Alexithymia and coping profiles in autoimmune disorders: a comparative study of AIT, RA, and type 1 diabetes

Abstract

Objective: This study aimed to explore the association between alexithymia levels and the frequency of constructive coping strategies in patients with autoimmune diseases, specifically autoimmune thyroiditis (AIT), rheumatoid arthritis (RA), and type 1 diabetes mellitus (T1DM).

Method: A total of 120 participants were enrolled: 30 with AIT (14 men, 16 women, mean age 39 years), 28 with RA (8 men, 20 women, mean age 58 years), 32 with T1DM (6 men, 26 women, mean age 40 years), and 30 healthy controls (9 men, 21 women, mean age 31 years). Patients with AIT and T1DM were examined at Yaroslavl City Endocrinological Center (Russia), and patients with RA at the rheumatology department of Yaroslavl Regional Clinical Hospital (Russia). The control group was recruited from the patients’ social circles without these diseases. Patients were assessed using the Method for the Determination of Individual Coping Strategies (E. Heim), the Toronto Alexithymia Scale (TAS), K. Izard’s Differential Emotions Scale (adapted by A. V. Leonova), and the Dembo-Rubinstein Self-Esteem Assessment (modified by A. M. Prikhozhan). Statistical analyses were performed using Statistica 13, employing Spearman’s rank correlation coefficient and the Mann-Whitney U test.

Results: Higher alexithymia levels were associated with reduced use of constructive coping strategies across all patient groups (p<0.01). The RA group exhibited the highest mean alexithymia score (74.46), followed by AIT (69.80) and T1DM (59.30). T1DM patients favored adaptive cognitive coping strategies (p=0.015), while AIT patients leaned toward adaptive behavioral coping (p=0.068). RA patients showed the least frequent use of behavioral coping strategies (p=0.048). In T1DM patients, a strong positive correlation was found between negative emotions and anxious-depressive states (r=0.74, p<0.001), while anxious-depressive emotions negatively correlated with behavioral coping (r=–0.45, p<0.05). Additionally, higher alexithymia levels were associated with reduced positive emotions (r=–0.54, p<0.01) and increased self-dissatisfaction (r=0.45, p<0.05), with self-dissatisfaction inversely related to emotional coping (r=–0.51, p<0.01).

Conclusions: Patients with chronic autoimmune diseases demonstrate elevated alexithymia levels compared to healthy controls, which negatively impacts their ability to employ adaptive coping strategies. Tailored psychotherapeutic interventions are recommended to address emotional expression issues in these populations.