Research Reports - Reductions in alexithymia and emotion dysregulation after training emotional self-awareness following traumatic brain injury

J Head Trauma Rehabil. 2017 Sep/Oct;32(5):286-295. doi:

Neumann D(1), Malec JF, Hammond FM.

OBJECTIVES: To examine the acceptability and initial efficacy of an emotional
self-awareness treatment at reducing alexithymia and emotion dysregulation in
participants with traumatic brain injury (TBI).
SETTING: An outpatient rehabilitation hospital.
PARTICIPANTS: Seventeen adults with moderate to severe TBI and alexithymia. Time
postinjury ranged 1 to 33 years.
DESIGN: Within subject design, with 3 assessment times: baseline, posttest, and
2-month follow-up.
INTERVENTION: Eight lessons incorporated psychoeducational information and
skill-building exercises teaching emotional vocabulary, labeling, and
differentiating self-emotions; interoceptive awareness; and distinguishing
emotions from thoughts, actions, and sensations.
MEASURES: Toronto Alexithymia Scale-20 (TAS-20); Levels of Emotional Awareness
Scale (LEAS); Trait Anxiety Inventory (TAI); Patient Health Questionnaire-9
(PHQ-9); State-Trait Anger Expression Inventory (STAXI); Difficulty With Emotion
Regulation Scale (DERS); and Positive and Negative Affect Scale (PANAS).
RESULTS: Thirteen participants completed the treatment. Repeated-measures
analysis of variance revealed changes on the TAS-20 (P = .003), LEAS (P < .001),
TAI (P = .014), STAXI (P = .015), DERS (P = .020), and positive affect (P <
.005). Paired t tests indicated significant baseline to posttest improvements on
these measures. Gains were maintained at follow-up for the TAS, LEAS, and
positive affect. Treatment satisfaction was high.
CONCLUSION: This is the first study published on treating alexithymia post-TBI.
Positive changes were identified for emotional self-awareness and emotion
regulation; some changes were maintained several months posttreatment. Findings
justify advancing to the next investigational phase for this novel intervention. 

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