Alexithymia in autism: cross-sectional and longitudinal associations with social-communication difficulties, anxiety and depression symptoms
BackgroundAlexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social–emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depressio...
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| Published in | Psychological medicine Vol. 52; no. 8; pp. 1458 - 1470 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Cambridge, UK
Cambridge University Press
01.06.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0033-2917 1469-8978 1469-8978 |
| DOI | 10.1017/S0033291720003244 |
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| Abstract | BackgroundAlexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social–emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depression and alexithymia. Nevertheless, the role of alexithymia in explaining individual variability in the quality/severity of social-communication difficulties and/or anxiety and depression symptoms in autism remains poorly understood.MethodsIn total, 337 adolescents and adults (autism N = 179) were assessed for alexithymia on the Toronto Alexithymia Scale and for social-communication difficulties, anxiety and depression symptoms. A total of 135 individuals (autism N = 76) were followed up 12–24 months later. We used regression models to establish cross-sectional and longitudinal associations between alexithymia, social-communication difficulties, anxiety and depression symptoms.ResultsAutistic individuals reported significantly higher alexithymia than comparison individuals (p < 0.001, r effect size = 0.48), with 47.3% of autistic females and 21.0% of autistic males meeting cut-off for clinically relevant alexithymia (score ⩾61). Difficulties in describing feelings were particularly associated with current self-reported social-communication difficulties [p < 0.001, β = 0.57, 95% confidence interval (CI) 0.44–0.67] and predicted later social-communication difficulties (p = 0.02, β = 0.43, 95% CI 0.07–0.82). Difficulties in identifying feelings were particularly associated with current anxiety symptom severity (p < 0.001, β = 0.54, 95% CI 0.41–0.77) and predicted later anxiety (p = 0.01; β = 0.31, 95% CI 0.08–0.62).ConclusionsOur findings suggest that difficulties in identifying v. describing emotion are associated with differential clinical outcomes in autism. Psychological therapies targeting emotional awareness may improve social-communication and anxiety symptoms in autism, potentially conferring long-term benefits. |
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| AbstractList | BackgroundAlexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social–emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depression and alexithymia. Nevertheless, the role of alexithymia in explaining individual variability in the quality/severity of social-communication difficulties and/or anxiety and depression symptoms in autism remains poorly understood.MethodsIn total, 337 adolescents and adults (autism N = 179) were assessed for alexithymia on the Toronto Alexithymia Scale and for social-communication difficulties, anxiety and depression symptoms. A total of 135 individuals (autism N = 76) were followed up 12–24 months later. We used regression models to establish cross-sectional and longitudinal associations between alexithymia, social-communication difficulties, anxiety and depression symptoms.ResultsAutistic individuals reported significantly higher alexithymia than comparison individuals (p < 0.001, r effect size = 0.48), with 47.3% of autistic females and 21.0% of autistic males meeting cut-off for clinically relevant alexithymia (score ⩾61). Difficulties in describing feelings were particularly associated with current self-reported social-communication difficulties [p < 0.001, β = 0.57, 95% confidence interval (CI) 0.44–0.67] and predicted later social-communication difficulties (p = 0.02, β = 0.43, 95% CI 0.07–0.82). Difficulties in identifying feelings were particularly associated with current anxiety symptom severity (p < 0.001, β = 0.54, 95% CI 0.41–0.77) and predicted later anxiety (p = 0.01; β = 0.31, 95% CI 0.08–0.62).ConclusionsOur findings suggest that difficulties in identifying v. describing emotion are associated with differential clinical outcomes in autism. Psychological therapies targeting emotional awareness may improve social-communication and anxiety symptoms in autism, potentially conferring long-term benefits. Alexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social-emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depression and alexithymia. Nevertheless, the role of alexithymia in explaining individual variability in the quality/severity of social-communication difficulties and/or anxiety and depression symptoms in autism remains poorly understood.BACKGROUNDAlexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social-emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depression and alexithymia. Nevertheless, the role of alexithymia in explaining individual variability in the quality/severity of social-communication difficulties and/or anxiety and depression symptoms in autism remains poorly understood.In total, 337 adolescents and adults (autism N = 179) were assessed for alexithymia on the Toronto Alexithymia Scale and for social-communication difficulties, anxiety and depression symptoms. A total of 135 individuals (autism N = 76) were followed up 12-24 months later. We used regression models to establish cross-sectional and longitudinal associations between alexithymia, social-communication difficulties, anxiety and depression symptoms.METHODSIn total, 337 adolescents and adults (autism N = 179) were assessed for alexithymia on the Toronto Alexithymia Scale and for social-communication difficulties, anxiety and depression symptoms. A total of 135 individuals (autism N = 76) were followed up 12-24 months later. We used regression models to establish cross-sectional and longitudinal associations between alexithymia, social-communication difficulties, anxiety and depression symptoms.Autistic individuals reported significantly higher alexithymia than comparison individuals (p < 0.001, r effect size = 0.48), with 47.3% of autistic females and 21.0% of autistic males meeting cut-off for clinically relevant alexithymia (score ⩾61). Difficulties in describing feelings were particularly associated with current self-reported social-communication difficulties [p < 0.001, β = 0.57, 95% confidence interval (CI) 0.44-0.67] and predicted later social-communication difficulties (p = 0.02, β = 0.43, 95% CI 0.07-0.82). Difficulties in identifying feelings were particularly associated with current anxiety symptom severity (p < 0.001, β = 0.54, 95% CI 0.41-0.77) and predicted later anxiety (p = 0.01; β = 0.31, 95% CI 0.08-0.62).RESULTSAutistic individuals reported significantly higher alexithymia than comparison individuals (p < 0.001, r effect size = 0.48), with 47.3% of autistic females and 21.0% of autistic males meeting cut-off for clinically relevant alexithymia (score ⩾61). Difficulties in describing feelings were particularly associated with current self-reported social-communication difficulties [p < 0.001, β = 0.57, 95% confidence interval (CI) 0.44-0.67] and predicted later social-communication difficulties (p = 0.02, β = 0.43, 95% CI 0.07-0.82). Difficulties in identifying feelings were particularly associated with current anxiety symptom severity (p < 0.001, β = 0.54, 95% CI 0.41-0.77) and predicted later anxiety (p = 0.01; β = 0.31, 95% CI 0.08-0.62).Our findings suggest that difficulties in identifying v. describing emotion are associated with differential clinical outcomes in autism. Psychological therapies targeting emotional awareness may improve social-communication and anxiety symptoms in autism, potentially conferring long-term benefits.CONCLUSIONSOur findings suggest that difficulties in identifying v. describing emotion are associated with differential clinical outcomes in autism. Psychological therapies targeting emotional awareness may improve social-communication and anxiety symptoms in autism, potentially conferring long-term benefits. |
| Author | Crawley, Daisy Murphy, Declan G. Charman, Tony Tillmann, Julian Oakley, Bethany F. M. Loth, Eva Jones, Emily J. H. Buitelaar, Jan |
| AuthorAffiliation | 1 Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London , De Crespigny Park, London SE5 8AF , UK 5 South London and Maudsley NHS Foundation Trust (SLaM) , London , UK 4 Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London , London , UK 3 Centre for Brain & Cognitive Development, Birkbeck, University of London , London WC1E 7HX, UK 8 Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna , Vienna , Austria 7 Karakter Child and Adolescent Psychiatry University Center , Reiner Postlaan 12, Nijmegen , The Netherlands 2 Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London , De Crespigny Park, London SE5 8AF , UK 6 Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour , |
| AuthorAffiliation_xml | – name: 5 South London and Maudsley NHS Foundation Trust (SLaM) , London , UK – name: 6 Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour , Kapittelweg 29, 6525 EN Nijmegen , The Netherlands – name: 3 Centre for Brain & Cognitive Development, Birkbeck, University of London , London WC1E 7HX, UK – name: 7 Karakter Child and Adolescent Psychiatry University Center , Reiner Postlaan 12, Nijmegen , The Netherlands – name: 8 Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna , Vienna , Austria – name: 2 Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London , De Crespigny Park, London SE5 8AF , UK – name: 4 Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London , London , UK – name: 1 Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London , De Crespigny Park, London SE5 8AF , UK |
| Author_xml | – sequence: 1 givenname: Bethany F. M. orcidid: 0000-0002-1968-134X surname: Oakley fullname: Oakley, Bethany F. M. email: bethany.oakley@kcl.ac.uk organization: 1Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK – sequence: 2 givenname: Emily J. H. surname: Jones fullname: Jones, Emily J. H. organization: 3Centre for Brain & Cognitive Development, Birkbeck, University of London, London WC1E 7HX, UK – sequence: 3 givenname: Daisy surname: Crawley fullname: Crawley, Daisy organization: 1Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK – sequence: 4 givenname: Tony surname: Charman fullname: Charman, Tony organization: 4Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK – sequence: 5 givenname: Jan surname: Buitelaar fullname: Buitelaar, Jan organization: 6Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands – sequence: 6 givenname: Julian surname: Tillmann fullname: Tillmann, Julian organization: 4Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK – sequence: 7 givenname: Declan G. surname: Murphy fullname: Murphy, Declan G. organization: 1Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK – sequence: 8 givenname: Eva surname: Loth fullname: Loth, Eva organization: 1Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK |
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| Keywords | anxiety depression mental health autism Alexithymia |
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| Snippet | BackgroundAlexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social–emotional and mental health problems... Alexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social-emotional and mental health problems in the... |
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| StartPage | 1458 |
| SubjectTerms | Alexithymia Anxiety Autism Autistic adolescents Clinical outcomes Communication Emotions Health problems Intellectual disabilities Males Men Mental depression Mental disorders Mental health Original Original Article Population Regression analysis Social anxiety Symptoms |
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| Title | Alexithymia in autism: cross-sectional and longitudinal associations with social-communication difficulties, anxiety and depression symptoms |
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