Alexithymia decreases altruism in real social decisions.

Alexithymia, a sub-clinical personality construct associated with disturbances in affect regulation and social functioning, is known to be comorbid with a number of psychiatric conditions. We combined a distressing real-time altruism task with functional magnetic resonance imagining to explore the brain behaviour relationship between alexithymia and prosocial action. Here we show that individuals high on the alexithymia spectrum report less distress at seeing others in pain and behave less altruistically. This behavioural result is mirrored in the brain, where individuals who have difficulty recognizing and experiencing others' emotional distress have reduced neural activation within the anterior insula and temporoparietal junction, key regions in the experience of distress and perspective-taking.