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Alexithymia has been linked to various disorders, including compulsive behaviors, anxiety disorders, and physical conditions with or without symptoms. It has been hypothesized that these disorders result from the alexithymic inability to differentiate and elaborate affect, which gives rise to physiological arousal and a negative subjective state, which are not regulated by psychological strategies. We tested these hypothesized mechanisms by comparing 42 alexithymic subjects with 42 sex- and race-matched non-alexithymic subjects on physiological and subjective responses to an autogenic relaxation exercise and three different laboratory stressors. Alexithymic subjects had tonically greater electrodermal activity and reported more arousal and displeasure in general than nonalexithymic subjects. Groups did not differ in the degree to which they relaxed, but alexithymic subjects reported less enjoyment of, less involvement in, and poorer imagery during relaxation. All three stressors evoked reactivity, and alexithymic women had less heart rate change when viewing disgusting scenes than did nonalexithymic women; in general, however, groups did not differ in reactivity or recovery to the stressors. We find some support for the hypothesized mechanisms of alexithymia, and we suggest specific links between alexithymia and clinical disorders.

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These results provide new evidence of prefrontal cortical alterations in pediatric MDD that may differ in familial and nonfamilial subtypes of MDD. Our findings must be considered preliminary, however, in view of the small sample size.

Objective The functioning of neural systems supporting emotion processing and regulation in bipolar disorder-not otherwise specified (BP-NOS) youth remains poorly understood. We sought to examine patterns of activity and connectivity in BP-NOS youth relative to youth with BP-I and healthy controls (HC). Method Participants (18 BP-I youth, 16 BP-NOS youth, and 18 HC) underwent functional magnetic resonance imaging while performing two emotional-face gender labeling tasks (happy/neutral, fearful/neutral). Analyses focused on a priori neural regions supporting emotion processing (amygdala) and emotion regulation (ventromedial prefrontal cortex (VMPFC), dorsolateral prefrontal cortex (DLPFC). Connectivity analyses used VMPFC as a seed region. Results During the happy-face task, BP-I youth had greater amygdala, VMPFC, and DLPFC activity to happy faces whereas BP-NOS youth had reduced VMPFC and DLPFC activity to neutral faces relative to HC, and reduced amygdala, VMPFC, and DLPFC activity to neutral faces versus BP-I. During the fearful-face task, BP-I youth had reduced DLPFC activity to fearful faces whereas BP-NOS youth had reduced DLPFC activity to neutral faces relative to HC. BP-NOS youth showed greater VMPFC-DLPFC connectivity to happy faces relative to HC and BP-I youth. BP-I youth showed reduced VMPFC-amygdala connectivity to fearful faces relative to HC and BP-NOS youth. Conclusions This is the first study to document differential patterns of abnormal neural activity in, and connectivity between, neural regions supporting emotion processing and regulation in BP-NOS versus BP-I youth. Findings suggest that despite similarities in symptom presentation, there are differential patterns of abnormal neural functioning in BP-NOS and BP-I relative to HC, which might reflect an “intermediate state” in the course of BP-I illness. Future longitudinal studies are needed to relate these findings with future conversion to BP-I/II.