The Role of Alexithymia in Interpersonal Psychotherapy for Depressed Adolescents

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Prevention and Interventions

Abstract

Alexithymia refers to a limited ability to identify and communicate one’s emotions. Alexithymia is a style of thinking that has been found, in adults, to be associated with depression and difficulties in interpersonal relationships. Less is known about associations between alexithymia, interpersonal relationships, and depression in adolescents. It is also not known whether alexithymia changes with an interpersonally-focused treatment in this age group. Adolescence represents a critical developmental window for understanding associations between alexithymia, interpersonal relationships, and depression, given that it is characterized by a significant rise in rates of depression and interpersonal stressors (Hankin et al 1998; Rudolph et al, 1999). The goal of the current study was to examine associations between alexithymia and interpersonal functioning in a sample of depressed adolescents treated with Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), an evidence-based treatment that helps adolescents improve overall interpersonal functioning, and as a result, reduce depressive symptoms (Mufson, et al. 2004). In addition, we examined change in alexithymia with IPT-A, change in alexithymia in association with changes in depression and interpersonal functioning, and alexithymia as a predictor of treatment outcome.

The study included a sample of 40 (77.5% female) adolescents (age 12-17, M = 14.8, SD = 1.7) who participated in a 16-week randomized trial evaluating the effectiveness of four adaptive treatment strategies for adolescents with depression. Each adolescent began with an initial treatment plan of 12 sessions of IPT-A. Insufficient responders were randomized to additional IPT-A sessions or the addition of fluoxetine. The Alexithymia Questionnaire for Children (AQC), Children’s Depression Scale Rating-Revised (CDRS-R), and Social Adjustment Scale – Self-report (SAS-SR) were administered at baseline and week 16. The AQC includes three subscales: 1) difficulty identifying feelings (DIF), 2) difficulty describing feelings (DDF), and 3) externally oriented thinking (EOT).

At baseline, DIF was positively correlated with CDRS-R (r = .38, p = .02) and SAS-SR (higher scores indicate more problems; r = .58, p = .00). DDF was positively correlated with SAS-SR (r = .49, p = .00). DIF and DDF both significantly decreased over the course of IPT-A (DIF: t(28) = 4.31, p = 0.00; DDF: t(28) = 4.25, p = .00). Change in CDRS-R from baseline to week 16 was significantly associated with change in DIF (b = .56, t = 3.26, p = .00), DEF (b = .71, t = 4.60, p = .00), and EOT (b = .39, t = 2.16, p = .04), controlling for medication status. Change in DIF and DDF were correlated with change in SAS-SR (DIF: r = .58, p = .00; DDF: r = .62, p = .00). None of the alexithymia subscales predicted CDRS-R or SAS-SR outcome with IPT-A.

The results suggest that dimensions of alexithymia are significantly associated with depression and interpersonal functioning in adolescents. Adolescents’ ability to identify and describe feelings significantly improved over the course of IPT-A. In addition, changes in alexithymia were significantly associated with changes in depression and interpersonal functioning with IPT-A. These results provide preliminary support for IPT-A as an efficacious treatment for alexithymia.

Authors

• Madeleine Rondestvedt, University of Minnesota - Twin Cities
  Presenting Author

• Jocelyn Teng, University of Minnesota - Twin Cities
  Non-Presenting Author

• Chenwei Yan, University of Minnesota
  Non-Presenting Author

• Meredith Gunlicks-Stoessel, University of Minnesota - Twin Cities
  Non-Presenting Author