Role of theory of mind in emotional awareness and alexithymia: Implications for conceptualization and measurement
Abstract
The goal of this study was to determine whether alexithymia, which is characterized by difficulty in recognizing and describing emotions, is associated with impairments in the ability to mentally represent emotional states. We studied 89 outpatients including 29 conversion disorder patients, 30 functional somatic syndrome [e.g. fibromyalgia] patients and 30 medical controls. Groups did not differ on affective or cognitive Theory of Mind (ToM) measures, the Levels of Emotional Awareness Scale (LEAS) or the Twenty-Item Toronto Alexithymia Scale (TAS-20) after adjusting for Positive and Negative Affect Scale (PANAS) variables. Across all patients, LEAS but not TAS-20 correlated positively with affective and cognitive ToM measures after adjusting for PANAS scores. Impairments in ToM functioning influence LEAS performance but not TAS-20 scores. These findings support the distinction between a milder "anomia" form of alexithymia associated with impaired emotion naming and a more severe "agnosia" form associated with impaired mental representation of emotion.
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Most research contradicts the Moriguchi finding across a number of ToM tasks, including the Strange Stories Test and the false-belief task.
“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 Lane, Hsu, Locke, Ritenbaugh, & Stonnington, 2015
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- Authors
- Lane, R. D., Hsu, C.-H., Locke, D. E. C., Ritenbaugh, C., & Stonnington, C. M.
- Affiliations
- University of Arizona (US)
- Mayo Clinic in Arizona (US)
- Corresponding author
- Lane, Richard D.
- Venue
- Consciousness and Cognition
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 33
- Pages
- 398-405
- ISSN
- 1053-8100 (ISSN-L)
- OpenAlex
- W1972938577
- Cited by
- 79
- References
- 10
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 15 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 11 · 2016: 3 · 2015: 2
- FWCI
- 5.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Consciousness and Cognition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute for Mental Health Research (#2008-LR-804)
- Mayo Clinic (08-001718)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- theory of mind, emotional awareness, alexithymia, emotion naming, conversion disorder, fibromyalgia, functional somatic syndromes, Levels of Emotional Awareness Scale, Toronto Alexithymia Scale, emotion recognition
- MeSH terms
- Adult, Affective Symptoms, Agnosia, Awareness, Emotions, Female, Humans, Middle Aged, Somatoform Disorders, Young Adult, Theory of Mind
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