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Alexithymia in Adolescents with Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition
Open accessAbstract
Alexithymia is a personality trait frequently found in adults with autism spectrum disorder (ASD), and has been linked to impairments in emotion recognition and empathy. The presentation of alexithymia within ASD at younger ages remains unexplored, and was examined in the present study. Alexithymia rates were significantly elevated in ASD (55%; 31/56 scoring above cut-off) versus non-ASD adolescents (16%; 5/32 scoring above cut-off). Within individuals with ASD, alexithymia was associated with increased self-reported anxiety, parent-reported emotional difficulties, self-reported sensory processing atypicalities, and poorer emotion recognition, but was not associated with theory of mind ability. Overall, our results suggest that alexithymia is highly prevalent, and has selective cognitive correlates in young people with ASD.
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“This may be particularly effective in the context of autism where anxiety is commonly linked to sensory processing differences and elevated levels of alexithymia (ALX; see Vorst & Bermond, 2001), which is characterised by difficulties in identifying and describing one’s own emotions (Maisel et al., 2016; Milosavljevic et al., 2016; Nicholson et al., 2019).”
From Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools. (2020) · cites this paper as Milosavljevic et al., 2016
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“However, most research contradicts this finding across a number of ToM tasks, including the Strange Stories Test and the false-belief task (Lane, Hsu, Locke, Ritenbaugh, & Stonnington, 2015; Milosavljevic et al., 2016).”
From ‘Theory of Mind’ is not Theory of Emotion: a cautionary note on the reading the Mind in the Eyes test (2016) · cites this paper as Milosavljevic et al., 2016
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“there is consistent evidence for a link between ALX and anxiety in both autistic as well as non-autistic individuals (Milosavljevic et al., 2016; Oakley et al., 2020).”
From Examining a model of anxiety in autistic adults (2024) · cites this paper as Milosavljevic et al., 2016
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“A growing literature has highlighted the importance of diagnosing comorbid alexithymia, which may explain some of the socioemotional and communicative deficits of autism and be worthy of targeted intervention [78–83].”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [79]
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“Alexithymia is implicated in a range of mental health difficulties in autistic youth, including depression and anxiety (Milosavljevic et al., 2016; Oakley et al., 2022).”
From Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation. (2025) · cites this paper as Milosavljevic et al., 2016
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Metadata
- Authors
- Milosavljevic, B., Carter Leno, V., Simonoff, E., Baird, G., Pickles, A., Jones, C. R. G., Erskine, C., Charman, T., & Happé, F.
- Affiliations
- King's College London (GB)
- Guy's Hospital (GB)
- Cardiff University (GB)
- Ecorys (United Kingdom) (GB)
- Corresponding author
- Milosavljevic, Bosiljka
- Simonoff, Emily
- Baird, Gillian
- Pickles, Andrew
- Jones, Catherine R. G.
- Erskine, Catherine
- Charman, Tony
- ORCID
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2015-12-11
- Volume
- 46
- Issue
- 4
- Pages
- 1354-1367
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2192012856
- Cited by
- 170
- References
- 92
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 12 · 2023: 17 · 2022: 22 · 2021: 27 · 2020: 19 · 2019: 16 · 2018: 10 · 2017: 10 · 2016: 7
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- green
- qmro.qmul.ac.uk
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- BIROn (Birkbeck, University of London) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Medical Research Council (G0400065)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- alexithymia, autism spectrum disorder, adolescents, internalizing problems, anxiety, sensory processing, sensory modulation, emotion recognition, social cognition, theory of mind, empathy, emotional problems
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Affective Symptoms, Anxiety, Emotions, England, Female, Humans, Internal-External Control, Male, Parents, Sensation Disorders, Social Behavior, Prevalence, Case-Control Studies, Theory of Mind, Self Report
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