Effects of Facilitated Emotional Disclosure on Psychological and Cardiovascular Reactivity in Alexithymia

Abstract

Alexithymia, meaning “lack of words for feelings”, is characterized by difficulty identifying and describing emotional experiences as well as increased somatization. These emotional difficulties, which can be exacerbated by social stressors, have been linked to psychopathology and negative health outcomes. Situations that include demand for emotional expression, which can thus increase uncertainty, have been found to increase psychological arousal and alterations in the autonomic nervous system in the individuals with alexithymia. However, most studies to date have not examined the influence of facilitated emotional disclosure, a commonly used therapeutic tool, on psychological and cardiovascular reactivity in individuals with alexithymia. Drawing from research on social facilitation and emotion disclosure, this study examined how increased demands for emotional expression may increase negative emotional and physiological arousal in individuals scoring higher in alexithymia. Using data from a larger study, one hundred forty-one participants with chronic lower back pain engaged in emotional disclosure tasks with differing levels of facilitation after an anger-inducing maze task involving harassment from a confederate. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20) scores during intake. Changes in negative affect were calculated by subtracting baseline values from post-experimental task reports. Also, blood pressure and heart rate were collected during both the anger-inducing and emotion expression tasks, and compared with baseline averages to obtain a change score. The results show that, in general, alexithymia as measured by TAS-20 was not associated with emotional or cardiovascular reactivity across expression groups. The lack of support for stress reactivity in alexithymia in the context of emotion disclosure demands is considered within the emotional disengagement characteristic of alexithymia as well as the decoupling and the alexithymia-stress model. Future studies to further investigate the cognitive appraisal and cardiovascular markers associated with alexithymia in situations with high emotional demand and perceived low resources as well as assessing task engagement may shed light on our understanding of stress processes and barriers to therapeutic treatments in alexithymia.