Low Alexithymia Scores Research Articles

Literally or prosodically? Recognising emotional discourse in alexithymia

ABSTRACT Alexithymia is characterised by difficulties in identifying, recognising, and describing emotions. We studied alexithymia in the context of speech comprehension, specifically investigating the incongruent condition between prosody and the literal meaning of words in emotion-based discourse. In two experiments, participants were categorised as having high or low alexithymia scores based on the TAS-20 scale and listened to three-sentence narratives where the emotional prosody of a key phrase or a keyword was congruent or incongruent with its literal meaning. The incongruent condition resulted in slower reaction times and lower accuracy in recognition of emotions. This incongruence effect was also evident for individuals with high alexithymia, except for anger. They recognised anger as accurately in both congruent and incongruent conditions. Contrary to our hypothesis, however, individuals with high alexithymia did not show an overall difference in emotion recognition compared to the low alexithymia group. These findings highlight the nuanced relationship between emotional prosody and literal meaning, offering insights into how individuals with varying levels of alexithymia process emotional discourse. Understanding these dynamics has implications for both cognitive research and clinical practice, providing valuable perspectives on speech comprehension, especially in situations involving incongruence between prosody and word meaning.

Longitudinal Investigation of Alexithymia as a Predictor of Empathy, Emotional Functioning, Resilience, and Life Satisfaction 2 Years After Brain Injury

ObjectiveTo examine the unique contribution of alexithymia at 1 year after traumatic brain injury (TBI) to the prospective prediction of emotional and social health outcomes at 2 years after injury. DesignMulticenter, longitudinal cohort study. SettingData were collected during year 1 and year 2 postinjury follow-up interviews across 4 TBI Model System centers. ParticipantsPersons with TBI (N=175; 134 men and 41 women) who had English fluency and were capable of providing self-reported data. InterventionsNot applicable. Main Outcome MeasuresPrimary independent variable was the Toronto Alexithymia Scale-20. Outcome measures included the Interpersonal Reactivity Index, National Institute of Health Toolbox Emotion Battery Anger, Difficulty with Emotion Regulation Scale, Connor-Davidson Resilience Scale, Posttraumatic Stress Disorder Checklist – Civilian, Satisfaction with Life Scale, General Anxiety Disorder-7, Patient Health Questionnaire 9, suicidal ideation, and problematic substance use. ResultsSimple adjusted models demonstrated that after controlling for the specific outcome at year 1, Toronto Alexithymia Scale-20 scores significantly predicted year 2 scores for perspective-taking, physical aggression, emotional dysregulation, resilience, anxiety, depression, and suicidal ideation. All of these predictive findings except for physical aggression were maintained in the fully adjusted models that also controlled for age, sex, education level, number of prior TBIs, and motor and cognitive functioning. ConclusionsCompared with those with lower alexithymia scores, persons with TBI who had higher alexithymia scores at 1 year after injury reported poorer emotional health at 2 years after TBI, even after controlling for year 1 outcome scores, sociodemographic characteristics, and injury-related factors. These results support the need to assess for elevated alexithymia and to provide interventions targeting alexithymia early in the TBI recovery process.

Configural processing of emotional bodies and faces in patients with attention deficit hyperactivity disorder

ABSTRACT Introduction: Attention Deficit Disorder (ADHD) is associated with interpersonal problems and difficulties in inferring other peoples’ emotions. Previous research has focused on face processing, mostly in children. Our study investigated configural processing of emotional bodies and faces in adults with ADHD in comparison with healthy controls, analyzing P100, N170 and P250 event-related potentials (ERPs) and relating them to (socio)cognitive functioning. Method: Nineteen patients with ADHD and 25 healthy controls were presented upright and inverted bodies and faces which had to be categorized as neutral, happy or angry while ERPs were recorded. Additionally, sociocognitive and executive functioning was assessed. Results: In ADHD patients relative to controls, recognition of emotions depicted by bodies but not by faces was impaired and P100 amplitudes were enhanced for angry bodies. Furthermore, patients showed enhanced P250 amplitudes in response to both bodies and faces, specifically for happy and neutral emotions. Larger N170 amplitudes to bodies and faces correlated with lower alexithymia scores only in controls, while enhanced P250 amplitudes to both categories were associated with poorer inhibition only in patients. Conclusion: Adults with ADHD show potentially compensatory enhanced semantic processing of emotional bodies and faces, as reflected by increased P250 amplitudes, associated with poorer executive functioning and subtle alterations of emotional and configural processing, as reflected by ERPs.

Corticospinal inhibition and alexithymia in multiple sclerosis patients–An exploratory study

ObjectivesAlexithymia is a multicomponent personality construct that could occur in up to 53% of patients with multiple sclerosis (MS), with recent works proposing higher rates of alexithymia in progressive MS. Among the available models of alexithymia, some propose a deficient interhemispheric communication and an aberrant GABAergic transmission at its origin. However, no single study has addressed the underlying physiological mechanisms of alexithymia in MS. The aim of this work was to assess the relationship between GABAergic neurotransmission and alexithymia in progressive MS by means of transcranial magnetic stimulation (TMS). MethodsTwelve patients with high alexithymia and fifteen patients with low alexithymia were included based on Toronto Alexithymia Scale (TAS). Sociodemographic, clinical and neuropsychological data were recorded. The following corticospinal excitability measures were obtained: resting motor threshold, cortical silent period (CSP which reflects cortical GABAergic function), and interhemispheric inhibition (i.e., GABAergic function mediated by interhemispheric fibers). ResultsNo significant group differences were observed regarding sociodemographic, clinical or neuropsychological variables. Patients with high alexithymia scores exhibited shorter CSP than those with low alexithymia scores (81.87 ± 45.72 ms vs. 145.27 ± 77.26 ms, respectively, p < 0.05). A significant inverse correlation was also found between TAS scores and CSP duration (r = −0.59, p < 0.05). ConclusionThis study offers insights into the neurophysiological mechanisms of alexithymia in MS. Reduced GABAergic transmission, as reflected by short CSP, seems to be associated with alexithymia in this population. Future studies would benefit from a more comprehensive evaluation of cortical and interhemispheric mechanisms in MS patients with alexithymia.

Understanding the role of personality and alexithymia in food preferences and PROP taste perception

Taste perception and food preferences are influenced by a variety of factors, including personality characteristics. The aims of this study were to examine the role of personality characteristics, such as alexithymia (a personality construct characterized by inability to identify, describe, and work with one's own feelings), in: 1) taste responses to the bitter genetic taste-marker PROP and 2) food liking. We studied 649 healthy subjects residing in six genetically-isolated villages of Northeast Italy. Data on PROP taste responsiveness, food liking, personality characteristics and TAS2R28 genotypes were collected.Results showed that PROP non-tasters had higher alexithymia scores than PROP tasters. Moreover, the presence of alexithymia in heterozygous individuals for the rs1726886 polymorphism of the TAS2R38 gene was associated with a reduction in the perceived intensity of PROP.Finally, higher alexithymia scores were associated with liking of alcohol, sweets and fats/meats whereas lower alexithymia scores were related to liking of vegetables, condiments and strong cheeses, Measures of temperament, character, anxiety and depression were also related to food liking.Our findings suggest that: 1) alexithymia, in addition to the TAS2R38 polymorphism, may play a role in responsiveness to the aversive and bitter taste of PROP; and 2) alexithymia, in combination with other personality traits, may provide important insights for better understanding food liking.

Psychophysiological decoupling in alexithymic pain disorder patients

Considering that impaired coping with stress is closely linked with emergence of stress-sensitive disorders most notably in alexithymic individuals, we conducted the first study examining stress-related autonomic reactivity in alexithymic pain disorder patients. Twenty-one pain disorder patients with high and an equivalent patient group with low alexithymia scores were exposed to three types of affect-inductive stimuli with variable affective involvement: arithmetic task, watching arousing video material and giving an oral presentation. Subjective appraisal of the induced emotional experience and physiological reactivity (heart rate, muscle tension and skin conductance) was documented. During oral presentation high alexithymia patients showed significantly lower skin conductance in combination with increased subjective negative affect compared to low alexithymia patients. Our results thus demonstrate a decoupling between physiological and affect processing in pain disorder patients with high alexithymia during a stressful situation that was subjectively associated with negative affect.

Asexuality: an extreme variant of sexual desire disorder?

Human asexuality is defined as a lack of sexual attraction to anyone or anything. Various theories have been proposed to explain how asexuality should best be classified, and some have maintained that asexuality is an extreme variant of hypoactive sexual desire disorder (HSDD)-a sexual dysfunction characterized by a lack of interest in sex and significant distress. To date, this has never been empirically examined. Using measures of sexual desire and behavior, sex-related distress, personality, and psychopathology, the aim of the current study was to compare individuals scoring above the cutoff for asexuality identification (AIS >40) (n = 192) to sexual individuals (n = 231). The sexual group was further divided into a control group (n = 122), a HSDD group (n = 50), and a group with symptoms of low desire that were nondistressing (n = 59). Analyses were controlled for age. Individuals in the AIS >40 group had a greater likelihood of never previously engaging in sexual intercourse, fantasies, or kissing and petting than all other groups and a lower likelihood of experiencing sex-related distress than those with HSDD. For women, those in the HSDD and AIS >40 groups had significantly lower desire than the subclinical HSDD and control groups. Men in the AIS >40 group had significantly lower desire than the other three groups. Symptoms of depression were highest among those with subclinical HSDD and HSDD, whereas there were no group differences on alexithymia or desirable responding. A binary logistic regression indicated that relationship status (long-term dating/married), sexual desire, sex-related distress, and lower alexithymia scores were the best predictors of group membership (HSDD vs. AIS >40). Taken together, these results challenge the speculation that asexuality should be classified as a sexual dysfunction of low desire.

How Does Emotional Context Modulate Response Inhibition in Alexithymia: Electrophysiological Evidence from an ERP Study

BackgroundAlexithymia, characterized by difficulties in identifying and describing feelings, is highly indicative of a broad range of psychiatric disorders. Several studies have also discovered the response inhibition ability impairment in alexithymia. However, few studies on alexithymic individuals have specifically examined how emotional context modulates response inhibition procedure. In order to investigate emotion cognition interaction in alexithymia, we analyzed the spatiao-temporal features of such emotional response inhibition by the approaches of event-related potentials and neural source-localization.MethodThe study participants included 15 subjects with high alexithymia scores on the 20-item Toronto Alexithymia Scale (alexithymic group) and 15 matched subjects with low alexithymia scores (control group). Subjects were instructed to perform a modified emotional Go/Nogo task while their continuous electroencephalography activities were synchronously recorded. The task includes 3 categories of emotional contexts (positive, negative and neutral) and 2 letters (“M” and “W”) centered in the screen. Participants were told to complete go and nogo actions based on the letters. We tested the influence of alexithymia in this emotional Go/Nogo task both in behavioral level and related neural activities of N2 and P3 ERP components.ResultsWe found that negatively valenced context elicited larger central P3 amplitudes of the Nogo–Go difference wave in the alexithymic group than in the control group. Furthermore, source-localization analyses implicated the anterior cingulate cortex (ACC) as the neural generator of the Nogo-P3.ConclusionThese findings suggest that difficulties in identifying feelings, particularly in negative emotions, is a major feature of alexithymia, and the ACC plays a critical role in emotion-modulated response inhibition related to alexithymia.

Confidence in Emotion Perception in Point-Light Displays Varies with the Ability to Perceive Own Emotions

One central issue in social cognitive neuroscience is that perceiving emotions in others relates to activating the same emotion in oneself. In this study we sought to examine how the ability to perceive own emotions assessed with the Toronto Alexithymia Scale related to both the ability to perceive emotions depicted in point-light displays and the confidence in these perceptions. Participants observed video scenes of human interactions, rated the depicted valence, and judged their confidence in this rating. Results showed that people with higher alexithymia scores were significantly less confident about their decisions, but did not differ from people with lower alexithymia scores in the valence of their ratings. Furthermore, no modulating effect of social context on the effect of higher alexithymia scores was found. It is concluded that the used stimuli are fit to investigate the kinematic aspect of emotion perception and possibly separate people with high and low alexithymia scores via confidence differences. However, a general difference in emotion perception was not detected in the present setting.

Impairment of conflict processing in alexithymic individuals

Alexithymia is characterized by difficulties in identifying and describing feelings and in distinguishing between feelings and bodily sensations. Several researchers have examined the impairment of executive functioning in alexithymia; however, only a few studies have been specifically concerned with conflict processing in alexithymia. Utilizing the attention network test (ANT), we investigated whether alexithymia is related to or independent of executive function, especially with respect to conflict processing. Participants included 33 subjects with high alexithymia scores on the 20-item Toronto Alexithymia Scale (TAS-20) and 30 matched subjects with low alexithymia scores. On the ANT, we found a significant difference between the two groups in conflict processing, and no significant difference in alerting and orienting dimensions. These findings suggested that subjects with high alexithymia scores have selective impairment in conflict processing.

Alexithymia and Circumcision Trauma: A Preliminary Investigation

This preliminary study investigates what role early trauma might have in alexithymia acquisition for adults by controlling for male circumcision. Three hundred self-selected men were administered the Toronto Twenty-Item Alexithymia Scale checklist and a personal history questionnaire. The circumcised men had age-adjusted alexithymia scores 19.9 percent higher than the intact men; were 1.57 times more likely to have high alexithymia scores; were 2.30 times less likely to have low alexithymia scores; had higher prevalence of two of the three alexithymia factors (difficulty identifying feelings and difficulty describing feelings); and were 4.53 times more likely to use an erectile dysfunction drug. Alexithymia in this population of adult men is statistically significant for having experienced circumcision trauma and for erectile dysfunction drug use.

Alexithymia in patients with alopecia areata: educational background much more important than traumatic events

Recent studies suggest a higher prevalence of alexithymia in patients with alopecia areata (AA). Some authors link alexithymia with the presence of early traumatic events, such as dysfunctional parent-child relationships. However, until today, no studies have been carried out on the association of alexithymia and early traumatic events in AA patients. The primary aim of this study was to explore if an association exists between the presence of traumatic childhood experiences and alexithymia in AA patients. A secondary aim was to confirm earlier observations indicating that the occurrence and/or degree of alexithymia is higher in patients with AA compared with individuals from the general population. We enrolled 90 patients with AA. Data on alexithymia and traumatic events were collected with two self-report questionnaires: the Toronto Alexithymia Scale-20 and the Traumatic Experiences Checklist. These data were compared with data obtained from control patients without AA randomly selected from patients presenting for dermatological surgery. In adult AA patients, we found no evidence for a significant association between Toronto Alexithymia Scale (TAS) scores and emotional neglect or childhood traumatic experiences. We found a significant association with educational level, higher levels of education being associated with lower TAS-20 scores (P = 0.002). The mean TAS-20 score of 51.22 (SD 11.90) in our adult AA patient group was significantly higher compared with control patients from the same setting (44.00, SD 10.33, P < 0.001). In adult AA patients, higher levels of education are significantly associated with lower alexithymia scores. Somewhat unexpectedly, we found no association between alexithymia score and emotional neglect or childhood traumatic experiences. Our results also confirm that alexithymia scores are significantly higher in adult patient with AA compared with control patients.

The Impact of Alexithymia on Asthma Patient Management and Communication with Health Care Providers: A Pilot Study

Background and objectives. Alexithymia is a personality trait associated with difficulty identifying and verbalizing feelings. It has been associated with poorly controlled asthma and near-fatal asthma. The primary objectives were to () determine the prevalence of alexithymia in a group of moderate to severe asthmatics who attended an Outpatient Clinic; and () investigate the relationship between alexithymia and asthma control, management, and communication. Methods. Twenty-five moderate to severe asthma patients were recruited from the Royal Adelaide Hospital Outpatient Respiratory Clinic. Participants were either mailed the questionnaire pack or completed it after a clinic appointment. Existing validated questionnaires were used to collect data. The primary outcome measures were alexithymia, asthma control, adherence to medication; patient satisfaction with communication with health care providers and health-related quality of life. Data were analyzed using Pearson correlations, linear regression and analysis of variance (ANOVA) in SPSS. A p value ≤ 0.05 was required for statistical significance. Results. A total of 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years ± 11) participated. Alexithymia scores ranged between 23.0-76.0 ( = 48.3, SD = 13.2); 12% of participants reported high alexithymia scores, 32% reported borderline alexithymia scores, and 56% reported low alexithymia scores. Alexithymia mean scores were not statistically different across sociodemographic variables. A higher alexithymia score was associated with worse asthma control score (r = 0.57, p < 0.01) (where higher asthma control scores indicate worse asthma control); poor adherence (p = 0.03), and worse quality of life (r = - 0.65, p < 0.01). Alexithymia score was not correlated with satisfaction with communication (r = − 0.27, p = 0.2).), or the number of hospitalizations for asthma (p = 0.25). Conclusions. This is the first study to investigate relationships between alexithymia, asthma control, asthma management and communication with health care professionals. The study reaffirms associations between alexithymia and asthma control, but a larger sample size is needed to determine the impact of alexithymia on self-management and provision of clinical care for asthma.

Gamma band activity and its synchronization reflect the dysfunctional emotional processing in alexithymic persons

In the present study, we investigated the gamma band response and its phase synchrony between electrodes in alexithymia, which is characterized by a disability in identifying and describing feelings. Individuals with high and low alexithymia scores were selected according to the scores on the 20-item Toronto Alexithymia Scale. EEG was recorded from alexithymic and nonalexithymic persons viewing emotionally negative or neutral stimuli. Nonalexithymic persons exhibited increased gamma band power and phase synchronization at the 400-450-ms time window when processing emotionally negative stimuli. Neither enhanced gamma band power nor phase synchronization was observed in alexithymic persons in the negative emotion condition. These results suggest that gamma band activity reflects emotional processing, and alexithymic persons may have a deficit in communication between brain regions or in the utilization of memory or emotional information during the processing of emotional stimuli.

Alexithymia is no risk factor for exacerbation in spasmodic torticollis patients

Objective: To assess whether alexithymia is a risk factor for exacerbation in spasmodic torticollis (ST). Methods: ST patients (2×10) with high vs. low alexithymia scores (mean score on the 20-item Toronto Alexithymia Scale [TAS-20]=69.2 vs. 28.7) were compared on physiological, motor and subjective responses to a cognitive and an emotional laboratory stressor. Changes in sustained abnormal head/shoulder positions and maximum range of motion (ROM) of the cervical spine were kinematically quantified. Skin conductance level (SCL), nonspecific skin conductance fluctuations (NS.SCF), heart rate (HR) and skin temperature (T) were measured. Results: High alexithymia had no effect on the abnormal head posture or movements, but high-alexithymic ST patients showed generally increased levels of autonomic arousal (more NS.SCF, higher SCL; analysis of variance [ANOVA]: P=.016 and P=.051, respectively) under all experimental conditions. When ST symptom severity (TSUI-score) was partialled out, these group differences were somewhat reduced (analysis of covariance [ANCOVA]: P=.052 and P=.143). Conclusions: High alexithymia did not lead to increased abnormal head movements to stressors, but may result in a subtle increase in tonic level of sympathetic activity.