Alexithymia and insomnia

The purpose of the present study was (1) to investigate the association between insomnia and alexithymia, as measured by the Toronto Alexithymia Scale (TAS-20) and its subscales, and (2) to test if the TAS-20 and its subscales show the same correlational pattern with anxiety, depression and perfectionism in insomnia patients as has previously been found in non-clinical samples. A consecutive series of 259 insomnia patients were compared with a community sample. Although the insomnia patients scored significantly higher on the TAS-20, this difference disappeared when trait anxiety was controlled for, and was primarily due to patients who suffered from insomnia associated with another psychiatric disorder. All insomnia groups, however, showed elevated scores on the TAS-20 subscale Externally Oriented Thinking (EOT). The correlational analysis showed moderate to high correlations between the TAS-20 (and its subscales Difficulties Identifying Feelings and Difficulties Describing Feelings, although not the EOT) and measures of depression, anxiety and perfectionism, thus replicating a pattern from non-clinical samples. The results are discussed in terms of externally oriented thinking being an interesting dimension of alexithymia, which is (a) not confounded by negative emotion and standards of performance, and (b) shows generally elevated scores in insomnia patients.