Alexithymia moderates effects of psychotherapeutic treatment expectations on depression outcome in interdisciplinary chronic pain treatment

Previous research has shown that patient's treatment expectations predict outcome in the multimodal therapy for chronic pain. Alexithymia, defined as the difficulty to identify, describe and express one's own feelings, may moderate treatment expectations and thereby effect treatment outcome. Accordingly, the aim of the current study is to examine the moderating role of alexithymia on the association of psychotherapeutic treatment expectation on depression outcome. 213 chronic pain inpatients completed a set of standardized self-report questionnaires, assessing alexithymia, psychotherapeutic treatment motivation and depression. A hierarchical linear regression model tested the moderating effect of alexithymia on the relationship of psychotherapeutic treatment expectations with depression as outcome variable. Both, alexithymia and psychotherapeutic treatment expectations predicted treatment outcome independently, and alexithymia moderated the effect of psychotherapeutic treatment expectations on outcome, above and beyond the effects of control variables. This study supports the beneficial role of positive psychotherapeutic treatment expectations in an interdisciplinary chronic pain treatment, and suggest to consider difficulties in identifying and describing feelings (alexithymia) in clinical decisions. •Alexithymia predicts depression outcome.•Psychotherapeutic treatment expectations predict depression outcome.•Alexithymia moderates the outcome prediction by expectations.•Patients with high levels of alexithymia and low expectations show poorest outcomes.