Influence of clinical status in the relationship between alexithymia and emotional recognition: a dimensional study

The results of this study are part of an investigation to determine whether the cognitive-emotional process of emotional recognition is deficient as a function of the clinical condition and alexithymia in subjects with somatization. This investigation applied the self-assessment of emotion and used a procedure that minimizes the use of verbal skills and verbal comprehension. The specific goal of this study was to verify whether there were differences in the covariation between alexithymia and self-evaluation of the emotional reaction in clinical and nonclinical subjects. The results of this study highlight the significant differences between clinical and control subjects. There were inverse significant correlations with the affective valence in clinical subjects, whereas in the ratings of the TAS-20 in control subjects, there were direct correlations with activation. In the conclusions, we discuss whether the variability of the results of previous research of the relationship between alexithymia and emotional recognition is a characteristic feature of this relationship or an effect of the different sampling and procedures utilized.     

The importance of identifying underlying process abnormalities in alexithymia: Implications of the three-process model and a single case study illustration

We present an in-depth case study of a rare individual (whom we will refer to as “Jane”) who reported an inability to experience emotion. Jane completed a range of assessments measuring alexithymia, emotional awareness, and emotion recognition ability. She, along with 22 control participants, also underwent skin conductance (SC) measurement and facial electromyography (EMG) during exposure to affective images, and self reported the valence/arousal of their responses to those images. Jane scored high on alexithymia and low on emotional awareness; yet she performed well on emotion recognition measures and showed a typical pattern of valence ratings. Her SC responses and subjective arousal ratings were atypically low, and some of her EMG responses were also atypical. Jane’s deficit profile highlights the dissociability of self-focused emotional awareness and other-focused emotion recognition ability, as well as the dissociability between the generation and representation of valence and arousal (with both subjective and objective measures).     

Affective flexibility and generalized anxiety disorder: valence-specific shifting difficulties

ABSTRACT

Background: Growing evidence suggests that generalized anxiety disorder (GAD) is associated with poor affective flexibility, defined as the ability to switch between emotional aspects and non-emotional aspects of a situation. However, it is unclear whether affective inflexibility is valence-specific in GAD.

Methods: Participants with GAD (n?=?21) and non-clinical control participants (n?=?28) were tested on an Affective Switching Task during which participants were asked to categorize pictures either by the valence or by the number of humans present in the pictures.

Results: Individuals with GAD, but not healthy controls, exhibited greater difficulty shifting from emotional aspects of negative material compared to emotional aspects of positive material and shifting to the emotional aspects of positive material compared to emotional aspects of negative material.

Conclusions: These findings suggest that GAD is associated with valence-specific affective flexibility biases. The relevance of the findings and directions for future research are discussed.     

Emotions associated with different textures during touch

Haptics plays an important role in emotion perception. However, most studies of the affective aspects of haptics have investigated emotional valence rather than emotional categories. In the present study, we explored the associations of different textures with six basic emotions: fear, anger, happiness, disgust, sadness and surprise. Participants touched twenty-one different textures and evaluated them using six emotional scales. Additionally, we explored whether individual differences in participants’ levels of alexithymia are related to the intensity of emotions associated with touching the textures. Alexithymia is a trait related to difficulties in identifying, describing and communicating emotions to others. The findings show that people associated touching different textures with distinct emotions. Textures associated with each of the basic emotions were identified. The study also revealed that a higher alexithymia level corresponds to a higher intensity of associations between textures and the emotions of disgust, anger and sadness.     

Emotional avoidance: an experimental test of individual differences and response suppression using biological challenge

The present study examined the affective consequences of response inhibition during a state of anxiety-related physical stress. Forty-eight non-clinical participants were selected on the basis of pre-experimental differences in emotional avoidance (high versus low) and subjected to four inhalations of 20% carbon dioxide-enriched air. Half of the participants were instructed to inhibit the challenge-induced aversive emotional state, whereas the other half was instructed to simply observe their emotional response. Participants high in emotional avoidance compared to those low in emotional avoidance responded with greater levels of anxiety and affective distress but not physiological arousal. Individuals high in emotional avoidance also reported greater levels of anxiety relative to the low emotional avoidance group when suppressing compared to observing bodily sensations. These findings are discussed in terms of the significance of emotional avoidance processes during physical stress, with implications for better understanding the nature of panic disorder.     

Control of impulsive emotional behaviour through implementation intentions

Past research has established that people can strategically enhance or override impulsive emotional behaviour with implementation intentions (Eder, Rothermund, & Proctor, 2010). However, it is unclear whether emotional action tendencies change by intentional processes or by habit formation processes due to repeated enactment of the intention (or both). The present study shows that forming implementation intentions is sufficient to modulate emotional action tendencies. Participants received instructions about how to respond to positive and negative stimuli on evaluation trials but no such trials were actually presented. Results showed that merely intending to approach and avoid affective stimuli influenced emotional action tendencies in a modified affective Simon task in which affective valence was irrelevant. An affective Simon effect (i.e., faster reactions when the valence of the stimulus corresponded with the valence of the movement) was observed when participants intended evaluations with affectively congruent responses (i.e., positive-approach, negative-avoid); in contrast, the effect was reversed in direction when participants planned evaluations with incongruent responses (i.e., positive-avoid, negative-approach). Thus, implementation intentions can regulate implicit emotional responses even in the absence of possible habit formation processes. Implications for dual-system accounts of emotion regulation are discussed.     

Personal and parents’ life stories in patients with borderline personality disorder

Patients with borderline personality disorder (BPD) display disturbances in understanding self and others. We examined whether these disturbances extended to how patients described their personal and parents’ life stories and to measures of identity, alexithymia, empathy, and emotional intelligence. Thirty BPD patients and 30 matched control participants described personal and parents’ life stories and completed measures of identity disturbance, alexithymia, empathy, and emotional intelligence. Compared to the controls, patients with BPD described their personal and their parents’ life stories more negatively and with fewer themes of agency and communion fulfillment. Patients and controls showed equally complex reasoning about their personal life stories, but patients displayed less complexity and more self‐other confusion, when reasoning about their parents’ stories. Patients also differed from controls on identity disturbance, alexithymia, and empathy. The results suggest that patients’ storied understanding of themselves and others are disturbed and should be taken into account to better understand BPD.     

Recognition of emotional pictures: Behavioural and electrophysiological measures

The effects of emotional content of images on recognition memory were studied, bringing together electrophysiological (Event-Related brain Potentials, ERPs) and behavioural (accuracy and speed of recognition, and remember/know judgements) indices. In the study phase, participants assessed 120 images on the scales of valence and arousal. In the test phase, ERPs were recorded while participants viewed again the images, put together with 120 new, and were asked to make old/new decisions and remember/know judgements on them. A clear arousal bias was obtained for remember/know judgements, which revealed that correctly recognised arousing images (negative and positive) received more remember judgements than nonarousing images (neutral and relaxing). Moreover, a Late Positive Component (LPC) activation revealed an old/new effect enhanced by arousing images. The LPC activation was located in parietal areas (precuneus), which appears to be mostly related to successful retrieval based on recollection. The results obtained through different indices supported the emotional bias found in previous studies for arousing material, but do not clarify the effect of the emotional valence on recognition.     

Control of impulsive emotional behaviour through implementation intentions

Past research has established that people can strategically enhance or override impulsive emotional behaviour with implementation intentions (Eder, Rothermund, & Proctor, 2010). However, it is unclear whether emotional action tendencies change by intentional processes or by habit formation processes due to repeated enactment of the intention (or both). The present study shows that forming implementation intentions is sufficient to modulate emotional action tendencies. Participants received instructions about how to respond to positive and negative stimuli on evaluation trials but no such trials were actually presented. Results showed that merely intending to approach and avoid affective stimuli influenced emotional action tendencies in a modified affective Simon task in which affective valence was irrelevant. An affective Simon effect (i.e., faster reactions when the valence of the stimulus corresponded with the valence of the movement) was observed when participants intended evaluations with affectively congruent responses (i.e., positive–approach, negative–avoid); in contrast, the effect was reversed in direction when participants planned evaluations with incongruent responses (i.e., positive–avoid, negative–approach). Thus, implementation intentions can regulate implicit emotional responses even in the absence of possible habit formation processes. Implications for dual-system accounts of emotion regulation are discussed.     

Attention to Television: Alpha Power and Its Relationship to Image Motion and Emotional Content

A laboratory experiment investigated the impact of image motion and emotional content in brief television clips on attention. Using an electroencephalogram (EEG) as a measure of attention, cortical activity in 25 participants was measured while they viewed either still or moving emotion-provoking images. Spectral analysis of the EEG was done to gauge changes in alpha-wave (8-13 Hz) power because reductions in alpha power are thought to indicate greater attention. The analysis revealed that subjective reports of emotional arousal were directly related to cortical activation (i.e., reduced alpha power), and this was particularly true at the parietal recording site. The relationship between alpha power and ratings of valence was curvilinear; cortical activation was associated with both positive and negative images relative to neutral images. Alpha power was also reduced during the viewing of moving compared with still images, and this effect occurred independent of stimulus valence. The association of greater cortical activation with moving than with still images is consistent with previous research using autonomic measures and suggests that image motion modulates emotional responding-and sustains attention-primarily through increasing "gain" in the arousal dimension.     

Alexithymia and the automatic processing of affective information: Evidence from the affective priming paradigm

In Study 1, we examined the moderating impact of alexithymia (i.e., a difficulty identifying and describing feelings to other people and an externally oriented cognitive style) on the automatic processing of affective information. The affective priming paradigm was used, and lower priming effects for high alexithymia scorers were observed when congruent (incongruent) pairs involving nonverbal primes (angry face) and verbal target were presented. The results held after controlling for participants' negative affectivity. The same effects were replicated in Studies 2 and 3, with trait anxiety and depression entered as additional covariates. In Study 3, no moderating impact of alexithymia was found for verbal-facial pairs suggesting that the results cannot be merely explained in terms of transcoding limitations for high alexithymia scorers. Overall, the present results suggest that alexithymia could be related to a difficulty in processing and automatically using high arousal emotional information to respond to concomittant behavioural demands.     

Memory for emotionally provocative words in alexithymia: A role for stimulus relevance

Alexithymia is associated with emotion processing deficits, particularly for negative emotional information. However, also common are a high prevalence of somatic symptoms and the perception of somatic sensations as distressing. Although little research has yet been conducted on memory in alexithymia, we hypothesized a paradoxical effect of alexithymia on memory. Specifically, recall of negative emotional words was expected to be reduced in alexithymia, while memory for illness words was expected to be enhanced in alexithymia.Eighty-five high or low alexithymia participants viewed and rated arousing illness-related (“pain”), emotionally positive (“thrill”), negative (“hatred”), and neutral words (“horse”). Recall was assessed 45 min later.High alexithymia participants recalled significantly fewer negative emotion words but also more illness-related words than low alexithymia participants. The results suggest that personal relevance can shape cognitive processing of stimuli, even to enhance retention of a subclass of stimuli whose retention is generally impaired in alexithymia.     

Stability in alexithymia levels: A longitudinal analysis on various emotional answers

Alexithymia refers to a specific disturbance in emotional processing that is manifested through difficulties in identifying and verbalizing feelings, and a tendency to focus and amplify the somatic sensations accompanying emotional arousal. The main purpose of the present study was to investigate the stability levels of alexithymia related to changes in emotional distress levels caused by university exams at two different times: after and during the exams. We carried out a 17-week follow-up on 36 university students, alexithymic features and self-reported emotional distress (anxiety, depression and somatic illness) were measured. Whereas emotional distress measures changed significantly during the follow-up period, the degree of alexithymia remained unchanged. We conclude therefore that alexithymia presents a constant trait in non-clinical samples, in contrast to anxiety and depression, which are state phenomena, influenced by stress levels.     

Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness

The present study examines psychological and physiological indices of emotional regulation in non-clinical high worriers after a mindfulness-based training programme aimed at reducing worry. Thirty-six female university students with high Penn State Worry Questionnaire scores were split into two equal intervention groups: (a) mindfulness, and (b) progressive muscle relaxation plus self-instruction to postpone worrying to a specific time of the day. Assessment included clinical questionnaires, daily self-report of number/duration of worry episodes and indices of emotional meta-cognition. A set of somatic and autonomic measures was recorded (a) during resting, mindfulness/relaxation and worrying periods, and (b) during cued and non-cued affective modulation of defence reactions (cardiac defence and eye-blink startle). Both groups showed equal post-treatment improvement in the clinical and daily self-report measures. However, mindfulness participants reported better emotional meta-cognition (emotional comprehension) and showed improved indices of somatic and autonomic regulation (reduced breathing pattern and increased vagal reactivity during evocation of cardiac defense). These findings suggest that mindfulness reduces chronic worry by promoting emotional and physiological regulatory mechanisms contrary to those maintaining chronic worry.     

Autonomic and subjective responsivity to emotional images in people with dissociative seizures

People with dissociative seizures (DS) report a range of difficulties in emotional functioning and exhibit altered responding to emotional facial expressions in experimental tasks. We extended this research by investigating subjective and autonomic reactivity (ratings of emotional valence, arousal and skin conductance responses [SCRs]) to general emotional images in 39 people with DS relative to 42 healthy control participants, whilst controlling for anxiety, depression, cognitive functioning and, where relevant, medication use. It was predicted that greater subjective negativity and arousal and increased SCRs in response to the affective pictures would be observed in the DS group. The DS group as a whole did not differ from controls in their subjective responses of valence and arousal. However, SCR amplitudes were greater in ‘autonomic responders’ with DS relative to ‘autonomic responders’ in the control group. A positive correlation was also observed between SCRs for highly arousing negative pictures and self‐reported ictal autonomic arousal, in DS ‘autonomic responders’. In the DS subgroup of autonomic ‘non‐responders’, differences in subjective responses were observed for some conditions, compared to control ‘non‐responders’. The findings indicate unaffected subjective responses to emotional images in people with DS overall. However, within the group of people with DS, there may be subgroups characterized by differences in emotional responding. One subgroup (i.e., ‘autonomic responders’) exhibit heightened autonomic responses but intact subjective emotional experience, whilst another subgroup (i.e., ‘autonomic non‐responders’) seem to experience greater subjective negativity and arousal for some emotional stimuli, despite less frequent autonomic reactions. The current results suggest that therapeutic interventions targeting awareness and regulation of physiological arousal and subjective emotional experience could be of value in some people with this disorder.     

Emotional granularity and borderline personality disorder

This study examined the affective dysregulation component of borderline personality disorder (BPD) from an emotional granularity perspective, which refers to the specificity in which one represents emotions. Forty-six female participants meeting criteria for BPD and 51 female control participants without BPD and Axis I pathology completed tasks that assessed the degree to which participants incorporated information about valence (pleasant-unpleasant) and arousal (calm-activated) in their semantic/conceptual representations of emotions and in using labels to represent emotional reactions. As hypothesized, participants with BPD emphasized valence more and arousal less than control participants did when using emotion terms to label their emotional reactions. Implications and future research directions are discussed.     

The Role of Differentiation of Self and Dyadic Adjustment in Predicting Codependency

Working within the framework of the Bowen’s Family Systems Theory and using data from 318 non-clinical participants, the present study assessed a model in which codependent behaviors were predicted by dyadic adjustment in couple relationships and differentiation of self. Results indicated that the dimensions of differentiation of self (I-position, emotional reactivity, emotional cutoff, fusion with others) were more important in explaining the codependent behavior compared to the dimensions of dyadic adjustment (dyadic satisfaction, cohesion, consensus, affective expression). These results suggest the importance of considering the dynamics and outcomes of the process of differentiation of self both in research and in counselling and clinical practice with individuals, couples, and families.     

Error monitoring is related to processing internal affective states

Detecting behavioral errors is critical for optimizing performance. Here, we tested whether error monitoring is enhanced in emotional task contexts, and whether this enhancement depends on processing internal affective states. Event-related potentials were recorded in individuals with low and high levels of alexithymia—that is, individuals with difficulties identifying and describing their feelings. We administered a face word Stroop paradigm (Egner, Etkin, Gale, & Hirsch, 2008) in which the task was to classify emotional faces either with respect to their expression (happy or fearful; emotional task set) or with respect to their gender (female or male; neutral task set). The error-related negativity, a marker of rapid error monitoring, was enhanced in individuals with low alexithymia when they adopted the emotional task set. By contrast, individuals with high alexithymia did not show such an enhancement. Moreover, in the high-alexithymia group, the difference in the error-related negativities between the emotional and neutral task sets correlated negatively with difficulties identifying their own feelings, as measured by the Toronto Alexithymia Scale. These results show that error-monitoring activity is stronger in emotional task contexts and that this enhancement depends on processing internal affective states.