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Background: The construct of alexithymia implies a deficit in symbolization for emotional, somatic, and mental states. However, the etiologic factors for alexithymia have not yet been fully elucidated. The present study investigated the use of mentalizing language, i.e. the utterance of internal states, from a developmental perspective according to attachment organization and disorganization. Methods: A longitudinal design across 4 time points was applied to a volunteer sample of 42 children. At 12 months, children were tested with the strange situation procedure, the standard measure of attachment at the optimal age, and attachment classifications were taken of videotapes. At ages 17, 23, 30 and 36 months, mother and child were observed in simplified separation episodes of 30 min duration. Transcripts of the sessions were subject to coding of internal state words. Results: During the investigated span, securely attached children rapidly acquired emotion, physiology, cognition and emotion-regulatory language, whereas insecurely attached and disorganized children either completely lacked internal state language or displayed a considerable time lag in the use of emotion and cognition vocabulary. Conclusion: The results raise the possibility that alexithymia might be a consequence of deficits in the development of internal state language in the context of insecure or disorganized childhood attachment relationships. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Objective: Previous studies have established an association between number of traumatic experiences and alexithymia. The present study examines this relationship in a large-scale representative sample of the German general population (N=2,507) and explores the potential mediating effects of posttraumatic symptomatology, particularly avoidance/numbing. Methods: Alexithymia was assessed with the German version of the Toronto Alexithymia Scale (TAS-20). Posttraumatic symptomatology was operationalized by the symptom score of the modified German version of the Posttraumatic Symptom Scale, and traumatic experiences were assessed with the trauma list of the Munich Composite International Diagnostic Interview. Two mediation analyses were conducted. Results: Of the total sample, 24.2% (n=606) reported at least one traumatic experience, 10.6% (n=258) were classified as alexithymic, and 2.4% (n=59) fulfilled the criteria of posttraumatic stress disorder (PTSD). Participants who had survived five or more traumatic experiences had significantly higher alexithymia sum scores. The PTSD symptom cluster avoidance/numbing mediated the association between the number of traumatic experiences and alexithymia. Conclusions: Our findings illustrate an association between number of traumatic experiences and alexithymia and the influence of emotional avoidance and numbing within this relationship. The significant relationship between alexithymia and number of traumatic experiences in a general population sample further supports the concept of multiple and complex traumatization as associated with alexithymia. The results suggest the importance of further investigations determining the causal impact of alexithymia both as a potential premorbid trait and as consequence of traumatization. Lastly, future investigations are needed to clarify alexithymia as a distinct trauma-relevant characteristic for better diagnostics and specialized trauma-integrative therapy.

Tendo em vista que os textos jornalísticos de vulgarização científica são predominantemente argumentativos, o estudo da argumentação presente neles permite elucidar algumas características de seu funcionamento textual. A análise proposta aqui privilegia o exame de dois de seus componentes centrais, considerados fundadores de sua configuração argumentativa típica: os lugares-comuns e os percursos argumentativos. Os primeiros referem-se a idéias ou modos de raciocínio socialmente aceitos e tidos como válidos independentemente de comprovação, constituindo objetos de acordo primários, com base nos quais a arguimentação se torna possível. Os segundos dizem respeito à forma como os lugares se encadeiam e sucedem no interior de um quadro argumentativo, dando forma à macroestrutura argumentativa dos textos de vulgarização científica. A análise procura demonstrar que a formulação da questão argumentativa e a escolha dos lugares-comuns determinam a forma assumida pelos percursos geradores da estrutura argumentativa e que, nos textos jornalísticos de vulgarização científica, essa estrutura tem configuração em forma de labirinto. Para tanto, o estudo se divide em três partes: na primeira, analisa-se a noção de vulgarização científica e se procura entender como pode os chamados textos de vulgarização podem se constituir como objetos analisáveis. Na segunda, busca-se um modelo analítico capaz de levar à compreensão do funcionamento dos textos de vulgarização. Na terceira, discute-se o papel dos lugares-comuns nos percursos argumentativos analisados. / The study of argumentation in popular scientific texts allows one to identify certain characteristics concerning their textual operation. An analysis of the argumentative structure of texts, in particular of those found in specialist scientific publications, shows two components essential to this type of text: the topoi (both commonplace and specialist) and the sequence of arguments. The topoi, be they true, plausible or generally accepted ideas, are at the heart of any argumentation, and it is on the basis of the topoi that the proponent constructs his persuasive reasoning. The sequence of arguments constitutes the manner in which the topoï are connected and follow one another within the argumentative structure. It brings together the discursive competence (which can be sometimes linguistic, rhetorical, logical or encyclopaedic) as well as the emotions of the advocate. In this way, the topoi give form to the micro/macrostructures arguments of the aforesaid published texts. The analysis is made starting from the components of enunciation theory, pragmatism and rhetoric and makes it possible to show that the choice of the topoi by the proponent or presenter determines the configuration or labyrintic of the arguments as presented in the text.

Background: The construct of alexithymia implies a deficit in symbolization for emotional, somatic, and mental states. However, the etiologic factors for alexithymia have not yet been fully elucidated. The present study investigated the use of mentalizing language, i.e. the utterance of internal states, from a developmental perspective according to attachment organization and disorganization. Methods: A longitudinal design across 4 time points was applied to a volunteer sample of 42 children. At 12 months, children were tested with the strange situation procedure, the standard measure of attachment at the optimal age, and attachment classifications were taken of videotapes. At ages 17, 23, 30 and 36 months, mother and child were observed in simplified separation episodes of 30 min duration. Transcripts of the sessions were subject to coding of internal state words. Results: During the investigated span, securely attached children rapidly acquired emotion, physiology, cognition and emotion-regulatory language, whereas insecurely attached and disorganized children either completely lacked internal state language or displayed a considerable time lag in the use of emotion and cognition vocabulary. Conclusion: The results raise the possibility that alexithymia might be a consequence of deficits in the development of internal state language in the context of insecure or disorganized childhood attachment relationships. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Ésta investigación tuvo como objetivo principal correlacionar la alexitimia y las conductas impulsivas en una muestra de adolescentes escolares de la Provincia de Ilo, y, además, establecer comparaciones según el sexo. Los participantes fueron adolescentes (53% hombres y 47% mujeres) entre los 13 y 18 años de edad, a quienes se les administró la Escala de Alexitimia de Toronto (1994) y el Inventario de Impulsividad de Dickman (1990). Los resultados indican que existe correlación entre la alexitimia y la impulsividad disfuncional. Se halló que dificultad para reconocer los sentimientos (rs =.36) y el pensamiento operatorio (rs =.41) correlacionaron de manera directa y moderada con la impulsividad disfuncional. Además, la dificultad para describir los sentimientos correlacionó de manera directa y baja con la impulsividad disfuncional (rs= 27) y de forma inversa y baja con la impulsividad funcional (rs= -.19). Finalmente, se halló mayor dificultad para describir y reconocer los sentimientos en las mujeres, y mayor impulsividad funcional en los hombres. / The objective of this research was to analyze the relationship between alexithymia and impulsive behaviors in a sample of school adolescents from Ilo, as well as to establish comparisons according to gender. The participants were adolescents (53% men and 47% women) between 13 and 18 years old, who were administered the Toronto Alexithymia Scale (1994) and the Dickman Impulsivity Inventory (1990). The results indicate that there is a correlation between alexithymia and dysfunctional impulsivity. Difficulty recognizing feelings (rs = .36) and the operative thinking (rs = .41) correlated directly and moderately with with dysfunctional impulsivity. In addition, the difficulty in describing feelings correlated directly and low with dysfunctional impulsivity (rs = 27) and inversely and low with functional impulsivity (rs = -.19). Finally, it was found more difficult to describe and recognize feelings in women, and greater functional impulsivity in men. / Tesis

N. Riethof - Burnout syndrome in Health Care Professionals ABSTRACT Burnout syndrome is a state of total exhaustion related to work condi- tions and prolonged stress. While initial phases of burnout resemble stress symptoms, final phases of burnout are characterized by feelings of hopelessness, loss of meaning and desperation that have similar qual- ities as depression as well as existential vacuum described by Frankl in his logotherapy. In addition, the burnout syndrome involves stages in which people detach from their emotions and feelings as a defense mechanism against stress and have decreased ability to experience their own feelings and emotional states. Burnout usually begins with feelings of enthusiasm and idealized visualizations and it is in contrast with sub- sequent disillusionment, disappointment experienced later. After decades of burnout research, there is still a need for better def- inition of this condition including more precise diagnostic criteria and internationally recognized measurement tools, especially within health care system where the risks of unrecognized and untreated burnout are high. This study is focused on examination of potential causes of burn- out and relationships of burnout symptoms with certain personality traits, defense mechanisms and coping reactions including...

Moral injury (MI) is associated with severe blame-related emotion and the development of psychopathology including posttraumatic stress disorder (PTSD). Little is known about how MI events are neurally processed when PTSD is comorbid, limiting the development of tailored interventions. Thus, this thesis sought to provide a novel, multi-method examination of the biological underpinnings of moral injury and relevant behavioural correlates. Study one provides the first investigation into the neural activation patterns elicited during MI event recall in military members and public safety personnel with PTSD, relative to MI-exposed civilian controls. In PTSD, emotional processing is challenged by heightened sensory information. Here, we provide evidence of heightened viscerosensory information processing (i.e. internal gnawing or gastrointestinal constriction related to blame-based emotion) during MI event recall, which appears to exert a strong influence over cortical regions facilitating moral cognitive processes including emotion regulation, autobiographical memory integration, and social cognition. Overwhelming visceral sensations can elicit defensive behaviour including tonic immobility (TI), a defensive response that facilitates viscerosensory dampening. Interestingly, more severe negative alterations in cognition and mood were associated with viscerosensory dampening in our PTSD group, pointing towards a compensatory pattern of emotional numbing. Studies two and three explore two posttraumatic symptoms consistent with emotional numbing: alexithymia and posttraumatic TI. In study two, we explore posttraumatic TI as a survival-based dissociative response and test a new measure of posttraumatic TI. In study three, we provide evidence that alexithymia is associated with an altered (muted) pattern of emotion-specific bodily sensation. This thesis provides a framework for embodied MI event processing in PTSD and highlights the importance of assessing the somatic experience of MI and screening for TI responses and emotional numbing as part of PTSD symptomatology. The evidence presented here suggests sensorimotor-based approaches and bottom-up regulatory strategies may be useful adjuncts to MI event processing. / Dissertation / Doctor of Philosophy (PhD) / Moral injury (MI) is a psychosocial-spiritual injury that can occur when deeply held values are violated either by oneself or a trusted other; it produces considerable pain and social alienation. MI has been linked to suicide and the development of posttraumatic stress disorder (PTSD), a mental health condition associated with distressing symptoms and reduced functioning in important areas of life, including social relationships. This thesis focuses on how MI events are processed by military members and public safety personnel, who are both at risk for MI and PTSD. We investigate how shame is experienced in the brain and body, and explore how intensified visceral sensations may become overwhelming (e.g., pit in stomach, vomiting) prompting emotional numbing or difficulties remaining embodied in the present moment (e.g., zoning out, freezing up). By understanding MI event processing when PTSD is present, we hope to gain insight into more effective treatments for these individuals.

[pt] A tomada de decisão vem sendo estudada por diversos campos do conhecimento e pode ser entendida como a capacidade de processar informações de um contexto, escolher entre duas ou mais opções e apreender com os resultados destas escolhas. Além de ser relacionada ao processamento cognitivo de informações, nas últimas décadas, diversos estudos têm apontado efeitos do processamento emocional na capacidade decisória. A alexitimia, uma condição caracterizada por dificuldades de identificar, compreender e verbalizar emoções têm sido relacionados com pior desempenho da tomada de decisão. O estresse causado pela pandemia de COVID-19 vem sendo associado com maior prevalência de transtornos mentais e alterações afetivas, contudo, poucos estudos têm explorado o impacto da COVID-19 na tomada de decisão. Sendo assim, o objetivo do presente trabalho é explorar efeitos de contexto na tomada de decisão, explorando a relação desta com níveis de alexitimia dos indivíduos e variáveis relacionadas a pandemia de COVID-19. Para concluir os objetivos desta tese, quatro manuscritos foram produzidos. No primeiro manuscrito foi apresentado uma revisão sobre a história da neuroeconomia, uma perspectiva interdisciplinar do estudo da tomada de decisão que integra cognição, comportamento e o funcionamento do sistema nervoso. O segundo manuscrito apresenta uma comparação entre duas versões brasileiras (uma convertendo o dólar ao real por valor equivalente e outra convertendo pelo câmbio) do Monetary Choice Questionnaire (MCQ-27), uma tarefa de desconto de futuro usada para medir decisões intertemporais. Este trabalho não mostrou diferenças entre as duas versões do MCQ-27. O terceiro manuscrito investigou as relações entre alexitimia e a tomada de decisão intertemporal de risco e de ambiguidade. Neste estudo a alexitimia esteve relacionada a déficits na tomada de decisão em contexto intertemporal e de ambiguidade, e não para risco. Por fim o manuscrito quatro explorou a influência da COVID-19 em ambos os contextos de tomada de decisão. Os resultados mostraram relações positivas apenas para a tomada de decisão sob risco, frente as variáveis gravidade dos sintomas de COVID-19 no participante e gravidade dos sintomas em seus familiares. Para ambos os estudos empíricos uma mesma amostra de 438 voluntários (M = 29.09 anos, DP = 7.80, 67.8 por cento mulheres) foi utilizada. Os resultados deste estudo contribuem para o entendimento da tomada de decisão e para compreensão da influência do processamento emocional e de variáveis de uma pandemia nas escolhas dos indivíduos. / [en] Decision-making has been studied by various fields of knowledge and can be understood as the ability to process information from a context, choose between two or more options, and learn from the results of these choices. In addition to being related to cognitive processing of information, in recent decades, several studies have pointed out the effects of emotion and context on decision-making ability. Alexithymia, a condition characterized by difficulties in identifying, understanding, and verbalizing emotions, has been associated with poorer decision-making performance. The stress caused by the COVID-19 pandemic has been associated with a higher prevalence of mental disorders and affective changes, however, few studies have explored the impact of COVID-19 on decision-making. Therefore, the objective of this study is to explore context effects on decision-making, investigating its relationship with individuals levels of alexithymia and variables related to the COVID-19 pandemic. To achieve the objectives of this thesis, four manuscripts were produced. The first manuscript presented a review of the history of neuroeconomics, an interdisciplinary perspective of decision-making that integrates cognition, behavior, and nervous system functioning. The second manuscript compares two Brazilian versions of the Monetary Choice Questionnaire (MCQ-27; one converting the dollar to the equivalent value of the real and the other converting it by exchange rate), a task of delay discounting used to measure intertemporal decisions. This study showed no differences between the two versions of the MCQ-27. The third manuscript investigated the relationships between alexithymia and intertemporal decision-making under risk and ambiguity. In this study, alexithymia was related to deficits in decision-making in intertemporal and ambiguous contexts, but not for risk. Finally, the fourth manuscript explored the influence of COVID-19 on both decision-making contexts. The results showed positive relationships only for decision-making under risk, with the severity of COVID-19 symptoms in the participant and severity of symptoms in their family members. For both empirical studies, a same sample of 438 volunteers (M = 29.09 years, SD = 7.80, 67.8 percent female) was used. The results of this study contribute to the understanding of decision-making and to the comprehension of the influence of alexithymia and pandemic-related variables on individuals choices.