The Emotional World
f. Alexithymia


From Wikipedia, the free encyclopedia

Alexithymia (pronounced: /ˌeɪlɛksəˈθaɪmiə/) from the Greek words λεξις and θυμος, literally "without words for emotions") was a term coined by Peter Sifneos in 1972 to describe people who appeared to have deficiencies in understanding, processing, or describing their emotions. Deficiencies may include:

  • problems identifying, describing, and working with one's own feelings, often marked by a lack of understanding of the feelings of others;
  • confusion of physical sensations often associated with emotions;
  • few dreams or fantasies due to restricted imagination; and
  • concrete, realistic, logical thinking, often to the exclusion of emotional responses to problems.
  • Those who have Alexithymia also report very logical and realistic dreams, such as going to the store or eating supper.

Alexithymia is classified as a mental disorder in the DSM IV. It is also a personality trait that varies in severity from person to person. A person's alexithymia score can be measured with questionnaires, such as the Toronto Alexithymia Scale.

It is unclear what causes alexithymia. Some neuropsychological studies indicate that alexithymia may be due to a disturbance to the right hemisphere of the brain, which is largely responsible for processing emotions

Alexithymia is a manifestation of a deficit in emotional cognition. People with this problem are mostly unaware of their feelings, or don't know what they signify, and hence they rarely talk about their emotions or their emotional preferences; they operate in a very functional manner and rarely use imagination to focus their drives and motivations. Alexithymia refers to this distinctive cluster of characteristics.

Alexithymics have been described as human robots, or emotional illiterates. They score very low on measures of emotional intelligence and are likely to fare rather poorly in life, whatever their intellectual abilities. Their interpersonal relationships are frequently hampered by poor emotional communication. Many also suffer chronic medical problems, particularly psychosomatic or somatoform illnesses.

Although alexithymia is a clinical construct, it does not constitute a diagnostic illness in its own right. It is a clinical feature associated with a range of medical diagnoses, such as Post-Traumatic Stress Disorder, Anorexia Nervosa or Asperger's Syndrome. There is, however, a strong case for construing it (or more properly the associated psychological deficit) as an independent condition or cognitive-affective dysfunction. It is arguably inappropriate to say that alexithymics have a disorder or disability, although their inability to interpret their own emotional signals may have profoundly disruptive effect on their personal lives.

How do I tell if I'm alexithymic?

If you have a marked deficiency in emotional understanding, there will be various clues evident in everyday life. For example, you might:

find it difficult to talk about your own emotions;
be perceived by others as excessively logical, or unsentimental without being unfriendly;
be perplexed by other people's emotional reactions;
give pedantic and long-winded answers to practical questions;
rarely daydream or fantasize about personal prospects;
have a subdued reaction to art, literature or music;
make personal decisions according to principles rather than feelings;
suffer occasional inexplicable physiological disturbances such as palpitations, stomach ache, or hot flushes.

Where did the term originate?

During the 1950s and 60s the psychiatrists Peter E. Sifneos and John C. Nemiah, working at the Beth Israel Hospital at Harvard, noted that a large proportion of patients with psychosomatic complaints had extreme difficulty talking about their emotions. These patients had other characteristics in common, including a stiff posture, a focus on functional details and a barren fantasy life. In 1972 Sifneos coined the term alexithymia to refer to this bundle of characteristics. He introduced it in two publications; in an article entitled "The Prevalence of 'Alexithymic' Characteristics in Psychosomatic Patients" published in the book Topics of Psychosomatic Research in 1972 and in the journal Psychotherapy and Psychosomatics in 1973; and (briefly) in his 1972 book Short-Term Psychotherapy and Emotional Crisis.

What are the key features of the alexithymia syndrome?

Difficulty identifying different types of feelings
Difficulty distinguishing between emotional feelings and bodily feelings
Limited understanding of what caused the feelings
Difficulty verbalising feelings
Limited emotional content in the imagination
Functional style of thinking
Lack of enjoyment and pleasure-seeking
Stiff, wooden posture

Titre du document / Document title

Prevalence and sociodemographic correlates of Alexithymia in a population sample of young adults

Auteur(s) / Author(s)

KOKKONEN Pirkko ; KARVONEN Juha T. ; VEIJOLA Juha ; LÄKSY Kristian ; JOKELAINEN Jari ; JÄRVELIN Marjo-Riitta ; JOUKAMAA Matti ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Department of Psychiatry, Oulu University Hospital, Oulu, FINLANDE
Department of Public Health, University of Oulu, Department of Epidemiology and Public Health, Oulu, FINLANDE
Imperial College School of Medicine, London, ROYAUME-UNI

Résumé / Abstract

We examined the prevalence of alexithymia and its associations with sociodemographic factors in a population cohort. The study forms part of the Northern Finland 1966 Birth Cohort. The original material consisted of all 12,058 live-born children in the provinces of Lapland and Oulu in Finland with an expected delivery date during 1966. The material represents 96% of all births in the region. In 1997, a 31-year follow-up study was conducted on a part of the initial sample. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was given to 5,993 subjects; 84% returned the questionnaire properly answered. It is known that alexithymia is associated with psychological distress. This was measured with the 25-item version of the Hopkins Symptom Check List (HSCL-25). The prevalence of alexithymia (TAS-20 score > 60) was 9.4% in male and 5.2% in female subjects. Alexithymia was associated with poor education and low income level and it was more common among unmarried subjects. After adjusting for psychological distress, these associations remained statistically significant. The prevalence of alexithymia was higher in men than in women and alexithymia was associated with poor social situation. As far as we know, this was the first study to assess the prevalence of alexithymia and its associations with sociodemographic factors in a large and representative cohort sample, adjusted for psychological distress.

Revue / Journal Title

Comprehensive psychiatry  (Compr. psych.)  ISSN 0010-440X  CODEN COPYAV

Source / Source

2001, vol. 42, no6, pp. 471-476 (23 ref.)

Titre du document / Document title

The prevalence of alexithymia in primary care patients

Auteur(s) / Author(s)

POSSE M. (1) ; HÄLLSTRÖM T. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Clinical Neuroscience and Family Medicine, Section of Psychiatry, Karolinska Institutet at Huddinge Hospital, Huddinge, SUEDE

Résumé / Abstract

The aim of this study was to describe how the scores of the test designed to measure alexithymia were distributed in this primary care outpatient population. We also wanted to examine the relationship of alexithymia to sociodemographic variables and personality traits. 450 consecutive patients at the Primary Health Care Centre; were asked to voluntarily complete an inventory consisting of several scales designed to test alexithymia and somatisation as well as general personality traits. The prevalence of alexithymia as measured using the Schalling Sifneos Personality Scale (SSPS) was 20.0% ( men 28%, women 12%). Alexithymia was significantly associated with higher age, having a lower educational background, living alone but having more children. The personality traits associated with SSPS scores were Suspicion and Distance. High grade SSPS scores were also associated with high scores on Somatic Anxiety, Psychastenia, and Irritability and with low scores for socialisation (p<0.01). The conclusions reached regarding prevalence rate, age, sex and education are consistent with other findings. When data was analyzed as continuous variables, high grade scores for alexithymia became significantly associated with Somatic Anxiety, Psychastenia, Irritability as well as low grade reability to socialise.

Revue / Journal Title

The European journal of psychiatry  (Eur. j. psychiatry)  ISSN 0213-6163  CODEN EJOPEO

Source / Source

1999, vol. 13, no1, pp. 5-11 (25 ref.)

The assessment and prevalence of alexithymia

Alexithymia (which literally translates as 'without words for emotion') is a construct used to encompass a constellation of features, including having difficulty identifying emotions within oneself, difficulty expressing one's emotions verbally, and using a particular style of thinking which can described as utilitarian and externally oriented. Although there has been much debate over the last two decades about the nature and content of the alexithymia construct, nonetheless it is viewed by researchers in the field as valid and as having a number of potential clinical applications (Taylor, 2000). As for several individual difference constructs that are quasi-clinical, the concept and its measurement is most usually dimensional, although prevalence is sometimes calculated using a cut-off score. On the basis of an albeit-small clinical sample of 39, Taylor, Bagby, and Parker (1997) suggest a cut-off of 61 and above on the Toronto Alexithymia Scale (TAS-20). Studies of alexithymia using a cut-off on the earlier 26-item TAS have reported rates of 17.1% in France (Loas, Fremaux, Otmani, & Verrier, 1995), and 18.8% in Canada (Parker, Taylor, & Bagby, 1989). In Finland, one study using the TAS-20 has resulted in rates of 13% (Salminen, Saarijarvi, Aarela, Toikka, & Kauhanen, 1999), while another study reported rates of 9.4% in males and 5.2% in females in a very large-scale cohort (Kokkonen et al., 2001). However, the cultural appropriateness of retaining a particular psychometric cut-off is unknown. Leff (1973) suggested that there might be variation across cultures, given differing values attached to both emotional awareness and expression in different countries.

To date there has been little study of alexithymia prevalence within a British population, and there is a general dearth of data about its nature and correlates in the UK. Although there is a range of measures that include interview schedules, the TAS-20 was chosen as it remains the most widely used because of its easy administration and well-developed psychometric pedigree. This is not to claim that it necessarily assesses all aspects of alexithymia comprehensively, as any assessment based on self-report probably suffers where insight into one's own psychological processes may be lacking.

In addition to putative cultural differences, Blanchard, Arena, and Pallmeyer (1981) have proposed that there may be gender differences in alexithymia, following an earlier investigation in which the levels of alexithymia in males were found to be much higher than in females. This study did not use a reliable or valid measure of alexithymia and later studies have not unequivocally supported the notion of gender differences (Parker, Taylor, & Bagby, 1989; Elzinga, Bermond, & Dyck, 2002). Kokkonen et al. (2001) found that males exceeded females by around 4%. Most recently, Parker et al. (2003) found that while males scored more highly, the difference was a trivial one. Potential gender differences in an undergraduate UK sample are unknown and therefore difficult to hypothesize about.

Prevalence studies to date have sampled both the general and undergraduate populations. Where the latter have been used, no attempt has been made to divide participants according to their subject of study, the common assumption being that undergraduates constitute a homogeneous group. However, previous research has indicated that students studying arts and science subjects differ with respect to personality variables that may be likely to be linked to alexithymia. Hudson (1966), for example, following a series of studies of boys in British secondary schools, noted a tendency among science students to concentrate 'upon the impersonal aspects of [their] culture, both in school and out' (p. 84). He goes on to comment that 'at some stage of his life [the science student] seems to have turned his back on the sphere of personal relations, and focused all his attention on areas where people and personal emotions are least likely to obtrude' (p. 85). The arts student on the other hand was found to appear drawn 'towards the human aspects of his culture' and to 'enjoy expressing his feelings about matters that are personal' (pp. 90-91). In later investigations, Butcher (1969) and Bamber, Bill, Boyd, and Corbett (1983) showed that science students scored significantly higher than their arts counterparts on Eysenck's psychoticism scale, a dimension which may have a diminished capacity for empathy in common with alexithymia. For these reasons, the present study chose to record degree subject and to recruit from a wide range of disciplines.

Prevalence rates of alexithymia

Overall, 17.92% were identified as alexithymic in the sample (defined by the recommended cut-off rate of 61 on the TAS-20). Rates of alexithymia are reported by gender, faculty (arts or science), and gender/faculty in Table 1.

The gender difference in prevalence (according to cut-offs) for females and males was statistically significant (χ2=11.85, df=1, p<.01).