This study measured the relationship between head-injury exposure and later-in-life cognitive and emotional symptoms in aging collegiate football players who participated in the College Level Aging Athlete Study. Linear regressions examined the relationship between various head-injury exposure variables (head-injury exposure estimate [HIEE], number of diagnosed concussions, and symptomatic hits to the head) and subjective cognitive function, objective cognitive function, and emotional/mood symptoms. Additional regressions evaluated the impact of emotional symptoms on subjective cognitive decline and objective cognitive function. Participants (n = 216) were 50-87 years old (M = 63.4 [8.5]), 91% White, and well-educated (bachelor\'s/graduate degree = 92%). HIEE did not predict scores on cognitive or emotional/mood symptom measures (p\'s > .169). Diagnosed concussions had a small effect on depression symptoms (p = .002, b = 0.501, R2 = .052) and subjective cognitive symptoms (p = .002, b = 0.383, R2 = .051). An emotional symptom index had a stronger relationship (p < .001, b = 0.693, R2 = .362) with subjective cognitive functioning but no significant relationship with objective cognitive function (p = .052, b = -0.211, R2 = .020). Controlling for emotional symptoms, the relationship between concussions and subjective cognitive symptoms was attenuated (p = .078, R2 = .011). Findings suggested that head-injury exposure was not significantly related to cognitive or emotional/mood outcomes in former collegiate football players and highlighted the importance of current emotional/mood symptoms on subjective cognitive function.

The advent of multiple transdiagnostic treatments in recent decades has advanced the field of clinical psychology while also raising questions for clinicians and patients about how to decide between treatments and how to best deliver a chosen treatment. The purpose of this paper is to review two prominent transdiagnostic treatments that target emotion dysregulation: dialectical behaviour therapy and the unified protocol for transdiagnostic treatment for emotional disorders. First, we review the theoretical underpinnings, research support and proposed mechanisms of action for these treatments. Next, we discuss patient and therapist variables that might indicate which treatment is more appropriate for a given patient and discuss decision-making guidelines to help make this determination with an emphasis on complex patients who may present with risk and/or clinical comorbidities. Finally, we discuss areas for future research that can help further ensure we work to match patients to the treatment that is most likely to benefit them.

BACKGROUND: Individuals on the autism spectrum commonly have differences from non-autistic people in expressing their emotions using communicative behaviors, such as facial expressions. However, it is not yet clear if this reduced expressivity stems from reduced physiological reactivity in emotional contexts or if individuals react internally, but do not show these reactions externally to others. We hypothesized that autism is characterized by a discordance between in-the-moment internal psychophysiological arousal and external communicative expressions of emotion.
METHODS: Forty-one children on the autism spectrum and 39 non-autistic, typically developing (TD) children of two age groups (2-4 and 8-12 years) participated in a low-level stress task whilst wearing a wireless electrocardiogram. Children\'s negative emotional expressions (facial, vocal, bodily) were coded following standardized protocols. Alexithymia traits were assessed using the Children\'s Alexithymia Measure with school-aged children only. Data analyses involved ANOVAs, correlations, and sensitivity analyses.
RESULTS: There were no group differences in physiological arousal (heart rate) or in communicative expressions of stress to the stress task. For TD preschoolers, physiological arousal during the stress task was associated with vocal expressions and for TD school-aged children, they were associated with facial and bodily expressions. By contrast, for children on the autism spectrum, physiological arousal during the stress tasks was not associated with communicative expressions across age groups.
CONCLUSIONS: Our findings suggest that children on the autism spectrum might experience emotional disconcordance, in that their physiological arousal does not align with their communicative expressions. Therefore, the internally experienced stress of children on the autism spectrum may be inadvertently missed by teachers and caregivers and, consequently, learning opportunities for teaching emotional communication and regulation may be also missed. Our results support the use of wearable biosensors to facilitate such interventions in children on the autism spectrum.

UNASSIGNED: The aim of this research was to ascertain the correlations between alexithymia, social support, depression, and glycemic control in patients diagnosed with type 2 diabetes mellitus. Additionally, this study sought to delve into the potential mediating effects of social support and depression in the relationship between alexithymia and glycemic control.
UNASSIGNED: A purposive sampling methodology was employed to select a cohort of 318 patients afflicted with type 2 diabetes mellitus, hailing from a care establishment situated in Chengdu City. This investigation embraced a cross-sectional framework, wherein instruments such as the General Information Questionnaire, the Toronto Alexithymia Scale 20, the Social Support Rating Scale, and the Hamilton Depression Scale were judiciously administered. The primary objective of this endeavor was to unravel the interplay that exists amongst alexithymia, social support, depression, and glycemic control. The inquiry discerned these interrelationships through both univariate and correlational analyses, subsequently delving into a comprehensive exploration of the mediating ramifications engendered by social support and depression in the nexus between alexithymia and glycemic control.
UNASSIGNED: The HbA1c level of patients diagnosed with type 2 diabetes mellitus was recorded as (8.85 ± 2.107), and their current status with regards to alexithymia, social support, and depression were measured as (58.05 ± 4.382), (34.29 ± 4.420), and (7.17 ± 3.367), respectively. Significant correlations were found between HbA1c and alexithymia (R=0.392, P<0.01), social support (R=-0.338, P<0.01), and depression (R=0.509, P<0.01). Moreover, alexithymia correlation with social support (R=-0.357, P<0.01) and with depression (R=0.345, P<0.01). Regarding the mediation analysis, the direct effect of alexithymia on HbA1c was calculated to be 0.158, while the indirect effect through social support and depression were 0.086 and 0.149, respectively. The total effect value was determined to be 0.382, with the mediating effect accounting for 59.95%, and the direct effect accounting for 40.31%.
UNASSIGNED: Alexithymia exerts both direct and indirect adverse effects on glycemic control, thereby exacerbating disease outcomes. Hence, it is imperative to prioritize the mental health status of individuals with type 2 diabetes to enhance overall well-being, ameliorate diabetes-related outcomes, elevate patients\' quality of life, and alleviate the psychological distress and financial burden associated with the condition.

UNASSIGNED: Previous studies have provided initial evidence supporting the association between compulsive sexual behavior (CSB) and alexithymia, but these studies did not investigate the psychometric property of a measure of alexithymia in individuals with CSB, which is necessary.
UNASSIGNED: This study investigated the factor analysis, reliability, and construct validity of the Toronto Alexithymia Scale (TAS) in men with CSB and control individuals.
UNASSIGNED: This cross-sectional study included 418 participants (304 individuals with CSB and 114 control individuals) who underwent a semi-structured psychiatric interview and completed the following instruments: the Sexual Compulsivity Scale, Hypersexual Disorder Screening Inventory, Beck Anxiety Inventory, Beck Depression Inventory, TAS, and Barratt Impulsiveness Scale. The eligible participants were men 18 years of age or older who were literate and residing in Brazil. Individuals who met the diagnostic criteria for Goodman\'s criteria for sex addiction were subsequently assessed for the excessive sexual drive (International Classification of Diseases-Tenth Revision F52.7) criteria. Those who met this second criteria were considered individuals with CSB. Participants who did not reach this point were considered control individuals. We conducted factor analysis, reliability analysis (internal consistency and temporal stability), and discriminant and construct validity analyses.
UNASSIGNED: The outcomes included the TAS total score and scores on TAS factors 1, 2, 3, and 4.
UNASSIGNED: The extracted factors explained 44% of the variance in the TAS. Factor 1 explained 21%, but 3 items (items 2, 9, and 21) did not load onto this factor. The Cronbach\'s alpha was 0.83, and the reproducibility (intraclass correlation coefficient) was 0.70. The TAS can differentiate between individuals with CSB and control individuals. The different forms of validity were demonstrated through correlations between factors 1 to 4 and the total score, as well as with impulsivity, hypersexuality, sexual compulsivity, and depression. Surprisingly, anxiety was only weakly correlated with factors 1 and 2. Moreover, the TAS-4 score was not correlated with impulsivity.
UNASSIGNED: The TAS can be used in clinical practice to identify men with difficulties in recognizing subjective experiences, and proper interventions can subsequently be provided to these patients to increase their treatment efficacy.
UNASSIGNED: Various dimensions of alexithymia covary with other key psychopathological symptoms of CSB. This study examined a convenience sample. The results cannot be generalized to the broader population. Factors 3 and 4 presented low internal consistency (0.50).
UNASSIGNED: In general, TAS presented good psychometric properties in a sample mainly composed of individuals with CSB.

BACKGROUND: Today, addressing issues related to the use of virtual space is of paramount importance due to its significant impact on mental well-being. This is especially crucial when the research community consists of teenagers who are cyber bullies or their victims who have higher vulnerability. The aim of the present study was to investigate the mediating role of alexithymia in the relationship between cyberbullying and psychotic experiences in adolescents.
METHODS: The research method employed in this study was correlational, and the study population consisted of all male and female middle school students in Tehran during the 2022-2023 academic years. As for data collection, the Cyber-Bullying/Victimization Experiences questionnaire, Community Assessment of Psychic Experiences, and the Toronto Alexithymia scale were applied. A total of 602 samples were gathered by using multi-stage cluster sampling from Tehran in Iran. Four selection of the sample, the regions in Tehran were selected randomly according to the geographical directions of them and then some schools and classes were chosen randomly. Sample was included in the analysis after data entry into SPSS software and subsequent structural equation modeling using AMOS software.
RESULTS: According to the findings, cyberbullying (β = 0.11,p < 0.05) and cyber victimization(β = 0.41, p < 0.001) were significant predictors of psychotic experiences. Alexithymia partially mediated the relationship between cyberbullying and psychotic experiences with the mediation effect of 0.28 and cyber victimization and psychotic experiences with the mediation effect of 0.18.
CONCLUSIONS: These findings underscore the importance of identifying cyber victims or cyberbullies in order to prevent alexithymia and psychotic experiences in future, in order to prevent more serious problems and becoming psychotic.
BACKGROUND: The goals and conditions of this research were investigated and approved by the Ethics Committee of Alzahra University in Tehran (code: ALZAHRA.REC.1402.055) on 13th September 2023.

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90-Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs (p < 0.05). The TAS-total scores also correlated with the number of total relapses (p < 0.01), as well as with the number of steroid cycles (p < 0.05), the number of hospital admissions (p < 0.05), and overall disease duration (p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs.

BACKGROUND: Alexithymia is a trait involving difficulties in processing emotions. Genetic association studies have investigated candidate genes involved in alexithymia\'s pathogenesis. Therefore, the aim of the present study was to perform a systematic review of the genetic background associated with alexithymia.
METHODS: A systematic review of genetic studies of people with alexithymia was conducted. Electronic databases including PubMed, Scopus, and Web of Science were searched for the study purpose. We used the words \"Alexithymia\", \"gene\", \"genetics\", \"variants\", and \"biomarkers\". The present systematic review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. We found only candidate gene studies. A total of seventeen studies met the eligibility criteria, which comprised 22,361 individuals. The candidate genes associated with alexithymia were the serotoninergic pathway genes solute carrier family 6 member 4 (SLC6A4), serotonin 1A receptor (HTR1A), and serotonin 1A receptor (HTR2A); the neurotransmitter metabolism genes dopamine receptor D2 (DRD2), ankyrin repeat and kinase domain containing 1 (ANKK1), catechol-o-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF), and oxytocin receptor (OXTR); and other pathway genes, vitamin D-binding protein (VDBP), tumor protein P53 regulated apoptosis inducing protein 1 (TP53AIP1), Rho GTPase Activating Protein 32 (ARHGAP32), and transmembrane protein 88B (TMEM88B).
CONCLUSIONS: The results of this study showed that only case-control gene studies have been performed in alexithymia. On the basis of our findings, the majority of alexithymia genes and polymorphisms in this study belong to the serotoninergic pathway and neurotransmitter metabolism genes. These data suggest a role of serotoninergic neurotransmission in alexithymia. Nevertheless, more and future research is required to learn about the role of these genes in alexithymia.

BACKGROUND: Dysfunctional imagery processes characterise a range of emotional disorders. Valid, reliable, and responsive mental imagery measures may support the clinical assessment of imagery and advance research to develop theory and imagery-based interventions. We sought to review the psychometric properties of mental imagery measures relevant to emotional disorders.
METHODS: A systematic review registered on the Open Science Framework was conducted using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Five databases were searched. COSMIN tools were used to assess the quality of study methodologies and psychometric properties of measures.
RESULTS: Twenty-three articles describing twenty-one self-report measures were included. Measures assessed various imagery processes and were organised into four groups based on related emotional disorders. Study methodological quality varied: measure development and reliability studies were generally poor, while internal consistency and hypothesis testing studies were higher quality. Most measurement properties assessed were of indeterminate quality.
CONCLUSIONS: Imagery measures were heterogenous and primarily disorder specific. Due to a lack of high-quality psychometric assessment, it is unclear whether most included imagery measures are valid, reliable, or responsive. Measures had limited evidence of content validity suggesting further research could engage clinical populations to ensure their relevance and comprehensiveness.

Successful emotion regulation is a critical component of mental health, and difficulties with emotion regulation have been associated with a wide range of disorders, including anxiety and depressive disorders. However, although much is known about commonly used forms of emotion regulation such as cognitive reappraisal and expressive suppression, the relative contribution of two important facets of emotion regulation-frequency and self-efficacy-is not yet clearly established. To address this issue, we conducted two studies. Study 1 employed a community sample (cross-sectional N = 431; 4- to 5-month longitudinal N = 182). Study 2 employed a clinical sample (cross-sectional N = 132). Both assessed emotion regulation frequency and self-efficacy, as well as affective outcomes (anxiety and depressive symptoms). Findings indicated cognitive reappraisal self-efficacy appears to be a relevant variable understanding negative affect outcomes, cross-sectionally, longitudinally and in the clinical sample. Our findings support the process model of emotion regulation in affective symptomatology. Implications for theory and treatment are discussed.