Alexithymia, Ego-Dystonicity, and Obsessive-Compulsive Symptoms: A Path Modeling Analysis.

AIMS: This cross-sectional study aimed to test the path relations between alexithymia, ego-dystonicity, anxiety, depression and obsessive-compulsive (OC) symptoms in obsessive-compulsive disorder (OCD) and healthy individuals.

METHODS

Fifty-eight patients with OCD (mean age 35.5 years) and 54 healthy participants (mean age 33.5 years) completed an assessment via a structured clinical interview. All of them completed the Toronto Alexithymia Scale (TAS-20), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Self-Consistency and Congruence Scale (SCCS), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The data were analyzed using partial least squares structural equation modeling (PLS-SEM).

RESULTS

In the OCD patients, alexithymia (a linear combination of difficulty identifying and describing emotions in the self) was associated with the OC symptoms either with or without the presence of ego-dystonicity (a profile of self-inconsistency and self-stereotype). In the heathy participants, alexithymia was associated with the OC symptoms only through ego-dystonic experiences.

CONCLUSION

This study provides evidence that ego-dystonicity partially affects the association between alexithymia and obsessive-compulsions. Alexithymia and ego-dystonicity have a synergistic effect on the symptoms of OCD. Alexithymia in healthy participants associates to the OC symptoms only through ego-dystonicity. Targeting ego-dystonicity dimensions in psychotherapy would help improve the symptoms of OCD.