Alexithymia Is Associated With Deficits in Visual Search for Emotional Faces in Clinical Depression

Suslow, Thomas; Günther, Vivien; Hensch, Tilman; Kersting, Anette; Bodenschatz, Charlott Maria · 2021 · Crossref

DOI: 10.3389/fpsyt.2021.668019

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates the relationship between alexithymia and visual processing of emotional facial expressions in patients with major depressive disorder (MDD). Alexithymia, characterized by difficulties in identifying and describing emotions, is prevalent in depression and associated with impaired recognition of others' facial expressions. While previous research established deficits in emotion identification, the specific impact of alexithymia on visual search efficiency in complex social contexts remained unexplored. The authors aimed to determine whether alexithymic depressed patients exhibit distinct impairments in locating emotional targets within crowds of faces compared to non-alexithymic depressed patients. The researchers conducted an eye-tracking study using a "face-in-the-crowd" paradigm with 39 patients diagnosed with MDD. Participants were classified as alexithymic (n=20) or non-alexithymic (n=19) based on scores from the 20-item Toronto Alexithymia Scale (TAS-20). In each trial, participants viewed eight facial photographs arranged in a circle and were instructed to identify if one face displayed a different emotional expression (angry, happy, or neutral) than the others. The study measured manual response times and specific gaze behaviors, including latency to target fixation, the number of distractors fixated before and after target fixation, and the number of fixations on the target itself. Statistical analyses included mixed ANOVAs and ANCOVAs to control for covariates such as education level and depression severity. The results indicated that alexithymic patients exhibited significantly slower manual decision latencies compared to non-alexithymic patients. However, the groups did not differ in early search metrics, such as the time to first fixate the target or the number of distractors fixated prior to target identification. Crucially, after initially fixating the target, alexithymic patients fixated significantly more distractor faces than non-alexithymic patients, regardless of the emotional expression involved. This pattern suggests that while alexithymic individuals can locate the target face, they struggle with subsequent processing, requiring more visual scanning of surrounding stimuli to make a decision. The deficits were not limited to a specific emotional valence, affecting the processing of both angry and happy faces. The findings suggest that alexithymia in clinical depression is associated with impaired visual search efficiency, specifically manifesting as delayed reaction times and prolonged scanning after target detection. This indicates difficulties in target identification confirmation and decision-making rather than initial attentional guidance. The authors conclude that alexithymic depressed patients may face disadvantages in understanding non-verbal communication in group settings due to these processing delays. The study highlights that alexithymia impacts the later stages of visual emotion processing, providing insight into the cognitive mechanisms underlying social impairments in depression.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-25; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• anxiety depression driving