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. 2021 Mar 24:12:637802.
doi: 10.3389/fpsyg.2021.637802. eCollection 2021.

Associations Between Mental Health, Interoception, Psychological Flexibility, and Self-as-Context, as Predictors for Alexithymia: A Deep Artificial Neural Network Approach

Darren J Edwards  1 , Rob Lowe  2
Affiliations

Associations Between Mental Health, Interoception, Psychological Flexibility, and Self-as-Context, as Predictors for Alexithymia: A Deep Artificial Neural Network Approach

Darren J Edwards et al. Front Psychol. .

Abstract

Background: Alexithymia is a personality trait which is characterized by an inability to identify and describe conscious emotions of oneself and others. Aim: The present study aimed to determine whether various measures of mental health, interoception, psychological flexibility, and self-as-context, predicted through linear associations alexithymia as an outcome. This also included relevant mediators and non-linear predictors identified for particular sub-groups of participants through cluster analyses of an Artificial Neural Network (ANN) output. Methodology: Two hundred and thirty participants completed an online survey which included the following questionnaires: Toronto alexithymia scale; Acceptance and Action Questionnaire 2 (AQQII); Positive and Negative Affect Scale (PANAS-SF), Depression, Anxiety, and Stress Scale 21 (DAS21); Multidimensional Assessment of Interoceptive Awareness (MAIA); and the Self-as-Context (SAC) scale. A stepwise backwards linear regression and mediation analysis were performed, as well as a cluster analysis of the non-linear ANN upper hidden layer output. Results: Higher levels of alexithymia were associated with increased psychological inflexibility, lower positive affect scores, and lower interoception for the subscales of "not distracting" and "attention regulation." SAC mediated the relation between emotional regulation and total alexithymia. The ANNs accounted for more of the variance than the linear regressions, and were able to identify complex and varied patterns within the participant subgroupings. Conclusion: The findings were discussed within the context of developing a SAC processed-based therapeutic model for alexithymia, where it is suggested that alexithymia is a complex and multi-faceted condition, which requires a similarly complex, and process-based approach to accurately diagnose and treat this condition.

Keywords: alexithymia; interoception; process based therapy; psychological flexibility; self-as-context.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Tests of normality using the P-P plot of regression standardized residuals: Total (top left), DDF (top right), DIF (bottom left), EOT (bottom right).
Figure 2
Figure 2
Tests of homoscedasticity with scatterplots of regression standardized residuals where the DVs are: Total (top), DDF (seconds from top), DIF (second from bottom), EOT (bottom).
Figure 3
Figure 3
Schematic representation of (above) a deep five-layer (17 × 30 × 30 × 30 × 3) ANN as used in Network 1, and (below) a deep five-layer (17 × 30 × 30 × 30 × 1) ANN as used in Networks 2, 3, and 4.
Figure 4
Figure 4
The mediated relationship, where emotional regulation interoception (x) predicts alexithymia total (y) and self as context (SAC, Mi) mediates this relationship. *p < 0.05; **p < 0.01; ***p < 0.001.
Figure 5
Figure 5
A partial mediated relationship, where attentional regulation interoception (x) predicts alexithymia total (y), and psychological flexibility (AAQ-II, Mi) partially mediates this relationship. *p < 0.05; **p < 0.01; ***p < 0.001.
See this image and copyright information in PMC

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