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Di Tella M, Benfante A, Castelli L, Adenzato M, Ardito RB. On the Relationship Between Alexithymia and Social Cognition: A Systematic Review. CLINICAL NEUROPSYCHIATRY 2024; 21:236-265. [PMID: 39309025 PMCID: PMC11411512 DOI: 10.36131/cnfioritieditore20240402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Objective This systematic review summarises the studies that have investigated the relationship between dimensions of social cognition (i.e., Theory of Mind - ToM, emotion recognition, and empathy) and alexithymia in the general adult non-clinical population. Method PubMed, PsycINFO, and Scopus databases were screened, using the following strings: ("alexithymi*") AND ("theory of mind" OR "ToM"); ("alexithymi*") AND ("empath*"); ("alexithymi*") AND ("emotion recognition"); ("alexithymi*") AND ("social cognition"). Results A total of 117 studies met the inclusion criteria and were included in this review. The total number of participants included in the reviewed studies was 40,231. Mixed results were found for alexithymia and ToM, while the relationship between emotion recognition or empathy and alexithymia was more homogeneous. Alexithymia was found to be significantly associated with both a reduced ability to recognise emotions and empathy. Conclusions These results support the existence of significant relationships between alexithymia and altered social cognitive abilities. Future research is needed to confirm the present findings and further elucidate the complex relationship between these processes. Suggestions are made on how to overcome some of the theoretical and methodological problems in the literature.
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Affiliation(s)
- Marialaura Di Tella
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Agata Benfante
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Mauro Adenzato
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Rita B. Ardito
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
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Sikström S, Nicolai M, Ahrendt J, Nevanlinna S, Stille L. Language or rating scales based classifications of emotions: computational analysis of language and alexithymia. NPJ MENTAL HEALTH RESEARCH 2024; 3:37. [PMID: 39085388 PMCID: PMC11291691 DOI: 10.1038/s44184-024-00080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/20/2024] [Indexed: 08/02/2024]
Abstract
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.
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Affiliation(s)
| | | | | | | | - Lotta Stille
- Department of Psychology, Lund University, Lund, Sweden
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McQuarrie AM, Smith SD, Jakobson LS. Alexithymia and sensory processing sensitivity account for unique variance in the prediction of emotional contagion and empathy. Front Psychol 2023; 14:1072783. [PMID: 37151350 PMCID: PMC10157231 DOI: 10.3389/fpsyg.2023.1072783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
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.
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Affiliation(s)
| | - Stephen D. Smith
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Winnipeg, Winnipeg, MB, Canada
| | - Lorna S. Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: Lorna S. Jakobson,
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Zhang L, Xuan R, Chen Q, Zhao Q, Shi Z, Du J, Zhu C, Yu F, Ji G, Wang K. High-definition transcranial direct current stimulation modulates eye gaze on emotional faces in college students with alexithymia: An eye-tracking study. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110521. [PMID: 35104607 DOI: 10.1016/j.pnpbp.2022.110521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- Lei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Rongrong Xuan
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Qiuyu Chen
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Qingqing Zhao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Zhulin Shi
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Jinmei Du
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Chunyan Zhu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - FengQiong Yu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Gongjun Ji
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China.
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Scarpazza C, Zangrossi A, Huang YC, Sartori G, Massaro S. Disentangling interoceptive abilities in alexithymia. PSYCHOLOGICAL RESEARCH 2021; 86:844-857. [PMID: 34097132 PMCID: PMC8182733 DOI: 10.1007/s00426-021-01538-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/25/2021] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, PD, Italy.
| | - Andrea Zangrossi
- Department of Neuroscience, University of Padua, Via Giustiniani, 5, 35128, Padua, Italy.,Padova Neuroscience Center (PCN), University of Padua, Via Giustiniani, 5, 35128, Padua, Italy
| | - Yu-Chun Huang
- The Organizational Neuroscience Laboratory, 27 Old Gloucester Street, London, WC1N 3AX, UK.,Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK
| | - Giuseppe Sartori
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, PD, Italy
| | - Sebastiano Massaro
- The Organizational Neuroscience Laboratory, 27 Old Gloucester Street, London, WC1N 3AX, UK.,Surrey Business School, University of Surrey, Guildford, Rik Medlik Building (MS), Guildford, GU2 7XH, UK
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