Dear Members of ARIA,
Now that our third official workshop, held in Louvain-la-Neuve, has concluded, we hope you had a great time attending the ARIA meeting physically.
We also hope you consider the future goals we have for the future of ARIA as exciting as we do.
You can find the final program with abstracts at this link.
ARIA Executive Board
Keynotes
Reflections on the Evolution of the Alexithymia Construct: A 40-year Retrospective and Some Observations for Future Direction in Research
Michael Bagby (University of Toronto, Canada)
In this paper I provide commentary and observation about the evolution of the alexithymia construct after publishing my first article in this area nearly forty years ago as a graduate student studying clinical psychology, personality trait theory and test construction/measurement-based science. I outline the history of this construct with an emphasis on its derivation from careful and systematic observation of patients with so-called psychosomatic diseases and subsequently other mental disorders and medical illnesses thought to be the result of difficulties with emotion regulation and how alexithymia has now become the focus of other disciplines far removed from its clinical roots (e.g., emotion theory, linguistics, cross cultural psychology, even philosophy). I discuss both theoretical and empirical efforts to define this enduring construct and the importance of moving away from measurement-based methods to validate or refine the construct, an approach that seems to continue to predominant the field. Instead I argue that to advance theories or models of alexithymia, the field needs and the need to embrace more fully experimental methodologies and also utilize advances in neuroscience. Finally, in the context of the broader concern of the replicability crisis in the behavioral and medical sciences, I discuss the need for replication studies especially in instances in which radical changes to theory in the field are advanced. In the same vein, I make argument for the need of an open science approach in alexithymia research, a position also advocated in other areas of research.
Alexithymia from the Cognitive Behavioral Perspective: Advances in Theory, Research, and Practice
David Preece (Curtin University, Australia)
There are both cognitive behavioral and psychoanalytic perspectives on many clinical phenomena or psychological constructs, with cognitive behavioral approaches being the most common clinical orientation in many countries. Alexithymia was originally formulated from a psychoanalytic perspective, but in 2017, the attention-appraisal model of alexithymia introduced a cognitive behavioral perspective on alexithymia. In this presentation, I will cover recent advances in alexithymia theory, research, and clinical practice, from this cognitive behavioral perspective. Firstly, I will outline how the attention-appraisal model integrates the alexithymia construct within broader affective science frameworks, and how this can explain why alexithymia impairs emotion regulation and is a risk factor for psychopathology. Secondly, I will present recent data from the Perth Alexithymia Questionnaire, a psychometric tool based on the attention-appraisal model, showing how deficits in the capacity to attend to and appraise emotions characterize a wide range of clinical symptoms. Finally, I will detail how the attention-appraisal model can inform the effective targeting of alexithymia in cognitive behavior therapy. Overall, it will be concluded that the attention-appraisal model has a strong evidence base and high clinical relevance, thus enabling the alexithymia construct to be usefully applied and considered within cognitive behavioral frameworks.
Alexithymia: Towards an Experimental, Processual Affective Science and Effective Interventions.
Olivier Luminet (UCLouvain, Belgium) & Kristy Nielson (Marquette University, USA)
Alexithymia is a multi-dimensional personality trait involving difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and an externally oriented thinking style (EOT). Poor fantasy life (PF) 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, vulnerabilities for both mental and physical illness, and treatment. We then focus on the importance of further experimental and processual affective science research that a) emphasizes facet-level analysis toward understanding the nuanced bases of alexithymia effects on neural, cognitive, and behavioral processes; b) distinguishes between emotion deficits and emotion over-responding, including when over-responding is functional; and c) clarifies when and how impairments occur for neutral and positively valenced information or contexts. Taken together, clarification of these issues will provide clear directions for effective, tailored, alexithymia interventions.
Abstract Overview
Chinese version of the Perth Alexithymia Questionnaire: psychometric properties and clinical applications
Cai, Xin-Lu (Hangzhou Normal University, China)
The Perth Alexithymia Questionnaire (PAQ) was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia. In this paper, we introduce the first Chinese version of the PAQ and examine its psychometric properties and clinical applications. In Study 1, the PAQ was administered to 990 Chinese participants. We examined its factor structure, internal consistency, test-retest reliability, as well as convergent, concurrent and discriminant validity. In Study 2, four groups, including a major depressive disorder (MDD) group (n=50), a matched healthy control group for MDD (n=50), a subclinical depression group (n=50) and a matched healthy control group for subclinical depression (n=50), were recruited. Group comparisons were conducted to assess the clinical relevance of the PAQ. In Study 1, the intended five-factor structure of the PAQ was found to fit the data well. The PAQ showed good internal consistency and test-retest reliability, as well as good convergent, concurrent and discriminant validity. In Study 2, the PAQ was able to successfully distinguish the MDD group and the subclinical depression group from their matched healthy controls. The Chinese version of the PAQ is a valid and reliable instrument for comprehensively assessing alexithymia in the general population and adults with clinical/subclinical depression.
Clarifying the relationship between alexithymia and subjective interoception
Gaggero, Giulia (Università di Trento, Italy)
Interoceptive deficits – i.e. deficits in perceiving internal bodily states – have been extensively investigated in conjunction with alexithymia and emotion dysregulation. However, the exact relationship between alexithymia and interoception is still debated. Our contribution to this issue relies on self-reported data collected in Italy, the US, and Singapore (N= 814). Correlation and machine learning techniques were applied to explore the association between different self-report measures of alexithymia and interoception. Results showed that the choice to use one or the other self-report measure can strongly influence the directionality and the magnitude of the association between the two constructs. Further analyses using the psychological network approach were performed in a subsample (N=504), where Big Five traits were also assessed. Results confirmed that externally oriented thinking is conditionally independent of interoception. Further, we showed that, when controlling for neuroticism, alexithymia was mainly revealing of the tendency to ignore sensations of pain or discomfort. These results clarify the association between self-reported alexithymia and interoception. Specifically, they suggest that (i) interoceptive deficits are a core component of alexithymia, although the latter cannot be reduced to the former, and (ii) alexithymia is mostly connected with an under-responding profile.
Exploring the concept of alexithymia using uncommon statistical methods
Grüning, David (Universität Heidelberg, Germany)
As is true for most psychological constructs, the statistical methods commonly used to conceptualize alexithymia are rather restrictive. In the present talk, I showcase three uncommon statistical approaches to further explore the construct of alexithymia and to compare different existing measures. First, the analysis of a construct’s measurement invariance across sociodemographic groups (e.g., age) is increasingly well known. Less popular is the idea that such invariance can also be tested across levels of other theoretically relevant psychological constructs (e.g., emotion beliefs or empathy). Second, hierarchical factor analysis can reveal conceptual links between different alexithymia factors and even individual items in one scale or across several scales. This analysis can, for instance, inform researchers about when different scales overlap conceptually and when they measure clearly distinct aspects of alexithymia. Third, we can use additional statistical features to further distinguish between multiple factors of alexithymia. In addition to the prominent distinction between factors through clustering items by similarity in their response patterns, factors can also be distinguished conceptually by their differing degrees of interindividual variance or differences in their average factor score in a population. The three introduced approaches are accompanied by applied examples of alexithymia measurement.
AI-Based Assessment of Alexithymia Through Natural Language Processing
Gvirts, Hila (Ariel University, Israel), Blumrosen, Gaddi (Holon Institute of Technology, Israel)
Objectives: Alexithymia is a personality trait characterized by difficulties in identifying emotions, recognizing the connection between emotions and bodily sensations, effectively communicating feelings to others, and an externally-oriented way of thinking. Typically, the TAS-20 self-report questionnaire is used to assess alexithymia. However, evaluating this trait can be difficult because individuals with alexithymia often lack self-awareness of their own emotions. Therefore, using information obtained from daily life communication through advanced AI models can provide a continuous assessment of alexithymia in individuals' natural environments.Methods: We conducted video interviews with 10 participants (5 males, 5 females, with a mean age of 23.37 years and standard deviation of 2.77 years ). The interviewer audio was extracted from the recordings and transcribed to text using audio-to-text software. Using a well-trained Large Language Model (LLM), we employed an AI-based approach to evaluate participants' levels of alexithymia. We compared the results obtained from the LLM assessment to participants' self-reported scores on the 20-item Toronto Alexithymia Scale (TAS-20), including subscale scores and the total score. Both, the accuracy and consistency of the LLM's evaluations were carefully examined. Results: The results show high correlation between our AI based predictions (total alexithymia, sub-score, and sub-questions) and participants' self-reported scores on theTAS-20. Our model showed consistency with lower standard deviation for each of the three alexithymia sub-scores in comparison to both participants' responses on the TAS-20 in the current study and the standard deviations reported in previous research using this scale. Conclusions: This research demonstrates the feasibility of using AI LLM models for accurate and consistent evaluation of alexithymia. Further studies are needed with a larger population and longer time intervals to validate these findings. The technology offers continuous assessment of alexithymia, saving time and resources, and reducing bias compared to the traditional assessment. Finally, it has the potential to develop clinical decision support tools for objective evaluation.
Alexithymia and its relation to empathy and emotion regulation in a healthy and clinical sample of adolescents and adults
Jarvers, Irina (University of Regensburg, Germany)
Alexithymia describes the difficulty to identify and describe one’s own emotions, as well as an externally oriented thinking style. It is considered to be a personality trait that increases the risk for later psychopathology. One possible mechanism through which alexithymia may contribute to psychopathology is considered to be less effective emotion regulation. Furthermore, difficulties in recognizing one’s own emotions are believed to affect the way we recognize other people’s emotions and empathize with them. To illuminate the relationship between (facets of) alexithymia and (facets of) empathy, as well as emotion regulation, we have conducted a large online study with a healthy (50%) and clinical (50%) population of adolescents and adults (n = 270) ranging from 14 years of age to 68 years of age. All facets of alexithymia were negatively correlated with all facets of empathy (cognitive, affective, somatic) and alexithymia was significantly negatively correlated with reappraisal and positively with suppression. Regression analyses revealed that a significant portion of variance in the alexithymia score could be explained by suppression, stress scores and particularly cognitive empathy. Differences in alexithymia, psychopathology and emotion regulation across the healthy/clinical and adolescent/adult sample will be presented.
Alexithymia, salience perception and executive functions:
Mas, Marine (UCLouvain, Belgium), Luminet, Olivier (UCLouvain, Belgium)
Alexithymia is associated with a lack of flexibility at several stages of emotion regulation. According to theoretical models from cognitive psychology, flexibility emerges from salience perception and efficient executive function. Additionally, previous studies associated higher alexithymia with particularities in emotional facial expression perception, and with deficits in executive function. The objective of our study was to explore the cognitive factors that may underlie the lack of flexibility associated with particularities in emotion regulation in alexithymia. One hundred and twenty-six non-clinical adults underwent executive tasks with neutral and emotional material (positive and negative emotional facial expressions of various intensities). Our results first show that emotional stimuli had an effect on executive performance that was differentiated according to both valence and arousal levels. In other terms, emotional salience influences executive performance, which adds evidence to the fact that salience perception plays an important role in cognitive flexibility involved in emotion regulation. Regarding alexithymia, alexithymia scores were not associated with executive performance in any of the three tasks with neutral stimuli. However, alexithymia moderated the relationship between emotional salience and executive performance for inhibition and updating. We discuss the implications of these findings in terms of emotional salience effects on cognition and their potential role in alexithymia.
Alexithymia in Adolescents: Psychometric Evaluation of the Perth Alexithymia Questionnaire (PAQ) and Its Relationship with Psychological Distress
Mazidi, Mahdi (University of Western Australia, Australia), Becerra Rodrigo (University of Western Australia), David Preece (Curtin University)
Alexithymia has been proposed as a key transdiagnostic risk factor that contributes to the development of different psychopathologies across the lifespan. Yet, investigations into alexithymia have primarily concentrated on adult populations, with research on adolescents hindered by the absence of age-appropriate validated assessment instruments. This study assessed the psychometric properties of the Perth Alexithymia Questionnaire (PAQ) within a cohort of Iranian adolescents (N = 557, 53% female, mean age = 14.94, SD = 1.29). Confirmatory factor analysis supported the intended five-factor model that distinguished between different facets of alexithymia across positive and negative emotions. This validation was further supported by a subsequent analysis with an independent sample of Iranian adolescents (N = 900, 53% female, mean age = 13.5, SD = 0.99), confirming the initial results. Moreover, the study examined whether alexithymia could predict depression, anxiety, and stress over a three-and-a-half-month follow-up in 632 adolescents. Findings revealed that greater difficulties in identifying and describing negative emotions, and identifying positive emotions, were significant predictors of greater levels of depression, anxiety, and stress. Overall, the present findings indicate that PAQ has strong psychometric properties among adolescents. Theoretical and practical implications of the findings will be discussed.
A Re-examination of the Empirical Foundation of the Attention Appraisal Model
McIntyre, Cheyenne (University of Toronto, Canada)
The Attentional Appraisal Model of Alexithymia is derived from the theoretical landscape of Gross’s (2015) extended process model of emotional regulation. The initial attempt to establish the empirical foundation for the attention appraisal resides in a study in which Preece et al. (2017) used a measurement-based approach to “outline the theoretical components or parameters of the alexithymia construct.” To this end, these authors factor analyzed several subscales from the Bermond Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond, 2001), the 20-item Toronto Alexithymia Scale (TAS-20; Bagby, et al. 1994), the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) and the Perth Emotional Reactivity Scale (PERS et al., 2017). The authors report results from an exploratory factor analysis of these subscales that they interpret revealed a four-factor solution, that is aligned with the attention appraisal, including factors that they label as ‘difficulty appraising feelings’, ‘negative reactivity’, ‘positive reactivity’ and ‘difficulty attending to feelings’. In this study, we factor analyzed the published correlation matrix from this study (see Supplementary Table 1, Preece et al., 2017) and forced a four-factor solution but the pattern of loadings was consistent with the traditional model of alexithymia – including factors corresponding to affective awareness and operatory thinking. Results are discussed in the context of the need for replication and the limits of relying solely on measurement-based methodologies to advance new models of the alexithymia construct.
Alexithymia and Emotion Regulation: The Role of Emotional Over-responding
Mehta, Ashish (Stanford University, USA)
When faced with negative emotions, people higher in alexithymia tend to disengage from their emotions rather than engaging with their emotions in an adaptive way. This emotion regulation profile is thought to explain links between alexithymia and negative life outcomes. What is not yet clear, however, is why alexithymia is linked to this emotion regulation profile. One possible explanation is emotional over-responding. Initial evidence suggests that alexithymia is related to greater negative emotional intensity, and it is widely thought that greater negative intensity predicts the use of disengagement over engagement emotion regulation strategies. To address this issue, we conducted two intensive longitudinal studies to test three propositions; (1) alexithymia is related to emotional over-responding (i.e. greater negative emotional intensity), (2) alexithymia is related to more emotional disengagement and less emotional engagement regulation strategies, and (3) negative emotional intensity is a mediator explaining the link from alexithymia to more disengagement and less engagement strategies. As expected, in both studies we found that alexithymia was related to greater use of disengagement regulation strategies and that this relationship was mediated by preceding negative emotion. Contrary to expectations, we did not find evidence that alexithymia was linked to the use of less engagement regulation strategies in either study. These associations were driven primarily by difficulties identifying and describing emotions.
Alexithymia Moderates Framing Effects in Politicians
Rodrigues Ferreira, Jean Roisse (USA)
This study examines the framing effect—where choices are influenced by the presentation of information as gains or losses—and its moderation by alexithymia, a trait marked by difficulty in identifying and describing emotions. Unlike prior research focused on clinical and general populations, our investigation shifts to politicians, a group of professional decision-makers who encounter unique decision-making challenges. We explore how alexithymia affects decision-making in political contexts, specifically through experimental tasks with Norwegian local politicians (N = 1,319) on digitalization policy decisions impacting jobs and data privacy. Our findings reveal that alexithymia's impact on the framing effect varies with the decision context: it lessens the effect in job-related decisions but amplifies it in data privacy decisions. This differential influence suggests that the interaction between personal traits like alexithymia and cognitive biases can significantly alter decision-making, especially in policy-making scenarios. This study not only contributes to our understanding of the framing effect and alexithymia but also opens new research avenues in the intersection of psychology and political decision-making.
Validation of the Dutch Version of the Perth Alexithymia Questionnaire
Walentynowicz, Marta (KU Leuven, Belgium)
Alexithymia is associated with negative mental health outcomes. The recently developed Perth Alexithymia Questionnaire (PAQ) allows for the assessment of alexithymia across both positive and negative emotions. The aim of this study was to validate the first Dutch version of the PAQ. Methods University students (N = 942, 85.6% women) completed the PAQ along with the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS), Emotion Regulation Questionnaire (ERQ), Trait Meta Mood Scale (TMMS), and Three-domain Interoceptive Sensations Questionnaire (THISQ). Factor structure, internal consistency, test-retest reliability, and concurrent and discriminant validity were investigated. In a currently ongoing study, PAQ-6 and DASS are being collected in a general population. Results Factor analysis supported the intended five-factor structure. The PAQ total score and all five subscales showed good internal consistency (.85-.94). Both 4-week and 8-week test-retests were acceptable. The PAQ showed medium to large correlations with the TAS-20, DASS, TMMS, and expressive suppression, confirming concurrent validity. Divergent validity was shown by small correlations with cognitive reappraisal and the THISQ. Most recent data from the ongoing study will be analyzed before the meeting. Conclusions The present results suggest strong psychometric properties for the Dutch version of the PAQ. These results reinforce the multidimensional nature of alexithymia, and should help to enable more comprehensive alexithymia assessments in Dutch-speaking populations.
Metaperception and the Alexithymia Construct
Luigia Zito (Sapienza University of Rome, Italy)
Metaperception is the belief about how other people perceive the self. In this study we examined whether persons with high levels of alexithymia have insight into how others experience them. Utilizing the self-report and informant versions of the TAS-20 from a sample of university students (N = 214), we examined the associations and mean differences among three sets of ratings on alexithymia – (1) target ratings (i.e., self-reports), (2) informant ratings (i.e., informant reports of the target), and (3) meta-perception ratings (i.e., targets’ meta-perception of how they thought informants would rate them). On average, the targets’ self-reported alexithymia was generally lower than the informant ratings of the targets’ alexithymia and that higher scores on informant ratings of alexithymia were associated with greater discrepancies between the targets’ self-report ratings and meta-perception ratings. These results support the longstanding observation that alexithymia is associated with poor insight into self, highlighting the need for the multimethod assessment of alexithymia.