Disentangling interoceptive abilities in alexithymia

Cristina Scarpazza,Giuseppe Sartori,Sebastiano Massaro,Andrea Zangrossi,Yu-Chun Huang

doi:10.1007/s00426-021-01538-x

Cristina Scarpazza, Giuseppe Sartori + Show 3 more

Open Access

https://doi.org/10.1007/s00426-021-01538-x

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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.

Highlights

“If the sheep eats the flower, it is for him as if, all of a sudden, all the stars went dark”
It follows that one’s ability to perceive more or less intensively their visceral responses, influences the strengths of the emotional experience (Critchley & Garfinkel, 2017; Garfinkel & Critchley, 2013): a high degree of interoception is supposed to reflect intense emotional experience and integration of bodily signals into emotional experience. This understanding is relevant for research on alexithymia, a personality trait which is characterized by a deficit in the cognitive interpretation of emotional arousal (Lopez-Munoz & Perez-Fernandez, 2019; Taylor et al, 2016), and impacts emotional experience
Twenty-two participants reported high levels of alexithymia (12.08% of the sample), which is a value fully aligned to the general population in which alexithymia has an average prevalence of 10% (Kokkonen et al, 2001; Muir et al, 2017; Taylor et al, 1991)

Summary

Introduction

“If the sheep eats the flower, it is for him as if, all of a sudden, all the stars went dark”. The capacities to interocept, or interoceptive abilities, are central to the peripheral theories of emotions, which hold that emotions are perceived as central representations dependent on automatic bodily responses (Fehr & Stern, 1970) It follows that one’s ability to perceive more or less intensively their visceral responses, influences the strengths of the emotional experience (Critchley & Garfinkel, 2017; Garfinkel & Critchley, 2013): a high degree of interoception is supposed to reflect intense emotional experience and integration of bodily signals into emotional experience. Individuals with high alexithymia levels are defective in their ability to use emotions to guide their decision making (Scarpazza et al, 2017; Starita et al, 2019)

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