-dönük düşünme boyutu OKB semptom şiddeti ile ilişkilidir. Aleksitimik OKB hastalarında bazı mizaç-kişilik özellikleri aleksitimik olmayanlara göre farklılaşmaktadır. Aleksitimi ve aleksitimiye etki eden faktörlerin değerlendirilmesi, OKB’nin etyolojisi ve tedavisini anlamak için yeni bir yaklaşım sunma potansiyeline sahiptir. 

Keywords

Obsesif kompulsif bozukluk aleksitimi mizaç kişilik

References

  • 1. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). American Psychiatric Association. Translated to Turkish by Ertugrul Koroglu. Ankara: Hekimler Yayin Birligi, 2014.
  • 2. Rice, E. Reflections on obsessive-compulsive disorders: a psychodynamic and therapeutic perspective. Psychoanal Rev 2004;91(1):23-44. https://doi.org/10.1521/prev.91.1.23.33826
  • 3. Cloninger CR. A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatr Dev 1986;4(3):167-226. https://pubmed.ncbi.nlm.nih.gov/3809156
  • 4. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arc Gen Psychiatry 1993;50(12):97590. https://doi.org/10.1001/arcpsyc.1993.01820240059008
  • 5. Bejerot S, Schlette P, Ekselius L, Adolfsson R, VonKnorring L. Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 1998;98(3):243-9. https://doi.org/10.1111/j.1600-0447.1998.tb10075.x
  • 6. Bejerot S, VonKnorring L, Ekselius L. Personality traits and smoking in patients with obsessive-compulsive disorder. Eur Psychiatry 2000;15(7):395-401. https://doi.org/10.1016/s0924-9338(00)00509-5
  • 7. Sifneos PE. Alexithymia and its relationship to hemispheric specialization affect and creativity. Psychiatr Clin North Am 1988;11(3):287-93. https://pubmed.ncbi.nlm.nih.gov/3067225
  • 8. Bankier B, Aigner M, Bach M. Alexithymia in DSM-IV disorder: comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder and depression. Psychosomatics 2001;42(3):235-40. https://doi.org/10.1176/appi.psy.42.3.235
  • 9. Herbert BM, Herbert C, Pollatos O. On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? J Pers 2011;79(5):1149-75. https://doi.org/10.1111/j.1467-6494.2011.00717.x
  • 10. Katz IM, Campbell JD. Ambivalence over emotional expression and well-being: Nomothetic and idiographic tests of the stress-buffering hypothesis. J Personality Social Psychol 1994;67(3):513–24. https://doi.org/10.1037/0022-3514.67.3.513
  • 11. Pozza A, Giaquinta N, Dèttore D. The contribution of alexithymia to Obsessive-Compulsive Disorder Symptoms Dimensions: an ınvestigation in a Large Community Sample in Italy. Psychiatry J 2015;2015:707850. https://doi.org/10.1155/2015/707850
  • 12. Roh D, Kim WJ, Kim CH. Alexithymia in obsessive-compulsive disorder clinical correlates and symptom dimensions. J Nerv Ment Dis 2011;199(9):690-5. https://doi.org/10.1097/NMD.0b013e318229d209
  • 13. Kosturek A, Gregory RJ, Sousou AJ. Alexithymia and somatic amplification in chronic pain. Psychosomatics 1998;39(5):399-404. https://doi.org/10.1016/S0033-3182(98)71298-8
  • 14. Rufer M, Ziegler A, Alsleben H, Fricke S, Ortmann J, Bruckner E, et al. A prospective long-term follow-up study of alexithymia in obsessive-compulsive disorder. Compr Psychiatry 2006;47(5):394–8. https://doi.org/10.1016/j.comppsych.2005.12.004
  • 15. Goodman WK, Price LH, Rasmussen SA, Mazure CM, Fleischmann RL, Hill CL, et al. The yale–Brown obsessive compulsive scale. I. Development use and reliability. Arch Gen Psychiatry 1989;46(11):1006-11. https://doi.org/10.1001/archpsyc.1989.01810110048007
  • 16. Karamustafalioglu KO, Ucisik AM, Ulusoy M, Erkmen H. Validity and reliability study of Yale Brown obsession compulsion rating scale. Presented in 29th National Psychiatry Congress, 1993;p(86)
  • 17. Kose S, Sayar K, Ak I, Kalelioglu U, Kirpinar I, Reeves RA, et al. Temperament and character inventory (Turkish TCI): validity, reliability and factor structure. Bull Clin Psychopharmacol 2004;14:107-31.
  • 18. Bagby MR, Taylor GJ, Parker JDA. The twenty-item Toronto Alexithymia Scale-II: Convergent, discriminant, and concurrent validity. J Psychosom Res 1994;38(1):33-40. https://doi.org/10.1016/0022-3999(94)90006-x
  • 19. Gulec H, Kose S, Yazici GM, Citak S, Evren C, Borckardt JJ, et al. Reliability and factorial validity of the Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20). Bull Clin Psychopharmacol 2009;19(3):213-19.
  • 20. De Berardis D, Campanella D, Gambi F, Sepede G, Salini G, Carano A, et al. Insight and alexithymia in adult outpatients with obsessive–compulsive disorder. Eur Arc Psychiatry Clin Neurosci 2005;255(5):350-8. https://doi.org/10.1007/s00406-005-0573-y
  • 21. Alonso P, Menchón JM, Jiménez S, Segalàs J, Mataix-Cols D, Jaurrieta N, et al. Personality dimensions in obsessive-compulsive disorder: relation to clinical variables. Psychiatry Res 2008;157(1-3):159-68. https://doi.org/10.1016/j.psychres.2006.06.003
  • 22. Chamberlain SR, Fineberg NA, Menzies LA, Blackwell AD, Bullmore ET, Robbins TW, et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry 2007;164(2):335-8. https://doi.org/10.1176/ajp.2007.164.2.335
  • 23. Grassi G, Pallanti S, Righi L, Figee M, Mantione M, Denys D, et al. Think twice: impulsivity and decision making in obsessive-compulsive disorder. J Behav Addict 2015;4(4):263–72. https://doi.org/10.1156/2006.4.2015.039
  • 24. Jylhä P, Isometsä, E. Temperament, character and symptoms of anxiety and depression in the general population. Eur Psychiatry 2006;21(6): 389-95. https://doi.org/10.1016/j.eurpsy.2005.09.003
  • 25. Lyoo IK, Yoon T, Kang DH, Kwon JS. Patterns of changes in temperament and character inventory scales in subjects with obsessive–compulsive disorder following a 4-month treatment. Acta Psychiatr Scand 2003;107(4):298–304. https://doi.org/10.1034/j.1600-0447.2003.00054.x
  • 26. Bach M, Bach D. Predictive value of alexithymia: a prospective study in somatizing patients. Psychother Psychosom 1995;64(1):43-8. https://doi.org/10.1159/000288989
  • 27. Casey JE, Joyce PR. Personality disorder and TCI in the elderly. Acta Psychiatr Scand 1999;100(4):302-8. https://doi.org/10.1111/j.1600-0447.1999.tb10865.x
  • 28. Soderstrom H, Rastam M, Gillberg C. Temperament and character in adults with Asperger syndrome. Autism 2002;6(3):287-97. https://doi.org/10.1177/1362361302006003006
  • 29. Rufer M, Hand I, Braatz A, Alsleben H, Fricke S, Peter H. A prospective study of alexithymia in obsessive-compulsive patients treated with multimodal cognitive behavior therapy. Psychother Psychosom 2004;73(2):101-6. https://doi.org/10.1159/000075541
  • 30. Dere J, Tang Q, Zhu X, Cai L, Yao S, Ryder AG. The cultural shaping of alexithymia: values and externally oriented thinking in a Chinese clinical sample. Compr Psychiatry 2013;54(4):362-8. https://doi.org/10.1016/j.comppsych.2012.10.013
There are 30 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Original Research
Authors

Mehmet Üstündağ 0000-0003-0897-6000

Pınar Şen Gökçeimam 0000-0001-5228-3784

Publication Date September 30, 2020
Submission Date June 26, 2020
Acceptance Date August 20, 2020
Published in Issue Year 2020 Volume: 5 Issue: 2

Cite

APA Üstündağ, M., & Şen Gökçeimam, P. (2020). Temperament, character traits and alexithymia in patients with obsessive compulsive disorder. Family Practice and Palliative Care, 5(2), 45-52. https://doi.org/10.22391/fppc.756632
AMA Üstündağ M, Şen Gökçeimam P. Temperament, character traits and alexithymia in patients with obsessive compulsive disorder. Fam Pract Palliat Care. September 2020;5(2):45-52. doi:10.22391/fppc.756632
Chicago Üstündağ, Mehmet, and Pınar Şen Gökçeimam. “Temperament, Character Traits and Alexithymia in Patients With Obsessive Compulsive Disorder”. Family Practice and Palliative Care 5, no. 2 (September 2020): 45-52. https://doi.org/10.22391/fppc.756632.
EndNote Üstündağ M, Şen Gökçeimam P (September 1, 2020) Temperament, character traits and alexithymia in patients with obsessive compulsive disorder. Family Practice and Palliative Care 5 2 45–52.
IEEE M. Üstündağ and P. Şen Gökçeimam, “Temperament, character traits and alexithymia in patients with obsessive compulsive disorder”, Fam Pract Palliat Care, vol. 5, no. 2, pp. 45–52, 2020, doi: 10.22391/fppc.756632.
ISNAD Üstündağ, Mehmet - Şen Gökçeimam, Pınar. “Temperament, Character Traits and Alexithymia in Patients With Obsessive Compulsive Disorder”. Family Practice and Palliative Care 5/2 (September2020), 45-52. https://doi.org/10.22391/fppc.756632.
JAMA Üstündağ M, Şen Gökçeimam P. Temperament, character traits and alexithymia in patients with obsessive compulsive disorder. Fam Pract Palliat Care. 2020;5:45–52.
MLA Üstündağ, Mehmet and Pınar Şen Gökçeimam. “Temperament, Character Traits and Alexithymia in Patients With Obsessive Compulsive Disorder”. Family Practice and Palliative Care, vol. 5, no. 2, 2020, pp. 45-52, doi:10.22391/fppc.756632.
Vancouver Üstündağ M, Şen Gökçeimam P. Temperament, character traits and alexithymia in patients with obsessive compulsive disorder. Fam Pract Palliat Care. 2020;5(2):45-52.

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