*Article* **Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients**

**Argyro Pachi 1, Athanasios Tselebis 1,\*, Ioannis Ilias 2, Effrosyni Tsomaka 1, Styliani Maria Papageorgiou 1, Spyros Baras 1, Evgenia Kavouria <sup>1</sup> and Konstantinos Giotakis <sup>1</sup>**


**Abstract:** Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire— BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (*p* < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (*p* < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.

**Keywords:** aggression; alexithymia; sense of coherence; schizophrenia; comprehensibility
