Research indicates that
alexithymia overlaps with autism spectrum disorder (ASD). Although alexithymia
is not a core feature of autism, recent studies have found varying degrees of
this trait in 50 to 85% of individuals with autism ASD. The alexithymia trait
appears to have the following properties: (a) it is more common in individuals
with ASD than in the general population (b) it is more common in parents of
individuals with ASD than in parents of individuals with another developmental
disabilities, (c) it is stable over time in ASD, and (d) problems in the domain
of emotion awareness are positively related to depression, anxiety, somatic
complaints, worry and rumination. There is also evidence to indicate that the
alexithymia trait might be part of the broader autism phenotype and a
significant component of the emotion processing difficulties observed in ASD. It
is uncertain whether the problem of emotion recognition
commonly attributed to individuals on the autism spectrum is a result of the
disorder itself, or if it is due to the large co-occurrence (comorbidity)
between alexithymia and autism.
Given the apparent
association between alexithymia and autism, it’s especially important to
investigate the relative contribution of this dimensional trait to the
impairment in social functioning experienced by individuals with ASD. An
important question for future research relates to the prevalence of high levels
of alexithymia in ASD compared to neurotypical individuals and how to explain
the high co-occurrence (comorbidity) between alexithymia and ASD. Is
alexithymia a neuroanatomical structural consequence or is the result of a
neurobiological impairment, or is it a distinctive personality trait of
individuals with ASD? Does the level of alexithymia predict symptom severity in
ASD? Although not a diagnostic feature of autism, would alexithymia be a useful
diagnostic marker for ASD? Because alexithymia is associated with increased
risk of mental health problems (i.e., anxiety and depression), should a measure
of alexithymia be included in an assessment battery for ASD? As with most
autism research, there are more questions than answers.
Bird, G., Silani, G.,
Brindley, R., White, S., Frith, U., & Singer, T. (2010). Empathic
brain responses in insula are modulated by levels of alexithymia but not
autism. Brain, 133, 1515-1525.
Szatmari, P., Georgiades,
S., Duku, E., Zwaigenbaum, L., Goldberg, J., & Bennett, T. (2008).
Alexithymia in Parents of Children with Autism Spectrum Disorder. Journal of
Autism and Developmental Disorders, 38, 1859-1865.
Lee A. Wilkinson, PhD,
NCSP is the is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism
and Asperger Syndrome in Schools. He is also editor of a best-selling text in
the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents:
Evidence-Based Assessment and Intervention in Schools and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A
Self-Help Guide Using CBT. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).