Alexithymic Traits Research Articles

Burnout Syndrome and COVID-19 Lockdown: Research on Residential Care Workers Who Assume Parental Roles with Youths.

Healthcare professionals are at higher risk of developing and experiencing burnout. Parents may also suffer from prolonged stressful conditions that lead to physical and emotional exhaustion. Residential youth care workers assume a caregiving role that can lead to persistent stressful conditions that affect their relationship with the youth. In addition, the COVID-19 lockdown has had a negative impact on both the organization and the work, as well as on the lifestyle of workers and minors. In fact, during the pandemic, contact with families was not possible due to restrictions and this increased the need for caregivers to assume a parental role. This research aims to examine the risk of burnout in a sample of 75 healthcare professionals working with youths and the association with psychological traits. Then, we aim to evaluate these aspects during the COVID-19 lockdown The measurements, conducted in both February 2019 and April 2021, included six questionnaires: MBI to assess burnout, TAS_20 to explore alexithymic traits, COPE_NVI to assess coping strategies, FDS_R to quantify frustration intolerance at work, IRI for empathy, and FFMQ to investigate awareness and emotional regulation. Our sample shows a medium-high risk of developing burnout, which worsened during the pandemic. A worsening of emotional skills, paralleled by a greater empathic investment required by the emergency situation, and an assumed parental role is observable. Coping strategies correlate with burnout risk, as avoidance strategies were strongly associated with emotional exhaustion. These findings suggest an urgent need to develop targeted and timely interventions for healthcare professionals in order to prevent long-term consequences.

Alexithymia and Parental Bonding in Women with Genitopelvic Pain/Penetration Disorder.

The role of emotion regulation and alexithymia in the pathophysiology of genitopelvic pain/penetration disorder (GPPPD) is emphasized. Parental bonding is linked to emotion regulation and alexithymia. This study aimed to examine the relationships between parental bonding, alexithymia, and GPPPD. Sixty-four patients with GPPPD were enrolled in the study, and 60 controls were matched for demographic features. Toronto Alexithymia Scale (TAS-20) was used to evaluate alexithymia, the Bonding to Parents Scale (BPS) was used to assess parental bonding, and sexual functions were assessed via Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The rate of alexithymic traits was statistically higher in the GPPPD group than in the controls (p = 0.005). Patients with GPPPD obtained higher scores on the maternal care/control (p = 0.003) and maternal overprotection (p = 0.008) compared to controls. Difficulty describing feelings factor of alexithymia (p = 0.012) emerged as a predictor of group membership (GPPPD vs controls). To test whether alexithymia was significantly associated with parental bonding, all subjects were divided into two subgroups, alexithymic and non-alexithymic. When the subgroups were compared in terms of parental attitudes, maternal (p = 0.034) and paternal (p = 0.006) overprotection subscale scores were higher in the alexithymic group than in the non-alexithymic group. According to the results, alexithymic traits are characteristic of patients with GPPPD; however, although patients with GPPPD may experience difficulties with perceived parental bonding, this factor does not appear to be a predictor of GPPPD.

Alexithymia and post-traumatic stress disorder symptoms in Chinese undergraduate students during the COVID-19 national lockdown: The mediating role of sleep problems and the moderating role of self-esteem.

This study examined whether sleep disturbance was a mediator between alexithymic traits and post-traumatic stress disorder (PTSD) COVID-19 pandemic-related stress symptoms, and explored whether self-esteem moderated the alexithymic contribution to poor sleep and PTSD symptoms. A representative sample of young adults (N = 2,485) from six universities in Southwest China completed online self-report surveys on alexithymia, sleep, PTSD, self-esteem, sociodemographic information, and health-related behaviors. High alexithymic young adults were found to be more likely to have higher sleep problems and higher PTSD symptoms. The moderated mediation model showed that sleep problems mediated the associations between alexithymia and PTSD symptoms. Alexithymic people with lower self-esteem were more likely to have elevated PTSD symptoms and sleep problems than those with higher self-esteem. Targeted psychological interventions for young people who have difficulty expressing and identifying emotions are recommended as these could assist in reducing their post-traumatic psychophysical and psychological problems. Improving self-esteem could also offer some protection for trauma-exposed individuals.

Difficulties in facial emotion recognition: taking psychopathic and alexithymic traits into account

BackgroundAlexithymic and psychopathic traits are closely associated, but distinct constructs. Both have been associated with facial emotion processing deficits reflecting empathy deficits, however the underlying mechanism contributing to these deficits is not well-understood.MethodsThis study investigated facial emotion recognition performance in a non-clinical sample (N = 110) including both male and female participants, with varying levels of psychopathic and alexithymic traits. Facial emotion recognition was assessed using a computerized task, that presented different expressions depicting five emotional states (pain, fear, sadness, anger, happiness) and neutral expressions.ResultsResults suggest that the high psychopathic traits group reported lower accuracy compared to the low psychopathic traits group, indicating a more generalized deficit in facial affect recognition, across all emotions. The alexithymic groups (high vs. low) on the other hand did not differ in their performance on the task for any of the emotions presented.ConclusionThese findings add to the current body of research regarding face processing categorization deficits in relation to psychopathic and alexithymic traits and can inform prevention and intervention efforts that aim to facilitate facial emotion recognition in individuals with these personality traits.

Posttraumatic stress and alexithymia: A meta-analysis of presentation and severity.

Improving treatment outcomes for posttraumatic stress necessitates consideration of factors that may impede treatment progress. Previous research suggests alexithymia-an emotion-processing deficit characterized by difficulties in identifying, describing, and attending to emotional information-may be a therapeutically relevant correlate of posttraumatic stress. Building upon previous work in this area, meta-analysis was used to investigate (a) how alexithymic traits typically present among those with a posttraumatic stress disorder (PTSD) diagnosis, (b) the strength of association between alexithymic trait severity and posttraumatic stress severity independent of diagnosis, and (c) alexithymia subdimensions most closely associated with posttraumatic stress. A total of 43 samples encompassing 5,069 participants were included in analyses. Results suggest individuals diagnosed with PTSD tend to experience alexithymic traits that, while just below the clinical cutoff, are 1.32 standard deviations more severe than the general population. These alexithymic traits are particularly prominent in male and veteran samples and for difficulties in identifying feelings. Independent of diagnosis, posttraumatic stress was moderately associated with alexithymic traits, and stronger associations were noted between posttraumatic stress and difficulties in identifying feelings than between posttraumatic stress and difficulties in describing feelings or externally oriented thinking. Results attest to the importance of considering, conceptualizing, and treating posttraumatic stress and alexithymia in tandem. Implications for ongoing treatment development for posttraumatic stress are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mapping the perception-space of facial expressions in the era of face masks.

With the advent of the severe acute respiratory syndrome-Corona Virus type 2 (SARS-CoV-2) pandemic, the theme of emotion recognition from facial expressions has become highly relevant due to the widespread use of face masks as one of the main devices imposed to counter the spread of the virus. Unsurprisingly, several studies published in the last 2 years have shown that accuracy in the recognition of basic emotions expressed by faces wearing masks is reduced. However, less is known about the impact that wearing face masks has on the ability to recognize emotions from subtle expressions. Furthermore, even less is known regarding the role of interindividual differences (such as alexithymic and autistic traits) in emotion processing. This study investigated the perception of all the six basic emotions (anger, disgust, fear, happiness, sadness, and surprise), both as a function of the face mask and as a function of the facial expressions’ intensity (full vs. subtle) in terms of participants’ uncertainty in their responses, misattribution errors, and perceived intensity. The experiment was conducted online on a large sample of participants (N = 129). Participants completed the 20-item Toronto Alexithymia Scale and the Autistic Spectrum Quotient and then performed an emotion-recognition task that involved face stimuli wearing a mask or not, and displaying full or subtle expressions. Each face stimulus was presented alongside the Geneva Emotion Wheel (GEW), and participants had to indicate what emotion they believed the other person was feeling and its intensity using the GEW. For each combination of our variables, we computed the indices of ‘uncertainty’ (i.e., the spread of responses around the correct emotion category), ‘bias’ (i.e., the systematic errors in recognition), and ‘perceived intensity’ (i.e., the distance from the center of the GEW). We found that face masks increase uncertainty for all facial expressions of emotion, except for fear when intense, and that disgust was systematically confused with anger (i.e., response bias). Furthermore, when faces were covered by the mask, all the emotions were perceived as less intense, and this was particularly evident for subtle expressions. Finally, we did not find any evidence of a relationship between these indices and alexithymic/autistic traits.

Somatic symptom disorder in patients with post-COVID-19 neurological symptoms: a preliminary report from the somatic study (Somatic Symptom Disorder Triggered by COVID-19)

ObjectivesTo assess the diagnosis of somatic symptom disorder (SSD) in patients with unexplained neurological symptoms occurring after SARS-CoV-2 infection, also referred to as long COVID.DesignSingle-centre observational study.ParticipantsAdult patients experiencing unexplained...

Alexithymia and internet gaming disorder in the light of depression: A cross-sectional clinical study

BackgroundSocial and emotional deficits are assumed to be involved in the development and maintenance of internet gaming disorder (IGD). Alexithymia refers to a personality construct, which is characterized by deficits in emotional awareness and processing. The constructs of alexithymia and depression share similarities, and depression is a common comorbidity of IGD patients. The aim of this study was to analyze the relationship between alexithymia and IGD when controlling for depression symptom severity. Moreover, we compared alexithymia traits of IGD patients with those of non-pathological video gamers. MethodsIn a cross-sectional study n = 38 male IGD patients (EG) were recruited at specialized healthcare services in Germany. In addition, n = 39 male non-pathological video gamers (CG) were recruited via social media and bulletin board announcement. Both groups completed questionnaires measuring alexithymia (TAS-20), depression symptom severity (BDI) and IGD severity (s-IAT). ResultsAlexithymia and depression symptom severity both predicted IGD severity. Yet, when including both factors in multiple regression analysis, only alexithymia predicted IGD severity. The prevalence of alexithymia in the EG was 34.2 % (n = 13). None of the non-pathological video gamers scored above the cut-off indicating alexithymia. IGD patients showed higher traits of alexithymia in general and on each subscale, irrespective of whether or not they were currently consuming video games. As previously observed, depression symptom severity was significantly greater in IGD patients compared to healthy video gamers. Yet, group differences in alexithymia traits remained stable, with a ~29 % decrease of effectiveness in the relationship, when controlling for depression symptom severity and sociodemographic factors. ConclusionThe results reveal that alexithymia is associated with and predicts IGD severity independently of depression symptom severity. Moreover, alexithymia is highly prevalent in IGD patients.

Psychological Functioning, Defense Strategies and the Contribution of Perceived Family Collaboration in Adolescents Who Experienced Multiple Motor Vehicle Crashes: A Descriptive Study.

Adolescents frequently experience motor vehicle collisions (MVCs). Research has mostly underlined the psychological outcomes, rather than adolescents’ general emotional–behavioral functioning and the role played by family. This study aims to explore the emotional–behavioral functioning, measured with the Youth Self Report (YSR), difficulties to identify and describe emotions, measured with the Toronto Alexithymia Scale (TAS-20), the use of defense strategies, measured with the Response Evaluation Measure for Youth (REM-71), and perceived family collaboration, measured with the Perceived Collective Family scale, in adolescents that have experienced more than three MVCs in a year. N = 150 adolescents who visited an emergency department for MVCs were assessed through self-report questionnaires. Adolescents showed difficulties to identify and describe their emotions and a massive use of defense strategies. Moreover, lower perceived family collaboration predicted adolescents’ alexithymic traits and the massive use of maladaptive defense strategies. These results may be useful in assessing and creating prevention programs for risky driving behaviors in adolescence.

The relationship between self-esteem and alexithymia in individuals with substance use disorders

ABSTRACT Background This study aimed to determine the self-esteem and alexithymia levels of patients diagnosed with substance use disorder and the relationship between these two concepts. Methods The study was conducted at the Treatment Center for Alcohol and Substance Addiction, with 105 individuals who were hospitalized between January and July 2019. Data were collected using the Personal Information Form, the Coopersmith Self-Esteem Inventory and the Toronto Alexithymia Scale. Results The mean score obtained from the Toronto Alexithymia Scale was 64.10 ± 4.07 and the mean score obtained from the Coopersmith Self-Esteem Inventory was 53.92 ± 17.33. There was a significant negative correlation between the total scores of the patients from the Toronto Alexithymia Scale and the Coopersmith Self-Esteem Inventory. Conclusion It was found in the study that the alexithymic traits of the patients were at moderate level, their self-esteem was slightly above the average, and as their self-esteem increased, their alexithymic traits decreased.

Autism traits outweigh alexithymia traits in the explanation of mentalising performance in adults with autism but not in adults with rejected autism diagnosis

BackgroundPronounced alexithymia traits have been found in autism spectrum disorder (ASD) and recent research has been carving out the impact alexithymia traits might have on mentalising deficits associated with ASD.MethodIn this cross-sectional study, a large representative referral population for diagnostic examination for possible ASD (n = 400) was screened for clinical alexithymia with a German version of the Reading the Mind in the Eyes test (RME). In contrast to previous attempts to carve out the impact of alexithymia traits on mentalising deficits though, we employed dominance analysis to account for the correlation between predictors. The relative relationship between alexithymia traits and autism traits with RME performance was investigated in the group of individuals with confirmed ASD diagnosis (N = 281) and compared to the clinical referral sample in which ASD was ruled out (N = 119).ResultsDominance analysis revealed autism traits to be the strongest predictor for reduced mentalising skills in the ASD sample, whereas alexithymia contributed significantly less. In the sample of individuals with ruled out diagnosis, autism traits were the strongest predictor, but alexithymia traits were in sum equally associated to mentalising, with the External-Oriented Thinking subscale as an important predictor of this association.LimitationsIt needs to be considered that the cross-sectional study design does not allow for causal inference. Furthermore, mentalising is a highly facetted capacity and measurements need to reduce this complexity into simple quantities which limits the generalizability of results.DiscussionWhile alexithymia traits should be considered for their mental health importance, they do not dominate the explanation of reduced mentalising skills in individuals with ASD, but they might do to a larger degree in individuals with ruled out ASD.

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients.

Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.

Alexithymic traits in adolescents with Anorexia Nervosa

IntroductionAlexithymia is a construct which has been described in persons under the autistic spectrum. Besides Autistic Spectrum Disorders, alexithymia nowadays is highly correlated with several psychiatric disorders, among them being Eating Disorders. Several studies suggested a “cognitive-affective” division in the inner experience of patients with Anorexia Nervosa, because of their difficulty in describing, identifying and recognising their own emotions as well as othersObjectivesThis study aims to identify how many adolescents diagnosed with Anorexia Nervosa meet the characteristics of alexithymic personality traits and in which domain of these traits they had the most struggles with.MethodsThe study lot includes 34 adolescents diagnosed with Anorexia Nervosa evaluated by a self report survey: Online Alexithymia Questionnaire-G2 (OAQ-G2). The cut-off scores are: 113 and above - correlated with alexithymia, 95-112 - correlated with possible alexithymia and under 94 - insignificant clinical score. We analyzed the result of every subcategory of the questionnaire in order to determine whether there is an area affected more than others.ResultsThe sample included 34 patients, female to male ratio 31:3, evaluated in the Department of Child and Adolescent Psychiatry, “Prof. Dr. Alexandru Obregia” Psychiatry Hospital. 29,41% had clinically semnificative scores for alexithymic traits, while 52,94% scored for possibile alexithymia according to the OAQ-G2.ConclusionsIn 82,35% of patients from the lot we identified alexithymic personality traits. The F1 subcategory (difficulty identifying feelings) and F5a (problematic interpersonal process) were the ones that distinguished the alexithymic group from the possible alexithymic one.DisclosureNo significant relationships.

Maternal Anxiety, Depression, Alexithymia, and Social Support: Association With Maternal-Fetal Attachment in Pregnancy

BACKGROUNDMaternal-fetal attachment (MFA) is the emotional bond between a mother and her fetus and is influenced by numerous risk and protective factors during pregnancy. However, according to the literature, the results relating to the influence of these factors are mixed.METHODThe aim of the study is to identify the relationship between MFA and maternal distress, evaluated as maternal depression and anxiety, alexithymia, and perceived social support during the prenatal period in an Italian community sample. Ninety-four pregnant women completed self-report questionnaires.RESULTSResults showed that total MFA was negatively associated with maternal anxiety and alexithymia and was positively associated with social support. Moreover, maternal depression was negatively associated with the quality subscale of MFA The quality subscale of MFA was negatively associated with maternal state and trait anxiety and alexithymia and was positively associated with social support. The intensity subscale of MFA was positively associated with social support. Multiple regression showed that alexithymia and social support predicted MFA with a higher effect than maternal depression and anxiety.CONCLUSIONSThe results are useful for planning interventions aimed at supporting the mother-infant bond starting from pregnancy.

Gyrus rectus asymmetry predicts trait alexithymia, cognitive empathy, and social function in neurotypical adults.

Reduced empathy and elevated alexithymia are observed in autism spectrum disorder (ASD), which has been linked to altered asymmetry in brain morphology. Here, we investigated whether trait autism, empathy, and alexithymia in the general population is associated with brain morphological asymmetry. We determined left-right asymmetry indexes for cortical thickness and cortical surface area (CSA) and applied these features to a support-vector regression model that predicted trait autism, empathy, and alexithymia. Results showed that less leftward asymmetry of CSA in the gyrus rectus (a subregion of the orbitofrontal cortex) predicted more difficulties in social functioning, as well as reduced cognitive empathy and elevated trait alexithymia. Meta-analytic decoding of the left gyrus rectus annotated functional items related to social cognition. Furthermore, the link between gyrus rectus asymmetry and social difficulties was accounted by trait alexithymia and cognitive empathy. These results suggest that gyrus rectus asymmetry could be a shared neural correlate among trait alexithymia, cognitive empathy, and social functioning in neurotypical adults. Left-right asymmetry of gyrus rectus influenced social functioning by affecting the cognitive processes of emotions in the self and others. Interventions that increase leftward asymmetry of the gyrus rectus might improve social functioning for individuals with ASD.

Religion and the Mediating Role of Alexithymia in the Mental Distress of Healthcare Workers During the Coronavirus Disease 2019 Pandemic in a Psychiatric Hospital in China.

The outbreak of the coronavirus disease 2019 (COVID-19) has created unprecedented challenges to the healthcare system, religion, and alexithymic trait that impacts the psychological resilience of healthcare workers during the COVID-19 pandemic. This study aimed to investigate the role religion and alexithymia play in mental distress and the level of happiness of psychiatric hospital healthcare workers in China amidst the COVID-19 pandemic. Furthermore, whether symptom dimensions (anxiety, depression, hostility, inferiority, and insomnia) are associated with the level of happiness, and a 6-month follow-up was also investigated. A total of one-hundred and ninety healthcare workers were recruited from a psychiatric hospital in Jilin, China, and 122 were followed up after 6 months. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire. The mental distress of healthcare workers decreased from 2.6 to 1.5% in 6-months. Religious belief was not associated with the mental distress or happiness of healthcare workers. Instead, for those whose anxiety decreased over 6 months, their social adaptation status increased. For those whose inferiority level decreased over time, their perceived level of psychological well-being and overall happiness increased. In over half a century of living in different societies, religion stabilizes the mental health of those in Taiwan amidst the stress of the COVID-19 pandemic, but not in China. However, both regions found healthcare workers with alexithymic traits experienced a higher level of mental distress, implying that the collectivist culture of Confucian philosophy continues to influence the emotional expression and alexithymic traits of healthcare workers in China and Taiwan. To ensure a healthy and robust clinical workforce in the treatment and control of the pandemic, the cultural impact on the psychological resilience of medical workers needs to be addressed.

Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions.

Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions.

Investigating the sense of agency and its relation to subclinical traits using a novel task

Tasks measuring the sense of agency often manipulate the predictability of action outcomes by introducing spatial deviation. However, the extent to which spatial predictability of an outcome influences the sense of agency when spatial deviation is controlled for remains untested. We used a novel task to investigate the effect of several factors (action–outcome contingency, spatial deviation, and spatial predictability when controlling for spatial deviation of action outcomes) on the sense of agency. We also investigated trait predictors of metacognition of agency—the degree to which participants’ confidence in their agency judgements corresponds to the accuracy of those judgements. Initial and replication samples completed contingency, deviation, and predictability versions of the task. Across samples, participants’ sense of agency was impacted by action–outcome contingency and spatial deviation of action outcomes. Manipulation of the spatial predictability of action outcomes did not reliably impact the sense of agency. Metacognition of agency was related to alexithymic traits—higher alexithymia scores were associated with reduced metacognition of agency.

Attentional processing of unpleasant stimuli in alexithymia: Early avoidance followed by attention maintenance bias

Alexithymia is a multifaceted personality trait linked to increased risk for psychological, psychosomatic, and physical health problems. One hypothesized mechanism through which alexithymia predisposes individuals to such problems is the interference of alexithymic characteristics in processing affective, particularly unpleasant content. This study aimed to investigate the relationship between alexithymia and biases in attentional processing of threatening vs. neutral pictorial stimuli, disentangling early (vigilance) from late (maintenance) attentional biases. One hundred participants (77 female; 18–35 years old) completed the Toronto Alexithymia Scale and underwent a free viewing task with picture pairs presenting illness, fear and neutral content, during which dwell time on each picture was recorded at time intervals of 0–500 ms, 501–1000 ms and 1001–6500 ms of exposure. Results from multilevel modeling showed that alexithymia interacted with time interval and picture type. Higher alexithymia scores were related to less dwell time towards fear pictures at 501 ms-1000 ms, but more dwell time at 1001 ms-6500 ms after stimulus onset. This effect was particularly observed for the externally oriented thinking and the difficulty in describing feelings facets of alexithymia, but not the difficulty in identifying feelings. There was no effect of alexithymia on early vigilance at 0–500 ms. This study provides evidence on the association between alexithymic traits and early avoidance, along with late maintenance bias to fear, which appears consistent with the view that alexithymia is associated with avoidant emotion regulation processes, but also greater requirements of cognitive resources for processing affective information.

Psychopathological and Interactive-Relational Characteristics in Non-Suicidal Self-Injury Adolescent Outpatients.

Non-suicidal self-injury (NSSI) is described as behaviors that directly and intentionally inflict damage to body tissue without suicidal intent and for reasons not linked to cultural expectations or norms. Literature has confirmed several “specific risk factors” related to NSSI behaviors; emotional reactivity, internalizing problems, alexithymia traits, and maladaptive family functioning can predispose an individual to intrapersonal and interpersonal vulnerabilities related to difficulties in regulating one’s own cognitive-emotional experience. The present study aims to analyze and define the psychopathological and family interactive-relational characteristics of adolescents with NSSI through a case-control study. Thirty-one patients with NSSI and thirty-one patients without NSSI paired for sex, age, and psychiatric diagnosis (ICD-10) were recruited in Padua among two Child Neuropsychiatry Units before the COVID-19 pandemic. Results show a higher prevalence of internalizing problems, alexithymia trait related to “difficulty identifying feelings”, and lower quality of family functioning related to inclusion of partners, child involvement, and child self-regulation. These results carry significant implications for the clinical management and therapeutic care of non-suicidal self-injury patients and further confirm the need for an in-depth investigation of internalizing problems, alexithymia, and quality of family interactions.