Furthering the language hypothesis of alexithymia: An integrated review and meta-analysis

Improving the Objective Measurement of Alexithymia Using a Computer-Scored Alexithymia Provoked Response Questionnaire with an Online Sample

The study and measurement of alexithymia - a trait marked by difficulty identifying and describing feelings - can be improved by incorporating objective measures to supplement self-report scales. The Alexithymia Provoked Response Questionnaire (APRQ) is an observer-rated alexithymia tool that shows promise yet can be time-consuming to administer. The present study aimed to assess the feasibility of computer administration and scoring of the APRQ. Further, the APRQ's association with verbal IQ and emotional vocabulary use was examined, as was the relationship between the APRQ and the self-report Bermond-Vorst Alexithymia Questionnaire-B (BVAQ-B). Adult participants (n = 366), including a proportion gathered through purposive sampling, participated in an online study. Inter-rater reliability measures indicated that computerized scoring of the APRQ is as reliable as human scoring, making the measure scalable for use with large samples. Alexithymia levels were independent of two measures of verbal IQ. Correlational analyses indicated overlap in alexithymia as measured by the APRQ and most of the subscales of the BVAQ-B. The APRQ, as an objective measure, may capture deficits in emotional awareness independent of self-insight.

Childhood language development and alexithymia in adolescence: an 8-year longitudinal study

Alexithymia (difficulties identifying and describing feelings) predicts increased risks for psychopathology, especially during the transition from childhood to adolescence. However, little is known of the early contributors to alexithymia. The language hypothesis of alexithymia suggests that language deficits play a primary role in predisposing language-impaired groups to developing alexithymia; yet longitudinal data tracking prospective relationship between language function and alexithymia are scarce. Leveraging data from the Surrey Communication and Language in Education cohort (N = 229, mean age at time point 1 = 5.32 years, SD = 0.29, 51.1% female), we investigated the prospective link between childhood language development and alexithymic traits in adolescence. Results indicated that boys with low language function at ages 4-5 years, and those who later met the diagnostic criteria for language disorders at ages 5-6 years, reported elevated alexithymic traits when they reached adolescence. Parent-reported child syntax abilities at ages 5-6 years revealed a dimensional relationship with alexithymic traits, and this was consistent with behavioral assessments on related structural language abilities. Empirically derived language groups and latent language trajectories did not predict alexithymic traits in adolescence. While findings support the language hypothesis of alexithymia, greater specificity of the alexithymia construct in developmental populations is needed to guide clinical interventions.

Alexithymia modulates emotion concept activation during facial expression processing

Alexithymia is characterized by difficulties in emotional information processing. However, the underlying reasons for emotional processing deficits in alexithymia are not fully understood. The present study aimed to investigate the mechanism underlying emotional deficits in alexithymia. Using the Toronto Alexithymia Scale-20, we recruited college students with high alexithymia (n = 24) or low alexithymia (n = 24) in this study. Participants judged the emotional consistency of facial expressions and contextual sentences while recording their event-related potentials. Behaviorally, the high alexithymia group showed longer response times versus the low alexithymia group in processing facial expressions. The event-related potential results showed that the high alexithymia group had more negative-going N400 amplitudes compared with the low alexithymia group in the incongruent condition. More negative N400 amplitudes are also associated with slower responses to facial expressions. Furthermore, machine learning analyses based on N400 amplitudes could distinguish the high alexithymia group from the low alexithymia group in the incongruent condition. Overall, these findings suggest worse facial emotion perception for the high alexithymia group, potentially due to difficulty in spontaneously activating emotion concepts. Our findings have important implications for the affective science and clinical intervention of alexithymia-related affective disorders.

How word meaning structure relates to executive functioning and theory of mind in children with developmental language disorder: A multiple case study

Background and aims

Many children with developmental language disorder (DLD) have difficulties in executive functioning (EF) and theory of mind (ToM). These difficulties might be explained by the theory that children's conceptual understanding changes over five stages of word meaning structure, from concrete and context-dependent to abstract and precise. We present a multiple case study examining how word meaning structure relates to EF and ToM in children with DLD.

Methods

Participants were five children with DLD aged 9-12 and five typically developing children matched for age, gender, and nonverbal intelligence. Word meaning structure was assessed using new dynamic test. EF was assessed using the Zoo Map Task and Behavioral Rating Inventory for EF. ToM was assessed using the ToM test, Frith-Happé Animations, and Bermond-Vorst Alexithymia Questionnaire. Behavioral problems were measured using the Child Behavior Checklist. Anamnestic interviews with the parents were conducted to describe the case histories.

Results

For the children with DLD, lower scores in the word meaning structure task were observed compared to those observed for their matched peers, with no statistical test applied. Word meaning structure related positively to EF and ToM, but not to behavioral problems. Instances in which word meaning structure dissociates from EF and ToM are discussed in individual case descriptions.

Conclusions

By linking language to conceptual development, variations in word meaning structure may explain some EF and ToM difficulties in children with DLD.

Implications

The present study offers a basis for future research on the relationships among word meaning structure, EF, and ToM.

Alexithymia in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates, and relationship with neurocognition and empathy

INTRODUCTION

Alexithymia is highly prevalent and strongly related to adverse consequences in patients with schizophrenia. However, its associated factors remain largely unexplored. The present study aimed to determine the prevalence of alexithymia and its association with sociocultural characteristics, clinical symptoms, neurocognition, and empathy in 854 Chinese patients with schizophrenia.

METHOD

Demographic information was collected through a self-designed questionnaire. Alexithymia was assessed by the Toronto Alexithymia Scale (TAS-20). We assessed clinical symptoms, neurocognition, and empathy via the following instruments: Positive and Negative Syndrome Scale, Repeatable Battery for the Assessment of Neuropsychological Status, and Interpersonal Reactivity Index. A multiple logistic regression model was conducted to determine the independent correlates of alexithymia.

RESULTS

Approximately one-third (n = 277, 32%) of patients with schizophrenia had alexithymia. Patients with alexithymia had significantly more severe negative symptoms, neurocognition, and empathy impairment than patients without alexithymia. Being male, negative symptoms, personal distress, empathic concern, and language functioning were independently associated with alexithymia.

DISCUSSION

Our findings demonstrate a high prevalence of alexithymia and its strong association with clinical symptoms, neurocognition, and empathy, which calls for timely screening and intervention for alexithymia in patients with schizophrenia. Targeting impaired language function, negative symptoms, and impaired affective empathy might help reduce alexithymia and its related negative consequences.