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=0.32, 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.