Alexithymia, Ego-Dystonicity, and Obsessive-Compulsive Symptoms: A Path Modeling Analysis

This cross-sectional study aimed to test the path relations between alexithymia, ego-dystonicity, anxiety, depression and obsessive-compulsive (OC) symptoms in obsessive-compulsive disorder (OCD) and healthy individuals.

Fifty-eight patients with OCD (mean age 35.5 years) and 54 healthy participants (mean age 33.5 years) completed an assessment via a structured clinical interview. All of them completed the Toronto Alexithymia Scale (TAS-20), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Self-Consistency and Congruence Scale (SCCS), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The data were analyzed using partial least squares structural equation modeling (PLS-SEM).

In the OCD patients, alexithymia (a linear combination of difficulty identifying and describing emotions in the self) was associated with the OC symptoms either with or without the presence of ego-dystonicity (a profile of self-inconsistency and self-stereotype). In the heathy participants, alexithymia was associated with the OC symptoms only through ego-dystonic experiences.

This study provides evidence that ego-dystonicity partially affects the association between alexithymia and obsessive-compulsions. Alexithymia and ego-dystonicity have a synergistic effect on the symptoms of OCD. Alexithymia in healthy participants associates to the OC symptoms only through ego-dystonicity. Targeting ego-dystonicity dimensions in psychotherapy would help improve the symptoms of OCD.