Objective Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emotional embodiment is therefore inherently interwoven with our sense of bodily self-awareness, and allows us to navigate complex social situations. Given that the core feature of schizophrenia (SZ) is characterized by the presence of bodily self-disturbances and social-emotional deficits, we hypothesized that embodiment of emotion would be disrupted in SZ. Method Twenty-six medicated individuals with SZ and 26 demographically matched controls used a computerized topographical mapping tool (“EmBODY”) to indicate on a body outline where they felt bodily sensations while experiencing an emotion. There were 13 different emotions plus a neutral state. The resulting bodily maps of emotions were quantitatively compared between groups using linear discriminant analysis and similarity scores. Results Bodily maps of emotions were anomalous in SZ as indicated by indistinguishable maps across different emotions. Relative to the control group, patients reported less discrete and less clear bodily sensations across emotions. In particular, bodily maps for low-arousal emotions were atypical in comparison with healthy controls. Conclusions Anomalous and undifferentiated mapping of embodied emotions in SZ could lead to deficits in linking bodily sensations to conceptual categories of emotions. Disrupted emotional embodiment could also contribute to poor social functioning. Abnormal bodily sensations of emotions might therefore be a promising target for future psychosocial interventions.
Alexithymia is associated with increased risk for mental and physical health disorders but available assessments rely exclusively on self-report. The major aim of the current study was to develop and implement a performance-based task designed to characterize and quantify the relationship between one's description of emotional experience and self-reported alexithymia. Specifically, we examined performance-based measures of affect labeling of one's own emotions, emotional granularity and dialecticism. Healthy participants (N = 108) completed the Toronto Alexithymia Scale-20 Item Questionnaire. Participants viewed a series of film clips standardized to elicit discrete emotional states. After each clip, they indicated the emotion they experienced "the most" and rated a list of non-primary emotions, which formed indices of emotional granularity and dialecticism. Alexithymia was associated with increased tendency to report experiencing "no emotion" following evocative film clips, reduced negative emotional granularity and dialecticism of experienced emotions. TAS-20 subscales were each associated with a unique set of emotional correlates. In a healthy population, alexithymia is associated with reduced awareness of emotional states, and reduced dialecticism and granularity of negative (but not positive) emotions. Our performance-based assessment enriches understanding of the mechanisms underlying alexithymia by underscoring the central importance of emotion awareness, negative emotional granularity and dialecticism.
Alexithymia, or a reduced ability to label and describe one's emotions, is a transdiagnostic construct associated with poor psychosocial outcomes. Currently, the mechanisms underlying affective deficits associated with alexithymia are unclear, hindering targeted treatment delivery. Recent research suggests deficient interoceptive awareness, or reduced awareness of one's internal bodily state, may be key in the etiology of alexithymia. It has long been demonstrated that mindfulness meditation can alter perceptions of one's own emotions and bodily cues. Therefore, it is possible that mindfulness meditation may reduce affective deficits associated with alexithymia by improving interoceptive awareness. In this study, we aimed to (1) elucidate the role of interoceptive accuracy and sensibility, two dimensions of interoceptive awareness, in alexithymia, and (2) test the efficacy of a brief mindfulness meditation for improving interoceptive accuracy, interoceptive sensibility, and emotional awareness. Seventy six young adults completed a baseline heartbeat detection task, to assess interoceptive accuracy and sensibility, and the Toronto Alexithymia Scale-20 item. They were randomly assigned to a brief mindfulness-based body scan meditation intervention or control condition. Afterwards, participants completed tasks assessing emotional awareness (i.e., affect labeling, emotional granularity) and follow-up heartbeat detection task. Relationships between alexithymia and interoceptive accuracy and sensibility were best described as quadratic (p = 0.002) and linear (p = 0.040), respectively. Participants in both conditions showed robust improvements in interoceptive accuracy from baseline to follow-up (p < 0.001; η 2 p = 0.15); however, there were no group (meditation or control) differences in degree of improvement. Similarly, there were no group differences in affect labeling or emotional granularity. These preliminary results suggest that heightened alexithymia may be associated with either relatively high or low interoceptive accuracy. The meditation condition did not result in improved interoceptive accuracy or sensibility above and beyond that of a control group. Improvements in interoceptive accuracy, interoceptive sensibility, and emotional awareness may require longer or more interactive intervention approaches. More research is needed to parse the potentially complex relationship between alexithymia and interoceptive awareness, and to develop targeted treatment approaches to ameliorating associated affective deficits.
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