An evaluation of the absolute and relative stability of alexithymia in patients with major depression

Background. Previous studies demonstrating an association between alexithym ia and depression have led to the proposal that alexithymia may be a state- dependent phenomenon rather than a stable and enduring personality trait. S everal longitudinal studies have provided support for a trait view of alexi thymia, but most of these studies evaluated absolute stability only (i.e., the extent to which alexithymia scores change over time) and did not examin e the relative stability of alexithymia (i.e., the extent to which relative differences among individuals remain the same over time) in the context of changes in illness symptomatology. The present study evaluated both absolu te stability and relative stability of alexithymia in depressed patients wh o experienced a marked reduction in the severity of depressive symptoms. Me thods: Forty-six psychiatric outpatients with major depression were assesse d for alexithymia and depression with the 20-item Toronto Alexithymia Scale and the Hamilton Rating Scale for Depression at the start of treatment (ba seline) and after 14 weeks of treatment (follow-up) with antidepressant med ication. Paired t tests and correlational analyses were performed to evalua te absolute stability and relative stability in alexithymia. Hierarchical r egression analyses were then used to assess the degree to which the relativ e stability in alexithymia scores was related to the severity of depressive symptoms, and the degree to which changes in alexithymia scores could be a ttributed to changes in depression scores. Results: Alexithymia scores chan ged significantly from baseline to follow-up, indicating a general lack of absolute stability. There was, however, strong evidence of relative stabili ty, as alexithymia scores at baseline correlated significantly with alexith ymia scores at follow-up and were also a significant predictor of follow-up alexithymia scores, after partialling the effects of depression severity. Conclusions: Although alexithymia scores may change in the presence of larg e changes in the severity of depressive symptoms, the finding of relative s tability of alexithymia supports the view that this construct is a stable p ersonality trait rather a state-dependent phenomenon. Copyright (C) 2001 S. Karger AG, Basel.