Alexithymia and family functioning in adolescence: a study on family clusters

Journal title PSICOLOGIA DELLA SALUTE
Author/s Mimma Tafà, Luca Cerniglia, Giulia Ballarotto, Eleonora Marzilli, Michela Di Trani, Michela Erriu, Silvia Cimino
Publishing Year 2020 Issue 2020/2
Language Italian Pages 19 P. 52-70 File size 286 KB
DOI 10.3280/PDS2020-002003
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Several studies have stressed the importance of the ability to identify and describe emo-tions to psychological well-being in adolescence. However, fewer studies have investigated adolescents’ alexithymic difficulties in relation to family functioning. The aim of this study was to investigate the alexithymic difficulties of adolescents belonging to the general popula-tion, in relation to their family functioning, taking into account their psychopathological risk. The sample was composed of N = 314 families with adolescents. Adolescents filled out some self-report questionnaires for the evaluation of alexithymic difficulties and psychopathological risk and mothers, fathers and adolescents filled out a questionnaire for the evaluation of family functioning. In order to verify the presence of different family functioning, authors have con-ducted a cluster analysis, which identified four distinct profiles of family functioning. Then, covariance analysis was conducted, which showed greater somatization and hostility in ado-lescents with families that show less cohesion and flexibility and greater levels of enmeshment or disengagement. Moreover, adolescents belonging to these families reported more difficul-ties in describing emotions and more concrete thinking.

Keywords: Adolescence; family functioning; alexithymia; psychopathological risk.

  1. Aldenderfer M.S. and Blashfield R.K. (1984). Cluster Analysis. Newbury Park, CA: Sage.
  2. Amianto F., Abbate-Daga G., Morando S., Sobrero C. and Fassino S. (2011). Personality development characteristics of women with anorexia nervosa, their healthy siblings and healthy controls: What prevents and what relates to psychopathology?. Psychiatry Research, 187 (3): 401-408.
  3. Angley M., Divney A., Magriples U. and Kershaw T. (2015). Social support, family functioning and parenting competence in adolescent parents. Maternal and Child Health Journal, 19 (1): 67-73.
  4. Arabie P. and Hubert L.J. (1992). Combinatorial data analysis. Annual Review of Psychology, 43 (1): 169-203.
  5. Are F. and Shaffer A. (2016). Family emotion expressiveness mediates the relations between maternal emotion regulation and child emotion regulation. Child Psychiatry & Human Development, 47 (5): 708-715.
  6. Bagby R.M., Parker J.D.A. and Taylor G.J. (1994). The Twenty-Item Toronto Alexithymia scale I. Item selection and cross- validation of the factor structure. Journal of Psychosomatic Research, 38: 23-32. DOI: 10.1016/0022-3999(94)90005-
  7. Langdon-Daly J. and Serpell L. (2017). Protective factors against disordered eating in family systems: a systematic review of research. Journal of Eating Disorders, 5 (1): 12.
  8. Bagby R.M., Taylor G.J. and Parker J.D.A. (1994). The Twenty-Item Toronto Alexithymia scale II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38: 33-40. DOI: 10.1016/0022-3999(94)90006-
  9. Baiocco R., Cacioppo M., Laghi F. and Tafà M. (2013). Factorial and construct validity of FACES IV among Italian adolescents. Journal of Child and Family Studies, 22: 962-970.
  10. Ballarotto G., Volpi B., Marzilli E. and Tambelli R. (2018). Adolescent Internet abuse: A study on the role of attachment to parents and peers in a large community sample. BioMed Research International, 5769250. DOI: 10.1155/2018/5769250
  11. Berge J.M., Rowley S., Trofholz A., Hanson C., Rueter M., MacLehose R.F. and Neumark-Sztainer D. (2014). Childhood obesity and interpersonal dynamics during family meals. Pediatrics, 134 (5): 923-932.
  12. Bornstein M.H. and Bradley R.H. (2014). Socioeconomic status, parenting, and child development. New York, NY: Routledge.
  13. Byng-Hall J. (1999). Family and couple therapy: Toward greater security. In Cassidy J. and Shaver P.R. (eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 625-645). New York: Guilford Press.
  14. Cerniglia L., Cimino S., Ballarotto G., Casini E., Ferrari A., Carbone P. and Cersosimo M. (2015). Motor vehicle accidents and adolescents: an empirical study on their emotional and behavioral profiles, defense strategies and parental support. Transportation research part F: traffic psychology and behaviour, 35: 28-36.
  15. Cerniglia L., Cimino S., Tafà M., Marzilli E., Ballarotto G. and Bracaglia F. (2017). Family profiles in eating disorders: family functioning and psychopathology. Psychology Research and Behavior Management, 10: 305-312. DOI: 10.2147/PRBM.S14546
  16. Ciarrochi J., Heaven P.C. and Supavadeeprasit S. (2008). The link between emotion identification skills and socio-emotional functioning in early adolescence: a 1-year longitudinal study. Journal of Adolescence, 31 (5): 565-582.
  17. Craparo G., Faraci P. and Gori A. (2015). Psychometric properties of the 20-item Toronto Alexithymia scale in a group of Italian younger Adolescents. Psychiatry Investigation 12 (4). 500-507.
  18. Crone E.A. and Dahl R.E. (2012). Understanding adolescence as a period of social–affective engagement and goal flexibility. Nature Reviews Neuroscience, 13 (9): 636-650.
  19. Derogatis L.R. (1994). SCL-90-R: administration, scoring and procedures manual. Minneapolis: National Computer Systems. Inc.
  20. Derogatis L.R. and Melisaratos N. (1983). The brief symptom inventory: an introductory report. Psychological Medicine, 13 (3): 595-605. DOI: 10.1017/S003329170004801
  21. Derogatis L.R. and Savitz K.L. (2000): The SCL-90-R and Brief Symptom Inventory (BSI) in primary care. In: Maruish M.E. (ed.), Handbook of psychological assessment in primary care settings (pp. 297-334). Mahwah, NJ, US: Lawrence Erlbaum Associates.
  22. Dishion T.J., Nelson S.E. and Bullock B.M. (2004). Premature adolescent autonomy: Parent disengagement and deviant peer process in the amplification of problem behaviour. Journal of Adolescence, 27 (5): 515-530.
  23. Doba K. and Nandrino J.L. (2010). Is there a family typology of addictive behaviors? Critical review of the literature in the families of adolescents with an eating disorder or with a substance-dependence. Psychologie Francaise, 55 (4): 355-371.
  24. El-Rasheed A.H., ElAttar K.S., Elrassas H.H., Mahmoud D.A. and Mohamed S.Y. (2017). Mood regulation, alexithymia, and personality disorders in adolescent male addicts. Addictive Disorders & Their Treatment, 16 (2): 49-58. DOI: 10.1097/ADT.000000000000009
  25. Erol A., Yazici F. and Toprak, G. (2007). Family functioning of patients with an eating disorder compared with that of patients with obsessive compulsive disorder. Comprehensive Psychiatry, 48 (1): 47-50.
  26. Everri M., Mancini T. and Fruggeri, L. (2015). Family functioning, parental monitoring and adolescent familiar responsibility in middle and late adolescence. Journal of Child and Family Studies, 24(10): 3058-3066.
  27. Ferguson C.J., Muñoz M.E., Garza A. and Galindo M. (2014). Concurrent and prospective analyses of peer, television and social media influences on body dissatisfaction, eating disorder symptoms and life satisfaction in adolescent girls. Journal of Youth and Adolescence, 43 (1): 1-14.
  28. Franko D.L., Thompson D., Affenito S.G., Barton B.A. and Striegel-Moore R.H. (2008). What mediates the relationship between family meals and adolescent health issues. Health Psychology, 27 (2): S109–S117.
  29. Gordon A.D. (1999). Classification. 2nd edition. New York: Chapman and Hall/CRC.
  30. Hasenboehler K., Munsch S., Meyer A.H., Kappler C. and Vögele C. (2009). Family structure, body mass index, and eating behavior. International Journal of Eating Disorders, 42(4): 332-338.
  31. Holtom-Viesel A. and Allan S. (2014). A systematic review of the literature on family functioning across all eating disorder diagnoses in comparison to control families. Clinical Psychology Review, 34 (1): 29-43.
  32. Honkalampi K., Tolmunen T., Hintikka J., Rissanen M.L., Kylma J. and Laukkanen E. (2009). The prevalence of alexithymia and its relationship with youth self-report problem scales among finnish adolescents. Comprehensive Psychiatry, 50 (3): 263-268.
  33. Hoste R.R., Hewell K. and le Grange D. (2007). Family interaction among white and ethnic minority adolescents with bulimia nervosa and their parents. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 15(2): 152-158.
  34. Hughes E.K., Burton C., Le Grange D. and Sawyer S.M. (2018). The participation of mothers, fathers, and siblings in family-based treatment for adolescent anorexia nervosa. Journal of Clinical Child & Adolescent Psychology. 47 sup1: S456-S466. DOI: 10.1080/15374416.2017.139075
  35. Jaramillo M., Burke N.L., Shomaker L.B., Brady S.M., Kozlosky M., Yanovski J.A. and Tanofsky-Kraff M. (2018). Perceived Family Functioning in Relation to Energy Intake in Adolescent Girls with Loss of Control Eating. Nutrients, 10 (12): 1869.
  36. Jozefiak T. and Wallander J.L. (2016). Perceived family functioning, adolescent psychopathology and quality of life in the general population: a 6-month follow-up study. Quality of Life Research, 25 (4): 959-967.
  37. Karukivi M., Joukamaa M., Hautala L., Kaleva O., Haapasalo-Pesu K.M., Liuksila P.R. and Saarijärvi S. (2011). Does perceived social support and parental attitude relate to alexithymia? A study in Finnish late adolescents. Psychiatry Research, 187 (1-2): 254-260.
  38. Karukivi M., Pölönen T., Vahlberg T., Saikkonen S. and Saarijärvi S. (2014). Stability of alexithymia in late adolescence: results of a 4-year follow-up study. Psychiatry Research, 219 (2): 386-390.
  39. Kivisto K.L., Welsh D.P., Darling N. and Culpepper C.L. (2015). Family enmeshment, adolescent emotional dysregulation, and the moderating role of gender. Journal of Family Psychology, 29 (4): 604-613.
  40. La Ferlita V., Bonadies M., Solano L., De Gennaro L., and Gonini P. (2007). Alessitimia e adolescenza: studio preliminare di validazione della tas-20 su un campione di 360 adolescenti italiani [Alexithymia and adolescence: a preliminary validation study of tas-20 on a sample of 360 Italian adolescents]. Infanzia e Adolescenza, 6 (3): 131-144.
  41. Latzer Y., Lavee Y. and Gal S. (2009). Marital and parent-child relationships in families with daughters who have eating disorders. Journal of Family Issues, 30 (9): 1201-1220. DOI: 10.1177/0192513X09334599
  42. Le Grange D., Hughes E.K., Court A., Yeo M., Crosby R.D. and Sawyer S.M. (2016). Randomized clinical trial of parent-focused treatment and family-based treatment for adolescent anorexia nervosa. Journal of the American Academy of Child & Adolescent Psychiatry. 55 (8): 683-692.
  43. Lebowitz, E.R. (2017). Family impairment associated with childhood obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 56 (3): 187-188.
  44. Levine M. and Smolak L. (2013). Toward a model of the develop- mental psychopathology of eating disorders: the example of early adolescence. In Crowter J.H., Hobfoll S.E., Stephens M.A. and Tennenbaum D.L. (eds.), The etiology of bulimia nervosa: The individual and familial context (pp. 59-80). Washington: Taylor and Francis.
  45. Liddle H.A. and Schwartz S.J. (2002). Attachment and family therapy: Clinical utility of adolescent‐family attachment research. Family Process, 41 (3): 455-476.
  46. Lumley M.A., Mader C., Gramzow J. and Papineau K. (1996). Family factors related to alexithymia characteristics. Psychosomatic Medicine, 58 (3): 211-216.
  47. Manninen M., Therman S., Suvisaari J., Ebeling H., Moilanen I., Huttunen M. and Joukamaa M. (2011). Alexithymia is common among adolescents with severe disruptive behavior. The Journal of Nervous and Mental Disease, 199 (7): 506-509.
  48. Milligan G.W. and Sokol L.M. (1980). A Two-Stage Clustering Algorithm with Robust Recovery Characteristics. Educational and Psychological Measurement, 40: 755-759.
  49. Morris A.S., Criss M.M., Silk J.S. and Houltberg B.J. (2017). The impact of parenting on emotion regulation during childhood and adolescence. Child Development Perspectives, 11(4): 233-238.
  50. Moyer D.N. and Sandoz E.K. (2015). The role of psychological flexibility in the relationship between parent and adolescent distress. Journal of Child and Family Studies, 24 (5): 1406-1418.
  51. Naghavi F. and Mar’of R. (2012). Relationship between family functioning, alexithymia and emotional intelligence among early adolescents in Tehran-Iran. Life Science Journal, 9(1): 396-401.
  52. Natalucci G., Faedda N., Calderoni D., Cerutti R., Verdecchia P. and Guidetti, V. (2018). Headache and alexithymia in children and adolescents: what is the connection?. Frontiers in Psychology, 9: 48.
  53. Nemiah J.C. (1977). Alexithymia: Theoretical considerations. Psychotherapy and Psychosomatics, 28 (1-4): 199-206. DOI: 10.1159/00028706
  54. Olson D.H. (1995). Family Satisfaction Scale. Minneapolis, MN: Life Innovations.
  55. Olson D.H. (2008). Faces IV Manual. Minneapolis, MN: Life Innovations.
  56. Olson D.H. (2010). Data analysis using Faces IV scores. Minneapolis, MN: Life Innovations.
  57. Olson D.H. (2011). FACES IV and the Circumplex Model: validation study. Journal of Marital and Family Therapy, 37 (1): 64-80.
  58. Olson D.H., Gorall D.M. and Tiesel J.W. (2006). FACES IV. Development and validation. Minneapolis: Life Innovations.
  59. Olson D.H., Waldvogel L. and Schlieff M. (2019). Circumplex Model of Marital and Family Systems: An Update. Journal of Family Theory & Review. 11 (2): 199-211.
  60. Paniccia M.F., Gaudio S., Puddu A., Di Trani M., Dakanalis A., Gentile S. and Di Ciommo V. (2018). Alexithymia in parents and adolescents with generalised anxiety disorder. Clinical Psychologist, 22 (3): 336-343.
  61. Parker J.D., Taylor G.J. and Bagby R.M. (2003). The 20-Item Toronto Alexithymia scale. III. Reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55 (3): 269-275. DOI: 10.1016/S0022-3999(02)00578-
  62. Parker J.D.A., Eastabrook J.M., Keefer K.V. and Wood L.M. (2010). Can alexithymia be assessed in adolescents? Psychometric properties of the 20-item Toronto Alexithymia Scale in younger, middle, and older adolescents. Psychological Assessment, 22(4), 798-808.
  63. Petanjek Z., Judaš M., Šimić G., Rašin M.R., Uylings H.B., Rakic P. and Kostović I. (2011). Extraordinary neoteny of synaptic spines in the human prefrontal cortex. Proceedings of the National Academy of Sciences, 108 (32): 13281-13286.
  64. Prunas A., Sarno I., Preti E., Madeddu F. and Perugini M. (2012). Psychometric properties of the Italian version of the SCL-90-R: a study on a large community sample. European Psychiatry, 27 (8), 591-597.
  65. Raboteg-Saric Z. and Sakic M. (2014). Relations of Parenting Styles and Friendship Quality to Self-Esteem, Life Satisfaction and Happiness in Adolescents. Applied Research Quality Life, 9 (3): 749-765.
  66. Repetti R.L., Taylor S.E. and Seeman T.E. (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin, 128 (2), 330. DOI: 10.1037/0033-2909.128.2.33
  67. Rieffe C. and De Rooij M. (2012). The longitudinal relationship between emotion awareness and internalising symptoms during late childhood. European Child & Adolescent Psychiatry, 21 (6): 349-356.
  68. Scarzello D e Prino LE. (2015). Il parenting stress nei primi anni di vita del bambino: il ruolo dell’alessitimia e dell’autoefficacia emotiva genitoriale [Parenting stress in the first years of the child’s life: the role of alexithymia and parental emotional self-efficacy]. Psicologia della Salute, 3: 45-64. DOI: 10.3280/PDS2015-00300
  69. Schimmenti A., Passanisi A., Caretti V., La Marca L., Granieri A., Iacolino C. and Billieux, J. (2017). Traumatic experiences, alexithymia, and Internet addiction symptoms among late adolescents: A moderated mediation analysis. Addictive Behaviors, 64: 314-320.
  70. Steinberg L. (2010). A dual systems model of adolescent risk‐taking. The Journal of the International Society for Developmental Psychobiology, 52 (3): 216-224.
  71. Tafà M. and Baiocco R. (2009). Addictive behavior and family functioning during adolescence. The American Journal of Family Therapy, 37 (5): 388-395. DOI: 10.1080/0192618090275474
  72. Tafà M., Cimino S., Ballarotto G., Bracaglia F., Bottone C. and Cerniglia L. (2017). Female adolescents with eating disorders, parental psychopathological risk and family functioning. Journal of Child and Family Studies, 26 (1): 28-39.
  73. Tambelli R., Cimino S., Cerniglia L. and Ballarotto G. (2015). Early maternal relational traumatic experiences and psychopathological symptoms: a longitudinal study on mother-infant and father-infant interactions. Scientific Reports, 5, 13984.
  74. Taylor G.J. and Bagby R.M. (2013). Psychoanalysis and empirical research: The example of alexithymia. Journal of the American Psychoanalytic Association, 61: 99-133. DOI: 10.1177/000306511247406
  75. Taylor G.J., Bagby R.M. and Parker J.D.A. (1997). Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press.
  76. Taylor G.J., Bagby R.M., Ryan D.P. and Parker J.D. (1990). Validation of the alexithymia construct: a measurement-based approach. The Canadian Journal of Psychiatry, 35 (4): 290-297. DOI: 10.1177/07067437900350040
  77. Terre L. and Ghiselli W. (1997). A developmental perspective on family risk factors in somatization. Journal of Psychosomatic Research, 42 (2): 197-208. DOI: 10.1016/S0022-3999(96)00237-
  78. Thorberg F.A., Young R.M., Sullivan K.A., Lyvers M., Connor J.P. and Feeney G.F. (2011). Alexithymia, craving and attachment in a heavy drinking population. Addictive Behaviors, 36 (4): 427-430.
  79. Tosto M., Merenda A. e Salerno A. (2016). Modelli di parenting multipli e benessere interpersonale. Una rassegna teorica sull’evoluzione del sistema motivazionale diadico verso il network dell’accudimento [Multiple parenting patterns and interpersonal well-being. A theoretical review on the evolution of the dyadic motivational system towards the care network]. Psicologia della Salute, 3: 64-82. DOI: 10.3280/PDS2016-00300
  80. van Duijvenvoorde A.C., Peters S., Braams B.R. and Crone E.A. (2016). What motivates adolescents? Neural responses to rewards and their influence on adolescents’ risk taking, learning, and cognitive control. Neuroscience & Biobehavioral Reviews, 70: 135-147.
  81. Verzeletti C., Zammuner V.L., Galli C. and Agnoli S. (2016). Emotion regulation strategies and psychosocial well-being in adolescence. Cogent Psychology, 3(1): 1199294. DOI: 10.1080/23311908.2016.119929
  82. Visani E., Di Nuovo S. e Loriedo C. (2014). II faces IV: il modello circonflesso di Olson nella clinica e nella ricerca. [The faces IV: Olson’s circumflex model in clinic and research]. Milano: FrancoAngeli.
  83. Ward J.H. (1963). Hierarchical grouping to optimize an objective function. Journal of the American Statistical Association, 58 (301): 236-244. DOI: 10.1080/01621459.1963.1050084
  84. Willems Y.E., de Zeeuw E.L., van Beijsterveldt C.E., Boomsma D.I., Bartels M. and Finkenauer C. (2019). Out of Control: Examining the Association Between Family Conflict and Self-Control in Adolescence in a Genetically Sensitive Design. Journal of the American Academy of Child & Adolescent Psychiatry, 59(2):254-262.
  85. Woodside D.B., Swinson R.P., Kuch K. and Heinmaa M. (1996). Family functioning in anxiety and eating disorders-A comparative study. Comprehensive Psychiatry, 37(2): 139-143.

Mimma Tafà, Luca Cerniglia, Giulia Ballarotto, Eleonora Marzilli, Michela Di Trani, Michela Erriu, Silvia Cimino, Difficoltà alessitimiche e funzionamento familiare in adolescenza: uno studio sui cluster familiari in "PSICOLOGIA DELLA SALUTE" 2/2020, pp 52-70, DOI: 10.3280/PDS2020-002003