COVID-19 Pandemisinde travma sonrası stres ile kaygı arasındaki ilişkide aleksitiminin aracı rolü
Year 2025,
Volume: 9 Issue: 2, 205 - 214, 25.08.2025
Pervin Tunç
,
Ayşegül Akgün Sütçü
,
Margörit Rita Krespi Ülgen
Abstract
COVID-19 pandemisinde, kaygı ve travma sonrası stres bozukluğunu da içeren birçok psikolojik sorunun düzeyinde artış olmuştur. Aleksitimi önemli bir psikolojik sorun olarak değerlendirilebilir. Bununla birlikte, kaçınma gibi semptomları paylaştıkları için travma sonrası stres belirtileri, anksiyete belirtileri ve aleksitimi arasında ayrım yapmak zor olabilir. Psikolojik müdahalelerin geliştirilebilmesi için aleksitiminin travma sonrası stres belirtileri ve anksiyete belirtilerini ne ölçüde etkilediğinin belirlenmesi yararlı olacaktır. Bu çalışma, Türkiye'de COVID-19 pandemisinde travma sonrası stres belirtilerinin anksiyete ile ilişkisinde aleksitiminin aracı etkisini incelemiştir. Örneklem, yaşları 18 ile 68 arasında değişen 417 erkek ve kadın yetişkinden oluşmuştur. İlişkileri incelemek için Pearson moment korelasyon katsayıları ve yapısal eşitlik modellemesi yapılmıştır. Veriler Demografik Bilgi Formu, Travma Sonrası Stres Bozukluğu Kontrol Listesi, Beck Anksiyete Envanteri ve Toronto Aleksitimi Envanteri kullanılarak toplanmıştır. Bulgular, travma sonrası stres belirtilerinin aleksitimi ve anksiyete belirtileriyle, aleksitiminin ise anksiyete belirtileriyle anlamlı düzeyde ilişkili olduğunu göstermiştir. Ayrıca aleksitiminin, travma sonrası stres belirtileri ile kaygı ilişkisinde kısmi aracılık etkisine sahip olduğu bulunmuştur. Bulgular, ruh sağlığı uzmanlarının travma sonrası stres belirtileri ve kaygı belirtileri gösteren bireyleri değerlendirirken ve tedaviyi planlarken aleksitimiyi dikkate almalarının önemine işaret etmektedir.
Ethical Statement
The study was approved by the ethics committee of Istanbul Arel University, (Date 29.04.2022; Approval number 2022/08).
Supporting Institution
No fund was obtained for this study.
Project Number
Not applicable
Thanks
Conflicts of interest/Competing interests: There is no conflict of interest.
Informed consent: Informed consent was obtained from all participants included in the study.
Project/Funding: No fund was obtained for this study.
Data Sharing/Availability: Data is available upon reasonable request.
Authors’ Contributions: All authors contributed to the conceptualization and design of the study. AAS gathered data and conducted data analysis. All authors contributed to the interpretation of the findings and the writing of the manuscript.
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-
Boysan, M., Ozdemir, P. G., Ozdemir, O., Selvi, Y., Yilmaz, E. & Kaya, N. (2017). Psychometric properties of the Turkish version of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5). Psychiatry and Clinical Psychopharmacology, 27(3), 306-316.
-
Brooks, S. K., Webster, R. K., Smith, L. H., Woadland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920.
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-
Damerdji, F., Rotsaert, M., Wacquier, B., Hein, M., & Loas, G. (2022). Prevalence and relationships between alexithymia, anhedonia, depression and anxiety during the Belgian COVID-19 pandemic lockdown. International Journal of Environmental Research Public Health, 19(22), 15264.
-
Darrow, S. M., & Follette, W. C. (2014). A behavior analytic interpretation of alexithymia. Journal of Contextual Behavioral Science, 3(2), 98-108.
-
Edwards, E. R. (2019). Posttraumatic stress and alexithymia: A meta-analysis of presentation and severity. Psychological Trauma: Theory, Research, Practice, Policy, 14(7), 1192.
-
Fang, S., Chung, M. C., & Wang, Y. (2020). The impact of past trauma on psychological distress: The roles of defense mechanisms and alexithymia. Frontiers in Psychology, 11, 992.
-
Feyzioğlu, A., Taşlıoğlu Sayıner, A. C., Özçelik, D., Tarımtay Altun, F., & Budak, E. N. (2023). The mediating role of early maladaptive schemas in the relationship between early childhood trauma and alexithymia. Current Psychology, 42(21), 17851-17861.
-
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Fukunishi, I., Numata, Y., & Hattori, M. (1994). Alexithymia and defense mechanisms in myocardial infarction. Psychological Reports, 75(1), 219-223.
-
Gross, J. J., & Levenson, R. W. (1993). Emotional suppression: Physiology, self-report, and expressive behavior. Journal of Personality and Social Psychology, 64(6), 970-986.
-
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-
Hogeveen, J., & Grafman, J. (2021). Alexithymia. Handbook of Clinical Neurology, 183, 47-62.
-
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema
construct. Social Cognition, 7(2), 113-136.
-
Janoff‐Bulman, R. (1992). Shattered assumptions. Free Press. Janoff‐Bulman, R., & Frieze, I. H. (1983). A theoretical perspective for understanding reactions to victimization. Journal of Social Issues, 39(2), 1-17.
-
Karaca Dinç, P., Oktay, S., & Durak Batıgün, A. (2021). Mediation role of alexithymia, sensory processing sensitivity and emotional-mental processes between childhood trauma and adult psychopathology: A self-report study. BMC Psychiatry, 21(1), 1-10.
-
Kim, N., Park, I., Lee, Y. J., Jeon, S., Kim, S., Lee, K. H., Park, J., Kim, H. K., Gwaq, A. R., Jun, J. Y., Yoo, S. Y., Lee, S. H., & Kim, S. J. (2020). Alexithymia and frontal–amygdala functional connectivity in North Korean refugees. Psychological Medicine, 50(2), 334-341.
-
Kline, R. B. (1998). Principles and practice of structural equation modeling. The Guilford Press.
-
Li, R., Kajanoja, J., Lindblom, J., Korja, R., Karlsson, L., Karlsson, H., Nolvi, S., & Karukivi, M. (2022). The role of alexithymia and perceived stress in mental health responses to COVID-19: A conditional process model. Journal of Affective Disorders, 306, 9-18.
-
Litz, B. T. (1992). Emotional numbing in combat-related post-traumatic stress disorder: A critical review and reformulation. Clinical Psychology Review, 12(4), 417-432.
-
McCaslin, S. E., Rogers, C. E., Metzler, T. J., Best, S. R., Weiss, D. S., Fagan, J. A., Liberman, A., & Marmar, C. R. (2006). The impact of personal threat on police officers' responses to critical incident stressors. The Journal of Nervous Mental Disease, 194(8), 591-597.
-
Merlo, E., Sicari, F., Frisone, F., Costa, G., Alibrandi, A., Avena, G., & Settineri, S. (2021). Uncertainty, alexithymia, suppression and vulnerability during the COVID-19 pandemic in Italy. Health Psychology Report, 9(2), 169-179.
-
Motan, I., & Gençöz, T. (2007). The relationship between the dimensions of alexithymia and the intensity of depression and anxiety. Turkish Journal of Psychiatry, 18(4), 333-343.
-
Nadeau, S. E. (2021). Neural mechanisms of emotions, alexithymia, and depression. Handbook of clinical neurology, 183, 299-313.
-
Nemiah, J., & Sifneos, P. (1970). Affect and fantasy in patients with psychosomatic disorders. In O. Hill (Ed.), Modern trends in psychosomatic medicine-2 (pp. 26-34). Butterworths.
-
Obeid, S., Lahoud, N., Haddad, C., Sacre, H., Fares, K., Akel, M., Salameh, P., & Hallit, S. (2020). Factors associated with anxiety among the Lebanese population: The role of alexithymia, self-esteem, alcohol use disorders, emotional intelligence, and stress and burnout. International Journal of Psychiatry in Clinical Practice, 24(2), 151-162.
-
Ogłodek, E. A. (2022). Alexithymia and emotional deficits related to posttraumatic stress disorder: An investigation of content and process disturbances. Case Reports in Psychiatry, 2022, 7760988.
-
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-
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-
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Alexithymia as a mediator in the relationship of posttraumatic stress with anxiety during the COVID-19 pandemic
Year 2025,
Volume: 9 Issue: 2, 205 - 214, 25.08.2025
Pervin Tunç
,
Ayşegül Akgün Sütçü
,
Margörit Rita Krespi Ülgen
Abstract
There has been an increase in the levels of many psychological problems including anxiety and post-traumatic stress disorder (PTSD), during the COVID-19 pandemic. Alexithymia can be considered an important psychological problem. However, it may be difficult to differentiate between post-traumatic stress symptoms (PTSS), anxiety symptoms, and alexithymia because they share symptoms like avoidance. To develop psychological interventions, it will be useful to determine the extent to which alexithymia influences PTSS and anxiety. This study examined alexithymia as a mediator in the relationship of PTSS with anxiety during the COVID-19 pandemic in Türkiye. The sample consisted of 417 male and female adults aged between 18 to 68. Pearson’s product moment correlation coefficients and structural equation modeling were computed to examine the relationships. Data were gathered through the Demographic Information Form, Post-Traumatic Stress Disorder Checklist, Beck Anxiety Inventory, and Toronto Alexithymia Inventory. Findings showed that PTSS was related to alexithymia and anxiety, and alexithymia was associated with anxiety. Moreover, alexithymia had a partial mediator effect in the relationship between PTSS and anxiety. The findings highlight the importance of mental health professionals considering alexithymia when evaluating and planning treatment for individuals with PTSS and anxiety.
Ethical Statement
The study was approved by the ethics committee of Istanbul Arel University, (Date 29.04.2022; Approval number 2022/08).
Supporting Institution
No fund was obtained for this study.
Project Number
Not applicable
Thanks
Conflicts of interest/Competing interests: There is no conflict of interest.
Informed consent: Informed consent was obtained from all participants included in the study.
Project/Funding: No fund was obtained for this study.
Data Sharing/Availability: Data is available upon reasonable request.
Authors’ Contributions: All authors contributed to the conceptualization and design of the study. AAS gathered data and conducted data analysis. All authors contributed to the interpretation of the findings and the writing of the manuscript.
References
-
Aker, A. T., Çelik, F., & Gündüz, N. (2022). Cinsel travma mağduru kadınlarda travmatik stres belirtileri ile diğer tıbbi nedenlerle açıklanmayan belirtiler ve aleksitiminin ilişkisi. Current Addiction Research, 6(1), 13-24.
-
Banerjee, D., Kosagisharaf, J. R., & Rao, T. S. (2021). The dual pandemic of suicide and COVID-19: A biopsychosocial narrative of risks and prevention. Psychiatry Research, 295, 113577.
-
Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. Basic Books.
-
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.
-
Beck, J. S. (1995). Cognitive therapy: Basics and beyond. The Guilford Press.
-
Beck, J. S. (2001). Bilişsel terapi temel ilkeler ve ötesi (N. H. Şahin, Trans.). Türk Psikologlar Derneği Yayınları. (Original work published 1995).
-
Berardis, D. D., Campanella, D., Nicola, S., Gianna, S., Alessandro, C., Chiara, C., Valchera, A., Marilde, C., Salerno, R., & Ferro, F. M. (2008). The impact of alexithymia on anxiety disorders: A review of the literature. Current Psychiatry Reviews, 4(2), 80-86.
-
Boysan, M., Ozdemir, P. G., Ozdemir, O., Selvi, Y., Yilmaz, E. & Kaya, N. (2017). Psychometric properties of the Turkish version of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5). Psychiatry and Clinical Psychopharmacology, 27(3), 306-316.
-
Brooks, S. K., Webster, R. K., Smith, L. H., Woadland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920.
-
Charney, D. S., Woods, S. W., Goodman, W. K., & Heninger, G. R. (1987). Neurobiological mechanisms of panic anxiety: Biochemical and behavioral correlates of yohimbine-induced panic attacks. The American Journal of Psychiatry, 144(8), 1030-1036.
-
Damerdji, F., Rotsaert, M., Wacquier, B., Hein, M., & Loas, G. (2022). Prevalence and relationships between alexithymia, anhedonia, depression and anxiety during the Belgian COVID-19 pandemic lockdown. International Journal of Environmental Research Public Health, 19(22), 15264.
-
Darrow, S. M., & Follette, W. C. (2014). A behavior analytic interpretation of alexithymia. Journal of Contextual Behavioral Science, 3(2), 98-108.
-
Edwards, E. R. (2019). Posttraumatic stress and alexithymia: A meta-analysis of presentation and severity. Psychological Trauma: Theory, Research, Practice, Policy, 14(7), 1192.
-
Fang, S., Chung, M. C., & Wang, Y. (2020). The impact of past trauma on psychological distress: The roles of defense mechanisms and alexithymia. Frontiers in Psychology, 11, 992.
-
Feyzioğlu, A., Taşlıoğlu Sayıner, A. C., Özçelik, D., Tarımtay Altun, F., & Budak, E. N. (2023). The mediating role of early maladaptive schemas in the relationship between early childhood trauma and alexithymia. Current Psychology, 42(21), 17851-17861.
-
Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20-35.
-
Frewen, P. A., Lanius, R. A., Dozois, D. J. A., Neufeld, R. W. J., Pain, C., Hopper, J. W., Densmore, M., & Stevens, T. K. (2008). Clinical and neural correlates of alexithymia in posttraumatic stress disorder. Journal of Abnormal Psychology, 117(1), 171-181.
-
Fukunishi, I., Numata, Y., & Hattori, M. (1994). Alexithymia and defense mechanisms in myocardial infarction. Psychological Reports, 75(1), 219-223.
-
Gross, J. J., & Levenson, R. W. (1993). Emotional suppression: Physiology, self-report, and expressive behavior. Journal of Personality and Social Psychology, 64(6), 970-986.
-
Güleç, H., Köse, S., Güleç, M. Y., Çitak, S., Evren, C., Borckardt, J., & Sayar, K. (2009). Reliability and factorial validity of the Turkish version of the 20-Item Toronto Alexithymia Scale (TAS-20). Psychiatry and Clinical Psychopharmacology, 19(3), 214-220.
-
Hogeveen, J., & Grafman, J. (2021). Alexithymia. Handbook of Clinical Neurology, 183, 47-62.
-
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema
construct. Social Cognition, 7(2), 113-136.
-
Janoff‐Bulman, R. (1992). Shattered assumptions. Free Press. Janoff‐Bulman, R., & Frieze, I. H. (1983). A theoretical perspective for understanding reactions to victimization. Journal of Social Issues, 39(2), 1-17.
-
Karaca Dinç, P., Oktay, S., & Durak Batıgün, A. (2021). Mediation role of alexithymia, sensory processing sensitivity and emotional-mental processes between childhood trauma and adult psychopathology: A self-report study. BMC Psychiatry, 21(1), 1-10.
-
Kim, N., Park, I., Lee, Y. J., Jeon, S., Kim, S., Lee, K. H., Park, J., Kim, H. K., Gwaq, A. R., Jun, J. Y., Yoo, S. Y., Lee, S. H., & Kim, S. J. (2020). Alexithymia and frontal–amygdala functional connectivity in North Korean refugees. Psychological Medicine, 50(2), 334-341.
-
Kline, R. B. (1998). Principles and practice of structural equation modeling. The Guilford Press.
-
Li, R., Kajanoja, J., Lindblom, J., Korja, R., Karlsson, L., Karlsson, H., Nolvi, S., & Karukivi, M. (2022). The role of alexithymia and perceived stress in mental health responses to COVID-19: A conditional process model. Journal of Affective Disorders, 306, 9-18.
-
Litz, B. T. (1992). Emotional numbing in combat-related post-traumatic stress disorder: A critical review and reformulation. Clinical Psychology Review, 12(4), 417-432.
-
McCaslin, S. E., Rogers, C. E., Metzler, T. J., Best, S. R., Weiss, D. S., Fagan, J. A., Liberman, A., & Marmar, C. R. (2006). The impact of personal threat on police officers' responses to critical incident stressors. The Journal of Nervous Mental Disease, 194(8), 591-597.
-
Merlo, E., Sicari, F., Frisone, F., Costa, G., Alibrandi, A., Avena, G., & Settineri, S. (2021). Uncertainty, alexithymia, suppression and vulnerability during the COVID-19 pandemic in Italy. Health Psychology Report, 9(2), 169-179.
-
Motan, I., & Gençöz, T. (2007). The relationship between the dimensions of alexithymia and the intensity of depression and anxiety. Turkish Journal of Psychiatry, 18(4), 333-343.
-
Nadeau, S. E. (2021). Neural mechanisms of emotions, alexithymia, and depression. Handbook of clinical neurology, 183, 299-313.
-
Nemiah, J., & Sifneos, P. (1970). Affect and fantasy in patients with psychosomatic disorders. In O. Hill (Ed.), Modern trends in psychosomatic medicine-2 (pp. 26-34). Butterworths.
-
Obeid, S., Lahoud, N., Haddad, C., Sacre, H., Fares, K., Akel, M., Salameh, P., & Hallit, S. (2020). Factors associated with anxiety among the Lebanese population: The role of alexithymia, self-esteem, alcohol use disorders, emotional intelligence, and stress and burnout. International Journal of Psychiatry in Clinical Practice, 24(2), 151-162.
-
Ogłodek, E. A. (2022). Alexithymia and emotional deficits related to posttraumatic stress disorder: An investigation of content and process disturbances. Case Reports in Psychiatry, 2022, 7760988.
-
Osimo, S. A., Aiello, M., Gentili, C., Ionta, S., & Cecchetto, C. (2021). The influence of personality, resilience, and alexithymia on mental health during COVID-19 pandemic. Frontiers in Psychology, 12, 630751.
-
Öhman, A. (2008). Fear and anxiety: Overlaps and dissociations. In Handbook of emotions (pp. 709-729). The Guilford Press.
-
Panayiotou, G., & Constantinou, E. (2017). Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability. Psychophysiology, 54(9), 1323-1334.
-
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