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Alexithymia and Sense of Coherence in Patients With Total Spinal Cord Transection

From the School of Psychology (R.E.O., R.A., S.M.O.), University of St. Andrews, St. Andrews, Fife; and Department of Clinical Psychology (N.T.N.), Salisbury District Hospital, Salisbury, United Kingdom.

Address reprint requests to: R. E. O’Carroll, BSc, MPhil, PhD, School of Psychology, University of St. Andrews, St. Andrews, Fife, KY16 9JU, United Kingdom. Email: ronan{at}st-and.ac.uk

OBJECTIVE: The study investigated the possibility that total spinal cord transection leading to tetraplegia would affect the ability to experience and identify emotions. It also examined whether the dispositional orientation of "sense of coherence" contributed to self-rated quality of life after spinal cord transection.

METHODS: Twenty patients with total spinal cord transection at the level of the sixth cervical vertebrae and 20 age- and sex-matched healthy control subjects completed measures of alexithymia, sense of coherence, and quality of life.

RESULTS: There were no differences between the two groups on alexithymia scores. However, spinal injury patients reported significantly decreased quality of life relative to matched healthy control subjects. A strong sense of coherence was associated with better self-reported quality of life. This relationship remained after controlling for current affective status.

CONCLUSIONS: We conclude that 1) loss of afferent feedback to the brain via the spinal cord does not have a significant effect on alexithymia scores, particularly factor 1 (difficulty in identifying feelings), and 2) sense of coherence may be an important factor in determining psychological adjustment after serious injury.

Key Words: sense of coherence • spinal cord injury • emotion • alexithymia.

Abbreviations: HADS = Hospital Anxiety and Depression Scale; SOC = sense of coherence; TAS-20 = Toronto Alexithymia Scale; WHOQOL = World Health Organization Quality of Life Scale.

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