Abnormalities in Automatic Processing of Illness-Related Stimuli in Self-Rated Alexithymia

Brandt, Laura; Pintzinger, Nina; Tran, Ulrich S. · 2015 · OpenAlex-citations

DOI: 10.1371/journal.pone.0129905

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Summary

This study investigates abnormalities in the automatic processing of illness-related and emotional stimuli in individuals with self-rated alexithymia, a personality trait characterized by difficulties in identifying and describing feelings. While alexithymia is historically linked to psychosomatic disorders, previous research on its impact on automatic information processing has yielded contradictory results, often due to small sample sizes, lack of control for confounding variables like depression, or methodological flaws that failed to isolate automatic from controlled processing. This research aimed to clarify these relationships using a representative community sample and a sequential affective priming task designed to ensure automatic processing. The study included 89 healthy subjects (60% female, aged 19–71) from the general population. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20) for self-ratings and the Observer Alexithymia Scale (OAS) for observer ratings of a subset of 58 participants. The experimental design employed a priming task with verbal (positive, negative, neutral, illness-related) and facial (angry, happy, neutral) stimuli. To ensure automatic processing, stimulus onset asynchrony was kept below 300ms. The study controlled for potential confounders, including depression (Beck Depression Inventory), affect (PANAS), and somatoform symptoms (SOMS-7T). Participants performed explicit valence ratings of target stimuli following brief prime presentations, allowing researchers to measure facilitation and inhibition effects in reaction times. The results indicated that higher self-reported alexithymia scores were significantly correlated with a greater number and intensity of current somatoform symptoms. Crucially, self-rated alexithymia was associated with faster reaction times (facilitation effects) when illness-related targets were preceded by negative or positive verbal primes. This suggests that individuals with high alexithymia allocate attentional resources more rapidly toward illness-related stimuli while disengaging from task-irrelevant information. In contrast, observer-rated alexithymia showed no significant correlation with self-rated scores or any priming effects, indicating that the OAS may not be an adequate measure for community samples. The findings remained significant after controlling for depression and affect. These findings support the theoretical view that alexithymia involves a heightened focus on bodily sensations of emotional arousal, manifesting as an automatic attentional bias toward illness-related cues. The study highlights a dissociation between self-perceived and observer-perceived alexithymia in non-clinical populations, suggesting that self-report measures are more valid for assessing automatic processing abnormalities in this context. By demonstrating that alexithymia affects automatic rather than just controlled processing, the research contributes to understanding the cognitive mechanisms underlying the link between alexithymia and somatization. The results imply that the difficulty in processing emotional information in alexithymia may stem from an automatic prioritization of bodily symptom cues, which could explain the high prevalence of somatoform complaints in this population.

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• anxiety depression driving