Alexithymia is linked to neurocognitive, psychological, neuroendocrine, and immune dysfunction in persons living with HIV

Brain Behav Immun. 2014 Feb:36:165-75. doi: 10.1016/j.bbi.2013.10.024. Epub 2013 Nov 1.

Abstract

The neuropathological changes resulting from Human Immunodeficiency Virus (HIV) infection may manifest in alexithymia (AL), a multidimensional trait characterized by impairments in the cognitive assimilation of feelings and emotions. A sample of 93 HIV survivors scoring high, i.e., ⩾74 on the 26-item Toronto Alexithymia Scale (TAS-26), were compared to 79 low AL (TAS-26⩽54) survivors on measures of neurocognitive, psychological, neuroendocrine and immune function. Neurocognitive function was evinced by a standardized test of psychomotor speed, cognitive flexibility and task switching ability, HIV Dementia and general cognitive status. Patients were also screened for levels of depression, anxiety and psychological stress. A 24-h urinary norepinephrine (NE) and cortisol (CORT) collection was taken; blood was drawn for T lymphocyte subset counts (CD4+CD3+) and HIV-1 viral load. Alexithymic patients exhibited higher levels of executive dysfunction, psychological distress, norepinephrine-to-cortisol (NE/CORT) ratio and viral load. Linear regression models accounting for sociodemographic and disease-related variables revealed two AL subscales, difficulties identifying and describing feelings, predicted and explained a significant proportion of variance in the outcome measures. Specifically, poorer executive task-switching/cognitive flexibility was associated with greater difficulty describing feelings; dysregulated autonomic response (high NE/CORT ratio) and depressive symptoms were predicted by difficulty identifying feelings; higher levels of anxiety and psychological stress were both predicted by greater difficulty describing and identifying feelings. Overall, the psychoneuroimmunological profile of alexithymia in HIV positive persons at mid-stage of infection suggests a greater vulnerability for disease progression.

Keywords: Alexithymia; Cortisol; Depression; Executive function; HIV/AIDS; Norepinephrine; Stress; Viral load.

MeSH terms

  • Adult
  • Affective Symptoms / etiology
  • Affective Symptoms / immunology*
  • Affective Symptoms / psychology*
  • Cognition Disorders / complications*
  • Cognition Disorders / psychology
  • Cognition Disorders / urine
  • Female
  • HIV Infections / complications*
  • HIV Long-Term Survivors / psychology
  • Humans
  • Hydrocortisone / urine
  • Male
  • Neuropsychological Tests
  • Norepinephrine / urine
  • Stress, Psychological* / immunology
  • T-Lymphocytes / metabolism

Substances

  • Hydrocortisone
  • Norepinephrine