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Alexithymia and Avoidance Coping Following Traumatic Brain Injury

Wood, Rodger Ll. PhD; Doughty, Caitríona MSc

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: March/April 2013 - Volume 28 - Issue 2 - p 98–105
doi: 10.1097/HTR.0b013e3182426029
Original Articles

Background: Individuals who develop maladaptive coping styles after traumatic brain injury (TBI) usually experience difficulty expressing their emotional state, increasing the risk of psychological distress. Difficulties expressing emotion and identifying feelings are features of alexithymia, which is prevalent following TBI.

Objective: To examine the relations among coping styles, alexithymia, and psychological distress following TBI.

Participants: Seventy-one patients with TBI drawn from a head injury clinic population and 54 demographically matched healthy controls.

Main Measures: Toronto Alexithymia Scale-20, Estonian COPE-D Inventory, Beck Depression Inventory-II, and Beck Anxiety Inventory.

Results: The participants with TBI exhibited significantly higher rates of alexithymia and psychological distress and lower levels of task-oriented coping than healthy controls. Levels of avoidance coping and psychological distress were significantly higher in a subgroup of TBI patients with alexithymia than in a non-alexithymic TBI subsample. There were significant relations among alexithymia, avoidance coping, and levels of psychological distress. Regression analysis revealed that difficulty identifying feelings was a significant predictor for psychological distress.

Conclusion: Early screening for alexithymia following TBI might identify those most at risk of developing maladaptive coping mechanisms. This could assist in developing early rehabilitation interventions to reduce vulnerability to later psychological distress.

Brain Injury Research Group, Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.

Corresponding Author: Rodger Ll. Wood, PhD, Department of Psychology, School of Human and Health Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom (

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.