Emotion processing deficits in alexithymia and response to a depth of processing intervention

Constantinou, Elena; Panayiotou, Georgia; Theodorou, Marios

doi:10.1016/j.biopsycho.2014.09.011

Cited by 38 publications

(40 citation statements)

References 74 publications

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“…Although not significant, this pattern is in line with the notion that the defensive responses of alexithymic individuals, especially when faced with intense unpleasant emotion (deep processing condition), may be less adaptive to the context than controls. Although consistent with past evidence of hypoarousal during emotion processing in alexithymia (Constantinou et al, ) and of poor habituation of emotional responses (Friedman & Thayer, ), replication of this pattern with a larger sample size is required to verify that this is indeed a real effect that can guide interpretation of alexithymic emotion regulation difficulties. Similar patterns of startle reactivity were observed during joy imagery, although the absence of habituation seemed specific to fear.…”

Section: Discussionsupporting

confidence: 61%

“…To the degree that HRV and especially indices of parasympathetic control indicate good emotion regulation and adjustment to the environment, these results add credence to the hypothesis that alexithymia entails deficits in these abilities. Importantly, emotion regulation deficits seem to be less linked to the cognitive components of alexithymia (difficulty describing feelings) and more to affective/experiential components (i.e., difficulty identifying feelings and external‐oriented thinking), suggesting that they may represent a coping mechanism in light of alexithymic individuals’ inability to handle intense emotions (Constantinou et al, ). Other researchers similarly suggested that the EOT factor may play a protective role by directing awareness away from emotional experiences (Davydov, Luminet, & Zech, ).…”

Section: Discussionmentioning

confidence: 99%

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Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability

Panayiotou

Constantinou

2017

Psychophysiology

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Alexithymia is associated with deficiencies in recognizing and expressing emotions and impaired emotion regulation, though few studies have verified the latter assertion using objective measures. This study examined startle reflex modulation by fearful imagery and its associations with heart rate variability in alexithymia. Fifty-four adults (27 alexithymic) imagined previously normed fear scripts. Startle responses were assessed during baseline, first exposure, and reexposure. During first exposure, participants, in separate trials, engaged in either shallow or deep emotion processing, giving emphasis on descriptive or affective aspects of imagery, respectively. Resting heart rate variability was assessed during 2 min of rest prior to the experiment, with high alexithymic participants demonstrating significantly higher LF/HF (low frequency/high frequency) ratio than controls. Deep processing was associated with nonsignificantly larger and faster startle responses at first exposure for alexithymic participants. Lower LF/HF ratio, reflecting higher parasympathetic cardiac activity, predicted greater startle amplitude habituation for alexithymia but lower habituation for controls. Results suggest that, when exposed to prolonged threat, alexithymics may adjust poorly, showing a smaller initial defensive response but slower habituation. This pattern seems related to their low emotion regulation ability as indexed by heart rate variability.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability

Panayiotou

Constantinou

2017

Psychophysiology

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“…The notion that alexithymia can be adopted as a reactive defence to cope with intense distress is not new (e.g., Bailey & Henry, ; Constantinou et al ., ; De Vente et al ., ), and is consistent with a clinical perspective that notes how affective states perceived as overwhelming might impair their mental representations (e.g., Fonagy, ). The main effects we reported for negative emotionality are consistent with this general perspective.…”

Section: Discussionmentioning

confidence: 98%

“…could be highly associated with alexithymia. In particular, we interpreted alexithymia as a functional emotional and cognitive tendency that is reinforced, or possibly initiated, by the behavioural tendency to avoid distressing emotional events (Constantinou, Panayiotou, & Theodorou, 2014).…”

mentioning

confidence: 99%

Being alexithymic: Necessity or convenience. Negative emotionality × avoidant coping interactions and alexithymia

et al. 2015

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“…In the same vein, autonomic responses have been used as robust indices of emotional brain processing (Sequeira et al, 2009; D’Hondt et al, 2010) and as markers of alexithymic reactivity (Stone and Nielson, 2001; Connelly and Denney, 2007; Bausch et al, 2011; Pollatos et al, 2011; Eastabrook et al, 2013; Constantinou et al, 2014). However, autonomic responses to emotional stimulation in alexithymia were in favor of either an hyper-reactivity (e.g., Stone and Nielson, 2001; Eastabrook et al, 2013) or an hypo-reactivity of the ANS (Franz et al, 2003; Neumann et al, 2004; Connelly and Denney, 2007; Bausch et al, 2011; Pollatos et al, 2011; Constantinou et al, 2014). While higher values of heart rate (Stone and Nielson, 2001; Eastabrook et al, 2013) and skin conductance responses (SCRs) to emotional stimulus (Stone and Nielson, 2001) were recorded in the first case, the same indices were unchanged or even attenuated in the second case.…”

Section: Introductionmentioning

confidence: 99%

Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia

et al. 2017

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Emotional difficulties in alexithymia and their social consequences have been linked to alterations in autonomic nervous system. However, most of previous studies did not take into account the distinction between the affective and the cognitive dimensions of the alexithymia, leading to inconsistent results.Aim: In this study, we compared the effects of both dimensions of alexithymia on the autonomic arousal to emotional and social visual stimulations.Methods: Skin conductance responses (SCRs) to items of the International Affective Pictures System characterized by emotional (unpleasant, neutral, and pleasant), social (with humans) or non-social (without humans) content were recorded in non-alexithymic (NA), affective (AA) and cognitive alexithymic (CA) participants, selected on the basis of the Toronto Alexithymia Scale and the Bermond-Vorst Alexithymia Questionnaire. All participants responded to questionnaires of empathy, social phobia, depression, and anxiety before the experiment and evaluated the arousal of the pictures after it.Results: Cognitive alexithymic group showed lower amplitudes of SCRs to pictures with social than without social relevance whereas the opposite pattern was observed for the NA group. Arousal emotional effects of the pictures on SCRs did not differ among groups. In addition, CA participants showed lower scores than NA in the Personal Taking sub-scale of the empathy questionnaire, while AA showed lower scores than NA in the fantasy sub-scale. The CA group showed higher social phobia, depression and anxiety scores, than the other two groups.Conclusion: This work has two original outcomes: first, affective alexithymics expressed lower empathic affective scores than other groups; second, alexithymia modulated the impact of the social relevance of the stimuli on the autonomic reactivity, this impact vanishing in affective alexithymics and reversing in cognitive alexithymics. Thus, though the groups could not be distinguished on the basis of emotional effect on SCRs, they clearly differed when the empathic characteristics and the autonomic impact of social relevance were considered. Finally, the described autonomic signature to social relevant information could contribute to elucidate the difficulty of alexithymics to deal with emotions during social transactions.

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Emotion processing deficits in alexithymia and response to a depth of processing intervention

Cited by 38 publications

References 74 publications

Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability

Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability

Being alexithymic: Necessity or convenience. Negative emotionality × avoidant coping interactions and alexithymia

Autonomic Reactivity to Arousing Stimuli with Social and Non-social Relevance in Alexithymia

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