The influence of alexithymia on psychological distress with regard to the seriousness of complicated grief and the time since bereavement in the Japanese general population

Introduction: The current study investigated whether the influence of alexithymia on psychological distress (PD) differed according to the seriousness of complicated grief (CG) and the time since bereavement in the Japanese general population. Methods: 1162 participants between 40 and 79 years of age (effective response rate: 58.8%) completed a cross-sectional anonymous questionnaire regarding the following factors: alexithymia (DD: Difficulty describing feeling, DI: Difficulty identifying feeling, EO: Externally oriented thinking), PD, and CG. To compare the non-bereaved (group 1) with four other groups, which were organized by CG score (high/low) and the time since bereavement (within half/two years postloss); the half year-low/high CG (group 2 and 3) and the two years-low/high CG (group 4 and 5), a simultaneous analysis of the five groups with standard maximum likelihood estimations was performed and hypothesized models were verified. Results: The model (RMSEA=0.000, AIC=57.686) showed that the models' constructions for group 1 and 4 were significantly similar. In the other groups, the degree of correlation between alexithymia (especially EO) and psychological distress was significantly different. Limitations: The study is a cross-sectional design and not with a clinical population. Conclusions: Our findings showed that the relationship between alexithymia and psychological distress was significantly same for group 1 and 4. In group 2, EO was less correlated with the other subscales of alexithymia, which suggests that EO is utilized as a coping style for bereavement that, in turn, influences convalescence during the half year following bereavement.