Stress Reactivity in Alexithymia: Decoupling of Physiological and Cognitive Responses

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Abstract
Alexithymia is described as the lack of awareness of the basis of emotion. Descriptions of alexithymia have primarily been based upon clinical observation with no laboratory validation of the construct. A proposed aspect of alexithymia is an inability to accurately identify emotional stimuli, with a hypothesized decoupling of peripheral physiological activity and accurate report of feeling state. The present study represents an initial attempt to determine whether such a decoupling of feeling state and physiology in response to stress exists in alexithymics. Males (18–25 years) screened for alexithymia using the Schalling-Sifneos Personality Scale (SSPS) were used in subjects (n = 15) along with age-matched nonalexithymic controls (n = 15). All subjects were asymptomatic. Each was individually exposed to a stress quiz while heart rate, frontal EMG, and blood pressure were monitored. The Profile of Mood States (POMS) was administered at four intervals (adaptation, prestress quiz, poststress quiz, and recovery). Results indicated that both the alexithymic and nonalexithymic groups displayed an increased heart rate and systolic and diastolic blood pressure response to the stressor. Alexithymics had higher resting heart rate levels throughout the experiment in contrast to controls. No differences in recovery from stress were observed between the two groups. EMG appeared stable across periods. Analyses of mood data revealed a significant increase in tension following the stress quiz in the nonalexithymic group, while the alexithymics demonstrated an increase in tension in anticipation of the stressor. Reports of depression, anger, and confusion were significantly higher following the stressor, while vigor was significantly higher during adaptation for both groups. These findings provide tentative support for the existence of a decoupling phenomenon following a stressor in alexithymia and indicate that subjective tension is the primary mood involved.

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