Clarifying the relationship between alexithymia and subjective interoception

PLoS One. 2021 Dec 13;16(12):e0261126. doi: 10.1371/journal.pone.0261126. eCollection 2021.

Abstract

The long-standing hypothesis that emotions rely on bodily states is back in the spotlight. This has led some researchers to suggest that alexithymia, a personality construct characterized by altered emotional awareness, reflects a general deficit in interoception. However, tests of this hypothesis have relied on heterogeneous assessment methods, leading to inconsistent results. To shed some light on this issue, we administered a battery of self-report questionnaires of interoception and alexithymia to three samples from Italy, the U.S., and Singapore (N = 814). Correlation and machine learning analyses showed that alexithymia was associated with deficits in both subjective interoceptive accuracy and attention. Alexithymics' interoceptive deficits were primarily related to difficulty identifying and describing feelings. Interoception showed a weaker association with externally-oriented thinking as operationalized by the Toronto Alexithymia Scale (TAS-20) and no association with the affective dimension of alexithymia later introduced by the Bermond-Vorst Alexithymia Questionnaire (BVAQ). We discuss our results with reference to the theoretical and psychometric differences between these two measures of alexithymia and their shortcomings. Overall, our results support the view that interoceptive deficits are a core component of alexithymia, although the latter cannot be reduced to the former.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms / psychology*
  • Correlation of Data
  • Female
  • Humans
  • Interoception*
  • Machine Learning
  • Male
  • Middle Aged
  • Self Report
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

This research was funded by the NAP-SUG program 2015-2021 of the Nanyang Technological University to G.E. https://www.ntu.edu.sg/engineering/aboutus/ourpeople/research-talent-development/nanyang-assistant-professorship-(nap) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.