Empirical study of alexithymia: methodology and results.

Starting with a review of selected examples of empirical studies on the concept of alexithymia, this paper then presents a new perspective that helps to integrate these diverse results. Studies are grouped into two types: those employing instruments (questionnaires, ratings) that directly assess alexithymia, and experimental studies. Studies of the first type are found to be inconclusive in that the search for a personality trait of alexithymia in psychosomatic patients has not been very fruitful. The evidence from experimental studies, however, does allow for some interesting interpretations: The apparent diversity in results can be resolved, if certain crucial dimensions are analyzed. On the stimulus side, interpersonal relevance and the degree of subjective involvement are found to be crucial, as results pointing towards alexithymia are mainly found when both of these are high. On the measurement side, large variations in results can be explained by reference to the "depth" of measurement level. On a more superficial or cognitive level, it is possible to find indications of alexithymia, whereas on a deeper, more unconscious level, psychosomatic patients' response to experimental stimuli are similar to that of controls. The implications of this are that alexithymia, rather than being understood as a personality trait, should be seen as a label for a set of coping behaviors that occurs in specific situations only.