The Multifaceted Nature of Alexithymia – A Neuroscientific Perspective
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Neuroscientific studies have mostly employed the 20-item Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994a) for the assessment of alexithymia, a self-report scale that assesses the alexithymia facets difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. These facets can be considered to capture difficulties in the cognitive processing of emotions associated with alexithymia. However, Nemiah and Sifneos' original conceptualization of alexithymia included also an affective component, a lack of imaginative capacities, which cannot be assessed using the TAS-20. Aiming to capture the entire alexithymia construct, the Bermond-Vorst Alexithymia Questionnaire (BVAQ; Vorst and Bermond, 2001) was developed, a self-report scale which assesses two affective facets (difficulty fantasizing and difficulty emotionalizing) in addition to three cognitive facets. Based on these facets, an affective and a cognitive dimension of alexithymia can be distinguished. By now, several neuroscientific studies have investigated the neural signatures of the different facets and dimensions of alexithymia. Here, I provide an overview of the history of the alexithymia facets and dimensions and review findings provided by functional and structural magnetic resonance imaging (MRI) studies that differentiated between the alexithymia facets and/or its affective and cognitive dimensions. I then provide a synopsis of the current neuroscientific evidence for dissociable substrates of alexithymia facets and dimensions. Finally, the scientific value and clinical implications of these findings are discussed.
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Alexithymia cannot be reduced to "Awareness", i.e., being aware of one's emotions; it also encompasses difficulties in describing feelings, externally orientated thinking and constricted imaginal processes.
“However, we note that alexithymia cannot be reduced to “Awareness”, i.e., being aware of one's emotions. Indeed, it also encompasses difficulties in describing one’s feelings, externally orientated thinking and constricted imaginal processes (Goerlich, 2018).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Goerlich, 2018
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- Authors
- Goerlich, K. S.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Goerlich, Katharina S.
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2018-08-29
- Volume
- 9
- Pages
- 1614-1614
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC6124373
- OpenAlex
- W2888861838
- Cited by
- 170
- References
- 49
- Citations by year
- 2026: 21 · 2025: 18 · 2024: 15 · 2023: 29 · 2022: 42 · 2021: 26 · 2020: 16 · 2019: 3
- FWCI
- 8.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- alexithymia, Toronto Alexithymia Scale, emotional processing, difficulty identifying feelings, difficulty describing feelings, externally oriented thinking
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