Is alexithymia a non‐neurotic personality dimension?

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Abstract
The basic hypothesis of the literature on alexithymia, i.e. that alexithymia has a higher prevalence in psychosomatic than in neurotic (and delusional) patients, was empirically tested by means of the well‐validated Toronto Alexithymia Scale (TAS). Surprisingly, neurotic and delusional patients (N = 71) had significantly higher mean total scores on the TAS, compared with the psychosomatic group (N = 150); the normal control sample (N = 224) was, as predicted, the lowest scorer. This hierarchical distribution was confirmed for the first two factors of alexithymia: (1) difficulty in distinguishing between feelings and bodily sensations, and (2) difficulty in expressing feelings. The psychiatric group was, instead, the lowest scorer on the third factor (lack of fantasy life). A substantial cross‐validation of the above findings was achieved by comparing on the TAS three subgroups of the normal sample (symptom‐free, somatizing and ‘neurotic’ normal controls). The postulate of the non‐neurotic nature of alexithymia, along with its many psychopathological and technical corollaries, is completely contradicted by the present findings.

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