Dear Members of ARIA,
Now that our fourth official workshop, held in Regensburg, 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 presentation abstracts below or as a PDF at this link.
ARIA Executive Board
Abstract Overview
Measurement and psychopathology
Author/s: David Grüning
Title: Exploring the concept of alexithymia using more uncommon statistical methods
Abstract: As with most psychological constructs, the statistical methods commonly used to conceptualise alexithymia are rather restrictive. In this talk, I will present three unusual statistical approaches to further explore the construct of alexithymia and to compare different existing measures. First, the analysis of the measurement invariance of a construct across sociodemographic groups (e.g., age) is increasingly well known. Less well known 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 between individual items within a scale or across scales. For example, this analysis can inform researchers 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 obvious distinction between factors by clustering items by similarity in their response patterns, factors can also be distinguished conceptually by their different degrees of interindividual variance or differences in their average factor score in a population. The three approaches presented are accompanied by applied examples from the measurement of alexithymia. The presentation is definitely not meant as a means to all ends argument for these analyses. Rather I would want to kickstart a discussion of expanding theoretical aspects of alexithymia through expanding our statistical toolbox for tests.
Author/s: Monika Mazur & Paweł Larionow
Title: Alexithymia in Gender Diverse People: A Scoping Review
Abstract: Alexithymia is a multidimensional psychological construct that includes: (1) difficulties in recognizing one’s own emotions, (2) difficulties in describing one’s emotions, (3) an externally oriented thinking, and (4) limited imaginative capacities. In the general population, high levels of alexithymia are more common in males (9–17%) than in females (5–10%). However, little is known about the prevalence of alexithymia among transgender and non-binary individuals (the ones, whose gender identity differs from the sex assigned at birth). The aim of this presentation is to provide an overview of the prevalence of alexithymia and its role in the biopsychosocial functioning of transgender and non- binary individuals. The presentation is based on a scoping review of the literature conducted in accordance with PRISMA-ScR guidelines (e.g., keyword selection, inclusion and exclusion criteria). Articles in English were analyzed, with no restrictions on the publication date. The analysis revealed a lack of studies directly examining the prevalence of alexithymia among transgender and non-binary individuals. However, existing research suggests that alexithymia may be a transdiagnostic risk factor for various psychopathologies (e.g., anxiety and depression symptoms) and, consequently, may hinder the transition process at various stages (e.g., social or medical transition, detransition). Further research (particularly longitudinal studies) is needed to better understand the role of alexithymia in the daily functioning and quality of life of transgender and non-binary individuals. The insights gained from such studies could help develop effective psychological support strategies for those facing unique challenges (e.g., gender dysphoria, stigmatization).
Author/s: Jack Brett
Title: Characterising the nature of alexithymia in autistic adults: Validation of the Perth Alexithymia Questionnaire
Abstract: Alexithymia—a trait characterised by difficulties focusing on emotions (sometimes referred to as externally oriented thinking), identifying emotions, and describing emotions—is of high interest in the autism field. However, the lack of validated alexithymia measures for autistic individuals limits progress. We aimed to address this gap by examining the psychometric properties of the Perth Alexithymia Questionnaire (PAQ). We used the PAQ to understand how alexithymia manifests in autistic individuals and its links with poor mental health outcomes (e.g., anxiety). The study consisted of 244 autistic and 383 non-autistic individuals (age range: 16 - 62 years) who completed the PAQ and a trait anxiety questionnaire online. We conducted numerous advanced statistical analyses (e.g., confirmatory factor analysis, item response theory, and moderated non-linear factor analyses) to investigate the psychometric properties of the PAQ, alexithymia differences between autistic and non-autistic individuals, and alexithymia’s influence on anxiety. Alexithymia manifested similarly in autistic and non-autistic individuals, comprising a general alexithymia factor and five components: difficulties identifying negative feelings, difficulties identifying positive feelings, difficulties describing negative feelings, difficulties describing positive feelings, and externally oriented thinking. The measure exhibited good to excellent reliability. The PAQ did not meaningfully bias scores for autistic individuals. Autistic individuals reported greater difficulties with alexithymia across all its components. Regarding anxiety, individuals reporting greater difficulties with alexithymia reported more anxiety. However, greater nuance was needed when investigating at the component level, particularly for autistic individuals. For the first time, our study illustrates that alexithymia can be validly and comprehensively assessed in autistic populations. As measured via the PAQ, autistic individuals, on average, have greater challenges across all aspects of alexithymia, which is linked to worse mental health outcomes. The PAQ, therefore, represents a critical assessment advancement for the field, providing a foundation for future work on alexithymia and autism.
Author/s: David A. Preece
Title: The Assessment of Alexithymia: What is the Gold Standard?
Abstract: Alexithymia is a trait comprising a set of emotion processing difficulties. In this review, we seek to determine the current “gold standard” self-report measure of alexithymia, by comparing the performance of the two most commonly used measures in contemporary practice—the Toronto Alexithymia Scale-20 (TAS-20) and Perth Alexithymia Questionnaire (PAQ). Factor analytic studies suggest that both have a theoretically congruent factor structure, though several of the TAS-20 externally oriented thinking items have poor factor loadings. The TAS-20 assesses alexithymia for negative emotions, and the PAQ for both negative and positive emotions. The TAS-20 was not originally designed for facet (subscale) level analysis, and if attempted, its externally oriented thinking score has poor reliability. In contrast, all PAQ subscales exhibit high reliability. The TAS-20 and PAQ correlate highly, and demonstrate good convergent validity with a range of other relevant constructs. Parts of the TAS-20 have discriminant validity problems (i.e., measuring distress rather than alexithymia), whereas the PAQ has displayed good discriminant validity. Overall, the PAQ therefore appears to be the superior option—both measures provide a similar total score, but only the PAQ provides robust subscale scores for all alexithymia facets. The PAQ therefore enables a higher-resolution assessment of alexithymia.
Author/s: Maxi Stiller
Title: The Role of Experiential Avoidance in Alexithymia: Latent Profiles and Implications for Psychopathology
Abstract: Alexithymia is a trait characterized by difficulties in processing emotions. It represents a key risk factor for various psychopathologies, yet its underlying mechanisms remain underexplored. According to the attention-appraisal model of alexithymia, one mechanism is experiential avoidance of emotions, a tendency to avoid or suppress aversive internal experiences. To investigate this proposed relationship, college students (N = 444) completed psychometric measures of alexithymia, experiential avoidance, and various psychopathology symptoms. Results showed a strong correlation between alexithymia and experiential avoidance (r = .55, p < .001), with experiential avoidance explaining a significant 25.3% of the variance in alexithymia. We used a latent profile analysis to identify how different combinations of alexithymia and experiential avoidance may coexist across people. Three profiles emerged: one with high alexithymia and high experiential avoidance, one with average levels in both, and one with low scores in both. We compared these profiles for their psychopathology levels, showing that the profile highest in both alexithymia and experiential avoidance had the most severe symptoms of depression, anxiety, stress, PTSD, and dissociation. These findings support the attention-appraisal model, demonstrating that experiential avoidance may play an important role in alexithymia. When high alexithymia is present, people are generally also engaging in high levels of experiential avoidance. Addressing experiential avoidance may therefore be a useful target in the treatment of alexithymia.
Author/s: Paweł Larionow & Karolina Mudło-Głagolska
Title: Is Alexithymia a Trait or State? Temporal Stability in a Three-Wave Longitudinal Study
Abstract: Alexithymia is a construct involving deficits in the cognitive processing of emotions. It is often regarded as an important risk factor for a variety of psychopathologies, but there is ongoing uncertainty about whether it might act as a stable trait, or if instead it is just a state reaction to distress. To explore this, in this three-wave longitudinal study, our aim was to examine absolute and relative stability of alexithymia over a period of 7 months. Our sample was 73 general community adults who, over three time points, completed the Perth Alexithymia Questionnaire-Short Form (PAQ-S) and a battery of self-report questionnaires assessing several key mental health outcomes (i.e., anxiety and depression symptoms, somatic complaints, well-being). Our results showed strong absolute stability for PAQ-S scores, with no significant differences in alexithymia levels between the three time points, whereas there were differences in the scores of other mental health outcomes. We also demonstrated good relative stability of alexithymia, with its scores being independent of changes in the other health outcomes. Our findings therefore support the capacity for alexithymia to act as a stable trait. As such, our results help to further uncover the nature of alexithymia and support its status as a risk factor for poor affective outcomes.
Cognitive/multimodal approaches, interoception
Author/s: Gaën Plancher and Maël Delem
Title: Objective assessment of aphantasia and cognitive profiles
Abstract: For some people, the experience of visual imagery without direct external stimuli is lacking, a condition recently termed aphantasia. Because of its recent discovery, the question of how to measure aphantasia and its impact on cognitive functioning is still under debate. In particular, to date, most studies of aphantasia have relied on subjective reports. In the first part of our presentation, we will outline an objective mental image measurement paradigm we have developed where people with aphantasia are not explicitly asked to generate mental images, but where images are generated by implicit priming. We observed that while control participants showed both implicit and explicit priming effect, participants with aphantasia showed no priming effect at all. These results suggest that aphantasia is linked to an absence of conscious and non-conscious mental images, and not to a deficit in access to these images. In the second part of the presentation, we will discuss the cognitive profile of aphantasics. In the majority of studies, aphantasics show good cognitive performance, which raises questions about the alternative strategies employed by these people. We have attempted to describe more precisely the cognitive profiles of aphantasics, focusing on three dimensions: visual, spatial and verbal, and to measure the impact of these profiles on cognitive tasks.
Author/s: Marine Mas
Title: Pilot Emotion Recognition Training and Alexithymia: Examining Its Impact and Feasibility
Abstract: While many studies associate alexithymia with particularities in emotion regulation, fewer have focused on implicit emotion regulation. Emotion regulation can be conceptualized as a two-fold process involving both salience perception and executive function. In a previous study, we observed that alexithymia was associated with particularities in salience perception while performing an executive task involving the processing of emotional stimuli (emotional Go/no-Go task). To further investigate this association, we developed a pilot emotion recognition training. The objective of this study was to measure the impact of a pilot emotion recognition training on executive function and the moderation effect of alexithymia on this impact. Forty adult participants came to the laboratory for baseline measurements (T0) that included TAS-20, anxio-depressive symptomatology measurements, and inhibition performance in neutral and emotional Go/no-Go tasks. Then, participants were invited to complete an online emotion recognition training for six days, either on their phone or their computer (T1). The training comprised two different sub-tasks and included one emotion recognition training session per day. At the end of the training phase, participants completed a second laboratory session that included the same measures as in T0 (T2). We evaluated the changes in the different measures of interest, as well as participants' adherence and impressions of the training. Specifically, we intend to investigate the trajectories in emotion recognition performance during the training and the effect of the training on executive performance at T2.
Author/s: Nathan Torunsky
Title: Alexithymia is not consistently associated with deficits in emotion recognition accuracy or metacognition: Evidence from three samples
Abstract: Alexithymia is characterized by difficulty identifying and describing feelings and a tendency to avoid emotional introspection. It is associated with a wide variety of health conditions and may be a powerful transdiagnostic predictor of unwellness. Although alexithymia is characterized by poor emotional insight, relatively little is known about its relationship to metacognition. Moreover, the relationship between alexithymia and domain-general cognition, beyond emotion, remains unclear. We collected data from in-person samp community (N = 123; study 1) and student (N = 125; study 2) groups and an online student sample (N = 317). All participants completed the TAS-20 and three decision-making tasks indexing different domains: visual motion detection (Random Dot Kinematogram), emotional mentalizing (Reading the Mind in the Eyes Test; RMET), and social decision-making (Trust Game). After each trial, participants rated how certain they felt about their answer. Alexithymia was associated with poorer accuracy in the RMET in study 2 (ρ=-.26, p =.0041) and poorer confidence in the RMET in study 1 (ρ=-.19, p=.032), but these findings did not replicate across samples. Alexithymia was not associated with overall accuracy, confidence, or metacognitive sensitivity in the visual or social tasks. Exploratory nonparametric analyses, age and gender covariate regressions, and subscale analyses corroborated our initial findings. However, participants’ confidence ratings across tasks were strongly correlated (ρ ∈ [.23, .48]), suggesting that confidence may be influenced by a domain-general trait. Contrary to convention, we found that alexithymia was not consistently associated with deficits in emotion cognition or metacognition. Future work should seek to understand the extent to which observed relationships, past and present, between alexithymia and emotion “deficits” are driven by alexithymia subtypes, situational factors, or methodology.
Author/s: Merlin Monzel
Title: Aphantasia & Alexithymia
Abstract: Visual aphantasia is the absence or severe reduction of visual mental imagery. This presentation reviews the consequences of aphantasia for autobiographical memory and emotional processing, raising the question of how the absence of mental imagery affects emotional self-awareness and, more generally, interoceptive abilities. Early evidence suggests that aphantasia may be associated with specific difficulties in describing feelings and with an overly externally oriented thinking style, components that are also central to alexithymia. This presentation explores these links, discussing potential overlaps between aphantasia and alexithymia, and considers how the capacity for mental imagery might contribute to the development of emotional competencies.
Author/s: Irina Jarvers
Title: Interoception and Alexithymia in Adolescents with Anorexia Nervosa: Impact on Symptom Severity
Abstract: Anorexia nervosa (AN) is a severe eating disorder characterized by low body weight, distorted body perception, and the highest mortality rate among psychiatric disorders. While adults with AN show altered body and emotion perception, it remains unclear if the same applies to adolescents and how these factors influence symptom severity. A study with 39 female adolescents with AN (M = 14.87 years) and 28 healthy controls (M = 15.04 years) assessed body perception (BPQ), emotional awareness (PAQ), and symptom severity (SIAB/EDI-II). Adolescents with AN exhibited heightened body awareness (p = .001), increased autonomic nervous system reactivity (p < .001), and greater difficulties in identifying emotions, especially negative ones (p = .002). Higher body awareness, autonomic reactivity, and reduced emotional perception correlated with greater symptom severity (p < .014). Regression analysis identified reduced emotional awareness as the strongest predictor of symptom severity, independent of body perception. Adolescents with AN show increased body awareness but struggle with recognizing emotions, potentially using body focus as a coping mechanism. The inability to identify negative emotions may contribute to symptom severity, emphasizing the need for targeted interventions.
Clinical psychology and health
Author/s: Martina Camelio
Title: The role of alexithymia in self-esteem modulation among patients in a weight-loss intervention: a longitudinal analysis
Abstract: Research on obesity shows that self-esteem decreases as BMI increases and is strongly and negatively correlated with difficulties in finding effective emotion regulation strategies. Moreover, high self-esteem levels are predictors of positive outcomes in standard weight-loss treatments. Alexithymia has been found to be closely associated with low self-esteem; however, this relationship remains underexplored among individuals with obesity. Understanding the interplay between alexithymia, self-esteem, and weight-related factors is crucial to developing effective psychological interventions. This study longitudinally explored the relationship between alexithymia and self-esteem in 120 patients with overweight or obesity undergoing standard weight-loss treatment. The sample was mostly female (n=79,65.8%), with a mean age of 48.92 years (SD=14.20). Standard treatment included weekly sessions on healthy habits, weight monitoring, and metabolic control. Assessments conducted at baseline (T0) and after 6 months (T1) revealed significant improvements in BMI, binge eating, stress, alexithymia, and self-esteem. Mediation analysis showed that difficulties in describing feelings (DDF) fully mediated the relationship between baseline and post-treatment self-esteem, while weight loss had only a partial mediating role. These findings highlight the central role of alexithymia in self-esteem changes among patients undergoing weight-loss treatment, emphasizing the need for further research into the interplay between alexithymia and self-esteem within the context of weight loss interventions.
Author/s: Emily Pappalardo
Title: Alexithymia and Alcohol Use Problems
Abstract: Alexithymia is a trait characterized by difficulties identifying and describing one’s own feelings. Conceptually, alexithymia impairs emotion regulation processes and is regarded as a transdiagnostic risk factor for a range of emotion-based psychopathologies. Alexithymia may play an important role in alcohol use problems, but this relationship remains underexplored. In this study, we aimed to comprehensively examine the links between alexithymia and alcohol use problems. College students (N = 754) completed a battery of psychometric self-report measures of alexithymia and alcohol use disorder symptoms, consequences, and drinking motives. Pearson correlations showed significant associations between alexithymia and alcohol use problems/consequences (r = .11-.21) and, in terms of drinking motives, most prominently with coping motives (r = .23). A latent profile analysis extracted 6 alcohol use profiles, comprised of different combinations of alcohol use symptoms, consequences, and motives. The profile with the highest levels of alcohol use problems, consequences, and coping motives, was also the profile with the highest levels of alexithymia. Overall, our findings support theorising that emotion processing difficulties may play an important role in risk of problematic alcohol use. Alcohol use may serve a maladaptive emotion regulation function in some people with high alexithymia. These results suggest that the targeting of alexithymia in psychological therapies might be a useful pathway to explore in the treatment of alcohol use problems.
Author/s: Qianrong Liu
Title: A network model of affective processes: Links between emotional reactivity, alexithymia, emotion regulation, and their mental health correlates
Abstract: Background Difficulties in emotion reactivity, awareness (alexithymia), and regulation are highly correlated and feature in a variety of psychological disorders. However, no studies have tested a detailed model of how and why they relate to one another using advanced network analysis techniques. In this study, we used network analysis to explore the synergistic patterns of these three emotional constructs across negative and positive emotions, as well as their links with depression and anxiety symptoms. Methods A total of 1105 community adults completed self-report measures. Subdimensions of emotion reactivity, alexithymia, and emotion regulation, as well as two indicators of depression and anxiety, were utilised to construct the network structures. Undirected graphical lasso networks that illustrate and directed Bayesian networks were constructed separately. Results Aspects of emotion regulation (difficulties inhibiting behaviors during positive emotions, difficulties down-regulating negative feelings) and alexithymia (difficulties identifying positive feelings) were highly influential nodes in undirected networks with and without depression and anxiety, while depression and anxiety appeared to be bridge components, mainly connecting emotion reactivity and regulation. The aspect of emotion regulation (difficulties inhibiting behavior during negative emotions) was the key node correlated with both depression and anxiety. The ease of activation of positive emotions, activation of negative emotions, and capacity to down-regulate negative feelings served as drivers of the directed network, whereas the intensity of negative emotions, difficulties activating behavior during positive emotions, and the use of expressive suppression were outcome factors. Conclusions The relationships among emotion reactivity, awareness and regulation and their association with depression and anxiety could be depicted in network-based models. Positive Inhibiting Behavior, Negative Controlling Experience, and Positive Difficulty Identifying Feelings are important submidensions in networks.
Author/s: Xanthe Muir
Title: Alexithymia and Eating Disorder Symptoms: The Mediating Role of Positive Emotion Regulation
Abstract: Objective: Preliminary research suggests that alexithymia contributes to the development of psychopathology symptoms, due to its impairing effect on emotion regulation ability. Eating disorder symptoms have been extensively linked to high levels of alexithymia and emotion regulation difficulties; however, the mechanisms underlying these relationships remain unclear. This study investigates whether difficulties regulating positive and negative emotions drive the association between alexithymia and eating disorder symptoms. Method: An online battery of psychometric self-report measures was administered to 255 undergraduate students. Measures included the Perth Alexithymia Questionnaire (PAQ), Perth Emotion Regulation Competency Inventory (PERCI), and the Eating Disorder Examination Questionnaire (EDE-Q). Results: A parallel mediation analysis was conducted, finding that the relationship between alexithymia and eating disorder symptoms was partially mediated by difficulties regulating positive emotions. Conclusions: These findings support contemporary theory, which recognises alexithymia as an important risk factor for psychopathology symptoms due to its impairing effect on emotion regulation ability. The results underscore the need to consider the relationship between alexithymia and emotion regulation when conceptualising eating disorder cases and developing treatment and prevention strategies.
Authors: Xanthe Muir (a), David Preece (a,b), Rodrigo Becerra (a) (a) University of Western Australia, Perth, WA, (b) Curtin University, Perth, WA
Author/s: Mahdi Mazidi
Title: Exploring Alexithymia in Inpatient and Outpatient Clinical Samples with the Perth Alexithymia Questionnaire: Latent Structure and Profiles of Alexithymia
Abstract: Objective: Alexithymia is an important transdiagnostic risk factor for a range of psychopathologies. The Perth Alexithymia Questionnaire (PAQ) was developed to try to enable more comprehensive assessments of alexithymia. In this study, we examined the performance of the PAQ in clinical samples, and used this measure to explore the structure and profiles of alexithymia. Method: Psychiatric inpatients (N = 110) and outpatients (N = 275) from Iran completed the PAQ and a battery of other psychometric measures of alexithymia, emotion regulation, and psychopathology symptoms. Results: Confirmatory factor analysis of the PAQ supported the intended five-factor model (which distinguished between different facets of alexithymia across positive and negative emotions) within both samples. All PAQ subscale and composite scores showed good internal consistency and correlated with other measures in expected ways. Latent Profile Analyses were conducted, exploring different profiles of PAQ subscales (i.e., different subtypes and manifestations of alexithymia). Conclusions: These findings suggest that the PAQ has strong psychometric properties in clinical samples, making it a valuable tool for comprehensively assessing alexithymia across diverse populations. Our results emphasise the value of facet-level and valence-specific alexithymia assessments in deepening our understanding of the construct.