Alexithymia in autism spectrum disorder

ABSTRACT Objective Alexithymia is a trait characterised by difficulty identifying and describing one’s own emotions and externally orientated thinking. Alexithymia is of clinical interest in people with autism spectrum disorder (ASD) given research that has highlighted elevated levels of overall alexithymia in people with ASD. Presently, little is known about what specific facets of alexithymia might be impaired in ASD, or whether deficits are present for both negative and positive emotions. This study therefore aimed to fill this gap, establishing a facet-level profile of alexithymia in people with ASD. Method Using the Perth Alexithymia Questionnaire, levels of alexithymia were assessed in sample of 55 people with a diagnosis of ASD and compared with 246 people in a community control sample. Results We found that all facets of alexithymia (across both valence domains) were substantially elevated in ASD (N = 55) compared to a community control sample (N = 246). Conclusions Assessing all facets of alexithymia, across both valence domains, may help identify subgroups with particular social and communication difficulties, and in turn, support the development of personalised interventions. Key Points What is already known on this topic: Alexithymia is a multidimensional construct, comprised of at least three interrelated components: difficulty identifying one’s own feelings (DIF), difficulty describing feelings (DDF), and an externally orientated thinking style (EOT). The Perth Alexithymia Questionnaire (PAQ) is a psychometrically sound measure of alexithymia. Alexithymia commonly occurs in people with Autism Spectrum Disorder (ASD). What this paper adds: In the ASD group, alexithymia was higher across all facets (i.e., DIF, DDF, EOT) compared to the community group, supporting the elevated levels of alexithymia in people with ASD. The PAQ may be important for recognising variability and individual differences among people with ASD, as whilst one third of participants with ASD scored in the “high alexithymia” range, two thirds did not. Identifying unique profiles of alexithymia may have key implications for personalised treatment and interventions.