The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees

Objective: The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms. Methods: The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D). Results: TAS-20 scores were positively correlated with IES-R scores (r = 0.21, p < 0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r = 032, p < 0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t = 2.10, p < 0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t = 2.90, p < 0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas. Conclusion: The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms. (C) 2014 Elsevier Inc. All rights reserved.