Alexithymia and the Processing of Emotional Facial Expressions (EFEs): Systematic Review, Unanswered Questions and Further Perspectives

Abstract

Alexithymia is characterized by difficulties in identifying, differentiating and describing feelings. A high prevalence of alexithymia has often been observed in clinical disorders characterized by low social functioning. This review aims to assess the association between alexithymia and the ability to decode emotional facial expressions (EFEs) within clinical and healthy populations. More precisely, this review has four main objectives: (1) to assess if alexithymia is a better predictor of the ability to decode EFEs than the diagnosis of clinical disorder; (2) to assess the influence of comorbid factors (depression and anxiety disorder) on the ability to decode EFE; (3) to investigate if deficits in decoding EFEs are specific to some levels of processing or task types; (4) to investigate if the deficits are specific to particular EFEs. Twenty four studies (behavioural and neuroimaging) were identified through a computerized literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2010. Data on methodology, clinical characteristics, and possible confounds were analyzed. The review revealed that: (1) alexithymia is associated with deficits in labelling EFEs among clinical disorders, (2) the level of depression and anxiety partially account for the decoding deficits, (3) alexithymia is associated with reduced perceptual abilities, and is likely to be associated with impaired semantic representations of emotional concepts, and (4) alexithymia is associated with neither specific EFEs nor a specific valence. These studies are discussed with respect to processes involved in the recognition of EFEs. Future directions for research on emotion perception are also discussed.

Recognition of Emotional Facial Expressions in Alexithymia

“…Based on these findings, Grynberg et al (2012) concluded that HAIs have problems labeling facial expressions, as they cannot process the perceptual information in a very short time.…”

“…These deficits have been found with tasks in which participants were required to reply in a very short period of time (Pedrosa et al, 2009), as well as in those with masked stimuli to make it difficult to recognize them (Kugel et al, 2008;Reker et al, 2010), and with static emotional stimuli, such as FACS, and dynamic videos (Kätsyri, Saalasti, Tiippana, von Wendt, & Sams, 2008;Ridout, Thomas, & Wallis, 2010) (for a review, see Grynberg et al, 2012).…”

Expressive Incoherence and Alexithymia in Autism Spectrum Disorder

“…Interestingly, in individuals with ASD it has been shown that the impairments with the recognition of emotional facial expression may be attributed to comorbid alexithymia rather than to the clinical condition of the individual (Grynberg et al 2012). Alexithymia has also been shown to play an important role in other (but not all) emotional difficulties in individuals with ASD such as empathy (Bird et al 2010) and eye-fixation (Bird et al 2011).…”

Illuminating the clinical significance of alexithymia subtypes: A cluster analysis of alexithymic traits and psychiatric symptoms

“…On the cognitive and affective level, alexithymia is associated with decreased empathy [10], problems in emotional processing [11] and emotional face recognition [12]. It is also associated with social anhedonia [13,14], interpersonal problems [15], and lower levels of satisfaction in intimate relationships [16].…”