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Simoncini G, Borghesi F, Mancuso V, Pedroli E, Cipresso P. Assessing alexithymia: the proposal of a psychometric tool based on spheric videos. Front Hum Neurosci 2024; 18:1375342. [PMID: 38562229 PMCID: PMC10982385 DOI: 10.3389/fnhum.2024.1375342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
The present perspective introduces a novel psychometric tool designed to enhance the evaluation of alexithymia. Alexithymia, a condition marked by difficulties in recognizing and expressing emotions, along with a propensity to direct attention outside rather than toward one's own interior experiences, is commonly investigated through self-report questionnaires. These instruments assume that individuals have sufficient self-awareness and abstraction capabilities, which restricts the understanding of the underlying mechanisms of emotional recognition in individuals who do not possess these capacities. To address this lack, emerging technologies like virtual reality (VR) and 360° videos facilitate the recreation of immersive contexts, enabling subjects to engage with scenarios even remotely. Our innovative tool employs spherical video technology to recreate social and non-social scenarios that elicit emotions. Psychophysiological measures are collected during video observation; then, questions are asked to investigate how the subject consciously processes the emotions they experienced. This multimodal approach aims to capture both implicit and explicit emotion processing, providing a comprehensive assessment. Overall, the proposed psychometric tool offers the potential for a more nuanced understanding of alexithymic traits and their real-life impact, empowering clinicians to tailor treatment processes to individual needs based on a richer set of information.
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Affiliation(s)
| | | | | | - Elisa Pedroli
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Surber C, Hoepfel D, Günther V, Kersting A, Rufer M, Suslow T, Bodenschatz CM. Deployment of attention to facial expressions varies as a function of emotional quality-but not in alexithymic individuals. Front Psychiatry 2024; 15:1338194. [PMID: 38510803 PMCID: PMC10950908 DOI: 10.3389/fpsyt.2024.1338194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Background Alexithymia is a risk factor for emotional disorders and is characterized by differences in automatic and controlled emotion processing. The multi-stimulus free-viewing task has been used to detect increased negative and reduced positive attentional biases in depression and anxiety. In the present eye-tracking study, we examined whether lexical emotional priming directs attention toward emotion-congruent facial expressions and whether alexithymia is related to impairments in lexical priming and spontaneous attention deployment during multiple face perception. Materials and methods A free-viewing task with happy, fearful, angry, and neutral faces shown simultaneously was administered to 32 alexithymic and 46 non-alexithymic individuals along with measures of negative affect and intelligence. Face presentation was preceded by masked emotion words. Indices of initial orienting and maintenance of attention were analyzed as a function of prime or target category and study group. Results Time to first fixation was not affected by prime category or study group. Analysis of fixation duration yielded a three-way interaction. Alexithymic individuals exhibited no prime or target category effect, whereas non-alexithymic individuals showed a main effect of target condition, fixating happy faces longer than neutral and angry faces and fearful faces longer than angry faces. Discussion Our results show evidence of attentional biases for positive and fearful social information in non-alexithymic individuals, but not in alexithymic individuals. The lack of spontaneous attentional preference for these social stimuli in alexithymia might contribute to a vulnerability for developing emotional disorders. Our data also suggest that briefly presented emotion words may not facilitate gaze orientation toward emotion-congruent stimuli.
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Affiliation(s)
- Chiara Surber
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Dennis Hoepfel
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Vivien Günther
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (PUK), University of Zurich, Zurich, Switzerland
- Center for Psychiatry and Psychotherapy, Clinic Zugersee, Triaplus AG, Zug, Switzerland
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Charlott Maria Bodenschatz
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Sancassiani F, Montisci R, Meloni L, Nardi AE, Carta MG. Why is it Important to Assess and Treat Alexithymia in the Cardiologic Field? An Overview of the Literature. Clin Pract Epidemiol Ment Health 2023; 19:e174501792307140. [PMID: 37916203 PMCID: PMC10507214 DOI: 10.2174/17450179-v19-230810-2022-ht15-4764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 11/03/2023]
Abstract
Background Alexithymia has been found to be associated with several somatic illnesses, such as cardiovascular, indicating that it might be a risk factor for early death in the long-term course of post-myocardial infarction. From the cardiology perspective, the aim was to collect current evidence about the relationship between alexithymia and somatic illness. Methods The literature was synthesized and summarized in a narrative format. The literature search was carried out in PubMed. Pertinent studies published in the last 50 years written in English were included and organized by three main topics ("The relation between alexithymia and somatic illness from the cardiology perspective"; "How do assess alexithymia?"; "Treating alexithymia") to be discussed. Results High alexithymia is a dimensional trait that affects around 10% of the general population and up to 55% of people with essential hypertension. Also, the link between alexithymia and cardiovascular activity has been pointed out. There are several validated tools to assess alexithymia, as well as treatment options. Conclusion Knowledge about the main features of alexithymia, as well as its assessment and treatment, can promote a multifactorial approach to the primary, secondary, and tertiary prevention of cardiac diseases.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Roberta Montisci
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Luigi Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
| | - Antonio Egidio Nardi
- Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E, SS 554 bivio Sestu 09042 Monserrato (CA), Italy
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Coppini S, Lucifora C, Vicario CM, Gangemi A. Experiments on real-life emotions challenge Ekman's model. Sci Rep 2023; 13:9511. [PMID: 37308555 DOI: 10.1038/s41598-023-36201-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
Ekman's emotions (1992) are defined as universal basic emotions. Over the years, alternative models have emerged (e.g. Greene and Haidt 2002; Barrett 2017) describing emotions as social and linguistic constructions. The variety of models existing today raises the question of whether the abstraction provided by such models is sufficient as a descriptive/predictive tool for representing real-life emotional situations. Our study presents a social inquiry to test whether traditional models are sufficient to capture the complexity of daily life emotions, reported in a textual context. The intent of the study is to establish the human-subject agreement rate in an annotated corpus based on Ekman's theory (Entity-Level Tweets Emotional Analysis) and the human-subject agreement rate when using Ekman's emotions to annotate sentences that don't respect the Ekman's model (The Dictionary of Obscure Sorrows). Furthermore, we investigated how much alexithymia can influence the human ability to detect and categorise emotions. On a total sample of 114 subjects, our results show low within subjects agreement rates for both datasets, particularly for subjects with low levels of alexithymia; low levels of agreement with the original annotations; frequent use of emotions based on Ekman model, particularly negative one, in people with high levels of alexithymia.
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Affiliation(s)
- Sara Coppini
- Department of Philosophy and Communication, University of Bologna, Bologna, Italy
| | - Chiara Lucifora
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy.
- Department of Philosophy and Communication, University of Bologna, Bologna, Italy.
| | - Carmelo M Vicario
- Department of Cognitive Science, University of Messina, Messina, Italy
| | - Aldo Gangemi
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
- Department of Philosophy and Communication, University of Bologna, Bologna, Italy
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Lee KS, Murphy J, Catmur C, Bird G, Hobson H. Furthering the language hypothesis of alexithymia: An integrated review and meta-analysis. Neurosci Biobehav Rev 2022; 141:104864. [PMID: 36087760 DOI: 10.1016/j.neubiorev.2022.104864] [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: 05/20/2022] [Revised: 08/26/2022] [Accepted: 09/04/2022] [Indexed: 11/27/2022]
Abstract
Alexithymia, including the inability to identify and express one's own feelings, is a subclinical condition responsible for some of the socioemotional symptoms seen across a range of psychiatric conditions. The language hypothesis of alexithymia posits a language-mediated disruption in the development of discrete emotion concepts from ambiguous affective states, exacerbating the risk of developing alexithymia in language-impaired individuals. To provide a critical evaluation, a systematic review and meta-analysis of 29 empirical studies of language functioning in alexithymia was performed. A modest association was found between alexithymia and multi-domain language deficits (r = -0.14), including structural language, pragmatics, and propensity to use emotional language. A more theoretically-relevant subsample analysis comparing alexithymia levels in language-impaired and typical individuals revealed larger effects, but a limited number of studies adopted this approach. A synthesis of 11 emotional granularity studies also found an association between alexithymia and reduced emotional granularity (r = -0.10). Language impairments seem to increase the risk of alexithymia. Heterogeneous samples and methods suggest the need for studies with improved alexithymia assessments.
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom; Yale Child Study Center, Yale School of Medicine, United States.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - Geoffrey Bird
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom
| | - Hannah Hobson
- Department of Psychology, University of York, United Kingdom
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Blose BA, Schenkel LS. Theory of Mind and Alexithymia in Deaf and Hard-of-Hearing Young Adults. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2022; 27:179-192. [PMID: 35253852 DOI: 10.1093/deafed/enac001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/28/2021] [Accepted: 02/05/2022] [Indexed: 06/14/2023]
Abstract
The aim of the current study was to examine theory of mind (ToM), the ability to infer the mental states of others, in young adults who are deaf and hard-of-hearing (DHH), and to explore the influence of alexithymia, an inability to understand emotions of the self and others, on ToM performance in this group. Compared to participants with typical hearing, DHH participants displayed significantly lower affective ToM skills and greater alexithymia. After accounting for verbal intelligence quotient, hearing status and alexithymia significantly contributed to poorer ToM performance, accounting for over 14% of the variance. Having a parent who is deaf and being part of the Deaf community were associated with better emotion processing and appear to be important protective factors. Findings provide support that ToM difficulties may linger into young adulthood among DHH individuals and that alexithymia may be a contributing factor. Early intervention programs emphasizing emotional understanding, perspective-taking, and communication skills are warranted for DHH children as well as their caregivers.
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Affiliation(s)
- Brittany A Blose
- Department of Psychology, Rochester Institute of Technology, Rochester, New York, USA
| | - Lindsay S Schenkel
- Department of Psychology, Rochester Institute of Technology, Rochester, New York, USA
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Luminet O, Nielson KA, Ridout N. Cognitive-emotional processing in alexithymia: an integrative review. Cogn Emot 2021; 35:449-487. [PMID: 33787442 DOI: 10.1080/02699931.2021.1908231] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Alexithymia is a multifaceted personality construct characterised by difficulties identifying one's feelings and distinguishing them from bodily sensations, difficulties describing one's feelings to others, and an externally oriented cognitive style. Over the past 25 years, a burgeoning body of research has examined how alexithymia moderates processing at the cognition-emotion interface. We review the findings in five domains: attention, appraisals, memory, language, and behaviours. The preponderance of studies linked alexithymia with deficits in emotion processing, which was apparent across all domains, except behaviours. All studies on behaviours and a proportion of studies in other domains demonstrated emotional over-responding. Analysis at the facet level revealed deficits in memory and language that are primarily associated with externally oriented thinking, while over-responding was most often linked to difficulty identifying feelings and difficulty describing feelings. The review also found evidence for contextual modulation: The pattern of deficits and over-responding was not restricted to emotional contexts but also occurred in neutral contexts, and in some circumstances, emotional over-responding in alexithymia was beneficial. Taken together, this review highlights alexithymia as a central personality dimension in the interplay between cognition and emotion.
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Affiliation(s)
- Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain, Louvain-la-Neuve, Belgium.,Fund for Scientific Research (FRS-FNRS), Belgium
| | - Kristy A Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, USA.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
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9
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Vermeulen N, Corneille O, Luminet O. A mood moderation of the Extrinsic Affective Simon Task. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.621] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Using an Extrinsic Affective Simon Task (EAST), we provide the first‐ever systematic examination of the role of affective states (negative and positive affectivity, depression, anxiety) and personality traits (alexithymia, optimism) in automatic evaluation effects. Results revealed that the EAST effect was negatively associated with depressive mood even if others affective states and traits were simultaneously entered in a regression model. These findings could reflect a preference for a systematic information processing style elicited during sadness. More generally, the present findings suggest that implicit attitudes measures that capitalise on automatic evaluation effects may lack validity when measuring attitudes of individuals who have negative emotional states. Individual measures relating to affective differences may thus contribute to better predicting the implicit attitude‐behaviour link. Copyright © 2007 John Wiley & Sons, Ltd.
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Affiliation(s)
- Nicolas Vermeulen
- Université catholique de Louvain, Belgium
- Belgian National Fund for Scientific Research, Belgium
| | | | - Olivier Luminet
- Université catholique de Louvain, Belgium
- Belgian National Fund for Scientific Research, Belgium
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10
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Vermeulen N, Toussaint J, Luminet O. The influence of Alexithymia and music on the Incidental Memory for Emotion Words. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.758] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Alexithymia is a multifaceted personality construct which encompasses difficulties in identifying and expressing feelings along with an externally oriented cognitive style. We investigated whether congruent vs. incongruent emotional musical priming (happy and angry music) during encoding would moderate the effects of alexithymia on recognition rates. We found that high alexithymia scorers recognized fewer joy and anger words than low scorers. Angry music decreased recognition rates in high alexithymia scorers compared to low alexithymia scorers. The congruency and incongruency effects between music and words depended on alexithymia level. The anger deficit in high alexithymia scorers and the possible support provided by happiness cues are discussed. Copyright © 2010 John Wiley & Sons, Ltd.
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Affiliation(s)
- Nicolas Vermeulen
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
- Belgian National Fund for Scientific Research, Belgium
| | - Julie Toussaint
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
| | - Olivier Luminet
- Psychology Department, Université catholique de Louvain at Louvain-la-Neuve, Belgium
- Belgian National Fund for Scientific Research, Belgium
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11
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Abstract
Alexithymia is a deficit in the recognition, expression and regulation of emotions, which has the following features: difficulty in identifying or describing feelings, difficulty distinguishing between feelings and bodily sensations, stringent imaginal processes, and externally oriented cognitive style. This personality trait is associated with many psychiatric and psychosomatic disorders, as well as with risky behaviors.
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Affiliation(s)
| | - Antônio Jaeger
- Department of Psychology, Universidade Federal de Minas Gerais, Brazil.,Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição e Ensino, São Carlos, SP, Brazil
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Preece D, Becerra R, Robinson K, Dandy J, Allan A. The psychometric assessment of alexithymia: Development and validation of the Perth Alexithymia Questionnaire. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.05.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Poquérusse J, Pastore L, Dellantonio S, Esposito G. Alexithymia and Autism Spectrum Disorder: A Complex Relationship. Front Psychol 2018; 9:1196. [PMID: 30065681 PMCID: PMC6056680 DOI: 10.3389/fpsyg.2018.01196] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/20/2018] [Indexed: 02/05/2023] Open
Abstract
Alexithymia is a personality construct characterized by altered emotional awareness which has been gaining diagnostic prevalence in a range of neuropsychiatric disorders, with notably high rates of overlap with autism spectrum disorder (ASD). However, the nature of its role in ASD symptomatology remains elusive. Here, we distill research at the intersection of alexithymia and ASD. After a brief synopsis of the studies that plaid a pioneering role in the identification of the overlapping fields between alexithymia and ASD, we comb the literature for evidence of its overlap with ASD in terms of prevalence, etiology, and behaviors. Through a formalized framework of the process of emotional interpretation and expression, we explore evidence for where and how deficits arise in this complex network of events. We portray how these relate to the dynamic interplay between alexithymic and autistic traits and find emerging evidence that alexithymia is both a cause and consequence of autistic behaviors. We end with a strategic proposal for future research and interventions to dampen the impacts of alexithymia in ASD.
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Affiliation(s)
- Jessie Poquérusse
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Sara Dellantonio
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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Preece D, Becerra R, Allan A, Robinson K, Dandy J. Establishing the theoretical components of alexithymia via factor analysis: Introduction and validation of the attention-appraisal model of alexithymia. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Alexithymia is thought to reflect a deficit in the cognitive capacity to process emotions. Prior research suggests that emotional valence has a memory enhancing effect in poor conceptual learning conditions. This study addressed the question of whether incidental learning of emotional words is a function of alexithymic tendencies. Incidental learning is unintentional learning that results from other activities. The 20-item Toronto Alexithymia Scale (TAS-20) and measures of depression and verbal intelligence were administered to 30 nonclinical subjects (15 women, 15 men) whose mean age was 35.5 yr. ( SD = 8.6) along with a sequential word-word evaluation task. Partial correlations indicated that the TAS-20 subscale, Difficulties identifying feelings was negatively correlated with recall of positive distractor words but not with recall of neutral distractors or recall of positive or negative target words. Emotional valence appears to have less organizational power in the memory of individuals with difficulties in recognizing their feelings.
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Affiliation(s)
- Thomas Suslow
- Department of Psychiatry, School of Medicine, University of Münster, Germany.
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Emotion processing deficits in alexithymia and response to a depth of processing intervention. Biol Psychol 2014; 103:212-22. [DOI: 10.1016/j.biopsycho.2014.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/20/2022]
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17
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Esin RG, Gorobets EA, Galiullin KR, Esin OR. Alexithymia - baseline trends of research. Zh Nevrol Psikhiatr Im S S Korsakova 2014; 114:148-151. [DOI: 10.17116/jnevro2014114121148-151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
An extensive body of research on the alexithymia construct is reviewed to show how various empirical methodologies can be used to evaluate the validity and increase our understanding of theoretical and clinically derived psychoanalytic concepts. The historical background of alexithymia and the theoretical framework in which the construct was formulated are presented, after which measurement- and experiment-based approaches to construct validation are described. This is followed by a review of empirical investigations that have yielded evidence that alexithymia is a dimensional personality trait associated with several illnesses of interest to psychoanalysts. Empirical research also supports clinical observations and impressions that individuals with high degrees of alexithymia principally employ primitive defenses, have a limited capacity for empathy, exhibit deficits in mentalization, and do not respond well to traditional interpretive psychotherapies. Also reviewed is empirical research that implicates genetic and environmental/developmental factors in the etiology of alexithymia, in particular childhood trauma and insecure attachments, factors generally associated with deficits in affect development and affect regulation. The clinical relevance of the empirical research findings is discussed in the final section.
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Boinon D, Sultan S, Charles C, Rosberger Z, Delaloge S, Dauchy S. How Social Sharing and Social Support Explain Distress in Breast Cancer After Surgery: The Role of Alexithymia. J Psychosoc Oncol 2012; 30:573-92. [DOI: 10.1080/07347332.2012.703769] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Although previous studies seem to indicate that alexithymic individuals have a deficit in their ability to recognize emotional stimuli, none had studied the relationship between alexithymia and verbal and non verbal abilities and their possible role in emotion recognition. The aim of the present study is to further investigate the relationship between alexithymia and emotion recognition ability. In particular we studied whether this relationship is mediated by verbal ability. Thirty-five students were selected from a group of 91 University students previously screened for alexithymia (Toronto Alexithymia Scale; TAS-20). Participants were shown black and white slides depicting facial expression of the following emotions: anger, sadness, disgust, surprise, happiness and fear. Compared to low alexithymic participants, and, more importantly, taking verbal IQ into account, high alexithymic and low alexithymic participants did not differ in emotion recognition.
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Goerlich KS, Witteman J, Aleman A, Martens S. Hearing feelings: affective categorization of music and speech in alexithymia, an ERP study. PLoS One 2011; 6:e19501. [PMID: 21573026 PMCID: PMC3090419 DOI: 10.1371/journal.pone.0019501] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 04/04/2011] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Katharina Sophia Goerlich
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Torres S, Guerra MP, Lencastre L, Roma-Torres A, Brandão I, Queirós C, Vieira F. Cognitive processing of emotions in anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2010; 19:100-11. [DOI: 10.1002/erv.1046] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rieffe C, Oosterveld P, Meerum Terwogt M, Novin S, Nasiri H, Latifian M. Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents: Evidence from an Iranian sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2009.11.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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The relationship between cognitive processing of affective verbal material and the basic personality structure. PSIHOLOGIJA 2010. [DOI: 10.2298/psi1003329o] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to investigate the relationship between cognitive processing of affective verbal material and the basic personality structure. For the purposes of research a new experiment was created, where affective priming was measured in a lexical decision task. The term affective priming stands for facilitation in recognition of the stimuli that comes after the presentation of stimuli of the same valence. In this experiment, two words were presented on a screen in front of the subject (stimuli-prime and stimuli-target). Those two words were of the same or different affective valence, and the subject's were instructed to respond whether the second word on the screen had a meaning or not. The basic personality structure was defined by the 'Big five' model and the Disintegration model and measured by NEO PI-R and Delta 10 questionnaires. The results of the affective priming experiment indicated a strong effect of positive facilitation and much weaker effect off negative facilitation. Two significant functions were extracted by quasicanonical correlation analysis. The first function showed correlation between the effect of positive facilitation and all of the subscales of Neuroticism, Extraversion and Conscientiousness (NEO PI-R), as well as all sub dimensions of Disintegration (DELTA 10). The second one indicated to a correlation between the negative facilitation effect and some subscales of Neuroticism, Extraversion and Agreeableness (NEO PI-R), as well as all subscales of Disintegration (DELTA 10).
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Mattila AK, Saarni SI, Salminen JK, Huhtala H, Sintonen H, Joukamaa M. Alexithymia and health-related quality of life in a general population. PSYCHOSOMATICS 2009; 50:59-68. [PMID: 19213974 DOI: 10.1176/appi.psy.50.1.59] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and, therefore, it may predispose individuals to both psychological and somatic symptoms. OBJECTIVE The authors investigated the relationship between alexithymia and health-related quality of life (HRQoL) in a nationally representative population sample of 5,418 subjects, age 30 to 97 years. METHOD Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and HRQoL measured with the 15D, a generic HRQoL measure. RESULTS Alexithymia was significantly associated with lower HRQoL independently of other variables. The TAS-20 subfactor Difficulties Identifying Feelings was the strongest common denominator between alexithymia and HRQoL. CONCLUSION Alexithymia may be a predisposing factor to poorer HRQoL.
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Affiliation(s)
- Aino K Mattila
- Tampere School of Public Health, FIN-33014, University of Tampere, Tampere, Finland.
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Humphreys TP, Wood LM, Parker JD. Alexithymia and satisfaction in intimate relationships. PERSONALITY AND INDIVIDUAL DIFFERENCES 2009. [DOI: 10.1016/j.paid.2008.09.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gu X, Liu X, Guise KG, Fossella J, Wang K, Fan J. Alexithymic trait and voluntary control in healthy adults. PLoS One 2008; 3:e3702. [PMID: 19002254 PMCID: PMC2577735 DOI: 10.1371/journal.pone.0003702] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Accepted: 10/21/2008] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Alexithymia is a personality trait characterized by deficiency in understanding, processing, or describing emotions. Recent studies have revealed that alexithymia is associated with less activation of the anterior cingulate cortex, a brain region shown to play a role in cognitive and emotional processing. However, few studies have directly investigated the cognitive domain in relation to alexithymia to examine whether alexithymic trait is related to less efficient voluntary control. METHODOLOGY/PRINCIPAL FINDINGS We examined the relationship between alexithymic trait and voluntary control in a group of healthy volunteers. We used the 20-item Toronto Alexithymia Scale (TAS-20) to measure alexithymic trait. Additionally, we examined state and trait voluntary control using the revised Attention Network Test (ANT-R) and the Adult Temperament Questionnaire (ATQ), respectively. Alexithymic trait was positively correlated with the overall reaction time of the ANT-R, and negatively correlated with the Effortful Control factor of the ATQ. CONCLUSIONS/SIGNIFICANCE Our results suggest that alexithymic trait is associated with less efficient voluntary control.
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Affiliation(s)
- Xiaosi Gu
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Xun Liu
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Kevin G. Guise
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
| | - John Fossella
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Kai Wang
- Anhui Medical University, Hefei, China
| | - Jin Fan
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
- * E-mail:
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Abstract
OBJECTIVE Even though the association between alexithymia and somatization seems plausible according to several studies with selected populations, it has not been verified in carefully controlled and nationally representative population studies. We conducted such a study to find out whether alexithymia is associated with somatization at population level. METHODS This study was a part of the Finnish Health 2000 Study. The nationally representative sample comprised 5129 subjects aged 30 to 97 years. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and somatic symptom reporting with the 12-item somatization scale derived from the Hopkins Symptom Checklist. Sociodemographic and health-related variables, including depressive and anxiety disorders, and physician verified somatic diagnoses, were treated as confounders in multivariate analyses. RESULTS Alexithymia was associated with somatization independently of somatic diseases, depression and anxiety and confounding sociodemographic variables. The TAS-20 factor scale "Difficulties Identifying Feelings" was the strongest common denominator between alexithymia and somatization. CONCLUSIONS This was the first time the independent association between alexithymia and somatization was established in a large, nationally representative nonclinical sample of both young and old adults with and without mental disorders and somatic diseases.
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Mattila AK, Ahola K, Honkonen T, Salminen JK, Huhtala H, Joukamaa M. Alexithymia and occupational burnout are strongly associated in working population. J Psychosom Res 2007; 62:657-65. [PMID: 17540223 DOI: 10.1016/j.jpsychores.2007.01.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Revised: 01/02/2007] [Accepted: 01/04/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The relationship between alexithymia and occupational burnout has not previously been studied. We investigated the association between alexithymia and occupational burnout in a representative nationwide population health study. METHODS This study was a part of the Finnish Health 2000 Study. The nationally representative sample comprised 3322 employees aged 30-64 years. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and occupational burnout with the Maslach Burnout Inventory-General Survey. Sociodemographic and health-related variables including depression were treated as confounders in the logistic regression analyses, which were performed alternately with TAS-20 total score and the scores of the three TAS-20 factor scales as alexithymia variables. RESULTS Alexithymia and its three facets were significantly associated with occupational burnout even when controlled for confounding factors. CONCLUSIONS Even though both alexithymia and depression are associated with burnout, alexithymia may be an independent risk factor for occupational burnout.
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Affiliation(s)
- Aino K Mattila
- Tampere School of Public Health, University of Tampere, Tampere, Finland.
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Mattila AK, Salminen JK, Nummi T, Joukamaa M. Age is strongly associated with alexithymia in the general population. J Psychosom Res 2007; 61:629-35. [PMID: 17084140 DOI: 10.1016/j.jpsychores.2006.04.013] [Citation(s) in RCA: 214] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2006] [Revised: 04/10/2006] [Accepted: 04/25/2006] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We studied the prevalence of alexithymia, its distribution in different age groups in a wide age range, its association with sociodemographic and health-related variables, and its co-occurrence with depression. METHODS The study forms part of the Health 2000 Study. The original sample comprised 8028 subjects representing the general adult population of Finland. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), and depression was measured with the 21-item Beck Depression Inventory. Altogether, 5454 participants filled in TAS-20 in their mother tongue. RESULTS The prevalence of alexithymia was 9.9%. Men (11.9%) were more commonly alexithymic than women (8.1%). Alexithymia was associated with male gender, increasing age, low educational level, poor perceived health, and depression. CONCLUSIONS The findings were in line with earlier population studies. For the first time, it was possible to analyze the prevalence of alexithymia in a wide age range (30-97 years). International comparative studies are needed.
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Affiliation(s)
- Aino K Mattila
- Tampere School of Public Health, University of Tampere, Tampere, Finland.
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Luminet O, Vermeulen N, Demaret C, Taylor GJ, Bagby RM. Alexithymia and levels of processing: Evidence for an overall deficit in remembering emotion words. JOURNAL OF RESEARCH IN PERSONALITY 2006. [DOI: 10.1016/j.jrp.2005.09.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vermeulen N, Luminet O, Corneille O. Alexithymia and the automatic processing of affective information: Evidence from the affective priming paradigm. Cogn Emot 2006. [DOI: 10.1080/02699930500304654] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rieffe C, Oosterveld P, Terwogt MM. An alexithymia questionnaire for children: Factorial and concurrent validation results. PERSONALITY AND INDIVIDUAL DIFFERENCES 2006. [DOI: 10.1016/j.paid.2005.05.013] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tull MT, Medaglia E, Roemer L. An investigation of the construct validity of the 20-Item Toronto Alexithymia Scale through the use of a verbalization task. J Psychosom Res 2005; 59:77-84. [PMID: 16186002 DOI: 10.1016/j.jpsychores.2005.02.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2003] [Accepted: 02/02/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The construct validity of the 20-Item Toronto Alexithymia Scale (TAS-20) was examined through a verbalization task requiring participants to discuss a past distressing event. METHODS Verbalizations were transcribed and coded for the frequency and number of different negative and positive emotion words used. Relationships between the TAS-20 and these variables were examined. RESULTS Controlling for negative affect (NA), the difficulty identifying feelings (DIF) subscale was positively associated with the frequency of negative emotion words used and negatively associated with the frequency and number of different positive emotion words used during the verbalization task. High, compared with low, scoring TAS-20 participants used a lower frequency of and fewer different positive emotion words. CONCLUSION The TAS-20 may be measuring negative emotional expressivity separate from negative affectivity, as well as a reduced capacity to access and elaborate upon positive emotion. Findings are discussed in regard to improving the conceptualization and measurement of emotional deficits in alexithymia.
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Affiliation(s)
- Matthew T Tull
- Department of Psychology, University of Massachusetts Boston, 02125, USA.
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Alexithymia and academic success: examining the transition from high school to university. PERSONALITY AND INDIVIDUAL DIFFERENCES 2005. [DOI: 10.1016/j.paid.2004.08.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Research investigating the alexithymia construct is advancing rapidly and has broadened considerably in recent years as a result of interdisciplinary efforts, new methodologies, and experimental techniques. New developments in the field include a shift from measurement-based validational studies to experimental investigations, which explore the relation between alexithymia and various aspects of emotional processing; the use of functional brain imaging techniques to explore neural activity associated with alexithymia; and experimental studies that measure multiple indices of physiological response to standardized emotion-inducing stimuli. Developmental research and attachment studies are providing ways for investigating potential etiological sources of the construct; and experimental approaches are being used to explore relations between alexithymia and other health-related personality constructs. In addition, longitudinal and treatment studies are clarifying the relation between alexithymia and psychopathology and the extent to which alexithymia predicts treatment outcome. Investigators need to embrace the new methods and techniques for the field of research to further increase understanding of the alexithymia construct and its association with physical and mental illness.
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Affiliation(s)
- Graeme J Taylor
- Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Clarke Site, Toronto, Canada.
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Franz M, Schaefer R, Schneider C. Psychophysiological Response Patterns of High and Low Alexithymics Under Mental and Emotional Load Conditions. J PSYCHOPHYSIOL 2003. [DOI: 10.1027/0269-8803.17.4.203] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract Compared to normals or low alexithymics, high alexithymic subjects show a modified psychophysiological reactivity under experimental stress. This study aims to differentiate these effects under different load conditions (mental vs. emotional load, 5min each). High (N = 33) and low (N = 33) alexithymic subjects were identified by the German version of the Toronto-Alexithymia-Scale (TAS-20). Subjects were exposed to two tasks of the continuous performance test as a mental load condition and two unpleasant movie sequences as an emotional load condition. Heart rate and electrodermal activity (nonspecific skin conductance reactions) were continuously recorded during stimuli presentation. High alexithymic subjects showed a decreased number of nonspecific skin conductance reactions under all load conditions compared to low alexithymics. Initial heart rate acceleration of high alexithymic subjects under mental load was stronger, whereas under emotional load high alexithymic subjects showed a stronger initial heart rate deceleration. Results are discussed with respect to a modified processing of emotionally qualified information in alexithymics.
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Affiliation(s)
- Matthias Franz
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Department, University of Düsseldorf, Germany
| | - Ralf Schaefer
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Department, University of Düsseldorf, Germany
| | - Christine Schneider
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Department, University of Düsseldorf, Germany
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