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Cited by 354Eating Disorders and BehaviorsPsychosomatic Disorders and Their TreatmentsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 112 of the 115 references it cites were found in a registry or an index.

Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale

Open access
Westwood, Heather, Kerr-Gaffney, Jess, Stahl, Daniel, Tchanturia, Kate·2017·Journal of Psychosomatic Research
DOI 10.1016/j.jpsychores.2017.06.007PMC PMC5986724
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Abstract

OBJECTIVE: The aim of this review was to synthesise the literature on the use of the Toronto Alexithymia Scale (TAS) in eating disorder populations and Healthy Controls (HCs) and to compare TAS scores in these groups. METHOD: Electronic databases were searched systematically for studies using the TAS and meta-analyses were performed to statistically compare scores on the TAS between individuals with eating disorders and HCs. RESULTS: Forty-eight studies using the TAS with both a clinical eating disorder group and HCs were identified. Of these, 44 were included in the meta-analyses, separated into: Anorexia Nervosa; Anorexia Nervosa, Restricting subtype; Anorexia Nervosa, Binge-Purge subtype, Bulimia Nervosa and Binge Eating Disorder. For all groups, there were significant differences with medium or large effect sizes between the clinical group and HCs, with the clinical group scoring significantly higher on the TAS, indicating greater difficulty with identifying and labelling emotions. CONCLUSION: Across the spectrum of eating disorders, individuals report having difficulties recognising or describing their emotions. Given the self-report design of the TAS, research to develop and evaluate treatments and clinician-administered assessments of alexithymia is warranted.

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Crossref · 10.1016/j.jpsychores.2017.06.007

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Figures

Fig. 1 Systematic review search process.
Fig. 1 Systematic review search process.CC BY · PubMed Central
Fig. 2 Funnel plot of Anorexia Nervosa (AN) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.
Fig. 2 Funnel plot of Anorexia Nervosa (AN) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.CC BY · PubMed Central
Fig. 3 Funnel plot of Anorexia Nervosa, Restricting subtype (AN-R) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.
Fig. 3 Funnel plot of Anorexia Nervosa, Restricting subtype (AN-R) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.CC BY · PubMed Central
Fig. 4 Funnel plot of Anorexia Nervosa, Binge-Purge subtype (AN-BP) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.
Fig. 4 Funnel plot of Anorexia Nervosa, Binge-Purge subtype (AN-BP) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.CC BY · PubMed Central
Fig. 5 Funnel plot of Bulimia Nervosa (BN) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.
Fig. 5 Funnel plot of Bulimia Nervosa (BN) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.CC BY · PubMed Central
Fig. 6 Funnel plot of Binge Eating Disorder (BED) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.
Fig. 6 Funnel plot of Binge Eating Disorder (BED) studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study's result.CC BY · PubMed Central
Fig. 7 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Anorexia Nervosa (AN) and Healthy Controls. CI, confidence interval.
Fig. 7 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Anorexia Nervosa (AN) and Healthy Controls. CI, confidence interval.CC BY · PubMed Central
Fig. 8 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Anorexia Nervosa, Restricting subtype (AN-R) and Healthy Controls (HC) and between Anorexia Nervosa, Binge-Purge subtype (AN-BP) and HCs. CI, confidence interval.
Fig. 8 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Anorexia Nervosa, Restricting subtype (AN-R) and Healthy Controls (HC) and between Anorexia Nervosa, Binge-Purge subtype (AN-BP) and HCs. CI, confidence interval.CC BY · PubMed Central
Fig. 9 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Bulimia Nervosa (BN) and Healthy Controls. CI, confidence interval.
Fig. 9 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Bulimia Nervosa (BN) and Healthy Controls. CI, confidence interval.CC BY · PubMed Central
Fig. 10 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Binge Eating Disorder (BED) and Healthy Controls. CI, confidence interval.
Fig. 10 Forest plot of mean TAS score: standardized mean effect size for differences (SMD) between Binge Eating Disorder (BED) and Healthy Controls. CI, confidence interval.CC BY · PubMed Central
Fig. 11 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Anorexia Nervosa (AN) and Healthy Controls (HC). CI, confidence interval.
Fig. 11 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Anorexia Nervosa (AN) and Healthy Controls (HC). CI, confidence interval.CC BY · PubMed Central
Fig. 12 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Anorexia Nervosa, Restricting subtype (AN-R) and Healthy Controls (HC). CI, confidence interval.
Fig. 12 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Anorexia Nervosa, Restricting subtype (AN-R) and Healthy Controls (HC). CI, confidence interval.CC BY · PubMed Central
Fig. 13 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Bulimia Nervosa (BN) and Healthy Controls (HC). CI, confidence interval.
Fig. 13 Forest plot of mean TAS subscale scores: standardized mean effect size for differences (SMD) between Bulimia Nervosa (BN) and Healthy Controls (HC). CI, confidence interval.CC BY · PubMed Central

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Citations

Cites

Show all 115 references

Research works printed but not linked: 3

  1. Deborde, 2008, The Bermond-Vorst Alexithymia Questionnaire cutoff scores: a study in eating-disordered and control subjects, Psychopathology, 41, 43, 10.1159/000109955 · DOI · Paper page
  2. Pollatos, 2008, Reduced perception of bodily signals in anorexia nervosa, Eat. Behav., 9, 381, 10.1016/j.eatbeh.2008.02.001 · DOI · Paper page
  3. Pollatos, 2008, Impaired central processing of emotional faces in anorexia nervosa, Psychosom. Med., 70, 701, 10.1097/PSY.0b013e31817e41e6 · DOI

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Metadata

Authors
Westwood, H., Kerr-Gaffney, J., Stahl, D., & Tchanturia, K.
Affiliations
  • King's College London (GB)
  • Ilia State University (GE)
Corresponding author
Westwood, Heather
ORCID
Venue
Journal of Psychosomatic Research
Publisher
Elsevier BV
Published
2017-08
Volume
99
Pages
66-81
ISSN
0022-3999 (ISSN-L)
DOI
10.1016/j.jpsychores.2017.06.007
PMC
PMC5986724
OpenAlex
W2624833759
Cited by
354
References
115
Citations by year
2026: 34 · 2025: 41 · 2024: 49 · 2023: 42 · 2022: 44 · 2021: 55 · 2020: 43 · 2019: 20 · 2018: 21 · 2017: 5
FWCI
3.71
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychosomatic Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
Funders
  • South London and Maudsley NHS Foundation Trust
  • Psychiatry Research Trust
  • National Institute for Health and Care Research
  • King's College London
  • Institute of Psychiatry, Psychology and Neuroscience, King’s College London
  • Medical Research Council
  • Economic and Social Research Council
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
alexithymia, eating disorders, Toronto Alexithymia Scale, anorexia nervosa, bulimia nervosa, binge eating disorder, emotional awareness, emotion recognition, healthy controls
MeSH terms
Adult, Affective Symptoms, Feeding and Eating Disorders, Canada, Emotions, Female, Humans, Male

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