Examining longitudinal changes in alexithymia and depressive symptoms following acquired brain injury

Alexithymia and depressive symptoms are common following acquired brain injury (ABI). However, their longitudinal relationship remains unclear. This study examined trajectories of alexithymia and depressive symptoms over 24 months post-injury and tested their temporal associations.

Adults with ABI (N = 116) (mean age = 44 years, 61% male, 82% moderate to severe ABI) were assessed at baseline (within two years post-injury), 3, 12, and 24 months using the Perth Alexithymia Questionnaire and the depression subscale of the Depression, Anxiety, Stress Scale. Bayesian latent growth models, and cross-lagged panel models were used to examine change, co-development, and directional relationships.

Mean alexithymia scores remained stable across timepoints, whereas depressive symptoms showed modest improvement. Both constructs exhibited moderate temporal stability, and were associated at baseline, demonstrating co-occurrence in early recovery. No consistent directional relationship was observed, and overall model fit was poor. Additionally, there was substantial missingness at 24 months (75%).

These findings suggest that alexithymia is relatively stable in the first two years following ABI and commonly co-occurs with depressive symptoms early after injury. However, there is no clear longitudinal direction association. Early assessment of emotional processing and mood may help identify individuals at risk for ongoing psychological difficulties.