Alexithymia is no risk factor for exacerbation in spasmodic torticollis patients

Adaptive and maladaptive emotion processing and regulation, and the case of alexithymia

In this conceptual review, we discuss models of emotion and its regulation and identify a spectrum of processes that characterise adaptive adjustment to the affective environment. We describe a dynamic-phasic model of emotion processing and regulation, focusing on five stages: anticipation, response, recovery, habituation and rest as part of a cascade of responses to emotional challenges, as these become progressively expected, proximal, chronic or repeated. We argue for the need to investigate beyond simple reactivity to emotional stimuli, in order to understand mental and physical health conditions where emotional dysregulation plays a role. We propose that a hallmark of an effective and adaptive emotion regulation system is its flexibility, in the service of life goals and values. Consistent with McEwen's model (1998, Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33-44), inflexible emotion regulation can lead to increased allostatic load, from frequent stress, inadequate reactivity, failed shutdown and habituation, which may result in physical and mental illness. Alexithymia exemplifies inflexible emotion regulation, with dysfunctions potentially across all stages of emotion processing, both psychologically and physiologically. These maladaptive processes and their consequence on allostatic load potentially explain the association between alexithymia and physical and mental illness.

Hearing feelings: affective categorization of music and speech in alexithymia, an ERP study

Background

Alexithymia, a condition characterized by deficits in interpreting and regulating feelings, is a risk factor for a variety of psychiatric conditions. Little is known about how alexithymia influences the processing of emotions in music and speech. Appreciation of such emotional qualities in auditory material is fundamental to human experience and has profound consequences for functioning in daily life. We investigated the neural signature of such emotional processing in alexithymia by means of event-related potentials.

Methodology

Affective music and speech prosody were presented as targets following affectively congruent or incongruent visual word primes in two conditions. In two further conditions, affective music and speech prosody served as primes and visually presented words with affective connotations were presented as targets. Thirty-two participants (16 male) judged the affective valence of the targets. We tested the influence of alexithymia on cross-modal affective priming and on N400 amplitudes, indicative of individual sensitivity to an affective mismatch between words, prosody, and music. Our results indicate that the affective priming effect for prosody targets tended to be reduced with increasing scores on alexithymia, while no behavioral differences were observed for music and word targets. At the electrophysiological level, alexithymia was associated with significantly smaller N400 amplitudes in response to affectively incongruent music and speech targets, but not to incongruent word targets.

Conclusions

Our results suggest a reduced sensitivity for the emotional qualities of speech and music in alexithymia during affective categorization. This deficit becomes evident primarily in situations in which a verbalization of emotional information is required.

The cognitive and affective alexithymia dimensions in the regulation of sympathetic responses

OBJECTIVE

The literature regarding research into alexithymia and sympathetic responses is far from consistent. An explanation might be on the way subjects are classified. Generally, subjects are diagnosed as either alexithymic or non-alexithymic on the basis of questionnaires focusing on the cognitive aspects of alexithymia. However, alexithymia, as originally defined, concerns both emotion-affective and emotion-cognitive deficits. The aim of the present paper is to study the importance of the affective and cognitive alexithymia components in the regulation of sympathetic responses.

METHODS

Subjects, who scored extremely (either high or low) on both the cognitive and the affective components of alexithymia, were shown neutral and emotional pictures, while their GSR was measured.

RESULTS

The affective alexithymia component, not the cognitive component, turned out to be an important factor in the regulation of GSR peak amplitude. The results further indicate a significant interaction of type of emotional deficit (cognitive by affective) on GSR latency times. Finally, suggestive evidence indicated that baselines values, defined by the levels during the second preceding the stimulus, are related to the cognitive component of alexithymia, in the sense that higher emotion-cognitive capacities result in higher baseline values.

CONCLUSIONS

We cautiously conclude that the classification of alexithymics on the basis of both the affective and cognitive components, rather than on the basis of the cognitive component only, might provide more consistent research results, and thus lead to a better understanding of emotional physiological responses in alexithymic subjects.

Regulation of emotions during experimental stress in alexithymia

OBJECTIVE

The aim of this study was to examine whether deficits in emotion regulation manifest as a relative lack of congruence between subjective reports of emotion and autonomic activity when confronted with stressors.

METHODS

A pool of 830 university students was screened using the Toronto Alexithymia Scale-Revised for deficits in emotion regulation associated with alexithymia. Those meeting a criterion floor cutoff and other inclusion criteria composed the experimental group and were matched on age, gender, and race to those in the control group. A final sample size of 94 students (47 in each group) was presented with experimental stressor tasks (the Stroop task and a conversation task) in counterbalanced order while autonomic activity data (heart rate and skin conductance) and subjective reports of negative affect were continuously collected during baseline, stressor exposure, and recovery periods. Data were analyzed to determine relative differences in congruence between the autonomic and subjective measures.

RESULTS

Data suggested that participants high in emotion regulation deficits reported consistently higher subjective negative affect relative to those without such deficits throughout baseline, stressor exposure, and recovery periods. However, autonomic activity remained nearly identical in both groups across phases. Explicit tests of group differences in congruence between autonomic and subjective emotion measures also partly supported evidence of subjective hyperarousal.

CONCLUSIONS

Deficits in emotion regulation, as evidenced in those with high levels of the alexithymic trait, appear to manifest as chronically elevated subjective negative affect relative to autonomic activity regardless of the level of environmental demands. Theoretical and clinical implications of these findings are discussed.