No Words for Feelings? Not Only for My Own: Diminished Emotional Empathic Ability in Alexithymia

Language or rating scales based classifications of emotions: computational analysis of language and alexithymia

Rating scales are the dominating tool for the quantitative assessment of mental health. They are often believed to have a higher validity than language-based responses, which are the natural way of communicating mental states. Furthermore, it is unclear how difficulties articulating emotions-alexithymia-affect the accuracy of language-based communication of emotions. We investigated whether narratives describing emotional states are more accurately classified by questions-based computational analysis of language (QCLA) compared to commonly used rating scales. Additionally, we examined how this is affected by alexithymia. In Phase 1, participants (N = 348) generated narratives describing events related to depression, anxiety, satisfaction, and harmony. In Phase 2, another set of participants summarized the emotions described in the narratives of Phase 1 in five descriptive words and rating scales (PHQ-9, GAD-7, SWLS, and HILS). The words were quantified with a natural language processing model (i.e., LSA) and classified with machine learning (i.e., multinomial regression). The results showed that the language-based responses can be more accurate in classifying the emotional states compared to the rating scales. The degree of alexithymia did not influence the correctness of classification based on words or rating scales, suggesting that QCLA is not sensitive to alexithymia. However, narratives generated by people with high alexithymia were more difficult to classify than those generated by people with low alexithymia. These results suggest that the assessment of mental health may be improved by language-based responses analyzed by computational methods compared to currently used rating scales.

Alexithymia and sensory processing sensitivity account for unique variance in the prediction of emotional contagion and empathy

Introduction

Empathy-the ability to identify and share another person's emotional state-is an important socio-emotional process arising, in part, from emotional contagion. In the current study, we assessed unique variance in emotional contagion and other empathy-related constructs accounted for by two personality traits, alexithymia and sensory processing sensitivity (SPS), when controlling for childhood emotional abuse and current depressed mood.

Methods

A sample of 305 adults (M _age = 20.1 years) watched brief film clips chosen to induce various emotional states. After each film, the participants rated how strongly they experienced each of nine different emotions. They then completed self-report measures of alexithymia, SPS, empathy-related constructs, childhood emotional abuse, and current mood.

Results

Those scoring high (vs. low) on SPS reported stronger primary emotions and a larger range of emotions when watching the films and were more apt to believe that their emotions matched those of the individuals featured in the films. They also scored higher on both self-oriented processes (such as the tendency to feel personal distress in tense situations) and other-oriented processes (such as perspective taking and empathic concern) related to empathy. Individuals scoring high (vs. low) on alexithymia reported feeling a larger range of emotions while watching the films but scored lower on other-oriented processes related to empathy. After controlling for SPS and alexithymia, current depressed mood predicted experiencing less varied reactions to mixed valence films that elicited strong feelings of embarrassment/humiliation, and less amusement when watching positive films. Childhood emotional abuse did not emerge as a predictor of emotional contagion or empathy.

Discussion

We propose that the strong and nuanced feelings elicited in those scoring high on SPS by observing others support their personal view that they are highly empathic. In contrast, by failing to closely examine their own mixed reactions to others, individuals with alexithymia may find it difficult to connect with, understand, and respond to others' feelings.

High-definition transcranial direct current stimulation modulates eye gaze on emotional faces in college students with alexithymia: An eye-tracking study

BACKGROUND

Atypical eye gaze on emotional faces is a core feature of alexithymia. The inferior frontal gyrus (IFG) is considered to be the neurophysiological basis of alexithymia-related emotional face fixation. Our aim was to examine whether anodal high-definition transcranial direct current stimulation (HD-tDCS) administered to the right (r)IFG would facilitate eye gaze of emotional faces in alexithymia individuals.

METHOD

Forty individuals with alexithymia were equally assigned to anodal or sham HD-tDCS of the rIFG according to the principle of randomization. The individuals then completed a free-viewing eye tracking task (including happy, sad, and neutral faces) before and after 5 consecutive days of stimulation (twice a day).

RESULTS

The results showed that twice a day anodal HD-tDCS of the rIFG significantly increased the fixation time and fixation count of the eye area on happy and neutral faces, but there was no significant effect on sad faces. According to the temporal-course analysis, after the intervention, the fixation time on neutral faces increased significantly at almost all time points of the eye tracking task. For happy faces, the improvement was demonstrated between 500 and 1000 ms and between 2500 and 3500 ms. For sad faces, the fixation time improved but not significantly.

CONCLUSIONS

Applying high-dose anodal HD-tDCS to the rIFG selectively facilitated eye gaze in the eye area of neutral and happy faces in individuals with alexithymia, which may improve their face processing patterns.

Disentangling interoceptive abilities in alexithymia

In recent years, research on interoceptive abilities (i.e., sensibility, accuracy, and awareness) and their associations with emotional experience has flourished. Yet interoceptive abilities in alexithymia—a personality trait characterized by a difficulty in the cognitive interpretation of emotional arousal, which impacts emotional experience—remain under-investigated, thereby limiting a full understanding of subjective emotional experience processing. Research has proposed two contrasting explanations thus far: in one model, the dimensions of interoceptive sensibility and accuracy in alexithymia would increase; in the other model, they would decrease. Surprisingly, the contribution of interoceptive awareness has been minimally researched. In this study (N = 182), the relationship between participants’ level of alexithymia and the three interoceptive dimensions was tested. Our results show that the higher the level of alexithymia is, the higher interoceptive accuracy and sensibility (R² = 0.29 and R² = 0.14); conversely, the higher the level of alexithymia is, the lower interoceptive awareness (R² = 0.36). Moreover, an ROC analysis reveals that interoceptive awareness is the most accurate predictor of alexithymia, yielding over 92% accuracy. Collectively, these results support a coherent understanding of interoceptive abilities in alexithymia, whereby the dissociation of interoceptive accuracy and awareness may explain the underlying psycho-physiological mechanisms of alexithymia. A possible neurocognitive mechanism is discussed which suggests insurgence of psychosomatic disorders in alexithymia and related psychotherapeutic approaches.