Illicit drug use in strength athletes

Derived from clinical observationaldata, the alexi thymia construct encompasses several ofthe charac teristics discussed or alluded to by Coltart, including (a) difficulty identifying and describing affects, (b) an inability to use affects as signals ofinner conflict or of responses to external situations, (c) restricted imagi native processes, as evidenced by a paucity of dreams and fantasies, and (d) an externally-oriented cogni tive style. Lacking access to feelings and other inner experiences, alexithymic individuals tend to focus on and amplify the physiological component of emotional arousal. This is thought to explain their tendency to somatisation and their proneness to dis charging tension through binge-eating, substance abuse, and other compulsive activities —¿ behaviours that were first reported in this type of patient by Horney(1952). While some psychiatrists associate psychological mindedness with socioeconomic status, educational level, and intelligence, our research with the TAS has shown no relationship between alexithymia and these variables in normal adults. Investigations with the TAS have also provided considerable empirical support for the validity of both the scale and the alexithymia construct (Taylor & Bagby, 1988). For example, factor analysis studies of the TAS have demonstrated a stable and replicable 4-factor struc ture theoretically congruent with the alexithymia construct. In addition, the TAS has been shown to correlatein predicteddirectionswith measures of other constructs, including the psychological mindedness subscale of the California Personality Inventory, the Need for Cognition Scale, the Anger Expression Scale, and the Short Imaginal Processes Inventory. Consistent with Coltart's view that the prospect of successful treatment is influenced by the level of psychological-mindedness, the TAS was also found to correlate strongly and negatively with Barron's Ego Strength Scale, a test that was designed to predict successful response to psychotherapy. Given their unsuitability for analytical psycho therapies, patients who are not psychologically minded have been largely neglected by psychoana lysts. The formulation and validation of the alexithymia construct, however, has focused atten tion on this difficult group of patients and prompted some analysis to devise modified psychotherapeutic techniques for treating them (Krystal, 1988, Taylor, 1987). Gi@ain TAYLOR MICHAEL BAGBY JAMES PAR@w@ Department of Psychiatry University of Toronto and Mount Sinai Hospital Toronto, Canada References