Investigating alexithymia in autism: A systematic review and meta-analysis

Eur Psychiatry. 2019 Jan:55:80-89. doi: 10.1016/j.eurpsy.2018.09.004. Epub 2018 Nov 3.

Abstract

Background: New research suggests that, rather than representing a core feature of autism spectrum disorder (ASD), emotional processing difficulties reflect co-occurring alexithymia. Autistic individuals with alexithymia could therefore represent a specific subgroup of autism who may benefit from tailored interventions. The aim of this systematic review and meta-analysis was to explore the nature and prevalence of alexithymia in autism using the Toronto Alexithymia Scale (TAS).

Methods: Online scientific databases were searched systematically for studies on ASD popu lations using the TAS. Meta-analyses were performed to evaluate differences in scores between the ASD and neurotypical groups, and to determine the prevalence of alexithymia in these populations.

Results: 15 articles comparing autistic and neurotypical (NT) groups were identified. Autistic people scored significantly higher on all scores compared to the NT group. There was also a higher prevalence of alexithymia in the ASD group (49.93% compared to 4.89%), with a significantly increased risk of alexithymia in autistic participants.

Conclusions: This review highlights that alexithymia is common, rather than universal, in ASD, supporting a growing body of evidence that co-occurring autism and alexithymia represents a specific subgroup in the ASD population that may have specific clinical needs. More research is needed to understand the nature and implications of co-occurring ASD and alexithymia.

Keywords: Autism; Psychometry and assessments in psychiatry (tests).

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms* / diagnosis
  • Affective Symptoms* / epidemiology
  • Affective Symptoms* / psychology
  • Autistic Disorder* / epidemiology
  • Autistic Disorder* / psychology
  • Comorbidity
  • Emotional Adjustment*
  • Female
  • Humans
  • Male
  • Prevalence
  • Psychological Tests*