How useful is the Construct of Alexithymia for Understanding the Risk of Mental Disorders?

Abstract

Alexithymia is a multidimensional construct characterized by an impoverished fantasy life, a difficulty in expressing or naming feelings, a difficulty in distinguishing between bodily sensations and feelings, and a preoccupation with external events. Alexithymia is considered a risk factor for the development of several mental disorders, such as major depression, panic disorder, eating disorders and substance use disorders. The TAS-20 is the most widely studied self-report questionnaire used to assess alexithymia. Several studies support the hypothesis that the TAS-20 is overly sensitive to a general distress syndrome, and therefore it is more likely to measure negative effects (distress, nervousness, fear, anger, guilt, sadness, scornfulness) rather than alexithymia itself. Future studies investigating alexithymia among psychiatric populations should control for the severity of anxiety and depression before arguing that alexithymia is a personality trait predisposing to mental disorders. Finally, any study’s finding, based only on a self-reported measure of alexithymia, should be confirmed by clinician-administered questionnaires.