Skip to main content Skip to main navigation menu Skip to site footer
Research Articles
Published: 2021-12-11

Alexithymia and addiction: the mediating role of stress

Bogomolets National Medical University
Pathological gambling ludomania alexithymia stress


Background. Gambling encourages people to want more money than they did at the beginning of the game. The growing availability and variety of games has made gambling a critical issue. Statistics show that out of 48.5 million Ukrainians, more than four million are players.
Objective. The purpose of this study was to determine the extent to which levels of alexithymia and stress may predict pathological gambling. The study also examines the role of stress mediators in the relationship between alexithymia and addiction.
Methods. The group of 123 male patients aged 18 to 64 years with a mean of 33 (SD = 11.5) participated in the study. Participants were selected from various rehabilitation centers in Kyiv. The study was conducted only with volunteers over 18 years of age who declared gambling and signed an informed consent.
Measuring instruments:
1) Form of demographic information
2) South Oaks Gambling Screen (SOGS)
3) Toronto Alexithymic Scale (TAS-20)
4) Psychological stress measure (PSM-25)
5) Lemyr-Tessier-Fillion PSM-25 scale
Data were collected from individuals through online surveys as well as in person. Data were analyzed using the t-test to determine the significance of differences between groups. However, no significant difference was found. Before the participants completed the survey, it was ensured that they all signed the consent form. The data was cleaned after all the data had been entered into the computer. A total of six participants who either did not answer more than half of the questions or had deviations (-3.29> z <3.29) were excluded from the study.

Results. Regression analysis showed that the amount of money betting on gambling, the total score of TAS-20 and PSM-25 significantly predicted pathological gambling. In addition, stress has a partial mediating role in the relationship between alexithymia and addiction.
Conclusion. It is claimed that people with a high level of alexithymia become prone to gambling addiction due to stress. In addition to alexithymia, stress also plays an important role in the formation of addiction. In this context, this study contributes to the relevant literature by combining alexithymia, stress, and pathological gambling in conjunction with each other.

Full-text of the article is available for this locale: Українська.


  1. Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: a meta-analytic review. Clin Psychol Rev 2010;30:217-37.
  2. American Psychiatric Association. DSM-IV-R - Diagnostic and Statistical Manual of Mental Disorders (4th ed., revised). Washington: American Psychiatric Association; 2000.
  3. American Psychiatric Association. DSM 5 - Diagnostic and statistical manual of mental disorders (5th ed). Arlington: American Psychiatric Publishing; 2013.
  4. Arcan K. Psychological predictors of problem gambling behaviors. Ankara: Yayımlanmamış doktora tezi ODTÜ; 2012.
  5. Berking M, Margraf M, Ebert D et al. Deficits in emotion-regulation skills predict alcohol use during and after cognitive-behavioral therapy for alcohol dependence. J Consult Clin Psychol. 2011;79:307-18.
  6. Bondolfi G, Jermann F, Ferrero F et al. Prevalence of pathological gambling in Switzerland after the opening of casinos and the introduction of new preventive legislation. Acta Psychiatr Scand. 2008;117:236-9.
  7. Bonnaire C, Bungener C, Varescon I. Alexithymia and gambling: a risk factor for all gamblers?. J Gambl Stud. 2013;29:83-96.
  8. Chen J, Xu T, Jing J, Chan RCK. Alexithymia and emotional regulation: A cluster analytical approach. BMC Psychiatry. 2011;11:33.
  9. Chou KL, Afifi TO. Disordered (pathologic or problem) gambling and axis I psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Am J Epidemiol. 2011;173:1289-97.
  10. Courty A, Godart N, Lalanne C et al. Alexithymia, a compounding factor for eating and social avoidance symptoms in anorexia nervosa. Compr Psychiatry. 2015;56:217-28.
  11. Dalbudak E, Evren C, Aldemir S et al. Relationship of internet addiction severity with depression, anxiety and alexithymia, temperament and character in university students. Cyberpsychol Behav Soc Netw. 2013;16:272-8.
  12. Dubey A, Pandey R, Mishra K. Role of emotion regulation difficulties and positive/negative affectivity in explaining alexithymia-health relationship: An overview. Indian Journal of Social Science Researches. 2010;7:20-31.
  13. Evren C, Kose S, Sayar K et al. Alexithymia and temperament and character model of personality in alcohol-dependent Turkish men. Psychiatry Clin Neurosci. 2008;62:371-8.
  14. Güleç H, Köse S, Güleç MY et al. Reliability and factorial validity of the Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20). Klinik Psikofarmakol Bülteni. 2009;19:214-20.
  15. Jazaieri H, Urry HL, Gross JJ. Affective Disturbance and Psychopathology: An Emotion Regulation Perspective. J Exp Psychopathol. 2013;4:584-99.
  16. Johansson A, Grant JE, Kim SW et al. Risk factors for problematic gambling: a critical literature review. J Gambl Stud. 2009;25:67-92.
  17. Kaare PR, Mottus R, Konstabel K. Pathological gambling in Estonia: relationship with personality, self-esteem, emotional states and cognitive ability. J Gambl Stud. 2009;25:377-90.
  18. Karaman MI. Küçümsenen büyük tehlike: şans oyunları ve kumar. Yeşilay Dergisi. 2014;967:6-7.
  19. Kessler RC, Hwang I, Labries R et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med. 2008;38:1351-60.
  20. Lang KB, Omori M. Can demographic variables predict lottery and parimutuel losses? An empirical investigation. J Gambl Stud. 2009;25:171-83.
  21. Lazarus RS, Folkman S. Stress, Appraisal and Coping. New York: Springer; 1984.
  22. Lesieur HR. The Chase. Cambridge: Schenkman; 1984.
  23. Lesieur HR, Blume SB. The South Oaks gambling screen (SOGS): a new instrument for the identification of pathological gamblers. Am J Psychiatry. 1987;144:1184-8.
  24. Matthews N, Farnsworth B, Griffiths MD. A pilot study of problem gambling among student online gamblers: mood states as predictors of problematic behavior. Cyberpsychol Behav. 2009;12:741-5.
  25. Mitrovic DV, Brown J. Poker mania and problem gambling: A study of distorted cognitions, motivation and alexithymia. J Gambl Stud. 2009;25:489-502.
  26. Moragas L, Granero R, Stinchfield R et al. Comparative analysis of distinct phenotypes in gambling disorder based on gambling preferences. BMC Psychiatry. 2015;5:86.
  27. Myrseth H, Brunborg GS, Eidem M. Differences in cognitive distortions between pathological and non-pathological gamblers with preferences for chance or skill games. J Gambl Stud. 2010;26:561-9.
  28. Orford J. Disabling the public interest: gambling strategies and policies for Britain. Addiction. 2005;100:1219-25.
  29. Parker JDA, Wood LM, Bond BJ et al. Alexithymia in young adulthood: a risk factor for pathological gambling. Psychother Psychosom. 2005;74:51-5.
  30. Petry NM. Pathological Gambling: Etiology, Comorbidity and Treatment. Washington: American Psychological Association; 2005.
  31. Rugancı RN. The relationship among attachment style, affect regulation, psychological distress and mental construction of the relational world. Ankara: Ortadoğu Teknik Üniversitesi, Psikoloji Bölümü; 2008.
  32. Stasiewicz PR, Bradizza CM, Gudleski GD et al. The relationship of alexithymia to emotional dysregulation within an alcohol dependent treatment sample. Addict Behav. 2012;37:469-76.
  33. Thorberg FA, Young RM, Sullivan KA et al. Alexithymia and alcohol use disorders: a critical review. Addict Behav. 2009;34:237-45.
  34. Toneatto T, Lecce J, Bagby M. Alexithymia and pathological gambling. J Addict Dis. 2009;28:193-8.
  35. Williams AD, Grisham JR, Erskine A et al. Deficits in emotion regulation associated with pathological gambling. Br J Clin Psychol. 2012;51:223-38.
  36. Wood RT, Griffiths MD. A qualitative investigation of problem gambling as an escape based coping strategy. Psychol Psychother. 2007;80:107-25.

How to Cite

Salnikova A. Alexithymia and addiction: the mediating role of stress. PMGP [Internet]. 2021 Dec. 11 [cited 2022 Nov. 27];6(4):e0604316. Available from: