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Lyvers M, Thorberg FA. Alexithymia and Alcohol Use: Evaluating the Role of Interoceptive Sensibility with the Revised Multidimensional Assessment of Interoceptive Awareness. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023:1-13. [PMID: 37361346 PMCID: PMC10072022 DOI: 10.1007/s10862-023-10034-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 06/28/2023]
Abstract
Alexithymia has been linked to risky or problematic alcohol use, with a common interpretation invoking deficient emotion regulation and use of alcohol to cope with distress. An alternative explanation positing a general deficit of interoception in alexithymia suggested that poor awareness of internal cues of overconsumption may promote excessive drinking. The present study assessed predictions based on these hypotheses in 337 young adult alcohol users recruited online. Participants completed validated questionnaire indices of alcohol use, alexithymia, emotion regulation, interoceptive sensibility, and sensitivity to reward and punishment. Alcohol use was positively correlated with alexithymia and reward sensitivity, and negatively correlated with emotion regulation as expected, but was uncorrelated with interoceptive sensibility. Alexithymia was not significantly correlated with most dimensions of interoceptive sensibility but was highly negatively correlated with emotion regulation. Hierarchical regression controlling for demographic variables indicated that alexithymia, emotion regulation, sex, and sensitivity to reward and punishment were significant predictors of alcohol use levels. Bootstrapped mediation test controlling for all other variables indicated mediation of the association between alexithymia and alcohol use by deficient emotion regulation but not interoceptive sensibility. Results supported the emotion regulation deficit interpretation of the association of alexithymia with alcohol use. Limitations concerning interoception measurement, online samples, self-report measures, cross-sectional designs, and collection of data during the COVID-19 pandemic are discussed. Future research could follow up on these findings by testing interoceptive accuracy in addition to interoceptive sensibility in relation to alexithymia and alcohol use.
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Lyvers M, Truncali J, Stapleton P, Thorberg FA. Alexithymia, reward sensitivity and excessive exercise in non-binge-eaters versus severe binge eaters: Implications for primary and secondary exercise dependence. CURRENT PSYCHOLOGY 2022; 42:1-14. [PMID: 35967495 PMCID: PMC9363868 DOI: 10.1007/s12144-022-03511-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/19/2022]
Abstract
A distinction has been made between primary and secondary exercise dependence, with the latter defined as excessive exercise secondary to disordered eating and weight concerns. Based on theoretical considerations from research on the roles of trait factors in addictions, the present study used validated scales to assess alexithymia, sensitivity to reward and punishment, emotion regulation and interoception in relation to exercise dependence symptoms in Australian male and female non-binge eaters (n = 228) and severe binge eaters (n = 126) aged 18-30 yr. In both groups, exercise dependence symptoms were significantly positively associated with reward sensitivity and interoceptive awareness, with the latter two variables predicting exercise dependence symptoms in hierarchical regression models; punishment sensitivity was significantly negatively related to such symptoms. Alexithymia was significantly associated with exercise dependence symptoms only in non-binge eaters; in severe binge eaters, alexithymia explained 0% of unique variance. Male sex was associated with more exercise dependence symptoms in severe binge eaters only. Participants in the severe binge group scored significantly higher on measures of exercise dependence, alexithymia, risky alcohol use, and sensitivity to reward and punishment, and significantly lower on emotion regulation, compared to those in the non-binge group. Hierarchical regression models explained 25% of variance in exercise dependence symptoms in non-binge-eaters and 43% in severe binge eaters. Findings are discussed in terms of the distinction between primary and secondary exercise dependence, the role of alexithymia, study limitations including data collection during the COVID-19 pandemic in Australia, and suggestions for future research.
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Lyvers M, Kelahroodi M, Udodzik E, Stapleton P, Thorberg FA. Alexithymia and binge eating: Maladaptive emotion regulation strategy or deficient interoception? Appetite 2022; 175:106073. [PMID: 35568089 DOI: 10.1016/j.appet.2022.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
Alexithymia has been linked to various excessive behaviors as a likely risk factor, including binge eating. Such relationships are often attributed to deficient emotional self-regulation in alexithymia, ostensibly leading to the use of maladaptive, externalized behaviors as strategies for coping with distress. An alternative view is that alexithymia reflects a fundamental deficit of interoceptive awareness that, in the case of binge eating, would suggest that internal satiety cues are poorly recognized, promoting overconsumption. The present study assessed the relationship between alexithymia and binge eating in the context of these competing hypotheses. A large online sample of young adults (n = 532) completed validated measures of alexithymia, emotion regulation, interoception, binge eating, emotional eating motivation, and sensitivity to reward and punishment. Correlations were as expected except for interoception, which showed minimal association with alexithymia or binge eating. In a hierarchical regression controlling for age, gender, education level and student status as covariates, binge eating was predicted by emotional eating motivation, emotion regulation (a negative predictor), alexithymia, and reward sensitivity, with the final model explaining 53% of variance in binge eating. Bootstrapped path analyses controlling for all other variables indicated that the relationship between alexithymia and binge eating was mediated by deficient emotion regulation but not deficient interoception, and that the relationships of both alexithymia and emotion regulation with binge eating were mediated by emotional eating motivation. Results are consistent with the notion that the association of alexithymia with binge eating reflects deficient emotion regulation in alexithymia, which can lead to adoption of maladaptive, externalized behaviors such as binge eating for coping with distress.
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Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, Gold Coast, Qld, 4229, Australia.
| | | | - Emily Udodzik
- School of Psychology, Bond University, Gold Coast, Qld, 4229, Australia
| | - Peta Stapleton
- School of Psychology, Bond University, Gold Coast, Qld, 4229, Australia
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Wang Z, Goerlich KS, Xu P, Luo Y, Aleman A. Perceptive and Affective Impairments In Emotive Eye-Region Processing in Alexithymia. Soc Cogn Affect Neurosci 2022; 17:912-922. [PMID: 35277722 PMCID: PMC9527467 DOI: 10.1093/scan/nsac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/13/2022] [Accepted: 02/20/2022] [Indexed: 12/02/2022] Open
Abstract
Alexithymia is characterized by impairments in emotion processing, frequently linked to facial expressions of emotion. The eye-region conveys information necessary for emotion processing. It has been demonstrated that alexithymia is associated with reduced attention to the eyes, but little is known regarding the cognitive and electrophysiological mechanisms underlying emotive eye-region processing in alexithymia. Here, we recorded behavioral and electrophysiological responses of individuals with alexithymia (ALEX; n = 25) and individuals without alexithymia (NonALEX; n = 23) while they viewed intact and eyeless faces with angry and sad expressions during a dual-target rapid serial visual presentation task. Results showed different eye-region focuses and differentiating N1 responses between intact and eyeless faces to anger and sadness in NonALEX, but not in ALEX, suggesting deficient perceptual processing of the eye-region in alexithymia. Reduced eye-region focus and smaller differences in frontal alpha asymmetry in response to sadness between intact and eyeless faces were observed in ALEX than NonALEX, indicative of impaired affective processing of the eye-region in alexithymia. These findings highlight perceptual and affective abnormalities of emotive eye-region processing in alexithymia. Our results contribute to understanding the neuropsychopathology of alexithymia and alexithymia-related disorders.
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Affiliation(s)
- Zhihao Wang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Magnetic Resonance Imaging Center, Center for Brain Disorders and Cognitive Sciences, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Katharina S Goerlich
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen 518106, China
| | - Yuejia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Magnetic Resonance Imaging Center, Center for Brain Disorders and Cognitive Sciences, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China
- College of Teacher Education, Qilu Normal University, Jinan 250200, China
- The Research Center of Brain Science and Visual Cognition, Medical School, Kunming University of Science and Technology, Kunming 650031, China
| | - André Aleman
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Magnetic Resonance Imaging Center, Center for Brain Disorders and Cognitive Sciences, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Lyvers M, Sweetnam T, Thorberg FA. Alexithymia, rash impulsiveness, and reward sensitivity in relation to symptoms of exercise dependence in physically active young adults. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1981747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, Gold Coast, Australia
| | - Taylor Sweetnam
- School of Psychology, Bond University, Gold Coast, Australia
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Wang Z, S Goerlich K, Luo Y, Xu P, Aleman A. Social-Specific Impairment of Negative Emotion Perception in Alexithymia. Soc Cogn Affect Neurosci 2021; 17:387-397. [PMID: 34406408 PMCID: PMC8972281 DOI: 10.1093/scan/nsab099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/25/2022] Open
Abstract
Alexithymia has been characterized as an impaired ability of emotion processing and regulation. The definition of alexithymia does not include a social component. However, there is some evidence that social cognition may be compromised in individuals with alexithymia. Hence, emotional impairments associated with alexithymia may extend to socially relevant information. Here, we recorded electrophysiological responses of individuals meeting the clinically relevant cutoff for alexithymia (ALEX; n = 24) and individuals without alexithymia (NonALEX; n = 23) while they viewed affective scenes that varied on the dimensions of sociality and emotional valence during a rapid serial visual presentation task. We found that ALEX exhibited lower accuracy and larger N2 than NonALEX in the perception of social negative scenes. Source reconstruction revealed that the group difference in N2 was localized at the dorsal anterior cingulate cortex. Irrespective of emotional valence, ALEX showed stronger alpha power than NonALEX in social but not non-social conditions. Our findings support the hypothesis of social processing being selectively affected by alexithymia, especially for stimuli with negative valence. Electrophysiological evidence suggests altered deployment of attentional resources in the perception of social-specific emotional information in alexithymia. This work sheds light on the neuropsychopathology of alexithymia and alexithymia-related disorders.
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Affiliation(s)
- Zhihao Wang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Katharina S Goerlich
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Yuejia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Faculty of Psychology, Beijing Normal University, Beijing, China.,Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Pengfei Xu
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China.,Great Bay Neuroscience and Technology Research Institute (Hong Kong), Kwun Tong, Hong Kong
| | - André Aleman
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518060, China.,Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Lyvers M, Senturk C, Thorberg FA. Alexithymia, impulsivity and negative mood in relation to internet addiction symptoms in female university students. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1942985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Michael Lyvers
- School of Psychology, Bond University, Gold Coast, Australia
| | - Cagla Senturk
- School of Psychology, Bond University, Gold Coast, Australia
| | - Fred Arne Thorberg
- School of Psychology, University of Queensland, Saint Lucia, Australia
- School of Psychology and Counseling, Queensland University of Technology, Brisbane, Australia
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Are perfectionism dimensions risk factors for bulimic symptoms? A meta-analysis of longitudinal studies. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.09.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Amianto F, Bertorello A, Migliore F, Abbate-Daga G, Fassino S. Alexithymia in anorexia and bulimia: Ubiquitous and primary trait? COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1185994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- F. Amianto
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - A. Bertorello
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - F. Migliore
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - G. Abbate-Daga
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - S. Fassino
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
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Nowakowski ME, McFarlane T, Cassin S. Alexithymia and eating disorders: a critical review of the literature. J Eat Disord 2013; 1:21. [PMID: 24999402 PMCID: PMC4081716 DOI: 10.1186/2050-2974-1-21] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 04/25/2013] [Indexed: 02/05/2023] Open
Abstract
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.
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Affiliation(s)
- Matilda E Nowakowski
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
| | - Traci McFarlane
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada ; Eating Disorder Program, The Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Stephanie Cassin
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
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