1932
0

Annual Review of Psychology

Volume 76, 2025

Alexithymia: Toward an Experimental, Processual Affective Science with Effective Interventions

  • Olivier Luminet1,2 and Kristy A. Nielson3,4
  • 1Research Institute for Psychological Sciences, UCLouvain, Louvain-la-Neuve, Belgium; email: [email protected] 2Fund for Scientific Research (FRS-FNRS), Brussels, Belgium 3Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA 4Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  • Vol. 76:741-769 (Volume publication date January 2025)
  • First published as a Review in Advance on September 25, 2024
  • Copyright © 2025 by the author(s).
    This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information.

Abstract

Alexithymia is a multi-dimensional personality trait involving difficulty identifying feelings, difficulty describing feelings, and an externally oriented thinking style. Poor fantasy life is debated as another facet. For over 50 years, the alexithymia literature has examined how alexithymia-related disturbances in perceiving and expressing feelings contribute to mental and physical disorders. We review the current understanding of alexithymia—including its definition, etiology, measurement, and vulnerabilities for both mental and physical illness—and its treatment. We emphasize the importance of further experimental and processual affective science research that () emphasizes facet-level analysis toward an understanding of the nuanced bases of alexithymia effects on neural, cognitive, and behavioral processes; () distinguishes between emotion deficits and emotion over-responding, including when over-responding is functional; and () clarifies when and how impairments occur for neutral and positively valenced information or contexts. Taken as a whole, a clarification of these issues will provide clear directions for effective and tailored alexithymia interventions.

Keyword(s): affect, cognition, emotion regulation, personality assessment, psychopathology, psychosocial interventions
Loading

Article metrics loading...

/content/journals/10.1146/annurev-psych-021424-030718
2025-01-17
2025-06-16
Loading full text...

Full text loading...

/deliver/fulltext/psych/76/1/annurev-psych-021424-030718.html?itemId=/content/journals/10.1146/annurev-psych-021424-030718&mimeType=html&fmt=ahah

Literature Cited

  1. Alexander F. 1950.. Psychosomatic Medicine: Its Principles and Applications. New York:: W.W. Norton
     [Google Scholar]
  2. Bagby RM, Parker JD, Onno KA, Mortezaei A, Taylor GJ. 2021.. Development and psychometric evaluation of an informant form of the 20-item Toronto Alexithymia Scale. . J. Psychosom. Res. 141::110329
     [Crossref] [Google Scholar]
  3. Bagby RM, Parker JD, Taylor GJ. 1994a.. The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. . J. Psychosom. Res. 38::23–32
     [Crossref] [Google Scholar]
  4. Bagby RM, Parker JD, Taylor GJ. 2020.. Twenty-five years with the 20-item Toronto Alexithymia Scale. . J. Psychosom. Res. 131::109940 Overviews TAS-20 psychometric progress and its contributions to the evolution of the alexithymia construct.
     [Crossref] [Google Scholar]
  5. Bagby RM, Taylor GJ, Parker JD. 1994b.. The twenty-item Toronto Alexithymia Scale—II. Convergent, discriminant, and concurrent validity. . J. Psychosom. Res. 38::33–40
     [Crossref] [Google Scholar]
  6. Bagby RM, Taylor GJ, Parker JD, Dickens SE. 2005.. The development of the Toronto structured interview for alexithymia: item selection, factor structure, reliability and concurrent validity. . Psychother. Psychosom. 75::25–39
     [Crossref] [Google Scholar]
  7. Baudic S, Jayr C, Albi-Feldzer A, Fermanian J, Masselin-Dubois A, et al. 2016.. Effect of alexithymia and emotional repression on postsurgical pain in women with breast cancer: a prospective longitudinal 12-month study. . J. Pain 17::90–100
     [Crossref] [Google Scholar]
  8. Beresnevaite M. 2000.. Exploring the benefits of group psychotherapy in reducing alexithymia in coronary heart disease patients: a preliminary study. . Psychother. Psychosom. 69::117–22
     [Crossref] [Google Scholar]
  9. Bermond B, Oosterveld P, Vorst HC. 2015.. Measures of alexithymia. . In Measures of Personality and Social Psychological Constructs, ed. GJ Boyle, DH Saklofske, G Matthews , pp. 227–56. Amsterdam:: Elsevier
     [Google Scholar]
  10. Bernstein EE, LeBlanc NJ, Bentley KH, Barreira PJ, McNally RJ. 2021.. A single-session workshop to enhance emotional awareness and emotion regulation for graduate students: a pilot study. . Cogn. Behav. Pract. 28::393–409
     [Crossref] [Google Scholar]
  11. Binder JR, Desai RH. 2011.. The neurobiology of semantic memory. . Trends Cogn. Sci. 15::527–36
     [Crossref] [Google Scholar]
  12. Bucci W. 1997a.. Psychoanalysis and Cognitive Science: A Multiple Code Theory. New York:: Guilford
     [Google Scholar]
  13. Bucci W. 1997b.. Symptoms and symbols: a multiple code theory of somatization. . Psychoanal. Inq. 17::151–72
     [Crossref] [Google Scholar]
  14. Burger AJ, Lumley MA, Carty JN, Latsch DV, Thakur ER, et al. 2016.. The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: a preliminary, uncontrolled trial. . J. Psychosom. Res. 81::1–8
     [Crossref] [Google Scholar]
  15. Cameron K, Ogrodniczuk J, Hadjipavlou G. 2014.. Changes in alexithymia following psychological intervention: a review. . Harv. Rev. Psychiatry 22::162–78 Illustrates effective alexithymia reduction through the targeting of specific alexithymia-related skills.
     [Crossref] [Google Scholar]
  16. Correro AN II, Paitel ER, Byers SJ, Nielson KA. 2021.. The role of alexithymia in memory and executive functioning across the lifespan. . Cogn. Emot. 35::524–39 Highlights the interactive effects of two alexithymia facets, difficulty identifying feelings and externally oriented thinking, on cognition.
     [Crossref] [Google Scholar]
  17. Costa PT, McCrae RR. 1992.. The five-factor model of personality and its relevance to personality disorders. . J. Personal. Disord. 6::343–59
     [Crossref] [Google Scholar]
  18. Crüwell S, van Doorn J, Etz A, Makel MC, Moshontz H, et al. 2019.. Seven easy steps to open science. . Z. Psychol. 227::237–48
     [Google Scholar]
  19. de Timary P, Luts A, Hers D, Luminet O. 2008.. Absolute and relative stability of alexithymia in alcoholic inpatients undergoing alcohol withdrawal: relationship to depression and anxiety. . Psychiatry Res. 157::105–13
     [Crossref] [Google Scholar]
  20. Desmedt O, Luminet O, Maurage P, Corneille O. 2023.. Discrepancies in the definition and measurement of human interoception: a comprehensive discussion and suggested ways forward. . Perspect. Psychol. Sci. In press. https://doi.org/10.1177/17456916231191537
    [Google Scholar]
  21. Diaz R, Prinz J. 2023.. The role of emotional awareness in evaluative judgment: evidence from alexithymia. . Sci. Rep. 13::5183
     [Crossref] [Google Scholar]
  22. Diener E, Larsen RJ, Levine S, Emmons RA. 1985.. Intensity and frequency: dimensions underlying positive and negative affect. . J. Personal. Soc. Psychol. 48::1253
     [Crossref] [Google Scholar]
  23. Dobrushina OR, Dobrynina LA, Arina GA, Kremneva EI, Novikova ES, et al. 2022.. Enhancing brain connectivity with infra-low frequency neurofeedback during aging: a pilot study. . Front. Hum. Neurosci. 16::891547
     [Crossref] [Google Scholar]
  24. Dobrushina OR, Vlasova RM, Rumshiskaya AD, Litvinova LD, Mershina EA, et al. 2020.. Modulation of intrinsic brain connectivity by implicit electroencephalographic neurofeedback. . Front. Hum. Neurosci. 14::192
     [Crossref] [Google Scholar]
  25. Dressaire D, Stone CB, Nielson KA, Guerdoux E, Martin S, et al. 2015.. Alexithymia impairs the cognitive control of negative material while facilitating the recall of neutral material in both younger and older adults. . Cogn. Emot. 29::442–59
     [Crossref] [Google Scholar]
  26. Edwards ER, Wupperman P. 2017.. Emotion regulation mediates effects of alexithymia and emotion differentiation on impulsive aggressive behavior. . Deviant Behav. 38::1160–71
     [Crossref] [Google Scholar]
  27. Fantini-Hauwel C, Luminet O, Vermeulen N. 2015.. Live happily live in hiding (from our affect): Alexithymia influences affect intensity and affect frequency ratings in men. . Psychiatry Res. 230::637–42
     [Crossref] [Google Scholar]
  28. Frohlich F, Townsend L. 2021.. Closed-loop transcranial alternating current stimulation: towards personalized non-invasive brain stimulation for the treatment of psychiatric illnesses. . Curr. Behav. Neurosci. Rep. 8::51–57
     [Crossref] [Google Scholar]
  29. Gay MC, Hanin D, Luminet O. 2008.. Effectiveness of an hypnotic imagery intervention on reducing alexithymia. . Contemp. Hypn. 25::1–13
     [Crossref] [Google Scholar]
  30. Goerlich KS. 2018.. Electrophysiology of alexithymia. . See Luminet et al. 2018 , pp. 250–66
  31. Goerlich KS, Aleman A. 2018.. Neuroimaging studies of alexithymia. . See Luminet et al. 2018 , pp. 207–49
  32. Goerlich KS, Votinov M. 2022.. Hormonal abnormalities in alexithymia. . Front. Psychiatry 13::1070066
     [Crossref] [Google Scholar]
  33. Grabe HJ, Schwahn C, Barnow S, Spitzer C, John U, et al. 2010.. Alexithymia, hypertension, and subclinical atherosclerosis in the general population. . J. Psychosom. Res. 68::139–47
     [Crossref] [Google Scholar]
  34. Gross JJ. 2015.. Emotion regulation: current status and future prospects. . Psychol. Inq. 26::1–26
     [Crossref] [Google Scholar]
  35. Grynberg D, Berthoz S, Bird G. 2018.. Social and interpersonal implications. . See Luminet et al. 2018 , pp. 174–89
  36. Gvirts HZ, Dery L. 2021.. Alexithymia and reaching group consensus. . Cogn. Emot. 35::510–23
     [Crossref] [Google Scholar]
  37. Henry JD, Phillips LH, Crawford JR, Theodorou G, Summers F. 2006.. Cognitive and psychosocial correlates of alexithymia following traumatic brain injury. . Neuropsychologia 44::62–72
     [Crossref] [Google Scholar]
  38. Hiirola A, Pirkola S, Karukivi M, Markkula N, Bagby RM, et al. 2017.. An evaluation of the absolute and relative stability of alexithymia over 11 years in a Finnish general population. . J. Psychosom. Res. 95::81–87
     [Crossref] [Google Scholar]
  39. Hobson H, Brewer R, Catmur C, Bird G. 2019.. The role of language in alexithymia: moving towards a multiroute model of alexithymia. . Emot. Rev. 11::247–61
     [Crossref] [Google Scholar]
  40. Hoemann K, Nielson C, Yuen A, Gurera JW, Quigley KS, Barrett LF. 2021.. Expertise in emotion: a scoping review and unifying framework for individual differences in the mental representation of emotional experience. . Psychol. Bull. 147::1159–83
     [Crossref] [Google Scholar]
  41. Hogeveen J, Grafman J. 2021.. Alexithymia. . In Handbook of Clinical Neurology, Vol. 183, ed. KM Heilman, SE Nadeau , pp. 47–62. Amsterdam:: Elsevier
     [Google Scholar]
  42. Honkalampi K, Hintikka J, Tanskanen A, Lehtonen J, Viinamaki H. 2000.. Depression is strongly associated with alexithymia in the general population. . J. Psychosom. Res. 48::99–104
     [Crossref] [Google Scholar]
  43. Horney K. 1952.. The paucity of inner experiences. . Am. J. Psychoanal. 12::3–9
     [Crossref] [Google Scholar]
  44. Ihme K, Sacher J, Lichev V, Rosenberg N, Kugel H, et al. 2014a.. Alexithymic features and the labeling of brief emotional facial expressions—an fMRI study. . Neuropsychologia 64::289–99
     [Crossref] [Google Scholar]
  45. Ihme K, Sacher J, Lichev V, Rosenberg N, Kugel H, et al. 2014b.. Alexithymia and the labeling of facial emotions: response slowing and increased motor and somatosensory processing. . BMC Neurosci. 15::40
     [Crossref] [Google Scholar]
  46. Jakobson LS, Pearson PM. 2021.. Alexithymic traits predict the speed of classifying non-literal statements using nonverbal cues. . Cogn. Emot. 35::569–75
     [Crossref] [Google Scholar]
  47. Jonsson G, Franzén L, Nyström MBT, Davis PA. 2020.. Integrating yoga with psychological group-treatment for mixed depression and anxiety in primary healthcare: an explorative pilot study. . Complement. Ther. Clin. Pract. 41::101250
     [Crossref] [Google Scholar]
  48. Kano M, Fukudo S, Gyoba J, Kamachi M, Tagawa M, et al. 2003.. Specific brain processing of facial expressions in people with alexithymia: an H2 15O-PET study. . Brain 126::1474–84
     [Crossref] [Google Scholar]
  49. Karlsson H, Näätänen P, Stenman H. 2008.. Cortical activation in alexithymia as a response to emotional stimuli. . Br. J. Psychiatry 192::32–38
     [Crossref] [Google Scholar]
  50. Kauhanen J, Kaplan GA, Cohen RD, Julkunen J, Salonen JT. 1996.. Alexithymia and risk of death in middle-aged men. . J. Psychosom. Res. 41::541–49
     [Crossref] [Google Scholar]
  51. Kelman N. 1952.. Clinical aspects of externalized living. . Am. J. Psychoanal. 12::15–23
     [Crossref] [Google Scholar]
  52. Koven NS, Thomas W. 2010.. Mapping facets of alexithymia to executive dysfunction in daily life. . Personal. Individ. Differ. 49::24–28
     [Crossref] [Google Scholar]
  53. Krystal H. 1995.. Trauma and aging: a thirty year follow-up. . In Trauma: Explorations in Memory, ed. C Caruth , pp. 76–99. Baltimore, MD:: Johns Hopkins Univ. Press
     [Google Scholar]
  54. Krystal JH, Giller EL Jr., Cicchetti DV. 1986.. Assessment of alexithymia in posttraumatic stress disorder and somatic illness: introduction of a reliable measure. . Psychosom. Med. 48::84–94
     [Crossref] [Google Scholar]
  55. Kuppens P, Verduyn P. 2017.. Emotion dynamics. . Curr. Opin. Psychol. 17::22–26
     [Crossref] [Google Scholar]
  56. Lane RD, Quinlan DM, Schwartz GE, Walker PA, Zeitlin SB. 1990.. The levels of emotional awareness scale: a cognitive-developmental measure of emotion. . J. Personal. Assess. 55::124–34
     [Crossref] [Google Scholar]
  57. Lane RD, Schwartz GE. 1987.. Levels of emotional awareness: a cognitive-developmental theory and its application to psychopathology. . Am. J. Psychiatry 144::133–43
     [Crossref] [Google Scholar]
  58. Lane RD, Weihs KL, Herring A, Hishaw A, Smith R. 2015.. Affective agnosia: expansion of the alexithymia construct and a new opportunity to integrate and extend Freud's legacy. . Neurosci. Biobehav. Rev. 55::594–611
     [Crossref] [Google Scholar]
  59. Lee KS, Murphy J, Catmur C, Bird G, Hobson H. 2022.. Furthering the language hypothesis of alexithymia: an integrated review and meta-analysis. . Neurosci. Biobehav. Rev. 141::104864
     [Crossref] [Google Scholar]
  60. Levine B, Schweizer TA, O'Connor C, Turner G, Gillingham S, et al. 2011.. Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. . Front. Hum. Neurosci. 5::9
     [Crossref] [Google Scholar]
  61. Leweke F, Bausch S, Leichsenring F, Walter B, Stingl M. 2009.. Alexithymia as a predictor of outcome of psychodynamically oriented inpatient treatment. . Psychother. Res. 19::323–31
     [Crossref] [Google Scholar]
  62. Li R, Kajanoja J, Karlsson L, Karlsson H, Karukivi M. 2023a.. Sex-specific role of alexithymia in associations between parental bonding and mental health: a moderated mediation model. . J. Clin. Psychol. 79::126–42
     [Crossref] [Google Scholar]
  63. Li R, Kajanoja J, Karlsson L, Karlsson H, Nolvi S, Karukivi M. 2023b.. Longitudinal patterns of alcohol use and psychological symptoms during COVID-19 pandemic and role of alexithymia: a latent transition analysis in the FinnBrain Birth Cohort Study. . J. Affect. Disord. 338::440–48
     [Crossref] [Google Scholar]
  64. Lindquist KA. 2017.. The role of language in emotion: existing evidence and future directions. . Curr. Opin. Psychol. 17::135–39
     [Crossref] [Google Scholar]
  65. Linn BK, Stasiewicz PR, Fillo J, Bradizza CM. 2020.. The great disrupter: relationship of alexithymia to emotion regulation processes and smoking among pregnant women. . Subst. Use Misuse 55::1113–21
     [Crossref] [Google Scholar]
  66. Lo C. 2014.. Cultural values and alexithymia. . Sage Open 4:. https://doi.org/10.1177/2158244014555117
    [Crossref] [Google Scholar]
  67. Luminet O, Bagby RM, Taylor GJ. 2001.. An evaluation of the absolute and relative stability of alexithymia in patients with major depression. . Psychother. Psychosom. 70::254–60
     [Crossref] [Google Scholar]
  68. Luminet O, Bagby RM, Taylor GJ. 2018.. Alexithymia: Advances in Research, Theory, and Clinical Practice. Cambridge, UK:: Cambridge Univ. Press Contemporary overview of alexithymia, including history, assessment, transdiagnostic risks, and cognitive, clinical, social-interpersonal, and neural/biological factors.
     [Google Scholar]
  69. Luminet O, Bagby RM, Wagner H, Taylor GJ, Parker JDA. 1999.. Relation between alexithymia and the five-factor model of personality: a facet-level analysis. . J. Personal. Assess. 73::345–58
     [Crossref] [Google Scholar]
  70. Luminet O, Nielson KA, Ridout N. 2021a.. Cognitive-emotional processing in alexithymia: an integrative review. . Cogn. Emot. 35::449–87 Reviews the cognition–emotion literature by alexithymia facets and context, distinguishing deficits and over-responding patterns.
     [Crossref] [Google Scholar]
  71. Luminet O, Nielson KA, Ridout N. 2021b.. Having no words for feelings: alexithymia as a fundamental personality dimension at the interface of cognition and emotion. . Cogn. Emot. 35::435–48
     [Crossref] [Google Scholar]
  72. Luminet O, Rime B, Bagby RM, Taylor GJ. 2004.. A multimodal investigation of emotional responding in alexithymia. . Cogn. Emot. 18::741–66 Exemplifies a multi-task, multi-processes facet approach to studying alexithymia.
     [Crossref] [Google Scholar]
  73. Luminet O, Rokbani L, Ogez D, Jadoulle V. 2007.. An evaluation of the absolute and relative stability of alexithymia in women with breast cancer. . J. Psychosom. Res. 62::641–48
     [Crossref] [Google Scholar]
  74. Luminet O, Zamariola G. 2018.. Emotion knowledge and emotion regulation in alexithymia. . See Luminet et al. 2018 , pp. 49–77
  75. Lumley MA, Stettner L, Wehmer F. 1996.. How are alexithymia and physical illness linked? A review and critique of pathways. . J. Psychosom. Res. 41::505–18
     [Crossref] [Google Scholar]
  76. Lundh L-G, Simonsson-Sarnecki M. 2002.. Alexithymia and cognitive bias for emotional information. . Personal. Individ. Differ. 32::1063–75
     [Crossref] [Google Scholar]
  77. Lyvers M, Makin C, Toms E, Thorberg FA, Samios C. 2014.. Trait mindfulness in relation to emotional self-regulation and executive function. . Mindfulness 5::619–25
     [Crossref] [Google Scholar]
  78. MacLean PD. 1949.. Psychosomatic disease and the visceral brain; recent developments bearing on the Papez theory of emotion. . Psychosom. Med. 11::338–53
     [Crossref] [Google Scholar]
  79. Marty P, de M'Uzan M. 1963.. La “pensée opératoire. .” Rev. Fr. Psychanal. 27:(Suppl.):1345–56
     [Google Scholar]
  80. McAtamney K, Mantzios M, Egan H, Wallis DJ. 2021.. Emotional eating during COVID-19 in the United Kingdom: exploring the roles of alexithymia and emotion dysregulation. . Appetite 161::105120
     [Crossref] [Google Scholar]
  81. McDougall J. 1982.. Alexithymia: a psychoanalytic viewpoint. . Psychother. Psychosom. 38::81–90
     [Crossref] [Google Scholar]
  82. McEnaney E, Ryan C. 2024.. Improving the objective measurement of alexithymia using a computer-scored alexithymia provoked response questionnaire with an online sample. . J. Personal. Assess. In press. https://doi.org/10.1080/00223891.2024.2320417
    [Google Scholar]
  83. Meltzer MA, Nielson KA. 2010.. Memory for emotionally provocative words in alexithymia: a role for stimulus relevance. . Conscious. Cogn. 19::1062–68 Illustrates the role of salience in memory and how salience effects influence cognition in alexithymia.
     [Crossref] [Google Scholar]
  84. Menon V, D'Esposito M. 2022.. The role of PFC networks in cognitive control and executive function. . Neuropsychopharmacology 47::90–103
     [Crossref] [Google Scholar]
  85. Mierop A, Mikolajczak M, Stahl C, Bena J, Luminet O, et al. 2020.. How can intranasal oxytocin research be trusted? A systematic review of the interactive effects of intranasal oxytocin on psychosocial outcomes. . Perspect. Psychol. Sci. 15::1228–42
     [Crossref] [Google Scholar]
  86. Mikolajczak M, Luminet O. 2006.. Is alexithymia affected by situational stress or is it a stable trait related to emotion regulation?. Personal. Individ. Differ. 40::1399–408
     [Crossref] [Google Scholar]
  87. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. 2000.. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. . Cogn. Psychol. 41::49–100
     [Crossref] [Google Scholar]
  88. Morie KP, Crowley MJ, Mayes LC, Potenza MN. 2022.. The process of emotion identification: considerations for psychiatric disorders. . J. Psychiatr. Res. 148::264–74
     [Crossref] [Google Scholar]
  89. Morie KP, Nich C, Hunkele K, Potenza MN, Carroll KM. 2015.. Alexithymia level and response to computer-based training in cognitive behavioral therapy among cocaine-dependent methadone maintained individuals. . Drug Alcohol Depend. 152::157–63
     [Crossref] [Google Scholar]
  90. Morie KP, Ridout N. 2018.. Alexithymia and maladaptive regulatory behaviors in substance use disorders and eating disorders. . See Luminet et al. 2018 , pp. 158–74
  91. Nemiah JC, Freyberger H, Sifneos PE. 1976.. Alexithymia: a view of the psychosomatic process. . In Modern Trends in Psychosomatic Medicine, ed. OW Hill , pp. 430–39. London:: Butterworths
     [Google Scholar]
  92. Nemiah JC, Sifneos PE. 1970.. Affect and fantasy in patients with psychosomatic disorders. . In Modern Trends in Psychosomatic Medicine, ed. OW Hill , pp. 26–34. London:: Butterworths
     [Google Scholar]
  93. Nielson KA, Lorber W. 2009.. Enhanced post-learning memory consolidation is influenced by arousal predisposition and emotion regulation but not by stimulus valence or arousal. . Neurobiol. Learn. Mem. 92::70–79
     [Crossref] [Google Scholar]
  94. Nielson KA, Meltzer MA. 2009.. Modulation of long-term memory by arousal in alexithymia: the role of interpretation. . Conscious. Cogn. 18::786–93
     [Crossref] [Google Scholar]
  95. Nielson KA, Yee D, Erickson KI. 2005.. Memory enhancement by a semantically unrelated emotional arousal source induced after learning. . Neurobiol. Learn. Mem. 84::49–56
     [Crossref] [Google Scholar]
  96. Norman H, Marzano L, Coulson M, Oskis A. 2019.. Effects of mindfulness-based interventions on alexithymia: a systematic review. . Evid.-Based Ment. Health 22::36–43
     [Crossref] [Google Scholar]
  97. Ogrodniczuk J, Kealy D, Hadjipavlou G, Cameron K. 2018.. Therapeutic issues. . See Luminet et al. 2018 , pp. 190–206
  98. Ogrodniczuk JS, Piper WE, Joyce AS. 2011.. Effect of alexithymia on the process and outcome of psychotherapy: a programmatic review. . Psychiatry Res. 190::43–48
     [Crossref] [Google Scholar]
  99. Ogrodniczuk JS, Sochting I, Piper WE, Joyce AS. 2012.. A naturalistic study of alexithymia among psychiatric outpatients treated in an integrated group therapy program. . Psychol. Psychother. Theory Res. Pract. 85::278–91
     [Crossref] [Google Scholar]
  100. Omejc N, Rojc B, Battaglini PP, Marusic U. 2019.. Review of the therapeutic neurofeedback method using electroencephalography: EEG neurofeedback. . Bosn. J. Basic Med. Sci. 19::213–20
     [Google Scholar]
  101. Otteman CBD, Paitel ER, Polking MC, O'Reilly EM, Nielson KA. 2023.. Frontal lobe connectivity during response inhibition shows age-related vulnerability due to alexithymia, especially in women. . Psychophysiology 60::S45
     [Google Scholar]
  102. Panayiotou G, Leonidou C, Constantinou E, Hart J, Rinehart KL, et al. 2015.. Do alexithymic individuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample. . Compr. Psychiatry 56::206–16
     [Crossref] [Google Scholar]
  103. Panayiotou G, Panteli M, Vlemincx E. 2018.. Processing emotions in alexithymia: a systematic review of physiological markers. . See Luminet et al. 2018 , pp. 291–320
  104. Panayiotou G, Panteli M, Vlemincx E. 2021.. Adaptive and maladaptive emotion processing and regulation, and the case of alexithymia. . Cogn. Emot. 35::488–99 Reviews the importance of adaptive emotion regulation and the inflexibility underlying emotion regulation in alexithymia.
     [Crossref] [Google Scholar]
  105. Pepe A, Ornaghi V, Belacchi C, Farina E. 2023.. Alexithymia as a risk factor for social indifference: a quantitative study with a large sample of female adolescents. . School Ment. Health 15::540–51
     [Crossref] [Google Scholar]
  106. Pinna F, Manchia M, Paribello P, Carpiniello B. 2020.. The impact of alexithymia on treatment response in psychiatric disorders: a systematic review. . Front. Psychiatry 11::311
     [Crossref] [Google Scholar]
  107. Polking MC, Paitel ER, Otteman CBD, Evans SE, O'Reilly EM, Nielson KA. 2023.. Alexithymia predicts response inhibition-related frontal theta power in healthy elders. . Psychophysiology 60::S45
     [Google Scholar]
  108. Porcelli P, Taylor GJ. 2018.. Alexithymia and physical illness: a psychosomatic approach. . See Luminet et al. 2018 , pp. 105–26
  109. Preece D, Becerra R, Allan A, Robinson K, Dandy J. 2017.. Establishing the theoretical components of alexithymia via factor analysis: introduction and validation of the attention-appraisal model of alexithymia. . Personal. Individ. Differ. 119::341–52 Presents the theoretical foundations for the attention-appraisal model of alexithymia.
     [Crossref] [Google Scholar]
  110. Preece D, Becerra R, Robinson K, Dandy J, Allan A. 2018.. The psychometric assessment of alexithymia: development and validation of the Perth Alexithymia Questionnaire. . Personal. Individ. Differ. 132::32–44
     [Crossref] [Google Scholar]
  111. Preece DA, Gross JJ. 2023.. Conceptualizing alexithymia. . Personal. Individ. Differ. 215::112375
     [Crossref] [Google Scholar]
  112. Preece DA, Mehta A, Petrova K, Sikka P, Bjureberg J, et al. 2023.. Alexithymia and emotion regulation. . J. Affect. Disord. 324::232–38
     [Crossref] [Google Scholar]
  113. Preece DA, Mehta A, Petrova K, Sikka P, Pemberton E, Gross JJ. 2024.. Alexithymia profiles and depression, anxiety, and stress. . J. Affect. Disord. 357::116–25
     [Crossref] [Google Scholar]
  114. Quilty LC, Taylor GJ, McBride C, Bagby RM. 2017.. Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder. . Psychiatry Res. 254::75–79
     [Crossref] [Google Scholar]
  115. Quirin M, Robinson MD, Rauthmann JF, Kuhl J, Read SJ, et al. 2020.. The dynamics of personality approach (DPA): 20 tenets for uncovering the causal mechanisms of personality. . Eur. J. Personal. 34::947–68
     [Crossref] [Google Scholar]
  116. Reilly EE, Brown TA, Arunagiri V, Kaye WH, Wierenga CE. 2022.. Exploring changes in alexithymia throughout intensive dialectical behavior therapy for eating disorders. . Eur. Eat. Disord. Rev. 30::193–205
     [Crossref] [Google Scholar]
  117. Reise SP. 2012.. Invited paper: the rediscovery of bifactor measurement models. . Multivariate Behav. Res. 47::667–96
     [Crossref] [Google Scholar]
  118. Ridout N, Smith J, Hawkins H. 2021.. The influence of alexithymia on memory for emotional faces and realistic social interactions. . Cogn. Emot. 35::540–58
     [Crossref] [Google Scholar]
  119. Robinson MD, Klein RJ, Persich MR. 2019.. Personality traits in action: a cognitive behavioral version of the social cognitive paradigm. . Personal. Individ. Differ. 147::214–22
     [Crossref] [Google Scholar]
  120. Ruesch J. 1948.. The infantile personality. The core problem of psychosomatic medicine. . Psychosom. Med. 10::134–44
     [Crossref] [Google Scholar]
  121. Rufer M, Albrecht R, Zaum J, Schnyder U, Mueller-Pfeiffer C, et al. 2010.. Impact of alexithymia on treatment outcome: a naturalistic study of short-term cognitive-behavioral group therapy for panic disorder. . Psychopathology 43::170–79
     [Crossref] [Google Scholar]
  122. Ryder AG, Doucerain MM, Zhou B, Dere J, Jurcik T, Zhou X. 2021.. On dynamic contexts and unstable categories. . In Handbook of Advances in Culture and Psychology, ed. M Gelfand, C-Y Chiu, YY-Y Hong , pp. 195–243. Oxford, UK:: Oxford Univ. Press
     [Google Scholar]
  123. Ryder AG, Sunohara M, Dere J, Chentsova-Dutton Y. 2018.. The cultural shaping of alexithymia. . See Luminet et al. 2018 , pp. 33–48
  124. Salles BM, Maturana de Souza W, Dos Santos VA, Mograbi DC. 2023.. Effects of DBT-based interventions on alexithymia: a systematic review. . Cogn. Behav. Ther. 52::110–31
     [Crossref] [Google Scholar]
  125. Salminen JK, Saarijarvi S, Aairela E, Tamminen T. 1994.. Alexithymia–state or trait? One-year follow-up study of general hospital psychiatric consultation out-patients. . J. Psychosom. Res. 38::681–85
     [Crossref] [Google Scholar]
  126. Scherer KR, Moors A. 2019.. The emotion process: event appraisal and component differentiation. . Annu. Rev. Psychol. 70::719–45
     [Crossref] [Google Scholar]
  127. Schimmenti A, Caretti V. 2018.. Attachment, trauma, and alexithymia. . See Luminet et al. 2018 , pp. 127–41
  128. Schroeders U, Kubera F, Gnambs T. 2022.. The structure of the Toronto Alexithymia Scale (TAS-20): a meta-analytic confirmatory factor analysis. . Assessment 29::1806–23
     [Crossref] [Google Scholar]
  129. Silveira S, Godara M, Faschinger A, Singer T. 2023.. Reducing alexithymia and increasing interoceptive awareness: a randomized controlled trial comparing mindfulness with dyadic socio-emotional app-based practice. . J. Affect. Disord. 341::162–69
     [Crossref] [Google Scholar]
  130. Smith PJ, Merwin RM. 2021.. The role of exercise in management of mental health disorders: an integrative review. . Annu. Rev. Med. 72::45–62
     [Crossref] [Google Scholar]
  131. Smith R, Killgore WDS, Lane RD. 2018.. The structure of emotional experience and its relation to trait emotional awareness: a theoretical review. . Emotion 18::670–92
     [Crossref] [Google Scholar]
  132. Stamenova V, Levine B. 2019.. Effectiveness of goal management training® in improving executive functions: a meta-analysis. . Neuropsychol. Rehabil. 29::1569–99
     [Crossref] [Google Scholar]
  133. Streiner DL. 2003.. Starting at the beginning: an introduction to coefficient alpha and internal consistency. . J. Personal. Assess. 80::99–103
     [Crossref] [Google Scholar]
  134. Strickland J, Parry CL, Allan MM, Allan A. 2017.. Alexithymia among perpetrators of violent offences in Australia: implications for rehabilitation. . Aust. Psychol. 52::230–37
     [Crossref] [Google Scholar]
  135. Subramaniam A, Liu S, Lochhead L, Appelbaum LG. 2023.. A systematic review of transcranial direct current stimulation on eye movements and associated psychological function. . Rev. Neurosci. 34::349–64
     [Crossref] [Google Scholar]
  136. Taylor GJ, Bagby RM. 2004.. New trends in alexithymia research. . Psychother. Psychosom. 73::68–77
     [Crossref] [Google Scholar]
  137. Taylor GJ, Bagby RM. 2021.. Examining proposed changes to the conceptualization of the alexithymia construct: The way forward tilts to the past. . Psychother. Psychosom. 90::145–55
     [Crossref] [Google Scholar]
  138. Taylor GJ, Bagby RM, Luminet O. 2000.. Assessment of alexithymia: self-report and observer-rated measures. . In The Handbook of Emotional Intelligence: Theory, Development, Assessment, and Application at Home, School, and in the Workplace, ed. R Bar-On, JDA Parker , pp. 301–19. San Francisco, CA:: Jossey-Bass/Wiley
     [Google Scholar]
  139. Taylor GJ, Bagby RM, Porcelli P. 2023.. Revisiting the concept of pensée opératoire: some conceptual, empirical, and clinical considerations. . Psychodynam. Psychiatry 51::287–310
     [Crossref] [Google Scholar]
  140. Taylor GJ, Ryan D, Bagby RM. 1985.. Toward the development of a new self-report alexithymia scale. . Psychother. Psychosom. 44::191–99
     [Crossref] [Google Scholar]
  141. Tolmunen T, Heliste M, Lehto SM, Hintikka J, Honkalampi K, Kauhanen J. 2011.. Stability of alexithymia in the general population: an 11-year follow-up. . Compr. Psychiatry 52::536–41
     [Crossref] [Google Scholar]
  142. Torlak MS, Unuvar BS, Gercek H. 2022.. Effect of aerobic exercise on the levels of pain, quality of life, and alexithymia in alexithymic individuals with chronic pain: a single-blinded randomized controlled trial. . J. Manip. Physiol. Ther. 45::652–59
     [Crossref] [Google Scholar]
  143. Torunsky NT, Knauz S, Vilares I, Marcoulides KM, Koutstaal W. 2023.. What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires. . Personal. Individ. Differ. 214::112308
     [Crossref] [Google Scholar]
  144. Vermeulen N, Domachowska I, Nielson KA. 2018.. Memory and executive functions in alexithymia. . See Luminet et al. 2018 , pp. 78–89
  145. Vermeulen N, Luminet O, Corneille O. 2006.. Alexithymia and the automatic processing of affective information: evidence from the affective priming paradigm. . Cogn. Emot. 20::64–91
     [Crossref] [Google Scholar]
  146. Vermeulen N, Toussaint J, Luminet O. 2010.. The influence of alexithymia and music on the incidental memory for emotion words. . Eur. J. Personal. 24::551–68 Importantly illustrates (in)congruency between emotional material and context, and the potential for nonverbal interventions.
     [Crossref] [Google Scholar]
  147. Vlemincx E, Walentynowicz M, Zamariola G, Van Oudenhove L, Luminet O. 2023.. A novel self-report scale of interoception: the Three-domain Interoceptive Sensations Questionnaire (THISQ). . Psychol. Health 38::1234–53
     [Crossref] [Google Scholar]
  148. Vorst HC, Bermond B. 2001.. Validity and reliability of the Bermond–Vorst alexithymia questionnaire. . Personal. Individ. Differ. 30::413–34
     [Crossref] [Google Scholar]
  149. Wang C, Pan R, Wan X, Tan Y, Xu L, et al. 2020.. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. . Int. J. Environ. Res. Public Health 17::1729
     [Crossref] [Google Scholar]
  150. Watters CA, Taylor GJ, Bagby RM. 2016.. Illuminating the theoretical components of alexithymia using bifactor modeling and network analysis. . Psychol. Assess. 28::627
     [Crossref] [Google Scholar]
  151. Wiebe A, Kersting A, Suslow T. 2017.. Deployment of attention to emotional pictures varies as a function of externally-oriented thinking: an eye tracking investigation. . J. Behav. Ther. Exp. Psychiatry 55::1–5
     [Crossref] [Google Scholar]
  152. Wittkower E. 1938.. Ulcerative colitis: studies of personality. . Br. Med. J. 2::1356–60
     [Crossref] [Google Scholar]
  153. Won J, Callow DD, Pena GS, Gogniat MA, Kommula Y, et al. 2021.. Evidence for exercise-related plasticity in functional and structural neural network connectivity. . Neurosci. Biobehav. Rev. 131::923–40
     [Crossref] [Google Scholar]
  154. Yiend J. 2010.. The effects of emotion on attention: a review of attentional processing of emotional information. . Cogn. Emot. 24::3–47
     [Crossref] [Google Scholar]
  155. Zahid A, Taylor GJ, Lau SCL, Stone S, Bagby RM. 2024.. Examining the incremental validity of the Perth Alexithymia Questionnaire (PAQ) relative to the 20-item Toronto Alexithymia Scale (TAS-20). . J. Personal. Assess. 106::242–53
     [Crossref] [Google Scholar]
  156. Zamariola G, Vlemincx E, Corneille O, Luminet O. 2018.. Relationship between interoceptive accuracy, interoceptive sensibility, and alexithymia. . Personal. Individ. Differ. 125::14–20
     [Crossref] [Google Scholar]
  157. Zhang L, Xuan R, Chen Q, Zhao Q, Shi Z, et al. 2022.. 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 116::110521
     [Crossref] [Google Scholar]
/content/journals/10.1146/annurev-psych-021424-030718
Loading
Alexithymia: Toward an Experimental, Processual Affective Science with Effective Interventions
Annual Review of Psychology 76, 741 (2025); https://doi.org/10.1146/annurev-psych-021424-030718
/content/journals/10.1146/annurev-psych-021424-030718
/content/journals/10.1146/annurev-psych-021424-030718
Loading

Data & Media loading...

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error