Reductions in Alexithymia and Emotion Dysregulation after Training Emotional Self-Awareness Following Traumatic Brain Injury: A Phase i Trial

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Objectives: To examine the acceptability and initial efficacy of an emotional self-awareness treatment at reducing alexithymia and emotion dysregulation in participants with traumatic brain injury (TBI). Setting: An outpatient rehabilitation hospital. Participants: Seventeen adults with moderate to severe TBI and alexithymia. Time postinjury ranged 1 to 33 years. Design: Within subject design, with 3 assessment times: baseline, posttest, and 2-month follow-up. Intervention: Eight lessons incorporated psychoeducational information and skill-building exercises teaching emotional vocabulary, labeling, and differentiating self-emotions; interoceptive awareness; and distinguishing emotions from thoughts, actions, and sensations. Measures: Toronto Alexithymia Scale-20 (TAS-20); Levels of Emotional Awareness Scale (LEAS); Trait Anxiety Inventory (TAI); Patient Health Questionnaire-9 (PHQ-9); State-Trait Anger Expression Inventory (STAXI); Difficulty With Emotion Regulation Scale (DERS); and Positive and Negative Affect Scale (PANAS). Results: Thirteen participants completed the treatment. Repeated-measures analysis of variance revealed changes on the TAS-20 (P =.003), LEAS (P <.001), TAI (P =.014), STAXI (P =.015), DERS (P =.020), and positive affect (P <.005). Paired t tests indicated significant baseline to posttest improvements on these measures. Gains were maintained at follow-up for the TAS, LEAS, and positive affect. Treatment satisfaction was high. Conclusion: This is the first study published on treating alexithymia post-TBI. Positive changes were identified for emotional self-awareness and emotion regulation; some changes were maintained several months posttreatment. Findings justify advancing to the next investigational phase for this novel intervention.

Original languageEnglish (US)
Pages (from-to)286-295
Number of pages10
JournalJournal of Head Trauma Rehabilitation
Issue number5
StatePublished - Jan 1 2017



  • affect
  • aggression
  • alexithymia
  • anxiety
  • brain injury
  • emotion
  • emotion regulation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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