Emotion Processing Deficits in Alexithymia


Alexithymia is a subclinical
condition characterised by an inability to express or identify felt emotions
(Berthoz et al.. 2002). It is thought to affect 10% of the population (Linden,
Wen & Paulhaus, 1994). Between Berthoz et al. (2002) and Vermeulen, Luminet
and Corneille (2006), the term also includes the following mix of

  • problems distinguishing
    emotions from physiological arousal,
  • difficulty describing emotions
    to other people
  • tendency to focus on external
  • conflict avoidance,
  • lower ability to engage in
An fMRI measure of alexithymia
In order to investigate the
brain activity that might be associated with alexithymia, Berthoz et al. (2002)
carried out an fMRI study, focussing on activity in the anterior cingular and
medial pre-frontal cortices. Both of these are thought to be involved in
emotion processing – specifically the conscious experience of internal
emotional states. Further, these areas are thought to regulate the expression
of emotion as well as inhibit excessive emotion.
Berthoz et al.’s (2002) study
compared a group of males who were found to be high on an alexithymia scale
with those who were low on the scale. Participants viewed images designed to
illicit positive and negative affective states while their brains were scanned.
The results showed differences
in the anterior cingular and mediofrontal cortices but not in areas involved in
lower levels of processing. Berthoz et al. (2002) suggest that alexithymia does
result from an emotion processing problem. I would add it provides, in people
exhibiting alexithymia at least, some support for the late model of appraisal
(discussed here).
Participants were also asked
to judge the affective component of the photographs they had seen. Here there
was no difference between the groups. This is consistent with findings that
those exhibiting alexithymia are able to describe affective stimuli, but do
not, in some sense, feel the emotion caused by the stimuli.
A behavioural measure of
Brain imaging studies seem to
show a difference in the way emotions are processed in alexithymia, but how
does this relate to the process model of appraisal? Vermeulen et al. (2006)
carried out three studies using behavioural measures.
In this study, participants
who were high and low on ratings of alexithymia were compared using an
affective priming paradigm. This involves presenting an affective prime
subliminally, in this case an angry face, followed by a word displayed
liminally (consciously). Participants have to decide on the emotional valence
of the word presented to conscious awareness. They should be quicker to respond
to words which have been primed with a congruent emotion.
This is exactly what was found
for low scorers on the alexithymia scale. But, as scores on the scale
increased, so the influence of the affective prime decreased. For Vermeulen et
al. (2006), this suggests that participants scoring at high levels on the
alexithymia scale have a deficit in the automatic processing of emotional
Returning to the process model
of appraisal, both of these studies might suggest that those scoring high on
alexithymia scales have a deficit in the automatic/associative processing of
emotional cues, but not in the type of emotional processing that occurs in focal
Perhaps a similar deficit can
also be seen in other disorders of emotion regulation such as autistic spectrum
disorders? The next post will examine this possibility.
About the author

Psychologist, Jeremy Dean, PhD
is the founder and author of PsyBlog. He holds a doctorate in psychology from
University College London and two other advanced degrees in psychology.
He has been writing about
scientific research on PsyBlog since 2004. He is also the author of the book
“Making Habits, Breaking Habits” (Da Capo, 2003) and several ebooks.

Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.