Is alexithymia a non‐neurotic personality dimension?

Abstract

The basic hypothesis of the literature on alexithymia, i.e. that alexithymia has a higher prevalence in psychosomatic than in neurotic (and delusional) patients, was empirically tested by means of the well-validated Toronto Alexithymia Scale (TAS). Surprisingly, neurotic and delusional patients (N = 71) had significantly higher mean total scores on the TAS, compared with the psychosomatic group (N = 150); the normal control sample (N = 224) was, as predicted, the lowest scorer. This hierarchical distribution was confirmed for the first two factors of alexithymia: (1) difficulty in distinguishing between feelings and bodily sensations, and (2) difficulty in expressing feelings. The psychiatric group was, instead, the lowest scorer on the third factor (lack of fantasy life). A substantial cross-validation of the above findings was achieved by comparing on the TAS three subgroups of the normal sample (symptom-free, somatizing and 'neurotic' normal controls). The postulate of the non-neurotic nature of alexithymia, along with its many psychopathological and technical corollaries, is completely contradicted by the present findings.

Alexithymia and Psychological Distress among Frequent Attendance Patients in Health Care

“…Similar findings have been published concerning the association of alexi thymia with depression and anxiety [26], and other kinds of neurotic manifestation [27,28],…”

Is alexithymia a non‐neurotic personality dimension? A response to Rubino, Grasso, Sonnino & Pezzarossa

“…The question arises whether these personality characteristics reflect a specific type of affect deficit (such as poor mental representation of emotions) (Lane & Schwartz, 1987;Sifneos, 1988), or psychological defences (such as repression, denial and reaction formation) against unconscious neurotic conflicts (Knapp, 1983). Rubino, Grasso, Sonnino & Pezzarossa (1991) recently reported data which they claim 'completely contradict the hypothesis that alexithymia . .…”

Relationship between Components of Alexithymia as Measured with Psychodγnamic Ratings and Subjective Lack of Well-Being

“…Some investigators have consid ered alexithymia to represent a new paradigm for psychosomatic medicine [2], though the relationship between alexithymia and psycho somatic disturbances has been questioned by others [3][4][5], w'hile some psychoanalytic au thors question the usefulness of the concept altogether [6][7][8], One of the reasons for the divergent opin ions might be that alexithymia is actually a multidimensional concept, the interpretation of which depends on one's own frame of refer ence. Possibly, different methods of assessing alexithymia tap different aspects, as they arc only weakly correlated with each other [9][10][11].…”